Local Health Innovations in Rhode Island
From equine therapy to new trends in weight loss, we consulted local experts on all things health and wellness.
Horses Healing Humans
A local program harnesses the connection between people and four-legged friends.
According to statistics from the National Alliance for Mental Illness, three of every four Americans are stressed to the point of developing a chronic illness and only one of every three gets help before that illness is realized. And while there are many ways to seek assistance, interactive equine therapy can help.
Locally, a program at Beachwood Center for Wellbeing in Saunderstown works with clients to address underlying issues and stress-related illnesses through equine therapy. Its approach, developed by Beachwood’s founder and executive director, Lynne Bryan Phipps, is an evidence-based protocol for the equine therapist, horse and client. The horse and equine therapist combination helps clients achieve a state of emotional relaxation and calmness, Phipps says. Brown University researchers are studying the program to see if it decreases participant stress scores, depression and anxiety; according to Phipps, preliminary data is promising.
Unlike other equine therapy programs, Beachwood’s clients work from the ground — no riding or caring for the horses is involved. “We begin a session with a grounding and mindfulness/meditation approach,” says Phipps. “This allows people to just be present in their bodies and the environment and it lets them connect to the horses. Through this connection, clients can access their underlying stress-related issues.”
Of course, this doesn’t happen over one ninety-minute session, but rather during the course of a few weeks. “It’s a very gentle process with little to no talking,” Phipps says. “We know that horses are fight or flight animals and they read things in their environment as either predator or as safe. So when clients are dealing with something really stressful, the horse will stay at a safe distance. When the person gets in touch with what they are feeling and are at a safer level — or building neural pathways — the horse draws closer.”
Through the horse’s behavior and movements — such as when they touch the client’s body — Phipps and the other therapists at Beachwood can tell what is going on with the person. Though the response may be subtle, the horses are objective readers of their surroundings and can sense a person’s ailments or mood. Because the therapists are familiar with each of the barn’s three therapy horses, they can detect when the four-legged friend is guiding the client with atypical movements (i.e. placing their chin on the client’s head).
While Phipps and the horses work with those who seek out the program, many clients are referred by local doctors including family physician Martin Kerzer in Warwick. “We recognize the importance of addressing patients’ mental health issues, especially as it affects their physical health,” says Kerzer. “Often, patients do not respond adequately to conventional treatment, and the work being done by Lynne Phipps at Beachwood can offer patients an alternative treatment to address their mental health needs. She has shown that equine therapy can successfully address issues such as trauma-related conditions, anxiety and other mental health issues in a shorter period of time compared to conventional treatments.”
One of Beachwood’s clients, Naomi Barnum, came to the program skeptical but in need of help; she had never been so mentally and emotionally stressed. After a period of conventional treatments, including regular therapy sessions, meditation and more, she still struggled. She found that connecting with an animal offered a different approach to combating her stress-related illnesses.
“I came [here] to work with the horses and the results from the sessions are truly hard to articulate,” Barnum says. “It has released a bound-up blockage of energy inside of me that I couldn’t get rid of before. It has allowed me to channel in the things that are calming, that are working and that are feeding my soul, all while keeping the bad blockage out. When we have help to access these parts of ourselves that we spend our lives repressing, we can take in the good things and let go of the stressors and everything else. A farm in Saunderstown is the last place I expected to find this kind of peace, but it has just been profound for me.”
Miriam Hospital’s Surewash simulator is more than just fun and games.
Many germs that cause serious infections in health care are spread by unsanitary hands. According to the Centers for Disease Control and Prevention, on average, health care providers clean their hands fewer than half of the times they should. This contributes to the spread of health care-associated
infections that affect one out of every twenty-five hospital patients. However, proper hand hygiene can prevent or help stop the spread of a variety of illnesses.
To aid health care staff with useful techniques, the Miriam Hospital invested in an interactive simulator to advance its infection control initiatives, all while making handwashing training both more efficient and fun. The device, SureWash, is among the first acquired by a hospital in the state and mimics that of a video game. The software instructs health care providers in proper handwashing techniques (according to the World Health Organization Protocol), such as scrubbing fingertips and both thumbs. Equipped with hardware including a camera and monitor, users simulate the techniques as the machine evaluates and rates their performance with computer graphics and high scores.
Staff at Miriam Hospital are required to complete five levels of competency training with increased levels of difficulty on the mobile kiosk SureWash device to spread more knowledge about proper hand hygiene, not germs.
How Does Rhody Stack Up?
With advanced medical research and doctor know-how, we compared little Rhody to the rest of the country on these key health issues.
How are we doing? Meh
Vincent Pera Jr., M.D. Medical program director of Lifespan’s Center for Weight and Wellness
National Median for Adults: 39.8% (2015–2016, CDC)
Rhode Island Median: 30% (2017)
While Rhode Island’s median obesity rate looks better on paper, it is important to note that the state’s rate has increased quite a bit. In fact, Rhode Island has the twenty-ninth highest rate of obesity in the country and is the leader in New England. Dr. Vincent Pera Jr., medical program director of Lifespan’s Center for Weight and Wellness, says higher levels of obesity rates on an individual basis are caused by a number of interacting factors including socioeconomic variables like lower income and lower levels of education. And while genetic predisposition, environmental influences (including large portions and sedentary lifestyle) ethnicity, medical, psychological and psychiatric issues and more, also play a role in obesity rates, there are many ways to combat the issue at hand. “The successful treatment of obesity can range from relatively simple caloric restriction and exercise programs
to complex integrated treatment that includes the ability to address the psychological, medical and social issues,” says Pera. “National and local programs that improve the availability of healthy foods and physical activity can help to build the foundation needed for improving obesity in the United States.”
Drug-Related Overdose Deaths
How are we doing? Not so good
Kirsten Langdon, PhD Director of Lifespan Recovery Center
National Median: 21.7% in 2017 per 100,000 standard population
Rhode Island Median: 31% in 2017 per 100,000 standard population (via the National Center for Health Statistics)
“According to the Rhode Island Department of Health, overdose deaths in Rhode Island have increased by almost 90 percent between the years of 2011 and 2017,” cites Kirsten Langdon, PhD, director of the Lifespan Recovery Center. “However, it is important to note that a slight decrease was observed between 2016 and 2017 [by thirteen deaths].” Rhode Island has certainly been hit hard by the opioid epidemic. The cause? “It is likely due to a combination of factors including prescribing practices, economy and geographic location,” says Langdon. To address the epidemic, Rhode Island has outlined several key initiatives that will lend a hand in preventing the overdose rate from continuing to rise, including prevention, rescue, treatment and recovery plans.
How are we doing? We’re working on it
Sandra Japuntich, PhD Former senior scientist with the Miriam Hospital’s Center for Behavioral and Preventive Medicine
National Cigarette Use: 14% (2017, CDC)
Rhode Island Cigarette Use: 14.9%
In 2005, the national average for cigarette use among adults clocked in at 20.9 percent. Just fourteen years later, the national average has dropped by almost 7 percent. If you haven’t quit yet, good news: Rhode Island ranks the thirteenth lowest of all fifty states for smoking and continues to see a decrease in use of tobacco products. “Rhode Island has many restrictions on cigarette use including where people are able to smoke and high tobacco taxes,” says Sandra Japuntich, former senior scientist with Miriam Hospital’s Center for Behavioral and Preventive Medicine. “There are also several demographic factors that contribute to the smoking rate in Rhode Island including access to high-quality health care and the level of education.” While cigarette use may become a thing of the past, electronic delivery systems such as vapes and Juuls are on the rise, particularly among youth. Food and Drug Administration commissioner, Scott Gotlieb, has even deemed e-cigarette use among young adults as an epidemic.
Editor’s note: Japuntich left Miriam Hospital and moved to the Hennepin Healthcare Research Institute in Minnesota after the interview was conducted.
Doctor tells all: Dr. E. Jane Carter, pulmonologist
Is vaping as bad for you as smoking? “While vaping is presented as a safer alternative to smoking, there are many unknowns about its long-term effects. In vaping, the cartridge does not contain tobacco and is not burned, so no smoke or ash is inhaled; this is how most of the cancer-causing materials in cigarettes are formed. The nicotine in the vaping cartridges is dissolved in a chemical called propylene glycol. However, we do not know what this chemical does to the lungs in long-term exposure. There is presently no oversight of the manufacture of the cartridges, so many have been found to have dangerous compounds mixed into them. The lung is a delicate organ and we are always concerned when we pass chemicals and materials through it.”
Searching For A Match
A twenty-six-year-old with sickle cell disease is searching for his perFect donor.
Sickle cell disease (SCD), an inherited red blood cell disorder, is caused by a change in hemoglobin; this results in crescent-shaped, stiff blood cells that block blood flow in small vessels and do not carry an adequate amount of oxygen throughout the body. It can cause people suffering with SCD severe pain or acute sickle cell pain crisis, organ damage, infections and more.
A twenty-six-year-old Rhode Islander and father of three, Jodeci De Jesus, suffers from severe sickle cell disease and the pain that comes along with it. After a stroke last year, De Jesus is now looking towards a bone marrow transplant — a process in which a patient undergoes chemotherapy that kills the cells making faulty hemoglobin and is injected with healthy cells — in hopes to cure his disease.
The catch? De Jesus must find his perfect match. To be compatible, his donor must have the same exact human leukocyte antigen (HLA) typing. By joining the Be the Match registry, donors can find out if they are a match with De Jesus or thousands of others through a simple two-step process that involves a five- to ten-minute digital questionnaire and a cheek swab kit.
We caught up with De Jesus to learn more about his experience with sickle cell disease and waiting for a donor.
RIM: How did you find out you had sickle cell disease? Were there symptoms?
I started having symptoms at a young age, like jaundice and my hands and feet would swell up. I learned that I had [SCD]. One of my parents carried the gene and it was passed on to me. I know someone that didn’t know they had it until they were in their twenties. It’s different for everyone.
RIM: What is your day-to-day like?
Most days I usually visit the hospital for pain fluids and medications to help with the pain I am feeling. Some weeks are better than others and I don’t go at all, but sometimes I have to go in multiple days a week. I used to be active and play sports, but I can’t anymore. I also have three kids, two boys and a girl who I spend my time with, now. My oldest son actually has sickle cell disease as well, though he is doing much better than I was at his age.
RIM: How long have you been waiting for a match? If they find a match, then what?
I have been waiting for a match since seeing a doctor in November after my stroke in May 2018. Getting a match would mean having a bone marrow stem cell transplant that could potentially cure my sickle cell disease. Some people who have had it done have had their sickle cell come back, but many people’s [SCD] have been cured.
Be the Match encourages people ages eighteen through forty-four and all ethnicities to join the registry. Currently, the likelihood of finding a match for patients in need ranges from 23 to 77 percent, depending on a patient’s ethnic background. Hispanic patients like De Jesus have a 46 percent chance of finding a match because only 7 percent of the Hispanic population makes up the registry. The more people who donate and the more diverse the population, the better probability a patient has for a match. To learn more about Be the Match and how you could become a donor, visit ribc.org/bethematch.
Doctor’s Office Alternatives
When the family physician is booked out and you just can’t get an appointment, take your symptoms to another health care facility and kick your sickness to the curb.
Condition Level Appropriate for non-life-threatening circumstances such as vaccinations, lab work, women’s services, physicals and minor illnesses and injuries including ear infections, sprains and more.
Prescriptions are provided when medically necessary. *For ages eighteen months and older
Hours 7 days per week; Located in select CVS Pharmacies and Target locations. cvs.com/minuteclinic
Appointment Required? No. Plus, hold your place in line and see wait times in advance.
Provider Level Nurse practitioners who specialize in family health care.
Cost: Most insurance plans accepted.
Condition Level Appropriate for non-life-threatening conditions like cold and cough, minor injuries, skin conditions and more. Connect with a medical professional from the comfort of your own home, however providers are limited to non-hands-on practices. Prescriptions are provided when medically necessary *For ages two and older (MinuteClinic Video Visit)
Hours 24/7 cvs.com/minuteclinic or uhc.com
Appointment Required? No (MinuteClinic Video Visit) Only if you prefer (United Health Care Virtual Visit)
Provider Level Nurse practitioners who specialize in family health care (MinuteClinic Video Visit). Board-certified medical professionals (United Health Care Virtual Visit).
Cost: $59 (MinuteClinic Video Visit) Benefit coverage for most UHC Plans (United Health Care Virtual Visit).
Condition Level Have direct access to a provider for several services including primary care, postpartum and newborn care, wellness and prevention, some minor procedures, labs and tests and more. Prescriptions are provided when medically necessary.
Hours Mon.–Fri. See website for appointment times directdoctors.org
Appointment Required? Yes
Provider Level Board-certified medical professionals who specialize in family medicine.No copay or deductible.
Cost: Monthly subscription fee: $25 child younger than 21 (with a parent), $75 ages 21–64, $100 ages 65 and older.
Condition Level Appropriate for non-life-threatening acute injuries and illnesses, like sprains and strains, physicals, infections, vaccines and more. Plus, x-rays and labs are available on site. Prescriptions are provided when medically necessary.
Hours 7 days per week at most facilities.
Appointment Required? No.
Provider Level Board-certified physicians, physician assistants and nurse practitioners who specialize in family medicine.
Cost: Most insurance plans accepted, plus self-pay options.
Doctor Tells All:
Dr. Corey Ventetuolo, pulmonary and critical care medicine
The intensive care unit can be, well, intense. What are the most difficult days on the job? “There have been many times in my career where we haven’t been able to save a patient’s life. I think that one of the things we contend with in the intensive care unit is that many of our patients don’t make it despite our best efforts and those can be very rough days. There’s a lot of conversation about burnout among physicians, ICU physicians among some of the highest of rates. One of the reasons why we keep going, though, is that while we have to get used to loss of life, we have new opportunities and new technologies like the ECMO heart and lung machine that help us save the lives of many people, too. We have been able to save many lives that we otherwise wouldn’t have without this technology and days like that make it worth it.”