Kentucky Doc Summer 2018

summer 2018 • volume 10 • issue 2

Physician Interests

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CONTENTS

Doctors, Walnut and Mahogany PAGE 5 Horseback Riding: PAGE 9 Physician Musician: Dr. James Borders PAGE 10 Pilot: Dr. Larry Cunningham PAGE 12 Childhood Illness and a Life in Medicine PAGE 14 Lee Kiefer: Mens Sana in Corpora Sano PAGE 16 GOLF Fitness & Lifestyle PAGE 19 Community News PAGE 22 S.T.O.P. A Simple Mindfulness Practice for Physicians and Patients PAGE 24 MILD Treatment Alleviates Pain PAGE 26 Hi-Tech Artificial Limbs PAGE 28

EDITORIAL

BOARD MEMBERS Robert P. Granacher Jr., MD, MBA editor of Kentucky Doc Magazine Tuyen Tran, MD Lowell Quenemoen, MD Tom Goodenow, MD John Patterson, MD Thomas Waid, MD Danesh Mazloomdoost, MD

FROMTHEEDITOR • SUMMER 2018 Robert P. Granacher Jr., MD, MBA, Editor-in-Chief, Kentucky Doc Magazine We welcome all readers to the summer edition of KentuckyDoc magazine, the magazine by physicians and for physicians of the Lexington Medical Society. We start off with an article

by Dr. Granacher about two of our LMS colleagues, Bill Wheeler, retired obstetrician-gynecologist, and David Bensema, Lexington internist and Past President of the Kentucky Medical Association. Both doctors are superb woodworkers and have gained that skill over the years by different paths, however. Dr. Wheeler spent considerable time in Indiana studying with Marc Adams. Mr. Adams is portrayed with Bill on the cover of KentuckyDoc, and is also noted in a large photo within the body of this work.

On the other hand, Dr. Bensema came to woodworking as a high school student and followed the very interesting path of self-development in woodworking, as noted within the body of the article.

Current LMS president, Tuyen Tran, M.D. has completed an interesting profile on Christine M. Lohr, M.D., Chief of Rheumatology at the University of Kentucky Medical Center. She finds horseback riding and caring for her horses mitigates the stress that a physician would normally experience in clinical practice. The article portraying Dr. Lohr informs us about various technical aspects of hobby horse-riding that most of us probably do not know or understand. It is worth your readership.

Jim Borders, M.D., a Lexington internist and LMS member, portrays himself and gives physicians an insight to how music has played a role in his avocation life. He began playing piano at age 10 and pursued rather informal education thereafter. Like many musicians, liturgical music and gospel music provided a strong impetus for his learning of music.

Past LMS President, Larry Cunningham, M.D., is a certified multi-engine pilot. There is a beautiful picture of him with his prize plane within this magazine. Dr. Tran has characterized flying as an escape for him and enables him to “leave it all behind.”

LMS member, John Patterson, M.D. provides us a poignant window to our colleague, Bill Witt, M.D. Bill sustained a C-3 cervical spinal fracture with resulting quadriplegia in 2015. This article enables us to enjoy Bill’s journey in medicine and his philosophical approach to a catastrophic accident. He is an example to all physicians and gives a physician’s view of a wonderful medical life, the origins of his entry into medicine, and his current challenges. We all wish Bill the best.

This quarter we have the first review of a medical student in KentuckyDoc magazine history. Lee Kiefer is currently a medical student at the College of Medicine at the University of Kentucky. She is not only a medical student but also a world class accomplished fencer. One of her remaining aspirations is to compete in the 2020 Tokyo Olympiad.

John Patterson provides us an informative second article on mindfulness practice for working physicians.

He points out how to improve one’s function during the day by following the acronym S.T.O.P. Mindfulness is a well-studied technique widely used for reducing stress in physicians and patients alike. It is worth reading. Lastly, our publisher, Brian Lord, provides us with an interesting review of Hi-Tech artificial limbs.

I think you will find the summer edition excellent reading for a quiet moment sitting by the pool or in the backyard of your home. Best wishes to all for a happy and productive summer.

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© Copyright Kentucky Doc Magazine 2018. All rights reserved. Any reproduction of the material in this magazine in whole or in part without written prior consent is prohibited. Articles and other material in this magazine are not necessarily the views of Kentucky Doc Magazine. Kentucky Doc Magazine reserves the right to publish and edit, or not publish any material that is sent. Kentucky Doc Magazine will not knowingly publish any advertisement which is illegal or misleading to its readers. Kentucky Doc Magazine is a proud product of Rock Point Publishing.

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Summer 2018 • Kentucky

Doctors, Walnut and Mahogany

By Robert P. Granacher, Jr., MD, MBA, KentuckyDoc Magazine This quarterly edition of KentuckyDoc features LMS physicians and their hobbies. Two LMS members, William Wheeler M.D. and David Bensema, M.D., have chosen woodworking as a hobby. As with most physicians who choose hobbies, Bill and David came to their hobbies by different routes. When Bill Wheeler began thinking about retirement, while continuing his practice as an obstetrician/gynecologist, he decided to choose woodworking as a hobby. Being a surgeon, he was afraid of injuring his hands, so initially he avoided power tools. He built a shop behind his home. He gradually concluded about woodworking, “I need to learn how to do this.” Thus, he became heavily involved with Marc Adams Woodworking School in Franklin, Indiana (www.marcadams.com).

As a companion to this article, there is a picture of Bill with Marc Adams while Bill was formerly studying at the woodworking school.

While practicing medicine, Bill based his woodworking shop in his garage. Working there helped him divert his mind from the stress and rigors of medical practice, and he believes his new hobby was instrumental in helping him avoid burnout. However, he had to clean up the garage extensively, move his equipment so the automobiles could be put in the garage, etcetera. This was some hindrance to the development of his woodworking hobby. Initially, Bill built mostly cabinets, detailed boxes, and furniture for his grandchildren. He now has a woodworking lathe that he acquired after his wife’s high school music teacher offered them the lathe and he has increased the numbers of other woodworking tools.

I asked Bill what advice he would give physicians who were interested in woodworking. He suggested that physicians first take a basic class in woodworking as it is important to learn the functions of various woodworking tools. Then one can choose an area, be it cabinetmaking, furniture carving, making fine furniture,

etcetera. It is important to formulate a plan such as how to do “X,” and then develop the plan with research or further education in woodworking. Bill believes that Marc Adams Woodworking School has been instrumental in the development of his skills in woodworking. Another aid to him was the magazine subscription to Fine Woodworking (Taunton Press: www. taunton.com/woodworking) Over the years, he has attended woodworking classes on site in Franklin, Indiana. Classes tend to run from 8:00 a.m. to 6:00 p.m. five days a week.

Classes are also available for those who want to learn how to sell their products, and the “business of woodworking” is taught within the overall academic framework of the Marc Adams Woodworking School.

After retirement, a great benefit has been derived from the woodworking hobby he has pursued. He notes that it gives him something to do every day. Bill said, “one thing physicians will note immediately upon retirement is that there are a lot of hours in the day.”

I reviewed the Marc Adams Woodworking website, and it is quite interesting. There are multiple pictures posted of attendees and their work products (Bill is noted with Marc Adams in an attached picture). Adams has taught 33,000 attendees since he developed his school 25 years ago. He encourages alumni of the school to come back and assist in teaching to further their skills, not unlike the old medical adage of “learn one, do one, teach one.”

Picture 1 accompanying this article is of Bill Wheeler and Marc Adams when Bill was attending a session at the woodworking school. Picture 2 is a recent bed swing currently under creation by Bill.

On-the-other-hand, David Bensema, M.D. followed an entirely different path to woodworking than did Bill Wheeler, M.D. David first became interested in woodworking at about age 14. He made shadowboxes at that time. He saved his money from their sales and he began to buy woodworking equipment. When he began

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David Bensema, M.D. in his woodworking shop.

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“Within minutes, one is able to see the product of one’s handiwork and within only a few days, a piece of furniture is born.” – David Bensema, M.D. making shadowboxes, he had only a miter box and various saws for tools. His father built the miter box for him. As he began to acquire more woodworking equipment, his skills improved. He continued woodworking when he went to college. Like many college students, he had little extra money, so he made most of the gifts that he gave to family members and others.

After David completed his residency and entered the practice of internal medicine, he and his wife Marian, built a home. During garage construction, he noted that the footprint of the garage was quite large. He asked the construction contractor if it would be possible to put a basement under the garage. The contractor agreed that it would not be a problem, and David now has a 28’ x 28’ woodworking shop under his garage.

David has since added lathes, and he has also incorporated a professional dust collector system. He finds the hobby of woodworking

to be extremely stress reducing. He works with earmuffs to protect his hearing, and a mask to protect his eyes and keep dust out of the nose. He finds the sensory deprivation to be quite calming to him as he works. He has made chests of drawers for six nieces, and he has also built other forms of chests for nephews to store items of interest to them.

I asked David to describe what he thinks is one of the greatest benefits from his woodworking hobby. He advised me that not only is it calming, but it provides an immediate emotional return to the woodworker. Within minutes, one is able to see the product of one’s handiwork and within only a few days, a piece of furniture is born. David pointed out to me that many physicians, such as myself, have careers in which getting feedback about one’s success at treating a patient may take years. With furniture making, the feedback comes in only days.

As examples of David’s work, Picture 1 demonstrates a beautiful storage box with dolphins in relief. Picture 2 portrays a spindle back classic rocking chair.

It was obvious to me that both Bill and David thoroughly enjoy their chosen hobby.

They have taken profound satisfaction from their work for many years, and they encourage any physician with a creative bent toward woodworking to pursue this hobby.

About the Author Robert P. Granacher, Jr., M.D., M.B.A. practices clinical and forensic neuropsychiatry in Lexington. He is a noted scientific author, past president of the Kentucky Psychiatric Medical Association, and past president of the Lexington Medical Society. He is a Clinical Professor of Psychiatry at the University of Kentucky, College of Medicine.

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Horseback Riding: Interview of Dr. Kristine M. Lohr, Chief of Rheumatology at U.K.

By Tuyen Tran, MD What is horseback riding?

Are there different types?

Horseback riding is exactly what it sounds like – riding a horse. There are a many different types. The two basic horseback riding styles are English and Western, the saddle is the biggest difference between the two. I started out as a hunter jumper.

Eventing, like the Kentucky Three Day Event at the Kentucky Horse Park could be termed an "equestrian triathlon." It involves working with a horse both on the flat and over fences. The three phases are: dressage, endurance (or cross-country), and show jumping. I switched to dressage (“working on the flat”) only because I didn’t have the mindset to get the horse over the jumps. Also popular is saddle seat riding which is also a form of English riding.

Examples of Western riding include Western Pleasure, reining, cutting, barrel racing, and endurance. And then there are racing events, such as, steeple chasing and vaulting.

The FEI World Equestrian Games (WEG), held in Lexington in 2010, combined eight disciplines – jumping, dressage and paraequestrian dressage, eventing, driving, endurance, vaulting and reining.

How did you get started?

I always wanted to ride as a child, but it wasn’t in the family budget (50 cents for a group ice skating lesson in an outdoor rink in Buffalo NY was affordable, as were piano lessons). During my rheumatology fellowship at Duke, I overheard other trainees in the lab talking about their riding lessons. I rode hunter jumper during those three years, transitioning to just dressage toward the end. We took lessons in the arena and went on trail rides through the nearby Research Triangle Park area. Initially the two trainers thought I wouldn’t be successful.

Henry the pinto, one of the horses I rode, had two trees out in the pasture – one for every time he bucked someone off, and another tree totally devoted to bucking me off. Eventually I caught up with my lab cohorts and graduated to leading trail rides.

With riding comes injury. I had massive bruising from being kicked in the thigh, a broken toe from being stepped on, delayed splenic rupture from a kick to the celiac axis, and a concussion after being bucked off.

So, training with someone who helps you understand equine behavior and teaches you safety tips to avoid most riding accidents is absolutely key. It’s all about safe habits and protective gear (especially an approved helmet), and maintaining your tack (e.g., saddle girth, stirrups and reins).

Why do you continue to pursue this hobby? Many of us are overwhelmed with our current responsibilities.

Where do you find the time?

I make the time. Riding is my stress relief; so is hugging my horses, dogs and cat. I competed for a couple years but realized that even that was stressful.

Initially I leased a horse, until my coach called and said she’d found my horse. (I wasn’t looking – but it was love at first sight). I boarded Miss Ella, a retired thoroughbred off the track, only seeing her pretty much when I went to the farm to ride her. But then I moved to the Bluegrass and chose a mini-farm and built a riding arena and barn. You develop a different relationship when you’re the one feeding the horse, cleaning the stall, and generally looking out for the horse and maintaining the farm. Now I can’t imagine not living in the country. Nine years ago, Ella retired when I adopted The Nth Degree, another thoroughbred off the track. Starting over again, teaching him dressage in the natural

horsemanship style is, to me, a physical form of meditation. (And Ella supervised – she just left me at age 34 years.)

I go to Keeneland about once a year, just to watch the athleticism of the horses. Starting in 2008, I volunteered for crossover gate and crowd control at the Kentucky Three Day Event. Since then I recruited three out-of-town friends to join me. There is nothing like being inches to a few feet away from a horse and rider that are galloping from one cross-country gate to another! For WEG 2010, I was a competition volunteer for 10 days. It is absolutely awesome being behind the scenes. I was a dressage scorer (stationed in the tower where I could watch all the rides and verify final scores), a crossover gate and crowd controller, and a stable manager, where I could watch live event feeds, when not handing out schedules or, yes, cleaning up roads and shower stalls after horse manure.

Physicians are extremely vulnerable to burnout. Do you find that your hobby mitigates the stress? Do you feel recharged after playing?

Indeed my “hobby” mitigates the stress.

You can’t think about prior authorizations and denials while focusing on your horse’s response to your aids and requests. Being the caregiver to my horses, dogs, and barn cat is a lifestyle. They keep me active – riding is aerobic exercise! Add lifting 50-lb feed sacks, hay bales, and water buckets to the program, and I can have that bite of chocolate. I’m mentally recharged.

Dressage is described as “the art of riding and training a horse in a manner that develops obedience, flexibility and balance.”

I’d change “obedience” to “willingness.” It’s all about the relationship and working as a team of two”.

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Physician Musician: Dr. James Borders

By James Borders, MD Currently, I do not play in a band, having left a band in the summer of 2015, but I continue to play piano. I remain available, on occasion, to play for background music for hospital events.

Previously, I played keyboards, for about three years, with a Lexington progressive jazz group called, "Ozone", a six-member group led by a seasoned and talented saxophone player named Paul Osborne. Our band consisted of a guitar, bass, xylophone, drums, keyboards, and saxophone/flute instruments. We played most often at Natasha's, a downtown restaurant and art venue. On occasion, we played at the Ecton Park weeknight jazz event and various local and private events. I was the "weakest link in the chain", performing with truly talented and dedicated musicians.

I started playing piano at age 10 with most of my music education being quite informal, having had about 5 total years of formal lessons over a wide timespan. I learned most of the "playing by ear" with church and gospel music.

I do believe that music is a wonderful stress reliever and have often said that one needs a strong avocation to balance a strong vocation. With regard to music and a life in the arts in general, I've cautioned others to be wary that making an avocation a vocation may ultimately prompt an individual to seek another avocation.

I feel fortunate to use my art as a hobby and stress reliever and not a source of income. American society undervalues art, as my two children, both of whom have made artistic pursuits their livelihood, can attest. My son Jason is a sculptor and artist and daughter Kathryn ("Kabby") is an actor – both living on the west coast.

When I was a senior in medical school, I was the student representative to the admissions committee and would ask prospective medical students the question, "If you had two lives to live, and this one was in medicine, what would the other be?"

Some candidates were crest-fallen to learn that, "The other one would be medicine, too!" was a disappointing answer for me.

The modern pressures of economic survival and customer service expectations have forced students and practitioners of medicine to spend less time developing the character traits and other personal skills that make for a well-rounded physician and person, a renaissance person possessing many talents and areas of knowledge.

These skills outside of formal medical education are, in my opinion, just as valuable in preparing a physician to fully appreciate, respect, engage, and counsel each patient as a unique and interesting individual. This ability in a physician helps fortify against physician burnout. A personal connection with the people we encounter built upon the ability to see the whole person creates an energizing and affirming experience as we engage in patient care, the very antidote to burnout.

“One needs a strong avocation to balance a strong vocation.”

– James Borders, MD

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Flying makes me feel powerful. It gives me the freedom to travel, independence. – Dr. Larry Cunningham

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Summer 2018 • Kentucky

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Pilot:

Proud to Dr. Larry Cunningham Partner with You

By Tuyen Tran, MD

For many physicians, the question is not “if,” but, “when” you will experience burnout. A recent systematic review and meta-analysis of physician burnout published in Lancet in 2016 estimated that about half of the US physicians will experience burnout. Of the many possible strategies proposed to mitigate burnout, hobbies offer an opportunity to recharge your body. Although many of us have little time to dedicate to hobbies, they do provide many benefits that outweighs the time they require. I asked one of our LMS members, Dr. Larry Cunningham to share his hobby.

Dr. Larry Cunningham, an oral surgeon, took me to the Bluegrass airport to show

me his plane. He admitted that he initially learned to fly because his father and uncle were pilots. “It was just a cool thing to do,” Dr. Cunningham commented. He continued, “Once you reach your 40’s, the stamina erodes and you realize that you don’t want to do this [surgery] all the time.

I fly to escape, leaving it all behind. Flying makes me feel powerful. It gives me the freedom to travel, independence.”

Flying a plane is not a stress-free situation. “Although I still have to be laser-focused while flying, there is no one up there. It’s peaceful,” Dr. Cunningham shared. He acquired his pilot’s license in 2005 and reported that he takes a trip at least once per month, often taking the entire family on trips.

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PROFILE IN COMPASSION

Childhood Illness and a Life in Medicine

By John A. Patterson MD, MSPH, FAAFP William O. “Bill” Witt, MD chaired the UK Department of Anesthesiology for thirteen years, during which time he created a chronic pain service, a full-time cancerrelated pain service, the nation’s first fulltime patient-controlled postoperative pain service, the first full-time pre-anesthesia clinic and one of the first accredited pain fellowships in the country. Retiring as Chairman, he was offered the directorship of the Duke Pain and Palliative Care Institute.

He elected to stay at UK, fearing that what he had created could collapse without an

institutional commitment of space and faculty.

When he retired from UK he wanted to fulfill his dream of “a medical practice exactly my way” and Cardinal Hill Hospital was eager to accede, down to the slightest detail.

Five years later, in 2015, his dream turned to a nightmare when a home accident caused a C-3 cervical spine fracture and quadriplegia.

Personal childhood illness inspired him to become a physician and, as he points out, he will always be a physician.

On being a pediatric patient Bill’s career in medicine was inspired by his experience of strep throat and tonsillectomy at age two. This future chair of anesthesia vividly recalls being forcibly

restrained and smothering under a mask for ether anesthesia as he struggled to get free. Today, we require parents to be with their small children but back then they were required to leave. He cried and cried until the mean nurse put him in a room by himself, slammed the door and said ‘shut up you little brat.’

He says-“I knew right then- that was no way to treat children.”

His family doctor’s kindness Bill’s strep throat led to rheumatic fever. He recalls Dr. Whittemore coming to his house after a full day to listen to his heart murmur.

He would interrupt Bill’s constant chatter with “OK, Billy, breathe real quietly now.” Bill studied the doctor’s face. He remembers the

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stubble of his beard, the smell of his cigarettes and the smell of his sweat. Although he didn’t even understand this man was a doctor, he recalls “an almost God-like experience of having him come to my house to help me.

Thinking about it to this day makes me emotional. I just wanted to be like him.”

“What impressed me most was his touch.

He would squeeze my shoulder and say ‘I’m going to take care of you, Billy’.” Bill received regular penicillin shots (the standard treatment then for rheumatic fever) but he never cried even though the shots hurt. “I just knew that he would come and touch me and reassure me. Throughout my teaching career in anesthesia and pain management, I always told medical students and residents ‘don’t ever leave a patient’s bedside without touching them’. Michelangelo said ‘to touch is to heal’.”

“Of all the things a doctor can do for a patient, it is crucial that they touch them and let them know the doctor is on their side.” As a physician, Bill would arrange the chairs in the exam room so he could sit right next to the patient, non-verbally communicating that he was on their side.

Geralyn Wojtowicz is a physical therapist who says “I learned more from Bill Witt than anyone else about how to interact with patients. They loved him. When he entered the exam room he always met them eye to eye, shook their hands and called them by their name, treating everyone with the same level of respect, regardless of age, race, title, sexual orientation or social status.”

Determined to be a doctor Like his family doctor, Bill realized that he “just wanted to help sick and injured peopleI always wanted to take care of people.” At age thirteen, he taught first aid for the Red Cross and got his Boy Scout first aid merit badge. He was on ski patrol in the Minnesota winters and a lifeguard in summer. He took EMT training and worked on an ambulance during home games of the Minnesota football Vikings and baseball Twins.

Inspired by his own early childhood experience, we wanted to be a pediatric cardiac surgeon “and repair children’s hearts.”

Though he scored in the 98th percentile on the MCAT, he had a B average in college (mostly due to playing music). He was an alternate for five straight years and remembers thinking “if I ever get in, I’ll show you.”

From alternate to top honors In medical school at the University of Minnesota, he almost lived in the labs and the hospital, driven to excellence and perfection. “I loved every specialty I rotated on.” He worked in a free OB clinic. He got over 50 deliveries by sleeping on a gurney outside the delivery room and asking the exhausted residents if he could do the delivery. He rarely went home. He was allowed to finish medical school in three years and was elected to AOA, the medical honor society. He was first in his class.

Choosing a career in anesthesia Bill remembers seeing a crying toddler standing alone after a circumcision “crying his poor little eyes out” with a bloody bandage wrapped around his penis. He thought “What has gone wrong with medicine? Why do we allow this?” Infant boys were strapped down on a papoose board and given no anesthesia for circumcisions because, as one boardcertified OB-GYN said, “they don’t feel pain at this age.” He decided to learn about anesthesia before training in pediatric heart surgery. He wanted to learn how to control the procedural pain being inflicted by wellmeaning physicians.

Ballard Wright was chair of UK anesthesia and permitted Bill to try some novel approaches to pain control in ICU patients.

Determined to do a better job than had been done on him at age two, he transferred from surgery to anesthesia and prided himself on his care of children.

Rocky Raccoon During his anesthesia residency, children were still being held down and a mask put over their face to administer anesthesia. Bill went to a magic store and bought a raccoon doll he named Rocky Raccoon. Before surgery, he would enter a child’s room, crawling on his knees to avoid intimidating the child. He told the parents he knew how stupid this looked but that it was important to the child. “I’m going to be a little silly so your kid thinks I’m a kid, too. Just bear with me. I know this child is the most precious thing in your life.” He loved the way young children kept looking back and forth between him and the parents, taking their emotional cue from the parents’ facial expression.

He’d show the child Rocky Raccoon on his left hand. In his right hand he had ketamine in a medicine dropper. After dropping one drop in each of the child’s nostrils, we would say “Oh, Rocky just sneezed. Did he get any on you?” The child would quickly be in twilight and ready to go to the OR. He had already told the OR nurses to keep it quiet- no music, no talking- saying “we are not going to have a traumatic experience that could affect this child for a lifetime.” He gently transitioned the child from his lap to the operating table and the anesthesia mask.

Rewards of academic anesthesia Eventually, Bill was appointed chair of UK anesthesia- the youngest in the country at age 40. He loved pediatric anesthesia, especially the little heart patients, though it was heartbreaking seeing the blue lips of cyanotic heart disease. He always saw the child and parents the night before and took as much time as necessary. He continued his Rocky Raccoon routine to put little kids to sleep without emotional trauma.

He always made parents a series of 4 promises. “I’ll do the best I possibly can. I won’t do anything to your child I wouldn’t do to myself or my own children. I won’t do anything for which there isn’t some evidence

for doing it. I’ll tell you the truth and the rest is up to God. These are the only four promises I can give you with the absolute guarantee they will not be broken.” He admits he can’t imagine handing over his own child“It’s such a huge thing.”

He started UK programs in cardiac anesthesia, creating a cardiac anesthesia group with defined protocols. Initially, he was the only anesthesiologist in the group but was on-call 24/7 until others could be recruited.

He had joint appointments to neurosurgery and hematology/oncology to teach residents and fellows. He smiles when he goes to his Cardinal Hill Hospital appointments with Dr. Salles, who he adores, and sees the signs to the Pain Clinic and the Pre-Anesthesia Clinicboth of which he started.

Of all the things a doctor can do for a patient, it is crucial that they touch them and let them know the doctor is on their side.

– William O. “Bill” Witt, MD

His main self-care strategy? “God.” Though he grew up in the church, he didn’t like it. He is grateful now to his parents for that foundation. It gave him something to go back to. “At some point in life, you will have enough stress that it puts you on your knees.” At the suggestion of a friend several years ago, he attended a men’s retreat at Gethsemani Abbey near Bardstown and had a life-transformative experience in the middle of the night.

“God created coincidence to protect his anonymity. Throughout my life, somebody has appeared for some random reason, and has changed my life. I’ve never prayed for material possessions. The only thing I have prayed for since that night at Gethsemani is wisdom.” He has a pastor friend who has said to him- “Doctor Witt, you don’t have a medical practice- you’ve got a ministry.” Bill WITT Continued on Page 23

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Lee Kiefer:

Mens Sana in Corpora Sano

By Thomas Goodenow, MD A link between exercise and mental and physical well-being has been recognized since antiquity. Even modest exertion is now thought to be associated with a decreased risk of obesity, diabetes, cardiovascular disease, and dementia, and most people feel more confident and capable if they are physically active. The Romans, specifically the poet Juvenal, had a saying which urged individuals to perfect the mind-body connection, calling for “mens sana in corpora sano,” or “a healthy mind in a healthy body.” This was one of Harry Truman’s favorite phrase. This also is a motto for many schools, military organizations, and sports teams.

One person who embodies this ideal is second year UK medical student Lee Kiefer of Versailles. Many practicing or aspiring doctors engage in recreational or competitive sports to bring balance and enjoyment to

their notoriously busy lives, but she takes the idea to its highest level. Lee is a competitive international fencer, and one of the world’s best. It is hard to believe that this young, rather humble and quiet, lean, five-feet-four woman is the same aggressive dynamo that one sees in competition. She credits her athletic and educational success to innate ability, hard work, and a very strong competitive drive, attributes that serve her well in both endeavors. She is also quick to credit much of her success as a fencer to the expert coaching she has received in Louisville, Lexington, and college, beginning with her first coach, her dad.

For Lee, fencing has truly been a family affair. Her father Steve grew up in Erlanger, was a foilist and fencing team captain at Duke.

When he was looking for an activity to engage seven-year-old Lee and her two siblings (something that would fit their personalities and less-than-massive physiques) he naturally

turned to fencing, with the foil as the weapon of choice. (Almost any foil fencer will assert, with good reason, that foilist are the smartest, quickest, most agile, patient, resilient, resourceful, and best looking of all fencers.)

So, Lee, her older sister Alexandra (“Alex”), and younger brother Axel took up fencing at an early age. Dad was a benevolent but demanding taskmaster, hammering away about the importance of boring things like footwork, while the kids also commuted to distant Louisville for expert instruction. “It was hard at first,” says Lee. “It takes two or three years before you know if you will be any good. We were getting tired. But there was one good thing. We were too tired to get into any trouble.” But a love for fencing eventually blossomed, especially since all three Kiefer children demonstrated great aptitude for the sport and winning became its own reward.

The situation further improved when Steven was able to persuade foil guru Amgad Khaz-

bak to relocate from Houston to Lexington as maestro of the newly established Bluegrass Fencers’ Club (BFC), where Lee still trains.

Under the new set-up, the Kiefer kids thrived even more than their father had ever dreamed. Alex would become an NCAA foil champion at Harvard, and Axel became a first team all-America selection at Notre Dame.

However, it was Lee who really excelled as she began to mount podiums at international cadet and junior championships. When she entered college at fencing powerhouse Notre Dame, Lee was, in the words of eventual head coach Gia Kvaratskhelia, “a finished product.”

By the time she graduated, she was arguably the most honored student-athlete in that school’s long, illustrious history. Her fencing accomplishments included a record number of consecutive Pan-American championships, four consecutive individual NCAA

championships in her event (a rare occurrence for any sport), participation in the 2012 (London) and 2016 (Rio) summer Olympics, several World Cup wins, and two International Fencing Federation (FIE) Grand Prix championships.

However, from a fencing standpoint, Lee says she is most proud of her performance in 2017. Not only did she capture her fourth individual NCAA title that year, but her efforts led the Fighting Irish to the first of two consecutive team titles. This closely followed a victory in the Long Beach FIE Grand Prix which propelled Lee to the #1 world ranking in women’s foil, a first for an American woman, as she also became only the eighth U.S. fencer of any sex or weapon to ever hold a top FIE ranking. Then in July, Lee led the American women’s foil team to a silver medal at the FIE Senior World Championships -the team’s highest finish ever.

A passion for medicine has also become a Kiefer family tradition. Lee herself never felt pushed into medicine, and she was not always certain that she would become a doctor, but gradually she succumbed to the allure and challenges of the profession. Her mother Teresa is a psychiatrist, and her father Steven is a neurosurgeon in Lexington. Following in her dad’s footsteps, Alex recently earned an MD degree from U of L and will soon start an internship. Axel will be a college pre-med senior this fall.

How does one stay near the top of a sport while pursuing the requirements for a medical degree?

Lee says that she is used to this kind of balancing act, accustomed to efficiently managing her time for all of her pursuits.

Discipline, mental toughness, attention to details, and especially competitive fervor are traits that carry over from her fencing to her medical studies, and vice versa.

She enjoys learning new things in school, and she says there are still plenty of new fencing tactics that she is learning, even after nearly seventeen years in the sport.

The two pursuits prevent tedium, keep her mind sharp and engaged.

Lee’s fencing career is not over. In April of this year she was on the podium again at a World Cup event in Germany, and currently she is ranked #3 in the world by the FIE. She fences and cross-fit trains for several hours a week at home or at the BFC. Competing in the 2020 Tokyo Olympiad is just one of her many remaining aspirations. Fencing is still fun. Lee says there is no better feeling than socializing and practicing new tricks and tactics with fellow fencers in the gym. When she eventually completes med school and ceases competition, she would like to give back to the sport in some way, perhaps as a source of knowledge and inspiration for aspiring newcomers.

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ANNOUNCEMENTS AWA R D S N E W S TA F F EVENTS AND MORE

EMAIL brian@rockpointpublishing.com TO SUBMIT YOUR NEWS

KentuckyOne Health encourages safe, healthy, summer weight loss Lexington, Ky. ( June 5, 2018) – Kentucky has the seventh highest obesity rate in the nation, with 66 percent of Kentuckians classified as overweight and 34 percent considered obese, according to the Centers for Disease Control and Prevention.

Excessive weight doesn’t only affect the number on the scale, but it can lead to harmful, chronic illnesses. With summer upon us, it’s the perfect time to take control of your weight loss goals. KentuckyOne Health is encouraging those who are overweight to consider a safe and healthy weight loss program this summer.

“Summer is an ideal time to begin a weight loss journey,” said Joshua Steiner, MD, medical director, KentuckyOne Health Center for Weight Loss Surgery at Saint Joseph East. “Fruits and vegetables tend to be fresher and more readily available, and since the daylight hours are longer, making time for exercise seems more feasible.”

Negative health effects of being overweight and obese include osteoarthritis, gallbladder disease, sleep apnea and other breathing problems, and a higher rate of morbidity. The condition can also lead to clinical depression and anxiety.

For more information about weight loss options through KentuckyOne Health, please visit www.kentuckyonehealth.org/ weight-management or call 859.313.2393.

Our Lady of Peace receives top honors from KHA Our Lady of Peace, part of KentuckyOne Health, received top honors from the Kentucky Hospital Association (KHA), demonstrating dedication to patient safety and care. On May 11, select hospitals were recognized with KHA Quality Awards

at the 89th Annual KHA Convention in Lexington, including Our Lady of Peace, part of KentuckyOne Health. The KHA Quality Awards honor hospital leadership and innovation in quality, safety and commitment to patient care.

Our Lady of Peace received a Quality Award for its Long-Acting Injection (LAI) Clinic. The LAI Clinic is the first pharmacist operated long acting injection clinic at a behavioral healthcare center in the United States. The LAI Clinic helps provide easy access for patients to receive their long-acting injection on an outpatient basis with flexible scheduling and little wait time.

“We are honored to once again receive an award from the Kentucky Hospital Association, which recognizes our commitment to quality patient care and patient safety,” said Jennifer Nolan, president, Our Lady of Peace. “Our patients benefit daily from the Long-Acting Injection Clinic at Our Lady of Peace. We are thrilled to have our hospital and staff recognized for these efforts.”

This is the fourth time Our Lady of Peace has received this award. The hospital also received the KHA Quality Award in 2012, 2014 and 2017.

Our Lady of Peace is a private, non-profit hospital that offers the most comprehensive array of behavioral health and substance use treatment services in the state. This includes specialized programs and services along the full continuum of care, including inpatient, partial hospitalization and intensive outpatient programming for children, adolescents and adults.

To learn more about programs offered at Our Lady of Peace, visit http://www.kentuckyonehealth.org/our-lady-of-peace.

Lexington Clinic Receives Healthcare Achievement Award Lexington Clinic just recently received the 2018 Intalere Healthcare Achievement Award

for Community Impact and Innovation.

The project, Innovation at Work: Creating a Preferred Network to Improve Employee Health and the Bottom Line, was recognized for outstanding and innovative contributions to patients, community, and business partners in reducing healthcare costs and improving healthcare quality.

The award was presented at the Intalere Elevate 2018 conference in Orlando, Florida May 20 – 23.

The award was received for Lexington Clinic’s groundbreaking work with the Direct-To-Employer program. Lexington Clinic’s Direct-To-Employer program offers customized, premier partnership options for progressive employers in the Commonwealth, and is able to address both preventive care and chronic health conditions of employee populations to improve both employee health and the bottom line.

Dr. Trevor Wilkes Contributes to The Journal of Bone & Joint Surgery CME Program Dr. Trevor Wilkes, of Lexington Clinic Orthopedics - Sports Medicine Center, has served as the associate editor and content provider for The Journal of Bone & Joint Surgery Continuing Medical Education program. Dr. Wilkes provided the testing content in his area of specialty - Shoulder and Elbow Pathology and Surgery - and worked with colleagues from around the country to edit and produce the content for the 2018 program.

The Journal of Bone & Joint Surgery ( JBJS) has been the most valued source of information for orthopaedic surgeons and researchers worldwide for over 125 years and is the gold standard in peer-reviewed scientific information in the field.

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Summer 2018 • Kentucky WITT continued from Page 15

says “I do believe in a soul that goes on after death but I don’t know in what form.” He agrees he will always be a physician and that his work is indeed a ministry.

Living with pain Bill has spent over 30 years studying pain.

He has had a craniotomy, broken bones and 2nd/3rd degree flash burns but the spinal cord pain he experienced after the accident that caused his quadriplegia “is another universe of pain altogether.” He never knew pain could be like this. “Having a steam iron on my skin doesn’t do justice to it.” He has experienced flashing lights, colors and hallucinations. He is currently using a medication mixture of his own design per intrathecal pump and high dose oral Lyrica. Pain is always present and flares at times. “Before we found the right combination, the pain was teaching me. I thought I knew about pain. I didn’t have a clue how bad pain can be. God’s busy teaching me right now about what pain can be.”

From the Grand Ole Opry to quadriplegia Bill played guitar and sang solo country music in coffeehouses as an undergraduate and after residency. He later formed a five man band named Stampede. After winning a Kentucky state competition, Stampede played the Ryman Auditorium, “standing on the same floor that Hank Williams stood on.” He played for UK HealthCare and physician CME events across the state and organized an event featuring Stampede, Vince Gill and Floyd Cramer, the

“Stampede for Kentucky's Kids,” to benefit the construction of UK Children’s Hospital. “My voice isn’t as strong as it used to be. I can’t sing anymore. But life is still the ultimate gift; one for which I am very grateful (although typing with my tongue is tedious at best).”

He shopped around to find a colleague to close his tracheostomy. “A guy with a hole in his neck is inherently scary.” He didn’t want to scare children- his own children and grandchildren and other children- even though this limits future treatment options and risks shortening his life.

“Throughout my career, my greatest fear was quadriplegia. I never feared death. I feared quadriplegia. Now it is my daily experiencebut it does not define me.” Quoting Werner Erhard, Bill says “The truth is never to be found in a different set of circumstances. The truth is always and only to be found in the circumstances you’ve got.”

Medicine as a career He says “Medicine is a calling more than a business. To be truly satisfied with their careers, physicians need to find a way to serve- to meet people’s needs- asking themselves where they can be of the greatest service to humanity with their minds and their hands.” His medical school dean and advisor, Dr. William Sullivan, said: “With your performance in medical school you can go anywhere. Why don't you talk to my friend Ward Griffen in Kentucky. He's a University of Minnesota graduate, along with Ed Todd, Pat Hagihara and about half his faculty.”

He feels fortunate and proud to have come to

a state that needed him and created so many programs for people who needed them.

“If you go into medicine for wealth or prestige, you just made the biggest mistake of your life. If you go into medicine for any other reason than feeling called to do it- something you were meant to do- then don’t do it. You will hold a special place in society, but it comes with a cost. Unless you are willing to be peed on, pooped on, puked on and remove a bandage to find a wound covered in maggots- don’t go into medicine. It comes with the territory. People aren’t always squeaky clean and sometimes they are really mean. Medicine’s not for you if you’re not willing to have compassion for all of life, including the dark side.”

He believes our Lexington Medical Society mentorship program is a way to keep compassion alive for both the medical student mentee and the practicing physician mentor.

Bill’s son just finished his second year of medical school.

Final thoughts Bill says “Doctors are practicing in a field that is God’s workshop. It’s not us doing the healing and the curing. We can prescribe medicine, speed things up and slow things down.

Ultimately, selfless service is what medicine is all about. But so many doctors seem to hate their work, in large part due to government and institutional interference, and just want to retire.

Life is so fragile- so precious. You can’t do it over. Don’t do something you hate.”

Despite quadriplegia, Bill Witt continues to be a physician with a ministry.

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PHYSICIAN HEALTH AND WELLBEING

S.T.O.P.

A Simple Mindfulness Practice for Physicians and Patients

By John A. Patterson MD, MSPH, FAAFP Modern life is taking its toll on our nation’s mental and physical health.

Physicians and their patients both suffer from stress-related conditions and burnout. Multiple national surveys in the last year have documented an alarming increase in perceived stress, anxiety, depression and suicide. Our health and our very lives depend on our ability to manage stress in healthy ways at home, at work, in traffic, in relationshipsand simply inside our own skin. We need simple tools that we can use personally and also prescribe to bring some calm to the chaos- some peace to the frenzysome kindness to the aggression and competition. S.T.O.P. is one such tooltaken from the Mindfulness-Based Stress Reduction curriculum (1). This practice can take as little time as 1 breath or as long as you like.

“S” is for “Stop” and take Stock Aren’t there times when you just need a break- even for a minute- even for a breath? Make yourself a promise to recognize several times each day when you need some self-care and rejuvenation and simply stop. Step out of the unskillful, habitual reactivity of automatic pilot mode and step into the present moment.

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Step out of the doing mode and into the being mode. Reconnect with yourself and your natural inner resources of resilience, relaxation, peacefulness, compassion and wisdom. Really tune in- paying attention to what is happening right now, right here, without expectation, without an agenda other than a curious, open inquiry into what is actually happening inside you and around you.

Even if you don’t remember this entire sequence, just remember the word stop.

Have the intention to truly inquire into the three primary domains of your experience- 1) Body- sense perceptions and physical sensations , 2) Mindthoughts, images, plans, memories and 3) Emotions and feelings. Bring some welldeserved self-compassion and kindness to yourself, especially if your experience is unpleasant, stressful or painful.

Ask yourself, ‘What is my experience right now?” Simply notice what’s going on around you and inside of you, take stock of the situation, take your foot off the accelerator and slow down, grounding yourself with some conscious, natural breaths. In the process, your pleasant experiences may be more fully nurtured and your unpleasant experiences may be less onerous.

Alternatively, you might ask, ‘What is absent from my experience right nowwhat have I forgotten about myself, my work, my colleagues, my family.’ Allow experiences of kindness, compassion, generosity, awe and beauty and smell the roses along the way.

“T” is for “Take” a Breath Take a normal, natural breath, directing your full attention to breathing. Even one breath experienced with your full, unhurried attention can counteract the stress response. Feel the physical sensations of each inbreath and each outbreath- sensations in the nostrils as the air moves in and out- sensations as the air moves back and forth across the upper lip- sensations as the air moves in and out of the back of the throat- sensations as the chest expands and contracts- and sensations as the belly expands and contracts.

You may find it helpful to say to yourself “in” on the inbreath and “out”

on the outbreath. Use your breath as an anchor to bring you into the present moment and help you tune intentionally into your natural state of calm awareness and restful alertness.

“O” is for “Open” and “Observe” Expand the field of your awareness beyond your breathing, including a sense of the body as a whole, your posture, your facial expression and the sensations on your skin. Notice all your sense perceptions- touch, sight, sounds, smells and tastes. Expanding your awareness beyond your body, connect to the trees and all the green growing things you depend on for oxygen. Notice your thoughts and their fleeting, impermanent nature. Notice that thoughts are not always facts and not necessarily true.

Notice that you can intentionally choose to think your thoughts or let them go. Allow your emotions to surface, recognizing and naming them without judgment- ‘this is anger’- ‘this is joy’‘this is grief ’- ‘this is happiness’- ‘this is anxiety’- ‘this is depression’- ‘I know you.

I am experiencing you but you do not define me.’

Naming your emotions without selfjudgment helps to cultivate emotional intelligence, magnifying the benefits of uplifting emotions and reducing the power of distressing emotions. Opening your heart to your own stress, difficult emotions and suffering can nurture your natural capacity for human affiliation and social support and your capacity to help relieve the stress and suffering of other people and all living things. Your own self-healing is the core foundation of your patient care.

“P” is for “Proceed”/new “Possibilities” After this intentional slowing down, stepping off the treadmill and out of the rat race, take the benefits of this practice into the next moment, the next task, the next meeting, the next conversation, the next relationship- informing ordinary daily activity with the physiological benefits of mindful self-care.

Notice the world around you, experiencing how things really are, tapping into your intuitive inner wisdom for what you need right now- a chat with

doc

Summer 2018 • Kentucky a colleague, a call or text to a friend, a quiet moment alone, a bite of chocolate, a cup of tea. Then proceed with more clarity, from a place of choice and skillful responding rather than reactive, habitual auto-pilot.

Proceed without any expectation of how others will act or speak or behave. Be realistic about your inability to control the pace at which other people are moving.

Know with increasing confidence that you can consciously choose the pace of your own mind and body, where you place your attention and whether you perceive your cup as half empty or half full. Feel your inner relaxation response naturally balancing your stress response.

With an open, curious mind, experiment with the S.T.O.P. practice several times a day, anywhere, anytime- as you enter the exam room, while listening to your patients, before each meal, before starting the car, turning on the computer, bathing, brushing your teeth, taking out the trash, during conversation, going to bed, waking

up in the morning- anytime, anywhere.

As you take control of where you place your attention, you will understand why ‘mindfulness’ is also translated as ‘heartfulness.’ Refining your ability to slow down and S.T.O.P. can help you promote resilience, manage stress, prevent burnout and cultivate compassion.

Keeping a log of your practice can be extremely helpful. The following questions are taken from the S.T.O.P. practice log (3) below.

What was the situation?

What was going on with you when you thought to S.T.O.P.? (body, mind, emotion) What did you notice WHILE you were practicing? (body, mind, emotion) What did you notice AFTER your practice? (body, mind, emotion, action) What did you learn?

Resources 1. U Mass Medical Center for Mindfulness in Medicine, Health Care and Society

https://www.umassmed.edu/cfm/ 2. Downloadable basic S.T.O.P. instruction summary https://palousemindfulness. com/docs/STOP.pdf 3. Downloadable detailed 1 week S.T.O.P. practice log https:// palousemindfulness.com/practice/ week4-informal.pdf About the Author Dr Patterson is past president of the Kentucky Academy of Family Physicians and is board certified in family medicine and integrative holistic medicine. He is on the family practice faculty at the University of Kentucky College of Medicine and the University of Louisville School of Medicine. He operates the Mind Body Studio in Lexington, specializing in stress-related chronic disease and burnout prevention for helping professionals. He can be reached through his website at www.mindbodystudio.org

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PAIN TREATMENT

MILD Treatment Alleviates Pain The Pain Treatment Center of the Bluegrass is the largest freestanding facility in Kentucky dedicated to the treatment of pain. It hosts 11 physicians of varying specialties and sub-specialties, all who have the goal of pain alleviation and management.

Dr. Steven Ganzel, one of the doctors practicing at the Center, has recently added Minimally Invasive Lumbar Decompression (MILD) treatment to his list of services for those seeking relief from pain and suffering.

“Vertos Medical, Inc. is the company that developed the MILD Treatment,” Dr. Ganzel said. “They supply the necessary instrumentation to those doctors trained in the technique. I trained in this specifically because I saw the benefit it was giving many patients, and now I’ve been offering it to those who meet the criteria and seeing a great deal of success.”

What are the criteria to receive the treatment?

“The person has to be 66 years of age and they have to have a thickening of the ligamentum flavum,” Dr. Ganzel mber of symptoms such as pain, numbness explained. These ligaments that run along lower back. It may also limit the amount of theyoulower spine tend to thicken with age ur symptoms increase when walk or stand, rward, then you may haveand a certain type of degeneration of the bone and discs. tissue that is causing the narrowing of the The ligaments start to take on more and more burden as those other structures

the spinal canal narrows and compresses age, the natural wear and tear on our spine cause the narrowing of the spinal canal – s bone, or compression/bulging of the discs.

about LSS

are compromised. This usually leads to weakness in the lower back and legs, which is called neurogenic claudication. The pathways through the back narrow and the nerves are constricted. This can also be hastened by arthritis and other degenerative diseases. If the person has had a fusion or spinal surgery in the past 12 months, he or she is not a candidate for MILD treatment.

Why is the procedure gaining momentum now?

“When Vertos first introduced the procedure, it did well for three to four years, then went into a bit of a lull due to clinical trials and other issues,” said Dr. Ganzel.

“Around 2016, it was given the full green light and is now picking up steam as a terrific procedure for pain relief.”

What are the advantages of this procedure?

“The biggest advantage is that the convalescence is minimal,” Dr. Ganzel said. “Minimally invasive means just that.

We go through two small holes to do the procedure, and it takes less than an hour to do both sides. By de-bulking the ligaments, the patient will find tremendous relief, and they are usually up and about within a few days versus up to six months for

(Lumbar Spinal Stenosis)

about LSS

(Lumbar Spinal Stenosis)

Aging Spinal Canal with Stenosis

Disc Bulge Aging

Spinal Canal with Stenosis

Healthy, Open Spinal Canal Disc Bulge

Spinal Canal

Disc

Healthy, Open Spinal Canal Spinal Canal

Disc

Spinal Cord

Bony Overgrowth

Thick Ligament

Thick

Cross-section view of the spine

• Pain, numbness & tingling

• No pressure on spinal cord

• Weakness with activity

• Mobile/flexible

Spinal Cord

• No symptoms (pain,view numbness, Cross-section of the spine tingling) • No pressure on spinal cord • Mobile/flexible • No symptoms (pain, numbness, source: mild® Patient Brochure,tingling) http://www.mildprocedure.com/the-mild-procedure.html

Bony

Overgrowth Ligament Stenosis Creates Pressure, Causing:

• Pain Stenosis relieved by flexion (sitting, Creates Pressure, Causing: leaning, bending) • Pain, numbness & tingling • Weakness with activity • Pain relieved by flexion (sitting, leaning, bending)

some spinal surgeries. Anesthesia is usually not necessary. Some patients do require ambulatory services, which are provided by the clinic since we are a full-service facility..”

How do people get a consultation to find out if they are candidates for MILD? “I have to have an MRI to know if there is thickening of the ligament,” Dr. Ganzel said. “If a patient has had an MRI elsewhere in the last year, that will work, but longer than that allows for too many changes in the body to develop, which might result in an improper clinical decision. Just contact us at The Pain Treatment Center and we will set up a consultation.”

Dr. Ganzel adds the procedure has worked wonderfully and with great success for many qualified candidates. “I wouldn’t spend time training on it and offering it to my patients if I didn’t believe in it 100 percent,” he said. Nor would the founder of The Pain Treatment Center, Dr. Ballard Wright, have undergone the procedure himself if he didn’t believe in it; and, in fact, he did, experiencing wonderful results and allowing him to once again walk without the use of a cane.

For more information on MILD and other services at The Pain Treatment Center of the Bluegrass, call (859)278-1316 ext. 258.

What is LSS?

Lumbar spinal stenosis (LSS) is a condition where the spinal cana the spinal cord nerves in your lower back. As we age, the natura can lead to a is number What LSS?of contributing factors that cause the narr thickening of ligament tissue,(LSS) formation of excess bone,the orspina com Lumbar spinal stenosis is a condition where the spinal cord nerves in your lower back. As we age, the n can lead to a number of contributing factors that cause th Whatthickening are theofSymptoms of LSS? ligament tissue, formation of excess bone, o The narrowing of the spinal canal can cause a number of sympt or a tingling sensation in your buttocks, legs and lower back. It m time/distance youthe are able to stand orof walk.

If your symptoms in What are Symptoms LSS? but you experience when you sit orcan bend forward, thenofyos The narrowingrelief of the spinal canal cause a number LSS that be treated by the of excess that isba ca or acan tingling sensation in removal your buttocks, legstissue and lower spinaltime/distance canal. you are able to stand or walk. If your sympt but you experience relief when you sit or bend forward, th LSS that can be treated by the removal of excess tissue tha spinal canal.

I wouldn’t spend time training on it and offering it to my patients if I didn’t believe in it 100 percent.

– Dr. Steven Ganzel

doc

Summer 2018 • Kentucky

Ballard Wright, MD, PSC 2416 Regency Road Lexington, Kentucky 40503 www.pain-ptc.com 859.278.1316

WHO QUALIFIES? The person has to be 66 years of age and they have to have a thickening of the ligamentum flavum.

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doc • Summer 2018 • Business Section

Kentucky

BUSINESS SPOTLIGHT

Hi-Tech Artificial Limbs

By Brian Lord In 1990 Jim McClanahan and Maurice Adkins founded a business called Hi-Tech Artificial Limbs, Inc. Jim started his prosthetic career in 1969, three years after losing his right leg above the knee to cancer. Since then, the company has become a major part of the medical community here in central Kentucky.

Both men have since passed away leaving their legacy to Shayne Adkins and Tori McClanahan, the next generation of leadership. Shayne is taking over from his father as the new president and oversees all patient care. Tori, wife of Jim McClanhan, serves as Vice President and continues to lead the office and help steer the ship.

It is evident that the entire staff passionately provides quality care for their patients. As you speak to the staff, you become aware of how deeply they care for those they serve. Tori joined Hi-Tech Artificial Limbs back in 2000.

She considers it a privilege and a blessing to be working in the business her husband started. As she runs the day to day operations, she works hard, along with her team, to continue the legacy she inherited

by ensuring their patients continue to have quality care. Shayne Adkins has been an important part of Hi-Tech Artificial Limbs since 1995. Shayne graduated from the University of Kentucky with a degree in Psychology and went on to complete his prosthetic training at Northwestern University in Chicago, IL. He received his prosthetic certification from the American Board of Certification (ABC) in 2002.

Shayne is also licensed by the Kentucky Board of Orthotics and Prosthetics and is a member of American Academy of Orthotists and Prosthetists. He is the past president of the Kentucky Orthotic and Prosthetic Association.

Shayne’s passion for their patients runs deep in his family history. As the son of an amputee, he has always had a passion for prosthetics and finds joy in helping his patients become mobile and active again. He feels that personal investment, understanding and empathy are just as important as technology when helping amputees regain their livelihood and confidence. Shayne states, “Growing up, I witnessed my dad use his prosthesis, allowing me to see him be an amazing dad, husband and business owner. I observed how much commitment and effort it took for a person to go through the process of being fit with a prosthetic

Custom Fabricated Prosthetics

Above the Knee

Below the Knee

Upper Extremity

doc

Business Section • Summer 2018 • Kentucky

I observed how much commitment and effort it took for someone to go through the process of being fit with a prosthetic device and how it impacted his life. Having high quality prosthetics plays a significant role in allowing an amputee to lead a normal life.

– Shayne Adkins

device and how it impacted his life.

Having high quality prosthetics plays a significant role in allowing an amputee to lead a normal life.” Shayne states that living with an amputee created in him a passion for working with amputees.

Shayne shared that the purpose of their business is to provide compassionate patient care, which is implemented by all members of their team. As a company started by two amputees, they set out to design a clinic that is viewed through the eyes of their patients, not the clinicians.

Many of the staff have family, friends or themselves are amputees, which fills them with a desire not to just provide a service but be a part of the solution to change people’s lives. They want to do more than provide the right products for their patients. “We combine compassion with technology. Many times, technology gets all the press, and rightly so, but unless it’s combined with compassion, you miss the mark of what you need to accomplish.”

Hi-Tech Artificial Limbs has their own lab and board-certified technicians and prosthetic assistants who create custom designs and adjustments for their patients.

This allows them to provide the best prosthetic for the individual patient. They make sure all fittings are completed by their team. Shayne explained that, “We design the right prosthetic device that will “marry” the patient’s body with the proper biomechanics.”

I asked him about what gets him excited to come to work each day, and Shayne responded, “Every amputee we work with is very different. There is a challenge to help people get their livelihood back. Living out these

moments with the patient and being a part of helping them to do things they didn’t know they would be able to do to again, like a child riding a bike again, or an athlete being able to learn to run again, excites me.” Each day is a new day for their team. They help family members become excited about the possibilities of a new or restored life with their significant other.

Matt Bradford, ​a United States Marine Corporal, is one of their patients. Matt came to Hi-Tech Artificial Limbs in 2012 at the age of 26. In combat, he stepped on an IED and lost both of his legs and his vision. Shayne shared that Matt has become a dear friend of his. Now in his 30’s, the two still talk regularly. “With Matt, we had to consider that he was young and desired to be very physically active. He came to us looking for answers.

So, we took the time to work on his prosthetics to fit his desired lifestyle.”

Since coming to Hi-Tech, Matt has competed in multiple Spartan endurance races, has graduated from the University of Kentucky, and now is giving inspiration talks on campus to athletes, students and faculty. His goal in July 2018, as a blind double amputee, is to climb Mount Rainier in Washington State. Matt is also a Purple Heart recipient and has been to the White House to meet with the President of the United States.

The staff of Hi-Tech Artificial Limbs have endless stories like Matt’s to share. Hi-Tech desires to provide top-quality service, and they do so because they love and care for their patients. This is the footprint this local business makes in the world and it’s a big one.

HI-TECH Artificial Limbs, Inc. Team

859.278.2389 1641 Nicholasville Road, Lexington, KY 40503 M-Th 8am–4:30pm, F 8am–3pm

 www.hi-techartlimbs.com  /hitechartificiallimbsinc  /Hi-Tech-Artificial-Limbs  View our YouTube Channel

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APPOINTMENTS AVAILABLE WITH FPA PROVIDERS AT BOTH LOCATIONS

Family Practice Associates of Lexington, P.S.C.

HAMBURG OFFICE

1775 ALYSHEBA WAY SUITE 201

SPRINGS OFFICE

2040 HARRODSBURG ROAD, SUITE 300 CHECK US OUT ON THE WEB

fpalex.com

859.278.5007

Take Care of Your Patients

by Taking Care of Yourself

The Lexington Medical Society

Physician Wellness Program

TAKE CARE OF YOUR PATIENTS

BY TAKING CARE OF YOURSELF The Physician Wellness Program (PWP) was designed as a safe harbor for physicians to address normal life difficulties in a confidential and professional environment.

WHY WAS THIS PROGRAM CREATED? Being a physician isn’t easy. Difficulties with the current health care delivery system, maintaining a healthy work/ life/family balance, and dealing with the normal stresses of everyday life can take their toll on physicians.

We serve not only as treating physicians, but many times as counselors to our patients who turn to us for guidance.

Who do we turn to when we need to talk through an issue or get some coaching for how to handle stress in our life?

Too often the answer is “no one,” and that is regrettable because it is imperative that we be as healthy as possible in our role as health care providers.

We deserve to function at our best in all areas of our life.

By addressing areas of difficulty, we can decrease our stress levels and increase our levels of resilience.

Some examples of those difficulties include: •

Family issues

•

Depression & anxiety

•

Relationship problems

•

Difficulty managing

•

Work-related

•

stress

difficulties

•

Mood swings

Alcohol/drug abuse

•

Suicidal thoughts

How PWP Works We have contracted our program with The Woodland Group. The Woodland Group will provide counseling to active physician members of the Lexington Medical Society and UK Graduate Medical Education residents and fellows. Non-emergency sessions will be scheduled during regular business hours. Emergency sessions can be scheduled on a 24-hour, 7 days-a-week basis.

Seven licensed psychologists make up the Woodland Group and have been vetted by LMS. Steven Smith, Ph.D. and Sandra Hough, Ph.D. are our program coordinators and will serve as points of contact to access PWP. The Woodland Group will maintain a confidential file for each physician, but no insurance will be billed and LMS will not be given any information about those who utilize the program. As such, this program is completely confidential which is crucial to its success. LMS will pay The Woodland Group a monthly bill based on the number of sessions provided. The Woodland Group will verify LMS membership from the physician finder on the LMS webpage.

TO MAKE YOUR APPOINTMENT 1) Call the confidential hotline at 1-800-350-6438 and leave a message in either Dr. Smith’s or Dr. Hough’s voice mailbox.

2) They will call you back to schedule an appointment. It’s that simple!

PWP Benefits 8 free sessions each calendar year Complete confidentiality Easy access Convenient location (535 W. 2nd Street, Suite 207) 24/7 availability

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What can a consultant do for you?

Think of me as both an “outsource resource,” as well as a coach to help:  Make sense of your competitive environment,  Leverage available tools to your advantage, and  Ensure you accomplish goals important to your personal vision.

Arrange a confidential discussion about the challenges you face.

I’m a coach with practical experience helping professional help you market your practice, differentiate your services and increase your patient base.

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