Upstate Health magazine, winter 2017

Health UPSTATE

U P S TAT E M E D I C A L U N I V E R S I T Y

Winter 2017

STROKE OF GREAT LUCK page 4

HELP FOR BACK PAIN page 8

LOOKING CLOSELY AT THE EYE page 10

ARE YOU WASHING YOUR HANDS CORRECTLY? page 12

LETHAL LIQUID: NICOTINE FOR E-CIGARETTES page 14

AN HERB FOR ANXIETY page 15

WELCOME

Contents 4

10

CARING FOR PATIENTS

cover story

Crucial and quick decisions saved his life page 4 More options for back pain

page 8

New fertility care

page 9

A new way to see anatomical changes

On the cover: Hesham Masoud, MD, with stroke survivor Larry Deshaw of Clayton.

See story, page 4.

PHOTO BY ROBERT MESCAVAGE

page 9

FROM OUR EXPERTS

Looking at how eyes develop

Amber Smith

WRITERS

Jim Howe Susan Keeter Amber Smith

DESIGNER

Susan Keeter

page 10 page 11

7 steps to clean hands

page 12

An anti-stress herb

page 15

Recipe: Apple and pear salad

page 20

Dancing from Cuba to the ’Cuse

page 21

Making music

page 22

DEPARTMENTS

Books with Upstate ties page 16

What’s Up at Upstate

IN OUR COMMUNITY

Lessons from Upstate page 14 Liquid nicotine can be lethal

Preserving paintings at a medical school

page 17

An Amazon getaway

page 18

What to do with your great idea

page 20

Winter 2017

EDITOR-IN-CHIEF

22

IN OUR LEISURE

Why breast-feeding matters

Health

EXECUTIVE EDITOR Leah Caldwell Assistant Vice President, Marketing & University Communications

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16

Visit us online at www.upstate.edu or phone us at 315-464-4836.

For corrections, suggestions and submissions, contact Amber Smith at 315-464-4822 or smithamb@upstate.edu

Upstate History Williams Hematology

page 3

page 16

Science Is Art Is Science back cover Studying concussion

Upstate Health magazine is a community outreach service of Upstate Medical University in Syracuse, N.Y. Upstate is an academic medical center with four colleges (Medicine, Nursing, Health Professions and Graduate Studies); a robust research enterprise and an extensive clinical health care system that includes Upstate University Hospital’s downtown and community campuses, the Upstate Cancer Center and the Upstate Golisano Children’s Hospital. Part of the State University of New York, Upstate is Onondaga County’s largest employer.

ADDITIONAL COPIES: 315-464-4836 Upstate Health offices are located at 250 Harrison St., Syracuse, NY 13202

Need a referral?

Contact Upstate Connect at 315-464-8668 or 800-464-8668, day or night, for appointments or referrals to the health care providers on these pages or anywhere at Upstate or for questions on any health topic.

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upstate.edu l winter 2017

WHAT’S UP AT UPSTATE

News you may have missed Manika Suryadevara, MD, and Joseph Domachowske, MD, received the Others’ Award, the highest civic honor bestowed by the Salvation Army, for their efforts to vaccinate children and families in Central New York.

Senior research support specialist Cynthia Bonville received a certificate of appreciation for her work with the Upstate Golisano Children’s Hospital team at the September ceremony. ●

Jennifer Moffat, PhD, is working on a drug that would treat the shingles virus, which causes a potentially debilitating and painful skin rash. Her lab has partnered with NanoViricides, a development stage company in Connecticut, to study new antiviral compounds and how they might work in nanoparticles. Moffat is an associate professor of microbiology and immunology.

Upstate University Hospital now makes available interpreters who are fluent in 275 languages 24 hours a day, through a company called Language Line Solutions.

Secure audio and video connections are available in 35 spoken languages, and audio connections are available for 240 other languages. ●

e Central New York Library Resources Council recognized the Health Sciences Library at Upstate as top academic library of the year, and clinical outreach librarian Olivia Tsistinas as academic library staff all-star of the year. Judges who represent library systems across the state said the Upstate library goes “above and beyond” what libraries typically offer. “ere is extensive outreach and collaboration with the community,” the judges noted.

Visit online at upstate.edu/library

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Students from Cornell and Syracuse universities raised more than $132,000 during dance marathons held on their respective campuses to benefit the Upstate Golisano Children’s Hospital. e Cornell Big Red on pulled in $21,000 on Nov. 5, while SU’s OttoTHON raised more than $ 111,000 a day later. More than 1,400 students registered to participate in the two events. ●

A new law allowing 16- and 17-yearolds to join the New York State Donate Life Registry takes effect Feb. 14. Teens will be able to document their intent for donation. Parents or legal guardians would be notified of the documentation and would still have final authorization. e law is designed to remove some of the burden from parents who may be le wondering about a child’s wishes with regard to organ donation. If a teen registered intent to become an organ donor, that would convert to consent when he or she turns 18. ●

e geneticist who discovered the BRCA1 gene and its link to breast cancer risk spoke at Upstate’s first Presidential Symposium in October. Mary-Claire King, PhD, addressed a standing-room-only crowd at Upstate’s CNY Biotech Accelerator.

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This is what the new 8-story Upstate Health and Wellness Center will look like from East Adams Street.

ArchitecturAl rendering courtesy stAntec

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Construction is set to begin this spring on a $140 million addition to Upstate’s health system. e Upstate Health and Wellness Center will rise on the parking lot across from the hospital’s main entrance on East Adams Street. A variety of services will be available in the building, aimed at providing medical access, better care and lower costs. ●

Upstate’s psychiatry department is collaborating with the state’s Hutchings Psychiatric Center on a Mental Health First Aid class called Project Aware. It’s designed to help identify youth with mental health problems and get them help, lessen the stigma and improve awareness of mental illness. e free, eight-hour course is for adults who work in schools, youth programs and other areas that deal with people ages 16 to 25. Learn more by calling Hutchings at 315-426-6812.

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A stroke of great luck

WHAT’S UP ATPATIENTS UPSTATE CARING FOR

Crucial decisions made quickly saved Larry Deshaw’s life when a blood clot settled in his brain

BY AMBER SMITH

TUESDAY AFTERNOONS are usually when Nancy Humphrey golfs. But she was still home a little aer 4 p.m. on July 19 because that day’s tournament didn’t start until 5 p.m., and the Clayton Country Club is only about a quarter mile from the home she shares with her husband, Larry Deshaw. ey were watching CNN. She was on the couch. He was in his recliner.

“All of a sudden I was seeing double. e room started spinning,” recalls Deshaw, 78. “I hollered Nancy’s name twice. I knew I had something going on. at was the last I could speak.

“My le side went limp. My right side had contractions in the leg. My right arm was the only thing I could move at the time. I couldn’t talk. My jaw was clamped shut.

“I could hear everything going on around me, but I couldn’t speak. It was the scariest thing I’ve ever been through.”

Humphrey quickly dialed 911.

“Mr. Deshaw’s wife saved his life,” Upstate interventional neurologist Hesham Masoud, MD, says plainly. “If he was not found in a timely fashion, he would not have survived.”

Nancy Humphrey of Clayton recognized the signs of a stroke in her husband, Larry Deshaw, 78, and summoned help. Deshaw is a veteran of the Army.

He’s retired now, but he used to work in a paper mill. He also sold real estate and owned a golf course. Before the stroke, he walked more than a mile a day.

Now because of an issue with balance, he walks about a half mile a day.

PHOTO BY ROBERT MESCAVAGE

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Masoud is a stroke specialist who received his medical degree in Cairo before completing his internship and residency training at Case Western Reserve School of Medicine in Cleveland. He went on to gain stroke therapy expertise with additional fellowship training in endovascular surgical neuroradiology and vascular neurology at Boston University School of Medicine — the precise skills Deshaw needed when a clot the size of a raisin lodged in the basilar artery at the base of his brain.

Deshaw’s wife called for help at 4:15 p.m.

Continued on page 5

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CARE FOR PATIENTS CARING PATIENT

A stroke of great luck

continued from page 4

On their drive to the couple’s house, ousand Islands Emergency Rescue Service paramedics Pamela Jones and Eimile Parker made the important decision to alert LifeNet of New York — and a helicopter based at Watertown International Airport in nearby Dexter was readied for flight, just in case. Patients in rural areas such as Clayton with certain medical emergencies including strokes or diabetic complications have better survival odds the faster they receive definitive medical care.

When she laid eyes on Deshaw at 4:22 p.m., Jones remembers he had “that look” of a man suffering a stroke, or a seizure, or both. His face had a subtle droop, he had weakness on his le side, and he was unable to respond.

Humphrey told the paramedics how healthy and active her husband was, and Jones made a silent vow to do what she could to bring him back. e paramedics knew Deshaw urgently needed to get to Central New York’s first and only comprehensive stroke center, some 90 miles away at Upstate University Hospital in Syracuse, and the quickest way was by air. ey made sure LifeNet was on the way and radioed the fire department to set up a landing zone for the helicopter.

Jones checked Deshaw’s blood sugar level and connected him to a cardiac monitor while Parker covered his mouth and nose with an oxygen mask and checked his pulse and blood pressure. en Parker started an intravenous line in his arm. All the while, Jones spoke to Deshaw, explaining what was going on. It felt strange because he never responded, but she kept talking, as she was trained to do.

A month later, when Jones checked on his recovery, Deshaw told her how much her talking had meant to him.

e ousand Islands ambulance drove Deshaw about a half mile to the Clayton Volunteer Fire Department parking lot, where the helicopter landed. Flight nurse Rod Kester and flight paramedic Jeff Simons climbed out. Once Deshaw was secured to their stretcher, they opened the door beneath the tail of the helicopter and wheeled him in. Deshaw remembers the feel of the heat rising up from the asphalt.

Flying took 25 minutes Driving the patient to Syracuse, even using lights and sirens, would have taken almost an hour and a half. Flying took 25 minutes.

Once LifeNet pilot Scott Talon pointed the helicopter toward Syracuse, the LifeNet crew radioed the emergency physician on duty at Upstate, Brett Cherrington, MD. At 5:17 p.m., he activated the hospital’s stroke team.

Masoud’s pager notified him, and he gathered in the emergency department with the other physicians and nurses who are part of the acute stroke team. ey were ready for Deshaw even before his helicopter landed on the helipad at 5:27 p.m.

Deshaw remembers everything. “ey were waiting for me,” he says. “ey took me immediately in. I remember them rushing, going fast with me on the gurney.”

Members of the team told Deshaw what was going on as they cared for him. ey wheeled him straight to the Continued on page 6

Larry Deshaw and his wife, Nancy Humphrey, gathered for a photo with rescuers at the spot behind the Clayton Volunteer Fire Department where the helicopter landed to pick him up. Among his rescuers were, from left, Clayton firefighter Curtis Harvey; paramedic Pamela Jones from Thousand Islands Emergency Rescue Service; and paramedic Jeff Simons and nurse Rod Kester, both from LifeNet. PHOTO BY SUSAN KAHN winter 2017 l upstate.edu

U P S TAT E H E A LT H

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CARING FOR PATIENTS

A particularly dangerous location Interruption of blood flow in the basilar artery is particularly dangerous because it’s the route oxygenated blood takes to get to areas of the brain responsible for vital functions such as consciousness and breathing – and there are no alternate routes, what doctors called collateral circulation. If the artery bursts or is blocked by a blood clot, patients usually sustain severe brain damage or organ malfunction, or they die.

The clot

Larry Deshaw’s angiogram

e basilar artery is at the base of the skull, where two vertebral arteries meet. It carries blood to the brainstem, which controls heart rate, sleeping, eating and breathing; the cerebellum, responsible for posture, balance, coordination and speech; and the occipital lobe, which handles visual processing.

Multiple arteries branch from the basilar artery to other areas of the brain, including the temporal lobe, where sound is processed, and the pons, where information is relayed between different areas of the brain.

A stroke of great luck

continued from page 5

computerized tomography suite in the emergency department for a CT scan, with the interventional neurologist, Masoud, at his side.

Deshaw had symptoms that suggested he had had a seizure or a stroke. “Anyone with these symptoms gets an immediate vessel imaging study. at way, we can identify the blocked artery and plan for immediate therapy,” Masoud explains.

Nurse Jennifer Schleier is the stroke coordinator. She says the CT scan helps rule out whether a vessel has burst within the brain. Patients with hemorrhagic strokes, in which a vessel bursts, are treated differently than those with ischemic strokes, in which a clot blocks a vessel.

Treatment was a team effort Deshaw received an injection of the clot-busting medication, tPA, or tissue plasminogen activator, at 6:18 p.m. through the intravenous line paramedics inserted at his home. en he returned to the scanner for a CT angiogram, another set of images that relies on a contrast material, so details of the arteries and veins are visible. ere, deep in the basilar artery of Deshaw’s brain, was the clot.

“Time is crucial anytime someone suffers a stroke. In many cases, other healthy arteries can temporarily keep the brain alive while we try to reopen the vessel. But for patients with clots lodged at the base of the brain, those other arteries aren’t there to help,” Masoud says. “For those strokes, time is exceedingly important.”

Hesham Masoud, MD, has expertise in endovascular surgical neuroradiology.

He’s the guy you want taking care of you if you have a stroke. He is holding a stent like the one he used to remove a clot from Deshaw’s brain. photo by robert MescAvAge

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Strokes in the basilar artery are rare, and the outcomes are usually poor. e brain area that can be damaged in this type of stroke controls essential functions such as consciousness, breathing and heart rate, balance and coordination and vision. “In my experience, without a rapid treatment, a majority of these patients die, usually within a couple days of having the stroke,” Masoud says.

Continued on page 7

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CARING FOR PATIENTS

A stroke of great luck

continued from page 6

Deshaw experienced what the interventional neurologist considers “a miraculous recovery.” e emergency physician inserted a breathing tube. en Deshaw was wheeled to the interventional radiology suite two floors above the emergency department.

At 7:10 p.m., Masoud inserted a small catheter into the artery of Deshaw’s right leg. Guided by an X-ray and contrast dye, the doctor delicately advanced a wirelike stent along the inside of the artery and into the brain. e stent wrapped around the clot, trapping it as if in a cage. Masoud gently backed the device out, removing the clot and restoring blood flow with a single pass of the device.

CRUCIAL DECISIONS MADE QUICKLY Larry Deshaw survived what could have been a fatal stroke because of multiple crucial decisions that were made quickly, including: l

His wife, Nancy Humphrey, recognized the signs of stroke (sudden one-sided weakness, speech difficulty) and immediately called 911.

l

Rescuers made the decision to send Deshaw directly to the comprehensive stroke center at Upstate University Hospital — by helicopter, so he would get there from Clayton as quickly as possible.

l

Stroke specialists at Upstate established a protocol that directs every patient suspected of having a stroke straight to the computerized tomography suite in the emergency department on arrival. e prompt CT scan reveals whether it’s safe to give the patient clot-busting medication. A rapid CT angiogram was used to identify the blocked artery and plan interventional treatment.

l

e hospital is outfitted with a modern interventional radiology suite that is available around the clock and staffed by doctors who have expertise in endovascular surgical neuroradiology — which means they are skilled at swily retrieving blood clots from the brain.

Deshaw’s wife arranged for her brother from Watertown to drive her to the hospital. By the time they arrived, he was already in surgery.

Surgery was complete at 7:43 p.m., and around sunset Deshaw was settled into the neurosurgical intensive care unit. e ninth-floor hospital unit is staffed by nurses and technicians with specialized training in the care of patients with stroke and other neurological emergencies.

“I didn’t really wake up until the next morning,” Deshaw says, “but when I woke up, everything was working.”

A steady stream of impressed doctors stopped by to see the patient who not only survived basilar artery thrombosis but was up and walking the next day.

Aer a stroke, many patients go through what can be a lengthy rehabilitation program. Deshaw was healthy enough to be discharged to his home three days later. ●

This team saved his life

Assembled in the suite where Larry Deshaw was treated are members of the Upstate Comprehensive Stroke Center team who cared for him, including from left: nurse Chelsea Wilson; radiology technician Gary Denigro; Aiga Rakhesh, MBBS; nurse Jillian Saunders; Elena Schmidt, MD; Hesham Masoud, MD; nurse practitioner Sari-Ann Yonaty, PhD; Larry Deshaw; Nancy Humphrey; J. Gene Latorre, MD; doctor of pharmacy Gregory Meola; nurse Alexis Coomey; Claribel Wee, MD; and radiology technician Jeff Ledbetter. photo by robert MescAvAge

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Back pain?

CARING FOR PATIENTS

Spine practitioner aims to get patients best possible treatment

BY AMBER SMITH

DENISE KARSTEN is someone you might not expect to find in the office of a neurosurgical practice, but she’s an important part of the Upstate Brain and Spine Center team. Karsten, a chiropractor and registered nurse, is a primary spine practitioner who this year began working alongside the neurosurgeons.

visit with Karsten usually takes more than an hour.

She asks dozens of questions about the pain, such as when it began, what it feels like, its location and what provokes it. She performs a neurological and orthopedic examination and reviews any imaging tests with the patient. is can help identify the cause of the back or neck pain.

Her role is like that of a primary care provider, whose focus is on the spine. Most of her patients suffer from back and neck pain.

It’s Karsten’s job to either give the patients tools to help alleviate or manage their pain, or to help them find an intervention that will help. is might include acupuncture, massage therapy, weight loss, physical therapy, chiropractic care, psychological support or surgery.

Karsten cites studies showing that seeing a primary spine practitioner can decrease a patient’s chances of an episode of back pain becoming a chronic, disabling condition.

“It’s all about how fast we act and delivering appropriate care at the first visit with the most appropriate provider,” she explains. e first

To make an appointment, call the center at 315-464-6386. ●

ARE YOU GRATEFUL? A gift of gratitude is a meaningful way to both express your appreciation to special caregivers and to help patients during their time of great need.

Friend in Deed, Upstate University Hospital’s annual fund, supports a variety of unmet patient needs, such as nutritional supplements for cancer patients, special pediatric needs, communication tools for the hearing impaired, and heart monitors, to name a few.

Foundation

To donate, visit upstatefoundation.org or contact the Upstate Foundation at 315-464-4416. To share your story, email FND@upstate.edu

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upstate.edu l winter 2017

Advanced fertility care now available

CARING FOR PATIENTS

residents who will participate in fertility care and innovative reproductive research.

THROUGH A PARTNERSHIP with Boston IVF, Upstate now offers advanced fertility services to individuals and couples in Central New York.

Two reproductive endocrinologists from Alan Penzias, MD Boston IVF — Alan Penzias, MD, and Michael Alper, MD — travel to Syracuse two or three times a month to see patients, conduct diagnostic tests and provide general fertility treatments from University OB/GYN Associates at the Physicians Office Building, 725 Irving Ave. in Syracuse. Patients travel to a facility in Albany for implantation, but monitoring takes place in Syracuse.

Michael Alper, MD

e American Society of Reproductive Medicine says one in eight couples have trouble getting pregnant or sustaining a pregnancy and that almost 25 percent of infertile couples have more than one factor that contributes to their infertility.

“Our extensive cycle volume, treatment data and library of fertility analysis allow us to both quickly diagnose and solve difficult and rare reproductive cases that many other centers cannot handle or have never before encountered,” says Penzias.

Robert Silverman, MD, professor and chair of obstetrics and gynecology at Upstate, says Boston IVF provides a valuable addition for patients, as well as medical school

Prospective patients can get more information by calling 315-703-3050. ●

A NEW POSITRON EMISSION TOMOGRAPHY machine at Upstate University Hospital can reveal the onset of a disease process before anatomical changes would show up on other types of imaging scans.

Patients receive the radiotracer through an intravenous line. It circulates through the body for about an hour, attracting the cells of interest, which then show up in the series of images taken by radiology technicians.

PET scans rely on a radiotracer — a radioactive atom attached to a chemical substance — to be able to show metabolic changes in an organ or tissue at the cellular level. e chemical substance used depends on the area being studied. Glucose is used for PET scans of the brain, for instance, because the brain uses glucose for its metabolism.

Cancer doctors oen use PET scans for help determining the stage of a cancer, to detect its spread or to follow the progress of treatment. PET scans are also used in the diagnosis of neurological conditions, to assess cardiac function, and for other reasons — and they may be done in conjunction with other tests and imaging scans. ●

Hospital adds new PET scanner

Hospitals collaborate as well as compete

BY AMBER SMITH

ADVERTISEMENTS for the various Syracuse hospitals may lead you to believe they’re locked in a competitive battle. But for the past two years, medical staffs and administrators have worked together on quality initiatives designed to keep patients safe.

Upstate University and Crouse hospitals and St. Joseph’s Hospital Health Center collectively are improving hand hygiene practices and reducing the rate of surgical site infections and life-threatening infection complications. ey have also standardized some protocols to improve patient safety. For example, wristband identification colors are the same at all of the hospitals.

“Our vision is to create a community of care in which a patient can receive the same commitment to quality and winter 2017 l upstate.edu

safe care in any hospital in the Syracuse area,” hospital officials wrote in e Post-Standard newspaper in October.

Signing the letter to the editor were Hans Cassagnol, MD, Upstate’s chief quality officer; Bonnie Grossman, MD, associate chief medical officer at Upstate; nurse Christopher Jordan, director of quality resources at St. Joseph’s; and Mickey Lebowitz, MD, clinical quality medical director at Crouse. rough this quality collaborative, officials have shared the best ways to treat patients and reduce medical errors and readmission rates. Working together helps eliminate variations in care and can help improve the overall health of the community, known as “population health.” It can also lead to more efficient use of health care resources. ●

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Looking at eye development

FROM OUR EXPERTS

BY AMBER SMITH

A DISCOVERY by a research team at Upstate reveals the minimal recipe for the creation of the retinal cells that make vision possible. is new knowledge offers a hopeful glimpse that scientists might be able to prompt the development of cells to treat retinal diseases someday.

e retina is the neural part of the eye, responsible for translating light into nerve signals. It connects to the brain by the optic nerve. Diseases of the retina, including age-related macular degeneration, can lead to blindness. e Upstate team discovered that just two genes — not seven, as previously believed — working together can begin the process of eye development. ose genes are called Tbx3 and Pax6. ey are two of a seven-gene group known as “eye field transcription factors.” e whole group is necessary for the formation of a normal eye.

Andrea Viczian, PhD, Michael Zuber, PhD, Reyna Martinez-DeLuna, PhD, and Zahra Motahari wrote the paper that appears in the August issue of the journal Development. ey study eye development in frog embryos, which contain the same retinal cell types and whose retinas develop in a manner similar to the human retina. ey work with stem cells that have the potential to form a variety of adult cell types. at’s important because one of the goals of their laboratory in Upstate’s Center for Vision Research is to identify the genes that are required to transform stem cells into cells that could be used to treat retinal diseases.

“An unlimited supply of retinal stem cells in the laboratory dish, using a patient’s own readily available tissues, would eliminate the risk of host rejection when using replacement therapies, such as cell transplantation to treat those suffering from retinal damage or degeneration,” Viczian explains.

Identifying which genes begin the process of eye development puts scientists one step closer to a more complete understanding of how stem cells transform.

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Michael Zuber, PhD, and Andrea Viczian, PhD. photo by WilliAM Mueller

STEM CELL BASICS

Embryonic stem cell — ese stem cells come from newly fertilized embryos and are “pluripotent,” meaning they have the ability to generate almost any type of cell in the body. ink of them as college freshmen with undeclared majors.

Adult stem cell — As if they have matriculated and declared their college major, these stem cells are specific to a particular type of body tissue. ey generate only cells of the same tissue to replace those that have died or lost function. For instance, blood stem cells make blood, and neural stem cells make neurons. Scientists call them “multipotent.”

Differentiated cells — When a cell matures into a specialized, functioning cell, scientists say it has “differentiated.” It’s kind of like college graduation.

Progenitor cells — Similar to a stem cell, progenitor cells have the ability to replicate, but not indefinitely. ey are tissue-specific; they come into college knowing what they want to study. Mostly the role of progenitor cells is to replace cells lost through attrition.

Image, upper right: Multiple cell types necessary for vision (identified by the different colors) can be generated using only two genes in stem cells. iMAge courtesy vicziAn/zuber lAb.

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upstate.edu l winter 2017

Breast-feeding

FROM OUR EXPERTS

Healthy for baby and mom

THE MAJORITY OF BABIES born in the United States receive some breast milk, but experts including Upstate’s Jayne Charlamb, MD, say mothers and their infants would benefit from breast-feeding exclusively for at least six months.

Charlamb, an associate professor of obstetrics and gynecology, medicine and pediatrics, specializes in breast health and breast-feeding medicine at Upstate. She points out that humans have nourished infants through breastfeeding for millennia.

“Breast-feeding is the physiologically normal way to nourish human infants,” says Charlamb.

Bottle-feeding overshadowed the practice so that in the early 1970s, just one of four infants was breast-fed at hospital discharge, she says. “Since that time, we’ve seen our breast-feeding rates go up.”

Seventy-nine percent of babies receive some breast milk.

By six months of age, 49 percent are still breast-feeding, and just 19 percent are exclusively breastfed, according to the U.S. Centers for Disease Control and Prevention national immunization survey conducted in 2011.

Charlamb says what’s optimal is for mothers to feed their babies only breast milk for the first six months of life and then gradually add complementary foods along with breast milk for the first one to two years of life — and even beyond if the mother and child both wish to continue.

Some of her patients have asked whether breast-feeding increases their risk for osteoporosis. Charlamb tells them that during pregnancy and lactation, a woman’s bone density naturally decreases. at’s temporary. Bone density is typically restored aer the baby is weaned. Charlamb also explains the multitude of lasting health benefits for the woman and her baby, including a decreased risk of certain cancers and other diseases.

“Health outcomes for both mom and baby depend on those first few years of the way we nourish our infants,” she says. ●

Babies who are breast-fed 10%

20%

30%

40%

Ever

50%

60%

70%

80%

79%

At 3 months, exclusively

41%

At 6 months, 19% exclusively 49%

At 6 months, not exclusively At 12 months, not exclusively

27%

SOURCE: U.S. CENTERS FOR DISEASE CONTROL AND PREVENTION NATIONAL IMMUNIZATION SURVEY CONDUCTED IN 2011.

89.9 & 90.3 FM

Now airing on Sundays on WRVO AT 6 AM & 9 PM Listen anytime: HEALTHLINKONAIR.ORG or ITUNES (search by topic)

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FROM OUR EXPERTS

Think you know how to wash your hands?

Here’s how – and why – to IT’S SIMPLE, quick and one of the best ways to reduce the spread of disease.

Hand washing is paramount in hospitals, but its importance may be overlooked at home.

Even if you recognize the health benefits of keeping hands clean, are you sure you’re washing your hands properly?

Here’s advice from Upstate infectious disease expert Waleed Javaid, MD, le, and the Centers for Disease Control and Prevention.

1. Turn on water to a warm — not boiling-hot — temperature.

Why: Water that is too hot can affect skin integrity. Repeated exposure to hot water increases the risk of dermatitis or skin irritation.

You might be tempted to wash with hot water, thinking the heat kills germs. It could.

But as Javaid points out, water that is hot enough to kill germs — greater than 100 degrees — would burn skin.

2. Place hands under running water.

Why: is aids soap activation, or lathering. Experts recommend against using a basin of standing water because of the risk it could be contaminated through previous use.

3. Apply just one squirt of liquid soap.

Why: Overuse of soap product may cause drying of hands, and dry, cracked hands may harbor bacteria, viruses and/or fungus.

In a household setting, bar soap is another option, using just enough to get the job done.

photos by susAn KAhn

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Surfactants in soap help li soil and microbes from the skin, according to the Centers for Disease Control and Prevention. Also, people tend to scrub hands more thoroughly when they use soap, rather than just water.

ABOUT HAND SANITIZERS

Why?

Soap and water is the best way to wash your hands — and the only proper way if your hands are visibly soiled. If soap and water are not available, an alcohol-based hand sanitizer containing at least 60 percent alcohol may be a good alternative.

Sanitizers without alcohol or with lower concentrations don’t work as well on all types of germs, may not effectively kill germs and may cause germs to build up a resistance to sanitizers, the CDC reports. Sanitizers that do not contain alcohol also are more likely to irritate skin.

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upstate.edu l winter 2017

FROM OUR EXPERTS

do it the way the pros do 4. Rubbing briskly, wash all surfaces of hands, including between fingers, for at least 15 to 20 seconds. That’s about two rounds of the “Happy Birthday” song, beginning to end.

Why: e principle of good hand-washing technique is primarily that of mechanical removal of dirt and microorganisms, using friction. e CDC guidelines acknowledge that the optimal length of time for hand washing depends on many factors. A surgeon who is likely to come into contact with germs that could spread to vulnerable patients washes her hands more thoroughly than a man who is preparing lunch for himself in his own kitchen.

5. Rinse thoroughly under running water.

Why: is helps remove any dirt or microbes that were raised through the friction of hand washing. It also lessens skin irritation from soap residue.

WHEN TO WASH YOUR HANDS THE CENTERS FOR DISEASE CONTROL AND PREVENTION SAYS TO WASH YOUR HANDS: • Before, during and aer preparing food.

• Before eating food.

• Before and aer caring for someone who is sick.

• Before and aer treating a cut or wound.

• Aer using the toilet.

6. Pat hands dry with paper towels, discarding the paper towels in waste container.

Why: Germs travel more easily on wet surfaces, so it’s important to dry your hands. e best method is up for debate.

In the hospital, disposable paper towels are favored, but the CDC says air drying is also effective.

7. Use a dry paper towel to turn off the faucet, if it is hand-operated.

Why: Treat faucet handles as if they are contaminated. You don’t want to get your nice clean hands dirty by touching a potentially contaminated faucet. e same advice applies to door handles in public rest rooms.

winter 2017 l upstate.edu

• Aer changing diapers or cleaning up a child who has used the toilet.

• Aer blowing your nose, coughing or sneezing.

• Aer touching an animal, animal feed or animal waste.

• Aer handling pet food or pet treats.

• Aer touching garbage.

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FROM OUR EXPERTS

Warning: Liquid nicotine can be lethal LESSONS FROM UPSTATE

BY AMBER SMITH

A MOHAWK VALLEY TODDLER got ahold of an uncapped container of “Heartland Vapes,” a liquid nicotine product. He drank some.

Within minutes, the 18-month-old boy was vomiting. en the seizures started. His heart stopped beating by the time the ambulance arrived. Paramedics worked to revive him as they raced to the hospital, where doctors and nurses took over. e youngster did not survive.

His death led to the Child Nicotine Poisoning Prevention Act, signed into federal law in January 2016. It requires eliquid manufacturers to comply with standards established by the Poison Prevention Packaging Act of 1970 by using special packaging that is difficult for children under 5 to open.

Just a quarter teaspoon of liquid nicotine is enough to kill a toddler, Upstate toxicologists point out in the journal Clinical Toxicology. Collaborating on the letter that was published Aug. 19 were doctors of pharmacy William Eggleston, Jeanna Marraffa and Christine Stork, and Nicholas Nacca, MD. e four work together at the

Upstate New York Poison Center in Syracuse. ey reported that the American Association of Poison Control Centers saw a 236 percent increase in calls related to e-liquid exposure in 2014, compared with the previous three years. “Nearly 60 percent of those exposures involved children less than 5 years of age,” their article says.

It goes on to say that severe outcomes occurred greater than 2½ times more frequently in children exposed to eliquid as compared with those exposed to traditional cigarettes.

Pediatricians and professionals working in poison control centers have expressed concerns over liquid nicotine products that are used in electronic cigarettes. e Upstate toxicologists say it’s important for people to be aware of the potential dangers — and to take precautions to prevent additional tragic exposures. Any liquid nicotine product should be kept out of the reach of children. ● The Upstate New York Poison Center is available 24 hours per day, every day at 1-800-222-1222.

PEDIATRIC EMERGENCY DEPARTMENT:

HERE WHEN YOU NEED US upstate university hospital has the area’s only Pediatric Emergency Department, now in its own newly renovated and expanded space. only at upstate will you find physicians and nurses specially trained in pediatric emergency medicine 24/7/365.

Pediatric Emergency Department C A R I N G F O R PAT I E N T S . S E A RC H I N G F O R C U R E S . S AV I N G L I V E S .

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upstate.edu l winter 2017

Ancient herb appears useful as anti-stress therapy

FROM OUR EXPERTS

BY AMBER SMITH

AN HERB USED FOR CENTURIES IN INDIA is gaining recognition in the United States as a way to reduce stress, and scientists at Upstate say their research indicates the herb called ashwagandha can help people with anxiety disorders.

Ashwagandha is an anti-inflammatory supplement that works as an adaptogen, helping the body resist damage from both physical and mental stress, says Kaushal Nanavati, MD, medical director of integrative therapy. He says it can also improve sleep quality.

Nanavati was involved in assessing five studies in which people took ashwagandha or a similarlooking pill known as a placebo. All of the studies showed that people who took ashwagandha saw a greater improvement in anxiety than those who took the placebo. Nanavati and colleagues published their assessment in the Journal of Alternative and Complementary Medicine. ey say additional studies would be necessary to determine the best dose of ashwagandha.

“Ashwagandha has an effect on receptors in the brain that impacts the serotonergic and GABAergic pathways, working as an adaptogen,” Nanavati told PsychiatryAdvisor.com. Serotonin pathways help regulate mood, and GABAergic pathways reduce nerve cell excitability throughout the nervous system. e herb, sometimes referred to as Indian ginseng, has been used to treat various maladies, from arthritis to hiccups to backache. As a stress-reduction aid, ashwagandha may help people with anxiety disorders and with depression, Nanavati says, although the study in which he was involved focused only on anxiety.

Depression and anxiety disorders affect a wide swath of the American population.

An article from the Archives of General Psychiatry projects that nearly 30 percent of Americans will be affected by an anxiety disorder sometime during their lifetime, and the National Center for Health Statistics says use of antidepressants increased by almost 400 percent from 1988 to 2008.

Physicians are eager to find reliable alternative treatments, to reduce the side effects from commonly prescribed antidepressant and antianxiety medications.

Upstate’s Christopher Morley, PhD, told PsychiatryAdvisor.com that both patients and physicians are becoming more open to plant-based remedies for mental disorders, partially because “while the ‘Western’ medical system has produced amazing strides in the treatment of human health issues, there are oen trade-offs associated with standard treatments.” Morley, associate professor of public health, family medicine, and psychiatry at Upstate, serves as interim chair of the department of public health and preventive medicine, as well as vice chair for research in the department of family medicine.

Ashwagandha plant

Ashwagandha is available in pill form or as a liquid extract. Nanavati says it is generally well tolerated in lower doses of up to 3 grams, but he cautions that people should consider taking it only with the advice of a health care provider.

Whether ashwagandha is likely to help you depends on your reason for taking it, and what other health conditions you have, he says. ● CAN ASHWAGANDHA HELP?

An ancient Indian herb called ashwagandha is gaining acceptance as a possible treatment for stress, which oen manifests as a symptom of anxiety, depression or both. l l

Anxiety is a mental health disorder characterized by feelings of worry or fear that are strong enough to interfere with one’s daily activities.

Depression is one of the most common mental disorders in the United States, an illness that negatively affects how you feel, the way you think and how you behave.

SOURCES: NATIONAL INSTITUTE OF MENTAL HEALTH, AMERICAN PSYCHIATRIC ASSOCIATION

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FROM OUR EXPERTS

He wrote the book on hematology UPSTATE HISTORY

BY AMBER SMITH

THE WORLD’S MOST HIGHLY REGARDED reference text on the mechanisms and clinical management of blood diseases has Upstate roots.

“Williams Hematology,” in its ninth edition, was first published in 1972 as just “Hematology.” e Williams name was subsequently added to honor the book’s first editor-in-chief, William Williams, MD. Williams was professor and chair of the department of medicine at Upstate when the book came out. Later he served as dean of the College of Medicine. roughout his career he was active in patient care, research and education. “Dr. Williams was known as the man with the bow tie and gentle smile who added a humanistic touch to a competitive field,” an internal medicine resident wrote about him in 2008 for the journal e Hematologist.

Williams’ book “guided generations of clinicians, biomedical researchers and trainees in many disciplines through the origins, pathophysiological mechanisms and management of benign and malignant disorders of blood cells and coagulation proteins,” publisher McGraw-Hill says. His presence at Upstate attracted medical residents who wanted to specialize in hematology.

Books to nurture the spirit

Each new edition of “Williams Hematology” is updated as the field advances, by authors and editors who are known internationally for their research and clinical achievements. Williams died Nov. 4 at his Jamesville home. ●

KAUSHAL NANAVATI, MD, EXPLAINS how nutrition, physical exercise, stress management and spiritual wellness “are the roots of health, peace and contentment” in “Core 4 of Wellness,” a book he published in May.

“You must feed these roots if you want to make real, positive change in your life,” says Nanavati, an assistant professor of family medicine and the medical director of integrative therapy at Upstate. e book is designed to help readers define and refine their values, goals and vision for life, and to figure out the source of any unhappiness or discontent. It provides exercises to help devise the best ways to handle stress, models for improving eating habits and routines for physical activity.

Nanavati provides guidance in how to pinpoint problems, so they can be solved, and how to remain calm and positive in any given situation by finding balance and peace.

Find “Core 4 of Wellness” for sale on Amazon.com.

“JOURNEYS BY HEART,” a new book produced by Upstate’s Center for Spiritual Care, contains 21 inspirational stories from people who work in the hospital.

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Bimenyimana Onesime, known as Kofi, was an intern when he interviewed staff members and brought their stories to life in a book designed by Susan Keeter, assistant director of marketing at Upstate.

Journ neys

by Heartt As told to Bimenyimana (Ko Kofii) Onsime The Revv.. Teerry Culbertson and The Revv.. Jane Dasher, editors

Onesime tells his own story of fleeing his homeland, the Republic of Congo, for a refugee camp in Tanzania and his life-changing immigration to Syracuse, where he flourished in high school. He now attends SUNY Canton.

“I could not believe that someone like me—who grew up in a camp, had no chance of higher education and struggled with the English language—was on his way to being successful,” Onesime writes.

Copies of this book, the fih published by Spiritual Care, are available by calling 315-464-4687 or emailing chaplain@upstate.edu e Rev. Terry Culbertson, who directs the Center for Spiritual Care, says the books have a special purpose.

“Spiritual care is about what gives us meaning, purpose and hope in our lives, especially when challenged by suffering and illness,” she says. “It is our hope and prayer that these books are instruments of encouragement for all who read them.” ● upstate.edu l winter 2017

Triage for masterpieces

IN OUR COMMUNITY

BY SUSAN KEETER

ON THE TABLE is a banged-up World War II soldier.

His le elbow is punctured. His skin is cracked. Something brown and gelatinous is stuck to his back. e soldier is photographed. His injuries and overall state of health are recorded. A chunk of the “unidentified organic matter” is scraped off and placed in a numbered glass vial for further analysis. is checkup lasts an hour and results in a four-page report on the care needed for the 1944 portrait of Arthur Ecker, MD, PhD, a neurosurgeon from Upstate Medical University who served in the U.S. Army’s 52nd General Hospital Unit in England. e analysis of the Ecker portrait is part of the first-ever art conservators’ condition survey of Upstate’s collection of 56 portraits of doctors, deans and scientists. e paintings, which hung throughout Weiskotten Hall and the downtown hospital, were moved to the Health Sciences Library for this project, under the supervision of Cara Howe, curator of historical collections.

Transporting the collection from Syracuse to an art conservator in Chicago, Boston or Philadelphia would have been cost prohibitive. Fortunately, Howe says, a nationally recognized conservation firm is nearby, in Skaneateles.

“Paintings are like people,” says Susan Blakney, chief conservator of West Lake Conservators. “ey are born, and then they begin to age. Our goals are to maximize life expectancy. ” Blakney recommends that paintings undergo a survey of their physical condition by a trained conservator every 10 years.

Working much like an emergency physician doing triage, Blakney and her team first assessed all 56 paintings to determine which were in greatest need of treatment and then developed a plan to care for the entire collection long term. Because they hang in public spaces, the paintings have suffered from changes in humidity and temperature, light, accumulated dirt and, in some cases, insects, water damage, spilled drinks and dents from accidental encounters with passers-by. e painting of Ecker, a professor in the medical school from 1939 until 1963, was deemed a top priority.

His portrait was created in England during WWII and, because of wartime shortages, was painted on burlap using house paint rather than on canvas with artists’ paints. e puncture wound on his elbow was one of four holes made

winter 2017 l upstate.edu

Art conservator Susan Blakney uses an LED light to examine the World War II portrait of Arthur Ecker, MD, PhD, founder of the neurosurgery department at Upstate Medical University. Cara Howe, Upstate’s curator of historical collections, observes.

At left: The portrait of Ecker, who died in 2006 at age 93. photo by WilliAM Mueller

by thumbtacks. Paint was flaking around the holes, and water damage led to some buckling. e frame was pressing against the edge of the painting, causing the burlap to fray in spots.

Ecker’s portrait was reframed with padding, backing board and removable hardware to prevent further damage.

Blakney and her staff spent a week in the Upstate library, photographing, analyzing and reframing the portraits.

Howe says restoration of individual portraits will take place over time. ● UPSTATE’S ART COLLECTION IS HISTORICALLY SIGNIFICANT and valuable in its artistic quality. e individual portraits are of people who shaped health care in Central New York and beyond. e earliest are the 19thcentury portraits of Frederick Hyde, MD, the first dean of the college of medicine, and William Plant, MD, a founder of the specialty of pediatrics. e portrait of Elizabeth Blackwell, MD — an 1849 graduate of the predecessor to the present medical college and the first female physician in the United States — was painted posthumously and added to the collection in 1963. To view the collection online, visit: library.upstate.edu and find “exhibits” under the “resources” tab.

Hear more at healthlinkonair.org. Search “Cara Howe.”

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IN OUR COMMUNITY

Amazon ecolodge A creation of father and son eye doctors

BY JIM HOWE

WHAT STARTED WITH A VACATION trip in the 1990s has blossomed into something of a second career in Amazon ecology and tourism for an Upstate ophthalmologist.

Charles A. Mango, MD, 72, of Solvay, who has a private practice in Syracuse and has been on the Upstate faculty for decades, said it was his son’s idea to see tropical wildlife that kicked off their family trips into the Latin American jungles.

His son, Charles W. Mango, 42, had studied birds and tropical lowland ecology, and a college field trip to Costa Rica inspired him to get his family to visit there, and later to cruise near the headwaters of the Amazon in Peru.

“We loved Peru – the people, the environment, the birds and animals,” says the younger Mango, who graduated from Upstate Medical School in 2000 and today is a clinical associate professor of ophthalmology at the Weill Cornell College of Medicine in New York City.

Return trips included a visit to a pristine branch of the Amazon, the Yarapa River, where the Mango family decided to create a preservation-minded project. ey befriended Victor Serrubio, a Peruvian guide the same age as the younger Mango, whom the elder Mango later brought to Syracuse to fix an eye problem and to see snow and who eventually became like a member of the family.

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“I asked him what his plans were,” the elder Mango said, “and he said he’d love in the future to own a small lodge, and that’s how the whole idea formulated, to start building this lodge. I said, ‘OK, let’s build something for you and your family to run, and it’ll be a fun project. Well, it turned into a huge project.”

Serrubio oversaw the building project for the Amazon Yarapa River Lodge, which had to be constructed faster and larger than originally planned to accommodate a Cornell University botanical research program. e Cornell program lasted several years and resulted in a large body of research being published about medicinal plants and the animals that ate them. Now the facility is used by a variety of schools from around the world. e lodge has a full-time staff of about eight and can accommodate about 40 guests, with dormitory-type rooms for about 28, and the remaining rooms larger, with private baths. Food and drinking water are brought in, and meals are cooked by chefs from a restaurant that Mango owns downriver in Iquitos, a city about 3½ hours away by car and boat. Serrubio and his wife manage both the lodge and the restaurant. Learn more at www.yarapa.com.

“At this point, the lodge is a sustainable ecology facility,” Mango says, noting that water for showers is unheated and guests are asked to limit electronic device use and spend time exploring the jungle.

Continued on page 19

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IN OUR COMMUNITY

Amazon ecolodge

continued from page 18

If you catch a piranha while fishing, a chef will cook it for you. As for unhooking a piranha, “We let the guides do that because they’re very vicious,” Mango notes. e lodge recently installed a 5-acre botanical garden, and a Peruvian professor oversaw the labeling of all the trees using GPS devices.

Mango would like to attract more research programs, but at the moment the lodge is mostly used by tourists, who can stay for either four or seven days at a time.

When speaking about the lodge and area, Mango enriches the story with background on everything from the local flora and fauna to his encounters with Amazon natives and government health care and public works officials.

“My main focus is on preserving the area around the facility. We have about 200,000 acres of land now in different trusts as well as owned, and seven lakes.” He has conservation agreements that limit commercial tree cutting and fishing but allow small-scale and traditional tree cutting, fishing and hunting that benefit the local communities.

“Everything I’ve done there, I’ve done because I love it.

It’s not a moneymaker for me. I enjoy it because I think I’ve helped a lot of local people, so it’s been fun for me,” he said, noting, “My family thinks I’m crazy.”

winter 2017 l upstate.edu

Mango currently enjoys overseeing all of the main tasks associated with running an ecolodge. He answers guest emails, confirms bookings and works with the locals on expanding the reserve. His son is content with continuing his role as adviser and promoter.

Charles A. Mango, MD

Both men agree that this project has enriched them with an understanding of how precious the people and natural environment of the Amazon truly are. “It won’t be around forever,” says the younger Mango, “so experience it while you still can.” ●

Charles W. Mango, MD

What is an ecolodge?

An ecolodge is a place for environmentally minded tourists to stay that is designed to have a minimal impact on the environment and is usually small and remote, to offer closeness to nature. It oen resembles indigenous dwellings and is staffed and/or owned by local residents to help support the local economy.

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IN OUR LEISURE

What to do with your great idea

BY AMBER SMITH

SEAN AMMIRATI BELIEVES the world has lots of problems that need to be fixed.

“Part of the key to fixing those problems is getting more and more people to think entrepreneurially,” he said at a conference at Upstate’s Central New York Biotech Accelerator this fall.

Ammirati, author of “e Science of Growth,” spent 12 years building and selling businesses in the media and soware industries. Today he teaches at Carnegie Mellon University and leads Birchmere Labs, a seed and studio fund focused on community driven commerce startups. He told conference attendees how to go about commercializing their innovations — and cautioned them that entrepreneurship has a high failure rate, even when done perfectly.

1. Have a great founders’ vision, one that is contrarian and correct.

Entrepreneurs create the world the way it ought to be, Ammirati says, but even if their vision challenges the status quo, it

may be incorrect. Or, their vision may be ahead of its time, and the world just has to catch up to it.

2. Is the market large enough to justify your time and resources? “Enough” is purposefully vague because the threshold differs among entrepreneurs and among projects.

“I’m shocked by the number of entrepreneurs who don’t research if they have a scalable idea,” Ammirati says.

3. Does it solve a real problem? When you create something, it’s easy to fall in love with its features. Just remember that customers only care about the problem you are solving for them.

Entrepreneurs face a straightforward question about whether their product solves a problem for a defined group of people, which Ammirati says is easily answered using the scientific method. at is, you build something, you measure it, you learn from it — and then you rebuild, measure again and learn more. ●

FEATURED RECIPE

Apple and Pear Salad With Almonds and Blue Cheese Here’s a light and tasty way to enjoy fruits that are available in Central New York during the winter months.

Ingredients 1 Anjou pear, cored and sliced 1 Fuji apple, sliced 1 teaspoon fresh lemon juice 1 ounce red onion, julienne sliced

4 cups spring mix lettuce ½ cup dried cranberries 2 ounces blue cheese crumbles ¼ cup sliced toasted almonds ¼ cup balsamic vinaigrette

Preparation Slice apple and pear into matchsticks. Place in water with lemon juice for 10 minutes to prevent browning. Drain and reserve. Toss apples and pears with the remaining ingredients just before serving. Chef ’s note: Use any local crisp fresh apples or pears in this recipe.

RECIPE FROM MORRISON HEALTHCARE, THE FOOD SERVICE PROVIDER FOR UPSTATE MEDICAL UNIVERSITY.

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Nutritional information This recipe makes four 1-cup servings, each containing: 205 calories 5 grams protein 28 grams carbohydrates 10 grams fat 11 milligrams cholesterol 331 milligrams sodium 4 grams dietary fiber

upstate.edu l winter 2017

IN OUR LEISURE

“These stories are my gift to you. If you want to cry, cry. If you want to laugh, laugh. But I want to be sure that you leave the theater with part of my essence, my being, my soul.”

-FROM THE PROGRAM NOTES TO “FROM CUBA TO ’CUSE”

His world is on stage

BY JIM HOWE

FOR YEARS, JoséMiguel Hernández would make people laugh and cry with his stories about growing up in Cuba and ending up in Syracuse.

A few years ago, Hernández, 45, a technician in Upstate’s pediatric emergency department, took a friend’s advice and turned those tales into a one-man stage show that he performs annually in Syracuse and around the region.

“From Cuba to ’Cuse” tells about a shy Cuban boy who found his voice in the theater, got a nursing degree and immigrated to the United States in 1997. e show, performed in English, showcases his struggles with the language and his effervescent personality.

“I try to do whatever I can do to be happy about myself. I cannot make somebody happy if I am not happy myself,” he says. His boundless energy is obvious on the job, too, as he tells a co-worker she looks like a movie star, gets a blanket for a patient or recalls a favorite phrase, such as “everything’s coming up roses.”

One of his show’s more poignant moments is when he recalls how a stranger once offered him a flower.

“When I end my show, I look into the audience at somebody, and I say, ‘Did I tell you that a stranger gave me a flower? So I have everything I need to be happy.’”

Hernández was given the choice of settling in Miami, somewhere in Texas or Syracuse. He thinks Syracuse was a good choice, partly because both his native city of Santa Clara and Syracuse share a love of the color orange, and both have sports teams that wear that color.

His show portrays one of his ongoing challenges. “English is very hard to me to speak because the pronunciation and winter 2017 l upstate.edu

PHOTOS BY SUSAN KAHN

Medical technician performs life story

the phonetics, and there’s so many meanings one word, and it gets hard,” he says.

Prior to coming to Upstate, he worked for several years as a physical therapy assistant at Rosewood Heights, a local nursing home that closed in 2014, and became known there as “Mr. Smile.”

He has loved working with both the elderly and children, which ties in with another of his free-time pursuits: directing a children’s theater troupe, which he started in 1999 through the Spanish Action League. e kids work all year to perform a play in Spanish every October. at program, La Joven Guardia del Teatro Latino, is free of charge, and Hernández hopes it helps keep underprivileged kids off the streets, build their self-esteem and expose them to music, drama and dance.

Most of the kids in his plays do not grow up speaking Spanish; they learn it for the performance, he notes, and many go on to college and successful careers in various fields.

He draws on his training at a prestigious Cuban theater school and on his desire to be positive about himself and others in both of these stage pursuits.

A phrase he saw on a lottery billboard soon aer arriving in town sums up his can-do attitude.

Hernández repeated that phrase when he spoke to his fellow graduates of Syracuse’s Johnson Center/Adult Education program years ago. He thanked everyone who had helped him and said, “is is just the beginning of what I want to be in this country,” then added the lottery slogan with his own ending: “Hey, you never know … until you try.”● U P S TAT E H E A LT H

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Making music

IN OUR LEISURE

Web designer’s secondary career is onstage singing, playing

BY AMBER SMITH

CATHY CADLEY is Upstate’s senior Web designer.

Her hands spend much of her work day on a computer keyboard.

On her favorite evenings, her fingers caress the strings of a guitar, and she sings of a land that she heard of

BY AMBER once in aSMITH lullaby.

Cadley is an accomplished musician who performs with her husband, John Cadley, and bandmates John Dancks and Perry Cleaveland. e group plays mostly new acoustic and bluegrass. “Somewhere Over the Rainbow” is one of their most-requested songs. ey perform monthly at the Upstate Cancer Center and at a variety of venues throughout Central New York. Check www.cadleys.com for dates and locations.

“You hear the rhythm because language has so much rhythm to it,” she says. “ere’s rhyme and rhythm in every line. You have to pay attention to the mood, the tenor and the tone of the lyric and follow that with the composing and the structure. Hopefully they support one another.”

Cadley confesses to occasional butterflies before a performance, “but once we get to making music and everyone is clicking, I’m good.

“I really do enjoy making the music.”

●

Cadley recalls a love of music and rhythm from an early age. Around age 7, she chose the violin for a school instrument. A few years later she learned guitar. en it made sense to begin singing as she played. Her earliest performances were in her church.

“I made a decision early on that I didn’t think I’d be able to make a living doing music. I made a conscious decision to pursue visual arts,” Cadley says. She earned a bachelor’s degree in fine arts in visual communications from Syracuse University.

Aer graduation, her pastor asked her to direct the church ensemble, a side job she kept for more than 20 years. She and John Cadley began playing as a duo in 2009, married in 2012 and enjoy what a Syracuse New Times review described as “an easy rapport that reveals much about their shared virtuosity and musical kinship.” eir band includes Dancks on bass and Cleaveland, who sings and plays mandolin and fiddle. John Cadley, who sings and plays guitar and mandolin, writes some of the group’s songs. Cathy Cadley has also begun songwriting, a process she admits does not come easily.

She describes how she slowly develops ideas for songs by jotting down phrases or interesting things that she reads or overhears. e lyrics and the melody start taking shape together.

photo by ericA hAsenjAger

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upstate.edu l winter 2017

DAKOTA A AND D HER PEDIAT TRIC ONCOLOG GIST, GLORIA KENNEDY Y MD Y,

If your child faaces a diagnosis of cancer,, turn to the experts at Upstate for p personalized care and treatment options. We off ffe er access to clinical research studies dies, exceptional technology and d support services at the Upstate Golisano Childr dren's Hospital and outpatient tr t eatment at the Upstate Cancer e Center. Our multidisciplinary teams of oncology-certified nurses and board--certified physicians are here for you.

MORE INF FORMAT TION CALL 855.964.HOPE OR VISIT UPSTA AT TE.EDU/CANCER R

CARING G FOR PA AT TIENTS. SEAR ARCHING FOR CUR RES. SAV VING LIVES.

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U P S TAT E H E A LT H

23

750 East Adams Street l Syracuse, NY 13210

SCIENCE IS ART IS SCIENCE IS ART 1S SCIENCE

A COMMON COMPLAINT aî‚?er a concussion injury is a feeling of unsteadiness or impaired balance. Monitoring balance deficits and recovery of balance may help to better understand concussion injury and recovery. Scientists at Upstate Medical University use infrared motion-capture technology to track body motion during a balance test. î ˘is allows analysis of various strategies used to maintain upright posture and to investigate impairments that lead to balance problems. People participating in the research stand on foam pads and on firm floor surfaces, allowing scientists to measure and compare their centers of pressure.

Christopher Neville, PhD, PT, has a doctorate in health practice research with a concentration in biomechanics. He is an associate professor in the department of physical therapy education in the College of Health Professions and serves as the director of research for the Upstate Concussion Center.

17.007 0117 42.8M ELsk