SleepTalker October 2020

SleepTalker

Volume 34 Number 4 Stony Brook, NY  <       October 2020     
sbm Read on Web Donate
Drs. Adsumelli and Steinberg Retire STARS Kudos ASA Meeting
Resident Recruitment Video CA-3 Resident Spotlight! Anesthesia Tech News New Publications
Photography Corner Where on Campus is That?
Drs. Adsumelli and Steinberg Retire


  On September 8, the Department held a farewell get together for the upcoming retirements of Dr. Rishimani Adsumelli and Dr. Ellen Steinberg. The HSC Galleria was adorned with balloons and flowers for the occasion.

  Dr. Adsumelli joined the department 24 years ago as a Fellow in OB Anesthesiology. Fortunately for us, she stayed after the one year fellowship to become an Assistant Professor. Over the years, she advanced along the academic ranks to Full Professor. Rishi has been a mainstay in the Division of OB anesthesia, but also served for many years as Chief of the Urological/Gynecological Anesthesia Division. Her service to the department included chairing the monthly QA Grand Rounds meetings. She also contributed to the academic aims of the department through some 12 peer-reviewed publications, more than 50 meeting abstracts and 40 medically challenging case presentations. Rishi officially retired on September 15, but will continue working with the department on a voluntary basis.

  Dr. Steinberg joined the department in 1988 and became chief of the OB Anesthesia Division in 1993. For the past 32 years, Ellen has contributed significantly to the anesthesiology department, Stony Brook hospital as well as the field of obstetric anesthesiology. She served as the Anesthesiology Residency Program Director from 2000-2008 and was Vice Chair of Education from 2003-2012. She is an accomplished educator, and was nominated “Teacher of the Year” awards twice and mentored many faculty and residents. Ellen played an instrumental role in the planning, design and organization of the current Labor and Delivery Unit which opened in 2011 and invested much of her time in the smooth running of the unit, with almost 4000 deliveries a year. Ellen participated actively in many committees, both locally and at the state level. She established the Obstetric Anesthesia Consult service at Stony Brook to improve the anesthesia care for the high-risk and complex obstetric patients. At the state level, Dr. Steinberg has served on the NYS ACOG Safe Motherhood Initiative in its various forms over the past ten years and she continues to be active. She recently completed a two-year term on the first NYC DOH Maternal Mortality Review Committee and is currently the only obstetric anesthesiologist on the newly formed NYS DOH Maternal Morbidity and Mortality Committee. Ellen will continue to work in the Department through the end of the year.

  In 2007, Drs. Adsumelli and Steinberg were awarded the prestigious Ellison Pierce Patient Safety Award from the Anesthesia Patient Safety Foundation for the Best Scientific Exhibit at the ASA. Their exhibit, "A Response to Maternal Hemorrhage, With a Proactive, Multidisciplinary Approach to Reduce Mortality and Morbidity" described the development of a multidisciplinary rapid response team and protocols for risk stratification, preparation and management of maternal hemorrhage.

  Photos from the retirement party, thanks to Ms. Marisa Barone-Citrano, can be viewed using this link.

STARS: STaff Appreciation and Recognition

Patient comments about the Ambulatory Surgery Center staff compiled by Marisa Barone-Citrano, MA from the Press Ganey questionnaires

    Nurse related my concerns regarding COPD to anesthesiologist who took time to address my concerns and provided a very positive experience.

    Dr. Eleanor Romano was superb - she noticed I was prescribed Percocet as a painkiller after surgery, and I am allergic to codeine which is in Percocet so she re-prescribed Tramadol for me.

    I have no complaints at all. Everyone was very clear, caring, clean. Reinforced the confidence I have in stony brook hospital and staff. thank you very much.

    The entire experience was excellent and would choose the ambulatory center again.

    Everything went very well. Everyone was very professional & courteous. I had no problem whatsoever. I would recommend this place to anyone who needs a procedure.

    I had only good experiences while at Stony Brook Ambulatory for my procedure.

    Excellent treatment from arrival to departure!

    I am really satisfied with all the care and information that I was given in the ambulatory center.

    Excellent care, procedure, and release. Very good aftercare: Two phone calls, check-up after six days. Check up a week after that. A good experience. Gratitude to all involved!

Deborah Richman MBChB, FFA(SA) received this text from a patient.

    All went well yesterday. Dr. Shaji Poovathoor brought in the ped’s Dr. Zvi Jacob to do my IV - so nice of them!! Thank you for such a great team. Please extend my gratitude 🙏

Kudos

Joy Schabel, MD

  A HUGE congrats to our CA2s for passing the 2020 ABA Basic Exam! The national pass rate typically ranges from 88-91%, so our residents did an incredible job despite the COVID impact during prime study months.

   Thank you to all of our Faculty for their Wednesday and day-to-day teachings throughout the year and to Dr. Poovathoor for his targeted exam prep. Thank you also to our CRNAs for assisting with clinical coverage for our weekly education days and on exam days. Our residents are fortunate to have such support!

   New York's Center for Economic Growth featured the cancer research being done by Dr. Jun Lin and Dr. Martin Kaczocha in the August 2020 issue of their Research Connection newsletter. Dr. Lin's project suggests that the choice of anesthesia may change the metastatic process of breast cancer by affecting the cytokine and microenvironment. Dr. Kaczocha and his collaborators are taking a new approach to target proteins involved in prostate cancer.

  
Stony Brook Anesthesiology at the ASA 2020 Meeting

  

Abstracts
Gan TJ, Wahlert A, Fox G. Intravenous Amisulpride Cardiac Safety When Administered to Surgical Patients for the Prevention of Postoperative Nausea and Vomiting.
• Humeidan M, Reyes J-P, Mavarez-Martinez A, Roeth C, Nguyen C, Sheridan E, Zuleta-Alarcon A, Otey A, Abdel-Rasoul M, Bergese SD. Impact of Cognitive Exercise on Postoperative Delirium in Older Adults: the Neurobics Trial.
Jin Z, Gan S, Schabel J, Gan TJ. Palonosetron-dexamethasone Combination vs Ondansetron-dexamethasone for PONV Prophylaxis, a Meta-analysis.
• Urman R, Khanna AK, Bergese SD, Buhre WF, Wittmann M, Le Guen M, Overdyk FJ, Di Piazza F, Saager L. Postoperative Opioid Characteristics Associated with Respiratory Depression: Results From the Prodigy Trial.

Medically Challenging Cases
Kang R, Kowal RA, Schwartz JA. Anesthetic Management of a Patient with a Tracheo-innominate Artery Fistula.
• Parsey D, Shuaib K, Watson E, Schwartz J, Kowal RA, Poppers JS. Diagnosis and Management of Unique Gerbode Defect Variation Consisting of a Bi-atrial Regurgitant Jet At the Base of the Inter-atrial Septum Originating From the Left Ventricular Outflow Tract.
Alam S, Tenure RS, Poppers JS. La Thrombus Formation on An Amplatzer Occluder Device in a Patient with Factor V Leiden on Dabigatran.
Scorsese G, Figueroa C, Zabirowicz E. Prone Compressions in a Coronavirus 2019 Intensive Care Patient.
Kang R, Chojnowski R, Kowal RA. Awake Tracheostomy in a Patient with a Supraglottic Mass.
Lee A, Guthrie D, Brar C, Fischl AM. Anesthetic Management of Patient with a Large Retropharyngeal Abscess Extending Into the Mediastinum.
Chojnowski R, Kang RS, Guo X. Emergent Intraoperative Tracheal Resection for Anterior Tracheal Mass with Extended Margins..
Watson E, Shim HB. Airway Management of a Patient with Recurrent Basal Cell Carcinoma with Reconstructive Tissue Flap, Limited Mouth Opening and Loose Dental Bridge.
Kant I, Kang RS, Brar C, Oleszak SP. Retrograde Nasal Fiberoptic Intubation in Duchenne Muscular Dystrophy.
Kang RS, Brar C, Oleszak SP. Airway Management of a Patient with a Multinodular Goiter Causing Tracheal Compression.
Shah R, Katz S, Atkinson DJ. Severe Post-induction Bronchospasm in a Patient with Atypical Carcinoid Tumor.
Kang RS, Kant I, Brar C, Oleszak SP. Reversal of Neuromuscular Blockade with Sugammadex in Duchenne Muscular Dystrophy.
• Barra D, Mock S, Jabaut J, Patel R, Benjamin J, Angelo T. Challenges In Obstetric Anesthesia In A Parturient With Native American Myopathy.
Bracero L, Alam S, Wang E, Costa AC, Schabel JE. Subdural Hematoma Requiring Surgical Evacuation Following Dural Puncture Epidural (DPE): a Newly Reported Complication.
• Thompson K, Daoud BE, Cahana RL. Intrapartum Cesarean Delivery In A Morbidly Obese Patient With Cystic Fibrosis: A Case Report.
• Tsai M, Feliciano J, Angelo TE. Anesthetic Management For Cesarean Delivery In A Pregnant Woman With Previously Ruptured Cerebral Arteriovenous Malformation.
Mathew A, Adsumelli RS, Tito M, Pollard J, Kowalska D. A Parturient with Symptomatic Covid Disease, Three Negative PCR Tests and Positive Antibodies: a Management Dilemma.
• Banegas LR, Winebrenner H, Jabaut J, Patel R, Angelo TE. Peripartum Management Of A Parturient With Congenital Hypofibrinogenemia And A Complete Placenta Previa Experiencing Vaginal Bleeding.
Alam S, Bracero LA, Costa AC, Schabel JE, Bergese SD. Subdural Hematoma Following Dural Puncture Epidural in a Patient with a Chronic Right Parietal Hemangioma.
• He L, Daoud BE, Meng M-L, Miller R, Nhan-Chang C-L. Anaphylaxis To Cefazolin In The Second Trimester.
Figueroa C, Kang RS, Kaushal AK. Hypertonia Observed After Omnipaque Administration.
Bracero L, Gupta A. Challenges in Clinical Management of Complex Regional Pain Syndrome (CRPS) Due to Covid-19 Outbreak in New York.
Kang RS, Figueroa C, Chojnowski R, Gupa AK. Complete Resolution of Phantom Limb Pain After Lumbar Sympathetic Block.

QA/QI
Xiao A, Kim B, Schwartz JA. Vent: a User Friendly Application for the Inexperienced Clinician Managing Ventilators in the Intensive Care Setting.
Kim B, Costa AC, Schabel JE. Changes in Practice for Obstetric Anesthesia in Parturients During the Covid-19 Pandemic.
Qureshi F, Romeiser J, Abola RE. Preventing Surgical Site Infections (SSI), a QA/QI Initiative on Peri-operative Antibiotic Administration Compliance-timing and Re-dosing.
Daoud B, Cahana RL, Ring LE. Developing “Code H,” A Maternal Hemorrhage Rapid Response Protocol At A Large Academic Medical Center.

Resident and Fellows Session, Lead Discussion Speaker
Mitchell D. How to Handle Crises and Unique Cases in the OR.

PBLD
Daoud B, Goodman SR. A Pregnant Woman with Complete Placenta Previa and Intraoperative Cardiac Arrest.

Resident Recruitment Video


Dr. Joy Schabel and the Residents have created a new Resident Recruitment Video.
Why would a prospective resident choose any other place for their residency?
CA-3 Resident Spotlight!
Meet Dr. Ramiz Shuminov

Ramanjot S. Kang, MD

Can you tell us a little about your background?
   My family immigrated to the States from the former USSR when I was young. I grew up in Brooklyn, attended undergraduate at SUNY Binghamton, medical school at SUNY Downstate, and now residency at Stony Brook.

What attracted you to anesthesiology?
   Anesthesiology catered to all the things I wanted from being a doctor. I'm able to provide personalized care to my patients, starting from my initial assessment and plan to every procedure I do and medication I administer. In a lot of ways we're the most self-sufficient doctors in the hospital, "owning" the complete care of a patient during a critical time of their life.

How did you come to be a resident at Stony Brook (Why SB)?
   I had a very positive interview day. I saw the residents were happy and cared for, which made them even more open and inviting. Since I wanted to stay in the NY area, this made Stony Brook a top choice.

What do you like most about being a resident?
   The freedom to learn new things, try various techniques, and be surrounded by mentors.

What do you like least about being a resident?
   Not having a choice in the amount of hours I work.

What pearls of wisdom would you like to share with your fellow junior residents to help them succeed in their time here and future careers?
   Treat others the way you would want to be treated. This will cover you in many areas like showing up on time, being respectful, having empathy for what others are going through, and being open-minded.


As you're soon to enter the real world of anesthesiology, what do you find most daunting?
   That the responsibility begins and ends with me. I expect I'll have a lot more to learn as a new attending.

If you hadn't chosen to go into medicine, what career path might you have followed?
   If I didn't choose medicine, I would've gone into dentistry. As for something less medicine-y, architecture with an urban planning specialty is something that is interesting to me.

What has been your favorite residency memory of your 4 years here at Stony Brook?
   Having everyone from my class over for our annual Secret Santa party.

When you aren't running on around the hospital saving lives, how do you like to spend your free time?
   Hitting the beaches, working out, painting, cooking for others.

What do you like the most (and least) about living on Long Island?
   There's plenty of space and opportunities for outdoor activities. Rent is still expensive though and it's harder to find a diversity of cuisines.

What is your favorite type of food?
   A nice home-cooked meal.

What's your favorite restaurant in LI/NYC?
   Basil in St James.

Where would you love to travel to next and why?
   Portugal. It has beautiful landscapes, world renowned cuisine, and spectacular beaches.

What's your favorite Tourist Activity in LI/NYC?
   All the things out East - beaches, kayaking, wineries, and restaurants.

Who is your role model and why?
   Bob Ross. He's a master of his craft, a great teacher, and is very soothing.

If you could make one wish, what would it be?
   For 2020 to be over and to start 2021 in a better direction.

If you could eat lunch with one person (fictional/alive/dead/etc), who would it be?
   Barack Obama

What are you looking forward to doing once you start receiving "attending" salary?
   The first thing I will do is take my parents out to dinner.

Anesthesia Tech News

  Maria Lagade, MD

  The Anesthesia Technology Interns 2020-2021 have commenced their Clinical AT Internship training this week. The interns graduated with a Bachelor's degree in Health Science from the School of Health Technology and Management at SBU. They are pursuing their studies in the Anesthesia Technology Program sponsored by the Department of Anesthesiology with SHTM. The Post-baccalaureate AT internship runs from September until June. Please welcome them as members of the Anesthesia team.


Alexa Christophides

Nina Fidanza

Jacqueline Gomez

Christine Guaraca

Amy Lizarraga

Natasha Morgan

Juliet Valdivia

Jennifer Wulff

Alfredo Ventura
New Publications

Figure from O'Sullivan and Kaczocha, 2020

  • Weingarten TN, Morimatsu H, Fiorda-Diaz J, Bergese SD, Ariyoshi M, Sprung J, Dahan A, Overdyk FJ. New-Onset Atrial Fibrillation Detected by Continuous Capnography Monitoring: A Case Report. Am J Case Rep. 2020 Sep 19
  • O'Sullivan SE, Kaczocha M. FABP5 as a novel molecular target in prostate cancer. Drug Discov Today. 2020 Sep 20:S1359-6446
  • Tam OH, Rozhkov NV, Shaw R, Kim D, Hubbard I, Fennessey S, Propp N; NYGC ALS Consortium, Fagegaltier D, Harris BT, Ostrow LW, Phatnani H, Ravits J, Dubnau J, Gale Hammell M. Postmortem Cortex Samples Identify Distinct Molecular Subtypes of ALS: Retrotransposon Activation, Oxidative Stress, and Activated Glia. Cell Rep. 2019 Oct 29;29(5):1164-1177
  • Schwartz J, Gan TJ. Management of postoperative nausea and vomiting in the context of an Enhanced Recovery after Surgery program. Best Pract Res Clin Anaesthesiol. 2020 Jul 31
  • Miller S, Daily L, Dharla V, Gertsch J, Malamas MS, Ojima I, Kaczocha M, Ogasawara D, Straiker A. Endocannabinoid metabolism and transport as targets to regulate intraocular pressure. Exp Eye Res. 2020 Sep 23:108266
  • Guthrie DB, Pezzollo JP, Lam DK, Epstein RH. Tracheopulmonary Complications of a Malpositioned Nasogastric Tube. Anesth Prog. 2020 Sep 1;67(3):151-157
Photography Corner

James P. Dilger, PhD
A wasp's work is never done!
Where on Campus is That?

James P. Dilger, PhD

Cedar of Lebanon
SleepTalker, the Stony Brook Anesthesiology Newsletter is published by the Department of Anesthesiology
Stony Brook Medicine, Stony Brook, NY
Tong Joo Gan, M.D., MHS, FRCA, MBA, Chairman
Editorial Board: James P. Dilger, Ph.D.; Stephen A. Vitkun, M.D., M.B.A., Ph.D.; Marisa Barone-Citrano, M.A.; Ramanjot S. Kang, M.D.