July 2024

A Note from Dr. Braza

PM&R colleagues,
I want to share my gratitude to you. It has been my privilege to serve you, lead and represent PM&R locally at MCW, FH, VA and CW, regionally and nationally over the last 13 years. Through your hard work and dedication, MCW PM&R has grown in clinical care, education, research, and community/ global engagement. I have learned much from all of you. Our MCW PM&R department is very strong, has earned a notable national reputation, and is well positioned for future growth.
Tomorrow, Dr. John Rhee, Professor and Chair of Otolaryngology, assumes the additional role of Interim Chair, MCW PM&R. We’ve been working together as institutional leaders for the last 13 years, and more recently, collaborated in his PM&R departmental onboarding. I have great respect for Dr. Rhee and look forward to working with him as a faculty member until the new Chair of PM&R is appointed.
Wishing you all the best,
Diane W. Braza, MD
Professor with Tenure, Physical Medicine and Rehabilitation
Medical College of Wiscosnin

Please Welcome our New PM&R Department Hires!

Dr. John Rhee- Interim Chair of the PM&R Department

Dr. John Rhee, MD, MPH, MBA started role as interim chair on July 1st to lead the PM&R Department during this period of continued growth and change.

Dr. Rhee is the John C. Koss Professor and Chairman of the Department of Otolaryngology and Communication Sciences (position held since 2011) and the Chief of the Division of Facial Plastic and Reconstructive Surgery and Professor of Dermatology at the Medical College of Wisconsin (MCW). He is the past Chair of the Board and Interim CEO of the Medical College Physicians multispecialty practice and Interim Senior Associate Dean of Clinical Affairs. He has also served as Interim Chair of the MCW Departments of Dermatology and Ophthalmology.

He attended Dartmouth College for his undergraduate education and SUNY at Stony Brook for medical school. Following completion of his otolaryngology–head and neck surgery residency at the Mount Sinai Medical Center in New York City in 1998, he did an additional fellowship year in facial plastic surgery at The University of Miami/Jackson Memorial Hospital. After joining the faculty at MCW in 1999, he obtained an MPH degree at MCW while building his research career on clinical outcome studies. He has held multiple funded grants as the Principal Investigator from the National Institutes of Health (NIH) in various aspects of clinical care including skin cancer (R03, National Cancer Institute), surgical nasal airway correction (R01’s and R43, National Institute of Biomedical Imaging and Bioengineering). He has served on NIH study sections and is a co-investigator and mentor on numerous NIH sponsored grants.

Dr. Rhee has been listed in the Best Doctors of America every year since 2003 and has been awarded a Top Doctor award from Froedtert Memorial Lutheran Hospital, the main hospital affiliate for MCW. Amongst his other notable awards include the George Adams Young Faculty Award from the Triological Society, The Distinguished Service Award from the American Academy of Otolaryngology – Head Neck Surgery, and Excellence in Professionalism from the Medical College Physicians, and the MCW Distinguished Career Service Award – the highest award for given to any MCW faculty. He has been invited internationally to speak on topics ranging from outcomes studies, nasal airway surgery, and biomedical research.

Dr. Rhee served as a Board member and Coordinator for Research & Quality for the American Academy of Otolaryngology – Head and Neck Surgery Foundation (AAO-HNSF). He is past Editor-in-Chief of JAMA Facial Plastic Surgery, the premier peer-reviewed medical journal for the subspecialty. He has held multiple leadership positions within the boards and committees of Facial Plastic and Reconstructive Surgery and Otolaryngology – Head Neck Surgery. He has authored or co-authored over 100 scientific publications and has served in the past as a residency program director for MCW. He served as a Director and President for the American Board of Otolaryngology – Head and Neck Surgery. He also served as the member and Chair of the Otolaryngology Residency Review Committee of the ACGME. He completed the AAMC Council of Deans Fellowship program in 2016. He recently obtained his MBA with combination credits from the Kellogg (Northwestern) and Isenberg (U Mass, Amherst) Schools of Management.

Please be sure to welcome Dr. John Rhee!

Dr. Lauren Shuda - Assistant Professor (Spasticity/ SCI)

On July 1st, Lauren Shuda, MD started her role in our department as a faculty member and assistant professor in Spasticity and Spinal Cord Injury. Lauren Shuda is a recent Spinal Cord Injury fellow graduate from MCW. She completed medical school at the University of Wisconsin School of Medicine and Public Health. Prior to that, she graduated from Drake University, majoring in Biochemistry, Cell & Molecular Biology, Chemistry, and Biology. Please be sure to welcome her to our department!

Angela Taylor, DO - Spasticity Fellow

On July 1st Dr. Angela Taylor started her role in our department as a fellow in Comprehensive Neurorehabilitation and Spasticity Management. Angela is originally from Grand Rapids, Michigan, and is thrilled to return to the Midwest. She recently graduated from Physical Medicine & Rehabilitation Residency at Temple University Hospital/MossRehab in Philadelphia and formerly completed a Transitional Year Residency at St. Joseph Mercy Health Ann Arbor. She earned a Doctor of Osteopathic Medicine degree at Alabama College of Osteopathic Medicine and a Bachelor’s degree in Neuroscience at the University of Michigan. During her medical and undergraduate career, she investigated the pathophysiology of cerebral palsy and hereditary spastic paraplegia, respectively. Her clinical interests include neurorehabilitation and the management of dystonia, spasticity, spasticity-associated muscle stiffness in the adult population. For fun, she enjoys spending time with family, and being outdoors: traveling, running, biking, and snowboarding. Please be sure to welcome her to our department!

Zhiling Kelly, PA-C - Inpatient Rehab APP

On July 8^thZhiling Kelly, PA-C will be starting her new role in our department working in Inpatient Rehab at our Froedtert Bluemound Rehab Hospital. Zhiling is a recent graduate of the Milwaukee VA Physician Assistant Primary Care Residency Program. Prior to that, she graduated with a Master of Physician Assistant Studies from Carroll University in Waukesha, WI in May 2023. She completed her undergraduate degree in Nutrition and Dietetics at Marywood University in Scranton, Pennsylvania. Before going back to school, she was a Clinical Dietitian working in hospitals and long-term care facilities for over 7 years. Zhiling is married and has a 7-year-old son. In her spare time, she enjoys spending time with her family, traveling and yoga. Please be sure to welcome her to our department!

A Farwell and Congratulations from our Department to Ryan Mockus

It is with mixed emotions that we announce the departure of Ryan Mockus, Administrative Assistant Senior from our department here at MCW. His last day with PM&R was on 6/19/24 and we celebrated his promotion with snacks and goodbyes. Ryan joined our PM&R Department in May 2022. Prior to that, he was a PASR and scheduling coordinator with the Froedtert Rehab Medicine/Neurosciences Clinic. He has a Master of Healthcare Administration he earned from Des Moines University and his undergraduate degree from Drake University both in Des Moines, Iowa. Ryan has lived in the Midwest region his entire life including Illinois, Iowa, and now Wisconsin with his lovely wife Kaitlin Mockus. Ryan will be greatly missed in our department but we are proud of him for advancing to his new role as Supervisor of the Froedtert Rehabilitation Medicine Clinic!

Dr. Stibb's Future Plans

Dear PM&R colleagues,
It is with mixed emotions that I share that Dr. Stacy Stibb has notified me of decision to leave MCW on Sept. 7, 2024, to pursue other practice opportunities.
Dr. Stibb joined the MCW PM&R faculty in Feb. 2017 as a board-certified pediatric physiatrist. Over the last seven years, Dr. Stibb led the planning, implementation and opening of the Acute Inpatient Rehabilitation Service at CW and served as the Medical Director of inpatient PM&R at CW since Oct. 2022. Dr. Stibb has provided numerous educational lectures for medical students, residents, and other audiences locally and nationally, and traveled to the Ukraine in 2019 with other PM&R faculty and therapists.
In 2022, she was the recipient of the “Outstanding Performance Child and Family Experience: Children’s Wisconsin” award. Dr. Stibb has served as an active volunteer for the American Board of PM&R, including service as an oral board examiner, longitudinal assessment question writer for Pediatric rehabilitation and Brain injury. She has been the PI on an investigator initiated clinical trial for SPIO Core-Max Expedition TLSO.
I am grateful for her service and leadership. We wish her the very best in her future practice; Jason and I will work with our Pediatric PM&R faculty leaders, CSG leaders and clinic leaders during the transition to accommodate her patient care needs, and inpatient service coverage.
Please extend your gratitude and appreciation to Dr. Stibb when you see her!
Sincerely
Diane W. Braza, MD
Professor and Chair, Physical Medicine and Rehabilitation

Dr. Vidakovic's Future Plans

"Dear PM&R colleagues,
With mixed emotions, I am sharing that Dr. Lynn Vidakovic has notified me of decision to leave MCW on Sept. 17, 2024, to pursue other practice opportunities. Dr. Vidakovic joined MCW in June 2022, after practicing PM&R at Shirley Ryan Ability Lab (formerly RIC) for over 15 years. Over the last 2 years, she has provided FH inpatient PM&R consults and practiced general PM&R in our SCB PM&R clinic. This year, she participated in the MCW Kern institute program for MCW faculty educational leadership development. We thank her for her clinical and teaching efforts over the last two years and wish her the best in her next position.
Jason, Dr. Rhee, and FH based PM&R physicians and APPs will be meeting soon to discuss staffing and optimizing the PM&R inpatient consult service during this time of transition. Thank you for your patience as the team navigates through this transition."
Sincerely,
Diane W. Braza, MD
Professor and Chair, Physical Medicine and Rehabilitation

Dr. Michael Acosta Selected as a Winner of the MCWAH Quality Improvement Award for 2024!

Congratulations Dr. Michael Acosta, our recent PM&R Residency Graduate, for being selected as one of the winners of the MCWAH Quality Improvement Award for 2024!

Housestaff were nominated by their respective program director and selected by the MCWAH Research and Quality Improvement Award Committee comprised of MCWAH Program Directors. As winner and recipient of this award, Dr. Acosta will be receiving a certificate and a monetary award! Please be sure to congratulate Dr. Acosta when you see him for this amazing achievement!

Updates in Research

Presentations

Dr. Mary Elizabeth Nelson-Biersach attended the International Society of Physical and Rehabilitative Medicine in Sydney Australia in June. While there, she presented a podium presentation, "Evaluating Resident Confidence and Competence Troubleshooting Intrathecal Baclofen Pump Emergencies Across Resident Levels". She also presented three posters titled: "Evaluating Resident Confidence and Competence Troubleshooting Intrathecal Baclofen Pump Emergencies Across Resident Levels", "Participant Perspectives on LMIC PRM Training Programs" and "Strengthening Workforce Through Fellowship Training in Rehabilitation" At the meeting, she was asked to be an inaugural member of the newest special interest group on spasticity, which will be producing educational, practice, workforce projects, papers and research projects going forward. Congratulations Dr. Nelson-Biersach on a productive conference!

Featured Study of the Month

The EPITOME project is funded by Ipsen, and Dr. John McGuire is the MCW PI. The purpose of this observational study is to determine the incidence rate of spasticity post-stroke and develop a best-practice model for monitoring the development of spasticity. Ipsen is trialing a survey that can be given to stroke survivors over the phone that may identify people who need to be seen in clinic for spasticity management. Alan Young is the lead coordinator on this project, and he has enrolled 10 participants into the study since it activated in March. Of the 31 international sites, PM&R is ranked as the 5^th leading site for enrollment. Well done Dr. McGuire and Alan!

Shout Outs

Congratulations to Alan Young, who was promoted to Clinical Research Coordinator III on July 1, 2024. Over the last year Alan stepped into a lead role for the department, supervising industry-sponsored clinical trials. He has championed rolling out MCW-directed research systems across the department, which has brought necessary alignment of day-to-day research practices across studies and investigators. Thank you, Alan, for all your hard work on behalf of the research program and on this much-deserved promotion!

Research Team Fun

The research team engaged in several fun team building activities over the last month. National Doughnut Day was celebrated with Wauwatosa-original Cranky Al’s on Friday, June 1. Delicious donuts were enjoyed by all. The team attended a Milwaukee Milkmen game on Wednesday, June 5. The Milkmen played a close one against the Chicago Dogs, and won 5-4 in a 10 inning game! The team particularly enjoyed the jumbo-tron shout out. Last, the team went on a sailing adventure with Captain John McGuire at the helm - OnaBOATulinum Party: Spasticity Social at SEA, with Captain McGuire. Youngest research team member, Conor Ketchum, was a happy addition. Reach out to Sarah Golus (sglous@mcw.edu) if you would like to be included on the invitations for future research events!

The ASIA Conference in San Jaun, Puerto Rico

The ASIA (American Spinal Injury Association) Conference this year took place in San Juan, Puerto Rico. Drs. Shuda, Michiko Paschall, Sauer, and Shields presented posters along with our recent Med Student, now Resident, Dr. Allyson Gorman. Dr. Will Bataller gave a podium presentation. Special thanks to Dr. White for sending in these photos!

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 of July, our department mascot 'Randy the Rhino' shares a photo of himself marching in last year's Fourth of July parade.

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

"My power has such immensity, that with just a few percents of me, I turn bridges to disrepair and blood to water and air. What am I?"

Answer to last month's riddle: The 4 men were playing in a band.

Monthly Wellness Feature: National Nutrition Month - All About Your Microbiome

During National Nutrition Month, and every month, good nutrition is Fuel for the Future. National Nutrition Month was originally observed in 1973 as National Nutrition Week, and it become a month-long observance in 1980. Because the bacterium in your gut impacts your overall health, let’s discover a little more about those “bugs” so you can feel good from the inside out.

What Is It?

Did you know your body is home to trillions of tiny organisms called microbes? No worries -- those “bugs” are supposed to be there! Together, they make up your microbiome. It is all over your body but mainly in your gut. Your microbiome is connected to your health in ways you might not expect. Researchers are studying how it might improve health from head to toe.

Your Skin

That does not mean you are dirty. Your microbiome helps keep your skin healthy. An imbalanced microbiome can lead to skin problems. For instance, too many pimple-causing bacteria can lead to acne. The allergic skin condition eczema is linked to another type of bacteria.

Your Weight

Your microbiome may change as you gain and lose weight. Some studies have found that overweight people tend to have more of the types of microbes that harvest energy from food and help the body store fat. This can set the stage for weight gain and it may be related to eating too much fat, sugar, and carbs with little fiber. But other researchers say it is too early to know the exact links between the microbiome and the scale.

Brain Health

Your gut and your brain talk back and forth to each other, connecting through millions of nerve cells. Scientists have linked certain changes in the gut microbiome to stress, depression, and anxiety. It may also be tied to Alzheimer’s disease. One study found people with Alzheimer’s have less diverse microbiomes. This may lead to inflammation and a rise in proteins related to Alzheimer’s disease. But that is not yet certain.

Your Mouth

There are more than 700 types of bacteria in your mouth. A few types of bacteria turn the sugar from food into acid. If you do not brush them away, the acid can eat into your teeth’s enamel. This causes cavities. Experts also think that certain microbes may trigger inflammation in the mouth, leading to gingivitis and gum disease. People who tend to get cavities have a different microbiome than those who don’t.

Autoimmune Diseases

With these conditions, your immune system attacks certain parts of your body. Examples include fibromyalgia, lupus, multiple sclerosis, rheumatoid arthritis, and type 1 diabetes. They tend to run in families, and some researchers think that they may be passed down through the microbiome.

Allergies and Asthma

The microbes in your gut and lungs may lead to allergies and asthma. These conditions cause your immune system to attack harmless substances, such as dust. In fact, the microbiome may be one reason allergies and asthma are on the rise. Over the past 30 years, rates have tripled. Some experts think that microbiome changes from antibiotic use and a shift in diet may be part of the reason for that.

Inflammatory Bowel Diseases

These are a group of conditions that cause your intestines to become inflamed. They include Crohn’s disease and ulcerative colitis. The way your gut microbes affect the cells that line your intestines may play a role in these diseases. Certain types of bacteria may irritate the intestines. Some people with Crohn’s disease have a gene glitch that lets gut bacteria enter the intestines’ walls. This can trigger inflammation.

When You are Born

Like a fingerprint, your microbiome is unique. Some of it may come from your mom, depending on how you were born. During vaginal delivery, babies get coated in their mother’s microbiome as they go through the birth canal. But that doesn’t happen in a C-section. Research shows that babies delivered by C-section are more likely to grow up to have allergies, but it is not clear why.

A New Area of Medicine

Scientists are looking for ways to improve the microbiome to help people avoid certain diseases or respond to treatments better. But some medicines can harm it. One round of antibiotics can change your microbiome for up to a year. (Antibiotics don’t just kill the bacteria that make you sick. They also kill your helpful gut bacteria.) And a study of more than 1,000 drugs showed that one in four affected bacteria growth. These included blood pressure, cancer, and diabetes medications.

It May Help Fight Cancer

Researchers are working to harness the power of the microbiome in cancer treatments. With immunotherapy, your body’s immune system destroys cancer cells. Research shows that the microbiome helps these drugs work better by sending signals to immune cells. Scientists are working on creating microbiome medicines that can be given alongside cancer treatments.

It Can Change

Your microbiome includes both “good” and “bad” bacteria. They create a healthy balance in the body. Some things, such as certain diets or antibiotics, can disrupt it. But your lifestyle can help it. Imbalances in the microbiome have been linked to a wide range of conditions, including Alzheimer’s, cancer, and immune system diseases. But doctors do not yet know if the microbiome is to blame or is an innocent bystander.

How to Help Your Microbiome

Simple daily habits make a difference. What you eat can change the microbes that live in your body. High-fiber foods (such as veggies, whole grains, and fruit) feed the helpful bacteria in your colon. They also discourage the growth of some harmful ones. Probiotic foods, such as yogurt and pickled vegetables, also deliver helpful bacteria to your gut. Getting enough sleep, easing stress, and exercising may also improve your microbiome.

Should You Take Probiotics?

Each year, Americans spend more than a billion dollars on probiotic supplements. Do they work? The jury is still out. Not all probiotics are the same, and everyone has different microbiomes. A supplement that is helpful for someone may not have an effect on another person. Talk to your doctor. Probiotics are usually safe for healthy people. But those with health conditions may need to steer clear. You can learn more information on this topic here.

Healthy Recipe of the Month - Seasame Chicken Recipie

INGREDIENTS:

1 lb chicken breasts, boneless skinless
1 tbsp garlic cloves (for sauce)
1/2 tsp ginger, ground (for sauce)
2 cups green beans
1 tbsp l (for chicken)
1 tsp lime juice (for sauce)
1 cup cooked white rice
1/2 tbsp avocado oil (for sauce)
1/4 tsp black pepper (for sauce)
1 tbsp sesame seeds (for topping)
2 tbsp rice wine vinegar (for sauce)
1 tbsp toasted sesame oil (for sauce)
1/4 cup coconut aminos (for sauce)

DIRECTIONS:

Rinse off chicken and cut into large cubes and place in a bowl.
put your 1 tbsp in bowl and mix to coat chicken cubes evenly.
Cook chicken on pan until browned and set to the side.
Get all your 'sauce' ingredients out and whisk together; coconut aminos, sesame oil, black pepper, lime juice, ground ginger, garlic cloves, toasted sesame oil, avocado oil and rice wine vinegar to make your sauce.
Place sauce mixture into medium saucepan on the stove and cook on medium until sauce starts to thicken, then set to the side in.
Pour sauce onto cooked chicken cubs and gently mix until all chicken cubes are evenly covered.
Prepare your plate with white rice, green beans and sesame chicken.
Sprinkel sesame seeds over meal to desired amount.

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

July is Disability Pride Month

It is a time to celebrate the diversity of the disability community and to recognize the accomplishments of people with disabilities. It is also an opportunity to raise awareness of the challenges that people with disabilities face and to advocate for equal rights and opportunities.

Month-long Observations:

French-American Heritage Month

Important May DE&I calendar dates:

July 1 – Canada Day (Canada)
July 4 – Independence Day (USA)
July 7 – Al-Hijra begins (Muslim)
July 9 – Martyrdom of the Bab (Baha’i)
July 11 – World Populace Day
July 14 – Bastille Day
July 18 – International Nelson Mandela Day
July 24 – Pioneer Day (Mormon)
July 24 – International Self-Care Day
July 26 – National Disability Independence Day (commemorates the signing of the Americans With Disabilities Act)
July 28 – Parents’ Day (USA)
July 30 – International Day of Friendship

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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