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SUMMONING THE WITHIN ATHLETE breakthroughs LIVING WELL ON THE WESTSIDE | SUMMER 2013 Spotting a Stroke and Acting Fast A Massive Blood Transfusion Saves a Life When Pets Roam, Spirits Soar Elite Orthopedics Care Keeps Former Olympian Going Strong

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Saint John's Health Center's community health magazine.

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Page 1: Breakthroughs Magazine

SUMMONING THE

WITHINATHLETE

breakthroughsLIVING WELL ON THE WESTSIDE | SUMMER 2013

Spotting a Stroke and Acting Fast

A Massive Blood Transfusion Saves a Life

When Pets Roam, Spirits Soar

Elite Orthopedics Care Keeps Former

Olympian Going Strong

Page 2: Breakthroughs Magazine

2 breakthroughs SUMMER 2013

letterfrom the CEO

I joined Saint John’s Health Center just a few short months ago, and in that time I have been privileged to meet and speak with countless numbers of patients, associates, physicians, donors and volunteers. Regardless of who I have spoken with, I have heard the same overarching sentiment: “We love Saint John’s!” When asked why, the reasons have been unanimous: “outstanding medical staff, compassionate nursing care, access to the latest technology and research and a personalized approach to care.”

In this issue of Breakthroughs, you’ll read stories that touch on all of these attributes. For instance, in the story

on page 16, you’ll learn how the top-notch sports medicine experts at the Santa Monica Orthopaedic Group do everything possible to make sure athletes, from weekend warriors to former Olympians, have their shot at success on the playing field. Then, on page 28, discover how the Patient Navigation Program at the world-class Margie Petersen Breast Center supports breast cancer patients with a personalized approach. On page 13, read about one mother’s harrowing ordeal during childbirth and how a rapid response protocol initiated by Saint John’s saved her life. All these stories of clinical triumph and compassionate care make it an honor for me to represent Saint John’s Health Center.

In recent news, the Sisters of Charity of Leavenworth Health System announced that it will enter into exclusive negotiations for Providence Health & Services, Southern California, to assume sponsorship of Saint John’s Health Center. As the hospital moves forward on this journey, Saint John’s will continue to provide the community with breakthrough medicine and inspired healing, and we look forward to a bright future ahead.

Mike WallActing President and CEO

Page 3: Breakthroughs Magazine

SUMMER 2013 breakthroughs 3

contents

in good health

features profiles

departments

ON THE COVERFormer Olympian Cliff Meidl

photographed by Jeff Berting

12 | Call in the Reinforcements A young family embraces life after a near tragedy during childbirth.

16 | Tapping Into Your Inner Olympic Spirit Santa Monica Orthopaedic Group knows how athletes tick.

24 | Quick Action is the Key to Stroke Treatment Many people don’t recognize a stroke — at their peril.

22 | PAWS 28 | Patient Navigator

2 | Letter from the CEO 4 | Letter to Friends and Supporters 10 | On the Horizon 30 | Happenings 34 | Shout Outs

5 | By the Numbers: Construction Facts

6 | Clinical Trials Highlights 7 | Healthy Recipe

Nutrition Tips 8 | Summer Safety 9 | Healthgrades

Page 4: Breakthroughs Magazine

4 breakthroughs SUMMER 2013

Dear Friends and Supporters of Saint John’s and John Wayne Cancer Institute: On May 17, 2013, the Sisters of Charity of Leavenworth Health System announced they had entered into exclusive negotiations with Providence Health & Services to assume sponsorship (ownership) of Saint John’s and John Wayne Cancer Institute.

The medical staff leadership and Foundation Trustees of Saint John’s Health Center, as well as the leadership of JWCI, embrace the initiation of negotiations. Although details of the transfer of sponsorship are yet to be determined, we believe this to be a very positive development for our hospital and community. We are pleased with the many strengths Providence brings to Saint John’s, including its expertise in managing Catholic hospitals in Southern California as well as its extensive physician and clinic networks.

The medical and Foundation leadership is eager to sit down with Providence to begin the process of learning about one another and what we anticipate will be a smooth and fruitful transition. We remain committed to strong community and physician engagement in the operation and management of Saint John’s. We anticipate this new relationship with Providence will allow further development of our many outstanding clinical service lines, including orthopedics, oncology, neurosurgery, women’s health and cardiovascular disease.

We also look forward to Providence’s support and collaboration in advancing the mission of JWCI. The Institute has been at the forefront of cancer research—making an impact worldwide for more than 30 years—and continues to train future leaders in cancer care through its renowned Surgical Oncology Fellowship Program.

Each of us has chosen Saint John’s for very personal reasons—some from the day their first child was delivered here. We realize that it is a different kind of hospital: a tertiary care institution with a compassionate, personal touch. For many on the medical staff, Saint John’s has represented the fusion of high-tech care in a community-based setting, creating a unique environment where the highest quality patient care always comes first.

Regardless of why we each call Saint John’s home, we are unified in our commitment to its future viability and continued success. With our new sponsor and state-of-the-art facility, we look forward to a reinvigoration of the Health Center and a renewed opportunity to care for our community and its patients for many years to come.

Paul Natterson, MDPresident, Saint John’s Health Center Medical Staff

Patrick WayneChairman of the Board of Directors, John Wayne Cancer Institute

Donna TuttleChair, Saint John’s Health Center Foundation

SAINT JOHN’S HEALTH CENTER EDITORIAL STAFF

Acting President and Chief Executive Officer

Mike Wall

Assistant Director, Marketing and CommunicationsAnita Bhatia Smith

VP, Branded Media Emily S. Baker

Art Director Ajay Peckham

EditorShari Roan

Copy Editor Laura Watts

ContributorsDawn Hoffman

Sandi Draper

PhotographersJeff Berting

Randi CurbyRemy Haynes

President & CEO Charles C. Koones

Chairman & Founder Todd Klawin

breakthroughsLIVING WELL ON THE WESTSIDE

SUMMER 2013

58 11th Street, Hermosa Beach, CA 90254

Tel 310-376-7800 Fax 310-376-0200moontidemedia.com

Hospital Staff and Trustees Look Forward to Continued Success

Page 5: Breakthroughs Magazine

SUMMER 2013 breakthroughs 5

BY THE NUMBERS: Mullin Plaza

Construction Facts

Mullin Plaza, the new entryway to Saint John’s Health Center, will open in the coming weeks. Over the past years, earth has been

moved, concrete poured and vegetation planted. Here are some facts and figures on

the construction.

in good health

Ground excavated:

30,000 CUBIC YARDS

Number of rose bushes:

131

Trees planted:

89Size of

water feature:

10.5 FEET X 58 FEET

Rebar needed:

1,000,000 POUNDS

Concrete poured:

28,000 CUBIC YARDS

Hedges in maze:

1,511 LINEAR

FEET

Page 6: Breakthroughs Magazine

6 breakthroughs SUMMER 2013

STEM-CELL THERAPY FOR BACK PAIN

More than 30 million people in the United States suffer from back pain. While physical therapy and medication provide a solution in some cases, about 4.5 million people still experience pain due to disc degeneration.

Hyun Bae, MD, a spine surgeon at Saint John’s Health Center, specializes in life-changing medical research for diagnosis and treatment of the spine.

In a recent high-profile study, he used adult stem cells to treat low back pain. This outpatient, non-surgical treatment uses a simple, intervertebral disc injection of allogeneic mesenchymal precursor cells that takes less than 20 minutes. Preclinical trials showed that a single, low dose of allogeneic adult stem cells resulted in dramatic reversal of the degenerative process and symptoms.

ADVANCED MELANOMA AND THE LIVER

Oncologists know that advanced melanoma (skin cancer) tends to spread more often to particular areas, including the liver. Mark Faries, MD, director of the Melanoma Research Program at the John Wayne Cancer Institute, has helped develop a treatment called “isolated liver perfusion.” This innovative, interdisciplinary technique involves physically isolating blood vessels leading to and from the liver and then delivering chemotherapy directly to the organ. 

By isolating the liver, the patient can receive very high doses of chemotherapy because the rest of the body is spared most of the exposure to the drug. Using this method, Dr. Faries and other researchers in the United States have demonstrated remarkable responses in patients whose tumors were resistant to all other forms of therapy. Saint John’s Health Center is the only site on the West Coast approved to perform this procedure.

BREAST CANCER IN YOUNG WOMEN

Marilou Terpenning, MD, is direct-ing the only California site for the national trial “Young and Strong,” which is designed to provide specific support for young wom-en newly diagnosed with breast cancer. The trial is sponsored by the American Society of Clinical Oncology and includes 24 academic and 40 community sites across the country.

The program is intended to identify gaps in the care of young women (ages 18 to 45) diagnosed with breast cancer and address their special needs. Investigators believe that if confronted early in a young woman’s care, concerns related to fertility, body image, sexual dysfunction and physical activity can be addressed, leading to an improved quality of life and enhanced care for this vulnerable population.

In order to be eligible, women must be seen by Santa Monica Hematology-Oncology within three months of their breast cancer diagnosis.

in good health

If you or someone you know is at least 18 years of age and has severe, long-term back pain, call 310-828-7757 or visit laspine.com to learn more about this study.

For more information or to see if you are eligible, call 310-453-5654.

For more information, call 310-582-7456.

AdvancementsSaint John’s distinguishes itself as a community hospital with a robust dedication

to medical research. Here are a few of our faculty’s current research projects.

Page 7: Breakthroughs Magazine

SUMMER 2013 breakthroughs 7

In a NutshellNuts are everywhere. They’re in baked goods, salads, cereals, ice cream and sprinkled into many fish and vegetable dishes. Nuts are con-

sidered healthy, although they contain a lot of fat. That’s why health experts recommend limiting

your consumption to a handful each day.

CALORIES

Source: United States Department of Agriculture

Pistachios

Peanuts

Almonds

Walnuts

Pecans

Macadamia nuts

14% 169

14% 161

18.5% 185

21% 196

21.5% 205

12.7% 159

in good health

1-OUNCE SERVING

GRAMS OF FAT

Healthy EatingA refreshing summertime dessert

By Sandy Andrews, RD, CDE, CPT, Director Nutrition & Diabetes Education, Saint John’s Health Center

Roasted Strawberries with Balsamic Vinegar and PepperIngredients:3 pints fresh strawberries, hulled1 tablespoon Smart Balance (use a no-trans-fat margarine)1 teaspoon vanilla1 tablespoon light brown sugar1 tablespoon balsamic vinegarFreshly ground black pepper3 cups Dreyer’s Light Slow Churned frozen yogurt (or a light ice cream)

Directions:1. Preheat oven to 400º. Melt margarine in

microwave on low power. Add vanilla, sugar and balsamic vinegar and whisk until smooth. Toss with berries to coat.

2. Place berries in a 9-by-13-inch baking dish and sprinkle with freshly ground black pepper (four to five grinds with a pepper mill).

3. Roast in the oven 12 to 15 minutes.  4. Serve with light frozen yogurt as a sundae topping. 5. A ¼-cup portion of the strawberry topping may be

cooled and refrigerated and used as a topping over oatmeal or Greek yogurt or cottage cheese. This can be counted as one breakfast fruit serving.

Serves 6 (½-cup portion) or 1 (ice cream scoop portion)

Nutrients per servingCalories: 180 per ½-cup servingTotal Fat: 4 to 5 gramsTotal Carbohydrates: 25 to 30 gramsFiber: 3 to 4 gramsSugar: 8 gramsSodium: 60 gramsCholesterol: 20 milligrams

Page 8: Breakthroughs Magazine

8 breakthroughs SUMMER 2013

Do you see different kinds of problems in the ER during the summer months?

“In the summer months, people are outdoors more. There are more sunburns and swimming accidents.

Here in the beach community, there are rollerblading and biking accidents—that kind of thing. We see a lot of jellyfish and stingray stings in the summer. But then there is less flu and pneumonia.”

Have you seen any changes in sum-mertime mishaps over the years?

“Rollerblades are a lot less popular than they used to be. I think we’re seeing fewer head injuries related to bicycles. There is no question that wearing a helmet has become much more en vogue, both in the snow and on bikes and skateboards and rollerblades. However, it doesn’t seem that wearing wrist guards makes a lot of difference to preventing forearm fractures.”

Do you think people are using sunscreen more?

“People may still be getting sunburned, but they’re just not coming to the ER. We tend not to see a lot of sunburn.”

What can people do to keep the summer months injury-free?

“The big, intuitive, common-sense thing is make sure you wear a seatbelt. If you’re doing anything on wheels, wear a helmet.”

It’s important to be consistent about these things, isn’t it?

“In general, people are eating better and living healthier lives. There is more education about eating better and avoiding sugary drinks. It’s these little things you do every day that affect your long-term health so profoundly.”

What should people do to stay safe at the beach?

“Probably the number-one thing is minimize sun exposure. I’d say that’s the most harmful thing that’s occurring there. Wear a hat and sunscreen and take

an umbrella. Make sure kids wear a hat and wear sunscreen. Make sure you can swim and stay in areas around the lifeguards.”

There may not be much you can do to avoid a marine sting, but you have a good remedy for stings. Tell us about it.

“Putting the warmest water you can manage will get rid of the sting in most cases. Buy a cup of coffee and let it cool a bit. Stick your foot in a cup of coffee. That will provide profound relief.”

What do you like the most about your job?

“It’s very meaningful. It’s very satisfying. Being an ER doctor, you get instant gratification. You see that you make a difference every day.”

What do you like to do in the summer?

“I like to surf in the summer. But I try to use sunscreen, a hat, sunglasses and stay out of the mid-day sun.”

in good health

Avoiding Summer BummersA conversation with Dr. Russ Kino about summer safety.

The long, warm summer days usually mean more fun for Southern Californians and visitors to the region. School’s out. Vacation’s on. It’s time to bike, swim, skate, surf and golf. But outdoor recreational pursuits can land people in the emergency room as well.

Since one of every five Americans visits an emergency department each year, we asked Russ Kino, MD, director of emergency services at Saint John’s Health Center, for some words of wisdom. With 29 years of experience as an emergency room physician—18 at Saint John’s—he’s seen it all.

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SUMMER 2013 breakthroughs 9

Saint John’s Health Center was recently named one of the nation’s 50 best hospitals by Healthgrades, an online resource for information on doctors and hospitals. Saint John’s is the only hospital in California and one of only 19 in the nation to have been named among the nation’s 50 best for seven years in a row. The designation ensures Los Angeles residents that the care they receive at Saint John’s is of the highest quality.

The health center was also named a Distinguished Hospital for Clinical Ex-cellence—ranking in the top 5% among all hospitals—for the 11th straight year. “By selecting a hospital on the Health-grades America’s 50 best hospitals list,

consumers can expect a commitment to exceptional quality and clinical care that is among the best in the nation,” says Evan Marks, Healthgrades’ executive vice president of informatics and strategy.

As one of the top 50 hospitals in the nation, Saint John’s ranks in the upper 1% among 4,500 hospitals evaluated over seven years. Among the hospital’s Healthgrades awards:

• One of America’s 100 best hospitals for cardiac care and coronary intervention for 2012 and 2013

• One of America’s 100 best hospitals for joint replacement for 2012 and 2013

• Cardiac Care Excellence Award for four straight years

• Coronary Intervention Excellence Award for four straight years

• Women’s Health Excellence Award for three straight years

“Saint John’s remains dedicated to providing the best possible care to its patients in a healing and comforting environment,” said Paul Natterson, MD, president of Saint John’s medical staff. “Being named one of America’s Top 50 hospitals for the seventh year in a row only further supports what I’ve always seen at Saint John’s: It’s dedicated to taking care of its patients.”

Performance rankings translate into lives saved, says Archelle Georgiou, MD, a strategic advisor to Healthgrades. If all hospitals performed at the level of the Healthgrades America’s 100 best hospitals during the years 2009 to 2011, he says, more than 165,000 lives potentially could have been saved.

in good health

Saint John’s Earns Top Healthgrades Ranking

have felt that they

made the wrong choice when selecting a doctor or hospital.

of Americans know where to

access information about a hospital’s performance.

90%

34%

50%

Being named one of America’s Top 50

hospitals for the seventh year in a row only further supports what I’ve always seen at Saint John’s: It’s dedicated to taking care

of its patients.”

SHOPPING FOR HEALTHCARE

A recent Healthgrades survey of 7,700 Americans found that people know they need to be smarter about choosing doctors and hospitals.

of Americans think that choosing a physician or hospital is at the top of the list of significant life decisions, but:

42% spend 10 or more hours researching a car.

34% spend less than one hour researching a physician.

Page 10: Breakthroughs Magazine

10 breakthroughs SUMMER 2013

JUNE 15Huck Finn DayDouglas Park9 a.m. to 1 p.m.The Santa Monica Jaycees host this annual event for children, featuring live trout fishing, pie eating contest and other games. For more information: smjaycees.org

JUNE 2313th Annual Main Street Summer SOULsticeMain Street11 a.m. to 7:30 p.m.Experience live music, sidewalk sale, children’s activities and entertainment. Street closures also include Kinney and Pier Ave.For more information: 310-899-9555

JULYChildbirth Preparation Classes and Maternity ToursTwo-part childbirth education classes at Saint John’s will be held on July 2 and 9, 5:30 to 8:30 p.m.; July 3 and 10, 5:30 to 8:30 p.m.; and July 6 and 13, 10 a.m. to 1 p.m. Maternity Tours will be held July 12 and July 18 at 11 a.m., 2 p.m. and 4 p.m.; July 16 and 29 at 1 p.m. and 6 p.m. and July 20 and 27 at 10 a.m., 12:30 p.m. and 3 p.m. For more information or to make reservations: 310-829-8887 or email elsa.ruedas@ stjohns.org

JULY 4Fourth of July ParadeMain Street9:30 a.m. to 1:30 p.m.Presented by the Ocean Park Association, the parade features All-American floats, bands and dancers. Wear your red, white and blue and join in the fun. Parking at the Civic Center garage and surface lot is $3 and opens at 6:30 a.m.For more information: opa-sm.org/parade

JULY 11Summer Twilight Concert Series Santa Monica Pier7 p.m. to 10 p.m.This is the opening night of the concert series, which runs every Thursday night throughout the summer. Concerts are free. For more information: twilightseries.org

on the horizon

36th annual Will Rogers 5K, 10K run sponsored by Saint John’s Health Center, July 4

Saint John's Health Center is a

proud member of the Santa Monica

community and encourages your

participation at events both at the

hospital and around town.

Page 11: Breakthroughs Magazine

SUMMER 2013 breakthroughs 11

JULY 12Cinema on the StreetThird Street Promenade at Wilshire Boulevard7 p.m. to 11 p.m.Outdoor movies tailored to all ages will be held each Friday on July 12 (Back to the Future), 19 (Despicable Me in 3D) and 26 (Three Amigos!). Bring a blanket or beach chair. Attendance is free.For more information: downtownsm.com

JULY 27 Santa Monica Chamber Health & Fitness FestivalThird Street Promenade12 p.m. to 5 p.m.The 38th annual Health & Fit-ness Festival promotes healthy living. Vendors will showcase their products and services. For more information: smchamber.com/healthandfitness

JULY 4 36th annual Will Rogers 5K, 10K run sponsored by Saint John’s Health CenterPacific Palisades6:30 a.m. registration8 a.m. race start timeThe 5k, 10k and Kids Run start and finish at the Palisades Recreation Center, 851 Alma Real Drive, Pacific Palisades. We look forward to seeing you at the starting line.For more information: 310-829-8424

AUGUST 2013Buehrle Golf ClassicMissouri Bluff Golf Course, Saint Charles, MOThe Buehrle Golf Classic, the premier fundraiser of The Buehrle Family Foundation, will be held to benefit JWCI as well as other institutions. Proceeds from the tournament benefit breast and colon cancer research in memory of Sharon Buehrle and Alan Pinkstaff. The two-shotgun event includes more than 300 participants. For more information: JWCI.org or 310-315-6111

AUGUST 11Jazz on the LawnStewart Street Park5 p.m. to 7 p.m.Bring a picnic, blanket and beach chair and enjoy a sampling of jazz. Bands will be announced in July. For more information: smgov.net/jazz

on the horizon

Summer Twilight Concert SeriesSanta Monica Pier, July 11

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12 breakthroughs SUMMER 2013

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SUMMER 2013 breakthroughs 13

REINFORCEMENTSCall in the

rances Armantrout was aware of some pregnancy complications with her second child. The baby was breech, as her first child had

been, and the placenta was in a low-lying position that caused some bleeding. So a repeat Cesarean section was scheduled for July, 2012, at Saint John’s Health Center.

As the date neared, though, more bleed-ing prompted the surgery to be moved up a bit. The obstetrician, Maria Ottavi, MD, knew the surgery might be more difficult than usual, so she had a couple units of blood on hand—just in case. But no one could have predicted what happened in the operating room on the afternoon of July 26.

After a healthy baby girl named Chloe was delivered, things took a frightening turn for the worse. In normal pregnancies, the placenta usually detaches from the uterus fairly easily after a baby is born, but not for Armantrout, 41, of Westwood. The C-section revealed that she had an unex-pectedly serious complication in which the placenta grew deep into the uterine wall and into the surrounding tissue—a severe condition called placenta percreta.

“I remember Dr. Ottavi saying she couldn’t deliver the placenta,” says Ar-mantrout. “It was stuck. She said she was going to do a hysterectomy.”

Armantrout quickly began losing massive amounts of blood, and Dr. Ottavi called for

more medical personnel—and more blood. “I knew this wasn’t normal, because I’d had a C-section before,” Armantrout says. “Then I was just knocked out.”

The Saint John’s Health Center surgical team spent the next five hours attempting to stop the massive hemorrhaging and

completing the hysterectomy. Armantrout received 16 units of packed red blood cells in addition to several units of other blood products. The average human body has about 10 units of blood. Doctors weren’t sure she was going to pull through and neither was her husband.

Instead of calling relatives to joyously announce the birth of baby Chloe, Kyle Armantrout had the horrible task of informing them he didn’t know whether Frances would survive childbirth. “I said, ‘She’s potentially bleeding to death, and you need to get here now.’”

But to the amazement of her family, Frances Armantrout did pull through. Now she and her doctors are crediting

When Frances Armantrout began losing blood after giving birth, her doctors implemented a lifesaving protocol.

F

Written by DAWN HOFFMANPhotographed by REMY HAYNES

I knew this wasn’t normal, because

I’d had a C-section before,” Armantrout says. “Then I was just knocked out.”

Page 14: Breakthroughs Magazine

14 breakthroughs SUMMER 2013

Call in the Reinforcements

her survival to a relatively new program at Saint John’s called the Massive Transfusion Protocol. Looking back now and hearing about all that transpired that day, Armantrout says, “I think that protocol totally saved me.”

PROTOCOL DESIGNED TO SAVE LIVESThe protocol, implemented early last year, is a series of steps to ensure that cases involving un-expected and rapid massive blood loss are treated in the best possible way. The steps include having all the appropriate medical personnel ready to help and the precise blood products available in the correct ratios to help stop the hemorrhaging. No new surgeries are started so that all hands are on deck to aid the most critical patient.

In Armantrout’s case, the protocol was initiated when it was clear the bleeding from the placenta was out of control. “This basically made her case the priority for the whole hospital,” Dr. Ottavi explains. “I think that’s what really saved her life; having this rapid response system in place.”

Major trauma centers that see serious accident and injury cases on a daily basis already are equipped to deal with massive bleeding. “Because Saint John’s is a community hospital and not a trauma center, we infrequently encounter patients with such emergent and profuse hemorrhage,” says Jaime Shamonki, MD, a pathologist and one of the developers of the new protocol.

Still, it happens. In 2011, Dr. Shamonki and John Robertson, MD, chair of the Saint John’s transfusion committee and director of thoracic and cardiovascular surgery, decided they wanted to be ready for it and began laying plans to implement the program. Massive bleeding can result unexpectedly during childbirth, as occurred with Armantrout, and during procedures such as neck and spine surgeries, aortic aneurysm surgeries and angioplasties that accidentally rupture a coronary artery. It also can occur in the emergency room with non-trauma patients, such as those who come in with stomach pain and experience massive gastrointestinal bleeds.

And when the bleeding starts, there is no time

to transfer a patient to a nearby trauma center. “You have minutes to respond,” Dr. Shamonki says, or the patient could bleed out and die.

BLOOD PRODUCTS READY FOR USEDr. Shamonki says that before the Massive Transfusion Protocol was in place there likely would have been more confusion and fewer resources—both in terms of medical professionals and blood products—available in these cases. “Now the whole hospital becomes aware that someone is bleeding,” she says. That frees up surgeons, anesthesiologists and other personnel to help.

The protocol also ensures that the ideal mix of blood products to stop the hemorrhaging is given.

Page 15: Breakthroughs Magazine

SUMMER 2013 breakthroughs 15

Call in the Reinforcements

“You have a system where you can deliver blood products efficiently, and you can deliver the right products,” Dr. Shamonki says.

Whole blood is made of various components, including red blood cells, platelets and clotting proteins. Packed red blood cells, which deliver oxygen to the body’s tissues, are one of the most important blood products. But they alone are not sufficient for people experiencing massive hemorrhaging, who also need platelets and clotting proteins to help their blood form “plugs” or clots, explains Dr. Robertson.

“You can give all the blood in the world, but if it doesn’t have the little

plugs to repair the artery, you won’t stop the bleeding,” says Dr. Robert-son. He likens this scenario to that of people with hemophilia who can bleed to death because they don’t have the proper clotting proteins to

halt bleeding. So far at Saint

John’s, the Massive Transfusion Protocol has been initiated six times, and all of the patients have survived. Prior

to the new protocol, there was a 34% mortality rate with these life-threatening hemorrhages, according to Dr. Robertson, who was called to scrub in during Armantrout’s emergency surgery.

“It really works,” he says. “There’s no question about it.”

When Armantrout awoke after her harrowing ordeal, she had no idea how close she came to cheating death. But she quickly realized her complications must have been worse than anyone realized.

“I woke up in the ICU with a ventilator in my mouth,” she remembers. “I couldn’t talk or breathe on my own.”

More than a week later, though, she was well enough to leave, and she and Chloe were discharged. “We left together,” Armantrout says, and they happily went home to join big brother, Grayson, age 2, and dad, Kyle.

For his part, Kyle was thrilled to be taking Frances and Chloe home—and also very grateful to the medical staff at Saint John’s for saving his wife and keeping his family together. “I didn’t get the Shakespearean ending,” he says. “I got the Hollywood ending.”

Survival stories like that of Frances Armantrout and countless others would not be possible without generous people taking the time to give blood.

“It’s important for people to donate blood, because it can’t be manufactured otherwise,” says Carol Blumenthal, blood bank supervisor at Saint John’s Health Center. “It’s only good for a certain amount of days; it has to be replenished continuously.”

The amount of blood products the hospital uses can vary widely from day to day, but the hospital is always well stocked. There is no need for patients coming in for surgery to donate blood in advance, she notes.

The whole process of giving blood at Saint John’s takes less than an hour, with the actual donation time being less than 10 minutes. Donors are given a mini-physical to check their blood pressure, pulse, temperature and hemoglobin levels, which ensures they are healthy enough to give blood.

However, the biggest perk of giving blood is the gratification of knowing you may have helped to save up to three lives with a single donation. “It makes you feel really good,” Blumenthal says, “and it doesn’t cost you anything.”

If you would like to donate blood at Saint John’s, call the Blood Donor Center at 310-829-8025 or email [email protected] to set up an appointment. You also can find out if a mobile blood drive is taking place at a business, school or church in your area, or you can arrange to set one up.

GIVE BLOOD SAVE LIVES

Frances Armantrout holds baby Chloe after recovering from a traumatic delivery.

Now the whole hospital becomes

aware that someone is bleeding.”

Page 16: Breakthroughs Magazine

16 breakthroughs SUMMER 2013

At Santa Monica Orthopaedic Group, every athlete deserves elite care.

Written by SHARI ROAN

TAPPINGINTOYOURINNER

Page 17: Breakthroughs Magazine

SUMMER 2013 breakthroughs 17

IIn March, Los Angeles jumped into the ring of competing cities seeking to host the 2024 Summer Olympics. The winning city won’t be known for some time. But if and when that time comes, the Santa Monica Orthopaedic and Sports Medicine Group (SMOG) will be ready to step in and do its part.

Few orthopaedic clinics have the sports pedigree of SMOG, which is affiliated with Saint John’s Health Center. The physicians and staff at the state-of-the-art clinic treat scores of elite athletes, including many Olympians.

Page 18: Breakthroughs Magazine

18 breakthroughs SUMMER 2013

Tapping Into Your Inner Olympic Spirit

From professionals to weekend warriors to athletes with special needs, the philosophy of the staff at SMOG is to keep people on top of their game, says Bert Mandelbaum, MD, an orthopaedic surgeon at SMOG.

“The level of experience we have. The level of focus on innovative research. Our focus on education, and the spectrum of care. No one else has a program quite like that,” he says, adding: “We know one thing: we know sports.”

As a youth, Dr. Mandelbaum embraced athletics, playing lacrosse and football. He also played college lacrosse and coached a lacrosse team while earning his medical degree. His world was sports—both inside and outside medical school.

“I went to medical school to be a sports doctor,” he says. “My desire to work with athletes was always there.”

After moving to Los Angeles as a young physician, he began caring for some of the area’s many professional and collegiate athletes. Eventually, he became the team physician for four U.S. Men’s World Cup Soccer teams, two Women’s World Cup Soccer teams, and he oversaw the soccer tournament at four consecutive Summer Olympic Games.

Dr. Mandelbaum has a special fondness for

the Olympic Games because, he says, it unifies athletes, from professional to amateur, young to old, famous to unheard of—igniting everyone’s dreams.

“The Olympics are truly emblematic of the concept that we’re all athletes, and the Olympic spirit is in all of us,” Dr. Mandelbaum says.

He has also cared for many elite athletes over the years as team physician with Pepperdine University, LA Galaxy, Chivas USA and as

director of research for Major League Baseball.Treating top-tier athletes has taught him a

lot about the rest of his patients, he says. “The difference between the most elite athlete and everyone else is that the individuals at the highest levels of their sport have the ability to run faster or jump higher and be more forceful.”

But, Dr. Mandelbaum adds, in spirit those athletes aren’t really all that different from the weekend warriors and Pop Warner players and retirees he sees at SMOG every day.

“We’re all meant to be athletes,” he says.

Perhaps no one can attest to the depth of care experienced by athletes at Santa Monica Orthopaedic and Sports Medicine Group better

The Olympics are truly emblematic of the concept that

and the Olympic spirit is in all of us.”

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SUMMER 2013 breakthroughs 19

Tapping Into Your Inner Olympic SpiritTapping Into Your Inner Olympic Spirit

than Olympian Cliff Meidl. In 1986, Meidl, from Manhattan Beach, was employed as an apprentice plumber when he received a massive electrical shock while working on a job site.

He had been using a jackhammer to drill through a concrete slab when the tool made con-tact with an unmarked electrical cable. The blast blew Meidl out of the hole he was working in. But he slid back into the hole and the still-energized jackhammer came into contact with his knees.

With more than 15% of his body burned and

his knees in shambles, he survived cardiac arrest immediately after the accident. He then underwent surgery to try to salvage his knees with muscle grafts taken from his calves, recalls Dr. Mandelbaum, who was brought into the

emergency room to consult after Meidl arrived. Meidl was discharged from the hospital after

three months and spent two years in supervised rehabilitation programs, racking up a total of 15 surgical procedures to reconstruct his knees and keep the joints free from infection. Dr. Mandelbaum became a chief ally in his recovery.

“I remember going through many trials and tribulations,” Meidl recalls. “I had bilateral muscle grafts and was missing a third of my knee joint with major tissue damage in both knees. It often

seemed like my recovery involved great progress and then some setbacks. I would take two steps forward and one step back. Dr. Mandelbaum told me, ‘Listen, you always want to push hard, but you know your body better than anyone.’ He had the

I would take two steps forward and one step back. Dr. Mandelbaum told me, ‘Listen, you always want to

push hard, but you know your body better than anyone.’ ”

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Tapping Into Your Inner Olympic Spirit

medical expertise to know I could only do so much with my injuries. He was a huge provider from the inspiration standpoint. He was a huge motivator.”

It took more than three years for Meidl to walk without crutches. He continued his rehab with weight lifting, riding a stationary bicycle, swimming and paddling in an outrigger canoe. Eventually, he switched to the sport of flat-water sprint kayaking, and by 1996—10 years after his near-fatal accident—he was named to the Olym-pic team that competed in Atlanta. Meidl also competed in Sydney in 2000 and was chosen by his U.S. teammates to carry the flag into the stadium at Opening Ceremonies.

“Marching with a normal gait and broad grin, no one would suspect that it took Cliff thousands

of hours and unimaginable pain to rebuild and re-strengthen his body,” Dr. Mandelbaum wrote in a soon-to-be-published memoir entitled Game On. Seeing him “overtook me with emotion.”

With Dr. Mandelbaum sitting nearby while he carried the flag into the stadium, Meidl suddenly felt that his recovery was complete and that he had honored those who had helped him along the way.

“Cliff embodies so much of what the Olympic athlete stands for,” Dr. Mandelbaum says. “Here is this injured individual. We thought he is an unfortunate kid. And yet out of him came this blossoming athlete. To go from that to carrying the American flag in Sydney—it’s one of the most unique stories in sports.”

Meidl concurs. “The Olympic rings kind of

Bert Mandelbaum, MD, is one of the leading sports medicine physicians in Los Angeles.

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Tapping Into Your Inner Olympic Spirit

symbolize how everything comes full circle,” he says. “It’s weird how life works that way.”

It’s a Friday afternoon, and Dr. Mandelbaum is back in his office after performing surgery on a patient at Saint John’s Health Center. He schedules all of his surgeries at the hospital.

“We have a close relationship with Saint John’s,” he says. “It’s a great hospital and patients get fantastic care.” In fact, Saint John’s has received many recognitions for its orthopedic care. The Health Center was recently recognized by Healthgrades, an independent hospital-quality review organization, as one of the top 100 hospitals in the nation for joint replacement and is ranked sixth in California. The Health Center also received a five-star rating, the highest ranking, for total knee and total hip replacement.

Meanwhile, at SMOG, a broad network of professionals are available to meet his patients’ needs—sports psychologists, nutritionists, biomechanists, podiatrists, chiropractors, physical therapists, athletic trainers, strength and conditioning coaches and physicians of every specialty.

But first, the athlete and a member of the clinic staff simply talk. “We want to get to know the athlete and how to optimize their performance and learn how we can prevent problems,” Dr. Mandelbaum says. “There is an emphasis on multi-disciplinary care.”

Susie Pitcher, a certified athletic trainer, helps steer patients to the professionals who will meet their needs. “We have such a broad range of doctors. For each body part and each type of injury, you can be seen for anything here.”

The emotional support is what athletes need as much as anything, Meidl says.

“A lot of clinics provide the care, but what

Dr. Mandelbaum’s group is so good at being able to do—what really benefits the athletes so much—is the care and inspiration they provide to each person who comes in the door. They want those athletes to go out there and be the best they can be.”

That’s a sentiment he and his staff try to apply to their work every day. The clinic’s experience with elite athletes translates to better care for everyone, Dr. Mandelbaum says.

“The truth of it is that it does make a difference,” he says. “Having that experience and being able to integrate that is important. Certain clinicians can look at someone and say there is a torn meniscus in a knee. I’ll fix it. I think, here is a kid, 16 years

old, and he has all of these aspirations of being a great athlete. How do we help him to the next step?”

He is still asking that question about Meidl, who today is a middle-aged father of a toddler, a motivational speaker and a weekend kayaker. His rebuilt knees now have some arthritis, and he recent-ly checked in with Dr. Mandelbaum to discuss the matter.

“He told me we have to get as many miles out

of these wheels as we can,” Meidl says with a laugh. “He is always looking for alternatives, though. He’s such a caring doctor. That’s what separates the good from the great.”

The clinic has established a stellar reputation by caring for many great athletes. But the point, says Dr. Mandelbaum, is that everyone who walks through the doors—from 12-year-olds with fractured wrists to grandmothers in need of knee replacement surgery—should receive a big dose of Southern California mojo.

“Some people come here because of our association with athletes,” he says. “But others gravitate here because they know I have that victorious spirit, and I will apply that to their care. We’re not going to give up. We’ll navigate through the stress and strain of it all.”

DR. BERT MANDELBAUM’S FIVE TIPS TO LIVE BY FOR

ATHLETES:

In life, you have to have fun. Choose things that are fun,

including exercising on a daily basis.

Pursue things and discover things you haven’t done before. Find new challenges,

new athletic goals or new dimensions

of goals. Climb mountains you’ve

never thought about climbing or do races you’ve never done.

Approach life with hope and optimism.

Build your own team. Select your relationships and

conserve them wisely.

Show compassion to all human beings and

believe in volunteerism.

1

3

4

5

2

Some people come here because of our

association with athletes. But others gravitate here because they know I have that victorious spirit, and I will apply that to their care. We’re not going to give up. We’ll navigate through the stress and strain of it all.”

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22 breakthroughs SUMMER 2013

Written by SANDI DRAPERPhotographed by RANDI CURBY

hen the alarm goes off on Saturday mornings,

Debbi Whitman isn’t always raring to go. But her dog, Dave, is.

The pair have been a fixture at Saint John’s Health Center since 2006—part of the 35 dog-handler volunteer teams that comprise the Paula Kent Meehan Pawsitive Pet Program. It’s not a small commitment for either of them. Teams participate in multiple-step training before being accepted into the program.

Whitman and a previous dog began visiting Southern California hospitals years before certification was required. That dog, a Lab, “seemed to enjoy the car rides more than the actual patient visits,” she says.

When it was time for a new dog, Whitman and her husband brought home a nameless golden retriever-shepherd mix rescue dog. The 1993 movie Dave was on TV, and when Whitman said “Dave,” the dog turned to look at her. The name stuck.

There’s work to be done before their every-other-weekend visits. Animals must be bathed and

W

Debbi and Dave Are In the HouseDebbi Whitman and dog Dave bring much-needed normality to hospital rooms.

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groomed within 24 hours of the visit. On visit days, Whitman dons a jacket with pockets to hold small treats for Dave and hand sanitizer for patients to apply before and after petting Dave.

For his part, Dave dons a stylish, embroidered, roy-al blue bandana that identifies him as a Pawsitive Pet Program member. Upon arrival at Saint John’s, Dave gets a short walk to relieve himself. Whitman checks in with security while Dave sniffs wastebaskets for a whiff of food.

Then they stop at the volunteer office for their floor assignment. Of the hospital’s four floors, Dave’s favorite is critical care and ICU—the second floor. It’s not that Dave is partial to very ill patients; he just loves the treats kept at the nurses’ station there.

“Sometimes I think the hospital staff need to see a dog as much or more than the patients do,” Whitman says.

Dave travels with calling cards: his picture and name on the front and pertinent “Dave info” on the back, such as favorite treats. Since the animal visitation program operates during waking hours seven days a week, some patients accumulate rows of

pet calling cards. While targeted to patients, pet visits are also im-

portant to visitors. “For visiting children, it makes the hospital a little less scary,” Whitman says. “Dog visits help patients and families remember that there’s a home—a whole world—outside of the hospital.”

Grenda Pearlman and Erin Pickerel, who co-ordinate the program—known as the Paula Kent Meehan Pawsitive Pet Program in honor of Meehan, co-founder of Redken Laboratories and the program’s benefactor—look for teams that can commit to two visits a month.

“I like to call the program ‘animal social work,’” Pickerel says. “Many volunteers are very dedicated and do more than two visits a month.”

From the nurses’ station, Whitman and Dave get guidance on which rooms to visit. They spend 60 to 90 minutes visiting rooms. About 70% of patients invite them in.

Once, the pair was turned away when a pa-tient announced, “I don’t like dogs.” As they stepped out, the patient said, “Well, I could just look at him.” They stepped back into the room. Soon the patient said, “You could bring him a little closer.” Before long, Dave had ingratiated himself chair-side for a petting.

On another visit, Dave’s presence was requested by the family of a failing loved one. The family explained that the man had been a lifelong dog lover. Then they took one of the patient’s hands and gently placed it on Dave’s head.

Moments like that keep them coming back. Whit-man might be tempted to hit the snooze button on Saturday mornings. But, she says, “The minute I get to Saint John’s, I know it’s the right thing to do.”

I like to call the program

animal social work,” Pickerel says. “Many volunteers are very dedicated and do more than two visits a month.”

profiles in health

Debbi Whitman and her dog, Dave, visit a patient during one of their Saturdays at Saint John’s.

FOR THE PET THERAPY PROGRAM, ONLY THE BEST WILL DO.

There’s more to joining Saint John’s Pawsitive Pet Program than showing up with your dog in tow.

The first step is a dog meet-and-greet in the hospital’s healing garden with Grenda Pearlman and Erin Pickerel from the Volunteer Services Office.

Next, the handler must complete Pet Partners’ Therapy Animal Handler Coursework. Upon completion, the dog-handler team may sign up for the Pet Partners Skills and Aptitude Test, which is conducted quarterly at Saint John’s Health Center by a licensed evaluator. The test includes greeting strangers, walking through a crowd and reacting to visual and auditory distractions. That’s the easy part. Part two includes testing for appropriate reactions to such things as an overzealous hug, angry yelling, simultaneous petting by several people and being bumped from behind.

If the team passes, there’s paperwork and health screening for the dog, in-house hospital training, and background and health screening for the handler. A coach supervises initial visits before the team goes solo.

For more information on becoming a Pawsitive volunteer, call the Saint John’s Volunteer Office at 310-829-8438.

FOR THE PET THERAPY PROGRAM, ONLY THE BEST WILL DO.

There’s more to joining Saint John’s Pawsitive Pet Program than showing up with your dog in tow.

The first step is a dog meet-and-greet in the hospital’s healing garden with Grenda Pearlman and Erin Pickerel from the Volunteer Services Office.

Next, the handler must complete Pet Partners’ Therapy Animal Handler Coursework. Upon completion, the dog-handler team may sign up for the Pet Partners Skills and Aptitude Test, which is conducted quarterly at Saint John’s Health Center by a licensed evaluator. The test includes greeting strangers, walking through a crowd and reacting to visual and auditory distractions. That’s the easy part. Part two includes testing for appropriate reactions to such things as an overzealous hug, angry yelling, simultaneous petting by several people and being bumped from behind.

If the team passes, there’s paperwork and health screening for the dog, in-house hospital training, and background and health screening for the handler. A coach supervises initial visits before the team goes solo.

For more information on becoming a Pawsitive volunteer, call the Saint John’s Volunteer Office at 310-829-8438.

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Quick ActionKnowing a few facts about stroke could save a life.Written by SHARI ROAN

troke is a brain attack, cutting off vital blood flow and oxygen to the brain. And in the same way that heart attacks require emergency treatment, so do strokes. That’s because there are ways to prevent damage to the brain if treatment is given

shortly after the stroke occurs. May is National Stroke Awareness Month, so we asked

Clifford Segil, DO, a board-certified neurologist at Saint John’s Health Center, to explain why we should know what a stroke looks like and what to do when we suspect one.

S

THE KEY TO STROKE TREATMENT

Clifford Segil, DO

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Quick Action: The Key to Stroke Treatment

Do people understand that stroke should be viewed as an emergency?

“In the United States, stroke is the fourth leading cause of death,

killing more than 133,000 people each year, and a leading cause of serious, long-term disabil-ity. People may not be aware that treatment options—if you get to a hospital within three hours—are different from treatments that you may get after three hours. Unfortunately, people often wait to see if it gets better and do not pres-ent to an emergency room in a timely manner.”

Why aren’t people getting that important message?

“I suspect a lot of people believe there are no treatments for an acute stroke. They don’t know that if you get to a hospital, there are treatment options available in a hospital emergency room. There are medications that we can give to people. People do not get to hospitals quick enough. They call their friends. They don’t call their doc-tors. They may wait it out. If it happens on a Saturday, they think, ‘Oh, I’ll wait until Monday and call the doctor.’”

Why is getting treated so important?

“Time is brain. Every minute of the stroke, the brain loses 14 billion synaps-es, 1.9 billion neurons and 7.5 miles of myelinated fibers—increasing risk of permanent brain dam-age, disability or death.”

Do people fail to recognize the symptoms of a stroke?

“Recognizing symptoms and using the acro-nym FAST to get medical attention can save a life and limit disabilities. People do not realize the symptoms of a stroke are ‘focal.’ Strokes are one of the few things that may cause the right side of your body to be different from the left side of your body.”

What is tPA, and why is this medication so important to treating stroke?

“Tissue plasminogen activator (tPA) is a clot-busting medication. Other medications that we give people to take every single day are clot-sta-bilizing medications. The clot-busters should be

offered to appropriate patients who arrive in a hospital emergency room in less than three hours from their last known well time. They are Food and Drug Administration-approved, and there is a better likelihood—if you get these medications—you will not have disability due to the stroke.”

Can tPA be used for every type of stroke?“There are two types of stroke: a burst type

and a clogged type. The burst type is a hemor-rhagic stroke, and the clogged type is an ischemic stroke. The hemorrhagic strokes are not candi-dates for the clot-busting medications. People who have ischemic stroke—about 87% of all strokes—are candidates. But most people do not get to the hospital in less than three hours after having a stroke. Also, many people have strokes while sleeping, so we don’t know what the last

‘well’ time is, and they are disqualified from re-ceiving tPA. But tPA works. From 1998 to 2008, the annual stroke death rate fell approximately 35% in the United States.”

What happens if you get to the hospital after three hours?

“After that time, there are other options for treatment. You can also get what I simplify as ‘roto-rootering.’ You can have a mechanical embolectomy, which is when a doctor uses a catheter-based device to go in and break up the clot or suck out the clot. There are FDA-ap-proved clot-clearance devices that we can use at Saint John’s. The line in the sand, or cut-off, is eight hours to have these procedures.”

Are there risks to having one of the roto-rootering procedures?

“There are lots of risks with these devices.

Time is brain. Every minute of the stroke, the

brain loses 14 billion synapses, 1.9 billion neurons and 7.5 miles of myelinated fibers—increasing risk of permanent brain dam-age, disability or death.”

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Quick Action: The Key to Stroke Treatment

But if you get these procedures, many people do better. George P. Teitelbaum, MD, is an interventional neuroradiologist at Saint John’s who is well-versed to do these kinds of mechanical embolizations and aspirations. He is very experienced with these devices. However, these devices are under-utilized, because not enough patients get to the hospital on time.”

Can people who are taking one of the newer blood-thinning medications have tPA if they suffer a stroke?

“Coumadin is the traditional medication to treat strokes, and it’s easy to antidote—to reverse its effects. This is important if people have hemorrhagic strokes with blood in their brains. Using Coumadin may not disqualify you from tPA for an ischemic stroke if a blood test result is not elevated. If this blood test is elevated, tPA is contraindicated. The newer generations of med-ications to treat atrial fibrillation—such as direct thrombin inhibitors like dabigatran (Pradaxa) or direct factor Xa inhibitors like rivaroxaban (Xarelto)—do not have any antidotes. It is safest at this time to say if people have used one of these medications in the last 48 hours, they are not a tPA candidate. The use of tPA with these newer medications is not routine.”

Have the newer class of blood-thinners made a big difference in preventing strokes?

“In theory, they should decrease both ischemic and hemorrhagic strokes. In practice, I’ve seen fewer hemorrhagic strokes. As for ischemic strokes, I’m still waiting to see if these newer

medications are any better than Coumadin. We have excellent cardiologists at Saint John’s who are utilizing these medications. People who are taking them are happy to stop taking Coumadin, as these newer medications do not require frequent lab draws and medication adjustments.”

What else are doctors doing these days to prevent strokes?

“Prevention is getting more emphasis. There are many things we can do in the doctor’s office: control blood pressure, treat atrial fibrillation, help patients stop smoking, drinking and treat diabetes.”

Is it true that stroke rates are rising in younger adults?

“Strokes are increasing in young adults. Some of the reasons include increasing rates of diabetes, obesity, recreational tobacco, drug and alcohol use. Also, our ability to diagnose strokes with neuro-imaging has improved. Three-quarters of strokes remain in people over age 65.”

Any final words of advice for us, Dr. Segil?“If there is any question that you may be

having a stroke, be safe and get seen by a doctor. In our community, it’s easy to get neuro-imaging, or pictures of your brain, to confirm if you have had a stroke or not. There is no reason not to see a doctor if you are concerned you have had a stroke. Once you’ve had a stroke, going to see a neurologist to prevent having a second stroke is smart. The neurologist will treat you more aggressively to prevent a second stroke.”

Blood clots are the cause of ischemic strokes, which can be treated with clot-busting medications.

STROKE FAST FACTS• There are an

estimated 7 million stroke survivors in the United States.

• Almost 800,000 strokes occur each year in this country.

• Stroke takes a life almost every four seconds.

• Slightly more women than men have strokes. Women are twice as likely to die from stroke as from breast cancer.

• African-Americans have almost twice the risk of stroke compared to Caucasians.

About 40% of people who have a mini-stroke—a transient ischemic attack—go on to experience a stroke.

FAST is the acronym to remember. It stands for Face, Arms, Speech and Time.

F - Face: Ask the person to smile. Does one side of the face droop?

A - Arms: Ask the person to raise both arms. Does one arm drift downward?

S - Speech: Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?

T - Time: If you observe any of these signs (independently or together), call 9-1-1 immediately.

Source: Dr. Clifford Segil and National Stroke Association

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Every Cancer Patient Needs a Guide, and She’s Their GPS

breast cancer diagnosis can make you feel like you were

dropped in a jungle without a compass. Registered nurse Amanda Rodriguez is like GPS navigation for patients of the Margie Petersen Breast Center at Saint John’s Health Center.

“Patients already have plenty to worry about,” Rodriguez says. “What I hope to provide is one person they can go to with their questions.”

On March 11, she officially stepped into the position of breast cancer patient navigator, although she has been filling the role for several months. The Breast Cancer Navigator Program was established as a direct result of the funds generated by the inaugural Power of Pink Fundraiser at Sony Studies in November. The annual event recognizes the strength of women who battle the disease.

Amanda Rodriguez is Saint John’s new breast cancer patient navigator.

Written by SANDI DRAPERPhotographed by RANDI CURBY

A

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“The program was been launched because we know that being diagnosed with breast cancer is stressful,” says Maureen Chung, MD, director of the Breast Center. “Studies have shown that patients who have navigation while undergoing therapy are more likely to complete their treatment and do so in a shorter time frame. This translates into better patient outcomes. It is important that health care providers who treat breast cancer patients understand the importance of treating the whole patient and not just the cancer.”

Rodriguez, who has been with Saint John’s since 2007, steps in after a patient has been diagnosed and seen the doctor. “After meeting with the doctors my goal is to spend some quality time with patients to determine their specific needs. I try to find out how I can best support them.”

Patient navigators were pioneered in the 1990s to eliminate barriers to timely cancer screening, diagnosis, treatment and supportive care. In 2005, President George W. Bush signed the Patient Navigator Outreach and Chronic Disease Prevention Act.

Breast cancer has touched the lives of Rodriguez’ friends and family. “I have an aunt who has gone through breast cancer,” she says. “She had a double mastectomy, chemotherapy, radiation. She actually made a spreadsheet to keep track of medication,

procedures and appointments.”To help Breast Center patients keep track of their

“new normal” lives, patients are given a Breast Patient Navigation Tool, which Rodriguez jokingly refers to as a “magic packet.” It’s an expandable, plastic envelope file with dividers for pathology/test results, research, insurance, bills and patient education. It includes a calendar, business cards for treating practitioners, medical history and appointment tracker, symptom tracker, sample questions for physicians, clinical trial and support group information, and a glossary of terms—just the types of information Rodriguez’ aunt had to track for herself on that spreadsheet.

Rodriguez also shares informa-tion on reputable medical websites; she doesn’t want patients Googling random, scary information. And she has been known to share her email address for after-hours concerns.

For Rodriguez, 37, the mother of a 1-year-old, the position is a natural transition from her work in on-cology. She is pursuing an oncology certification and a navigator certification. She also plans to pursue a Master of Science in nursing.

So how is her aunt? Rodriguez says, “She’s 74 now, still here, still kickin’, working with support groups. She’s my inspiration.”

Amanda Rodriguez, RN, breast cancer patient navigator, understands the challenges patients face.

Patients already have plenty to

worry about,” Rodriguez says. “What I hope to provide is one person they can go to with their questions.”

profiles in health

RESOURCES FOR PATIENTS AND FAMILIES

Those who oversee the Margie Petersen Breast Center at Saint John’s Health Center are aware that it’s not just the patient who deals with a disease such as breast cancer. So the center also offers:

• In-house cancer resources for patients, family and friends, including the Margie Petersen Patient Education Room, Banchik Family Library and Feldman Audio Visual Center

• Information on a variety of cancers, support groups, aids and recovery

• A television equipped to provide instructions on cancer treatment as well as a computer to access additional resources on the Internet

• Information on nutrition programs and the nutritionists at Saint John’s

• Promotional materials regarding support groups, yoga for cancer patients and a “Look Good, Feel Better” program that offers suggestions for makeup, headwear and wigs

RESOURCES FOR PATIENTS AND FAMILIES

Those who oversee the Margie Petersen Breast Center at Saint John’s Health Center are aware that it’s not just the patient who deals with a disease such as breast cancer. So the center also offers:

• In-house cancer resources for patients, family and friends, including the Margie Petersen Patient Education Room, Banchik Family Library and Feldman Audio Visual Center

• Information on a variety of cancers, support groups, aids and recovery

• A television equipped to provide instructions on cancer treatment as well as a computer to access additional resources on the Internet

• Information on nutrition programs and the nutritionists at Saint John’s

• Promotional materials regarding support groups, yoga for cancer patients and a “Look Good, Feel Better” program that offers suggestions for makeup, headwear and wigs

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30 breakthroughs SUMMER 2013

WE LOVE SAINT JOHN’S CAMPAIGN KICK-OFFMore than 300 Saint John’s associates, volunteers and physicians gathered in the Tarble Atrium of the Howard Keck Diagnostic Center on April 10 to pose for a group photograph that kicked off the health center’s 2013 ad campaign entitled “We Love Saint John’s.” The campaign is visible throughout the Los Angeles area in print in the Los Angeles Times, Los Angeles Magazine, Santa Monica Mirror, Beverly Hills Courier and other publications, and on digital billboards in Santa Monica Place. Radio spots are airing on various stations such as KBIG, KOST and KFI.

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SUMMER 2013 breakthroughs 31

happenings

Tell Us Why You

Saint John's

Share your inspiring story with us on Facebook or Twitter, or visit us on the

web at www.newstjohns.org.

/NEWSAINTJOHNS /SAINTJOHNS2#LOVESJHC

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32 breakthroughs SUMMER 2013

NEW GRADUATE REGISTERED NURSE PROGRAMSaint John’s Health Center is known for the outstanding care its nurses provide, a reputation that is maintained in part by the amount of training provided to new nurse recruits through our New Grad Registered Nurse Program. Chosen from more than 500 applicants, this year’s graduates will complete a six-week intensive training program that teaches them about Saint John’s quality assurance program, work safety policies, benefits and other general information. New grads are each assigned to a preceptor — a more experienced nurse who acts as a mentor to guide and support them. Students attend weekly classes and learn about the services and peoplewho can assist them in patient care.

The students, left to right: First row: Valeria Figuereo, Nicole Correia, Bradley Runyon Second Row: Leah Kushman, Amber Rusinyak, Ameachi Ajakwe

Third Row: Osarmeka Emenike and John Morrison

POWER OF PINKThe inaugural Power of Pink fundraising event was held November 12 at Sony Studios to recognize and celebrate the strength of women who battle and beat breast cancer. Gram-my award-winning artist P!nk gave a rousing performance for more than 500 attendees. Funds from the event helped establish the Nurse Navigator Program at the Margie Petersen Breast Center at Saint John’s Health Center.

top: P!NK with Associate Director of the Margie Petersen Breast Center,

Maggie DiNome, MD and Director of the Margie Petersen Breast Center,

Maureen Chung, MD, PhD.

middle: Power of Pink guests Heather Locklear and Valerie Bertinelli

bottom: P!NK performs for supporters of the Margie Petersen Breast Center

at Saint John’s Health Center

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happenings

GIRLS SCOUTS VISITThe Girl Scouts of Greater Los Angeles Juniors Troop 13615 toured the emergency department at Saint John’s Health Center earlier this year, learning how emergency care is provided and earning their merit badges in first aid. Perhaps we even inspired some future healers.

Girl Scouts of Greater Los Angeles Juniors Troop 13615 pictured here with Saint John’s Emergency Room nurse Chris Collins, RN.

Members of Troop 13615 receive merit badges in first aid.

Emergency Room nurse Chris Collins, RN, shows a member of Troop 13615 how to use a stethoscope.

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34 breakthroughs SUMMER 2013

shout outs

The staff at Saint John’s Health Center pay close attention to feedback

from our patients and visitors. We are proud to share some of the

wonderful comments we’ve received in the past few months.

“I wanted to extend my deepest thanks to all the kind people in the ER and hospital who were so kind to me. My three visits, two in the ER, in November and December of 2012 ... had so many wonderful nurses and others who cared for me ... You sent me two Christmas cards. Thank you!”

Saint John’s Health Center was excellent in every way. My stay

was comfortable. The nurses were beyond excellent. The food was

delicious. It was like a Four Seasons of hospitals, with excellent nursing and doctor care. I would refer the

hospital, and already have, to friends and family. I also would refer them to the Caritas Suites, which were

stellar. Did I get my point across? It was just a wonderful experience.”

“We would like to thank you for taking such excellent care of our mother during her stay at Saint John’s hospital a few weeks ago ... Your staff of dedicated RNs and CNAs was exemplary, and we would like to thank them for making all of us feel so much at ease during such a difficult time. It makes a HUGE difference when there is

staff who truly care and are working so hard to do so much for the people we love.”

“It was so thoughtful of you to send a follow-up note regarding

my sister’s well-being. I’m writing to thank you and your staff for the gracious care

and attention given to her last month. She is feeling much better, and we have you

and your staff to thank for that.”

“I was a patient in the Critical Care and Post Critical Care Units ... I wanted to inform you of the excel-lent care I received from your nurs-ing staff, particularly Sabra, Susan and Alma in the CCU, followed by Dee Lowe, Rosalie and Kristina in the PCCU. Each of them went above and beyond to make sure I was com-fortable, well cared for and contin-ually updated on my condition and treatment during my stay.”

“Your hospital is physically beautiful ... All equipment is immaculate. I am very im-pressed with the total compli-ance with hand-washing and gloving. Your kitchen staff deserves commendation as well. Tina went out of her way to ensure that my food was served warm and exuded a genuine concern in her patient.”

“The nursing care at

Saint John’s is far and

away the best we’ve

ever experienced.

Every nurse and those

who work with them

were superb. All were

professional, attentive

and empathetic. Their

excellent skills were

matched by their

warm and generous

personalities. We

cannot say enough

good things about

the nursing care on

the fourth floor. I’m

sure it led to an even

speedier recovery.”

WWW.NEWSTJOHNS.ORG | 1.800.STJOHNS

The ONLY hospital in California to receive Healthgrades® America’s 50 Best Award™ Seven Years in a Row

ONE MORE REASON WHY

TELL US WHY YOU LOVE SAINT JOHN’S // #LOVESJHC

NEWSAINTJOHNS SAINTJOHNS2

Page 35: Breakthroughs Magazine

WWW.NEWSTJOHNS.ORG | 1.800.STJOHNS

The ONLY hospital in California to receive Healthgrades® America’s 50 Best Award™ Seven Years in a Row

ONE MORE REASON WHY

TELL US WHY YOU LOVE SAINT JOHN’S // #LOVESJHC

NEWSAINTJOHNS SAINTJOHNS2

Page 36: Breakthroughs Magazine

Stem-Cell Therapy For Back PainCall 310-828-7757 or visit laspine.com to learn more about this study.

Mullin Plaza, the new entryway to Saint John’s

Health Center, will open in the coming weeks.

p.5

p.6

Saint John’s Health Center2121 Santa Monica Boulevard

Santa Monica, CA 90404 USA

310.829.5511 1.800.STJOHNS

www.newstjohns.org

NONPROFIT

ORGANIZATION

U.S. POSTAGE

PAIDLOS ANGELES, CA

PERMIT NO. 14954

Since its founding in 1942 by the Sisters of Charity of Leavenworth, Saint John’s Health Center has been providing the patients and families of Santa Monica, West Los Angeles and ocean communities with breakthrough medicine and inspired healing. Saint John’s provides a spectrum of treatment and diagnostic services with distinguished areas of excellence in cancer, spine, orthopedics, neurosurgery, women’s health, cardiac and specialized programs such as the internationally acclaimed John Wayne Cancer Institute. Saint John’s is dedicated to bringing to the community the most innovative advances in medicine and technology.