upstate health, fall 2014

Health UPSTATE MEDICAL UNIVERSITY Fall

2014

UPSTATE

GESTURE OF LOVE page 5

FINDING CARE ON FACEBOOK page 8

GETTING TOO MUCH CALCIUM? page 10

HOW TO SPOT AUTISM IN BABIES page 11

TONY WINNER GOT HER START AT UPSTATE page 16

TRI-ING TO STAY FIT page 20

w w w . u p s t a t e . e d u2 U P S TAT E H E A LT H fall 2014

PUBLISHER Wanda Thompson, PhD,Senior Vice President for Operations

EXECUTIVE EDITOR Leah CaldwellAssistant Vice President, Marketing &

University Communications

EDITOR-IN-CHIEF Amber Smith

DESIGNER Susan Keeter

Visit us online at www.upstate.edu orphone us at 315-464-4836.

For corrections, suggestions and submissions, contact Amber Smith at315-464-4822 or [email protected]

ADDITIONAL COPIES: 315-464-4836

Upstate Health offices are located at 250 Harrison St., Syracuse, NY 13202

HealthFall 2014

On the cover: Brandon Hudson, left, donated ahealthy kidney to his father, Timothy.He is with nurse Ellen Havens, living donor transplant coordinator at Upstate. Photo by Robert Mescavage

Upstate Health magazine is a com-munity outreach service of UpstateMedical University in Syracuse, NY.Upstate is an academic medical center with four colleges (Medicine,Nursing, Health Professions andGraduate Studies); a robust researchenterprise and an extensive clinicalhealth care system that includes Upstate University Hospital’s downtown and community campuses,the Upstate Cancer Center and the Upstate Golisano Children’sHospital. Part of the State University of New York, Upstate is Onondaga County’s largest employer.

KATHLEEN PAICE FROIO

KidzBop performing for patients and families at the Kinney Performance Center, Upstate Golisano Children’s Hospital

This issue brought to you by the number

years ago, the Upstate Golisano Children’s Hospitalopened its doors in a “treehouse” addition above Upstate University Hospital in downtown Syracuse.

members of KidzBop visited patients at the children’s hospital in June.

patents are held by Gary Nieman, who recently received a $50,000 grant from the SUNY TechnologyAccelerator Fund to develop minimally invasive infusion and suction therapy, a novel medical devicethat removes harmful abdominal fluid buildup causedby trauma, infection or burns.

miles per shift is the distance that environmental services workers typically walk, helping to keep thedowntown hospital campus clean and disinfected, says John Kolh, operations manager.

medical mission trips to Ethiopia have been organizedby otolaryngologist Rick Kelley, MD, in recent years to provide care and to train other ear, nose and throat doctors.

thousand dollar donations to the Upstate Cancer Center are recognized on a ceramic tile mural in the healing garden. So far, 33 $5,000 gifts have been received. To honor your loved one in this space, contact the Upstate Foundation at 315-464-4416.

learning communities — consisting of medical students for the class of 2017, led by faculty members, Drs. Lawrence Chin, Robert Corona, JamesGreenwald, Michael Iannuzzi and Robert Silverman —are named after the Finger Lakes: Canandaigua,Cayuga, Keuka, Seneca and Skaneateles.

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3fall 2014 U P S TAT E H E A LT H

Bus banners promote Upstate missions of care, research, education

The most populated areas of this region are servedby the Syracuse-based Centro bus service. Upstatebanners appear on the sides of some of these buses.Being at eye level, the advertisements dominate.

Many people see the banners, as the buses travel hundredsof miles per day. Upstate has a broad reach.

This issue of Upstate Health illustrates that reach and thebreadth of what we do with the variety of our articles.

You’ll find stories about the medical care we provide andthe research in which we’re engaged. Some of our expertsshare their advice. (Too much calcium? Page 10. Signs ofautism? Page 11. Need to burn 600 calories? Page 21) Youwill also meet some students – some of whom traveled toother continents as volunteers (page 15) and a pair who developed a case of puppy love as residents of downtownSyracuse (page 21.)

You will learn how Tony-winning actress Jessie Mueller gother start at Upstate (page 16), why nurse Sarah Martinloves kayaking (page 19), what author Walt Wasilewskilearned while researching his book about spiritual care(page 14), and the question every doctor will ask himself or herself eventually (page 16.)

Find a roundup of Upstate news on page 4, a recipe on page 22, and cool scientific artistry on page 24, this time from the laboratory of assistant professor Mehdi Mollapour, PhD.

We hope you enjoy making Health part of your life.

Need a referral?

Contact Upstate Connect at 1-315-464-8668 or 1-800-464-8668, day or night, for appointments or referrals to the health care providers on these pages or anywhere at Upstate or for questions on any health topic.

Contents

WELCOME

“Cancer care for all ages at Upstate” announces this bus, heading east on East Genesee Street, Syracuse.

PATIENT CAREA son’s life-saving gesture page 5

Protecting the heart without touching it page 6

Would you give a kidney to a stranger? page 7

Facebook connection page 8

FROM OUR EXPERTSHow to stave off Alzheimer’s with exercise page 9

5 questions after a car wreck page 9

Are you getting too much calcium? page 10

How to tell if your baby has autism page 11

What to do when a tooth is knocked out page 11

Protect yourself from food-borne illness page 22

IN THE KNOWInside the new Upstate Cancer Center pages 12-13

Searching for ways to inhibit cancer back cover

IN OUR COMMUNITYBook shares spiritual care advice page 14

Helping others, oceans apart page 15

Talking – without words page 17

Meet 7 volunteer firefighters page 18

IN OUR LEISUREOne with her kayak page 19

Tri-ing to stay fit and healthy page 20

How to burn 600 calories page 21

Students afflicted by puppy love page 21

Herb-stuffed tomatoes with white beans page 22

SARA TUCKER

coverstory


WHAT’S UP

You may recall that four runnersfrom Upstate were invited tocompete in the JP Morgan ChaseCorporate Challenge in London this summer for the 3.5-mile championship race.They sent a group post card – a cut-out of Queen Elizabeth –saying “the race experience wasone-of-a-kind and inspiring. We connected with athletesfrom across the country and the world.”

The Upstate team’s total time was 1 hour, 32 minutes and 39 seconds. John Kolh of environmental services finished in 21:24. Exercise physiologist Kristin Kmack finished in 22:26. Chris Loughlin,a member of the electronic medical records technical team, finishedin 24:13. And registered nurse Cara Lavier finished in 24:36.

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Happy holidays: Did you celebrate the start of summer at the LEON Festival in June? LEON (“noel” spelled backward) marks thehalfway point to Christmas. There were fireworks instead of treelights, Kidz Bop instead of carols, and no snow.

Staff from Upstate Golisano Children’s Hospital distributed 500 free bicycle helmets along with advice for keeping kids safe. The celebration is expected to become an end-of-the-school-year tradition.

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Construction is underway to expand the Joslin Diabetes Centerso that more patients can be cared for at the center at 3229 E. Genesee St., Syracuse.

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The American Academy of Sleep Medicine reaccredited the Upstate Sleep Center, which offers sleep studies for people of all ages. Its director, Robert Westlake, MD, says this “reaffirms our dedication to sleep health.”

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Good news for the Master of Public Health program. It received afive-year accreditation from the Council on Education for PublicHealth. The joint program between Upstate Medical and Syracuseuniversities offers an MPH degree and a certificate program. Students include physicians and other health care professionals,plus people just entering the field of healthcare. Part-time study is an option. Learn more at upstate.edu/cnymph/academic.

Upstate’s MD/PhD program adds eight new students this year,bringing to 27 the total number of future physician/scientists. The dual degree program sandwiches a three-year PhD researchsegment between the first two and last two years of medical school.

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An initiative to decrease hospital re-admissions for heart failure patients, a program offering financial assistance for childbirthclasses and an annual symposium that updates medical teams onadvances in cancer care are among 61 projects at Upstate to share$120,000 in funding this year from the Advocates for UpstateMedical University. The Advocates raise money through events suchas Mystery, Malt and Merlot to support hospital programs that im-prove patient care, support medical education and enhance health.

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Speaking of money that helps society, researchers in the Depart-ment of Psychiatry received a $2.8 million Mental Health ResearchGrant from the National Institute of Mental Health. Over the nextfive years, they will investigate genetic susceptibility to a widerange of childhood psychiatric disorders.

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The Upstate Cancer Center received a$50,000 grant from the Susan G. KomenCNY Affiliate to help increase the ratesof mammography screening in low-income African-American women. Thegrant helps create a program called “SheMatters,” which will use trained health advocates to educate, encourage and fa-cilitate mammography screening amongwomen over age 40 who live in SyracuseHousing Authority’s Pioneer Homes development in downtown Syracuse.

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Upstate is among nine State University of New York campuses to share $900,000 in funding for biomedical research projectssupported by the SUNY Health Network of Excellence.

Gerontologist Sharon Brangman, MD, is involved in two of the projects – one that will investigate frailty through a collaborationwith researchers at the University of Buffalo, Downstate MedicalCenter and Stony Brook University, and another that explores thecreation of hand-held biosensors that could detect neural diseasessuch as stroke, Alzheimer’s disease and traumatic brain injury.

John Epling, MD, and Christopher Morely, PhD, received a planninggrant to create a SUNY-wide centralized “big data” repository ofelectronic health record data.

News from around Upstate Medical University

c o m m u n i t y c a m p u s

GEM CARE

FOR MORE INFORMATION, CALL UPSTATE CONNECT AT 800.464.8668 4900 Broad Road, Syracuse

(the former Community General Hospital)

Brandon Hudson acts like it was nothing. His father,Timothy Hudson, sometimes has to pause. The 56-year-old Syracuse man is rendered speechless,overwhelmed by emotion, when he thinks about

how Brandon donated one of his healthy kidneys to him.

“I was fading fast,” the father recalls. “I don’t know howmuch longer I would have lasted.”

In June son and father became the 11th living donor kidneytransplant pair at Upstate this year. They were the third setof African Americans, which represents an upward trend inrecruiting people of color to donate organs for transplant.

African Americans are the largest minority group in need of organ transplant but make up a comparatively small percentage of people willing to donate, according to the Department of Health and Human Service’s Office of Minority Health. The National Kidney Foundation saysAfrican Americans have an increased risk of developing kidney failure because of high rates of diabetes, high blood

pressure and heart disease. That drives the demand for kidney transplants — and the need for kidney donations.

Transplant surgeon J. Keith Melancon, MD, says CentralNew Yorkers spend an average of four to five years on thewaiting list. About a third will die before a kidney becomesavailable. Among the rest, some will receive kidneys fromdeceased donors. Others may have family members orfriends who offer to be living donors.

“People who get transplanted pretty much have a normallife expectancy compared to people who have end stagerenal disease and have to be on dialysis,” the surgeon says.

Hudson was on dialysis and not doing well.

He had been living what he believed was a healthy lifeabout five years ago, running 5 or 6 miles a day, liftingweights, stocking his refrigerator with milk and healthyjuices. Then he developed a cough, and soon he was struggling to breathe. At the hospital, he was diagnosed

A life-saving gesture

BY AMBER SMITH

Timothy Hudson at his Syracuse home with his son, Brandon.

PATIENT CARE


Continued on page 6

ROBERT MESCAVAGE

Son donates kidney to father

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PATIENT CARE

U P S TAT E H E A LT H fall 2014 w w w . u p s t a t e . e d u

with congestive heart failure and kidney failure and admitted to the intensive care unit. Doctors were not sure he would survive.

When he was discharged, Hudson was on dialysis. His high blood pressure was closely monitored, and he took 35 medications per day. He developed pneumonia andother infections. Three years in a row, he spent his birthdayhospitalized with some type of complication.

His 23-year-old son Brandon kept offering one of his kidneys for transplant. One of Hudson’s daughters and abrother offered, too, but were ultimately unable to donate.Hudson did not believe Brandon knew enough about whathe was offering. Plus, he says, “I didn’t want him to feel likehe had to do this.”

Brandon wanted to see his father healthy again. Hebroached the topic of donating a kidney multiple times,“and Dad would be like ‘we’ll see.’ He was kind of just putting it off.”

When Brandon began speaking about creatinine levels —the byproduct of muscle metabolism excreted by the kidneys that doctors use to assess renal health — Hudsonknew his son had done his homework. They agreed to pursue a living donor transplant.

Even on the morning of surgery, Hudson told his son itwould be OK to back out. He pulled aside Melancon andVaughn Whittaker, MD. “I don’t want anything to happento me,” he told the two surgeons, “but PLEASE don’t letanything happen to my son.”

After the surgeries, the father and son spoke briefly by telephone as they recovered in their hospital rooms. Brandon later took a wheelchair to visit his father’s room.He just wanted to make sure he was all right.

To be a kidney donor, you must: • undergo thorough physical and mental evaluations, including kidneyfunction testing, cancer screenings and a variety of other tests, whichare organized by living donor transplant coordinator Ellen Havens.

• be free of health problems such as uncontrolled high blood pressure,diabetes, cancer, hepatitis, HIV and organ diseases.

• fully describe your reasons for wanting to donate, and the impact itwill have on all aspects of your life.

• understand there will be no compensation, although some expensesmay be covered.

• learn your compatibility through blood tests, tissue typing and antibody screens.

• consider that if you are not compatible with your loved one, you still may be able to donate to someone else. That person would supply a compatible donor for your loved one in what is called a“paired exchange.”

• realize that complications could include pain, infection, blood loss,blood clots, allergic reactions to anesthesia, pneumonia, injury to surrounding tissue or other organs or even death. In addition, some donors report trouble obtaining or keeping life, disability and health insurance policies.

A son’s life-saving gesture, continued from page 5

Protecting the heart without touching it

Anew style of implantable defibrillator provides protection against sudden cardiacarrest without having electrical wires placed in the heart. Instead, all componentsof the device are sewn into place just beneath the skin.

The device — which The Heart Group of Syracuse cardiologists Traian Anghel, MD, and Jamal Ahmed, MD, began usingthis year at Upstate — monitors a patient’s heart rate and delivers a shock if necessary, “which essentially resets all of theelectrical activity of the heart cells,” says Anghel.

He says a battery-operated pulse generator about the size of a deck of cards is placed beneath the skin below a patient’sarmpit. A wire electrode stretches below the skin from the generator to the breastbone above the heart. It senses the heart’selectrical signals and transmits that data to the generator, and delivers therapy back to the heart if needed.

Implantable defibrillators have been in use for about 40 years. Earlier models rely on a wire to be threaded through a bloodvessel, into the heart, across a valve and then attached to the heart wall.

Anghel says that for patients who are prone to a rapid heart rhythm called ventricular fibrillation, the risk of sudden cardiacdeath can be as high as 1 in 6 per year. He says an implantable defibrillator can significantly improve those odds.

Listen to a HealthLink on Air radio interview on this subject by visiting www.upstate.edu/healthlinkonairand typing “kidney” in the search box.

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He was about to turn 30 and feeling blessed. Hehad a great family, a solid support system, and hehad found a way to help someone. A woman atthe man’s church had severe kidney disease and

was on dialysis three times a week. He could not help her.But he could help someone.

Most people are born with two kidneys but can live normal,healthy lives with just one. Among those willing to becomeliving donors, most donate to family members, friends orpeople they know. Some are willing to donate to peoplethey have never met. The transplant team at Upstate refersto them as “altruistic” donors.

The man had never heard the word altruistic, which meansa selfless concern for the wellbeing of others. He simplywanted to help someone, without acknowledgement. He did not want to be identified by name in this story.

Living donor coordinator Ellen Havens says this happenssometimes. “Some donors just feel like they have this calling. Some say they knew somebody that they couldn’tdonate to, or they saw somebody suffering.”

The man contacted Upstate University Hospital’s transplantcenter and learned that he was healthy enough to donateone of his kidneys. It was a good match for a Central New York woman, whose husband was not a match for her. The husband was still willing to donate a kidney, though,and his was a good match for another Central New Yorkwoman.

That is how transplant surgeons came to perform the first kidney exchange at Upstate: four surgeries involvingtwo donors and two recipients on one long summer day.The spark was the altruistic donor.

Transplant surgeon J. Keith Melancon, MD, removed theman’s kidney and while his colleague, Vaughn Whittaker,MD, was sewing it into the recipient, Melancon left the operating room to let the donor’s mother and father knowthat all was well. “You have a great boy. I know you knowthat,” he began.

Melancon says an average of 17 people die each day waitingfor a kidney transplant. “We have to do something besideswait for deceased donors,” he says.

Altruistic donors can help ease the shortage. So can kidneyexchanges, a practice that Melancon helped implement during his year at Upstate’s transplant center. He is nowchief of the division of kidney and pancreas surgery atGeorge Washington Hospital in Washington, DC.

Instead of helping one person, an exchange can save thelives of multiple people. Google “32-person kidney swap”for coverage of 16 kidney transplants involving Melanconin 2011.

The two transplants at Upstate began to acquaint staff withthe myriad details of orchestrating exchanges. As much asanything, it requires a shift in thinking. “It’s a whole newconversation that I’m having with people today,” Havenssays. Instead of simply matching donors with recipients, thetransplant team now asks would-be recipients if they knowsomeone who is willing to donate a kidney.

The altruistic donor liked that his kidney would go to awoman whose husband was willing to pay it forward.Melancon did too. “Every day I get to see the best side ofhumanity,” the surgeon says. “This is one person helpinganother person.”

J. Keith Melancon, MD, says surgeons usually remove the left kidney from someone who is willing to donate, since the renalvein on that side is generally longer. The donor kidney is usually sewn into place in the recipient without the recipient’s kidneysbeing removed.

Would you give akidney to a stranger?BY AMBER SMITH


PATIENT CARE

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PATIENT CARE

U P S TAT E H E A LT H fall 2014

Internet researchleads family to Upstate for rare surgery

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Many Facebook connections provide a quick di-version or fun way to stay in touch. Sometimesthe social network makes a connection that doesmore — by improving someone’s life.

A mother in Istanbul, Turkey joined a Facebook group forparents of children with tuberous sclerosis complex (TSC), a rare disease caused by a genetic mutation and marked bynoncancerous tumors that grow throughout the body. Shewas looking for a way to help her 5-year-old daughter, Mia,who suffered from seizures related to TSC.

The mother, Micheale Kovalkovic, wound up connectingwith Jennifer Failla of Central Square, NY, whose daughterArianna has TSC. Arianna underwent MRI-guided thermallaser ablation last fall at Upstate. Her parents saw steadyprogress afterward with her behavior and cognitive abilities.

Kovalkovic learned more about the minimally invasive procedure. It allows doctors to insert a small laser into thebrain and use a burst of heat to eradicate brain tumors orthe epilepsy focus. Because it does not require the skull tobe cut open, or radiation therapy, which can damage surrounding tissue, ablation is safer for patients and reduces complications and recovery time.

Would it work for Mia?

Kovalkovic sent an email inquiry to Zulma Tovar-Spinoza,MD, and received a quick response from the director of pediatric neurosurgery at Upstate Golisano Children’s Hospital.

“Upstate is one of the few centers in the world that is usingthis technique for patients with brain tumors and epilepsy,”she says, explaining how precise measurements can be taken before patients are wheeled into the MRI suite formagnetic resonance imaging and the placement of a thin fiber optic applicator.

“The beauty of this technology is that you can actually seeon the monitor the change of colors and temperature of thearea that you are ablating,” Tovar-Spinoza explains. “It’s so

precise. You know that are you preserving areas of the brainwhere you want to preserve function.”

The Kovalkovics came to Syracuse last March for the firstphase of treatment from Tovar-Spinoza and her pediatricneurology colleague, Yaman Eksioglu, MD, PhD, a nativeof Turkey who put the family at ease. The family returnedin August for the second phase and plans to come back oncemore this winter.

Tuberous sclerosis was detected in utero, when MichealeKovalkovic was in her third trimester. Twice during Mia’sinfancy, Micheale and Ivan Kovalkovic brought theirdaughter to a New York City hospital for surgery; twice,the surgeries were cancelled when the baby had a reactionto anesthesia. They began exploring options. Soon, Mia wasenrolled in a special school in Turkey where she received in-tensive therapy seven days a week but remained nonverbal.

“We wanted to do whatever it took to get her well,” saysher father, Ivan Kovalkovic, a business executive who lefthis job to concentrate on his family during Mia’s medicaltreatment.

When they are in Syracuse, the family resides at the RonaldMcDonald House, 1100 E. Genesee St. “It’s like a 6-starhotel, luxurious with fine food and an enormously helpfulstaff,” he says.

Since her first procedure, Mia sleeps and eats better. Andwhile they remain hopeful their daughter will speak someday, Ivan and Micheale are grateful for the elimination ofmost of their daughter’s seizures.

Senior patients with complex medical needs, who are clinically stablebut require ongoing hospital care, now have access to a new type of

specialized care.

Upstate University Hospital’s Community campus opened a TransitionalCare Unit this summer. Patients are expected to stay from five to 20days in the 20-bed unit. Some will be recovering from planned surgerywhile others will be experiencing a medical emergency or a new diagnosis. Patients in need of wound care, IV therapy or orthopedic care may also be admitted.

Sharon Brangman, MD, Upstate’s geriatrics division chief, will guide theinterdisciplinary team of nurses, case managers, therapists, dietary staffand hospitalists assigned to the unit. Nurses selected for the unit willhave completed the Nurses Improving Care for Healthsystem Elders(NICHE) program, which works to improve the care of older adults.

For more information about the Transitional Care Unit, call 315-492-5847. This new unit complements the emergency and urgentcare services at GEM Care, also on Upstate’s Community campus.

Micheale Kovalkovic and her husband, Ivan Kovalkovic, stayed at the Ronald McDonald House when they brought their daughter, Mia, to Syracuse for treatment at Upstate Golisano Children’s Hospital.

ROBERT MESCAVAGE

New hospital unit designed for seniors

ROBERT MESCAVAGE


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In all her years of presentations, physical therapist Dale Avers has never seen a handraised when she asks audiences who aspires to live in a nursing home.

People fill conference rooms to hear Avers explain how to avoid ending up in nursing homes.The key, she says, is a healthy brain. And the key to a healthy brain is exercise.

Our brains, which continue to generate new brain cells even in our senior years, demand 25 percent of the blood and nutrients from every beat of our hearts. So, increasing our heartrate increases blood flow to the brain.

We increase our heart rate through aerobic exercise that is strenuous, that makes us sweatfor at least 15 or 20 minutes at a time. We don’t have to run marathons; we can take stairsinstead of escalators, park far away rather than near. But when a particular exercise is nolonger challenging, Avers says it’s time to make it more challenging — or try something new.

“The more you do, the more benefits you’re going to reap,” Avers says. People who exercisefewer than three times a week, compared with those who exercise more than three times aweek, are dramatically more likely to develop Alzheimer’s disease. After age 85, the risk ofdeveloping Alzheimer’s rises to 50 percent, according to the Alzheimer’s Association.

Mental stimulation is also important in maintaining brain health, she says.

“Easy, to me, is a four-letter word. Things that are easy are not good for us.

“Somehow, as we get older we feel entitled to take things easy — and that’s the worst thingwe can do.”

Walking around a flat track isn’t as beneficial as walking through hilly neighborhoods.

Crossword puzzles that are easy aren’t stimulating.

Avers — a regular speaker at Upstate’s HealthLink seminar series — suggests audience members ask themselves: “What have I quit doing because it was too tough?”

Sometimes as people become hard of hearing, they give up trying to understand a conversation. Sometimes as people age, they become reluctant to pursue new fields of study. Instead, they go easy.

“You’ve got to change your belief that easy is good,” Avers says.

Learn about Upstate’s HealthLink Seminar series by calling 315-464-8668 or visiting www.upstate.edu/hospital/healthlink/

Listen to a HealthLink on Air radio interview on this subject by visitingwww.upstate.edu/healthlinkonair and typing “exercise” in the search box.

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Ask these 5 questions after a car wreck

Emergency physician WilliamPaolo, MD, explains what to

do if you find yourself in a carwreck. If you answer yes to anyof these questions, call 911 foran ambulance.

1. Did your airbags deploy? If the impact was strongenough to deploy airbags, itmay have caused injury, aswell. You may notice a chemical-smelling white powder from the airbag, butit’s not dangerous unless itgets into your eyes.

2. Was there what’s known as “intrusion?” Did the carand the cabin around you collapse into you? Would youneed help getting out of the car?

3. Did you lose conscious-ness? Do you remembereverything that happened?

4. Did you wear your seatbelt? “If you didn’t wearyour seatbelt and you findyourself outside of your car,then you want to see an ambulance provider rightaway,” Paolo says.

5. Are you in pain? Even whatseem to be minor wrecks cancause injury, so pay attentionto your body.

If you are transporting a child ina car seat, keep him or her in thecar seat. Paramedics will likelybring the child to the hospitalthat way.

Paolo says most importantly:Stay in your car unless it is onfire or about to be on fire, whichwould be exceedingly rare.

“We don’t want you up andmoving around if we don’t knowwhat your injuries are,” he says.“We worry that you may have injured something that may getworse by moving around.”

Not only that, but if you get outof your car, you are liable to beinjured by other vehicles.

FROM OUR EXPERTS

How to stave offAlzheimer’s with exercise

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FROM OUR EXPERTS


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QThe colored cornstarch used in promotional running events is supposedly safe for the skin, but what aboutthe lungs? I awoke in a coughing fit the morning after the event.

“Most likely the coughing was not related to the cornstarch. However, if you have environmental allergies, it might bepossible to develop an allergy to a protein found in the cornstarch. (It is unlikely that the starch is pure starch, and

there are probably some proteins from the corn in the cornstarch). This could produce an asthma attack if you develop an allergy, an IgE antibody to the protein. This would be similar to inhaling ragweed, dust mites, cat dander, or other environmental allergens and then developing an asthma attack. Sometimes asthma manifests as a cough, and one does not develop wheezing or shortness of breath.

“An alternative explanation for your cough is exercise-induced asthma. This occurs because you lose heat from your airwaywhen you exercise, and this may precipitate an asthma attack in those who are predisposed to exercise-induced asthma. As mentioned, asthma may manifest itself as a cough without other symptoms.

“A third explanation for the cough is that while you were running you inhaled environmental allergens such as tree pollens.These allergens may have precipitated an asthma attack.

“Finally, you may have been coming down with a viral respiratory infection, and that caused a cough.”

—ROBERT LENOX, MD, PROFESSOR OF MEDICINE AND DIVISION CHIEF OF PULMONARY/CRITICAL CARE AT UPSTATE UNIVERSITY HOSPITAL.

ROBERT LENOX MD

Q AANDWITH

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The Color Me Rad 5K run took place on Onondaga Lake Parkway in May.

Getting enough calcium is important, tokeep your bones healthy. But getting too much may increase your risk for developing kidney stones or calcium

toxicity or interfere with your body’s ability to absorb other minerals.

Adults should ingest no more than 2,000 to 2,500milligrams of calcium per day, depending on age, according to a recent government-ordered reportfrom the Institute of Medicine. That is “elemental”calcium.

When calcium is taken as a supplement, differentpreparations contain different amounts of calcium,and that should be noted on the label. For example,1,000 milligrams of calcium carbonate will contain400 milligrams of elemental calcium, and 1,000 milligrams of calcium citrate will contain 200 milligrams of elemental calcium.

In addition to supplements, you may get a

significant amount of calcium from your diet, if it isfull of calcium-rich foods. (Yogurt, milk, cheese,salmon, collards and black eyed peas are some examples.) And—don’t forget—if you take over-the-counter antacids, most contain calcium as well.

Taking the maximum amount of calcium in supplements, plus antacids puts a person “at highrisk for complications associated with excess calcium intake,” writes Shristi Neupane, MD, in theAugust issue of the journal Public Health Nutrition.Neupane recently completed her internal medicineresidency at Upstate.

She and co-author Stephen Knohl, MD, an associateprofessor of medicine at Upstate, point out that theFood and Drug Administration has not required anupdate in labeling on antacids, some of which stillindicate that up to 3,000 milligrams per day is safe.

The lesson: Keep antacids in mind when you calculate your calcium intake.

Are you getting too much calcium?

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MICHAEL GREENLAR/SYRACUSE.COM

CALCIUM

Upstate Answers


FROM OUR EXPERTS

What to dowhen a toothis knocked out

Fracturing or losing a tooth ina fall or other accident is a

fairly common occurrence. Whenthat happens, “you have a verylimited timeframe in which totreat that situation,” says assistant professor and dentist,Patrick Smith.

Athletic facilities and schoolsports programs may have Save-a-Tooth preservation kits atthe ready. They contain a liquidthat preserves a tooth for a shortperiod of time.

Smith says to help the toothmaintain moisture constantly.Milk is fine. Water works, too. Or,you can place the tooth in thepouch of your cheek. “The tissueis alive, and we need to maintainit until we can re-implant it intothe socket,” he says.

Make sure to handle the toothonly by its crown, or the partthat you can see in the mouth.Do not touch the root.

Get to a dentist, oral surgeon orthe emergency department atUpstate University Hospital asquickly as possible, so the tooth can be re-implanted and secured.

Google “causes of autism” and you get millions of hits — and a multitude of conjecture. Is a genetic predisposition to blame? Are environmental factors atplay? Maternal or paternal age, perhaps? Some sort of pregnancy complication? A virus, or pollutant in the air?

We do not know for sure, but genetics and the environment likely play a combined role, saysHenry Roane, PhD, an associate professor of pediatrics and division chief of the Center forBehavior, Development and Genetics at Upstate. Regardless of the cause of autism or thereason for its recent growth, he says treatment is most effective when begun early.

One in 68 children have autism spectrum disorder. The term “spectrum” is used now in reference to the range of impairment children can have, from mild to severe disability.

That represents a 30 percent increase in diagnoses from a few years ago, partly because several individual disorders are now considered part of the autism spectrum. Awareness is also behind the increase, with more parents, teachers and primary care doctors on thelookout for early signs.

“It’s not like having a medical disorder where you can do a blood test and test for certainpathogens in your bloodstream and say ‘well, you have that disease.’ Autism is not likethat,” Roane says “It is, to some extent, a subjective diagnosis in many cases. What oneprovider sees as autism, another provider might not see it as such.”

Treatment is intensive behavioral therapy of 25 to 40 hours per week, to help improve cognitive and language skills. Roane says proper medical care plus early intervention canhelp change the trajectory of autism, especially in children who begin treatment before age6. That means caregivers have to know what to look for, and what to ask the pediatrician.

Upstate’s Center for Development, Behavior and Genetics (315-464-6395) and the MargaretL. Williams Developmental Evaluation Center (315-472-4404) provide comprehensive reviews of children up to age 7 in 17 counties.

Autism identifiers: How to tell which babies are affected

� lack of sustained eye contact, especially topeople or visually interesting objects

� slow progression of language or delayedspeech formation (not babbling, or makinga single repetitive sound)

� not responding to his/her name by 12 months of age

� preference for playing alone

� flat or inappropriate facial expressions

� not pointing at objects by 14 months of age

� flapping hands, rocking body or spinning in circles

� avoiding or resisting physical contact

� unusual reactions to the way things sound,smell, taste, look or feel

� not playing pretend games (such as “feeding” a doll) by 18 months

� reversing pronouns (“you” instead of “I”)

� talking in flat, robot-like or sing-song voice

� lining up toys or other objects, or playingwith them the same way every time

� repetitive movements, in older children

� getting upset by minor changes

Some signs of autism may be visible when a baby is just a few months old, although expertscaution that the signs and symptoms of autism are highly variable among those affected.These 15 behaviors are possible signs:

Listen to a HealthLink on Air radio interview on this subject by visitingwww.upstate.edu/healthlinkonair and typing “autism” in the search box.

Sources: Centers for Disease Control and Preventionand the National Institute of Mental Health

Red flags?

12 U P S TAT E H E A LT H fall 2014

IN THE KNOW

Making an Impactfrom page 4

Cancer care expands with new center

The gleaming new Upstate Cancer Center is morethan a hub for a nearly $18 million investment in revolutionary cancer-fighting equipment. It signals a progressive multidisciplinary approach

to cancer care at Upstate University Hospital — and communicates hope.

Designers sought to create “a cutting-edge modern lookthat would reassure people of the level of care they’re goingto receive,” says architect Saul Jabbawy, director of designfor EwingCole, the architectural and engineering designfirm. The building also is meant to instill calm. Patientshelped select a “healing through nature” theme, and localartists provided more than 100 pieces of art that are displayed throughout the center, offering visual escape. In addition, the adult infusion area overlooks a healing garden on the roof between the center and Upstate University Hospital.

Patients receiving outpatient care in the center can easily get to imaging and testing appointments in the hospital. Hospital inpatients will have easy access to diagnostic andtreatment services available in the center. Also, the parkinggarage is accessible through a walkway that is protectedfrom the weather.

Cancer care at Upstate is coordinated across disciplines,rather than segregated by department.

“For example, if a patient has breast cancer, a medical oncologist, radiation oncologist and surgeon may come together to plan the best therapy,” says associate administrator Dick Kilburg. “We needed the physical structure to match what we were beginning to accomplish organizationally.”

The center provides comprehensive care for children andadults with cancer or blood disorders with an unmatchedbreadth of options in the Central New York region. Complementing Upstate’s existing diagnostic and treatment arsenal are some new key pieces of technology.

Advanced Technology

• an intra-operative suite dedicated to cancer proceduresand neurosurgery that is one of only 10 similar facilities inthe country. Advanced imaging is provided in rooms thatconnect to the full-service operating room.

• the Varian TruBeam, with a rotating arm that allowsphysicians to target tumors with extreme precision, while sparing healthy tissue.

w w w . u p s t a t e . e d u

The Central New York community contributed $17.4 million — almost a quarter of which came from Upstate employees, advocates, volunteers and foundation boardmembers – to help build the $74 million Upstate Cancer Center.

STEVE GARLOCK


IN THE KNOW

Listen to an interview at upstate.edu/healthlinkonair by searching “cancer.”

• the Vero stereotactic body radiotherapy system for advanced treatment of lung, liver, prostate and other cancers. “The Vero system permits what I refer to as4-D imaging, with the fourth dimension being time,” says Jeffrey Bogart, MD, professor and chair of radiation oncology and co-director of the prostate cancer program.“By that I mean we can visualize the tumor in the patient’s anatomy in three dimensions and also track its changes across time and modify our treatment accordingly.”

Along with the new technology are the sort of extras thatpatients appreciate.

Within the center is a meditation room and a Family Resource Center with access to Upstate’s academic medicallibrary. There is also space for nutritional assessment andguidance, genetic counseling, cancer rehabilitation and con-sultations for pain management and integrative medicine.

Plus, a grant from a generous donor allows for the additionof a cancer center music coordinator. Greeting visitors inthe main atrium, providing ambient music at certain times,is a baby grand piano.

Ajeet Gajra, MD, is one of the many cancer experts who sees patients in the newUpstate Cancer Center.

The “Tree of Hope” sculpture by Ellen Steinfeld at the entrance of the UpstateCancer Center is one of 100 pieces of artwork with a “healing in nature” theme.

SUSAN KAHN

ROBERT MESCAVAGE


IN OUR COMMUNITY

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Abook called “Open the Eyes of My Heart” showcases the spiritual care that takes placewithin the hospital as part of professional and volunteer chaplaincy provided by the

Department of Spiritual Care.

Spiritual care volunteer Walt Wasilewski crafted the bookfrom interviews with 18 spiritual care volunteers. He is ajournalist who teaches at Syracuse University’s S.I. New-house School of Public Communications. In his spare time,he meets with patients who request a spiritual care visit.

“I felt like it was a 6-month intensive tutorial in the bestpractices in spiritual care,” he says of the time he spent researching. “I learned so many things, some esoteric, some fairly difficult to ponder, but a lot of practical things:What do you say when this happens? How do you reactwhen that happens?

“It has affected the way I relate to patients,” saysWasilewski. “And the hope is that the book will do thesame for people in other places, other hospitals, other settings, where they might read this and be a little bit inspired.”

One story is about a volunteer in her 30s who uses Reiki toconnect with patients. Another tells of a woman who beganvolunteering in her 70s and who glowed as she spoke of herdays visiting patients.

“Open the Eyes of My Heart” was published by Upstate’sCenter for Spiritual Care through a Friend in Deed grantfrom the Upstate Foundation. Imani Shabazz, a summer2013 Synergy/Mercyworks spiritual care intern, also contributed to the book. It sells for $5 through the center, at upstate.edu/hospital/spiritualcare.

More than 100 people volunteer through the center, saysthe Rev. Terry Culbertson, who manages the center. She says the program includes a full spectrum of faith traditions. “Offering spiritual care as a volunteer can add afulfilling dimension to life. There are so many ways our volunteers offer spiritual care, whether it is through prayer,Reiki, music, a gentle touch or merely just by spendingquiet moments with patients.”

Wasilewski was impressed with the volunteers he met during his research. “How knowing and wise these volunteers are about how to prepare a place in time – ourplace, in this hospital – so that the spirit can do its work.

“The doctors and nurses are always doing their work. The spirit is, as well.”

Listen to a radio interview about this book atupstate.edu/healthlinkonair by searching for“spiritual care.”

AMaster of Public Health student at Upstate is calling for more consistent identification of hospital patients who are homeless and for more attention to the health issues faced by

this special patient population.

To complete her degree, Lauren Wetterhahn analyzed 760 homeless patient visits to the emergency departments of four hospitals in Onondaga County from 2006 to 2011.Drawing from statewide hospital discharge data, she compared homeless patients to non-homeless patients at the same hospitals.

She found that homeless patients’ diagnoses tended to be re-lated to mental illness and drug and alcohol use. They wereless likely to be discharged from the emergency departmentthe same day they arrived and, once admitted, their hospitalstays were usually longer. Those lengthy stays are especiallycostly, Wetterhahn says, because hospitals’ reimbursementsfrom insurers do not increase for longer patient stays.

More attention to the health issues facing the homeless – including better patient screening and research on theirhealth care needs – and a focus on special transitional housing after discharge might help the hospital bottom lineas well as provide better care for patients without homes.

A way to help the homeless and hospitals

Inspiration insideBook shares advice from spiritual care volunteers

Spring and summer breaks don’t necessarily meansunny beaches for students who are training for careers in the health professions. Upstate studentsvolunteer for additional medical experience and

training at sites all over the world.

“We are continually building international medically relatededucational opportunities,” says Sue Stearns, PhD, directorof the Center for Civic Engagement. “We encourage ourstudents to explore new horizons but are always concernedabout their safety as well as the value of their experiences.”

Respiratory therapy roommates Stephen Johnson and AdlinNoel spent some of their break between classes last year in countries on opposite sides of the Atlantic Ocean.

Johnson headed to the jungles of Honduras for what turned out to be “the highlight of my medical experiences.”He volunteered with an organization called Adventure inMissions and spent four weeks providing care to hundredsof families.

He found reactive airways disease, or asthma, was preva-lent. This is because household kitchens there are almost always thatch huts right next to the homes. “The blacksmoke from the stove rises and quickly fills up the kitchenhut, and children breath this their entire lives. The constantairways irritation leads to the development of chronic in-

flammation and narrowing of the bronchioles, which thenleads to asthma-like symptoms.” Johnson distributed manymetered dose inhalers to help treat acute bronchospasms.

Noel volunteered with medical and nursing students for two weeks last summer to provide rural medical care inNicaragua. He jumped at the opportunity earlier this yearto deliver medical care to people in rural villages of Ghanathrough the Americans Serving Abroad Projects. The tripwas organized by Upstate nurse Lauri Rupracht. As part ofhis work there, Noel conducted research that revealed a significant lack of knowledge of the detrimental effects ofsmoking among villagers.

Noel says his experience “renewed my purpose as a futurehealth professional to respond to the medical needs of thoseless fortunate.”

He also inspired other respiratory therapy students to seek out international opportunities. Catie Zopf and AlexTabone traveled to Nicaragua this summer along with nineUpstate medical students as volunteers helping rural healthcare providers.

Johnson says his experience in Honduras “has given me anentirely new perspective on what it means to serve, and arenewed drive to make sure I am providing the best carewhen they do find themselves in my hospital.”

IN OUR COMMUNITY


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Adlin Noel takes blood pressure at a clinic in Ghana. At right: Noel and Stephen Johnson at Upstate’s commencement.

Shared educational options, an ocean apart

Astudy of low-wage workers in Syracuse reveals unstable and unpredictable work lives on many levels, says Jeanette Zoeckler,

a public health project manager at Upstate’s CNY Occupational HealthClinical Centers.

“Imagine working two or three jobs just to put food on the table, having no transportation other than buses to get to those jobs and no security that their job or the wages agreed upon will be available tomorrow. Low-wage workers face these hardships and this uncertaintyon a daily basis,” she says.

Zoeckler and colleagues queried 275 Syracuse adults whose low-wagejobs necessitated support from government programs to subsidize basichousehold needs. Survey questions dealt with working conditions, ac-cess to health care, wages and hours, and more. Participants were alsoasked what they would change in their workplace. Top answers werethe need for respect and less discrimination in the workplace.

The data collected in the survey will be used for longer-term goalsmeant to improve conditions for workers with low-wage jobs. For a copyof the study contact the center at 315-432-8899, extension 103.

STEPHEN JOHNSON

Low-wage jobs provide hardships, uncertainty

Before she won a Tony for her role in “Beautiful: the Carole King Musical,” Jessie Mueller performed as a patient for medical students at Upstate. Like many drama students at Syracuse University, she was a standardized patient.

Amber Hansel, who helps oversee Upstate’s standardized patient program now, remembersMueller well. “I was working at SyracuseStage when she appeared in several per-formances there,” Hansel says. “I got toknow her a little when she was in the SUDrama production of ‘Kiss Me Kate.’”

Actors chosen to be standardized patientsare carefully trained to portray patientswho simulate common medical conditions.Encounters give medical students, residents orother health care professionals the opportunity to learn and practice effective communicationand examination techniques with real peoplewithout fatiguing actual patients. Hansel sayssophomores, juniors and seniors are consideredfor the roles, which are paid.

Hansel joined Upstate in 2005. “I now use the skills I learned studying directing at SU when I train/coach the standardized patients to portray their patient cases.”

Mueller, 31, is a resident of Astoria, Queens. She is expected to continue in “Beautiful” for months to come.

Carole King told The New York Times that during “Beautiful” tryouts, “Jessie just came across to me as very devoted to the material, respectful about the music and the story, and had a wonderful energy to her.” King performed “I Feel the Earth Move” with Mueller during the Tony’s telecast.

Tony winner played the role of a patient at UpstateBY AMBER SMITH

Upstate Neurosurgery Chairman Lawrence Chin, MD, spoke at Upstate’s annual White Coat Ceremony last summer,

when medical students receive the jackets they will wear during their clinical rotations.

He told of a patient who had back pain that left him unable towalk because cancer had spread to his spinal cord. One surgeonsaid the patient was not fit for surgery, but Chin’s resident feltthat the patient deserved a chance. The resident proposed an operation that would be complicated and time-consuming, to decompress the patient’s spinal cord and remove as much of the tumor as possible.

The date was July 4.

Chin and the resident both had plans to spend the day with family in town for the holiday. Maybe the surgery could waituntil tomorrow?

“There comes a time when every doctor has to ask: Am I doingthe best thing for this patient?” Chin told the medical students.

He and the resident faced that question on July 4 – and the surgery took place that day.

Chin said it was the right decision. “Three weeks later, that man walked out of the hospital.”


IN OUR COMMUNITY

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The question every doctor asks eventually

IN OUR COMMUNITY


A new way of talking – without wordsBY RICH O’NEILL, PHD

My mom is 97, has Alzheimer’s and has become less verbal and logical. She nowlives in a residential health care facility, a nursing home. This has been a hardjourney for her, and for me.

One of the most difficult things has been being with her when her words are nonsense. Shestarts a sentence with three or four words and then says unrelated words. What does shemean? What can I say back? For a long time I got frustrated, sad, even desperate.

But I’ve discovered that we can converse and both feel good if I just let go of her words,tune in to her emotional message, and respond from there.

I had to let go of my idea that as a grown woman she should talk sensibly and understandme, too.

Attuning emotionally now, I’m surprised that once in a while she listens to my emotion andresponds to me there. For example, last week we were lunching. Now, she eats extremelyslowly, almost one grain of rice at a time. I was getting antsy because of other obligationsbut hadn’t said anything. Somehow she knew and said, “Do you have to go home to yourfamily now?”

Wow.

The other day I went over for lunch. She was at her table. I was expecting her usual greetingfor me, which I call her “whole body smile.” This is when she lights up, looks right in myeyes, beams a smile, coos “Oh! Oh! You! You’re here! So good!” and stretches out her arms.And I smile back and hug and kiss her. “Hi, Sweetie. Nice to see you.”

But this day she was slumped, eyes closed, not eating the lunch in front of her even thougheating is one thing she still enjoys. I thought she might be sleeping. So I gently said “Hisweetie,” and patted her shoulder. No response. I rubbed her back, gave her some kisses,made sure her hearing aid was on and said more soothing words. Her eyes remained shut,her body slumped.

I found her nurse’s aide, who told me she had to be a bit forceful cleaning her in the bathroom, and right after that experience Mom had gone into this whole body frown, possibly angry but who knows? I went back to her again, but she still did not respond, so I said goodbye and headed for the door. Before I could leave, the aide caught me: “She’s looking for you now.”

I returned to find those loving eyes and gentle smile. With soothing tones and kisses and love pats, we shared a very pleasant meal.

Who knows when we share our last one. I’m careful not to exhaust myself, to both care for myself and do the best I can caring for Mom, hoping our kids and theirs and theirs, will learn this talking without words.

Psychologist Rich O’Neill, PhD, shares “Check Up From the Neck Up” on Upstate’s weekly talk radio program, HealthLink on Air. Listen to the show from 9 to 10 p.m. Sunday on WRVO Public Media or anytime at www.upstate.edu/healthlinkonair

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�

Dominick Albanese, 21Moyers Corners Fire Department Experience: almost 2 yearsRoles: interior firefighter. “My duty is to respond to the fire house and provide serviceto every call, no matter the nature, that weare dispatched for.”Time investment: “I do about three calls a day, so it turns out I provide about 30 hoursa week.”Aspiration: “I want to become a police officer. Providing service to my community and being the ‘help’ that people call for is/was my dream.”Reward: “I love helping people. Seeing the smiles on their faces after providing theservice needed is great. Other than that, I love the adrenaline rush when entering a burning building.”

Troy Barrett, 21Moyers Corners Fire DepartmentExperience: 5 yearsTime investment: about 20 hours per weekAspiration: Make a career of firefighting.Reason: family tradition

Jess Brown, 49Minoa Fire DepartmentExperience: 25 yearsRoles: firefighter, first responderBest part: “Being there to help.”

Evan Buschbascher, 28Liverpool Fire DepartmentExperience: 3 yearsRoles: interior firefighter, first aidReason: I am all about the community. I love helping out the people of the Town of Salina. It is something different every time the bell rings.Time investment: 15 to 20 hours per week Reward: Nothing is better than when you areat someone’s house to assist them, and theysay ‘thank you for coming.’

Stephen L. Mauser, 58Moyers Corners Fire Department (MCFD)Experience: 40 yearsRoles: fire captain, dive team, underwater recovery team, driver, fire police lieutenant,paramedicInspiration: “My father was a volunteer with MCFD in the 1960s. At the age of 18, I witnessed MCFD operate during a fatal caraccident. The way they all worked as a team and used all of their power toolswas just amazing. I knew then I wanted to be a part of this fire department helping the public.”Time investment: “It’s hard to say. We drillweekly, along with specialty drills or classeson any given day, plus we get called out anytime 24 hours a day, seven days a week.”Memory: “I delivered a baby solo one time,and it was one of the greatest days of my lifeto be a part of actually help bringing life intothe world.”

William O’Connor, 22Marcellus Fire DepartmentExperience: 8 years, including junior firefightingRoles: firefighter, fire prevention education,emergency medical technicianHow he began: “My family has a history of becoming both career and volunteer firefighters, so I guess you could say it is in my blood. My parents always taught me tohelp others when in need and give back asmuch as possible.” Best part: “Not only do I have the opportunity to help my community, but my fellow firefighters are like a family. We are always there for each other, whether someoneis moving or needs help fixing their house.Cooking dinner around the fire house and sitting at the table is just like sitting athome—except for maybe some jokes thatmom probably would not be fond of.”

Richard Powell, 39Camillus Fire DepartmentExperience: “I have been a volunteer here for about 1½ years, but I volunteered with afire department in North Carolina outside ofCharlotte for about 10 years.”Position: scene support, emergency medicaltechnicianTime investment: about 20 hours per week.Why: “I got into the fire/emergency medicalservices back in 1994, but really got involvedin 1999 after my mother passed away of amassive heart attack at the age of 50.”

Thriving on thank-yous

Upstate public safety officers — and volunteer firefighters — Stephen Mauser, Jess Brown, William O’Conner and Dominick Albanese.


IN OUR LEISURE

ROBERT MESCAVAGE

They give back to the community as volunteers

Several Upstate employees extend public service into their private lives, as volunteer firefighters. Meet seven public safety officers who do:

IN OUR LEISURE

l.


One with her kayak

When she’s not caring for patients in the spring, summer and fall, nurse Sarah Martin makes time for kayaking at least once a week.

“I love to be in nature. I love the peacefulness of it. When you are out on a body of water, your problems are so far away from you. For me, it’s spiritual,” Martinsays. She works at Upstate University Hospital at the Community campus.

Martin is an experienced boater who discovered as she gotolder that she preferred boats without motors. She boughther lilac kayak a couple years ago and quickly became anenthusiastic disciple of kayaking.

She tells people who are interested in joining the activity:

1. Get the best kayak you can afford. You can get a moldedplastic one for probably $600. I would suggest going to akayak specialty store. This one was probably $1,800 used.It would have been $2,300 new.

2. The longer your kayak, the more stable it will be. Shorterkayakers are for the more advanced. Kayaks are prettysturdy. I bought this particular kayak because I wanted tolearn how to roll it. I have yet to master that. It’s very difficult to get it to roll. The biggest thing is getting in and out of it; you may end up in the water.

3. Paddles make a huge difference in fatigue level and overall maneuverability of the boat. Get the lightest one you can find.

4. I wear a dry suit, especially in the spring when the wateris still cold. I bring my phone, something to drink and arain jacket to keep in a little porthole right in front of me.Also, I keep flotation gear in the boat with me.


IN OUR LEISURE

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Six Upstate women got the chance to compete in the annual Iron Girl triathlon this year as representatives of Upstate’s Women’s Health Network. That means on Aug. 3 they swam

600 meters, biked 30K and ran 5K at Oneida Shores Park with 1,094 other women.

For weeks and months leading up to that day, these womenswam, biked and ran, fitting their training between jobs,classes and families.

Heather Nelson, 24, bicycles to and from the laboratorywhere she is a graduate student in cell and developmentalbiology, and on weekends she bikes as much as 40 miles.That’s part of how she trains, in addition to the running shehas done regularly since the age of 12. She is enthusiasticfor all kinds of physical activity. Iron Girl was Nelson’s firsttriathlon — and she finished first in her age category with atotal time of 1 hours, 30 minutes and 21 seconds.

Iron Girl was to be the first triathlon for Wendi Burnette,43, who works in the department of neuroscience and physiology. She has been a runner for 20 years, and a fewyears ago a friend reintroduced her to the pleasures of cycling. “I had forgotten how much fun it is to ride a bike,”she says. Two months before race day, she assessed herreadiness. “That means I just have to learn how to swim,something stronger than a dog paddle.”

Fresh off her second half marathon, physical therapy student Liz Van Nortwick, 23, was searching for a newchallenge. She got a new bike at the end of last summer, so

she was anxious to try a triathlon. Iron Girl was perfect, shesays, “because my second clinical finishes the last week ofJuly, so I will be back in Syracuse just in time to compete.”

Catarina Walter, 40, a programmer analyst in informationmanagement and technology, is an experienced triathletewho has competed in Iron Girl. “Last year there was a 69-year-old woman who beat my time by approximately 2 minutes,” she says. “I’m not ashamed of my time. Rather,I am proud of the 69-year-old who beat someone 30 yearsyounger than her. I’m hoping I can still do this at 69, too.”

Social worker Kimberlee Garver, 45, did not expect to be atop finisher but kept reminding herself that someone wouldwin, but many would not even try. “For me, participatingand finishing will be victory.” After nearly two decades ofshuttling her children to sports practices and games, she’s finally focusing on her own physical and mental health.Plus, she suspects that her children were inspired by seeing their mom cross the Iron Girl finish line.

Marika Toscano, 26, is a fourth-year medical student whosays the focus required for long days in the operating roomis similar to that required for training for endurance eventssuch as triathlons. She relies on the same protein shakes,protein bars and sports beverages to keep her going at thehospital, and she says she intends to remain an athletethroughout her medical training and beyond. “I want to beable to motivate my future patients to stay fit, live well andeat healthy,” Toscano says. “If I’m not practicing thislifestyle, I cannot ask my patients to do the same.”

Tri-ing to stay fit and healthy

Kimberlee Garver, Catarina Walter, Wendi Burnette and Heather Nelson are members of Upstate’s Women’s Health Network IronGirl team.

ROBERT MESCAVAGE

IN OUR LEISURE

calorie BURN

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Two Upstate students sharing an apartment in downtown Syracuse have developed enduring – and contagious – cases of puppy love.

First Tim Lentini got Freya, a golden retriever. Then he and his puppy went with roommate, Connor Policastro, to choose Leila, a Weimaraner.

“We agreed that there was no way that either of us was going to get a puppy unless we were both in agreement,” Policastro says. “It’s all about teamwork. It’s tough being a single parent.”

Policastro grew up in Connecticut and attended Syracuse University; he is in the MD/PhD program at Upstate. Lentini, who grew up in Queens, is a second-year medical student.

The men share dog care duties. Their apartment in an old watch factory is a half block from a small park. Dog lovers in nearby apartments are willing to pitch in with feedings or walks if Policastro and Lentini are tied up in laboratories or classrooms on campus — which is an 8-minute bike ride away.

Policastro grew up with many dogs and other pets. Lentini had one German shepherd briefly in childhood. Both were eager to have dogs of their own. They chose puppies they could train over summer, when their schedules were lighter. Today, Freya and Leila fight like sisters, mostly over toys and attention. They’ve brought a warmth to the apartment.

“It’s nice having somebody be SO excited to see you when you get home,” Lentini says.

Downtown dogs

Medical students open their home to puppies

So you indulged in a pair of apple fritters. (No one can blame you.) But now you want to undo the damage.

Each fritter is about 300 calories, according to CalorieKing.com. Here are some ways a 145-pound person could burn off600 calories. The precise number of calories a person burns is influenced by the person’s age, body weight, gender, activitylevel and movement efficiency. Use this only as a guide.

Medical students ConnorPolicastro and Tim Lentiniwith their puppies.

KATE COLLINS, SYRACUSE.COM

3 hours, 2 minutes ofleisurely canoeing

2 hours, 46 minutes ofwalking at 3.4 miles perhour on a flat surface

1 hour, 2 minutes of cycling at 12 to 13.9miles per hour on a flat road

2 hours of vigoroushousecleaning

50 minutes of vigorouslap swimming

—reviewed by exercise physiologist Carol Sames, PhD, director of the Vitality fitness program at Upstate’s Institute for Human Performance.



IN OUR LEISURE

186 calories

7 grams protein

25 grams carbohydrates

7 grams fat

0 milligrams cholesterol

509 milligrams sodium

RECIPE FROM MORRISON HEALTHCARE, FOOD SERVICE PROVIDER FOR UPSTATE MEDICAL UNIVERSITY.

HEALTHY

Cut the top ½-inch off the tomatoes and, using a melon baller or spoon, remove the insideof the tomato. Sprinkle insides with salt and leave upside down while preparing remainingingredients.

Heat oil in a hot pan and sauté onions and garlic for 1 minute. Add the chopped olives andcapers and toss.

Remove from heat and combine with remaining ingredients. Gently stuff each tomato withabout ½ cup of filling. Then roast in a preheated 325-degree oven for 30 to 45 minutes,until inside is heated to 165 degrees Fahrenheit.

Yields five servings.

Chef’s note: Filling can also be used to stuff portabella mushrooms, zucchini or eggplant.

2 ½ pounds fresh tomatoes (look for tomatoes atleast 8 ounces)

¼ teaspoon kosher salt

2 tablespoons olive oil

1 cup yellow onion, diced

1 tablespoon garlic cloves, minced

2 tablespoons Kalamata olives, pitted andchopped

½ ounce green olives, pitted and chopped

2 tablespoons capers, drained and chopped

1 tablespoon fresh parsley, chopped

1 ½ tablespoons fresh oregano, chopped

1 ½ tablespoons fresh mint, chopped

1 ½ cups cannellini beans, drained and rinsed

¾ cup Panko bread crumbs

Herb Stuffed Tomatoes with White Beans

Nutritional information, per serving

Ingredients

Preparation

Looking for a healthy meal that makes use of the abundance of fresh tomatoes in Central New York? Here’s a tasty meatless solution.

eatsGUARD AGAINST FOODBORNE ILLNESS

When pregnant, a woman’sability to fight infection is

lowered, and she becomes moresusceptible to illness. Registereddietitian Juliann Mellen explainshow to prevent three commonfoodborne illnesses:

� Listeria is a harmful bacteriathat grows in refrigeratedready-to-eat foods such as unpasteurized milk and milkproducts, ciders and lunch-meats. To stay safe, avoid hotdogs and lunchmeats unlessthey are reheated until theyare steaming hot; and brie,feta and other soft cheeses unless they are pasteurized.

� Mercury in high levels canharm a baby’s developingnervous system, so skip eatingshark, swordfish and kingmackerel, which have high levels of mercury. Instead,Mellen says it is OK to eat upto 12 ounces per week of fishthat are lower in mercury, including shrimp, tuna, salmon and catfish.

� Toxoplasma is a parasite thatcan be ingested by eating undercooked meats, contami-nated water or produce thathas not been thoroughlywashed. It is also found in thefeces of infected animals, particularly cats. So, pregnantwomen should have someoneelse change cat litter boxesand always wear gloves whengardening, Mellen advises.

“Good food safety practices willbenefit you and your family for a lifetime.”

CAR I NG FOR PAT I ENT S , S E A RCH I NG FOR CUR E S , S AV I NG L I V E S .

The Upstate Cancer Center provides advanced cancer-fightingtechnology, including the third Vero SBRT installed in the nation.

Skilled radiation oncologists, such as Upstate’s Anna Shapiro, MD, use the Vero to locate, target and treat tumors in real time.

The Vero provides a 3-D view then precisely delivers radiationthrough beams concentrated on the tumor, sparing healthy cellsand tissues. The Vero also can be used for tumors that havespread or that are hard to reach with surgery.

Accredited by the American College of Surgeons’ Commission on Cancer, Upstate connects patients to the care, education and research resources of the region’s only medical university.

The third Vero in the U.S. is close to home.

750 EAST ADAMS ST. � SYRACUSE, NY

WWW.UPSTATE.EDU/CANCER

750 East Adams Street l Syracuse, NY 13210

Non Profit Org.US Postage

PAIDPermit No 110Syracuse, NY

14.243 0814 34.150M ELsk

SEARCHING FOR WAYS TO INHIBIT CANCER

Aprotein calledHsp90, shortfor “heat shockprotein-90,”

acts as a chaperone orguardian of cancer cells,helping them grow andsurvive. This image showsthe carefully folded partsof the protein, and the resulting pockets, whichare occupied by energychemicals called ATP(Adenosine Triphosphate)at one ten-billionth of ameter atomic resolution.Drugs compete with ATPto occupy these pockets,which cuts off the energysupply to the protein,consequently killing can-cer cells. Assistant profes-sor Mehdi Mollapour,PhD, and colleagues are exploring ways to selectively inhibit Hsp90using natural productsand hope to enhance the efficacy of Hsp90 inhibitors in cancer patients. Mollapour splitshis time between the departments of urologyand biochemistry andmolecular biology.

Mehdi Mollapour, PhD

SCIEN CE I S ART I S SC IENCE I S ART 1S SC IENCE I S ART

upstate health, fall 2014

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