Providence - Winter 2015 by Moon Tide Media

Stopping Ebola, Flu and Other Infectious Diseases

Singer P!nk Turns a Spotlight on Breast Cancer

Rheumatoid Arthritis is No Match for Modern Therapies

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THE PURSUIT OF WELLNESS IN SOUTHERN CALIFORNIA | PROVIDENCEHEALTHONLINE.ORG | WINTER 2015

SAILING

CARDIAC PATIENTS THRIVE WITH NEW AND IMPROVED THERAPIES

PROVIDENCE FALL 2014

OUR MISSION As people of Providence, we reveal God’s love for all, especially the poor and vulnerable, through our compassionate service.

Core Values Compassion

letter

from the Chief Executive At Providence Health & Services, we continually strive to advance medicine and improve the lives of our patients. This dedication to innovation is reflected in our care for patients with heart disease. Today many patients can be treated with less-invasive techniques. Moreover, new innovations, such as the Watchman device for atrial fibrillation, provide our patients with more treatment options. In this issue of Providence, we invite you to read about new interventional devices and techniques in cardiac care that have advanced our abilities to more effectively treat arrhythmias, malfunctioning heart valves and other conditions. Control of highly infectious disease—from seasonal flu to Ebola virus—has dominated the news in recent months. Our Providence physicians believe in enhancing health at all ages by providing patients with appropriate vaccinations against everything from childhood disease to seasonal flu. By guarding against these serious diseases, you and your children have a much better chance of maintaining your health and fighting viruses and other bugs as they make their rounds. Read about how you can protect yourself and your family. This issue also features a story on strategies to overcome arthritis and other rheumatic conditions that plague millions of Americans. Providence physicians have a broad arsenal of therapies to defeat pain and improve quality of life. You’ll also read in this edition about a patient who has excelled in our movement disorders clinic, which treats those with Parkinson’s disease, essential tremor and other conditions. We also celebrate the success of the 39-week rule, credited with reducing the numbers of premature babies who require specialized care in our neonatal ICUs. This two-year campaign has limited elective deliveries before 39 weeks gestation to help ensure infants reach optimal birth weights and other important milestones. Finally, from the Providence family to you and your family, we wish you a happy and healthy 2015!

Karl Carrier Interim Regional Chief Executive

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Caring for each person as part of our family.

Justice

Working for a fair and equitable society.

Respect

Affirming the God-given dignity and worth of each person.

Excellence

Continually improving all that we do.

Stewardship

Wisely caring for and sharing human, environmental and financial resources held in trust.

Interim Regional Chief Executive Karl Carrier Providence Editor-in-Chief Nancy Franklin Providence Managing Editors Patricia Aidem Jennifer Fagnani Connie Matthews Robert Lehner Natasha Shows Andrew Werts Cyndee Woelfle

Contributors Ann Beurskens Tiffany DeVall Brenda Goettemoeller Kathryn Sprague

58 11th Street, Hermosa Beach, CA 90254 Tel 310-376-7800 Fax 310-376-0200 moontidemedia.com

VP, Branded Media, Emily S. Baker; Art Director, Ajay Peckham; Editor, Shari Roan; Copy Editor, Laura Watts; Managing Partners, Charles C. Koones, Todd Klawin If you no longer wish to receive Providence Magazine, please let us know by calling 1-888-HEALING or writing to Providence Magazine, Attn: Marketing, 20555 Earl Street, Torrance, CA 90503. Please allow 4-6 weeks to honor this request.

contents

departments 2 | Letter from the Interim Chief Executive 10 | On the Horizon 30 | Happenings 34 | Shout Outs

features

profiles

12 | An Arsenal to Fight Arthritis

22 | P!NK Takes the Stage for Breast Cancer

Modern treatments help slow arthritis before the disorder damages joints.

17 | Cardiac Care at its Best

Providence hospitals offer patients the latest treatments to manage heart problems.

24 | Watch Those Germs

Experts explain what to fear—or not—about infectious diseases.

Singer-songwriter Alecia Moore joins the fight against a common disease.

28 | Relief from Parkinson’s Disease

Deep brain stimulation helps an active woman remain on the go. ON THE COVER After angioplasty, Michael Kommel was soon sailing again near his home in the Channel Islands. WINTER 2015 PROVIDENCE

ISN’T FAR AWAY… With a charitable gift annuity, you transfer your cash or investments to Providence and we’ll pay you for life. Your payment amount will never change and is backed by all of our assets making it a reliable source of income for your future. To learn how you can secure your future, simply visit our website at ProvidencePowerOfGiving.org or call us at: Providence Holy Cross Providence Saint Joseph Providence Tarzana

818.847.4673 Providence Little Company of Mary / Torrance or San Pedro

310.303.5340 Providence TrinityCare Hospice

818.847.4673 310.543.3440

in good health

One-Quarter of Americans Consume Sugary Drinks Daily

Breakfast? Think Eggs, Not Pancakes. Many nutrition studies have found that eating breakfast makes a big difference in health. Starting the day with a meal helps maintain energy throughout the day and stabilizes insulin levels, while skipping breakfast has been linked to weight gain and a higher risk of obesity. Now a new study shows that high-protein breakfasts may pack the most health benefits. The study, published in the Nutrition Journal, looked at breakfast choices and obesity rates in adolescent women. One-third of U.S. teens are overweight or obese—and this group is notorious for skipping breakfast. The researchers looked at what the study participants ate for breakfast and then measured levels of a metabolite of the neurotransmitter dopamine in the blood. The study found that the girls who ate a high-protein, 350-calorie breakfast had sustained levels of dopamine through lunchtime and fewer cravings for savory foods. Evidence suggests that dopamine levels in the brain affect food cravings. When we eat, dopamine is released by the brain to provide a feeling of satisfaction and satiety. In people who are overweight or obese, however, dopamine levels are blunted. Skipping breakfast or eating low-protein foods for breakfast appears to further blunt dopamine. “Dietary protein has been well-documented to improve appetite control and food intake regulation through physiological increases in satiety and subsequent reductions in intake,” the authors noted.

Cutting sugar-sweetened beverages from our diets is one of the most highly endorsed strategies to improve health and reduce obesity rates. But a new study shows just how hooked American adults are on soft drinks and fruit juice. The study, a sweeping survey of more than 115,000 adults from 18 states, examined how often people consume regular soda or fruit drinks. Researchers from the Centers for Disease Control and Prevention found that 26.3 percent of adults drink regular soda or fruit drinks—or both—at least once a day. The incidence ranged widely by state, with 20.4 percent of adults in Hawaii consuming sugar-sweetened beverages daily compared to 41.4 percent in Mississippi. (In California Consumption of regular soda, fruit drinks or both daily: the figure was 22.9 percent.) People ages 18 to 34 were the NONE: 28.5% biggest consumers of sugarLESS THAN ONCE A DAY: 45.2% sweetened beverages. Putting a dent in consumpONE OR MORE TIMES A DAY: 26.3% tion of sugary drinks could make a big difference in public Consumption of regular soda daily: health. According to the report, adults consume an average of 151 NONE: 41.6% calories a day in sugar-sweetened LESS THAN ONCE beverages. A DAY: 41.3% “Sugar-sweetened beverages such as regular soda and fruit drinks conONE OR MORE TIMES A DAY: 17.1% tain added sugars and are sources of calories but have few, if any, essential Consumption of nutrients,” the authors noted. “Because fruit drinks daily: of the potential adverse impact of NONE: 52.8% sugar-sweetened beverage consumption on diet quality, obesity and other LESS THAN ONCE A DAY: 35.6% chronic health conditions, reducing sugar-sweetened beverage conONE OR MORE TIMES sumption as part of a healthy A DAY: 11.6% lifestyle might help with weight management and the reduction of chronic diseases among U.S. adults.”

Source: CDC, Morbidity and Mortality Weekly Report, Aug. 15, 2014, Vol. 63, No. 32

CHOICES FOR A HIGH-PROTEIN BREAKFAST A peanut butter sandwich, one cup of low-fat cottage cheese or a lean hamburger patty may be untraditional, but those foods may be good choices for a healthy breakfast that pays dividends throughout the day.

SERVING

GRAMS OF PROTEIN

Egg

1 large

Egg whites

Milk

1 cup

Yogurt

1 cup

Cottage cheese

½ cup

Almonds

1 ounce

Peanut butter

2 tablespoons

Bread

2 slices

Lean ground beef patty

3 ounces

Source: USDA

WINTER 2015 PROVIDENCE

in good health Providence’s MyChart Electronic Health Record System Puts Patients in Charge Think about the times you’ve waited anxiously by the phone for medical test results or for your doctor to call. Many of those agonizing moments can be avoided today because of huge advances in electronic health care communications. All hospitals, clinics, physicians and patients in the Providence Health & Services network are now part of the Epic electronic health records system, a state-of-the-art product that paves the way for better, more comprehensive and expeditious health care. An electronic health record is a digital collection of patient health information—all the paper material that used to be stuffed in a ‘chart’ (folders or binders) and kept at a doctor’s office or hospital. The record typically includes patient demographics, progress notes, problem lists, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The problem with paper records is that the hospital may have some of your records, while various doctors have other records. An electronic health record bundles everything together and gives the patient access to his or her own records with a patient portal called MyChart. “MyChart allows a level of interaction with the patient that is a must-have in today’s health care,” says Wes Odneal, an information services site manager at Providence. “We see similar types of health care communication tools on the internet, but these programs are not integrated into a system. MyChart is integrated within the Providence system. This is an invaluable tool to both the patient and provider in delivering effective care, coordination and communication.” Electronic systems have huge benefits, Odneal says. Electronic health records put information in the hands of people who need it. If a patient has more than one physician, each doctor on the network can review the patient’s file to see what tests

PROVIDENCE WINTER 2015

or medications the other members of the health care team ordered. Such oversight improves safety and reduces wasteful, repetitive tests and procedures. Patients benefit not only from improved, more efficient care, they are also relieved of some of the more annoying aspects of managing their care. MyChart is the patient portal in the Epic system that provides consumers with numerous tools. These include: • Scheduling or changing an appointment or receiving appointment reminder emails • Accessing and reviewing bills and paying bills • Accessing records to review medical history, obtain dates of services and immunizations • Accessing test results • Requesting prescription renewals • Viewing your medication list • Communicating with a physician or health care provider via secure messaging • Receiving health care reminders, such as when to schedule a wellness check-up or immunization Epic allows doctors and patients to communicate much more effectively, says Jennifer Chan, MD, a hospitalist with Providence Medical Associates. “If we didn’t have MyChart, people have to call the physician office, get triaged, then directed to the right person who then directs them to the doctor,” she explains. “That takes a lot longer.” Through Epic, doctors are also communicating much better during key periods of a patient’s health called “transitions of care,” Dr. Chan says. These are periods when a patient is discharged from a hospital or from an emergency department. The primary care doctor receives a “discharge summary” that updates the patient’s condition to minimize gaps in care during

MyChart is free and available to anyone age 18 or older. You can sign up online or when you visit your health care provider. To sign up for MyChart go to mychartor.providence.org/mychart. There is now a mobile MyChart app available. Search the keyword “mychart” to download and install the free app from the iTunes App Store or the Google Play Store. Select Providence as your health care provider. Log in using your Providence MyChart login ID and password.

the transition. “This really helps improve care,” she adds. Discharge summaries are available only for patients hospitalized for care, but treatment provided in the ER, such as imaging and lab work, is available on MyChart. Consumers who don’t have a digital electronic communications device can authorize a close relative or caregiver to have access to MyChart. It’s easy to sign up for MyChart, and consumers can be assured that the tightest security technology is in place to protect privacy, Odneal says.

in good health Cusumano Outpatient Neuroscience Center Opens The state-of-the-art Cusumano Outpatient Neuroscience Center for the treatment of a broad range of neurological conditions will open in early 2015 at Providence Saint Joseph Medical Center. The outpatient facility augments the Hycy and Howard Hill Neuroscience Institute at the hospital. Plans for the new, $4.5 million center were launched in 2011 with a $1 million gift from the Cusumano family of Burbank. The Cusumano family has deep ties to Saint Joseph—Michael Cusumano serves on the Providence Saint Joseph Medical Center Foundation board. The centerpiece of the facility, a biplane angiography suite, will be added in the near future. This new “interventional radiology” technology uses 3-dimensional images to plan and perform noninvasive surgery. The facility will house and support the movement disorders center, neurovascular center, neuro-diagnostics department, and the speech and language pathology department. Moreover, the facility will allow for the addition of several new programs including the Skullbase and Neurosurgical Center, the Concussion Management Clinic, and the Balance and Vestibular Clinic. For more information, call 1-888-HEALING (432-5464).

Endobronchial Ultrasound Offered at Holy Cross An innovative, minimally invasive procedure that enhances doctors’ abilities to sample tissue and lymph nodes in the chest is now available at Providence Holy Cross Medical Center. The procedure, called endobronchial ultrasound— or EBUS—is typically only found at academic medical centers. The technology holds many benefits for patients with lung cancer or other infections or diseases that cause enlarged lymph nodes in the chest. EBUS allows physicians to perform transbronchial needle aspiration, which is used to sample tissue from surrounding lymph nodes in the chest, in a minimally invasive outpatient procedure. Before EBUS, the only way to obtain lymph node samples was through an incision in the chest, says Ali Farrokh, MD, a pulmonologist at Providence Holy Cross. “Before the advent of this technology, blind transbronchial needle aspirations were attempted to obtain tissue, and oftentimes we were not getting answers,” he says. “Now we can use the ultrasound probe to directly visualize the lymph node and watch the needle in the lymph node and obtain samples in real time. It has been revolutionary for lung cancer staging and for diagnosing other diseases, such as lymphoma, sarcoidosis and other diseases that involve mediastinal lymph nodes.” Precise staging of lung cancer helps determine the most appropriate course of treatment. “With EBUS, we’re staging and diagnosing at the same time,” Dr. Farrokh says. “The patient goes home in a couple of hours.” EBUS evaluations at Holy Cross can be expediently scheduled at 1-888-HEALING (4325464), with the patient returning to his or her referring physician for follow-up care.

Save the Date for Providence High School’s Gala Providence High School’s biggest fundraiser of the year is just around the corner. The 2015 Gala will be on Saturday, March 28, at Lakeside Golf Club in Toluca Lake. This year we are excited to celebrate 25 years of the Medical Focus Program. One of three unique, four-year programs at Providence High School, the Medical Focus Program prepares students for the rigors of medical school by focusing on advanced science classes and offering students opportunities to volunteer at various medical institutions, including Providence Health & Services. Join us for a spectacular evening complete with complimentary cocktails and hors d’oeuvres, great live and silent auction items, dinner and dancing. For more information, please contact Vickie Bagwell at 1-818-846-8141, ext. 14413 or Vickie.Bagwell@providencehigh.org or visit providencehigh.org.

CORRECTION

A story in the Fall 2014 issue of Providence failed to mention that single-incision gallbladder surgery is also provided by physicians at Providence Tarzana Medical Center. We regret the omission. WINTER 2015 PROVIDENCE

in good health

Healthy Eating It’s cold and flu season. So in addition to hand-washing and a flu vaccine, reduce your risk of picking up the latest bug with a healthy diet. Certain foods have the power to boost your immune system, including this delicious and unusual soup. Recipe by Joy Cantrell, executive chef and production manager at Providence Saint Joseph Medical Center, and Veronica Johnson, RD, clinical nutrition manager at Providence Saint Joseph Medical Center and clinical dietitian at the Roy and Patricia Disney Family Cancer Center

Immune-Boosting Winter Soup (Serves 8) 1 red onion, minced 1 green chili, minced (serrano or jalapeno, depending on degree of heat preferred) 4 garlic cloves, minced 2-inch piece fresh ginger root, minced 2 tablespoons olive oil 2 medium sweet potatoes, diced, skins left on 1 small acorn squash, diced and peeled 4 ounces shiitake mushrooms, sliced ½ cup fresh carrots, diced 1 cup chopped kale (or 1 cup chopped spinach) vegetable stock, to cover 1 cup fresh pineapple salt and black pepper to taste 1 cup roasted, unsalted sunflower seeds

Cook the onion, chili, garlic and ginger in a large pan with the olive oil over mediumhigh heat for about 5 minutes or until the onions soften. Add the sweet potatoes and next four ingredients to the pan. Stir well, then pour enough vegetable stock to cover all the ingredients. Simmer well for 15 to 20 minutes or until potatoes are soft. Add pineapple. Season with salt and pepper to taste. Transfer the soup into a blender in batches; blend until smooth. Top each serving with 2 tablespoons of sunflower seeds. Serve with fresh fruit, whole grain bread and almond butter for added immune-boosting, antioxidant nutrition.

Nutritional Facts (per serving) Calories: 320 Calories from fat: 170 Total fat: 19 grams (30% Daily Value) Saturated fat: 2.5 grams (10% Daily Value) Trans fats: 0 grams Cholesterol: 0 grams

PROVIDENCE WINTER 2015

Sodium: 95 grams (4% Daily Value) Total carbohydrate: 30 grams (10% Daily Value) Protein: 13 grams (Nutrient analysis does not include “salt to taste” and assumes 1 cup of stock per serving.)

in good health The 39-Week Rule: Doing What’s Best for Babies Healthy babies are worth the wait. That’s what Providence Health & Services believes, and that’s why Providence hospitals Dr. Farid adhere to a guideline Yasharpour established by the American College of Obstetricians and Gynecologists to reduce unnecessary deliveries prior to 39 completed weeks of pregnancy. The 39-week rule was adopted in response to a nationwide trend showing that the number of labor inductions and cesarean sections for non-medical reasons prior to 39 weeks gestation was soaring. We asked Farid Yasharpour, MD, an obstetrician and gynecologist at Providence Holy Cross Medical Center, to explain the benefits of the rule.

What is the 39-week rule? “Patients who request induction of labor or patients who have had a previous cesarean section and would like to proceed with a repeat C-section need to be scheduled for delivery. We now recommend that they schedule their delivery at 39 weeks of pregnancy or beyond.”

Prior to recent research on this issue, did people think there were no risks associated with birth at 37 or 38 weeks? “Nobody was doing elective birth at 37 weeks, but they were doing elective, repeat C-sections at 38 weeks. This rule encourages everyone to strictly adhere to 39 weeks. Those few extra days make a big difference.” How successful has this rule been? “Certainly at 39 weeks we have fewer babies that require transfer to the neonatal ICU. We have been very successful with this initiative at our hospitals. The majority of elective deliveries at 39 weeks do not require NICU care.” Have patients been supportive of the need to wait? “With proper education, patients understand how important this is. The March of Dimes has a beautiful poster that shows a baby’s brain at 37 weeks and 39 weeks, and you can see the difference in development. Most patients understand this is best for the baby.”

Why is this rule important? “Waiting until 39 weeks gestation or later allows the baby’s brain to continue to develop and helps the baby feed and breathe better after delivery. Studies show that 1 percent of babies born at 38 weeks may have difficulty breathing or feeding. That baby may then be transferred to the neonatal intensive care unit. Waiting until 39 weeks for birth spares the mom and the baby from that temporary separation.”

Are doctors still learning how to best apply this guideline? “The 39-week rule has been a wonderful initiative. But I hope we can expand on it and change it to 40 weeks for elective labor inductions. The repeat C-section at 39 weeks is appropriate. But for elective induction, I don’t think the 39-week rule will be the final version. I think we may move to inductions at 41 weeks.”

This rule is for healthy women— not women who have medical emergencies that require immediate delivery, correct? “That’s correct. If there is a medical indication for induction of labor, such as preeclampsia, growth retardation or loss of amniotic fluid, among other reasons, the induction of labor should be done much earlier. The 39-week rule is focused on healthy moms delivering healthy babies.”

What are the benefits to that? “It will decrease the C-section rate because more women will go into labor naturally. If you induce labor and the cervix is not ready, the risk of C-section is two to three times higher than what it should be in healthy moms. The main purpose of the

39-week initiative was to decrease NICU admission. But just because the baby is going to be OK, we should not induce if the mom’s body is not ready. A big reason people end up with unnecessary C-sections is premature induction of labor.”

Are more women choosing to avoid induction of labor if possible? “There is a niche of patients, a minority that is growing, who understand the benefits, and they want to wait for nature to take its course. We need to encourage the public to get more education about labor and delivery and the risks or benefits of inducing labor.” Should women discuss the 39-week rule with their obstetrician? “Yes, I think during the prenatal period mothers should make sure their obstetrician shares the same goals that the mother has about how they view labor and birth and make sure they are on the same page.”

WINTER 2015 PROVIDENCE

on the horizon Providence hosts dozens of lectures, events and classes each week across the region. Here are some upcoming highlights. Check our website for more activities.

Heart Valve Screenings can detect a cardiac problem well before it becomes severe.

ONGOING Heart Valve Screenings Have you or one of your family members been diagnosed with a heart murmur or valvular heart disease? Providence Saint Joseph Medical Center is offering low-cost heart valve screenings to the community. Getting screened today could help avoid problems in the future. To register call 1-844-MY-MURMUR (1-844-696-8768). Hip or Knee Pain Referrals If hip or knee pain has limited your mobility, you have options. The board-certified orthopedic specialists at all Providence medical centers can provide advanced treatments that help you regain function, relieve pain and experience the life you deserve. For a free physician referral call 1-888-HEALING (432-5464). Bariatric Wellness Center If you (or a loved one) are struggling with weight issues, the nationally renowned experts

PROVIDENCE WINTER 2015

at the Bariatric Wellness Center would love to help you find the right option for your successful weight loss. The board-certified specialists at Providence Saint Joseph Medical Center provide weight loss treatments, including minimally invasive options, that may be just right for you. To schedule a consultation call 1-888-HEALING (432-5464).

Joint Replacement Community Lectures Beginning on January 28, Providence Tarzana Medical Center will offer a series of total joint replacement community lectures. Attendees will be exposed to some of the latest techniques used for joint replacement including anterior hip replacement and advanced anesthesia that allow patients to be up and walking, often on the day of surgery. To register call 1-888-HEALING (432-5464). Bereavement Support Group Journeying down the path of grief can feel overwhelming when you are walking by

yourself. Join with others and share your stories to help you heal. No charge to participants. For more information call the spiritual care department at Providence Tarzana: 1-818-708-5015.

Pregnancy and Early Loss Support Group (Sharing to Heal Early Loss) Free six-week sessions are available to new participants. The group meets 7:15 to 9:30 p.m. at Providence Tarzana Medical Center, 18321 Clark St. in Tarzana, in the Administrative Conference Room. For more information call Yanelin Ramo: 1-818-609-2264. Low-Cost Heart Screenings Providence Little Company of Mary is proud to offer valuable, low-cost heart screenings to the community, now available in three convenient locations: Torrance, San Pedro and Manhattan Beach. Screenings are available during the week as well as on the weekends. Register online or call 1-888-HEALING (432-5464).

Cancer Genetics and Prevention Program Does your family have a history of cancer that makes you feel like you might be at risk? The Genetics and Prevention Program at the Sheri and Roy P. Disney Center for Integrative Medicine, Providence Saint Joseph Medical Center, provides risk assessments, genetic counseling services and genetic testing for people concerned about a family history of cancer. To schedule a consultation call 1-818748-4748. Farmers Market A Farmers Market is held every Thursday from 9 a.m. to 2 p.m. in the west parking lot at Providence Little Company of Mary Medical Center San Pedro, 1300 W. 7th St., San Pedro. Another Farmers Market takes place every Friday, 9 a.m. to 2 p.m., in the Atrium parking lot at Providence Little Company of Mary Medical Center Torrance, 4101 Torrance Blvd., Torrance.

on the horizon FEBRUARY 18 Lecture: Healthy Living — Improve your heart health Providence Little Company of Mary Medical Center San Pedro, De Mucci Conference Center 6:30 to 8:30 p.m. Join us for a free lecture on heart health. You’ll learn the signs and symptoms of disease and how to take better care of your heart with lifestyle changes and prevention. We’ll also discuss the latest advancements in atrial fibrillation, or irregular heartbeat, which can help restore your heart’s normal rhythm. Register online or call 1-888-HEALING (432-5464). FEBRUARY 19 Lymphedema Support Group Providence Holy Cross Cancer Center, Conference Room, 15031 Rinaldi St., Mission Hills 4 to 5 p.m. This group is for individuals and their loved ones who have been affected by any type of lymphedema. In an informal and supportive environment, individuals can share concerns, fears and experiences. The group will also meet on March 19. For more information or reservations call 1-818496-1643. MARCH 10 Lecture: Suffering from knee pain? Providence Little Company of Mary Medical Center Torrance Del Webb Center for Health Education 6:30 to 8:30 p.m. MAKOplasty® partial knee resurfacing is a minimally invasive procedure powered by highly advanced robotic

arm technology for those suffering with painful early to mid-stage osteoarthritis. This procedure offers a potentially shorter hospitalization with smaller incisions, faster recovery times and a rapid return to daily activities. Don’t let bad knees keep you from learning about the leading-edge technology of MAKOplasty®. Register online or call 1-888-HEALING (432-5464).

MARCH 12 Lecture: What are you bringing to the table? Strategies for better food choices Providence Little Company of Mary Medical Center San Pedro, De Mucci Conference Center 6:30 to 8:30 p.m. Join us for this free lecture where you’ll learn how to create lasting, positive nutritional changes for you and your family. Register online or call 1-888-HEALING (432-5464). MARCH 17 Lecture: Arthritis & Joint Replacement Options Providence Holy Cross, 15031 Rinaldi St, Mission Hills North Building Conference Rooms 6 to 7:30 p.m. This free seminar will answer your questions about arthritis and the latest techniques offered with joint replacement surgery. Light refreshments will be served and parking validated. APRIL 11 30th Annual John Wayne Cancer Institute Auxiliary Odyssey Ball Beverly Wilshire, Beverly Hills

The Odyssey Ball is held by the John Wayne Cancer Institute Auxiliary to fund innovative research, provide financial support to the prestigious Surgical Oncology Fellowship Program and purchase critical new laboratory equipment. For more information visit providence.org/saintjohns or call 1-310-829-5511.

APRIL 14 Lecture: Hip, Knee or Shoulder Pain? Providence Little Company of Mary Medical Center Torrance Del Webb Center for Health Education 6:30 to 8:30 p.m. Hip, knee and shoulder pain are common afflications. This pain can have a significant impact on your occupation and activities of daily living. Attend this lecture to learn about the most current techniques to relieve hip, knee and shoulder pain. Register online or call 1-888-HEALING (432-5464). APRIL 15 Lecture: The Latest on Spine/Back Treatment Options Providence Holy Cross Medical Center, 15031 Rinaldi St., Mission Hills North Building Conference Rooms 6 to 7:30 p.m. Does back pain put limits on your life? Do you want to learn about the latest options for treating your pain? If so, this free event is for you. Light refreshments will be served and parking validated.

APRIL 29 Lecture: Hip, knee or shoulder pain? Providence Little Company of Mary Medical Center San Pedro, De Mucci Conference Center 6:30 to 8:30 p.m. Hip, knee and shoulder pain are common afflications. This pain can have a significant impact on your occupation and activities of daily living. Attend this lecture to learn about the most current techniques to relieve hip, knee and shoulder pain. Register online or call 1-888-HEALING (432-5464). MAY 6 ABCs Mother’s Day Luncheon Four Seasons, Los Angeles, Beverly Hills, CA The Associates for Breast and Prostate Cancer Studies (ABCs) will host its celebrated annual Mother’s Day Luncheon to benefit breast and prostate cancer research at the John Wayne Cancer Institute at Providence Saint John’s Health Center. For more information visit providence.org/ saintjohns or call 1-310-829-5511.

VISIT US ONLINE From support groups to fitness classes, Providence provides the programs you need to live healthfully. View our many classes, events and screenings online at ProvidenceClasses.org or call 1-888-HEALING (432-5464)

WINTER 2015 PROVIDENCE

Pain Free at Last Providence rheumatologists provide treatments for the aches of arthritis. Written by DAWN HOFFMAN | Photgraphed by MICHAEL NEVEUX

hen Aimee Bower’s feet started hurting during her recreational hikes in the fall of 1999, she didn’t take it too seriously–and neither did her primary care physician. She was diagnosed with metatarsalgia, a sports-related condition marked by inflammation in the balls of the feet. Her doctor said the pain would go away with the help of foot soaks, well-padded shoes and some Advil. But over the next few months the pain spread far beyond Bower’s feet, to her knees, arms, elbows, shoulders, fingers and jaw. “My symptoms were just getting worse and worse,” says Bower, 44, of Venice, who works in data analysis. “Everything was hurting. I couldn’t turn the key in my car ignition. I couldn’t walk upstairs. It hurt to lift my arms to wash my hair. It hurt just to roll over in bed. It was very scary and extremely painful.” Bower didn’t get any relief until the following spring when, due to the severity of her symptoms, she finally was referred to Orrin M. Troum, MD, a rheumatologist at Providence Saint John’s Health Center. He immediately began treating Bower for rheumatoid arthritis, an autoimmune condition that attacks the joints and affects an estimated 1.5 million Americans, mostly women. The disease usually strikes between the ages of 40 and 60, but it can appear in people of all ages, even children, according to the Arthritis Foundation. If not detected early, rheumatoid arthritis can be an extremely painful and debilitating condition. Without treatment, patients have a 50% chance of total disability within 10 years, says Dr. Troum. But through early diagnosis and proper care with the range of effective tools and powerful treatments available today, patients like Bower can maintain active, healthy lives with remarkably little or no pain. “My goal as a doctor is to get all of my patients in remission or at the point of low disease activity,” Dr. Troum says. Bower is now back to hiking and more. “I can go play volleyball on the beach for hours and go backpacking too,” she says. “I’m as active as I’ve ever been, with no pain or impairment.” Overall, the prognosis is excellent for rheumatology patients who are getting the standard of care, says Eileen Schwartz Breyde, MD, of the Facey Medical Group in Burbank. “There have been so many advances in the field,” she says. “I have patients with rheumatoid arthritis who never thought they would feel good again, and they are functioning normally with treatment.” It’s important for people who have painful joints to seek early treatment with a rheumatologist. Many people make the mistake of brushing off recurring aches, pains and joint stiffness, especially those that occur in the mornings, as mere annoyances

PROVIDENCE WINTER 2015

WINTER 2015 PROVIDENCE

Pain Free at Last

that simply will go away on their own. “Recognize that it’s not just a little stiffness or a little arthritis,” Dr. Troum says. And make sure your doctor isn’t hastily ruling out more serious issues either. “Don’t let your symptoms be dismissed.” Postponing a medical consultation can allow an inflammatory type of rheumatoid disease to progress and damage joints, says William Liu, MD, a rheumatologist with Providence Medical Institute in Redondo Beach. “Some patients may think the symptoms are not important and will go away,” he says. “But if there’s inflammation going on, like rheumatoid arthritis, it’s really important to evaluate that. The hardest part is to make sure it’s the right diagnosis.” Gout, in particular, is a type of inflammatory arthritis that is often overlooked, notes Dr. Breyde. It occurs when uric acid builds up in the blood and causes joint inflammation. “It is, unfortunately, frequently undertreated and can be very destructive. It can be a very serious problem when it’s not managed properly.” Patients with painful joints may try to treat themselves at home with over-thecounter nonsteroidal anti-inflammatory drugs (NSAIDs), like Advil or ibuprofen. But liberal use of NSAIDs can cause problems, she says. A full dose of Tylenol, 2,000 milligrams a day, may be a safer way to combat milder arthritic aches and pains, she says. The key is to ask a doctor for advice. “The problem is people take NSAIDs without consideration of the possible side effects. They think that because they are over-the-counter they must be ‘safe,’” Dr. Breyde says. “They can cause gastritis, bleeding ulcers, high blood pressure. There is a possible link to cardiac events. Kidney function decreases if you take these medications for a long period of time. I think it’s a good idea for patients to see their doctors and find out what they can safely take.” The pain and suffering of rheumatoid arthritis results when the immune system goes haywire and starts attacking the synovium, the thin membrane that lines the joints. No one knows the cause of rheumatoid arthritis, though doctors suspect

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Pain Free at Last

that genetics plays a role. Other risk factors include smoking and poor dental hygiene. When the joints are attacked, fluid can build up and cause pain, inflammation and swelling, progressively damaging the cartilage and bone, decreasing mobility and potentially causing joint deformities. In some patients, symptoms may periodically improve, with periods of mild disease activity followed by “flares” of increased disease activity and more symptoms. Eventually, poorly controlled disease can affect other areas besides joints, including the heart, lungs and skin. Thankfully, physicians now have an arsenal of medications to help do just that, including disease-modifying antirheumatic drugs, or DMARDs, such as methotrexate, that inhibit inflammation and work to alter the course of the disease and prevent

joint destruction. Another new class of medications, called biologics (or biologic response modifiers), has helped many patients recover, Dr. Liu says. These genetically engineered drugs act on abnormalities of the immune system that lead to the joint inflammation. “In the past 15 years amazing progress has been made with the new biologics,” he says. “We can take care of 95% of rheumatoid arthritis with a combination of methotrexate and a biologic.” Biologics carry some rare but serious side effects, such as the risk of infection. Some patients hear or read about these side effects and fear taking the medications. But these agents are very effective and the benefits most often outweigh the risks, Dr. Breyde says. “What a lot of people don’t realize is,

FACTS ABOUT RHEUMATOID ARTHRITIS

1.5 million

Nearly Americans have RA.

The disease affects nearly three times as many women as men.

with untreated rheumatoid arthritis life expectancy can be less compared to patients who are adequately treated. It can be disabling and interfere with many activities of daily living,” she explains. “People get very nervous about what the Food and Drug Administration tells them in, for instance, TV commercials. It’s very scary, but they aren’t really seeing all of the details about the studies that have been performed prior to approval by the FDA. It is very frequently safer to take these agents than leave rheumatoid arthritis untreated. There is a nearly 100% probability that untreated rheumatoid arthritis will cause permanent harm to a patient’s health but the chance of serious side effects from these treatments is very low. Patients with rheumatoid arthritis need to have a meaningful discussion with their rheumatologist so they can make an

HOW RHEUMATOID ARTHRITIS ATTACKS JOINTS (1) The ends of the bones in the joints are covered by a tough, elastic tissue called cartilage. A capsule surrounding each joint is lined with a type of tissue called synovium, which produces synovial fluid, a clear substance that lubricates and nourishes the cartilage and bones inside the joint capsule.

RA usually develops between the

ages of 30 and 60 in

women and later in life in men.

severity of RA can vary widely among individuals. The

no cure

There is for , but there are many medications that help ease symptoms.

Early diagnosis is

important to prevent joint damage.

(2) Rheumatoid arthritis is an autoimmune disease which means the immune system, that normally helps protect the body from infection and disease, attacks joint tissues for unknown reasons. White blood cells travel to the synovium and cause inflammation. The synovium thickens and makes the joint swollen, painful and sometimes warm to the touch.

(3) As rheumatoid arthritis progresses, the inflamed synovium invades and destroys the cartilage and bone within the joint. The surrounding muscles, ligaments and tendons that support and stabilize the joint become

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

weak and unable to work normally. WINTER 2015 PROVIDENCE

Pain Free at Last

William Liu, MD; Eileen Schwartz Breyde, MD; Orrin M. Troum, MD

informed decision about treatment.” Along with the introduction of the powerful disease-modifying medications for rheumatoid arthritis, doctors today also are using newer imaging technologies to better assess the health of joints in order to specifically tailor treatments to individual patients and monitor their disease progression, Dr. Troum says. In the past, doctors have used X-rays to view joint damage. But X-rays aren’t as good at revealing all of the signs of rheumatoid arthritis—such as inflammation and bone erosion—compared to ultrasounds and MRI, and additionally expose patients to a small amount of radiation, he notes. Dr. Troum, current president of The International Society for Musculoskeletal Imaging in Rheumatology (ISEMIR), is a big advocate of the newer imaging scans for rheumatoid arthritis treatment, especially in the early stages. Ultrasound and MRI imaging show how active the disease is in a patient and how much damage has occurred,

PROVIDENCE WINTER 2015

says Dr. Troum, who has published review articles on the subject. When doctors see the extent of the disease, they can better determine whether medications are working and how aggressive to be with future treatments. For the last few years, Bower has been in remission while on a treatment regimen of methotrexate and the biologic etanercept (brand name Enbrel). Bower also takes fish oil supplements for their purported antiinflammatory properties. She couldn’t be happier with her treatment results. “I feel fine, with no pain, tenderness or any problems,” she says. Over the years, she also found that Iyengar yoga has helped. “It felt good, especially in the beginning when I was really in a lot of pain,” she says. “It just felt good to stretch and do something healthy for myself.” Information on exercise, a healthy diet and psychosocial support should be part of each patient’s treatment package, Dr. Liu says. People in the early phase of treatment,

when joints may still be swollen, can do gentle exercises to increase joint range-ofmotion and improve muscle strength. Later, many patients find water exercise, low-impact aerobics, yoga and other activities bolster both their physical and mental health. “An important aspect of this kind of chronic illness is addressing a patient’s attitude and how the patient copes with the problem,” he says. Conversely, patients should be wary of prescriptions for narcotics to cope with pain, Dr. Breyde says. “I try not to use narcotics for treatment of chronic pain,” she says. “It can be a deadend. There are a lot of other medications and modalities we can use to treat chronic pain that won’t interfere with a patient’s life or cause problems like addiction or dependency. I want to keep patients working, exercising, doing hobbies and enjoying their lives. With the current treatments for rheumatoid arthritis, they can do those things.” Looking back at her early struggles with rheumatoid arthritis, Bower is very thankful that she found the care she needed. “When I was first diagnosed, I was in pain and scared and wondering, ‘What’s wrong with me?’” Bower says. “I would go online and get information, and I would end up in tears reading about people being completely debilitated. I feel so fortunate to have Dr. Troum as my doctor.”

Cardiac

Care THAT DOESNâ&#x20AC;&#x2122;T MISS A BEAT An emphasis on prevention and minimally invasive procedures keeps heart patients living life to the fullest. Written by BETH HOWARD Photographed by VINCE TAROC

WINTER 2015 PROVIDENCE

ichael Kommel was doing everything right. He stayed fit by playing ice hockey several times a week, ate a mostly vegetarian diet and took a cholesterol-lowering statin for more than a decade, as his doctor prescribed. But the 61-year-old business owner who lives on a boat in Channel Islands Harbor couldn’t outsmart his strong familial history of heart disease. When imaging tests showed a dangerous buildup of plaque in a coronary artery (one of the major arteries feeding his heart), he underwent angioplasty at Providence Holy Cross’ Cardiac Catheterization Lab. To perform angioplasty, the doctor threads a catheter—a thin, flexible tube with a small, inflatable balloon at the tip—through an artery in the leg or wrist to the site of the blockage. The doctor uses special X-rays to guide insertion of the catheter through the arteries and injects dye to reveal narrow or blocked areas. The balloon, which is advanced through the catheter into the blockage, is then inflated to compress the plaque against the artery wall, allowing blood to flow more easily. Usually a stent is inserted to prop it open and keep the artery from collapsing. Kommel seems to have dodged a bullet. “I had no symptoms at all—pain or anything,” he says. “The only warning sign I would have had was a major heart attack.” Increasingly, physicians are using sophisticated imaging technologies and minimally invasive surgical techniques to identify and repair heart and blood vessel abnormalities before patients are stricken with a life-threatening heart attack or stroke. Providence Health & Services medical centers throughout the Southern California region offer leading edge therapies, including cardiac catheterization, advanced ablation techniques, specialized care for women with heart disease and even an innovative new treatment for atrial fibrillation.

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Cardiac Care That Doesn’t Miss a Beat

We have all the latest modalities. There is nothing we can’t treat in terms of coronary disease.”

These innovations and an emphasis on preventive care have led to significant strides in reducing cardiovascular mortality rates and improved quality of life. However, when a heart attack occurs, Providence hospitals have protocols in place to provide high quality care, including rapid treatment in a cardiac catheterization lab. Holy Cross, like four of the five other Providence Health & Services hospitals in Southern California, participates in the STEMI Program—a nationwide initiative developed by the American College of Cardiology and the American Heart Association to improve the treatment of patients with symptoms of a heart attack. STEMI stands for ST segment elevation myocardial infarction, a severe type of heart attack that occurs when the coronary artery is completely blocked. The program represents collaboration among hospital emergency departments, cardiologists and paramedics to ensure that patients experiencing STEMIs are diagnosed and treated quickly. “Our goal is to encourage patients to come right away if they have chest pain or suspect heart attack,” says Adel El-Bialy, MD, the Providence Holy Cross cardiologist who performed Kommel’s angioplasty. “Our message is: Call 911 right away; do not drive yourself. Paramedics have EKG machines and can activate the system so that by the time the patient hits the ER, everybody is ready.” He adds, “When an artery is blocked, no blood can go to the heart muscle. After six hours, the heart starts to die. Even when patients survive, damaged heart muscle can compromise their heart function and lower their quality of life.” Holy Cross’s cath lab boasts a solid record for treating these heart attack patients. While the national “door-toballoon” time averages 90 minutes, Providence Holy Cross Medical Center does it in, on average, 23 to 35 minutes, Dr. El-Bialy says. “We are way ahead of many hospitals in the nation.” WINTER 2015 PROVIDENCE

Cardiac Care That Doesn’t Miss a Beat

IMPROVING WOMEN’S HEART HEALTH

Often heart attack patients are women. In fact, a woman experiences a heart attack every 90 seconds in the United States. “Heart disease is the No. 1 killer of women,” says Nazanin Azadi, MD, a cardiologist at Providence Little Company of Mary Medical Center Torrance. “But women are not aware of their risks.” The medical center’s physicians focus on increasing awareness and preventing heart disease through community outreach programs. They aggressively treat women who present with heart attack symptoms, which can be different than those typical for men. “For women, it’s not the ‘elephant sitting on your chest,’” Dr. Azadi says. “Fatigue and low energy for the last two weeks might be the sign.” Both Providence Tarzana and Providence Holy Cross Medical Centers earned the 2014 Women’s Health Excellence Award from Healthgrades™, ranking them among the top 10 percent in the nation for women’s health care. This represents the highest scoring of

For women, it’s not the ‘elephant sitting on your chest.’ Fatigue and low energy for the last two weeks might be Nazanin Azadi, MD the sign.” full-service hospitals in women’s health, based on 15 conditions and procedures. Women who go to a Healthgrades Women’s Health Excellence Award hospital have a lower risk of dying across eight heart-related conditions.

ATRIAL FIBRILLATION INNOVATIONS

Providence hospitals also are renowned for cardiac innovations, such as the Watchman device, pioneered at Providence Saint John’s Health Center. The device treats atrial fibrillation, or A-fib, a heart rhythm abnormality that can cause blood to clot in

the heart’s left atrial appendage, putting patients at a high risk for stroke. Although blood-thinning drugs like warfarin lower stroke risk, people on these drugs must be tested frequently because blood levels can be affected by foods and other medications. Blood thinners also increase a patient’s bleeding risk, which becomes more worrisome as people grow older and face a greater risk for falls. “We’re stuck in a difficult position with elderly patients,” says Shephal K. Doshi, MD, director of cardiac electrophysiology and pacing at Saint John’s. “It’s a catch-22.” The Watchman device is inserted into a vein in the leg and guided to the atrium to block the left atrial appendage so blood can’t collect and clot there. According to a study authored by Dr. Doshi and published in November in The Journal of the American Medical Association, the device performs as well as warfarin, causes less bleeding and improves cardiovascular survival. “Patients get the benefit of blood thinners with a lower risk of bleeding,” says Dr. Doshi, who has performed hundreds of Watchman procedures as part of his research and trained physicians around the world in the technique. Training will begin mid-year for other Providence physicians interested in learning this technique.

ADVANCED ABLATION TECHNIQUES

While an alternative to blood thinners is welcomed by many patients, Saint John’s is on the leading edge of something perhaps even more desirable—a permanent surgical solution for atrial fibrillation through catheter ablation. Saint John’s performed the first endoscopic laser balloon ablation for atrial fibrillation in the United States, which allows physicians to peer into the heart through a catheter equipped with a tiny camera and use laser energy to burn unhealthy heart tissue where arrhythmias may originate. Through such groundbreaking work, Saint John’s has earned the reputation as a world-class center for ablation developments. “We boast some of the most advanced technology, certainly in Los

PROVIDENCE WINTER 2015

Cardiac Care That Doesn’t Miss a Beat

We boast some of the most advanced technology, certainly in Los Angeles but also in the United States.” Peter Pelikan, MD

Adel El-Bialy, MD

Angeles but also in the United States,” says Dr. Doshi. Patients benefit from a sophisticated, 3-D mapping system and an electrophysiology lab that trains physicians from all over the world. “We have some of the highest success rates with ablation and a low complication rate, compared to other reported rates,” Dr. Doshi explains. One of the medical center’s advances is minimizing patients’ exposure to X-ray radiation during ablation—typically 20 to 40 minutes. Dr. Doshi averages less than 30 seconds per case. “As A-fib has become an epidemic for our aging population, we will continue to seek innovative approaches to correct it,” Dr. Doshi says.

MINIMALLY INVASIVE HEART VALVE REPLACEMENT

Providence’s commitment to providing the most innovative cardiac techniques extends to heart valve treatment, currently available at most Providence Southern California hospitals. Beginning later in 2015, Saint John’s Health Center will open Providence’s first transcatheter aortic valve replacement (TAVR) program, a collaborative effort by physicians from all Providence Southern California hospitals. TAVR is a minimally invasive procedure that repairs a damaged valve instead of replacing it. The technique involves placing a collapsible replacement valve through a catheter into the old valve, much like placing a stent in an artery. Traditional valve surgery requires opening the sternum while the patient goes on a heart-lung machine. Surgeons replace the faulty valve with an artificial one while the heart is stopped. “TAVR is far less stressful for the

Shephal K. Doshi, MD

patient,” says Peter Pelikan, MD, medical director of Saint John’s cardiac catheterization laboratory. “Valves are put in either through an artery in the groin or a small incision in the chest. The heart keeps beating, and the patient avoids all the trauma of opening the chest and cardiopulmonary bypass.” Patients experience less pain and leave the hospital earlier. “The average patient goes home two to three days later feeling pretty well,” says Dr. Pelikan. Older patients are ideal candidates, because open-heart surgery is too risky for them. The backdrop to the new treatment at Saint John’s is a multi-specialty valve clinic, offering “one-stop shopping,” Dr. Pelikan says. Patients are evaluated by a team of health professionals— cardiologists, surgeons, nurse practitioners—and receive needed tests, including ultrasounds of the heart and CT scans. Importantly, the clinic assesses patients with valve disease over time and treats them appropriately. Plans for the valve clinic include a hybrid operating room, which combines the functions of a catheterization lab and an operating room and is equipped with the advanced medical imaging devices required to perform minimally invasive cardiac procedures, when circumstances warrant. From groundbreaking treatments for A-fib and valve disease to women’s unique heart concerns, Providence Health & Services hospitals are the region’s leaders in providing many of the most patientfriendly and up-to-date advances in cardiac care. “We have the latest modalities,” says Dr. Azadi. “There is very little we can’t treat in terms of coronary disease.” “I was very favorably impressed with

my experience,” say Kommel, who has returned to his healthy lifestyle with greater peace of mind. “Everyone I dealt with was very qualified. It’s really nice to feel that way when people have part of your life in their hands.” For more information, call 1-888-HEALING (432-5464).

The Watchman device is an alternative to long-term warfarin therapy to reduce the risk of stroke in people with atrial fibrillation.

WINTER 2015 PROVIDENCE

profiles in health

The Healing Power of Music Singer/songwriter Alecia Moore raises awareness for breast cancer services. Written by SHARI ROAN

reast cancer strikes one in nine women, an unacceptable reality that has prompted Alecia Moore to step up and help make a difference. The singer and songwriter, better known by her stage name P!nk, has become a prominent advocate for breast cancer treatment and research in recent years. Breast cancer patients who seek care with Providence Health & Services have benefitted greatly from Mooreâ&#x20AC;&#x2122;s support.

PROVIDENCE WINTER 2015

profiles in health For two years the Grammy award-winning artist has partnered with Providence Saint John’s Health Center to hold a fundraising concert to support breast prevention, treatment and research programs. The most recent event was 2014 Power of Pink: An Acoustic Evening with P!nk and Friends, held at the House of Blues in West Hollywood. The event netted $400,000 for the Cancer Prevention Program at Saint John’s. The idea for the fundraiser was launched a few years ago when Moore met Maggie DiNome, MD, chief of general surgery at Providence Saint John’s. Dr. DiNome also is acting director of the Margie Petersen Breast Center and medical director of the Cancer Prevention Program.

Alecia feels very much a part of the world around her. Her incomparable talent, as extraordinary as it is, is truly eclipsed by the generosity of her heart.” “We decided to do this fundraiser together,” Moore says. “I had gotten to know Maggie and realized all of these things that she was doing. With breast cancer being such an incredibly prevalent disease, we decided we needed to work together to help find a cure.” Music and public service work have long been pillars in Moore’s life. Born in Pennsylvania, she began singing in Philadelphia clubs as a teenager. By 2000 she had adopted the stage name P!nk and released her first solo album, Can’t Take Me Home. The record was a huge hit, and her career soared. She has gone on to release seven albums and was named Billboard’s 2013 Woman of the Year. Her latest LP is a collaboration with Dallas Green called Rose Ave. But Moore has chosen to use her celebrity for good in the world. She has supported many causes, including No Kid Hungry and Ride to the Flags to stand up against childhood hunger and to stand behind our veterans.

“I was raised in a household full of people who serve,” Moore says. “My dad served his country and went to war. My grandpop served his country and went to war. My mom was an ER nurse, caring for people every day. My stepmom was an Army nurse in Vietnam. My brother serves now in the Air Force. My stepbrother is a volunteer firefighter. I have always known I would need to give back, to ‘serve’ somehow. It’s in our blood. I am extremely fortunate and proud that I can do it on a grand scale, so to speak, and people like Maggie make it possible.” The Cancer Prevention Program at Providence Saint John’s Health Center provides services that are close to Moore’s heart, including personalized breast cancer risk assessment, nutrition counseling and yoga. “I really believe in yoga, and I really believe that complementary methods of treatment like acupuncture and nutrition, having a healthy diet and finding a way to de-stress and unplug in this world that is so high-speed and constant are just so important,” she says. Breast cancer prevention has taken on even more significance to Moore since she gave birth to her daughter, Willow Sage Hart, with husband Carey Hart in 2011. “Everything means more to me now that I’m a mom,” she explains. “Anything that I can do to help my daughter’s future, I’m 100 percent in.” Moore’s recent Power of Pink performance has permitted an expansion of services so that these important aspects of cancer care, such as nutrition, exercise and stress

reduction, can be integral, not ancillary, parts of a patient’s care, says Dr. DiNome. “I am so honored and grateful that Alecia has dedicated so much of her time, energy and talent toward helping our fight against breast cancer,” says Dr. DiNome. “Her partnership with us and her commitment to Saint John’s has enabled us to develop both our navigator and cancer prevention programs, which have had such a positive impact on the lives of our patients fighting this disease. Alecia feels very much a part of the world around her and never shies away from the opportunity to connect with others. Her incomparable talent, as extraordinary as it is, is truly eclipsed by the generosity of her heart. I absolutely adore her.” The Power of Pink events have been enormously successful and have drawn heartfelt praise. The 2014 concert featured artists including Linda Perry, Nate Ruess, Dallas Green, Butch Walker, Justin Derrico and Billy Mann. Moore says her favorite moment was when Mann joined her onstage to sing a song she co-wrote with him called “Beam Me Up,” which Dr. DiNome had requested. “It was a very special moment because I knew that every single person in that room had lost someone they had loved,” Moore says. “And we were all there to come together to help make it so that there isn’t as much loss in the future from this terrible disease.” For more information, call 1-888-HEALING (432-5464).

Power of Pink committee chair Mary Flaherty, P!nk and Bernadette Leiweke

WINTER 2015 PROVIDENCE

Written by VICTORIA CLAYTON

CATCHING

THE PREVENTION BUG A healthy dose of caution—coupled with action—is the best bet for avoiding infectious diseases.

PROVIDENCE WINTER 2015

o matter where you turn for your news—online, radio, newspaper or television—it’s likely that you’ve heard the frightening reports about Ebola. It isn’t a horrific virus

killing thousands solely in Africa. It has been here. The death of Thomas Eric Duncan in Texas sent shock waves through our country. While intellectually we may understand that what public health officials tell us is true—namely, the risk of contracting Ebola in the United States is extremely low—worrying about it is rather normal, says Cesar Chavarria, MD, a pediatric critical care specialist at Providence Tarzana Medical Center. “When there is a new disease or a new condition and there are health care workers getting sick, we all worry,” says Dr. Chavarria. “It’s not really a very rational worry. It’s more of an emotional thing.” Angelique Campen, MD, medical director of Providence Saint Joseph emergency department in Burbank, puts it this way: “Right now in the United States you are more likely to die from having your pajamas catch on fire than you are from Ebola.” Not to suggest Ebola isn’t deadly. Of course, it is. However, it is a virus that’s not easily spread. You can’t, for example, get the disease from touching a doorknob or even merely being in the same room with an Ebola patient. To contract it, you must be in direct contact with an infected person’s bodily fluids. And mercifully the United States has the medical wherewithal to properly and quickly treat the condition if diagnosed promptly. Yet the Ebola scare uncovers an interesting paradox when it comes to infectious disease: Too many of us worry

about what we’ll likely never contract, and too few of us take action to prevent what we realistically might get. Pertussis (whooping cough), for example, is a highly contagious and very real disease here in the United States. It’s a respiratory infection caused by the bacterium Bordetella pertussis. It’s usually spread when an infected person coughs or sneezes when in close contact with others. Pertussis most commonly affects infants and young children and can be fatal, especially in babies. Doctors recommend that all young children get the diphtheria-tetanuspertussis shot (also called the DTaP). Adults, including pregnant women, and children 11 years and older, should get a version of this shot that contains different levels of the virus, the tetanus-diphtheria-pertussis shot, or “Tdap.” Despite the serious risk the virus presents to infants and babies, however, as many as 10 percent of children aren’t fully vaccinated, and those rates are even higher in some communities. Meanwhile, in recent years pertussis cases nationwide

WINTER 2015 PROVIDENCE

Catching the Prevention Bug

have climbed to their highest since 1955, according to the Centers for Disease Control and Prevention. Lower-than-ideal vaccination rates have also led to outbreaks of measles in recent years. Even mumps and chicken pox outbreaks have been reported this winter. But perhaps the best example of something that’s easy to catch and easy to prevent is a condition so common the name serves as a stand in for nearly any winter illness: the flu. In the United States, fall and winter constitute flu season. Outbreaks can begin in October and last even as late as May. Learning how to prevent the spread of flu would go a long way in helping Americans cope with other potential communicable diseases. Flu is highly contagious. It’s spread through the air—if you inhale infected droplets after someone has sneezed or coughed— or through direct contact with an infected person’s secretions (for example, by kissing, touching or sharing a drink).

DO WHAT DOCS DO TO STAY HEALTHY Angelique Campen, MD, medical director of Providence Saint Joseph’s emergency department in Burbank, says if you truly want to stay healthy, in addition to getting immunizations you should do what doctors do. “I can’t stress enough how washing your hands often will do wonders in keeping you from getting sick,” she says. In order for hand-washing to be effective, apply soap and scrub hands for

There is a real misconception about what the flu is. It’s not a winter cold. The flu is a serious illness caused by a particular virus. It makes you extremely sick for at least five to seven days.” According to the CDC, millions of people are infected with the flu each year. In 2011, the most recent data available, more than 53,000 people died from seasonal flu-related illness. Children, people with compromised immune systems and those ages 65 and older are most vulnerable. Part of the reason people don’t have a healthy dose of fear when it comes to flu may be simply because they don’t truly understand it. “There is a real misconception about what the flu is,” says Dr. Campen. “It’s not a winter cold. The flu is a serious illness caused

PROVIDENCE WINTER 2015

at least 20 seconds. A good tip is to hum the “Happy Birthday” song twice. Dr. Campen also says that training yourself to simply not touch your face—particularly your nose and eyes—is extremely effective. “This is one of the first things that ER doctors learn. I have young children at home and I’m around sick people all the time at work, yet I almost never get sick because I don’t touch my face.”

by a particular virus. It makes you extremely sick for at least five to seven days. You are in bed, you have no energy, you have a fever, severe body aches and most people say they feel like a train has run them over.” If you truly have the flu, you will be incapacitated: You will miss work or school; caregivers won’t be able to attend to their families, warns Dr. Campen. In fact, hundreds of thousands of Americans are hospitalized each year because of the flu. Seasonal flu is largely prevented by a simple yearly vaccine, which is now covered by insurance (free to patients) due to the

Affordable Care Act. Public health officials recommend that everyone ages 6 months and older get the vaccination, with the exception of people who have severe allergies to the ingredients in the vaccine. But as bad as the condition sounds and as cheap and easy as it is to prevent, it’s still a struggle to motivate everyone to get vaccinated. People who have compromised immune systems or underlying illnesses generally adhere to flu vaccine recommendations. It’s more difficult, however, to convince those who have always been healthy and whose children have always been strong and healthy to take the time to just do it, according to Dr. Chavarria. Then there are the folks who are actually afraid to get immunized or have their children immunized. “In Los Angeles, we have a few public figures, people who are not doctors, who have spoken out against immunizations, and there are some parents who follow their advice,” says Dr. Chavarria, who spends a lot of time talking to patients to dispel the myths about immunizations. For example, some people believe they’ll get sick from the flu shot. “The flu shot does not contain live virus. It contains little particles of the virus. The risk of getting ill from it are extremely low.” Dr. Chavarria notes that the benefit, especially for children who have asthma, far exceeds any risk. Kids with asthma are particularly vulnerable to getting very sick with the flu. In addition, a 2005 study published in the American Journal of Epidemiology concludes that immunizing all preschool age children against seasonal flu is crucial to arresting the spread of flu in the broader community since young kids are super efficient at spreading germs. “The message is really everyone should get a flu shot. Period,” says Dr. Campen. Providence Healthcare asks all employees to get a flu vaccination. If a health care worker cannot be vaccinated or opts not to, he or she must wear a mask when treating patients, explains Jamie Jolly, RN, manager of infection prevention at Providence Little Company of Mary Medical Center Torrance. “We’ve also established respiratory etiquette policies in all hospitals to help

Catching the Prevention Bug

Providence infectious disease experts are prepared for this winter’s viral illnesses. From left: Jamie Jolly, RN; Cesar Chavarria, MD; and Angelique Campen, MD

PROTECTION: PROVIDENCE EMPLOYEES KNOW THE DRILL Nurses, doctors and other health care workers know personal protective gear such as gloves, gowns and

protect against flu or any contagious cold or cough,” says Jolly. “We have stations all over the hospitals, particularly by the elevators, with signage that asks everyone to please wear a provided mask if they can’t cover their coughs. We have this yearround, and people are very willing to do it.” And while masks work well in the health care setting, Jolly says she doesn’t recommend them for most people in real life because there are other more feasible measures to take to keep yourself and your entire community as healthy as possible. For example: If you get sick, stay home!

Syndrome, or SARS, is a coronavirus that sickened more than 8,000 people worldwide in 2003. And in 2009, a particularly bad strain of the flu, called H1N1, resulted in the deaths of more than 12,000 Americans and the hospitalization of more than 274,000 people. H1N1 was particularly dangerous for pregnant women and serves as a reminder to this day that pregnant women should always get a flu shot. “Viruses mutate—it’s called antigenic drift,” Dr. Chavarria says. “They evolve, change, mutate over time. Our immune

masks are crucial to prevent disease from spreading. Ebola, however, requires a much higher level of personal protection, says Jamie Jolly, RN, manager of infection prevention at Providence Little Company of Mary Medical Center Torrance. “Although it’s extremely unlikely we’ll ever see a case of Ebola here, and the immediate threat seems to be gone, it has given us an opportunity to drill our staff and establish

You have to think of it this way: It’s really a civic duty to stay home and not share your virus when you’re sick.”

strict protocols in the event of an outbreak of any highly contagious disease.” Over the last few months, all Providence health care

A new law, Healthy Workplaces, Healthy Families recently signed by California Governor Jerry Brown, should make this easier. Under the law, most employers in California will be required to provide up to three days of paid sick leave to their employees beginning July 1, 2015. Dr. Chavarria says he empathizes with parents who are in a bind and send sick children to daycare or school, but he notes it’s a major public health hazard. If you send your kids to school, they will certainly spread illness. Other kids will get sick. “Children are not very good at staying away from each other,” he says. “You have to think of it this way: It’s really a civic duty to stay home and not share your virus when you’re sick.” The emergence of Ebola is a reminder that viruses are part of humanity, and every once in a while a new virus or a particularly bad strain emerges. For example, Severe Acute Respiratory

systems are ready to fight the old virus but are surprised when the virus mutates.” Another virus, called enterovirus-D68, emerged several months ago as a serious threat to children who have asthma or underlying illnesses. Enterovius-D68 is not new; enteroviruses are common types of respiratory illnesses that typically cause mild illness in children. But the 2014 outbreak was harsh, causing at least 12 deaths in children. Public health authorities are still studying the outbreak to better understand it and how it might be prevented. “We are very fortunate that, in California, enterovirus-D68 didn’t really take off; there have only been a few scattered cases,” Dr. Chavarria says. “This virus, at times, can be very severe, especially in children with asthma. So we have been concerned about it and very vigilant.” For more information, call 1-888-HEALING (432-5464).

workers have gone through additional personal protective gear training. Hospitals have designated small teams of health care workers with the required expertise who have volunteered to be activated should there be a patient with a serious disease such as Ebola. Most important, says Jolly, they’ve reviewed admissions policies so that anyone who is sick and has traveled to West Africa recently can immediately be identified and helped. “If there’s anything good that could come out of the Ebola situation in Texas, it’s that we are now even more prepared and more vigilant.”

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profiles in health

Freedom from Tremors Deep brain stimulation at Providence was a “miracle” for patient Beverly Beyer. Written by LAUREL DIGANGI

Photraphed by MONICA OROZCO

great-grandmother and active octogenarian, Beverly Beyer was not ready to let a diagnosis of Parkinson’s disease threaten her independence. However, over time her tremors became increasingly intense. “Everything was moving—my hands, my eyes, my mouth,” Beyer says. “I was very uncomfortable.”

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Her everyday activities, from showering to drinking coffee, became difficult. Soon Beyer felt self-conscious dining with her friends at the independent living residence where she currently resides. “I wasn’t as outgoing,” she says. “I just curled up inside myself so people wouldn’t notice me.”

profiles in health After consulting with her neurologist, Michael M. Marvi, MD, Beyer decided to consider deep brain stimulation (DBS). Dr. Marvi initiated a series of neurological tests to determine if she was a good candidate. Beyer decided to go ahead with the procedure after consulting with neurosurgeon Ronald Young, MD, who also is medical director of the Movement Disorders Center in the Hycy and Howard Hill Neuroscience Institute at Providence Saint Joseph Medical Center in Burbank. “Deep brain stimulation was a miracle for me,” Beyer says. “I had two surgeries. The day after the final surgery, nothing shook. The people at the facility couldn’t believe it when I went to dinner the next day. They were amazed.” Perhaps more amazing is that Beyer’s results are typical. “The success rate is high—as many as 80 to 90 percent of patients see improvement,” says Dr. Young. DBS treatment involves two separate surgeries. In the first, the patient is awake and kept comfortable through a combination of local anesthesia and intravenous sedation. A tiny incision is made in the scalp, and thin wires—called stimulating electrodes—are placed in precise target areas of the brain. Then a low level of electrical current is passed through the electrode, and the surgical team can assess the effect of the current on the patient’s symptoms and make necessary adjustments. Several days later the patient receives a second surgery while under general anesthesia. An insulated wire is attached to the electrode’s lead and surgically guided to the area where a permanent electrical stimulator—much like a pacemaker—is implanted in the chest. The patient returns to the doctor about two weeks later to have the stimulator turned on and programmed through a small device similar to a TV remote. “Once we turned the stimulator on, we saw a dramatic improvement in the degree of tremors that Mrs. Beyer had,” says Dr. Marvi. In general, Dr. Young says he utilizes deep brain stimulation in the treatment of Parkinson’s patients and those with

essential tremor or dystonia. “The symptoms must be bad enough to prevent the patients from doing everyday activities,” he says. In addition, most patients who undergo DBS have not gotten adequate relief from standard medications for Parkinson’s, or the required dosages result in unwanted side effects. Dr. Young also adds that patients who have cognitive dysfunction or memory issues generally are not good candidates for DBS because their conditions could be significantly worsened. At the Movement Disorders Center, prospective DBS patients consult with an experienced team that includes the neurologist, neurosurgeon, nurse coordinator and neuropsychologist. This team follows the patient from the initial consultation to follow-up care. “Unlike some major centers, the patient has contact with the people who are actually going to be performing the procedure,” says Dr. Young. And patients like Beyer appreciate that personal level of attention. “Saint Joseph is a wonderful hospital,” she says. “I love it here because everyone is so very kind and caring.” “Our center has an excellent track record, and we have been doing this procedure for many years,” says Dr. Marvi. Two years after her surgery, Beyer still enjoys her independence. She goes to a yoga class twice a week, and on off days she visits the residence’s fitness center, where she works out on a treadmill. Recently she acquired Miss Kitty, a ragdoll kitten, and trained her to walk down stairs on a leash. Beyer wants prospective deep brain stimulation patients to understand that although the procedure has high success in alleviating certain symptoms, it does not cure Parkinson’s. “My speech doesn’t work like it used to,” she says. Still she is grateful for the impact the procedure has had on her life. “Before, it was like my body had a mind of its own,” she says. “Today I look around and am extremely grateful for where I am, so I don’t worry about tomorrow.” For more information, call 1-888-HEALING (432-5464).

Deep brain stimulation was a miracle for me. I had two surgeries. The day after the final surgery, nothing shook. The people at the facility couldn’t believe it when I went to dinner the next day. They were amazed.”

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happenings SELLABRATION GALA The biannual Sellabration Gala presented by American Honda Motor Co., Inc., was held Nov. 1 at Terranea Resort in Palos Verdes. The evening was a rousing success with almost 700 guests attending and generating record-breaking giving of more than $1.8 million. Honda pledged $1 million to Providence Little Company of Mary Medical Center Torrance to help fund the Cardiovascular Center of Excellence. Honda executive Steve Morikawa received the Providence Little Company of Mary Corporate Leadership Award which recognizes outstanding leadership and generosity among members of the local business community. The Sellabration benefits the Cardiovascular Center of Excellence at the Torrance campus and critical patient services at Providence Little Company of Mary Medical Center San Pedro. 1

1. Sister Terrence Landini, LCM.; Torrance Little Company of Mary chief of staff, Michele Del Vicario, MD; and gold sponsor Priscilla Hunt 2.The Scharffenberger family, represented by Marion and her children (from left): George, Ann, Tom, Joan, Marion, John and Jim. The family was honored for its major gift to the Cardiovascular Center of Excellence. 3. Event cochair Paula Del Vicario; Honda executive Steve Morikawa; board chair, Tom Connaghan; Providence Little Company of Mary chief executive, Liz Dunne; and event co-chair Shannon Ryan

ROSE DEDICATION CEREMONY In partnership with One Legacy and our sister ministries in the Valley (Holy Cross and Saint Joseph), Providence Tarzana Medical Center hosted the annual Rose Dedication Ceremony on Nov. 5. During this event we honored patients who died at our hospitals in the past year and who were organ and tissue donors. The families were presented with a single yellow rose and a rose vial. The vials were filled with roses and used to decorate the One Legacy float at the 2015 Rose Parade.

PROVIDENCE WINTER 2015

happenings

CARITAS GALA The Irene Dunne Guild, in partnership with the Saint John’s Health Center Foundation, hosted the 2014 Caritas Gala on Oct. 27 at the Beverly Wilshire Hotel in Beverly Hills. The annual black-tie event celebrates individuals who demonstrate compassion for others through exceptional service to the community. Multi-award-winning musician and producer David Foster and his wife, television personality, model and interior designer Yolanda Foster, received the Caritas Award. Tonian Hohberg, president and founder of FIDM/ Fashion Institute of Design & Merchandising, was presented the Spirit of Saint John’s Award. Gala chair Evelyn Guerboian and John Robertson, MD, chairman of Saint John’s Health Center Foundation board of trustees, welcomed the more than 550 guests. Since the guild’s inception in 1987, members have raised more than $11 million for Saint John’s.

5 1. Tonian Hohberg, Yolanda Foster and David Foster 2. Enid Lieber; Daniel Lieber, MD; David Krasne, MD; and Paola Pini 3. Gil Kuhn, MD; Ernie Prudente, MD; Tonian Hohberg; Peter Pelikan, MD; Amita Davis and Tim Davis, MD 4. Marcel Loh, Providence Saint John’s Health Center chief executive 5. Sister Maureen Craig, SCL, and David Foster

THE 24TH ANNUAL SUNDAY BY THE SEA FOOD AND WINE TASTING GALA Friends old and new celebrated the 24th annual Sunday by the Sea Food and Wine Tasting Gala, presented by Western National Group, on Sept. 28 at the seaside estate of Carolyn and Julian Elliott in Palos Verdes Estates. The event raised more than $200,000 to support the programs and services of Providence TrinityCare Hospice and its pediatric palliative care and hospice program, TrinityKids Care. More than 50 premier restaurants, wineries and beverage purveyors from Southern California tempted 800 guests with delicious morsels and fabulous libations. 1

1. Diamond sponsor Jacky Glass (center) with Laura Khouri and Michael Hayde from Western National Group, the event’s presenting sponsor 2. Chef Michael Shafer and Steve Morikawa from American Honda Motor Co., Inc., the platinum sponsor 3. Providence TrinityCare team members: Scott Sharpe, Terri Warren, Yvonne Byock, Ira Byock, MD, and Barbara Roberts

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happenings REP. CARDENAS VISITS HOLY CROSS Rep. Tony Cardenas, 29th District, toured Providence Holy Cross Medical Center on Oct. 28 to observe the impact of the Affordable Care Act on services. The ACA has helped millions of Americans gain health care coverage, including many in the San Fernando Valley. Providence is working in the community to assist with enrollment in Covered California health plans and Medi-Cal while also transforming the delivery of health care to meet the needs of this growing area.

Holy Cross chief executive Bernie Klein, MD, and Rep. Tony Cardenas tour the hospital.

From left: Rep. Cardenas; Jason Fisher, MD; and Dr. Klein

Rep. Cardenas and Dr. Klein in the lobby at Holy Cross Medical Center

MISSION TRIPS TO GUATEMALA AND MEXICO

FEAST OF OUR LADY OF GUADALUPE Celebrating the feast day of Our Lady of Guadalupe inside the hospital chapel, Dr. Bernie Klein, Holy Cross Medical Center chief executive (center), presents California State Assembly member Patty Lopez (left) with a framed print of Our Lady of Guadalupe. Also pictured is Maria Townsend, business and community development manager for Providence Holy Cross.

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The Providence Southern California region recently completed two Mission trips. The leadership formation trip to Tijuana focused on building homes and learning about health and immigration issues affecting our neighbors to the south. The second trip was a medical Mission to Guatemala where more than 50 surgeries were performed.

happenings 5K RUN/WALK/RELAY Providence Holy Cross partnered with the city of San Fernando to host a 5K run/walk/relay event on Oct. 11. Holy Cross chief executive, Bernie Klein, MD, along with the hospital’s emergency room physicians and many caregivers from across the hospital, participated in this fun community event to promote staying healthy and active.

1. Race start line 2. Team of volunteers help at the race day event.

1 HISSRICH FAMILY TOY DRIVE The annual Hissrich toy drive took place in early December at Target in Burbank. A group of the Hissrich family’s friends spent $15,300 (earned on CrowdRise) for toys, clothes, books and toiletries, which ultimately filled 28 Target carts and created a 27-foot register tape! The result was a much happier Christmas for hundreds of children and their families. The toy drive is spearheaded by Mike and Lauren Hissrich and their family friend Michelle Lankwarden in partnership with the Providence Saint Joseph Foundation and with additional assistance from Target. It was launched after Saint Joseph doctors saved the life of Harry, who was born prematurely.

1. The 27-foot cash register tape held by the toy drive shoppers 2. Elizabeth LaBorde, executive director of Providence Saint Joseph Foundation 3. The Hissrich family with Michelle Lankwarden (right)

INTRODUCING S.A.M.

From left: Sister Terrence Landini, LCM; Father Peter F. Mallin, Spiritual Care; Paul Makarewicz, director of Mission Leadership; Treasure Joyce, stroke program coordinator; and Catrice Nakamura, stroke coordinator

On Nov. 4 Providence Little Company of Mary Medical Center Torrance introduced S.A.M. (Stroke Assessment Manager), the latest in telemedicine—also called telestroke. Telemedicine is a new way neurologists remotely evaluate people who’ve had acute strokes and make diagnoses and treatment recommendations to emergency medicine doctors.

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shout outs We value feedback from our patients and visitors and strive to ensure that every individual entering Providence Health & Services is treated with kindness and respect. We are proud to share some of the wonderful comments we’ve received in the past few months. We invite you to share your story with us at providence.org/share or join us on Facebook at facebook.com/Providencecalifornia.

My daughter was a recent patient in your facility (Providence Saint Joseph Medical Center) and was cared for on three different units. I’m writing this as her mother and as a retired nurse who tends to look at all things medical more closely. I want you to know that I was so impressed by your staff on every unit as well as her team of physicians. Everyone we dealt with could not have been more caring and friendly! ... We were so blessed to wind up at Providence Saint Joseph. There is a spirituality there which brought peace even through the critical times.” – Judith Marshall

“I am writing on behalf of my 82-year-old mom who had a potentially difficult and life-threatening neck surgery. Dr. Go, my mom’s anesthesiologist at Providence Saint John’s Health Center, was outstanding! He came and spoke with us before the surgery, sensed my mom’s anxiety, listened with full attentiveness and patience, and reached out to give her a reassuring hug. Amazing! I have never seen such kindness and compassion in any physician experience I have ever had! ... Dr. Go, you are a wonderful physician, and I hope that others see this review. You touched our lives and made a great impression on my family.” — Lynn “This is a letter of thank you for the fine care that was afforded me when I was admitted as a patient at Providence Tarzana Medical Center. The care given

“I owe my life to the skill and fast action of Providence Little Company of Mary Medical Center San Pedro’s medical and surgical team.” — Grateful Patient

by nurse Kelly and other nursing staff in the CVU ward was very welcome, since hospital stays can be stressful. I particularly want to mention the professional and kind care provided by student nurse Marlen, who was attentive and patient, considering my primary motive was release as soon

“I’ve always thought that Providence Little Company of Mary Medical Center Torrance was a good choice. But when my husband had to be there for one whole week, not knowing what was wrong with

as possible. Thank you again for making the experience at Providence Tarzana a rewarding visit.” — Stephen Snow

him, I am now convinced it is the only place that I would recommend as

“As a retired customer relations supervisor

a hospital choice. The nurses, nurses’ aides, doctors and caregivers are

for over 37 years at a government facility,

absolutely wonderful, loving and kind. I’d like to give a special shout-out

I truly understand the importance of

to Angie, Kristy, Maria, Rachel, Alpha and all the others. Dr. Camel and Dr. Okawa and Dr. Brian Wong, you are my HEROES. Thank you.” — Alison and Ken Duboff

providing quality service to all customers. The personal concern, professionalism and courtesy extended to me by Katina

Love this hospital (Providence Holy Cross Medical Center). Me and my family will always remember and have thanks for all of your staff who saved my brother’s life.” — Sidonna Niche

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Salvato (at Providence Medical Institute) were so impressive. I got the feeling that Katina takes great pride in her job, caring a lot about patients and good customer service.” – Grateful Patient

Experience life Ken Brown, 55 | heart surgery patient South Bay resident Read Ken’s full story at california.providence.org/kenstory

Experience Providence heart care “I love living in Southern California – and thanks to Providence, I’m living a great life.” When it comes to living your life, we don’t want you to miss a beat. We’ve got a team of heart specialists that make sure you don’t have to. Providence Southern California medical centers offer some of the most advanced heart and vascular treatments available. Our cardiovascular and thoracic surgeons, cardiologists and other cardiac team members apply the latest evidence-based therapies to your treatment for the best possible outcomes. And with six hospitals and 40 clinics throughout Southern California, first-class heart care is within reach. Whether you need a simple screening or comprehensive surgery, our accomplished cardiac experts give you what you need to get back to living the life you want. Experience life. Experience Providence heart care. A simple screening could save your life. Get a free physician referral or learn more. 888-HEALING (432-5464) | california.providence.org

888-HEALING (432-5464) california.providence.org Providence Holy Cross Medical Center Providence Little Company of Mary Medical Center San Pedro Providence Little Company of Mary Medical Center Torrance Providence Saint John’s Health Center Providence Saint Joseph Medical Center Providence Tarzana Medical Center Providence TrinityCare Hospice Providence Affiliated Medical Groups

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Developing a healthy p. respect for viruses and other infectious diseases.

Timely cardiac care erases a heart attack risk and gets an active man back to his life.

A new rule gives newborns a healthier start.