10 days in Ghana: Upstate volunteers help build community in Africa

Upstate nurse Meghan Lewis gives a Days for Girls reusable menstrual kit to a young mother at a market in Kumasi, Ghana. (PHOTO BY SUSAN KEETER)

Upstate nurse Meghan Lewis gives a Days for Girls reusable menstrual kit to a young mother at a market in Kumasi, Ghana. (PHOTO BY SUSAN KEETER)

BY SUSAN KEETER

Near the end of an 11-hour flight from New York’s John F. Kennedy International Airport, we finally see Ghana out the plane’s windows: saffron-colored earth and lush green foliage dotted with bright blue and pastel pink buildings. The country’s beauty is overwhelming.

We descend into Accra, the African nation’s capital, and the plane passes over the Gulf of Guinea, which I later learn has the most beautiful white sand beach that I have ever seen.

Nearly 1,000 girls assembled in an open-air classroom at Namong Senior High School in Offinso, Ghana, to receive menstrual education from a team of ASAP volunteers. Students with the greatest need received reusable menstrual kits made by the nonprofit organization Days for Girls. At right in the blue flowered dress is Nancy Addo, headmistress of the school. At far right, seated, is Upstate nurse Maisha Brown, a volunteer for ASAP, which stands for the Americans Serving Abroad Program. (PHOTO BY MEGAN LEWIS)

Nearly 1,000 girls assembled in an open-air classroom at Namong Senior High School in Offinso, Ghana, to receive menstrual education from a team of ASAP volunteers. Students with the greatest need received reusable menstrual kits made by the nonprofit organization Days for Girls. At right in the blue flowered dress is Nancy Addo, headmistress of the school. At far right, seated, is Upstate nurse Maisha Brown, a volunteer for ASAP, which stands for the Americans Serving Abroad Program. (PHOTO BY MEGAN LEWIS)

Getting through checkpoints and searches of some of our 24 suitcases and backpacks at the airport takes a couple of hours. The place is huge, confusing and packed with humanity, reminding me of Manhattan’s Penn Station. Thankfully, all signs are in English, the official language of Ghana.

Lauri Rupracht, an Upstate pediatric nurse and founder of the Americans Serving Abroad Program, or ASAP, holds a baby during a November 2017 mission trip in Ghana. (PHOTO BY MEGHAN LEWIS)

Lauri Rupracht, an Upstate pediatric nurse and founder of ASAP, holds a baby during a November 2017 mission trip in Ghana. (PHOTO BY MEGHAN LEWIS)

The head of our team is Lauri Rupracht, an Upstate nurse and director of the Americans Serving Abroad Program (ASAP), a nonprofit organization she founded four years ago. This is her ninth mission trip to Ghana. This time she is leading seven volunteers — Upstate nurses Maisha Brown, Cyndy Carr and Meghan Lewis; Qiana Williams, an educator from Syracuse; Traci Bender, a social worker from Buffalo; Sara Tucker, a college student; and me, an Upstate graphic artist.

We are on a 10-day mission trip to work with women and children in rural Ghana to address needs identified by the Ghanaian nonprofit organization Sem Fronteiras: menstrual education, oral health, dementia awareness and literacy.

Maisha Brown, a pediatric nurse at Upstate, shows a chart of the reproductive system to female students at Fufulso Presbyterian Primary School. The students and teachers speaks different Ghanaian languages, but all read and speak English. (PHOTO BY MEGHAN LEWIS)

Maisha Brown, a pediatric nurse at Upstate, shows a chart of the reproductive system to female students at Fufulso Presbyterian Primary School. The students and teachers speaks different Ghanaian languages, but all read and speak English. (PHOTO BY MEGHAN LEWIS)

We are greeted by Agyapong Gyamfi, chief operating officer of Sem Fronteiras (which means Without Borders), and his assistants, Lawrence Osei Asamoah and Isaac Appiah, who we quickly learn will be our guides, protectors and teachers for the entire trip.

We board a small school bus and take off on the highway, which was built with support from the United States during the administration of President George W. Bush.

Cyndy Carr, an oncology nurse at Upstate, with a group of Ghanaian students who received toothbrushes and toothpaste -- and instruction on good brushing habits -- as part of an oral health program. (PHOTO BY MEGHAN LEWIS)

Cyndy Carr, an oncology nurse at Upstate, with a group of Ghanaian students who received toothbrushes and toothpaste — and instruction on good brushing habits — as part of an oral health program. (PHOTO BY MEGHAN LEWIS)

If it weren’t for the sheep and chickens by the side of the road, I’d think we were driving through the Bronx. The traffic is crazy. We see gleaming high-rise office and apartment buildings, but much of the roadside looks like a ramshackle farmers’ market. There are sheds built of scrap wood, corrugated tin and palm fronds, plus the occasional crashed car or truck left by the side of the road.

Street vendors maneuver between the lanes of whizzing cars, selling plantain chips, chocolate bars and small plastic bags of drinking water (tap water in Ghana is not safe to drink). Most are women carrying their wares on their heads.

It is a six-hour drive north to Offinso, the district where we will be doing most of our work. We quickly become accustomed to the unpredictable functioning of things in Ghana. A public bathroom may have sinks, but no running water. The guest house may have air-conditioning, but multiple power outages. Ghana is, as Rupracht tells us, “a good place to practice flexibility.”

The villages are quieter and more peaceful than the capital, and I continue to be wowed by the beauty that is everywhere: the artistry of kente cloth clothing, the rich colors of buildings, the golden dirt paths and tropical flowers. Everywhere, groups of children play outside, women walk and talk, and clusters of men sit together in the shade. The atmosphere is warm and sociable.

Meghan Lewis, an oncology nurse at Upstate, and Traci Bender, a social worker from Buffalo, give fluoride to two of the 372 students who received treatments. (PHOTO BY AGYAPONG GYAMFI)

Meghan Lewis, an oncology nurse at Upstate, and Traci Bender, a social worker from Buffalo, give fluoride to two of the 372 students who received treatments. (PHOTO BY AGYAPONG GYAMFI)

The sun sets at 6 p.m., as it does year-round. The first morning in Offinso, we begin by meeting with street women and children at a market in Kumasi, the capital city of the Ashanti region.

We do a presentation on the menstrual cycle, answer questions and distribute reusable menstrual kits, multivitamins and mosquito tents to protect the women and children from malaria, a leading cause of death in children under 5. Over 10 days, we provide services to more than 1,500 people.

The November 2017 mission was a community development trip. This spring, Rupracht is leading a larger mission of volunteers to provide medical care.  

To learn how to donate or participate, go to healthlinkonair.org and search “Ghana” or visit, www.asap.ngo

Women’s health/menstrual education

For girls in Ghana, starting their periods may lead to ending their education. Many, especially in poor, rural communities, lack access to sanitary napkins or any equipment to manage menstruation.

A young woman holds the "Days for Girls" reusable cloth menstrual kit she received at an ASAP presentation for street women in Kumasi, Ghana. (PHOTO BY SUSAN KEETER)

A young woman holds the “Days for Girls” reusable cloth menstrual kit she received at an ASAP presentation for street women in Kumasi, Ghana. (PHOTO BY SUSAN KEETER)

As a result, they miss several days of school each month, which leads to falling behind in classes and eventually quitting school. An unfinished education often condemns women to lives of limited opportunity and poverty.

To begin to combat this problem, volunteers used flip books to teach students about the menstrual cycle, female anatomy and ways to care for the body. Upstate nurse Meghan Lewis answered questions such as, “If the menses does not come, should I drink medicine to make it come?” The team demonstrated how to use the reusable cloth menstrual kits that are made by Days for Girls sewing groups across the United States. All female students received the training, and those with the greatest need received kits. In addition to visiting schools, volunteers distributed kits and did the training with a group of women living in the streets in Kumasi.

The goal of future missions is to provide manufacturing equipment and train staff and students at a vocational school in Offinso to sew the kits.

Dental health

Students played a game of selecting foods that are good for your teeth and foods that are bad for your teeth. (PHOTO BY SUSAN KEETER)

Students played a game of selecting foods that are good for your teeth and foods that are bad for your teeth. (PHOTO BY SUSAN KEETER)

The challenge was to find practical dental care solutions for children who have limited access to safe drinking water and no access to dentists.

Volunteers used illustrated posters to explain the causes and progression of tooth decay and played a game challenging students to identify foods that are good for teeth (yams and bananas) and bad for teeth (soft drinks and candy).

Students took turns demonstrating proper brushing on a large anatomic model of teeth.

Volunteers gave fluoride treatments to the youngest students and distributed toothbrushes and toothpaste donated by dental offices in Central New York.

Dementia awareness

According to Agyapong Gyamfi, ASAP founder Lauri Rupracht’s counterpart in Ghana, dementia is a misunderstood and undiagnosed condition in Ghana, resulting in the isolation and, in some cases, mistreatment of elders. The volunteers’ goal was to help children recognize dementia symptoms and develop constructive ways to interact with elders affected by the disease.

Rupracht created role-playing skits for the classrooms. Volunteers asked students, “Does an elderly person in your family forget things or get confused?” and described scenarios such as, “There are lots of visitors and noise in your home and the elderly person starts to get agitated.” Volunteers took turns portraying the elderly person and family members who behaved badly (yelling) or constructively (talking softly and helping the elder to a quiet place). Then, students were asked to come up with ideas for good ways to help elderly people with dementia.

Keeter, Rupracht and Gyamfi are creating a book on dementia for children in Ghana.

Literacy

English is the official language of Ghana, and classes are taught in English beginning in elementary school, but there are more than 50 Ghanaian languages. Volunteers visited schools in the Ashanti region, where Twi is the primary language spoken.

Every school received autographed copies of “My Daddy’s Eyes” by Syracuse author Fatimah Salaam. (PHOTO BY SUSAN KEETER)

Every school received autographed copies of “My Daddy’s Eyes” by Syracuse author Fatimah Salaam. (PHOTO BY SUSAN KEETER)

They began by reading a children’s book aloud and asking students to repeat the text to practice their spoken English language skills. Each child created his or her own book by completing sentences such as  “I am…” and “I like…” on preprinted sheets and illustrating their words with colored markers donated by ASAP. “Beautiful,” “gifted,” “talented,” “clever,” “helpful,” “intelligent” and “good boy” were words the students used to describe themselves in the books they created.

These young men are making their books during the literacy program. They walk four hours to attend school in an outdoor classroom with a dirt floor and metal roof supported by tree branches. (PHOTO BY SUSAN KEETER)

These young men are making their books during the literacy program. They walk four hours to attend school in an outdoor classroom with a dirt floor and metal roof supported by tree branches. (PHOTO BY SUSAN KEETER)

 

Upstate Health magazine spring 2018 coverHealthLink on Air logoThis article appears in the spring 2018 issue of Upstate Health magazine. Hear a podcast where Lauri Rupracht and fellow Upstate nurse Caitlin Phalen talk about their mission efforts in Ghana.

 

 

 

Posted in adolescents, Alzheimer's/dementia, community, health care, HealthLink on Air, international health care, nursing, prevention/preventive medicine, public health, women's health/gynecology | Tagged , , , ,

The halls are alive with the sound of music

Medical students Benjamin Meath and Joe DeRaddo perform in the Upstate University Hospital lobby as Abigail and Stephen McSweeney listen. (PHOTO BY SUSAN KAHN)

Medical students Benjamin Meath and Joe DeRaddo perform in the Upstate University Hospital lobby as Abigail and Stephen McSweeney listen. (PHOTO BY SUSAN KAHN)

BY JIM HOWE

Some volunteers are bringing live music — and, they hope, a smile — to patients and staff at Upstate University Hospital.

The Music at Upstate group includes strolling violinists and a guitar and vocal duo who play in the lobby at the downtown campus. Some of the performers have known each other since their high school days.

“Everyone is so welcoming and appreciates the music,” says Joshua Rim, a fourth-year medical student from New York City who helped organize the free performances. “We really love playing for patients. We can forget about life for a while.”

Rim plays the violin, as does Christine Ly, a fourth-year MD/PhD student. Also a native of New York City, she and Rim played in the same orchestra while in high school.

Ly says their performances “bring a bit of the outside world to the patients in the hospital, giving them a sense of change and sense of escape.”

She recalled an autumn day where the group played for fun in the Weiskotten Hall courtyard. “While we were just enjoying ourselves, the people listening came up to us and put money in our instrument cases. This meant a lot to me because their random act of kindness showed me that they really supported us and our music. We further relayed their support in us to the patients by donating the $64 we raised to the Upstate Cancer Center.”

Often joining Ly and Rim are violinist Dona Occhipinti, who works at the private firm Welch Allyn, and pianist Ben Craxton, an Upstate graduate who is now a resident physician in family medicine at St. Joseph’s Hospital Health Center. They sometimes can be heard practicing a mix of classical and other tunes in the early evening around the piano at the Upstate Cancer Center, which has long encouraged music as part of a healing atmosphere.

Sometimes just a couple of them will play together, strolling through the hospital or performing at Café Kubal in the Upstate Golisano Children’s Hospital.

The music program was organized through Upstate’s employee health series, Pathway to Wellness.

Rim also recruited the duo of Joe DeRaddo and Benjamin Meath, both third-year medical students. DeRaddo, from Seneca Castle, and Meath, from Clifton Springs, both attended Midlakes High School, outside Geneva.

DeRaddo played trumpet before moving to electric bass guitar. Meath played the drums, including in church, and trombone before teaching himself acoustic guitar in college. Each also played in garage bands in high school.

“We take pop songs and make them kind of ‘coffee-shoppy’ and acoustic. We’ll take (songs) like “Wagon Wheel,” “Wonderwall,” some Jackson Five and John Mayer and give a kind of easy-listening feel to it — definitely things you could hum along to,” DeRaddo says. Meath does the lead vocals, with DeRaddo doing harmonies.

The two have done some open-mic performing at the Campus Activities Building in addition to playing at the hospital.

“It’s just fun to be able to do what we enjoy in that kind of a setting,” Meath says. “A lot of people would give us a thumbs-up and crack a smile, and it was nice to be where we work and go to class every day and see other people, see some fun, some joy in other people’s lives. It’s a nice alternative to the rigors of medical school.”

DeRaddo agrees. “Music is definitely a way we can escape and ground ourselves every once in a while, and get out of the books.”

Medical student Joshua Rim and Dona Occhipinti of Welch Allyn perform for Aaron Johnson, a patient. (PHOTO BY SUSAN KAHN)

Medical student Joshua Rim and Dona Occhipinti of Welch Allyn perform for Aaron Johnson, a patient. (PHOTO BY SUSAN KAHN)

Upstate Health magazine spring 2018 coverThis article appears in the spring 2018 issue of Upstate Health magazine.

Posted in entertainment, health care, medical student

Concept of ‘designer’ babies raises thorny questions, few answers

'designer' baby graphicBY JIM HOWE

If parents could create a “better” baby, should they?

Would “better” mean a healthier child than the average baby? Cuter? Smarter? Taller?

Should scientists and doctors help parents to genetically customize an embryo that would become that better or “designer” baby?

The issue — still theoretical — brings up more questions than answers, as a visiting expert told an Upstate Medical University audience recently.

It is the latest chapter in a debate that stretches back at least as far as the early 20th century, when proponents of eugenics claimed they could improve society by selective breeding and forced sterilization.

cartoon of childGenetic engineering has proved popular in science fiction, from “Brave New World” to “Jurassic Park” and “Gattaca,” noted George Annas, JD, MPH, the William Fairfield Warren Distinguished Professor at Boston University and director of the Center for Health Law, Ethics and Human Rights at the BU School of Public Health, who has written and lectured extensively on health law and bioethics, including “Genomic Messages” co-authored with his longtime geneticist colleague, Sherman Elias.

Annas offered these points:

— “If we start selecting children based on characteristics, then we will start treating our children more and more like products or pets, rather than as real human beings.”

— A United Nations declaration against the genetic engineering of humans exists but carries no enforcement mechanism.

— It’s almost impossible in the United States today to get a broad societal consensus on anything, let alone how to handle genetic engineering. Scientists would need to mount a tremendous effort to educate a scientifically illiterate public before an informed debate could even start. Getting the world to a consensus would be even harder.

— Faith in genes as a sort of guarantee to how a child will turn out — he used the term “genism” — downplays the role played by the child’s upbringing and environment.

The biggest questions about the genetic engineering of humans: Who should decide whether such experiments should be carried out? And, would parents and scientists accept the strong possibility of unintended, even disastrous, results?

“We wouldn’t know whether genetic engineering is safe until we have followed at least three generations of humans, so it would take 60 to 80 years to know whether it’s safe,” he said.

“We’re in a situation where we can’t do this until we know it’s safe, and we can’t know it’s safe till we do it,” he concluded.

Upstate Health magazine spring 2018 coverThis article appears in the spring 2018 issue of Upstate Health magazine.

Posted in genetics, health care, maternity/obstetrics, research, technology

7 ways to care for aging skin

BY AMBER SMITH

What causes our skin to look old?

You can blame intrinsic processes, such as changes in lipid content and shortening of the capillaries, which are universal and inevitable. But the most visible signs of aging — including wrinkles and blotchiness — come from extrinsic factors, such as our sun or tanning bed exposure, smoking habits and other factors.

Ramsay Farah, MD, the chief of dermatology at Upstate, says that changes in the skin can affect the whole body.

Ramsay Farah, MD

Ramsay Farah, MD

Thermoregulation is one function of skin. “Our internal core body temperature has a lot to do with our skin,” Farah explains. “When the skin is diseased, whether it’s in the young or in the old, that ability to regulate our core body temperature is compromised.”

The nerves in our skin undergo physiologic changes and don’t work as well when we are old as they did when we were young. That relates to a common complaint. “The elderly tend to itch,” Farah says, providing the medical term: pruritis. “We don’t know exactly why they itch, but it must surely have something to do with cutaneous nerve endings.”

Also, “the skin is one of the first barriers or points of contact our immune system has with the outside world,” the dermatologist says. With a depleted number of immune cells in the skin, an older person’s immune system is less effective against germs of all types.

We can’t stop time. So, what can we do to care for aging skin?

  1. Sunscreen is still important. Older skin has less of an ability to repair DNA damage that occurs during exposure from the sun or ultraviolet light, so making sure skin is protected will help reduce that threat. And, be aware of skin changes. Decades of DNA damage can lead to skin cancers in one’s senior years.
  2. Moisturize. Farah says this is the least costly and most effective step you can take to protect your skin. Find an over-the-counter lotion or cream that contains ceramides. Blot dry after showering, leaving a little bit of water on the skin. Within three minutes, liberally apply the moisturizer.
  3. Bathe using lukewarm water, with a soap such as Dove or Aveeno that contains oil. Avoid products containing perfumes because they can contribute to dry skin.
  4. Use a humidifier. Moisture in our skin evaporates when the surrounding air is dry. A humidifier can combat that dryness.
  5. Eat a healthy diet. Vitamins and minerals in fruits and vegetables are good for your whole body, including the skin.
  6. Practice good hygiene. If an older person has become infirm, he or she may need help with this.
  7. Consider hormonal therapy. Women who take estrogen supplements may improve their skin’s ability to retain moisture.

As it ages, skin:

— is drier because it retains less water.

— becomes thinner and more sensitive.

— loses the ability to regenerate quickly.

— is more prone to inflammation.

— has fewer immune cells.

— loses sweat glands, decreasing the ability to regulate body temperature.

— experiences decreased blood flow.

— can bruise more easily because of a reduction in collagen.

— undergoes physiological changes in the nerves.

— may develop skin cancer from cumulative DNA damage.

Upstate Health magazine spring 2018 cover

This article appears in the spring 2018 issue of Upstate Health magazine. To hear a podcast/radio interview in which Farah speaks about the special needs of aging skin, click here.

Posted in aging/geriatrics, dermatology/skin care, health care | Tagged , ,

Maybe less harmful – but not harmless: Use of e-cigarettes carries health risks

An e-cigarette, also called a vape pen, for vaping -- inhaling the vapor -- of the liquid nicotine within.

An e-cigarette, also called a vape pen, for vaping — inhaling the vapor — of the liquid nicotine solution within.

BY AMBER SMITH

A pharmacist in China in 2007 developed the first of what scientists call an electronic nicotine delivery system — what’s now known as an electronic cigarette or e-cig.

Seeking to kick his own smoking habit, the pharmacist designed the device as a substitute for combustible tobacco products, explains Lee Livermore, public education coordinator for the Upstate New York Poison Center.

Ten years later, it’s not clear whether e-cigs are a better choice than regular cigarettes. But the use of e-cigs has soared, especially among American youth who may be attracted by the multitude of sweet flavorings and a new generational take on the old rebellious act of smoking. E-cig devices today come in a variety of styles. Some look like cigarettes or pipes. Others are disguised as asthma inhalers or thumb drives.

One of the most popular devices among youth is a brand called Juul, which is powered by a USB charger to provide an “intensely satisfying vapor.” The Boston Globe referred to ‘juuling’ as the most widespread phenomenon you’ve never heard of. Livermore suggests parents learn more about this trend because it’s showing up in junior and senior high schools throughout Central New York.

Both conventional and electronic cigarettes contain nicotine, plus other chemicals. Even e-cig liquid labeled “nicotine-free” has been found to contain the highly addictive substance, Livermore says. E-cigs typically contain a smaller amount of nicotine, but vaping (inhaling) habits may mean a person ingests a larger overall quantity of nicotine.

Some users carry their e-cig devices on lanyards around their necks, so it’s convenient to vape mindlessly and continually without scheduling any sort of smoking break, says Livermore. “If you’re using it more frequently and at higher and deeper rates, then you’re actually getting a higher level of nicotine into your system,” he says.

Some users put drugs other than nicotine into their e-cigs. Any chemical that can be converted into an oil or a liquid may be used; some devices are designed to burn finely ground plant material.

E-cigs don’t typically have the stink of tobacco cigarettes. Livermore says that disguises how harmful the products can be. As for the dangers of breathing in the secondhand vapor of an e-cig, he says studies are ongoing.

A report from the National Academies of Sciences, Engineering and Medicine analyzed the evidence available on vaping. It indicated that e-cigs may help adult smokers transition off of tobacco cigarettes, just as the pharmacist from China intended, but that the devices also may entice younger smokers to transition to tobacco cigarettes.

Livermore has studied the report’s findings. Depending on how it’s used, an e-cig may be less harmful than a conventional cigarette. “However, it by no means is harmless or safer,” he says. “You’re still consuming chemicals into the human body.”

The Upstate New York Poison Center is receiving an increased number of inquiries from school districts throughout Central New York concerned about the student vaping trend. The center provides public education. To learn more, call 315-464-5375.

What the research says

— Nicotine intake among experienced adult e-cigarette users can be comparable to that from conventional cigarettes.

— Exposure to toxic substances other than nicotine from e-cigarettes is significantly lower than from conventional cigarettes.

— Completely switching from conventional cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.

— E-cigarette use by youth and young adults increases their risk of ever using conventional cigarettes.

— E-cigarette use increases airborne concentrations of particulate matter and nicotine in indoor environments.

— Adolescents who use e-cigarettes have increased coughing and sneezing and increased asthma exacerbations.

— Drinking or injecting e-liquids can be fatal.

Source: National Academies of Sciences, Engineering and Medicine study sponsored by the U.S. Food and Drug Administration.

Upstate Health magazine spring 2018 cover

HealthLink on Air logoThis article appears in the spring 2018 issue of Upstate Health magazine. For a podcast/radio interview with Upstate New York Poison Center staffers Livermore and nurse Michele Caliva about e-cigarettes and vaping, click here.

Posted in adolescents, health care, poison center/toxicology, Smoking Cessation | Tagged , , , , ,

Why your baby needs tummy time

Baby crawlingBY AMBER SMITH

The American Academy of Pediatrics says babies need to be placed to sleep on their backs to reduce the risk of sudden infant death syndrome during the first year of life. But daily supervised play time while on their tummies is recommended for developmental reasons.

“You really want to start tummy time as soon as the baby is born, as long as they’re medically stable,” says Erin Wentz, PhD, an assistant professor of physical therapy at Upstate.

“Early tummy time can be done on the parent’s chest because the baby is most familiar and most comfortable around their parent. By placing them on their chest, the baby can smell their parent, they can hear their parent, and when they lift their head up, they’re close enough to see their parent.”

Wentz says this supervised time is important for babies to help strengthen their neck and trunk but also to stimulate exploration.

If you put your baby on his tummy and he sees a rattle lying on the floor nearby, he will naturally want to figure out what to do with his body in order to obtain the rattle.

“That is developing their cognitive abilities. They are problem-solving. They’re learning to persevere and stick with a task until they achieve it,” Wentz explains. “Once they obtain the rattle, then they want to talk about it — in their own way, of course — but they want to interact with those whom they are most familiar with. So that promotes not only their language development but their social development.”

Wentz is leading a study to determine the best daily cumulative amount of “tummy time” and seeks full-term newborns up to 8 weeks of age to participate. Families are placed into one of three categories: 0 to 30 minutes, 31 to 60 minutes, or 61 minutes or more.

“We ask the families to do their best to accumulate that much tummy time per day until the baby can transition in and out of sitting.”

The study continues with monthly home visits by Wentz until the baby reaches 18 months of age. “We want to compare the developmental curves from each of these groups, and that way we can get a better idea of how much tummy time we should be recommending.”

To learn more about the study, send Wentz an email at wentze@upstate.edu.

What is tummy time?

Tummy time is the deliberate placement of babies on their tummies for exercise and developmental reasons while they are awake. It should always be supervised. An Upstate researcher is trying to determine how much tummy time is best — and she is conducting a study that you can join.

Upstate Health magazine spring 2018 coverHealthLink on Air logoThis article appears in the spring 2018 issue of Upstate Health magazine. Click here for a radio/podcast interview with Wentz about the idea of tummy time.

Posted in fitness, health care, physical therapy/rehabilitation, Upstate Golisano Children's Hospital/pediatrics | Tagged

A change of plans: Stroke affects family routine, son’s career path

BY JIM McKEEVER

John Licata had a decade of experience in TV/film, print and marketing when he made an abrupt career change.

John Licata

John Licata

It was Father’s Day weekend of 2013. His father, John Licata Sr., suffered a stroke that left him with partial paralysis, some neurological deficits and blindness, which, fortunately, went away five days later.

Those five days, the lengthy recovery process and the caregiving role that was thrust upon John Licata’s mother, Sue, helped make him aware of the rewarding role of physical therapist.

As he saw physical therapists interacting with patients, Licata says, “I could see myself energized to do this, to contribute to somebody’s life.”

He had no science background, so Licata enrolled at Onondaga Community College. In two years, he completed the required courses, applied to and was accepted into Upstate’s Doctor of Physical Therapy program. He’s on track to graduate this spring.

Licata and his sister help their mother care for their father. As hard as it is on all of them, they realize the benefit of having each other for support.

Licata, who loves to write, is working on a book as part of an independent study course in his physical therapy program. It’s called “The Steaks Are Marinating: Reflecting on Life After Dad’s Stroke.”

“My dad was an awesome cook,” he recalls. “That Father’s Day weekend, he had marinated steaks. The plan was to play golf in the morning and cook out in the afternoon.”

The stroke changed those plans and others.

From his hospital room, as his speech returned, Licata’s father told his family: “The steaks are still marinating.”

Later, when Licata and his mother and sister finally went home, they cooked those steaks. As they ate, they realized it was likely the last meal they would enjoy that had been prepared by their patriarch.

“It was a symbolic moment of a family trying to gain acceptance,” says Licata. “It was the transition from what we were, to what we were becoming.”

Licata is not certain in which area of physical therapy he will specialize.

But he knows he will strive to connect with his patients and contribute to their lives.

Upstate Health magazine spring 2018 coverThis article appears in the spring 2018 issue of Upstate Health magazine.

Posted in brain/neurology, health care, health careers, physical therapy/rehabilitation, stroke

‘She’s alive today because of them’

Kaelynne Driscoll and Zulma Tovar-Spinoza, MD (PHOTO BY WILLIAM MUELLER)

Kaelynne Driscoll and Zulma Tovar-Spinoza, MD (PHOTO BY WILLIAM MUELLER)

BY SUSAN KEETER

Eight-year-old Kaelynne Driscoll and her father, Christopher, were riding an inner tube on Skaneateles Lake on July 6, 2016, when a wave knocked them off the tube and under water. They were struck by a boat and injured, Kaelynne severely. Two nearby boaters, Dave Goetzman and Eric Marcinkowski, heard screaming, helped the family pull the two out of the water and used towels and a shirt as tourniquets to slow blood loss from Kaelynne’s injuries.When the rescuers got the father and daughter to the dock, paramedics were waiting, thanks to the family’s 911 call.

The pediatric trauma team members saved Kaelynne’s life, said pediatric neurosurgeon Zulma Tovar-Spinoza, MD.  Kaelynne’s mother, Amber Ousler, remembers Tovar-Spinoza holding her hands and telling her, “Kaelynne is out of surgery. She has traumatic brain injury, but she’s alive.”

It would be several days before they would know if Kaelynne had permanent brain damage. Because of brain swelling, Tovar-Spinoza had to remove the left part of Kaelynne’s skull. Kaelynne was on a breathing machine for a week, so she could begin to heal.  She spent the first two of six weeks at the Upstate Golisano Children’s Hospital in the pediatric intensive care unit.

During that time, Kaelynne would undergo 10 surgeries, including two neurosurgeries to manage the swelling and bleeding in her injured brain. Four surgeries — amputation of her left leg above the knee, amputation of her left arm at the elbow, and the shaping of limbs for prosthetics — were performed by orthopedic surgeon Kathryn Palomino, MD, and plastic surgeon Jon Loftus, MD.

After four weeks in the hospital, Kaelynne was sitting up and beginning to talk again. Thankfully, cognitive testing showed no brain impairment. She started physical and occupational therapy.

Six weeks after the accident — wearing a helmet to protect her brain — Kaelynne and her family went to Boston’s Spaulding Rehabilitation Hospital for specialized pediatric amputee rehabilitation. Five weeks later, Kaelynne walked out on her first prosthetic leg and returned home to begin third grade. She started school a few days late because of her rehabilitation, attended for half days and tired easily. She was learning to walk again and still wearing her helmet. Kaelynne was healing.

It was time to replace the part of her skull that had been removed. Tovar-Spinoza designed a 3-dimensional model of the missing portion of Kaelynne’s skull, had it fabricated in plastic and installed it during a 1½-hour surgery. Kaelynne was back in the hospital for two weeks, disappointed to have part of her hair shaved again but remaining positive.

Kaelynne was stable for several months, but fluid buildup and swelling in her head became a problem. Trauma to her head was so extensive — Kaelynne’s jaw had been broken in three places during the accident — that it was difficult to locate the sources of swelling and fluid. She had MRIs and treatments at Upstate.

During the February 2017 school break, Kaelynne had another setback. While vacationing with her father and family in Disney World, she ended up in the emergency room of an Orlando hospital. Pockets of fluid caused the scars on Kaelynne’s head to burst. When they returned to Syracuse, Tovar-Spinoza met with Kaelynne and her parents, and they made the difficult decision to remove the prosthetic skull, knowing it was likely contaminated when the scars opened. This meant another surgery and another hospitalization. Kaelynne was back to wearing a helmet.

A new piece of skull was fabricated, and plastic surgeon Prashant Upadhyaya, MD, was brought in for a consult. The portion of Kaelynne’s scalp covering the prosthetic had weakened and shrunk. In November 2017, Tovar-Spinoza and Upadhyaya performed a joint surgery to install the new skull piece and move the scalp so that stronger skin would cover the site.

Throughout her ordeal, Kaelynne has remained the spunky, smart girl who amazes her parents, and her doctors. She’s at the top of her class at Homer Intermediate School and is an avid reader who loves to write stories and draw.  She has worked with staff at Hanger Clinic in East Syracuse to select the features of her prosthetic leg and arm. Kaelynne is playing soccer, swimming and has a prosthetic arm with movable parts so she can do gymnastics and dance. She’s designing leggings with sturdy fabrics for girls with prosthetic legs and front-zippered shirts for kids with prosthetic arms. Kaelynne dreams of becoming a fashion designer and an interior designer. She loves to create and has designed and built a nine-room dollhouse, with help from her mother and a family friend.

What do her parents think about the people who have cared for their daughter?  “Beautiful humans who are great professionally,” says her mother. Her father says, “Amazing. She’s alive today because of them.”

And her doctors believe Kaelynne is a brave young lady who never complained and always has a plan for her future.

Upstate Health magazine spring 2018 cover

This article appears in the spring 2018 issue of Upstate Health magazine. 

 

Posted in bones/joints/orthopedics, brain/spine/neurosurgery, emergency medicine/trauma, health care, patient story, surgery, Upstate Golisano Children's Hospital/pediatrics | 1 Comment

Burn survivor: New laser assists in patient’s recovery from house fire

Burn surgeon Joan Dolinak, MD, uses a laser to restore skin on the back and arms of Stephanie Bridge, who survived a fire that destroyed her home. (PHOTO BY SUSAN KAHN)

Burn surgeon Joan Dolinak, MD, uses a laser to restore skin on the back and arms of Stephanie Bridge, who survived a fire that destroyed her home. (PHOTO BY SUSAN KAHN)

BY AMBER SMITH

She lies on her stomach, exposing her bare back to a laser wielded by her surgeon.

“Dr. Dolinak saved my life,” Stephanie Bridge says emphatically, as she positions herself for treatment that will help restore the texture of her skin.

Burn surgeon Joan Dolinak, MD, took care of Bridge when a helicopter brought her to Upstate University Hospital in the early morning hours of Nov. 19, 2016. The skin of Bridge’s back and arms was burned by the flames of a house fire that nearly killed her.

Bridge shows her skin grafts prior to laser treatments. (PHOTO BY SUSAN KAHN)

Bridge shows her skin grafts prior to laser treatments. (PHOTO BY SUSAN KAHN)

Bridge remembers hoisting both her boxer and her bullmastiff puppy out a first-floor bathroom window. Opening the window created a backdraft; Bridge ended up on the floor outside the bathroom. She reached for a towel to cover her face. She heard wood crackling. She prayed.

She was unconscious when firefighters just before 1 a.m. pulled her from the burning house in Rotterdam (Schenectady County) where she lived with friends. Firefighters never determined what started the fire. The house was a total loss.

For a month Bridge was a patient in Upstate’s Clark Burn Center intensive care unit. She spent the first week on a ventilator. She has vivid memories of skin being grafted from her legs to her back and arms.

“Usually I’m pretty tough,” she says, “but I cried.

“It was excruciating. I had to get up and move. If I didn’t keep stretching the skin, I would have had really limited motion.”

Bridge after the fire

Bridge after the fire

A year after the fire, Bridge makes regular trips to Upstate for laser treatments that help reduce her scarring.

Dolinak and the technicians, and Bridge, must wear protective glasses over their eyes when the laser is on. Dolinak moves the device above Bridge’s back, and along her arms. Afterward, Bridge says she feels like she has a sunburn, and ibuprofen helps.

The Upstate Foundation is partnered with the Burn Foundation of Central New York to raise $150,000 to buy the laser therapy system, which is currently being leased. Bridge credits the laser with smoothing her skin. She also says it helps with itching.

Dolinak

Dolinak

Dolinak told Bridge the itching — a symptom of nerve regrowth — would probably last a couple of years. Lotion also helps, and Bridge wears compression shirts to muffle the sensation.

The road to recovery has been long. Sometimes she has nightmares about the fire. After she was released from the hospital, Bridge went in person to thank the South Schenectady volunteer firefighters who saved her.

Because of their swift action, and Dolinak’s expert care, Bridge, 44, was alive to become a grandmother in August.

To support the Clark Burn Center’s purchase of the scar laser therapy system, click here or contact the Upstate Foundation at 315-464-4416.

Upstate Health magazine spring 2018 cover

Upstate Health magazine spring 2018 cover

This article appears in the spring 2018 issue of Upstate Health magazine. 

 

Posted in dermatology/skin care, emergency medicine/trauma, health care, patient story, surgery, technology | Tagged , , , , , , ,

Surgical solution: A fix for sunken chests

This X-ray shows a surgically inserted metal bar that will help to correct a sunken chest, a somewhat rare condition.

This X-ray shows a surgically inserted metal bar that will help to correct a sunken chest, a somewhat rare condition..

Upstate thoracic surgery chief Jason Wallen, MD, offers surgery to repair sunken chests, a somewhat rare condition some people are born with called pectus excavatum.

Those affected may be self-conscious and also have trouble breathing.

“It’s not felt to be due to compression of the lungs as much as it is from compression of the heart,” the surgeon explains. “Heart trouble can cause people to have the symptom of difficulty breathing.”

Surgery can lead to permanent improvement.

Jason Wallen, MD

Jason Wallen, MD

The procedure is almost always done with small incisions, one on either side of the rib cage. “It involves placing a bar across the chest underneath the sternum, to lift it up and cause it to be nearly flat or completely flat,” Wallen describes. The bar provides structural support while bone and cartilage remodel to provide natural support (see the X-ray above).

Wallen says he places two small holes in the sternum (breastbone) so that he can secure the bar to the underside of the sternum with sutures. This is meant to prevent the bar from slipping. The bar — made of stainless steel or titanium — stays in place for two or three years before it is removed.

Surgery takes a couple of hours, followed by a three- or four-day hospital stay. “There is some soreness,” Wallen acknowledges, “so we utilize a number of different pain medications to make sure the patient is comfortable in the short term.”

Patients are encouraged to get up and around as soon as they feel able. After a recovery of four to six weeks, Wallen says they can usually return to all activities, including contact sports.

To learn more about treatment for pectus excavatum, contact Upstate’s thoracic surgery clinic at 315-464-1800.

Upstate Health magazine spring 2018 cover

Upstate Health magazine spring 2018 cover

HealthLink on Air logoThis article appears in the spring 2018 issue of Upstate Health magazine. To hear a podcast where Wallen describes the sunken chest and its repair in more detail, click here.

Posted in health care, surgery | Tagged , , , , , ,