How to Stand Tall with a Healthy Spine and Back

Posted on by Michael Chananie

The spine is the backbone of human function. It allows us to stand upright, supports our weight, and enables movement. It also protects the spinal cord, which controls mind and body. So what can we do to guard it? Dr. Marc Arginteanu, chief of neurosurgery at Englewood Health, shared his advice.

Who may be at risk for spine and back problems?

Dr. Arginteanu: If you have a family history of scoliosis, you should have your children checked just before puberty. Pediatricians know what to look for in an initial screening. If there is a problem, a child should go for X-rays and then be seen by a spine specialist. Those with spondylolisthesis—where one vertebra slips forward over the next—should also be checked if they have a lot of back pain.

What are some common spine and back issues you see?

Dr. Arginteanu: The most common issue in younger people is a herniated disc in the lower back or neck, which can cause sciatica pain to run down the leg or arm. In older people, the most common issue is stenosis—pinching of the nerves. Stenosis occurs as the joints, spine, and connecting tissue deteriorate over time, crowding the nerves that run through the neck and lower back. It can lead to sciatica and neurogenic claudication (inflammation of the nerves stemming from the spinal cord), limiting walking. It can also cause myelopathy, weakness in the arms and legs.

How can people be proactive about spine and back care?

Dr. Arginteanu: First, maintain a healthy weight. Fat in males tends to be on the belly, which pulls them forward, putting stress on the spine. Second, don’t smoke. Smoking decreases the oxygen that goes to the spinal discs. Third, exercise regularly, staying active 3–5 times a week. Those who do heavy lifting at work should also see if their employers offer a “back class” demonstrating techniques to prevent injury.

With the winter weather and holidays approaching, what should we be aware of?

Dr. Arginteanu: With all the holiday parties, we tend to eat more and exercise less. As you grab a plate, remember that extra weight puts stress on the spine, so make healthy diet choices whenever possible. It’s important to exercise, even when your schedule is busy. Wear appropriate footwear and be careful not to slip on ice. If you fall backward, try to tuck your chin and keep your shoulders, neck, and head up off the ground. Throw your hands and forearms to the ground with palms facing down. Exercise caution before moving someone who’s fallen and has neck pain or weakness in the arms or legs. When in doubt, wait for emergency medical services.

What are the warning signs that a person should seek help?

Dr. Arginteanu: Pain is usually the body’s sign that things aren’t right. But certain conditions like myelopathy can be painless. Progressive weakness or numbness of the arms or legs can indicate a spinal problem—even without spinal pain. Neurogenic claudication can also be painless, but if you have it you may find that you’re able to walk less and less, or experience cramping or weakness in the legs when you do.

Posted September 2018

Ask the Doctor: Dr. Maz Ganat

Posted on by Michael Chananie

Maz Ganat, MD, is program director of urologic oncology at The Lefcourt Family Cancer Treatment and Wellness Center at Englewood Health. He specializes in the diagnosis and treatment of cancers that affect the male and female urinary tract and the male reproductive organs.

My husband absolutely hates going doctors’ appointments, and I’m sure the responsibility of getting him to prostate screenings at the appropriate age will be mine. That being said, at what age should men begin regular prostate exams?

Dr. Ganat: If your husband has an average risk for developing prostate cancer, he should begin prostate exams at age 50–55. If he is at a higher risk for prostate cancer—for example, if he is African-American or has a father or brother who was diagnosed with prostate cancer—he should begin exams at about 45. If he is at even higher risk—meaning multiple first-degree relatives had prostate cancer at a young age—he really should be seen by a doctor by about 40.

If life gets in the way, as it often does, and I miss my cancer screenings, are there any physical symptoms I can look for that would let me know if I have prostate cancer?

Dr. Ganat: Prostate cancer symptoms can vary, and often there are no symptoms in the early stages of the disease (which is why screenings are so important). However, some men may experience difficulty urinating, blood in the urine, bone pain, erectile dysfunction, and discomfort in the pelvic region, typically in the later stages of the disease.

Truth or myth: my father had prostate cancer, so I will, too, someday.

Dr. Ganat: Myth… with this caveat: having a first-degree relative with prostate cancer does increase your chances of getting the disease. However, that does not mean you will definitely get it. You may have a genetic predisposition to developing the disease. Young men who have a father or brother who has had prostate cancer should focus on maintaining a healthy and active lifestyle and consider starting prostate screenings in their early to mid-40s.

Posted September 2018; updated September 2021

First in New Jersey, and One of First in Nation, to Use New Technology for Treatment of Lung Cancer

Posted on by Michael Chananie
The radiation oncology team at Englewood Health administers lung stereotactic body radiation therapy (SBRT) with Varian Calypso® Anchored Beacon® transponders.

August 27, 2018 – The Lefcourt Family Cancer Treatment and Wellness Center at Englewood Health is the first center in New Jersey, and one of the first in the entire nation, to offer lung stereotactic body radiation therapy (SBRT) with Varian Calypso® Anchored Beacon® transponders for lung. The team at Englewood Health has successfully performed this new, more advanced form of radiation therapy on an 83-year-old New Jersey resident with stage 1 lung cancer.

The Calypso system, which was cleared by the FDA in April 2018, is the only device on the market that delivers real-time, 3D tumor position information 25 times per second, improving confidence that the prescribed dose has been delivered to the tumor.

Originally introduced for the treatment of prostate cancer, the Calypso system uses transponders, each the size of a grain of rice. These transponders are inserted into and around the lung tumor and are used to continuously track the exact location of the tumor during treatment. This allows for previously unachievable levels of precision and accuracy, enabling better tumor targeting and sparing of nearby healthy tissue.

David Dubin, MD, chief of radiation oncology at Englewood Health, explains that “SBRT is a relatively new method of delivering very high doses to small, targeted areas. In lung, this is especially challenging as the target naturally moves as the patient breathes.”

“Calypso is like a real-time GPS of the target, which is exceptionally powerful for lung treatments,” Michael Speiser, Ph.D., chief physicist at Englewood Health, said of the Calypso system. “Restricting dose to the target and sparing healthy tissue requires that you know where the target is, and Calypso lets us track the tumor with sub-millimeter precision.”

“Here at the Lefcourt Family Cancer Treatment and Wellness Center at Englewood Health, we have been successfully performing SBRT for multiple sites for years,” says Dr. Dubin. “However, not all SBRT is equal. This new technique provides a clear improvement in accuracy that is not otherwise achievable.”

Bergen Neurology Consultants Joins Englewood Health Physician Network

Posted on by Michael Chananie

August 17, 2018 – Bergen Neurology Consultants, a group of eight neurologists specializing in all areas of brain, spine, and nerve disease, has joined the Englewood Health Physician Network. The group—Gary Alweiss, MD; Yun-Beom Choi, MD, PhD; Lauren DeNiro, MD; James Ko, MD; Kirk Levy, MD; Sepideh Akbaripanahi, MD; Rikki Racela, MD; and Jamuna Rajasingham, MD—has been located in Englewood for more than 25 years and the physicians are members of the medical staff at Englewood Hospital, part of Englewood Health. As part of the Englewood Health Physician Network, Bergen Neurology Consultants offers patients a more integrated care experience through a shared electronic health record and greater collaboration and coordination of care with other specialists in the network and at Englewood Hospital.

Led by Gary S. Alweiss, MD, Englewood Hospital’s chief of neurology, Bergen Neurology Consultants specializes in diagnosing and treating a full range of neurological conditions including Alzheimer’s disease, concussion, dementia, epilepsy, migraines, movement disorders, multiple sclerosis, neuromuscular diseases, stroke, spine disorders including back and neck pain, and sleep disorders. Using innovative techniques, the team provides up-to-date diagnostics and treatments including EMG and nerve conduction studies, Neurotrax™ testing for concussion and cognitive disorders, ambulatory EEG, sleep studies, Botox® injections for migraine and dystonia, CPAP, and other specialized treatments.

“Our physicians are highly compassionate in treating some of the most difficult diseases. Each of the neurologists in the practice has an area of expertise and specialized clinical interests,” said Dr. Alweiss. “Members of our team also serve in various roles throughout Englewood Hospital, including providing medical direction for the certified Stroke Center, the Center for Sleep Medicine, the Intensive Care Unit, The Lefcourt Family Cancer Treatment and Wellness Center, and for the Department of Neurology as a whole.”

“Patients with complex neurological diseases often have co-existing conditions,” said Dr. Alweiss. “By sharing a medical record and improved communications systems, we can work together to enhance care for our patients.”

Additionally, Dr. Ko, a neurologist and sleep medicine specialist who has been in private practice in Englewood and a member of the medical staff at Englewood Hospital for over 10 years, has joined Bergen Neurology Consultants and the Englewood Health Physician Network. Dr. Akbaripanahi, a general neurologist who recently completed her residency at the University of Maryland School of Medicine, also joins the team.

Bergen Neurology Consultants is located at 25 Rockwood Place in Englewood, New Jersey. Dr. Ko sees patients at 177 North Dean Street. The staff speak multiple languages including Korean, Polish, and Spanish and accept a full range of insurance plans.

To reach Bergen Neurology Consultants or to find an Englewood Health physician, visit englewoodhealthphysicians.org or call 833-234-2234.

Dr. Maz Ganat Appointed Program Director of Urologic Oncology

Posted on by Michael Chananie

August 3, 2018 – Dr. Maz Ganat has been named program director of urologic oncology at The Lefcourt Family Cancer Treatment and Wellness Center at Englewood Health. Dr. Ganat completed a two-year fellowship in urologic oncology at Memorial Sloan Kettering Cancer Center (MSKCC), where he received an outstanding clinical performance award and additionally achieved a Responsible Conduct of Research Program certificate. Most recently, Dr. Ganat was a member of a basic science research lab at MSKCC that focuses on translational research in kidney cancer with the ultimate goal of using precision medicine for metastatic kidney cancer.

A urologic surgeon who practices general urology and specializes in urologic oncology, Dr. Ganat will help meet an important clinical need for patients in the Englewood Health Physician Network and broader Englewood Health community.

“With a growing population of individuals diagnosed with cancer in our region, Dr. Ganat adds to an already superb base of physicians who have put our cancer center in a position to not only meet, but exceed expectations and deliver the highest possible standard of care,” says Dr. Steven Brower, medical director of The Lefcourt Family Cancer Treatment and Wellness Center at Englewood Health.

Dr. Ganat specializes in the diagnosis and treatment of cancers of the prostate, bladder, kidney, testis, and penis. He performs robotic surgery, laparoscopic and open urologic procedures, and MRI ultrasound fusion biopsies, which superimposes MRI images with real-time ultrasound images to produce a 3D image of suspicious areas which leads to a more accurate biopsy of the prostate.

“As we continue to expand the Englewood Health Physician Network and focus on providing complete and personalized cancer care for our community, we are thrilled to have Dr. Ganat join the Englewood family,” says Dr. Stephen Brunnquell, president of the Englewood Health Physician Network. “His expertise in urology, and urologic oncology are great additions to the growing number of specialists and primary care physicians in our network who are dedicated to helping patients make choices that will best serve their health.”

In addition to English, Dr. Ganat is fluent in Farsi and has a working knowledge of Spanish.

For appointments and referrals, call 201-608-2849.

 

This post was updated in January 2020 to reflect a legal name change.

Cirrhosis and Liver Cancer Rates on the Rise – What You Need to Know

Posted on by Michael Chananie

A recent study published in the British Medical Journal found that deaths from liver disease have increased significantly in the United States over the past two decades. Deaths related to cirrhosis (inflammation of the liver that leads to scarring and malfunction) have risen 65 percent since 1999, with the largest affected population being people ages 25 to 34. The study suggests that the disproportionate rise in cirrhosis among millennials may be the result of alcohol misuse and abuse.

“When my 40-year-old patients tell me they drink socially, it means a totally different thing from when my 20-something patients tell me they drink socially,” said Matthew Blaszka, MD, gastroenterologist, Englewood Health Physician Network.

According to Dr. Blaszka, the millennial generation suffers from a misunderstanding of what constitutes tempered, social drinking and what would be classified as binge drinking and alcohol abuse. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as five or more drinks for a man, and four or more drinks for a woman, in the span of two hours.

“Social drinking for my 40-year-old patients means two glasses of wine every other Saturday, while social drinking for my younger patients often means drinking to the point of intoxication or even blacking out,” said Dr. Blaszka.

A common misconception is that it takes decades of heavy, daily drinking to develop cirrhosis, when in reality it can take less than a decade and doesn’t require a daily drinking routine. Dr. Blaszka is convinced that this is why we need to begin educating children about alcohol much earlier.

“When does social alcohol use begin? In high school. So we have to intercept kids with alcohol education before they are presented with the opportunity to drink. We’ve done a good job of educating people on the dangers of smoking. We’ve got advertisements on TV and campaigns to stigmatize and end smoking – yet alcohol continues to be glorified,” said Dr. Blaszka.

However, Dr. Blaszka does not attribute the rise of liver disease to alcohol use alone. Factors like obesity and the presence of conditions like hepatitis C may also play a role.

“As the American population becomes heavier and obesity is on the rise,” said Dr. Blaszka, “so is something called fatty liver disease. Fatty liver disease, like other conditions involving liver inflammation, can eventually cause cirrhosis. Alone, this can take decades, but combined with heavy alcohol consumption, the process speeds up quite a bit.”

The cirrhosis that results from fatty liver disease or alcohol abuse can lead to liver cancer, which – no surprise – is also on the rise.

“What we’re also seeing, particularly among baby boomers,” said Dr. Blaszka, “is undiagnosed cases of hepatitis C, which is also associated with a higher risk of liver cancer.” The presence of hepatitis C among baby boomers, he added, is an issue that everyone should be made aware of, as there are antiviral medications that can treat hepatitis C and prevent cirrhosis.

According to the study, there was an “inflection point” in about 2009, when the rate of cirrhosis-related deaths began to increase 10.9 percent each year through 2016. The study suggests that the timing of this sudden increase might correlate with the economic crisis that began around the same time. The implication is that factors such as unemployment and financial strain may have turned many Americans to alcohol as a means of stress relief.

When it comes to this theory, however, Dr. Blaszka is not entirely convinced. “I’m hesitant to place all of the responsibility on the recession,” he said. “My feeling is that what we’re seeing is a lot of comorbid conditions such has fatty liver, untreated hepatitis C, and a lack of education about alcohol. Why none of this occurred before 2009 is unclear at this point.”

When asked how much alcohol intake is too much, Dr. Blaszka said there is no hard and fast rule. Everyone’s relationship and response to alcohol is different, based on a number of factors such as weight, gender, and individual biology. Dr. Blaszka typically tells his patients that if they think they might be drinking too much, they probably are.

“The good news is that cirrhosis caused by alcohol abuse is a reversible condition,” said Dr. Blaszka. “As soon as you stop drinking and stop introducing the insult to the body, your liver can quickly normalize. It is a uniquely regenerative organ – the scarring can reverse, and patients can go back to having a normal, healthy liver.”

Posted August 2, 2018

Wheelchairs Facilitate Accessibility for bergenPAC Patrons

Posted on by Michael Chananie
Wheelchairs for bergenPAC Patrons
Marc Farrand (far left), on behalf of bergenPAC accepts four donated wheelchairs from Englewood Health. Pictured from left to right, Marc Farrand, bergenPAC, Ernie Cantos and Richard Sposa, Englewood Health.

 
August 2, 2018 – Englewood Health recently donated four wheelchairs to the Bergen Performing Arts Center (bergenPAC), in Englewood, New Jersey to help ticketholders with physical limitations navigate the facility and provide them with necessary accommodations before, during, and after show times.

“When people come to see a show, we want them to enjoy the performance and leave the theater having had the best possible experience,” said bergenPAC president and CEO Dominic Roncace. “We thank the team at Englewood Health for once again ensuring that we have the tools and equipment to provide a safe, healthy environment for everyone who passes through our doors.”

New Artificial Heart Valve Offers Younger Patients More Options

Posted on by Keri Flaccomio

INSPIRIS RESILIA aortic valve - inside view
 
June 27, 2018 – Surgeons at Englewood Health performed the first INSPIRIS implant for aortic valve replacement in New Jersey, following U.S. Food and Drug Administration (FDA) approval for the valve, which is made by Edwards Lifesciences Corporation, a patient-focused medical innovator for structural heart disease. The artificial valve is made of pericardial tissue from cows and has two distinct advantages. First, early indicators show anti-calcification properties will make it more durable and longer lasting than existing valves. Second, the valve’s frame has built-in joints, making it expandable and facilitating any future re-replacement that may be necessary; through a minimally invasive or percutaneous procedure, a larger valve can be placed inside the deteriorating valve.

“In years past, aortic valve replacement typically substituted a mechanical valve for the damaged valve, requiring recipients to be on blood thinners for the rest of their lives,” says Adam Arnofsky, MD, cardiothoracic surgeon at Englewood Health who performed the first procedure in the state. “INSPIRIS has the potential to be a game changer for patients under the age of 70.”

“This is the perfect valve for a young patient who needs an aortic valve replacement and wants to avoid long-term anticoagulation,” he said. “You’re strategizing for life—better durability of the valve and the ability to place a large valve inside this one if it deteriorates over time. This can really set a younger patient up for lifelong aortic valve health while avoiding anticoagulation medication, which can lead to bleeding and clotting complications.”

Englewood Health’s first patient to receive the implant was a physically fit 53-year-old male who, aside from having a damaged aortic valve, was otherwise healthy. Englewood Health’s cardiothoracic surgery team, a leader in cardiac outcomes, clinical research and early adopters of the most beneficial treatment options for heart patients, is subsequently incorporating the INSPIRIS valve into its decision-making process when evaluating patients preoperatively.

Dr. Arnofsky says this innovation is just one of many new and exciting cardiovascular advancements underway at Englewood Health.

For more information, visit englewoodhealth.org/heart.

Comprehensive Joint Replacement Program Reports Excellent Results

Posted on by Michael Chananie

For the majority of patients, general musculoskeletal injuries take about six to eight weeks to heal. But proper pre- and post-operative orthopedic care can significantly expedite the healing process. Over the past five years, Englewood Health has taken significant steps to improve quality of life, minimize pain, and maximize mobility for patients needing a hip or knee replacement or spinal surgery. To achieve these goals, the health system, comprising Englewood Hospital and the Englewood Physician Health Network, has committed to an interdisciplinary approach.

In 2016, Englewood Health launched the Comprehensive Joint Replacement Program, a Medicare-initiated care model that supports better and more efficient care for patients undergoing hip and knee replacements, the most common inpatient surgeries for Medicare beneficiaries. Bringing together representatives from 15 disciplines, the model encourages hospitals, physicians, and post-acute care providers to work together to improve the quality, safety, and coordination of care from pre-surgical assessments to hospitalization and through recovery.

“Within 18 months of the program’s inception, the number of patients discharged from the hospital directly to their homes increased from 15 percent to 56 percent,” said Stephen Brunnquell, MD, president of Englewood Health Physician Network. “In the second year of the program, our complication rate was zero percent.”

The Joint Commission Gold SealIn the same year, Englewood Health earned recertification by The Joint Commission for total hip and total knee replacement, and became the only hospital in New Jersey to be Joint Commission-certified in spinal fusion. Englewood Hospital also expanded its main operating room with four new state-of-the-art operating rooms dedicated to orthopedic and neurological surgery. The rooms include advanced imaging tools, digital technology, and other features to support patient safety and high-quality care.

Asit Shah, MD, PhD, chief of orthopedics at Englewood Health, said his team is constantly following the latest improvements in engineering. “Robotics are making their way into orthopedic surgery more and more,” he said. “And technology is constantly enhancing in-office optics and diagnostics. We can now insert an 18-gauge needle into the knee and do an arthroscopy in the office—without anesthesia—instead of going into the operating room. There are also new materials being introduced. Components like bond materials and artificial cartilage are definitely enhancing.”

In addition, Englewood Health is focusing on minimizing the use of medication for pain management by incorporating services such as acupuncture, therapeutic massage, and yoga into the patient recovery process through its Graf Center for Integrative Medicine.

Posted July 9, 2018