Quick and easy recipe: Blueberry Ginger Kale Smoothie

Blueberry smoothie

Ingredients

3 cups frozen blueberries

3 cups coconut milk

1 cup kale, or more if desired

½ cup plain Greek yogurt

2 teaspoons pure maple syrup

2 teaspoons grated ginger

water, if necessary, for consistency

Preparation

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 2 servings includes:

297 calories

8 grams protein

9 grams total fat

7 grams fiber

Source: organizeyourselfskinny.com  

Upstate Health Fall 2017 coverThis article appears in the fall 2017 issue of Upstate Health magazine.

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How to raise a reader: Pediatrician shares her love of books and the almost-magical benefit of reading

Upstate pediatrician Jaclyn Sisskind, MD, reads to her sons, Eli, Jacob and Ari, as her husband, Ben Gnacik, looks on. (PHOTO BY SUSAN KAHN)

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 read 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.

“The 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 singsong pattern to your voice as you read. That 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 series, 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, 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. “They should catch you reading,” she says. “They 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.

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 list of favorite books

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

“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

Upstate Health Fall 2017 coverHealthLink on Air logoThis article appears in the fall 2017 issue of Upstate Health magazine. Hear Sisskind speak about reading and children in this podcast interview from “HealthLink on Air.”

 

Posted in adolescents, education, health care, HealthLink on Air, Upstate Golisano Children's Hospital/pediatrics | Tagged , , , , , , , , | Leave a comment

Rolling iPads and sign language are part of her job

 

Sue Freeman, center, communicates via American sign language in an instructional video demonstrating the interpreting services available at Upstate. Also appearing are Upstate employees Priscilla Santana, left, and Rod Freeman, right. English, Spanish and ASL versions of the video can be found on Upstate's YouTube channel.

Sue Freeman, center, communicates via American sign language in an instructional video demonstrating the interpreting services available at Upstate. Also appearing are Upstate employees Priscilla Santana, left, and Rod Freeman, right, who are both looking at an iPad set up as an “interpreter on wheels.” English, Spanish and ASL versions of the video can be found on Upstate’s YouTube channel (see below for links).

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 (ASL), 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.”

That’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. The 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

ASL 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 ASL/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 left 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 translated into ASL 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.

Video available in 3 languages

The interpretive services department at Upstate has made a video, available on YouTube in three versions, that demonstrates how the service works for a patient trying to communicate with her doctor.  Click here to see the version for speakers of English. Click here to see the version for the deaf. Click here to see the version for speakers of Spanish (haga clic aquí para ver la version para hispanohablantes).

Upstate Health Fall 2017 coverThis article appears in the fall 2017 issue of Upstate Health magazine.

 

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12 things you might not know about the United States military

stars and stripes designUpstate’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:

William Marx, DO

William Marx, DO

* 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, after World War II. What percentage of America’s military makes up each force? Army, 37 percent. Navy and Air Force, 23 percent each. Marine Corps, 13 percent. Coast Guard, 3 percent.

* Three-quarters of 1 percent of the population of America has served in the military.

* The 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.

* This 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.

* There 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. The Marines are 5 percent female.

* Ninety percent of enlisted men and women are high school graduates, and 90 percent of the officer corps have a bachelor’s degree.

* 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.

* The 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.

* The incidence of disease in the military is the same as for the general population. That applies to physical illness 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.”

* In war, common medical illnesses (such as appendicitis, ectopic pregnancies, influenza, pneumonia) cause the loss of more soldiers than combat injuries.

Upstate Health Fall 2017 coverThis article appears in the fall 2017 issue of Upstate Health magazine.

Posted in health care, history | Leave a comment

What you can do about the public health crises of gun violence and drug addiction

A makeshift "cemetery" at Onondaga Lake Park was set up in August by a surviving family members who lost someone to a drug overdose. Each tombstone represents someone who died from a drug overdose. (PHOTO BY RICK MORIARTY/SYRACUSE MEDIA GROUP)

A makeshift “cemetery” at Onondaga Lake Park was set up in August by a surviving family members who lost someone to a drug overdose. Each tombstone represents someone who died from a drug overdose. (PHOTO BY RICK MORIARTY/SYRACUSE MEDIA GROUP)

The number of Americans dying from gun violence or drug overdoses now surpasses the number of motor vehicle fatalities in the United States. The public health crises of gun violence and drug addiction are also felt in Central New York.

Gun violence

The 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.

Margaret Formica, PhD

Margaret Formica, PhD

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 1 ½ times higher than the national rate, Formica says.

She says national data shows 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.”

Drug addiction

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, 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.

 William Eggleston

William Eggleston

Opioid drugs such as morphine and oxycodone are used to treat moderate to severe pain, and they work well for a day or two. The drugs are not intended for use long term, but some patients, in chronic pain, take the drugs longer than is safe and become addicted.

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

  • 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.
  • Upstate offers help through the Violence Education Prevention Outreach Program.

Drug addiction prevention

  • If you receive an opioid prescription for pain, make sure it’s for the lowest effective dose.
  • Realize opioids do a good short-term job of relieving pain for a few days. They are not meant for long-term use.
  • New York state offers assistance through the Opioid Overdose Prevention Program.

Upstate Health Fall 2017 coverHealthLink on Air logoThis article appears in the fall 2017 issue of Upstate Health magazine. Click here for a podcast interview where Formica describes how gun violence can spread like an infectious disease. Click here for a podcast interview with Eggleston where he analyzes the opioid crisis.

 

 

Posted in addiction, Check-Up From The Neck-Up, drugs/medications/pharmacy, health care, HealthLink on Air, poison center/toxicology, prevention/preventive medicine, public health, research | Tagged , , , , , , , | Leave a comment

Could a spit test identify autism in children? Researchers seek early diagnosis

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.

Swab device for saliva collection

For a research study on autism, this swab is used to gently collect a bit of saliva from a child’s mouth. The blue cap is then unscrewed, inverted and screwed back on, immersing the saw in a tube of stabilizer solution as it awaits analysis.

Using a simple swab — like a one-headed Q-tip with a spongy head — 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.

The 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. The tool would supplement, not replace, current ASD testing.

The 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.

Frank Middleton, PhD

Frank Middleton, PhD

“The 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 pediatrics, neurosciences and physiology, psychiatry and biochemistry. “We also think it can likely be used to monitor potential improvement in a child’s level of functioning.”

The 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

To learn more about the study or to enroll your child, click here or leave a message at 315-464-7729. Participants get a $25 gift card and free parking during the test.

Upstate Health Fall 2017 coverThis article appears in the fall 2017 issue of Upstate Health magazine. Click here to listen to Middleton discuss this autism study in an interview with “HealthLink on Air.”

 

 

 

Posted in autism, genetics, health care, HealthLink on Air, psychology/psychiatry, research, Upstate Golisano Children's Hospital/pediatrics | Tagged | Leave a comment

News you may have missed: medical inventions, lactation counselors, cardiac surgery chief

Program encourages medical innovators 

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. “The 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.”

The 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. They 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.

Grant aims to fight lead poisoning

The New York State Department of Health awarded a $1.25 million grant to the Central/Eastern New York Lead Poisoning Resource Center at Upstate. The 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.

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.

New York State mandates blood lead testing in all children at 1 and 2 years of age.

Counselors offer support for breast-feeding

More than a dozen nurses at Upstate University Hospital recently became certified lactation counselors. This means they are prepared to provide breast-feeding support, including assessing the latching and feeding process, providing corrective interventions and counseling mothers.

The 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.

Hospital is recognized for its technology

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.

New cardiac surgery chief joins staff

The new division chief of cardiac surgery at Upstate is cardiothoracic surgeon G. Randall Green, MD. He will also serve as co-director of a new heart institute at Upstate 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 The 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.

Free bike helmets distributed 

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.

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.

Training focuses on treating abused children

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 Maimonides Medical Center in Brooklyn.

Upstate Health Fall 2017 coverThis article appears in the fall 2017 issue of Upstate Health magazine.

 

 

 

Posted in community, health care, heart/cardiovascular, maternity/obstetrics, nursing, prevention/preventive medicine, public health, research, safety, surgery, technology, Upstate Golisano Children's Hospital/pediatrics

Fighting back: How a martial artist recovered from stroke

Physical therapist Kelly Grier, left, 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)

Physical therapist Kelly Grier, left, 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. (PHOTOS 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. The message he heard was: “not good enough.”

Recovering from stroke can feel like starting over, having to relearn 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. They thought he had fallen. A test called computed tomography angiography, 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.

Grier watches Bouchard as he performs karate kicks, which he requested as part of his therapy.

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 after 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 sparing 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.”

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.

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 left side than I thought,” he said.

Grier admits that her sessions with Bouchard are work-outs 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 lifted. Grier used those objective measurements to show Bouchard that he was making progress toward his personal goals. It helped him realize he was doing great.

Upstate Health Fall 2017 coverThis article appears in the fall 2017 issue of Upstate Health magazine.

Posted in brain/neurology, health care, medical imaging/radiology, patient story, physical therapy/rehabilitation, stroke, surgery | Tagged

Operating through the nose can lead to quicker recovery

Someone with an alternately stuffy and drippy nose, ears that feel full, headache, even nosebleeds, is most likely suffering from allergies or chronic sinusitis.

Mitchell Gore, MD, PhD

Mitchell Gore, MD, PhD

But tumors deep in the nose or at the base of the skull can cause those same symptoms. “The symptoms can overlap with a lot of other innocuous conditions. That’s why a lot of these tumors are found relatively late,” says Mitchell Gore, MD, PhD, an ear, nose and throat doctor at Upstate with fellowship training in skull base surgery.

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.

Upstate Health Fall 2017 coverHealthLink on Air logoThis article appears in the fall 2017 issue of Upstate Health magazine. Click here to hear Gore talk about other aspects of skull base surgery in a podcast interview from  “HealthLink on Air.”

 

 

 

Posted in cancer, ear, nose and throat/otolaryngology, surgery | Tagged

Stroke team extends 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.

Gene Latorre, MD

Gene Latorre, MD, explains how new technology can improve outcomes for people who have strokes. He is medical director of the stroke program at Upstate. (PHOTO BY JIM HOWE)

The clot-busting, tissue plasminogen activator 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 after 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 Gene Latorre, MD, medical director of the stroke program. Unless the time the stroke began could be reasonably approximated within that 6-hour window, doctors had to err on the side of caution and skip using tPA.

The Upstate stroke team has opened that window wider with the addition of innovative imaging software 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.

The software program shows changes in brain tissue perfusion and diffusion in digital images captured by computerized tomography and magnetic resonance imaging. This allows doctors to tell the precise area of the brain that is affected by the stroke, and the area still in jeopardy.

Upstate Health Fall 2017 coverHealthLink on Air logoThis article appears in the fall 2017 issue of Upstate Health magazine. Click here for a “HealthLink on Air” podcast interview with Latorre where he explains the time frame for stroke treatment and the use of the clot-buster tPA in more detail.

 

 

 

 

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