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Clinics:
Medical Intensive Care Unit:
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The John Stroger Jr. Hospital of Cook County is a primary care and tertiary referral center with a full range of critical care services. The Medical Intensive Care Unit (MICU) is the largest of the six intensive care units at our hospital. The MICU is a state of the art facility with twenty-two private patient rooms. It is staffed by fulltime, board-certified Critical Care specialists, dedicated Critical Care nurses, fellows and residents from our training programs, as well as a pharmacist and a nutritionist. The MICU provides care for patients with non-surgical severe and life threatening medical conditions like: gastrointestinal bleeding, respiratory failure, shock, and cardiac arrest. In the year 2006, one thousand patients were admitted to our unit.
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Medical Bronchoscopy Unit:
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Medical fiberoptic bronchoscopy with video imaging is utilized to perform inspection of the upper and lower airways, and obtain fluid and tissue specimens of the lung to aid in the diagnosis and treatment of pulmonary diseases.
The bronchoscopy unit is part of the medical and surgical endoscopy suite which also includes gastro-intestinal endoscopy and colo-rectal endoscopy. It is located on the 2nd floor, west wing of the new Stroger Hospital of Cook County. Our instruments are up to date and include new fiber-optic video-bronchoscopes, ultra-modern C-arm for fluoroscopy guidance, and tools to perform transbronchial biopsies, transtracheal aspirates, bronchial brushing, endobronchial biopsy, and broncho-alveolar lavage. We also maintain the capability to perform bronchoscopy at the bedside of patients admitted to the intensive care unit when clinically appropriate.
On average, we perform about 40 to 50 bronchoscopies per month. We also routinely perform closed pleural biopsies and diagnostic and therapeutic thoracentesis in the bronchoscopy suite.
Our referral base includes the inpatient pulmonary consult service which provides expert consultation to all adult inpatients admitted to the hospital, including all critical care and non-critical care units. Patients are also referred for bronchoscopy from the pulmonary clinic as well as from community hospitals and ambulatory clinics and health centers (via the pulmonary clinic).
Patient safety is a key consideration in planning for a bronchoscopy. As a result, every bronchoscopy in the hospital is staffed from start to finish by a board certified pulmonologist with the assistance of pulmonary fellows and staff nurses. In fact prior to obtaining privileges at the hospital, all the pulmonologists currently on staff had performed over hundreds of bronchoscopies. In addition, patients are screened thoroughly prior to each procedure, and are continuously monitored, in line with current practice standards, for the entire duration of the procedure, and until recovered from sedation. As a result, we have maintained a low complication rate over the years.
The bronchoscopy unit also provides educational experience that contributes significantly to the training of pulmonary fellows. Under supervision by the Attending Pulmonologist, pulmonary fellows are guided to acquire the requisite skills to ultimately become capable to independently perform bronchoscopies safely and completely. Many of our fellows achieve and demonstrate this competence in their first year of training as a result of the volume of procedures that they are exposed to, and excellent hands-on training. The fellows also benefit from the vast spectrum of pathology that is encountered at this hospital which helps significantly to advance their knowledge and is unrivalled in many tertiary care hospitals across the country.
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Pulmonary Function:
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The Division of Pulmonary Medicine/Critical Care runs a full service pulmonary physiology laboratory. We perform several tests of lung function including spirometry, a measure how well air moves in and out of the lungs, Lung Volumes by Nitrogen or Body Plethysmography, which measures how big the lungs are, and Diffusion Capacity, which measures the ability of the lungs to transfer gases like Oxygen and Carbon Dioxide from the air into the blood stream. We also perform bronchoprovocation challenge tests with Methacholine, Cold Air, and Exercise to determine if someone might have asthma. Finally we perform several types of exercise tests from complete cardiopulmonary exercise tests with a metabolic cart, indwelling arterial line and a 12 lead EKG, to a more simple oxygen desaturation study which only measures oxygen saturation, EKG, and work on a bike. Exercise tests are used to determine why someone may be short of breath, and can measure how much work they can actually perform.
The lab is directed by Robert Cohen, M.D., with technical supervision by Moises Ortega, RCPFT, RMLT. We have three pulmonary physiology technicians: Audrey Brown, CMLT, Jocelyne O'Keefe, CMLT, and Thelapilly Skariya, CRTT, CPFT.
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Sleep Laboratory:
After comprehensive evaluation at the Sleep Disorders Clinic, the patients are studied at the Sleep Disorders Laboratory at Stroger Hospital or at the Rush Medical Center Sleep Disorders Laboratory. The majority of the patients tested have complex disorders and many have multiple sleep disorders, like severe sleep apnea, parasomnias and movement disorders. After interpreting the studies, our board certified specialists contact the patients directly to discuss the study results and the plan of action. These plans comprehensive are guided by the availability of the full medical record at the time of interpretation.
For patients with sleep apnea, the plans are forwarded to the vendor of durable medical equipment that will follow up with the patient to set an appointment to give detailed instruction on the use of positive airway pressure device.
Our contact information:
Sleep Clinic Appointments: (312) 864-7371
Sleep Laboratory Rescheduling: (312) 864-2910
Pulmonary Rehabilitation:
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The Division of Pulmonary Medicine/Critical Care runs two American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) certified Pulmonary Rehabilitation Programs. We run complete Phase II outpatient pulmonary rehab program which consists of 36 sessions given 3 times per week over 12 weeks. The program has capacity for 13 new patients every 12 weeks. The sessions are 2½ hours long and consist of 30 minutes of lecture and health education, and 90 minutes of stretching, warmup, and upper and aerobic exercise. We also offer Phase III outpatient maintenance pulmonary rehabilitation to 14 patients at a time, usually for 6 months to one year. This program consists of two 90 minute sessions per week of stretching, warmup, and aerobic exercise. The program is equipped with three treadmills, two recumbent bikes, two arm ergometers, and free weights. We also have the capacity for EKG telemetry monitoring of up to 5 patients at one time. One feature of the program is an optional Yoga class which teaches very useful breathing and stretching techniques. The program also runs a "Better Breathers Club" pulmonary support group which meets monthly.
The medical director of the program is Robert Cohen, M.D., but the heart and soul of the program is our Pulmonary Rehabilitation Coordinator, Gail Harris, RRT, CPFT, our Social Worker is LaSharon Denis, MSW, our Dietician is Jennifer Lynch, R.D., our Nurse Clinician is Loretta Odom, R.N., B.S.N., and Susan Gilkey, M.D. is our Yoga instructor.
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