Ready to help your teen gain health independence? Step 1: leave the exam room

Alone time between a teen patient and doctor can be beneficial to the child’s long-term health

Teen transition to adult healthcareAs parents, everything concerning our child’s health concerns us. We are the ones who take them to the doctor for that first shot, first fever and first broken limb. We naturally always want to be there, so it can be nerve-wracking to let our kids begin to take the lead at health visits, especially the first time we are asked to leave the exam room.

As our children grow up to be adolescents, it’s clear that they aren’t always comfortable talking about their bodies and health with us in the room. Despite this, we still may be hesitant to leave. Some parents may be concerned that their child is keeping secrets from them, or that the doctor may give their child guidance they don’t agree with. Other parents may just want to feel like they’re “in the loop.”
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Patient says, ‘Don’t wait!’ for hip replacement surgery

Pam Brandon horizontal

Pam Brandon knew something wasn’t right. She had been an active runner for several years and always tried to keep up a steady work-out routine, but over the past three years she started to develop hip pain that wouldn’t go away. In fact, it was worsening.

“This past year was awful,” says Brandon, who happens to also be a registered nurse at U-M Health System. “I tried to keep up working out every day, but was crying in pain.”

She participated in physical therapy sessions, but those were only helping to relieve the pain temporarily. “I wanted to make sure it wasn’t cancer or something worse,” Brandon says.

That’s when her physical therapist recommended her to Joseph Maratt, M.D., an assistant professor of orthopaedic surgery at U-M. Continue reading

Hairstylist almost cuts off arm, but is back in salon after hand reattachment surgery

Surgeon leading hand transplant program rebuilds patient's arm, reattaches hand

Robert Ruffer was working on his farm with a saw, cutting up pieces of wood, when a horrible accident happened.

His sleeve got  caught on the blade. The blade ripped through his arm and his bones.  His son fashioned a quick tourniquet out of a belt and waited for an ambulance to arrive.

Ruffer arrived at the University of Michigan Health System with his arm hanging by just a flap of skin.

Ruffer ended up in the care of Kagan Ozer, M.D., the hand surgeon who is leading U-M’s new hand transplant program. Ozer reconstructed Ruffer’s arm, building back bone, tendons and nerves. Continue reading

Wanderlust deferred

An ENT nurse discovers it’s never too late to seek adventure abroad


Working as a Peace Corps volunteer was something Bianca Waller, R.N., dreamed about doing when she was a nursing student at the University of Michigan. But after graduation, her life took a different turn.

“I found a wonderful man I wanted to marry,” she said. “I definitely wanted to have children. I just didn’t know that I’d be able to keep going in that type of environment with the kind of life I wanted to have.”

The chances of going overseas seemed to become even more remote when she settled into her career. Waller discovered her passion was working as a surgical nurse in otolaryngology – commonly known as ear, nose and throat, or ENT. Although she loved being in the operating room, she thought specializing in such a way would “pigeon hole” her, moving her further from her dream of adventure in faraway lands.

That wasn’t the case.

Two years ago, she got an offer to go to Kenya with Greg Basura, one of the physicians she works with in the Department of Otolaryngology at the U-M Health System. Basura was traveling to the East African nation on a medical mission with two dozen doctors and nurses.

“He said to me, ‘You know, it would be really nice if you could help me get some instruments and supplies together. You would be more than welcome to come on the trip. Why don’t you think about it?’” Waller said.

She was interested but the timing seemed bad. She had a family at home, and the cost of travel was expensive.

But a nurse anesthetist who was also going urged Waller to join the group. The instruments used in ENT are unique, she said, and the cases are special. Waller’s skills were needed.

“I asked my husband, and he said, ‘If this is something you want to do, you should go,’” Waller said.

She went to Kenya and had an incredible experience. One month after she returned, Basura approached her again. “What do you think about Ghana?” he asked.

She responded, “I don’t know. What should I know about Ghana?”

Basura explained that the trip to the West African nation would be different – not a medical mission like the one to Kenya. The Department of Otolaryngology was setting up an educational collaboration with Komfo Anokye Teaching Hospital, or KATH, in Kumasi, the second-biggest city in Ghana. Waller would help teach nurses in a new otology training program.

“Is that something you would like to be part of?” Basura asked.

“That sounds amazing,” Waller answered.

The opportunity excited her because a nurse was being included in the early planning. Also encouraging was that physicians in her department had already surveyed the situation at KATH and were optimistic about the partnership.

“I never thought I’d get to be part of something like that,” she said.

Last March, she made her first trip to Ghana, and she returned for a week in late October. She worked side-by-side with her Ghanaian colleagues in the operating room, observing their routines and trading best practices.

Waller said that the nursing model at KATH is different from the one at U-M. In Ghana, they use two different teams of nurses in the operating room. One team includes nurses who work in the ENT clinic. The other team includes surgical nurses.

“This is completely different from what we do back home,” she said. “We have teams of nurses in the OR who are specific to otolaryngology. They almost never work in the hospital in-patient unit or the clinic. And the clinic nurses would only come to the OR to observe.”

Waller said that in Ghana trying to work and communicate with the two different teams was challenging at first. But she observed over time that they were able to work together and take good care of the patient.

Going to Ghana has been a great opportunity to discover the need people have for education, Waller said.

“But you have to go into it with an open mind and remember we’re not here to change everything, but to try to improve one process at a time,” she said.  “And it’s a privilege to participate in that.”

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Hoping for a domino effect

A physician has a challenging first day on the job in Ghana


Greg Basura, M.D., Ph.D., remembers the first time he examined patients in an ear, nose and throat clinic in the West African nation of Ghana.

The examination room was crowded with 10 to 15 nurses, doctors, residents and other people. He was trying to figure out the set-up and the workflow. What instruments were available? How did the patient’s chair work? What did the medical records say?

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A collaboration, not a mission trip

U-M physicians train their Ghanaian ear, nose and throat colleagues

Ghana Blog - First Story2

U-M otolaryngologist Mark Prince (right) confers with Dr. Alex Oti of the Komfo Anokye Teaching Hospital in Kumasi, Ghana. Prince and several colleagues recently spent a week in Kumasi collaborating with Ghanian doctors.


Doctors do “mission trips” all the time. They take a week or so off from work and travel to a developing country. They treat several patients and then they fly home.

No doubt, such trips can have a huge impact on a patient’s life. But Mark Prince, M.D., wanted to do much more than that when he and his colleagues began thinking about working in the West African nation of Ghana. They didn’t want to just provide sporadic care.

“We wanted to go to a place where care was already being delivered at a certain level and assist them with getting to the next level,” said Prince, of the Department of Otolaryngology-Head and Neck Surgery at the U-M Health System.

The U-M physicians’ goal was to work with their Ghanaian colleagues to create a training program — an educational collaboration. In the past two years, they’ve already made much progress with such a project at the Komfo Anokye Teaching Hospital, or KATH, in Kumasi — the second-biggest city in Ghana.

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