Halloween safety

Don’t let real dangers take the fun out of Halloween

Before you head out for trick-or-treating with your little ghouls and goblins, princesses and superheroes, take a few moments to think about – and talk to your kids about – safety. As fun as it is, Halloween is also unfortunately the most dangerous night of the year for children – twice as many kids are killed on Halloween night, usually in pedestrian accidents – as any other day of the year.

A few moments to consider safety will help keep the night fun, not dangerous.

For parents and kids:

1. Check costumes before you leave the house. Decorate your children’s costumes with reflective materials and, if possible, choose light colors that can be seen in the dark. Make sure masks or wigs do not obstruct the child’s vision, and make sure they can walk without tripping or dragging any part of their costume.

2. Carry flashlights or glow sticks. These will help trick-or-treaters see and be seen by drivers.

3. Review safe pedestrian behaviors with kids before heading out.

4. Cross the street safely at corners, using traffic signals and crosswalks if they’re available. Look left, right and left again when crossing and keep looking as you cross. Walk, don’t run, across the street.

5. Walk on sidewalks or paths. If there are no sidewalks, walk facing traffic as far to the left as possible.

6. Slow down and stay alert. Watch out for cars that are turning or backing up, and never dart out into the street or cross between parked cars.

7. While pedestrian safety is a main concern on Halloween, parents and kids should also be careful when dealing with candy. Remind children to only eat treats in original and unopened wrappers. It’s best to wait until you get home and can inspect candy under good lighting.

For drivers:

8. Be sure to turn your full headlights on between 6-8 p.m., Lexington and Fayette County’s designated time for trick-or-treating.

9. Slow down in residential neighborhoods and be on the lookout for kids who may dart out unexpectedly. Some may be wearing dark clothing.

10. Be especially alert and take extra time to look for kids at intersections, on medians and on curbs. Children are excited on Halloween and may move in unpredictable ways.

11. Slowly and carefully enter and exit driveways and alleys.

12. Reduce any distractions inside your car, such as talking on the phone or eating, so you can concentrate on the road and your surroundings.


Next steps:

  • Before your kids leave the house in search of candy, make sure their costumes are as safe as they are spooky. Check out our guide for Halloween costume safety.
  • Happy Halloween from all of us here at UK HealthCare! Have fun and be safe, and remember,  our Makenna David Pediatric Emergency Center is always open in case you need us.
stroke

When it comes to a stroke, timing is everything

Dr. Michael Dobbs

Dr. Michael Dobbs

Written by Dr. Michael Dobbs, a stroke expert at the Kentucky Neuroscience Institute and the director of the UK HealthCare/Norton Healthcare Stroke Care Network

A sudden onset of blurred vision, slurred speech, or numbness or paralysis in the face, arm, or leg can be indications of a stroke.

Many people experiencing these symptoms wait to seek help, but this can be a fatal mistake: The risks of permanent damage or death increase the longer treatment is delayed. In fact, six million people die and five million more become permanently disabled because of a stroke each year.

Nationally, the number of stroke deaths has declined, but in Kentucky, strokes are increasing. Yet stroke is a largely preventable disease: keeping blood pressure, cholesterol, weight and/or diabetes in check can greatly reduce the risk.

When a stroke occurs, however, the most important factor is time.

BE-FAST

Oct. 29 was World Stroke Day – a day to reflect on a significant cause of death and disability in the U.S. and the steps you can take to help reverse that trend. Take preventive measures, know the symptoms and BE-FAST if you suspect a stroke.

Balance – Does the person have trouble walking or standing?

Eyes – Are there any changes to eyesight, such as blurry vision?

Face – Do the eyes or mouth appear to be drooping?

Arms – Does the person complain of arm weakness?

Speech – Does the person slur their speech or mix up words?

Time – If any of those signs are present, it’s time to call 911.

If you or someone you are with show any of the above symptoms, call 911. It’s better to have a false alarm than to delay any treatment.

As with any medical issue, prevention is key in avoiding a stroke. High blood pressure and cholesterol are two main risk factors. Engaging in regular physical exercise, quitting smoking, and cutting back on salty and/or fatty foods can make a big difference.

Stroke Care Network

The Stroke Care Network, a partnership between UK HealthCare and Norton Healthcare, is an affiliation of 34 regional hospitals dedicated to the highest-quality stroke care. Based on extensive research, the Stroke Care Network has developed a system of care that provides prompt diagnosis and treatment to minimize the damage a stroke can cause.

A key step in stroke diagnosis is a computerized tomography (CT) scan to find bleeding in the brain or damage to the brain cells. Since 2015, the time it takes to get a CT scan read by doctors and begin a treatment plan has decreased from 52 minutes to 39 minutes in a Stroke Care Network hospital. Clot-busting medication may reduce long-term disability, but is only available within a few hours of the first symptom.


Next steps:

UK collaboration provides improved stroke care in Eastern Kentucky

Kentucky has one of the highest rates of stroke in the nation, and in Eastern Kentucky, the burden of cardiovascular disease is especially severe. An innovative program is improving patient outcomes and saving money in the region by providing intensive, personalized support for stroke survivors and their families.

The Kentucky Care Coordination for Community Transitions program − a partnership between the UK Center of Excellence in Rural Health (CERH) in Hazard, Appalachian Regional Healthcare (ARH), and the UK College of Health Sciences − integrates a CERH community health worker with the ARH rehabilitation team to help stroke survivors transition back to their homes and to facilitate a network of community support.

Established in 2014 with pilot funding from the UK Center for Clinical and Translational Science and ARH, the project evolved into a permanent program in 2015. Just past its two-year anniversary, the program has supported nearly 150 individuals, helping them adjust to the new realities of life after a stroke, learn about chronic disease self-management, navigate complex health care and insurance systems, monitor their rehabilitation, and connect with other survivors and caregivers.

Improving health and saving money

The program has markedly improved health and well-being for participating stroke survivors, among whom there have been zero 30-day hospital readmissions and only one emergency department visit (which wasn’t stroke related). This is compared to 19 percent and 8 percent, respectively, of the matched control group of stroke survivors who chose not to join the program. The result is not only better health and quality of life for survivors and caregivers, but also a cost savings of more than $1.4 million over two years to the local healthcare system.

“We’re keeping people healthier and saving a phenomenal amount of money for the health care system,” said Patrick Kitzman, PhD, founding director of the program and professor of physical therapy in the UK College of Health Sciences. “But we also concentrate very much on the caregiver and family − we always look at the whole unit with our follow-up education and support.”

In 2016 alone, the program supported 70 individuals, including 512 encounters between the community health worker and participants and more than 1,000 provided services. Half of participants needed assistance obtaining durable medical equipment, 71 percent needed assistance obtaining essential medications, and 35 percent needed assistance obtaining health insurance.

Personal care

A critical element of the program’s success is the integration of the community health worker, Keisha Hudson, with the stroke rehabilitation team at ARH. Hudson, who is from the local community, participates in the discharge planning for participating stroke patients so that she can establish a relationship with them and their families while they’re still in the hospital and get a head start on arranging for anything they might need when they get home − shower chairs, wheelchair ramps, medical equipment, etc.

Hudson then visits patients at their home within a week of discharge and provides weekly face-to-face meetings or phone follow-up calls which tapers to bi-weekly or monthly check-ins as patients improve. Some patients, however, have stayed with the program since its beginning.

As she works with patients and families, Hudson provides health education and tracks compliance with medical visits and medication; when she notices that a patient has missed an appointment or medication, she figures out why. Sometimes the problem can be as simple as the patient lacking transportation, in which case Hudson can help them make arrangements to get to the clinic or pharmacy.

Such attention and regular communication allows Hudson to develop a personal relationship with patients and their families to the extent that she can often sense when something is “off” and intervene before a serious problem develops. While none of the patients in the transition program have been readmitted to the hospital for stroke complications within 30 days of discharge, Hudson’s attentive care has led to life-saving interventions related to patients’ other health issues; nearly 60 percent of participants have five or more co-morbid health conditions. Once, while speaking with a patient over the phone, Hudson recognized that the woman’s breathing sounded especially labored, and she told the patient to go to the hospital immediately. It turned out the woman had a dangerous level of fluid on her lungs and needed urgent treatment. While making a routine visit to check on a different patient, Hudson arrived to find them in a diabetic coma. With yet another patient, she caught an infected surgical site that required immediate attention.

Connecting with the community

Hudson also hosts a monthly stroke survivor and caregiver support group. It meets at the hospital, which allows currently hospitalized stroke survivors or their caregivers to come downstairs from the care unit and connect with the group before they go home.

“The program has evolved in the community because we’ve built trust as people hear about us through word of mouth. Some patients and caregivers have become really big advocates for us. One of the patients we’ve worked with for a while has had people in his community who’ve had strokes and he himself has referred them to us. We’ve proven to our community that we’re here to help and we’re here to stay and when we say we’re going to do something, we do it − that’s helped a lot,” Hudson said.


Next steps:

  • When it comes to preventing a stroke, simple lifestyle changes can make all the difference. Here are six things you can do to help reduce your risk of a stroke.
  • At the UK Comprehensive Stroke Center, we offer treatment, prevention and rehabilitation services for stroke patients.

Cancer is her fight, precision medicine is her weapon

Making the RoundsIn our latest Making the Rounds conversation, we had a chance to chat with Jill Kolesar, PharmD, a professor in the UK College of Pharmacy, co-director of the UK Markey Cancer Center Molecular Tumor Board and director of Markey’s Precision Medicine Clinic.

Dr. Kolesar came to UK HealthCare last year from the University of Wisconsin. Her research is focused on precision medicine, the field of finding new drugs to treat specific cancer mutations. 

Tell us about your precision medicine research.

Precision medicine is a type of treatment that targets a specific genetic mutation in a tumor. Clinical trials have shown that, if you have one of these mutations, not only will the precision medicine work better, but you’ll have fewer side effects. There’s no question that they’re better. Unfortunately, not everyone has a mutation that we have a drug for, but that’s really what we’re working on with our research.

My research is focused on finding new drugs. We look at particular mutations and then use different drugs to target those mutations to determine what the most effective therapy is.

What is the Molecular Tumor Board?

The Molecular Tumor Board brings these precision medicine options to patients and their doctors. The board is made up of doctors, pharmacists and scientists who are experts in genetic sequencing and the treatment of cancer. These people come together to look at each patient’s genetic report and make a treatment recommendation specific to that person.

It’s a real benefit to the patients of Kentucky and their physicians. The treating physician usually knows the patient much better, but the Molecular Tumor Board usually knows the genetics and the new treatments much better. It’s really a partnership between the physician, the patient and the Molecular Tumor Board.

What types of patients benefit most from the Molecular Tumor Board?

The types of patients that are candidates for the Molecular Tumor Board are patients with rare tumors, as well as patients who haven’t responded to standard therapies. And actually, patients with lung cancer can be seen by the tumor board after their initial diagnosis.

Why did you decide to pursue research?

When I was a junior in college, I saw a TV program on PBS about tumor-infiltrating lymphocytes (white blood cells) and how they could be taken out of a patient and activated and then given back to make a positive impact.

And so that was the day I decided I was going into cancer research. I’ve never looked back and I’ve always been happy with that decision.

What do you do in spare time?

I like to garden, I like to travel, I like to cook – and I enjoy good food.


Check out our video interview with Dr. Kolesar, where she talks more about the benefits of the Molecular Tumor Board.


Next steps:

  • Watch our TV spot that features the work of our Molecular Tumor Board.
  • Markey is Kentucky’s only NCI-designated cancer center, providing world-class cancer care right here in the Commonwealth. Learn more about why patients choose Markey for their cancer treatment.
chronic cough

Got a chronic cough? Knowing the cause might help you find relief.

Dr. Jonathan Kiev

Dr. Jonathan Kiev

Written by Dr. Jonathan Kiev, a cardiothoracic surgeon at UK HealthCare.

Coughing all the time can be a major annoyance to you and those around you. Even worse, chronic cough can affect your sleep, your job performance, and your overall health and well-being.

So, what causes chronic coughing and what can be done to find relief? I answer those and other questions below. Check it out.

What causes chronic cough?

Chronic cough is very common and can be caused by many things. Your doctor will work with you to narrow down the possible causes of your cough and help you find a solution.

Other symptoms that accompany a chronic cough can tell you more about what’s causing it. These symptoms include a stuffy or runny nose, the frequent need to clear your throat, hoarseness, and heartburn. If you have chronic cough and also have shortness of breath or are coughing up blood, you should see your doctor right away.

Does smoking cause chronic cough?

Yes, it can. Hot cigarette or cigar smoke can irritate the membrane and lining of the nose and the throat, which can cause chronic cough. Secondhand smoke is also a common trigger of chronic cough.

Quitting smoking can help you find relief from chronic coughing, in addition to having an array of other health benefits. Talk to your doctor about products and programs that can help you quit.

Can work hazards cause chronic cough?

Work-related irritants, including soot and dust, can also cause the condition. To prevent inhalation on the job, many employers will provide a mask to employees working around paint, woodworking materials, concrete dust and other particles that can be easily inhaled.

High-risk professionals who work around asbestos – including shipyard workers, fiberglass industry professionals and insulation installers – should be especially cautious and take active measures to prevent potential inhalation.

What are some of the less common causes?

Food entering the airway instead of the esophagus is a very common cause of coughing. In children, swallowed objects, such as peanuts or a small battery, can become lodged in the airway and cause coughing. (Always do your best to keep batteries and other choking hazards out of children’s reach.)

Less commonly, lung cancer can be the cause of chronic coughing. Your doctor will use X-rays and other tests to look for early signs of the disease.

Asthma and sarcoidosis (an inflammatory disease that can affect the lungs) are two conditions that can cause a chronic cough. These conditions require active management by your doctor to minimize coughing and to prevent these diseases from causing organ damage.

What happens if I cough up blood?

Sources of bleeding need to be looked at more aggressively. Your physician may recommend a CT scan or referral to a lung specialist (pulmonologist) who may recommend a bronchoscopy to pinpoint the source of bleeding.

I’ve heard people say that severe coughing can cause a broken rib? Is that really possible?

This is not an uncommon story. A hard cough may, in fact, fracture a rib, cause dizziness, or cause a patient to lose bladder control or even pass out.

Many patients are not able to lie flat because it aggravates their cough, causing them to feel like they’re choking. These are symptoms of severe chronic cough and require urgent evaluation by a physician.

How is chronic cough treated?

It really depends on what is causing your cough.

Many medicines, especially certain blood pressure medications, can cause chronic cough and can be adjusted to provide relief.

Patients with postnasal drip often have chronic cough and may need specific medicines to prevent the irritating trigger of excess mucus.

Patients who have GERD or gastrointestinal reflux can have irritated vocal cords, which can also cause chronic coughing. These patients can be prescribed acid-blocking medication to provide relief, and in some cases, may require surgery.


Next steps:

First steps to take if your baby has Down syndrome

If you’re expecting a baby who has been diagnosed with Down syndrome, you may have many questions and concerns.

While this diagnosis may seem overwhelming, there is no need for panic – or despair. Although having Down syndrome means your baby will face challenges, many people with Down syndrome live full, productive, happy lives.

The most important thing you can do is educate yourself about the resources and support available to you and your family so that you can become your baby’s best advocate. Traci Brewer, executive director of the Down Syndrome Association of Central Kentucky (DSACK), offers these tips:

Your baby’s health. Children born with Down syndrome have a higher rate of heart abnormalities and other medical concerns than the general population. Your first step is to ensure that medical professionals are following the healthcare guidelines recommended by the National Down Syndrome Society. Your obstetrician and later your pediatrician may not have a great deal of experience with children with Down, so it is up to you to advocate for screenings at birth to rule out potential health risks. If you need help making a case for these screenings, enlist the aid of a genetic counselor.

Early intervention. Federal law mandates that states must provide early intervention for children with certain conditions, and Down syndrome qualifies. In Kentucky, this program is called First Steps. First Steps provides therapists such as speech-language pathologists, occupational therapists and physical therapists that will come to your home for therapy sessions. Make sure your hospital or pediatrician makes a referral to First Steps before you leave the hospital.

Fear. It’s normal to feel scared, but know that you are not alone. Try to relax, get to know your baby and enjoy your time together. Realize that many of your struggles are the same as those faced by any new parent. Statistics have shown that married couples with children who have Down syndrome have a lower rate of divorce than the general population, and siblings are often more compassionate and well-adjusted because of their relationship with their brother or sister with Down syndrome.

Get connected. The best resource for new parents will always be other parents. Many organizations offer free resources and lists of local parent groups. Locally, the Down Syndrome Association of Central Kentucky hosts new parent dinners, coffee chats, special events and much more to help parents connect with other parents of children with Down syndrome. DSACK can be found on the web at www.dsack.org.

Take it one day at a time. Stay informed, get connected and remember that you are doing your best. You don’t have to be a superhero, and just like other parents, you will make the best decisions you can. Love your children and try to keep everything in balance. Know that the positives far outweigh the negatives. People with Down syndrome go to school, have meaningful jobs and make significant contributions to society.


Next steps:

Gluten-free: Fad or medical necessity?

It’s common these days to hear people say they are avoiding gluten, and gluten-free foods are everywhere. While it’s true that going gluten-free is just a dietary fad for some people, for those with celiac disease or gluten sensitivity, there’s a genuine medical need to avoid gluten.

What is gluten?

Gluten is a general name for the proteins found in certain grains, including wheat, rye and barley. It acts as a sort of glue that holds food together, giving it its shape.

Celiac disease

Celiac disease is a genetic illness that makes a person unable to digest gluten. Eating gluten causes the body to mount an immune response that inflames and damages the small intestine, and the small intestine stops absorbing nutrients properly. This creates a host of uncomfortable symptoms, including stomach problems such as gas and diarrhea. Those with the disease might lose weight and feel tired and achy. Other symptoms include:

  • Bone, joint pain or arthritis.
  • Depression or anxiety.
  • Tingling numbness in hands and feet.
  • Fatigue.
  • Chronic diarrhea or constipation.
  • Itchy skin.
  • Sores in the mouth or tooth discoloration.

If you think you have celiac disease, your doctor can do a test to be sure.

Gluten sensitivity

Gluten sensitivity includes many of the unpleasant symptoms of celiac, but tests for celiac come back negative. While the symptoms are real, a recent study published in Gastroenterology suggests gluten sensitivity may not be sensitivity to gluten at all, but a reaction to something called FODMAPs, short-chain carbohydrates that coincidentally are found in many foods containing gluten. If you think you are gluten-sensitive, it may really be FODMAPs that are causing your problems, so do some research or talk to your doctor to make sure you’re avoiding the right foods.

Foods to avoid

If you have been diagnosed with celiac disease, avoiding gluten is imperative. But there’s also nothing wrong with going gluten free if you choose to do so.

Avoiding gluten isn’t so easy – it’s found in an amazing variety of foods and drinks. Here’s a short list:

  • Beer.
  • Breads.
  • Cakes and pies.
  • Candies.
  • Cereals.
  • Cookies and crackers.
  • French fries.
  • Pastas.
  • Processed lunch meats.
  • Salad dressings and sauces, including soy sauce.
  • Seasoned rice mixes and snack foods, such as potato and tortilla chips.
  • Soups and soup bases.

What CAN you eat?

The news is not all bad. Here’s a list of things you CAN eat if you have celiac disease:

  • Fruits.
  • Vegetables.
  • Most meat, poultry, fish and seafood.
  • Dairy.
  • Beans, legumes and nuts.

Gluten-free also doesn’t mean you have to give up bread. There are many safe breads and snacks made with gluten-free ingredients. These foods are made with grains and starches from plants including rice, corn, quinoa, gluten-free oats and many others. Wheat-free doesn’t always mean gluten-free, so check nutrition labels.

Next steps:

Exercise pain could be compartment syndrome, says UK team doctor

Dr. Kimberly Kaiser

Written by Dr. Kimberly Kaiser, a physician with UK Orthopaedic Surgery & Sports Medicine and a team physician with UK Athletics.

Each of our arms and legs have compartments that contain muscles and nerves which are surrounded by tough walls of tissue called fascia.

When we experience an injury or overuse our muscles, these compartments can fill with fluid and swell. In some people, the fascia surrounding each compartment is not very flexible and swelling can restrict blood flow, which can lead to pain, numbness and weakness in the affected limb. These may be signs of compartment syndrome.

Compartment syndrome occurs when excessive pressure builds up in an enclosed muscle space. The acute condition is often the result of bleeding or swelling into the muscle after an injury like a severe bone fracture or a crush injury, and while rare, it is a surgical emergency.

The chronic condition, called chronic exertional compartment syndrome or CECS, is often the result of prolonged physical activity and is most common in endurance athletes like runners and soccer players.

Symptoms and treatment

For those experiencing CECS, the associated symptoms occur, or worsen, during physical activity and subside immediately after stopping. Symptoms of CECS can mimic symptoms of other overuse injuries such as plantar fasciitis or shin splints, and if you’re middle aged or older, it may be the result of cholesterol build-up in the blood vessels. Your doctor may want to perform several tests to rule out other diagnoses.

Treatment for CECS depends on your activity levels and fitness goals. A physician may suggest modifying or taking a break from the exercise causing the injury or performing low-impact activities such as biking or swimming. Physical therapy, strengthening and stretching are a few approaches that can help relieve symptoms.

For those who don’t respond to conservative measures, or if activity modification is not an option, surgery may be the most effective treatment. The surgical procedure, called a fasciotomy, involves opening or removing the fascia in each affected compartment to relieve pressure. While there is a risk of complications associated with surgery, compartment syndrome left untreated can lead to permanent muscle and nerve damage, or the inability to continue participating in your favorite activity.

If you experience symptoms after an injury, or if symptoms develop during physical activity and worsen over time, it’s important to talk with your primary care provider and see a doctor who specializes in sports medicine.


Next steps:

UK researcher working to prevent concussions in jockeys

It’s the fifth race on a beautiful, sunny day at Keeneland Race Course in Lexington and the jockeys are on their mounts up in the gates. The bell rings and the horses spring forward, looking for the perfect spot from which to make their charge. At the second turn, the No. 8 horse stumbles and recovers, but its jockey tumbles to the dirt. He sits for a few seconds, dazed, but then leaps to his feet and scrambles to safety.

Injuries are frequent among jockeys. During a recent interview, one jockey listed a jaw-dropping succession of injuries: two broken collarbones, a fractured wrist, broken ribs, a fractured spine and several occasions when he “got his bell rung.” These athletes get back to their jobs as quickly as possible – and potentially before they’re completely healed. That’s because, unlike other professional sports which offer guaranteed contracts to their players, horse racing operates on a “pay-to-play” model:  jockeys don’t get paid unless they’re riding.

Concussion dangers

While broken bones are nearly impossible to miss, concussions are a subtle but potentially more dangerous injury. Concussions – a brain injury caused by whiplash or other blow to the head – are notoriously difficult to diagnose, and symptoms are transient but can last several days or even weeks.

Repeated concussions have a cumulative effect. A recent study in JAMA, the Journal of the American Medical Association, determined that 110 of 111 autopsied brains donated to science by former NFL players showed evidence of chronic traumatic encephalopathy, a degenerative brain disease caused by repeated blows to the head and believed to be responsible for later cognitive impairment, depression and/or aggression. At this time there is no data to document the incidence of CTE among jockeys, although anecdotal evidence exists; for example, the effects of Gwen Jocson’s repeated concussions forced her retirement from racing in 1999.

During the healing process after a concussion, victims can experience headaches, memory loss, balance issues, sleep disturbances and/or disorientation. According to UK College of Health Sciences researcher Carl Mattacola, PhD, ATC, that’s a dangerous state to be in if you’re trying to pilot a 1,000-pound horse around a track at 30 miles per hour. That’s why he’s developed a clinical and research interest in helping jockeys.

Developing a safety protocol

Historically, Mattacola says, attention for the jockeys has been secondary to the equine athlete. But as the awareness of the dangers of concussion has risen, all corners of the racing industry – the tracks, the horse owners, and the jockeys themselves – have come together to assess the situation and lay the groundwork for a new model. And that process has its origins in Kentucky, born of a partnership between the Jockeys’ Guild, the Jockey Club, and the UK College of Health Sciences, among others. This is the second year of a pilot project to gather baseline cognitive data on every jockey racing in Kentucky. Mattacola spearheads the project, and starting with Keeneland’s Fall Meet this month, baseline cognitive and neuromuscular testing was mandatory for every mount.

Mattacola explains that most major professional sports – the NFL, the NHL, FIFA – have concussion protocols that guide decisions about when a player is healthy enough to return to play, but it’s difficult to copy their model exactly because each state – and sometimes each individual track – operates under different set of rules, so return to ride protocols aren’t consistent.

“Our group wants to create change in how we manage and assess concussions in horse racing, so we’re beginning local and we hope to use that data to develop a protocol that can be transferred to other states,” he says.

To illustrate how the data he’s collecting would be useful, Mattacola uses blood pressure as a metaphor.

“If we know what your blood pressure is this year and you come back and that changes, we can try to determine the underlying factors or the underlying mechanisms that contributed to that change,” he said. “Similarly, the baseline assessment provides additional information to the health care provider when a jockey falls, which can help him/her make a decision about whether to suspect a concussion.”

Establishing a strong rapport

Jockeys’ Guild National Manager Terry Meyocks said that the Equine Jockey/Rider Injury Prevention Initiative is a logical extension of the Jockey Health Information System (JHIS), a database that stores jockeys’ medical histories for access by racetrack medical personnel in the event of an injury.

“Our job is to protect jockeys by making sure that they operate in a safe racing environment,” Meyocks said. “As the issue of concussions has come to the forefront, we’ve made it a priority to educate our jockeys and find ways to protect them, which is in everybody’s best interest.”

At the Jockey’s Quarters on Keeneland’s opening day, the Clerk of Scales sends a jockey to Carolina Quintana, a certified athletic trainer and a doctoral student from the UK College of Health Sciences, who administers the SCAT-5 assessment tool, which gathers injury history and data related to cognitive and neuromuscular performance. Then the jockey completes several simple tasks, such as counting backward by threes and standing on one foot.

The jockey acts a bit sheepish as his friends look on in amusement, but this testing, which will be entered into his JHIS record, will be invaluable should he suffer a head injury.

There was not instant buy-in among jockeys, however, who were concerned that the project might affect their livelihood. But Mattacola and Quintana quickly won them over in a series of meetings as the pilot project took shape.

“We – but especially Carolina – have established a strong rapport with the jockeys and they now recognize that we are not here for any other reason than to help them. If they were to be injured, we would have the data to make a healthy decision on their behalf,” he said.

Building on previous research

This is not Mattacola’s first foray into the jockeys’ world. In 2015, he conducted a series of tests to determine how well several equine helmet models protected wearers from repeated impacts, which helped inform guidelines for replacing helmets after a fall and prompted the Jockeys’ Guild to reinforce that all riders wear ASTM-approved helmets. His work on helmet safety lent him credibility with the jockeys as he nudged the concussion pilot study to fruition. “It’s impossible to eliminate all concussions in sports, but we’re obligated to do what we can to prevent it, to recognize it when it occurs, and to keep the jockey’s long-term health and safety first in mind,” he said.

His next great chapter may well be applying the resources of the UK Sports Medicine Research Institute (SMRI), a state-of-the-art multidisciplinary research center dedicated to improving athletes’ performance and preventing injuries, to helping the jockeys.

 


Auditorium is renamed in honor of Dr. Michael Karpf and his wife, Ellen

On Oct. 18, during a celebration of former Executive Vice President for Health Affairs Dr. Michael Karpf and his wife, Ellen, UK President Eli Capilouto announced that the UK Albert B. Chandler Pavilion A auditorium will now be known as the Karpf Auditorium in the couple’s honor.

Karpf retired in September after helping create a smooth transition with his successor, Dr. Mark F. Newman.

Karpf came to UK from UCLA in 2003 with the firm belief that art can make a difference in patient care. This principle guided Karpf to build a healthcare facility that would “make every visitor, patient and staff member feel comfortable and at home” and “complement and enhance the healing environment.”

The auditorium is just a part of that building, Pavilion A, and even inside the auditorium the details reinforce Karpf’s vision. The seats are upholstered in a specially commissioned fabric reminiscent of a field of flowers, a design inspired by Ellen Karpf’s admiration of a similar interior at Disney Hall in Los Angeles.

Since Pavilion A opened in May 2011, the 305-seat auditorium has served as a high-tech education center where physicians and staff can take part in grand rounds and other learning opportunities.

In the past six years, the auditorium has hosted international scientific symposia, policy summits, movies, variety shows, employee training and recognition programs, masters and doctoral thesis programs, major hospital announcements, and theater and musical performances from opera to bluegrass.

The auditorium is also an integral part of the UK Arts in HealthCare program, which features a large and internationally recognized visual arts collection and an endowed performing arts program.

When the auditorium was constructed and designed with a grant from the Sarah Scaife Foundation, Scaife Foundation Chair Richard Scaife, a longtime friend of the Karpfs, asked that the auditorium be named in honor of the couple at the appropriate time in the future.

“Mike and Ellen Karpf will never know the names of all the families and patients they’ve touched with their vision, even though I know that the Karpfs make an effort to try to meet them and uplift them in their times of need. But that is the highest form of giving — the type that serves many who may never know their names — and which echoes through generations,” Capilouto said.

See more photos of the Karpf Auditorium below.


Next steps:

  • Read about the award-winning UK Arts in HealthCare program, which brings the work of local, national and international artists into our hospitals and clinics.
  • Earlier this year, Dr. Karpf received the Kentucky Hospital Association’s highest honor for his career of exceptional service to UK HealthCare, the community and the state. Learn more about Dr. Karpf’s recognition.