Read our Winter 2017 issue of Healthy Directions, a quarterly publication by CentraState Healthcare System.

1. WINTER 2017
www.centrastate.com
Advancing
Cancer Care
With Powerful
New Therapies
page 4
ALSO IN THIS ISSUE:
Why More People
Are Surviving Cancer
page 3
One-of-a-Kind Treatment for
Abdominal Aortic Aneurysms
page 6
ECT: A Viable Treatment
for Severe Depression
page 13
Memory Screenings are an Important
Component of Brain Health
page 14

2. New CentraState
Chief of Staff
W
e are proud to announce that Michael Greller, MD, has been
elected to a two-year term as chief of staff by the Medical and
Dental Staff of CentraState Medical Center. He replaces outgoing
chief of staff Moustafa Shafey, MD.
As part of the overall medical management team, the chief of staff serves
as a key liaison between the hospital’s physicians and leadership. The chief
of staff represents the Medical and Dental Staff and works directly with the
hospital president to address topics of mutual interest while helping to ensure
high-quality, integrated care.
“We greatly appreciate Dr. Shafey’s collaborative leadership as chief of
staff over the past two years,” says John T. Gribbin, FACHE, president and
CEO of CentraState Healthcare System. “As we welcome Dr. Greller to this
position, I am confident that his expertise will enhance our strategic planning
and quality care efforts.”
Dr. Greller is a board-certified, fellowship-trained orthopedic surgeon
and president of Advanced Orthopedics and Sports Medicine Institute in
Freehold. He is a member of the CentraState Healthcare System’s Board
of Trustees and has been a member of the CentraState Medical Center staff
since 2000. He has served as chairman of credentials and vice chairman of
the Department of Orthopedic Surgery. He is also a fellow of the American
Academy of Orthopedic Surgeons.
Dr. Greller earned his medical degree from Albert Einstein College of
Medicine in New York. He completed his residency in orthopedic surgery
at the Hospital for Joint Disease Orthopedic Institute - NYU Medical Center,
and a fellowship in sports medicine at Temple University in Philadelphia.
John T. Gribbin, FACHE
President and CEO
This issue of Healthy Directions
marks a refined focus and
fresh look for the publication,
with an emphasis on CentraState’s
plentiful programs, treatment options,
and leading-edge technology.
As the new year starts and we embrace new
beginnings, it is also an ideal time to reflect on
our progress. Over the past year, CentraState
received many accreditations and recognitions,
such as the elite 4-star quality rating from the
Centers for Medicare & Medicaid Services. We also
achieved several medical milestones, participated
in groundbreaking clinical trials, opened new
facilities such as CentraState Health Pavilion at
East Windsor, and continued to expand treatment
options for our patients.
Cancer care at CentraState is a great example
of our progress. Our cancer care services are led by
a team of renowned specialists who are initiating
effective new treatments and clinical trials right
here at our Statesir Cancer Center. As you’ll read
in these pages, several of these industry-leading
technologies and therapies are available at only a
handful of hospitals throughout the country, and
they are making a true difference in the lives of our
patients. Patients undergoing cancer treatment
here can be fully confident that they are receiving
the most advanced care with compassionate
physicians who are leaders in their field.
The future is bright for CentraState, and we
hope that the new approach for Healthy Directions
helps reinforce our promise to provide the highest
quality care to people throughout our region.
PRESIDENT’S MESSAGE
Dr. Moustafa ShafeyDr. Michael Greller
Healthy Directions is produced by CentraState Healthcare System, Freehold, New Jersey.
Please note that physicians on staff are private practitioners and not employed by CentraState.
We hope you enjoy this issue of Healthy Directions. Comments about the publication can be directed to the Public Relations and Marketing Department, CentraState Healthcare System, 901 West Main Street,
Freehold, NJ, 07728. (732) 294-7080. Healthy Directions is published by CentraState Healthcare System to provide general health information. It is not intended to provide personal medical advice, which should
be obtained directly from a health care provider.
EDITORIAL ADVISORS
Stephen G. Perrella, Esq.
Chair, Board of Trustees
John T. Gribbin, FACHE
President and CEO
Thomas W. Scott, FACHE, FABC
Senior Vice President and COO
Vincent L. D’Elia
Vice President, Marketing & Public Relations
Jack H. Dworkin, MD, FACC
Vice President and Chief Medical Officer
Linda W. Geisler, RN, MNEd, NEA-BC, FACHE
Vice President, Patient Care Services
Kim A. Kelly, RN, MS, NEA-BC, FACHE
Vice President, Clinical Services
Abbey M. Luterick
Director, Public Relations and Communications
EDITOR—CENTRASTATE
Brian Johnson
WINTER 2017 www.centrastate.com

3. Why More People Are
SURVIVING CANCER
By Bhavesh Balar, MD
O
ver the past few years, the cancer community has been encouraged
that our ability to fight cancer seems to improve by the day. In fact, the
American Cancer Society reports that from 1991 to 2012 (the most current
data available), the combined cancer death rate for men and women decreased a
remarkable 23 percent.
There are more than 100 types of cancer, so it’s difficult to pinpoint the exact
reasons for this decline. However, several factors have certainly had a major impact.
Cancer is most treatable when it is detected at an early stage. Advances in
mammography, including new 3-D mammograms, allow us to detect more cases
of breast cancer earlier. Similarly, studies have shown that longtime smokers
can benefit from lung cancer screenings with low-dose computed tomography
(CT scans). The scans can detect small tumors that are often not visible on
conventional X-rays, allowing lung cancer to be treated earlier.
Advanced Treatments that Make a Difference
Traditionally, chemotherapy drugs have acted on the entire body, attacking
cancer but with the potential of causing injury to healthy tissue. Newer types of
chemotherapy target specific types of cancer based on genetic mutations, without
harming normal cells.
Better surgical techniques and radiation therapy have certainly contributed
to the decline in cancer deaths. Techniques such as robotic surgery and intensity-
modulated radiation therapy (IMRT) allow even more precise destruction of tumors.
Some of the most exciting recent advances have come in the area of immunotherapy,
which helps the body’s own immune system destroy cancer cells. In essence, it turns off
a tumor’s ability to protect itself, allowing the immune system to attack cancer as it would
any infection, like a common cold.
In addition to better treatments, we’ve made great strides in addressing problems that
make cancer care more difficult. Advances in techniques for pain control, for example, can
significantly improve a patient’s ability to tolerate cancer treatments.
I also believe that a greater overall awareness of good heath has played a role in the decline
in cancer deaths. For example, we’re making historic progress in stamping out cigarette
smoking. The smoking rates among U.S. adults dropped from 25.5 percent in 1990 to
16.8 percent in 2014, a decline that almost certainly has had an impact on lung cancer deaths.
While the fight against cancer is likely to continue throughout our lifetimes, we are
more hopeful than ever that the positive trends we’ve seen in cancer survival will continue. •
Dr. Bhavesh Balar is a board-certified hematologist and oncologist on staff
at CentraState Medical Center, where he serves as chairman of the hospital’s
Cancer Committee. He is also a medical director at Regional Cancer Care
Associates in New Jersey.
For more information about CentraState’s cancer services, visit
www.centrastate.com/cancer or call 855-411-CANCER (855-411-2262).
GETTING
SCREENED COULD
SAVE YOUR LIFE
For a complete list of
upcoming health screenings, visit
www.centrastate.com/events
or call 732-308-0570.
WINTER 2017 www.centrastate.com
3

4. ADVANCING COMMUNITY
Removing Colorectal Cancer with Robotics
Our colorectal cancer specialists were the first in Monmouth and
Ocean counties to perform robotic surgery for colorectal cancer.
Using the da Vinci®
Surgical System , also known as a robotic
surgery system, surgeons work through the arms of a robot to
perform delicate and complex surgery through four tiny incisions.
This minimally invasive approach offers exceptional control, range
of motion, and visibility. Compared with traditional open surgery,
patients undergoing robotic surgery may recover faster, have less
pain and scarring, and often have reduced blood loss.
Removing Lung Cancer through
Tiny Incisions
As an alternative to open-chest surgery, lung cancer specialists
at CentraState are using VATS (video-assisted thoracic surgery)
to remove lung tumors through tiny incisions made between the
ribs. Our thoracic surgeons helped pioneer VATS, and have since
performed more than 7,500 of these minimally invasive surgeries.
The procedure can be used to conduct complex surgeries inside
the chest, including removing diseased sections of the lung with
minimal impact on the ribs and chest wall muscles. This greatly
reduces post-surgery recovery time, pain, and bleeding compared
with open-chest surgery, and most patients can return home
within one or two days.
Sparing Healthy Tissue in
Prostate Cancer Treatment
After a 15-month clinical trial conducted at CentraState led to
FDA approval of a special hydrogel known as SpaceOAR (Organs
at Risk), CentraState recently became one of the first hospitals in
the country to offer it to prostate cancer patients. Administered on
an outpatient basis, this “spacer” hydrogel is injected between the
prostate and the rectum. It serves as a barrier near the rectum to
greatly diminish the exposure of radiation to this critical organ. In
about three months, this harmless gel liquefies and is eventually
eliminated from the body through the patient’s urine.
CentraState is advancing community-based cancer care through clinical
trials, pioneering procedures, and industry-leading technologies now
available to patients throughout our region.
4

5. For more information about cancer services
at the Statesir Cancer Center at CentraState,
visit www.centrastate.com/breakthroughs
or call 855-411-CANCER (855-411-2262).
Y-BASED CANCER CARE
Targeting Tumors with Precision
Working with ProCure Proton Treatment Centers and
Princeton Radiation Oncology, CentraState helped bring
the first proton therapy center to the New Jersey/New
York region. This advanced form of radiation therapy
aims protons directly at cancerous tumors to stop the
growth of cancer cells and ultimately destroy them. It also
minimizes exposure to surrounding tissue. The painless,
targeted therapy helps prevent harmful side effects while
treating cancer in a powerful way.
Treating Skin Cancer without Surgery
Brachytherapy is a new, nonsurgical treatment option
for patients with basal and squamous cell carcinomas,
particularly in highly visible areas such as the face, where
scarring is a concern. Our radiation oncology team uses
a special applicator placed directly onto the cancer site
to deliver radiation. The technique enables physicians
to concentrate a high dose of radiation in a very specific
area to destroy the cancer cells. Compared to skin cancer
surgery, this minimizes potential side effects and greatly
improves the cosmetic outcome. •
Nonsurgical
Skin Cancer
Treatment Takes
Scarring Out of the Picture
When Alyce McKinleywas diagnosed with basal
cell carcinoma in a prominent area on her nose, she
was apprehensive about having it surgically removed.
While this traditional approach, called Mohs surgery,
is very effective, it would likely result in scarring that
would require plastic surgery.
“If the cancer was on my back or arm, scarring wouldn’t
have been an issue,” says Alyce. “But this was right out there
on the tip of my nose, and I needed to know if there was a
better option.”
Her search led the 78-year-old Freehold
resident to Edward Soffen, MD, a board-
certified radiation oncologist with Princeton
Radiation Oncology and medical director
of the Radiation Oncology Department at
CentraState’s Karen Olbis Radiation Oncology
Center. After examining Alyce, he told her that she was a
perfect candidate for skin brachytherapy.
Alyce received seven skin brachytherapy outpatient
treatments over the course of about two weeks at the Statesir
Cancer Center at CentraState. The radiation delivery time for
each session was only about three minutes. According to
Dr. Soffen, the cosmetic outcome is superb following some
initial redness and healing at the area of application, and
Alyce’s prognosis is outstanding.
“The team there was so calming and the healing
progressed exactly the way Dr. Soffen said it would,”
adds Alyce. “I’m completely relieved, and I’m thoroughly
convinced that this was the way to go.” •
WINTER 2017 www.centrastate.com
5

6. ONE-OF-A-KIND
TREATMENT for
Abdominal Aortic
Aneurysms
Dee Nemeth had rarely been sick
in his life, so it was unusual when the
75-year-old Freehold resident began
experiencing bloating last fall. After
seeking care at a health clinic, he
was sent to CentraState’s Emergency
Department for a potential gall bladder
issue. There, he was diagnosed with a
more complex problem: He had several
large abdominal aortic aneurysms.
An abdominal aortic aneurysm
is a weak, bulging area in the aorta,
the body’s largest artery that carries
blood from the heart to the rest of the
body. Aneurysms can rupture, which
is fatal in about 80 percent of patients
who have this complication.

7. Minimally Invasive Repair Had Limitations
Many abdominal aortic aneurysms can be corrected with minimally invasive
endovascular repair (EVAR), which involves inserting a stent graft (a synthetic tube-like
device) into the femoral artery in the groin and guiding it to the damaged area of the
blood vessel in the abdomen. The stent graft relines the blood vessel so that it can absorb
the force of each heartbeat instead of the weakened artery. But in some patients, the
aneurysm may be too close to other important arteries to make this procedure possible.
Dee was one of these patients. His large aneurysms were in risky locations—one
was next to his renal arteries that branch out to the kidneys, and another was close to
the iliac arteries that branch down into the pelvis.
“Major abdominal surgery was once required for patients with these
complex abdominal aortic aneurysms, because blood flow would be cut
off to important organs if EVAR were performed,” says Tushar Tripathi,
MD, a board-certified vascular surgeon on staff at CentraState. “If the
renal arteries lost blood flow during the procedure, the patient would
need dialysis for the rest of his life. Likewise, cutting off blood flow to the pelvic area
would result in impotence. Fortunately, we now have newer minimally invasive options.”
Introducing New Custom-Made Options
Dr. Tripathi is the only surgeon in Monmouth and Ocean counties who is
performing a new minimally invasive procedure called fenestrated endovascular aortic
repair (FEVAR) for complex abdominal aortic aneurysms located near the renal arteries.
He is also one of only a handful of surgeons in the region performing the iliac branch
endograft repair for abdominal aortic aneurysms near the iliac arteries. Both procedures
require extensive experience along with special training by the stent graft manufacturers.
FEVAR uses a fenestrated endograft, which means it has holes that Dr. Tripathi
precisely aligns with the renal arteries that branch off the aorta. He can then connect
smaller stent grafts to the aortic branches, allowing continuous blood flow to the kidneys.
The fenestrated stent graft is custom made to the precise size of the individual patient’s
aorta using CT scanning with 3-D modeling prior to the aneurysm repair. Similarly, the
pants-shaped iliac branch endograft is custom made, enabling it to fit the iliac branch
arteries and preserve blood flow to the pelvic area.
Dee was happy to have these new minimally invasive options, or he may have
chosen to forego surgery entirely, despite the risk of rupture. When he was being
measured for his custom stent grafts, Dr. Tripathi walked him through the entire
process and answered his questions.
“That initial measurement gave me 100 percent confidence in Dr. Tripathi,” Dee
says. “He had a positive attitude right from the beginning. Plus, my wife, Barbara, was
very happy that I would no longer be walking around at risk.”
Home the Next Day
FEVAR and the iliac branch repair are performed in the Cardiac and Endovascular
Lab at CentraState, and they offer a number of significant benefits over traditional open
surgery, including a shorter hospital stay, fewer complications and risks, and a faster
recovery time. In fact, Dee was able to return home the day after his surgery.
“I was shocked at how easy the recovery was, especially for something that complex,”
Dee adds. “I had two band-aids on a small incision, and that was it. As Barbara says, it’s
great to know we have this level of expertise right here in our hometown.” •
What Are the
RISK FACTORS
for Abdominal
Aortic Aneurysms?
Abdominal aortic aneurysms
often don’t cause any symptoms,
so it’s important to know the risk
factors. They include:
• Being over age 60
• Being male
• Family history of aneurysms
• High blood pressure
• Atherosclerosis (hardening
of the arteries)
• Smoking
Patients who experience a
throbbing feeling in the stomach
or deep pain in the lower back
or side of the abdomen, or those
who have a family history of
aneurysm, should consult with
their physician about their risk.
For more information about
fenestrated endovascular aortic
aneurysm repair (FEVAR), iliac
branch repair, or other endovascular
interventions at CentraState’s
Cardiac and Endovascular Lab, call
866-CENTRA7 (866-236-8727).
WINTER 2017 www.centrastate.com
7

8. They are among 516 U.S. physician practices selected for this randomized controlled trial,
which is designed to lower heart disease risk in people across the country. It is open to Medicare
fee-for-service beneficiaries who meet certain criteria, including being between ages 40 and 79
with no history of heart attack, stroke, or end-stage renal disease. The program is part of the
Million Hearts®
initiative, which has brought together organizations nationwide in an effort to
prevent one million heart attacks and strokes over five years.
“This program will expand our efforts to prevent cardiovascular disease through more formal
risk assessments and specific prevention interventions,” says Robert Pedowitz, DO, a board-
certified osteopathic family physician and the medical director of Family Practice of CentraState.
“We use a heart disease risk calculator to predict a patient’s individual risk for heart disease and
stroke over the next 10 years. If patients have more than 30 percent probability, we’ll work with
them to identify the best next steps to reducing their risk.”
The risk reduction program is expected to reach more than 3.3 million patients throughout
the country by its conclusion in August 2021. •
Family Practice Physicians Selected for
Million Hearts Risk Reduction Program
For more information about Family Practice of CentraState or other CentraState physicians
who are part of a PCMH, call 866-CENTRA7 (866-236-8727).
For more information about CentraState’s cardiology services or to learn if you’re eligible
for the Million Hearts trial, call 866-CENTRA7 (866-236-8727).
Family Practice of CentraState and Marc Feingold, MD, a CentraState family medicine physician
based in Manalapan, were recently chosen by the Centers for Medicare & Medicaid Services to
participate in the Million Hearts®
Cardiovascular Disease Risk Reduction Model.
Dr. Marc Feingold Dr. Robert Pedowitz
Dr. Cristina Ignacio
Coordinating Care with Patient-Centered
Medical Home Programs
F
amily Practice of CentraState has achieved Level 3 Recognition as a patient-
centered medical home (PCMH) from the National Committee for Quality Assurance
(NCQA), which is the highest achievable level for a PCMH. A PCMH is a health care
model that coordinates treatment through a primary care physician to ensure patients
receive any necessary care when and where they need it. The goal is to empower patients
to communicate more with their physicians and to take control of their health.
Being recognized as a Level 3 PCMH means that a practice has met or exceeded specific
standards of the NCQA, including those related to access, data, care management, population
management, tracking, and continuous quality improvement.
“A PCMH provides better access to personalized care, while taking advantage of technology to gather
information from different specialists and facilities involved in a patient’s care,” explains Cristina Ignacio,
MD, a board-certified physician specializing in family medicine and preventive care with Family Practice
of CentraState. “We believe that the patient is the center of the team, and we’re committed to using that
approach to improve the health care experience.” •
WINTER 2017 www.centrastate.com
8

9. “I was frequently uncomfortable, especially after certain meals,”
says Doris, an 85-year-old grandmother of two from Marlboro.
“I went through life day by day, but I had to say, ‘excuse me!’ a lot.”
At the recommendation of a friend, she met with Heenal Vora, RDN,
a registered dietitian nutritionist at CentraState Medical Center, to see
whether her problems might be related to her eating habits. Heenal
suggested trying a relatively new approach to helping people with chronic
gastrointestinal discomfort: the FODMAP elimination diet . FODMAP is an
acronym for fermentable, oligosaccharides, disaccharides, monosaccharides
and polyols—a group of carbohydrates (sugars and fibers) found in certain
foods and beverages.
“Many people can eat FODMAP foods without any problem, but in certain
individuals they can cause symptoms ranging from cramping to diarrhea,”
Heenal says. “People who have these symptoms cannot absorb nutrients
from these particular food items.”
Trial and Error
During a six-week trial, Heenal first had Doris eliminate all FODMAP
foods from her diet for two weeks. Next, Doris introduced a new FODMAP
food into her diet for a few days, recording what she ate and whether she had
any symptoms. She then would eliminate that food, wait a few days, and try
other foods from a different FODMAP group.
By the end of the trial, Doris had identified a number of foods that
she couldn’t eat without discomfort, including beans and broccoli. She
also found that some foods she suspected as triggers were actually fine if
prepared differently. For example, onions were a problem, but not when
they were cooked.
“Doris now knows very well what foods trigger certain symptoms
for her,” Heenal says. “The FODMAP elimination diet takes time, patience,
and effort, including shopping strategies like reading food labels. We did
it together, and it worked.”
The FODMAP approach may also benefit people with gastrointestinal
conditions such as irritable bowel syndrome (IBS), according to Heenal.
The diet doesn’t mean you have to eliminate a food forever; you just have
to understand how it affects your body, she adds.
“I’ve had problems for a long time, and I’m happy to have finally
found some relief,” says Doris, a retired schoolteacher. “The program was
wonderful, and Heenal was very understanding and gave me good tips.” •
Solving Abdominal Distress Through Diet
After consulting with doctors and doing her own research for years, Doris Rickles was still unable
to find relief for her chronic bouts of gas, bloating, and other abdominal symptoms.
FODMAP-FRIENDLY
RECIPES
Following an elimination diet like FODMAP
can make it challenging to find adequate recipes
that stick to your dietary needs and avoid trigger
ingredients. Adhering to the guidelines set by
your nutritionist is vital to your success with
this diet, but to help with your meal planning,
we’ve compiled a few FODMAP-friendly recipes
on our website that should taste great while
conforming to your plan. Find these recipes at
www.centrastate.com/recipes.
For more information about CentraState’s specialized dietary and
nutrition services, visit www.centrastate.com/healthylife or
call 866-CENTRA7 (866-236-8727).
WINTER 2017 www.centrastate.com
9

10. I
f you have diabetes—type 1, type 2, gestational, or prediabetes—getting
up from your couch or desk chair for some light-intensity physical
activity can help you manage your blood sugar.
Within updated guidelines for regular physical exercise that for the first
time address people with all types of diabetes, the American Diabetes
Association (ADA) recommends that patients reduce sedentary time
(awake time that involves prolonged sitting) by engaging in three or more
minutes of light-intensity physical activity every half hour. These activities
are easy and can even be performed near job stations.
Examples suggested by the ADA include:
• Leg lifts or extensions
• Overhead arm stretches
• Desk chair swivels
• Torso twists
• Side lunges
• Walking in place
“Even simple motions help patients improve cardiovascular health,
enhance blood glucose management, and reduce insulin sensitivity,”
says board-certified endocrinologist Kenneth Ordene, MD, chairman of
endocrinology and medical director of the Novo Nordisk Diabetes Center
at CentraState. “People who do not have diabetes also benefit from getting
up every 30 minutes to take a three-minute physical fitness break. These
activities have the added benefits of increasing metabolic rate, reducing
joint stiffness, and improving muscle tone.”
The ADA’s guidelines are based on the latest diabetes research and
the expertise of leaders in the fields of diabetes and exercise physiology
throughout the U.S., Canada, and Australia. The guidelines add that these
light-intensity activities should be completed in addition to regular exercise
of at least 30 minutes each day, which may include walking, resistance
training, aerobic exercise, or balance training.
Dr. Ordene notes that wearable technology, smart
watches, or phone apps that alert patients to get up and
move or track their steps throughout the day can be a fun
source of motivation. “My patients enjoy using these to
work toward their fitness goals,” he adds. •
Get Up andMove!
New Exercise Guidelines for People with Diabetes
What Is Your
Diabetes
Risk Score?
Many factors can increase
the odds of developing
diabetes—from family
health history to lifestyle
choices. With this tool, you
can estimate your personal risk and identify
risk factors that you may be able to modify.
Participants receive a report that can be
shared with a doctor or personal health
coach. Take the free risk assessment at
www.centrastate.com/diabetes-hra.
For more information about CentraState’s diabetes services,
visit www.centrastate.com/diabetes or call 866-CENTRA7
(866-236-8727).
FREE
ONLINE HEALTH
ASSESSMENT
WINTER 2017 www.centrastate.com
10

11. F
or Bob Granito, the personal obstacles he conquers during a 12-mile Tough
Mudder® are harsher than the challenges of a 16-foot-high wall, dangling live
wires, or a water pit. A veteran participant of 10 Tough Mudders, the 55-year-
old Freehold resident demonstrates that his multiple sclerosis (MS) does not define
what he can accomplish.
“I do these events because I refuse to let MS beat me,” Bob says. “My goals are
to bring awareness to this disease and to let others who are afflicted know that a
wheelchair is not a predetermined fate.”
Diagnosed in 2011 at CentraState’s Linda E. Cardinale MS Center, Bob follows a
treatment plan that includes injections of an MS disease-modifying medication; an
exercise regimen of running, bicycling, and lifting weights; nutrition supplements;
and evaluations three times a year at the MS Center.
“Our center is large and growing, with 2,000 patients currently
under our care using state-of-the-art treatments that stop MS
relapses, modify disease progression, and manage symptoms,” says
Amos Katz, MD, a board-certified neurologist and medical director
of the MS Center. “Our robust clinical trials program is evaluating a
host of promising new therapies for their safety and effectiveness.”
Bob feels fortunate that a world-class MS Center is located right in his own
hometown for his ongoing care.
“I’m carefully following Dr. Katz’s treatment plan to deter the possibility that my
MS may progress,” Bob says. “I want to make sure that MS is only an inconvenience
to me, and not a debilitating disease.” •
He’s One Tough Mudder
Despite MS, Bob Granito Scales Physical Challenges
DISRUPTING THE
INFORMATION PIPELINE
Multiple sclerosis is a chronic neurologic
disease that affects the central nervous
system and disrupts the flow of
information within the brain and between
the brain and body.
Disrupted nerve impulses produce a
variety of symptoms that can range from
mild to severe. The most common are
fatigue, difficulty walking, numbness or
tingling, muscle tightness or weakness,
vision problems, dizziness, bladder
and bowel dysfunction, sexual issues,
headaches, and cognitive problems.
Promising Treatments and Support Services
The Linda E. Cardinale MS Center’s interdisciplinary team of specialists includes
neurologists, a nurse coordinator, registered nurses, rehabilitation therapists,
dietitians, social workers, and home care personnel. The MS Center offers the
following services to help treat patients with MS:
• Immunomodulators/
disease-modifying therapies
• Intrathecal baclofen (a muscle
relaxant medication administered
into the spinal fluid)
• Bowel and bladder management
• Botox®
• VitalStim®
therapy for swallowing
disorders
• MRI and neurologic tests
• Cognitive tests and training
• Physical, occupational, speech,
and aquatic therapy
• Balance, muscular, and urologic
evaluations
• Patient and family support,
education, and wellness programs
For more information about the Linda E. Cardinale MS Center or
to schedule an appointment, call 866-CENTRA7 (866-236-8727).
WINTER 2017 www.centrastate.com
11

12. CEN TR A S TATE NE WS BRIEFS
To keep up to date on all CentraState news, visit www.centrastate.com/news.
The Manor Named a Top Nursing
Home by U.S. News & World Report
The Manor Health and Rehabilitation
Center at CentraState Medical Center
is proud to announce that it has been
named one of the Best Nursing Homes
for 2016-17 by U.S. News & World Report,
a nationally recognized magazine that
routinely evaluates and rates health care
providers across the country.
The Manor provides comprehensive short-term rehabilitation
and long-term skilled nursing services to help residents achieve
their maximum potential for independence, personal comfort, and
quality of life.
The Manor earned this designation by demonstrating appropriate
use of key services and consistent performance in national quality
measures, along with meeting performance standards set by
U.S. News & World Report, such as earning at least 4 stars in the
Centers for Medicare & Medicaid Services (CMS) overall rating for
all 12 months of the reporting period. The Manor exceeded this
standard by earning 5 stars in overall rating from the CMS.
New Social Skills
Awareness Program
For Young Adults with Autism
Spectrum Disorder (ASD)
A generous grant from the TD Charitable
Foundation will allow CentraState to provide a free
program to help adolescents with autism spectrum
disorder (ASD) develop and enhance their social skills.
Those with ASD are at high risk for social isolation,
which is correlated with negative health outcomes
and decreased psychological well-being.
Social isolation results from the difficulty
youth with ASD have in making friends
and engaging in social activities. This
program will support adolescents
with ASD as they discuss and
practice the social skills necessary
to reduce social isolation and
improve their quality of life as
they enter adulthood.
A
s part of our commitment to
deliver the highest quality
patient experience and to ensure
the continuous development of a
positive partnership with our patients,
CentraState has formed a Patient and
Family Advisory Council.
This working task force is comprised
of representatives from the community,
former and current patients, and family members, along with
CentraState’s nurse management, administration, volunteers,
and support department staff.
The council will meet at least four times each year, giving
members the opportunity to share feedback on the care
experience and to provide opinions and recommendations.
Members represent a diverse patient population, including
different ages, geographic locations,
and ethnic backgrounds.
“It’s so important to be in tune with the
voice of our community, and the Patient
and Family Advisory Council represents
another way we can hear those valuable
perspectives,” says Deborah Ventz-
Migneco, director of Patient Experience
at CentraState. “Working together,
we will identify health needs that the community considers a
priority, so that we, in turn, can better address those needs.”
For more information about the council, contact
Deborah Ventz-Migneco at dmigneco@centrastate.com or
732-294-2523. To learn about other ways to volunteer at
CentraState Healthcare System, please contact Volunteer
Services at 732-294-2622.
CentraState Forms Patient and Family Advisory Council
WINTER 2017 www.centrastate.com
12

13. ECT
What makes
ECT effective?
No one knows for certain how ECT
helps treat severe depression and other
mental illnesses. We still have much
to learn about how the brain works.
What is known is that the seizure
caused by ECT releases chemicals
in the brain. These chemicals, called
neurotransmitters, deliver messages
from one brain cell to another. The
release of these chemicals makes
the brain cells work better. As a
result, depressive disorder and other
psychiatric condition symptoms
can be overpowered by this
improved brain cell function.
A Viable Treatment
for Severe Depression
Many patients
notice an improvement
in symptoms after two
to three treatments.
By Moustafa H. Shafey, MD
It’s estimated that more than 40 million Americans suffer
from depression. Many see therapists and take medication.
But for those with severe depression episodes—as well as
conditions like severe mania, bipolar disorders, and psychosis—
electroconvulsive therapy (ECT) is generally viewed as the most
viable treatment modality.
How Does It Work?
ECT involves a brief electrical current lasting a fraction of a
second to six seconds. It produces a controlled seizure within
the brain of up to one or two minutes. Before the procedure,
the patient is given general anesthesia and a muscle relaxer to
reduce muscular response. ECT is pain free and takes about 10
to 15 minutes from beginning to end, with an electroencephalogram (EEG) monitoring brain
activity throughout the procedure.
Today’s treatment is quite a contrast to decades ago when ECT, then more commonly
referred to as “shock therapy,” was not medically managed quite so well and patients
were susceptible to long-term memory loss. Over the years, the media has portrayed
ECT as a quick fix to “shock” away depression, and negative images and misperceptions
unfortunately remain for many.
An Improved Quality of Life
We’ve seen rapid improvement in patients who first visit us exhibiting severe symptoms.
Many of these patients were not eating or were uninterested in life, while some had
suicidal tendencies and were detached from reality. Others were hopeless, depressed, and
practically confined to bed. Today, after a normal course of six to 12 treatments at a rate
of three per week, many of these same individuals are now leading happy and active lives.
Patients often notice an improvement in symptoms after two to three treatments. The
response to antidepressant medications, in comparison, can take several weeks or more.
When ECT treatment is provided at the right time in the right way, it can be a truly
life-saving experience. We are very clear, however, that ECT can produce side effects
such as headache, muscle soreness, nausea, and grogginess. Some patients also may
temporarily experience short-term memory loss, which may clear in a few days or few
weeks. In comparison to life-threatening risks of mental illness, though, treatment
benefits can far outweigh these side effects. •
Dr. Moustafa H. Shafey is a board-certified psychiatrist and forensic
examiner. He is the former chief of the Medical and Dental Staff and
director of the Electroconvulsive Therapy (ECT) Department at CentraState
Medical Center. Dr. Shafey can be reached at 866-CENTRA7 (866-326-8727).
Psychiatric Services at CentraState Medical Center include inpatient and
outpatient ECT in our state-of-the-art ECT Treatment Suite. ECT is administered by our
team of doctors who have specialized training and experience in this type of treatment,
with the assistance of our skilled anesthesiologists, nurses, and technical team.
WINTER 2017 www.centrastate.com
13

14. Memory Screenings are an
Important Component of Brain Health
A
s an AFA screening site, CentraState will administer memory screenings
and provide educational materials about memory concerns, brain health,
and successful aging to anyone who is concerned about memory loss or
experiencing warning signs of Alzheimer’s disease or dementia. Those who want
to assess how their memory is now compared to the future may also find the
screenings useful.
“A memory screening should be part of a regular annual wellness check-up,”
suggests CentraState speech-language pathologist Marilyn Abrahamson, MA, CCC-SP.
“The screening simply involves a series of questions and tasks, and it takes only five to 10 minutes to complete.”
Last year, more than 250,000 people were screened through the National Memory Screening Program.
A recent study suggests that screenings may detect cognitive impairment up to 18 years prior to a clinical diagnosis
of Alzheimer’s disease or dementia.
“The idea is to catch any concerns earlier and teach strategies and lifestyle modifications to slow down and
compensate for them,” Abrahamson says. “Many patients come in feeling scattered or concerned that they don’t
remember things as they go about their daily lives. Often, it’s not memory loss but rather a product of the distractions
in our lives, especially for those who have demanding schedules. We provide people with improved management
strategies, and generally they walk out feeling a lot better.”
Abrahamson adds, “Through research, we know that lifestyle changes and the use of compensatory strategies can
positively affect a person’s overall brain health, delaying symptoms of age-related cognitive changes and dementia.” •
CentraState’s confidential memory screenings are available for a fee of $5 by appointment only.
For more information about memory screenings, call the Star and Barry Tobias Health Awareness Center
at 732-308-0570.
CentraState Medical Center has been selected by the Alzheimer’s Foundation of America (AFA) as one of
only a handful of sites in New Jersey to participate in the AFA’s National Memory Screening Program.
In recognition of the importance of
brain health, CentraState is also
developing a comprehensive initiative
that includes brain fitness classes and
education about memory. This new
program, called MINDS IN MOTION,
aims to improve memory and thinking
skills through specific strategies.
For more information, call the Star
and Barry Tobias Health Awareness
Center at 732-308-0570.
WINTER 2017 www.centrastate.com
14

15. PROGRAMS
HEALTH SCREENINGS, CLASSES, AND PROGRAMS
All screenings, classes, and programs are held at The Star and Barry Tobias Ambulatory Campus, Health Awareness
Center, Suite 100, 901 West Main Street, Freehold, NJ, 07728, unless otherwise indicated.
Registration is required for all screenings. To register for these or other CentraState screenings, classes, and programs,
visit www.centrastate.com/healthprograms or call the Star and Barry Tobias Health Awareness Center, Monday
through Friday, 8:30 a.m. through 4 p.m. at 732-308-0570.
Read Healthy Directions online at www.centrastate.com/publications.
Subscribe to our free health e-newsletter at www.centrastate.com/enews.
LIGHTEN UP WEIGHT LOSS FOR
PREDIABETES AND DIABETES
Wed., Feb. 1, 9:30 – 10:30 a.m.
Join us for a fun, interactive weight-loss program that will
lead to a healthier you. Each group session includes an
in-depth discussion of the skills needed to take control of
blood sugar and weight. Taught by registered dietitians from
the Star and Barry Tobias Health Awareness Center and the
Novo Nordisk Diabetes Center.
Cost: $49
FREE CHRONIC DISEASE
SELF-MANAGEMENT PROGRAM
Wed., March 1, 5:30 – 8 p.m.
If you have conditions such as diabetes, arthritis,
high blood pressure, heart or lung disease, depression,
or any ongoing health condition, or if you care
for someone who does, this Chronic Disease
Self-Management Workshop can help.
• 6-week series, held for 2 1/2 hours per week
• Learn from trained peer leaders with chronic
health conditions
• Set your own goals and make a weekly
step-by-step action plan to improve your life
NUTRITION COUNSELING
Do you want to lose weight, eat healthier,
and reduce your risk of chronic disease?
A nutrition counseling session with a registered
dietitian nutritionist includes an evaluation of
your current eating patterns, assessment of your
nutritional needs, and a customized nutrition plan. Individualized
nutrition counseling is provided for medical conditions (obesity,
cardiovascular disease, prediabetes, etc.) and lifestyle changes
(healthy eating, vegetarianism, etc.). Metabolic rate analysis is
also available (not covered by insurance).
For more information, call 732-294-2766.
FREE BLOOD PRESSURE &
GLUCOSE TESTING
Every Monday, 10 a.m. – 4:30 p.m.
(except holidays)
FREE THYROID SCREENING
Wed., Feb. 22, 6 p.m.
FREE COLORECTAL LECTURE & SCREENING
Wed., March 29, 6 – 7:30 p.m.
You will be given a collection kit to take home as a
part of the colorectal screening. Instructions will be
provided at the screening. The kit should be returned
to the CentraState Outpatient Lab within one week
after the screening.
SMOKING CESSATION:
FREE ORIENTATION
Mon., Feb. 6, 6:30 – 7:30 p.m.
CentraState’s Star and Barry Tobias
Health Awareness Center offers a
seven-week, evidence-based smoking
cessation program for anyone who is
thinking of quitting or is ready to quit.
The program provides the support and
professional guidance you need to quit.
SCREENINGS
CLASSES
15
WINTER 2017 www.centrastate.com

16. CentraState Medical Center
901 W Main St
Freehold, NJ 07728
CentraState Healthcare System The full circle of health and wellness dedicated to excellence.
A
ccreditation by the CoC is given only to facilities that have voluntarily committed
to providing the highest level of quality cancer care and undergo a rigorous evaluation
process and review of their performance. To maintain accreditation, facilities with
CoC-accredited cancer programs must undergo an on-site review every three years.
“This was a true team effort by all members of the clinical and ancillary services that
make up the Statesir Cancer Center,” says Barry Asch, assistant vice president of Cancer
Services at CentraState. “This award is a third-party endorsement of the excellent quality
standards of our cancer program. It shows our patients that the care they receive is among
the best in the country.”
Also, for the first time, the Star and Barry Tobias Women’s Health Center has been
awarded Three-Year Full Accreditation by the American College of Surgeons, National
Accreditation Program for Breast Centers (NAPBC).
Like CoC, the NAPBC accreditation process is a thorough evaluation and performance
review, in which health care centers must monitor compliance with the NAPBC standards
and undergo an on-site review every three years. NAPBC accreditation means that a center
has demonstrated a firm commitment to offer its patients every significant advantage in
their battle against breast disease, including comprehensive care, a multidisciplinary team
approach to coordinate the best treatment options, information about ongoing clinical
trials and new treatment options, and quality breast care. •
CentraState Healthcare System has been awarded Three-Year Reaccreditation
with Commendation by the Commission on Cancer (CoC).
CentraState Earns Two National
Accreditations for Quality Cancer Care
NONPROFIT
ORGANIZATION
U.S. POSTAGE
PAID
CENTRASTATE
HEALTHCARE SYSTEM