November 2023

Brain Injury Medicine 

Anjum Sayyad, MD, MBA, FAAPMR and Mary Voegeli, FNP-BC, MSN, CRRN, CBIS

There have been several important events over the past year for Brain Injury Medicine in the Department of PM&R. 

• In Froedtert Acute Care: Volumes for Brain Injury have increased, onset days have reduced
• In IPR: Volume of admissions have increased,  functional efficiency has improved, 30 days readmits have reduced
• Engaging with Community Hospital Division for improving care of TBI patients
• Deb Soley has been hired as Neurotrauma RN case manager to help with patients (SCI and TBI) and family transition to post-acute phase of care
• Oversight committee has been established as part of the WINS initiative to optimize practice of TBI and SCI across the continuum of care
• Quality improvement project targeting ileus is showing improvement with notable reduction
• Dr. Anjum Sayyad presented at the 2^nd Annual F&MCW Neurotrauma Symposium on "Gut-Brain Axis"

A Farewell to Dr. Nicholas Ketchum 

Dear colleagues,

It is with truly mixed emotions that I share with you that Dr. Ketchum has submitted his resignation from MCW PM&R effective 2/29/24 to pursue another practice opportunity.

Dr. Ketchum completed his PM&R residency training at MCW in 2010 and served in his PG4 year as a chief resident. He completed the Spasticity Management and Neurorehabilitation fellowship in 2011, and then joined our faculty.  He served as Program Director of the PM&R residency from 2015 -2021, and then Associate PD for two additional years.  He was promoted to Associate Professor rank in 2017 and has been an outstanding clinician/ educator/ and clinical researcher with a regional, national, and international reputation.  In 2015, he was the recipient of the Edward J. Lennon Endowed Clinical Teaching Award, Medical College of Wisconsin. In 2023, he was the Founding Vice President, Spasticity Teaching, Advocacy, and Research Society.

We will miss Dr. Ketchum’s many professional talents, contributions, and his collegiality as he moves to the next stage of his professional career.  We will work with Dr. McGuire and team to develop a plan for patient coverage and consider faculty recruitment needs in the weeks ahead.

Good luck Dr. Ketchum!

Sincerely,

Diane W. Braza, MD
Professor and Chair, Physical Medicine and Rehabilitation

Dr. Nelson Continues to Expand her Global Health Involvement

Dr. Mary Elizabeth Nelson-Biersach continues to expand her involvement in global health initiatives. This month she was nominated to the International Society of Physical and Rehabilitation Medicine’s WHO-Liaison committee (ISPRM-WHO-LC). This committee works to help strengthen rehabilitation in health systems worldwide. One of the many tasks of the committee will be to promote the world health assembly resolution on rehabilitation as well as the WHO package for interventions in health systems.  This new committee role is in alignment with her current role as the Vice President of the International Rehabilitation Forum (IRF) as well as her position as a representative to the WHO- World Rehabilitation Alliance Research Workstream.

Residents Accepted into the PM&R Residency Research Intensive Track

Dr. Hans Anderson and Dr. Colton Sauer have been accepted into the PM&R Residency Research Intensive Track. The research intensive track is designed to provide an immersive, highly-mentored experience in clinical translational research to support residents interested in pursuing substantial, independent clinical research after residency. This track provides an opportunity for protected research time, funding, advanced research mentorship, and independent continuation of their research upon graduation.

Dr. Anderson’s project “Advancing optogenetic peripheral nerve interfaces through viral vector driven coexpression of spectrally-separated optogenetic actuators” will be mentored by Dr. Jordan Williams in the joint Biomedical Engineering department of Marquette University and MCW. This study will explore the use of adenoassociated viral vectors to enhance recovery of sensory nerves and regeneration and maintenance of neuromuscular connections in an animal model of spinal cord injury.

Dr. Sauer’s project “Impact of Tibial Peripheral Neurectomy on Pediatric Ambulation” will be mentored by Dr. Goodfriend. This study will use three-dimensional motion analysis at Children’s Hospital of Wisconsin’s Center for Motion Analysis to measure quantitative changes in gait after tibial peripheral neurectomy.

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!

Congratulations to Dr. Daniel Jin and Family on their Second Child!

Dr. Daniel Jin and his family welcomed a baby girl on 8/21/23 at Froedtert! Her name is Rosa Jin! Please congratulate him if you haven't already! 

PM&R Community Giving Campaign Results and Raffle Winners! 

The Community Giving Campaign ended Friday, October 13^th! We wanted to reach out and thank you all for your pledges and support. Your generous participation in this campaign has contributed to our department raising a total of $3,610 that included online donations and raffle tickets purchases.

  RAFFLE WINNERS!!!!

CONGRATS TO:

Dr. Kim Zvara (Milwaukee Zoo Gift Card)

Dr. Stacy Stibb (Wine Country Gift Basket)

Alan Young (Pictured above with Milwaukee County Park’s Gift Card, and Ultimate Snack Box)

PM&R Halloween Photos

Here is the pic from the research team. After the ACRM conference today we went to Top Golf as characters from Barbie: Dr McGuire (Golf Ken), Dr Scheidt (a Marquette collaborator - Science Teacher Allen), Meghann (Business Barbie), Kim (a Marquette collaborator - Astrophysicist Barbie), Sarah (Stereotypical Barbie).

This Halloween, VA SCI leadership dressed up representing the 7 Bristol Stool From Scale, as scale to describe the stool of neurogenic bowel. Dr. Lee is the Poopcredible. Which poop was yours today?

Department Mascot's Outfit for the Month of November

For the month of November department mascot 'Randy the Rhino' shares a photo of his recent visit to a local pumpkin farm.

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

"You have 8 pills and one is poison. They are all the same color, shape, and size. You can only use a balance scale two times. How do you find out which pill is poison"

Answer to last month's riddle:  "carrot"- (the only word that isn't a word without it's first and last letter)

Monthly Wellness Feature: Improving your Eating Habits 

When it comes to eating, many of us have developed habits. Some are good (“I always eat fruit as a dessert”), and some are not so good (“I always have a sugary drink after work as a reward”).  Even if you’ve had the same eating pattern for years, it’s not too late to make improvements.

Making sudden, radical changes, such as eating nothing but cabbage soup, can lead to short term weight loss. However, such radical changes are neither healthy nor a good idea and won’t be successful in the long run. Permanently improving your eating habits requires a thoughtful approach in which you reflect, replace, and reinforce.

• REFLECT on all of your specific eating habits, both bad and good; and, your common triggers for unhealthy eating.
• REPLACE your unhealthy eating habits with healthier ones.
• REINFORCE your new, healthier eating habits.

Reflect:

• Create a list of your eating and drinking habits. Keep a food and beverage diary for a few days. Write down everything you eat and drink, including sugary drinks and alcohol. Write down the time of day you ate or drank the item. This will help you uncover your habits. For example, you might discover that you always seek a sweet snack to get you through the mid-afternoon energy slump. Use this diary [PDF-105KB] to help. It’s good to note how you were feeling when you decided to eat, especially if you were eating when not hungry. Were you tired? Stressed out?
• Highlight the habits on your list that may be leading you to overeat. Common eating habits that can lead to weight gain are:
  • Eating too fast
  • Always cleaning your plate
  • Eating when not hungry
  • Eating while standing up (may lead to eating mindlessly or too quickly)
  • Always eating dessert
  • Skipping meals (or maybe just breakfast)
• Look at the unhealthy eating habits you’ve highlighted. Be sure you’ve identified all the triggers that cause you to engage in those habits. Identify a few you’d like to work on improving first. Don’t forget to pat yourself on the back for the things you’re doing right. Maybe you usually eat fruit for dessert, or you drink low-fat or fat-free milk. These are good habits! Recognizing your successes will help encourage you to make more changes.
• Create a list of “cues” by reviewing your food diary to become more aware of when and where you’re “triggered” to eat for reasons other than hunger. Note how you are typically feeling at those times. Often an environmental “cue”, or a particular emotional state, is what encourages eating for non-hunger reasons. Common triggers for eating when not hungry are:
  • Opening up the cabinet and seeing your favorite snack food.
  • Sitting at home watching television.
  • Before or after a stressful meeting or situation at work.
  • Coming home after work and having no idea what’s for dinner.
  • Having someone offer you a dish they made “just for you!”
  • Walking past a candy dish on the counter.
  • Sitting in the break room beside the vending machine.
  • Seeing a plate of doughnuts at the morning staff meeting.
  • Swinging through your favorite drive-through every morning.
  • Feeling bored or tired and thinking food might offer a pick-me-up.
• Circle the “cues” on your list that you face on a daily or weekly basis. While the Thanksgiving holiday may be a trigger to overeat, for now focus on cues you face more often. Eventually you want a plan for as many eating cues as you can.
• Ask yourself these questions for each “cue” you’ve circled:
  • Is there anything I can do to avoid the cue or situation? This option works best for cues that don’t involve others. For example, could you choose a different route to work to avoid stopping at a fast food restaurant on the way? Is there another place in the break room where you can sit so you’re not next to the vending machine?
  • For things I can’t avoid, can I do something differently that would be healthier? Obviously, you can’t avoid all situations that trigger your unhealthy eating habits, like staff meetings at work. In these situations, evaluate your options. Could you suggest or bring healthier snacks or beverages? Could you offer to take notes to distract your attention? Could you sit farther away from the food so it won’t be as easy to grab something? Could you plan ahead and eat a healthy snack before the meeting?

Reinforce:

• Replace unhealthy habits with new, healthy ones. For example, in reflecting upon your eating habits, you may realize that you eat too fast when you eat alone. So, make a commitment to share a lunch each week with a colleague, or have a neighbor over for dinner one night a week. Another strategy is to put your fork down between bites. Also, minimize distractions, such as watching the news while you eat. Such distractions keep you from paying attention to how quickly and how much you’re eating.
• Eat more slowly. If you eat too quickly, you may “clean your plate” instead of paying attention to whether your hunger is satisfied.
• Eat only when you’re truly hungry instead of when you are tired, anxious, or feeling an emotion besides hunger. If you find yourself eating when you are experiencing an emotion besides hunger, such as boredom or anxiety, try to find a non-eating activity to do instead. You may find a quick walk or phone call with a friend helps you feel better.
• Plan meals ahead of time to ensure that you eat a healthy well-balanced meal.

Reinforce:

• Reinforce your new, healthy habits and be patient with yourself. Habits take time to develop. It doesn’t happen overnight. When you do find yourself engaging in an unhealthy habit, stop as quickly as possible and ask yourself: Why do I do this? When did I start doing this? What changes do I need to make? Be careful not to berate yourself or think that one mistake “blows” a whole day’s worth of healthy habits. You can do it! It just takes one day at a time!

Flu Season is Approaching

The Medical College of Wisconsin, in partnership with Froedtert Health, Children’s Wisconsin, the Clement J. Zablocki VA Medical Center and the Medical College of Wisconsin Allied Hospitals (MCWAH), will facilitate a mandatory influenza (flu) vaccination program for the 2023-2024 influenza season. Flu vaccination is important for the safety of our patients, colleagues, learners and community. Details on obtaining a flu vaccine at Internal Occupational Health (IOH) Flu Clinics will be provided late in August. If vaccinated anywhere other than an IOH Flu Clinic, employees must send documentation to IOHflu@Froedtert.com.

*All MCW faculty, staff, students, postdoctoral fellows, volunteers, MCWAH residents and fellows are required to either receive the flu vaccine or apply for and be granted an exemption. MCW Clinic Dates and Locations to be announced soon! Search “Flu” on InfoScope.

Important Dates Regarding the Flu Vaccine

• Sept 18–Nov 10 | Free MCW vaccination clinics

• Nov 10 | Compliance Deadline for employees

• Late Nov | Noncompliance reporting distributed to Department Leaders

• Dec 4 | Employment actions effective for noncompliant individuals

November is Diabetes Awareness Month

November is National Diabetes Month, a time when communities across the country seek to bring attention to diabetes. This year’s focus is on taking action to prevent diabetes health problems.

Diabetes is a disease that occurs when your blood glucose, also called blood sugar, is too high. It affects about 37 million Americans, including adults and youth. Diabetes can damage the eyes, kidneys, nerves, and heart, and it is linked to some types of cancer.

But there’s also good news: Taking charge of your health may help you prevent diabetes health problems.

Other November Celebrations:

• November 1-2 – Dia de Muertos
• November 1 – All Saints’ Day (Roman Catholic)
• November 1 – National Stress Awareness Day
• November 2 – All Souls’ Day
• November 9 – Diwali (Hindu)
• November 9 – World Freedom Day
• November 9 – World Adoption Day
• November 11 – Remembrance/Veterans Day
• November 13 – World Kindness Day
• November 16 – International Day for Tolerance
• November 19 – International Men’s Day
• November 20 – Transgender Day of Remembrance
• November 20 – Universal Children’s Day (Human Rights, U.N.)
• November 23 – Thanksgiving
• November 25 – Day of the Covenant (Baha’i)
• November 27 – Ascension of Abdu’l-Baha (Baha’i)

COVID-19 Updates

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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