Health UPSTATE
U P S TA T E M E D I C A L U N I V E R S I T Y
MEET A FROSTBITE BURN SURVIVOR s
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HOW A FIGHTER RECOVERED FROM STROKE page 6
9 WAYS TO HELP SOMEONE IN THE HOSPITAL page 12
A SPIT TEST FOR AUTISM page 16
SECRETS TO RAISING READERS page 22
STUDYING TUMOR FORMATION back cover
Fall 2017
welcome
5 random facts
you would know if you listen to ‘HealthLink on Air’ UPSTATE PRODUCES A WEEKLY PODCAST/ radio talk show called “HealthLink on Air” that airs on WRVO Public Media at 6 a.m. and 9 p.m. Sundays and is available in iTunes or on demand at healthlinkonair.org e program explores health, medical and scientific topics with a variety of experts from Upstate. Listeners are liable to learn something new, even surprising, every week.
For instance, do you know: –does posture cause shoulder pain? Doctor of physical therapy Adam Rufa reviewed the research on posture and shoulder pain. “I found very consistent evidence that posture does not play a big role in developing shoulder pain,” he says, adding, “at does not mean if somebody already has shoulder pain, that changing their posture and how they move might not help. e key is to change up your activity and your position.”
–the most painful injury a human body can endure? Severe burns. “Your skin is what protects your body, and when you damage the skin, you’re affecting all those nerves,” explains nurse Tamara Roberts, manager for Upstate University Hospital’s Clark Burn Center. “When you affect those nerves, it is extremely painful. e larger the burn area, the more painful the burn is. It sets off an inflammatory response in the body, which also progresses the pain for these patients.”
–what cartilage feels like? Orthopedic surgeon Todd Battaglia, MD, describes the cushion that coats the bones in our joints as “sort of a rubbery substance. “It feels somewhat like a slippery hard-boiled egg.”
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–how to tell whether a baby is a boy or girl? It’s not always simple. Specialists estimate one in every 2,000 births at a hospital “involves a child whose genitals are atypical enough to make the sex unclear that day,” says pediatric endocrinologist Susan Stred, MD, from Upstate’s division of pediatric endocrinology and diabetes. “One estimate even says that one in 100 persons has some kind of difference in sex anatomy. “It’s hard to know for sure. We’d have to have a consensus first on what is different enough from average to count as a difference of sex development, also known as intersex,” she explains. In complex intersex cases, doctors examine hormone levels, chromosomes and imaging studies to determine if a baby is a girl or boy.
–the worst thing you can do after orthopedic surgery? Smoking delays healing, and in some cases makes proper healing impossible, says orthopedic surgeon Michael Fitzgerald, MD. “It’s the worst thing you can do for your recovery,” he says. Nicotine, a vasoconstrictor, decreases blood flow and the activity of osteoblasts, the cells that help produce bone. Carbon monoxide decreases the blood’s ability to carry oxygen, which is necessary for bones and so tissues to heal. ●
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welcome
Contents 5
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patieNt care
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One man’s rapid recovery page 5
From our experts
iN our commuNity
How a martial artist fought his way back from a stroke
Sign language is part of her job
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Nurses share the best ways to help when someone you love is hospitalized page 12
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How you can help develop a new autism test page 16
What you can do to prevent gun violence, addiction
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Who are the workers doing low-wage jobs?
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Extending the time frame for stroke care
Frostbite burns threatened his life, his music page 8 Operating through the nose
12 things you might not know about the U.S. military
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2 ways young people can protect themselves page 9
Raising readers On the cover: George Myers shares his appreciation of the burn center staff. See story, page 8.
Health UPSTATE
U P S TAT
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MEET A FROSTB BURN ITE SURVIVO R
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AL UN IV
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His doctor gave him hope when his liver failed page 10
HOW A FIGHTER RECOVERE D FROM A STROKE
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9 WAYS TO HELP SOMEONE THE HOSP IN ITAL
page 12
A SPIT TEST FOR AUTI SM
page 16
SECRETS TO RAISI READERSNG
Health UPSTATE
Fall 2017
EDITOR-IN-CHIEF
Amber Smith
WRITERS
Jim Howe Susan Keeter Amber Smith
DESIGNER
Susan Keeter
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 ADDITIONAL COPIES: 315-464-4836 Upstate Health offices are located at 250 Harrison St., Syracuse, NY 13202
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DepartmeNts News you might have missed
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Lessons from Upstate page 15 4 interesting pieces of research Science Is Art Is Science back cover Studying tumor formation
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PHOTO BY SUSAN KAHN
EXECUTIVE EDITOR Leah Caldwell Assistant Vice President, Marketing & University Communications
iN our leisure
STUDYING TUMOR FORMATIO N page 24
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.
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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News you may have missed
WHAT’S UP AT upstate
A heat sleeve designed for limb amputees, an at-home glaucoma measurement test and a personal health and wellness messaging system are among seven medical devices and service proposals selected to participate in the Medical Device Innovation Challenge sponsored by the Upstate MIND (Medical Innovation and Novel Discovery) Center.
“As people age and desire to be active longer, medicine is changing. At the forefront of the change is the need for innovative and new medical devices and services,” said Robert Corona, DO, Upstate’s pathology chair and vice president for innovation and development. “e Medical Device Innovation Challenge is a way to jump-start our region’s push into the medical device market. It’s a growing market worldwide.” e seven winners receive six months of rent-free space at the Central New York Biotech Accelerator on the campus of Upstate Medical University, plus use of the Upstate MIND Creation Garage, a space equipped with technology such as 3-D printers to help go from idea to prototype. ey also get free consultations with business experts on how to pitch their products to gain funding, deal with regulations and produce data to help assess product marketability. l
e New York State Department of Health awarded a $1.25 million grant to the Central/Eastern New York Lead Poisoning Resource Center at Upstate. e money, dispersed over five years, allows the center to continue its work as one of three lead resource centers in the state. While the number of children requiring treatment for lead poisoning has decreased dramatically over the years, youngsters continue to be exposed through lead paint in homes built prior to the 1970s. Laws now limit how much lead is allowed in household paint.
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Upstate landed on the 2017 national list of Most Wired Hospitals, based on a survey of technology use and capability by the American Hospital Association. In the past year, Upstate has added new applications for radiology, infection control, dental and case management to its electronic medical record system, called EPIC, which also saw a system upgrade. Also added was a bedside lab specimen collection application. l
e new division chief of cardiac surgery at Upstate is cardiothoracic surgeon G. Randall Green, MD. He will also serve as co-director of the Upstate Heart Institute and help strengthen Upstate’s cardiovascular service by expanding existing cardiology and cardiovascular services and adopting new cardiac and surgical treatments and procedures. Green is a 1989 graduate of Le Moyne College who obtained his medical degree from Northwestern University Medical School. He also has a master of business administration degree from e Johnson School at Cornell University and a doctor of law degree from Syracuse University College of Law. He went to Stanford University for his medical residency, internship and fellowship and did an additional fellowship at the University of Virginia. l
In the Syracuse area, one in 10 children has elevated lead levels, says Travis Hobart, MD, an assistant professor of pediatrics and public health and preventive medicine at Upstate. Such exposure puts the children at high risk for school and behavior problems.
Upstate gave away 800 bicycle helmets to children during this year’s New York State Fair. Staff from Upstate’s Pediatric Trauma Service and Safe Kids Upstate New York were on hand to make sure each helmet was properly fitted.
New York state mandates blood lead testing in all children at 1 and 2 years of age.
By law, all bicyclists under the age of 14 are required to wear approved bicycle helmets when bicycling or riding as passengers on bicycles in New York state.
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More than a dozen nurses at Upstate University Hospital recently become certified lactation counselors. is means they are prepared to provide breast-feeding support, including assessing the latching and feeding process, providing corrective interventions and counseling mothers.
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e increase in lactation certifications reflects the progress the Family Birth Center has made as part of the New York State Breastfeeding Quality Improvement in Hospitals Collaborative. Statistics from Upstate’s Community Campus show that mothers feeding their children exclusively through breast-feeding increased from 40 percent in December 2016 to 68 percent in June 2017, while moms doing some breast-feeding jumped from 75 percent in January 2017 to 91 percent in June 2017.
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Upstate Golisano Children’s Hospital offers for the first time a three-year pediatric fellowship with a special focus on treating child abuse and neglect. Just 30 institutions nationwide offer a child abuse pediatric fellowship. Upstate is one of two in New York; the other is at Maimonidies Medical Center in Brooklyn. upstate.edu l fall 2017
PATIENT care
Remarkable and rapid recovery
Stroke survivor Jagdish M. Saini, center, with his granddaughter, Rhea, and son, Rajeev Saini, MD, who did his internal medicine residency at Upstate. PHOTO BY ROBERT MESCAVAGE
Family called 911, got him to Upstate stroke team quickly BY AMBER SMITH
RAJEEV SAINI, MD, typically leaves for work in the morning and doesn’t come home until evening. He came home at lunchtime on May 18 to check on his 16-year-old daughter, who was home sick.
a good stroke program.” Saini was impressed with the care his father received.
“By the time we got there, they were ready for us,” he says, remembering an Saini is a doctor of internal medicine who especially helpful doctor, Ruham Nasany, practices in both Fulton and Baldwinsville, Grahame Gould, MD Ruham Nasany, MD MD. “It was such a fast pace. Immediately, near where he lives with his wife and they did a CT scan. ey gave him a children, and his 81-year-old father, clot-buster medication.” Jagdish M. Saini. Dr. Saini spoke with his father briefly Neurosurgeon Grahame Gould, MD, took care of Saini. before he went upstairs to check on his daughter. He inserted a collapsible stent into an artery in Saini’s Several minutes later he came downstairs. “I’m leaving,” he groin and threaded it to the blocked blood vessel in his said to his father. For a moment, he thought nothing brain. en he captured the clot within the cage-like of the man’s silence. e elder Saini is hard of hearing. stent and removed it from the body. e intervention Something compelled Saini. He went to his father. took 23 minutes. “I could see that his face was drooping. He tried to talk, Saini says the type of stroke his father had could have and he couldn’t,” Saini recalls. He couldn’t move his paralyzed him forever. right arm or leg. Instead, Saini’s father recovered for three nights in the e doctor recognized signs of stroke, of course, but he hospital. He required no rehabilitation and no physical, didn’t want to think this was happening to his father. occupational or speech therapy. e stroke le him with a His daughter prompted him to act: “Don’t you think slight shake in his hand and a mild difference in his gait. we should call 911?” “I’m just amazed,” he says of the difference he saw in his An ambulance arrived within 10 minutes. Saini asked father aer Gould completed the clot retrieval. “Everybody the rescue crew to take his father to Upstate University is amazed.”● Hospital. “I trained at Upstate,” he says. “I knew they had
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PATIENT care
Fighting back
How a martial artist recovered from stroke
Physical therapist Kelly Grier tailored a recovery program for William Bouchard, an avid martial artist, that included boxing. Physical medicine and rehabilitation student Joey Feliciano assisted by holding targets for Bouchard.
PHOTO BY SUSAN KAHN
BY AMBER SMITH
IN THE FIRST DAYS OF PHYSICAL THERAPY, when the therapist would say “great job,” it didn’t feel that way to William Bouchard. e message he heard was: “not good enough.” Recovering from stroke can feel like starting over. Patients oen have to re-learn various motor skills that the stroke has affected, physical therapist Kelly Grier explains. It’s inevitably frustrating, especially for a healthy martial artist such as Bouchard, accustomed to a high level of physical activity. On April 4, co-workers found Bouchard, 72, slumped in a stairwell at the Syracuse VA Medical Center, where he works as a biomedical engineer. ey thought he had fallen. A test called computed tomography angiography,
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which showed detailed images of the blood vessels of his brain, revealed a clot on the right side. Bouchard was having a stroke. He was quickly transferred to the Comprehensive Stroke Center at Upstate. Medication helped shrink the size of the clot, and neurosurgeon Grahame Gould, MD, used a clot retrieval device to remove what remained. Bouchard only remembers when “they told me I wasn’t going to karate the next morning.” Bouchard trains regularly at Impact Martial Arts near his home in Clay. It would be three months before he would return to the dojo, as martial arts schools are called. continued on page 7
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PATIENT care
Fighting back
continued from page 6
In the meantime, he would spend 22 nights at Upstate University Hospital. First, Bouchard recovered in the neurological intensive care unit, a space devoted to patients with neurological injuries and illnesses, staffed by nurses and technicians with specialized training. Later he transferred to inpatient rehabilitation. Upstate has the largest adult and pediatric inpatient rehabilitation center in Central New York. Once back home, Bouchard continued with outpatient physical and occupational therapy. “Studies show that the earlier you can get people to rehabilitation, the better the outcome,” says Shernaz Hurlong, DO, Bouchard’s physical medicine and rehabilitation doctor. She says most of the recovery that will occur aer a person has a stroke takes place within the first three months. Some of Bouchard’s success is due to his persistence, and the fact that he was active and healthy before his stroke. “Having goals and motivating factors is also important,” she says. His therapy began with a stretch band while he was still in the intensive care unit, already voicing the desire to get back to the dojo. Ten weeks later, Bouchard progressed to wall kicks, running and sparring movements using his boxing gloves during twice-weekly sessions with Grier, his physical therapist. “He’s had a remarkable recovery,” Grier says. “What really stands out is his high self-efficacy to get better.”
Adding time
Grier can’t recall a patient with goals as ambitious as Bouchard’s. He told Grier he wanted to run a mile and do
500 karate kicks — per leg — as part of his therapy. So, she built a therapy plan incorporating karate moves that were familiar to Bouchard before his stroke. When he said he wanted to walk up the hill that is Adams Street, that, too, became part of his rehabilitation. “I do my very best to make sure that each patient’s goals and interests are being talked about in therapy, so that rehabilitation is meaningful to them,” Grier explains.
Karate kicks as therapy.
On a recent weekday, Bouchard strapped on boxing gloves and punched a target held by his daughter, Kristin Bouchard of Phoenix, also a martial artist. Grier stood behind Bouchard, ready to steady him if he wobbled. Bouchard surprised even himself. “I’m more stable on my le side than I thought,” he said. Grier admits that her sessions with Bouchard are workouts for her. “I find it hard to keep up with him.” She remembers how at the beginning of his therapy, like many patients, Bouchard wanted to see results overnight. In the weeks to come, he learned that physical therapists track progress incrementally: distance walked, number of repetitions, amount of weight lied. Grier used these objective measurements to show Bouchard that he was making progress toward his personal goals. It helped him realize he was doing great. ●
Program extends stroke clot-busting ability to 24 hours TIME IS A CRITICAL element in the treatment of stroke, and now the stroke team at Upstate’s Comprehensive Stroke Center is able to offer more of it to some patients. Tissue plasminogen activator, the clot-busting medication called tPA, is most effective when it’s given to someone whose stroke began within the previous six hours. So what happens with the patients who awaken paralyzed by stroke — with no way of knowing if the stroke occurred right aer they fell asleep at 10 p.m. or right before they woke up at 5 a.m.? “It’s dangerous to do an intervention if they will not benefit,” explains neurologist Gene Latorre, MD, medical director of the stroke program. Unless the time the stroke began could be reasonably approximated within that six-hour window, doctors had to err on the side of caution and skip using tPA.
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e Upstate stroke team has opened that window wider with the addition of innovative imaging soware called RAPID DICOM that can expand the window of treatment for some strokes up to 24 hours. “Implementing this technology will improve our patients’ outcomes and quality of life following stroke,” Latorre says. “is technology allows stroke specialists to identify and select patients who not only can be treated safely but also can be expected to have a good outcome.” e soware program shows changes in brain tissue perfusion and diffusion (relating to the blood supply) in digital images captured by computerized tomography and magnetic resonance imaging. is allows doctors to tell the precise area of the brain that is affected by the stroke and the area still in jeopardy. ●
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Musician gives thanks
PATIENT care
Violist’s hands saved from life-threatening burns BY SUSAN KEETER
CLASSICAL VIOLIST GEORGE MYERS was taking photographs of construction on his family’s property in Trumansburg in October 2014 when a propane tank tipped and fell on him. e 250-pound cylindrical tank pinned him in a ditch. As the ruptured tank discharged, causing chemical injury, its metal surface, lying across his body, cooled to 40 degrees below zero, causing significant damage. He did not know it then, but he was burning. Myers struggled to push the freezing tank, his hands becoming increasingly numb at each attempt. Finally, in a burst of adrenaline, he freed his leg and pulled himself from the ditch. He crawled to the house. With frostbitten hands, Myers called 911 and his wife, Jennifer, who was teaching 40 miles away. Propane is flammable, but it wasn’t fire that burned Myers. He suffered from severe frostbite, which jeopardizes life and damages the skin in much the same way. e next thing Myers remembered was being on a stretcher in the back of an ambulance. He was shaking uncontrollably. He soon arrived at Cayuga Medical Center in Ithaca. Doctors there cut off his chemical-covered clothes and made the decision that he needed care available at Upstate’s Clark Burn Center. Joan Dolinak, MD, and George Myers greet each other, three years after she began treating him for life-threatening frostbite burns. PHOTOS BY SUSAN KAHN
“When a patient is burned on more than 10 percent of his body – particularly if the hands, feet or face are affected — protocol is to transfer to a burn center,” explains Tamara Roberts, program manager of the burn center on the sixth floor of Upstate University Hospital in downtown Syracuse. Myers had burns over 30 percent of his body. At the burn center, Myers and his wife were met by Joan Dolinak, MD, medical director. “My job is to get you back to where you were,” she reassured them. In Myers’ case, that meant repairing his Dolinak legs and feet so that he could walk, making sure the chemical burns didn’t damage his vision and that the frozen skin on his torso would heal — and repairing his frostbitten hands and arms so that he could play viola with the Cayuga Chamber Orchestra. Dolinak graed skin from Myers’ thigh to his right calf and foot, which had third-degree frostbite burns. e skin gra was painful, as were exercises to ensure the new tissue would heal properly and allow normal movement. Roberts worked with Myers on the skin-stretching exercises and remembers telling him, “You’ll hate me now, but you’ll thank me in a year when you are able to walk through that door.” Aer two weeks in the burn center, Myers returned home, unable to walk. Physical therapists came to the house, and his wife and visiting nurses changed the dressings that covered his arms and legs, a painstaking daily process. Myers was readmitted to the burn center for a second skin gra surgery because his le leg wasn’t healing. By anksgiving, Myers was home again and recovering. He, his wife and their adult children, Rachel and David, traditionally give thanks by talking about people and experiences for which they are grateful. Myers was speechless. Looking back, Myers realizes he was overwhelmed by the gratitude he felt for the burn center staff, and for the fact that he had survived his ordeal. “How does a hospital get everyone to give such compassionate care?” he remarked. “Everyone — from the doctors and nurses, to the women who cleaned my room or brought me my meals — was kind, caring and sensitive. No one ever rushed. ey took the time to ask how I was feeling and to listen.” continued on page 9
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PATIENT care
Musician plays again
continued from page 8
A few months aer the accident, Myers was able to walk outside, with the support of a cane and a physical therapist. He was seen at the burn center’s outpatient clinic weekly at first, then less frequently as he improved. ree years later, Myers, 71, is in excellent health. Scars on his legs and skin that require extra protection from ultraviolet rays are the only remnants of his accident. He is training to become a peer support leader for the burn center’s survivors’ support group. Myers with nurses Debra Abbott (left) and Tamara Roberts, two of the burn center staff members who cared for him. Upstate’s Clark Burn Center serves 27 counties from northern Pennsylvania to the Canadian border. In 2016, the burn center treated 308 patients.
And he’s able to say what he couldn’t say at anksgiving 2014: “e amount that I was burned,” he says, smiling, “I am so grateful for my care and healing, and that I can continue to be a musician. It’s pretty miraculous.” ●
SOMEONE WITH AN ALTERNATELY STUFFY and drippy nose, ears that feel full, headache, even nosebleeds, is most likely suffering from allergies or chronic sinusitis.
fellowship training in skull base surgery.
Operating through the nose
But tumors deep in the nose or at the base of the skull can cause those same symptoms. “e symptoms can overlap with a lot of other innocuous conditions. at’s why a lot of these tumors are found relatively late,” says Mitchell Gore, MD, an ear, nose and throat doctor at Upstate with
Such tumors can be benign or cancerous. Depending on their size and location, many can be removed using an endoscope inserted through the nose. Gore says surgical equipment, cameras and video technology have advanced in the past couple of decades. Endoscopic skull base techniques now provide surgeons with a better view – and patients with a faster recovery.●
Strokes affecting more young people BY AMBER SMITH
A GROWING NUMBER OF YOUNG PEOPLE are at risk for stroke today because so many people age 20 to 55 have diabetes, high blood pressure, high cholesterol and/or obesity. ese diseases increase any person’s risk for stroke, no matter their age. Having more than one amplifies the risk. Most of the strokes that occur in younger people are ischemic, in which a blood clot settles in an artery in the brain, blocking blood flow, says Gene Latorre, MD, a neurologist who oversees Upstate’s stroke service. Some happen because of an irregular heart rhythm, but most develop from a buildup of plaque in the arteries of the neck.
what can you do to protect yourself? 1. RECOGNIZE THE RISK. “e first thing to realize is, you are equally vulnerable,” says Latorre. 2. ACT. Get your diabetes under control. Get treated for high cholesterol. Monitor your blood pressure. Some primary care doctors are not quick to treat a young person whose blood pressure is high in the doctor’s office. So, check your blood pressure regularly, perhaps at a pharmacy. If it runs high, alert your doctor. Latorre explains, “the earlier you diagnose hypertension, the earlier you can control it.” He says young people who have strokes typically recover more quickly — and more completely — than older people. But prevention is still preferred. ●
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PATIENT care
Their team of doctors offered expertise — and hope BY AMBER SMITH
ORLANDO BARRERA WORKED HIS WHOLE LIFE in construction. He was strong and relatively healthy — until May 2015, when stomach pains forced him to seek medical care. e Syracuse man underwent emergency surgery to remove his gallbladder. Surgeons noticed tumors in Barrera’s liver. Barrera knew he had chronic hepatitis C, a viral infection that attacks and inflames the liver. Over time, healthy cells were replaced by scar tissue, and he developed cirrhosis. en he learned his liver contained two tumors that were cancerous. e chemotherapy provided by the interventional radiologists at the Upstate Cancer Center under the supervision of Dilip Kittur, MD, and Ajay Jain, MD, helped shrink the tumors, but for months, Barrera was in and out of the hospital with complications of cirrhosis. Barrera’s cancer doctor, Muhammad Naqvi, MD, arranged for him to see Savio John, MD, a hepatologist or doctor who specializes in diseases of the liver. John treated Barrera’s hepatitis C infection and the various complications of cirrhosis. Barrera’s wife, Mary Barrera, remembers how sick he was in October 2016 with hepatitis C infection, liver cancer and life-threatening complications from liver cirrhosis. ey were considering hospice care because doctors at one transplant center told Barrera he was not a candidate for liver transplantation. John told the couple Barrera would probably not live another six months without a liver transplant. e hepatologist “was really pushing him to look into a liver transplant at another facility because he said that he was a good candidate for it,” Mary Barrera recalls. e couple was at the UMass Memorial Medical Center in Worcester, Mass. before Barrera turned 64 on Oct. 9, 2016. A liver became available for him on Nov. 12. continued on page 11
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PATIENT care
about the liver l
secretes bile, which helps with digestion and performs more than 500 functions.
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processes and stores nutrients.
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regulates energy production.
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removes toxins from the body.
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metabolizes medications.
Mary Barrera remembers how alone she felt, waiting for the transplant surgery, which lasted almost 12 hours. When her husband awoke, he cried. “He knew he had made it through,” Mary Barrera says.
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filters about 1.4 liters of blood per minute.
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manufactures proteins and hormones.
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produces enzymes and chemicals important for blood clotting.
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plays a role in controlling blood sugar levels and all other metabolic processes.
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has two lobes and is the largest internal organ, located on the right side of the abdomen.
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can regenerate itself — A person can donate a portion of his or her liver to someone else, and the remaining portion will grow back to its original size, while the transplanted portion grows to the appropriate size in the recipient.
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was considered the seat of emotions for the Greeks, who viewed the organ as being in closest contact with the divine.
Dilip Kittur, MD
Ajay Jain, MD
Muhammad Naqvi, MD
Their doctors
Savio John, MD
ey stayed in Worcester until the doctors said Orlando Barrera could return home to Syracuse at the end of January 2017. He’s eating on his own, gaining weight that he lost to illness, taking his medications and using an exercise bike to regain his leg strength. e jaundice, abdominal fluid distension and confusion related to the cirrhosis are now gone. As Barrera recovers, he and his wife reflect on how fortunate they were to find a hepatologist who gave them hope and helped arrange the liver transplantation. “We really owe a lot to the UMass transplant team and Dr. John,” Mary Barrera says. “Without them, my husband wouldn’t be alive right now.”●
coulD a hepatologist help you?
A hepatologist is a physician who specializes in disorders of the liver and biliary tree, the system that makes, stores and secretes bile. Hepatology is a sub subspecialty of gastroenterology, which encompasses all of the organs of the gastrointestinal tract including the esophagus, stomach, small intestine, colon and rectum, plus the pancreas, gallbladder, bile ducts and liver. Hepatologists treat patients with all types of hepatitis, liver cancer, cirrhosis and liver diseases. To find a liver specialist, call University Gastroenterology at 315-464-1600. Hepatologist Savio John, MD, at a follow-up appointment with Orlando Barrera PHOTOS BY ROBERT MESCAVAGE
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FROM OUR experts
Nurses share 9 ways to help when someone is hospitalized BY AMBER SMITH
A FRIEND OR RELATIVE IS HOSPITALIZED. Maybe for a few days, maybe a few weeks. You want to help. What’s the best way?
Nurse John Seller was a patient himself. “e best gi I ever received was a surprise visit from my sister who made a special trip from the other side of the country.”
We tapped the corps of nurses who care for patients throughout Upstate University Hospital to share some of the most memorable gis they’ve seen. Not everything will work for all patients, of course, but we hope these suggestions give you some ideas.
2. be personal.
1. be present.
Several nurses suggested photographs of friends, family and pets. Compile a selection in a tiny album. Or, print a few favorites to stick on the wall. ey can provide inspiration to work hard at getting better. At the same time, photographs help hospital staff see the patient outside of the patient role. “Pictures of family with the patient are great reminders of their loved ones who support them, along with encouragement for them to get better when they see how healthy they were before,” says pediatric nurse Stephanie Cooney.
Nurse Mary Kampf says the best gi is a simple one: “Just being there.
“It’s helpful for patients to see a reminder of who they are and what they are fighting for,” adds nurse Mary Walsh, from the intensive care unit.
“It’s frightening to be ill and not have someone there with you to help with decisions and understanding of what is going on medically.” Kampf works in clinical documentation.
Nurse Annette Sutherland, from the emergency department, points out that personal photos also serve as a way for nurses to initiate conversations with the patient about his or her life.
Nurse Marilyn O’Connor from radiology adds that companionship can be important. But, she advises, “Know when to leave. Recognize when the patient needs to rest.”
3. be creative. (but first, run your ideas past your loved one’s nurse.)
For patients who are mentally alert but require lengthy rest and recovery, intensive care unit nurse Owen Flynn says phone calls or visits can help provide mental stimulation. “Humans are naturally social creatures,” he says. “is gives the patient encouragement to get better and a feeling of normal social interactions that they were used to having outside the hospital.”
“I once had a patient who was celebrating her 70th wedding anniversary in the hospital,” recalls nurse Jacqui Aldinger, a clinical training specialist. “Her husband brought in a corsage, music player, takeout food — including the chocolate chip cookies she always used to make for him — and a battery-lit candle, so they could enjoy a candle-lit dinner. It was beautiful.” continued on page 13
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FROM OUR experts
Nurses share
continued from page 12
5. be mindful. Nurses caution against cluttering up a room that’s designed to help sick people heal, but sometimes there are exceptions. Nurse Caitlin Nye, from nursing recruitment, recalls a patient during the Christmas season who was a fan of “A Christmas Story.” His family surprised him with a replica of the movie’s leg-shaped lamp. Nurse Emma Lestrange from family medicine has seen visitors who sing or play guitar for a patient. “is was heartwarming, and it meant a lot to the people who were ill,” she says. “Something like this could really brighten someone’s day.” Intensive care unit nurse Jennifer Kozlowski agrees, recalling a man recovering from a traumatic injury who was a big fan of Italian culture and classical music. For his birthday, friends sent a traveling violinist to his hospital room.
4. be inspiring. Some of the most enjoyable gis Nurse Heidi See has seen are bags or boxes filled with small thoughtful or funny gis that were wrapped individually and opened on different days. “I have also seen the same kind of thing done with notes instead of gis,” she says. See works with bone marrow transplant patients. Nurse Michelle Archer from the medical intensive care unit favors photo boards or collages. “One of the more unique presentations given to a convalescing patient that I have seen was a series of drawings with accompanying jokes, from the students of a school custodian — because he would always provide jokes for the children. His wall was full of them,” recalls nurse Sherod Harris, from intensive care. Nurse manager Kyle Choquette has seen rooms decorated with encouraging quotes. He also recommends a small stuffed animal to represent a beloved dog or cat, for a patient with a lengthy hospital stay. A drawing by a young relative or neighbor can also be enjoyable.
Nurse Ann Macwan, who takes care of heart patients, says some patients will appreciate lava lamps, Himalayan salt lamps (which look like glowing rocks) or essential oil diffusers – as long as they are small and don’t compete with medical care space.
6. be thoughtful. A hand or foot massage, manicure or pedicure can be soothing, says nurse Arlene Heer. Human touch can be meaningful. “One woman, days away from going to heaven, so wanted her hair washed,” recalls Heer. “I found another nurse free for the 30-minute task, and we used a plastic bag to help wash her hair at the end of the bed. She passed away with a big smile on her face.” Nurse Mary Kampf remembers the small bottle of bubbles someone brought to her son when he was a patient in the hospital. She also remembers staying next to him in the intensive care unit for three days. “A nurse brought me a cup of coffee. I will never forget that. e simple things mean so much.” A home-cooked meal or favorite snack can be a treat, as long as your loved one has no dietary restrictions. Sometimes a tall milkshake hits the spot, says nurse Michelle Henry, from gastroenterology.
7. be supportive. Nurse Scott Jessie, from emergency services, suggests offering to provide childcare or transportation for family members. Catching up on the patient’s laundry, mowing the lawn, picking up mail, watering plants or fetching groceries are all tasks that might be helpful, says nurse Heidi See. “I oen remind my patients that they have people who want to help them but have no idea what they need done,” she says. “I tell them that by allowing someone else to help, they are not only getting continued on page 14
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FROM OUR experts
Nurses share
continued from page 13
something done that they need, but they are allowing the other person to feel that they have contributed something of value and made them feel less helpless.” Nurse Nancy ompson says such gis are great because they allow the patient to focus on recovery. Purchase a housecleaning gi certificate. Prepare casserole meals that can be frozen and eaten when he or she returns home. Offer to help a child with homework.
8. be generous. “e best gis are ones that encourage self-care of the families,” says nurse Sarah Seargent, who works in the hyperbaric unit. An example: Set a time to sit with the patient, so parents/loved ones can take a break for a shower or to get a cup of coffee. Nurse Lynne Jones from clinical practice analysis calls it the gi of time. “is is an easy and very giving gi,” she says. “It can be any amount of time, time to sit and talk, time to help with meals, cleaning or whatever they may need. Ask what they need.”
9. be practical. Pay for television service while the person is hospitalized. Or pick up the cost of a parking pass for their family. Gi cards for the coffee shop or nearby restaurants may also be appreciated. A gi that may be particularly meaningful to a critically injured patient is for friends and family to “pay it forward” by making donations of blood or blood products, suggests nurse Michael Bennett from radiology. If you want to bring something to the hospital when you visit, operating room nurse Amy O’Rourke advises against anything scented or flavored, and she says shawls are a better gi than sweaters. “Patients can’t tolerate scents or flavors when they are already nauseous. And, a shawl has no sleeves, for ease with intravenous or other medical lines.” ●
good gifts for patients
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Lip balm
Paperback books
Earplugs
Tissues in a colorful box
Neck pillow
Unscented lotion
Colored pencils and coloring books
Baby powder
Stuffed animal
Robe, shawl or bed jacket
Detangling hairbrush
Playing cards
Cozy blanket
Breath strips
Photographs
Water bottle
Scrunchies or hair ties
Music
“Get well” cards
Magazines
Sleep mask
U P S TAT E H E A LT H
upstate.edu l fall 2017
FROM OUR experts
LESSONS FROM UPSTATE STROKE RISK A CONCERN IN STEM CELL TRANSPLANTS A patient who will undergo autologous stem cell transplants (using one’s own cells) typically precedes the transplant with high doses of the chemotherapy drug melphalan, two days before.
NEW MEDICATIONS CAN CAUSE REACTIONS Umair Masood, MD, and colleagues from Upstate’s department of internal medicine shared the story of a 57year-old man with a history of alcoholism in the Journal of Basic and Clinical Pharmacy. e man came to the emergency department with sharp, stabbing abdominal pain and yellowed skin, and tests showed liver damage. Doctors initially suspected the man had alcoholic hepatitis, a liver disease caused by alcoholism. But he said he had been sober for four months. e man also had a history of rheumatoid arthritis — and two months prior, his doctor prescribed the antiinflammatory medication sulfasalazine. Liver toxicity is a rare but serious side effect of sulfasalazine, which typically occurs within the first month. In this man’s case, stopping the sulfasalazine solved his problem. Masood writes that since “drugs are frequent causes of liver toxicity, they should always be considered in the differential diagnosis.” ●
CHILDREN, ADOLESCENTS WITH ADHD MORE LIKELY TO BECOME TEEN PARENTS Are people with attention-deficit/hyperactivity disorder more likely to become teen parents, compared to individuals who do not have ADHD? Previous research has shown that ADHD is associated with risky sexual behavior, but Stephen Faraone, PhD, wondered about the likelihood of pregnancy. He and colleagues studied data from Denmark, from January 1960 through December 2001. ey found females and males with ADHD were significantly more likely to become teen parents from the ages of 12 to 19. “It might be appropriate to target this group with an intervention program that includes sexual education and contraceptive counseling,” the researchers wrote in the Journal of the American Academy of Child and Adolescent Psychiatry.
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A 65-year-old man who received melphalan, and his transplant, went on to develop an irregular heart rhythm the day aer his transplant at Upstate. Writing about his case, assistant professor of medicine, Amishi Desai, MD, and colleagues suggest in the American Journal of erapeutics that the Food and Drug Administration add atrial fibrillation as significant potential side effect of melphalan. Older patients, especially those who have other medical problems — including congestive heart failure, high blood pressure, diabetes or vascular diseases — are at a higher risk for stroke if they develop atrial fibrillation. at’s because the anticoagulant medicine commonly used to treat atrial fibrillation would not be recommended in the weeks aer stem cell transplants, since patients have depleted numbers of red and white blood cells and platelets. ●
TRIATHLON COMPETITORS MAY NOT FOLLOW MEDICAL ADVICE irty-five of the 750 Ironman Syracuse 70.3 triathletes in 2011 sought medical care at the finish line medical tent. How many followed up with a health care provider aerward, as advised? Just two, according to a study published in the journal Emergency Medicine International by Upstate emergency physicians Jeremy Joslin, MD, and Derek Cooney, MD, and colleagues. is is concerning because triathlons are long-duration, high-intensity events, attracting a majority of participants from 30 to 50 years of age, “a group that may conceivably carry greater susceptibility to injury,” they describe. Typical injuries include dehydration, cardiovascular complications, metabolic abnormalities, heat-related illness and musculoskeletal injuries. “Because medical encounters at race events are oen limited and noncomprehensive, it is essential for patients to obtain follow-up care,” the authors write. Most of those who disregarded follow-up care recommendations said they did so because their symptoms resolved. ●
U P S TAT E H E A LT H
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FROM OUR experts
Seeking an early diagnosis
COULD A SPIT TEST IDENTIFY
IN CHILDREN? BY JIM HOWE
A RESEARCH STUDY AT UPSTATE is employing a novel method as it seeks to develop a quick, painless tool to help diagnose autism in children. Using a simple swab — like a one-headed Q-tip with a spongy head (at right) — researchers collect a bit of saliva from a child’s mouth, immerse the swab in a tube of stabilizer solution, screw it shut and send it for analysis. e saliva is analyzed for tiny particles called microRNA, which were shown in the study’s first phase to be highly reliable markers for autism spectrum disorder, or ASD. For the child, the parents and the researchers, saliva is much easier to collect and store than blood or urine. As the researchers study microRNA and its relationship to ASD, they also hope to develop an easy-to-use tool that ASD specialists could use alongside their current diagnostic methods, which involve observing a child’s behavior and development. e tool would supplement, not replace, current ASD testing. e researchers are seeking the participation of children ages 2 to 6 who have been diagnosed with ASD or a developmental delay, such as speech or motor skills, with a suspected diagnosis of ASD. ASD is a complex developmental disability that emerges in early childhood and can involve delayed learning of language; difficulty making eye contact or holding a conversation; narrow, intense interests and sensitivities to noise or light.
While there is no cure for autism, early treatment can make a huge difference, and the saliva test could be one way to speed up early diagnosis. “e goal is to facilitate the process. If having a molecular screening tool that says it’s positive will help accelerate this process in any way to make the diagnosis accurately, in a more timely fashion, it can make a big difference,” says the study’s principal investigator, Frank Middleton, PhD, an Upstate associate professor of neuroscience and physiology. “We also think it can likely be used to monitor potential improvement in a child’s level of functioning.” e three principal institutions conducting the study are Upstate Medical University, Penn State University and Quadrant Biosciences, which is headquartered at Upstate. Funding has come from both the National Institutes of Health and a private foundation. About 600 children are in the study so far (200 children with ASD, 200 with developmental delays, and 200 with typical development, for comparison), and the researchers hope eventually to at least double those numbers. ● HOW TO PARTICIPATE IN THE STUDY
To learn more about the study or to enroll your child, go to www.upstate.edu/autismstudy or leave a message at 315-464-7729. Participants get a $25 gi card and free parking during the test.
Sundays at 6 a.m. & 9 p.m. Listen anytime: HeALTHLINKONAIR.ORG or iTunes (search podcasts for “HealthLink”)
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upstate.edu l fall 2017
12 things
FROM OUR experts
you might not know about the United States military UPSTATE’S DIVISION CHIEF of trauma, critical care and burns is Army veteran William Marx, DO. He recently gave a presentation about the military to medical colleagues that included these dozen pieces of information:
i
Of the five branches of the military, the Army is the oldest, founded in 1775. Next are the Navy, Marine Corps and Coast Guard and then the Air Force, aer World War II. What percentage of America’s military make up each force? Army, 37 percent. Navy and Air Force, 23 percent each. Marine Corps, 13 percent. Coast Guard, 3 percent.
i i i i i i i i i i
ree-quarters of 1 percent of the population of America has served in the military.
e president is commander of all branches of the military. However, Congress determines the size of the force and is the only body that can declare war.
is year, more United States college students will study abroad (300,000) than enlist in the military (200,000.)
To be a veteran, one must have served six consecutive months. Being in the reserves and serving multiple shorter periods of time does not count.
ere are eight categories of veterans, and not all are eligible to receive all of their care through the Veterans Affairs medical system.
Women comprise about 15 percent of all but one of the branches. e Marines are 5 percent female.
Ninety percent of enlisted men and women are high school graduates, and 90 percent of the officer corps have bachelor’s degrees.
Officers and enlisted personnel are not allowed to fraternize, in order to keep the chain of command intact and to avoid any appearance of favoritism, especially during combat situations. e military justice system is quite different from the civilian justice system, and the Uniform Code of Military Justice has jurisdiction over all members of the military services. Civilian rules do not apply in the military. e incidence of disease in the military is the same as for the general population. at applies to physical as well as mental illness. Military training does not cause mental illness. Marx says mental illness only seems to occur at a higher rate among members of the military because the military population is small by comparison. “But per capita, the incidence is not any higher.”
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In war, common medical illnesses (such as appendicitis, ectopic pregnancies, influenza, pneumonia) cause the loss of more soldiers than combat injuries. ●
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IN OUR commuNity
ROLLING SIGN iPADS AND LANGUAGE ARE PART OF
HER JOB
BY JIM HOWE
A DESIRE TO COMMUNICATE with a deaf acquaintance led Sue Freeman from her old job in the insurance business to a new career. Now, as manager of interpreting services at Upstate, she not only communicates with deaf people through American Sign Language, she oversees interpreting services for any Upstate patients who need help understanding English.
ipad interpreters keep things rolling When in-person interpreters are not available, patients can receive interpreting services through an “interpreter on wheels.” at’s the term for an iPad attached to a rolling stand that can be used to contact interpreters of 240 languages, so patients can communicate with their doctors and other care providers. Live video, similar to Skype, is available for the 35 most popular languages. For the other languages, audio interpreting only — like a phone call — is available, and more languages are constantly being added to the video service. “People are getting excited about them as they hear about them and see them in action,” Freeman said of the devices. With the interpreters on wheels, you can contact an interpreter instantly, anytime. e patient can point to the language name (written in both English and the language
in question) on the iPad to get things started. If the patient cannot read, the language can be found by the country of origin. Once the patient goes home from the hospital, a related interpreting service called video relay service can be used to set up three-way communication with a doctor and an interpreter.
communicating with the deaf American sign language is the second most requested language (behind Spanish) for interpretation at Upstate. “Sign language is a very visual language, so you have to make the concept visual,” Freeman said. Her desire to speak to a friend she met years ago through her church led her to meet other deaf people, to take sign language classes and eventually to get a bachelor’s degree in American Sign Language/English translation at the National Technical Institute for the Deaf at the Rochester Institute of Technology. She began going out to interpreting jobs before she le her old job in an insurance company finance department, and she recalls a question she was asked at a Leadership Greater Syracuse workshop: “Do you want to be known as someone who made a difference, or as someone who just went to work every day? “And every time I went to an (interpreting) assignment, I felt I was making a difference in two people’s lives,” she said. She got up the courage to leave the insurance job four years ago and began providing interpreting services for deaf people through an agency. She has interpreted into American Sign Language at local colleges, medical appointments, political speeches and concerts, preparing for what might come up in a song by country star Jason Aldean or a talk by Gov. Andrew Cuomo. Freeman joined Upstate last year. ● Sue Freeman, center, in an instructional video about the interpreter services at Upstate. english, Spanish and American sign language versions can be found on Upstate’s YouTube channel. VIDEO STILL BY SHONNAN USMAN
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IN OUR commuNity
WHAT YOU CAN DO
ABOUT THE PUBLIC HEALTH CRISES OF GUN VIOLENCE AND DRUG ADDICTION THE NUMBER OF AMERICANS DYING from gun violence or drug overdoses now surpasses the number of motor vehicle fatalities in the United States. e public health crises of gun violence and drug addiction are also felt in Central New York.
more than 1,000 were reported, says Upstate pharmacist and toxicologist William Eggleston. Now the nation and Central New York are dealing with an epidemic of drug addiction and overdose deaths. It started with prescription opioids, he says.
gun violence
Opioid drugs such as morphine and oxycodone are used to treat moderate to severe pain, and they work well for a day or two. e drugs are not intended for use long term, but some patients, in chronic pain, take the drugs longer than is safe and become addicted.
e rate of motor vehicle fatalities decreased 59 percent from 1969 to 2012. If that trend continues, deaths from gun violence will surpass those from motor vehicles nationally within a few years. Already 21 states have higher death rates due to firearms than motor vehicle deaths, says Margaret Formica, PhD, from Upstate’s department of public health and preventive medicine. Public health experts call gun violence an epidemic. “A growing body of research indicates gun violence spreads like an infectious disease. It’s contagious,” Formica says. “We know that gun violence clusters in time, in geographic areas, and that gun violence spreads among social networks just like the flu.” Syracuse has an annual rate of six shooting victims per 100,000 people, which is 1½ times higher than the national rate, Formica says.
As their prescriptions run out, patients seek alternatives. Heroin is inexpensive and available on the street. Eggleston says its addiction rates have doubled over the last decade in the United States. He says the high from heroin is different than from other opioids. Nothing else feels the same, which makes heroin highly addictive. “Addiction doesn’t discriminate,” he says. “It doesn’t matter your socioeconomic status, your gender, where you live, what you do for work,” he says. “We all know someone, or are related to someone or love someone who is suffering from addiction.” ● guN violeNce preveNtioN
She says national data show more than 32,000 deaths due to firearms, and more than 67,000 injuries from firearms each year, by far the highest numbers among industrialized nations. What may appear to be good news — a plateau in the rate of gun deaths since the year 2000 — actually reveals a shortfall, Formica says. “We’re not doing a very good job of preventing gun deaths.”
• Upstate offers help through the Violence Education Prevention Outreach Program.
Drug addiction
aDDictioN preveNtioN
From 2005 to 2015, the national number of heroin overdose deaths jumped 500 percent. New York state saw fewer than 100 heroin overdose deaths in 2005; in 2015,
• If you receive an opioid prescription for pain, make sure it’s for the lowest effective dose.
Photo above: A makeshift “cemetery” at Onondaga Lake Park was set up in August by a surviving family member who lost someone to a drug overdose. each tombstone represents someone who died from a drug overdose.
• Realize that having guns in the home is a strong risk factor for homicide and suicide. • Explore “smart gun” technology, so that no one but the owner is able to fire the gun.
• Realize opioids do a good short-term job of relieving pain for a few days. ey are not meant for long-term use. • New York state offers assistance through the Opioid Overdose Prevention Program.
PHOTO BY RICK MORIARTY/SYRACUSE MEDIA GROUP
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A look at low-wage jobs
IN OUR commuNity
Home health aide is one of the vital jobs identified in research on low-wage occupations.
Here’s a look at New York state statistics showing who’s doing the low-wage work in Syracuse:
EVER WONDER who the people are who are doing low-wage work? It’s not just young people getting their first work experience, or retirees looking for extra cash. Occupational health researchers from Upstate are involved in a long-term project studying the health of people with low-wage jobs. In the Syracuse area, a low wage would be work that pays up to $15 per hour.
Jeanette Zoeckler, PhD, MPH
e researchers have learned that substantial numbers of low-wage workers come from every age group. And, many of those working in their golden years are doing so out of necessity. “At the same time, there is concern that teens who need valuable early work experience are being edged out of entry level jobs by those over 25 who are primary breadwinners,” says a report by Jeanette Zoeckler, PhD, Michael Lax, MD, MPH, and colleagues.
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5 percent are age 16 to 19
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15 percent are older than 55
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75 percent are older than 25
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53 percent are women
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75 percent are people of color
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75 percent work full time
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53 percent have some college experience
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33 percent have children
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27 percent are the sole providers of income in their home
e low-wage occupations tend to require entry-level skills and are vital to basic operations in the retail, restaurant, health care, education, manufacturing and government sectors. Among the fastest-growing job titles are bartender, cook, home health aide, physical therapy aide, medical assistant, ophthalmic medical technician, emergency medical technician, paramedic and medical secretary. ●
Blueberry Ginger Kale Smoothie ingredients
preparation
3 cups frozen blueberries 3 cups coconut milk 1 cup kale, or more if you desire ½ cup plain Greek yogurt 2 teaspoons pure maple syrup 2 teaspoons grated ginger water, if necessary, for consistency
Add all ingredients to a blender and blend until smooth. Add water if needed to get the consistency you like. Experiment with other fruit if blueberries are not available.
Nutritional information Each of two servings includes: 297 calories 8 grams protein 9 grams total fat 7 grams fiber
SOURCE: ORGANIZEYOURSELFSKINNY.COM
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upstate.edu l fall 2017
Time doesn’t lessen parents’ gratitude
IN OUR commuNity
ALTHOUGH IT WAS 31 YEARS ago, Tony and Vicky Regulbuto remember the birth of their son Anthony, “AJ,” as if it were yesterday. Vicky’s labor and delivery at Community General Hospital (now Upstate’s Community campus) went quickly with no complications. It was time for celebration… or so the family thought. AJ Regulbuto as a newborn with his father.
A few hours later, when pediatric neonatologist James Pergolizzi, MD, was checking the baby in the crib next to AJ, he noticed AJ was turning blue. He knew by AJ’s distressed breathing that too much air had entered AJ’s chest, which caused his lungs to collapse. He immediately began treatment and had highly trained nursing staff watch over AJ for the next 18 hours until he was out of danger. As Mrs. Regulbuto recalled, “I still remember the panic we felt when our baby boy was taken away for lifesaving treatment. We could not comprehend how quickly our joy became a fear so great that it is still hard to describe 31 years later. We are still so grateful to Dr. Pergolizzi for saving our baby’s life.” Soon aer AJ’s birth, his new parents wanted to express their gratitude to Pergolizzi in deed as well as in words. “Even though we were just starting our home and family,” Mrs. Regulbuto explained, “we asked him if there was some small item he could use in the labor and delivery unit that we might purchase for him.”
Architect’s rendering of the family lounge in the Birth Center at Upstate’s Community campus.
e Regulbutos funded a pediatric scope for the neonatal nursery.
grateful patient to grateful parents Even today, the Regulbutos feel as grateful as they did decades ago for the care their newborn son received. When they learned of the Upstate Foundation’s campaign to raise money for the maternity unit and nursery at the Community campus, their decision to contribute was swi, and they are proud to be early supporters of the “Brighter Beginnings” campaign. “We are so proud of the man AJ has become,” the couple says. “We will always be grateful to Dr. Pergolizzi for giving him a life of purpose and promise.”
Garden replaces smoking room
To donate, visit www.upstatefoundation.org or contact the Upstate Foundation at 315-464-4416. ●
BY SUSAN KEETER
RONALD JACKSON REMEMBERS when people congregated in the smoking room at Toomey Abbott Towers, a public-housing high-rise in Syracuse. at ended in 2015, when the Syracuse Housing Authority enacted a smoke-free policy for its nine building complexes. Several residents, trained by Upstate to do health outreach, liked the idea of transforming the smoking room into an indoor garden where they could grow vegetables. Several years earlier, they had created an outdoor community garden at nearby Pioneer Homes, and they wanted to expand their “grow your own vegetables” health initiative. Upstate’s Aldrine Ashong-Katai sought guidance from Matthew Potteiger, a professor at the SUNY College of Environmental Sciences and Forestry. Potteiger recruited students Brian Swank and Joshua White to research plants and design the indoor garden. Swank and Ashong-Katai, with painting help from Upstate medical students, built the “Garden of Health,” which opened in August 2017. e light-filled room has built-in tables designed to accommodate wheelchairs, so that all residents can tend fall 2017 l upstate.edu
to the plants. Lights and shelving attached to windows encourage plant growth. Potteiger worked with Ashong-Katai and the resident health advocates to select seeds that will grow easily indoors. “Greens like lettuce and Bobby Little (left) and Matthew spinach have a quick life Potteiger discuss seeds for the Garden cycle,” he explained, “so of Health at Toomey Abbott Towers. residents can pluck off PHOTO BY SUSAN KEETER leaves for dinner, and the plants will continue to yield more edible greens. ey’ll be able to grow tomatoes year-round, and herbs like basil, rosemary and chives.” Bobby Little, a resident health advocate who oversees the garden, remarked on its value: “Life’s better when you eat right.” ● U P S TAT E H E A LT H
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IN OUR leisure
Raising readers Pediatrician shares her love of books and the almost-magical benefit of reading BY AMBER SMITH
Once upon a time,
there was a family with three little boys.
Ari was 8, and he liked making chalk villages and playing the drums. Eli was 4, and he liked Legos and cooking. Jacob was just a baby, too little to say what his likes would be. Their father was a science teacher, and he liked books. Their mother was a pediatrician, and she really liked books. So the boys would grow up liking music and building things and probably a lot of other stuff — plus books. Their mother read lots of books, starting when she was little. And she still reads lots of books as a grown-up. She knew that reading books could help kids develop language and listening skills, that it could improve their vocabulary and spur imagination. She liked being able to expose her sons to varying points of view and expand their understanding of the world by opening the pages of a book. In fact, reading was so spectacularly beneficial that the mother wanted books to be a part of everyone’s life. So, when the mother went to her office to take care of her patients, she often talked about books with them. She would ask her oldest patients if they had read any good books lately. And she would offer the parents of her youngest patients suggestions of books to read with their children. In her own quiet way, the mother set out to teach the world how to raise children who read.
Here’s how: Read to babies. “It’s a great way to establish a bond between a baby and a caregiver,” says Jaclyn Sisskind, MD. “e baby’s on your lap, you’re kind of cuddling, and most of the books that are written for this age are very rhythmic, there’s a lot of rhyme to them, and there’s a sing-song pattern to your voice as you read. at can be very soothing and entertaining to a baby.” Make reading part of a pattern as children get older. Children do not outgrow reading and its benefits. Even teens should be encouraged to read for pleasure, she says. Share books that you remember from childhood. Sisskind says the Boxcar Children and Little House on the Prairie series, books by Roald Dahl, the Anne of Green Gables books by L.M. Montgomery and the Harry Potter series still hold up. Explore newer titles, too. Websites for book suggestions: kidsreads.com, spaghettibookclub.org, 22
U P S TAT E H E A LT H
slimekids.com/book-reviews, dogobooks.com, teenreads.com, goodreads.com, onlib.org and apps.npr.org/best-books-2016 Visit the library, so everyone can select his or her own books. Sisskind says, “I think there’s some excitement in discovering a book on your own, that you choose.” Read with them, but also model the behavior you want in them. “ey should catch you reading,” she says. “ey should see books around the house.” Use books to stimulate conversation. Parenthood is full of uncomfortable subject matter. Sisskind says books can be a go-between, a way to get kids talking. “Being able to read something together and say, ‘how did you feel about what we just read?’ or ‘look what that character was going through,’ is a way to diffuse what can be a difficult discussion,” she says. continued on page 23
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IN OUR leisure
Upstate pediatrician Jaclyn Sisskind, MD, reads to her sons eli, Jacob and Ari as her husband, Ben Gnacik, looks on. PHOTO BY SUSAN KAHN
Some of her recommendations to spark conversation Books about puberty “Who Has What? All About Girls’ Bodies and Boys’ Bodies” by Robie H. Harris “What’s Happening to My Body?” by Lynda Madaras “The Care and Keeping of You, the Body Book for Girls” by Valorie Schaefer, Cara Familian Natterson and Josee Masse Books that teach compassion “Not Your Typical Dragon,” by Dan Bar-el “Red, a Crayon’s Story,” by Michael Hall “Wonder,” by R.J. Palacio “Last Stop on Market Street,” by Matt de la Pena “I Am Jazz,” by Jessica Herthel “Exclamation Mark,” by Amy Krouse Rosenthal “George,” by Alex Gino
Books about serious illness and death “Water Bugs and Dragonflies,” by Doris Stickney “The Fall of Freddie the Leaf,” by Leo Buscaglia “Sadako and the Thousand Paper Cranes,” by Eleanor Coerr “The Copper Tree,” by Hilary Robinson “Let My Colors Out,” by Courtney Filigenzi Books about modern families (divorce, adoption, same-sex parents) “When My Parents Forgot How to Be Friends,” by Jennifer Moore-Mallinos “The Huge Bag of Worries,” by Virginia Ironside “Two Homes,” by Claire Masurel “Tell Me Again About the Night I Was Born,” by Jamie Lee Curtis
“And Tango Makes Three,” by Justin Richardson and Peter Parnell “Love Is a Family,” by Roma Downey Books that are just fun to read “We Found a Hat,” by Jon Klassen “17 Things I’m Not Allowed to Do Anymore,” by Jenny Offill “Moira’s Birthday,” by Robert Munsch “Have I Got a Book for You!” by Melanie Watt “I’m Bored,” by Michael Ian Black “Interrupting Chicken,” by David Erza Stein “A Perfectly Messed Up Story,” by Patrick McDonnell “The Pigeon Finds a Hot Dog,” by Mo Willems
Dr. Sisskind’s Book list of favorites Books for the youngest readers Sandra Boynton books “Pat the Bunny,” by Dorothy Kunhardt “Goodnight Moon,” and “The Runaway Bunny,” by Margaret Wise Brown Books to read aloud, for ages 2 to 6 Dr. Seuss books “The Book With No Pictures,” by B.J. Novak “Dragons Love Tacos,” by Adam Rubin Books by Mo Willems Books by Robert Munsch “Stuck” by Oliver Jeffers “Little Pea,” by Amy Krouse Rosenthal “Press Here,” by Herve Tullet
fall 2017 l upstate.edu
“Goodnight, Goodnight, Construction Site,” by Sherri Duskey Rinker “Digger Dozer Dumper,” by Hope Vestergaard Books by Eric Carle Shel Silverstein poetry collections “The Adventures of Beekle,” by Dan Santant Books for advancing readers “Hatchet,” by Gary Paulsen “Heroes of Olympus,” by Rick Riordan The Boxcar Children series, by Gertrude Chandler Warner The Little House on the Prairie series, by Laura Ingalls Wilder Books by Roald Dahl The Harry Potter series by J.K. Rowling
Books for teens “Humans of New York,” by Brandon Stanton “I’ll Give You the Sun,” by Jandy Nelson “The Book Thief,” by Markus Zusak “Eleanor and Park,” by Rainbow Rowell “Belzhar,” by Meg Wolitzer “Lucy and Linh,” by Alice Pung “Reading ‘Lolita’ in Tehran,” by Azar Nafisi Graphic novels “Maus,” by Art Spiegelman “Persepolis,” by Marjane Satrapi “Fun Home,” by Alison Bechdel “This One Summer,” by Mariko Tamaki
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is image is a series of cells undergoing cell division, a process where duplicated genetic material needs to be distributed to two daughter cells. A similar image was selected for the cover of the journal Current Biology in March 2016. Heidi Hehnly, PhD, assistant professor of cell and developmental biology, studies why sometimes these cells’ mitotic machinery is asymmetric. is question has important implications toward understanding stem cell homeostasis and the formation of tumors.
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