June 2024

Pediatrics

Kimberley Zvara, MD, Medical Director Pediatrics Physical Medicine & Rehabilitation

Since the recruitment of Renee Barany, APNP and Dr Mitch O’Neill, MD in fall and winter of 2023, our division is finally well staffed!  We have improved our TTNA at the Children’s Wisconsin main campus from 98 days in 2023 to 7 days currently.  This is the first time in years that we have met the institutional goal of less than 14 days. 

With Jason Mattern’s transition from director of the neurosciences service line at Children’s Wisconsin to our PM&R department administrator, Caroline Nesheim has stepped into the interim role.  Additionally, Bridget Shaffer joined as CW joint division administrator for PM&R, neurology and neuropsychology in Sept 2023.

We have continued to have inpatient and outpatient development of Pediatric Rehabilitation including:

The AIRS (Acute inpatient rehab service) service had its first anniversary in Feb 2024.  Numbers of patients admitted to the service have been increasing in 2024.  PT and OT are now available on the weekends for AIRS patients. 

We have continued to remain active in multidisciplinary clinics and recently have joined regional site equipment clinics to streamline ordering of durable medical equipment for our patient population.

Dr Mitch O’Neill attended the Boston Children's Hospital Sport Related Concussion and Spine Injury Conference 2024 virtually in May and learned a lot that applies to the population of concussion we see, which he shared with the team.

PM&R Chair Transition Update

As previously shared, Diane W. Braza, MD, Professor and Chair of PM&R, will be stepping down from her Chair role after nearly 13 years of service. Dr. Braza will be stepping away from her leadership role on June 30, 2024. Starting in July, Dr. Braza will continue her clinical practice part-time at MCW Comprehensive Pain and SpineCare, as a full professional effort faculty. John S. Rhee, MD, Chair of MCW’s Department of Otolaryngology and Communication Sciences, has graciously agreed to serve as Interim Chair of PM&R, effective July 1, 2024. The search process for a new PM&R chair will continue to move forward under the leadership of Dr. Joe Gravel. Please be sure to thank Dr. Braza for her many contributions to MCW and welcome Dr. Rhee to our department! 

A Farwell to Sue Abrahms

understanding of ACGME accreditation through her experience coordinating residents, fellows and medical student educational rotations, didactics, orientation and mentorship. Her dedication to advancing medical education program coordination at an institutional level and mentoring new PM&R coordinators nationwide has established her as an excellent collaborative team member and resource. She continually strives to be a better resource to colleagues through ongoing professional development.

"I want to take a moment to thank Sue Abrahms for all of her years in the MCW Department of Physical Medicine and Rehabilitation.  Sue came to us in 2011 as the residency program coordinator.  Over the years, she has seen this program through many new adventures:  the transition to the HUB, the COVID Pandemic and transition to virtual platforms, the opening of the Froedtert Bluemound Rehabilitation Hospital, and now the efforts to bring the department back together after years of virtual engagement. On a personal level, she has been my friend and colleague since I arrived as a PGY2. She made my transition to program director seamless, and I want to express my sincerely appreciation for everything.  Sue is now going to spend quality time with her family including her grandchildren Ellie, Jonah and ​Jack, whom she adores. We wish her nothing but the very best."

-Dr. Karin Goodfriend

Please Welcome Education Program Coordinator II Mary Inloes 

Please welcome Mary Inloes who has accepted the role of Education Program Coordinator II to the team!. Mary is currently the Education Program Coordinator for the Office of Educational Improvement here at MCW. Prior to MCW, Mary was an elementary school teacher. She received her bachelor’s degree in Communications Sciences from the University of Wisconsin – Eau Claire and her master’s degree in Education, Literacy, and Leadership from Cardinal Stritch University. During the summer months, Mary enjoys kayaking and paddleboarding with her family.

Research Day 2024

PM&R Research Day 2024 showcased the research projects of this year’s graduating PGY IV's. Discussion was lively at this year’s event, and the residents and fellows did a great job with the many questions and comments. Well done and congratulations to all the graduates! Pictured below from left to right are Dr. Diane Braza, Matt Durand, Dr. Eric Bobel, Dr. Colton Sauer, Dr. Taegun Jin, Dr. Trenton VandeWater, Dr. Abdihakim Mohamoud, Dr. Karin Goodfriend, Meghann Sytsma. 

Poster Topics Presented:

Eric Bobel

Title: The Role of Clinical Reaction Time in Concussion Evaluation of Wheelchair Sport Athletes

Mentors: Drs. Ken Lee and Beth Wineman

Trenton VandeWater

Title: Evaluating the Relationship Between Hip and Low Back Injuries in NBA Athletes

Mentor: Dr. Heather Curtiss

Daniel Jin

Title: Does Fear and/or Anxiety Stop People From Coming Back for Repeat Botulinum Toxin Injections

Mentor: Dr. Nick Ketchum

Hakim Mohammad

Title: Navigating the Emotional Landscape: Exploring the Prevalence of Pseudobulbar Affect Following Brain Injury

Mentor: Dr. Anjum Sayyad

Colton Sauer

Title: Gait Analysis Outcomes of Tibial Peripheral Neurectomy on Pediatric Equinovarus Ambulation

Mentors: Drs. Xue-Cheng Liu, Karin Goodfriend and Matt Durand

Featured Study of the Month

The featured study for this month is Wearable. The Wearable Project was started as a collaboration between Dr. John McGuire and Dr. Bob Scheidt (Marquette) through Dr. Braza’s AHW award “Optimizing Functional Outcomes of Stroke Survivors through Translational Research.” Pilot data generated from this initial project led to the successful funding of a MPI R21 “Addressing learned non-use during early recovery from stroke” and brought Dr. Whitney Morelli into the team. The purpose of this study is to determine feasibility and useability of wearable technology to harness idle time for prompted therapeutic activities during stroke recovery. Sarah Golus is the lead coordinator on this project. This was the first study to begin enrolling at Froedtert Bluemound Rehabilitation Hospital. Sarah enrolled over 40 subjects in less than one year! Data from this study has been used in 9 posters and 4 presentations in the last year, including an invited symposium. The team submitted a NSF proposal to the M3X mechanism in March to explore using machine learning to help determine ideal timing for exercise. A R01 proposal for adherence to treatment protocol will be submitted for NIH Cycle 2 this year, and a R01 proposal for efficacy is planned for Cycle 2 or 3 of 2025. Congratulations to this productive team!

Shout Out

Embracing Global On-site Observations in Rehabilitation Medicine

This month Dr. Mary Elizabeth Nelson-Biersach continues her dedication to global health and PM&R education. She had the opportunity to spend a Saturday in Toronto with two of the graduates of the International Rehabilitation Forum’s (IRF) Africa Fellowship (Training in Physical and Rehabilitation Medicine) who have traveled to Canada on medical observerships of clinical and hospital-based care practices in PM&R and meet with their hosts and collaborators.

In efforts to continue expanding relationships in global rehabilitation practices, Dr. Nelson and the IRF team partner with expert clinicians across the globe to support the education of the IRF fellows. Currently, Drs. Benedict Okoe Quao and Leslie Wheatley Ajavon have traveled from Accra Ghana to Canada to witness rehabilitation medicine in practice. Hosted by Dr. Larry Robinson in Ontario and Dr. Colleen O’Connell in New Brunswick, the graduated fellows are being exposed to patient care practices across the discipline of rehabilitation medicine while also observing team-based approaches to care and varied therapeutic interventions. Additionally, Dr. Pierre Cote, Director of Ontario Techs Institute for Disability and Rehabilitation Research was able to meet with Dr. Nelson and team to discuss global rehabilitation research and foster new relations with the IRF training program.

The opportunity to observe well-established PM&R practices is paramount to the education of Rehabilitation physicians. While the value of textbook and didactic-based learning is evident, the experiences an on-site observation brings help solidify the training and makes evident the next steps in developing rehabilitation medicine within the local context and resources. Engaging directly with well-established PM&R physicians provides real-world exposure to the health system and clinical techniques, exposes the nuances of patient and family interactions, enhances clinical skills, and fosters adaptability. From bedside manner to diagnostic techniques, these observerships bring a heightened level of confidence to move forward in establishing PM&R practice in the fellows’ local regions. Additionally, it nurtures strong collaborative relationships to facilitate knowledge exchange and a foundation for future partnerships.

To learn more about the International Rehabilitation Forum or the Africa Fellowship program please see the website at www.rehabforum.org . If you wish to contribute funding for our fellows or know someone who could host an observership for our next cohort of fellows, please contact Dr. Nelson directly.

MCW Kern Program Completion 

Please congratulate Drs. Lynn Vidakovic and Jennifer Yacub Martin on their completion of the Kern Faculty Development Program! 

Congratulations Dr. Kimberley Zvara 

Congratulations to Kimberley Zvara, MD, Brain Injury Medicine and Physical Medicine Rehabilitation, on being recognized by the Ambulatory Patient Experience Steering Committee as Champions of Purpose for March 2024. Their strong clinical care, team partnerships, caring and supportive traits make their patients feel valued and heard. Thank you for your dedication. Each month, the committee reviews all positive patient and family experience comments. Providers and teams who have multiple positive comments and meet the criteria outlined above are considered for recognition.

PM&R Faculty Featured in Milwaukee Magazine

This year's May issue of Milwaukee Magazine featured faculty doctors from our very own PM&R Department. The May issue features 900 highly regarded medical professionals. The doctors surveyed and selected were from Milwaukee, Waukesha, Ozaukee, Washington and Racine counties. The featured professionals were selected through the verification of licensing, review of any infractions through various applicable boards, agencies, and rating services. Recognized faculty from the PM&R Department include; Dr. Diane Braza, Dr. David Del Toro, Dr. Nicholas Ketchum and Dr. Kim Zvara!

Dr. Ball Shares her Experience Attending Leadership Academy Capstone Presentation Day

 "I had the pleasure of participating in the 2023-2024 MCW Leadership Academy, a collaboration with the UWM School of Business. Through the course, I learned valuable schools related to communication and crucial conversations, institutional financial and budget management, and change management, amongst a variety of other topics.  The program concluded with a capstone project and presentation in which I was able to collaborate with others at the institution with similar passion for medical student and resident education and program leadership. This was overall a valuable experience that provided me with extensive networking opportunities, personal and professional growth, and a strong foundation in leadership skills."

-Charlotte Ball, MD

The N. Muni Reddy, MD Endowed Student Award in Physical Medicine and Rehabilitation Recipient is Allyson Gorman

The N. Muni Reddy, MD Endowed Student Award is given every year to a student that demonstrates the characteristics and virtues essential to the field of Physical Medicine and Rehabilitation, including intense dedication, academic prowess, and a passion for helping patients see only potential and not obstacles. Please be sure to congratulate Allyson Gorman on being awarded the N. Muni Reddy, MD Endowed Student Award!

Dr. Paras Patel and his family welcomed a baby boy, Kiran Paras Patel, on 4/11/24.  Please congratulate him if you haven't already! 

PM&R Philanthropy Case 

Please contact Meg Bilicki, Senior Director of Development  mbilicki@mcw.edu or Dr. Braza dbraza@mcw.edu for more information.

To support Physical Medicine and Rehabilitation click on this link!

Department Mascot's Outfit for the Month of June

For the month our department mascot 'Randy the Rhino' shares a photo of himself from June 2023 attending a parade downtown Milwaukee in honor of pride month. 

The answer to the riddle below will be provided in next month's newsletter. This riddle is courtesy of Alan Young, Clinical Research Coordinator:

"One night, 4 men sat down to play. They played all night 'til break of day. They played for gold and not for fun, with separate scores for everyone. When it came time to square accounts, all men had made quite fair amounts. Can you explain - if no man last, how could all gain?"

Answer to last month's riddle: The anwser is 'Mt. Everest'

Monthly Wellness Feature: A Complex Recipe for Well-being

"The recipe for well-being that has been most successful for me involves a complex group of ingredients. First comes support and connection from family and loved ones — this means not only receiving support and love, but giving it as well. It makes sense that relationships need to be continually nurtured to stay healthy, which means spending time together and providing care for your partner and loved ones. Caring, giving to and loving someone all take energy and work, but the acts of loving, caring and giving are mutually beneficial and help support our own well-being too.

Staying physically and mentally active are also crucial ingredients. My parents taught me that you can enjoy the outdoors any day of the year in Wisconsin if you wear the appropriate gear, and I have learned this is true 99% of the time. I try to make the most of my weekends and vacations by spending time in the woods, our gardens and on the lakes and rivers of Wisconsin in every season. Seeing the beauty of rare birds like the snowy owl or the whooping crane is exciting to behold. I find that nature nourishes my well-being — there is nothing better than seeing the sun rise on a lake, or sitting by the campfire under the stars.

Kayaking, hiking, fishing, gardening, birdwatching, hunting, ice fishing and cross-country skiing all are activities that bring me great joy. I also enjoy the labor of cutting wood and building things with my hands. I have started to harvest wood and carve and sand it into wooden bowls — I appreciate the natural beauty of wood, especially the magnificent burls. Creating something from hand that I can give to a friend or family member brings me joy and satisfaction.

At MCW and the VA, both giving and receiving mentorship support my well-being. Working together as an integral part of a well-performing team gives me joy, and feeling respected and valued along with a having a sense of accomplishment all go a long way towards optimal well-being. “Respect” is one of MCW’s six core values, and treating everyone in a respectful manner is crucial to providing a workplace that supports employee engagement and well-being. I keep this in mind as I work to build and maintain a culture in my department that is inclusive and respectful of all — one that supports each departmental family member’s personal growth.

As you see, there are many ingredients involved in my recipe for well-being. I find that when any of these important ingredients is missing — even for a short period of time — my well-being is noticeably affected and begins to suffer. For me, the trick is finding the right balance. I can put one ingredient aside for a few days to focus on a different aspect of my work or life, but not for too long."

-Author: Jon A. Lehrmann MD, chair and Charles E. Kubly professor, Department of Psychiatry and Behavioral Medicine

Healthy Recipe of the Month - Spicy Cucumber Salad

INGREDIENTS:

• Soy Sauce - 2 tbsp
• Rice Vinegar - 1 tbsp
• Sesame Oil - 1 tsp
• Garlic- 1 clove
• Crushed Red Pepper Flakes - 2 tsp
• Mini Cucumbers- about 8
• Sesame Seeds - 1 tbsp

DIRECTIONS:

• Rinse mini cucumbers, cut off ends, and cut into small slices, then place in large bowl.
• Whisk together soy sauce, rice vinegar, sesame oil, diced garlic, crushed red pepper flakes together to make dressing.
• Pour dressing over the chopped cucumber slices and sprinkle sesame seeds on top.
• Enjoy! : )  

*If you would like to share a favorite healthy recipe in next month's newsletter please email Rhiannon Shewczyk at Rshewczyk@mcw.edu

June is Pride Month 

Around the world, June is recognized as LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, and Queer) Pride Month to commemorate a tipping point in queer history — the Stonewall Uprising, which lasted 6 days in Manhattan in June 1969 as police clashed with LGBTQ protesters.

In June pride celebrations attract millions of participants each year as queer communities and allies honor the queer identity through parades, workshops, parties, picnics, lectures, concerts, and more.

Month-long Observations:

• Alzheimer’s and Brain Awareness Month
• Black Music Month
• National Caribbean American Heritage Month
• Pride Month (LGBTQ+)

Important May DE&I calendar dates:

• June 5 – World Environment Day
• June 9 – Race Unity Day
• June 12 – Loving Day
• June 16 – Eid al-Adha (Muslim)
• June 16 – Father’s Day
• June 19 – Juneteenth
• June 20 – World Refugee Day
• June 20 – Litha, Summer Solstice (Pagan)
• June 21 – National Indigenous Peoples Day (Canada)
• June 23 – Public Service Day
• June 24 – St-Jean-Baptiste Day (Quebec)
• June 27 – Helen Keller Day (USA)
• June 28 – Pride Day (LGBTQ+) (varies by city and country)

PM&R Book Club 

If you have any questions please email Dr. Charlotte Ball at chball@mcw.edu. 

COVID-19 Guidelines 

Both Froedtert and MCW employees with an approved COVID-19 vaccination exemption are no longer required to wear masks at Froedtert & MCW facilities except when and where masks are required for all. To remain consistent within all adult clinical spaces, MCW clinics will follow this same guidance. Masks have not been required for unvaccinated individuals in MCW non-clinical spaces since October 2022.

The COVID-19 vaccine requirement was discontinued for employees effective on June 13, due to recent guidance from the CDC and Centers for Medicare and Medicaid Services (CMS). COVID-19 vaccinations and boosters will continue to be strongly recommended, but not required as a condition of employment with MCW.  Vaccination will continue to be required for students and learners who participate in clinical care due to many healthcare partners who have not yet lifted their COVID-19 vaccine requirement. This requirement is being actively re-evaluated as a high priority, and we will provide follow-up information as soon as feasible. Individuals who work in partner healthcare facilities that require vaccination must also continue to follow the guidance and requirements of those facilities. 

For additional information visit the COVID-19 page on infoscope. 

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