Skip to primary navigation Skip to main content

UB researcher looks to take a bite out of obesity epidemic

K.medler
Kathryn Medler, an associate professor of biological sciences at the University at Buffalo, uses a new computer system to perform calcium imaging. Calcium is a key ingredient of human taste cells. (Charles Lewis/Buffalo News)


By Scott Scanlon – Refresh Editor

The process of trying to learn more about a challenging human condition that could one day improve thousands – if not millions – of lives also can have its unpleasantries.

In Kathryn Medler’s case, that involves fattening up, and euthanizing, mice.

“The worst part of the job is having to euthanize the animals and we all take it very seriously and do it humanely,” said Medler, an associate professor of biological sciences at the University at Buffalo, and subject of this week’s “In the Field” story in WNY Refresh.

Medler hopes research she and others at UB are conducting will help scientists determine how taste buds impact obesity. If they are successful, this could be an important ingredient in efforts to improve treatments and medications that can take a big bite out of the growing obesity epidemic.

The Houston native has gone far afield academically in her pursuit. She grabbed her bachelor’s at Texas A&M, her master’s at San Diego State University and her PhD at Louisiana State University – all in biology – before landing at UB.

Which city has the best food?

Baton Rouge.

“The Mexican food in Texas, I miss that dreadfully, and all of the food in Louisiana – fried crawfish and catfish, and everything’s in a creamy sauce – pralines. It’s better for my waistline I don’t live there anymore.”

In fact, she generally loves the weather in Western New York and she and her husband are raising a family here.

Meanwhile, her research continues in a small laboratory in Cooke Hall on the UB North Campus in Amherst.

During an interview last month in her office, she drove deeply enough into her research that I didn’t have enough room in the print edition for more details of her work. Below are excerpts from our discussion:

What are some of the things that drive obesity now?

The change in our lifestyles the last 25 years has contributed to it ... and the way we eat, the diet. The number of processed foods that are available now that are cheap and easy. Everybody’s working now. There’s no time to make a roast for dinner. You’ve got to get something to eat quick, because it’s 7 o’clock. But the food tastes good! Everybody knows that it’s bad for you. Forget about the heart attack and the diabetes. It’s just walking down the street, through the house. All of that is hard, but it’s harder to stop eating because we’re programed to eat. I mean, I eat when I’m not hungry, (so I’m observing, not judging)...

If we all ate just broccoli and kale, there wouldn’t be an obesity epidemic, but we’re not all going to do that. We’re not going to get rid of the food companies. ... There’s some realistic constraints of what you can do within that. For people who can’t stop, they need some medical intervention.

Lap band surgery is an option, but what if we can come up with something less invasive?

Why use mice?

You don’t want to use people because we want to look at the cells themselves. No one’s going to donate their taste buds to us. ... The nice thing about mice, in general, is that researchers have found a way that if we can selectively remove one protein, we can figure out that Protein A is dramatically reduced in the obese mouse in the diet, then we can go buy a (genetically modified) mouse that doesn’t have that gene and then we can do all these studies with that. We use a mouse because it’s a mammal and more closely related to humans than, say, a fish.

Talk about the science behind this research study. How do you work with the mice?

After they are weaned from their mother, we put half of them on a high-fat diet; it’s basically 60 percent fat. Then, the rest of them are normal and have balanced food. We left one group of mice to eat as much as they wanted and they very rapidly gained weight and were way heavier than their brothers and sisters on the low-fat diet. Then, when they’re 30 or 40 percent heavier than the other mice, we did some behavior tests, including a two-bottle preference test.

In this preference test, we put them in a cage by themselves and they’re given two different bottles: one that has water and one that has a taste solution in it. If it’s something that they like, sucrose, once they can taste that, they’re just going to drink that. They’re not going to drink the regular water. ... We can measure how much water did they drink and how much sucrose did they drink.

We know these obese animals that aren’t tasting sweet as well, because their normal litter mates might prefer the sucrose 80 or 90 percent of the time, whereas the fat mice only about 60 percent. So we infer from that maybe they don’t taste it as well, and so they don’t prefer it because they can’t detect how sweet it is.

Anyway you can confirm that?

We isolated the cells and loaded them with dye (the mice are killed during this process) and then we’ll put the sweeteners on the cells and we can test the cells and measure how the cell responds to the stimulus. We did a bunch of cells and found that about twice as many cells responded in the normal mice than responded in the obese mice.

The number of sensitive cells were significantly reduced in the obese mice and the characteristic responses were different. So we and many, many other labs now know that once you stimulate the cell, you get a certain type of response and that translates information being sent to the brain and those signals were being significantly affected by obesity. I can’t tell you yet how, but that’s the next thing were trying to understand, what’s different inside the cell. Once we do that, then we can start trying to figure out how to fix it.

How do you try to understand this?

In other labs, people have shown some of the impact of hormones that control your appetite – leptin and ghrelin, which work together. These are hormones that regulate whether you feel hungry or whether you feel full. We all have these hormones and your body fat secretes these hormones. People who are morbidly obese, with significantly more fat, have a disregulated level of these hormones. They’re just not normal anymore. What’s also been established is that there are receptors for those hormones in taste receptor cells. Our hypothesis is – though we have not proven this yet – is that when those hormones are disregulated they are not going to modulate the taste receptor cells like they normally would, and that can change how the cells are going to respond.

So when we do some future experiments, we can see – and that’s when the transgenic mice come in handy – we can knock out the receptor for lepin and then the cell’s not going to be able to respond to that anymore. Then we can start understanding how that signal pathway helps control what’s going on inside the cell.

How will you be able to remove the protein?

That’s the transgenic mice. It’s a complicated thing that (scientific mice breeders) do. They go in and remove it from the genome, so it’s no longer present for the cells to be able to turn it on and make it.

So you can make a mouse without a protein?

Yes, for me I can buy that mouse from a company that’s already done it. Mice don’t exist for all proteins, because if you don’t have particular proteins you’re not going to survive. But this hormone, when animals don’t have this protein, leptin, they become very obese and develop diabetes. It definitely seems like a relationship.

So is the leptin the ‘I’m full’ protein?

Yes.

Would there be a way you could put more of this protein into a human being?

Yeah, it’s a hormone we normally have, so it wouldn’t be anything that could make you crazy sick or anything, but we first need to understand how it works before we start injecting people. There could be other implications.

There are people who study nothing but obesity that definitely are investigating and trying to understand. The problem is that injecting your body with something, if you give somebody too much of something, your cells will recognize that and will quit producing the receptors in their own. You just never know. People have to do a lot of experiments and studies to figure it out.

So first you’d better do that with mice?

Yes. That’s why these things take a long time. It’s so complicated. We could inject you with leptin but it might mess up your pancreas. There’s all these other things that have to be in balance.

So, are researchers using animals like this to save lives?

It’s not just to understand things. There’s a very strong human health relationship to it. I always tell people we design experiments to minimize the number of animals that we use. ... This is more of an enviable life than most of the animals who live you your backyard. We have veteranarian-approved, American Medical Association-approved techniques where we kill the animals with the minimal amount of discomfort. ... It’s not a great life living out in the dirt, because they’re probably going to be eaten or starve to death. The worst part of the job is having to euthanize the animals and we all take it very seriously and do it humanely.

The more we understand these (human eating) processes, the more we can make everybody healthier.

There’s so many cancers that people can survive today that they couldn’t have 50 years ago, unfortunately, not all of them yet. People have seen how medicine has progressed. That’s because we figured it out with animals first.

Is this a chicken and egg thing? Does this change take place and then a person gets obese, or does a person get obese and then this change takes place?

That is a very good question that we have not answered yet, and we are in the process of setting up those experiments. The only two differences between my fat mice and the normal mice – because they’re genetically identical – is this one’s on a high-fat diet and gets obese and this one’s on a normal diet and doesn’t. So there’s the diet and the obesity. So is the diet affecting the taste cells and the taste cells aren’t working because they’re on this diet and then they become obese and it feeds forward that way? Or do they have too much fat in their diet, they become obese, and because of the hormonal changes the taste cells go down? We don’t know that but we have a way we can design that experiment where we can keep the animals on a high-fat diet but if we give them this drug, they don’t get fat. And we’re going to be able to figure out is it the diet or did they have to become obese before the taste cells change?

Obesity studies in this context, are they relatively new?

Obesity as an epidemic has blown onto the scene in the last 20 years. There’s a huge change even when I was a kid. There were very few people and certainly you didn’t see people walking around at 5, 600 pounds, which you can see pretty regularly, unfortunately, now. We don’t understand very much about it because science doesn’t (always) move that rapidly.

What do the taste receptor cells do to the nerve cells?

The chemicals in your food will activate the receptor that’s on the taste receptor cell. If you have a sugar receptor on the cell and you’re eating sugar, it stimulates that cell and it sends the information. The taste cell sits out on your tongue and there’s a nerve that comes out and gets the message. It carries that information up to the brain and it goes to several spots in the brain for processing.

Are there parts in your brain that say, ‘Hey, I’m full’ or ‘I’m still hungry?’

Yes. There’s cells from your tongue and your stomach and small intestines that send information up to your brain that say, ‘You’re full,’ the ones from your gut that are saying, ‘We’re busy, we’re digesting, you don’t have to send us anymore.’ There’s information from your tongue that’s saying, ‘It’s sweet, it’s good.’ If it’s sour or bitter, it’s not good and you’re not going to eat it. We don’t really understand how the signals from the tongue go back to the brain to generate an appetite but they definitely make a significant contribution...

Your test cells on your tongue are an excitable cell, like most neurons in your body, but they’re actually in physical contact with your environment. All of the rest of your neurons are not. They’re encapsulated inside your body. They’re mostly in your brain with a bone wrapped around them to keep them safe. But in your tongue, it’s a changing environment, so they continuously turn over, so you’re always getting new taste cells. So if you have a cup of coffee and burn your taste cells in your 20s, you haven’t ruined your taste cells for life.

The turning over breaks down a bit as we age – and malnutrition becomes an issue (because food doesn’t taste as good).

The taste system is a very plastic system. It changes over time and it changes culturally. ... Our preferences for things kind of change depending on our environment and what we’re around, and what we’re used to eating. I’m not trying to set up myself as an expert on the food industry, but they’ve definitely added more concentrated sweeteners and a lot more salt in our food. ... Now, if you eat something without salt, it tastes horrible. I do the same thing. I want my sugar...

If we pulled someone out of a time machine from the ‘60s, and dropped them here, and showed them the size of a meal, or gave them a bag of potato chips or french fries, they would probably horrified with how salty or sweet some of that stuff is.

And food can dull our taste buds?

Right. They just don’t work that well. I don’t know what it says for us in Buffalo with our pizza and chicken wings.

It’s easy to tell somebody, ‘How can you eat two candy bars? One’s enough.’ I’m fine at one, but perception is an interesting thing. We both can eat the same thing, but how do we know we taste it the same way? So maybe it’s helpful to know, ‘If I’m obese, maybe I’m not tasting this as well.’

What does the lack of ability to sense sweetness mean? Do you have to eat more for the same payoff?

Yeah. People have done studies on obese people – some of them are conflicting – but obese people don’t taste sweet as well, but once they taste it, they like it more ... because they’re not tasting it as well, they’re not getting the same satisfaction and finish at the same rate as other people. That seems to be what our data is supporting.

How might this research help when it comes to this connection between taste, appetite and obesity?

Once we can understand the relationship between how obesity can affect taste, which can affect appetite, we can understand the relationship between those things. Once you see how it’s supposed to work, it’s easier to understand why it’s being disregulated by obesity and we can develop the most effective therapies to interrupt it. We can see that it’s connected, but we have to understand what’s happening inside the cells.

Do you have a ballpark of when someone might be able to bring a product or treatment to market?

No. Even when someone has a great candidate drug, they have to go through rounds of test with mice and then rabbits and then humans. It all depends on so many factors. If it works really well, someone can streamline things and get something to market within five years. But it hasn’t been identified yet. Obesity’s a really important health problem. A lot of attention has been focused on it and the amount of work is growing ... but we just don’t understand a lot of cellular mechanisms that have been controlling it yet.

email: refresh@buffnews.com

Twitter: @BNrefresh

The Super Bowl can break your heart, literally

The favorite team for most of you reading this hasn’t played in the Super Bowl for two decades. Hasn’t even had much of a sniff at the game since then. But that doesn’t mean Sunday’s game won’t prove to be a real heartbreaker for some fans.

Recent studies suggest that the emotional stress fans feel after a loss may trigger fatal heart attacks, especially in people who already have heart disease, according to the Catholic Health System.

Stress generates the so-called fight-or-flight response, which causes sharp upticks in heart rate and blood pressure that can strain the heart.

“Fans often become emotionally invested in the game and get to the point of actually feeling like they are at the game,” said Dr. Harry McCrea, chief of cardiology at Kenmore Mercy Hospital. “As a result, they start to feel the effects of being overly stressed, which leads to elevated blood pressure.”

Stress can be aggravated by common game-related past times, such as trash-talking and betting. Consuming copious amounts of beer and fatty foods like chicken wings – practically a requirement at many Super Bowl parties – can increase the risk of heart disease and trigger abnormal heart rhythms such as atrial fibrillation.

“Food is directly involved in many of the risk factors for coronary heart disease,” McCrea said. “Paying attention to what you eat is one of the most important preventative measures you can take. Saturated and trans fats in the diet tend to increase LDL (bad) cholesterol in the blood. Common sources of saturated fats include animal products and processed foods.”

According to the Calorie Control Council, Americans eat about 30 million pounds of snacks during the Super Bowl, and averages out to about 1,200 calories and 50 grams of fat per person. The majority of those calories are likely from unhealthy food like pizza, chips and dip, chicken wings and snack food. That’s nearly a full day’s worth of calories, based on the USDA’s Dietary Guidelines for Americans – and 43 percent more fat than is recommended for an entire days. 

“The key is not to avoid the Super Bowl,” McCrea said, “rather, just be aware of over indulging too much. Try not to associate your consumption with the emotions you’re feeling with the game.”

Author to talk of growing up Polish, Catholic and bipolar in Buffalo

Anthony Antek, author of “Bipolar Buffalo – A Mosaic of Minds Journey,” will give a talk entitled, “The Bipolar Advantage: The Link to Creativity,” from 7 to 9 p.m. today at the Museum of disABILITY History, 3826 Main St.

Antek’s presentation – part of the museum’s ongoing Dialogues on disABILITY Speaker Series, will focus on his book, as well as personal stories about living and coping with bipolar disorder. Using personal stories, original art and photos, Antek writes of the struggles, fun and adventures of a second generation working-class youth growing up Polish, Catholic and bipolar in Buffalo during the mid-20th century. He also will address other topics, including positive aspects of the disorder and reflections on the debate of neurobiology vs. social conditions as causal factors. The presentation will also include a Q&A session.

Members are free; otherwise, the cost is $5 for adults and $2.50 for seniors, students and human service employees (includes museum tour). For more information or to register, call 629-3626 or email dfarley@people-inc.org.

Group seeks to honor top state senior volunteers

The search is on for New York’s “outstanding senior volunteer.”

The Salute to Senior Service program, sponsored by Home Instead Inc., seeks nominations for those age 65 and older who give at least 15 hours a week to volunteer for their favorite causes.

“Senior volunteerism not only benefits others but also helps seniors stay active and socially engaged in their communities – important elements of healthy aging,” said Lisa Wiedemann, owner of the Home Instead Senior Care office in Buffalo.

Those interested in nominating or voting for a candidate may do so by March 1 at SalutetoSeniorService.com. For more information, call 630-0657.

Study suggests option for cancer treatment

Treatment with the drug decitabine prior to administration of chemotherapy and a cancer vaccine yielded clinical benefit for women with recurrent ovarian cancer, suggesting that this combination may provide a new treatment option, according to a study published in Cancer Immunology Research, a journal of the American Association for Cancer Research.

A prerequisite for a patient’s immune system to recognize and attack his or her tumor is the presence of high levels of a protein not normally found in the patient’s healthy cells. Proteins with this profile are called tumor antigens and can be good targets for anticancer vaccines.

Dr. Kunle Odunsi was principal investigator of the study. He is the M. Steven Piver professor and chair of the Department of Gynecologic Oncology, and director of the Center for Immunotherapy at Roswell Park Cancer Institute.

“We propose that patients should actively seek these kinds of combination therapies,” Odunsi said in a news release. “Even though the majority of these types of therapies are experimental at this point, there is enough scientific and clinical evidence to indicate that they are likely to be beneficial.”

Choosing a gym as the BAC coed window closes

11503 REFRESH EASTERN HI#19

The Buffalo Athletic Club next to the Eastern Hills Mall in Clarence was among the locations bought by LA Fitness. File photo by Mark Mulville/Buffalo News.


By Scott Scanlon – Refresh Editor

A health scare pushed me into my first gym membership when I was in my mid-30s, almost two decades ago. The specialist who took out a benign tumor and my right adrenal gland told me afterward that I could live to be 100, if I exercised regularly and ate mostly vegetables.

I still remember thinking, “I won’t live to be 100.”

Historically, I’ve not been a big veggie guy, even after that harrowing half year of diagnostic tests, hospitalization and recovery. But I did take the exercise advice to heart – sort of.

I’ve thought back on that horrible period in recent weeks, in the wake of LA Fitness buying the quartet of Buffalo Athletic Club coed fitness centers at Christmas time. I’ve also thought about how I approached my early forays into gym memberships and the more thorough approach I took in choosing the BAC when I moved back home to Buffalo from Central New York in September 2004.

BAC coed members have until Jan. 31 – this Friday – to shift their allegiance, and money, to LA Fitness or find another place to work out.

After talking with a few dozen folks about the sale in recent weeks, I’d be willing to guess that by week’s end most former BAC coed club seniors will have found their way to YMCA or JCC fitness centers (read why here); that the majority of women who spent most of their time taking BAC group fitness classes will end up at the BAC for Women clubs; and that LA Fitness will keep most younger BAC members, middle-aged, married coed members who like to work out together, and members who prefer spinning classes and cardio equipment.

I plan to do something a bit differently, and it’s a decision based on talking with lots of fitness and nutrition experts since starting my job as Refresh editor last February. I’ve also decided to take the advice several of those experts gave me for the Jan. 4 Refresh cover story on questions to ask when choosing a gym

I started the process by deciding to take most of the last few weeks to carefully consider what to do, and to start with this bottom line: My decision would be limited to the rest of this year, no longer.

It also would be a decision based in part on my previous experiences. Does any of this sound familiar to you?

  • Why bother joining a gym? I can just run outside. Walk the dog. Play with the kids.
  • I’ll buy a treadmill and put it in the basement. That’s barely more than the cost of an annual family membership to some gyms and I can watch sports on the small TV while I work out.
  • I’ll join a gym, have someone show me the Cybex machine circuit a couple of times and be power lifting in no time.
  • Why aren’t I losing all the weight I wanted? Maybe I’ll take some fitness classes.

A busy job and civic life, and active kids, short-circuited the stay-at-home exercise plan in the mid-90s. And it isn’t easy finding gym time when you work late, have night meetings, and need to be relied upon as the chauffeur for dance lessons, missed school buses and after-school sports.

The treadmill was great for a while, starting in about 2000, but it broke down after a couple of years and I didn’t want to pay to repair it. After all, I could just run outside, walk the dog and play with the kids. I ended up hanging my laundry on it while I watched sports on the small TV in the basement.

So I joined some gyms, and did the same exercise routines over and over and over: first the treadmill, stairmaster, sit-ups and curls, and later, in more recent years, spinning or stationary bike and elliptical, followed by crunches and curls. I worked out as often as I thought a busy person could, one to three times a week.

Like many other fitness club members out there, I didn’t mind shelling out $299 a year to have four BAC branches available to me. It gave me less guilt during those times I made the wrong eating choices, and the club was there when that guilt, and some added pounds, became nagging enough for me to want to do something about them.

After having spent the last 11 months thinking, talking and writing about health and fitness for a living, that’s no longer good enough. Here’s why:

  • A growing number of fitness trainers I’ve talked with since February, when The Buffalo News was getting ready to launch Refresh, have talked about how muscle confusion, through changing up your workouts, leads to more strength. And more strength burns more calories, even at rest.
  • Some of the top experts I’ve interviewed – including Kathy Corff Rogers, a Jewish Community Center group fitness instructor – have underlined the importance of using good form when exercising. I’ve since watched young guys trying to curl way more than they’re able to properly, while lurching their backs and straining their shoulders, and have similar thoughts as when I see young women smoking cigarettes: “Enjoy the façade while it lasts.”
  • And I remember what Cheryl Reddish, a personal trainer who has become a friend of mine, told me just before Christmas about personal training: It’s worth the expense to learn how to exercise properly; take a few personal training sessions before you attack a larger fitness plan, wherever it may be. (And make sure to check with your primary care doctor to make sure you can handle such a routine.)

I’ve kept these things in mind during the last three weeks as I’ve worked out and written about my experiences at the following gyms:

LA Fitness

Independent Health Family Branch YMCA

Hive: The Lifespan Center

I asked for, and received, free guest passes to try the trio of clubs, and you can, as well. That’s one of the recommendations made in my choosing a gym story

Other advice I followed included sticking with three gyms that are between where I live and where I work; paying attention to cleanliness and how gym members treat their facility, equipment and each other; paying attention to how staff treats members; sticking to clubs with spinning classes, the mainstay of my workouts; trying the clubs at times I would use them; and balancing all of that with a price I can afford.

I’ve already changed my diet considerably –including far more vegetables and almost no processed foods – since becoming Refresh editor, but I’ve been stuck when it comes to fitness.

I aim to change that in the coming weeks, using the following strategy:

  • I’m going to pay $88 to work out at Hive for 30 days. That will include access to all the equipment and unlimited use of classes, which generally cost $5 a la carte for group fitness classes including spinning and $24 for specialty classes similar to group personal training sessions in other gyms. It also includes four semi-private coaching sessions and a customized workout program with “no contracts, no hard sell, no pressure.”
  • Meanwhile, I’m going to pay even more for six personal training lessons at Maximum Fitness Training, in Amherst, where Reddish or her husband, Ed, will help show me proper form and school me on even better nutrition.
  • And I’m going to grit my teeth and stick with LA Fitness – though I plan to work out mostly at the former Eastern Hills BAC LA Fitness location instead of the one a half-mile up the road in the Walmart Plaza. Both clubs are in Clarence, and your guess is as good as mine about how long LA Fitness will keep open the older former Eastern Hills BAC.
  • I’m also going to spend the next 11 months trying to convince my girlfriend to join with me in a 2015 membership at the Independent Health Family Branch YMCA, next to ECC North in Williamsville, which truly is the most impressive gym I’ve seen in the region. I suspect most of my workout time would be when kids are in school, asleep or at home, and the extra amenities they have are incredible. But the Y costs $50 a month for an individual membership – $20 a month more than LA Fitness – and is further away from the Transit Road corridor where I live. The place costs $66 per couple, which would make the Y comparable in price, with lots more features.

The LA Fitness choice has been the hardest for me. Its communications office has ignored requests from me and another Buffalo News reporter for interviews since the sale, which should be enough to give anyone pause, not just journalists. I’ve spent hours in interviews in recent weeks with people upset at how the chain has treated them in the former BAC fitness facilities, though I’ve also heard good things from some folks, too. And this Yelp review page I read last week on the LA Fitness club in Valencia, Calif., did little to shake my ambivalence about the chain.

I get the sense that this new force on the WNY fitness landscape is the new Walmart of fitness, and have heard others describe it the same way, but I will say that, on balance, I’ve been treated well by staff members who have taken time to chat with me this month.

If I lived closer to BikeorBar on Elmwood Avenue, or one of the two JCCs, or Crunch, Catalyst, Planet Fitness or World Gym, I would have checked out those spots. If I was younger, I might have put less thought into this decision. If I was a senior citizen, I already would have fled to the YMCA.

But I am a 53-year-old guy who just renewed my annual BAC membership the night before the owners told the staff they were selling the coed clubs to LA Fitness.

I’m in a long-term relationship, and my girlfriend and I want to be part of a club where we can work out together. (She is upset by the sale, and her BAC friends have split into those who went to the BAC for Women and those, like her, who’ve chosen to go with LA Fitness, including some of her favorite fitness instructors.)

I don’t like to be bothered when I’m working out – especially by staffers trying to sell me additional services, or asking if I may know of a friend who might like to join a fitness club – but I do like to meet new people and make new friends. I sense LA Fitness may be the best choice for me in these ways.

My daughters are both college-aged now, so I can do without kids running around my gym. Been there, done that. I’ve yet to see a kid at LA Fitness in Clarence.

I’m also not crazy about a gym where every guy looks ripped, every woman looks buff and plastic, and everyone my age has a $40,000-plus vehicle in the parking lot - except me! I’ve not experienced that in any of the clubs I’ve checked out.

This said, those differences make the fitness world go round. It’s just a question of finding what works best for you – particularly before you sign some long-term agreement at a club you might sour on within a few weeks.

One thing I’ve heard from regional experts in recent weeks is that every club feels uncomfortable at first, just like a new job or a new relationship often does. 

Once you decide, give it some time, a few months, and don't sign a longer term deal, at least at first.

And, most importantly, stick to your exercise and healthy eating plan as best you can.

You might just look in the mirror come bathing suit season and like very much what you see.

Email: refresh@buffnews.com

Twitter: @BNrefresh

Refresh editor liked buzz at Hive fitness center

Fitz
Eileen Fitzgibbons is among the sought-after trainers at Hive: The Lifespan Center, in East Amherst (Charles Lewis/Buffalo News)


By Scott Scanlon – Refresh Editor

Anyone who’s ever taken a spinning class or worked out on the exercise equipment at a coed Buffalo Athletic Club has grown to appreciate the availability of small towels and sanitizing spray bottles throughout the four clubs.

One of the biggest surprises as I’ve checked out other fitness centers in recent weeks is the absence of these things. Wet Wipes yes, but those seem far less efficient or environmentally friendly.

Things changed this weekend, when I took a couple of spinning classes and checked out the digs at Hive: The Lifespan Center, in East Amherst, close to where I live.

My girlfriend’s daughter and fiancé are members here and rave about the place. Owner Christopher Salisbury – a former Gold’s Gym manager who looked to put together a more complete fitness experience when he opened Hive in April 2010 – has been among the go-to fitness experts I’ve turned to as a source since The Buffalo News launched Refresh last March.

Not only does this place have towels its members can bring into the group fitness rooms and cardio spaces, and towels you can use after a shower, spinning instructor Lindsay Meagher handed out cool washcloths scented with eucalyptus or lavender, or maybe both, after her class on Saturday morning.

Hive isn’t a gym for everybody. It costs more than most. But Salisbury has endeavored to bring some of the top fitness instructors in the region into his space, combine them with a wide range of exercise forms, and top it off with physical therapy, nutrition counseling and massage therapy services, as well as a juice/smoothie bar.

Salisbury told me recently, while I was reporting the Jan. 4 Refresh cover story on choosing a gym, that there are three things a gym can provide: the quality of the product; the quality of the service; and the lowest price.

“You can’t get all three,” he said, and many people sacrifice the first two for the third.

Hive – which stretches thinly along a storefront plaza it shares with a Tim Hortons, martial arts studio and a couple other retailers along Transit Road, south of North French Road – focuses on service and quality.

The club is offering a 30-day membership for $88 as it looks to chisel away some of the BAC coed members who want to consider other options now that LA Fitness owns those clubs. The California-based chain has given BAC coed members until Friday to decide whether they want to take their business elsewhere.

The monthly trial includes access to all the equipment and unlimited use of classes, which generally cost $5 a la carte for group fitness classes including spinning and $24 for specialty classes similar to group personal training sessions in other clubs, said Tom Frost, senior fitness director at Hive. It also includes four semi-private coaching sessions and a customized workout program with “no contracts, no hard sell, no pressure.”

Frost also made sure to point out that Hive accepts Silver Sneakers and other Medicare Advantage Plan-related discount programs for senior citizens.

I was able to get a one-week trial membership from a current club member.

I’m frugal, so I felt as though I landed on a different planet when overhearing some chatter in the men’s locker room after I arrived Saturday morning. Two guys were talking about taking flights out of Buffalo in a way I might talk about going to dinner in Amherst. Still, I liked the overall buzz of the place. Here’s what I experienced:

  • Something different when I first stepped in from the cold and snow: Folks who work out here are expected to take their shoes off before they come in. No outdoor shoes are allowed in the gym.
  • Club members come in all shapes, sizes and ages – though tend to be slightly better dressed than some folks in other clubs.
  • The gym is open and airy, the group fitness classes small and intimate. The spinning classroom, for instance, has only 18 bikes, about half the number at the Independent Health Family Branch YMCA in Williamsville, and one-third the number at LA Fitness in Clarence and the former BAC Eastern Hills, where I’ve been a member for more than nine years. I took classes Friday and Saturday, and had to schedule a seat in advance for the classes, which were half-full at best.
  • I’ve been blessed to have great spinning instructors over the years, but Meagher, who has a day job with Horizons Health Services, was a bit better. Her class was the hardest I’ve taken in recent weeks and she shouted out more instructions than I’m generally used to hearing. I’m used to: “Keep your shoulders down,” “Find a pace that is challenging but works for you” and “Get ready for jumps.” I rarely hear, “Your heel should be lower in this position” or “Your knees should be even with your pedals." She kept a closer eye on individual students, something you can’t expect an instructor in bigger classes to accomplish.
  • The spinning music also is the choice of the instructors here, as is the case at the BAC and YMCA, but not the more corporate LA Fitness. Hive classes had a more decidedly modern mix than some of the other classes, including more dance music. I also heard REM, My Chemical Romance and Nickelback.
  • The cardio machines share space with pockets of mats, flooring and other patches where trainers work with members one-on-one or in small groups. The place is loaded with kettle balls, resistance bands and resistance machines, as well as exercise equipment and free weights.
  • Service here is top notch. When you’re new to a club, you don’t always know how everything works. For me, that included the lockers and the spinning room door, which slid open instead of pushed open. A non-judgmental staff member helped me deal with both. Another staffer grabbed a towel I mistakenly brought into the lobby as I was leaving Friday, and volunteered to take it back to the locker room area. All staff members smiled and were friendly. That wasn’t always the case in the bigger clubs I visited.
  • The whole place was very clean, including the men’s locker room. I wished the lockers were bigger but the shower stalls were far better than I’ve seen in other clubs and the soap dispensers actually shot out enough soap with one hit.

The visit underlined the differences between budget gyms and those that offer a greater level of service.

It got me to thinking about all the people in Western New York who think nothing of dropping a few hundred dollars on a night out at a Niagara Falls casino or a weekend trip to Toronto, then balk about having to fork over a smaller sum over a year on putting together an exercise regimen that can improve their lives in a far more lasting way.

The visit also clarified how I expect to approach my fitness club membership for the rest of this year.

I’ll share my choice, and the process I used to get there, Monday in the Refresh Buffalo Blog.

Email: refresh@buffnews.com

Twitter: @BNrefresh

 

 

 

 

 

 

 

 

 

Visit to Northtowns Y reveals mother of all WNY fitness centers

L.fletcher
Retired speech therapist Lora Fletcher, of Williamsville, is among the interesting people Refresh Editor Scott Scanlon met at the Independent Health Family Branch YMCA. She's playing "pickle ball," a combination of ping pong, tennis and badminton. (Photos by John Hickey/Buffalo News)

By Scott Scanlon – Refresh Editor

I should have shaved.

That was the prevailing feeling I had last Sunday when I took my second spinning class at the Independent Health Family Branch YMCA in Williamsville.

I had no idea I would run into anyone I might know, or want to know.

First was the spinning instructor, Eleanor Payne, an assistant principal by day who knows my brother, Todd, and sister-in-law, Sheila.

Then it was Jim Dempsey, a fellow spinning enthusiast who overheard me talking with Payne and introduced himself as one of my relatives. His father was my Grandma Scanlon’s brother.

After spinning class, I hit the ellipticals and some of the exercise equipment, where I said hello to Maurie Materise, who I’ve seen around The Buffalo News office. He specializes in selling advertising to banks and other financial institutions.

Who knew I’d meet so many interesting people toward the tail end of a lazy weekend, while covered in two-day-old facial stubble?

The visit was part of my quest to determine by Jan. 31 what to do about my fitness club future in the wake of the Christmastime sale of the Buffalo Athletic Club coed gyms to LA Fitness. Read my previous blog posts about the search here and here, and my WNY Refresh story about choosing a gym here.

The guest tryouts last weekend at what many call the "Northtowns Y" underlined what YMCA Buffalo Niagara CEO Olin B. "Buddy" Campbell Jr. told my girlfriend, Karen, and I on New Year’s Day while he led us on a tour of the place: One of the blessings of the YMCA is the social connections you can make.

That should shed some light for folks like Mike Hilburger and other members of his former "Zipper Club," a group of guys who’ve undergone open heart surgery and worked out together for a decade or more at the Eastern Hills BAC, but have scattered in recent weeks as LA Fitness employees have told senior citizens the chain would no longer honor Medicare Advantage Plan discounts. (Read this weekend’s WNY Refresh story about that and other insurance discounts.)

"We socialize together about once a month," a dejected Hilburger told me earlier this month. "Everybody’s going to miss that."

Maybe not. Many of them ultimately may end up at the Northtowns Y.

Take if from Lora Fletcher, who left the BAC for the big gym early last year, when the Northtowns Y first opened, because she wanted more fitness options to deal with the aftermath of left knee surgery.

“I have made some really good friends here,” the retired Buffalo Public Schools speech therapist told me. “I’ve also seen some of my son’s friends who have little kids.”

For those in the market for a new fitness club, here’s what you want to know about the YMCA in general:

• Each YMCA focuses on fitness and wellness for the entire family, ranging from infants to seniors.

• The offerings go far beyond weights, weight machines and aerobic classes. Healthy cooking classes, comprehensive child care and health and wellness programs are among other options.

• The YMCA will waive the $75 join fee for any BAC member who signs up by Friday.

• Western New York has the added blessing of having two Jewish Community Centers – one in Amherst, the other in Buffalo – that offer a similar slate of activities. These clubs are offering $100 off an annual membership, two extra months free and four free personal training sessions for BAC members through Friday.

Here’s what you want to know about the two major YMCA branches in the region – the Northtowns Y, next door to Erie Community College North, and the Southtowns Y, at 1620 Southwestern Blvd., less than a mile from the LA Fitness (former BAC) Southtowns branch:

• They are the mother of all fitness centers in the region. The Northtowns Y is the largest, at 94,000 square feet, and the Southtowns a close second.

• Their buildings include full-sized basketball courts; multi-purpose rooms for cooking classes and other gatherings; two group fitness studios; large cardio and free weight spaces; sprawling child care sections; massage therapy; physical therapy offered by Buffalo Rehab Group; wading and lap pools, steam rooms and saunas, and a hot tub. There are even "family" locker rooms, which contain private, individual stalls big enough for mom or dad to help get their sons and daughters ready for swim lessons, and ready to go home, together.

• Both of these sites are relatively new, with new equipment and, because of their sheer size, plenty of elbow room, even on weekends.

Still, for some, this isn’t wellness Nirvana.

Teenagers can use the facilities, and it’s not uncommon for younger children to wander around looking for parents.

Seniors can have run of the clubs, and some group fitness classes, at times.

There’s no escaping the bustle, particularly on weekends. Those who prefer a quiet workout, alone, may feel overwhelmed here.

The cost for an individual membership also can be prohibative, at $50 a month for an individual membership. The cost falls into better line for seniors who have Medicare Advantage Plan discounts, as well as couples and those looking to join a fitness center as a family. Membership also includes a 12-week training introduction that would cost extra in almost all discount clubs in the region.

I loved belonging to the Oswego and Fulton YMCA branches when my now-college-age daughters were younger and I was married. I could drop them off at child care, hit the Cybex machines and weights, and we could all take a dip in the pool or hot tub afterward.

I also enjoyed my pair of workouts last weekend at the Northtowns Y.

The spinning classes were a bit clunkier than those at the BAC and LA Fitness, because you have to roll out the Keiser bikes onto a group fitness studio floor used for various classes. But bikes were available both last Saturday and Sunday, and that has not always been the case in January at the BAC. The teachers also compared to those in the other gyms – and it was clear that they were allowed to play their own music. Payne’s set list included tunes from Aerosmith, Creed and Tina Turner. She also asked spinning class participants to request music for future classes.

It also was nice to hop onto equipment after class in the second-floor cardio section. Many treadmills and ellipticals tout individual TVs and iPod ports, and all look out the multi-pane swath of glass that yields to a 600-space parking lot and the front grounds of ECC. Running on the banked, rubberized second-floor track that circles, from above, two full-sized basketball courts on the ground floor, also was a kick.

What child wouldn’t love the Alaskan Adventure Room, a two-plus story maze in the child-care section? And what parent wouldn’t appreciate the many windows in the cardio, free weight and other adult sections that look out onto the pools and Alaskan Adventure Room?

For those BAC coed members still feeling the sting of that chain’s sale to BAC – because change, after all, can be daunting – there also another thing for prospective members to keep in mind when it comes to the YMCA Buffalo Niagara.

"We’ve been around 162 years," Campbell said.

And they’re not going anywhere.

Coming Sunday at the Refresh Buffalo Blog: Scott Scanlon gets a feel for a smaller gym.

emai: refresh@buffnews.com

Twitter: @BNrefresh

 

Ymca.ss
This YMCA yoga class is one of dozens of classes, and a wide range of other programs, that take place each week at YMCA Buffalo Niagara branches across the region.

Fitness comes first for this lawyer dad

J.turcotte
Jerry Turcotte and his son, Max, 7, enjoyed putting together “Exercise Like The Animals A to Z,” available on amazon.com. (Harry Scull Jr./Buffalo News)

By Scott Scanlon – Refresh Editor

Jerry Turcotte weighed 232 pounds three years ago, far from an ideal weight for a guy who stands 5-feet-4.

Basketball, Leonardo da Vinci and a commitment to community fitness helped him to shed 70 pounds since.

Turcotte, 41, subject of today’s “What are you eating?” feature in WNY Refresh, was obese for three decades when he broke his ankle in 2011.

"I realized how difficult it was to get around on crutches with all the weight that I had, and I swore that it wasn’t going to happen again,” he told me. "That, and realizing that my youngest runs everywhere; he doesn’t walk. I needed to be able to keep up."

He and his wife, Diana Proske, have two sons, Max, 7, and Simon, 3½, who’ve inspired Turcotte to become a stay-at-home dad, author and child fitness instructor. The couple met at the University at Buffalo Law School in 2001.

"It was the very best thing that came from going to law school," he said.

We hear a lot about folks moving away from Buffalo, but this pair settled here, in a neighborhood near Delaware Park.

Proske grew up in Kent, Ohio; Turcotte in central Maine.

Turcotte got his bachelor’s degrees in history and French at the University of Maine, and became involved in the Maine People’s Alliance, a state advocacy group similar to NYPIRG. "I took an early interest in health policy," he said, “and that that interest led me to want to go to law school, so that led me to law school in Buffalo."

It was an interest born out of a goal to shape both public and personal perceptions.

"I always saw myself as a fat ass,” he said. “I was always picked last and I played a lot of sports. I was too heavy, and I couldn’t have fun doing it.”

Life freshly off crutches began to shape a change.

“I started to ride my bike more and to stretch – the most important thing I’ve ever done, because stretching helps me to avoid injury,” he said. In the months that followed, he also joined a basketball league, one he continues to enjoy. He met a personal trainer in the neighborhood and the two men started working out together, mostly using resistance training.

As the pounds melted away, Turcotte decided it was time to create a website, vitruvianrenaissance.com, and write an online book: "Journey to Fitness: Solving my Inner Vitruvian, and you can, too."

A da Vinci exhibit came to the Buffalo Museum of Science about the time he was writing the book. He spent those months biking or pulling his kids by wagon to the museum "over and over again," and the sight of da Vinci’s  Vitruvian man, drawn standing inside a circle, became an ideal.

"To me, it symbolizes the balance of the human body,” Turcotte said. “We are a perfect form if we can get there. It opened my eyes to what my own possibilities were…

“The book is meant to help adults to understand, and give them tools to understand, that they have the strength inside of them to make the right choices to live a fair lifestyle. Sure, it takes diet and it takes exercise, but for somebody who’s been overweight for a long time, it takes time in their head to see themselves differently. I thought I could help.

“Now I have lots of fun. I play basketball every Friday and Sunday, I play in a men’s wood bat league in the summer.”

He also became certified by the International Fitness Association to do group aerobics training for adults and kids.

Today, he weighs about 160 pounds.

Last August, taught adult-toddler fitness at the Crane Branch Library on Elmwood Avenue.

"Having the extra motivating factor of a parent doing the same thing encourages children to do the action, as well,” he said. “Plus, it’s a sneaky way of encouraging parents to exercise, I’ve got to admit."

He’s also taught at North Park Community Preschool and the George E. Blackman School of Excellence.

With help from his sons, he recently published his second digital book, a book for kids, titled "Exercise Like The Animals A to Z," which ties together animal movements and the alphabet. It’s available for $5 on amazon.com.

"Every letter of the alphabet has its own animal, with some surprises,” Turcotte said. “They all move in different ways.

"As a writer, I wanted to do a rhyming piece that would teach kids about the animals – where they live and a little bit about their habitats – and the rhymes are meant to be instructive but also to encourage their movements.”

He and his son Max and a family friend came up with 26 animals. A former art teacher put together the book cover.

"The bear to me is an important animal for people who are overweight to identify with a little bit,” Turcotte said. “It carries so much extra weight, but they are immensely strong. Accepting that I had that kind of strength, the results became almost overwhelming at times, in terms of just how responsive my body would get."

The animal images are silhouettes of son Max, who posed for each of the shots.

"Obviously, you have to use a little bit of imagination," Turcotte said.

The angler fish starts off the book: "The movement is a squat where you wiggle your behind as if you have a tailfin, and you move your arms out in front of you as if you have pectoral fins. It read, ‘They have a special trick, they can make their own light. So you stand up and reach your hands to the left and to the right.’

“When I teach fitness classes, I try to do them in order because I’m also trying to teach kids the alphabet,” he said. "It doesn’t seem like work when you look out and see 10 kids doing squats and they have these great big smiles and are having a ton of fun."

email: refresh@buffnews.com

Twitter: @BNrefresh

 

Orthopedic surgeon muses on his profession

 N.violante

The bottom half of this Hana table moves up and down to make anterior hip replacement surgery more effective, says Dr. Nicholas J. Violante, second from right, shown with his Erie County Medical Center operating team, from left, registered nurse Charlaina Turner; Kenny Burzynski, operating room technician; physician's assistant Nicole Ksiazek; and Jim Turner, vice president of ECMC surgical services. (John Hickey/Buffalo News)

 

By Scott Scanlon – Refresh Editor

Dr. Nicholas J. Violante might not be a dentist like his dad, but he puts in long hours and has made a big impact in the field of hip and knee replacement surgery since he landed a job in 2006 with Excelsior Orthopaedics, based in Williamsville.

Violante is the subject of today’s “In the Field” feature in WNY Refresh.

His family has built a legacy in the dental community in Lewiston, but he’s staked his ground south of the Niagara County border, though he does work out of Niagara Falls Memorial Medical Center at times.

Below are excerpts from questions that were not included in today’s WNY Refresh piece.

What is residency like for an orthopedic specialist?

I did a general residency the first year and then they decide the next year who they want to pick for their ortho residents. They took five interns for two spots and made you compete for it, which not a lot of programs do anymore. Now, most of the programs streamline you right in. Before, the thought was everybody ought to do a little bit of everything in that first year before you specialize. So you have some general surgery, pediatrics, general medicine. And our residency was different. Because we were based out of such a small hospital, we got sent out for a lot of things. We traveled quite a bit, which was tough. I was in Pittsburgh six months for trauma. We did our peds as Shriners, which was local in Erie at the time. I went to Cleveland, to the University Hospital System for six months. It’s like the Cleveland Clinic counterpart, sort of.

Then there were a bunch of small hospitals in Western Pennsylvania, like Meadville, Sharon, UPMC Northwest.

It was tough, but the nice thing about it is because we were all over the place, we got a nice variety of trainers.

If you’re in the same hospital, you might have eight or 10 trainers. In that setting, I had 35-plus trainers, and for me, doing total joint replacements, I saw every different system on the market. … That helped kind of groom my interest in total joints.

What was the first big case you had to address and how did it work out?

When you’re in residency and fellowship, you have a lot of help. My first big case on my own was a hip revision I did on a gentleman who owns a maple syrup farm. He came to me after having six failed hip surgeries. I looked at his X-rays, paused for a few minutes and had a conversation in my head of, ‘Can I do this on my own?’ I had the confidence, I had the skills to do it, but just making that leap of faith to say, ‘I know I can do this, be prepared, get all the equipment there.’ That was my biggest case. That was about six months ago. The guy’s doing fantastic. He’s brought me a case of maple syrup and offered to have me come out to his farm with my family to do a tour.

You operate out of Erie County Medical Center?

I have complete confidence taking big cases to ECMC. I know that if there are going to be complications, I have the support staff around me to manage them.

What special challenges do hip and knee joints present and why?

One of the things that makes my job tough is peoples’ overlap with pain, function and work. A lot of the things I get tied up in with my patients is pre- and post-operative disability, as far as return to work, return to life. There’s a lot of social issues surrounding pain and loss of function. When people come to me and say, ‘I need a hip replacement,’ it’s not something as easy as, ‘OK, I’ll replace your hip.’ They want to know, ‘How long am I going to be out of work?’ ‘When can I drive?’ ‘When can I go up the stairs; I have 12 sets of stairs in my house.’ ‘My bathtub is not well equipped.’ Those are some of my bigger challenges. It’s not the surgery. The surgery is fairly reproducable, it’s managing their social and life problems.

And how do you do this?

With people. We have a lot of people around: our physical therapists, our care coordinator, our nursing staff. Knowing that, at ECMC, we started a Total Joint Steering Committee out of necessity. When I started working there, there was a lot of disconnect between doctors, nurses, therapists, surgery department. All those people should be together to discuss a patient’s experience from start to finish, so that it’s reproducable, smooth, with less hiccups. When you have all those different people knowing what their jobs are, and what your expectations are, it makes things so much easier. It turns out the patients will ask the right people the right questions.

How has orthopedics changed during the last decade?

It’s changed a lot in terms of the subspecialties. When I was an intern, most people were doing fellowships, but there were 50 percent of the people who graduated still doing general orthopedics. When I graduated, and the classes below me, probably 100 percent of people were going into fellowships, going into more specialty training. People’s expectations of their surgery are higher, their expectations of return to function quicker, faster.

During my training, a lot of people going in for hip or knee replacements were in the hospital for five, six, seven days. They were out of work for three months. Part of it was just expectations. The post-operative complications were often (more common). We use different pre-operative medications now to prevent post-operative stuff. There’s more planning involved now, so that recipe has changed. Even in my fellowship, things changed. Us trying new things, what worked what didn’t work, and that eventually sort of thing kind of bleeds out into the community.

Are you seeing more computer-generated research where you’re looking at more best practices?

Yeah, at least theorectically. It’s coming. There’s all this talk about outcomes are going to determine reimbursement. I think people coming out of residency now are not as confident about managing everything. They’d rather focus in on one thing and be confident in one thing. ... The push for subspecialties really is all about confidence.

How will the Affordable Care Act change what you and your fellow orthopedic surgeons do?

It’s going to be all about outcomes. I think that’s the only way they can subjectively determine reimbursement.

Do you expect things to become more challenging or efficient?

One of the things that concerns me the most – right now, we take all insurance ... so eventually you get busy with people who want to see somebody who does a good job – the concern is if it becomes financially too strenuous. … There was a push when I was in residency to stop taking Medicare because the reimbursement rates weren’t as good as the private insurance payers. The thing I like is to just take care of people. I don’t want to decide not to take care of people because I can’t afford to. I want to generally show up to work, solve whatever problem’s in front of me and help that person. I don’t want it to be what their insurance is. I would tell you, most doctors feel the same way. You don’t want finances to influence the people that you help.

What are the youngest and oldest patients you’ve operated on?

I had a 26-year-old patient who I did both hips at the same time on. He had auto-immune hepatitis and the amount of medications and steroids he was on post-operatively from a liver transplant ended up secondarily killing the cartilage in his hips. Complete success so far. It’s been less than a year. He stood up the day after surgery and walked down the hallway and he did not use a walker, a cane or a crutch. It was truly remarkable. The oldest patient was an 89-year-old who I did a total knee replacement on. He was sent by one of my partners. He was a very healthy 89-year-old who still had a very good quality of life. I talked with him multiple times before I made the decision to operate on him. He said, ‘Doc, you’ve gotta fix me.’ He felt he still had a lot of good years in him.

I tell people, ‘I don’t know how long this joint replacement is going to last you,’ and I tell them about the risks ahead of time.

Can you talk a bit about when surgery shouldn’t be considered versus when it should?

Part of it depends on their medical status. If patients are at high risk for anesthesia, it should definitely not be considered. When I talk to people about their medical status, I often ask, ‘How many subspecialists are you seeing?’ If they have a laundry list of doctors on speed dial, usually that’s a bad sign. The second thing is diabetes management. A lot of things can subtlety get missed. Someone can tell you they’re a controlled diabetic when they’re really uncontrolled. Those are very risk, very dangerous. ... Risk of infection is considerably higher. (That has to be addressed first)

Does a joint have to degenerate to a certain point?

If I see a patient who says they have an enormous amount of pain and their X-rays seem completely normal, they’re not a candidate for a knee replacement. It usually means you don’t have the right diagnosis. … There has to be degeneration in the joint.

What should someone consider when confronted with the prospect of replacing a joint with a prosthetic?

Number 1, I tell everybody, ‘It’s never going to be the knee God gave you,’ ‘It’s never going to be the hip God gave you.’ I tell most people, ‘It should restore your function, but it may not always get rid of all of your pain.’ People have pain for different reasons. If you restore a replace a joint, the ultimate goal is pain relief, but part of it is functionality. ... If they couldn’t walk before, now they can walk but they still have pain, it wasn’t necessarily unsuccessful, but it’s all about people’s perception. If someone has no pain but it’s not functioning, most people aren’t happy about that either. Most of the time, patients experience both, but I may relieve your pain, but not restore your function. I may restore your function but not relieve all of your pain. That’s somewhat on the patient, somewhat on the doctor. If it’s a perfect surgery and a patient doesn’t do any of their rehab, they may not have a great outcome. So part of what I tell people is, ‘You can expect to have pain for X amount of time, but you have to have somewhat of the onus on your own care.

What’s the threshold in determining whether a full or partial hip or knee replacement is needed?

Partial knee versus a total knee is based on the diagnosis. So, you have X-rays and degree of pain, history and physical exam. If the pain is slowly on one side of the knee and X-rays confirm their arthritis is only on one side of the knee, then typically that person is a candidate for a partial knee. If their pain is on both sides of the knee and they have significant problems with function, and the X-rays confirm that, they’re a candidate for a total knee. Typically, age has nothing to do with that.

I don’t do a lot of joint preservation. That’s unveiling into a category of its own, and that’s usually sports medicine.

How does a replacement differ from someone who’s broken a hip?

Hip fractures typically involve patients who have more illness. They’re generally older. They generally are more functionally declined to begin with. Their bones are typically not as healthy. You can give them the same procedure but they tend not to do as well. ... If I have a debilitated older patient that has advanced arthritis and is not functionally doing so well, I don’t think they’re a good candidate for joint replacement. They may fall post-operatively. But in this case, they’ve beaten me to the punch. They’ve made me operate because they fell and now they can’t walk. There’s a couple different ways to look at it. Typically, functionally, they’re older, they’re not as mentally there, they have other medical problems, so their functional outcome is not as good for a variety of reasons.

You have an emergency center here in the Williamsville office. Are you ever on call for that?

All the folks in the group take general call. Mostly, I deal with lower extremity fractures: ankles, femurs, tibias.

What is your typical work week like?

Our group also takes general call at Kenmore Mercy Hospital. Generally, if we’re on call here, we’re also on call at Kenmore Mercy. I’m always generally on call for my own patients. During my normal work week, I have two OR days. I do two days a month at Niagara Falls Memorial and the rest of my time is mostly ECMC as far as those OR days. I have a half day a week in the Buffalo Surgery Center here, if I have an ankle fracture or a knee scope. I do partial knee replacements at the surgery center. Mondays, Thursdays and Fridays I see patients in the office and I’m on call every 10th night, every eighth weekend, so it’s not bad. I probably put in 70 to 75 hours a week. I’m putting in minimum 12 hours a day. I’m usually here at the office or making my rounds in a hospital around 6 a.m.

email: refresh@buffnews.com

Twitter: @BNrefresh

 

 

« Older Entries
Advertisement

About The Refresh Buffalo Blog

Scott Scanlon

Scott Scanlon

Scott Scanlon is an award-winning reporter and editor who has covered various topics in his quarter-century as a journalist in South Florida, Syracuse and Buffalo. He is aiming to pass along what he is learning these days about health, fitness, nutrition and family life.

@BNRefresh | refresh@buffnews.com

Subscribe

Advertisement