Westfield native leaves California in quest of advanced surgery at Trinitas.

When Sena O’Connor-McLellan embarks on her regular daily run along the trails of the Diablo Mountains of California’s Bay Area, she is doing something her West Coast doctors said would never happen: regaining the physically active lifestyle she enjoyed before uterine prolapse began slowing her down. A native of Westfield and an avid runner, O’Connor-McLellan initially consulted with her California physicians, who recommended a radical solution.

“They said I’d have to have my cervix removed and give up running,” she recalls. “That didn’t feel right to me. That’s when I called Dr. Riachi.”

Dr. Labib Riachi, Chairman, OB/GYN, and Director of Robotics at Trinitas Regional Medical Center, had treated O’Connor-McLellan for a separate condition in 2009, using a robotics-assisted procedure that she says resulted in a smoother-than-anticipated recuperation. The surgical scars were practically unnoticeable, and the discomfort was minimal. After a phone call to Dr. Riachi, she boarded a plane back to New Jersey, consulted with him at his office, and was scheduled for surgery the next day. Once again, the robotics-assisted procedure delivered results.

“Four small incisions—that’s all it took,” says O’Connor-McLellan, a mother of four sons ages 15 to 20. “So unobtrusive, so simple. It wasn’t painful to roll over and I could pull myself up to get out of bed. Within a week, I was on a plane back to California. By two weeks, I was completely back to being myself.”

The procedure, which is performed using the daVinci Surgical System, is called a robotic cervicosacropexy. It involves the insertion of an abdominal mesh to relieve the prolapse and in most cases is a permanent solution with few if any lingering effects. After six weeks, as Dr. Riachi promised, O’Connor-McLellan was able to restart her trail work with a slow jog. “It is very rewarding to see people such as Sena benefit from this minimally invasive technology,” he says. “The daVinci system enables us to perform delicate surgeries in a faster and more secure way. It allows us to be more aggressive in how we treat, while giving us almost unlimited access within the surgical field.”

Labib Riachi, MD
Chairman, OB/GYN, and Director of Robotics
at Trinitas Regional Medical Center
908.282.2000

The daVinci system allows a surgeon working at a console to manipulate four robotic “arms” that maneuver a camera and carry out cutting, holding and coagulating all through a single or multi-port precise abdominal incision. Dr. Riachi has used the system to perform corrective surgeries for conditions such as prolapse, bleeding, fibroids, uterine cancer, and endometriosis. He now trains other surgeons to do the same. In all, he has carried out more than 800 robotic procedures since 2009.

“I call him the rock star,” O’Connor-McLellan says. “I would still go back to New Jersey if I needed another procedure, and I recommend anyone else to make that trip as well. I wouldn’t trust anyone else; I wouldn’t put my health in anyone else’s hands. I feel that strongly about what he can do, and about robotics in surgery. People shouldn’t be afraid of it. The healing is incredible.”

NO COMPARISON

In 2007, Sena O’Connor-McLellan (below and on page 46) underwent a non-robotic laparoscopic procedure to treat Crohn’s Disease. “The recuperation was longer, more painful, and generally much worse,” she reports, adding that she hopes that her experience will lead other women to explore the benefits of robotics-assisted surgery. “Women put off things like [prolapse correction] because they think they can’t get it done and get back to life. You think the only option is surgery that will put you on your back for two weeks. But the robotics option gets you back on your way in a few days. The flu will put you down for longer!”

Editor’s Note: Sena O’Connor-McLellan is back to enjoying the lifestyle she loves, hitting the trails every day for a running routine which, less than a year ago, she was advised to give up. Every mile she covers is a testament to the difference Dr. Riachi and the daVinci system can make. Next up for O’Connor-McLellan is the Rock & Roll Half-Marathon for the Crohn’s and Colitis Foundation of America in November on the Las

New diagnostic devices are taking gastroenterologists on a fantastic voyage

Imagine possessing the ability to enter the body to conduct reconnaissance, diagnose and perhaps save a life without traditional invasive measures. In 1966, sci-fi authors imagined—and Hollywood created—that exciting scenario. In Fantastic Voyage, a CIA agent, a surgeon and three others are charged with removing a life-threatening blood clot from the brain of a comatose Soviet scientist, who barely survived an assassination attempt while defecting to the West.

You probably know the story. The CIA shrinks the crew and its submarine down to one micrometer and inserts the vessel into the scientist’s body. It’s a race against time, as the effects of miniaturizing begin wearing off after an hour.

Pretty exciting stuff back then—not to mention a field day for the special effects team.

Miniaturization took a more humorous turn in the 1987 film Innerspace, when an experimental craft piloted by a naval aviator is miniaturized and—through a series of unlikely events—injected into a hypochondriacal grocery clerk, played by Martin Short. For the record, both Fantastic Voyage and Innerspace won Oscars for Best Visual Effects.

Fast-forward a few decades. People, submarines and aircraft aren’t miniaturized, but medical devices complete with cameras and data retrieval capabilities are.

In 2006, MIT Technology Review reported on a then recently-FDA-approved diagnostic device the size of a vitamin pill, which could be ingested. Once inside the body, the device for diagnosis of gastroenterological conditions could gather information along its way through the digestive system. The sensor could then transmit information to an external receiver, about the size of a cell phone, worn by the patient. Once its data gathering was complete, the diagnostic device was excreted through normal bodily functions. The patient could then return to the gastroenterologist’s office with the external receiver for data analysis.

While being interviewed for this article, Dr. Neil Kheterpal described the intricacies of the PillCam SB 3 to writer Kathryn Salamone.

At that time, such a device gave gastroenterologists information on digestive disorders that could not be easily obtained through previous methods. Before the advent of this type of diagnostic sensor, taking a look at the twists and turns of the intestines was both invasive and unpleasant for the patient. In less than a decade, these devices have become a valuable tool for gastroenterologists in diagnosing digestive disorders. They make exploring the 25 feet of the small and large intestines almost as easy as using a GPS device.

Dr. Neil Kheterpal, gastroenterologist at Trinitas Regional Medical Center, has been using the PillCam line of medical diagnostic devices—developed and manufactured by Israel-based Given Imaging—since 2007. He is confident that the latest generation, the PillCam SB 3, will be of great benefit to the diagnostic procedures he performs on his patients at Trinitas.

“This technology has played a major role in our better understanding of the small intestines,” Dr. Kheterpal explains.  “The mobility of the device has made viewing the intestines much easier and has improved our diagnostic capabilities as a result.  I have found it to be an exceptionally valuable tool in my role as a diagnostician.”

Equipped with a sophisticated camera and sensors, the latest generation offers diagnosticians two new benefits, notes Dr. Kheterpal.  “I have used the two earlier generations of the PillCam in the past seven years.  They offered images of excellent quality.  But, this latest version exceeds that level with images of even higher resolution, a 30 percent improvement over the PillCam SB 2.”

Also, the device now has the capability of capturing images at varying rates of speed through an adaptive frame rate technology.  In other words, while traveling through the intestinal track, sensors will respond when the capsule is moving slowly or quickly. Slow movement will allow the camera to capture images at two frames per second, while faster movement will capture up to six images per second.

In his years of using the earlier generations of PillCam, Dr. Kheterpal has recognized the high standards of the device. He considers the PillCam “the pioneer” in diagnostic devices for gastroenterologists. “What started out as a promising concept and purpose has shown its worth in successive generations as these refinements demonstrate,” he observes.

Neil Kheterpal, DO Gastroenterologist, TRMC 908.282.0500

However, Dr. Kheterpal stresses that the PillCam SB 3 or any future generations of this device will not replace tradi-tional colonoscopies. “The PillCam SB 3 and its predecessors have given us a view of the intestinal track that we didn’t have before. It’s just one of the tools that we have in the arsenal of disease diagnosis that ultimately helps in diagnosis and in recommending potential disease treatment, helping to contribute to the best possible outcomes for patients. Treatment will continue to be the domain of other more invasive procedures. Diagnosis is the one thing that this device is designed for and it does it exceptionally well.”

WATCH WHAT YOU EAT

As in the case of many chronic conditions, diet can play an important role relieving the impact of various digestive disorders. According to the U.S. National Library of Medicine, these strategies can help ease symptoms…

• Eating small amounts of food throughout the day.
• Drinking lots of water (drink small amounts often throughout the day).
• Avoiding high-fiber foods (bran, beans, nuts, seeds, and popcorn).
• Avoiding fatty, greasy or fried foods and sauces (butter, margarine, and heavy cream).
• Limiting dairy products if you have problems digesting dairy fats.

Try low-lactose cheeses, such as Swiss and cheddar, and an enzyme product, such as Lactaid, to help break down lactose.

• Avoiding foods that you know cause gas, such as beans.

Also, ask your doctor about extra vitamins and minerals you may need, such as iron supplements (if you are anemic), calcium and vitamin D supplements to help keep your bones strong, and vitamin B12 to prevent anemia.

A Trinitas Family Spans Three Generations

What’s in a name? Every day, we pass by buildings and parks and other public spaces that bear the names of people we know little or nothing about. In the case of the new Thomas and Yoshiko Hackett Ambulatory Surgery Center at Trinitas Regional Medical Center, there’s more to those names than perhaps anyone knows.

The Hacketts have left behind a thriving legacy of a hardworking family which has remembered its roots. Tom Hackett was born in Elizabeth to Irish immigrants. He served in the Air Force during the Korean War, and while overseas he met his future wife, Yoshiko, in Japan. The Hacketts lived in Elizabeth for three decades, raising eight children, all of whom were born in St. Elizabeth Hospital. They moved to Roselle Park and then Clark in 2007. Tom was a letter carrier for the U.S. Post Office in Elizabeth for 35 years. He also worked many part time jobs in order to provide for his family of 10. Yoshiko worked part time for the Elizabeth Board of Education for a number of years. Tom passed away in 2010 and Yoshiko earlier this year.

During their lifetimes, Tom and Yoshiko were longtime supporters of Trinitas. Their legacy lives on since their generosity has made it possible for Trinitas to realize a vision for better health care for the community. In 2014, the family’s generosity and devotion was recognized with the opening of the Ambulatory Surgery Center bearing their names. The 9,500 square foot outpatient facility has already proven vital to the community, and has reduced the demands on the hospital’s busy main operating rooms.

As Gary S. Horan, President and Chief Executive of Trinitas, explains, “The measure of a man is often based on what he does in his lifetime and in the legacy he leaves behind. Tom and Yoshiko Hackett loved Elizabeth and never forgot the City in which they lived, worked and raised their family. They passed along that abiding love and regard for their hometown to their children who, like their parents, are committed to supporting programs and initiatives that help Trinitas meet the health care demands of the communities it serves.”

Their daughter, Eileen, is currently a member of the Trinitas family, working in the Information Technology department, and their son, Patrick, serves on the Trinitas Regional Medical Center Board of Trustees. Eileen and Patrick’s siblings—Ali, Faith, Tom, John, Michael and Mary Catherine—have also remained connected to the hospital in various ways, including annual giving to the Trinitas Health Foundation. A third generation is also involved with Trinitas as several of Tom and Yoshiko’s 19 grandchildren are donors and event volunteers.

“Our parents were hard-working and very caring, and taught all of us the importance of helping each other and supporting others in the community,” says Patrick Hackett. “We are so pleased to have the opportunity to honor them at Trinitas, an organization they had such important connections to and that meant so much to them.”

The Hackett family’s connection to Trinitas—now three generations and growing—continues to move the medical center forward. More important, it will benefit the people in Union County and beyond for generations to come. EDGE

Editor’s Note: In addition to the Ambulatory Surgery Center, Thomas and Yoshiko’s names also grace the Trinitas Emergency Services headquarters (right) in the Center for Regional Education (CORE) on Elizabeth Avenue in midtown Elizabeth. Nick Schoendorf, Communications Supervisor, (right) represents his fellow EMTs.

Bright Ideas for Book Lovers

SUPER HEROIC

Who says literary jewelry has tobe high-brow? The Marvel Comic Book Bracelet turns mini-comic charms into high fashion.    Available at sweettreatsjewelry.com.

A LEG UP

The design on these Bookworm Unisex Socks is woven right into the fabric. Available at alwaysfits.com.

PLAYFUL PLASTERS

Archie McPhee’s latex-free Jane Austen Bandages turn “owies“ into teachable moments—and come with a free prize inside!Available at mcphee.com.

WRAP-AROUND

The Shakespeare Brass Cuff Bracelet  features famous quotes from the legendary playwright. Available at alwaysfits.com.

BARELY LEGAL

The Banned Book Bracelet by Carolyn Forsman is a true conversation piece. Available at loc.gov/shop.

COMPOSING ROOM

Shoes of Note flats turn those dreaded composition notebooks from junior high into an adult fashion statement. Available at modcloth.com.

PAGE TURNER

Luciana Frigerio transforms hardcovers into Folded Book sculptural works of art. Available at lucianapaper.com.

GREAT OUTDOORS

The Fully Booked Tent  can accommodate two campers and is built to withstand Tempest conditions. Available at fieldcandy.com.

O TRUE APOTHECARY!

The Shakespeare Pill Box by Unemployed Philosophers Guild features one of the Bard’s better quips about the medical profession. Available at philosophersguild.com.

GOING PUBLIC

The New York Public Library marble Lion Bookends celebrate one of the literary world’s most iconic Beaux Art works of art. Available at nytstore.com.

COVER TO COVER

Heather Alston designed these metal Fairy Tale Bookends, which feature hand-cut silhouettes of a prince, princess and castle.  Available at notonthehighstreet.com.

ALL KEYED UP

Laptops may have replaced trusty Smith-Coronas, but their spirit lives on in the Typewriter Satchel.  Available at theliterarygiftcompany.com.

EDGE takes you inside the area’s most creative kitchens.

The Office Beer Bar & Grill • Grilled Bratwurst

728 Thompson Ave. • BRIDGEWATER 32–34 Chestnut St. • RIDGEWOOD 1–7 South Ave. • CRANFORD 61 Union Pl. • SUMMIT

619 Bloomfield Ave. • MONTCLAIR 411 North Ave. West • WESTFIELD

We fire finish our beer-braised bratwurst on the grill and serve it with sautéed onions and peppers on a char-grilled garlic-infused baguette.

— Kevin Felice, 40North Executive Chef

Paragon Tap & Table • Butternut Squash Ravioli

77 Central Ave. • CLARK

(732) 931-1776 • paragonnj.com

Our new restaurant blends hand-crafted ravioli preparations with creative twists on classics. A popular addition to the fall menu at our new restaurant has been the butternut squash ravioli served, which we sautée with butternut squash and sage sauce. 

— Eric B LeVine, Chef/Partner

The Black Horse Tavern & Pub • Bone-in Ham Chop

1 West Main Street • MENDHAM

(963) 543–7300 • blackhorsenj.com

Our ham chop is served bone-in, with a bing cherry compote, and is accompanied by celery root purée and citrus-sautéed spinach.

— Kevin Felice, 40North Executive Chef

Piattino Neighborhood Bistro • Neapolitan Pizza

88 East Main Street • MENDHAM

(973) 543-0025 • piattinonj.com

Our house special Neapolitan-style Piattino pizza is stone-fired and topped with roasted chicken, basil-and-pine-nut pesto, pecorino romano cheese, fresh-pulled mozzarella, braised onions and tomatoes.

— Kevin Felice, 40North Executive Chef

George and Martha’s American Grille • Maple Pumpkin Pie

67 Morris Street • MORRISTOWN

(973) 267-4700 • georgeandmarthas.com

This season we are featuring maple pumpkin pie. It’s a maple-infused, spiced pumpkin pie topped with cinnamon and fresh whipped cream.

— Kevin Felice, 40North Executive Chef

The Office Tavern Grill • Belgium-Style Stout Braised Mussels

3 South Street • MORRISTOWN

(973) 285-0220 • officetaverngrill.com

We braise Prince Edward Island mussels in a local craft ale, with garlic and onions. They’re finished with herbs and served with fresh-cut fries.

— Kevin Felice, 40North Executive Chef

Daimatsu • Tuna Tataki

860 Mountain Ave. • MOUNTAINSIDE

(908) 233-7888 • daimatsusushibar.com

The must-try favorite on our appetizer menu is tuna tataki—diced tuna marinated in sesame-flavored soy sauce and mixed with finely chopped onion, spicy sprouts and nori on top.

— Momo, Chef

Publick House • Sesame-Crusted Ahi Tuna

899 Mountain Ave. • MOUNTAINSIDE

(908) 233-2355 • publickhousenj.com

This has been one of our signature dishes since we opened in 2009. For the Fall season, the tuna is crusted in black and white sesame seeds and seared rare. It is sliced and served over a medley of stir-fried vegetables, which are cooked in soy sauce. The dish is finished with scallions and accompanied with a side of wasabi.

— Bernie Goncalves, Owner

Morris Tap & Grill • Roasted Pork Tenderloin

500 Route 10 West • RANDOLPH

(973) 891-1776 • morristapandgrill.com

We serve our seasonal roasted pork tenderloin with roasted Brussels sprouts and finish it with a port wine demi. We pair all of our dishes with selections from our best-in-the-state craft beer menu for an ever-evolving craft-beer and food experience.

— Eric B LeVine, Chef/Partner

Thai Amarin • Curry Beef Short Ribs

201 Morris Ave. • SPRINGFIELD

(973) 376-6300, (973) 376-6301 • thaiamarinnj.net

Our juicy beef short ribs, cooked to perfection with rich, mild Massaman curry—emphatically the king of curries—is perhaps the king of all foods. Spicy, coco-nutty, sweet and savory, its combination of flavors has more personality than a Thai election! 

— Amy Thana, Owner

Café Z • Chicken Rapa

2333 Morris Avenue • UNION

(908) 686-4321 • CafeZNJ.com

One of our crowd favorites is our Chicken Rapa. We prepare a boneless chicken breast with sundried tomatoes, fresh diced tomatoes, broccoli rabe and serve it over capellini with a white wine, oil and garlic sauce.

— Patricia Inghilleri, Owner

Chestnut Chateau • Smoked Meats

649 Chestnut Street • UNION

(908) 964-8696 • chestnutchateaunj.com

With football season in full swing, we’ve added smoked certified angus meats to our menu, while cooking up the best brisket, ribs, pork bellies and butts north of the Mason-Dixon Line. Our baby back ribs fall off the bone and with my homemade barbecue sauce a loss by your favorite team won’t matter anymore. 

— George Niotis, Chef

Mario’s Tutto Bene • Vinegar Pork Chops

495 Chestnut Street • UNION

(908) 687-3250 • mariostuttobene.com

Our vinegar pork chops feature three thin-cut Frenched chops that are coated with Italian breadcrumbs and sautéed with sweet vinegar peppers, prosciutto and garlic. They arrive with house-made roasted or mashed potatoes. Our regulars love this entrée.  

— John Garofalo, Owner

Rio Rodizio • Brazilian Meats

2185 Rte. 22 West • UNION

(908) 206-0060 • riorodiziounion.com

We offer an “All-You-Can-Eat” dining experience transported straight from the streets of Rio de Janeiro to your tableside. Each customer gets to witness a never-ending parade of freshly roasted meat and poultry. Our authentic Gaucho chefs carve these melt-in-your-mouth meats to your liking.

— Paul Seabra, Owner

The Manor • Herb-Crusted Rack of Lamb

111 Prospect Avenue • WEST ORANGE

(973) 731-2360 • themanorrestaurant.com

Our herb-crusted rack of lamb is moist, tender and full of flavor—and contrasted with a wonderfully seasoned,crispy exterior texture. The dish is served with a rosemary-mint demi-glace on the side. To complement the lamb, we add a decorative potato basket featuring an array of seasonal vegetables and a rich eggplant caponata.

In search of the ultimate Generation Z vacation

Can spring vacation be just around the corner? For families who embrace the idea of advanced planning, it most certainly is. In decades past, New Jerseyites typically targeted Florida, the Bahamas or the Caribbean. But with the startling growth of eco-tourism industry—and the development of top-of-the-line sustainable and responsible luxury resorts—there is now no reason not to consider a different kind of spring break.

Children today are growing up in a different world than their parents did. From an environmental perspective, it’s a world that past generations have done a remarkable job screwing up. Plant and animal species are being extinguished from the planet at an unprecedented rate and the job of reversing this biodiversity crash will soon fall upon our kids. What better way to foster an appreciation of the natural world than to combine it with an unforgettable family vacation?

Both sustainable tourism and responsible tourism are centered on “sustainable development,” which is shorthand for meeting the needs of the present without compromising the ability of future generations to meet their own needs. The Global Sustainable Tourism Criteria establishes the minimum global standards for what qualifies as sustainable or “green” tourism practices, and there are a total of 23 criteria that lodging and tour operators must meet. They fall into four major categories:

• Demonstrate effective sustainable management.
• Maximize social and economic benefits to the local community and minimize negative impacts.
• Maximize benefits to cultural heritage and minimize negative impact.
• Maximize benefits to the environment and minimize negative impact.

The broader concept of ecotourism ties together the values of sustainable tourism, conservation, and nature-based tourism—and is roughly defined as “travel to natural places.” The International Ecotourism Society defines ecotourim as “responsible travel to natural areas that conserves the environment and improves the well-being of local people.”

In order to experience and support true ecotourism practices, vacationing families must focus on the following objectives:

• Minimize impact.
• Build environmental and cultural awareness and respect.
• Provide positive experiences for both visitors and hosts.
• Provide direct financial benefits for conservation.
• Provide financial benefits and empowerment for local people.
• Raise sensitivity to host countries’ political, environmental, and social climate.

Every year, the range and depth of ecotourism possibilities increases. There are destinations for older vacationers, singles and adrenaline junkies. Great options for families are out there, too. Safety and security are, obviously, of paramount concern and in this regard many families will opt for highly rated properties that offer a blend of traditional amenities along with natural-world experiences. Needless to say, these internationally recognized eco-resorts and lodges tend to be pricey. They are, however, excellent starting points for planning a truly unforgettable spring vacation. Among the best are…

Lapa Rios • Osa Peninsula • Costa Rica

LapaRios.com • 506–2735–5130

Tiny Costa Rica claims a full five percent of the planet’s biodiversity, and has developed a thriving ecotourism industry. In 2012, the country earned the #1 ranking in the Americas (and #5 in the world) on the Environmental Performance Index and has been cited by the United Nations Development Program for “attaining high human development and equality as well as environmental sustainability.” Located near Corcovado National Park, Lapa Rios is ranked among National Geographic’s Top 50 Ecolodges, Forbes Traveler’s Hotels with the Most Beautiful Views, and is one of the best hotels in the world according to both Travel + Leisure and Condé Nast Traveler. Lapa Rios has also been awarded the Rainforest Alliance’s Sustainable Standard-Setters Award, as well as the 5 Leaf Award Certificate of Sustainable Tourism.

The property’s luxurious eco-resort rainforest bungalows feature views of the Pacific Ocean and wake-up calls from howler monkeys and the inescapable aroma of Costa Rican coffee. Coatamundis, sloths, bats, scarlet macaws, toucans, lizards, geckos, and crabs are regular sights around the resort, as well as the occasional puma, jaguar, ocelot, river otter, crocodile, sea turtle, dolphin, or whale. Family activities include bird watching, cooling off in waterfalls, a local medicine tour, hikes and nature walks along beaches and in the jungle, surfing, kayaking, horseback riding, zip lines, dolphin-spotting tours, and excursions through Corcovado National Park by plane or land vehicle.

SUMMER FUN

Some of the best eco-resorts are situated outside the tropics and thus are a better choice for a summer adventure. Sadie Cove Wilderness Lodge in Alaska’s Kachemak Bay State Park, has been recognized both locally and internationally for its ecological efforts, ranking among North America’s Top 10 Eco Resorts and earning the title of “United States’ Leading Green Resort.” The lodge runs on non-polluting wind and hydropower and is completely self-sustaining, receiving the Alaska Green Star Award for recycling and sustainable tourism efforts.

Situated on a private beach across the bay from the town of Homer, Sadie Cove provides families with the opportunity to experience some of Alaska’s most stunning natural scenery and wildlife firsthand. The area is considered the bear-viewing capital of the world and is also home to humpback and beluga whales, seals, sea lions, sea otters, marmots, coyotes, wolves, and foxes.

This is a particularly appealing destination for kids interested in outdoor adventures, including wildlife photography, bird watching, mountain biking, hiking, berry picking, sea kayaking, fishing, clamming or simply beach combing. The lodge arranges a wide range of guided tours, chartered sailboat excursions, seaplane trips to a nearby volcanic island, kayak expeditions between glaciers and river rafting.

A special feature of this lodge is the Sailboat Cabin, a separate private guest lodge built into a refurbished classic old sailboat. Your children may take it personally if you don’t book these particular accommodations.(SadieCove.com • (888) 283–7234)

Campi ya Kanzi • Mtito Andei • Kenya

Maasai.com • 254–45–622516

Ecotourism Kenya recently conferred its “gold” rating on Campi ya Kanzi, which is probably the most honored vacation lodge in East Africa. The property has received the Skaal Ecotourism Award, the Tourism for Tomorrow Award, the Eco-Warrior Award, and the Condé Nast World Savers Award. Campi ya Kanzi is also a Long Run Alliance Member, recognized for “significantly influencing the management of a natural area of conservation value.”

Campi ya Kanzi sits on 280,000 acres of wilderness, which actually boasts a greater diversity of species than the typical national Park, with elephants, buffalos, rhinos, lions, leopards, gazelles, impalas, hippos, baboons, hyenas, foxes, wart hogs, cheetahs, porcupines, and aardvarks playing starring roles. Guests can explore the area in a number of ways, including game drives and walks, forest walks, bird watching, scenic flights, and Maasai village visits. A view of Mt. Kilimanjaro—as well as a gathering of dozens of species of animals and birds at the nearby watering hole—is literally as close as one’s veranda.

Campi ya Kanzi utilizes ecotourism to support environmental conservation and sustainable community development, partnering with and advocating for the local Maasai community. The lodge uses rain cropping for water, gathers electricity and hot water from solar panels, and cooks all food with eco-friendly charcoal. Guests can choose between a luxury canvas-tented cottage or a private villa in the bush (which is larger and more family-friendly). In addition to the cost of housing each day, visitors pay a $100 conservation fee to the Maasai Wilderness Conservation Trust, which is used to compensate Massai landlords for livestock losses to predators. In essence, every family visiting the property is paying the locals not to shoot lions and other big cats, which is the definition of money well spent.

ECOTOURISM TIPS

• Think like an Ecotourist- Find reputable, nature-friendly lodging and tour activities that promote conservation. Choose protected or World Heritage sites. Visit government-run game preserves over private ones, which may be for-profit—meaning that the money does not actually go toward conservation.
• Research your destination- Before you push the PAY button, learn as much as you can about the region, country, flora and fauna. This will enable you to make a smart, informed decisions, minimizing stress once you arrive.
• Pack light- Limit the amount of packaging you bring with you. This will only become waste and you can save more room for souvenirs.
• Travel green- Travelling by bus, train, coach, bicycles, or even on foot greatly reduces your carbon emissions and allows you to take in more of the scenery along the way. It’s also fun for the kids.
• Respect the wildlife- Coach your kids in advance not to disturb the plants or animals they may encounter, and to maintain a careful distance.
• Eat smart- Opt for local, in-season produce and avoid foods you suspect have been flown in from great distances. Obviously, avoid any endangered species that may be on the menu.
• Choose souvenirs carefully- Never purchase products made from endangered species and avoid plant species that may become invasive to your homeland and native wildlife.
• Get involved- Often, you can become a member of local sustainable organizations or conservations programs at your destination. This will create a lasting memory for your children, and demonstrate how they can continue to have a positive impact on the region they visited.

Al-Maha Desert Resort & Spa • Dubai

Al-Maha.com • 971–4–832–9900

The Al-Maha Desert Resort & Spa achieves a tricky balance of ecofriendly, sustainable practices and luxurious accommodations, helping it to earn the Middle East’s Responsible Tourism Award and a Top 50 Ecolodge ranking from National Geographic. The family won’t be roughing it here. Al-Maha is a 5-star resort that has been singled out in a couple of Internet surveys as the top resort in the Middle East.

Situated in a palm oasis within the Dubai Desert Conservation Reserve, Al-Maha celebrates the cultural heritage and architecture of the Bedouins. The spa uses holistic treatments from Middle Eastern and South Asian traditions, such as rhassoul mud bath chambers. Each meal includes organic international and indigenous delicacies served amongst the dunes (or poolside, if preferred). Al-Maha also offers vacationers two desert activities each day, such as archery, camel and horse rides, falconry and safaris.

The resort recycles 100% of its water, has a seed bank of over 6,000 species of trees, shrubs, and grasses, and is a major contributor to the conservation effort at the reserve—most notably the Arabian Oryx, which was nearly hunted into extinction. The largest free-roaming herd of Arabian Oryx now inhabits Al-Maha. Other native species include gazelles, foxes, hedgehogs, “sand fish,” side-winding vipers, colorful parakeets, eagles, ospreys, owls, and falcons.

Satwa Elephant Eco Lodge

Lampung Province/Sumatra • Indonesia SatwaEcoLodge.com • 62–361–7474-205

Located just outside the Way Kambas National Park, a sprawling protected lowland rain forest, Satwa Elephant Eco Lodge helps fund a program to protect the endangered Sumatran elephant and rare Sumatran tiger and rhino. The lodge itself is set inside a walled garden of fruit trees, and includes four cottages, which are ideally suited for a family of four. The cottages are powered by solar energy, as is the lodge. The lodge is dedicated to empowering local communities in long-term conservation and sustainable development.

Satwa is not a conventional resort in terms of opulence and luxury; the show is 500 meters down the road in Way Kambas, where the wildlife includes sun bears, tapirs, gibbons, macaques and more than 300 bird species. Tiger sightings are a rarity, but all of the other park residents—including elephants and rhinos—are commonly encountered on the lodge’s land and river tours. Satwa Elephant Eco Lodge has been recognized by Sustainable Travel International, is Green Globe certified, and is part of network of eco-lodges on the Indonesian islands of Borneo and Bali.

FORE FOR FOURS

(Left photo) Bill Murray, Mike Hannan, Eugene Kennedy, MD, Chair-man of Radiology at Trinitas and Co-Chair of the Trinitas Health Foundation Golf/Spa Classic, and Michael Pantony were among the golfers who helped raise more than $175,000 at this year’s event.

(Right photo) Nick Brown, Tom Pennimpede, Joseph Santo, Principal, Premier Energy Group, LLC, Middlesex and Co-Chairman of the Trinitas Health Foundation Golf/Spa Classic, and Chuck Wilk, paused on the greens at Echo Lake Golf Club in Westfield during the event at which former heavy weight contender Gerry Cooney was a special guest.

WITH TAX TIME AROUND THE CORNER, THERE’S A WAY TO REAP BENEFITS OF GIVING

It’s not too late to cash in on tax savings for 2014!  Consider making a tax-effective, high impact gift to Trinitas Health Foundation.

You can qualify for your tax deduction with a gift today or by creating a Charitable Gift Annuity (CGA) that can earn high-interest income for life (and for a second beneficiary, if you  c  h o  o s e ).  Through a CGA established with cash, stocks or bonds, you will enjoy an immediate and a long-term tax benefit.  If you make a gift of appreciated property, you will only pay capital gains tax on part of the appreciation (which will be spread out over years if you are the annuitant).

Wondering what your tax deduction and annual high-interest income might be from a CGA? Call Andi Koenig-Feldman at (908) 994-8249 to find out today.

A SOLID INVESTMENT

Bank of America continues its support of the Trinitas Health Careers Exploration Program through a $15,000 grant. The bank has made an investment in thousands of young people in Elizabeth and other Union County communities.  The ROI?: Thousands of students given the opportunity to explore career opportunities. More than a few successful doctors, nurses and healthcare professionals got their start through this program. Goreti M. Muñoz of Bank of America (center) proudly presented the check representing the Bank’s latest grant to (from left), Lisa Liss, Director of Volunteer Services, Eileen Mulroy, Coordinator of Health Occupations at Trinitas, Nadine Brechner, Chief Development Officer and Vice President, Trinitas Health Foundation, and Jasmine Jones and Kristian Adap, students at Union County Vocational Technical High School who are recent participants in the Health Careers Exploration Program. Photo courtesy of Debbie Jones

AMAZON SMILE

If you shop at Amazon.com, you can help Trinitas. Just go to http://smile.amazon.com/ch/22-2353773 and Amazon will donate 0.5% of the price of your eligible purchases to Trinitas Health Foundation.  We’re all grins.

IT’S BLACK FRIDAY SOON, SO GIVING TUESDAY CAN’T BE FAR BEHIND…

This holiday shopping season consider opening your wallet to give a special gift to a deserving child.

On Giving Tuesday, December 2, (#GivingTuesday 2014), you can join the Trinitas Health Foundation at the kick off of the Giving season by making a donation by giving the gift of health to less fortunate children.

Your $25 Gift will help provide the quality care that pediatric patients at Trinitas deserve!

Please visit https://www.genestorasp.com/trinitasdonations/secured.aspx. Contact the Trinitas Health Foundatio

News, views and insights on maintaining a healthy edge.

Brown Bagging It

Is your child’s packed lunch getting the job done? A recent report by the Boston Nutrition Obesity Research Center and the National Institutes of Health suggests that it may not. Only 27 percent of lunches brought to school by the 3rd and 4th graders in the study satisfy minimum standards of one ounce of protein, a half-cup of fruit or vegetables, a half-cup of grains and a cup of milk. What’s interesting about these numbers is that the study focused primarily on upper-income families with college-educated parents. In this case, poor food choices are not a function of affluence or education. Among the suggestions nutrition experts offer are packing the lunch the night before, when there is less of a time crunch, and a dedicated section of your fridge for school lunch ingredients.

Is Obesity the New Normal?

With all the talk of stemming America’s childhood obesity epidemic, one crucial component has actually gone underreported: the failure of parents to recognize that their child has a weight problem. A 2014 study published in Pediatrics revealed that the percentage of parents who believe their child is “about the right weight” has risen considerably compared to the previous generation—despite irrefutable evidence to the contrary. Parents of girls in a n earlier study (1988 to 1994) said their kids were about the right weight, as opposed to 78 percent of current parents. The increase was not as dramatic for boys (78 percent to 83 percent). However, 37 percent of parents of obese boys said their weight was about right. These numbers worry researchers because children are less likely to lose weight if their parents don’t see a problem. One contributing factor may be that the percentage of obese adults is double the number of obese children.

Deep 6 BPA

Despite the fact the FDA has declared Biphenol A (BPA) to be safe, mounting concern about its long-term effects on the brains and behavior of young children has many parents opting to be safe rather than sorry. “Technology has given us many advances in the food and beverage industry,” says Dr. Kevin Lukenda of Trinitas Regional Medical Center. “Responsible parents need to stay on top of—and be aware of—the possible downside of these conveniences. We need to always remind ourselves that certain products may make our lives easier…but need to know which of these advances can be a risk to our health.”

BPA is an industrial chemical used to create rigid plastic products—including food and beverage containers, as well as some dental sealants and register receipts.  A number of studies are under way, but until their results are in, here are some basic precautions parents can take:

• Never microwave in plastic containers.
• Get rid of any container marked with a #7 or marked PC.
• Store food in glass, ceramic or steel containers instead of plastic.
• Cut down on processed food purchases at the grocery store—most come in plastic packaging.
• Bring your own bags to the store. California recently banned plastic ones. New Jersey should, too.

E-Lim-I-Nate the Negative

A recent study conducted at Carnegie Mellon University found that too many negative social interactions can trigger bouts of inflammation that overwhelm a person’s adaptive system and lead to hypertension in older adults. The study (which focused on subjects 50 and older) defined these interactions as involving excessive demands, criticism, disappointment, or other unpleasantness with partners, children, family members, and friends. The effects appear to be more serious among individuals between 51 and 64, and among women in general. One way to manage these situations—besides avoiding them, if possible—is to practice stress-management techniques, including paced breathing and meditation. “The research coming from Carnegie Mellon indicating that unpleasant or demanding interpersonal encounters increase hypertension risk among older adults should come as no surprise to any of us,” points out Rodger Goddard, PhD, Chief Psychologist and Director of Wellness Management Services at Trinitas. Dr. Goddard adds that controlling stress should be very high on one’s priority list. “We cannot become monks and live in a cave in the mountains, so we need to deal productively with what is in our lives,” he says. Stress management involves using both passive and active tools and skills.  Passive skills involve improving the capacity to calm our body and muscles down all throughout the day, and involve deep-breathing, stretching, muscle softening and self-calming thoughts all day long. Active skills involves using:

• Tough Thinking to fight against and banish our negative worries and emotions
• PIPS (Problem Identification Problem Solving) to dwell on the solutions to our difficulties and not on the problems
• Radical Self-Support to build social skills, avoid the negative interactions cited in the study, nurture ourselves, resolve conflict and get our need for love and support filled

Your Germs, My Germs

The next time you check into a hotel or motel and start thinking about all the icky-sticky bacteria you’re being exposed to, consider this: Within 24 hours of check-in, that room will be microbiologically identical to your home. According to the recently released Home Microbiome Study by the Argonne National Lab in Chicago, the bacteria you carry with you does a remarkable job wiping out whatever the previous occupant left behind. “Those who travel regularly, or even just occasionally, tend to be very suspicious of their environment when they check into a hotel, whether it’s in Des Moines or Dubai,” observes Michelle Gillis-Harry, RN, MPH, CIC, Director of Infection Prevention and Control at Trinitas. “By using a sanitizing spray or a disinfectant wipe that kills germs, you create a line of defense against germs that others leave behind. But, based on the findings of this study, as you close the hotel door behind you, you’re leaving your own unique microbial imprint. Simply put, we all leave our mark on the places we live, visit, work or play. It’s part of being human and living within the complex environment we call the Earth.” The true potential of the Chicago study (and others in the works) may be in forensics, since microbiological evidence left by humans may be more useful than fingerprints.

Trinitas Joins Elite Group of Palliative Care Programs

Earlier this year, Trinitas received the Joint Commission’s Advanced Certification status for its Palliative Care Program, becoming just the fifth medical center in New Jersey to attain this distinction. TRMC’s multidisciplinary team—which includes medical specialists, nurses, pain management specialists, chaplains, social workers respiratory/physical/speech therapists and nutritionists—was singled out for having demonstrated exceptional patient- and family-centered care, optimizing the quality of life for patients with serious illness. Gary S. Horan, President and Chief Executive Officer, praised the work of the team, noting that their commitment to achieving the Advanced Palliative Care Certification was “a tribute to their dedication to these patients and families who need this highly specialized compassionate care. ”According to Valerie Ramsberger, RN, MSN, ACHP—who initiated, developed and directed the Palliative Care Program—in recent years, palliative care has become a specialty that melds the unique skills of a broad spectrum of healthcare professionals dedicated to relieving pain and other symptoms in the most challenging of circumstances. Ramsberger (at center, above), who recently retired as Director of Palliative Care at Trinitas, began the qualifying process more than three years ago by participating in collaborative activities with the Greater New York Hospital Association (GNYHA), Institute for Healthcare Improvement (IHI), and the New Jersey Hospital Association. Geraldine “Magie” Cruz, RN, MSN, CCRN—an ICU staff

FLU SEASON

It’s that time of the year again. Winter is around the corner and flu season—which can stretch from October to May—is already well under way. As Benjamin Franklin once stated, “ An ounce of prevention is worth a pound of cure.” The key to avoiding the flu is prevention. The cornerstones of flu management are based on a three-pronged approach: getting vaccinated, washing hands well and often, and protecting others by staying at home if infected. Once you’ve contracted the influenza virus, the best cure is time. The virus will typically last from 7 to 10 days. It’s important to manage a fever with acetaminophen or ibuprofen and to keep well-hydrated. Antiviral therapy (for example, Tamiflu) started within two days of symptom onset has been reported to decrease the length of the flu by one or two days. However, there is much debate within the medical community as to whether or not antivirals play any role at all. Consult your healthcare provider to determine the appropriate plan of action in your scenario. But first things first…

Who should get vaccinated?

If you are reading this, the answer is almost certainly You. The exceptions would be babies under 6 months, people with allergies and active asthma—need to discuss their options with their physician to determine an appropriate plan of action (i.e., those with an egg allergy)—and those with weakened immune systems, who might be best served to receive the Inactivated Influenza Vaccine (IAV) as opposed to the Live Attenuated Influenza Vaccine (LAIV).

So there are more than one kind of flu shot available?

Yes. You will need to discuss the most appropriate option for yourself with your physician, taking your age and medical history into account. The most common options are:

1. Standard Dose Trivalent Shot (Contains Killed Viruses). This shot is approved for people ages 6 months and older.
2. High-Dose Trivalent Shot (Contains Killed Viruses). This shot is approved for people ages 65 and older. As we age, our immune system becomes less robust. The aging immune system can lack the necessary immune response to combat the flu. The high dose flu-shot contains three times the exposure (antigen) to the virus resulting in a more immunogenic response to the flu.
3. Trivalent Shot (Standard) contains 2 Influenza A strains and 1 Influenza B strain
4. Quadrivalent Shot contains 2 Influenza A strains and Influenza B strains
5. Nasal Spray Flu Vaccine (Contains Live Viruses). The CDC recommends this as an option for healthy children from ages 2 through 8 years old, as studies have shown that nasal sprays are more efficacious than the flu shot in children in this age group.

Do I need to get vaccinated every year?

Yes, you do. Researchers isolate the top three flu viruses that will be most prevalent each season and create one flu vaccine. Therefore, you need to get a new flu shot every year to make sure that you are protected. Ninety percent of deaths related to the flu occur in people 65 years of age or older, so it is especially important for this group to get annual vaccinations.

How does the flu actually spread?

The flu virus is contained in droplets. The flu is spread when an infected person with the flu sneezes, coughs or talks. As with most viruses, it spreads from our hands to our nasal and oral cavities.

What’s the best way to avoid getting the flu?

If you are sick, stay home from work, school or daycare. It is imperative to practice excellent hand-washing hygiene in order to prevent the spread of the flu. A helpful tip is to wash your hands with soap and water for approximately 15 seconds—the same time it takes to sing the Happy Birthday song. You can also use an alcohol-based hand rub.

What are the common symptoms that tell me I’ve got the flu?

Cough, runny nose, stuffy nose, sore throat, fever, fatigue, muscle aches, vomiting and diarrhea.

How do I know when to seek medical attention?

If you are at the extremes of age, pregnant or have multiple co-morbid conditions such as diabetes, COPD, asthma—or if you are immuno-compromised—get to the doctor the instant you suspect you have the flu.

Editor’s Note: John D’Angelo, DO, is the Chairman of Emergency Medicine at Trinitas Regional Medical Center. He has been instrumental in introducing key emergency medical protocols at Trinitas, including the life-saving Code STemi, which significantly reduces the amount of time it takes for cardiac patients to move from the emergency setting to the cardiac catheterization lab for treatment.

EV-D68

Enterovirus-D68 was first detected in California in 1962. It occurs less frequently than other types of Enteroviruses (EV), which can be difficult to distinguish from any of the viruses that cause the common cold.

The viruses are called “Entero” because they enter the body through the stomach or intestinal tract. There are over 100 types of EV, which affect 10-15 million people each year in the U.S. The strain in question was identified as D68 in August by the CDC. More than 40 states have confirmed respiratory cases caused by EV-D68. In the state of NJ, there are a total of nine laboratory-confirmed cases as of October 3. The counties affected included are: Sussex, Essex. Passaic, Middlesex, Mercer, Morris, Camden and Burlington counties. EV-D68 was detected in specimens from four patients who have died and had samples submitted.

What are symptoms of EV-D68 infection and how is it spread?

Symptoms are nearly indistinguishable from the common cold—cough runny nose, sneezing, body aches and sometimes fever. Severe symptoms include difficulty breathing, wheezing and worsening of asthma. Enteroviruses can be found in secretions from the nose, mouth and through the entire gastrointestinal tract. The virus spreads from person to person via fecal oral contamination, coughing, sneezing or by touching your hands to your face after touching infected surfaces.

Are children at particular risk?

They are. Little ones get their hands in everything. Children are in close contact with one another. Whereas most adults have been exposed to the many types of Enterovirus—and over time, our immunity strengthens and we are able to combat the assailant—infants, children and adolescents lack the immunity necessary to fight the virus. Children with reactive airway disease are particularly susceptible to EV-D68. Parents of children with asthma should use particular vigilance. If their child becomes ill or has increase in his/her work of breathing they should consult their healthcare provider. Adults can contract the virus, of course, but are less likely to become very ill. Even so, EV-D68 can masquerade as the flu or any other “cold-like” illness. Medical professionals view EV-D68 as a possible cause of severe respiratory illness. If you, a member of your family or community experience a new onset of difficulty breathing or shortness of breath, please seek medical attention.

Can it be treated with antibiotics?

No. Antibiotics treat bacteria, not viruses. A patient will be treated by supportive care—namely medications for breathing, fever control and hydration. Practicing proper hand hygiene is paramount to protecting yourself and others. Wash with soap and water for 20 seconds, especially after changing diapers. Hand sanitizers are not effective against Enterovirus. Avoid contacting your eyes, nose, and mouth with unwashed hands. Cough or sneeze into a tissue or an elbow as opposed to an uncovered space. Keep your children or yourself at home if you are not feeling well. Disinfect high-traffic household items such as bathroom surfaces, countertops and toys with bleach-based household cleaners. EV is resistant to alcohol disinfectants. Look for products that list “Alkyl dimethyl benzyl ammonium chloride” as the active ingredient on the label. The product should state that it kills norovirus and rhinovirus.

Should my child stay home from school if I suspect EV?

Parents should never send a sick child to school. And they should not return to school until they are symptom-free and fever-free, meaning a temperature less than 100 degrees for 24 hours without fever-reducing medications.

Breast cancer ‘co-pilots’ help to steer the ship through treatment and recovery. 

Too often, cancer treatment is complex and the added stress of making one’s way through myriad mazes of treatment options, insurance forms, doctors’ appointments, and various medical procedures can sap a person’s energy that would be better spent on fighting the disease. Several years ago, Trinitas Comprehensive Cancer Center recognized that many women with breast cancer were in need of a “navigator service” that would help them cut through the red tape surrounding their treatment.  Breast cancer patients, Trinitas administrators surmised, would be able to best articulate their concerns and challenges to compassionate healthcare professionals, who could then direct them toward resources designed to help manage the disease. An innovative program was initiated, which showed promising results. Two years ago, the program was revamped to sharpen its focus, resulting in the Breast Cancer Patient Navigator program.

Veronica C. Vasquez, MHA, CN-BA, (left) heads the Breast Cancer Patient Navigator program at Trinitas and works to provide seamless care coordination while considering the unique needs of each patient. “The program helps facilitate patients’ access to doctors’ appointments, deal with insurance claims, and directs them to complimentary transportation and other supportive services,” she says. “Finally, a breast cancer patient navigator offers much-needed emotional support to patients at all phases of breast cancer treatment.”

One of the most frustrating parts of any medical treatment is getting answers to questions in a prompt manner. The Breast Cancer Patient Navigator program helps patients obtain answers to their queries regarding screening, diagnosis, treatment, insurance claims, follow-up visits, clinical trial participation, referrals, transportation, supportive services, and any other concern that may arise. It also assists patients in finding information on self-education resources, and with accessing community resources and cancer management services.

“We also direct patients to support groups that have been shown to help boost emotional well-being while providing coping mechanisms from others who have gone through cancer treatment,” adds Vasquez.

Breast Cancer Navigator, Veronica Vasquez, brings thoughtful caring and support to patients, as shown in the photo on page 44. From her office that overlooks the City of Elizabeth, she manages each patient’s case during their treatment at Trinitas.

Breast Cancer Navigator, Veronica Vasquez, brings thoughtful caring and support to patients, as shown in the photo on page 44. From her office that overlooks the City of Elizabeth, she manages each patient’s case during their treatment at Trinitas.

Dacia Gaillard, 43, who was diagnosed with breast cancer this past August, calls the Navigator program “a godsend.” Referred to the program by her physician, she gave it high marks and said it has enabled her to cope with a potentially overwhelming and stressful situation.  “I am amazed by the amount of compassion I receive,” she says. “I feel reassured that I am not just a name or a number.”

In addition to helping navigate her way through doctors’ visits and insurance queries, Gaillard explains that she can count on Vasquez to “hold her hand” throughout the often long, and arduous, process. Vasquez had her first personal encounter with breast cancer in 2011, when a beloved aunt was diagnosed with Stage III IBC (inflammatory breast cancer). “Not only was it a life altering moment for her but for the entire family, as she was the first member of the family to receive a cancer diagnosis,” she recalls. “She passed away in 2012, but her legacy lives within all those she encountered, forever.”

At the time, Vasquez—who earned her master’s degree in health care administration from Seton Hall—never dreamed that she would have the position that she holds today. “Having had a close family member diagnosed with breast cancer, I hold the work I do to help these women in high regard,” she says. “I dedicate the work I do in loving memory of my aunt, who I miss greatly.”

There’s no time to spare when responding to a stroke.

You’re having a normal day, going about everything as usual, not giving much thought to what might possibly create issues. You are convinced you have everything under control. You certainly don’t give any thought to the fact that you might become a statistic: Every 40 seconds, someone in the United States experiences a stroke; every 4 minutes, someone dies from one.

Let’s get back to your day. First, you start to feel your face drooping. Next, there is a weakness in your arm. You speak but your words don’t make sense. Don’t wait a moment longer. Time is critical. Call 911 for help.

Bernard Schanzer, MD, Chairman of the Division of Neurology, and Debbie Milkosky, RN, Coordinator of the Trinitas Primary Stroke Center, review a CT scan that reveals the presence of a stroke. With decades of experience, Dr. Schanzer serves as the primary neurological consultant for stroke cases at Trinitas, while Debbie seamlessly brings together a team of medical and nursing professionals to address the treatment and care of stroke patients throughout the medical center.

The American Stroke Association has summed up these symptoms in the acronym FAST to encourage a greater awareness of stroke (also know as brain attack). Those who suffer stroke notice a drooping in their Face (F), followed by Arm (A) weakness, and then Speech (S) abnormalities. These symptoms—and others, such as loss of balance or severe headache—mean it’s Time (T) to to call 911.

The person who is symptomatic (experiencing some or all of these symptoms) may be taken so off guard that an observer is often better able to act quickly and place that call. Whatever the case, stroke leaves little time for hesitation. In fact, the longer the delay, the greater the chance for brain damage; approximately 2,000,000 brain cells (neurons) die every minute a stroke goes without treatment.

This past October 29th was World Stroke Day. Now in its ninth year of international observance, it calls attention to what can be a life-altering or fatal health emergency. Statistics bear this out. The Centers for Disease Control and Prevention (CDC) report that one of every 19 deaths is caused by stroke—taking the lives of nearly 130,000 Americans each year. The disability that results from stroke costs the nation $38.6 billion annually; that’s a hefty price tag that includes health care services, medication and lost productivity. Although the American Stroke Association emphasizes that 80 percent of all strokes are preventable, uncontrollable risks such as heredity, age, gender and ethnicity remain key factors that can lead to stroke.

Root Causes

Strokes occur when a blood clot blocks the blood supply to the brain or when a blood vessel within the brain bursts. Medical conditions such as high blood pressure, high cholesterol, heart disease, diabetes, being overweight or obese, and previous “mini strokes” (transient ischemic attacks, TIAs), can all exert negative influences and cause someone to be a candidate for stroke. Of the 795,000 people who suffer stroke each year, 610,000 are first or new strokes; 185,000 are recurrent strokes.

That being said, positive lifestyle choices—such as avoiding smoking and excessive alcohol, eating a balanced diet, and getting regular exercise—can all make a difference in reducing the risk of stroke.

Neuro is called,” she says, “an Emergency Room physician evaluates the patient within 10 minutes of arrival. Within the next five minutes, a neurological consult takes place to determine the likelihood of stroke. Based on the neurologist’s recommendation, a patient may be given a clot-busting medication. At 25 minutes after arrival, a CT scan is done. The results are then interpreted within 45 minutes of the patient’s arrival. All of this happens so rapidly because every minute counts in reducing brain damage.”

Education = Prevention

Trinitas’s targeted education plays a pivotal role in pointing out the dangers of stroke and, ultimately, in lessening the frequency of Code Neuros. Trinitas has conducted community outreach that shares information with an average of 700 people each year. With the assistance of the Rotary Club of Elizabeth and a grant from the Rotary District 7510 of Central Jersey, Trinitas created educational resources for family members and friends who may be caregivers to a stroke patient.

In addition, Milkosky and a team of healthcare professionals wrote and produced a video that drives home the important points about acting FAST in the stroke situation. The video follows a patient from the moment he begins to experience initial stroke symptoms through his arrival at the emergency room, to his treatment, and, ultimately his discharge in the care of loving family members. “We’ve put a face on stroke that makes it real for viewers,” she explains.

Milkosky realizes that little can be done to reduce the likelihood of stroke based on genetics, age, gender and ethnicity. However, a better-informed community has a greater chance of striking a blow against stroke. “We conduct cholesterol and glucose lab testing, blood pressure and pulse checks, and offer stroke-related counseling to encourage a better understanding and awareness of stroke.”

She stresses being pro-active to reduce the risk of stroke by eating better, exercising regularly, and avoiding tobacco and alcohol. “In the case of stroke, long-term commitments to healthier living can sometimes help avoid a devastating health crisis that can literally happen in an instant.”

The grandkids are coming…is your home ready?

How long has it been since I’ve had to worry about child-safety in my home? It seems like lifetimes ago that my own babies and toddlers began to explore their environment. And, in a way, I guess you could say it has been. Alas, the clock has kept ticking and I now have come full circle, with children of varying ages starting to descend once again. I believe I speak for all grandparents when I say that I’m ready for all the love and laughter they bring with each visit. The question is, is my adults-only house safe and sound for these home invasions?

Having recently been introduced to my “grand-dog”—a 3- month old Golden Doodle gifted by my son to his two children—I am impressed that childproofing and puppy-proofing have much in common. Both species require one to take the time to think ahead in order to identify and eliminate unhealthy but irresistible attractions, any vulnerable but off-limits personal items, any unidentifiable yet edible crumbs (and other easily digested floor debris), and certainly any potentially dangerous household items capable of being ingested or harmfully dispensed. So much to consider; so little time to correct…especially since the little barbarians are already at the gate.

The lapse of time between my children and my children’s children is enough to make me feel very insecure about how to eliminate juvenile HazMat. In theory, I should be able to slip back into my parental shoes and see my world as they do—a house of potential horrors. Or perhaps, I could regress even further and evaluate domestic terror from the standpoint of a toddler. I am reminded, in fact, of a very dear friend and neighbor who, upon being advised that my two-year old grandson had hidden the TV remote, fell on all fours and crawled through my house, explaining that she felt a toddler’s eye view would ultimately reveal the well-hidden device. And so it did! However, I can’t imagine me, as someone who is definitely more knee-challenged these days, performing such a physically demanding search. There must be a better way.

www.ithinkstockphotos.com

An Accident Waiting to Happen?

About 2.3 million children are accidentally injured every year and more than 2,500 are killed in what seem to be “perfectly safe” homes. Unintentional childhood injury statistics are alarming, as evidenced by a 2012 report from the Centers for Disease Control:

• Every hour, one child dies from an injury.
• About 1 in 5 child deaths is due to injury.
• Every 4 seconds, a child is treated for an injury in an emergency department.

The above statistics reflect not only accidents that occur in the home, but also external tragedies such as car crashes and fires. According to the KidsHealth web site (kidshealth.org), household injuries are responsible for the majority of ER visits for children under age 3; 70% of accident fatalities in children under 4, not surprisingly, occur where the very young spend most of their time: at home.

SAFETY WATCHDOGS

Safe Kids Worldwide (www.safekids.org)

Safe Kids has an extensive network of more than 500 domestic and 25 international coalitions that are dedicated to reducing childhood injuries and fatalities. Since it was co-founded in 1988 by Dr. Marty Eichelberger (Children’s National Medical Center) with support from New Brunswick-headquartered Johnson & Johnson, the accidental injury rate among children 19 years and younger has decreased by 56%.

International Association for Child Safety

(www.iafcs.com)

The mandate of IAFCS is triple-fold:

• Encourage manufacturers to produce higher quality child-safe products.
• Educate parents on home safety issues.
• Enhance professionalism among child safety professionals through certification of professional providers.

US Consumer Product Safety Commission

(www.cpsc.gov)

A conservative estimate of the CPSC is that child and adult deaths, injuries, and property damage from consumer product incidents cost the nation more than$1 trillion annually. Over the past 40 years, CPSC has successfully protected consumer families’ children through its vigilance in identifying a long list of unsafe products to include cribs, strollers, bicycle helmets, pajamas, and innumerable toys and gadgets.

www.ithinkstockphotos.com

There is some very good news. Even though Safe Kids Worldwide (www.safekids.org) has reported that the estimated number of emergency room visits for children has increased 31% over the last decade, the CDC has reported that the number of childhood fatalities from injury has dropped nearly 30% over the same time period. Thankfully, most accidents are preventable and much is being done to prevent them. According to a recent National Safe Kids’ Report to the Nation, many factors have contributed to the dramatic decline in the accidental childhood fatalities:

• Recognizing that child injury is a preventable public health issue.
• Educating the public through campaigns at the national and community levels.
• Improving safety devices through ongoing R&D and encouraging their use.
• Collecting feedback from “child-proofers,” both private and professional, to develop even safer new products.
• Enacting and enforcing child safety laws.

www.ithinkstockphotos.com

What can you, as a grandparent (or non-parent caretaker) do to keep those numbers moving in the right direction? Create a safety-product checklist that applies to your particular situation. It should include standard-issue items such as safety gates, kitchen and bathroom cabinet safety locks, corner and sharp edge bumpers, doorknob covers and door locks, outlet covers and outlet plates, window guards or safety bars, doorstops and door holders (to prevent fingers getting caught), wall brackets (to secure tip-able furniture and TVs to the wall), safety hinges on toy chests and window seats, and non-skid bathtub strips.

Once you’ve covered the basics, consider safety precautions that are not always obvious. These include outdoor alarms made for pools, gates and doors, blind winders and drapery cord cleats, anti-scald devices for baths and taps, safety netting for balconies and decks, appliance locks for dishwashers and stoves, safe-locked storage for firearms & ammo, toilet lid locks, and fire escape ladders. If your grandkids are “regulars” at your home, you should consider enrolling in an infant & child CPR class (or at least purchase a how-to DVD). And if you own a dog or other animal that is threatened by little ones, talk to a professional pet consult to understand how you can desensitize your pet.

Big Business

Professional childproofing has evolved into a very lucrative business over the past two or three decades. So perhaps it’s time to turn to the pros for some advice—hopefully accompanied by some reasonable housecall pricing. Industry experts recommend that child-proofing be done before a child can crawl (typically at 3-6 months). According to the pros, the six main areas of focus for proofing purposes are:

• Electrical safety
• Physical access
• Chemical access
• Medicine access
• Fire safety
• Reporting potentially dangerous products

As with most professional home services, the cost for childproofing comes with a price tag. An initial at-home consultation typically ranges between $50-$100. Actual services rendered depend upon the size and safety conditions of each home. Complete packages can begin as low as $300, but can easily soar to $1,500 or more. As an example, the typical two-bedroom/two-bath apartment might cost $300-$600, whereas a suburban two-story home can reach the top of the price scale.

Professional Proofers…

These NJ-based childproofing experts confirm that business is booming:

A–Plus Childproofing • Jersey City apluschildproofing.com

Baby Proofers Plus Inc. • Summit babyproofersplus.com

Home Safe Home • Livingston homesafehomenj.com

Royal Baby Safety Corp • Summit

babysafe.com

Home Safe Home

Whether you’re brand new at the baby game, a seasoned parent of a rollicking group of toddlers (and their slightly older siblings), or proud grandparents of a growing second-generation brood, the houseproofing challenge remains the same. The responses to this challenge can vary, from complete paranoia to a somewhat less vigilant “my kids survived, so will theirs” attitude. Personally, I am closer to the former than the latter. I am not sure whether it is the added generational difference or a bit of senior OCD that makes creating the perfect germ-free, chemical-free, hazard-free home environment such an inordinate obligation for me. Thinking back, I question whether I was this conscientious? To be honest, probably not.

Ironically, after paying a visit recently to my grandchildren’s home, I found myself somewhat taken aback by what I considered to be their parent’s rather laid-back attitude toward houseproofing. I actually noticed a sharp table corner missing a buffer cushion, an electrical outlet with a safety plug dangling, and a kitchen cabinet with a childproof lock unlocked. Hard to admit, but it does remind me somewhat of my own home back when my kids were as young as their children are now. It was a reminder of how easy it is to let things slide as an overwhelmed parent.

Even with the most vigilant and meticulous household policing, there’s always the potential for some danger to be overlooked or to go unsuspected. Even the most painstaking household safety campaign is never as effective as the ever-watchful eye of an alert and devoted caretaker, regardless of the generational relationship. Despite the most intensive childproofing protocol, vigilance is the real secret. And, of course, that primordial responsibility does not stop within the confines of our homes.

Finally, in my hyper-vigilance to ensure that my home is not a toddler trap, I think I’ve discovered an additional benefit. I’ve started thinking very realistically about the safety measures I might want to take in anticipation of growing old in this very same home. Indeed, down the road, my “senior-proofing” project should be much easier after everything I’ve learned. Just one change—no more childproof caps!

Editor’s Note: According to Safe Kids Worldwide, a non-profit organization based in Washington DC, last year suffocation was by far the major cause of fatal childhood accidents—including 77% of the deaths under the age of 1. Choking and falls came next, followed by furniture and TV tip-overs and fatal injuries caused by toys.

“A feisty, rather luxurious eggplant curry, ennai kathrikai, may have been my favorite dish of the night.”

Karaikudi

1671 Oak Tree Road, Edison. Phone: 732.516.0020

Open Monday through Friday for lunch from 11:30 a.m. to 3 p.m. and Saturday and Sunday noon to 4 p.m. Dinner: Monday, Wednesday through Saturday from 5:30 to

10 p.m., Sunday from 5:30 to 9:30 p.m. and Tuesday dinner buffet from 6:30 to 10 p.m. Major credit cards accepted. Call to inquire about reservations.

Karaikudi isn’t your average restaurant groupie’s trend-of-the-minute, Instagram-ready hot spot. It’s posh in a traditional way, neither deliberately un-decorated nor all-out artfully attired in a manner that attracts the “Well, I-was-there-last night” crowd.

No, Karaikudi, located in a large parking lot behind one of many shopping centers on Oak Tree Road in Edison, is a rare-for-America Chettinad restaurant, specializing in the little-known cuisine of a region in the state of Tamil Nadu, in Southern India, where typically vegetarian food reigns and spices star.

Yet Chettiars, the people of Chettinad, are not vegetarians. They do not eat beef or pork for religious reasons, but they are huge fans of fish, chicken, lamb and goat. They celebrate spice arguably with more passion than any people in the Spice Belt of South India, and serve their spices, including a variety of chilies, not in fiery doses but by skillfully integrating them into their dishes.

Karaikudi, where members of the New Jersey Indian community and the devoutly food-centric congregate, is a favorite of James Beard Award- winning chef Floyd Cardoz, whose landmark restaurant Tabla brought high-style Indian fare to New York City. It’s where learning something new in food is a delight.

Two of my favorite dining companions, Lily Mullen, 15, and May Mullen, 13, made the trip from Ocean County to experience foods completely foreign to them at Karaikudi. They’re not exactly novices in the kitchen, serving as extremely able sous chefs during my own recipe-testing projects and helping their parents, Eileen and Shannon Mullen, with nightly dinners. They also win 4-H awards for the produce they raise in their extensive backyard garden and for the chickens they’ve nurtured for years. As they efficiently combed Karaikudi’s menu, asking questions both pertinent and probing, I thought to myself, “These two could teach a CIA grad a thing or five.”

We quickly dug in. I could’ve eaten five portions of a signature Chettinad dish, Gobi 65, aka chili-infused cauliflower. Lily coated her tongue and tummy with a silky, creamy mango lassi, which she describes as a lovable “milkshake-like drink,” before, during and after the Gobi 65. It was, she said, “covered in the crispy coating of orange spices that looked like nothing I’ve ever eaten before.”

“They both were deliciously different,” Lily said of the lassi and cauliflower. “I soon realized that Indian cooking has very spicy flavors or mild, simpler ones.”

In other words, Lily caught on to the very essence of Indian fare: balance. If you drink a yogurt-based fruit lassi as a counterpoint to a chile-powered dish such as Gobi 65, you’ll catch flavor not fire.

May took a liking to a playfully presented starter called chicken “lollypops.” Dusted in masala, it was a textbook example of how a classic spice mixture can energize a basic such as chicken.

“The chicken lollypops were my favorite dish,” May said.

“The color, the taste, the spiciness and flavor just really hit the spot.”

Mysore bonda, a warming lentil stew enriched with chilies and served alongside coconut dumplings, is something I’d curl up to gladly on a rainy night. May, not a fan of coconut, thought the dumplings a tad bland. But she’d happily reprise the chicken biryani, which was a far more spice-roused rendition than the stuff too often doled out at restaurants without Karaikudi’s finesse.

“The chicken biryani was intriguing!” she exclaimed. “It’s unlike anything I have ever tasted. It wasn’t too spicy or too bland.”  Lily summed it up by saying, “The chicken rice with the egg dish looked like what I imagined Indian food to look like.”

I always imagine a banquet of India’s unfailingly gregarious vegetables as a perfect meal, and I’d want Karaikudi’s paneer 65, spiced and fried cheese, on any groaning board. With black pepper and ground chilies as key components, neither one overpowering the other, this is Indian cheese taken to a new level.

A feisty, rather luxurious eggplant curry, ennai kathrikai, may have been my favorite dish of the night: Eggplant stewed with onions, tomatoes and chilies in a tamarind-based sauce proved tart, tangy and inviting as a side show to both the bone-in mutton kurma, a casserole of goat in a silky cashew gravy, and butter chicken, another saucy-yet-sassy stew of chicken with a creamy tomato-infused base.

“Out of the five gravy dishes we tried, the fish one was my favorite,” Lily said. For her, the Chettinad fish curry, with kingfish simmered in a multifaceted masala, bested the chicken, mutton, eggplant and pea-cheese sauce-rich dishes.

Fish curries are a specialty of Chettinad cuisine, so Lily’s spot on in her assessment. Karaikudi’s shows off its spice know-how, fusing seasonings warming and soothing in a way that lends depth to the finfish. I could’ve eaten that dish all night.

I have to admit that I was most excited to watch Lily and May have a proper experience with both a dosa and an uthapam – specifically a paper masala dosa and an onion uthapam. The paper dosa, a large, lacy and extremely light crepe made with rice flour and, in this case, stuffed with potatoes and onions licked by masala, prompted Lily to say it had “the texture of a French fry.”  May enjoyed the dosa, but thought the filling “a little too spicy.”  The onion-flecked uthapam, often dubbed an Indian “pizza,” is made with a rice flour-lentil base and is thicker than a pancake. Lily enjoyed it straight, no chasers — without “dips,” as she cleverly termed the chutneys, sambhar and raita that accompanied our food.

Pineapple kesari, anyone? That’d be a pineapple semolina pudding that’s a kind of second cousin to a fruited bread pudding. Gulab jamun? Snap up these milk dumplings soaked in rose-flavored sugar syrup at Karaikudi. Both desserts are sweet, yes, but not cloying, particularly the gulab jamon, which Lily referred to as “pancake balls.” They “seemed daunting at first, yet they tasted like a pancake soaked in syrup.”

The only dish we all didn’t take to was billed as chakara pongal and described as a “beet halwa.” It wasn’t like the chakara pongal I’d had before, a very sweet crumble-esque dish starring nuts, dried fruits, basmati rice, milk and lots of jaggery (palm sugar). This shredding of beets was sweet without counterpoint, which set it apart from Karaikudi’s norm.

And Karaikudi’s norm is food so transporting, a dinner here is as good as a stamped passport.

Editor’s Note: The ritual of the International Night dinners that became the cookery book of the same name by Mark Kurlansky and his daughter Talia omits India only by fate. In all the spins of the globe that directed the Kurlansky family to their cooking destination, somehow Talia’s finger didn’t land on the sizable country of India. So we filled in the gap for the many, many devotees of Indian cuisine in Edge-land.

A father-daughter duo embarks on culinary flights of fancy

In March 2009, when Talia Kurlansky was 9, her father Mark spun a big globe with an airplane as its base that sat on a desk in their Manhattan apartment…and let his daughter’s finger fall where it may. That fateful fall of the finger dictated what was to become a family ritual: a dinner menu culled from the cuisine of a foreign land. Fifty-two menus later, the fruits of the family’s ritual have become a joint father-daughter book, International Night (Bloomsbury; $29), a globetrotting adventure in food, history and culture.

Mark Kurlansky is one of the most respected and decorated writers in America, author of The New York Times best-sellers that include Cod, Salt, The Big Oyster, The Basque History of the World and 1968—as well as a host of adult fiction and children’s books. Talia, now 14 and a freshman at The Calhoun School in New York, may not (yet) have her father’s catalog of books, but in her debut with International Night, she explains in a voice both sure and entertaining how to separate an egg, why spaghetti Bolognese is her favorite dish, who grills the best sardines and

Courtesy of Mark Kurlansky

what steps are necessary to achieve a perfect pizza made from homemade dough tossed, softly and gently, in the air (“Try not to let the dough land on the dog, or in a potted plant. But the dog usually loves it”).

International Night is a book that schools would be wise to include in their curriculum, and parents in their home library. The Kurlanskys’ experiences—both in the cooking (“I tried dishes we don’t normally make in our house,” says Talia; “Some recipes in this book are ones I’ve made for years, but have refused to share until now,” adds Mark) and the off-the-beaten path traveling—are primers in how to learn.

“I’d been to 41 of the places in the menus,” Mark says of the bills of fare that range from Andalusia, Algeria, Aquitaine and Argentina to Quebec, Sri Lanka, Tanzania and Turkey. “That left 11 where I’d never been.”

All international dinner nights involved homework. Mark and Talia researched culture, customs and cuisines, and made sure music was part of the evening’s festivities. Talia added another component: costumes.

“I’d learn what traditional dress and what the outfits were like, and I’d use things from our home to come up with a costume I’d wear for International Night,” she says.

“Kids contribute a lot of ideas through the questions they ask,” Mark notes.

“I got a great sense of the timeline of history and a realistic sense of place,” Talia adds. Her mother Marian took hints of history and culture to guess which country her family was traveling to via the edible route.

Sometimes, when Talia’s finger landed on a destination, the end result was a trip. As Mark writes in their book, “When I learned that for the first time in history there was a cooking school in Morocco, I decided that Talia and I had to go.” They studied with dadas, women trained by their mothers in the crafts, secrets and recipes of Moroccan cookery. They cooked with their dadas several hours a day, taking in the sights and curiosities of this North African country in their non-kitchen time.

“While on this trip, I went up a level in my cooking,” Talia writes. When it came time to write a menu, “we realized that we had too many dishes [for just one dinner], so we had two Morocco Nights.”

Morocco may have served forth a bounty for the Kurlanskys, but every aspect of the project brought insight and new skills to the father-daughter team. Talia talks of using the back side of a ladle to spread crepe batter around a pan: “Move the ladle in a circular motion and that spreads the batter evenly.”

Mark, whose expansive knowledge of all things culinary has brought him honors from the James Beard Foundation, Bon Appetit magazine, the National Council of Teachers of English and National Parenting Publications, still marvels at the “universality of salt,” and points out that “peppers are different everywhere (because), like wine, they taste differently everywhere they are grown,” and offers tips on spices such as cardamom: “It gives dishes a magical perfume, but get the green, not the white.”

Courtesy of Mark Kurlansky

International Night also offers the recipe for Mark’s prize dessert, “Rigo Jancsi” from Hungary, which he spent weeks perfecting during a stint in the 1970s as a chef at a restaurant in Greenwich Village. The cake was easy, the chocolate topping not all that hard to learn, but “I worked on the filling for weeks, trying, throwing it out, trying again.”

Finally, Mark got it.

As Talia says, “A lot of people making dessert don’t understand the chemistry. They don’t use a recipe.”

But with most of the savory recipes in International Night, the Kurlanskys agree the instructions should be “suggestions.” Home cooks should let inspiration flow.

Researching for the book, and cooking for the book, left Talia with an even stronger desire to travel. “I love being places where I don’t speak the language,” she says. “I want to travel everywhere.”

Mark, who currently is writing a book about the impact of paper on civilization and whose Twitter handle is @codlansky, wishes Talia’s finger had landed on Scotland, since he spent time there fly-fishing and had many tales to tell—and India, a huge country he’s yet to explore.

What? Never been to the land virtually ruled by his beloved spices?

“No,” Mark says, his voice expressing regret. “I’ve never been to India. We need to correct that.”

International Night…the sequel.

RECIPE FILE: HARIRA* (a soup for Moroccan Night)

• one-half pound lamb, cut into bite-size pieces
• 2 medium white onions, finely minced
• one-half pound dried lentils
• one-half cup canned chickpeas (aka garbanzo beans), drained and rinsed
• 1 celery rib, finely minced
• 6 tablespoons olive oil
• Large pinch salt
• one-half teaspoon turmeric powder
• 1 teaspoon clarified butter
• 9 cups water
• 3 medium tomatoes
• 1 slice fresh ginger root, peeled and chopped
• 2 tablespoons tomato paste
• 4 turns of peppermill containing black peppercorns one-quarter cup rice, cooked
• 3 tablespoons flour

Place the lamb, onions, lentils, chickpeas, celery, 3 table-spoons olive oil, salt, turmeric and clarified butter in a pot. Cook over medium heat for 10 minutes.

Add the water. Cook over medium heat for one hour.

Meanwhile, take the tomatoes, blacken the skin over a burner, and rub it off. Quarter the tomatoes and remove the seed and gel. Save yourself a lot of chopping by pureeing the tomatoes in a food processor with the ginger root.

Mix in a bowl with the tomato paste, remaining 3 tablespoons olive oil and the black pepper. Add this mixture to the soup pot. Stir well and cook another 20 minutes. Add the rice. Cook 10 minutes more.

Take some liquid from the soup and mix it in a bowl with the flour until it is smooth and without lumps. Stir it back into the soup. Stir constantly while cooking soup for another 5 minutes. Serves 3.

Growing Pains?

Maybe not. A look at the cost of LBP in kids.

What is the leading cause of disability in the world today? The answer, according to the World Health Organization’s 2010 Global Burden of Disease study, is low back pain (LBP). LBP is defined as pain in the area on the posterior aspect of the body, from the lower margin of the twelfth ribs to the lower gluteal folds, with or without pain referred into one or both lower limbs that lasts for at least one day. The common image of an LBP sufferer is a hard-laboring adult, or a senior citizen, but the fact is that low back pain in children and adolescents is a significant health problem, too.

As Dr. Naomi Betesh points out, in children and teens, back pain increases with age. And because LBP in adolescents leads to increased risk of recurrence in adulthood, physicians are realizing the importance of early detection and treatment in the pediatric population.

“Patients, whether adult or pediatric, have the best outcomes with a multidisciplinary treatment approach,” explains Dr. Betesh, a pain management and rehabilitation specialist at Union County Orthopedic Group in Linden and Clark. “Treatment strategies include core strengthening, postural training, proper biomechanics education, medication management and minimally invasive procedures.”

The 2010 WHO study, which was released in March 2014, concluded that LBP causes more global disability than any other condition. With the planet’s aging population, the report stated, “there is an urgent need for further research to better understand LBP across different settings.”

LBP: DID YOU KNOW?

• The annual bill for chronic pain in America, which includes healthcare costs plus lost productivity, is more than $600 billion.
• More than 15% of that cost is related to lower back pain.
• In 2014, 1 in 34 Americans will lose two weeks or more in productivity to LBP.
• Only one-third of the annual cost of LBP in America is related to healthcare; lost wages and diminished productivity accounts for the remaining two-thirds.

Editor’s Note: The above statistics were part of a 2013 study that included information sourced from the CDC, the Center for Medicare & Medicaid Services and the U.S. Bureau of Labor Statistics.

MAKING STRIDES IN WESTFIELD

The EDGE Magazine crew—Rob Rubilla, Jeff Shanes, Doug Harris and Jama Bowman—man the Trinitas booth at the 13th Annual Downtown Westfield 5K & Pizza Extravaganza in July. Around 2,700 runners crossed the finish line moments before the skies opened up for a group cool-down. Trinitas was a Platinum Sponsor of the 5K. EMTs Jose Caba, Angela Boyd & Jon Abello led the runners off the start line in a Trinitas ambulance. Harris, Vice President of Marketing and Public Relations at Trinitas, presented awards to the top finishers along with Sherry Cronin, president of the Downtown Westfield Corporation.

WIDE WORLD OF NURSING

Two faculty mem-bers and 12 nursing students from the University of Notre Dame in Jacmel, Haiti, spent two weeks with faculty and students at the Trinitas School of Nursing.  The College of St. Elizabeth and the Sisters of Charity of St. Elizabeth joined the School of Nursing in hosting the program                     , which included classes and opportunities to improve their nursing skills by treating patients in the simulation lab. Bilin-gual faculty members and student “buddies” from the School of Nursing communicated with the students in Creole, and con-tributed to their immersion in U.S. nursing practices.

TRINITAS CIO NAMED CHAIR OF JERSEY HEALTH CONNECT

Jersey Health Connect has named Judy Comitto chairperson of its board of directors. Comitto is Vice President of Information Technology at Trinitas and Chief Information Officer. Jersey Health Connect—the state’s largest health information organization—offers a comprehensive network of 29 health systems and hospitals, over 3,500 clinicians, and long-term and post-acute care facilities.

CAPED CRUSADERS

Children visiting the Trinitas Family Health Center were transformed into superheroes recently, courtesy of employees and interns at Verizon. Verizon supplied dozens of capes to Trinitas as part of a nation-wide program that brings cheer to children undergoing medical care. Two-year old Walter Garay, and his sisters Yartiza (center) age 5 and Melissa, age 7, show off their colorful capes to mom Lisseth (left) and Teresa Andrews, Clinical Coordinator, Pediatric Health Center.

Relax…let your nano-robots do the dishes

Speckled linoleum. Avocado appliances. Fluorescent lighting. These design tragedies are a distant memory compared to the contemporary kitchens of the 21st century. There’s no doubt about it: We’ve come a long way, baby. Yet, by 2020, the kitchen we are so proud of today may be just as outdated, antiquated and embarrassingly obsolete. And although the word kitchen will never entirely disappear from our vocabulary, it’s possible that we may be grasping for a new name that describes a room that plays a much more expanded role in our domestic surroundings.

Photos courtesy of Michael Harboun

If you have redone your kitchen in the past decade, you may be in for a rude awakening when the 2020’s hit. The state-of-the-art hallmarks that we so proudly (not to mention, expensively) included in our dream kitchens will seem like art only in the sense that some will belong in a museum. Indeed, the kitchen of the not-too-distant future will embrace science and technology as well as aesthetics.

Whirlpool already began previewing its Kitchen of 2020 at the recent Consumer Electronics Show (CES) in Las Vegas. One item in particular had kitchen remodelers dancing in the aisles: a refrigerator that will be Bluetooth-enabled to stream music into your kitchen. You will be able to coordinate your menu to an appropriate musical background at a tap of a finger. If it’s salsa your prepping, then salsa can be your music of choice. If it’s an elegant and high-end Beef Wellington, then something classical may be in order. Downhome spread? How about some Brad Paisley? No need to drag that iPod or iPad into your work area. That’s so 2013.

One day, by the way, your refrigerator may not even have a door—at least as we know it today. Instead, you’ll be able to push and pull your food through a see-through gel-like framework (hopefully tinted to coordinate with your color scheme). If you think this sounds like something out of a Jetsons cartoon, think again. To retrieve an item from the Bio Robot Fridge, all you will have to do is reach through an odorless, non-sticky polymer gel and pull it out. No more leaving that refrigerator door open or endlessly wiping off greasy little fingerprints. Russian student Yuriy Dmitriev took second place at the Electrolux Design Lab competition with this idea. Four years ago.

HOT TOPIC

One cannot discuss the Kitchen of 2020 without addressing its very essence, the stove. From huge cauldron-bearing hearths to black and bulky cast iron relics to built-in multi-burner tops, the kitchen remains first and foremost a place to cook. The word kitchen actually comes from the Old Latin word coquere, meaning “to cook”—which evolved into the Old English Cycene, to kichene in Middle English, to cucina in Europe, and eventually to our word. At its CES exhibit, another Whirlpool highlight was an induction cooktop designed to turn your countertop into a stove. Four dozen micro-inductors create one large cooking surface on which you can position up to four pots and pans. Since the heat is produced only where needed, the rest of the top stays cool to the touch. By the time this technology hits the market, there won’t be any control knobs; you’ll just tell the stove what you want it to do. Voice recognition technology will almost certainly be available on most appliances in 2020 and—perhaps more intriguingly—appliances may be talking back. Think about that for a second.

A go-green sensibility will also be part of new kitchens in 2020. Eco-clean, eco-friendly and eco-smart features will be available in almost every aspect of kitchen design. We might be looking at recycling sinks that hygienically reuse the same water supply, as well as more advanced versions of products that are already hitting the market: Nutrima (a foldable appliance to calculate nutritional values, possible toxins and food freshness), the Kitchen Hub (a food inventory and expiration monitor), the GE Advanced Filtration System (which removes 98% of important trace pharmaceuticals), and the LG Blast Chiller (five minutes to chill a can and eight for a bottle of wine).

Glass will almost certainly play an expanded role in the Kitchen of 2020. It is already becoming a popular design choice, replacing ceramic tiles above counters, sinks and stoves. However, in the next decade, we will begin to see glass used as part of energy solutions and not just aesthetics. There are plans afoot to use this material in roof and wall components that will funnel the power of the sun into kitchen appliances. We could also see glass-enclosed “living” walls that produce herbal greenery and edible fish and sea vegetation. The goal? To make the kitchen of the future a standalone, self-sufficient space that will reflect sustainability above all else.

GREAT EXPECTATIONS

When envisioning the Kitchen of 2020, one of the greatest challenges is separating fantasy from reality. It’s one thing to brainstorm and another to pick the brains of people in the know. Two individuals with hands-on knowledge of what’s actually waiting in the wings are Maria Stapperfenne and Brian Pagel. Stapperfenne is a Certified Kitchen and Bath Designer, President-Elect of the National Kitchen & Bath Association, and a Manager at Tewksbury Kitchens & Baths. Pagel, a VP of the Kitchen and Bath Group for Emerald Expositions—one of North America’s largest trade show producers—gets the ultimate sneak peak of future products as he works with exhibitors to showcase their most innovative kitchen components.

Stapperfenne shared what she learned on her recent travels to expos in Las Vegas, Los Angeles and Milan. She saw, up-close and personal, some technological “super products” and design concepts that may not be available by 2020, but which are certainly in the pipeline. Her enthusiasm for what’s to come is infectious (see page 26). At Eurocucina in Milan in April, she was allowed to photograph one of the aforementioned induction-type cooking spaces that has been seamlessly integrated into a countertop. Understandably, makers of advanced technologies can get touchy about photos; this was the exception that proved the rule.

According to Stapperfenne, most major kitchen renovations are being undertaken by people in the 30-to-50 age range. These clients often save up for years for a new kitchen, so naturally they expect their investment to last 20 years. Given the increasing speed of technological advances, the actual “lifespan” may be much more compressed. Which can make for some nervous customers. Consequently, Stapperfenne describes her professional mission as “educating our clients to make intelligent and informed decisions, and then to have confidence in their choices.”

Cost is another issue. According to Stapperfenne, a kitchen remodel is a reflection of individual budgeting. She found an exhibitor at the Milan show who indicated that the level of investment for his displayed 18’ x 20’ kitchen was somewhere between $495,000 and$500,000! When asked what she would want most in her own future kitchen design, Stapperfenne put comfort and convenience at the top of her list.

Brian Pagel feels that, despite all the technological advances, the Kitchen of 2020 will still reflect many of today’s design touchpoints—in other words, what’s in now won’t necessarily be out by then. However, for longer-range predictions, he believes emphasis will be placed on accessible living, aging in place and the “totally wired” kitchen, with technology as integrated as in the rest of the house. Pagel also predicts that manufacturing will focus on reclaimed, reused and eco-friendly materials, along with energy efficiency. His most recent exposition in Las Vegas, the 2014 Kitchen & Bath Industry Show, was a joint venture with the National Association of Home Builders. This co-sharing opportunity reflects his conviction that close collaboration between construction and design—with the added advances in technology—represents the future not just for the kitchen, but for the entire home.

ALWAYS A GATHERING PLACE

With all its cutting-edge electronic enhancements and techno-friendly gadgets, tomorrow’s smart kitchen will remain the hands-down favorite gathering space—where “gathering” is the operative word. Granted, a kitchen may no longer be defined by any distinct perimeters, and will almost certainly migrate into other functional areas of the home. However, as the designated area for food-focused activity, high-tech efficiency and social interaction, it will remain the heart and soul of our homes in 2020 and for generations to come.

2020 & BEYOND

When Maria Stapperfenne looks into her crystal ball, this is what she sees…

Wireless Power

We will power up our kitchens as easily as we access our Wi-Fi connections elsewhere in the house today. Countertops will be equipped with conveniences like Duracell’s PowerMat, a built-in charging pad that makes plugs obsolete, and we’ll get wireless delivery of our morning newspaper simply by tapping on the counter surface.

Lower Maintenance

People generally don’t like to clean, so the trend in kitchens is to modern styling with less ornamentation and flowery crevices in which to catch dirt. Modern and minimalism go together.

Transiency

One day, you may be able to change the look of your kitchen as easily as you change your wardrobe. Kitchen cabinetry and appliances will no longer be permanently installed, but instead will be wall-hung for easy removal to minimize the labor and upheaval associated with kitchen remodeling.

Voice Recognition

With a simple code word, you will be able to turn on your lights, start your oven, or order your favorite latte.

Personalization, Organization  and Accessibility

Cabinet shelves and drawers can be personally outfitted, right down to contour-specific routing and grooving as cradles for your personal cutlery and dishware. Another exhibit at the Milan exposition featured a center island complete with a built-in storage unit that rises from the counter via remote control for quick access, much like today’s lift cabinets that hide large flat-screen TVs.

So what else will be in your kitchen in 2020 and beyond? Interactive cookbooks and recipes should be available on pop-up or drop-down video screens, or through tablets and other devices connected to your kitchen’s “brain.” There are folks looking at creating smart countertops with bio scanners that can assess your nutritional needs. Your fridge will keep track of what you’ve got, what you need, and what’s about to go bad—and connect with your smartphone when you’re at the grocery store. The most-used source of heat in your kitchen? It could very well be steam. And that smart countertop may include built-in extractors to transform the steam to water for other general uses after it flows through the heating element. Nothing wasted; everything gained.

Speaking of water, Perez Zapata’s Mab, a first-place winner in the 2013 Electrolux Design Lab competition, is a futuristic system designed as a spherical hive of hundreds of small flying robot drones that clean surfaces just by touching them with a drop of water. Getting still more fantastical, Michaël Harboun’s Living Kitchen explores “claytronics,” which is basically a form of nanotechnology, where tiny little robots can arrange themselves into macroscopic structures that will let you create any forms out of a moldable mass. Touch the moldable mass and you will be able to pull out a faucet, scoop out a deep sink, or access any appliance on demand (google Harboun on youtube for a truly “unbelievable” video). And if it’s company you long for, laser hologram technology will let you invite your favorite chef into your kitchen or arrange a face-to-face cook-off with virtual friends and relatives. Virtual relatives…hmm. The kitchen of the future is sounding better and better!

STEAM POWER

Whatever high-end kitchen solutions the future brings, it’s a pretty good bet that the Eardly T. Petersen Company will be involved in some aspect of floorcare and water filtration. Interestingly, the company carries one particular product that has been a component of cutting-edge kitchens for 35 years…and is likely to be there in another 35: The Ladybug. The beachball-shaped Dry Steam Vapor cleaner cuts through the biofilm created by bacteria on countertops without the use of chemicals or toxins. “Study after study shows that the kitchen is the most contaminated room in the home, and that bleach does not kill all bacteria,” Keith Petersen points out. “The Ladybug cleans and disinfects surfaces with ordinary tapwater heated to make a hot, dry steam. Countertops, floors, ovens, stoves, sinks, dishwashers, refrigerator interiors, windows, doors—it’s amazing.”

Since the 1950s, the Westfield-based company has identified, sold and serviced leading-edge products for inside and outside the home. The founder’s sons, Keith and Douglas, have doubled down on their father’s unbending commitment to quality, offering the most revered brands in the industry and backing them up with the human touch. “People look to us for our knowledge,” says Douglas. “They come to our retail location on Elmer Street and say, Wow, this is like an old-fashioned store. If we don’t think a product is the best in its industry, we won’t sell it.”

A professional take on that most personal of male spaces.

By Stacy Ewing

One of the terms we’ve seen thrown around a lot of late is Man Cave. A lot of interior designers cringe when they hear it. It carries with it testosterone-laced connotations of memorabilia- choked dens and musty basements with cheesy paneling, with a crudely scribbled No Girls Allowed sign thumbtacked onto the door. I’m not really sure those even exist; I have yet to meet the man who would actually want one. When you reach a certain point in life, your vision of a Man Cave is distinctly un-cavelike. I love those two words. What guys are really talking about is a lifestyle space, and that’s something every designer should be happy to hear. 

Photo by Wendy Gedack

Which is a good thing…because when my design team is hired to build a Man Cave in a new or existing home, I need husband and wife on the same page. When a wife tells me, “I don’t care, the basement’s his, just do it,” that’s a huge red flag—just as it is when a husband says, “I don’t care, my wife makes all the decisions, I just want the house decorated.” I have yet to encounter the couple that doesn’t want significant (if not equal) input on a design project. Better to come to a meeting of the minds in the planning stage, because once the build-out begins, changes can get contentious and expensive.

I always start with the assumption that a couple shares similar tastes. Sometimes, it doesn’t seem that way, but at the end of the day they’re usually not that far apart. They may have different visions for a space, but if you listen carefully, you’ll find that common ground. I typically do a three-hour consult and also ask prospective clients to fill out a detailed questionnaire. Occasionally, I’ll have to employ techniques a psychologist would, but it’s really critical to get everyone on the same page. My job at that point is to evaluate the space, to determine what’s going on in with rest of the house in terms of architectural style and color, to understand how people relate to the different spaces, and then continue that into the Man Cave. Continuity is really the key. Whatever you do in that Man Cave has to marry with the rest of the house. That’s where the magic happens. You don’t want it to look like What exploded in that room?

One of the mistakes people make when they start a project like this is to tear out pictures from architectural magazines and say, “I want that.” What’s big right now in the interior design business is finding eclectic touches and working them into a space. That’s particularly true for a Man Cave. I saw a story about a home that belonged to the director of one of the Batman movies. He had a full-size Batman model that would have looked terrible standing by itself in any other part of the house. But the entire room was designed intelligently and tastefully and it looked great. That’s why eclectic items work really well in a Man Cave. It really personalizes the space. If that item

Photo by Wendy Gedack

is a neon beer sign, well, that may present more of a challenge than a deer head or an autographed jersey, but you can definitely pull it off. Even if you don’t have that one off-the-wall detail to work with, in an ideal situation you like to start a Man Cave with a focal point—a pool table, a fantastic piece of furniture, a large collectible item—that’s Design 101. More often than not, however, your client just says, “Just create a space that blows me away.”

Photo by Wendy Gedack

In those cases, again, it’s important to listen. You’re trying to find a way to bring his things and her things together in a space, especially if the Man Cave is a place that a couple is going to share and entertain in. Recently I had clients where the husband and wife were both Starbucks executives. He grew up on a farm in Minnesota. She was a city girl from Chicago. He wanted warm tones and lots of wood. She liked glass and steel and cool colors, and really disliked wood.

Immediately, I knew I had to figure out what they both liked. In our discussions, it turned out she was very focused on her wine collection, and was keen on having some sort of storage configuration in their dining room. At the same time, he liked sports but his Man Cave didn’t have to be full of Broncos memorabilia. He just wanted a really cool, refined space—”a place where I can smoke a cigar, have a mug of beer and enjoy the space.” I ended up using two basement storage areas to create a wine grotto. It had the wood that he wanted and enabled her to show off her collection in a space they were both comfortable in. He feels good about it because he can have his buddies over, and she’s happy because the shelves we built were tilted at 45 degrees so that people could see the labels of the wine bottles.

Of course, not everyone can afford to hire an interior designer to plan out a Man Cave. If you are tackling this project yourself, there are a few rules of thumb. Limit yourself to two or three colors. Ideally, carry through the main color of your house into the space, and pick one or two others. If one of those colors is a bright team or school color, that may present a challenge—but also an opportunity. For the “NFL Female” Super Bowl Party, I purchased a black and white cowhide, Googled “chalk paint by Annie Sloan” and found a local stockist who painted it orange crush and blue (see below) and it really pulled the room together.  Another way to get continuity with the rest of your home is in the matting and framing of photos and collectibles. 

Most importantly, re-read the beginning of this article. It’s critical to get on the same page as your spouse. Understand what’s important and what’s not, and pick your battles wisely. You’ll end up with a space you’ll both be happy with.  

Photo by Elizabeth de Sordi

Editor’s Note: Stacy Ewing runs Stacy Ewing Interiors & Design in Denver. The company works from concept through completion for a wide range of residential, commercial and hospitality projects. Stacy has designed Man Caves for six residential clients in recent years. Many of her past and current projects can be viewed at stacyewinginteriors.com.