Dialysis companions: Students get to know patients, another view of health care

Medical students Colleen Fei, left, and Megan Harris are volunteer companions at the University Dialysis Center. (PHOTO BY JIM McKEEVER)

Medical students Colleen Fei, left, and Megan Harris are volunteer companions at the University Dialysis Center. (PHOTO BY JIM McKEEVER)


A program sponsored by Upstate’s Center for Civic Engagement matches student companions with patients at the University Dialysis Center, a short walk from campus.

The patients – most of whom undergo treatment three days a week, four hours at a time – appreciate having a student to talk to or play games with.

The students enjoy developing friendships with the patients. They commit to weekly or biweekly visits of an hour or 90 minutes.

“My patient was shy at first,” says Megan Harris, who is in her second year of medical school. “He’s an older man with cool life stories. Once I got him talking, I’d listen and reflect on what he was saying.

“Sometimes we talk about my life, and what I may be stressing about that week. He’s always appreciative. He’ll tell me, ‘You have no idea how much better this makes it when you’re here.’” Harris typically visits at 6 to 7 a.m., before her classes.

Classmate Colleen Fei makes her visits on Saturdays. Fie says most patients like talking about anything other than dialysis. Time spent listening “tells you a lot about health care outside the minutiae of medicine. The patients face other barriers besides kidney disease. They also provide their perspective of health care — what makes a good doctor or a bad doctor.”

Harris says she feels for the patients who don’t have visitors. “I wish I could talk to all of them,” she said. “I love my classmates, but it’s nice to talk to someone on the other end of health care.”

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





Posted in health care, illness, kidney/renal/nephrology, medical student | Tagged ,

‘Stop the bleed’: You need to know this potentially lifesaving action

William Marx, DO

Surgeon William Marx, DO, is Upstate’s chief of trauma, critical care and burns.

A person can bleed to death within minutes. You can potentially save a life by intervening quickly to stop blood loss.

Trauma centers such as the one at Upstate University Hospital are promoting a “Stop the Bleed” campaign, an effort to educate regular people about how to help someone who is bleeding severely.

The traumatic injury could happen in a car crash, from a fall during a hike or as the result of a shooting. So first, a precaution: Be aware of your surroundings and, if necessary, move yourself and the injured person to safety. Call 911.

And then, in the time before medical help arrives, here are three actions you can take to help save a life:

  1. Apply pressure on the wound.

Remove clothing to find where the bleeding is coming from and apply firm, steady pressure to the bleeding site, preferably with both hands. You can use a commercial dressing or pack the wound with any available cloth. Continue to apply firm, steady pressure on top of the dressing.

This can be painful for the injured person, so it’s important to talk to them, Lenworth Jacobs, MD, told The New York Times. He’s a trauma surgeon and director of the trauma institute at Hartford Hospital in Hartford, Conn.

“You need to speak to them with kindness and explain it to them and say, ‘Hold on. We’re going to stop the bleeding. We’re going to get you to care.’ That makes a huge difference,” Jacobs told the newspaper.

  1. For injuries of the arms or legs in which the bleeding does not stop, apply a tourniquet. This is a thick, beltlike strap made of rubber or plastic that can be cinched tight and locked into place. It goes two or three inches above the wound, closer to the torso.

“It’s really tight, and it’s not meant to be taken off,” said William Marx, DO, chief of the trauma service at Upstate. Mark the time you apply a tourniquet. That helps doctors at the hospital decide on treatment options, he said.

  1. If one tourniquet does not control the bleeding, a second one can be placed even closer to the torso.

Marx said an effort to increase survivability after mass shootings began in 2012 after 20 children and six adults were gunned down at Sandy Hook Elementary School in Newtown, Conn.

Fellow trauma surgeon Jacobs attended the autopsies of the victims. “There were five or maybe six children who bled to death from extremity injuries,” Marx explained. “If they had a tourniquet, Jacobs thought they would have been able to survive.”

Tourniquets were used on the battlefield during the Civil War, although not consistently, Marx said. Their use was popular during the wars in Iraq and Afghanistan. Military body armor does a good job of protecting the trunk of the body, but to guard against bleeding to death if they were hit in an extremity, Marx said soldiers would wear uncinched tourniquets on their arms and legs. That way, if a soldier was injured, he could cinch his own tourniquet to stop the bleeding and save his own life.

For more on “Stop the Bleed,” including short, informative videos, click here.

Register for a course

Experts from Upstate’s trauma program offer a free “Stop the Bleed” program to individuals and groups. To learn about courses or schedule an educator to come to your place of business, contact Upstate Connect at 315-464-8668. Medical professionals can sign up for a train-the-trainer course.

Upstate Health magazine winter 2018 issueHealthLink on Air logoThis article appears in the winter 2018 issue of Upstate Health magazine. Hear Marx and trauma program manager Jolene Kittle further describe the “Stop the Bleed” campagin in a “HealthLink on Air” interview. 


Posted in emergency medicine/trauma, health care, prevention/preventive medicine, safety | Tagged , ,

Recipe: Acorn Squash and Apple Soup

Squash and apples make a soothing cold-weather soup.

Squash and apples make a soothing cold-weather soup.

This soup takes an hour to prepare. It’s loaded with fiber and is a good source of potassium. It’s a nice dish for someone with nausea. It’s also easy on mouth sores. This recipe makes six 1-cup servings.


1 medium acorn or butternut squash (1½ to 2 pounds)

2 tablespoons butter or margarine

1 medium yellow onion, sliced (1/2 cup)

2 medium-sized tart cooking apples (such as Granny Smith), peeled and sliced

1 teaspoon dried thyme leaves

¼ teaspoon dried basil leaves

2 14-ounce cans chicken broth (4 cups)

½ cup half-and-half

1 teaspoon ground nutmeg

½ teaspoon salt

¼ teaspoon white or black pepper


1. Heat oven to 350 degrees. Cut squash in half; remove seeds and fibers. Place cut sides up in 13-by-9-inch pan. Pour ¼ inch water into pan. Bake uncovered about 40 minutes or until tender. Cool. Remove pulp from rind and set aside.

2. Meanwhile, in heavy 3-quart saucepan, melt butter over medium heat. Add onion; cook 2 to 3 minutes, stirring occasionally, until crisp-tender. Stir in apples, thyme and basil. Cook 2 minutes, stirring constantly. Stir in broth. Heat to boiling. Reduce heat; simmer uncovered 30 minutes.

3. Remove 1 cup apples with slotted spoon; set aside. Place one-third each of the remaining apple mixture and squash in a blender or food processor. Cover; blend on medium speed about 1 minute or until smooth, then pour into bowl. Continue to blend in small batches until all soup is pureed.

4. Return blended mixture and 1 cup reserved apples to saucepan. Stir in half-and-half, nutmeg, salt and pepper; cook over low heat until thoroughly heated.

Nutritional information

Each 1-cup serving contains:

190 calories

7 grams fat

20 milligrams cholesterol

670 milligrams sodium

690 milligrams potassium

6 grams fiber

5 grams protein

Source: “Betty Crocker Living With Cancer Cookbook”

This article appears in the fall 2017 issue of Cancer Care magazine.


Posted in health care, recipe

Up Close: Breast imaging

Radiologist Amina Akhtar, MDRadiologist Amina Akhtar, MD, works from a bank of monitors to analyze mammography images at the Wellspring Breast Care Center at Upstate University Hospital’s Community campus. The center offers routine screening and diagnostic mammograms, ultrasound, tomosynthesis and breast magnetic resonance imaging, and image-guided biopsies provided by a dedicated staff of nurses, technologists, radiologists and surgeons. Hours are 7:30 a.m. to 5 p.m. Monday through Friday, plus some Saturday mornings for screening mammograms; call 315-492-5702 for appointments. Upstate also offers imaging services at its downtown campus; call 315-464-2588. (PHOTO BY SUSAN KAHN)

Posted in cancer, health care, medical imaging/radiology | Tagged , ,

WRVO app makes listening to Upstate podcast easy

Upstate’s “HealthLink on Air” podcast airs at 6 a.m and 9 p.m Sundays on WRVO Public Media.

HLOA1400x1400But you can listen whenever you like through the WRVO Public Media app, which is free to download onto Apple or Android devices. Find it through the App Store or Google Play. “HealthLink on Air” is also available in podcast form through iTunes.

The Upstate “HealthLink on Air” program is in its 12th year. It began as an hourlong radio talk show featuring experts from Upstate and around Central New York on subjects of health, medicine and science. “HealthLink on Air” is produced by journalists in Upstate’s marketing and university communications department.

Through the WRVO app, you are able to choose to hear an entire hourlong program or individual interview segments. Each show typically features three interview segments. The shows and segments are also available on the Upstate website at www.upstate.edu/healthlinkonair

To suggest topics for discussion, please email host Amber Smith at smithamb@upstate.edu, or producer Jim Howe at howeja@upstate.edu.

Amber at HLOA

Amber Smith hosts the Upstate podcast and WRVO talk show, “HealthLink on Air.” 

Posted in entertainment, Expert Advice, health care, podcast

Advanced imaging, clot-retrieval help save stroke patients during holiday at Upstate Comprehensive Stroke Center

The Christmas feast was about to begin.

Twenty-three of Judy Klein’s loved ones were gathered in her Syracuse home. Her grandson had prepared a plate for her mother, Fannie Barber, 101. Klein’s daughter was talking with the matriarch, who was seated at the head of the table.

Barber suddenly could not speak. The right side of her face drooped into a crooked smile.

“You need to come and look at Grandma, quick,” Klein heard her daughter saying.

The Barber clan was one of nine families whose Christmas Eves or Christmas Days included stroke treatment at the Upstate Comprehensive Stroke Center.

Swarnkar (1)

Amar Swarnkar, MD

Amar Swarnkar, MD, director of diagnostic neuroradiology, and Gene Latorre, MD, medical director of the stroke service, were on duty. Along with other members of the stroke team, they were poised to care for patients with neurological emergencies during the holiday. Among the patients they cared for was Barber, who they believe is the oldest patient to undergo clot-retrieval at Upstate. They also took care of a man whose stroke was detected through a sophisticated brain scan and software program that’s only available at comprehensive stroke centers.

Alton Oherien, 40, of Oneida had no idea he was having a stroke when he awoke around 2 a.m. Dec. 24 with the worst headache of his life. He decided to try to sleep it off. Hours later when he awoke again, he stood up and lost his balance.

“I didn’t know what was going on. I just

Latorre, Julius Gene

Gene Latorre, MD

knew something was wrong,” he says. He called his sister, who lives nearby. She took him to Oneida Healthcare. In a standard computerized tomography scan, Oherien’s brain appeared normal, but his symptoms still suggested he was having a stroke. Doctors there sent him by ambulance to Upstate.Time is critical in stroke care. Normally, Oherien would be ineligible for any acute stroke treatment since he sought care more than six hours after the onset of his symptoms.

Upstate’s Comprehensive Stroke Center has state-of-the-art CT scan software that helps select patients who may still benefit from acute stroke interventions, even if they are outside of the standard time window for treatment. This allows doctors to offer life-saving treatment up to 24 hours after the onset of stroke symptoms, something no other stroke center in the region can do.

The CT perfusion imaging scan done at Upstate revealed brain tissue in jeopardy of dying. Circulation to this area, called the penumbra, was impaired and needed to be restored promptly. To do that, Swarnkar would insert a catheter in Oherien’s groin and thread it into his brain to find and remove the troublesome clot.

Oherien remembers everything. He followed instructions to stay still, and to not talk during the procedure, called a thrombectomy.

Soon after the clot was out, Oherien says he felt better. “The next day, I really got to feeling back to normal.” Three days later, he got to go home, but Oherien spent Dec. 25 easing back to usual activities. Nurses helped him out of bed to walk, and later in the day he was able to eat lunch.

While Oherien recovered from his stroke, several blocks away from Upstate, Barber was enjoying the Christmas festivities from her spot at the head of the table. A plate of appetizers was in front of her, and her grand-daughter was at her side.

“She was perfect up until that moment,” recalls Judy Klein, Barber’s daughter.

When it was clear that something was wrong, Klein wrapped her arm around her mother: Are you in pain? Can you breathe? “She couldn’t get any words out.” Klein reassured her mother. “I kept telling her, ‘you’re fine. We called 911, and they’re coming to help us.’ ”

Klein rode with Barber in the ambulance to Upstate University Hospital’s emergency department. “When we got there, the doctor and his team were at the door,” she recalls. Her mother was whisked down the hall for a CT scan.


One of the caregivers talked with Klein about a clot-busting medication that could help Barber, since the stroke had begun less than three hours ago. They also discussed the thrombectomy procedure Barber would undergo with Swarnkar.

Everything happened swiftly.

“Within an hour, she was back to herself,” Klein says. “Her face was straight. She could move her left arm. She could speak clearly. And she wanted to go home.”

Klein, who describes her mother as a very healthy 101-year-old, says she will undergo rehabilitative therapy before returning home. Evenso, her mother’s rapid recovery from stroke seems to Klein like something of a Christmas miracle.


Posted in aging/geriatrics, brain/neurology, brain/spine/neurosurgery, emergency medicine/trauma, health care, medical imaging/radiology, patient story

5 ways to cope with nausea and vomiting

Maria Erdman, registered dietitian nutritionist at the Upstate Cancer Center.

Maria Erdman, registered dietitian nutritionist at the Upstate Cancer Center. provides

Here are some tips to deal with the nausea and vomiting, provided by Maria Erdman, the Upstate Cancer Center’s registered dietitian nutritionist:

— Eat small, frequent meals.

— Avoid unpleasant odors.

— Avoid foods that are hot, spicy and strong-smelling or fried and greasy.

— Avoid drinking liquids at meals.

— Eat dry foods — such as crackers, toast and dry cereals – every two to three hours during the day.

Cancer Care magazine fall 2017 coverThis article appears in the fall 2017 issue of Cancer Care magazine.

Posted in cancer, diet/nutrition, health care, prevention/preventive medicine

Cows for cancer: Grateful granddaughter raises livestock to brighten patients’ days

Paige Lee with a cow she sold in 2016.

Paige Lee with a cow she sold in 2016.

Thomas Elwood lived his whole life on his farm in the village of Walton, in New York’s Southern Tier, with steers, pigs and chickens.

He was retired from Breakstone, the local creamery, where he worked for 45 years. He beamed when his grandchildren – he had seven — showed animals at county fairs. Beef cattle were his favorite.

Recalled his granddaughter, Paige Lee, 11, “Papa would help us wash our cows and get them ready for show and help us lead them.”

Paige's grandfather, Thomas Ellwood.

Paige’s grandfather, Thomas Ellwood.

Elwood especially enjoyed working with his grandchildren at the Broome County Fair in July in Whitney Point.

When Elwood developed lung cancer, he sought treatment at the Upstate Cancer Center. Rahul Seth, DO, took care of him. Elwood died at the age of 71 at the end of May 2016.

Two months after her Papa’s funeral, Paige brought one of the steers he helped her raise to the Broome County Fair. It sold for $2,200.

Some of that money Paige used to buy a pregnant cow, a plan she and her Papa had to help further her herd. The rest, she donated to the cancer center.

Paige with a cow she sold in 2017.

Paige with a cow she sold in 2017.

She remembered all the times her mother, Anne Lee, took her Papa for chemotherapy in Syracuse.

Paige decided to help people with cancer because she knows chemotherapy treatments can take a long time. “Having something to do makes it a lot better,” the sixth-grader explains. Her money paid for bags filled with special gifts for cancer patients from Thirty-One Gifts.

This article appears in the fall 2017 issue of Cancer Care magazine. To donate to Friends of Upstate Cancer Center, click here or contact the Upstate Foundation at 315-464-4416.

Posted in cancer, community, fundraising, health care, patient story

Will this tumor cause trouble? Need treatment? Researcher seeks answers in gene he discovered

Still images from two videos of prostate cell growth. The cluster of cells on the top, in blue, are spherical, indicating healthy cell growth. The images on the bottom, which has had the gene/protein Abi1 removed, show cell clusters that are nonspherical and loosely attached, and are trying to migrate out. (FROM THE LAB OF LESZEK KOTULA, MD, PhD)

Still images from two videos of prostate cell growth. The cluster of cells on the top, in blue, are spherical, indicating healthy cell growth. The images on the bottom, which has had the gene/protein Abi1 removed, show cell clusters that are nonspherical and loosely attached, and are trying to migrate out. (FROM THE LAB OF LESZEK KOTULA, MD, PhD)


Ever since he discovered a gene that causes prostate cancer 20 years ago, Upstate cancer researcher Leszek Kotula, MD, PhD, has focused on understanding the mysteries of the cancer that, besides skin cancer, is most common in men.



Much of his career is devoted to prostate cancer – because of the numbers.

Each year, 23 million men undergo prostate-specific antigen screening tests. Some 1.2 million men who are found to have high PSA levels undergo a biopsy. Some 240,000 are diagnosed with prostate cancer.

The vast majority of those men will have tumors that are noninvasive. About 3 percent will have an aggressive form of the disease that is difficult to treat.

That 3 percent represents some 7,200 husbands, fathers, brothers.

Those are the numbers that concern Kotula.

He dreams of being able to tell men who are diagnosed with prostate cancer more definitive news about their future. He wants to answer whether they have a tumor that will lie quietly within their prostate and cause no trouble, or a tumor that will spread to other organs and require treatment.

Kotula wants to be able to predict which tumor will remain indolent, and which will become invasive.

If he can do that, he can save lives.

Working together, Kotula’s team of biochemists and cell biologists uses a genetic engineering technique to study the disruption of “Abi1,” the gene he discovered in 1998.

They want to learn how the gene interacts with other genes and whether it plays a role in leukemias, breast, ovarian and other cancers.

Disharee Das, left, a doctoral student in biochemistry and molecular biology, puts a cell sample into a liquid nitrogen tank with help from her mentor, Kotula. (PHOTO BY WILLIAM MUELLER)

Disharee Das, left, a doctoral student in biochemistry and molecular biology, puts a cell sample into a liquid nitrogen tank with help from her mentor, Kotula. (PHOTO BY WILLIAM MUELLER)

“If we are successful, then we can make an impact on treatment,” Kotula says.

Discovering the Abi1 gene set him on this course.  Fast-forward two decades, and Kotula is focused on the function of the Abi1 gene. Its presence seems to inhibit prostate cancer, while the loss of function of this gene leads to prostate cancer.

Today his research involves three cell lines, one purchased commercially, one from genetically engineered mice at Upstate, and one from Upstate’s biospecimen bank, where some patients donate tissue from their tumors.

Looking under the microscope before the Kotula gene is removed – the scientific term is “”gene knockout” — the cells look as if they were melting into one big blob, and that blob spins.

The spinning stops when the gene is removed, and the cells are more individual, like a cluster of grapes. Some cells start to move out from the blob. “That’s where the process of invasion occurs,” Kotula says, explaining the moment the cancer begins to spread at the cellular level.

So far, there’s no easy way to tell when that occurs in an individual. Once cells metastasize to the lung or the bone, a patient’s tumors become visible through medical imaging. Before that happens, cellular changes aren’t visible.

But one day, Kotula hopes, doctors may be able to read a man’s genetics and tell him whether he has an aggressive form of cancer, or not.

About prostate cancer

When a man turns 60, his chance of developing prostate cancer soars. The American Cancer Society says three in five men over the age of 65 will develop prostate cancer.

It’s the most common cancer in men, other than skin cancer, and it is the third leading cause of cancer death in men, behind lung cancer and colorectal cancer.

The American Cancer Society projects that almost 27,000 men will die from prostate cancer this year.

Cancer Care magazine fall 2017 coverThis article appears in the fall 2017 issue of Cancer Care magazine.


Posted in cancer, health care, men's health, research, urology | Tagged , ,

73-mile trip for breast care is worth it to her

Laurie Gildea doesn't mind the drive from Binghamton to Syracuse for her care at Upstate. (PHOTO BY ROBERT MESCAVAGE)

Laurie Gildea doesn’t mind the drive from Binghamton to Syracuse for her care at Upstate. (PHOTO BY ROBERT MESCAVAGE)


Laurie Gildea’s husband, Kevin does the research. She goes with her gut.

Lisa Lai, MD

Lisa Lai, MD

So when a routine mammogram in May 2017 found a suspicious lesion, and when a subsequent biopsy revealed breast cancer, Gildea suddenly needed a surgeon with breast cancer expertise.

“I have to feel confident with the people I’m with,” she says. As soon as she met Lisa Lai, MD, and Prashant Upadhyaya, MD, and the nurses and staff at the Upstate Cancer Center, Gildea recalls, “I immediately felt the connection.”

The Gildeas live in Binghamton. Laurie is a teacher’s aide. Kevin is a systems engineer.

Prashant Upadhyaya, MD

Prashant Upadhyaya, MD

The doctors’ credentials and experience impressed Gildea’s husband. Both are board-certified surgeons who frequently work together at Upstate. Lai completed her surgery residency in 2015. Upadhyaya finished his surgery residency in 2010 and then his plastic surgery residency in 2013.

The news of cancer that Gildea got after her mammogram was a surprise. Having survived so many previous medical tribulations – including a lung infection in 2001 that led to a partial lung removal – “I basically thought I’ve gone through enough in my life,” she says.

Gildea’s lung surgeon, Leslie Kohman, MD, helped arrange the biopsy and put her in touch with the two surgeons.

Leslie Kohman, MD

Leslie Kohman, MD

Her breast cancer was considered stage 1. It was small and had not spread from the breast. She did not require chemotherapy or radiation treatments. She underwent a mastectomy in early July. After her body heals, Upadhyaya would insert Gildea’s new implant.

The Gildeas are happy to travel to Syracuse to see the Upstate doctors.

“It’s really not that far,” Gildea says. “And for the care I’m given, it’s so worth the drive.”

Breast cancer stages

The stage of a breast cancer helps determine treatment options and a patient’s survival outlook.

Doctors determine the stage based on the size of the tumor, whether lymph nodes are involved and whether cancer has spread elsewhere in the body.

Ductal carcinoma in situ, for instance, is considered stage zero. It is small and contained in the milk ducts of the breast.

Stages I and II are early breast cancers with tumors of various sizes that may involve one or two lymph nodes.

Stages II and III are locally advanced breast cancers, meaning the tumors are larger and/or the cancers may involve up to two lymph nodes.

Stage IV is metastatic breast cancer, which means it has spread to other parts of the body.

Cancer Care magazine fall 2017 coverThis article appears in the fall 2017 issue of Cancer Care magazine.


Posted in cancer, health care, lung/pulmonary, surgery, women's health/gynecology | Tagged ,