Simply Medicine 4/29/2023

None

Episode Transcript

(00:08):
You want a revel We all wantto change the world. Stress. We
know how bad it can be foryour health, But what about an unborn
child if you're pregnant. There's somenew research coming out on that. I'm
Enginette Levy and welcome to Simply Medicine, the show designed to make medicine better,

(00:31):
simpler, and less expensive for you. Thanks for joining us for this
latest edition of Simply Medicine. Wehope you've had a great week. We've
got a lot to talk about thisweek, as always, including atrial fibrillation.
We'll talk with a doctor from Christ'sHospital about that. Also, there's
a new virtual reality training that canteach people how to care for older adults.

(00:52):
Caring for older adults, of course, is a really big topic in
this country. But first let's talkabout stress and the impact it could have
on an unborn child of fetus whilethat fetus is in the womb. There's
some interesting research going on at theUniversity of Cincinnati, and recently there were
some findings published in a journal aboutthis topic. Joining me to discuss this

(01:14):
as Anna Ruleman. She is apostdoctoral fellow at the University of Cincinnati.
Anna, Welcome to simply medicine.Thank you for having me, it's a
pleasure to be here. When didyou start this research? So this was
a long project that actually started aboutthree and a half years ago. The
lab that I work in is thelab of Kelly Brunts in the Department of
Environmental and Public Health Sciences, andKelly began this project with this idea in

(01:42):
mind to study maternal stress during pregnancy, and when I came on as a
post doc into her lab, Iwas the one that basically took the project
over and it has been my mainresearch for the last three and a half
years. And what have you foundabout this? Because I've heard about women
who have pre acclaim ampsia, jujit, different factors that are going on in

(02:02):
their pregnancies that can be incredibly dangerousnot only for mom but also for the
fetus. So what are you findingwith your research? Yeah, it's very
interesting and what you mentioned is exactlyright. There are a lot of physiological
and biological processes that can affect thefetus, pre aclampsia being one major one.

(02:22):
What we were looking at mostly ishow it's been studied previously that stress
that mom undergoes during pregnancy does affectthe fetus. The real question is how
that is really working. And previousstudies have really looked at stress genes,
the genes that are involved sort ofin the fight or flight response which you

(02:42):
may have heard of, which adjustcortisol and response to stress. So there
have been studies that have shown thosegenes do play a role in somehow altering
the developing fetus's DNA through a mechanismcalled DNA methylation. And what that is
is not a sequence change. Itdoes nothing to the actual genetic coding of

(03:07):
the DNA. However, it's thoughtto be a mechanism of gene expression control.
So there's a modification that's placed onthe DNA that can be dynamic,
which means it can or can't.It can be removed, it can stay,
We're not quite sure yet, dependingon where it's located. And they
believe that this is how genes areturned on and off. So our study

(03:30):
was the first of its kind toinclude so many moms. We had over
five thousand pregnant moms included from allover the world that looked at not just
the stress genes, we looked atall of the available genes that are involved
in DNA methylation. So we basicallytry to just throw a large net out

(03:51):
and see how mom stress affects anytype of gene in the developing fetus.
And what was interesting was we didfind several of the areas of DNA methylation
are involved in genes that could possiblybe related to neurodevelopment in the fetus.
That's interesting because I would think anythinggoing on with mom could have an impact

(04:14):
on development, whether it's stress.We know that, you know, what
you eat, what you drink canhave an impact on the child, you
know, depending on what you're taking. You know, obviously things like alcohol
and drugs not good. Tell usa little bit more about exactly what you
found. Absolutely, so, yes, you make excellent points that there are
many things that affect developing fetus.The one interesting thing about maternal fetal development

(04:41):
is it is such a dynamic processand how everything is occurring is still obviously
kind of a big question. Sowhat we found was mothers who experienced cumulative
stress such as death of a familymember or a conflict with a partner or
financial stress. Even this accumulation ofstressful events is enough to produce an effect

(05:02):
on the baby's DNA. In termsof DNA methylation. So it was really
interesting because we did find specific stressdomains that actually made a change themselves,
such as death of a family memberor a relative. However, the accumulation
of different stressors also had an impacton the baby. We are here talking

(05:23):
with Anna Ruleman. She's a postdoctoralfellow at the University of Cincinnati, and
we're talking about some research that she'sbeen a part of there, and a
study has recently been published discussing thisabout how things in mom's life or whatever
can impact the development of a fetus. Now, obviously you're talking about things
like stress. You know, Unfortunately, you know, most women, especially

(05:46):
these days, can't block themselves ina stress free bubble. Although it would
be nice. I would like toenter a stress free bubble, and I'm
not even pregnant. But so whatdo you do? Do you just become
cognizant of these things and try tofind ways to cope with stress more efficiently
or effectively or deep breathing, Imean, what is the recommendation? That's

(06:09):
a great question. So yes,of course, just being pregnant, as
we all know who you know,those of us who've been pregnant, is
a stress We didn't have data inthis set of subjects to study something called
resilience, and resilience is actually somethingthat does mitigate stress in different people,
So we don't know the contribution ofthat piece. And that's one thing that

(06:30):
obviously what makes others more resilient thanothers who can't tolerate as much stress.
We don't know that yet, butyes, absolutely, I think the awareness
of knowing how stress can affect youand your child obviously remove removal of yourself
from certain stressful situations. Even withpregnancy being such a dynamic as I mentioned

(06:54):
earlier, dynamic process, with thegrowing fetus, even timing of how long
you endure a stress will make adifference. So I think keeping these things
in mind, and obviously if noneof those factors matter, what I think
our research kind of shows also isthat you might want to be aware of
your child and what the fetus hasgone through during development moving forward in childhood

(07:19):
and adolescents to look for possible neurodevelopmentalissues. Very interesting, and I think
this is a really important topic becausea lot of women may not really be
thinking about that. I mean,of course, you're pregnant, you want
to reduce stress levels in your life, but a lot of women can't,
and so maybe even timing, youknow, if as much as you can

(07:42):
timing getting pregnant, or you know, just being aware of the stress in
your life and trying to bring itdown and reduce it, whether it's just
taking ten minutes or going outside fora walk, taking some deep breaths,
anything like that. Absolutely, andI also feel strongly about sort of community
interventions, social interventions, sort ofkeeping tabs on others. And obviously not

(08:05):
all women are able to leave culturallyor these other stressful situations that we may
not all experience, but having sortof a community or a societal awareness where
that can be helpful is also animportant thing, no doubt, no doubt.
Well, Anna Ruleman, thank youso much for coming on to talk
about this. They really appreciate it. Really fascinating research that you're doing over

(08:26):
there at you See. Thank youso much for having me. Coming up,
we'll talk about a virtual reality trainingdesigned right here in Cincinnati that can
help train people on how to carefor older adults. And then much later
in the show, we're going totalk about a baby cafe and how it's
helping mothers new mothers with breastfeeding I'mAnginette Levy and you're listening to Simply Medicine
on fifty five KRC the talk station. I'm an Ginette Levy and you are

(08:54):
listening to Simply Medicine on fifty fiveKARC the talk station. Caring for older
adults is something that's becoming a biggerand bigger issue. We have the boomer
population, the baby boomers aging,and we hear stories sometimes about the challenges
of caring for older adults, especiallywhen they're family members. Well, there
has been something designed here in theCincinnati area to assist people in learning how

(09:20):
to do just that, and itinvolves using virtual reality. I think about
virtual reality and I think about videogames or laser tag or something. But
virtual reality is a really interesting thingthat has a lot of different purposes.
Joining me to talk about this isLinda Dunseith. She's the executive director of
the Livewell Collaborative. Also, jayLa Norad is the senior Innovation designer at

(09:45):
the Council on Aging. Ming Tangis an associate professor at the University of
Cincinnati's ADAPT program that stands for Design, Architecture and Planning, and he specializes
in architecture so they all work togetheron this. Thanks everybody for joining me.
I really appreciate it absolutely, JayLaw. Let's start with you.

(10:05):
Obviously, your agency, the Councilon Aging, saw a need for this
to be used to help people learnabout caring for older adults. Yeah.
Absolutely. So one of our valuesat Council on Aging is innovation, and
we are an innovative organization. We'reconstantly focused on developing new and collaborative solutions

(10:28):
to meet the needs of the peoplethat we serve. And so at the
beginning of the pandemic, that's exactlywe were wearing our innovation very proudly because
there were so many different things thatwere happening at that point. There were
so many new challenges that were beingbrought up, and one of the things

(10:52):
that we encountered was caregivers calling ourfront door, which we call the ADRC,
and reporting, you know, howdo I do this, and how
do I do that? And whenis adult Day going to open up again?
And different things like that, andso hearing all of those calls and

(11:13):
needing a solution to really try toprovide some level of respite two caregivers,
we wanted to attack that issue,not just for the short term, but
for the long term. And soafter a lot of discussions and research and
trying to figure out what would bea great way to leverage new tools such

(11:35):
as VR, we came up withUS as a solution primarily to help caregivers
build their skills and help navigate throughsome of the tougher conversations that come up
and that had come up in thosephone calls to help their loved one.
So mean, talk to me alittle bit about what you see dat per

(12:00):
gram dead you are? You knowyour program to help facilitate and build this
virtual reality training absolutely well. Ihave gotten involved in the virtual reality for
a long long time, probably seemsto Selven say, and technology is really
getting cheaper and accessible for all thedevelopers, from game industry to the education

(12:22):
to healthcare. So when Linda reachedup to me, I saw this is
a great opportunity to work with littlewell, work with CoA to address the
real world problem. The challenge ishow we can translate this everyday challenge from
the physical world into the virtual world. So that requires multiple components. Number

(12:43):
one is we have to create thishigh fidelity, fidelity physical mirror in the
virtual reality, such as the building, the environment, the furnitures, all
the props. Second is we haveto mapping the decision making from the real
world to the virtual world. Ishow people communicate, how they engage each
other. And certain one I thinkis very important is the behavior and emotional

(13:07):
connections to the virtual avatars. Sowe have a really great team to create
a whole narrative for the training tohave the virtual advatar is able to communicate
with you, so during that conversationyou can learn a lot of challenges about
caregiver So I think that is areally good example to integrate the expertise research

(13:31):
from the academic field with the industryand the platform of the well is wonderful
to really google everybody together from students, faculties, clay teams and also our
you know, the caregivers and thecaregiver client who we have a lot of
connections in the interview and have thebetter testing through the usability testing. It's

(13:54):
a wonderful opportunity. We are heretalking with three people who've been involved with
creating a virtual reality training of sortsto assist people with learning how to care
for elderly adults, and it's areally big topic because as we get older,
and I mentioned earlier the baby boomerpopulation, there are going to be

(14:15):
more aging adults. There are goingto be older people needing help, and
there will be a lot more ofthem. Linda Dunseeth is with us.
She's the executive director of the LivewellCollaborative. Also Jay law Noreed, the
senior Innovation designer at the Council onAging here in Cincinnati, and Ming Tang,
who is an associate professor at theUniversity of Cincinnati's DAT program. Linda,

(14:37):
tell me a little bit about basicallyhow this works. Yeah, So
the Livewell Collaborative was founded back intwo thousand and seven by p And in
US, you see, mainly tofocus on using design thinking to develop products,
service and system solutions for the fiftyplus marketplace. P And saw this

(14:58):
as a huge opportunity and with DAPthe College of Design, Architecture, Are
and Planning being in UC's backdoor,they wanted more design in their research function.
So that's how we were founded andthat was the original premise and what
livewell does. Like Ming And mentioned, livewell will recruit faculty and students from

(15:20):
across many of the colleges too.That have the expertise to work on these
things. So, for example,with the VR project, Ming was the
lead faculty and we recruited students withspecific VR experience from DApp. We actually
had a student from CCM that knewhow to do set design so that we

(15:41):
could set up these scenarios. Soit's a variety of students that actually take
an idea during week one of thesemester and then working with the faculty,
working with our partner Council on Aging, working actually testing it with stakeholders from
Council on A to develop scripts,to develop the scenarios to actually make the

(16:04):
headsets more user friendly for older adults. So it's a total co creation kind
of system where we go from ideato concept in about sixteen weeks. For
this particular project, because we developedfive scenarios, it was actually over the
course of four to five semesters.So jaylat, if I want to come

(16:25):
to the Council on Aging and Iwant to take part in this, do
I put on the headset or howdo I do this? Yeah? Absolutely?
So right now we are working ona few different ways that we're deploying
the use of ever talk. Soone way that we're doing that is we're
kind of coming to you. We'vegone to a number of caregiver centric events

(16:48):
over the past year with the headsetsand given people who are their opportunities to
put the headset on, to talkwith our team to figure out what issue
they may arise, maybe arising intheir relationships, or to give them more
context on the potential of a particularscenario happening in their life and how they

(17:11):
should navigate that. So that's oneway we're doing it. The second way
that we're doing it is we havea wonderful program here called Caregiver Support and
anyone in our five county region cancall in and set up time to speak
with some one of our caregiver supportnurses and basically they're here to support the
caregiver. So their role in ourorganization is to figure out what does that

(17:37):
giver need, what does their lovedone need, How can we reinforce their
care by supporting this individual who issometimes the sole primary person who's filling all
their needs. And so that's anotherway that we're doing it. And we've

(17:57):
also worked with several partners in thecommunity. So we've worked with Catholic charities
We've worked with Hospice of Cincinnati,and we're looking to work with more people
and are currently working through the processof figuring out what's the best way to
look to our community partnerships so thatwe can deploy our headset and ever talk

(18:19):
in their organizations. Well, Ithink it's really exciting. Innovation always exciting,
and helping care for elderly people isa big issue. You know,
we don't have as many caregivers aswe need professional ones and just people willing
to do it. I mean,it's a big undertaking. So we thank
all of you for talking with us, Jay law Noora at Maintang and Linda

(18:41):
den Sith. We look forward tohearing more about this. Coming up in
the next half hour of Simply Medicine, we'll talk about atrial fibrillation and a
new treatment for it being used atthe Christ Hospital here in Cincinnati. Imaginette
Levy and you're listening to Simply Medicineon fifty five KRC the talk station.

(19:03):
I'm anaging that Levy and you're listeningto Simply Medicine on fifty five KRC the
talk station. Atrial fibrillation is acondition that can be quite frightening if you've
ever experienced it, it's kind ofa fluttering of the heart. I had
it temporarily once for just about thirtyseconds or so, well really maybe more
like an hour, but still itwas really frightening. It was a constant

(19:25):
flutter. Other people can have itconstantly. And joining me to talk about
atrial fibrillation and a new procedure thatis being performed at the Christ Hospital to
treat it, is doctor Jeffrey AnnSweeney, Doctor and Sweeney, Welcome back
to Simply Medicine. Thanks for havingme, Thanks for coming on. Let's
talk about first, just a quickreminder primer, what is atrial fibrillation.

(19:49):
Atrial fibrillation is an electrical abnormality,the part where the atrium sits there and
basically doesn't contract normally. It'll beat, you know, several hundred times a
minute, and we'll cause the heartrate to race at rates sometimes up over

(20:11):
you know, one hundred and fiftyto two hundred times a minute. It
can be pretty scary. I knowwhen I experienced this, I thought to
myself, what is going on withmy chest? But there are people who
can live with this consistently. Isthat right? Yeah, that's true.
That's true. Most people that areyounger, when they get this elevated heart

(20:34):
rate, it makes them feel reallybadly, you know, and that's why
it gets scary, because the heartrates racing and they can't get it to
slow down. Whereas patients that endup having it for long periods of times
sometimes can get used to it anduse medications to slow down the heart rate
or to decrease the risk for UHfor stroke. So there's two different categories,

(21:02):
you know, ones that are supersymptomatic from it, and then there's
another group of patients that can bemanaged medically that can control their symptoms and
not feel badly when they're in theAPHID. So the patients that we usually
target for interventions, you know,either oblations through the groin or a hybrid
procedure where you do surgery and anoblation through the groin, they are typically

(21:27):
the ones that are symptomatic and it'syou know, creating problems for their quality
of life. We are here talkingwith doctor Jeffrey and Sweeney. He is
a surgeon at the Christ Hospital.He essentially helps fix hearts and they have
a new procedure there to treat atrialfibrillation. They call it aphib for short.

(21:48):
Doctor and Sweeney tell me about thisnew procedure that christ is using and
performing to treat aphid. Yeah,the procedures call it the convergent procedure,
and what it is, it's aminimally invasive procedure where we could go in
right below the sternum, which isthe main bone in the frontier chest.
We don't have to cut any bone. We just kind of go underneath it

(22:12):
and enter into the chess cavity minimallyinvasively with a camera. And they have
a device that they've developed that hassuction cups on it that will allow this
to go underneath the heart and toablate areas on the left atrium that are
known to cause atrofibrillation. And itallows us to reach areas that the cardiologists

(22:37):
sometimes have trouble reaching with their cathetersup through the groin. So it allows
us to treat patients that have moreof a difficult type of a FIB.
There's different types of a FIB thatare more refractory to treatment, and the
ones that the cardiologists have difficulty withare the ones that you know where the

(23:00):
AFIB has been lasting for longer periodsof time that they don't come go in
and out of a FIB like youdid, you know when you described earlier.
These patients have a tendency to bein the longer term a FIB,
and the longer you're in it,the harder it is to get you out
of it. So the patients thatreally benefit from this are ones that are

(23:22):
in it for long term and theydon't really have a whole lot of options
for just doing the ablation through thegroin. So what we do is we
team up with our electrophysiology colleagues andwe do the ablation in the area that
they have difficulty addressing in the cathlab, and then after three months,

(23:45):
we send them back to the cathlab to get the completion ablation done,
so they get the boast of bestof both worlds, where you get minimally
invasive surgery, the ablation done throughthe groin, and then a much better
long term outcome to keep people outof a fit. Minimally invasive obviously reduces
your recovery time, potentially reduces potentialfor complications, am I writer, There're

(24:10):
other benefits. The main benefit isjust you know, reducing the r time
and and and the recovery time.Like you said, you know, we
do it through a much smaller incisionso people can recover from it quickly.
And um the uh they're able toyou know, sometimes get out of the
hospital after just like two or threedays. That's amazing. So how many

(24:30):
of these procedures have you performed todate? Uh, We've done um somewhere
around uh twenty to thirty of them. Um. The my my partner,
doctor j Michael Smith does them aswell. And um the but but the

(24:51):
uh, the volume is increasing becauseyou know, the words getting out now
that we're offering this as a potentialsolution to help people get out of a
FIP. So we have people comingfrom as far as Lexington, Kentucky and
parts of Ohio that normally we wouldn'tsee patients from those areas, but now

(25:12):
that they know that we're doing thisprocedure, they're coming here to see us
to help them with this you getthem out of a fi Well. Very
exciting. Doctor Jeffrey and Sweeney,thank you so much for coming on to
talk with us, talk with usabout this. It's good to see you
again. Yeah, sure, happyto be here and hope you guys have
a great day. Up next,we'll talk about robotic surgery, how it's

(25:34):
improving surgeries and the milestone one hospitalis celebrating. I'm Anginette Levi and this
is Simply Medicine on fifty five KARCthe talk station. I'm Anginette Levi and
you're listening to Simply Medicine on fiftyfive KARC B talk station. They are
celebrating a milestone in surgery. Overat the Christ Hospital. They have a

(25:59):
robot. It's called the Da Vincirobot, and I've touched on this in
the past. It's something that makessurgery less invasive. And at the Christ
Hospital they are celebrating performing their tenthousand surgery with the Da Vinci robot.
Joining me to discuss this is doctorJanice Rafferty. She is a surgeon at
the Christ Hospital. Doctor Rafferty,Welcome back to Simply Medicine. Thanks for

(26:22):
coming on, Thanks so much forhaving me, Nice to see you.
Good to see you too. Firstof all, just briefly, what Da
Vinci robot is. I mean,I always think of it, at least
back when I did a story onit many years ago. It was almost
like It looked almost like a videogame controller or something, and it helps
you, guys perform surgery so youdon't have to cut as deeply or as
widely into the body. That's right, So we use robot arms to do

(26:45):
the surgery. Now the robot iscompletely controlled by the surgeon. I have
patients sometimes wonder if I will actuallybe doing the surgery or if I'm essentially
just turning the robot loose, kindof like you know, the robot from
that movie in the seventies. Ithink it was Space Odyssey or something like
that. If this is not alet's be clear, it's not an AI

(27:07):
robot that's going to take over yourbody in the world or whatever. I'm
kind of like freaked out by thewhole AI thing. But no, you
control it. You're the one operatingit. Absolutely, one thousand percent.
The surgeon is controlling the robot,and there are all sorts of safety features
built in so that you know,accidents with arms going awry cannot happen.

(27:30):
So it's an incredibly safe modality wedo. When we use the robot,
we do the same exact operation thatwe did twenty years ago. For example,
we just do it through a smallerincision, and we don't have to
have our hand in the out ofend. The result of this is that
the patient has a smaller incision,they have less pain, they have a

(27:52):
shorter hospital state, if they evenget admitted to the hospital earlier, returning
normal activities. It's really a veryamazing modality. You know, we went
from traditional open surgery in the olddays to labaroscopic surgery, which is also
minimally invasive, and that has morphedinto an even somewhat less invasive modality called

(28:14):
robotic surgery. And you're right,we have not only one robot here at
the Christ's Hospital, we currently havefour downtown. We have one up in
Liberty, and the robot is incrediblyuseful for all sort of procedures. I
would assume too, correct me ifI'm wrong, that it reduces the possibility
of complications and infection. Since youknow, I know you guys, I've

(28:37):
been in an operating room before.I know you scrub your hands very roughly
and aggressively. Then you have gloveson the whole nine yards. Is that
an added benefit as well? Yes, there is a lower risk of wound
infection when we're using a minimally invasivemodality simply because the incision is smaller and

(28:57):
you're right, there are not youknow, hands and arms going through that
incision. So yeah, the woundinfection rate is lower, that's correct.
We are here talking with doctor JaniceRafferty. She is a surgeon at the
christ Hospital. She was on justlast month. We were talking about colon
Cancer Awareness Month, and we're talkingnow about the da Vinci robot that has

(29:18):
been in service for many years.Recently they're celebrating there at the Christ's Hospital.
There ten thousandth procedure using the DaVincirobot, which is less invasive than
you know, traditional surgery. Onething I think is interesting about this obviously
is that you can use this robotfor a number of procedures. I remember

(29:40):
back, I think in two thousandand eight or so, I did a
story on the da Vinci robot andhow it was being used to perform hysterectomys,
and so that was really interesting.So when I witnessed this hys direct
me. You know, they wereable to go in with the arms,
snip and then pull the uterus outthrough the birth canal, so there was

(30:03):
no big incision and I actually,I have to tell you, I got
to actually hold the uterus, sothat was actually kind of interesting after the
surgery, which was kind of crazy. But it's not just hysterectomies. Obviously,
you're a cholorectal surgeon. So howmany surgeries or procedures can you use
the DA vincion? Oh my gosh, the possibilities are almost endless. Gynecologists

(30:30):
were perhaps at the forefront of roboticsurgery because they work in for the most
part, one quadrant looking down inthe pelvis, and they do have a
natural orifice through which to extract theirspecimens, so they really were at the
forefront of this technology. But ithas expanded since then to multiple other specialties,

(30:52):
and I'm sure i'll I'm leaving someout, but general surgery, so
there are hernias and gall bladders,and appendix surgery, and pancreas surgery and
liver surgery done robotically, colorectal surgery, all sorts of colon receptions are done
robotically. Thoracic surgery so lung surgery, heart surgery is done by incredibly talented

(31:18):
cardiac surgeons here at the Christ's Hospital, and the things they do and the
way they do it. Even tome as a robotic surgeon watching their procedures,
it's amazing. It's amazing that thattechnology can be used through such tiny
incisions on such an important organ thatis, you know, still beating.
It's it's amazing to me. Soit's expanded too. It's also expanded to
for example, the pulmonologists. Theycan do lung invasive lung procedures using the

(31:45):
robot going through the trachea. Soit's it truly is yeah, wow,
that's interesting. So if you're doingsay a surgery, I mean, can
you use it to remove like apall up a tumor or is that thing
more like? Because I'm just thinkingabout how a colonoscopy operates and if you
found something like that, so canyou do it? You know, the

(32:08):
colon's really long, it's like sixfeet long or something, so how would
you go about doing that? Sowhen we do robotic surgery for the colon,
we're actually operating on the outside ofthe colon and taking out a piece
of colon. Colonoscopy goes through thebottom and is looking at the lining of
the colon. So when you docolonoscopy, you're not outside the collon.

(32:30):
That's how polyps are removed. However, if someone has a huge polyp that
cannot be removed using a colonoscope,then we will use the robot to take
out a segment of colon that hasthat huge polyp in it. So we're
actually taking out a segment of acolon and then putting the bottlens back together
using robotic techniques. How much moreefficient has this made your job as a

(32:50):
surgeon? Are you able to performmore surgeries, more quickly and more you
know because of this technology, orhow is it changed your practice? It
hasn't necessarily sped things up. It'snot necessarily a shorter operation to have it
done any minimally invasive fashion. However, the visualization using three D robotic technology

(33:15):
is amazing. We can see thingsmuch more clearly. We can see the
planes much more clearly. You know, when we're using the human eye,
we are at our focal length tolook at, for example, pelvic dissection.
When we're using the robot, wecan get the camera right up there

(33:36):
by the plane in which we're dissecting, and everyone in the room can see
exactly what we're dissecting. Because they'relooking at the screen. Well, very
interesting. Well, we hope thatyou guys have about ten thousand more surgeries
to celebrate there with this. Ithink it's a really cool device. It's
fascinating and anything that can reduce recoverytime and complications, I'm all for it.

(33:57):
Doctor Janis Rafferty thinks so much forjoining us. We appreciate it.
Thank you so much for having me, and we're well on our way to
the second ten thousand, right.Not that we're wishing surgery on anybody,
but hey, if you've got tohave it, why not make it as
easy as possible. That's great.Thank you so much More to come on
Simply Medicine, including a baby cafehelping new mothers with breastfeeding. I'm Anginette

(34:20):
Levy and this is Simply Medicine onfifty five KARC the talk station. I'm
Anginette Levy and you're listening to SimplyMedicine on fifty five KARC the Talk station.
Breastfeeding can be a really big challengefor new mothers, but it's a
really great way to build immunity inyour newborn, your infant away for them

(34:44):
to get the best possible nourishment isfrom mom rather than formula, although some
people prefer that. And there's anew place in Cincinnati where women can get
help with this. It's called theBaby Cafe, very catchy name. I
love it. Enjoy me to discussthis is Don Thomas. She is an
internationally board certified lactation specialist with ucHealth. Don, welcome to Simply Medicine.

(35:09):
Thank you. Tell us a littlebit about the Baby Cafe, right,
So, we started but Baby Cafeat u See Westchester about seven years
ago, and then we opened upanother one within Butler County County with Primary
Health Solutions in twenty twenty, whichhad its own obstacles, and then last

(35:30):
week we opened up the one atthe Ambrose Health Center. And it's been
great to be able to help momswith their breastbeeding journey and problems that they've
had throughout their breastfeeding experience. I'veactually witnessed that. I remember my stepsister
when she had one of her children. She was in the hospital with a

(35:52):
newborn baby and he wasn't latching onand it was really difficult, and she
was upset, the baby was upset. I mean, it was just a
whole thing so tell me a littlebit about the issues that you can run
into while trying to breastfeed. Alot of women want to do that for
the mention reasons I mentioned, butalso you know, it can be very

(36:15):
difficult, especially if you're not ableto get everything to work. Absolutely.
I mean, we see families basedchallenges on a daily basis. That's why
we have a dog, for sure. Latching is a big problem. Just
learning that dance with the mom andthe baby is just takes time, and

(36:37):
just learning different techniques and having somebodycome in to help you. A lot
of times babies are born and they'resuper sleepy, so we're expecting them to
learn how to eat, sleep,and breathe right away, and sometimes those
challenges are just created when they're tryingto feed in general. So latching,

(36:58):
like you said, is a bigone. But just being patient with yourself
and your baby and trying to learnthat with each other just takes some time.
What is it with the latching on? I mean I feel like sometimes
you hear about oh, the babyjust takes right to it. Other times
the baby doesn't and has to bebottle fed. So is it just every

(37:19):
baby is different? Is it?I mean? I don't know. So
every baby is different, every mom'sanatomy is different, and that mom and
baby have to learn together on whatthat looks like with wlatching, and it
can just be challenging. As youknow, we're sleepy right after we have
babies, we've been through labor,babies are sleepy. So it's just a

(37:42):
learning time for both people. AndI think just learning to be patient with
yourself and giving your baby time tolearn is really important and not giving up
right away. It just takes time, and I think a lot of times
we think it's just going to instantlyhappen, and just learning the techniques from

(38:02):
when you're in the hospital just reallyhelp. We are here talking with Don
Thomas. She's an internationally board certifiedlactation specialist, and we're talking about the
Baby Cafe. It's a partnership betweenthe City of Cincinnati and also you See
Health and they help moms with breastfeeding. Talk to me, Don, if

(38:23):
you would, about why breastfeeding isso important and why it's probably better for
the baby than maybe formula. Notthat formula is terrible, you can of
course use that, So breastfeeding isimportant for both mom and baby. For
baby it helps them be less sick, It helps them attached to their mom,

(38:45):
help with bonding for mom, ithelps them lose their pretty pregnancy weight
very quickly, bond with their babyat lessons their chances a varying cancer and
breast cancer, so does benefits forboth mom and baby. It is constantly
changing for the baby's needs, whereformula just constantly stays the same, So

(39:08):
as baby grows, the breast milkchanges for their baby. So if I
come into the baby cafe, whathappens. So when you come into Baby
Cafe, um, we'll greet you. We typically will ask you questions on
how your feedings are going, ifyou have any concerns or questions about your

(39:30):
breastfeeding, will weigh your baby ifyou would like, and then we can
help you with watching your baby oraddressing any concerns or questions that you might
have about your feedings. We alsotalk about what's going good with your breastfeeding
experience, so we're getting those goodthings in with the moms too. And

(39:51):
then we'll let you feed your babyand then we weigh the baby after the
feedings to see what the baby's transferredwhile they're on the breast A lot of
families worry about how much my babyis getting because we don't have clear breasts
to be able to see what they'regetting. And this is just kind of
a checkpoint to kind of make surethey're getting enough while they're breastfeeding. And

(40:13):
is it free. It is free. It's open to anyone that needs breastfeeding
help. They can be breastfeeding andformula feeding, or are just pumping,
just providing any breast milk to theirbaby. They're welcome to be there and
tell me the hours if you would. It is on Thursdays from two to
three thirty And can you just walkin or do you have to make an

(40:36):
appointment? You just have to walkin. There's no registration required. When
you do come in, you're goingto scan a bar code that just takes
down your name. And Baby Cafeis a or organization that sends out like
surveys periodically just to make sure thatthey are helping reach all the moms that
are needing to be reached and thatthe moms are reaching their goals and that

(40:59):
Baby Cafe is helping them. DohnI noticed that this Baby Cafe is located
in Avondale. There's a higher populationof African Americans in that neighborhood in particular.
Obviously, anyone is welcome to cometo the Baby Cafe, but there
are also some stats that are prettydisturbing regarding maternal mortality rates for African Americans.

(41:22):
Absolutely, we know even gimils aCaney and Butler County that is very
high, and breastfeeding is one ofthose pieces that can really reduce that infant
mortality. So the more we canhelp get them to reach their breastfeeding goals
and help them where they're at,hopefully we'll start reducing those numbers and seeing

(41:44):
that happen. Well. Don Thomas, thanks so much for joining us to
talk about the Baby Cafe. Ithink it's a great resource and we're hoping
that people listening will take advantage ofit if they need help. Thank you,
and again, the Baby Cafe isheld on Thursdays at two o'clock.
You can just walk in to gethelp, and it's at the Ambrose H.
Clement Health Center on Reading Road.And that's it for this edition of

(42:07):
Simply Medicine. Thanks so much forjoining us. We're already working on next
week's show, so you'll want totune in for that. If you miss
any part of this show or anyof the other shows, don't worry.
We have the podcast. Just goto the iHeart app and put in simply
Medicine. It'll pop right up.So we hope you have a great week,
a safe week, and we'll seeyou back here next week. I'm
Enginette Levy and you're listening to SimplyMedicine on fifty five KRC, the talk station