New Jersey’s ‘Kitchen Cousins’ have a lot on their plate in 2015.
So you thought your kitchen was a train wreck? Anthony Carrino and John Colaneri, HGTV’s ubiquitous Kitchen Cousins, pride themselves in transforming hopeless residential and commercial cooking spaces into spectacular, high-functioning showplaces. This summer, the cousins embark on their newest reality venture, America’s Most Desperate Kitchens.
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Back in late-2014, HGTV asked viewers to send in 90-second videos that proved their kitchens were totally hopeless. The network received a flood of submissions that ranged from shameful to catastrophic, picked the most challenging (and funniest) and then dispatched Carrino and Colaneri to make a little magic. America’s Most Desperate Kitchens marks the fourth series for the talented and likeable duo, who run Brunelleschi Construction in Jersey City. They have gained a legion of fans with Kitchen Cousins, Cousins On Call and Cousins Undercover.
Fans of the cousins are already setting their DVR’s for the opening episode, which airs on July 1. In the meantime, one can enjoy their latest renovation creation on Erie Street in Jersey City, where Carrino and Colaneri recently opened Carrino Provisions, a gourmet market with a family-style Italian restaurant housed in a reclaimed 19th century factory building.
Authenticity is everything in the Reality TV game, and the cousins have taken their lumps on more renovations than they care to remember. Prior to their new show (which has them traveling all over the country), they had worked almost exclusively in New Jersey. What better proving ground for construction and design skills than the old (and not-so-old) homes of the Garden State? As much as they love the challenge of updating antique houses, both agree that falling in love with an old home can be a slippery slope.
“I love a good old home or structure, but they can very quickly become money pits,” Carrino cautions. “The important thing for buyers is to get a really good home inspection prior to purchase, so you understand what you’re getting into.”
Courtesy of HGTV
What are the Kitchen Cousins’ favorite materials to work with?
John Colaneri: Wood, metal and stone. All three of these materials give any space a warm and unique feeling. I love using natural materials when designing and building homes. I always try to incorporate these three elements into my designs.
Anthony Carrino: I use myriad materials depending on the project. It’s my job to know what’s out there, so I have a good stockpile of materials I love to work with. If I had to pick three I would say live edge wood slabs, raw steel and concrete. Raw materials just speak to me.
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“I love old homes and the history they have,” adds Colaneri. “You find architectural features that are so hard to come by these days. The only downside of an old home is that nothing is up to code, and it’s going to cost a lot of money to renovate.”
Brunelleschi Construction only does restoration work. According to Colaneri, the blending of old and new is what fuels the cousins’ passion. They find New Jersey to be an ideal place for their specialty because of the large number of older and historic homes. They also find it amazing how little most owners know about their dwellings. Nine out of 10, says Colaneri, have no clue as to the condition of the mechanical systems.
“These are the things that are not in front of your face or too glamorous, but they will cost you the most in the end,” he warns. “If you are buying an old home, make sure the air conditioning and heating systems and the electrical have been maintained and updated over the years. It’s just like a car—what’s under the hood makes a big difference.”
Courtesy of HGTV
Prior to launching their new show, Carrino and Colaneri completed a major project in Jersey City in partnership with Chef Dale Talde: Carrino Provisions, a food destination that features a market, coffee bar and Osteria. The market space, which was designed by the cousins, has an old-country feel with white brick walls, hand-painted signs, fresh-baked breads and pastries, artisanal meats and cheeses, and local produce. The Osteria offers Chef Talde’s take on Italian cuisine, with large shareable portions of handmade pasta.
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Dale Talde made a name for himself across the harbor in Brooklyn, where he and partners John Bush and David Massoni operate TALDE and the Thistle Hill Tavern, both in Park Slope. His take on Asian-American cuisine earned rave reviews and a loyal following. The trio opened TALDE Jersey City a stone’s throw from Carrino Provisions, with a major renovation assist from Carrino and Colaneri, who incorporated the circa 1880 building’s elevator wheels into the restaurant’s industrial chic design. Meanwhile, the lighting has a distinctly Asian influence, with silk-and-wire lanterns illuminating the main dining space. Both TALDE Jersey City and Carrino Provisions are located on Erie Street, between Bay and 1st Street.
Anything having to do with the foundation or structural integrity of an old home is a potential deal-breaker, adds Carrino. “Along with a roof that’s in poor condition, those are things that can suck your budget dry before you even begin your renovation.”
When is a house a tear-down? Everything is fixable, the cousins claim. It’s just a matter of time and money. However, if the structural integrity of a home is profoundly compromised, it may not be worth saving. On the subject of newer homes, Carrino and Colaneri tend to be tepid. They are not fans of the boxy “McMansions” popping up where farms and forests used to be. Will they one day qualify as older homes? Better yet, will they even outlast their 30-year mortgages?
“That’s a hysterical question!” Carrino laughs. “Not that I want to avoid it, but without knowing the builders or walking the homes, I wouldn’t be able to comment as to the build quality.”
“Hey, if the local municipality approves the plans, then they have to deal with them down the road,” smiles Colaneri.
Courtesy of HGTV
“I hope towns realize that they do not look good and put a stop to it.”
Obviously, neither cousin would think of purchasing a brand-new house. After all, one has to keep up appearances. But would they consider buying an older one that needed absolutely nothing done to it?
“Never,” insists Colaneri.
“I don’t think so,” Carrino agrees. “I couldn’t buy something I couldn’t gut…or rebuild from the ground up.” EDGE
Editor’s Note: John and Anthony were discovered by an HGTV producer who lived in Hoboken. Their all-time favorite New Jersey build was a firefighter’s home flooded during Sandy, done in conjunction with Ellen DeGeneres. The cousins can also be seen in the online series Chill & Grill (Ulive.com) and MANuSCRIPT (AOL).
News, views and insights on maintaining a healthy edge.
The science on e-cigarettes is sketchy at best, and because they currently do not fall under the FDA’s purview, manufacturers are not compelled to list product ingredients. “When e-cigarettes started to become available, I thought it could be a good thing as it could satisfy both chemical craving associated with cigarette smoking by administering nicotine and psychological craving associated with the act of smoking,” recalls
Vipin Garg, MD
Director, Trinitas Comprehensive Sleep Disorders Center 908.994.8880
Vipin Garg, MD, of Trinitas who is board certified in pulmonology, critical care medicine, internal medicine, and sleep medicine. “I had patients who reported early success.
However, as the market for e-cigarettes exploded, I soon realized that e-cigarettes are essentially vaporizing systems and any known chemical could be administered—and it often varies manufacturer to manufacturer. They open the door for more dangerous and potent chemicals/drugs being inhaled.”
There has been a proliferation in California of shops selling e-cigarettes and, according to the journal Pediatrics, e-cigarette marketing to minors has tripled in recent years. More than 5,000 Californians signed a petition this year urging the Food and Drug Administration to regulate e-cigarettes. Senator Barbara Boxer delivered to the petition FDA commissioner Margaret Hamburg. Not surprisingly, e-cigarette use by children under 18 has risen dramatically, not just in the Golden State, but across America. A 2014 national study showed that more teens are using e-cigarettes than regular cigarettes, which on the surface may not be a bad thing. The fear, of course, is that e-cigarettes—which most teens consider to be “safe”—will lead young people into cigarettes and other tobacco products.
“As a pulmonologist,” says Dr. Garg, “I know anything other than air at ambient temperature administered to lungs can cause damage to pneumocytes, which are the breathing units of the lungs. Noxious particles, heated vapors, varying degrees of humidity associated with these products have the potential of causing Reactive Airway Disease. Glorifying e-cigarettes—especially to minors—will be a big mistake. I support a complete ban of e-cigarettes.”
Americans may want to rethink their marriage vows. Iowa State University released a study in March tracking 2,700 couples in the U.S. from 1992 to 2010. It found that divorce rates increase when the wife becomes seriously ill. This was not true when husbands had long-term illnesses. The results suggest that American men are ill-equipped to function as caregivers to a seriously ill spouse. Overall, 32 percent of the couples divorced during the 18 years they were tracked; that figure rose to 38 percent when a wife fell ill. During his years as an oncologist,
Barry Levison, MD
Medical Director, Trinitas Comprehensive Cancer Center 908.994.8772
Barry Levinson, MD, Medical Director of the Trinitas Comprehensive Cancer Center, has observed spousal caregiving first hand. “When taken on a case-by-case basis, there are many men who are superb caregivers. On the whole, however, I think in our society, the traditional role of women as caregivers still predominates. As these societal roles change, and men become more involved in caring for family, I think the data will change, as well.”
Is it your imagination, or do people in love seem skinnier? It’s not your imagination. According to new research out of Massachusetts General Hospital, the hormone oxytocin—aka The Love Hormone, which surges when couples hug or kiss—also appears to be an appetite suppressant. A group of men (half of whom were overweight) inhaled oxytocin spray an hour prior to breakfast and consumed 122 fewer calories and 9 fewer grams of fat than men given a placebo spray. The men who inhaled the oxytocin also burned fat slightly faster and handled insulin better. The study results were presented at the 2015 meeting of the Endocrine Society in San Diego.
A study of schoolchildren in Barcelona, Spain suggests that air pollution impacts brain development. Students ages 7 to 10 in schools located in neighborhoods with heavy vehicle traffic showed reduced cognitive development compared to kids in less-congested areas.
Kevin Lukenda, DO
Chairman, Family Medicine Department
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Dr. Kevin Lukenda, DO, Chair of the Family Medicine Department at Trinitas, says that it is a well-known fact that “fuel exhaust competes with oxygen in our body. By breathing in excessive fuel exhaust, we compromise the amount of oxygen that is much needed by our brains. With lower levels of oxygen in our brain, our cognition is then compromised.” Among the conclusions drawn from the Barcelona data were that school buses in Spain (which run on unleaded fuel) should be fitted with particle filters, and classrooms facing busy streets should always keep their windows closed. Dr. Lukenda sums up: “In this era of technology, we must do whatever it takes to prevent noxious chemicals from entering our bodies. Whether it be through a filtering process or other mechanical barriers, the less fuel exhaust and more oxygen we breathe the greater the ability we have to process cognitive information.”
The latest research on coffee swings the pendulum back toward America’s favorite hot beverage. Scientists in South Korea exploring the link between coffee consumption and the level of calcium in arteries determined that drinking up to five cups a day may reduce the risk of heart attacks. Their study of 25,000 men and women found the lowest levels of calcium among those who drank 3 to 5 cups of coffee a day. Calcium in the arteries is an early indicator of cardiovascular disease. So should we drink even more? Not so fast. The same study found the highest levels of calcium in subjects who drank over 5 cups a day.
Does love at first sight translate into successful long-term relationships? Study after study says No. Couples that marry due primarily to physical attraction have a higher rate of divorce than other couples. Rutgers University anthropologist Helen Fisher points out that our bodies actually develop a tolerance to the chemicals that trigger initial feelings of love—just as they build up tolerances to other chemicals. Add to this the fact that “looks fade,” and eventually all you’re left with is conversation and common interests. Physical attraction is important, of course, but in the balance it is not a good predictor of long-term compatibility. Full disclosure: Dr. Fisher is also the chief scientific advisor for the dating web site Match.com.
Mexican scientists believe they have found a skin test that may predict Alzheimer’s and other degenerative brain diseases. Minimally invasive skin biopsies on Alzheimer’s and Parkinson’s patients turned up significantly elevated levels of Alpha-Synuclein and Tau, proteins linked to decline in brain function. Brain and skin tissue share the same embryonic origin, which suggests that definitive tests for Alzheimer’s and related problems could be performed long before obvious symptoms arise. Early detection, in turn, could be the key to managing or even curing brain disease.
A long-honored tradition has become a high-profile mainstream sport.
Our image of cheerleaders hasn’t changed much over the years. Perky and pretty, with pleated skirts, ponytails and pom-poms, they are throwbacks to a bygone era which, truthfully, probably never existed. The reality of cheerleading, however, has changed dramatically within the course of one or two generations. Nowadays, cheerleaders are performing and competing on a scale once reserved for elite athletes. Skilled in jumps, stunts, spins, tumbling and formation, they must possess the grace of a dancer, the strength of a football player and the body control of a gymnast, while performing short, supercharged choreographed routines to all genres of music.
Something else is different now: For the best of the best, career opportunities abound.
Some 3.7 million people participate in cheer nationwide, either through community and school squads or private cheer gyms, according to estimates from Varsity, the biggest and best-known industry provider of cheerleading products and services. And despite debates of their merits, or lack thereof, cheerleaders do indeed serve an important purpose.
“Cheerleaders are extremely effective at uniting a crowd, getting them excited and yelling,” says Mike Stickle, coach of the Rutgers Coed Cheer Team and an Emmy-winning writer and producer of live events, television, and video. “That’s not an easy task when competing with a 300-piece marching band, piped in music and 100,000 rowdy people. Without question, cheerleaders are an instrumental part of any game. They bring atmosphere. They also play a major role in alumni functions as important representatives of their university. It’s by no means a stretch to call cheerleaders performers.”
At the college level, Stickle adds, cheerleading is not only all business, it’s coed business.
“It takes a certain kind of guy to join a cheer squad,” he says. “A lot were high school athletes who find it empowering to throw and catch their cheermates with crowds gaping in awe. But honestly, they’re just equipment. No one is watching the guy doing the tossing. They’re watching the girl sailing through the air. Nonetheless, as cheer has morphed into more of a sport than an activity, we’re seeing more interest from the guys. Plus, there are incentives.”
Indeed, scores of major universities offer full cheerleading scholarships. Dozens of smaller colleges offer stipends or partial scholarships. While cheer falls within the purview of the athletic department at many schools—thus providing scholarships and travel money—at many other schools it falls under the student activities umbrella. There they fundraise to meet expenses. The disparity exists because the National Collegiate Athletic Association, the non-profit association regulating athletes of 1,281 institutions, conferences and organizations, doesn’t deem cheer a sport. Given the ever-ascending profile of cheer, this has become a bone of significant contention. The NCAA committee voted not to classify cheer as a sport in 2014.
“At the moment, cheerleading is not an NCAA-sponsored championship, and we haven’t had any new proposals submitted to the committee,” says NCAA spokesperson Megan Durham. Reasons cited were lack of participation opportunities and feedback received from NCAA schools and student athletes. “That doesn’t mean competitive cheerleading won’t one day become a sport,” Durham adds.
The American Medical Association (AMA), meanwhile, staunchly supports designating cheerleading a sport. In an email to Edge, the AMA said it recognizes the potential dangers of cheerleading, “including the potential for concussion and catastrophic injury, and supports the implementation of recommendations designed to improve its safety.” Those recommendations include proper training of coaches, avoidance of inappropriate surfaces when performing stunts and adherence to rules for the proper execution of stunts.
While cheerleading isn’t officially recognized as a sport, the AMA added it is unequivocally a business. Indeed, some competitions host over 26,000 athletes with 30,000 spectators. Event producers profit not only from participation, but also from merchandise and apparel sales. Host cities’ hospitality industries enjoy a boost. Gyms see an increase in memberships.
“All Star Cheer has even recently gone mainstream with the release of a second movie, The Champions League 2,” points out Elaine Pascale, owner and founder of Freehold’s World Cup All Stars—one of the country’s premier cheering gyms, boasting more than 35 competitive teams. “It provides insight into the exciting world of cheer. Plus, social media is full of profiles with tens of thousands of followers hoping to hear the latest news about their favorite cheer programs. It’s easy to realize the potential progress cheer can have at this pace.”
To be sure, Memphis-based Varsity raked in more than $1.2 billion in sales last year. Not surprisingly, the company attracted the eye of “smart money” investors and last November Varsity was acquired for an undisclosed amount by Charlesbank Capital Partners. Headquartered in Boston and New York City, Charlesbank is a middle-market private equity investment management firm with some $3 billion in assets under management.
The irony is that cheerleading can be a relatively inexpensive activity. More and more, however, the price of growth has translated into a higher price tag. Some now pony up big bucks for private competitions, training, equipment, and camps. Joining a competitive cheer gym costs around$2,000 to $3,000 per year. Private lessons can cost $100 an hour. Add in uniforms, practice clothes, personalized duffel bags, summer camps, tumbling classes, squad practices with professional cheerleading programs, and choreography fees, and the annual tally for cheer families soars into the many thousands. Furthermore, cheerleaders
have a big influence on their families overall spending habits, especially in terms of clothing, health and beauty products, food, and travel. For members of competitive cheer teams (there are an estimated 5,000-plus nationwide) the annual bill for a family can easily reach the five-figure level.
As the competitive aspects of cheerleading have grown, so too have the opportunities. Most professional cheerleaders aren’t in it for the money, but for the doors it may open. NBA and NFL cheerleaders make very little per game. However, full-time coaches of cheer squads earn $40,000 to more than $70,000 a year. And of course, a handful go on to bigger and better things, perhaps most famously Paula Abdul, who launched her show biz career as a member of the LA Lakers dance team. Did you know that Ike, FDR and George W. Bush were high-school cheerleaders? So were Jimmy Stewart, Steve Martin, Meryl Streep, Sandra Bullock, Christina Aguilera and Jennifer Lawrence. Katie Couric was a cheerleader at the University of Virginia and Rick Perry whipped up crowds at Texas A&M. Lindsay Lohan, Miley Cyrus, Madonna (right), Mitt Romney and Samuel L. Jackson were members of cheer squads. Let that soak in for a second.
While fame and fortune are not guaranteed, cheer-leaders at top colleges are recruited by a wide range of industries in need of dynamic sales people. Pharmaceutical companies are especially fond of that combination of enthusiasm and discipline cheerleaders bring to the table. Overall awareness of cheerleading talent has also increased with the proliferation of college sports broadcasts.
Whether done for fun, competition or as a career-builder, cheerleading has lasting influences. According to Stickle, cheer provides participants with “powerful lessons in community, character, camaraderie, skill development, and goal setting.” Pascale says it teaches young people to overcome fears and learn that there are no limitations to what they can achieve.”
Editor’s Note: Diane Alter was a Pop Warner cheerleader growing up in Rumson. She is pictured above standing on the far right.
Chef Sam Byrne is making waves at Asbury Park’s Cross & Orange.
Starting around mid-May every year, the Jersey Shore witnesses a wondrous mass migration, as hungry visitors glide in for a meal or two before picking up and heading north. Just to be clear, we’re talking about people (not birds). For generations, residents of landlocked Northern and Central New Jersey have flocked to the beach towns in search of memorable dining experiences. In the old days, that translated as lobster, fried shrimp, steamers and pitchers of beer. To be sure, fresh seafood and water views are still staples of Jersey Shore dining. However, a handful of talented chefs are breaking this mold by creating innovative, important menus for those with greater expectations.
Which explains, at least in part, what Sam Byrne is doing in Asbury Park at Cross & Orange. Byrne, a native of Ireland, began working under some of Europe’s top chefs as a teenager in a career that included two years in Spain at El Bulli (regarded by many as the finest restaurant in the world) and stints in London and Paris. He arrived on our shores in 2011 with the goal of opening a restaurant that reflected the most outstanding elements of American culture and cuisine.
“My background in Europe opened doors to wherever I wanted to go,” says Byrne. “I came to the U.S. because I wanted a change, but also to create something totally new.”
According to Byrne, the Cross & Orange menu celebrates the remarkable diversity, work ethic and ambitions of 19th century Manhattan, paying homage to the “makers and doers who built the country.” The restaurant’s name references two of the streets that made up the notorious melting pot of New York’s Five Points neighborhood. As a tribute to that era, Byrne and his kitchen staff make everything from scratch, and delight in working unexpected ingredients into every menu item.
The owners of Cross & Orange, brothers Chris and Bob Fahey, grew up in the restaurant business. They worked in a number of bars and restaurants in the City and earned their spurs on the Jersey Shore with Edgar’s Pub in Manasquan, and at trendy Asbury Lanes, a few blocks away. They opened Cross & Orange in February on Cookman Avenue, the epicenter of Asbury Park’s culinary renaissance.
Initially, the brothers’ ambition was to up their game and stake their claim in the town’s red-hot restaurant scene. The first step was to secure a prime location, which they did, in the old Park Overlook building—which, as the name implies, overlooks a park (Lincoln Park). Next it was time to secure the services of a first-rate chef. So they ran an ad. Their goal was to be extremely selective and find someone young, creative and ahead of the trends. Someone who, as Chris puts it, “would give us an identity.”
“When we first met Sam, our expectation of a chef was here,” Bob recalls, putting his hand at eye level.
“What we got,” says Chris, raising his hand a foot above his head, “was here.”
Byrne says he was being equally selective. He had come to Monmouth County to help a friend open a restaurant and was blown away by what was happening in Asbury. Initially, he had planned to work in Manhattan. “But as soon as I saw the building, I signed,” he says. The space is arguably the best in town in terms of its layout and energy. A long bar rises a few steps above the dining area, which is open to the adjacent park, about a three-minute stroll from the boardwalk.
Assembling the Cross & Orange menu was a collaborative effort. The Faheys wanted a place people “would feel comfortable coming to twice a week” as opposed to a destination restaurant, yet one that addressed Asbury Park’s ever-ascending taste and sophistication. They made big investments in staffing; the service is friendly and professional (several waiters have managed restaurants themselves), and the kitchen is driven and motivated. As for Byrne, his marching orders were clear: “Gears-forward, no holding back.”
Not surprisingly, it is the food at Cross & Orange that sets it apart. Bring your appetite and, just as important, your reading glasses, because it’s the small print under each menu item that demonstrates Byrne’s creativity and commitment to quality. The ingredients, he says, are the best he can buy, and there are always specials on the blackboard perched above the dining area.
“The meats are always prime, the lamb is from Colorado, the octopus is fresh from Portugal,” he says. “Now we move into summer, my favorite season, so I get to play off the shore with different types of fish and light dishes.”
“Sam learned the styles of the masters and developed his own way of cooking and presentation,” says Chris Fahey. “Once he earns the trust of our customers, we see them coming back to explore more of his cuisine—sometimes returning with a bigger group, or sometimes coming alone and ordering a couple of appetizers at the bar.”
Among the more intriguing starters are charred octopus, hand-cooked with a blowtorch and set on a bed of mizuna, olives and oregano; sashimi tuna tartare with pistachio and cucumber; PEI mussels with chorizo and barlotti beans in a minestrone broth; and a smoked bacon and watermelon salad featuring daikon, radicchio, chili and pork belly.
Meat entrees range from a 60/40 burger topped with garlic spinach, red onion jam and gruyere to an herb-crusted rack of spring lamb, and include all manner and size of steaks, both on the menu and on the specials board. Roasted Chilean sea bass, Nordic cod and other seafood specials are extremely popular. If Dover sole happens to be available, dive right in.
Editor’s Note: Cross & Orange is located at 508 Cookman Avenue. Summer hours and days of operation are posted at crossandorangeap.com. The restaurant is extremely busy on Fridays and Saturdays, so call for reservations as far in advance as possible at (732) 361–5502. Street parking in the summer is nearly impossible, so ask about nearby garage options when you call, even if you’ve booked through Open Table.
Two New Jersey restaurants are elevating the American Gastropub experience.
The menus at Morris Tap & Grill and Paragon Tap & Table have something very special in common, and it’s not the word Tap. Both restaurants—in Randolph and Clark, respectively—have built their kitchens on the immense talents of chef Eric LeVine. The East Hanover resident has racked up some serious hardware, including recognition as “Outstanding Chef of the Year” by the James Beard Foundation, Restaurant Guild International’s “Chef of the Year” Award, and the International Chef’s Association’s “Creative Caterer of the Year” and “Chef of the Year” awards. The two restaurants feature extensive lists of craft brews, imaginative spirit and craft-beer cocktails, local farm foods, cutting-edge burgers and an assortment of creative menu items and desserts.
“The great thing about both is that you will always have a unique dining experience,” says LeVine. “We’re always creating something new and having fun with the menu, and we work hard to keep it interesting and whimsical. It’s casual, it’s comfort food, but there’s always a twist.”
LeVine is known for his ability to make culinary magic happen no matter what he’s preparing, whether it’s a hand-crafted burger or a six-course prix fixe menu. “We’re not pulling food out of the freezer,” he points out. “We’re making everything from scratch, from smoking our meats in-house to making our own sorbet and gelato.”
That philosophy extends to the food truck-inspired selections at Morris Tap & Grill (regulars rave about the award-winning wings) or the rotating “retro” menu at Paragon. Picture a TV dinner menu with entrees like surf & turf with garlic broccolini and apple cobbler served, of course, in a traditional TV dinner tray. “Both restaurants have an amazing team of people who are all about taking the dining experience to the next level and making our customers happy,” he says.
One of those people is general manager Mike DeSimone, whose intense interest in craft beer quickly set the restaurants apart from their competitors. “I had craft beer experience, but I’d never been able to put a program together like we did at Morris Tap & Grill,” he says. “Initially, we weren’t really thinking that we’d have such an influence on the craft beer scene in Morris County, but we quickly realized that we were pioneers. At the same time we were building the restaurant back in 2011, New Jersey was launching its brewing culture.”
The timing couldn’t have been better. Customers were amazed to find so many local beers on tap, and flocked to the craft-beer events. Those events became a tradition at Morris Tap & Grill and gained instant traction at Paragon, which opened in 2014.
“I give Eric the flavor profiles of the beers, and he builds menus around them,” DeSimone says. Along the same lines, DeSimone makes sure his servers and bartenders are attentive and proactive when it comes to pairing craft beers and food. “We don’t just hand you a menu and walk away, we guide you through the process and suggest menu items that go particularly well with the beer you’re drinking. We also ask what you find appealing about a particular beer and recommend others to try.”
While the philosophy and concepts of the two restaurants are similar, there are some differences. Paragon is about half the size of the more established Morris Tap & Grill and the bar tends to be busier. It features a wider selection of New Jersey beers. Clark being more urban than Randolph, Paragon attracts a younger demographic, which in turn makes for a more casual atmosphere. “Paragon really brands the craft experience, whereas Morris Tap & Grill has a broader reach,” DeSimone says.
The confluence of skills and experience DeSimone and LeVine brings to Morris Tap & Grill and Paragon Tap & Table certainly helps explain the unique qualities of each location. DeSimone began his career in Hoboken, with stops in New York City, Philadelphia and Charlotte before settling in New Jersey.
CRAFT BREW FAST FIVE
New Jersey’s Craft Beer scene is bursting at the seams. More than two dozen new breweries will open this year alone. If you’re just getting into this trend, here are five Mike DeSimone recommends…
Kane Head High IPA “Brewed in Ocean, it is a world class IPA that hangs with the best of that style from around the country. Always fresh, which is the most important factor in this style.”
Carton Milk Stout “We don’t carry Guinness on draught, but nobody misses it once they have tried this creamy, lightly sweet & bitter Milk Stout from the boys in Atlantic Highlands.”
Bolero Snort “One of my favorite breweries from North Jersey. Their beer gets better and better. Blackhorn Black Lager is a masterful blend of hops and roasted chocolate malts. Singlehandedly got me drinking lager again.”
Forgotten Boardwalk “This beer is on fire! Since they opened a few months ago they have been everywhere. What The Butler Saw Witbier is amazing and will be on tap all summer along at both MTG & Paragon.”
Ramstein Double Platinum Blonde “A Weizen Bock from the local masters of the German beers styles. 96 on Ratebeer.com. Fantastic!”
In LeVine’s case, one might say that life circumstances bred him for success. His passion for cooking was sparked at age six (thanks to a Disney cookbook, he recalls) in his Brooklyn household, where money was tight. “My mom did the best she could, but I grew up pretty poor,” he says. “When it came to food, pickings were slim. You ate what you got, and that was it.”
LeVine was working in restaurants at age 12, and went on to work alongside chefs from Italy, Japan and France. He studied at the Culinary Institute of America in New York and, after graduation, cooked for celebrity chef (and EDGE contributor) David Burke at the River Café. LeVine ended up as chef de cuisine at the Marriott Marquis in New York City and, at the age of 23, he was already launching his own catering business.
At age 29, he was told he had cancer. Now in his 40’s, LeVine has been diagnosed with cancer a total of five times. While battling the negative side effects of his chemotherapy treatments in 2011, he was also battling it out on the popular Food Network cooking competition show Chopped…and won.
“You come out of the other side of all of this and start looking at things with a very different perspective,” he says. “I know now that it’s not about me, and I always try to put others first, whether it’s my family or my staff and customers. More than ever, I’ve learned to see past my own personal tastes and how I like to cook and eat, and focus on my customers and their dining experience.”
How has celebrity influenced LeVine’s work?
“Time goes by and you win awards and you’re on TV,” he says, “but at the end of the day, I’m not a ‘celebrity chef.’ I’m just a cook. And I’ve had to learn the hard way what’s really important.
“I’m always a work in progress…and, so far, it has been an amazing journey.”
Editor’s Note: Paragaon Tap & Table is located at 77 Central Avenue in Clark, just off the GSP. Morris Tap & Grill is located at 500 NJ 10, about 10 minutes west of Rte 287 and a few miles south of Rte 46. Eric LeVine has authored two cookbooks: Stick It, Spoon It, Put it in a Glass and Small Bites, Big Flavor: Simple, Savory, and Sophisticated Recipes For Entertaining.
PAYING IT FORWARD
Though chef Eric LeVine’s personal health struggles impacted every aspect of his life—including his approach to food and cooking—it also translated into a strong desire to help others in need. LeVine and his restaurants are closely linked with local organizations such as the Family Reach Foundation and the Community FoodBank of New Jersey; he frequently advocates for the American Cancer Society, and has been recognized with their prestigious Heart and Soul Award. He also teaches classes and seminars for organizations like the International Caterers Association to help aspiring caterers develop innovative methods of growing their business. “No matter what, it’s about people and doing for others…and hoping to help them make a difference in their own lives,” he says.
“Red snapper, flashy with a spinach pesto and happily plated with roasted onions and smashed potatoes pocked with olives, took a liking to the shellfish-infused butter sauce the kitchen whipped up.”
A short stroll up Centennial Avenue in Cranford from landmark restaurant A Toute Heure sits the intriguingly named 100 Steps Supper Club and Raw Bar. Smile at this not-so-in-house joke. It’s the heel-to-toe step count from Mama Restaurant to lovingly conceived Baby Restaurant, as divined by owners Andrea and Jim Carbone.
A Toute Heure, never light on diner traffic—and diner traffic from near and far, given the restaurant’s stellar reputation as a place for exquisite plates of carefully sourced, skillfully prepared food—begged for offspring. The Carbones, and their executive chef Kara Decker, fielded pleas from their fans for more, for another place to eat and learn from the folks who understand so well how to give a restaurant a singular voice.
They didn’t want to shortchange A Toute Heure in the slightest; not their religion. They didn’t want to leave the neighborhood; it’s their home. They didn’t want to miss a beat, ever; their mission is pure, their ethic unshakeable. When a place up the street came on the market, they jumped. Rather, they took that 100-step journey and found the perfect partner for A Toute Heure.
Jennifer Lavelle/Courtesy of Andrea Carbine
Where A Toute Heure is intimate, 100 Steps is social. It’s the difference between a tete-a-tete and a party. But don’t think noisy and uncontrolled: 100 Steps is as smart food-focused as its parent restaurant. It’s the atmosphere that’s different, open and airy, casual in a bump-into-friends, strike-up-a-conversation-with-strangers way. Since it opened a year and a half ago, 100 Steps has become a spot where folks drop in for some oysters at the Raw Bar Happy Hour Thursday through Saturdays from 4 to 5:30, then return a day or three later with the family for the Sunday Supper menu. It’s neighborhood-y, even though—as with A Toute Heure—diners are traveling a distance to partake in the hospitality and soul-satisfying fare.
I came for the oysters, scarfing down in short order Wiley Points, briny, yet meaty, from Damariscotta, Maine; Island Creeks, which finished with a snappily sweet tang, from Duxbury, MA; and Fin de la Baies, subtle and coy, from New Brunswick in Canada. Maine came to our table again, in the form of a peekeytoe crab remoulade, a chop of the sweetest crab on the planet and cornichons, capers, parsley and lemon, all bound by an aioli brightened by crème fraiche. My, this was yar.
The scallop ceviche was rockin’. Given sizzle by a shot of Calabrian chili oil and calmed by a thyme-laced buttermilk aioli, this reinvention of a standard had an elusive element to it—a riff of umami powered by miso that tasted at once charred and sweet.
Jennifer Lavelle/Courtesy of Andrea Carbine
Clam chowder plumped by littlenecks and made hearty by potatoes not just boiled or baked but given the slow-cook of confit status, should be ordered not by the cup, but the gallon. If you’re an Ironbound regular and high on the classic shrimp with garlic staple found everywhere in that ‘hood, don’t pass up a chance to up your game with the local version: Here, shrimp is sautéed with pimenton, a smoked paprika, then given a bath in butter refreshed with cilantro and sideshows of tomato and arugula. Talk about eating and learning. While we’re on the subject, 100 Steps’ charred octopus is one for the textbooks, served as it is with creamy cannelini beans, slivers of red onion and a crème fraiche topper energized by more of that smoky pimenton.
Jennifer Lavelle/Courtesy of Andrea Carbine
Only the roasted cauliflower, mushy and overwrought with a bitter pesto and served with radishes whose pepperiness wasn’t the appropriate counterpoint, didn’t make the grade in our opening rounds.
But gnocchi, sitting pretty with shiitake confit in a miraculously light buttery fondue of a sauce topped with shreds of crisped sage, warmed us. I couldn’t stop myself from hoarding the entrée known as “K’s Braise,” as Provencal a rabbit stew as you can find this side of Aix, cosseted with polenta and dotted with green olives, pancetta and currants. Everything that should be there was there.
Red snapper, flashy with a spinach pesto and happily plated with roasted onions and smashed potatoes pocked with olives, took a liking to the shellfish-infused butter sauce the kitchen whipped up. If you have kids aboard, consider booking here on a Tuesday, which is Taco Night, complete with live music. Ours loved the fish tacos, stuffed with pollock, as well as the chicken tacos.
Jennifer Lavelle/Courtesy of Andrea Carbine
I only wish my own childhood included 100 Steps’ caramel banana pudding. Vanilla drop cookies! A pop of sea salt in the caramel! Modern meets Harriet Nelson. Chocolate But gnocchi, sitting pretty with shiitake confit in a miraculously light buttery fondue of a sauce topped with shreds of crisped sage, warmed us. I couldn’t stop myself from hoarding the entrée known as “K’s Braise,” as Provencal a rabbit stew as you can find this side of Aix, cosseted with polenta and dotted with green olives, pancetta and currants. Everything that should be there was there.
Red snapper, flashy with a spinach pesto and happily plated with roasted onions and smashed potatoes pocked with olives, took a liking to the shellfish-infused butter sauce the kitchen whipped up. If you have kids aboard, consider booking here on a Tuesday, which is Taco Night, complete with live music. Ours loved the fish tacos, stuffed with pollock, as well as the chicken tacos.
I only wish my own childhood included 100 Steps’ caramel banana pudding. Vanilla drop cookies! A pop of sea salt in the caramel! Modern meets Harriet Nelson. Chocolate cake with a fudge brownie base comes with sour cream ice cream and a fudge sauce and English toffee AND salted pecans. Can life get any better? Yes. Yes, if you remember to ask for peanut butter chocolate chip cookies in a to-go bag.
The name 100 Steps
Jennifer Lavelle/Courtesy of Andrea Carbine
might, for some, inspire all sorts of puns, gimmicky one-liners and general silliness. I can’t do that: It’s too hard to find a casual restaurant with this level of conscientiousness; any assessment must be serious. The folks behind the scenes here set the bar high with A Toute Heure, yet managed to hit the heights again with a restaurant completely different in attitude and atmosphere. As I left 100 Steps, I plotted: Some night, soon, I’m going to eat dinner at both 100 Steps and A Toute Heure. I can do it, I know I can. EDGE
Editor’s Note: Andy Clurfeld has been shouldering the load on restaurant reviews since the second issue of EDGE. During that time, she was a 2010 Pulitzer Prize finalist in Public Service for her work exposing the flaws, injustices and abuses in New Jersey’s property tax system. Andy also has published in-depth reporting on a range of topics, including criminal street gangs, agriculture, politics and the environment. A longtime member of the James Beard Restaurant & Chef Awards Committee, she is a specialist in artisan wines and recently was appointed Wine Director at Buy-Rite Corporation, implementing educational programs, coordinating special events and developing artisan wine sections for select stores.
New Jersey’s ‘Kitchen Cousins’ have a lot on their plate in 2015.
So you thought your kitchen was a train wreck? Anthony Carrino and John Colaneri, HGTV’s ubiquitous Kitchen Cousins, pride themselves in transforming hopeless residential and commercial cooking spaces into spectacular, high-functioning showplaces. This summer, the cousins embark on their newest reality venture, America’s Most Desperate Kitchens.
Back in late-2014, HGTV asked viewers to send in 90-second videos that proved their kitchens were totally hopeless. The network received a flood of submissions that ranged from shameful to catastrophic, picked the most challenging (and funniest), and then dispatched Carrino and Colaneri to make a little magic. America’s Most Desperate Kitchens marks the fourth series for the talented and likable duo, who run Brunelleschi Construction in Jersey City. They have gained a legion of fans with Kitchen Cousins, Cousins On Call, and Cousins Undercover.
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Fans of the cousins are already setting their DVR’s for the opening episode, which airs on July 1. In the meantime, one can enjoy their latest renovation creation on Erie Street in Jersey City, where Carrino and Colaneri recently opened Carrino Provisions, a gourmet market with a family-style Italian restaurant housed in a reclaimed 19th century factory building.
Authenticity is everything in the Reality TV game, and the cousins have taken their lumps on more renovations than they care to remember. Prior to their new show (which has them traveling all over the country), they had worked almost exclusively in New Jersey. What better proving ground for construction and design skills than the old (and not-so-old) homes of the Garden State? As much as they love the challenge of updating antique houses, both agree that falling in love with an old home can be a slippery slope.
“I love a good old home or structure, but they can very quickly become money pits,” Carrino cautions. “The important thing for buyers is to get a really good home inspection prior to purchase, so you understand what you’re getting into.”
Courtesy of HGTV
What are the Kitchen Cousins’ favorite materials to work with?
John Colaneri: Wood, metal and stone. All three of these materials give any space a warm and unique feeling. I love using natural materials when designing and building homes. I always try to incorporate these three elements into my designs.
Anthony Carrino: I use myriad materials depending on the project. It’s my job to know what’s out there, so I have a good stockpile of materials I love to work with. If I had to pick three I would say live edge wood slabs, raw steel and concrete. Raw materials just speak to me.
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“I love old homes and the history they have,” adds Colaneri. “You find architectural features that are so hard to come by these days. The only downside of an old home is that nothing is up to code, and it’s going to cost a lot of money to renovate.”
Brunelleschi Construction only does restoration work. According to Colaneri, the blending of old and new is what fuels the cousins’ passion. They find New Jersey to be an ideal place for their specialty because of the large number of older and historic homes. They also find it amazing how little most owners know about their dwellings. Nine out of 10, says Colaneri, have no clue as to the condition of the mechanical systems.
“These are the things that are not in front of your face or too glamorous, but they will cost you the most in the end,” he warns. “If you are buying an old home, make sure the air conditioning and heating systems and the electrical have been maintained and updated over the years. It’s just like a car—what’s under the hood makes a big difference.”
Prior to launching their new show, Carrino and Colaneri completed a major project in Jersey City in partnership with Chef Dale Talde: Carrino Provisions, a food destination that features a market, coffee bar and Osteria. The market space, which was designed by the cousins, has an old-country feel with white brick walls, hand-painted signs, fresh-baked breads and pastries, artisanal meats and cheeses, and local produce. The Osteria offers Chef Talde’s take on Italian cuisine, with large shareable portions of handmade pasta.
Dale Talde made a name for himself across the harbor in Brooklyn, where he and partners John Bush and David Massoni operate TALDE and the Thistle Hill Tavern, both in Park Slope. His take on Asian-American cuisine earned rave reviews and a loyal following. The trio opened TALDE Jersey City a stone’s throw from Carrino Provisions, with a major renovation assist from Carrino and Colaneri, who incorporated the circa 1880 building’s elevator wheels into the restaurant’s industrial chic design. Meanwhile, the lighting has a distinctly Asian influence, with silk-and-wire lanterns illuminating the main dining space. Both TALDE Jersey City and Carrino Provisions are located on Erie Street, between Bay and 1st Street.
Anything having to do with the foundation or structural integrity of an old home is a potential deal-breaker, adds Carrino. “Along with a roof that’s in poor condition, those are things that can suck your budget dry before you even begin your renovation.”
When is a house a tear-down? Everything is fixable, the cousins claim. It’s just a matter of time and money. However, if the structural integrity of a home is profoundly compromised, it may not be worth saving. On the subject of newer homes, Carrino and Colaneri tend to be tepid. They are not fans of the boxy “McMansions” popping up where farms and forests used to be. Will they one day qualify as older homes? Better yet, will they even outlast their 30-year mortgages?
“That’s a hysterical question!” Carrino laughs. “Not that I want to avoid it, but without knowing the builders or walking the homes, I wouldn’t be able to comment as to the build quality.”
“Hey, if the local municipality approves the plans, then they have to deal with them down the road,” smiles Colaneri.
“I hope towns realize that they do not look good and put a stop to it.”
Obviously, neither cousin would think of purchasing a brand-new house. After all, one has to keep up appearances. But would they consider buying an older one that needed absolutely nothing done to it?
“Never,” insists Colaneri.
“I don’t think so,” Carrino agrees. “I couldn’t buy something I couldn’t gut…or rebuild from the ground up.” EDGE
Editor’s Note: John and Anthony were discovered by an HGTV producer who lived in Hoboken. Their all-time favorite New Jersey build was a firefighter’s home flooded during Sandy, done in conjunction with Ellen DeGeneres. The cousins can also be seen in the online series Chill & Grill (Ulive.com) and MANuSCRIPT (AOL).
From its chaotic recent past, Colombia has emerged as a popular travel destination.
A line of Colombians clasping bouquets of carnations, roses and lilies forms in the quiet of the nearly deserted Central Cemetery in Bogota. Not far from the alley of the lonely tombs of Colombia’s presidents sits a polished bronze statue, a somewhat less-artistic version of Rodin’s Thinker, flanked by a serious middle aged man in a crisp tailored suit whispering intently into the statue’s ear. Seated near the statue sits a robed “priest” (I am told he is not ordained) who has set up a card table and reads a Mass, for which he is paid by supplicants. He rings a bell to indicate the man’s time is up.
Sarah Fleming
Scores of bouquets have been left around the statue, covering the grave of the long-dead man, which is said to have been endowed with the power to grant wishes. There are many stories of his posthumous prowess in fulfilling desires, bestowing love, healing the sick and easing financial or emotional distress. One young man tells me of his frustrating job search. He made a pilgrimage to the statue and petitioned for help. Right after making this request, a sudden breeze arose around the gravesite, lifting leaves and flowers into a mini swirl. He took this as a sign that his wish had been heard. Only two days later, he received an overseas call with a job offer from an international firm in Miami.
Such is the magical realism you might find in a Gabriel Garcia Marquez novel. In fact, this is the grave of Leo Kopp, my great-grandmother Ida’s brother. Leo Kopp was a German Jewish agnostic, who immigrated to Colombia and founded the Bavarian Brewery—now South America’s second largest brewery—in the late 19th century.
This is my first trip to Colombia. For five generations, my family in North and South America has more than kept in touch. We have become good friends. Our friendship was forged in the 1990s when Colombia was plagued with violence. Murders and kidnapping—from both guerrilla and drug wars—convinced my cousins to move their children, who were my kids’ ages, up to New York. We spent many fun, multi-generational holiday dinners together and, since they returned to a safer, saner Colombia, we continue the family tradition of keeping in touch.
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If you are drawn to Caribbean beaches and snorkeling, you can take a boat to the islands (Islas del Rosario), where one can either spend the day or the night. The Santa Clara Hotel has a sister hotel in the islands, the Hotel Majagua. For travelers who prefer smaller boutique hotels, villas or B&B’s, Cartagena offers quite a few, including Tcherassi Hotel, Hotel Casa del Arzobispado, Hotel LM, Ananda Hotel Boutique and Hotel Casa San Agustin. It’s also a good idea to make dinner reservations at some of the better restaurants, including La Vitrola, Don Juan, Harry Sasson Bar at the Hotel Santa Teresa, La Vera, Juan del Mar, Cafe del Santisimo, 8-18, Alma, Café San Pedro, Restaurante Club de Pesca and Fuerte de San Sebastián del Pastelillo.
For years, Colombia was off the tourism radar. Recently, however, travel stories have been cropping up in The New York Times, The Wall Street Journal and The London Times. Even Bergdorf Goodman’s 2015 spring fashion magazine ran a two-page story on the picturesque coastal city of Cartagena. Though still a relatively well-kept secret, Colombia is fast becoming a go-to destination.
As well it should be. Colombia is a country rich in history, geography and diversity. From the haciendas of the coffee region, to the coast that stretches from the Pacific to the Caribbean Sea and Atlantic coast, from the Amazon River jungle, to the Andean Mountains, Colombia offers many climates and experiences within an hour’s plane flight of the capital city of Bogota.
Cartagena, a fortressed town on the Caribbean, is the country’s most tourist-friendly. It offers an array of large resorts, boutique hotels and hostels within the old town, which has been designated a World Heritage site by UNESCO. With its bright pink, ochre, salmon and sky-blue painted villas, old town Cartagena is “Cuba Lite,” without visa complications.
Sarah Fleming
On our most recent visit, we stayed at the Sofitel Santa Clara, one of the two best luxury hotels, the other being Hotel Santa Teresa. Built within the thick historic walls of the 1621 Franciscan convent of the nuns of Santa Clara, the Hotel Santa Clara successfully blends traces of its past with modern amenities. Alongside the original convent chapel, wells, crypt and confessional booths is a lush courtyard punctuated with a reclining nude holding an apple by sculptor Fernando Bortero—a plus-size Eve in paradise. In contrast to the building’s former monastic life, the Santa Clara offers a spa, as well as an Olympic-sized pool with attendants happy to serve you snacks and fruit drinks. You’ll need to plan your trip early. When we called for a reservation a month in advance, the town was booked—with multiple destination weddings, conferences and a golf tournament. In addition to being a tropical getaway, Cartagena plays host to music, film and literary festivals in the winter months. By some stroke of luck (thank you, Leo Kopp?) we snagged the last accommodation at the 123-room hotel.
Formerly a strategic harbor—where the galleons of the Spanish conquistadors were loaded with pillaged treasures of gold, silver and gems to be shipped in heavily armed convoys back to Spain—Cartagena has seen quite a bit of action over the centuries. Under Spanish colonial rule, it functioned as a slave-trade center and endured catastrophic fires, pirate attacks and battles for independence. It witnessed a civil war, decades of political strife and an economic downturn at the end of the 20th century. And speaking of action, you may recall that Cartagena was in the headlines for some Secret Service indiscretions prior to a conference visit from President Obama, and also for an infamous selfie that featured a snoozing Justin Bieber.
As Monty Python once said, nobody expects the Spanish Inquisition. And it’s true. We were surprised to learn that for much of the 17th century, friendly Cartagena was one of three South American seats of the Spanish Inquisition. Here, tribunals condemned heretics and practitioners of witchcraft. A visit to the building known as Palacio de la Inquisicion confirms this fact. It houses a museum of the Inquisition’s relics, ranging from a device that determines if the accused was a witch (innocent or not, you die either way) along with assorted instruments of torture.
Sarah Fleming
Whatever the challenge, like a phoenix, Cartagena has risen from rubble over and over. Ten years ago, for example, the old section was a poverty-stricken barrio. Today, you can safely walk the circumference of the old city and gaze out on the bay from the thick fortification wall, a defense built after Sir Francis Drake plundered Cartagena and held it for ransom in 1568. Within the ramparts, you will find brightly painted villas covered in bougainvillea which line narrow streets of fruit-vending carts, stores selling Colombian crafts, and restaurants offering fresh-caught fish carpaccio and ceviche, with the sound of Cuban salsa drifting through the air. Cartagena is punctuated with lovely tree-shaded plazas, including the Plaza Santo Domingo, with a reclining plump nude Botero bronze.
In stark contrast to the sleepy Caribbean resort town of Cartagena is Bogota, an easy 70-minute flight away. A teeming metropolis of 7 million people situated 8,660 feet above sea level, Bogota’s climate is a temperate 40 to 70 degrees. This Andean city has emerged from decades of guerrilla war, drug trafficking and kidnappings to become a vibrant cosmopolitan center. A sign of the times is that many international hotel chains are investing in Bogota. The Four Seasons Hotel is renovating two additional properties there.
Yes, peace has come to Colombia. No more need for bulletproof cars or bodyguards. That’s not to say that you can totally let down your guard. While Cartagena is safe even at night in many sections, guidebooks still caution visitors to Bogota to leave their passports in the hotel safe, not to wear valuable jewelry or flaunt expensive cameras, and to beware of pickpockets. Of course, the same warning could also apply to the New York City subways. While visiting high Masses in churches in La Candelaria, a woman approached my cousin suggesting she turn the stone of her small diamond ring around. Random taxis are also to be avoided—your hotel can give you an app to contact a reliable car service.
The changes in Colombia over the last dozen years have been nothing short of astonishing. The peace process initiated by President Alvaro Uribe (2002–2012) led to the demobilization of guerilla and paramilitary groups, which in turn gave the government control of the nation’s drug-producing regions. This further reduced the level of danger and violence. About a year ago, the Colombian government met in Cuba with representatives of the rebel group FARC to hammer out an agreement to keep the peace permanently. The country has a robust economy, with an oil industry that cranks out a million barrels a day. In the last few years, nearly a million Colombians have been lifted out of poverty, and economic reforms have been put in place that aim to lift millions more.
Home to many libraries, museums and universities, Bogota is known as the “Athens of South America.” Many of the finer institutions are housed in the Centro, as well as Bogota’s old section, La Candelaria, which dates back to the 16th century and features the ornate, colonial-era cathedral and churches that border Plaza de Bolivar. Not to be missed in La Candelaria are two world-class museums. The Museo del Oro artistically displays over 55,000 pieces of gold from the pre-Colombian era, while Museo Botero exhibits Botero’s signature rotund people, fruit, animals and birds, as well as the sculptor’s first-class collection of impressionist and modern art, including works by Monet, Matisse, Degas, Picasso, Balthus, Klimt, Moore and Calder. Besides being a quirky, prolific artist, Fernando Botero had a terrific eye for other artists’ work. A perfect conclusion to a day in La Candelaria is dinner on the rooftop patio of the Hotel de la Opera, which overlooks the tops of churches and the Palace of Justice.
On the recommendation of my cousins, we stayed at the Sofitel Bogota Victoria Regia on a street with very good restaurants. We particularly enjoyed Primi, an Italian restaurant located across the street from the hotel.
The food scene in Bogota is growing rapidly. We liked the light crust pizzas at Julia’s, a popular hole-in-the-wall pizzeria, the grilled meat and Latin beat of Andres, and the Peruvian-Chinese fare at Maman Tusan’s in Usaquen, a picturesque old village within the northern border of the city.
Bogota has several high-end shopping malls. The top (3rd) floor of El Retiro shopping center has a Colombian food court called La Plaza de Andres with reasonably priced meals. If you’re looking for pre-Colombian-inspired jewelry, L.A. Cano in the Centro Andino shopping mall offers some affordable and attractive earrings and necklaces. Or if you are looking for indigenous crafts, Artesanías de Colombia is a reliable resource.
Back at the Central Cemetery on my last day in Colombia, it’s finally my turn to leave a bouquet of roses at Leo Kopp’s statue. Together with my cousin, we step up on either side and each whisper in his ear. That the strong family Colombian connection lives on through future generations, I’m sure Leo and Ida would be very, very happy.
Science and technology are paving the way for a mind-altering experience.
What lies within our heads, protected by the bony shell of the skull, is a collection of soft nerve tissue that weighs only about 3 pounds on average—less than most other human organs. The brain is 75% water and consists of 100 billion neurons (equal to the number of stars in the Milky Way). Stretched out, these neurons would reach 600 miles.
At the mere mention of diseases of the brain, many of us might think first of tumors. According to the American Cancer Society, about 22,000 Americans are diagnosed with brain tumors annually. The most common variety is the primary brain tumor, which includes more than 125 different types according to cells of origin. When a tumor grows within the bony confines of the skull, it can press on and damage the brain itself. Other tumors can migrate from elsewhere in the body and are therefore labeled metastatic. A variety of symptoms can present with a tumor: headaches, vomiting, blurred vision, seizures, memory and/or speech impairment, motor and/or sensory problems, personality changes and failing vision.
Specific treatment for a brain tumor is dependent on a variety of personal factors:
Recommended treatment options include:
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The biggest challenge in brain tumor surgery cited by most neurosurgeons is how to remove all of the cancer while preserving the greatest possible brain tissue. Certain advanced procedures are already in place and available:
And what about aging and the brain?
As the Boomer generation is approaching retirement, public and scientific attention has centered on other neurodegenerative brain challenges, for instance, dementias such as Alzheimer’s Disease. The National Institute on Aging (NIA) defines dementia as a disease that affects communication skills and the ability to perform “activities of daily living (ADLs).” Alzheimer’s dementia results in impaired thought processing, forgetfulness, loss of recent-term memory, and language difficulties. All currently acceptable descriptions refer to symptoms and not causes of these diseases, and for good reason. The causes continue to elude the investigators. Sadly, the diagnosis of Alzheimer’s disease often can only be confirmed by autopsy.
Statistics justify the growing concern in neuroscientific communities and in private lives about dementia. More than 5 million people in the US have been diagnosed with Alzheimer’s, accounting for 50-70% of all dementia cases per CDC research. And this number is projected to reach 13.5 million by 2050. The total costs involved are equally mindboggling, at $226 billion per year.
As the focus, particularly on Alzheimer’s, intensifies, so does the level of personal concern as life expectancy continues to increase in the US. A critical if somewhat oversimplified question that often arises is: When is forgetfulness a normal part of aging and when does it become a cause for concern?…a very good question with no easy answer. Instead, a continuum of stages is applied to generically categorize the disease in terms of the varying degrees of impairment ranging from Stage 1 (no impairment) to Stage 7 (very severe decline).
As a testament to our growing interest (to put it mildly) in Alzheimer’s, we have only to revisit the 2015 Best Actress Oscar going to Julianne Moore for her poignant portrayal of an Alzheimer’s victim in Still Alice. Although conclusive diagnostic capabilities to identify the onset of Alzheimer’s are still undergoing intensive testing and theorizing, great strides recently have been made.
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When any or all of the above diagnostic testing indicate the possible presence of early or later stage Alzheimer’s, the next proactive step is how best to slow down the progression of the disease, since there currently are no proven cures. The Mayo Clinic has been in the vanguard of institutions that are researching and evaluating possible treatment alternatives. Although positive results have been documented, most recommended treatments remain in the process of being evaluated. There are no guaranteed cures…at least not yet. The emphasis today is always on may help not will help. Some of the most promising and popular regimens are:
Promising studies on new advances are being conducted to get a head start on conquering brain disease. A sampling of current ongoing research indicates the extent, variety and potential for adding to our knowledge basis when it comes to analyzing what’s inside all of our heads.
A nasal spray vaccine has been shown to reduce brain plaque in lab mice (an Alzheimer’s disease change). This research is ongoing to assess the possibility of nasal delivery in humans. Such a breakthrough would be dramatic, however, one of the critical challenges is how to direct drugs introduced nasally to the relevant locations in the brain.
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Today, an interoperative MRI allows the neurosurgeon to take an MRI post-resectioning, but while the patient is still on the operating table. This enables the surgeon to assess successful cancerous tissue removal on the spot and to react accordingly.
Neurogenetics is a flourishing field of scientific research, which promises to refine genetic markers so that they will be able to predict the possibility of brain disease even before any symptoms appear. Advanced genetic marking may allow the physician to design an early and highly personalized preventative program that could avoid more radical post-diagnosis alternatives.
Stanford University has seen many advances in the Cyber or Gamma Knife technology over the past two decades. Most impressively, this has resulted in expanding its potential surgical applications from removing brain tumors to addressing other brain-related issues such as depression, Obsessive Compulsive Disorder, and chronic neurological pain.
Over the past decade, the work of many researchers has indicated a strong relationship between the brain and the gastrointestinal system, often referred to as the Gut-Brain Connection. According to researchers at the Harvard Medical School, this connection apparently works both ways in that GI disorders can be the cause or the result of stress and emotional upset. Much remains to be done to fully understand the close interaction between the brain and the digestive system.
Finally, there has been much research focusing on the ability of the brain to remodel itself. This phenomenon is called neuroplasticity. A recent patient who was born without a cerebellum has been studied in-depth by Dr. Jeremy Schmahmann, a neurology professor at Harvard Medical School. Through hard work and dedication, other parts of the patient’s brain apparently have taken over as the patient has learned how to work around his limitations. Exactly how this has happened remains to be further explored, but it does offer great promise to those suffering from brain damage.
Medical and research professionals alike remain enthusiastic, committed and hopeful about the future. Their goal is to one day find new and better ways to treat the many devastating brain-related diseases, which includes the debilitating downward spiral of dementia, and even schizophrenia and autism.
Certainly harnessing the power of the human brain remains as intriguing a possibility as it has been through the centuries. The quest to fully understand the brain goes on. In the meantime, we can improve our own mental well-being by indulging in pleasurable and brain healthy pursuits, such as listening to soothing music, socializing, or simply completing the latest New York Times crossword puzzle. The evidence may not yet be scientifically supportable, but the positive effect on our state of mind is incontrovertible.
Editor’s Note: Special thanks to Anwar Ghali, MD Chairman of Psychiatry, Trinitas Regional Medical Center, and Rodger Goddard, PhD, Chief Psychologist and Director of Wellness Management Services at Trinitas. for their input on this story.
A green landscaping strategy demands planning and perseverance.
In today’s culture of heightened environmental awareness, our gardens, yards and other outdoor living spaces not only have to look good, they have to make us feel good, literally and figuratively. Calling a lawn or landscape “green” doesn’t necessarily make it so, just as calling food “organic” doesn’t guarantee that it is. The quest for personal landscape perfection traditionally focused on irrigation, pesticides, weed control and maintenance, all weighed against the various associated costs.
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Now, however, more and more New Jersey homeowners are raising the bar and demanding that their landscape design gives back more than meets the eye. Not only do we seek healthy and hardy plants, we want our outdoor living spaces to help keep us healthy and happy. Professional landscapers are being asked to apply holistic principles in designing both softscape plantings and hardscape elements, such as fire pits and places, outdoor kitchens, and child- and animal-friendly zones.
In a modern context, the key to successful landscaping lies in sustainability. To get the most from an often-sizeable investment, homeowners look for a landscape design that is low-maintenance, drought tolerant and filled with native specimens. It may also include edible, herb, and specialized flower gardens, cultivated for their health and healing qualities as well as their resiliency and eye appeal.
Growing in popularity, especially in urban areas, are container- and raised-bed gardens that offer complete control over soil conditions. For city dwellers, options include roof gardens and living walls. There also are bee gardens, which focus on pollen-rich planting to support bees, as well as gardens that cater to hummingbirds, butterflies, and certain bats that feed on flower nectar. Then there are special gardens that lend romance and mystery, such as a night garden featuring plants from the noctiflora group, which release their fragrances only after sundown. If aroma is a prime consideration, then a scented garden is the ideal.
www.istockphoto.com
The value of the vegetable garden should not be underestimated. Even the staid British Royal Botanic Gardens elevated this timeless genre by presenting a special event in 2013 called IncrEdible Edibles. Some gardeners have gone “beyond edible” to incorporate vineyards on their property to assure a supply of organic grapes for their wine cellars (and a possible agricultural tax exemption, as well).
Needless to say, there are certain practical elements that go into successful gardening. Every garden, for example, should be season-appropriate, with staggered blooming periods to assure the garden shows to best advantage throughout the year. In challenging cold-weather situations (such as New Jersey this past winter), consideration should be given to some architectonic elements, such as trees that present well even when leafless and snow-blanketed.
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Paul Martoccia points out another interesting aspect of the trend toward environmentally friendly landscape design. He runs Martoccia Landscape Services in Somerset County, a business started by his father in 1962. In the past 10 years, the company has completed 800 projects. Its typical client five years ago was age 50-65 and anticipating retirement, with women as the primary decision-makers. Today, the clientele is younger (late-30s to 40s, he says) with men and women on an equal footing about their landscaping expectations. Rather than the simple patio of 10-15 years ago, Martoccia adds, homeowners are interested in creating what he calls a “backyard destination.” These projects involve a lot of client interaction and site analysis—terms that were not exactly part of the landscaping lexicon back in the early ’60s.
All told, the annual price tag for landscaping in the U.S. is$73 billion. According to a 2014 Ibis World market research report, there are almost 400,000 U.S. companies with almost 900,000 employees. Companies range from small multi-generational father & son residential operations to billion-dollar commercial firms. Projections indicate that the biggest increase in consumer spending will be in the design/installation area. And within that growth sector is a rising demand for environmentally friendly designers.
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So does that mean more companies are bringing aboard workers who understand how to create a healthy, sustainable outdoor space? According to Burke Honnold, owner of T. Burke Honnold Landscaping in Monmouth County, it does not. “Today, there are more landscape ‘designers’ with far less landscape education out there,” he says. Honnold’s greatest challenge, in fact, is hiring qualified help. He considers himself fortunate to have three core employees on board with a decade or more of experience.
To start a… Look for…
Hummingbird Garden Flowering plants that are red in color and tubular in shape (e.g., Bee Balm or Cardinal Flower).
Butterfly Garden Tropical Sage, Butterfly Bushes, Phlox, Purple Coneflower, Zinnias, and Sedum.
Bat Garden As an organic pest control, they need shelter (trees and large shrubs), water features, and night-blooming flowers (e.g., Moonflower, Primrose, and Nicotania).
Moon or Night Garden Night-bloomers such as Moonflowers, Four-o-clocks, Angels’ Trumpets and even some grasses to add soothing swishing sound effects.
Healing Herb Garden Culinary: (Sage, Rosemary, Thyme, Mint)
Medicinal: (Motherwort, Passionflower, Echinacea, Wild Bergamot)
Aromatic: (Lavender to calm, Eucalyptus to invigorate)
Often, homeowners will engage a landscape architect to create an environmentally friendly outdoor area. The landscape architect’s credentials are relatively more rigorous, so it is not surprising that the fees are usually higher. That being said, the modern mission for both the landscape architect and landscape designer is much the same, and many landscaping companies tout their eco-consciousness in their company names (e.g., Keep It Green Landscaping in Bergen County and Landscape Aesthetics in Somerset County).
Recent statistics indicate 80 percent of Americans consider themselves to be environmentally conscientious when it comes to their private grounds. No surprise then that Feng Shui consultants have found new opportunities in our backyards. Laura Benko, who has taught design at the Pratt Institute and was recently named Best Feng Shui Consultant by New York magazine, applies her expertise to create a more meaningful outdoor environment. “Landscaping with Feng Shui principles allows for a deeper meaning and connection to your environment,” she says.
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“It’s not just sustainable landscaping, but emotional sustainability too.”
Gone are the days when a rolling, weed-free, golf-course-quality lawn represented everyone’s suburban ideal. Back then, you hired a lawn service, installed a sprinkler system, planted a few geraniums, and assumed you were done. Homeowners today tend to have a more cultivated vision for their property, as well as a greater awareness and concern for the environment. Indeed, we may still peer over the fence and wonder why the grass is greener on our neighbor’s lawn. But now we are asking the right question: At what cost?
Some relatively common plants offer a surprising array of cleansing and air-filtering attributes. They live outdoors in warm weather, but need to be moved indoors with the first chill.
Common Name
Aloe Vera Aloe Barbadensis
English Ivy Hedera Helix
Boston Fern Nephrolepsis Exaltata Bostoniensis
Gerbera Daisy Gerbera Jamesonii
Mums Chrysanthemum Morifolium
Peace Lily Spathiphyllum
Philodendron P. Cordatum
Weeping Fig Ficus Benjamina
Snake Plant Sansevieria Trifasciata
Editor’s Note: Chris Gibbs writes about a wide range of home- and wellness-related topics, and also edits EDGE’s It’s A Gift pages. Special thanks to the experts who contributed to this story, including Laura Benko (laurabenko.com), Paul Martoccia (njlandscaping.com) and Burke Honnold (honnoldlandscaping.com).
For many of us, the path to a healthier diet begins with those first timid forays into new ethnic dishes. In this regard, few if any states can match New Jersey for the number of dynamic ethnic populations, density of population, and number of restaurants. Which ethnic foods are the healthiest? In most lists created by nutritionists, the “winning” countries are Greece, Viet Nam, Japan and India. Greek food makes wonderful use of dark, leafy vegetables and other heart-healthy, cancer-fighting ingredients. However, a helping of spanakopita—which is something of a national dish—is only slightly healthier than a Wendy’s Baconator. Vietnamese food gets high marks for its use of water and broth for cooking instead of oil. Many of the basic ingredients in this cuisine have been used in alternative medicine for centuries. Japanese dishes (we’re not including sushi here) are also prepared in a healthy manner, including steaming and rapid wok frying. Their fruits and vegetables are remarkably high in antioxidants, vitamins and minerals. White rice and soy sauce are problematic staples for some. The aromatic spices commonly used in Indian cuisine—including cardamom, coriander, cinnamon, turmeric, ginger, cumin and various chilies—not only produce a distinctive palate, some have been shown to ward off cancer and possibly Alzheimer’s. Skip the fried appetizers on most Indian menus. Italian cuisine (which is practically its own level on the New Jersey food pyramid!) also gets high marks for its liberal use of tomatoes, olive oil, garlic, basil, oregano and parsley. Not so much for the cheese. No matter which region’s cuisine appeals to you, there is a simple way to get through the maze of food options out there, according to
Michelle Ali, RD
Director of Food and Nutrition, Trinitas Regional Medical Center 908.994.5396
Michelle Ali, RD, Director of Food and Nutrition at Trinitas. “Healthier eating and a healthier lifestyle go together like peas and carrots,” she points out. “Healthy eating means watching what you eat—especially foods that may be higher in sugar, sodium or fats.” Make it a priority to reduce portions and try to limit those foods to special occasions, she suggests, and consider walking or doing an extra 15 minutes on the treadmill to offset your dietary decisions.”
The good folks at global food giant Nestle have been working for the better part of a decade on what one might be tempted to call “exercise in a wrapper.” According to an article in Chemistry & Biology, scientists in the company’s Swiss labs are beginning to understand how a compound called C13 can stimulate an enzyme in charge of regulating metabolism. It’s an important step in developing a way to mimic the fat-burning effect of exercise. The next step would be finding plants or fruits that contain C13, which might then lead to the creation of nutritional products that could actually help consumers drop weight by eating. This type of breakthrough could be a game-changer in the packaged food industry, which has come under fire for making the flavors of less-than-healthy snacks increasingly irresistible. It also sheds light on the increasingly fine line that separates the food and pharma industries. The companies that solve riddles such as this one not only will gobble up big shares of the snack food market. They will also enable people who are immobile due to obesity, diabetes or old age to enjoy the chemical benefits of exercise.
Ari Eckman, MD
Chief of Endocrinology and Metabolism 908.994.5187
Dr. Ari Eckman, Chief of Endocrinology and Metabolism and Director, Trinitas Diabetes Management Center, concurs. “However, it is obviously too premature to know if the compound C13 can indeed be the secret to more exercise,” he says. “We look forward to learning more about this possibility in the future.” In the meantime, no one should be waiting around for a miracle food. In this generation of a more sedentary lifestyle, Dr. Eckman points out, anything that encourages and promotes exercise will be extremely beneficial to help with weight loss and prevent conditions such as diabetes and heart disease.
More and more people are realizing that almost everything humans need is contained in the Earth. Now that also seems to be true of antibiotics. Researchers at Rockefeller University have concluded testing on soil samples from 185 different sources worldwide and discovered valuable compounds that could help create new drugs and improve existing ones. For instance, a sample from Brazil contained genes that offered a new version of the cancer-fighting bleomycin. A sample from New Mexico yielded epoxamicin, a molecule used in other cancer-fighting drugs. Another soil sample, from a southwestern state, appears to contain compounds similar to rifamycin, which helps treat tuberculosis. Only a small fraction of microbes can be grown in a lab environment; most need soil to do their thing. The idea of valuable microbes coming from the ground is hardly a new one; there are more microbes in a handful of soil than there are humans on earth. And lest we forget, penicillin and other important antibiotics started as uncultured bacteria in the dirt. Meanwhile, at Northeastern University, researchers have been building “soil hotels” to culture bacteria, and this effort has produced more than two dozen promising antibiotics. This is a huge step in battling the growing problem of antibiotic-resistant microbes. The last time a new antibiotic actually made it into the marketplace was more than 25 years ago.
In a recent survey, 90 percent of Americans said they believed that certain foods—the kind that help stave off aging or disease—offered health benefits beyond basic nutrition. Whether this 90 percent was looking past advertising claims and correctly identifying which foods offer these benefits is certainly a topic for debate. However, there is no question that science is working hard to identify foods that deliver on this promise. One you are likely to be hearing a lot about in 2015 is microalgae. Foods containing this ingredient (a uni-cellular plant species found in freshwater and marine systems) have just begun to show up on store shelves. “It’s a well-known fact that micro-organisms in our body have a positive effect on our metabolism and proper physiologic function of our body,” explains
Kevin Lukenda, DO
Chairman, Family Medicine Department 908.925.9309
Dr. Kevin Lukenda, Chairman of Family Medicine at Trinitas. “The human gut is filled with bacteria and other micro-organisms that help keep the gastrointestinal tract functioning at its highest level. When this micro-organism environment is disrupted, normal body function is often compromised. Probiotics—algae in a pill—offer obvious benefits to our gastrointestinal tract as they help support the microalgae diet.” Microalgae can be used in certain high-fat foods not only to reduce cholesterol and saturated fat, but also to add antioxidants and protein. Proponents of omega-3 fatty acids already know about microalgae; fish don’t actually produce omega-3—they get it from.
The most talked-about diet of 2014 was probably the Paleo Diet, which was outlined by author Loren Cordain several years ago in a best-selling book. Cordain’s basic premise is that nature determined what our bodies needed long before agricultural societies took root, and that eating food made of grains (and livestock raised on grains) is fundamentally unnatural and unhealthy. The Paleo Diet focuses on the consumption of fruits, vegetables, nuts, seeds, plant-based oils and meat from grass-fed animals. Grains, legumes, potatoes, salt, refined sugar and dairy are off the menu. In a Washington Post story published earlier this year, several experts lined up against this concept. For example, Harvard professor Daniel Lieberman points out that we didn’t evolve as a species because of our health so much as our reproductive fitness. Also, many Stone Age humans were consuming grains and dairy products (and we have since developed the genetic mutation to metabolize milk). Marlene Zuk, an evolutionary biologist at the University of Minnesota, believes the Paleo Diet concept is based more on some misplaced nostalgia than actual facts. Evolution is full of inexplicable twists and turns, she says, pointing out that bipedalism came with back pain, that didn’t send early hominids scrambling back into the trees. It’s worth noting that none of the experts cited by the Post claims the Paleo Diet is unhealthy—obviously, we consume far too much sugar and empty calories compared to our 300-x great-grandparents. They only question whether it is scientifically better than other ways of eating.
What’s With the Measles Outbreak?
One of the big healthcare headlines this past winter concerned the outbreak of measles in the United States. Worldwide, an estimated 20 million people each year become infected with measles annually and nearly 150,000 die. Yet, back in 2000, we had been told the virus had been eradicated in America. The recent cases in California, Ohio and New York were traced to travelers returning from endemic countries who subsequently came into contact with people in the U.S. who had not been vaccinated.
How do I not get measles?
Experience has shown that vaccines are highly effective in preventing the disease. The bottom line is that the best treatment for measles is prevention.
But there has been a lot of discussion in the media about the safety and effectiveness of vaccinations. Where do you stand on the measles vaccine?
The Centers for Disease Control (CDC) is recommending that anyone traveling outside of the United States should receive a measles vaccine if they haven’t already. After an initial dose, follow-up blood work should reveal immunity. If the blood lacks evidence of immunity, then a second MMR vaccine should be administered at least 28 days after the initial dose. The repeat dose increases immunity to nearly 97 percent. Scheduled pediatric dosing remains the same.
How do I know if I am already immune?
Several methods show evidence of measles immunity, including laboratory evidence and vaccination records from your physician.
What is Community or “Herd” Immunity?
When a critical portion of a community is immunized against a contagious disease, most members of the community are protected against that disease because there is little opportunity for an outbreak…thanks to “herd” immunity. Even those who are not eligible for certain vaccines—such as infants, pregnant women, or immuno-compromised individuals—have some degree of protection, because the spread of contagious disease is contained.
What are the signs of measles and when is a patient considered contagious?
Measles is a viral infection from the Rubeola (Paramyxoviridae) family. Clinicians look for fever and the disease’s characteristic rash. The fever occurs rapidly, sometimes as high as 104 degrees. As a viral exanthema—from Latin for eruption—measles starts on the head, typically behind the ears and the face, and then spreads to the trunk and lower extremities. The measles rash is accompanied by the three C’s: Conjunctivitis (reddish color of the whites of the eyes), Coryza (a runny nose) and Cough. Often there is a rash in the mouth, which appears as lesions on the fleshy portion of the inner cheek. As a highly contagious disease, the transmission rate of measles from person to person approaches 90 percent. It is spread via respiratory droplets, such as sneezing or coughing, and also by direct contact. The patient is contagious four days prior to experiencing fever. They are also contagious four days after the rash disappears.
What are some complications of measles?
The disease can cause ear infections, pneumonia, diarrhea and, in rare cases, encephalitis (inflammation of the brain). People at high risk for severe illness and complications from measles include infants and children aged less than 5 years and people with compromised immune systems. One or two out of every 1,000 children who become infected with measles die from respiratory and neurologic complications.
If my child begins to show symptoms, should I go to the ER right away?
I think it’s best to call your child’s pediatrician. Explain your concerns and ask your pediatrician to recommend your next step.
How do you treat measles?
The cornerstone of therapy for measles is isolation and quarantine. Post-exposure Prophylaxis, or PEP, is a treatment that consists of administering the MMR vaccine within 72 hours of exposure. Immunoglobulin (IG) and Vitamin A can be given to a specific subset of patients, but do not reduce transmission or infection.
What happens if I, or my child, gets the virus?
The first step is to take universal airborne precautions by isolating the suspected case and giving you or your child a mask. We recommend an N95 respirator. A determination is then made about the degree of severity of the illness. Does it require hospitalization or can the case be managed on an outpatient basis? After stabilization, public health professionals will ask questions about your particular case and begin contact tracing. The CDC or local public health departments will then reach out to individuals who were exposed to you or your child. They will recommend vaccination and self-monitoring precautions in order to mitigate the further spread of the disease.
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.
Do you have a hot topic for Dr. D’Angelo and his Trinitas ER team?
Submit your questions to AskDrD@edgemagonline.com
EDGE takes you inside the area’s most creative kitchens.
728 Thompson Ave. • BRIDGEWATER
(732) 469-0066 • office-beerbar.com/locations/bridgewater
Seared rare and served with Asian rice stir fry with seasonal vegetables.
— Kevin Felice, 40North Executive Chef
77 Central Ave. • CLARK
(732) 931-1776 • paragonnj.com
Playing with food is one thing that we enjoy doing at Paragon Tap & Table. This appetizer is a perfect example of that. This dish plays with different textures and tastes; while it’s light in texture, it’s big in flavor.
— Eric B LeVine, Chef/Partner
232 Centennial Avenue / 215 Centennial Avenue • CRANFORD
(908) 276-6600 • localrootscranford.com
Our restaurants offer the best ingredients from ocean, farm, and garden on their seasonal menus. A wonderful example is our “catch of the day” dish, on offer at both locations, sourced that morning at the fish market—each chef creates a unique dish each night that highlights the local catch.
— Andrea Carbine, Owner
1–7 South Ave. • CRANFORD
(908) 272-3888 • office-beerbar.com/locations/cranford
Sesame & Citrus Soy infused chicken wontons with a wasabi crème and soy glaze.
— Kevin Felice, 40North Executive Chef
1 West Main Street • MENDHAM
(963) 543–7300 • blackhorsenj.com
Pan seared and served with roasted apples and pork belly rested on top of herb-infused barley risotto.
— Kevin Felice, 40North Executive Chef
88 East Main Street • MENDHAM
(973) 543-0025 • piattinonj.com
Served on top of angel hair pasta tossed with fresh basil pesto, toasted pine nuts and shaved parmigiano reggiano finished with a drizzle of extra virgin olive oil.
— Kevin Felice, 40North Executive Chef
619 Bloomfield Ave. • MONTCLAIR
(973) 783-2929 • office-beerbar.com/locations/montclair
House-made herb-infused hummus with toasted pita, roasted red peppers, Greek Olives & fresh mozzarella cheese.
— Kevin Felice, 40North Executive Chef
67 Morris Street • MORRISTOWN
(973) 267-4700 • georgeandmarthas.com
Open-faced Chimichurri Grilled Hanger Steak, topped with a citrus-dressed tomato & arugula salad and served on rustic garlic toast.
— Kevin Felice, 40North Executive Chef
3 South Street • MORRISTOWN
(973) 285-0220 • officetaverngrill.com
Coated in lemon oil and toasted sesame seeds, served with a baby lettuce salad with a lemon and citrus vinaigrette.
— Kevin, 40North Executive Chef
860 Mountain Ave. • MOUNTAINSIDE
(908) 233-7888 • daimatsusushibar.com
Toro Tartare finely chopped toro coated with rice cracker, masago caviar, oba, pickled radish and roasted nori on top served in Dashi soy sauce with hint of wasabi oil.
— Momo, Chef
899 Mountain Ave. • MOUNTAINSIDE
(908) 233-2355 • publickhousenj.com
The grilled swordfish is a perfect addition to our menu this Spring. Served over a fresh cut watermelon salad of red onion, pan-roasted brussel sprouts, feta cheese and tossed in a red wine vinaigrette. The swordfish is topped with lemon zest. The balance of flavors and diversity in textures makes this dish a true star.
— Danilo Ayala, Executive Chef
500 Route 10 West • RANDOLPH
(973) 891-1776 • morristapandgrill.com
A gastropub is a place where great spirits and food meet in a comforting atmosphere. This dish is our Duck Quesadilla with Ghost pepper cheese. Its a dish where heat meets sweet, topped with a plum slaw and garlic aioli. This great dish goes with craft beer and craft cocktails to create an elevated dining experience.
— Eric B LeVine, Chef/Partner
201 Morris Ave. • SPRINGFIELD
(973) 376-6300, (973) 376-6301 • thaiamarinnj.net
Everything here is prepared fresh to order. Our salmon steak is grilled to perfection and topped with a mouthwatering panang curry sauce, sautéed string beans, bell peppers, lime leaves, and coconut milk for all those spice lovers out there.
— Amy Thana, Owner
61 Union Place • SUMMIT
(908) 522-0550 • office-beerbar.com/locations/summit
Fresh baked potato wedges topped with apple butter BBQ pulled pork, white cheddar cheese, sour cream and chives.
— Kevin Felice, 40North Executive Chef
2333 Morris Avenue • UNION
(908) 686-4321 • CafeZNJ.com
Jumbo shrimp encrusted with panko bread crumbs served with our hot and spicy marinara sauce that we make here.
— Patricia Inghilleri, Owner
649 Chestnut Street • UNION
(908) 964-8696 • chestnutchateaunj.com
One of my house specialties is our domestic slow braise lamb shanks. Seared and cooked slow and low for hours and served with a reduction of its own juices. A dish you will remember for quite some time as the tender lamb melts in your mouth and falls off the bone. Every bite will be quite the experience.
— George Niotis, Chef
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
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
111 Prospect Avenue • WEST ORANGE
(973) 731-2360 • themanorrestaurant.com
Our new menu has many highlights, including this absolutely luxurious duet of foie gras that features my own hand-made torchon, painstakingly created over the course of several days, that results in a distinctive cured sweetness that practically melts on your tongue as though it were the creamiest of butters.
— Mario Russo, Chef de Cuisine
411 North Ave. West • WESTFIELD
(908) 232-1207 • office-beerbar.com/locations/westfield
Skirt steak covered with a stout gravy, roasted red peppers and onions on top of garlic whipped potatoes.
— Kevin Felice, 40North Executive Chef
Fossil aficionados call this 50-million-year-old collection of knightia eocaena from the Green River formation in Wyoming a Mass Mortality Plate. Available at fossilera.com.
Glycerin-based Dead Sea Salt Rub Soap helps to lather off toxins and circulate positive energy. Available at origins.com.
This hand-carved Himalayan Salt BBQ Plank holds heat for meat off the grill…or cold for your eat-in sushi. Available at uncommongoods.com.
Unique pieces like this Natural Teakwood End Table by Pacific Northwest furniture retailer Moe’s can now be purchased in New Jersey through a Hoboken retailer. Available at battagliashome.com.
The Recycled Succulent Living Wall Planter Kit helps you “get your Spring on” all year ’round. Available at uncommongoods.com.
The Mamani Necklace features hand-washed seeds from South American rainforests, sun-dried to seal in their naturally vibrant colors. Available at greenolastyle.com.
Designer Jenny Hoople scours riverbeds for natural materials to create one-of-a-kind Rainbow Rock necklaces. Available at jennyhoople.com.
Emilie Shapiro makes a bold statement by fusing rough-cut emeralds and textured brass into her Organic Mosaic Ring. Available at uncommongoods.com.
This handmade Periodot and Turquoise Necklace by Thai artisan Sukanya Thongperm evokes a sense of jungle organics. Available at novica.com.
Thousands of families in Ecuador earn a living from the Tagua Palm (aka Ivory Palm), including makers of the fair-trade Tagua Seed Bracelet. Available at enamoratreasures.com.
The made-in-NJ Wine Barrel Garden Bench is fashioned of wood reclaimed from vintage French-made oak barrels retired by California wineries. Available at uncommongoods.com.
A hot party trend is now for the birds thanks to the Mason Jar Hummingbird Feeder. Available at birdfeeders.com.
As with all Sneeboer tools, the Hand-Forged Garden Trowel is made in Holland and guaranteed for life.
Available at sneeboerusa.com.
Extended arm cuffs and sturdy palms make eye-catching Arm Saver Garden Gloves a fashionable option for weeding, digging and planting. Available at womanswork.com.
The Traditional Trug Garden Basket is hand-built with reharvested wood and signed in Sussex, England
by a master basket-maker. Available at claringtonforge.com.
For lovers of food and wine, the winter festival in Key West offers unparalleled bang for the buck.
A gentle breeze moves through your sun-kissed hair. Sand and sea squeeze up between your toes. You catch the unmistakable aroma of fresh-caught seafood on the grill. You take another sip of wine and scan the impossibly blue water for dolphin fins breaking the surface. You’d swear someone is playing that Jimmy Buffet song you haven’t heard since college. In fact, you’d swear it’s Jimmy Buffet. And you might just be right. It’s January in Key West and (uh, yeah) there’s a reason why people flock to this southernmost tip of Florida’s famous coral cay archipelago.
The last week in January is a particularly popular time to visit Key West, especially for sun-worshipping foodies. That’s when the sleepy town perks up for the Key West Food & Wine Festival, which just completed its sixth spin around the block (the block being Duval Street, main drag of the Conch Republic). The brainchild of local legend Marc Certonio (left), the Wednesday-thru-Sunday gathering is, happily, still something of a well-kept secret. There are more than 30 different events, including various strolls, tastings and beach parties—but with dozens, not a mob of hundreds. Also, Certonio has cultivated strong relationships with wine purveyors and wine makers, so you’re likely to see wines of small production and hard-to-find beauties. This year, Archery Summit, Foxen and Byron wines were being poured.
In case you’re wondering, Key West has changed in recent years. Its reputation as a laid-back, booze-soaked haven for alternative couples and fast-lane refugees has always had more than a little truth to it, but over the last decade I’ve noticed a lot more vacationing families and cruise-ship tourists in the Florida Keys. During the festival, however, they play second fiddle to all the food and wine devotees.
The 2015 festival started off with a bang. Stephanie Southgate (left) from Noble Wine Estates had an intimate gathering of 25 people to sample wines from around the world. All rated 92 and up from Robert Parker, Wine Spectator and Steven Tanzer. Once we stumbled out of that one, we had the option of joining one of three neighborhood strolls through downtown Key West before turning in.
On Day Two, I had the pleasure of working with James Braun (left), a product manager for one of the big whiskey distributors in South Florida. We partnered on a two-hour talk about whiskey and scotch, during which attendees sampled 17 different whiskeys. All different, all boutique and incredibly delicious. The host restaurant, Square One, served small bites of raw fish and pot stickers that blended perfectly.
It only got better. Thursday night was the official welcoming party, Key West style: flip-flops, shorts and loose shirts for the guys, swim club casual for the ladies. The Beachfront at Casa Marina resort offered 10 different wines, a carving station to die for, and a buffet bursting with seafood fished out of local waters. This event alone was worth the price of the plane ticket—and it was just a warm-up for dinner at the nearby Strip House (it’s not what you think). Luciano Castiello from Banfi Vintners of Montalcino, Italy shared his passion for wine and the story of the fabled Banfi family. Each course delivered to our table was accompanied by an impossible-to-find, small-production selection from his winery. Returning to the room that night, I was holding my stomach wondering how I could possibly make it through three more days. Obviously, I’d have to force myself to soldier on and take one for the team!
Friday brought a special section of Santa Barbara wines, along with the makers, to talk about all the West Coast goodies they brought. Buttonwood, Byron and Foxen wineries were represented at the Hyatt Resort, which overlooks the water and (as I discovered that evening) offers a spectacular viewpoint for Key West’s world-class sunsets. The property actually hosted two days of wine-intensive seminars, brunches and dinners.
Friday at the festival also featured a chocolate-making seminar, chocolate and food pairing with wines, a Key West kitchen tour, an East vs. West sunset wine tasting, and—ta-dah!— the Grand Tasting, the focal point of the five days for people like me. This year’s Grand Tasting took place poolside at the brand spanking new Marker Resort. More than fifty wines were poured at tables arranged around the two pools in an enclosed deck area. The evening had an easy vibe, live music, a cool breeze and knowing whispers: Did you try that pinot over there? The malbec from Argentina was incredible. As I raved about the New Zealand sauvignon blanc while chewing on my third coconut shrimp, my date reminded me that we had dinner reservations.
On Marc Certonio’s advice, we snagged a pair of tickets to the event at Charlie Mac’s, a local spot that has some of the best food in town. Juan Hernandez (right), the southeastern director for Domaine Select wines, was conducting a six-course, six-wine dinner for 30 people. I don’t even know where to begin, but suffice it to say that when the braised pork and pasta dish came out paired with a semi-dry Lambrusco, my eyes rolled back into my head. That was course four or five. At some point, Juan decided that seven courses was better than six; either that, or I just lost track. Chef Michael Schultz was the man behind the culinary madness. He is the chef for Pat Croce’s various restaurants and establishments in Key West and he has an unbelievable talent for all things fish. If you do one thing when you come down to Key West, eat at one of Chef Mike’s establishments (my favorite is the Turtle Kraals cevicheria at the marina).
No trip to the Keys is complete without a shrimp boil. On Saturday, we crossed over the bridge from Key West onto Stock Island and settled into our seats at the funky, island-cool Hogfish Bar and Grill, where one can track the comings and goings of the shrimp boats that make this place famous. We watched the shrimp go from boat to pot, and Hogfish served them with a Mark West pinot. We walked off this meal on Duval Street. Well, maybe that’s not entirely accurate. More than 20 establishments on this half-mile strip were pouring small-production wines, so it was more of a sultry stroll. Hungry again? It was back to the Hyatt deck that evening for cheeseburgers in paradise, with wines to match. A Santa Barbara winemaker dinner followed, but by then we were spent.
Sunday is getaway day. But who wants to leave? We returned to Stock Island for Prosecco and jazz at Rustica Pizzeria before packing up and checking out. As the festival-goers on our flight settled in for the trip back home, I noticed more than the usual wriggling and shifting as we all tried to get comfortable.
Somehow, in just five days, the seats had gotten smaller.
Editor’s Note: Mike Cohen is EDGE’s Food Editor. A longtime New Jerseyan, he recently made South Carolina his permanent home. He teaches wine courses at The College of Charleston. Check out his Q&A with Key West Food & Wine Festival founder Mark Certonio at edgemagonline.com.
The 2016 Key West Food & Wine Festival is scheduled for January 27- 31. The festival is comprised of more than two dozen ticketed events‹most of which are extremely limited. For more information or to reserve space in 2016, log onto kwfwf.com.
Does your pain need an intervention?
Aside from cold, flu and upper respiratory conditions, the most common reason people see a doctor is due to neck and lower back pain. The causes of neck and back pain can vary greatly. Some are attributable to repetitive injuries, but more commonly the pain is traceable to a single event, such as bending or lifting, or something more direct, for example a fall. Sports injuries are also a very common source of neck or back pain, as are impacts from motor vehicle accidents.
Most neck and back muscle sprains will resolve spontaneously, or with conservative treatments. Patients whose pain persists may seek out stronger pain medication from their primary physicians, and go for various therapies such as massage, physical therapy, chiropractic treatment or acupuncture. These injuries typically resolve within several months of the accident.
But what if they don’t?
If the condition persists despite several months of conservative therapy, then interventional pain management is the logical next step. The goal of interventional pain management is to diagnose and treat the condition with the simplest and least number of treatments possible. Of the patients I see, over 95 percent will improve from these interventions; only a handful will ever need conventional surgery.
Your first visit to an interventional pain management practice involves the taking of a comprehensive history and an in-depth physical examination. Most patients I see have already had an MRI done, which I will review. If it turns out you have not undergone appropriate conservative treatment, then that will be recommended. The focus of the initial visit is aimed toward forming an accurate diagnosis, and from there a discussion of the most likely causes of the condition and the best treatment options.
The mainstay of treatments that interventional pain physicians perform is diagnostic and therapeutic nerve blocks or epidural injections. Once I’ve formed a diagnostic impression, I utilize these interventional therapies to confirm it and treat the condition. Pain physicians use the term “the pain generator” to describe the structure that ultimately is determined to be the origin of the pain. Sometimes it is obvious, but other times it is not. These “tools”—the diagnostic nerve blocks—can help determine if any particular structure is producing the condition.
After the nerve block injection, the patient returns a week later to report on any progress or changes. I instruct patients to keep a diary on how they felt on Day 1, Day 2 and so on. If they report that they felt very little or no pain for a time after the nerve block, then it is very likely that structure is the source of what’s causing the pain. Basic interventions, such as nerve blocks or epidural injections, are the first line of therapy. Once the cause of the condition has been identified, if necessary, more definitive treatments can be performed such as nerve ablation or percutaneous disk decompression procedures. Some patients will be cured outright, and most will achieve sustained pain relief for an extended period of time.
MRIs are an important part of the evaluation, but they often don’t tell the whole story. In many cases, the patients that interventional pain practices see have already been to multiple doctors and received multiple opinions on causes and treatments. More times than not, the actual origin of the pain is not immediately obvious. A phrase I say a lot is that it’s normal to be abnormal—meaning that most patients will not have a MRI study that is completely normal. Most people exhibit some degree of disk degeneration, disk bulging or other abnormalities on their MRIs, because frankly disk degeneration begins at around 30 years of age for everyone. This is true even if they have never had any back pain. So I can’t automatically assume that abnormalities on the MRI are a true indication of what’s causing the pain.
The most common neck and back injuries are sprains and strains—in other words, some type of muscle injury. Most initial injuries are treated similarly: rest, ice application (within the first 24 to 48 hours) and anti-inflammatory medications (NSAIDS). More severe neck and back injuries can involve the disks in the neck and back, nerves, joints and even bones (fractures).
The severity of an injury dictates whether or not you need to seek immediate medical attention. If the injury causes a significant limitation in function (standing, bending, walking, etc.), then it is advisable to be seen by a doctor ASAP.
There are two main components of being a good interventional pain specialist. The first is being a good diagnostician (this is the art part), and the second is being a good injectionist. The latter involves the precision and technique required to perform the nerve block, or whatever treatment is being done. Treatment is an ongoing, dynamic situation. My over 16 years of experience has certainly improved both aspects of my care. Evaluating the results of one treatment, and from there forming a treatment plan leading to permanent relief, is paramount to being a good interventional pain management physician.
Patients usually ask me how many treatments they will need. Most patients only need a few treatments. I would say that 25 to 30 percent who undergo a single treatment return reporting so much relief from their pain that they are basically cured. Most of the remaining patients require two or three treatments to achieve benefit; unfortunately, there is no way to predict when someone walks through the door how many treatments he or she will require. Then, of course, you have those stubborn conditions, which require a more aggressive level of interventional care. What I say to most patients is that it’s not whether they are going to get better, just a matter of how many treatments and what level of therapy they will require.
There are, of course, conditions we see where we know right away that a cure is not possible. One such condition is when there is permanent nerve injury. In such cases, the goal is palliative care, to relieve as much of the pain and improve as much of the function as possible, using various interventional techniques and other modalities.
Lastly, there are of course some patients whose condition is beyond what interventional treatment can offer and do need surgery. Even so, undergoing a good “pain workup” can improve surgical outcomes because, at the point where someone is referred for surgery, we have already ruled out a good number of possible causes—and most times determined the precise condition that needs surgical intervention.
A need has always existed for a focused discipline that can monitor, diagnose and treat patients with pain-producing conditions. Pain is one of the most common reasons people visit their doctor, and at some point many of those patients will find themselves in need of a specialist who can manage and direct them to the most appropriate course of treatment. The field of interventional pain management actually originated as a subspecialty of anesthesiology. It makes sense if you think about it—anesthesiologists, after all, are doctors who specialize in rendering patients pain-free during surgery and childbirth. The field has grown substantially over the last two-plus decades, and physicians now enter from other fields, including physical medicine, rehabilitation and neurology.
The take home message here is to always go from a conservative to a more aggressive course of treatment.
If you haven’t gone through a course of physical therapy, you must. Medications such as anti-inflammatories and muscle relaxants can also be beneficial. If symptoms persist, you need to get a comprehensive physical examination. Remember that MRI findings do not tell the whole story. While the most common type of spine injuries involve disk herniations, injuries can also involve the joints and other supportive structures which make up the spine.
If the disk herniation is shown to be the cause of the condition, you may be a candidate for a type of minimally invasive pain interventional therapy, which have fewer possible complications and a shorter recovery time.
When is it time to seek out professional help?
Listen to your body. If you have suffered an injury, you should not do things that exacerbate the pain. Some rest (but not too much) is important—ignoring the pain can sometimes lead to permanent and devastating disability. If the pain has not resolved quickly, seek medical care so that you can be evaluated and begin a course of conservative therapy.
Also, know that—when conservative treatment strategies don’t solve the problem—there are doctors who specialize in getting to the bottom of the pain. Again and again, I see patients who have waited months (or even years) before seeking interventional pain treatment. What I have learned from them is that, unfortunately, the longer a condition has persisted, the more difficult it can be to treat. Interventional pain management is not for everyone, of course, but the benefits greatly outweigh the risks in most cases. At the very least, any patient who is still experiencing pain after several months of conservative therapy—and is not improving—should be evaluated for the appropriateness of interventional therapy. The most important rule of thumb is to begin treatment with conservative therapies, and work your way up from there.
Editor’s Note: Dr. Todd Koppel is a board-certified pain specialist and
anesthesiologist, and Division Chief of Pain Management at Trinitas
Regional Medical Center. The variety of conditions he treats and the
techniques he utilizes can be found on his website, gspmweb.com. His practice, Garden State Pain Management, has offices in Clifton, Elizabeth and other New Jersey locations. Dr. Koppel can be reached at (973) 473-5752.
Issues with the Affordable Care Act include big changes in the way hospitals do business
No one wants to be a “repeat customer” when it comes to hospital care. However, many individuals who spent time in hospitals before the implementation of the Affordable Care Act (ACA)—also known as “Obamacare“—are likely to notice some interesting changes should they need to be hospitalized again.
Gary S. Horan, FACHE, President & Chief Executive Officer of Trinitas
U.S. health care expenditures prior to the ACA had crept north of $2 trillion. The projected goal of Obamacare (besides making coverage available to more people) was to lop a half-billion off that number, with a sharp focus on controlling reimbursement rates to hospitals and insurance plans—primarily in Medicare—by encouraging efficiency and productivity. Hospitals account for more than a third of total healthcare spending in the U.S., more than any other sector. The next largest is physician care (e.g. visits to the family doctor) and clinical work (e.g. blood tests), which combined make up roughly a quarter of health care costs. The changes mandated by the ACA mostly affect these sectors.
One area of significant savings projected by the ACA is the reduction of uncompensated care in hospitals. In theory, as more individuals find affordable coverage, the number of people who use hospital ER’s for non-emergency situations is declining. In practice, however, hospitals serving charity and Medicaid patients are seeing just the opposite.
“We’re already seeing a change with regard to patients moving from Charity Care to Medicaid,” Gary S. Horan, FACHE, President & CEO of Trinitas, told NJBIZ during a recent interview. “Since they now have ‘coverage’ through Medicaid, we’re experiencing a pent-up demand for health services from these patients. Unfortunately, physicians receive very low reimbursement from Medicaid—the lowest in the country—resulting in many physicians not accepting the Medicaid insurance product. This results in a double- whammy for hospitals, as more of these patients are directed to the Emergency Room, where Medicaid reimbursement for hospitals is only about 70 percent of actual costs. Make that a triple whammy—the ACA charges a tax on the hospital industry to help pay for coverage. This comes right off the bottom line and in our case results in a charge of about $250,000.”
Reimbursement was reduced for providers anticipating that they would receive a higher number of patients with insurance but, according to Horan, “As of now it is not quite working out that way.”
One byproduct of the ACA will almost certainly be a shift from the traditional hospital campus to standalone clinics and ambulatory care facilities. Will this spur a radical change in the way new hospitals are designed? Perhaps. The more immediate changes will likely take the form of additions like the $5.2 million Ambulatory Surgery Center that opened at Trinitas last year. Another result of the ACA that will be apparent to consumers is an uptick in acquisitions and mergers of hospitals and even whole hospital systems. In some cases, this may be the fastest way to create the efficiencies demanded by the new reforms and regulations.
One of the more interesting reforms introduced by the ACA is in the way medical services are delivered. For decades, health insurers reimbursed hospitals in a complex and often convoluted manner. Although this pay-per-fee system did not reduce the quality of care, in some cases it de-incentivized coordination of care. Hospitals that took care of their patients with greater efficiency often were not paid for going the extra mile.
To correct this problem, the ACA is phasing in initiatives aimed at reimbursing hospitals and doctors per “episode.” In other words, they get paid X dollars for an appendectomy or knee replacement—which rewards them for quality of care and reduction of wasteful spending. Hospitals with a high rate of readmission for certain cases (ranging from pneumonia to heart attacks) will be penalized, further incentivizing the completeness and quality of care. Interestingly, this could create more opportunities in the nursing field, as hospitals will almost certainly step up their “after-care game“ to visit discharged patients and make sure they are following recovery instructions.
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The Affordable Care Act has already begun to change the way insurance companies approach the marketplace. For instance, they can now base their premiums for a family on the number of children in that family. Prior to the ACA, they were compelled to offer a flat rate regardless of the number of kids a couple had. However, families with more than three children cannot be charged for more than three, so in this case the flat rate remains in effect. Insurers can also adjust premiums based on the age of the adults covered, but not on gender.
Dozens of services that had been excluded from health plans in the past are now covered as part of “Obamacare” in most states. These services range from autism screenings to shingles shots to prenatal supplements. That’s the good news. The bad news is that insurers will find ways to cover these added benefits in the form of higher deductibles and co-pays.
Some changes brought about by the ACA won’t impact New Jerseyans. Tobacco users can be charged 50 percent more than non-users now, but not in New Jersey, which prohibits this type of surcharge. Another change mandated by the ACA which does not affect New Jersey is the rule that says insurance companies must spend at least 80 percent of premiums on medical reimbursements or medical education. The Garden State already has a similar regulation in place.
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Another ACA initiative involves the reduction of infections. This has been an industry priority for a long time, but in 2015, hospitals that are still behind the curve in infection reduction will see their reimbursement cut by one percent.
Of course, not all of these changes are hitting all hospitals at the same time. In some cases, pilot programs have begun. In others, training for the ACA changes is underway. There are invariably some hiccups whenever new procedures are introduced into the health care field, so the ACA has devoted $10 billion to track the success of its initiatives and, presumably, tweak them as necessary. What might be a great fit for one hospital may present unanticipated hurdles for another.
The goal is to optimize the hospital experience for each patient, from the moment they come through the door to the day they leave, and for weeks after, while enabling a hospital to run its business successfully and efficiently.
DRIVEN TO CARE
The Trinitas Health Foundation successfully secured funding from multiple benefactors to purchase a new vehicle that will serve as a Specialty Care Transport Unit. The SCTU expands the current transport capabilities of Trinitas by providing a higher level of care for patients who need to be accompanied by a Registered Nurse who is also a paramedic. For example, the new vehicle will be used for critical care patients who are being transferred to the Trinitas Cardiac Catheterization Lab from neighboring hospitals or for ventilator-dependent dialysis patients during transport for treatments.
The following benefactors made the purchase possible: Bayway Refinery of Phillips 66 (recipient of the Trinitas Health Foundation’s Celebrating Philanthropy Award at the Foundation’s 2014 Gala); the Gertrude L. Hirsch Charitable Trust, and the Paragano Family Foundation.
Shown at the recent unveiling of the SCTU are Kathleen Shevlin, Director, Resource Development, Trinitas Health Foundation; Rod Muench, Director Pre-Hospital Services; Nancy Sadlon, Public Affairs Manager, Phillips 66 Bayway Refinery; Darren Cunningham, Refinery Manager; Gary Horan, FACHE, President and CEO; Nadine Brechner, Chief Development Officer & Vice President, Trinitas Health Foundation; Mary Phillips, Community Relations Coordinator, Phillips 66 Bayway Refinery; Brant Maslowski, Mobile ICU Coordinator; Bryan Garrett, SCTU Coordinator, and Joseph McTernan, Senior Director of Community & Clinical Services.
A SURE BET!
The Trinitas Health Foundation’s 11th Evening at the Races was a welcome bright spot in a winter filled with subzero days and nights. Action heated up at The Meadowlands on February 28 as more than 175 guests including Trinitas board trustees, senior administration, physicians, grateful patients, vendors, and employees enjoyed exciting harness racing and raised more than $38,000 to benefit patients of Trinitas. Dr. Richard Mackessy of Union County Orthopaedic and his wife Karen shared a moment with Gary S. Horan, President and CEO of Trinitas, and his wife Arlene.
CELEBRATING A PROUD PAST, ENVISIONING A PROMISING FUTURE
Join enthusiastic supporters of Trinitas at the Trinitas Health Foundation’s 2015 Gala on Thursday, May 14. The theme, “Proud Past, Promising Future,” captures the spirit of Trinitas’ 15th anniversary. Wakefern Food Corporation will receive the Foundation’s Celebrating Philanthropy Award; recording star Gloria Gaynor, long time advocate of Trinitas Regional Medical Center, will receive the Humanitarian Award. The Gala returns to The Venetian in Garfield where the breath-taking ambiance of the venue is rivaled only by the extraordinary food and drink. During a full cocktail hour, guests can meet and mingle as they bid on extremely desirable Silent Auction items including trips and one-of-a-kind experiences. Opportunities such as a 50/50 raffle will help raise funds to benefit patients at Trinitas.
For information about the Gala or sponsorship opportunities, contact Laura Ciraco at lciraco@trinitas.org, or (908) 994-8249, or go to www.trinitasrmc.org/foundation.htm and click on the Gala invite.