BARBARA ALBANI, M.D.//Photo BY LESLIE BARBARO
As a neurointerventional surgeon in one of the country’s busiest stroke centers, Barbara Albani, M.D., treats the most complex stroke and brain vascular cases.
“The tools and techniques we’re using today have rapidly evolved over the last several years and have revolutionized our ability to treat acute stroke,” Albani says. “Acute strokes treated with these procedures are large and life threatening, typically resulting in death or severe disabilities. Today, we have the ability to safely enter the brain through a small incision in the wrist or leg to remove blood clots blocking critical arteries feeding the brain, giving these patients a second chance at a meaningful life and, in some cases, allowing the patient to walk out of the hospital.”
Albani is the medical director of the Department of Neuro-Interventional Surgery at Christiana Care Health System, the only Comprehensive Stroke Center in the region outside Philadelphia and Baltimore. The designation means that her team has the expertise, experience and technology to treat the most complex types of strokes and vascular disease of the brain.
The techniques she employs involve sophisticated technology that enables her to see inside the brain while she guides tiny devices through blood vessels to remove blockages or repair damaged brain vessels.
“In some patients with acute blockages of the major blood vessels of the brain, I can remove the clots using minimally invasive procedures and minimize the patient’s long-term disability,” she says. “In patients with brain aneurysms, we can repair the vessel using small devices such as coils or stents through a small incision in the leg.”
Her passion is her patients and her team. “I love helping people,” she says. “One of the best parts of my job is being part of a team that not only shares that love for the patient but also for each other.”
Patricia Curtin, M.D.//Photo by Leslie Barbaro
For many people, getting older increases the likelihood of developing health issues.
Arthritis, heart disease, pneumonia and fractures caused by falls are all more common in people 65 and older, notes Patricia Curtin, M.D., chief of Christiana Care’s section of geriatric medicine, medical director of the Acute Care of the Elderly Units, and director of clinical strategy and community affairs at the Swank Memory Care Center.
Our minds are impacted by aging, too.
“Many people who are aging are concerned about cognitive issues,” Curtin says.
There is evidence that regular exercise, a healthy diet, adequate sleep, social engagement and stress reduction can reduce the risk of memory loss. The most common form of memory loss is Alzheimer’s but there are other types of dementia. At the Swank Memory Care Center, patients and their families can get a diagnosis, a plan of care and other resources.
The ACE Units at Christiana and Wilmington hospitals provide specialized, compassionate care for older patients.
Fortunately, many conditions associated with aging are treatable or preventable, she says.
There are medications and exercises to treat arthritis. Exercise and diet can help prevent heart disease, and there are medications to treat existing heart problems. A vaccine that lowers the chance of getting some strains of pneumonia is recommended for people 65 and older. Eliminating tripping hazards at home can reduce falls.
In addition to caring for patients, Curtin is a devoted volunteer. As part of the Notre Dame Haiti Program, she has traveled to Haiti 13 times to lead and organize medical mission teams to provide care to families in mobile clinics and children in orphanages. In 2016, her work was recognized when she was named the national winner of the Jefferson Award, a prestigious honor celebrating extraordinary acts of service.
Muhammad Siddique, M.D.//Photo by Leslie Barbaro
In Delaware, the incidence of cancer is 10 percent higher than the rest of the country.
That may be because more people are getting tested in the First State, says Muhammad Siddique, M.D.
“The screening rate is 7 percent to 8 percent higher than the national average,” he says. “Cancer is being diagnosed earlier, which will contribute to survival rates.”
He notes that about 80 percent of women over age 40 in Delaware are getting mammograms. “That was the second-highest rate in the nation last year.”
The most common cancer in women is breast cancer. For men, it’s prostate cancer. They are followed by lung and colorectal cancers in both sexes.
Siddique notes that nearly one in five adults in Delaware is a smoker, which is slightly higher than the national average. That has a direct impact on the rate of lung cancer, but the link doesn’t stop there.
“There are at least 14 cancers associated with smoking, including bladder cancer and colorectal cancer,” he says.
Nearly one in three Delawareans is obese, which increases the risk of cancers of the breast, colon, rectum, esophagus, kidney and pancreas.
On the prevention front, a vaccination for the HPV virus associated with cervical cancer and head and neck cancer has the potential to save lives for generations to come. The vaccine is currently recommended for females up to age 26.
In emerging treatments, immunotherapies are targeting cancers so they can be treated more efficiently and effectively. “In essence, we unleash the immune system to kill the cancer,” he says. Treatment includes therapies in which oncologists profile the molecular characteristics of a tumor in order to tailor treatment to the specific tumor.
“It is a time of great promise in improved treatments for people who have cancer,” he says.
Ray Blackwell, M.D.//Photo by Leslie Barbaro
Ray Blackwell, M.D., is a cardiothoracic surgeon who operates on patients with diseased or otherwise damaged hearts. As chief of cardiac surgery for Christiana Care Health System, he is a leader in the cardiac surgery practice, which performs more than 800 heart surgeries each year.
He also is an advocate for measures that can help to prevent heart disease.
“Regular exercise can reduce blood pressure, lower bad cholesterol and raise good cholesterol levels, promote weight loss, improve mood and reduce stress, and improve blood glucose control,” says Blackwell, a competitive runner and annual participant in the American Heart Association Heart Walk.
Diet is important, too. The AHA recommends two servings a week of fish that are rich in omega-3 fatty acids, such as salmon or tuna.
Other dietary recommendations include decreasing salt consumption and avoiding trans fats, which are often found in baked goods, coffee creamer, frozen pizza and fast food. Foods with trans fats show partially hydrogenated oils on the ingredients list.
Blackwell notes that hypertension is called the “silent killer” because people are not aware they have it unless they have their blood pressure tested. Hypertension resonates with him personally. He learned his blood pressure was high when he was 20. He has maintained control with a single medication and exercise. He also chairs Christiana Care’s Blood Pressure Ambassador Advisory Committee.
“Blood Pressure Ambassadors are volunteers who deliver the message about diagnosing and treating hypertension to patients in the community,” he says. “The more people who know they have hypertension, the more people we can treat, the more lives we can save.”
Carolyn Glazer-Hockstein, M.D.//Photo by Leslie Barbaro
Want to take good care of your eyes?
Start with your body, says Carolyn Glazer-Hockstein, M.D.
“One of the most important things you can do for your eyes is take care of yourself,” she says. “That means your diet—what you eat—and keeping your blood sugar and your cholesterol under control.”
If you smoke, kick the habit. Smoke doesn’t just get in your eyes. It can harm your vision. Also keep your weight at a healthy level with a low-fat diet and regular exercise.
One of the most common issues Glazer-Hockstein sees is age-related macular degeneration, which occurs when neurons in the central part of the retina deteriorate. The disease robs millions of older Americans of clear vision.
Though there is no cure, there is treatment that can slow damage to the retina, the layer of tissue at the back of the inner eye that converts light images to nerve signals and sends them to the brain.
The treatment is, literally, a needle in the eye: The doctor gently injects medication that stops new blood vessels from forming and blocks the leaking from the abnormal vessels that causes macular degeneration.
Retinal vein occlusion, another common disorder, is a blockage of the small veins that carry blood away from the retina. People with high blood pressure, hardening of the arteries and diabetes are at increased risk.
An aging population and an increase in the number of people with type 2 diabetes both contribute to eye diseases, including small-blood vessel disease and glaucoma. The good news is that new medications and treatments, including lasers, are improving care.
“It is a much more hopeful time for people with these diseases,” Glazer-Hockstein says.
Matthew Gotthold, M.D.//Photo by Leslie Barbaro
As a pediatrician, Matthew Gotthold, M.D., cares for children. He also sees himself as a partner with parents in raising healthy kids.
“It’s a priority for pediatricians to get education into a parent’s hands,” he says. “The relationship with parents is very important.”
It’s also important that parents get accurate, evidence-based education regarding kids and their health.
“We live in an age of information, and there is so much information out there that it can be confusing for parents,” Gotthold says. “It’s my job to help parents discern what is accurate and what is not.”
When Gotthold was growing up he spent much of his time playing outdoors. Today, kids often are drawn away from sports and other forms of exercise and toward sedentary activities, such as video and computer games, which is contributing to an increase in the child obesity rate, which in turn contributes to type 2 diabetes and heart disease.
“What kids are eating is an even bigger concern,” he says. “Muscles are put on in the gym and pounds are put on in the kitchen.”
He advises passing on cheese sticks and pretzels and focusing on snacks that have not been processed, such as raw fruits and veggies. He also encourages parents to cross soft drinks off their grocery lists.
“Soda is liquid candy, really terrible,” he says. “Choose water, instead.”
Raising emotionally healthy kids is another concern. “Anxiety that presents as stomachaches and headaches is something we are seeing more frequently,” he says.
Staying in tune and in touch with kids is essential. Don’t trivialize their feelings or ignore signs that a child is struggling. “Each child is an individual who is completely unique. Different parents have different approaches to raising children,” he says. “Together, we can come up with a strategy that is best for the family.”
G. Jeffrey Milan, M.D.//Photo by Leslie Barbaro
As a general clinical nephrologist, G. Jeffrey Milan, M.D., treats all aspects of health related to the kidneys, though most of his patients have chronic kidney disease as a result of diabetes and high blood pressure.
“I also help manage patients who have developed kidney failure and now require dialysis or who have had a kidney transplant,” he says.
There are other illnesses that affect the kidneys, such as polycystic kidney disease and glomerulonephritis, an acute inflammation of the kidneys. Milan notes that the increasing prevalence of obesity in Delaware not only increases the risk of diabetes, which can cause kidney damage, but obesity itself can cause kidney injury.
“Unfortunately, there is no magic bullet that prevents chronic kidney disease, but there are ways to help minimize the risk of progression of CKD, if diagnosed,” he says.
Helpful measures include keeping blood sugar under control in diabetics and keeping blood pressure under control in anyone. A diet low in salt and animal fat is important, too. Weight loss is key, since it helps control blood sugars and blood pressure while also preventing the kidneys from working too hard. Chronic use of medications such as NSAIDs (ibuprofen) should be avoided.
“Above all, people should get their annual physical exam, which includes routine blood work and urine studies,” he says.
Medications that treat diabetes and high blood pressure are the main treatments for many nephrology patients. ACE-I or angiotensin receptor blockers are beneficial in slowing the progression of kidney disease. Immunosuppressive medications prevent the rejection of kidneys after a transplant.
Other exciting medications also are in the works. “Hopefully, in the near future, nephrologists will have their first medication approved specifically for the treatment of polycystic kidney disease,” he says.