Julia’s dream: prosthetics for a better world

Christopher Neville, PT, PhD, and research assistant Julia Rogers in the Motion Analysis Lab at Upstate. They are reviewing files associated with Neville’s studies on the mechanical effects of flatfoot deformity. Photo by Susan Keeter

Christopher Neville, PhD, a physical therapist and associate professor of physical therapy education, and research assistant Julia Rogers in the Motion Analysis Lab at Upstate. They are reviewing files associated with Neville’s studies on the mechanical effects of flatfoot deformity. (PHOTOS BY SUSAN KEETER)

BY SUSAN KEETER

Julia Rogers’ dream is to design prosthetics for amputees.

As a high school student in Lagos, Nigeria, Rogers saw people who faced tremendous obstacles trying to meet their basic needs. “Dad would be driving me home from school, and our car would be swarmed by people who were missing limbs, blind, children barely able to walk,” she explains.  “They begged, ‘I am hurt; I need help.’ The only power they had was to use their disabilities to gain sympathy and a few coins from passers-by.

“In our world, we have so much technology, so much everything,” Rogers continues. “Nobody should live with anything less than what is possible.”

That belief led Rogers, a biomedical engineering student at Syracuse University, to look for experience using technology to develop orthotics and prosthetics for people with mobility disabilities. Orthotic devices support or brace a weak body part, such as a knee brace. Prosthetic devices replace or augment a missing or impaired body part, such as an artificial arm or leg.

She read about the research of Christopher Neville, PhD, and, via email, expressed interest in working with him in the Motion Analysis Lab at Upstate Medical University.

Neville, who is principal investigator for several clinical trials, responded to Rogers’ interest. “People working in this area often come through an engineering program,” he explains.  “It’s well worth it to give Julia the opportunity to see inside the world of prosthetics and orthotics. It’s a good way for her to see what she really likes.”

As a volunteer research assistant, Rogers is analyzing data from Neville’s clinical trial  titled “Kinematic and Kinetic Effects of Orthotic Devices for Subjects with Stage II Posterior Tibial Tendon Dysfunction.”

Julia Rogers holds an orthotic device used to help people with progressive flat foot.

Rogers holds an orthotic device used to help people with progressive flatfoot.

People suffering from posterior tibial tendon dysfunction, commonly known as progressive flatfoot,  wear ankle-foot orthoses, or corrective devices, to reduce pain and assist with daily function. The goal of Neville’s clinical trial is to test the clinical effectiveness of the braces and understand how they work.

During the testing completed in the Motion Lab, subjects were photographed wearing light-sensitive markers on their thighs, feet and lumbar areas while a camera recorded their movements. Using The MotionMonitor visualization software from a Chicago-based company (Innovative Sports Training Inc.), Neville is able to analyze the gait of the subject three-dimensionally and in motion.

To the average viewer, the images look much like those created by architects and cartoon animators using computer-assisted design software.

Rogers’ task is to help analyze the data collected when the subjects were recorded. She began with Excel spreadsheets, looking for common trends in the data. Once she gained an understanding of the data, Neville encouraged her to consider questions such as, “What is the data showing us? How are the foot and ankle braces working for the people in the study?”

This research experience is providing Rogers with a variety of opportunities, such as learning to use The MotionMonitor software and going to the Upstate Bone and Joint Center to observe the process of casting patients’ extremities to fit them for orthotic devices. Neville has also put her in touch with Hanger Clinic, a prosthetic and orthotic practice that works with Upstate’s Orthopedics Department.

“Biomedical engineering is hands-on, physical,” says Rogers as she considers the value of the work. “I’ll be able to have an impact on people’s lives.”

Three-dimensional model of the foot of a patient enrolled in a clinical trial on flat foot deformity. From the lab of Christopher Neville, PhD, Upstate Medical University. (Model generated with The Motion Monitor (Innsport Inc. Chicago, IL).

Three-dimensional model of the foot of a patient enrolled in the clinical trial on flatfoot deformity, from Neville’s lab at Upstate. (Model generated with The MotionMonitor, from Innsport Inc., Chicago, Ill.).

Posted in bones/joints/orthopedics, disability, education, health care, health careers, physical therapy/rehabilitation, public health, research, technology, volunteers | Leave a comment

Lessons from Upstate: Sleep diaries, jungle races and ankle surgery

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A roundup of news about people at Upstate Medical University:

Studying how best to track sleep

Wrist-worn devices are at least as accurate as paper diaries kept by people tracking their sleep habits, according to a study published in December in the journal Sleep Disorders.

Karen Klingman, PhD, an associate professor in Upstate’s College of Nursing, is one of the researchers who studied 35 sleep-tracking adults over a two-week period. The research project was assembled because paper diaries can be lost, illegible or unreliable “and are considered out of date, according to the newer technology-savvy generations,” the researchers wrote.

Keeping athletes safe in the tropics

Mandatory rest stops for athletes competing in distance-running events in hot climates – such as the Jungle Marathon in Para, Brazil – can improve the safety of the athletes and help them acclimate to the tropical environment.

For a study published in January in the journal Prehospital and Disaster Medicine, Jeremy Joslin, MD, and colleagues from Upstate’s department of emergency medicine reviewed six years of records for the Jungle Marathon.

Before mandatory rest stops were instituted, more than half of the runners who dropped out of the race did so because of a heat illness.

With mandatory rest stops in place during the first two days of the seven-day staged ultramarathon, just 15 percent of those who did not finish blamed heat-related factors.

Easing back into activity

How active can someone be after ankle replacement surgery? Though the surgery is becoming more common, consensus guidelines about recovery activity levels have not been available – until now.

Upstate orthopedic surgeon Scott Van Valkenburg, MD, was involved in research published in December in the European medical journal Foot and Ankle Surgery.

His group surveyed orthopedic surgeons about 50 sports and activities and found that, in general, “surgeons were comfortable with aerobic or low-impact sports and activities” after ankle surgery. High-impact activities and sports requiring cutting and jumping were discouraged.

Surgeons were most restrictive with three types of patients: those who were young, those who were overweight or obese, and those with poor bone quality.

summer16UHThis article appears in the summer 2016 issue of Upstate Health magazine.

Posted in bones/joints/orthopedics, community, emergency medicine/trauma, fitness, health care, illness, nursing, prevention/preventive medicine, public health, research, safety, sleep, surgery, technology | Leave a comment

Recipe: Freekeh Fruit Salad with Pecans and Cinnamon Vinaigrette

Freekeh is one of the whole grains used in this salad.

This whole-grain and vegetable salad easily layers into a jar, for a single 2-cup serving. You can mix and match with grains, vegetables and dressings that you have on hand. And remember, grating ginger releases more juice and adds more flavor than chopping with a knife.

Ginger root XXXLIngredients for salad

½ cup freekeh, cooked

¼ cup red quinoa, cooked

½ cup fresh blueberries

¼ cup fresh pineapple, diced

½ cup canned mandarin orange sections, drained

1 tablespoon pecan halves, chopped and toasted

2 tablespoons cinnamon cider vinaigrette dressing (see recipe)

 

Fruit: BlueberriesIngredients for dressing

½ cup apple cider vinegar

1 teaspoon ground cinnamon

½ teaspoon ground nutmeg

½ teaspoon kosher salt

2 tablespoons fresh gingerroot, grated

 

½ cup olive-canola blend oil

½ cup orange juice

1 tablespoon dark brown sugar

Open can of mandarins in light syrup.Preparation

Cook freekeh and red quinoa according topackage directions, but overcook slightly, so they are tender when cold. Whisk together salad dressing ingredients and set aside. For each salad in a jar, arrange ingredients in the following order: freekeh, quinoa, blueberries, pineapple, oranges and pecans.


Nutritional information per 2-cup serving

400 calories

Nuts: Pecan Nuts8 grams protein

63 grams carbohydrates

15 grams total fat

0 milligrams cholesterol

104 milligrams sodium

10 grams fiber

— Recipe from Morrison Healthcare, the food service provider for Upstate Medical University

pineapple chunksWhat is freekeh?

Freekeh was created by accident nearly 2,000 years ago when a Middle Eastern village was attacked and its crop of young green wheat was set ablaze. Many folks would sulk over such misfortune, but the crafty villagers rubbed off the chaff, cooked it up and Eureka! Freekeh was created.

summer16UHThis article appears in the summer 2016 issue of Upstate Health magazine.

Posted in diet/nutrition, history, recipe

Can a pancreas transplant help someone with severe diabetes?

An overview of the pancreas. A diagram of a pancreatic islet appears at the end of this article.

An overview of the pancreas. A diagram of a pancreatic islet appears at the end of this article. (ILLUSTRATIONS BY DAN CAMERON)

BY AMBER SMITH

Upstate doctors are now offering a pancreas transplant option for some patients with diabetes mellitus, the most common cause of kidney failure.

“Rather than waiting until the kidney fails, you may want to be proactive and go for a pancreas transplant, specifically if you have brittle, or labile, diabetes,” says Rainer Gruessner, MD, Upstate’s transplant chief and professor of surgery. He and his team are offering these transplant surgeries — separately or combined with kidney transplants.

In the future, Gruessner’s team may also offer transplants of just the clusters of cells that produce insulin, called pancreatic islets.

Ruth Weinstock, MD, PhD, Upstate’s division chief of endocrinology, diabetes and metabolism, says, “The treatments for diabetes are getting better and better, but they are still imperfect.”

An experienced kidney, liver, pancreas and intestinal transplant surgeon, Rainer Gruessner, MD, joined Upstate last fall as the division chief of transplant services. (PHOTO BY ROBERT MESCAVAGE)

An experienced kidney, liver, pancreas and intestinal transplant surgeon, Rainer Gruessner, MD, joined Upstate last fall as the division chief of transplant services. (PHOTO BY ROBERT MESCAVAGE)

Type 1 diabetes, in which the body’s immune system destroys insulin-producing cells, requires multiple insulin injections daily or insulin pump therapy along with frequent monitoring of blood sugar. Many people with long-standing type 1 diabetes, despite vigilance in glucose monitoring and administering their insulin, can no longer feel symptoms of low blood sugar, called hypoglycemia unawareness. They can have unpredictable and life-threatening episodes of low blood sugar, called severe hypoglycemia, and wide fluctuations in blood sugar levels.

Progress has been made in the development of insulin pump therapy and continuous glucose monitoring, components needed for the eventual development of an “artificial pancreas.” They are a great step forward, says Weinstock, but they are not a cure.

Only a properly functioning pancreas or pancreatic islets would be a real cure.

Gruessner says a pancreas transplant can improve the lives of some patients with diabetes and also halt or reverse complications such as diabetic changes in the eyes and kidneys. Those who may be considered for pancreas transplants have particularly hard-to-control type 1 diabetes, known as “brittle diabetes.” They experience frequent and extreme swings in blood sugar, which increase their risk of heart attack, stroke, kidney failure, blindness, circulatory disorders and death.

Mark Laftavi, MD (left). and Oleh Pankewycz, MD (right), were recruited by Gruessner to be the surgical director and medical director, respectively, of Upstate University Hospital's pancreas transplant program. The two men previously directed the transplant program at the Erie County Medical Center, the teaching hospital for the University at Buffalo Jacobs School of Medicine. (PHOTO BY DEBORAH REXINE).

Mark Laftavi, MD (left). and Oleh Pankewycz, MD (right), were recruited by Gruessner to be the surgical director and medical director, respectively, of Upstate University Hospital’s pancreas transplant program. The two men previously directed the transplant program at the Erie County Medical Center, the teaching hospital for the University at Buffalo Jacobs School of Medicine. (PHOTO BY DEBORAH REXINE).

Some people with diabetes who develop irreversible kidney damage may need a kidney transplant. They may be candidates for a pancreas transplant at the same time.

For pancreas transplants, the donor organ comes from a person who has died. The pancreas is added to the recipient’s body, and the recipient retains his or her original pancreas, which continues to produce digestive enzymes. The new pancreas immediately begins producing insulin.

No surgery is without risk, but Gruessner says the risk of dying from a pancreas transplant is 2 to 3 percent, compared with an annual risk of dying that can be higher for some patients. “Of course, we are selective about who should have a pancreas transplant, but the results in terms of patient survival are excellent.”

He says 85 percent of transplanted pancreases function as they are supposed to. Patients no longer have to check their blood sugar levels multiple times a day or inject themselves with insulin. They are able to eat what they like. But, they must take anti-rejection medication.

“It’s lifesaving,” Gruessner says of the surgery, “but it’s also life enhancing.”

The islet option

Transplants of the pancreatic islets, the clusters of cells that produce insulin, show promise in treating people with severe diabetes and those with chronic pancreatitis and intractable pain.

Research published in April in the journal Diabetes Care shows that islet transplantation “offers a potentially lifesaving treatment that in the majority of cases eliminates severe hypoglycemic events while conferring excellent control of blood sugar,” says Anthony Fauci, MD. He is the director of the National Institute of Allergy and Infectious Diseases.

In the United States, islet transplants are currently available only through clinical trials. Research is underway to encapsulate the islets, so they will not be recognized by the recipient’s body as foreign. The hope is that in the future, islets will be able to be implanted without the patient having to take anti-rejection drugs, which suppress the immune system.

Pancreas care a specialty at Upstate

Upstate is one of 37 National Pancreas Foundation designated Centers for the Care and Treatment of Pancreas Diseases, and the only one in New York outside of New York City.

The designation, earned in March, means Upstate has all the services, health care professionals and programs necessary to provide multidisciplinary treatment for patients with diseases of the pancreas, including pancreatitis, diabetes and pancreatic cancer. Designated centers also play a role in advancing research and leading the way for heightened awareness of pancreatitis and related conditions.

“It’s a seal of approval for how we care for patients with pancreatitis,” says Nuri Ozden, MD, an interventional gastroenterologist at Upstate and the medical director of the foundation’s New York State chapter.

In addition, Upstate provides the Liver, Gallbladder and Pancreas Center. Established in 1994, the center provides comprehensive evaluation of patients with both malignant and nonmalignant diseases involving these organs.

Pancreatic islets, such as seen here, produce insulin. Islet transplantation is being studied for possible treatment of severe diabetes and chronic pancreatitis but is currently only available in clinical trials in the U.S.

Pancreatic islets, such as seen here, produce insulin. Islet transplantation is being studied for possible treatment of severe diabetes and chronic pancreatitis but is currently only available in clinical trials in the U.S.

hloa-art2Layout 1This article appears in the summer 2016 issue of Upstate Health magazine. Hear interviews with: Gruessner on kidney and pancreas transplants and also how pancreas transplants could help some people with diabetes; Gruessner and Laftavi further discussing pancreas transplants and the effects of diabetes on kidneys and other organsOzden and a patient on chronic pancreas disease; and Ajay Jain, MD, on surgical techniques to fight diseases of the liver, pancreas and gallbladder.

Posted in diabetes/endocrine/metabolism, health care, HealthLink on Air, illness, kidney/renal/nephrology, liver/ gallbladder/ pancreas, organ donation/transplant, pancreas/liver/gallbladder/bile ducts, surgery | Tagged , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Science is art: a glimpse into the mysteries of regeneration

Scienceisartimage

Dasgupta

Dasgupta

Amack

Amack

These are the cellular components of a zebrafish pectoral fin. Green indicates the endoskeleton; red staining shows the epithelial cells; blue marks the nucleus of each cell. Unlike humans, zebrafish can fully regrow limbs (fins) that have been damaged or lost. Understanding how fin development and regeneration happen in the zebrafish may guide regenerative approaches in humans. PhD student Agnik Dasgupta captured the image using a spinning disk confocal microscope in the laboratory of Jeffrey Amack, PhD, in Upstate’s department of cell and developmental biology.

summer16UHThis article appears in the summer 2016 issue of Upstate Health magazine.

Posted in health care, research

It’s complicated: Gender reassignment operations sometimes require repairs

BY AMBER SMITH

A surgeon skilled in reconstructive urology for men and women has developed a specialization in caring for transgender patients at Upstate.

genderDmitriy Nikolavsky, MD, does not perform initial gender reassignment surgeries. Rather, he handles occasional complications that may occur in the months afterward, as well as follow-up medical care for years to come.

“Patients after such complex operations, even without complications, will need lifelong urologic care,” he says. “It is not surprising that urologists who are not familiar with specificities of transgender anatomy may not be comfortable offering even routine urologic care.”

His first patient was a Central New Yorker who traveled out of state for gender reassignment surgery. Three months later, the person was still unable to urinate properly. Nikolavsky, in collaboration with the original surgeon, made surgical repairs, and the patient recovered.

Some of the most common complications after gender reassignment surgery include strictures caused by scar tissue, abscesses that harbor pus and the formation of abnormal passageways called fistulas. Niklolavsky says it’s not uncommon for a patient to have more than one complication concurrently.

Dmitriy Nikolavsky, MD

Dmitriy Nikolavsky, MD

To stay current with his techniques, Nikolavsky connects with other reconstructive urologists who offer repairs, and he stays in touch with reconstructive plastic surgeons who perform gender reassignment surgeries. Multiple approaches can be used for male-to-female and female-to-male surgeries, and the initial approach can dictate the type of repair for which Nikolavsky must be prepared.

He says this specialty is something he did not envision when he graduated from Wayne State University School of Medicine in 2004 in Michigan. Even today, the number of gender reassignment surgeries remains low, but it’s growing. In addition to providing surgical expertise, Nikolavsky says he has diligently helped select properly trained nurses and office staff who want to create a trans-friendly office environment.

In January, Upstate hosted a Transgender Health Panel, designed as an introduction to the challenges transgender patients face in the health care system.

Also, parent Terri Cook spoke on campus about the “long and difficult process” of her child transitioning from female to male, the subject of a book called “Allies and Angels: A Memoir of Our Family’s Transition.”

hloa-art2“I watched my son grow from a depressed, struggling-with-anxiety, bullied, withdrawn, isolating individual into a young man who is now rising in his life,” she describes in an interview with Nikolvasky on Upstate’s weekly podcast and talk radio show, “HealthLink on Air.”

Cook goes on to discuss the surgery and its results. “He is a successful college student,” she says. “He has held a full-time job. He is in a happy, healthy relationship. I don’t know what more any parent could want for their child.”

Common steps in transition 

 Gender transition is a different experience for everyone. Some common steps in a medical transition are:

  1. Live in the new gender role for a year.
  2. Seek therapy from mental health professionals who can provide letters of support, which a health care provider may require for surgery later on.
  3. Take appropriate hormones for another year.
  4. Schedule surgery, which would be done in stages. Some transgender men may desire chest reconstruction. Some transgender women may seek a tracheal shave, facial feminization surgery or other feminization procedures.
  5. Undergo genital reconstruction.

summer16UHThis article appears in the summer 2016 issue of Upstate Health magazine.

 

 

Posted in health care, HealthLink on Air, patient story, sexuality, surgery, urology

Memoir focuses on race and medicine

Author Damon Tweedy, MD, signs a copy of his book, Black Man in a White Coat, for Upstate medical student Adekorewale Odulate-Williams as Angela Rios, another Upstate medical student, looks on.

Author Damon Tweedy, MD, signs  copies of his book, “Black Man in a White Coat,” for Upstate medical students Adekorewale Odulate-Williams (center) and Angela Rios (left). (PHOTO BT DEBORAH REXINE)

BY SUSAN KEETER

In “Black Man in a White Coat,” Damon Tweedy, MD, uses memoir to grapple with the evidence that, in his words, “being black is bad for your health,” shorthand for the fact that many diseases are more prevalent, and more lethal, among people of African descent. That reality struck home when the author — then a physically fit, 23-year-old medical student — was diagnosed with high blood pressure and kidney disease. In the book, Tweedy uses this and other experiences to dissect societal issues of class and race and to show how people of color are disproportionately derailed by diseases and circumstances.

Tweedy writes about events of racial bias that are painfully familiar: the medical school professor who mistakes him for a maintenance man; the staff who assume a clinic patient is unemployed; and a hospital patient who complains, “I don’t want no N-word doctor.”

In that case, Tweedy explores his own bias when he meets the foul-mouthed patient, Chester, and his daughter and grandson, both of whom wear Confederate battle flag T-shirts.

Driven to prove his medical skill and avoid racial politics, Tweedy works to stay focused on caring for Chester. The doctor-patient relationship thaws when Tweedy uncovers their mutual love of the Atlanta Braves. Tweedy further adjusts his view of Chester when he learns that the man had devoted his life to caring for his ill wife.

After multiple medical complications, Chester dies, and Tweedy must inform the family. Chester’s once mistrustful daughter tells him tearfully, “Thank you for all you did for my daddy,” and the grandson says, “Thank you, Sir. My granddaddy liked you.”

Bonds formed. Stereotypes overcome. Lessons learned.

510NKWMCr0L._AC_US160_Tweedy’s book covers his four years of medical school, the years of internship and residency training in psychiatry, and his early years of clinical practice. It also explores affirmative action, the intersection of economics and ethnicity, and the need for a person of color to navigate multiple worlds, which Tweedy describes as “double consciousness.”

In February, Tweedy spoke to medical students, faculty and alumni at Upstate Medical University. “These are incredibly complex issues,” he told a packed auditorium. “Be humble. Treat everyone as an equal.”

Tweedy’s highly readable, thought-provoking book hit stores — and the New York Times’ best-seller list— last fall. He is an assistant professor of psychiatry at Duke University and a staff physician at the Durham VA Medical Center in North Carolina.

summer16UHThis article appears in the summer 2016 issue of Upstate Health magazine.

Posted in bioethics & humanities, community, education, entertainment, health care, health careers, history, illness, medical education, medical student, mental health/emotional health, psychology/psychiatry, public health | Tagged , , ,

The short answer to why Frank Middleton doesn’t eat bacon: cancer prevention

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BY AMBER SMITH

The backstory: Today Frank Middleton is an associate professor at Upstate with appointments in three departments and extensive research related to neurological and psychiatric diseases. A few decades ago, he was a doctoral student at Upstate Medical University.

He attended a lecture by John Lucas, PhD, about the “Bacon Mismatch Repair Pathway.”

Lucas now works at an international biomedical research institute in Philadelphia. In the 1990s, when Middleton was working on his doctorate, Lucas was a biochemist focused on the field of glycobiology. For his lecture, Lucas presented slides demonstrating how cells use the repair pathway for DNA alterations that are introduced by high levels of nitrates in bacon.

“It stuck with me,” Middleton recalls. “It is an established fact that there is a significantly greater risk of DNA modification in cells exposed to high nitrates.”

He shares an article from the journal Nucleic Acids Research that explains how carcinogenic compounds form and may prompt mutations that lead to cancer: “The smoking process of meats is thought to introduce heterocyclic amine byproducts in the food, and the curing process involves nitrate salts that cause nitroso-compounds, which are thought to act as potential mutagens,” says the article from 2006.

Middleton says the molecular mechanisms are all completely worked out now.

“It’s a fact that it happens, and that our cells can respond to these mutations and repair them. But, over one’s lifetime, certain cells that are continually exposed to these types of mutagens will become less efficient at repair, and — voila — you can have a cancer cell.”

summer16UHThis article appears in the summer 2016 issue of Upstate Health magazine.

Posted in cancer, diet/nutrition, health care, medical education, prevention/preventive medicine, public health, research | Tagged , , ,

In this Upstate classroom, se habla español

Maria-Lourdes Fallace (center) talks with students during the Medical Spanish course. Students (from left) are Laura Sxczesniak, Faniel Farrell, Dulce Barrios and Ryan Nightingale. (PHOTO BY WILLIAM MUELLER)

María-Lourdes Fallace (center) talks with students during a doctor-patient exercise in the Medical Spanish course she teaches at Upstate. Students (from left) are Laura Szczesniak, Daniel Farrell, Dulce Barrios and Ryan Nightingale. (PHOTO BY WILLIAM MUELLER)

BY JIM HOWE

Si nadie entiende mi lengua en el hospital, ¿cómo van a entender mis problemas médicos?

If you had trouble understanding that first sentence, you can probably sympathize with a Spanish speaker who might say it. It means, “If no one understands my language in the hospital, how are they going to understand my medical problems?”

Bridging that language gap is the goal of María-Lourdes Fallace, who has been teaching medical Spanish to future doctors and others at Upstate for more than a decade.

The elective classes range from basic to advanced and include students who never studied Spanish as well as native Spanish speakers who never learned medical terms.

As they learn the proper names for body parts, symptoms and diseases, the students also enlarge their conversational ability and their grasp of the cultural norms and attitudes they are likely to encounter among native Spanish speakers. Fallace, a native of Ecuador who has lived in Syracuse for several decades, enhances her teaching with insights into Latin American cultures.

For example, in a recent advanced class, students spoke in Spanish about diversity in the Hispanic world, including how different countries, regions and ethnic groups regard skin color.

Medical students Ryan Nightingale of Chatham and Daniel Farrell of Syracuse are taking the class to sharpen their Spanish. Both have spent time in Latin America and plan to do dengue virus research in Ecuador this summer.

Fellow student Dulce Barrios from Miami is a native of Cuba who grew up speaking Spanish. She says the class reinforces the importance of explaining things to patients and the need to show respect.

The classes also teach the importance of observation, notes Laura Szczesniak of Utica, another student, who adds that patients appreciate being greeted and spoken to in their own language.

Fallace began learning medical terms from her grandfather, a retired physician, when she was a child. She also works as a bilingual medical interpreter and was honored in 2015 by the state Assembly for leadership and advocacy among the region’s Hispanic residents.

“I find both teaching the medical Spanish to the students as well as the interpreting so incredibly rewarding,” she says. “You are helping people where they need it most, I tell my students. The moment they greet the patients, culturally, they have already made the contact, and the patient thinks, ‘He cares for me.’”

In the advanced class, the students work with cases taken from real life, play various roles and ask relevant questions, keeping an eye on their grammar all the while.

A recent class, for example, featured a visitor who played the role of a 54-year-old man with chest pain and other problems. The students, acting as various specialists, had to diagnose his problem, explain to him what they were doing and act professionally in the face of his distrust, lack of cooperation, and, for added realism, his hysterical wife (played with glee by Fallace).

The students learned that this patient likes to eat hamburguesas con queso (cheeseburgers) and cebolla frita (fried onions), that he has a 95 percent obstrucción (blockage) in an artery and that his mother had an ataque al corazón (heart attack) before she was 50.

They convinced him not to leave the hospital until they could perform more exámenes (tests), advised him to start eating food that was más saludable (healthier) and suggested that his diet was not totally the fault of his esposa (wife).

The 6 most popular languages

Spanish is just one of more than 100 languages that might be spoken by Upstate patients every year. The other most frequently used languages include Arabic, Nepali, Somali, Karen (from Southeast Asia) and sign language, according to Upstate’s patient education and interpreter services department.

summer16UHThis article appears in the summer 2016 issue of Upstate Health magazine.

 

 

 

 

Posted in bioethics & humanities, community, education, health care, health careers, international health care, medical education, medical student, public health

Paddleboarding balances fun and exercise

Kevin and Martha O'Keefe, who are both nurses at Upstate University Hospital, can often be found on paddleboards in Skaneateles Lake in the summertime. Their two young children like to come along, too. (PHOTO BY ROBERT MESCAVAGE)

Kevin and Martha O’Keefe, both nurses at Upstate University Hospital, can often be found on paddleboards in Skaneateles Lake in the summertime. Their two young children like to come along, too. (PHOTO BY ROBERT MESCAVAGE)

BY JIM HOWE

Kevin O’Keefe was intrigued when he saw a man and a woman standing on boards on Skaneateles Lake. Soon afterward he read about a paddleboard shop that gave lessons.

“My wife and I had a lesson and fell in love with it from there,” O’Keefe said.

The two Upstate University Hospital nurses, both in their mid-40s, became stand-up paddleboarders, something that has given them a lot of fun and exercise around the Finger Lakes and beyond. Their 11 foot, 6 inch paddleboards resemble surfboards propelled by long paddles.

“A lot of people say they’d like to try it. And many people say it seems like you’d have to have a lot of balance to do that. But it’s deceivingly easy,” said O’Keefe, who works in hematology/oncology at the downtown campus.

“It was a lot easier than it looked,” his wife, Martha, agreed. She works part time in the pre- and post-anesthesia care unit at the downtown campus.

Momentum helps keep you balanced, O’Keefe explained. “It’s kind of like a bicycle — you don’t just sit on a bicycle with your feet off the ground and not move. You’re paddling, so using the paddle will increase your balance.”

While the O’Keefes took up paddleboarding mostly as a leisure activity they could do together, “it serves the purpose of a good workout if you want it to,” said O’Keefe, who has also competed in races.

Their hobby now includes their children, Cathleen, 9, who can paddle by herself, and James, 5, who just goes along for the ride. Everyone wears life jackets, and the kids enjoy jumping into the water and climbing back onto the boards.

They go out for about an hour every couple of weeks in the summertime, usually on Skaneateles Lake, which is an easy drive from their Camillus home.

Martha O’Keefe gives this advice to people who ask her about paddleboarding: “Definitely try it, but rent a paddleboard a few times before they think about buying one. It’s easier than it looks, and it’s a lot of fun. We’ve met a lot of nice people through paddleboarding.”

Interested in paddleboarding?

Paddleboards come in different sizes (9 to 12 feet) and styles and range from less than $400 to more than $2,000. Try renting a few types to see which suits you.

You’ll also need a paddle, a leash (so the board can’t float away), a life jacket and, unless you live by the water, a vehicle that can transport the board.

You’ll only need a wet suit if you plan to go out when it’s cold.

Once you’ve got your board, it could get “a bit dinged up, but more or less it’ll last forever,” Kevin O’Keefe said.

summer16UHThis article appears in the summer 2016 issue of Upstate Health magazine.

Posted in community, entertainment, fitness, nursing