First Bilateral Hand Transplant in Region Performed at Penn Medicine

The first bilateral hand transplant in the Greater Philadelphia region was recently performed at the Hospital of the University of Pennsylvania. Under the leadership of the Penn Transplant Institute, the extensive 11 1/2-hour procedure was performed by Penn’s Hand Transplant Program in close partnership with the Gift of Life Donor Program.

Penn’s Hand Transplant Program is a joint venture of the Penn Transplant Institute, Penn Orthopaedics and Penn Plastic Surgery. The multidisciplinary team is dedicated to working together to restore independence to amputees who have lost their arms and legs

• Read more about the region's first bilateral hand transplant
• Learn more about Penn’s Hand Transplant Program
• Learn about the Gift of Life Donor Program

Summertime Injuries – Penn is Here to Help

Summer is finally here and with it comes trips to the pool, going to the beach, outdoor runs, tending to our gardens, and firing up the grill. Kids are out of school and begging you to play basketball, soccer or other outdoor activities.

For some, these extra activities are a kind of seasonal re-commitment to fitness, weight loss and relaxation. But for a few, some of these activities can lead to unexpected injuries and accidents, some even needing serious medical attention. And, as the motto goes, an ounce of prevention is worth a pound of cure. Which means, knowing where to go if anything does happen is a good idea to have in mind.

In case of injury, whether a sprained ankle, broken foot or any other musculoskeletal injury, the orthopaedic team at Penn Medicine is ready to help. In most cases, you can even see a physician on the same day.
Highly skilled and highly specialized, Penn Orthopaedic physicians treat each joint condition, spinal disorder or sports injury with a personalized approach. With ten orthopaedic subspecialties, physicians at Penn Orthopaedics not only treat more complex conditions — they are uniquely qualified to treat each condition individually.

Penn Orthopaedics offer same-day appointments for:

• Foot and ankle
• General orthopaedics
• Hand and wrist
• Joint replacement
• Neuro orthopaedics
• Orthopaedic oncology
• Shoulder and elbow
• Spine
• Sports medicine
• Trauma and fracture care

“You call with any musculoskeletal need and we’ll see you that day,” says L. Scott Levin, MD, chair of Orthopaedic Surgery.

Please be safe and enjoy this summer. If you need us, we’re a call or a click away.

Atrial Fibrillation: Causes, Symptoms and Prevention Methods

Does your heart ever feel like it’s racing or doing somersaults in your chest?

Approximately 2.5 million Americans experience atrial fibrillation (AFib) each year. This common heart disorder occurs when electrical signals in the heart become irregular, causing the heart to beat out of rhythm. The normal range for a heart rate is 60 to 100 beats a minute while the heart rate in atrial fibrillation may range from 100 to 175 beats a minute.

Causes and Symptoms
Causes of atrial fibrillation vary and range from existing heart problems to infections to chronic conditions like obesity and sleep apnea.  Common risk factors and conditions that may cause AFib are:

• Congenital heart defects (defects you are born with)
• Heart attack, or a damaged heart muscle from a past heart attack
• Heart valve diseases
• Heart failure or coronary artery disease
• High blood pressure
• Hyperthyroidism 
• Substances or drugs, including alcohol, caffeine, or stimulants 

Symptoms of atrial fibrillation vary and many people are unaware they have AFib until it’s diagnosed during a regular physical exam. While the most common symptom is a fast or irregular heartbeat, others who have AFib may also experience lightheadedness, shortness of breath, lack of energy and chest pain. The biggest danger of atrial fibrillation is to leave it untreated.  If you experience symptoms, call your physician immediately.

How You Can Defend Against AFib
Since atrial fibrillation is often caused by conditions that cause damage or place extra strain on the heart, making simple lifestyle changes to improve your heart health may help protect against AFib.

• Don't smoke. Avoid alcohol and stimulants.
• Eat a heart-healthy diet that includes fish, fruits, vegetables, whole grains and olive oil. 
• Stay active. Get regular exercise on most days of the week. Your physician can suggest a safe level of exercise for you. 
• Control your cholesterol and blood pressure. 
• If you have diabetes, keep your blood sugar in your target range.
• Find ways to cope with stress.

For additional information on atrial fibrillation and treatment options, download Penn’s Guide to AFib.

Why Choose Penn Medicine for AFib Care
Penn Medicine’s Cardiac Arrhythmia Program is one of the largest in the country and performs more than six times the national standard of AFib ablations procedures. So patients like Dominic, a retired Philadelphia police officer, receive the most advanced care from an experienced team of physicians, nurses and support staff.

Contact with Families after a Patient's Death

On April 28 I wrote a post to report that the New York Times Ethicist column had taken a quote about doctor-patient sex from this site. The next day I received a phone message from Langley Danowitz, daughter of Emily Lublin, a long time patient of mine, who had died in 2000 at age 84. Emily had a great sense of humor. We had a warm, friendly relationship and very much enjoyed working together on various vicissitudes of her 70s and 80s. At one point Emily said - "you have to promise not to retire before I die." I was sad when she died, but happy to have been able to keep my promise.

Emily and her daughter Langley were close. Over the years I heard a lot about Emily's visits with Langley, who lives in New York. Langley and her husband Jeff conducted a memorial for Emily in Boston, which I attended, and met them there. When Langley saw my name in the New York Times column she called me, to thank me for caring for her mother and to give some news about herself.

When I returned Langley's call we reminisced about her mother, and I heard about how Langley has reinvented herself as an actor when a job she'd been in for 30 years ended. Langley told me she is a "young looking 70 year old," and explained how the advertising industry has used her when they want an athletic, youthful-looking, older person. Since aging is one of the topics I write about on this blog (as well as on Over65, which I co-edit) I invited Langley to write about how she adapted to the end of her long time job. She wrote the delightful piece that follows. I'm publishing it and have spoken in this post about her mother Emily with her permission:

           Part I - Adjusting

Five years ago, when I was (requested to) retire from being the corporate controller (MBA) for a manufacturing company, I was relieved but mostly terrified. After 30 years of non-stop work, I had no idea what I would do to keep myself sane, out of trouble and out of the refrigerator. And although I had always enjoyed the domestic scene, was an avid gym-goer, and had loving family, my life had revolved around the office for as long as I could remember. My 2 thoughts when I got the word were: “you mean I don’t have to come here anymore?” and “omg, now what do I do?” My wonderful husband, Jeff, who had served as Homefront Captain for years, graciously re-introduced me to Laundry and I stampeded into the fray. For weeks, I used my considerable energy cooking and cleaning, organizing and discarding, baking and searing, writing and phoning. Mind you, I was still getting up at 5:30 AM to get to the gym by 6:30 – sleeping in had not occurred to me. Change my Type A style? Never in my mind! Occasionally, I must admit when I raced around my Upper East Side NYC hood, I noticed other gals of an age lunching together and shopping or just strolling…where did they find each other and why did they look so…was it “relaxed”? I wished I had some friends too but – it seemed everyone I knew was still working. Where would I find people to like who would like me too?

Part II – I find a friend

I decided to take up the piano – I’m musical and love a challenge. I hung a sign in our Laundry Room – “Adult student, plays by ear, needs patient piano teacher” and someone penciled on it: “Apt 1222 teaches”. I adopted Friend #1 – my 1982 Kawai console piano, which, as the movers remarked, matches our living room furniture. I found not one, but two teachers, who proceeded to complement and battle each other for my soul. I played in my first recital after 4 lessons – a day which shall live in my annals of terror forever. I basked in the applause and drank lots of wine afterwards.

Part III – I hit the boards

As you can tell, I was learning how resilient I am. So – I finally tackled something I had always wanted to do – become an actor! You should know, I probably came out of the womb taking a bow. After all, I studied Speech at Northwestern and played Little Buttercup in junior high. Now, I had the time to do it professionally – could I? Only one way to find out - headshots, acting resume (somewhat bogus at first), agents – ta dah! As you can tell – modesty is not moi. And, with my physical fitness + energy, I figured that if I said I could do it, I would do it. And now I have the hula hooping (Wellcare Insurance), push upping (Advil) and headstanding (Geisinger) TV credits to prove it.

More to come????

Having the opportunity to know people in depth and work with them on their health and well-being over time is one of the core privileges in being a physician, nurse or other health professional. Thirteen years after Emily Lublin's death I had fond memories of her, and I was moved that her daughter Langley, who I'd only met once, had memories of me from what she'd heard from her mother. Having an opportunity to be once again in the role of Emily Lublin's clinician talking about her with her daughter 13 years after her death is an experience I cherish and feel lucky to have had.

(I couldn't find YouTube videos showing Langley standing on her head in a Geisinger commericial, doing push ups for Advil, or hula hooping for Wellcare, but I did find this tamer video of her in an advertisement for iYogi.