Holyoke Medical Center's Valley Health & Life: Fall 2024
BREAST CANCER FROM SURVIVING TO THRIVING RAISING THE BAR IN DIABETES CARE
One woman’s positive outlook helped her through breast cancer treatment. Now, she’s focused on helping others stay healthy.
DIAGNOSTIC
HMC’s new radiology equipment is faster, safer and more advanced.
An insurance denial and a misdiagnosis led this patient to HMC’s Institute for Minimally Invasive Spine Surgery—and relief from debilitating pain.
one local resident lost 135 pounds with surgery and lifestyle changes through the Weight Management Program at HMC.
HMC Rheumatology welcomes two new providers.
HEALTHY HABITS
FOR YOU AND YOUR FAMILY
BENEFITS OF ACTIVE COMMUTING
People who walk or cycle to work have lower risks of both physical and mental health issues. Cyclists experience the greatest health benefit—research found that folks who bike to work have a 47% lower risk of dying from any cause.
SKIP THE IN-FLIGHT DRINK
—BMJ Public Health
PROCESS THIS…
Adults who consume 20% of their calories from uberprocessed foods showed faster rates of cognitive decline compared to those adults who ate fewer
The combination of alcohol and cabin pressure at cruising altitude may threaten sleeping plane passengers’ heart health, particularly on long-haul flights, suggests the first study of its kind. The combination lowers the amount of oxygen in the blood and raises heart rate for a protracted period—even in the young and healthy. The higher the alcohol consumption, the greater these effects might be, particularly among older passengers and those with preexisting medical conditions. —Thorax
Neurology
SKIP THE CANDY DISH
As tempting as those chocolatecovered mints or jelly beans appear, keep walking. A recent study reports that people fail to properly wash their hands before eating 97% of the time. —U.S. Department of Agriculture
TEENS BENEFIT FROM VIRTUAL DRIVING ASSESSMENT
Motor vehicle crashes are a leading cause of death for adolescents, mostly due to driver error. Researchers implemented a 15-minute selfadministered virtual driving assessment test in 19 primary care practices. More than 3,000 adolescents 15 years and older completed the assessment. Drivers received an evidence based, personalized report identifying risks and areas for targeted practice. Of the teens who completed a survey post assessment, 77% said they agreed or strongly agreed with the findings.
—Annals of Family Medicine
WHEN METABOLISM SLOWS
After age 63, metabolism, the rate your body burns calories, declines. That means you need fewer calories to function.
—Science
RAISING THE BAR IN DIABETES CARE
HOLYOKE MEDICAL CENTER’S ENDOCRINOLOGY & DIABETES CENTER HAS EXPANDED ITS TEAM AND ITS LEVEL OF CARE TO BETTER SERVE EVEN MORE PATIENTS.
THOUGH THERE currently is no cure for diabetes, there are many things that people who live with diabetes can do to manage it. Education, diet, exercise and medication are key to the proper management and treatment of diabetes. But with so much information and so many choices available, knowing where and how to start can be challenging.
That’s where the Endocrinology & Diabetes Center at Holyoke Medical Center (HMC) comes in. The knowledgeable, bilingual team at the center helps people with diabetes improve their health by changing their behaviors. The center, which has a diabetes education program recognized by the American Diabetes Association, comprises highly trained diabetes professionals and offers comprehensive care. It also offers individual and group instruction on such topics as healthy cooking, glucose monitoring, and insulin pump training.
Now, with the addition of five new diabetes providers, the Center has expanded its level of care so that it can serve more patients with shorter wait times. The practice, which includes Robert J. Cooper, MD, FACE, FACP, Zoraida C. Rodriguez, Registered Dietitian, and Corina Valvo, RN, BSN, CDE, Certified Diabetes Educator, has added two physicians, two certified physician assistants and a nurse practitioner, all of whom are experienced in diabetes prevention, care and treatment.
Robert Cooper, MD
MEET THE NEW TEAM MEMBERS
Aysha Khan, MD, who is boardcertified in Internal Medicine and completed a fellowship in Endocrinology in June 2024 at the University of Connecticut, joined the Diabetes Center in August. “The expanded level of care at the Diabetes Center will ensure that we maintain continuity of care with ease of appointments for our patients and practice more proactive care to prevent some of the other co-morbidities that occur when glucose levels are uncontrolled,” says Dr. Khan, who believes that one of the biggest misconceptions about diabetes care is that it is led by the provider.
“As healthcare is moving away from provider-centered care and practicing more patient-centered care, diabetes, especially, is one of those diseases that needs a partnership between provider and patient to drive the management plan together.”
HMC Endocrinology & Diabetes Center is accepting new patients. To make an appointment, call 413.534.2820 .
Sarah O’Shea, MD, who is board certified in Internal Medicine, joined the Endocrinology & Diabetes Center in June. Dr. O’Shea received a BA in Psychology at Harvard University before attending the Ross University School of Medicine and then completing a residency with UConn Internal Medicine. During her residency, she worked one-on-one with an endocrinologist to learn about the management of diabetes. Dr. O’Shea is excited to be a part of the Diabetes Center team and believes that the expanded level of care is extremely beneficial to the community. “We are able to accommodate consultations much more readily,” she says. “Patients can get in to see endocrinology faster and can be followed more closely with the expansion of the Diabetes Center.”
Dianne Lavoie, PA-C, is a certified physician assistant who joined the Diabetes Center in June. She received her bachelor’s degree at UMass Amherst and completed her MS in Physician Assistant Studies at the Massachusetts College of Pharmacy and Health Sciences in Worcester. “I wanted to work in medicine since I was very young,” says Lavoie. She loved science and biology and she wanted to help people, so healthcare was a natural trajectory. “My philosophy of care is collaborative healthcare,” she says. “I enjoy building relationships with my patients. I want them to be involved in their diagnosis and their treatment process, and I want them to feel that they have the knowledge that I do about their health condition so that they can actively participate in their healthcare.”
Kenzi Holden, PA-C, who joined the HMC Diabetes Center in 2024, received a BS, General Studies and an MS, Physician Assistant, from Springfield College. She is board certified by the National Commission on Certification of Physician Assistants (NCCPA). Holden has been on the medical staff at Holyoke Medical Center since May. “Post-pandemic, I know healthcare has had a lot of challenges, and my philosophy of care has become to treat people as people, and how I would want my family members to be treated.”
Sheila Whelan, APRN, is an advanced practice nurse who holds a master’s degree in nursing as a nurse practitioner. She brings 30 years of experience to the HMC Diabetes Center, which she joined in June. Prior to that, Whelan worked in two private practices specializing in diabetes care. “I specialize in treating adult patients with both type 1 and type 2 diabetes and, in particular, I have focused on those individuals with tough-to-treat blood sugars,” says Whelan. “HMC has set improving Hemoglobin A1C in the community as one of our main goals,” says Whelan. “Having patients with well controlled diabetes lowers the risk of heart disease, eye damage, and chronic kidney disease. The hemoglobin A1C is a three-month sugar average and achieving a target of 7 percent (average blood sugar of 154) is essential to prevent or delay diabetic complications, which can occur when the blood sugars are not well managed. HMC has expanded the Diabetes Center to improve the health of the greater community.”
FROM SURVIVING TO THRIVING
HER POSITIVE OUTLOOK HELPED HER THROUGH CANCER TREATMENT. NOW, SHE’S FOCUSED ON HELPING OTHERS STAY HEALTHY.
Becky Gonzalez turned to HMC for expert breast cancer care.
BECKY GONZALEZ KNEW something was wrong when, in 2019, while doing a self-exam, she discovered a lump in her breast. The 49-year-old mother of two from Westfield had a mammogram but, despite what she felt, the mammogram did not detect anything amiss.
However, around August 2021, she felt the lump again, and this time it was bigger. Becky saw her primary care provider for a physical and told him that the lump had grown. “My doctor scheduled me for a mammogram and a breast ultrasound,” says Gonzalez. “Once again, the mammogram did not find the lump—but the ultrasound did.”
THE ‘SHOCKING’ DIAGNOSIS
In September 2021, Becky had a breast biopsy followed in October by a lumpectomy performed by Holyoke Medical Center (HMC) surgeon Francis Martinez, MD. Becky was diagnosed with Stage 3 breast cancer.
BECKY’S TREATMENT REGIMEN
After her surgery, Becky was referred to Zubeena Mateen, MD, Medical Director of Hematology and Oncology at HMC, for further treatment.
“After her surgery, Becky was given chemotherapy to prevent the tumor from coming back, to ensure that any microscopic disease in her body or potential cells left behind at the time of surgery were eliminated, and to help improve survival,” says Dr. Mateen.
According to Dr. Mateen, Becky started chemotherapy in December 2021 and finished about a year and a half later. “The courses of chemo varied depending on the treatment,” she says. “Different types of treatments and chemotherapy drugs were administered over different time periods.”
After completing chemotherapy, Becky was given whole-breast radiation every day for six weeks, with weekends off. “Toward the end of radiation, she was given a ‘boost,’ exactly where the tumor cavity is,” says Dr. Mateen. “It’s like an insurance policy.”
THE HEALING POWER OF POSITIVITY
Dr. Mateen believes that Becky’s positive attitude helped her through her treatment. “She was a trooper, and she was very positive, often making jokes,” says Dr. Mateen. “Patients’ immune systems work better if they’re positive.”
According to Becky, she’s always been a positive person. “I’m always looking for the good in everything,” she says. “So, when I got this diagnosis, I knew the only way I would get through it was to stay positive.”
MAKING HEALTH HER BUSINESS
In 2019, the same year Becky first discovered a lump in her breast, she became a certified health coach. “I
wanted to better my life and my family’s lives and help others live a healthier life,” she says. “I got into Superfoods (nutritionally dense foods packed with vitamins, minerals and antioxidants), which are a great way to boost your immune system.”
Becky developed a “Superfood Booster Mix” of 11 ingredients that can be added to coffee, baked goods, smoothies and more. In 2020, her company, En3rgy Up, was born. Becky then became interested in juicing, which she considers her passion. “I would take my carrot juice and ginger shots with me during infusions. I knew I had to put it out there to help other people,” she says. Becky now has a store and is hoping to incorporate her certified health coach services into the company.
CONTINUING HER HEALING JOURNEY
Becky continues to see Dr. Mateen and follow a course of treatment. “In the beginning, I saw her every month,” says Dr. Mateen. “Now she sees me every six months. She is on maintenance treatment. She will continue to get annual mammograms and be examined by Dr. Martinez every six months and, after five years, she can come in once a year. Because breast cancer can come back later down the line, we will continue to do labs and a tumor marker to make sure the tumor isn’t growing back.”
At first, Becky’s diagnosis came as a shock, especially since two mammograms showed no signs of a malignancy. Becky was found to have dense breast tissue and, according to the American Cancer Society, dense tissue makes it harder to find breast cancer on a mammogram. Fortunately, her doctor ordered additional imaging and the ultrasound detected the cancer. “Once the diagnosis sank in, I was fine with it, only because I had become a certified health coach two years before, so I knew what I needed to do for myself while going through treatment.” To learn more about the HMC Oncology Center, please call 413.534.2543 .
‘LIKE FAMILY’
“We’re not a big hospital,” says Dr. Mateen. “We provide personalized care, and it’s more like a family. The patients get attached to the nurses, who take good care of them.” Becky is grateful to her doctors, nurses, and the HMC team. “Dr. Mateen was great,” she says. “She explained how everything was going to go and answered all my questions. Her staff is wonderful, too. I got to know them on a level where I can say that we are like family.”
Francis Martinez, MD Zubeena Mateen, MD
The new MRI unit at Holyoke Medical Center is faster with more appointments available, including weekends.
STATE-OF-THE-ART DIAGNOSTIC IMAGING
HMC’S NEW RADIOLOGY EQUIPMENT IS FASTER, SAFER AND MORE ADVANCED. IT ALSO IMPROVES PATIENT COMFORT.
EVERYONE WILL have a radiology test or diagnostic imaging at some point in their lives, whether it’s an X-ray, a CAT (computerized axial tomography) scan, an MRI (magnetic resonance imaging), an ultrasound or one of many other radiology tests and scans. Radiology tests allow your doctor to see the structures in your body— including bones, muscles and organs— as well as any changes or abnormalities in order to screen for diseases, to diagnose symptoms and to monitor your body’s response to treatment.
Holyoke Medical Center (HMC) recently underwent a radiology equipment overhaul, including the addition of new, state-of-the-art digital equipment. Here are some of the upgrades:
MRI UNIT
“Magnetic resonance imaging (MRI) scans use a magnetic field and radio waves to take pictures inside your body,” says HMC Director of Imaging Services Susan Lavoie, BA, RT(R), ARRT. “MRIs are safe, painless procedures that do not use radiation. MRIs are ordered to look at diseases of the soft tissue, blood vessels and nerves in more detail where a CT scan might not give enough information. They also are used to evaluate bone fractures, joint injuries and diseases of the spine, along with identifying stroke, tumors and cancer.” MRIs produce clearer, more detailed pictures than some other imaging methods.
HMC’s new MRI unit was designed to put patients at ease and reduce
anxiety with lighting, music and soft, ultra-lightweight coils. Its large open design is also more comfortable for patients. New technologies and techniques have substantially reduced scan times, in some cases by more than 60 percent. “For example, on our old scanner, a scan of the knee would take 25 minutes,” says Lavoie. “With the new scanner, it takes just nine minutes. With the increased efficiency, HMC now has additional appointments available, along with weekend availability and improved read times by the radiologists.”
X-RAY ROOM
X-rays, also known as radiography, are the most common (and oldest) form of medical imaging. X-rays use very small
doses of ionizing radiation to produce images of the body’s internal structures and are often used to help detect and diagnose broken bones, fractures, injuries or infection. X-ray exams sometimes use iodine or barium to help improve the visibility of specific bones, organs or blood vessels, commonly used for Fluoroscopy.
“Our new X-ray room was selected for its image quality and safety features for patients’ ease on and off the table,” says Lavoie.
NUCLEAR MEDICINE
“Nuclear imaging shows your doctor your organ and tissue structure,” says Lavoie. “It works by injecting a small amount of radioactivity, called a radiopharmaceutical. When the camera scans your body, it looks for the area that is ‘taken up’ by the radiopharmaceutical and creates an image.”
HMC chose the new nuclear camera because of its outstanding image quality and equipment use. The
table can hold up to 500 pounds and lowers to accommodate patients with mobility issues.
INTERVENTIONAL RADIOLOGY ROOM
Interventional radiology (IR) procedures are minimally invasive procedures that use image guidance and make tiny incisions in your body using needles and catheters. IR treatments can be used for a number of conditions and involve lower risk, less pain and shorter recovery time than open surgery.
“Your provider can watch the catheter advance into your body with guidance from fluoroscopy,” says Lavoie.
“They can also perform biopsies and drainages using the guidance of ultrasound and CT scans.” Examples of IR procedures include repairing or unblocking an artery or vein; treating a narrow artery with a stent to open it up and restore blood flow; dissolving or retrieving a clot in the leg, arm, or lung; performing a biopsy on a soft tissue or organ; freezing a tumor; ablating a
nerve; draining fluid from the abdomen or chest; and fixing a collapsed vertebra in the spine.
“Our new Interventional Radiology Room has the latest advancements in imaging technology that fit with our desire to provide top-quality care to our patients,” says Lavoie.
FLUOROSCOPY ROOM
Fluoroscopy uses X-rays to create a video of the inside of your body. The fluoroscope captures the images and shows them on a monitor for the radiologist to watch. “Usually, patients have either an injection or swallow some contrast so the radiologist can see it move through your body. This is often used to view your digestive tract, urinary tract, cardiovascular system, reproductive tract, bone joints and vessels,” says Lavoie.
“The new unit allows us to care for all patients,” says Lavoie. “The table design is wide, clean and has a weight capacity of up to 550 pounds. The table height is also adjustable, making it easier for patients with mobility issues. In addition, it offers state-of-the-art digital imaging with excellent image quality and optimizes X-ray doses, reducing unnecessary radiation.”
For questions related to Imaging Services at Holyoke Medical Center, please call 413.534.2523.
Left: Nuclear Medicine team members Blanca Marrero, Tony Graziano and Kathy Krisak with the new equipment. Right: The new X-ray and fluoroscopy equipment.
The new interventional radiology equipment.
SECOND TIME’S THE CHARM
AN INSURANCE DENIAL AND A MISDIAGNOSIS LED THIS PATIENT TO HMC’S INSTITUTE FOR MINIMALLY INVASIVE SPINE SURGERY—AND RELIEF FROM DEBILITATING PAIN.
PAM MINER , a retired convenience store owner who lives in Colrain with her husband, Joe, had been living with severe lower back pain for more than two years, and it was getting worse. By the time she saw her primary care doctor in the spring of 2023, she was walking with a cane and was unable to stand for more than a couple minutes without excruciating pain.
Pam had had a hip replacement 21 years earlier, and originally thought there might be a problem with the replaced hip. So she made an appointment with a doctor who performed hip replacement revisions. “He told me I had no problems in my hips, and that my replacement was stellar,” she says. With her hips ruled out as a source of pain, in September 2023, Pam’s primary doctor referred her to a physical medicine and rehabilitation physician who diagnosed her with sacroiliitis, a condition that affects the sacroiliac
Pam Miner found relief from debilitating pain at the Institute for Minimally Invasive Spine Surgery at Holyoke Medical Center.
(SI) joints, causing pain and stiffness in the lower back and/or buttocks. “He did no diagnostic tests, no X-rays, no MRI—nothing,” says Pam. “He was just guessing.”
Pam was given cortisone injections in the sacroiliac joints, but the resulting pain relief was short-lived. So the doctor recommended radiofrequency ablation (RFA) of the sacroiliac joints, which uses radiofrequency waves to produce heat that damages the nerves so that they can no longer transmit pain signals from the sacroiliac joints to the brain. “What put the kibosh on that is that my insurance wouldn’t cover it,” says Pam. “I was so upset then but, boy, it saved my life!”
ENTER THE INSTITUTE FOR MINIMALLY INVASIVE SPINE SURGERY AT HMC
With no other treatment option to offer based on his diagnosis, the doctor referred Pam to Frederik Pennings, MD, who leads the then newly opened Institute for Minimally Invasive Spine Surgery at Holyoke Medical Center (HMC). But first, he ordered an MRI, which was required for Pam to see Dr. Pennings.
Pam. “How come all spine doctors don’t know that?”
During that first appointment, Dr. Pennings sent Pam to have X-rays taken of her spine. “Then I went back to his office and we finished my appointment,” she says. “I was so impressed with that.”
THE CORRECT DIAGNOSIS
According to Dr. Pennings, Pam’s symptoms were not compatible at all with sacroiliitis. “Her symptoms— pain in the back when walking or standing that gets better when sitting, leaning forward or using a cane— were indicative of spinal stenosis (a narrowing of one or more spaces within the spinal canal),” he says. “I made the diagnosis based on her history, her symptoms and the MRI and X-rays.”
INDIRECT DECOMPRESSION
On April 29, 2024, Dr. Pennings performed an oblique lumbar interbody fusion (OLIF) on Pam. “This is a minimally invasive technique that approaches the spine from the side through a one-inch incision in the left lower abdominal quadrant,” says Dr. Pennings. “Through that incision, I put spacers in from one side of the disk to the other. This procedure not only corrects the scoliosis curvature but also reduces the slip (spondylolisthesis) and realigns the lumbar spine. Returning the lumbar spine to a relatively normal position creates the space needed for the nerves.”
“When I met Dr. Pennings in January 2024, he said, ‘Tell me your story,’” recalls Pam. “I told him mornings are really bad; I don’t sleep well.” Dr. Pennings, an internationally recognized expert in minimally invasive spine surgery and the only spine fellowship-trained neurosurgeon in the area, asked Pam whether she slept on her back or on her side. She told him she went from side to side and that she couldn’t sleep on her back. “He said, ‘People with SI joint problems can’t sleep on their side,’” says
Pam’s MRI was very significant, according to Dr. Pennings. “It showed a lot,” he says. “In addition to spinal stenosis, she also had degenerative lumbar scoliosis, a curve of the spine, as well as spondylolisthesis, a condition where one vertebral body slips forward onto the one below it. That combination lumbar scoliosis and spondylolisthesis caused the spinal stenosis.”
The X-ray also contained valuable information. “When you have an MRI, you’re lying down, so the gravity is not there. Because of that, you won’t see the scoliosis that much,” says Dr. Pennings. “But if somebody is standing, the gravity works, and you see the scoliotic curve and the spondylolisthesis much better. That’s why, in spine cases, it’s important not just to do an MRI, but to do a regular X-ray, which is often overlooked by doctors.”
Pam discussed her options with Dr. Pennings and it was determined that she needed surgery to correct her conditions. “It was crystal clear what needed to be done,” says Pam. “I was done messing around.”
According to Dr. Pennings, most surgeons in Pam’s case would have used an open direct decompression technique, which involves removing bone and ligaments and is a much bigger undertaking. Dr. Pennings used a minimally invasive indirect decompression of the nervous structure. “With indirect decompression, I do not remove any bone, ligaments, or muscles,” he says. “Just by realigning the spine and putting it in the position it should be, I get the decompression the nerves need.” The procedure takes 90 minutes to three hours depending on the number of levels fused and involves minimally invasive placement of screws and two rods as well.
PAIN-FREE AT LAST
“I stayed overnight for observation and the next day, I could walk up the stairs,” says Pam. “My recovery was amazing. I felt much steadier right away and was walking with no pain. I’m still ecstatic over this. I can’t say enough about Dr. Pennings—I love that guy! He has a great personality, a great bedside manner, and he’s brilliant. I’m so grateful to him and to HMC.”
To learn more about the Institute for Minimally Invasive Spine Surgery at Holyoke Medical Center, please call 413.535.486 0 .
Frederik Pennings, MD
Nothing Left to LOSE
HOW ONE LOCAL RESIDENT LOST 135 POUNDS WITH SURGERY AND LIFESTYLE CHANGES THROUGH THE WEIGHT MANAGEMENT PROGRAM AT HMC.
KENNY ULERIO, a 37-year-old social worker from Holyoke, weighed 324 pounds when he walked into the office of Yannis Raftopoulos, MD, Director of the Weight Management Program at Holyoke Medical Center (HMC), in September 2023. “I had been struggling with my weight for about 10 years,” says the married father of three. Upon his discharge from the military, in which he’d served for five years, Kenny admittedly began to “let himself go” and it wasn’t long before he’d ballooned to an unhealthy weight. “I didn’t pay attention to my health and just kept eating,” he says. “After a while, I knew I wanted to be healthy, but it was hard as I have a full-time job and a lot of responsibility.” Kenny tried going to the gym, but he was not getting the results he wanted. He was afraid that, if he didn’t do something soon, his health would continue to decline, and he wouldn’t be around to see his children grow up.
So, Kenny shared his concerns with his primary care physician, who referred him to the HMC Weight Management Program. Kenny already knew that he wanted to explore surgical weight-loss options, and it turned out that Kenny’s weight was not his only problem. “In addition to being morbidly obese, Kenny also had fatty liver disease, significant acid reflux disease, gallstones, and high cholesterol,” says Dr. Raftopoulos. Those conditions, coupled with a BMI (Body Mass Index) of 43.9 (a BMI of 30 or greater indicates obesity), made Kenny an excellent candidate for bariatric surgery.
CHOOSING THE PROCEDURE
the gastric sleeve). “It was just a gut feeling,” says Kenny, not realizing the pun. “I chose it because the recovery time was shorter and it was less invasive (than other surgical options).”
Unlike some other bariatric procedures, sleeve gastrectomy does not reroute the intestines or alter the digestive system and, according to Dr. Raftopoulos, the advantages of the procedure include a lower risk of serious early complications, long-term complications and vitamin deficiencies.
LIFESTYLE INTERVENTION: THE KEY TO WEIGHT LOSS SUCCESS
According to Dr. Raftopoulos, regardless of the type of surgery performed, it is not the surgery itself that determines a successful weight loss outcome. “The primary factor of success is lifestyle intervention,” he says. “Without that, surgery eventually fails.”
The Lifestyle Intervention Program, developed by Dr. Raftopoulos, is a novel approach to weight loss based on 22 years of clinical experience and research. The program provides individualized and structured nutritional and exercise plans based on new concepts such as protein intake, sleep/work schedule, accurate portion measurement and calorie-burning exercise goals, not on counting calories or points, weighing food or goalless exercise. Recently, Dr. Raftopoulos, with the support of HMC, designed a software application that can automatically generate patient-specific nutritional and exercise plans integrating the Lifestyle Intervention Program.
BARIATRIC SURGERY WITH THE WEIGHT MANAGEMENT PROGRAM
HMC’s Weight Management Program has been accredited as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a joint program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).
Recently many local insurance companies, recognizing the superior benefits of bariatric surgery, have lowered the criteria for bariatric surgery which is now more widely accessible than ever before and certainly more accessible than the anti-obesity medications.
Presently, to qualify for bariatric surgery, patients need to meet one of the criteria:
• BMI of 30-34.9 with at least one very serious medical condition:
- Insulin dependent diabetes
- Sleep apnea with apnea index greater than 30
- Hypertension (over 5 year duration and 2 or more medications)
- Heart attack before the age of 50
- Heart (cardiac) conditions
- Insulin- and non-insulindependent diabetes
After consulting with Dr. Raftopoulos, who has performed more than 2,000 bariatric procedures, Kenny opted for sleeve gastrectomy (also known as
“It’s a unique tool that can provide patients with customized, structured, individualized meal and exercise plans,” he says. Patients can change or adjust their nutritional plan as often as they like and those who use the app lose fat at a rate 2.5 times higher than actual weight while they maintain or increase their muscle mass. This app is unique because it provides each user a specific recipe on how to
- High blood pressure (hypertension)
- Obstructive sleep apnea/ snoring
- High cholesterol (hyperlipidemia)
• BMI greater than 35 with, or without medical conditions
Yannis Raftopoulos, MD
lose weight customized for them. “Patients are tired of being told what to eat or not to eat, or how many calories to burn or have on their daily ‘budget’ because they know all this,” Dr. Raftopoulos says. “Instead, they want a method for how to achieve longterm successful weight loss that meets their preferences.”
SCREENING, PREPARATION AND SURGERY
Before being approved for bariatric surgery, all patients must see a behavioral health specialist. They also must have an upper endoscopy, an abdominal ultrasound, a stomach X-ray, a chest X-ray, an EKG (electrocardiogram) and blood work. “Most importantly, they participate in our Lifestyle Intervention Program through our software app with the goal of losing 10 percent of their initial weight,” says Dr. Raftopoulos.
To achieve that goal, Kenny worked with Dr. Raftopoulos and his team to come up with a tailored diet and exercise regimen prior to his surgery. “In September 2023, I started on a meal plan that consisted of protein shakes and bars, along with lean protein and vegetables for dinner,” says Kenny. He followed an exercise program at home, with the goal of burning 2,000 calories per week. “Through this Lifestyle Intervention Program, I lost about 38 pounds in three months.”
A NEW START FOR THE NEW YEAR
Kenny’s surgery took place on January 2, 2024. To perform the sleeve gastrectomy, which took about 90 minutes, Dr. Raftopoulos freed the stomach from its surrounding tissues and then divided it along its long axis with a surgical stapler. “In contrast to most other surgeons, when performing this procedure, I suture the remaining stomach back to its original attachments to restore its original anatomical position. In addition, the fact that I don’t use a calibration tube, which distorts the stomach, allows me to create a more even-caliber sleeve throughout and helps prevent postoperative heartburn and reflux, a common issue in other practices throughout the country,” he says.
Kenny stayed in the hospital overnight and was back to work in 10 days. “Kenny is a shining example of a successful transition to our Lifestyle Intervention Program,” says Dr. Raftopoulos. “He was focused, consistent, communicated well with me throughout this process, and remained committed to changing his lifestyle.”
To date, Kenny has lost more than 135 pounds and his BMI is now 25.2. He has gone from a size 48 pants and a 3XL shirt to a size 32 pants and a medium shirt. He checks in with Dr. Raftopoulos weekly and has increased his exercise routine to include running, walking, stretching, and strength training. Most of all, he has his life—and his health—back, and he and his family couldn’t be happier. Kenny’s advice to those who are considering bariatric surgery? “Just do it,” he says. “It will change your life.”
MEET THE
HMC RHEUMATOLOGY WELCOMES TWO NEW PROVIDERS. RHEUMATOLOGISTS
RUMATOLOGISTS are board-certified internists who specialize in the diagnosis and treatment of arthritis as well as other inflammatory and autoimmune conditions of the joints, muscles, and bones. Autoimmune diseases can also affect the eyes, nervous system, skin, and internal organs. These conditions and diseases can cause pain, swelling, stiffness, and other symptoms.
There are more than 200 types of diseases and conditions that rheumatologists treat, the most common of which are:
• Rheumatoid arthritis
• Osteoarthritis
• Gout
• Lupus
• Back pain
• Osteoporosis
• Tendinitis.
Holyoke Medical Center (HMC) has added two new providers to its rheumatology team.
Dilpreet Singh, MD, FACR, will join HMC in November and will have an office in Springfield. Dr. Singh received her medical degree from Trinity College at the University of Dublin in Ireland. Her postdoctoral training includes an internal medicine residency at Tufts University School of Medicine/Baystate Medical Center in Springfield, followed by a rheumatology fellowship which she completed at Case Western Reserve University School of Medicine/MetroHealth Medical Center in Cleveland, Ohio. She enjoys the multifaceted nature of being a rheumatologist. “Rheumatology is a discipline that requires a physician to wear many hats: detective, proceduralist, teacher, and most importantly, learner,” she says. “It is a growing field with new treatments coming out of the pipelines every year.”
Juliann Allen, MBBS (Hons), joined HMC in September 2024. Dr. Allen earned her Bachelor of Medicine & Surgery (Hons) at the University of the West Indies Faculty of Medical Sciences in Jamaica followed by a residency at Hackensack Meridian/ Englewood Health in Englewood, New Jersey. She completed a twoyear fellowship in rheumatology at the Albert Einstein College of Medicine/ Montefiore in Bronx, New York, in July 2024. Dr. Allen says she is excited to get to know the community that HMC serves. “I hope that I’m able to utilize my diverse background to be able to connect with patients and improve their healthcare experience,” she says. “The most rewarding part of my job is being able to diagnose and treat a patient who has been in years of distress and pain and see them do well and be able to live their lives.”
Among the things Dr. Singh is most excited about in the field of rheumatology are advances in targeted therapeutics. “These advances are exciting and give hope to our patients with debilitating diseases,” she says. “In addition, MSK ultrasound has provided another tool for rheumatologists aiding in diagnosis and providing targeted therapy. Over the last year, new biosimilars (drugs that are very similar in structure and function and have the same mechanism of action as biologic medicines) are emerging, increasing the availability of treatment options for our patients.” One of the most fulfilling aspects of Dr. Singh’s work as a rheumatologist is helping patients with painful and sometimes debilitating conditions. “When treatment is a success and function and quality of life is regained, it’s the best reward,” she says.
To make an appointment with Dr. Allen or Dr. Singh, please call HMC Rheumatology at 413.534.2682.
