Diabetes app: ways to set, track your goals

behaviors_screenWhat’s the best way to monitor your activity, if you have diabetes?

You can spend lots of money for a fancy activity-tracking device.

You can invest in a pedometer to count your steps.

Or, consider downloading a free app on your smartphone created by the American Association of Diabetes Educators. Upstate physical therapist Karen Kemmis is an executive board member of the association.

“This helps a person set and track goals related to seven self-care behaviors for diabetes self-management, including increasing physical activity,” Kemmis says.

The others include eating healthier, monitoring blood glucose, taking medications as prescribed, learning how to solve ordinary and unusual problems, reducing the risk for complications and coping with emotional issues.

magazine-fall16cvrThis article appears in the fall 2016 issue of Upstate Health magazine.




Posted in diabetes/endocrine/metabolism, diet/nutrition, fitness, illness, Joslin Diabetes Center, physical therapy/rehabilitation, prevention/preventive medicine, technology

Meth lab dangers: Exposure can cause lasting effects




Rescuers whose jobs take them to clandestine methamphetamine labs risk exposure to chemicals that can cause what appears to be permanent damage to their memory-making ability.

Specialists in anesthesiology and neurology at Upstate Medical University tell about a middle-aged firefighter who developed profound anterograde amnesia in 2001 after he was exposed to fumes from spilled material that was used to synthesize meth.

Awss Zidan, MD

Awss Zidan, MD

Chemicals commonly used in labs that produce the illegal stimulant are known to cause headaches, respiratory and eye irritation, and nausea and vomiting. Exposure to certain toxic chemicals can produce detrimental cognitive deficits, including amnesia. In a study from 2009, more than three-quarters of police officers reported memory loss after exposure to clandestine meth labs.

Amnesia is memory loss, which may be partial or complete and may relate to stored memories or the ability to commit something new to memory. Anterograde amnesia is when the ability to memorize new things is impaired. Its development indicates that particular regions of the brain have been affected.

Awss Zidan, MD, and Amy Sanders, MD, write about the firefighter’s case in the March issue of the Journal of Neurology and Stroke.

Amy Sanders, MD

Amy Sanders, MD

The firefighter lost consciousness and was hospitalized. He had trouble recalling events of the recent past. “He could not remember dates or names for more than a few minutes,” the researchers write. After he went home, he developed “out of body experiences,” generalized shaking, angry outbursts, depressed moods and impaired cognitive functioning. He had trouble memorizing new things.

The man sought care at Upstate University Hospital 12 years after the incident.

“Although there has been no improvement in his memory impairment since the time of the injury, he has learned to cope with his limitations,” Zidan and Sanders write. “His family provides him with written notes, organizing his chores and tasks, such as shopping or household maintenance, on a daily basis; he is able to follow these instructions. He is able to drive with the help of a global positioning device.”

The researchers suggest the connection between meth lab exposure and memory deficits warrants further study.

People with anterograde amnesia may:

— repeat comments or questions several times.

— not recognize people they have just met.

— have suffered damage to the hippocampus or medial temporal lobe of their brains.

— retain the ability to learn new skills and habits (procedural memory).

— lose the ability to recollect some facts (declarative memory). While they might not recall autobiographical information, they may be able to remember language, history and geography.

— recover functioning for some memories, over time, if the damage is limited to one side of the brain.

magazine-fall16cvrThis article appears in the fall 2016 issue of Upstate Health magazine.





Posted in brain/neurology, community, disability, drugs/medications/pharmacy, health care, illness, mental health/emotional health, patient story, poison center/toxicology, research, safety | Tagged , , , , , , , , ,

Safe houses: 11 things emergency doctors ban from their homes


Doctors at Upstate University Hospital’s emergency department are on the front lines of the mayhem and mishaps that befall young Central New Yorkers.

kid2They care for people with every imaginable injury or illness at their workplace, the Level 1  trauma center for a region stretching from the state capital through Finger Lakes wine country, from the border of Pennsylvania to Canada.

They handle crises with calm.

Then they go home.

Some aspects of the job go with them, visions such as struggling to revive a child who wandered into a backyard pool, or comforting a parent whose teen who put a gun to his head. Such experiences inform the rules they put in place for their own children in their own households.

Here are 11 things that are so dangerous as to be generally forbidden in the homes of emergency doctors:

1. Trampolines

trampSide nets and completely covered springs are safety features of modern trampolines, but Derek Cooney, MD, still won’t allow a trampoline at his house. “They’re just too dangerous.

“Many of the most serious injuries are related to falls from the trampoline, collisions when multiple people are jumping, and exposed springs that lead to gruesome extremity lacerations,” he explains, adding that serious neck and back injuries, joint or limb fractures are not uncommon.

bouncesk2. Bounce houses

Inflatable bounce houses can lead to collision injuries and falls, as with trampolines, but there’s a secondary reason they’re not welcome in the home of Risa Farber-Heath, DO. “They spread germs.”

3. Motorcycles, snowmobiles or all-terrain vehicles

snowmobile“I see a large number of patients with severe trauma while riding these. Your body is unprotected, and you are going at a high rate of speed,” says Louise Prince, MD. “I do not permit my children to ride them at friend’s houses, either.”

4. Wading pools

poolclrThey’re tiny when compared to a full-size swimming pool, but that doesn’t make them safe. A small plastic or inflatable wading pool can be a drowning risk when kids are unsupervised, reminds Farber-Heath.

5. Dishwasher detergent pods

Kelsey Stack, DO, says dishwasher detergent pods look like bright, yummy candy to kids “but can cause all sorts of issues, the most significant being caustic burns to the mouth, esophagus or airway.

“After seeing many kids in the emergency department who have bitten into them, and the consequences of that one bite, I banned them from our house.”

6. Riding mowers

mowerGrowing up with a pediatric surgeon for a father, Cooney heard of horrible lawn mower accidents long before he began taking care of patients who were injured by lawn mowers. Every summer, he sees children who are run over by parents on riding lawn mowers who did not know their child was anywhere nearby. Some of the children lose limbs or are permanently disfigured, and some of them die.

When the lawn is being mowed, the Cooneys follow the rule that “children should not be outside unless a second adult is directly supervising them and ensuring they are kept well away from the yard,” he says. They do not have a riding mower. If they did, they would not allow older children to use it. Too often he’s seen the result of judgment errors: a mower operated on a slope that rolls and crushes a person, or someone loses a hand or a foot while working on a mower with the engine still running.

7. Hand sanitizers

soapclr“I want my kids exposed to everything and building a strong and healthy immunity,” Jeremy Joslin, MD, says in explaining why his family skips hand sanitizer products in favor of plain soap and water.

(Joslin spoke shortly before the U.S. Food and Drug Administration issued a rule that essentially agrees with him. The FDA is banning several chemicals from over-the-counter antibacterial soaps, calling such soaps unnecessary, possibly dangerous and no better than ordinary soap and water. This will not apply to antibacterial soaps used for hospitals and food services.)

8. Foam dart guns

“I won’t let my kids play with Nerf-type guns unless they are wearing goggles,” says Alison McCrone, MD, medical director for Upstate Golisano After Hours Care. She’s concerned about poor aim, accidental close shots and other moves with the potential for injury.

9. Teapots and coffeepots.

teapot“I have seen so many kids coming in with burns to the face, chest and arms from hot coffee or tea that they have pulled over on themselves, or that a caregiver had spilled on them. It’s terrible,” Stack says. “I only boil water on the back burners and always make sure while cooking that pan handles are turned toward the inside and not sticking out for little hands to grab.”

10. Co-sleeping

babyclrJoslin will not sleep with a baby in his bed. He always makes children sleep by themselves. “I’ve taken care of too many dead babies from co-sleeping arrangements.”


11. Gaming systems

game“It isn’t exactly a safety issue as much as the belief that they are time consuming, addictive and have many violent games,” says Prince in explaining why her home contains no game system. “We want our kids to do other things with their time.”


Three more dangers

So far this year authorities from the Upstate New York Poison Center, which fields phone calls from 54 counties outside of New York City, have noticed an increase in the number of calls about emergencies involving someone 19 or younger and laundry pods (similar to dishwasher detergent pods), electronic cigarettes and button batteries.

Item                        All of 2015   First half of 2016

Laundry pods                217                         105

E-cigarettes                   2                              4

Button batteries           35                            26

(Source: Michele Caliva, Upstate New York Poison Center)

magazine-fall16cvrThis article appears in the fall 2016 issue of Upstate Health magazine.

Posted in adolescents, community, emergency medicine/trauma, entertainment, health care, poison center/toxicology, prevention/preventive medicine, public health, safety, Upstate Golisano Children's Hospital/pediatrics | Tagged , , , , , , , , , , ,

Quick call to 911, prompt response and fast flight to Upstate stroke center helped save the life of Larry Deshaw

Larry Deshaw, 78, (center in red) survived what could have been a fatal stroke because of multiple crucial decisions that were made quickly, including: 1. Wife, Nancy Humphrey (behind him) recognized the signs of a stroke and immediately called 911. 2. Rescuers in Clayton made the decision to send Deshaw directly to the comprehensive stroke center at Upstate University Hospital by helicopter so he would arrive as quickly as possible. 3. Stroke specialists at Upstate led by Gene Latorre, MD, (to the right of Deshaw) established a protocol that directs every patient suspected of having a stroke straight to the computerized tomography suite in the emergency department on arrival. The prompt CT scan reveals whether it's safe to give the patient clot-busting medication. A rapid CT angiogram was then used to identify the blocked artery and plan interventional treatment. 4. The hospital is outfitted with a modern interventional radiology suite that is available around the clock and staffed by doctors including Hesham Masoud, MD, (to the left of Deshaw) who have expertise in endovascular surgical neuroradiology -- which means they are skilled at swiftly retrieving blood clots from the brain.

Larry Deshaw, 78, (center in red) survived what could have been a fatal stroke July 19 because of multiple crucial decisions that were made quickly.

wdtTuesday afternoons are usually when Nancy Humphrey golfs. But she was still home a little after 4 p.m. on July 19 because that day’s tournament didn’t start until 5 p.m., and the Clayton Country Club is only about a quarter mile from the home she shares with her husband, Larry Deshaw.

They were watching CNN. She was on the couch. He was in his recliner.

“All of a sudden I was seeing double. The room started spinning,” recalls Deshaw, 78. “I hollered Nancy’s name twice. I knew I had something going on. That was the last I could speak.

“My left side went limp. My right side had contractions in the leg. My right arm was the only thing I could move at the time. I couldn’t talk. My jaw was clamped shut.

“I could hear everything going on around me, but I couldn’t speak. It was the scariest thing I’ve ever been through.”

Nancy Humphrey knew what to do when her husband, Larry Deshaw displayed signs of a stroke.

Nancy Humphrey knew what to do when her husband, Larry Deshaw, displayed signs of a stroke. Deshaw, 78, of Clayton is a veteran of the Army who worked in a paper mill until retirement.

Humphrey quickly dialed 911.

“His wife is what saved his life,” Upstate interventional neurologist Hesham Masoud, MD, says plainly. “If he was not found in a timely fashion, he would not have survived.”

Masoud is a stroke specialist who received his medical degree in Cairo before completing his internship and residency training at Case Western Reserve School of Medicine in Cleveland. He went on to gain additional stroke therapy expertise with additional fellowship training in endovascular surgical neuroradiology and vascular neurology at Boston University School of Medicine — the precise skills Deshaw needed when a clot the size of a raisin lodged in the basilar artery at the base of his brain.

Deshaw’s wife called for help at 4:15 p.m.

On their drive to the couple’s house, Thousand Islands Emergency Rescue Service paramedics Pamela Jones and Eimile Parker made the important decision to alert LifeNet of New York – and a helicopter based at Watertown International Airport in nearby Dexter was readied for flight, just in case. Patients in rural areas such as Clayton with certain medical emergencies including strokes or diabetic complications have better survival odds the faster they receive definitive medical care.

This story appeared in the Watertown Daily Times

When she laid eyes on Deshaw at 4:22 p.m., Jones remembers he had “that look” of a man suffering a stroke, or a seizure, or both. His face had a subtle droop, he had weakness on his left side, and he was unable to respond. Humphrey told the paramedics how healthy and active her husband was, and Jones made a silent vow to do what she could to bring him back.

The paramedics knew Deshaw urgently needed to get to Central New York’s first and only comprehensive stroke center, some 90 miles away at Upstate University Hospital in Syracuse, and the quickest way was by air. They made sure LifeNet was on the way and radioed the fire department to set up a landing zone for the helicopter.

Jones checked Deshaw’s blood sugar level and connected him to a cardiac monitor while Parker covered his mouth and nose with an oxygen mask and checked his pulse and blood pressure. Then Parker started an intravenous line in his arm. All the while, Jones spoke to Deshaw, explaining what was going on. It felt strange because he never responded, but she kept talking as she was trained to do. A month later when Jones checked on his recovery, Deshaw told her how much her talking had meant to him.

The Thousand Islands ambulance drove Deshaw about a half mile to the fire department parking lot, where the helicopter landed. Flight nurse Rod Kester and flight paramedic Jeff Simons climbed out. Once Deshaw was secured to their stretcher, they opened the door beneath the tail of the helicopter and wheeled him in. Deshaw remembers the feel of the heat rising up from the asphalt.

Driving the patient to Syracuse, even using lights and sirens, would have taken almost an hour and a half. Flying took 25 minutes.

Paramedic Pamela Jones with flight nurse Rod Kester and flight paramedic Jeff Simons.

TIERS paramedic Pamela Jones (left) with LifeNet flight nurse Rod Kester and flight paramedic Jeff Simons.

Once LifeNet pilot Scott Talon pointed the helicopter toward Syracuse, the LifeNet crew radioed the emergency physician on duty at Upstate, Brett Cherrington, MD. At 5:17 p.m., he activated the hospital’s stroke team.

Masoud’s pager notified him, and he gathered in the emergency department with the other physicians and nurses who are part of the acute stroke team. They were ready for Deshaw even before his helicopter landed on the helipad at 5:27 p.m.

Deshaw remembers everything.

“They were waiting for me,” he says. “They took me immediately in. I remember them rushing, going fast with me on the gurney.”

Members of the team told Deshaw what was going on as they cared for him. They wheeled him straight to the computerized tomography suite in the emergency department for a CT scan, with the interventional neurologist, Masoud at his side.

Larry Deshaw's stroke was in a particularly dangerous location in his brain. Interruption of blood flow in the basilar artery is particularly dangerous because it’s the route oxygenated blood takes to get to areas of the brain responsible for vital functions such as consciousness and breathing – and there are no alternate routes, what doctors called collateral circulation. If the artery bursts or is blocked by a blood clot, patients usually sustain severe brain damage or organ malfunction, or they die. The basilar artery is located at the base of the skull, where two vertebral arteries meet. It carries blood to the brainstem, which controls heart rate, sleeping, eating and breathing; the cerebellum, responsible for posture, balance, coordination and speech; and the occipital lobe, which handles visual processing. Multiple arteries branch from the basilar artery leading to other areas of the brain including the temporal lobe, where sound is processed, and the pons, where information is relayed between different areas of the brain.

Interventional neurologist Hesham Masoud, MD, explained to Larry Deshaw that his stroke was in a particularly dangerous location, the basilar artery. This is the route oxygenated blood takes to get to areas of the brain that are responsible for vital functions such as consciousness and breathing, so any interruption of blood flow can be devastating.

Deshaw had symptoms that suggested that he had a seizure or a stroke. “Anyone with these symptoms gets an immediate vessel imaging study. That way, we can identify the blocked artery and plan for immediate therapy,” Masaoud explains.

Nurse Jennifer Schleier is the stroke coordinator. She says the CT scan helps rule out whether a vessel has burst within the brain. Patients with hemorrhagic strokes, in which a vessel bursts, are treated differently than those with ischemic strokes, in which a clot blocks a vessel.

Deshaw received an injection of the clot-busting medication, tPA, or tissue plasminogen activator, at 6:18 p.m. through the intravenous line paramedics inserted at his home. Then he returned to the scanner for a CT angiogram, another set of images that rely on a contrast material so details of the arteries and veins are visible.

There, deep in the basilar artery of Deshaw’s brain, was the clot.

Time is crucial anytime someone suffers a stroke. In many cases, other healthy arteries can temporarily keep the brain alive while we try to reopen the vessel. But for patients with clots lodged at the base of the brain, those other arteries aren’t there to help,” Masoud says. “For those strokes, time is exceedingly important.”

Strokes in the basilar artery are rare, and the outcomes are usually poor. The brain area that can be damaged in this type of stroke controls essential functions such as consciousness, breathing and heart rate, balance and coordination and vision. “In my experience, a majority of these patients die, within a couple days of having the stroke,” Masoud says.

Deshaw experienced what the interventional neurologist considers “a miraculous recovery.”

The emergency physician inserted a breathing tube. Then Deshaw was wheeled to the interventional radiology suite two floors above the emergency department.

Hesham Masoud, MD, shows the clot retriever.

Interventional neurologist Hesham Masoud, MD, shows the clot retriever device that can restore blood flow to patients suffering from ischemic strokes.

At 7:10 p.m., Masoud inserted a small catheter into the artery of Deshaw’s right leg. Guided by an X-ray and contrast dye, the doctor delicately advanced a wire-like stent along the inside of the artery and into the brain. The stent wrapped around the clot, trapping it as if in a cage. Masoud gently backed the device out, removing the clot and restoring blood flow with a single pass of the device.

Deshaw’s wife arranged for her brother from Watertown to drive her to the hospital. By the time they arrived, Deshaw was already in surgery.

Surgery was complete at 7:43 p.m., and around sunset Deshaw was settled into the neurosurgical intensive care unit. The ninth floor hospital unit is staffed by nurses and technicians with specialized training in the care of patients with stroke and other neurological emergencies.

“I didn’t really wake up until the next morning,” Deshaw says, “but when I woke up, everything was working.”

A steady stream of impressed doctors stopped by to see the patient who not only survived “basilar artery thrombosis” but was up and walking the next day.

After a stroke, many patients go through what can be a lengthy rehabilitation program. Deshaw was healthy enough to be discharged to his home three days later. #

Larry Deshaw and his wife, Nancy Humphrey (center) reunited with rescuers in Clayton about a month after he suffered a stroke. This is the parking lot of the Clayton Fire Department, where the LifeNet helicopter picked Deshaw up to transport him to the comprehensive stroke center at Upstate.

Larry Deshaw and his wife, Nancy Humphrey (center) reunited with rescuers in Clayton about a month after he suffered a stroke. This is the parking lot of the Clayton Fire Department, where the LifeNet helicopter picked Deshaw up to transport him to the comprehensive stroke center at Upstate.

Posted in brain/neurology, brain/spine/neurosurgery, community, emergency medicine/trauma, health care, patient story, public health, stroke

Helping newborns by helping moms off drugs

baby feet and oxygen saturation monitor


One quarter of the babies born in Onondaga County have been exposed to an opioid drug of some sort in the womb, making for one of the highest rates of newborn drug exposure in New York state.

That doesn’t mean women in Central New York are more prone to drug use. Neonatologist Michelle Bode, MD, an assistant professor of pediatrics at Upstate,  explains that “in New York City they don’t have a problem because they don’t test.”

Michelle Bode, MD

Michelle Bode, MD

Pediatricians who serve the three Syracuse hospitals with maternity care screen for drug use in the same way, Bode says, “so we’ve got some cohesiveness that isn’t necessarily found in other areas of the state.” Upstate University and Crouse hospitals and St. Joseph’s Hospital Health Center deliver most of the babies from Onondaga and 14 surrounding counties.

Still, Bode says, the numbers are troubling.

In 2001, 5 percent of newborns were exposed to an opioid during pregnancy. Today it’s up to 25 percent. The majority of exposures come from prescription opioids such as hydrocodone or oxycodone, but the number of babies exposed to illicit opioids such as heroin has increased, too.

Bode says data from birth certificates for babies living along the Interstate 81 corridor shows 2.1 percent were affected by illicit drug use in 2006. Almost three times as many – 5.9 percent – were affected in 2015.

Whether exposed to legal or illegal substances, the babies are born with what is called neonatal abstinence syndrome. “These infants do not have a normal newborn experience,” Bode says.

Often free of symptoms at birth, the babies within the first week become irritable and jittery, with a shrill cry. They don’t feed well or sleep well, and they have diarrhea. Hospitalization may last three days or more than three weeks as they go through withdrawal, depending on the substance they were exposed to and for how long.

Long-term consequences can include birth defects, problems with development and behavior and a greater risk for sudden infant death syndrome. If the mother gets help for her addiction, and if she brings the baby into a loving and stable home, there may be no lasting effects. “The environment the child is raised in will determine their outcome,” Bode says.

She points out that mothers-to-be who admit to opioid use during prenatal visits can receive expedited referrals to addiction treatment services in Central New York.

Studies show that pregnancy can be a window of opportunity to get women into treatment. Ask 100 pregnant women how important their baby’s health is to them, and, Bode says, fewer than 1 percent will say it is not important. If health care providers explain how halting opioid use can help the woman have a healthy baby, she is likely to be receptive to addiction treatment. And, Bode notes, women have a slightly higher success rate for treatment when they are pregnant.

magazine-fall16cvrHLOA-4C-VERT-REVThis article appears in the fall 2016 issue of Upstate Health magazine. Click here for a radio interview/podcast in which Bode discusses opioid use during pregnancy and its effects on newborns.

Posted in addiction, drugs/medications/pharmacy, health care, HealthLink on Air, maternity/obstetrics, poison center/toxicology, public health, Upstate Golisano Children's Hospital/pediatrics, women's health/gynecology | Tagged , , , , , , , , , , ,

Grateful patient loses his voice … creates Voice of PALS


Cliff Maus woke up one morning with slurred speech. He and his wife knew something was wrong, but neither imagined he would be diagnosed with amyotrophic lateral sclerosis, more commonly known as Lou Gehrig’s disease. After several appointments with physicians who specialize in neurological disorders, who all agreed that he had ALS, Maus was referred to Upstate’s ALS Research and Treatment Center.

Cliff Maus

Cliff Maus

Maus, a retired Canandaigua police officer, was diagnosed with a rare form of ALS called progressive bulbar palsy, which impacts the throat and lungs. Globally, 20 percent of ALS patients who have trouble with speaking and swallowing at diagnosis are classified as bulbar-onset. These patients lose their abilities to speak very early in the course of the disease. Most other ALS patients develop speech loss as the disease progresses.

Maus cannot speak, but he communicates using his iPad. Motivated to help find a cure, he enrolled in a clinical trial at Upstate. He also organized a Frank Sinatra tribute in Geneva last winter and used $6,500 in proceeds to open a Voice of PALS (persons with ALS) fund through the Upstate Foundation to benefit ALS treatment and research at Upstate.

In addition, Maus’ friends at the National Barrel Horse Association held a fundraiser in June at the Seneca County Fairgrounds in his hometown of Waterloo, raising $1,200 for the Voice of PALS. Supporters are planning a golf tournament for summer 2017.

“With a disease that has no cure or treatments to stop the progression, research is our only hope,” Maus says.

Neurologist Eufrosina I. Young, MD, directs the center and leads a study using transcranial magnetic stimulation to diagnose ALS. That research also involves Upstate’s department of neurosurgery.

Voice of PALS was established through the foundation’s Grateful Patient and Family Program, which identifies and establishes relationships with patients and their families who are grateful for the care provided by Upstate health care professionals.

“What Cliff Maus is doing to help Upstate’s ALS clinic is more than meaningful. It is brave and selfless,” says Eileen Pezzi, vice president for development at Upstate. “We are extremely grateful for patients like Cliff who make a difference in research and patient care.”

To donate to this fund, click here or contact the Upstate Foundation at 315-464-4416.

magazine-fall16cvrThis article appears in the fall 2016 issue of Upstate Health magazine. 


Posted in brain/neurology, brain/spine/neurosurgery, disability, fundraising, health care, illness, patient story, research, technology | Tagged , , , , , , , , ,

A way to help you communicate your pain to your doctor

Doctors rely on patients to accurately describe their pain in order to create an effective pain management plan.

You can use a printout of the chart below to keep track of your pain, noting when it began, its intensity, what it feels like, its location and whether it expands. Also, take note of any medication’s effects on your pain. Some doctors ask patients to maintain a pain diary.
Layout 1

cancercaresummerThis article appears in the summer 2016 issue of Cancer Care magazine.


Posted in aging/geriatrics, arthritis, autoimmune, bones/joints/orthopedics, cancer, health care, illness

How can you help patients at Upstate?

State Police Sgt. Jeff Cicora, who is battling stage 4 cancer, threw a party for patients at the Upstate Golisano Children's Hospital to take his mind off his health problems. Cicora was joined by about 20 fellow troopers and police dogs. (PHOTO BY KATHLEEN PAICE FROIO)

State Police Sgt. Jeff Cicora, who is battling stage 4 cancer, threw a party for patients at the Upstate Golisano Children’s Hospital to take his mind off his health problems. Cicora was joined by about 20 fellow troopers and police dogs. (PHOTO BY KATHLEEN PAICE FROIO)

Some of the best gifts for a person facing a medical crisis are simple, with a “thinking of you” message, and many Central New Yorkers with giving spirits make such donations to Upstate University Hospital.

If you would like to donate something to patients at the Upstate Cancer Center, contact Matt Capogreco at 315-464-3605 or capogrem@upstate.edu. To donate to patients at the Upstate Golisano Children’s Hospital, contact Margaret Nellis at 315-464-7547 or nellism@upstate.edu (all donation ideas must be approved).

Some examples of recent gifts that were well received:

* New teddy bears, donated to children at the Upstate Golisano Children’s Hospital by State Police Sgt. Jeff Cicora of Baldwinsville, who has a rare form of cancer.

* Adult coloring books, donated by Adam Thomson of Cazenovia. The books were collected for his bar mitzvah.

* Totes, bags and pillows from Thirty-One Gifts, donated by a variety of Central New York consultants.

* Comfort items that stock a cart made available to outpatients and inpatients. Brandon Spillett of Syracuse receives monetary donations through his organization Room 2 Smile, and the funds pay for playing cards, puzzle books, greeting cards and personal care items for the cart.

* Hats and caps, 400 of which were donated by students from Norwich Elementary School.

* Blankets, donated by Central New York Subaru dealers and The Leukemia & Lymphoma Society.

Are you grateful?

There are many ways to make donations to the Upstate Cancer Center and the Upstate Golisano Children’s Hospital. For details, contact the Upstate Foundation at 315-464-4416.

Posted in adolescents, cancer, community, health care, illness, Upstate Golisano Children's Hospital/pediatrics, volunteers

Breast cancer diagnosis? Next step: surgeon consult

The Upstate Cancer Center will soon provide the services of four breast surgeons, including Mary Ellen Greco, MD (left), and Kristine Keeney, MD (right). In the accompanying article, Keeney discusses the role of fellowship training specifically for breast cancer and disease. (PHOTO BY ROBERT MESCAVAGE)

The Upstate Cancer Center will soon provide the services of four breast surgeons. From left are Mary Ellen Greco, MD, and Kristine Keeney, MD. In the accompanying article, Keeney discusses the role of fellowship training specifically for breast cancer and disease. (PHOTO BY ROBERT MESCAVAGE)

If a woman has an abnormal finding on a mammogram, further tests will confirm or rule out cancer.

While the vast majority will turn out to be benign conditions, the first stop for a woman who has a diagnosis of breast cancer is usually a breast surgeon.

“Getting seen quickly is important, both to relieve the woman’s anxiety and to plan her next steps, as the treatment plan is highly personalized to each patient,” commented Scott Albert, MD.

Albert is a surgeon and a member of a multidisciplinary team of breast cancer experts. Together, the team creates the treatment approach for breast patients.

The team also offers the expertise of fellowship-trained breast surgeons.

A fellowship is additional, advanced training after medical school and residency.

The Society of Surgical Oncology, which oversees the fellowship program for breast surgeons, accepts a few dozen surgeons each year.

The yearlong training covers breast imaging, surgery, genetics, medical oncology, plastic and reconstructive surgery, radiation oncology and psychological oncology.

The goal of the training is to use the expertise to provide excellent care and contributions to the treatment team, as these areas all relate to the care of breast patients, says Kristine Keeney, MD.

Layout 1This article appears in the summer 2016 issue of Cancer Care magazine.


Posted in cancer, health care, health careers, illness, medical education, medical imaging/radiology, surgery, women's health/gynecology

Why a kidney biopsy may be unnecessary


Experts are examining when it is appropriate for the kidneys, shown in red, to undergo a biopsy.


For decades, kidney experts believed that biopsies of the organ were not helpful in determining how to treat a small kidney tumor. Today, more doctors believe a biopsy helps guide treatment.

It can – sometimes, says Gennady Bratslavsky, MD, chair of Upstate’s department of urology.

Gennady Bratslavsky, MD

Gennady Bratslavsky, MD

A biopsy may be appropriate for some patients with solid kidney tumors that have not spread beyond the organ. But he says the procedure, in which tissue is removed for laboratory analysis, should not be used routinely for everyone diagnosed with a renal mass.

Bratslavsky and co-authors from the Fox Chase Cancer Center in Philadelphia and the Mayo Clinic in Rochester, Minn., argue for selective use of kidney biopsy, writing in the journal European Urology that “most patients can avoid the unnecessary procedure and its associated risks.”

Their article says a biopsy probably would not make sense for a patient with a small mass in the kidney, who is frail or has other serious medical conditions, since results are not likely to influence the patient’s treatment.

The authors give three reasons people with small kidney tumors should not automatically undergo a biopsy:

  1. Growing evidence suggests that such patients can be safely monitored through active surveillance without the tumor spreading.
  1. Kidney biopsies do a poor job of predicting how likely a tumor is to grow and spread. While learning what kind of cells make up a tumor may provide comfort — or concern — for a patient, “our experience suggests that if a renal mass in a frail, elderly or infirm patient is best managed with active surveillance, knowledge of the pathology is often irrelevant and rarely helpful for initial management,” the authors write.
  1. Many patients with kidney tumors take prescription medication that helps reduce blood clots. That increases their risk of dangerous bleeding during a biopsy.

3 patients who may require a biopsy

  • patients whose tumors have grown while they are being monitored through active surveillance.
  • frail or elderly patients with large (greater than 3 centimeters) or rapidly growing tumors.
  • patients who are extremely anxious about the tumor.

cancercaresummerThis article appears in the summer 2016 issue of Cancer Care magazine.


Posted in cancer, health care, illness, kidney/renal/nephrology, prevention/preventive medicine, research, urology