Why Stacey Karasinski loves floor hockey

Stacey with her Dad.

Stacey with her Dad.

Stacey Karasinski, an employee in payroll services at Upstate, competed in the state Special Olympics Winter Games with her floor hockey team. The 11-player roster includes a goalkeeper and two “lines” of five players that the coach swaps out throughout the game. Only six players play at a time.

Here’s what Karasinski likes about floor hockey, a sport she has played for 10 years:

1. She likes being the only girl on the team, even though sometimes the boys are a little rough.

2. She plays offense and prefers the face-off position.

3. She enjoys flicking the puck (made of heavy felt with a hole in the middle) into the air and knowing that it is destined for the goal.

4. She makes new friends through the games.

5. She loves to win.

 

 

 

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Upstate Answers: How soon will stem cells treat orthopedic injuries?

Q (from reader, Sally White of Syracuse) Studies are underway in other countries, and a couple in the United States using a product that helps with regenerating one’s injured knee. The procedure uses both your own stem cells and umbilical stem cells. How soon will we have such treatments in Syracuse?

A (from Kevin Setter, MD, associate professor of orthopedic surgery at Upstate) “I’m actually starting to develop some FDA trials for this procedure – which is not just for the knee — so we’re hoping by this summer. Stem cell therapy is pretty new in the United States, but it is already in use in Asia and Europe, and it holds a lot of promise.

“Stem cells are cells which haven’t differentiated yet. In the right environment, they can differentiate into the tissues you would like.

“There are three trials we are designing protocols for now. One is for overuse injuries such as tennis elbow and Achilles tendonitis. The second one is for tendon repair, for certain tendons that are stubborn and don’t like to heal. The third trial we want to do is looking at how to use stem cells to treat arthritis.

“Anyone who wants to learn more about these trials can contact me at 315-464-8634.”

If you have a question for the experts at Upstate, please submit it to whatsup@upstate.edu. We may feature your question – and answer – in an upcoming issue of Upstate Health.

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Reducing stroke risk in patients with atrial fibrillation

Dr. Antonio Culebras during a television interview. Photo by Kathleen Paice Froio.

Dr. Antonio Culebras during a television interview. Photo by Kathleen Paice Froio.

If you have been diagnosed with atrial fibrillation, new guidelines to reduce your risk of stroke include talking to your healthcare provider about taking an oral anticoagulant.

Upstate neurologist Antonio Culebras, MD, is the lead author of the new guideline from the American Academy of Neurology. “These guidelines are not commandments. They are recommendations,” he says, acknowledging that some people may be at greater risk of bleeding than of stroke.

Culebras says in patients who suffer a stroke for which doctors can find no cause, “we strongly suspect atrial fibrillation is the culprit.” The guidelines also suggest that these people be evaluated for atrial fibrillation, which may require wearing a heart monitor for several days. Atrial fibrillation is an irregular heartbeat which can be fast or slow and cause symptoms including fatigue, dizziness or lightheadedness. It can be constant, or it can come and go. “Because the heart does not beat regularly, there is a change in the circulation of the blood,” Culebras explains. Blood may sit in the corner of the heart, facilitating the formation of a clot that later migrates to the brain, causing a stroke.

The risk is even greater in people with atrial fibrillation who have had a stroke or TIA, transient ischemic attack, which has symptoms that mimic those of stroke but are temporary.

Anticoagulants are designed to prevent clots by thinning the blood, but they can put some patients at risk for bleeding complications.

A new series of anticoagulants — including dabigatran, rivaroxaban and apixaban — are safer and perhaps more effective than warfarin, Culebras says.

The World Health Organization calls atrial fibrillation a “growing and serious global health problem” and projects one in 20 people around the world have this condition, which tends to develop as people age.

Other factors that put a person at risk for developing atrial fibrillation include underlying heart disease, high blood pressure, binge drinking and sleep apnea, along with thyroid problems, diabetes, asthma and other chronic medical conditions, according to the American Heart Association.

Listen to a radio interview with Dr. Culebras on this subject

 

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How to keep your cool: the secrets of one manager’s success

Malay.DanielDan Malay is one of the people who for more than two years has orchestrated the meticulous and monumental conversion of Upstate University Hospital’s medical records into a new electronic medical records system called Epic. His title is manager of clinical systems, but what Malay is really known for is unflustered professionalism in times of high stress.

Some of that may be explained by his Irish Catholic upbringing, the strong work ethic instilled by parents adept at managing chaos (his mother is a nurse; his father, a police officer.) He admits that the last few months have been “very, very, very busy” — at work and at home. He and his wife, Erin added a third daughter to their young brood just weeks before the Epic deadline.

So, what is Malay’s secret for keeping calm and carrying on?

* He strives to understand where people are coming from. When someone is contrary, he says, “most of the time it’s because they are worried about what you are proposing, how it will impact what they’re comfortable with.”

* He removes emotion, so people don’t feel threatened.

* He determines what is most important. “I try prioritizing the most important things, those that impact the quality of the care we provide and the safety of our patients, and knowing which things you can do something about and which things you can’t. You have to be able to accept the things you cannot change.”

* He realizes that some people are not easy to work with, and some have expectations that are not reasonable.

* He avoids dictating. “People usually don’t respond well when you roll in and tell them how it’s going to be.”

* He listens.

* He takes time to chill. Running, and spending time with his wife and daughters, are his favorite ways.

* He follows the habits ingrained through golf and running, high school sports he played. “Those are not traditional team sports,” he explains. “Those are sports where it’s pretty much on you to stay in control and to pace yourself to continue to perform. You’ve got to stay calm, cool and collected.”

What happens when he has a bad day? Does Malay ever want to jump up and down, pull out his hair, scream, throw something, melt down?

No, he says plainly.

“That wouldn’t do anybody any good.”

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Christine LaFave battles breast cancer with strength

Breast cancer warrior Christine LaFave was happy to participate in the “Image is Everything” fashion show in April. Her creative outlet is fashion, and she writes a blog where she shares various outfits. “I like opening up my closet and putting things together. I do some thrifting and consignment clothes buying, as well as wearing items that are my Mom’s from 50 years ago.”

Breast cancer warrior Christine LaFave, right, participated in a fashion show in April to raise awareness of breast cancer. Her creative outlet is fashion, and she writes a blog where she shares various outfits. “I like opening up my closet and putting things together. I do some thrifting and consignment clothes buying, as well as wearing items that are my Mom’s from 50 years ago.”

Christine LaFave became a breast cancer warrior on Jan. 28, 2013. That’s when she discovered that the lump she felt in her breast was cancerous. After an ultrasound, biopsy and complete body scan, LaFave was left with the diagnosis of stage IV metastatic breast cancer. The cancer has spread to her breastbone, liver and lungs.

Christine shares the cover of Upstate Health with her oncologist, Dr. Sam Benjamin.

Christine shares the cover of Upstate Health with her oncologist, Dr. Sam Benjamin.

“Mine’s a terminal disease. I’m going to die of this,” LaFave knows. “But I’m going to live my life, and I’m going to be happy.”

She is a biology professor at Colgate University. Students established a college fund for her 6-year-old daughter, Grace with $8,000 they raised in a “LaField Day for LaFave” fundraiser that had professors taking turns in a dunk tank. She took leave last spring for chemotherapy and completed radiation therapy at the beginning of fall, when she returned to the classroom.

Now LaFave, 46, sees Dr. Sam Benjamin to undergoes maintenance chemotherapy once a month. She will do that the rest of her life. It leaves her achy for four or five days after infusion.

Her favorite course to teach is the upper level elective, Human Physiology. Her knowledge of the human body, at first, felt like a benefit as she dealt with her own medical appointments. She was determined to scour the medical journals until she discovered how to beat the disease. Then she reached a saturation point and decided to focus on what she needed to do, day by day, to persevere.

LaFave with her daughter,

LaFave with her daughter, Grace.

“My doctors are amazing,” she says. “I love them so much. They respect me. They talk to me on almost a peer level. I know I don’t have any control of this disease, but it helps me feel like I have a bit of a handle.”

LaFave says survival odds for metastatic cancer are grim, maybe just 2 ½ years. She says there is a 78 percent chance that she won’t be here in five years, when her daughter turns 11.

She remains focused: “One day at a time. Living my life. Loving my life. Doing the things that are important to me.

“This is the hand that I have been dealt, and I am doing everything I can to be as strong as I can.”

Learn about cancer services at Upstate

Read the Upstate Health issue with Christine’s story on the cover

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A ship, a fort and the medical school meeting

Ernest Braun, Viennese chemist and Holocaust survivor (center) met with Herman Weiskotten MD, dean, College of Medicine (left) and , JG Fred Hiss MD professor, College of Medicine (right).

Ernest Braun, Viennese chemist and Holocaust survivor (center) met with Herman Weiskotten MD, dean, College of Medicine (left) and JG Fred Hiss MD, professor, College of Medicine (right) in 1945.

Every Thursday in 2014, we’ve posted a story about the opening of the hospitals fifty years ago. This week, however, we’re going back 70 years in honor of a Viennese chemist and his pivotal encounter with medical school professors.

How did a Viennese chemist escape the horrors of war and wind up in Syracuse?

In August 1944, Ernest Braun landed in “safe haven” in Oswego, NY after a harrowing two-week voyage on a US Army transport ship from Naples, Italy. He was one of a thousand Holocaust refugees who would live in the barracks of the former Fort Ontario as “guests” of President Franklin D. Roosevelt.

During his 18-month stay in the Oswego fort, Braun continued to develop medicinal skin ointments he had been working on in Europe. In Oswego, Braun applied for a patent and wrote letters to the US Attorney General and others in Washington, DC. After a year of research and letter writing, Braun was invited to Syracuse to present his work to Dr. Weiskotten, Dr. Hiss and colleagues at the medical school.

“I was finally given the opportunity to exhibit the properties of my preparations,” wrote Braun about his meeting with the faculty. “The experiments were successful and I was advised…to produce the (skin ointments) so that the Army and Navy (could) make use of them. They cure certain skin diseases…due to infection and inflammation.”

Despite enormous obstacles, Braun had created a medical compound that would revolutionize presurgical wound care, and, because of the support of our medical school faculty, would be used to care for injured soldiers and hospital patients.

It’s hard to imagine how Ernest Braun built a laboratory in the sparse Oswego army barracks, but he did. He’d had to learn to do science in strange places. In the early years of World War II, Braun used the Vatican Library to conduct experiments. (He’d fled to Rome after the Germans annexed Austria in 1938. His language skills landed him shelter, and a job, at the Vatican.) There, Braun’s research included using ancient Hebrew texts to understand Dead Sea minerals.

Even when Braun was imprisoned by Fascists in 1941, he found ways to continue his experiments. After two years of confinement, Italian surgeons and dermatologists wrote letters describing Braun’s discoveries as “highly necessary for hospital use.”

After the end of World War II, and his release from the Oswego fort, Braun moved to New York City, married and eventually settled in Israel, where he died in 1996. As his daughter writes, “His legacy live on.”

Beginning this evening, the legacies of Braun, the thousand refugees, and those who helped them — including the medical school professors —  are being remembered at Oswego’s Safe Haven Museum, located in Fort Ontario. The museum is hosting a four-day celebration in honor of the 70th anniversary of the refugees’ arrival  in Central New York.

 

 

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Tony winner played the role of a patient at Upstate

Syracuse University graduate Jessie Mueller stars in "Beautiful: the Carole King Musical."

Syracuse University graduate Jessie Mueller stars in “Beautiful: the Carole King Musical.”

Before she won a Tony for her role in “Beautiful: the Carole King Musical,” Jessie Mueller performed as a patient for medical students at Upstate. She was a standardized patient, like many of the drama students at Syracuse University.

Jessie_Mueller_Beautiful_168_Photo_Credit_Nathan_JohnsonAmber Hansel, who helps oversee Upstate’s standardized patient program now, remembers Mueller well. “I was working at Syracuse Stage when she appeared in several performances there,” Hansel says. “I got to know her a little when she was in the SU Drama production of ‘Kiss Me Kate.’ “

Actors chosen to be standardized patients are carefully trained to portray patients who simulate common medical conditions. Encounters give medical students, residents or other health care professionals the opportunity to learn and practice effective communication and examination techniques with real people without fatiguing actual patients. Hansel says sophomores, juniors and seniors are considered for the roles, which are paid.

Hansel joined Upstate in 2005. “I now use the skills I learned studying directing at SU when I train/coach the standardized patients to portray their patient cases.”

Mueller, 31, is a resident of Astoria, Queens. She is expected to continue in “Beautiful” for months to come.

Carole King told The New York Times that during “Beautiful” tryouts, “Jessie just came across to me as very devoted to the material, respectful about the music and the story, and had a wonderful energy to her.” King performed “I Feel the Earth Move” with Mueller during the Tonys telecast.

Read The New York Times profile of Jessie Mueller

Watch Mueller and King perform during the Tonys

Read about this year’s Tony Award winners

Learn more about the standardized patient program at Upstate

She played the role of a patient at Upstate before she was cast in "Beautiful: The Carole King Story."

She played the role of a patient at Upstate before she was cast in “Beautiful: The Carole King Musical.”

 

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Struggling to conceive? Consider lubrication

Ask a question at an academic medical center, and you just may inspire research to get the answer.

That is how andrology lab director Kazim Chohan, PhD, lit up the Internet recently with news that sexual lubricants may impede a couple’s chances of conceiving.

A fertility patient asked how a store-bought lubricant affected sperm. Chohan and his team of students crafted a study to find out. They tested several commercial lubricants found on store shelves in Central New York.

“We looked at their impact on sperm motility, and interestingly we found that majority of commercial lubricants – except for PreSeed – significantly decreased sperm motility.  KY products (warming and tingling) were almost spermicidal. So if a couple is using them as a coital lubricant, the possibility is, they may not conceive,” says Chohan, a professor of pathology and of obstetrics and gynecology at Upstate.

His findings, published in the journal, Fertility and Sterility, made headlines on a variety of national and international news websites.

The team also tested some household products that may be used for lubrication: canola oil, baby oil, sesame oil and mustard oil. The oils turned out to be sperm-friendly except sesame oil.

“Mustard oil gave us really good results. It enhanced the sperm motility. The sperm were consistently hyperactive during incubation under mustard oil ” Chohan says. “This needs to be studied further.”

Family planning expert Renee Mestad, MD, is quick to point out that couples who are not seeking to become pregnant should not assume a commercial lubricant will prevent conception. “They do need to use an additional method of contraception,” she says.

Listen to a HealthLink on Air radio interview on this subject

Read the journal article about this research

 

 

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“Happy to share,” writes Dr. Albert Falcone

Plastic surgeon Alfred Falcone DDS, MD, 2014 cared for the first baby born at Community Hospital on January 1, 1963.

Alfred Falcone DDS, MD cared for the first baby born at Community Hospital on January 1, 1963.

“I am full of stories and happy to share,” wrote Alfred Falcone DDS, MD in response to a request for first-hand memories of the opening of Upstate’s downtown and community campus hospitals 50 years ago.

Dr. Falcone (left)  and Dr. Bernard Sisson (center) selected  the plastic surgery instruments for the new Community Hospital in 1961. (Also pictured: Drs. Brewer, Poushter and Stark)

Dr. Falcone (left) and Dr. Bernard Sisson (center) selected the plastic surgery instruments for the new Community Hospital in 1961. (Also pictured: Drs. Brewer, Poushter and Stark)

Dr. Falcone, a retired plastic surgeon, has more than 50 years of professional connections with Upstate. He did his residency training at the then-new SUNY Upstate Medical Center from 1951 to 1957 (including two years as a US Air Force flight surgeon). He was a clinical assistant instructor at Upstate for close to 20 years, helped outfit the plastic surgery center at Community, and cared for the first baby born at the then-new Community Hospital.

“I was enjoying an early breakfast on New Year’s Day 1963 when I received a call for a consultation,” remembers Dr. Falcone. “The first baby born at Community Hospital had a cleft lip. She had the repair performed when she was three months old. I did her surgery and provided follow-up care. She was a model patient, and her family was appreciative.”

That first patient, baby Suzanne, and Dr. Falcone have corresponded for decades, and he noted that she is married, has two daughters, and lives in the western United States.

In the 1960s, Dr. Falcone performed about 20 cleft lip surgeries a year. (Today, Upstate’s Sherard Tatum MD, Otolaryngology, performs 50 to 60 cleft lip and palate surgeries a year.)

What does Dr. Falcone remember about Community when it opened? “It was a model hospital. Spacious, wide corridors, TVs in every patient room (novel in those days), and a spectrum of bright colors. Like Miami Beach.”

Dr. Falcone's 1959 physician's license.

Dr. Falcone’s 1959 physician’s license.

When Dr. Falcone began his private practice in 1957, neither of Upstate’s hospitals had been built. Downtown’s predecessor, the Hospital of the Good Shepherd, was open and the Onondaga Tuberculosis Sanatorium would close in 1959. The sanitorium’s grounds became the site of the Community Hospital.

Dr. Falcone remembers being a surgical resident at the Good Shepherd Hospital on Marshall St.: “There was a rotunda on the eastern side of the building with a circular slide. In case of a fire emergency, the plan was for patients to slide down on mattresses.”

How about the new downtown hospital? “Night and day difference. There were electric doors, nice lobby and patient rooms. Good clinical facilities, supportive staff.”

Dr. Falcone’s childhood home is in the historic Hawley-Green section of Syracuse. He attended Central High School, which he describes as “that beautiful building on the corner of South Salina and East Adams streets.”

Philip Falcone MD '84

Philip Falcone MD ’84

What does he say about his decision to raise his family and build his career locally? “Syracuse is ideal.”

Dr. Falcone and his wife have eight children, including plastic surgeon Philip Falcone MD, a 1984 graduate of Upstate’s College of Medicine.

Posted in alumni, community, ENT, health care, history, hospital, medical student | Leave a comment

Here’s how to obtain a free colon cancer screening kit

Kinney Drugs offers free kits for colon cancer screening that will be analyzed at Upstate laboratories. People 50 and older can visit the drug store chain — with multiple locations throughout the Syracuse and Central New York region, including at Upstate University Hospital — for a fecal occult blood test kit, which checks stool samples for hidden blood. This can be a sign of colon cancer.

Kinney partnered with the American Cancer Society and Upstate Medical University for this colon cancer screening project, which began June 1 and continues through June 30.  Patients do the testing at home and mail the kits to the Upstate lab, where specimens are analyzed. The kits have to be returned by Aug. 15.

People with negative tests or incomplete samples receive letters sent from the American Cancer Society, with the help of an intern from Upstate’s master of public health program.

Upstate medical providers will contact those people who have positive test results, as well as their primary care providers, to schedule appointments with a colorectal specialist, and any subsequent diagnostic or treatment procedures.

 

 

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