A trusted guide through cancer treatment: the nurse navigator

GuideBY JIM HOWE

Cancer patients can feel overwhelmed as they face not just their disease, but a bewildering array of appointments, treatments and insurance forms.

Many are looking for one person who can explain the next procedure, remind them of an appointment and help them deal with an insurance company.

That person is the nurse navigator.

One of the Upstate Cancer Center’s nurse navigators, Holly Briere of Baldwinsville, explains the role as “the central point of contact for the patient. We’re the person they can come to if they have any questions or concerns. We kind of put it all together for the patient.”

Briere works with liver, gallbladder and pancreas patients. The center also has nurse navigators devoted to other cancer teams: thoracic/lung, bone marrow transplant and head and neck, plus plans to fill a vacant breast cancer and survivorship position soon.

“We’re kind of the face of the program we represent, that person the patient can always come to and rely on us and know that we are making sure that things are getting done on their behalf,” Briere says.

“Navigation brings together all the best parts of nursing. It’s that personal interaction, but it’s also quality, making sure that our program is as efficient as it can be.”

The need to improve access and guide patients through the complexities of the medical system became apparent to a surgical oncologist in Harlem by the late 1980s. Harold Freeman, MD, founded a navigation program in 1990 that evolved into the nonprofit Harold P. Freeman Patient Navigation Institute. Other groups have also formed to support the concept of navigation.

Navigator roles are still evolving and take different forms depending on the institution and the diseases involved, but “their primary role is to identify and remove barriers to care,” says Rose Valentino, the nursing director at the Upstate Cancer Center. This might involve problems with transportation, family or insurance, for example, and the navigator keeps busy behind the scenes — monitoring patients as they move from, say, surgery to radiation treatments.

“In addition to smoothing the patient’s experience, navigators have been shown to improve outcomes and efficiency for health care providers,” Valentino adds.

Experience counts in a job like this. Briere, for example, draws on her 17 years as an oncology nurse to help educate and support her patients.

One of those patients, Mark Vamvakias, 50, of North Syracuse, refers to Briere as a godsend.

“I cannot stress enough the help and assistance that Holly provides to me and my family as we cope with my condition and all the endless paperwork and scheduling demands required to monitor, treat and recover from my condition,” says Vamvakias, who met Briere a month before his April 2015 surgery for neuroendocrine tumors. He has kept in touch during subsequent chemotherapy.

“Holly is only a phone call away to answer any question we have, no matter how insignificant we may think it is, or to just talk and give us some sense of reassurance. … To be honest, I really don’t think we could have done any of this without her.”

What is a nurse navigator?

“Patient navigator” is the general term for people who work to identify and overcome barriers to patients’ medical treatment and move them through the health care system efficiently.

Some institutions use lay people as navigators, particularly for nonmedical issues, such as scheduling or transportation.

The Upstate Cancer Center requires its navigators to be registered nurses, so they are not just patient navigators but “nurse navigators.” The center also recommends at least three years of nursing experience, at least a bachelor’s degree in nursing or a related field and oncology or case management experience.

Currently, no state or national certification is required for nurse navigators, but efforts are underway to develop certification through the Academy of Oncology Nurse and Patient Navigators, says Rose Valentino, the nursing director at the Upstate Cancer Center.

spring16cancerThis article appears in the spring 2016 issue of Cancer Care magazine

Posted in cancer, health care, health careers, medical education, nursing, pancreas/liver/gallbladder/bile ducts | Leave a comment

She tells everyone: Read your medical records

Seung Shin Hahn, MD, talks with his patient Dorette Thompson. (PHOTO BY WILLIAM MUELLER)

Radiation oncologist Seung Shin Hahn, MD, talks with his patient Dorette Thompson. (PHOTO BY WILLIAM MUELLER)

BY AMBER SMITH

As the world marked the turn of the millennium on Dec. 31, 1999, Dorette Thompson and her husband, David, were in New Jersey for a black-tie celebration. Thompson, in her late 50s, awoke that morning to unusual spotting.

That was the beginning of her ongoing endometrial cancer journey.

She had abnormal tissue removed from her uterus. In the spring of 2000 she underwent a hysterectomy and therapy that she believed left her cancer free.

Four years later an imaging scan showed a tiny uterine tumor, and Thompson sought treatment in Rochester. It was 2005 when her leg began to swell, revealing an enlarged lymph node in her pelvis. She was referred to radiation oncologist Seung Shin Hahn, MD, at Upstate.

“He was the first person who was honest with me,” says Thompson, who lives in the village of McGraw in Cortland County. Hahn told her the tumor was large and inoperable. It was pressing on her intestines and the main artery leading to her leg, and the physician was surprised that Thompson’s leg wasn’t hurting because of it.

Until then, Thompson believed the tumor to be tiny. She had not read her medical records, which clearly listed the tumor’s size and location. That’s the lesson she now shares with anyone facing cancer: Read all of your medical records.

Hahn’s plan was to weaken the tumor with a special type of radiation therapy then available at MedStar Georgetown University Hospital in Washington, D.C. Thompson went there. “I came back home, and a month or two later, they checked – and the tumor had disappeared.”

In 2012, she learned her endometrial cancer had spread. Again, she was treated with radiation, this time at Upstate. She takes a hormone pill daily to reduce the risk of a new cancer developing.

“I feel fine,” insists Thompson, now 76. “I owe my life to Dr. Hahn.” She says the last 16 years have been positive. She accepted her cancer diagnosis, found a doctor and a plan of action she fully believed in, and always has something she is looking forward to do or accomplish.

About endometrial cancer

— The average age of women diagnosed is 60; it is uncommon among pre-menopausal women.

— Pregnancy, use of birth control pills and the use of an intrauterine device are linked to a lower risk.

— Overweight women are twice as likely to develop endometrial cancer, compared with women who maintain a healthy weight, because fat tissue can increase a woman’s estrogen level, which increases risk.

— It is up to four times more common in women with diabetes.

— Women who have had breast or ovarian cancer may have an increased risk, as may women who have undergone pelvic radiation therapy.

— Abnormal vaginal bleeding is the most common symptom and should be evaluated right away.

— In addition to a physical exam, tests for endometrial cancer may include ultrasound, a biopsy of the uterine lining and blood tests, with additional tests if the doctor suspects the cancer is advanced.

— Surgery is the main treatment, but in some cases radiation therapy, hormonal therapy and/or chemotherapy may be recommended.

Source: American Cancer Society

spring16cancerThis article appears in the spring 2016 issue of Cancer Care magazine.

 

 

 

Posted in cancer, health care, illness, medical imaging/radiology, patient story, women's health/gynecology | Leave a comment

A different stroke: Hers happened after a neck adjustment

Carmella Carroll, seven years after a stroke. (PHOTO BY ROBERT MESCAVAGE)

Carmella Carroll, seven years after a stroke. (PHOTO BY ROBERT MESCAVAGE)

BY AMBER SMITH

In seeking relief for tension headaches, Carmella Carroll sought treatment that – she later learned – increased her risk for a stroke.

The Manlius woman was 33 in October 2009 when she went to a chiropractor for a neck adjustment. She wound up spending more than 20 days hospitalized and months in rehabilitation after suffering a type of stroke called a vertebral artery dissection.

It’s a rare but serious injury, says Lawrence Chin, MD, the chairman of Upstate’s neurosurgery department. “I’ve seen it happen,” he says. The vertebral arteries thread through the vertebrae of the spine on each side of the neck. They can be damaged through spinal manipulation, leaving small tears in the inner lining of the arteries. Blood clots can develop and travel to the brain, causing a stroke.

Carroll's sons visit her in the hospital, shortly after her 2009 stroke.

Carroll’s sons visit her in the hospital, shortly after her 2009 stroke.

“In those situations you can’t say that the chiropractic adjustment wasn’t a significant contributing factor — although maybe not the only factor. Some patients do have other predisposing factors,” Chin says. “And, many people who get dissections don’t have chiropractic adjustments.”

Carroll remembers the last time she left her chiropractor’s office, feeling groggy and almost intoxicated. Once home, she lay down to calm her dizziness. She was vaguely aware of carving pumpkins with her husband and their children, who were 2 and 4 at the time.

Her equilibrium remained strange when she got up the next morning. As she drove to work, Carroll’s vision began to dim. She pulled over, and she threw up. She called for help through her vehicle’s security system. She lost sensation on her right side, and her vision. Her face drooped, and her speech became slurred.

She did not know what was happening. “I just remember there was a lot of chaos,” she recalls. “The reality is, if I didn’t get help soon enough, I was going to die.”

Both of her vertebral arteries were affected. Carroll says doctors immediately placed a stent inside one of the arteries, as reinforcement. After she was stabilized, they placed a stent on the other side.

She was in the intensive care unit for five days and had a difficult time regaining her health, although her vision was restored. For the first two weeks, Carroll couldn’t swallow, and for months after she could only eat soft foods. She walked with a cane when she left the hospital, and her home had to be modified with ramps and stairs that helped her reach her bed.

Carroll worked with occupational and physical therapists and audiologists during her rehabilitation. “Each time things would get a little bit easier, I would start to see this ray of hope.”

Seven years later, she is grateful for her health. She has a new husband, a third child, plus two stepchildren. She still has trouble eating some foods. When she is tired, her speech slurs. Her temperature regulation is sometimes off. But her headaches are under control, with medication.

Layout 1hloa-art2This article appears in the summer 2016 issue of Upstate Health magazine. Hear radio interviews about various aspects of stroke — how to recognize one; how today’s treatment is rapid and minimally invasive;  the surgical options; the relationship to atrial fibrillationsupport groups; and how emergency response is coordinated throughout the region.

Posted in brain/neurology, disability, eye/vision/ophthalmology, health care, illness, patient story, physical therapy/rehabilitation, stroke, surgery | Leave a comment

Without symptoms: How a CT scan found a hidden lung cancer

Glen Wells of Central Square volunteers at Upstate University Hospital one day a week. (PHOTO BY RICHARD WHELSKY)

Glen Wells of Central Square volunteers at Upstate University Hospital one day a week. (PHOTO BY RICHARD WHELSKY)

Glen Wells was a smoker most of his life, and cancer runs in his family.

So in 2013 when his family doctor, David Page, MD, suggested he be screened annually for lung cancer, Wells followed the advice – not realizing at the time that it would ultimately save his life.

Medical insurance did not cover the cost of the screening at that time. Wells paid $235 out of his own pocket. The computerized tomography scan revealed nothing unusual in his lungs. He returned in 2014, and again the scan was clear.

By the third year, his insurance plan was paying for the screening. This time, the scan showed a troubling spot.

Wells, 67, who lives in Central Square, had no cough. He was never out of breath. Nothing was a chore for him. “I had absolutely no symptoms whatsoever,” he says.

A biopsy revealed cancer. It was a small cancer in the early stages, confined to the upper lobe of his right lung. Lung cancers that are discovered at such an early stage have a good chance for cure.

Within a month, he underwent surgery to have that lobe removed. That was it. He required no chemotherapy and no radiation.

His treatment was over before the diagnosis really sank in. Today, almost a year after the surgery, he’s healthy, and he’s grateful for the screening. “Without that screening, I never would have known.”

How you can get screened

Most insurance plans now pay for annual screening for lung cancer for smokers and those who have quit within the last 15 years if they are between ages 55 and 80 and have no symptoms of lung cancer. Low-dose computerized tomography (CT) scans are designed for people with a history of “30-pack year” smoking. (See definition below.)

Studies have shown more than 80 percent of the lung cancers detected in screening are stage 1, meaning they are treatable or curable, says Santiago Miro, MD, who leads Upstate’s lung cancer screening program.

He says lung cancer deaths drop by about 20 percent in smokers and former smokers who undergo annual screening. Death rates also drop from other causes, since the CT scan sometimes discovers other potentially life-threatening problems that can be treated.

Patients have to understand nodules that are harmless may appear similar to nodules that are cancerous, so additional testing may be required.

While the U.S. Preventive Task Force recommends annual screenings for people between age 55 and 80, the Centers for Medicare and Medicaid Services reimburses for people age 55 to 77. Miro said most insurance companies cover people from age 55 through 79.

Schedule a screening by calling 315-464-8668.

What’s a pack year?

Multiply the number of packs of cigarettes smoked per day by the number of years smoked. Thirty pack years is equal to smoking one pack a day for 30 years, or two packs a day for 15 years, and so on.

spring16cancerhloa-art2This article appears in the spring 2016 issue of Cancer Care magazine. Hear a radio interview about lung cancer screening with radiologist Santiago Miro, MD.

Posted in cancer, health care, HealthLink on Air, illness, lung/pulmonary, medical imaging/radiology, patient story, public health, Smoking Cessation | Leave a comment

She’s his lifesaver: Her bone marrow cured his leukemia

Donor Andrea Chroston gets a thank-you kiss from marrow recipient Greg Siwinski.

Donor Andrea Chroston gets a thank-you kiss from marrow recipient Greg Siwinski.

 

BY AMBER SMITH

Greg Siwinski and his family looked forward to hosting a woman from Hildesheim, Germany, last October at their home in Syracuse. He had never met her, but the two had a special connection. Bone marrow from her body provided Siwinski with healthy stem cells to replace those that were destroyed by leukemia.

“Basically, I owe my life to this person,” says Siwinski, 60, an industrial hygienist who works in the Occupational Health Clinical Center at Upstate. Andrea Chroston, in her early 40s, and her two daughters stayed with the Siwinski family for two weeks. The trip was the first time Chroston had been on an airplane.

Siwinski treated his donor and her daughters to the highlights of New York state, including trips to New York City and Niagara Falls.

It was almost nine years ago that Siwinski was diagnosed with acute myeloid leukemia, a fast-growing form of cancer of the blood and bone marrow that he believes he developed from exposures to workplace chemicals more than 20 years ago. This type of leukemia is often treated with chemotherapy, radiation and/or stem cell transplant. Siwinski’s initial treatment did not work, and a transplant became his hope for increasing his long-term survival.

The bone marrow registry is international in scope, and the best match for Siwinski turned out to be in Germany. After Siwinski was matched with his donor, FedEx transported her bone marrow to Memorial Sloan Kettering Cancer Center in New York City, where he went for the transplant.

“I’m glad to report I seem to be cured,” he wrote in January in a note to the Upstate Medical University campus asking people to attend a bone marrow drive. “I urge you all to sign up and swab your cheek to see if you are the ‘right stuff’ for someone in need,” he wrote.

Siwinski and his donor had to wait two years after the transplant to connect. They communicated by email and telephone over the years, until they met in person in October. Their meeting was sealed with a thank-you kiss at Hope Lodge in New York City, where Siwinski spent his initial recovery after the transplant.

How you can join the registry

Younger donors provide the greatest chance for transplant success, so the National Marrow Donor Program seeks donors between the ages of 18 and 44. Patients are most likely to match with someone of their own race or ethnicity, so the program seeks to recruit registry members of diverse ancestry.

A list of medical and weight guidelines for potential donors is available at BeTheMatch.org.

A blood sample or a cheek swab is used to add a person to the registry. If they become a match for someone, donors are asked to make a time commitment of 20 to 30 hours over a four- to six-week period to attend appointments and donate.

Donor stems cells can be removed in a couple of ways. A bone marrow harvest is a minor surgical procedure in which marrow is removed from the back of both hipbones. A procedure called leukapheresis is similar to a regular blood donation, except that donors receive several days of shots to help stem cells move from the bone marrow into the blood. When the blood is removed, the stem cells are separated, and the remaining red blood cells are returned to the donor.

Find a donor registry drive by visiting the program at BeTheMatch.org. (Click here for a humorous video about the donor registry, including a parody of a Taylor Swift song.)

Sources: BeTheMatch.org, U.S. National Library of Medicine

spring16cancerhloa-art2This article appears in the spring 2016 issue of Cancer Care magazine. Hear radio interviews about bone marrow transplantation with Matthew Elkins, MD, PhD, Upstate’s medical director of transfusion medicine, and with Charlene Hubbell and Susan Byrns, Upstate’s stem cell program laboratory supervisor and bone marrow transplant coordinator, respectively.

 

Posted in cancer, community, genetics, health care, illness, international health care, organ donation/transplant, patient story, volunteers | Leave a comment

Going the distance: Good news, good vibes help runner regain footing after stroke

Several months after his stroke, Kyle Reger takes a walk with his wife, Martha Velky-Reger, and their sons, Jackson, left, and Max, this spring near their Cazenovia home. (PHOTO BY SUSAN KAHN)

Several months after his stroke, Kyle Reger takes a walk with his wife, Marla Velky-Reger, and their sons, Jackson, left, and Max, this spring near their Cazenovia home. (PHOTO BY SUSAN KAHN)

BY JIM HOWE

Months after dragging himself across a hotel room floor to phone for help, Kyle Reger, 41, has diligently worked his way toward recovery from a stroke.

Physical therapist Daisy Sandbek works with Reger in University Hospital's Rehabilitation Center last September. (PHOTO BY ROBERT MESCAVAGE)

Physical therapist Daisy Sandbek works with Reger in University Hospital’s Rehabilitation Center last September. (PHOTO BY ROBERT MESCAVAGE)

That meant weeks in a hospital bed, months of rehabilitation and — particularly hard for a lifelong athlete and runner who has finished marathons — having to depend on others for things like car rides as he struggled to regain the use of his left side.

Throughout his recovery, Reger was bolstered by the support of his family and friends, his hometown of Cazenovia and his employer, and he learned a new appreciation for the little things, like being able to pick up and use a pepper shaker.

Further, some long-awaited good news arrived during his rehabilitation. Reger and his wife, Marla Velky-Reger, were told that their son Max, a first-grader, is now considered cancer free.

Reger, who travels the Northeast for his sales job, was alone in a Massachusetts hotel room on Sept. 4 when he awoke with a calf cramp in the wee hours of the morning. He had run the night before.

“I remember trying to flex my toe, to prevent it from continuing, and I couldn’t flex my toe, and I just thought it was odd,” Reger said. Then he noticed his left side felt asleep, and he tried to jump out of bed to shake it out but crashed onto the floor instead.

Reger speaks with Shernaz Hurlong, DO, the physician overseeing his rehabilitation, at a session in September. (PHOTO BY ROBERT MESCAVAGE)

Reger speaks with Shernaz Hurlong, DO, the physician overseeing his rehabilitation, at a session in September. (PHOTO BY ROBERT MESCAVAGE)

It finally dawned on him: He was having a stroke.

He managed to drag himself to the phone and call for help.

He was admitted to Springfield’s Baystate Medical Center, with a bleed in his brain, a hemorrhagic stroke. Six days later, he was transferred to Upstate University Hospital in Syracuse, where he stayed about three weeks.

“I don’t think I could move anything when I arrived at Upstate,” he says, but in the months of outpatient rehabilitation that followed – working with parallel bars, bikes and other equipment – he has been relearning how to use his left hand, arm and leg.

From the thrill of watching his thumb move a tiny bit to walking (at first with a cane) to being able to drive a car again in February, he estimates his abilities have come back about 90 percent, enough to play the piano.

His doctors concur.

“Having a positive attitude and an active lifestyle prior to his stroke have certainly helped him progress,” says Shernaz Hurlong, DO, the physician overseeing Reger’s rehabilitation.

“He made an excellent recovery in part because of his good health and excellent attitude, but also because he received expert care at the hospitals he was taken to. This gave his brain the best possible chance to heal itself. He’s well on his way to a full recovery,” agrees Lawrence Chin, MD, Upstate’s chairman of neurosurgery. Reger’s stroke resolved itself and did not require surgery.

Friends, neighbors and former college soccer teammates held fundraisers to defray his medical costs, brought meals, drove him to appointments and cheered him on.

His company hired a retiree to help cover his job, and Reger returned to work part time in December, then full time in February. Being able to drive again was “a huge gain to my mental health” he says, both restoring his independence and ability to work and relieving some of the strain on his wife.

Reger with his son Max, 7, who is now considered free of cancer after being treated for WIlms' tumor as a toddler. (PHOTO BY SUSAN KAHN)

Reger with his son Max, 7, who is now considered free of cancer after being treated for WIlms’ tumor as a toddler. (PHOTO BY SUSAN KAHN)

The couple has two sons, Jackson, 3, and Max, 7, who was diagnosed with Wilms’ tumor, a kidney cancer, at 16 months and underwent chemotherapy, the removal of a kidney and radiation treatments. Max recently achieved “survivor” status, meaning he has been free of cancer for five years.

Max ran the Chilly Chili 5K, a January race in Cazenovia, then returned to walk the route alongside his father, who was determined to finish the course, and did.

Reger hopes to be able to run again by the end of summer and to do a marathon again someday. He also considers himself blessed for the support and insights his stroke revealed.

What is a stroke?

Stroke occurs when a blood vessel to the brain either bursts or is blocked, thus killing brain cells. Stroke is the fifth leading cause of death and a leading cause of disability in the U.S. All strokes and TIAs should be treated as emergencies with immediate attention.

Ischemic strokes occur when clots block the flow of blood to the brain. They account for about 87 percent of all strokes.

The other 13 percent are hemorrhagic strokes, which occur when a blood vessel in the brain breaks, resulting in blood seepage and damage to brain cells.

A transient ischemic attack or TIA, sometimes called a “mini-stroke” is temporary, often lasting only a minute or more and usually leaving no lasting damage.

Source: American Heart Association/American Stroke Association

Layout 1hloa-art2This article appears in the summer 2016 issue of Upstate Health. Hear interviews about various aspects of stroke — how to recognize one; how today’s treatment is rapid and minimally invasive;  the surgical options; the relationship to atrial fibrillation; support groups; and how emergency response is coordinated throughout the region.

Posted in brain/neurology, community, disability, health care, HealthLink on Air, illness, physical therapy/rehabilitation, stroke | 1 Comment

Clean cooking Mother-daughter team turns love of healthy food into blog

Killian Cardinali in her kitchen with protein pancakes and blueberry sauce. (PHOTO BY SUSAN KAHN)

Jillian Cardinali in her kitchen with protein pancakes and blueberry sauce. (PHOTO BY SUSAN KAHN)

BY JIM HOWE

A lifelong interest in fresh, healthy food and a love of cooking together inspired an Upstate physical therapist and her mother to launch a food blog in their spare time.

Jillian Cardinali, DPT, of Liverpool, grew up on a farm in Fredonia, south of Buffalo, where her mother, Michelle Johnson, still lives. Together, they started The Clean Cooks blog in 2014. “Clean” means not processed. Their recipes avoid white sugars and highly processed grains.

“We’ve always loved to cook, and then when I moved away, I missed cooking with my mom,” Cardinali explains. “We still call each other to share recipes. The blog evolved from there.”

Much of the blog is devoted to advance preparation.

“Because we both work full time, meal prep is a huge part of our blog,” says Cardinali. “A lot of people say, ‘I want to eat healthy, but I don’t have time.’ If you prepare ahead of time what you want, what your diet is going to be, then you have more control.”

For someone just starting out with meal prep, Cardinali suggests preparing a week’s worth of snacks, and then building up to the larger meals.

She spends part of each weekend making a list for the week of the foods she plans to eat for breakfasts, lunches and dinners. Typically she cranks a Taylor Swift album while cooking.

Cardinali is known for her mason jar salads, wide-mouthed jars containing all the makings of a green salad.

“If you build your salad with your heaviest ingredients on the bottom and your light greens on top, I have successfully eaten salads that are made eight days prior. No one believes me until they do it.”

Meats, cheeses or croutons can be kept atop the salad in a zip-lock bag or small recycled fruit cup.

Cardinali and Johnson aim to post one new recipe each week. Most are original, although they choose some recipes from elsewhere and “clean” them to eliminate sugar or gluten.

Protein pancakes with blueberry sauce

From The Clean Cooks

Pancake ingredients:

1 cup egg whites

1 cup cottage cheese

1 cup old-fashioned oats

2 teaspoons vanilla

1 teaspoon cinnamon

1 teaspoon lemon juice (optional)

1 teaspoon baking powder (optional)

¼ cup coconut flour (optional)

Coconut oil for griddle

Note: The lemon juice, baking powder and coconut flour can be omitted without affecting the recipe, but adding them will bring depth to the flavor.

Preparation:

Combine all ingredients in a blender and blend until smooth. Cook on a griddle with coconut oil. Flip pancakes when bubbles appear and edges are slightly dry. Serve with Blueberry Sauce. Makes 15 pancakes (3 pancakes per serving).

Blueberry sauce ingredients:

1 cup blueberries

1 cup raspberries

1 cinnamon stick

1-inch piece of fresh ginger

2 tablespoons water

1 teaspoon honey

¼ teaspoon vanilla powder (ground vanilla bean)

Preparation:

Bring all ingredients to a boil in a saucepan. Allow to simmer for 10 minutes, stirring occasionally. Remove cinnamon stick and ginger.

Nutritional information

Pancakes:

Serving size: 3 pancakes

173 calories

16.7 grams protein

19.2 grams carbohydrates

3.1 grams sugar

2.7 grams total fat

2.3 milligrams cholesterol

448.4 milligrams sodium

4.2 grams fiber

Nutritional information

Blueberry sauce:

Serving size: 2 tablespoons

11 calories

3 grams carbohydrates

2 grams sugar

1 gram fiber

zero protein

zero fat

zero cholesterol

zero sodium

Layout 1 finalThis article appears in the spring 2016 issue of Upstate Health magazine.

Posted in community, diet/nutrition, physical therapy/rehabilitation, recipe

Why I served my country: Veterans tell how military experience opened doors, broadened outlooks, taught valuable skills

Upstate veterans and friends at the Central New York Veterans Day parade in 2012. (PHOTO BY SUSAN KEETER)

Upstate veterans and friends at the Central New York Veterans Day parade in 2012. (PHOTO BY SUSAN KEETER)

BY JIM HOWE

For some it was a way to afford college or gain entry into the working world. For others, it was duty.

Military service changes the lives of many Americans, including several who now work in a variety of jobs at Upstate. They are influenced by lessons and skills learned in the Army, Navy, Air Force, Coast Guard or Marine Corps.

Don Sadeckas was a military police officer in the Army who retired as a sergeant first class in 2001. He still feels pride when he sees a military member in uniform, knowing that they are up to whatever comes at them.

“I am proud to be a veteran, and I am also proud of those who served before and after me. I thank them every opportunity I get,” he says.

When Yetta Williams enlisted in the Air Force, she at first didn’t recognize the significance of her role. It began sinking in when she arrived at Lackland Air Force Base in Texas.

“We were told that we were now ambassadors for the president of the United States, and that we should be aware of that at all times and conduct ourselves accordingly,” she recalls. “It occurred to me that I didn’t just represent myself. I represented my family, my church, Christ, the company I work for. I have never forgotten that.”

Williams married an airman named Austin, who now works at National Grid.

Of no relation is an Upstate coworker, Elliott Williams, who says men from his family have served in every war or conflict in America’s history from the Civil War to Iraq.

“Being a veteran is more than just a label or a title. It is who and what you are,” he says. “Though I am far removed from military service, I am still a soldier and always will be – just like those relatives who came before me and those who will come after me.”

Among the more than 9,000 employees at Upstate Medical University are 251 military veterans. Here’s what eight have to say about their experiences serving America.

Elliott Williams

Elliott Williams

Name: Elliott Williams of Auburn.

Upstate job: Patient registration in the emergency department.

Military service: Army, 1980-83.

Reason for joining: Family obligation. “My family has produced soldiers and sailors in every war or conflict in this country’s history from the Civil War to the present-day Iraq conflict. All males in my family are expected to participate in some type of military service.”

What he gained: “Being from Brooklyn, I had already been exposed to different cultures, but going to different countries (at age 18, he was stationed in Camp Stanley, South Korea) and seeing those cultures in their native lands and living by their own traditions, I quickly learned I was wrong about thinking one group of people was fundamentally better than another group of people because of money or educational status or color or whatever. I learned that there is no better or worse when it comes to people, there is only different: different lands, norms, beliefs, languages, etc.”

Gregory L. Eastwood, MD

Gregory L. Eastwood, MD

Name: Gregory L. Eastwood, MD, of Jamesville.

Upstate job: Professor of bioethics and humanities and former president of Upstate Medical University.

Military service: Navy, 1972-74.

Reason for joining: “During the Vietnam War, military service was required of male physicians either after one year of residency or after full training. I entered the Navy after full training in internal medicine and gastroenterology.”

What he gained: “My two years in the Navy allowed me to improve my clinical skills. Also, I was able to spend about half my time doing research, and I developed close personal and professional associations with several people, which persisted for many years after I left the Navy.”

Don Sadeckas

Don Sadeckas

Name: Don Sadeckas of Cicero.

Upstate job: Director of equipment and supply logistics.

Military service: Army, 1980-2001.

Reason for joining: “It was a great opportunity to travel, meet great people and do things that I never imagined or thought I would do. I was fortunate to serve during a time when there were not many conflicts in the world and only a small portion of the military needed to deploy.”

What he gained: “Three lessons I took with me: 1. Appearance matters. Dress for who you will meet, not for the day of the week. 2. You can’t do everything on your own. Most successes come from teamwork. 3. Confidence is king. Don’t second-guess yourself.”

William Marx, DO

William Marx, DO

Name: William Marx, DO, of Jamesville.

Upstate job: Chief of the division of trauma, critical care, burns and acute-care surgery.

Military service: Army, 1978-2001.

Reason for joining: “I had a Health Professions Scholarship to pay for medical school.”

What he gained: “I learned structure, leadership skills and surgery. My residency was at Letterman Army Medical Center on the Presidio of San Francisco. We had a very close relationship with the University of California at San Francisco, so I was able to learn from the surgical faculty at UCSF and from the faculty at Letterman. The residency was excellent, and I am fortunate to have had the opportunity.

“I think my service affects all aspects of my career and life. I appreciate the things most people take for granted. To use a cliché, freedom isn’t free.”

Willie White

Willie White

Name: Willie White of Jamesville.

Upstate job: Central receiving manager.

Military service: Army, 1977-98.

Reason for joining: ”I was ill-equipped to attend college. I was still in high school and decided in advance that I was going to join the Army to get experience in something that would become a career.”

What he gained: “Leadership qualities. Being a team player. Diversity. Multitasking. Opportunities that I never would have had if I remained in my small world and surroundings, opportunities to travel and experience different cultures, countries and even other states; to learn skills and earn a living through my experiences and travels; and just being a part of something bigger while serving my country.”

Yetta Williams

Yetta Williams

Name: Yetta Williams of Syracuse.

Upstate job: Staff assistant in environmental services.

Military service: Air Force, 1974-78; Army wife, 1980-1983.

Reason for joining: “I couldn’t get the kind of job I wanted because I had no experience, and I couldn’t get any experience because no one would hire me without experience.”

What she gained: “I learned to be flexible and adapt to change. Life is full of changes on and off the job. I learned to change direction and to take a stand, as necessary. When told to do a task that I really don’t want to do, military service taught me to grit my teeth and do it without complaint.“

Nancy K. Markowski

Nancy K. Markowski

Name: Nancy K. Markowski of Erieville.

Upstate job: Nursing station clerk in the medical intensive care unit.

Military service: Army, 1979-81.

What she gained: ”Discipline, strength, training — and how much I love this country.”

Timothy P. Endy, MD

Timothy P. Endy, MD

Name: Timothy P. Endy, MD, of Manlius.

Upstate job: Chief of infectious disease division.

Military service: Army, 1982-2006.

Reason for joining: “Medical education, and to serve my country.” He grew up on Air Force bases around the world, watching B-52 bombers taking off from Plattsburgh during the Cuban Missile Crisis, and watching medical evacuation planes landing in Japan near the end of the Vietnam War.

What he gained: “As an active-duty medical officer, I helped soldiers prepare for both Gulf wars and vaccinated soldiers as they pre-deployed in Kuwait for Gulf II. I remember the strength of the wounded soldiers with terrible wounds and amputations as I took care of them and their infections at Walter Reed (Army Medical Center in Washington, D.C.) I’m proud to have served with such great Americans.”

Layout 1 finalThis article appears in the spring 2016 issue of Upstate Health magazine.

Posted in community, education, health careers, history, volunteers

A sculptor shares her life history

45th Anniver055

Dorothy Riester speaks at the 45th anniversary of the opening of Upstate University Hospital as hospital CEO John McCabe, MD, listens. In the background is her bronze commemorative plaque, which was reinstalled in the hospital lobby in 2010. (PHOTO BY WILLIAM MUELLER, NOV. 23, 2010).

BY JOEL POTASH, MD

On the back wall of Upstate University Hospital’s lobby is a bronze plaque memorializing the Syracuse Dispensary. It was created in 1964 by the artist Dorothy Riester.

As she neared her 99th birthday last fall, Riester published an enlightening and enjoyable book of her life called “The Art of a Life, a Memoir,” by Dorothy Riester as told to Victoria Kennedy.

Riester's book is $25 plus shipping at stonequarryhillartpark.org or by mail at PO Box 251, Cazenovia, NY 13035. Proceeds go to the Stone Quarry Hill Art Park.

Riester’s book is $25 plus shipping at stonequarryhillartpark.org or by mail at PO Box 251, Cazenovia, NY 13035. Proceeds go to the Stone Quarry Hill Art Park.

Reading it called to my mind two things: a sign on the Onondaga Nation that says “Respect The Elders” and a lesson in communication skills taught to medical students called a “life history.” The value of a life history comes both from the listener paying close attention to the uniqueness of a person’s life story and the therapeutic exercise of the teller/writer letting herself be known.

Riester was born in Pittsburgh on Thanksgiving in 1916. She was the product of a happy marriage and had a sister named Bet. Her father instilled in her a love of nature, taking her on long rambles and encouraging her sense of freedom: “I was adventurous and impulsive all my life,” she writes. Her mother may be responsible for her love of flowers and floral design.

Riester began art lessons at age 12, “as a physical way to feel experience.” Before attending Carnegie Institute of Technology (now known as Carnegie Mellon University), she went to the College of William and Mary. She remembers hearing novelist Gertrude Stein say, “When you know what you want to do, just do it.”

She studied ceramics at the University of Pittsburgh and was apprenticed to a wood-carver, but mostly Riester developed her own talents. She met the man who would become her husband in the detention room in high school in the 10th grade, and her book relates their wonderful love story. Bob Riester was an inventor, a silent type, pipe in hand or mouth at all times — and supportive of her art. They married in 1939.

While at Carnegie, where she later taught design and art, Riester and her husband bought an old farmhouse/barn with no heat, light or water. They restored the structure and built an art studio. At that time sculpture was primarily the reproduction of the human form in clay or bronze. Riester introduced the use of steel and abstract art, requiring heavy machinery and welding, to Carnegie.

When the Riesters moved to Syracuse, where she received a master’s degree and taught art at Syracuse University, they bought a house on Townsend Street and restored it as a home and studio. Later they designed and built, with some help, their home on Stone Quarry Road in Cazenovia. It began as a summer home, in 1958. They expanded it and moved there year-round in 1965.

In 1991 they incorporated the 104-acre Stone Quarry Hill Art Park as a not-for-profit, “a place where artist and nature could interact,” and where Riester was truly an artist in residence.

Twenty years later, National Geographic listed the Art Park No. 2 among sculpture parks and trails in “Secret Journeys of a Lifetime, 500 of the World’s Best Hidden Travel Gems.” The home and studio were placed on the National Register of Historic Places in 2014.

For those of us getting up in years and for younger people with visions and hopes for a future long life, this book is an inspiration. It includes many photos of Dorothy throughout her life as well as photos of her art and sculptures.

Joel Potash, MD, is an emeritus professor at Upstate’s Center for Bioethics and Humanities and a member of the Board of Directors of Stone Quarry Hill Art Park.

 This article appears in the spring 2016 issue of Upstate Health magazine.

Posted in bioethics & humanities, community, education, entertainment, history

Diana’s reason for donating blood

Diana Pelletier

Diana Pelletier

By Stephanie DeJoseph

Nine years ago this June, Diana Pelletier of Camillus was in a serious car accident. She was driving her husband, 22-month-old toddler and 3 1/2-week-old infant when the car crashed, flipping over three times.

Her family was fine, but Pelletier was seriously hurt. She broke her neck and lost a lot of blood.

Four weeks in the intensive care unit at Upstate University Hospital, followed by five months in the hospital and a lengthy recovery gave Pelletier time to think about the importance of donating blood. The accident left her in a wheelchair and unable to drive for three years. She still comes to Upstate for physical and occupational therapy. And, now she is a regular at Upstate’s blood drives, where she donates a maximum four times a year.

“I wouldn’t be here today if it weren’t for the generosity of others,” she says. “Blood donation is the renewable resource that takes so little time and gives so much to others.”

The hospital’s spring blood drive will be held from 9:30 a.m. to 5 p.m. Thursday, April 21 and  from 7 a.m. to 1 p.m. Friday April 22, in Café 750 on the second floor of Upstate University Hospital’s Downtown Campus. To schedule an appointment, contact Linda Underwood at underwol@upstate.edu or 464-6755.

Posted in community