April 9, 2013
Inside this issue
Caring for hundreds of thousands
of patients, training tomorrow’s caregivers
while contributing to the economy - that’s
just a snapshot of CAMC … Page 2
Prevention First: girl born as a
preemie now thriving at 17… Page 3
CAMC Cleft Center earns national
recognition … Page 3
THE CUTTING EDGE
Surgeon uses new technology and
techniques to treat strokes and brain
aneurysms … Page 4
Surgeon brings patients the
latest advances in hip and knee
replacement surgery … Page 4
Connect with us
From volunteer to employee
CAMC’s volunteers help keep the hospitals
running smoothly. Last year 218 community
members, ages 15 to 95, collectively gave
more than 31,000 hours of their time
to CAMC. Many CAMC volunteers have
gone on to accept other roles in the health
system, including Christena Ross and Cathy
Ritchey.
Christena Ross, MSM and current director
of research and grants administration,
became a junior volunteer at the age of 13,
and continued until she graduated from
college. “When I started we were called ‘candy
stripers’ and wore red and white striped
dresses,” said Ross.
During her time as a junior volunteer,
Ross worked in departments all over the
hospital. Her duties included everything
from running the gift shop and delivering
flowers to transporting patients and staffing
the pediatric playroom to filing, registration
and answering phones. “My favorite ‘job’ was working in the
pediatric playroom,” she said. “I always
volunteered for that area as much as I
could.”
Cathy Ritchey began volunteering at CAMC
a few years ago, and is now a staff assistant
in the clinical trials department.
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“When I first started, I volunteered in
epidemiology doing hand hygiene data
entry,” said Ritchey. “Then flu season
started, and I worked in the flu clinics
entering data into the state database.” Because of her good work, she was elected
to the office of secretary of the General
Hospital Auxiliary. After that ended, she
volunteered at Women and Children’s
Hospital doing data entry and organizing
files. During that same time she spent one
day each week in clinical trials, training on
the clinical conductor program. “The staff assistant in clinical trials accepted
another job and someone was needed five
days a week to fill that position,” Ritchey
said. “So, I was offered a contract job as
staff assistant.”
Both ladies began as volunteers,
but have gone on to become
valued employees. Getting
started as a junior volunteer
helped Ross decide to pursue a
career in health care.
“Like most people that enter
health care, I had a desire to
help others,” Ross said. “I
wanted to make sure the
career I chose would make
a difference. I also enjoyed
the diverse jobs and activities
throughout the hospital.
Cathy Ritchey, Christena Ross
The most important lesson I
learned as a junior volunteer
was that I couldn’t stand the
sight of blood, or the thought of sticking
someone with a needle! This insight led
me to the business side of health care.”
Ross has worked at CAMC since 2000. She has worked as a fundraiser, educator
and now oversees research and grants
administration. “CAMC offers a rare opportunity – you
can completely change careers without
ever leaving the same employer,” she said.
“Other than for a few years right out of
college, my life - volunteer and work - has
been associated with CAMC.”
Ritchey offers advice for someone who is
unsure about becoming a volunteer.
“The best advice I can give someone who
is thinking about volunteering is to take
the free classes and learn as much as you
can during your volunteer work,” she
said. “Every department you work in has
something to teach you. All the knowledge
you gain will help you in the future.”
“Junior volunteers learn the ‘spirit’ of
volunteering at an early age, and that can
carry throughout their lives,” Ross said. “It
did for me. Volunteering has always been a
part of my adult life.”
Save the date!
CAMC HealthFest
Saturday, June 1
7 a.m. to 2 p.m.
Charleston Civic Center
Some screenings require
registration and are on a
first-come, first-served
basis. Look for the CAMC
HealthFest ad in Charleston
Newspapers in the upcoming
weeks for registration
information. Registration
will begin Monday, May 13.
For more information about volunteering
at CAMC, visit camc.org/volunteer, or call
(304) 388-7426.
New private rooms help Women and
Children’s Hospital celebrate 25 years
CAMC leading
the charge in
workplace wellness
Charleston Area Medical Center revamped
its wellness initiative with the creation of a
new wellness advisory group and wellness
committee in 2010. CAMC Women and Children’s Hospital
celebrates its 25th anniversary in 2013. What
better way to celebrate than by opening
private rooms for families having babies?
“The opening of the private rooms means
that we now can offer an environment
that meets the needs of our patients and
the community, and that compliments
the exceptional care that patients receive
at Women and Children’s,” said Denise
Burgess, RN, LPC, NBCC, director of
obstetrical services.
Having an environment that is reflective of
the highest level of care and compassion
patients and families receive is a source
of great pride for the entire Women and
Children’s team. “CAMC has invested a tremendous amount
of resources to ensure that our region has
a state-of-the-art healing environment in
which to enjoy the birthing experience,”
said Andrew Weber, vice president and
administrator of Women and Children’s
Hospital. “Pregnant women throughout our
region no longer have to choose between
the highest level care and the comfort of
a private room for themselves and their
newborn. Women and Children’s Hospital
is THE choice.”
During renovations, each room has
undergone a complete transformation
with warm finishes, soothing colors, flat
screen TVs and new private bathrooms
and showers. The common areas also have
received a new look with finishes, colors and
lighting to compliment the patient rooms. “The rooms have more of a hotel-like
look now,” Weber said. “All of this change
is designed to create a warm, quiet and
comforting environment to promote healing
and a special environment for parents and
families during this joyous occasion.”
Misty Bradley, first-time mom, agrees that
the new rooms don’t have a hospital feel.
“I truly felt like I was at a hotel, not a
hospital,” she said. “Really! The room
was comfortable, spacious and if I needed
anything at all, I just asked and it was
taken care of. I didn’t get that cold, sterile,
uncomfortable feeling that you usually get
in hospitals. I didn’t hear lots of people
talking or bells, whistles and alarms going
off and waking me up. “
Providing this type of environment helps to
make the total patient experience a positive
one for women delivering here. Women
and Children’s already boasts outstanding
providers, the most experienced nurses in
both labor and delivery and mother/baby,
24-hour anesthesia coverage and the highest
level NICU with 24-hour neonatologists on
hand. “All of these things are what we believe to be
the gold standard in patient care,” Burgess
said. “The new rooms just wrap that up in a
beautiful package.”
“I had never stayed overnight in a hospital
or had a major surgery, so this experience
was all very scary to me,” Bradley said.
“Pair that with all of the overwhelming
feelings I was having as a first-time mom,
thank goodness for the kind and wonderful
nurses and my beautiful cozy room to help
the whole experience, both joyous and
bittersweet, be much more tolerable.”
The private rooms also have allowed
Women and Children’s to change its
visitation practice, and parents and families
are enjoying the opportunity to share their
special occasion with many loved ones in a
more intimate environment.
For more information about maternity
services at CAMC Women and Children’s
Hospital, visit camc.org/babies.
CAMC Today is a publication of CAMC Health System
“In 2011, the committee branded
a new program called My Health,”
said Maureen Kendall, corporate director
of total compensation. “The focus of the
My Health program is to develop activities
that promote a long-term strategy aimed at
improving overall employee health.”
It is important for an organization the size
of CAMC to promote health and wellness to
its employees.
“Our workforce is about caring for our
community,” Kendall said. “The wellness
program is about caring for our workforce.”
To help with this initiative, a new wellness
coordinator was hired in February. Evan
Thoman came to CAMC from the YMCA,
where he was director of health and fitness. “Evan’s education and work experience,
along with our well-established wellness
committee, will move us forward in meeting
our long term strategy and commitment of
improving our overall employee health,”
Kendall said.
CAMC is planning a number of new
programs in the coming year, including a
new walking program, smoking cessation
program, diabetes program and online
financial wellness program. Continued on P. 3
2
camc.org
A Snapshot of CAMC Health System*
CAMC Health System
Nearly 7,000 people work for companies
within the CAMC Health System including:
Charleston Area Medical Center, CAMC
Foundation, CAMC Health Education
and Research Institute, CAMC Teays Valley
Hospital and Integrated Health Care
Providers, Inc.
Charleston Area Medical Center
CAMC is the flagship of the CAMC Health
System. CAMC offers thousands of families
convenience and accessibility through
three Charleston locations: CAMC General
Hospital, CAMC Memorial Hospital and
CAMC Women and Children’s Hospital.
CAMC Foundation
The CAMC Foundation is the fundraising
organization for CAMC. The foundation
accepts gifts from individuals, businesses
and foundations to support programs and
services at CAMC.
CAMC Health Education
and Research Institute
The CAMC Institute provides continuing
medical education, outreach education and
research support to physicians and allied
medical professionals in West Virginia.
CAMC Institute also operates schools of
cytotechnology and nurse anesthesia as well
as the 11 graduate medical, three pharmacy
and one psychology residency programs
jointly directed by the institute, WVUCharleston Division and the community
hospital track jointly directed by CAMC/
WVSOM.
Want to become
a nurse?
Becoming a nurse requires time and
dedication, but you can do it. CAMC’s
nurse education assistance program will
help cover your educational costs in
exchange for a work commitment. You’ll
finish the program ready to start your
career in the exciting, rewarding health
care field.
Hear our graduates’ stories and
apply online at camc.org/nursinged.
Applications accepted until May 31.
Teays Valley Hospital (TVH)
TVH is an acute care hospital offering a
variety of critical inpatient and outpatient
services in one of West Virginia’s fastest
growing counties. The hospital has 70
beds and 156 physicians and allied health
professionals on its medical staff.
CAMC Physicians Group
CAMC Physicians Group is a network of
physician practices affiliated with CAMC
that provides a continuum of care to
patients and their families through a broad
range of medical specialties including:
bariatric surgery, dentistry, fertility, facial
and maxillofacial surgery, general and
vascular surgery, neurology, oncology,
orthopedics, pathology, plastic surgery,
urgent care, urology and urology/transplant.
Community Highlights
• Served more than 49,000 people seeking
health information or community benefit
services such as screenings
• 386 participants in outreach professional
education programs at 20 outreach sites
Teaching Hospital (CAMC & CHERI)
• CAMC serves as a clinical training site
for about 800 students/year through
educational affiliations with WV/regional
colleges and universities.
• 176 residents, interns and fellows
• 50% of graduates establish practice/
continue training in WV
• Nearly 49% of CAMC’s medical staff
received training here
CAMC offers two Ornish programs.
The heart disease Reversal Program is
a research- based, one-year treatment
plan with four components: nutrition,
stress management, social support and
exercise. The Spectrum Program is a sixweek lifestyle improvement program
consisting of weekly two-hour
educational sessions also focusing on
nutrition, exercise, social support and
stress management.
The next Spectrum
class starts July 1.
Spectrum is for individuals who want
to prevent disease, reduce the risk for
developing chronic conditions, or
learn lifestyle changes that can help
manage diabetes, high blood pressure,
heart disease and cancer.
The Reversal Program includes onsite exercise, stress management
instruction, group support and chefprepared meals.
The next Reversal class
begins May 20.
The Reversal Program requires a
physician to authorize participation in
the program.
Call (304) 388-9411 for more
information or to register for any of
the classes.
Licensed Beds (CAMC)
• 838 total
• 268 General Hospital
• 424 Memorial Hospital
• 146 Women and Children’s Hospital
Patient Care (CAMC)
• 567,956 outpatient visits
• 98,371 emergency room visits
• 3,169 trauma patients admitted
• 40,335 inpatient discharges
• 39,400 general operating room
procedures
• 28,218 ambulatory surgery procedures
• 1,390 open-heart bypass procedures
• 14,330 procedures performed in cardiac
cath labs
• 40,659 David Lee Cancer Center
encounters (IHCPI & CAMC)
• 1,562 newly diagnosed patients with
cancer
• CAMC treated 12% of the total 2010 adult
cancer discharges in WV
• 2,910 babies delivered
• 401 neonatal intensive care unit
admissions
• 44 kidney transplants
Operating Rooms (CAMC)
• General Hospital: 13
• Memorial Hospital: 14
• Women and Children’s Hospital: 6
• SurgiCare (outpatient): 4
Research (CHERI)
• 400 active research protocols
• 36 various types of industry sponsored
trials (not including cancer studies)
Employees and Physicians (CAMC)
• 5,151 full time equivalent employees
• 637 physicians on medical staff
Financial Facts (CAMC Health System)
• Payroll and benefits = $338 million
• Community benefit = $120,971,264
• $39,030,011 in charity care at cost
• $29,676,338 to provide health
professions education/graduate medical
education
• $820,674 in subsidized health services to
meet identified community needs
• $2,950,736 for community benefit
programs and services
• $17.9 million for Medicaid provider tax
• $78,763,643 unreimbursed cost for
treating patients with Medicare coverage
• $46,283,038 unreimbursed cost for
treating patients with Medicaid coverage
• $15,217,453 unreimbursed costs for
treating patients with PEIA coverage
• $21,545,282 written off as bad debt
at cost
For more information, visit camc.org.
*Based on 2011 data.
Computerized processes improve care
When you’re a hospital patient, you see
many outward displays of patient safety
practices. For example, providers check your
ID bracelet, ask you to confirm your name
and birth date, and scan the barcode on
your ID and your medication before giving
it to you.
Additionally, many other processes are
going on behind the scenes to improve
patient safety and quality of care.
About two years ago, physicians practicing
at CAMC started using Computerized
Physician Order Entry (CPOE), which
means that physicians enter their patient
CALENDAR
Dr. Dean Ornish
Program for Reversing
Heart Disease
• 75 students enrolled in CAMC’s nurse
anesthesia program
• In 2011, 1,863 continuing education
programs were offered with 54,140 hours
of CE credit issued
Run for Your Life
The annual 5-mile run is scheduled
for Saturday, June 22 at 8 a.m.
It begins and ends at the Capitol.
All entry fees from Run for Your
Life go to the CAMC Foundation
to support colorectal cancer
awareness and screening. Call
(304) 388-9864 for more
information. Register online
at camc.org/foundationspecialevents
CAMC MEDICAL REHABILITATION CENTER
CHALLENGED SPORTS PROGRAM
19th ANNUAL WEST
VIRGINIA CHALLENGED
SPORTS CHAMPIONSHIPS
May 1 – 4, 2013 – Charleston
Featuring competitions in Track
& Field, Swimming, Archery,
Weightlifting and Marksman
(sanctioned by the NRA)
Open to athletes of all ages with
physical disabilities
REGISTRATION REQUIRED. To register
(athletes) or volunteer to help with any of
the events, please contact Jeremiah Gagnon
at (304) 388-7608 or jeremiah.gagnon@
camc.org. For more information or athlete
entry forms, visit camc.org/challengedsports.
care orders directly into CAMC’s electronic
medical record system. CPOE is an
important step in improving patient safety,
quality and efficiency of care.
Using CPOE, physicians can enter an order
from within the hospital or remotely. Once
an order is entered, it goes to the designated
department (pharmacy, radiology, etc.)
so that it can start being processed
immediately and expedites the delivery of
care to the patient. Prior to CPOE, physician
orders were written into a patient’s paper
chart and then had to be entered into the
system by a nurse or unit coordinator.
The key benefits of using CPOE include
reducing errors in the order entry process,
gaining faster turnaround times for
medications, labs, images and diagnostics,
and eliminating duplicate orders. If there
is a possible drug interaction, physicians
are alerted at the time they place the order.
CPOE also eliminates handwriting legibility
issues.
CPOE is one part of meeting the
government’s requirement of Meaningful
Use, which provides incentives to
organizations who meet guidelines of
expanding electronic health record (EHR)
technology. These national priorities are
seen as important parts of the role of
technology in the national effort to improve
health care safety, quality and efficiency.
“CPOE has been a significant change and
opportunity for physicians, nurses, clinical
staff, information services and others at
CAMC. We appreciate the years of work by
all to adopt CPOE as one way to continue
to improve how we care for our patients,”
said Glen Wright, MD, clinical director for
medical informatics.
CAMC receives award in stroke care
CAMC has received the American Heart
Association/American Stroke Association’s
Get With The Guidelines®–Stroke Silver
Quality Achievement Award. The award
recognizes CAMC’s commitment and
success in implementing a higher standard
of stroke care by ensuring that stroke
patients receive treatment according
to nationally accepted standards and
recommendations.
To receive the Get With The GuidelinesStroke Silver Quality Achievement Award,
CAMC consistently complied, for at least
one year, with the requirements in the
Get With The Guidelines–Stroke program.
These include aggressive use of medications
like antithrombotics, anticoagulation
therapy, deep vein thrombosis prophylaxis,
cholesterol reducing drugs and smoking
cessation. This 12-month evaluation period
is the second in an ongoing self-evaluation
by the hospital to continually reach the 85
percent compliance level needed to sustain
this award.
In addition to the Get With The GuidelinesStroke award, CAMC has also been
recognized as a recipient of the association’s
Target: Stroke Honor Roll, for improving
stroke care. Over the past quarter, at
least 50 percent of the hospital’s eligible
ischemic stroke patients have received tissue
plasminogen activator, or tPA, within 60
minutes of arriving at the hospital (known
as ‘door-to-needle’ time). A thrombolytic,
or clot-busting agent, tPA is the only
drug approved by the U.S. for the urgent
treatment of ischemic stroke. If given
intravenously in the first three hours after
the start of stroke symptoms, tPA has been
shown to significantly reverse the effects of
stroke and reduce permanent disability.
Get With The Guidelines® is the American
Heart Association/American Stroke
Association’s hospital-based quality
improvement program that empowers
health care teams to save lives and reduce
health care costs by helping hospitals
follow evidence-based guidelines and
recommendations. For more information,
visit heart.org/quality.
Published by CAMC
Marketing &
Public Affairs
Elizabeth Pellegrin
Editor
Dale Witte
Jessica Duffield
Editors/Writers
Tony Campbell
Graphic Designer
Julia Noland
Leslie Carpenter
Ashley Showen
Writers
2013
camc.org
Wellness
Continued from P. 1
“Employees need to get involved in their
wellness,” Kendall said. “We are looking at
programs in an effort to offer something for
everyone. If you like to run, get involved
in our Couch to 5K programs. If you like
to walk, watch for announcements about a
new walking program. If you are interested
in weight loss, look at getting involved in
Drop 10 in 10, Weight Watchers at Work or
our new Team Lean program. And don’t
forget about the Dean Ornish programs,
yoga and ZUMBA.” “We are offering Great Living and reducedcalorie entrée and side items daily, and
offering fruit as a side option at the grill
area,” Foster said. “We are also training
our service staff on proper portions and
educating them on recommending better
for you options that meet our FIT criteria.”
CAMC offers a variety of fitness and weight
loss options for employees. In an effort to
help them make healthier choices when
visiting CAMC cafeterias, Morrison’s has
established the Morrison Healthy Dining
Standards to ensure access to healthy food
choices.
Some of Morrison’s longer term goals
include reducing the amount of fried foods
sold annually, increasing annual purchases
of fresh fruits and vegetables, adding whole
wheat and whole grain breads, buns and
rolls as a default option, including calorie
counts on all available food options,
offering healthy FIT combos for every
meal, bundling combo meals with bottled
water instead of soft drinks and continuing
education of the staff.
“We have begun reducing the size of dessert
portions, offering low calorie and reduced
sugar desserts on a daily basis and offering
healthier snacks at the register stands,
such as baked chips and bottled waters,”
said Danny J. Foster, nutrition services.
“Marketing and placement of products also
is important so that the healthier choices
are the default options.”
Which means fruit and baked chips at the
registers instead of giant cookies and other
large desserts, and water placed at eye-level
with sugary sodas not as readily available.
“In West Virginia, you have the perfect
storm—an older workforce, prevalence of
obesity, long work hours and work that
requires repetitive motion that can lead to
sprains and strains or neurological issues,”
said Art Lilly, MS, ATC coordinator of the
CAMC industrial rehabilitation program.
The goal of CAMC’s industrial
rehabilitation program, which is part of
the CAMC Physical Therapy Center, is to
get people back to work quickly after an
accident or injury on the job. Utilizing
a state-of-the-art testing system, the
therapist can determine a person’s level of
functionality and assess what steps need to
be taken to get that person back to work.
The ARCON Functional Capacity Evaluation
System measures a patient’s ability through
strength testing, musculoskeletal screening,
cardiovascular assessment and other
functionality.
Girl born prematurely thriving at 17
Items marked as FIT meet criteria consistent
with current dietary recommendations for
the amount of calories, fat and sodium etc.,
allowed in various items.
“Morrison feels that health care institutions
should be role models in healthy eating
choices,” Foster said. “We feel very fortunate
to have been selected as leaders of this
nationwide endeavor.”
If you have any questions about Wellness
related programs at CAMC, please contact
Evan Thoman, wellness coordinator, at
(304) 388-7593.
Industrial rehabilitation program
helps patients get back to work
Work-related injuries are unfortunately
prevalent in West Virginia, largely because
of the demanding types of manual labor
many of our large industries require.
3
“The program is designed to get people
back to work,” Lilly said. “I work with the
vocational rehab community, employers,
insurance companies, physicians and the
injured worker and his or her family to
provide a goal oriented, work injury rehab
program.”
Doug Wallace, 59-year-old native of St.
Albans, recently went through the program
after falling off a 12-step ladder while
working for a painting contractor. Wallace’s
work injury left him with a broken hip and
knee, and the inevitability of months of
rehabilitation.
After going through surgery, Wallace
completed basic physical therapy and was
then sent to the industrial rehab program
for work study therapy. From November
to February, Wallace attended sessions at
industrial rehab.
Wallace had nothing but good things to say
about Lilly and the program.
Lilly, who has been the coordinator of the
program for 16 years, is a proponent of
employee education.
“I felt like I was a member of Mr. Lilly’s
family. He had a genuine concern for my
health,” Wallace said. “It was very uplifting
and gave me a reason to hope. My balance
and strength improved.”
“Prevention is the key. Monitor your
workers, and teach them to work smarter,
not harder,” he said.
Wallace continues to recover and is working
with his employer to determine in what
capacity he can return to work.
The CAMC industrial rehabilitation
program works closely with West Virginia
Worker’s Compensation to evaluate
patients. The program sees an average of
250 patients each year from all over West
Virginia.
The industrial rehabilitation program
also provides expert testimony, back
care education, work hardening and
conditioning programs and more.
For more information about industrial rehabilitation at CAMC, call (304) 388-4900.
Extended hours
Open select evening and weekend hours.
Call (304) 720-9729 for more information or to schedule.
60 RHL Blvd., South Charleston
Located at the Trace Fork Shopping Center behind
O’Charley’s restaurant
camc.org/imaging
Left: Ayla, 1 pound 2 ounces held by her mom Lisa in the NICU. Right: Ayla and Lisa, 17 years later.
Lisa Morgan never imagined having to
deliver her first baby at 24 weeks gestation,
but that possibility became very real on
Dec. 8, 1995.
“I lived in Southern West Virginia and was
planning to deliver in Beckley,” Morgan
said. “However, due to preeclampsia that
isn’t what happened.”
After a routine visit to her obstetrician,
Morgan began having severe cramps
and went to the emergency room before
returning to her home 45 minutes away.
There, she was told about CAMC Women
and Children’s Hospital and the team of
doctors that was available to help someone
in her situation.
“When they told me what was happening,
my blood pressure doubled,” she said.
“I was then brought by ambulance to
CAMC where they immediately began
administering medications to help with my
baby’s lungs.”
By Dec. 10 the baby, Ayla Chandler
Edwards, had to be delivered by c-section,
weighing 1 pound, 2 ounces. She was 105
days early, and Morgan was able to see her
baby briefly before she was taken to the
neonatal intensive care unit (NICU).
“Being born at 24 weeks gestation 17 years
ago meant that there was a possibility of
a dismal outcome,” said Stefan Maxwell,
MD, medical director of the NICU at CAMC
Women and Children’s Hospital and the
neonatologist who was present when Ayla
was born. “Extremely premature babies
like Ayla have a high risk of mortality,
not to mention other complications such
as growth restrictions and possibilities
of hearing and vision loss, intra-cranial
hemorrhage with the associated morbidity
of compromised neurodevelopment, etc.”
Ayla spent three and a half months in the
NICU, from Dec. 9, 1995 to March 23,
1996. She was on a ventilator for 40 days
and had an intestinal perforation, which
was surgically repaired. Despite those
setbacks, she was discharged from the
hospital on her original due date.
“It meant so much to have a high standard
of care for Ayla,” Morgan said. “It was all
very magical to me. She has remarkable
vision for someone who was born that
early, and has no lasting respiratory issues.
We had to come back to the hospital
monthly for IV therapy the first year of
her life, but other than that she hasn’t had
any major issues that stemmed from her
prematurity.”
Today, Ayla is a thriving 17-year-old who
loves the theater and performs in many
school plays. She also excels in her school
work, and scored a 28 on the ACT when
she took it for the first time before the
beginning of her junior year of high school.
“I like science,” Ayla said. “I want to get
my PhD or medical degree and go into
something like genetics.”
“Like any preemie, Ayla had many
problems, but she has gone on to be a
genius,” Maxwell said.
Many babies like Ayla are still being born
or transferred to Women and Children’s
Hospital every day. Funds raised through
the CAMC Foundation Gala help to provide
care for these babies. For more information
about the gala or how you can help these
tiny babies, visit camcfoundation.org or call
(304) 388-9860.
CAMC cleft center earns
national accreditation
The Cleft Center/First
Appalachian Craniofacial
Deformity Specialists (FACES)
at CAMC has been recognized
by the American Cleft PalateCraniofacial Association
(ACPA) as an accredited
center for the disciplinary
care of children with cleft and
craniofacial differences – the
only clinic in West Virginia to
earn this designation.
The ACPA, which is the
governing association of cleftDrs. Bruce Horswell (left) and Michael Jaskolka with cleft
craniofacial centers in North
lip and palate surgery patient Bradley Blankenship, 9, of
America, is comprised of health
Gilbert, W.Va.
care professionals whose
work involves treating and
researching birth defects such as cleft clip and
As stated in the ACPA notification letter, “The
cleft palate, as well as other facial conditions.
purpose of the Commission on Approval of
Earning accreditation means that the
Teams is to assure patients and families that
CAMC cleft team is committed to providing
the teams to which they are referred meet the
comprehensive, quality care for patients
Standards for Cleft Palate and Craniofacial
affected by craniofacial conditions.
Teams as set forth by the ACPA and Cleft
Palate Foundation.”
In 2012, the Cleft Center/FACES had 722
patient visits for cleft and craniofacial-related
The CAMC Physicians Group Cleft
diagnoses.
Center/FACES is located at Women and
Children’s Hospital and specializes in the
“We have always focused on providing
management of congenital and acquired
the best care to children who need our
craniomaxillofacial deformities (skull, scalp,
services, and to be recognized among some
eyes, ears, nose, jaws, lips and mouth) and
of the best cleft centers in the country is an
other related problems. Under the direction
honor,” said Bruce B. Horswell, MD, DDS,
of Drs. Bruce Horswell and co-director
MS, FACS, co-director of the Cleft Center.
Michael Jaskolka, the team is comprised of
“This was a very lengthy and consuming
craniomaxillofacial surgeons, neurosurgeons,
application, which required demonstration
ENT surgeons, pediatric dentists,
of a closed-loop evaluation and treatment
orthodontists, geneticist and counselors,
process among patients/families, referrals
speech pathologists, dieticians and social
and primary care physicians, and involved
workers.
health care professionals with outcomes
results and a database acquisition of those
For more information visit camc.org/faces.
results. We couldn’t have done it without
the perseverance and hard work of our clinic
team coordinator, Lola Forester, RN, and
clinic manager Amy Dean.”
4camc.org
Surgeon brings latest advances
in hip/knee replacement surgery
Hip and knee surgery have come a long way,
baby. Just ask Alexander Rosenstein, MD,
who has been instrumental in helping to
advance orthopedic surgery for his patients
over the past 25 years.
Rosenstein was a bioengineer before going
into medicine, which led him to improve
some of the very techniques and devices
used in his profession. He holds U.S. and
Canadian patents as well as approval for
implant designs used in joint reconstruction.
“I like to bridge the gap between engineering
and medicine so patients can have a better
quality of life,” Rosenstein said.
Rosenstein graduated from the University
of Minnesota Institute of Technology with
a degree in bioengineering. He then earned
his medical degree from the University
of Minnesota School of Medicine and
completed his orthopedic residency training
at the University of California, San Diego
Medical Center. Rosenstein was awarded the
Girdlestone Scholarship and completed his
fellowship training in adult reconstruction
and joint replacement at Oxford University.
Rosenstein is one of the first U.S.
orthopedic surgeons to implant the Oxford
Unicompartmental Knee, which allows for
restoration of complex, normal motion of
the knee. This minimally-invasive procedure
preserves bone and ligaments and is usually
associated with less discomfort after surgery,
faster recovery and a shorter hospital stay.
“With unicompartmental knee replacement,
we don’t have to replace the entire knee,”
Rosenstein said. “We can preserve the parts of
the knee that are still in adequate condition,
and only replace the damaged parts of the
knee. It only requires a small incision, and it
does not completely change the mechanics
of the knee as total knee replacement devices
do.”
Muskuloskeletal issues are at the forefront of
the aging U.S. population, with an estimated
50 million Americans suffering from
arthritic disorders and half of them reporting
significant disability. But orthopedic
problems don’t just affect the elderly.
According to the National Foundation, baby
boomers are now at prime risk for arthritis.
More than half those affected are under
age 65, and as a result, arthritis is now the
leading cause of disability in the U.S.
“Hip and knee replacement surgery is one
of the greatest medical advances of our time.
These procedures can improve a person’s
quality of life by relieving pain, improving
range of motion, and restoring function.
There are also many effective non-surgical
techniques, including a variety of injections
and bracing that can prolong the use of joints
before surgery is necessary.”
It is estimated that over 700,000 hip and
knee replacements are performed in the
United States each year.
A replacement joint that wears out, loosens
or develops a problem can be resurfaced or
revised with a second procedure, called joint
revision surgery, which Rosenstein specializes
in.
Joint revision is more complex than the
original procedure because of the alteration
to a patient’s bone structure that was made
during the initial surgery, but it is likely to
become more common as an increasing
number of younger patients (under 55 to
60) have joint replacement surgery and as
the population continues to live longer and
outlive their implants.
To promote patients’ comfort and to
expedite the recovery after joint replacement
surgery, Rosenstein uses “multi-modal”
pain management techniques that involve
combining medications and administering
them at key times during and after surgery
to effectively control pain with fewer side
effects.
In the past when using narcotics alone
following joint replacement surgery, patients
had to experience pain before it was treated,
which resulted in more pain and required
more medication to relieve pain, thereby
increasing the chance of side effects. With
modal pain management, the goal is to stay
ahead of the pain so patients can recover
faster.
With so many options in joint replacement
surgery and therapies, Rosenstein says people
don’t have to live in pain or leave the area for
the most advanced procedures.
“We’ve redefined orthopedic surgery in
recent years so patients of all ages have more
options and can live active lives longer,”
Rosenstein said. “Best of all, everything
patients need can be found right here.”
Dr. Rosenstein is board certified by the American
Board of Orthopaedic Surgery and specializes
in adult hip and knee, joint preservation, joint
replacement and revision surgery.
Before joining CAMC Physicians Group as
director of reconstructive and orthopedic surgery
in January 2013, Rosenstein served as professor
of orthopaedic surgery and chief of adult
reconstruction division at the University of Texas
Medical School Houston and adjunct professor
of biomedical engineering at the University of
Texas Austin. He has held academic positions
of assistant clinical professor of orthopaedic
surgery at the University of California Irvine
and associate professor of the department of
orthopaedic surgery and adjunct associate
professor of the department of mechanical
engineering at Texas Tech University. Rosenstein
has also served as chief of surgery and chief of
medical staff at South Coast Medical Center in
Laguna Beach, Ca.
Rosenstein has co-authored a book for arthritis
sufferers titled: “Everything You Ever Wanted to
Know About Shoulder, Hip and Knee but Didn’t
Know What to Ask.”
For more information visit camc.org/orthosurgery.
New technology, techniques treat strokes, brain aneurysms
drugs or devices can be delivered directly
to the site of a blockage to remove it to
prevent the stroke from completing; and in
brain aneurysms, specialized coils can be
inserted into the aneurysm to prevent it from
rupturing and to treat aneurysms that have
ruptured.
According to the National Brain Aneurysm
Foundation, an estimated 6 million people
in the United States (1 in 50) have an
unruptured brain aneurysm. Of those, 30,000
will suffer an aneurysm rupture.
David Carrington, MD, describes himself
quite simply as a “brain plumber.” But there’s
nothing simple about what he does. As
CAMC’s only interventional neuroradiologist,
Carrington uses tiny catheters and state-ofthe-art imaging techniques to treat complex
vascular diseases of the brain and spine
without open surgery. Instead, he performs
surgery inside tiny, delicate blood vessels.
“Similar to a cardiac catheter that goes
to the heart, an endovascular surgical
neuroradiologist uses long, specialized tubes
(microcatheters) over microwires, and stateof-the-art imaging equipment to treat blood
vessel problems in the brain,” Carrington
said.
Shorter recovery times and decreased
procedural risks are among the benefits of
endovascular surgical neuroradiology and
minimally-invasive neurointerventional
techniques. In stroke cases, clot-busting
There are two approaches to treating an
aneurysm: the traditional surgical approach,
which involves making an opening in the
skull to repair the aneurysm by surgically
clipping it; or coil embolization, which is a
non-surgical endovascular approach where
a tiny catheter is guided from an artery in
the groin into the brain vessels and the
aneurysm is packed with tiny coils. Coils
accomplish from the inside what a surgical
clip would accomplish from the outside: they
stop blood from flowing into the aneurysm
but allow blood to flow freely through the
normal arteries.
“An aneurysm is a ballooning of a defect
in the blood vessel, much like a tire inner
tube balloons out when there is a defect,”
Carrington said. “As the bulge gets larger
the wall of the blood vessel gets very thin
and may rupture or give way. Through a tiny
catheter, I place coils inside the ruptured
aneurysm, which stops bleeding from
reoccurring, and also causes the blood to
clot, heal and form a scar.”
According to the American Stroke
Association, most people develop aneurysms
after age 40. They tend to develop at
branching points of arteries and are caused
by constant pressure from blood flow.
Aneurysms often enlarge slowly and become
weaker as they grow, just as a balloon
becomes weaker as it stretches.
Carrington and the team of neurologists,
neurosurgeons, radiologists, emergency
medicine physicians, pharmacists and
medical rehabilitation specialists at the
CAMC Stroke Center at General Hospital
provide rapid, comprehensive evaluation and
management of stroke to provide patients
with the most advanced treatment options.
“Aneurysms happen in about 6 percent
of the population, and generally there are
no symptoms,” Carrington said. “But if an
aneurysm leaks, called a sentinel bleed, it
causes tremendous pain. Patients feel an
extreme headache, which is like being hit in
the head with a baseball bat. That pain often
subsides for several days or a week before it
fully ruptures.”
“The intra-arterial treatment for stroke is to
go where the stroke is happening, or to the
blocked artery itself, and either dissolve the
clot using medicine in the microcatheter or
capture the clot using a device that can be
placed through the microcatheter.”
While it is unknown why an aneurysm bleeds
or exactly when it will bleed, Carrington says
there are risk factors people can control to
reduce their chance of bleeding from a brain
aneurysm. Most notably the risk factors are
smoking, high blood pressure and heavy
alcohol use. These are some of the same risk
factors for stroke, which occurs when a clot
blocks the blood supply to part of the brain
or when a blood vessel in or around the
brain bursts.
Treatment for stroke depends on the type of
stroke: an ischemic stroke is most common,
where an artery is blocked; whereas a
hemorrhagic stroke involves bleeding into
the brain. To treat an ischemic stroke, blood
flow must quickly be restored to the brain
via intravenous clot-busting medications or
endovascular procedures.
The key to optimal stroke treatment is quick
and accurate action. The longer blood flow is
cut off to the brain, the greater the damage.
“Many people still don’t recognize
when they’re having a stroke. At first
their symptoms may not be perceived as
symptoms of a problem, but when they don’t
get better or when symptoms progress to a
profound weakness or difficulty speaking,
then they might think it is a stroke.”
Carrington says when it comes to stroke,
the most important step to survival and
reducing disability is seeking immediate
medical care at the onset of stroke symptoms:
sudden numbness or weakness of the face,
arm or leg (especially on one side of the
body); sudden confusion, trouble speaking
or understanding; sudden trouble seeing in
one or both eyes; sudden trouble walking,
dizziness, loss of balance or coordination;
and sudden severe headache with no known
cause.
Carrington is certified in neuroradiology by
the American Board of Radiology.
Carrington came to West Virginia because
of the large number of patients with
neurovascular disease.
“Interventional neuroradiology has
revolutionized how we treat complex
cerebrovascular diseases,” Carrington said.
“We can perform any neuroendovascular
procedure that can be done anywhere in the
country, which can give some of our most
complicated patients a chance for better
outcomes.”
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