LEXINGTON, Ky. (May 16, 2016) − Anyone who's 13 years old — or who was once 13 — can relate to the embarrassment of a parent insisting on sitting in the room while they showered.
Unfortunately, that was the reality for 13-year-old Joey Maggard until a delicate surgical procedure eliminated his epileptic seizures this past January.
At the time of his surgery, Joey's seizures were so frequent and unpredictable — about 20-30 per month — that his mother, Erin Smith, would sit in the bathroom in case he seized while showering.
"It was so frustrating for him and heartbreaking for me," Erin recalls. "He wanted so much to be 'just a kid,' but the reality was that being 'just a kid' could have been dangerous for him."
Adding to the disappointment were the other restrictions imposed upon Joey. He could no longer play his beloved sports or have sleepovers with friends. He was forced to follow a restricted diet and reduce Xbox and electronics use. After his seizures increased in frequency, his school district asked that he be tutored at home for the last half of his sixth grade year.
"Epilepsy is often misunderstood by the lay public, and epilepsy patients are often teased or shunned, particularly when they are younger," said Dr. Meriem Bensalem-Owen, director of the Epilepsy Program at the Kentucky Neuroscience Institute at the University of Kentucky. "As a result, they often isolate themselves for fear of losing control in public, and depression and anxiety commonly go hand-in-hand with the stigma of epilepsy."
Bensalem-Owen considers it part of her responsibility to reassure patients that they are not alone in their journey.
"More than 150,000 Kentuckians are living with epilepsy today," she explains. "I think many patients are surprised when I tell them that."
Even more reassuring, Bensalem-Owen believes, is the fact that she has a personal experience with epilepsy.
"My son had seizures few years ago, and I literally told myself 'OK, so now I have to be as brave as the parents of my patients and do what I tell them to do.' So I understand, not just as an epileptologist but as mom, what Joey and his family were going through and I can reinforce with them that there is a team with them every every step of the way."
Joey's odyssey began when he was nine. Erin said that while Joey's birth was stressful, otherwise "he was great, he hit every milestone." With no family history, his first and second seizures — about six months apart — were a shock to his family. After Joey experienced a grand mal seizure — considered the most violent and dangerous of all seizures — a CAT scan at a hospital close to their Lincoln County home found a lesion in his brain. He was referred to Dr. Qutubuddin G. Khan, a pediatric neurologist at the UK Kentucky Neuroscience Institute (KNI).
The Epilepsy Program at KNI is accredited by the National Association of Epilepsy Centers (NAEC) as Level 4 Center — its highest designation. A Level 4 center provides more extensive medical, neuropsychological, and psychosocial treatment, including thorough and highly technical evaluation for a wide range of surgical treatment for epilepsy. Since 2003, US News and World Report has included NAEC Level 4 adult epilepsy centers as a part of its ranking criteria.
"Level 4 epilepsy centers have the professional expertise and facilities to provide
the highest-level medical and surgical evaluation and treatment for patients with complex epilepsy,” said Dr. Larry Goldstein, chair of the UK Department of Neurology and KNI co-director. "To achieve this designation is an apt reflection of our institutional commitment to provide the best subspecialty care to the people of Kentucky and beyond."
At first, Khan tried a variety of medications, alone and in combination. Each time, says Erin, they would work for a while, but Joey's seizures would eventually return.
"One of the things I loved most about Dr. Khan was how candid he was," said Erin. "After each setback, he'd sit with us and explain patiently what our next options were and the pros and cons of each option."
Based on initial testing to determine what areas of the brain Joey's seizures came from, Khan felt Joey was a good candidate for surgery, and referred him to Bensalem-Owen for further evaluation.
A crucial step in the process of assessing Joey’s seizures — and a hallmark of centers with NAEC Level 4 accreditation — is invasive brain monitoring, where the skull is opened and a delicate web of electrodes is placed directly on the brain. Over a period of days Joey was monitored and brain mapping was performed to pinpoint exactly which parts of his brain controlled essential functions like speech, and those points were compared to the areas were his seizures arose. It's a painstaking and uncomfortable process.
"I asked Joey if he was ready for this, and he looked me straight in the eye and said YES," said Bensalem-Owen. "He said he was tired of missing school and having poor grades. I was impressed by how determined and brave he was."
Brain mapping indicated three small areas that were leading to Joey's seizures. Two areas were perilously close to the part of Joey's brain that controlled vision and motor function; Bensalem-Owen knew that precision was critical to a successful outcome for Joey.
Once the doctors knew which parts of Joey's brain to target and which parts to avoid, KNI neurosurgeon Dr. Thomas Pittman performed the surgery to remove the lesions that were causing his seizures. Then began the waiting game.
"Joey's been seizure-free since his surgery," said Amy. "He now can take showers and be alone outside without my constant supervision. I know we've got a ways to go before we're out of the woods, but this has been a huge burden lifted."
Furthermore, says Bensalem-Owen, Joey's vision and other motor function have remained intact. "We couldn't have hoped for a better outcome," she said.
Bensalem-Owen stresses that while surgery isn't an option for everyone, there are large swaths of individuals with epilepsy who either don't know about or are afraid of surgery, and those people are suffering needlessly.
"In the U.S., there are more than 100,000 patients who are candidates for surgery, and only about 2,000 people elect to have the surgery every year," she said. "We need to educate patients and healthcare providers that surgery shouldn't be treated as a last resort, that patients don't need to suffer from the physical and emotional effects of epilepsy for ten or twenty years. If someone has uncontrolled epilepsy for more than a year, they should seek an opinion at an accredited epilepsy center."
In a post-surgery appointment with Bensalem-Owen, Joey was bouncy and talkative. His hair was growing back, mostly covering the scar that extends from the top of his head to just behind his ear. His grades have rebounded since his return to school in March and he has been cleared to play sports in June. He will continue epilepsy medication as an added precaution, but Bensalem-Owen predicts a complete return to the life that allows kids to be just that — kids.
"On my first day back to school, as I was going down the hall teachers were shrieking and kids were hugging me," Joey recalled with a smile. "I was back with my buddies again, and I was so happy."
UK is the University for Kentucky. At UK, we are educating more students, treating more patients with complex illnesses and conducting more research and service than at any time in our 150-year history. To read more about the UK story and how you can support continued investment in your university and the Commonwealth, go to: uky.edu/uk4ky. #uk4ky #seeblue
Media Contact: Laura Dawahare, Laura.Dawahare@uky.edu, (859) 257-5307
LEXINGTON, Ky. (April 26, 2016) – An editorial by University of Kentucky’s Dr. Larry Goldstein concerning the use of screening tests to detect narrowing of the carotid artery was published in the Journal of the American Medical Association (JAMA) Internal Medicine last week.
With more than 35 years of practice, Goldstein is the chair of the Department of Neurology at the UK College of Medicine and co-director of the Kentucky Neuroscience Institute.
Practice guidelines developed by professional societies to screen for narrowings in this major artery supplying blood to the brain are intended to summarize the best available evidence for specific questions to support clinical decisions. However, noted Goldstein, guideline recommendations from different organizations or groups can vary in minor or substantial ways.
"Evidence-based medicine is a linchpin of contemporary clinical practice,” said Goldstein. "However, these disparities among guidelines can lead to considerable uncertainty and variability in clinical practice."
According to Goldstein's editorial, screenings for carotid disease are offered in a variety of settings, yet there is no validated proof showing it is useful for identifying those in the general population who do or do not have a clinically important ACAS. There is a high proportion of carotid imaging studies performed for uncertain indications.
Goldstein wrote that “[S]creening for a disease or condition is rational only if its identification has a meaningful impact on patient management." In the case of narrowing of the carotid artery that is not associated with symptoms, the best approach is currently uncertain. “Specific educational programs, the use of alerts embedded into the electronic health record and audits with feedback, among other interventions, may be helpful in reducing inappropriate testing.”
Knowing the dilemmas that they are now facing, it can be difficult for physicians to understand when it is appropriate to recommend testing. Issues facing clinicians include:
· How can inconsistent guidelines be balanced?
· How are these complicated issues being presented and discussed with patients who look to their clinician for guidance?
· Should a screening test be performed in the face of equivocal, limited, or conflicting data regarding the intervention that would be considered if the condition was detected?
· To what degree should the potential for false-positive or false-negative test results and the attendant need for confirmatory testing be factored into the decision?
According to Goldstein, "despite the available evidence from randomized trials and practice guidelines, decisions regarding whether to proceed with testing are often a matter of informed opinion."
UK is the University for Kentucky. At UK, we are educating more students, treating more patients with complex illnesses and conducting more research and service than at any time in our 150-year history. To read more about the UK story and how you can support continued investment in your university and the Commonwealth, go to: uky.edu/uk4ky. #uk4ky #seeblue
LEXINGTON, Ky. (April 21, 2016) − University of Kentucky’s Dr. Larry Goldstein and Donna Arnett, Ph.D., took part in drafting a policy statement that was published in the American Heart Association’s (AHA) flagship journal Circulation this month.
The statement was intended to provide a thorough review of the scientific underpinnings of the AHA’s public advocacy strategies as they pertain to the association's 2020 Strategic Impact Goals, which target a 10-year 20 percent improvement in the cardiovascular health of all Americans and a 20 percent reduction in deaths from cardiovascular disease and stroke.
"Our goal was to assist the AHA in determining how well the best available science aligns with the AHA’s public policy goals and identify research opportunities that would help fill gaps and support their further development," said Goldstein, the paper's co-lead author.
According to Arnett, the consensus was that there was generally close alignment between current policy and the 2020 metrics; however, some policies require a more robust evidence base.
"We were particularly concerned about cardiovascular health metrics by age, which currently are divided into just two groups: children up to age 20 and adults," Arnett said. "Since there are important differences in policy needs for infants, children, adolescents, and young adults, we'd like to see research that informs policy for each of these subgroups."
The intent of the AHA 2020 Impact Goals is to improve epidemiological factors (physical activity, healthy diet, tobacco use, and healthy weight) that contribute to cardiovascular health and refine clinical response (improved acute care processes and secondary prevention therapies) to prevent and treat cardiovascular disease and stroke.
Policies stemming from these goals include efforts to promote smoking cessation, improve BMI, reduce consumption of sugar-sweetened beverages, and encourage behaviors that promote healthy cholesterol, blood pressure and glucose levels.
"We hope that this intensive review will aid in translation and implementation of current policies, provide a roadmap to expand and strengthen the evidence base for the development of new policies, and help evaluate their overall impact in terms of targeted improvements in population health," said Goldstein.
With more than 35 years of practice, Goldstein is the chair of the University of Kentucky's Department of Neurology and co-director of the Kentucky Neuroscience Institute. He served as the co-chair of the writing group, providing his expertise on how evidence-based research can help public health organizations realize their organizational goals and policies.
As a transformative leader with core values of excellence, Arnett serves as dean of the UK College of Public Health and is also the former president of the American Heart Association. Her professional efforts have focused on bringing public health, medicine and other health-related disciplines closer together to improve population health.
Media Contact: Laura Dawahare, Laura.Dawahare@uky.edu, (859) 257-5307
LEXINGTON, Ky. (April 11, 2016) —The University of Kentucky College of Medicine Departments of Neurology and Neurosurgery and the Kentucky Neuroscience Institute will host an accredited event to bring health care providers up to date on care practices dealing with neurology and neurosurgery.
On April 29, all health care providers who treat patients with neurological issues - from primary care physicians to occupational and physical therapists - are invited to join several forums discussing new evidence-based practices in neurology. Presentations will cover advances in medical management for headache, memory complaints, Parkinson's disease, epilepsy and acute ischemic stroke.
The event is free but participants must register through CE Central to reserve a spot. Onsite registration and breakfast will start the day at 8 a.m. in the Pavilion A auditorium of the UK Albert B. Chandler Hospital with the welcome and introduction beginning at 9:30 a.m. The event ends at 4 p.m. Participants attending this event will receive free validated parking in the hospital parking garage at the corner of South Limestone and Leader Avenue.
To register visit http://www.cecentral.com/live/11652
For questions regarding this event please call 859-218-5074 or email firstname.lastname@example.org
LEXINGTON, Ky. (March 9, 2016) — The University of Kentucky College of Medicine Departments of Neurology and Neurosurgery and the Kentucky Neuroscience Institute will host an accredited event to bring health care providers up to date on care practices dealing with neurology and neurosurgery.
On April 29, health care providers who treat patients with neurological issues from primary care physicians to occupational and physical therapists are invited to join the Practical Update in Neurology and Neursurgery — several forums discussing new evidence-based practices in neurology. Presentations will cover advances in medical management for headache, memory complaints, Parkinson's disease, epilepsy and acute ischemic stroke.
The event is free, but participants must register through CE Central before April 11 to reserve a spot. Onsite registration and breakfast will start the day at 8 a.m. in the Pavilion A auditorium of the U.K. Albert B. Chandler Hospital with the welcome and introduction beginning at 9:30 a.m. The event ends at 4 p.m. Participants attending this event will receive free validated parking in the hospital parking garage at the corner of South Limestone and Leader Avenue
LEXINGTON, Ky. (Feb. 17, 2016) – UK HealthCare has achieved Magnet Status – the highest institutional honor awarded for nursing excellence from the American Nurses Credentialing Center's (ANCC) Magnet Recognition Program. Out of nearly 6,000 health care organizations in the United States, less than 7 percent have achieved Magnet designation.
"Magnet recognition is a mindset and an approach in patient-centered care,” said UK HealthCare Chief Nursing Executive Colleen Swartz. “Our team has been extremely dedicated, focused and committed in achieving this goal and it shows in every interaction we have with patients and their families.”
UK HealthCare has 4,473 nursing services employees including 2,006 full-time registered nurses.
Achieving Magnet Status is a process that culminates in a rigorous review to demonstrate the hospital's commitment to sustaining nursing excellence and improving professional practice. The status represents a solid commitment to continuing education and nursing specialty certification, a cultural transformation of the work environment involving a shared governance model and laser focus on patient safety.
“Our nursing staff have worked very hard to achieve this important distinction and have been committed to this goal and truly deserve this Magnet recognition,” said Dr. Michael Karpf, UK executive vice president for health affairs.
In 2001, UK HealthCare became just the 38th Magnet-recognized organization. The hospital maintained its designation until it was up for renewal in 2009, when the ANCC restructured the Magnet Recognition Program criteria. The fundamental shift from a process-structured infrastructure to an outcomes-based infrastructure led to UK HealthCare needing to make changes to regain its status.
“From a nursing practice perspective, we used the loss of Magnet as a call to action for us to really focus on quality outcomes, patient experience and staff experience,” Swartz said. “The end goal for us was superb clinical care; Magnet status is a byproduct of that goal and we should embrace it as such.”
From 2010 to 2013, UKHC began an improvement process that signified a cultural change toward patient- and family-centered care. That process included evaluating the nursing strategic plan, identifying areas in need of quality improvement, and developing strategies for improvement, measurement and accountability.
“While Magnet recognition is awarded by a nursing organization, it is truly an honor resulting from the leadership of our nurses to demonstrate that it is all of our caregivers who focus on meeting the needs of our patients, their families, and one another each and every day in our hospitals and clinics,” said Bo Cofield, UK HealthCare vice president and chief clinical operations officer. “Everyone at UK HealthCare is proud to be one of less than ten hospitals in Kentucky and one of less than 500 in the nation to have earned this distinction.”
To achieve Magnet recognition, organizations must pass a rigorous and lengthy process that demands widespread participation from leadership and staff. The process begins with the submission of an electronic application, followed by written documentation demonstrating qualitative and quantitative evidence regarding patient care and outcomes. If scores from the written documentation fall within a range of excellence, an on-site visit will occur to thoroughly assess the applicant. After this rigorous on-site review process, the Commission on Magnet will review the completed appraisal report and vote to determine whether Magnet recognition will be granted.
Magnet recognition, which hospitals must reapply for every four years, has become the gold standard for nursing excellence. The recognition is based on adherence to Magnet concepts and demonstrated improvement in patient care and quality. U.S. News & World Report’s annual showcase of “America’s Best Hospitals” includes Magnet recognition in its ranking criteria for quality of inpatient care.
Media Contact: Kristi Lopez, email@example.com or 859-323-6363
LEXINGTON, Ky. (Dec. 9, 2015) — Dr. Michael Dobbs,associate chief medical officer for UK HealthCare, has been named associate editor for the publication, Quality Management in Health Care (QMHC), published by Wolters-Kluwer Health.
QMHC is a peer-reviewed journal that provides a forum for readers to explore the theoretical, technical and strategic elements of health care quality management. The journal's primary focus is on organizational structure and processes as they affect the quality of care and patient outcomes.
“Michael Dobbs is a natural fit for this postiion, and we're delighted that he has accepted,” said QMHC Editor Kathleen White, Ph.D., R.N. “His experience as an academic physician leader and improvement scientist will prove highly valuable to the journal.”
This column appeared in the Dec. 6, 2015 edition of the Lexington Herald-Leader.
LEXINGTON, Ky. (Dec. 7, 2015) — Commonly thought of as a problem primarily affecting older men, stroke is a woman’s disease. Approximately 60 percent of deaths related to stroke in the United States occur in women, and the lifetime risk of stroke is higher in women (about one in five) compared to men (about one in six) for those aged 55 to 75 years. The good news is that stroke can often be prevented.
Although men and women have several modifiable stroke risk factors in common such as high blood pressure (normal less than 120/80 mmHg), diabetes, cigarette smoking, overweight-obesity, atrial fibrillation (an irregular beating of the upper chambers of the heart), excessive alcohol consumption, poor diet or lack of regular exercise, several risk factors are unique to women.
Stroke risk can be increased during pregnancy, in part leading to a higher stroke risk among women of childbearing age compared to similarly aged men. Migraine with aura (neurologic symptoms such as seeing sparkling or zigzag lights) is also associated with a higher stroke risk, particularly among women who smoke or use oral contraceptives. Women who have had eclampsia or pre-eclampsia associated with pregnancy (high blood pressure, protein in the urine, and in the case of eclampsia, seizures) are at increased risk of stroke up to 30 years later.
What can women do to reduce their stroke risk?
- Follow a healthy diet such as the DASH or Mediterranean diet.
- Get regular exercise such as walking at a brisk but comfortable pace for 20-30 minutes most days of the week.
- No more than one alcoholic drink per day (no alcohol during pregnancy)
- Don’t smoke and avoid exposure to tobacco smoke
- Have your blood pressure checked regularly
In addition, talk to your health care provider about reducing your stroke risk if you:
- Have migraine, particularly migraine with aura
- Have ever had eclampsia or pre-eclampsia
Memorize some common stroke symptoms using the FAST acronym:
- Facial droop
- Arm weakness
- Speech slurring
- Time — call 911 – Stroke is frequently preventable and treatable, but you need to get help quickly
Larry B. Goldstein, MD, FAAN, FANA, FAHA, is the Ruth L Works Professor and Chairman of the UK Department of Neurology and Co-Director, Kentucky Neuroscience Institute.
LEXINGTON, Ky. (Dec. 3, 2015) — UK HealthCare's Kentucky Neuroscience Institute (KNI) has been re-designated a Comprehensive Stroke Center (CSC) by The Joint Commission (TJC) and the American Heart Association/American Stroke Association.
UK HealthCare was first designated a CSC in 2014. It is one of 96 U.S. institutions — and the only one in Lexington — with CSC-designation. This is the highest level of stroke certification available from The Joint Commission, reflecting the availability of resources, staff and training when treating complex stroke cases.
“UK’s re-certification attests to our team’s ability to provide the highest possible quality multidisciplinary care to the most medically complex patients with stroke,” said Dr. Larry Goldstein, chair of the Department of Neurology at the University of Kentucky. “The certification process is quite rigorous, and the recognition is afforded to only a small number of elite hospitals nationwide. We are thrilled to have our professionals' hard work recognized and to be able to offer these services to the citizens of the Commonwealth.”
An advanced Comprehensive Stroke Center has an unparalleled amount of resources in infrastructure, staff, and training to provide state-of-the-art care to all patients. They offer a neuro-intensive care unit for complex stroke patients who require 24/7 care, advanced imaging capabilities, and participate in stroke research. They also coordinate post hospital care for patients, use a peer review process to evaluate and monitor the patient’s care, and analyze and use standardized performance measure data to continually improve treatment plans.
LEXINGTON, Ky. (Nov. 30, 2015) — Dozens of neurologists, other medical professionals and researchers gathered at the University of Kentucky Nov. 25 to hear the words of Dr. Walter Koroshetz, director of the National Institute of Neurological Disease and Stroke of the National Institutes of Health.
In his first year as director, Koroshetz has made it a point to travel around the U.S. to share the Institute's plans to reduce the burden of neurological disease through vigorous investments in basic, translational and clinical research.
Alzheimer's disease, Parkinson's disease or multiple sclerosis are the most commonly known neurological diseases. However, Koroshetz reminded the audience that this classification includes disorders like substance abuse, depression and neurodevelopmental diseases.
"Neurological disease is today what infectious disease was to the 20th century: the most disabling and expensive group of chronic diseases today," Koroshetz said.
The good news: the world has begun to recognize the potential economic and quality-of-life impact of investment in research in the neurosciences. The brain and its mysterious functions — and malfunctions — has caught the eye of major consumer publications like Time, Scientific American, and National Geographic. There are rising numbers of Ph.D. candidates in the neurosciences. And the U.S. Congress has requested that the NIH present directly to them plans (and an accompanying budget) to solve the mysteries of neurological diseases, bypassing the usual funding mechanisms. Previously, only cancer and AIDS have been blessed with this designation.
As a part of that process, several government agencies and private groups have banded together to form The Brain Initiative. Called "The Next Great American Project," the Brain Initiative's goal is to provide the tools and resources necessary to map and understand the circuits and networks in the brain. By doing so, the hope is to understand how brain circuits function, find the basic mechanisms by which cellular pathways contribute to circuit dysfunction, and figure out ways to improve outcomes for patients.
That effort will require a whole new set of tools, says Koroshetz. He points out that while advances in imaging have revolutionized how we look at the brain, we are still largely reliant on antiquated technology.
"The EEG was developed in the 1920's, and the MRI, while effective, only records images at the rate of one per half a second, whereas the brain fires in milliseconds,” Koroshetz explained. "It's said that new tools are often more valuable than new concepts, and that is equally applicable in this case."
Dr. Larry Goldstein, chair of the UK Department of Neurology, emphasized the importance of Koroshetz's message.
"The Brain Initiative is the Manhattan Project of our age, and pursuit of effective treatments for this group of debilitating and costly diseases is a worthy cause," Goldstein said.
Goldstein added that, in light of the fact that UK already has research strengths in several relevant areas such as Alzheimer’s disease and related disorders, epilepsy, stroke, spinal cord and brain injury, Parkinson’s disease, and substance abuse, having Koroshetz present to UK faculty and staff was particularly timely.
"We were extremely fortunate to have Dr. Koroshetz as our guest at UK HealthCare to help welcome the advent of a new chapter in neurological research both at UK and around the world."
LEXINGTON, Ky. (Nov. 14, 2015) —The American Board of Psychiatry and Neurology (ABPN) has named Dr. Jonathan H. Smith of the University of Kentucky a recipient of its Faculty Innovation in Education award to support the development of innovative education projects that provide effective residency and fellowship training, as well as lifelong learning for practicing psychiatrists and neurologists.
Every year up to two neurologists are selected for this prestigious award. The two-year award provides a maximum of $100,000. Smith's project will explore the use of unannounced simulated patients to evaluate neurology residents' communication and interpersonal skills.
Dr. Larry Goldstein, chair of the UK Department of Neurology, said Smith's work reflects the department’s long-term emphasis in providing the best possible experience for trainees. “Jonathan is an excellent teacher with a creative approach to neurology resident education, and this award is a well-deserved acknowledgment of that," said Goldstein.
Smith is currently an assistant professor in Neurology and the program director of adult neurology residency at UK. He is a graduate of the University of Rochester with a B.S. in biochemistry and a minor in clinical psychology. He received his M.D. from the Chicago Medical School at Rosalind Franklin University of Medicine and Science. He completed his neurology residency and headache fellowship at the Mayo Clinic, where he also served as chief resident.
Some of Smith's previous awards include the American Academy of Neurology’s (AAN) Annual Meeting Resident Scholarship Award in 2011 and the Chief Resident Award at the Mayo Clinic Department of Neurology in June 2012, and the Excellence in Teaching in the Department of Neurology award at UK in June 2015.
The ABPN’s main mission is to develop and provide valid and reliable procedures for certification and maintenance of certification in psychiatry and neurology. They have been a non-profit since 1934 and are one of 24 boards of the American Board of Medical Specialties (ABMS).
Media contact: Laura Dawahare, Laura.Dawahare@uky.edu, (859) 257-5307
LEXINGTON, Ky. (Nov. 11, 2015) — Two women, seated at a table, told their stories in quiet tones. A group of chefs, some standing, others seated, leaned forward eagerly, clearly interested in what these two women had to say. They peppered the women with questions: did food taste better cold or hot? Was texture an issue? Did a glass of wine before dinner help or hurt the flavor experience?
The women have both taken chemotherapy for their cancer. One of them — Gina Mullin — will be taking chemotherapy every three weeks for the rest of her life. Both she and patient Jen Cooper tell heartbreaking stories about a side effect of chemotherapy that gets swept under the rug: food tastes terrible.
"Can you imagine how much quality of life you lose when you can't enjoy your food?" asked Cooper.
Chemotherapy, by design, kills all fast-growing cells in the body. As cancer cells die, so do all the healthy fast-growing cells, including the cells responsible for hair growth and taste buds. So your hair falls out and everything tastes metallic.
"Here they are, critically ill, needing good nutrition more than ever and they can't enjoy food? It's beyond unfair," said Dan Han, a neuropsychologist at the University of Kentucky.
Han has become an ardent advocate for the concept that quality of life issues — specifically, the enjoyment of food — should be measured as a clinical outcome for patients. A chance meeting in 2012 with internationally acclaimed chef Fred Morin brought the issue to his attention.
"Like most clinicians, when patients brought up the issue of reduced or distorted flavor perception (if they brought it up at all), I was sympathetic but not motivated, because there's not much we can do to help," said Han.
But Morin, chef and owner of the legendary restaurant Joe Beef, is a bioengineer by training and hugely interested in the concept of neurogastronomy, which merges the science and culinary worlds by studying the human brain and the behavior that influences how we experience food. Morin encouraged Han to read a book by Yale neuroscientist Gordon Shepherd, who coined the term in 2006.
"I was hooked," said Han. "I knew that if we could bring together chefs, neuroscientists and food scientists to explore ways to help these patients enjoy a meal, break bread with family and friends and enjoy that process again, it would be a significant contribution to science and to life."
That chance meeting was the spark for the founding of the International Society of Neurogastronomy (ISN), and last week more than 200 scientists, patients, chefs, foodies and others gathered at UK for the inaugural ISN Symposium, sharing their knowledge and exploring opportunities to improve quality of life for people who have lost their perception of taste or smell due to cancer, brain injury, stroke, Alzheimer's, Parkinson's, or other neurological disorders.
During breaks, participants were encouraged to visit eight tasting stations, where experiments demonstrated how the perception of flavor is shaped by more than just the tongue. Attendees wore blindfolds, sniffed scent jars, held their noses, and more while they sampled. At one station, tasters eating a pink cookie while listening to gentle music were astonished to learn that it was equally as sweet as the black cookie paired with harsh music.
The most emotional part of the day looped back to the conversation between the chefs and the cancer patients. Chefs were paired with neuroscientists and physicians to create two teams, which then competed in the "Applied Neurogastronomy Challenge "— a friendly competition to make food that appealed to Mullin and Cooper.
"Team Morin" prepared a chunky potato soup with a range of toppings to customize the flavor experience: diced potato and bacon, pulled chicken and ginger, garlic broccoli, and fried chicken skin with paprika. "Team Mehta" also took a mix and match approach, offering peppered scallops, grilled chicken and mustard lime halibut to be paired with chili jam, apple goji reduction, lemon marinated apples, carrot yogurt salsa, or a chocolate chili mole.
"I tried every dish, and it was really fun," said Mullin, who said the only time she cried during her diagnosis and treatment was the day she ordered two of her favorite restaurant dishes only to throw them away after one bite because they tasted so bad.
"Potato soup wins!" shouted Jen Cooper to widespread applause. In truth, replied Leah Sarris, program director for the Goldring Center for Culinary Medicine at Tulane University and a member of Team Morin, everyone won.
"I learned so much from you, Jen and Gina, and it will inform the way I cook and teach others to cook," she said. "We read in books about how chemo affects taste, but your stories made it real."
While neurogastronomy, as a science, is still in its infancy, the symposium has opened the door to the flow of information and ideas among neuroscientists, culinary professionals, food scientists and agriculture scientists. Participants were enthusiastic about the day's successes and the prospect for continued conversations that advance the science in the context of neurologically-related taste impairments, sustainability, disease prevention, and more.
"This really organically grew into something amazing, because people from such randomly different disciplines came together," said Han. "The commonality that united us was to achieve better food, better flavor, better health, and better quality of life."
To view the symposium presentations, go to https://vimeo.com/album/3650327
LEXINGTON, Ky. (Oct. 22, 2015) — A new science called neurogastronomy explores brain and behavior in the context of food, and the International Society of Neurogastronomy's inaugural symposium will bring together for the first time the "four pillars" of neurogastronomy to share their knowledge and begin a dialogue that, they hope, will ultimately lead to real changes in brain behavior as it relates to food.
Registration is still open for the symposium, which will take place Saturday, Nov. 7, 2015, in Pavilion A of the Albert B. Chandler Hospital. UK Neuropsychologist Dan Han and his ISN co-founders have structured the day to be very different than the typical scientific symposium. Instead of long lectures, there are several presentations in a TED-talk style format. Among the speakers:
Chefs: Next Iron Chef Runner-up Jehangir Mehta; James Beard finalist and Mind of a Chef host Ed Lee; Leah Sarris, program director for the Goldring Center for Culinary Medicine at Tulane University; and Fred Morin of Joe Beef Montreal.
Scientists: Physiologist Tim McClintock; prize-winning experimental psychologist Charles Spence; and Dr. Gordon Shepherd, who coined the term neurogastronomy -— first in 2006 in an article in Nature and six years later in an eponymous book.
The symposium will be a true culinary experience as well, with tasting breaks to help participants grasp the fundamentals of flavor perception (sweet, salty, umami, etc.) and chef-quality breakfast and lunch breaks.
Han is anxious to begin the dialogue that might ultimately provide tangible improvement to quality of life for people with neurologically-related taste impairments. "When the concept of neurogastronomy was introduced, people realized it was a need that had been there for a long time – ever since mammals started eating," Han said. "If we could get together and simply provide ways to help these patients enjoy a meal, break bread with family and friends and enjoy that process again, then I would be very proud of that contribution to clinical sciences."
For more information about the ISN Symposium or to register, go to http://www.isneurogastronomy.org/
LEXINGTON, Ky. (Oct. 7, 2015) – UK HealthCare has more than 125 physicians practicing medicine with UK Albert B. Chandler Hospital, Kentucky Children's Hospital, UK Good Samaritan Hospital and Shriner's Hospitals for Children who appear on the Best Doctors in America list for 2015-16 – more than any other hospital in Kentucky. Only 5 percent of doctors in America earn this honor, decided by impartial peer review.
The Best Doctors in America list, assembled by Best Doctors Inc. and audited and certified by Gallup, results from polling of more than 40,000 physicians in the United States. Doctors in more than 40 specialties and 400 subspecialties of medicine appear on this year’s List.
The experts who are part of the Best Doctors in America database provide the most advanced medical expertise and knowledge to patients with serious conditions – often saving lives in the process by finding the right diagnosis and right treatment.
2015-16 Best Doctor's List:
Sadiq Ahmed Nephrology
Kenneth B. Ain Endocrinology and Metabolism
Michael I. Anstead Pediatric Specialist
Rony K. Aouad Otolaryngology
Susanne M. Arnold Medical Oncology and Hematology
Henrietta Salvilla Bada Pediatric Specialist
Hubert O. Ballard Pediatric Specialist
Robert J. Baumann Child Neurologist
Louis Bezold Pediatric Specialist
Peter James Blackburn Ophthalmology
Christopher A. Boarman Pediatrics
David C. Booth Cardiovascular Disease
Edwin A. Bowe Anesthesiology
Robert A. Broughton Pediatric Specialist
Raeford E. Brown, Jr. Pediatric Specialist
Scottie B. Day Pediatric Specialist
Christopher P. DeSimone Obstetrics and Gynecology
Philip A. DeSimone Medical Oncology and Hematology
David J. DiSantis Radiology
John Draus Pediatric Specialist
John H. Eichhorn Anesthesiology
Eric D. Endean Vascular Surgery
Deborah R. Erickson Urology
B. Mark Evers Surgery
John L. Fowlkes Pediatric Specialist
Peter J. Giannone, Jr. Pediatric Specialist
Jacqueline S. Gibson Internal Medicine
Larry B. Goldstein Neurology
Donna G. Grigsby Pediatrics
John C. Gurley Cardiovascular Disease
Wendy Fetterman Hansen Obstetrics and Gynecology
Andrew Hoellein Internal Medicine
Robert Hosey Family Medicine
Joseph A. Iocono Pediatric Specialist
Mary Lloyd Ireland Orthopaedic Surgery
Henry Iwinski Pediatric Specialist
Gregory A. Jicha Neurology
Darren Lee Johnson Orthopaedic Surgery
Raleigh O. Jones Otolaryngology
Jamshed F. Kanga Pediatric Specialist
Dennis Karounos Endocrinology and Metabolism
Edward J. Kasarskis Neurology
Douglas G. Katz Ophthalmology
Philip A. Kern Endocrinology and Metabolism
Stefan G. Kiessling Pediatric Specialist
Mahesh R. Kudrimoti Radiation Oncology
Cheri D. Landers Pediatric Specialist
Philip B. Latham Pediatrics
Steve W. Leung Cardiovascular Disease
Robert W. Lightfoot, Jr. Rheumatology
Richard Lock Anesthesiology
Grace F. Maguire Pediatrics
Scott D. Mair Orthopaedic Surgery
Hartmut H. Malluche Nephrology
Jeremiah T. Martin Thoracic Surgery
Erich C. Maul Pediatrics
Hanna W. Mawad Nephrology
Ronald Charles McGarry Radiation Oncology
Patrick C. McGrath Surgical Oncology
Adrian W. Messerli Cardiovascular Disease
Todd Milbrandt Pediatric Specialist
David J. Minion Vascular Surgery
Amr El-Husseini Mohamed Nephrology
David J. Moliterno Cardiovascular Disease
Alba E. Morales Pediatric Specialist
Peter E. Morris Critical Care Medicine
Timothy W. Mullett Thoracic Surgery
Kevin R. Nelson Neurology
Nicholas J. Nickl III Gastroenterology
M. Elizabeth Oates Radiology
John M. O'Brien, Jr. Obstetrics and Gynecology
Hatim A. Omar Pediatric Specialist
Amit Patel Plastic Surgery
Kevin A. Pearce Geriatric Medicine
P. Andrew Pearson Ophthalmology
Luther C. Pettigrew, Jr. Neurology
Barbara A. Phillips Sleep Medicine
Thomas Pittman Pediatric Specialist
Andrew R. Pulito* Pediatric Specialist
Marcus E. Randall Radiation Oncology
Annette Rebel Critical Care Medicine
Hassan K. Reda Thoracic Surgery
Aru Reddy Pediatric Specialist
L. Raymond Reynolds Endocrinology and Metabolism
Julie Ribes Pathology
Scott A. Riley Hand Surgery
John J. Rinehart* Medical Oncology and Hematology
Kimberly Ringley Pediatrics
William C. Robertson, Jr. Child Neurologist
David W. Rudy Clinical Pharmacology, Internal Medicine
Sarah S. Rugg Cardiovascular Disease
Sibu P. Saha Thoracic Surgery
Sheila P. Sanders Ophthalmology
B. Peter Sawaya Nephrology
Douglas J. Schneider Pediatric Specialist
Jeffrey Bryan Selby Orthopaedic Surgery
Lori Shook Pediatric Specialist
Michael Sekela Thoracic Surgery
John Slevin Neurology
David A. Sloan Surgical Oncology
Charles D. Smith, Jr. Neurology
Mikel D. Smith Cardiovascular Disease
Susan Smyth Cardiovascular Disease
Vincent L. Sorrell Cardiovascular Disease
William Henry St. Clair Radiation Oncology
Carol Steltenkamp Pediatrics
Julia C. Stevens Pediatric Specialist
Stephen Strup Urology
Lisa R. Tannock Endocrinology and Metabolism
Vishwas R. Talwalkar Pediatric Specialist
Alice C. Thornton Infectious Disease
Kathryn M. Thrailkill Pediatric Specialist
Phillip A. Tibbs Neurological Surgery
Dale E. Toney Internal Medicine
Fred Rand Ueland Obstetrics and Gynecology
Joseph Valentino Otolaryngology
Craig Van Horne Neurological Surgery
Woodford S. Van Meter Ophthalmology
John R. van Nagell Obstetrics and Gynecology
Henry C. Vasconez Pediatric Specialist, Plastic Surgery
Lars M. Wagner Pediatric Specialist
Carmel Wallace Pediatrics
Gretchen Lois Wells Cardiovascular Disease
Thomas French Whayne, Jr. Cardiovascular Disease
Michael L. Wittkamp Pediatric Specialist
Thomas L. Young Pediatrics
Khaled M. Ziada Cardiovascular Disease
Joseph B. Zwischenberger Critical Care Medicine, Thoracic Surgery
LEXINGTON, Ky. (Sept. 29, 2015) — Register now for the inaugural International Society of Neurogastronomy symposium, which will be held at the University of Kentucky on Nov. 7, 2015. Featuring speakers like "Mind of a Chef" host and restauranteur Ed Lee and the father of neurogastronomy, Dr. Gordon Shepherd, the symposium will explore the concept of brain and behavior in the context of food.
The term, "neurogastonomy, was coined by Dr. Gordon Shepherd, professor of neurobiology at Yale University — first in 2006 in an article in Nature and six years later in an eponymous book. While Shepherd has been interested in the concept from a research perspective, UK neuropsychologist Dan Han and a group of neuroscientists, chefs and food scientists are enthusiastic about making it a clinical translational science, with applications in cancer, stroke and brain injury, (which can destroy the sense of taste) and disease like diabetes and heart disease.
The day's format differs from the typical symposium, featuring brief presentations modeled after the popular TED talks and punctuated with breaks for tastings and a contest where food from regional and national chefs will be judged by patients with taste impairments.
For more information about the symposium and how to register, click here.