The Inside Press

Magazines serving the communities of Northern Westchester

White Plains Hospital

Advancing Stroke Care in Our Community

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Saving brainpower in stroke patients demands medical insight and quick thinking. At White Plains Hospital, the standard of care includes the most advanced technology and services.

Dr. Paul Lleva, Director of Stroke Services, White Plains Hospital

Each year, approximately 795,000 people in the U.S. suffer strokes – 17% of which are fatal. With one of the most comprehensive stroke programs in the region, providing immediate and lifesaving stroke care is an area where White Plains Hospital and its newly appointed Director of Stroke Services, Dr. Paul Lleva, is proud to excel.

Board-certified in neurology, vascular neurology, neurosonology (or brain imaging), and internal medicine, Dr. Lleva currently sees patients at White Plains Hospital Physician Associates in Somers and is working to further enhance the Hospital’s robust stroke care program. “White Plains Hospital has been building a world-class stroke program, bringing in top specialists and the latest technology and treatments,” Dr. Lleva says. “As we look to the future, our program aims to be the top advanced stroke care provider in our region and beyond.”

Recent notable advances in stroke care at the Hospital include:

Quicker Clot Busters. “For every minute elapsed after a stroke, a patient may lose 1.9 million neurons,” or nerve cells in the brain, says Dr. Lleva. The team at White Plains Hospital relies on the newest medicine, called Tenecteplase, to rapidly dissolve the clots obstructing blood flow. “This drug works very specifically against the clot, destroying it more quickly and more effectively than previous medications,” he says.

The Gold Standard Of Care. The highest-quality acute care currently available for strokes, a procedure called a mechanical thrombectomy, is currently being performed at White Plains Hospital. During this minimally invasive procedure, specially designed instruments are inserted into a large blood vessel in the groin through a small port and threaded through thin catheters to reach – and remove – blood clots in the brain within 24 hours from symptom onset.

To assist in these procedures, the Stroke Team at the Hospital also uses advanced imaging, called perfusion imaging, to differentiate salvageable brain tissue from irreversibly damaged brain tissue to pinpoint cases where mechanical thrombectomies will be most effective.

Artificial Intelligence (AI)-Powered Software. This modern technology guides radiologists and neurologists toward the correct intervention within seconds. “Our team uses software that will detect the amount and location of salvageable brain tissue, as well as damaged tissue,” Dr. Lleva says. “As a tool for our care team, it provides a more uniform and consistent diagnosis in rapid time.”

24/7 Emergency Consultations. At White Plains Hospital, a neurologist is always available for an emergency consultation at the bedside, either in-person or remotely. “With telestroke services, a vascular neurologist can expeditiously see the patients within minutes of arrival, allowing us to quickly diagnose patients and get them appropriate care immediately,” Dr. Lleva says.

World-Class Team. The increasing complexity of stroke cases seen at White Plains Hospital has driven the recruitment of experts in neurocritical care and neuroendovascular surgery with decades of experience in treating and managing advanced stroke cases.

Smoother Recovery. After stroke, some patients will develop arm and leg spasticity, language difficulty, pain, inability to walk, and limited ability to care for themselves. These complications are addressed in our outpatient stroke center in collaboration with Burke Rehabilitation to improve patients’ mobility, lessen discomfort, and restore quality of life.

To make an appointment with Dr. Lleva at 325 Route 100, Somers, NY, call 914-849-5300.

This article originally appeared in Health Matters, a White Plains Hospital publication.

White Plains Hospital Ranks Among the Top 5% Nationally for Safety

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White Plains Hospital announced today that it has been awarded the Patient Safety Excellence Award™ and Outstanding Patient Experience Award™ from Healthgrades. The Hospital is one of only two in New York and 79 across the nation to receive top honors in both categories. With these awards, White Plains Hospital ranks among the top 5% in the nation for patient safety and among the top 15% for patient experience.

Healthgrades analyzed more than 4,500 institutions, with safety honors given to those who scored highly in 13 quality measures determined by the Centers for Medicare & Medicaid Services (CMS). Patient experience scores were based on patients’ perceptions of their hospital care, from cleanliness and noise levels to medication explanations and staff responsiveness. This is the 9th time White Plains Hospital has received the Outstanding Patient Experience Award.

“We are honored to continue to be consistently ranked among the top hospitals in the nation for quality care,” said Dr. Rafael E. Torres, Chief Quality Officer at White Plains Hospital. “Quality, safety, and the patient experience are at the center of everything we do and to receive these awards from Healthgrades highlights the efforts of our entire staff to deliver exceptional patient care.”

“We commend White Plains Hospital for going above and beyond to provide a best-in-class care experience for patients during their hospital stay,” said Brad Bowman, MD, chief medical officer and head of data sciences at Healthgrades. “White Plains Hospital’s dedication to superior patient care is particularly impressive given recent declines in patient satisfaction scores across the country. We look forward to their continued leadership and commitment to ensuring the health and wellness of all patients.”

In addition to the Patient Safety Excellence Award and Outstanding Patient Experience Award, earlier this year Healthgrades named White Plains Hospital one of “America’s Best Hospitals for Coronary Intervention.” A full list of White Plains Hospital’s accreditations and awards can be found here.

About White Plains Hospital  

White Plains Hospital is a proud member of the Montefiore Health System, serving as its tertiary hub of advanced care in the Hudson Valley. The Hospital is a 292-bed not-for-profit health care organization with the primary mission of providing exceptional acute and preventive medical care to all people who live in, work in or visit Westchester County and its surrounding areas. White Plains Hospital has outpatient medical facilities across Westchester, including multispecialty practices in Armonk, Hawthorne, Larchmont, New Rochelle, Rye Brook, Somers, Yonkers and Yorktown Heights; and Scarsdale Medical Group locations in Harrison and Scarsdale.

The Hospital is fully accredited by the Joint Commission and in 2023, White Plains Hospital received another 5-star rating from the Centers for Medicare and Medicaid Services (CMS) – the highest distinction offered by that federal agency for the second consecutive year. In addition, the Hospital received its third Magnet® designation from the American Nurses Credentialing Center (ANCC), a distinction held by only two percent of hospitals in the country. In 2023, White Plains Hospital was awarded an “A” Safety Grade from the Leapfrog Group for the 10th consecutive time.

https://www.wphospital.org/

Rotator Cuff Repair: Recovery Can Be the Biggest Challenge

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Hear the phrase “rotator cuff repair” and you may think of professional athletes who have gone through the procedure. But anyone can be at risk for the condition, according to Dr. Gregg Cavaliere, a board-certified Orthopedic Surgeon and Sports Medicine physician at White Plains Hospital Physician Associates, practicing in Hawthorne and Yonkers.

“Anyone whose work involves repetitive overhand activities, like athletes in certain sports, carpenters, and electricians” can be particularly susceptible to a rotator cuff tear, he says. Even Today weatherman Al Roker underwent a rotator cuff repair on his left shoulder in 2014.

The main cause of a rotator cuff tear is injury, but in Roker’s case the trouble was caused by advancing osteoarthritis; as with many body parts, erosion can take its toll over time. In fact, rotator cuff tears are most common in people older than 60.

The rotator cuff is a group of four muscles and four tendons that hold the shoulder joint in place, allowing you to move your arm and shoulder. The “tear” in question is usually one of the tendons. Symptoms can include recurring pain at that site – sometimes so severe that sleep is difficult; a limited capacity for moving the affected arm; “cracking” sounds when moving the arm; and muscle weakness.

Dr. Greg Cavaliere

Such symptoms do not always set off alarm bells for the person experiencing them, however. “There will always be people who just take some more Advil and just hope the pain goes away,” says Dr. Cavaliere’s WPHPA colleague Dr. Anthony Maddalo, also a board-certified orthopedic surgeon. “Sometimes they live with the pain for years.”

The two surgeons have worked together for about 30 years, assisting each other with major procedures; they estimate they have done “thousands” of rotator cuff repair surgeries during that time, to the point where “we’re like a right hand and left hand working together,” Dr. Maddalo says. “That helps us do the procedures most efficiently and expeditiously.” Typically that means between 60 and 75 minutes for Drs. Maddalo and Cavaliere.

The majority of the procedures are shoulder arthroscopies, minimally invasive operations that involve inserting a small camera, or arthroscope, into the shoulder joint. The resulting images are displayed on a video monitor and are used to guide the miniature surgical instruments being used. Because of this, incisions are relatively small, certainly in comparison to open rotator cuff repairs, which involve incisions that are typically several inches long – more invasive and time-consuming, and usually requiring a longer recovery time.

There are two ways of conducting the surgery: the patient either lies down on their “good” side or is in a seated position. “We like the seated option,” says Dr. Maddalo, “because that allows us more easily to address any other issues we may discover when we go in.”

The surgeons recommend their patients, now with stitches and wearing a sling, avoid physical activity involving the affected shoulder for two weeks, followed by “passive motion” therapy for another two weeks; that involves a therapist or an assistant at home putting the arm through a comfortable range of motion while the patient is lying down.

Dr. Anthony Maddalo

“One of the biggest sticking points is educating patients on what ‘passive motion’ is,” Dr. Maddalo says. “They’ll come into the office for a follow-up and use both arms to push themselves out of a chair – exactly what they should not be doing, but it’s habitual and they don’t think about it. They also need to be careful about starting to drive again. If the surgery was on their right shoulder, they’ll need to use their left hand to put the car in gear.”

At the six-week mark, the sling and passive motion therapy are usually discontinued in favor of active assisted range of motion exercises, such as the patient lifting their arms above their head without help from a therapist in order to stretch the muscles used during a routine motion. Strengthening exercises then begin 10-12 weeks after the procedure; all told, Dr. Cavaliere says, full recovery usually takes four to six months, depending on the severity of the tear.

The key to all of this, the physicians say, is to not ignore the pain. “Everyone is different,” Dr. Maddalo says, “and everyone has a different tolerance level of pain. A sudden injury is one thing, but if they’ve been having chronic pain in their shoulder for a long time, they really do need to see a specialist. There’s no reason to keep experiencing that pain when there are many options available.”

Dr. Gregg Cavaliere and Dr. Anthony Maddalo are orthopedic surgeons at White Plains Hospital Physician Associates in Hawthorne and Yonkers. To make an appointment, call 914-631-7777 (Hawthorne) or 914-375-7777 (Yonkers).

White Plains Hospital Launches Structural Heart Program with First Minimally Invasive Heart Valve Replacement Procedures

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Transcatheter Aortic Valve Replacement (TAVR) is the Newest Addition to the Hospital’s Comprehensive Cardiac Services

White Plains Hospital has announced the launch of the Montefiore Structural Heart Program at White Plains Hospital with the successful completion of its first three minimally invasive heart valve replacement procedures, known as Transcatheter Aortic Valve Replacements (TAVR). The procedures were performed by Dr. Azeem Latib, a leading expert in interventional cardiology and Director of the Montefiore Structural Heart Program at White Plains Hospital, in one of the Hospital’s state-of-the-art cardiac catheterization laboratories, marking a key milestone in the growth of the Hospital’s advanced cardiac services.

More than five million Americans are diagnosed with heart valve disease each year, including 1.5 million with aortic stenosis – or the narrowing of the aortic valve. This condition often appears in those 65 and older and deteriorates with age. Older patients with aortic stenosis and other congenital heart diseases can often benefit from a TAVR.

The procedure, which typically takes less than an hour, involves specially trained cardiac interventionalists, in collaboration with world-class cardiac surgeons, using advanced imaging techniques to guide a flexible tube called a catheter through a small needle hole in the groin, up through the blood vessels, to the diseased aortic valve. The team then uses the catheter to deploy a new valve, immediately restoring function and blood flow. Patients are cared for by highly trained cardiac intensivists in the Hospital’s Cardiac ICU, and many of our patients go home the next day.

White Plains Hospital is one of just two healthcare facilities in Westchester offering this life-saving procedure to patients in Westchester County. Every patient is fully evaluated by a cardiac surgeon, interventional cardiologist, cardiologist and radiologist to determine the ideal course of treatment, whether that is a TAVR procedure or open-heart surgery. Also, with advanced imaging technology on-site, including high-resolution CT scanning, fusion imaging and cardiac MRI, patients can undergo convenient, same-day pre-operative testing at the Center for Advanced Medicine & Surgery (CAMS) in White Plains prior to the procedure.

The addition of the Montefiore Structural Heart Program at White Plains Hospital builds on the success of the Montefiore Cardiac Surgery Program at White Plains Hospital, which has exceeded national benchmarks for quality with exceptional patient outcomes in the two years since its launch. The program was recently recognized with a distinguished 3-star rating, the highest available, from The Society of Thoracic Surgeons, a designation that places it among the top 10% of programs for heart bypass surgery in the United States and Canada. White Plains Hospital’s cardiac care capabilities are further strengthened by its world-class Interventional Cardiology program and Cardiac Electrophysiology department, which is focused on the diagnosis, treatment and prevention of arrythmias and other emergent cardiac issues. White Plains Hospital’s experts work closely with a network of cardiologists and specialists throughout the Hudson Valley to ensure each patient receives the specialized care they need, close to home.

“This program underscores White Plains Hospital’s commitment to growing its advanced cardiac services for patients across the Hudson Valley,” said Dr. Latib. “These expanded capabilities allow us to provide the most appropriate treatment based on our patients’ needs, whether they require open-heart surgery or a minimally invasive procedure like a TAVR. We are excited to begin performing these procedures and look forward to continuing to advance the Structural Heart Program at White Plains Hospital.”

To learn more about the Montefiore Structural Heart Program at White Plains Hospital, call (914) 849-4200.

News and Photos Courtesy of White Plains Hospital

 

About White Plains Hospital 

White Plains Hospital is a proud member of the Montefiore Health System, serving as its tertiary hub of advanced care in the Hudson Valley. The Hospital is a 292-bed not-for-profit health care organization with the primary mission of providing exceptional acute and preventive medical care to all people who live in, work in or visit Westchester County and its surrounding areas. White Plains Hospital has outpatient medical facilities across Westchester, including multispecialty practices in Armonk, Larchmont, New Rochelle, Rye Brook, Somers and Yorktown Heights; and Scarsdale Medical Group locations in Harrison and Scarsdale.

The Hospital is fully accredited by the Joint Commission and in 2023, White Plains Hospital received another 5-star rating from the Centers for Medicare and Medicaid Services (CMS) – the highest distinction offered by that federal agency for the second consecutive year. In addition, the Hospital received its third Magnet® designation from the American Nurses Credentialing Center (ANCC), a distinction held by only two percent of hospitals in the country. White Plains Hospital has consistently received the Outstanding Patient Experience Award from Healthgrades®, and in 2022 became the only Hospital in Westchester to be awarded with an A Safety Grade from the Leapfrog Group for the 9th time.

https://www.wphospital.org/</a

Your Guide to Staying Well in the Winter

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Whether it’s below-freezing temperatures, rising respiratory illnesses or dangerous driving conditions, the winter season can provide unique health challenges. Here’s how you and your family can stay well throughout the season.

Exercise, but with Caution

It’s important to maintain healthy habits, such as a balanced diet and regular exercise, throughout the year. Working out – especially outside – wards off winter weight gain and gives you energy, and there are many enjoyable outdoor activities to choose from, such as ice skating, cross-country skiing or even walking. Just 10 minutes of outdoor aerobic exercise boosts the endorphins, dopamine, and serotonin which improves mood and decreases the risk of seasonal affective disorder.

There are a few things to watch for with outdoor winter workouts, however. One early symptom of hypothermia, or low body temperature, is shivering, which can progress to slurred speech, decreased coordination, and confusion. Frostbite is injury caused by freezing, resulting in the loss of feeling and color of the nose, ears, fingers, and toes. And dehydration is an issue far too many overlook during the winter. The key is to drink water before, during, and after exercise, because while you might not sweat as much in the winter, you are still evaporating water.

Protect Your Heart

While it’s important to stay active, those with heart disease or other risk factors such as high blood pressure, diabetes, a history of smoking, high cholesterol, or a family history of heart disease are advised to avoid shoveling, explains Dr. Gabriela Grasa, cardiologist with White Plains Hospital Physician Associates. Cold weather makes the arteries constrict and increases the blood’s ability to clot. The cold, combined with activity that may increase blood pressure – like shoveling snow and following it with a cup of hot caffeinated coffee to warm up afterward – could trigger a cardiac event.

Upgrade Your Skincare Routine

Lighter moisturizers may not be enough to protect your skin from winter’s harsh conditions, so consider switching to creams, balms or oils, advises Dr. Anisha Kumar, Director of Facial Plastic and Reconstructive Surgery at White Plains Hospital. Look for facial cleansers that say “gentle” and “moisturizing” on the bottle, and avoid those that contain alcohol, as this can dry out your skin. If you have very dry skin, minimize use of exfoliants containing glycolic acid or retinol or use them only every other day. The sun’s UV rays can cause just as much damage to your skin in the winter as in the summer, especially if you are skiing, so it’s important to wear sunscreen every day.

Boost Your Immunity

As we spend more time indoors, the spread of viruses such as the flu, COVID-19 and RSV tends to increase. Consult with your physician about which vaccinations are right for you: a new RSV vaccine is now available for select groups. There are plenty of additional protective measures you can take to boost your immunity, says Dr. Michael Finkelstein, Internal Medicine physician at Scarsdale Medical Group. Wash your hands regularly, avoid smoking, get plenty of sleep, and eat a well-balanced, nutritious diet. Vitamin C, found in most fruits and vegetables, helps heal wounds and repair and maintain healthy bones, teeth, skin and cartilage. Zinc can help control infections by slowing down the immune response and preventing runaway inflammation. Garlic has antibiotic properties that are effective in fighting a range of bacteria, fungi and viruses. However, anyone with a persistent cough, pain or other abnormal symptom should see their physician as soon as possible.

Stay Safe on the Road–and at Home

Winter weather can create hazardous driving conditions, so use caution when driving on snowy, slushy or icy pavement. If you start to skid, take your foot off the gas, then steer in the direction of the skid, so when your wheels regain traction, you don’t have to overcorrect to stay in your lane. Keep an emergency kit in your car that includes a portable cell phone charger, blankets, jumper cables, a flashlight, batteries, a first-aid kit, non-perishable snacks, bottled water and a bag of salt, sand or cat litter for traction.

Heat your home safely by keeping your fireplace and/or furnace well-maintained. Make sure your chimney is in good condition and free of debris before using your fireplace. Have your gas furnace serviced regularly and install a carbon monoxide detector as a secondary safety measure.

The winter needn’t be an overly stressful time–as long as you keep health and safety top of mind. With the right attitude and proper precautions, you and your family can enjoy the best the season has to offer.

Need a physician? Call 914-849-MyMD to find the right provider for your needs.