Faces of Tomorrow surgeons transform lives in Ecuador



Dr. Brian Rubinstein stores some of his medical supplies for his nonprofit group Faces of Tomorrow in his garage in Davis. Over the years, U.S. doctors with the group have helped as many as 400 Ecuadorans with deformed lips and palates, most of them young children.

For much of her 39 years, the woman hid behind a scarf and could not bear to see herself in the mirror. She kept her gaze down, her eyes averting those of the doctor who came from afar to help her smile.

The woman was born with a cleft lip, a common facial deformity in many parts of the world. She had heard that Dr. Brian Rubinstein and his crew were again back in Quito, Ecuador, to offer their help.

In less than two hours, Rubinstein, a Kaiser Permanente facial plastic surgeon from Davis, repaired the woman’s lip.

You don’t have to wear your scarf anymore, he told the woman, Carmen Rivas, on a January day a year ago.

Freed from her scarf and embarrassment, Rivas told Rubinstein that she was finally empowered to look for a job.

“She touched all of our hearts,” said Rubinstein, whose team, under the banner of the nonprofit group Faces of Tomorrow, is heading back to Ecuador later this month as part of a 10-day humanitarian mission.

Over the years, U.S. doctors have helped as many as 400 Ecuadorans with deformed lips and palates, most of them young children, now saved from the ignominy of a congenital condition.

“They have these facial deformities and are outcasts,” he said.

Many cannot afford the surgeries and rely on Rubinstein and his team to “transform their lives.”

Oral-facial clefts are usually genetic, but can sometimes develop because of nutritional deficiencies during fetal development. The tissues of the mouth and lip aren’t properly formed, producing a noticeable gap.

In the United States, clefts occur in 1 in 700 births. But in Ecuador, Rubinstein said, the rate is about double.

“A lot of those kids wouldn’t have a chance,” said Rubinstein.

He has three daughters, all of whom have done what they can to support their father’s endeavor. They’ve collected toothbrushes at school, raised money for equipment and collected blankets for children abroad.

Faces of Tomorrow receives grants, money from friends and family members and has raised thousands of dollars from community fundraisers.

Rubinstein’s wife has accompanied him to Ecuador to work as part of the mission that brings nearly three dozen health professionals to Quito, including three Kaiser surgeons who serve as the centerpiece of the operation.

One of Rubinstein’s partners, Nima Pahlavan, another Kaiser surgeon from Sacramento, is also a dentist.

There are nurses, anesthesiologists, social workers, speech therapists, psychologists and other health professionals who help in the effort.

The transformation goes beyond aesthetics. “We try to treat the whole problem,” Rubinstein said.

“We give them a fair chance at life,” said Pahlavan, the chief of head and neck surgery for Kaiser Permanente’s hospitals in Roseville and Sacramento.

He recalled a particular boy, perhaps about 3 months old, who arrived with a severe deformity.

The child was too young to recognize the burden that his condition could bring him later in life, if not surgically fixed.

But his mother knew. And when Pahlavan was done, she was overwhelmed with gratitude, the doctor said.

“She had no idea that her child could look so normal,” said Pahlavan, whose Spanish, he said, could be better. “Not many words were exchanged, just a lot of tears.”

The next trip to Ecuador will be the second for Pahlavan and the sixth for Rubinstein, whose first excursion was in 2001 as a University of California, Davis, medical resident.

There is talk of expanding the mission to other parts of the world, perhaps to the Philippines.



Dr. Brian Rubinstein, a Kaiser Permanente facial plastic surgeon from Davis, packs for another Ecuador trip with his team that fixes deformities.

Tags: , , , , , , , , , , , , , , , , , , ,

Read Users' Comments (0)

Carmichael mom expands personal crusade against deadly meningitis



Rose Kwett started her awareness campaign after losing daughter MaryJo, 15, to meningococcal meningitis in 2000. Cases of the disease have declined in Sacramento County since her efforts began.

Since her daughter died abruptly and unexpectedly of meningitis in 2000, Rose Kwett of Carmichael has made it her mission to educate others about the disease.

She works 40 hours a week and gives up to 200 presentations a year on spotting and preventing meningitis.

But at some point, the laws of time and physics restrained Kwett, who also works full-time as a nurse.

Now Kwett hopes to spread her message to the rest of California and eventually America with a free DVD she will mail out to 2,000 schools and organizations.

“We were getting requests to have her travel to Redding and beyond,” her husband, Peter Kwett, said. “I said to her, ‘You’re 110 pounds, and you’ll get sick covering all of California.’ Now Rose can duplicate herself everywhere.”

Meningitis is an infection of the meninges, the fluid that surrounds the brain and spinal cord. While it can be caused by a virus or bacteria, a bacterial type called meningococcus is what concerns Kwett. That’s the strain that killed her daughter just 13 hours after the teenager awoke feeling ill.

Since Kwett started her awareness campaign, Sacramento County’s meningococcal disease rates have tapered off.

“Rose has worked very hard to increase awareness of meningococcal meningitis, and it certainly has made an impact in Sacramento County,” said Dr. Glennah Trochet, Sacramento’s public health officer.

Trochet said another factor that has reduced disease incidence is that meningococcal vaccination has become more common for children in the past several years.

In 2000, there were 21 cases and four deaths. The number of cases has declined: There were four cases in 2007, seven in 2008, and six in 2009. The latest death statistics are from 2006, and there were no deaths that year.

Raising awareness is key, Kwett said, because it’s so difficult to spot meningitis.

Kwett’s daughter MaryJo was a healthy 15-year-old who had a black belt in kung fu and danced hula. One morning the teenager awoke at 5 a.m. feeling feverish, and her mother assumed it was a run-of-the-mill virus. By 6 p.m., MaryJo Kwett had died.

“I’m a registered nurse, so I’m supposed to know about meningitis,” said Rose Kwett. “And if I couldn’t even figure it out, how would other parents?”

That’s what drove Kwett to form her nonprofit, Meningitis Awareness Key to prevention. In her presentations, she tells people about meningitis’ symptoms, which include headaches, fever, stiff neck and a rash.

This flu season is a special concern because of reports of meningitis being misdiagnosed as H1N1, Kwett said.

Her presentations are targeted at schoolchildren because they are most likely to engage in the behaviors that spread the infection: exchanging saliva and mucus.

“I tell students to be aware and don’t share,” she said. “Meningitis can be transferred through lip gloss or cigarettes or kissing.”

When Menactra – a vaccine that protects against four of five kinds of meningococcal bacteria – became available in 2005, Swett started urging children to get vaccinated.

Her DVD covers her entire presentation and is the product of several years’ work. Kwett says she will start writing to school districts soon to let them know the video is available, and she has already given out 50.

Suzi Villere of Sacramento is a beneficiary of Kwett’s work.

In 2002, Villere’s son Chris contracted meningitis. He was treated immediately and now is a 19-year-old sophomore at Sierra College.

“I think the awareness makes a huge difference,” Villere said. “When Chris came down with the symptoms I knew what it was and rushed him to the hospital.”

For more information, visit www.makinfo.org.

Tags: , , , , , , , , , , , , , , , , , , ,

Read Users' Comments (0)

Racers make strides in new year



Participants head out at the start of the Total Body Fitness duathlon on the shores of Folsom Lake in Granite Bay. The free bicycling-running event drew a field of about 500. “We used to spend money on print ads,” said Mark Shaw, co-founder of the multisport outdoor training company in 1991. “Then we decided to spend the money on an event that brings people out who might not normally do this.”

Debbie Combs may have placed second-to-last in the Total Body Fitness duathlon Saturday, but she is well out of the gates when it comes to New Year’s fitness regimes.

Most of the soup had been slurped, the bike racks packed up and the tents taken down when the 56-year-old Combs – trimmed in pink – crossed under the inflatable arch as the digital clock hit two hours, four minutes and 19 seconds.

“I wasn’t last,” said Combs, a Galt accountant. “Finishing is sweet.”

About 500 people hit the shores of Folsom Lake in Granite Bay for the free event that took donations for St. John’s Shelter Program. Participants of the seven-mile bike ride sandwiched between two two-mile runs ranged from those who finished well within an hour to entire families racing together.

“We used to spend money on print ads,” said Mark Shaw, who co-founded the multisport outdoor training company in 1991. “Then we decided to spend the money on an event that brings people out who might not normally do this.”

Blake Jackson, 37, heard about the event from friends a few weeks ago. The member relations manager for the California Chamber of Commerce decided to give it a try even though his equipment included a mountain bike and 12-year-old running shoes.

He still finished in an hour.

Kevin Denison, 41, a Sacramento Web developer, did the entire race, as did his wife, while their three sons – ages 9, 13, and 15 – each took a running or biking leg in a relay.

“It’s a good way to spend time together and not sit in front of the TV the whole time,” Denison said.

Sheryl Faris, 36, of Colusa is six months pregnant with her third child and still finished. The toughest part was crouching down on her road bike with the extra load in front.

“I didn’t deliver, so I’m good,” Faris joked upon finishing.

“But I probably won’t be doing these much longer.”

Gloria Browner, 63, of Granite Bay heard about the race in a spin class about a week ago. When she checked her bike Friday night, she noticed a tire wouldn’t hold air.

She brought the bike anyway, and Bicycles Plus of Folsom replaced the inner tube free of charge before the event.

The retired teacher hoped to finish under two hours and came in just shy of one hour and 40 minutes.

“My New Year’s resolution was to be as fit as I can, as healthy as I can,” she said.

Jessica Tabayoyong, 41, of Land Park did the event with five girlfriends. They regularly work out together, trying to do at least one organized race a month, but more importantly, they planned to hit dim sum after.

“Any form of fitness we can get a bunch of people together for, the better,” said Tabayoyong, a state worker.

For Combs, who not only was wearing pink but has a bike trimmed in pink, fitness recently became part of the vocabulary and is now a lifestyle.

“Three years ago, I got up off the couch because the doctor said if I didn’t do something I would have a heart attack or stroke,” she said. “I’ve lost 80 pounds and I feel great.”



Katie McDonald of West Sacramento gives her daughter Marie-Claire, 2, a high-five as she sits on the shoulders of her dad, Jeff, during a transition point in the duathlon.



Andrew Love, 23, of Citrus Heights gets a high-five from friend Pat Pavis as he finishes his first duathlon. Participants went solo or in groups of family members or friends.

Tags: , , , , , , , , , , , , , , , , , , ,

Read Users' Comments (0)

H1N1 vaccination clinics

Some area counties are offering free H1N1 vaccination clinics. The clinics below are open to all county residents.

Sacramento County

• Monday: 10 a.m.-2 p.m., First Baptist Church, 4401 San Juan Ave., Fair Oaks.

• Tuesday: 4:30-8 p.m., Elk Grove High School, 9800 Elk Grove-Florin Road, Elk Grove.

• Wednesday: 3-7 p.m., Grant Union High School, 1400 Grand Ave., Sacramento.

• Thursday: 10 a.m.-2 p.m., Sunrise Mall drive-through, 6041 Sunrise Blvd., Citrus Heights (no walk-ins, vehicles only).

• Friday: 3-7 p.m., Inderkum High School, 2500 New Market Drive, Sacramento.

• Jan. 11: 4-8 p.m., Valley High School, 6300 Ehrhardt Ave., Sacramento.

• Jan. 12: 10 a.m.-2 p.m., Sacramento Japanese United Methodist Church, 6929 Franklin Blvd., Sacramento.

• Jan. 13: 10 a.m.-2 p.m., Christ Community Church, 5025 Manzanita Ave., Carmichael.

• Jan. 14: 1-5 p.m., Chabolla Center, 610 Chabolla Ave., Galt.

• Jan. 15: 10 a.m.-2 p.m., County Administrative Center, 700 H St., Sacramento.

El Dorado County

• Tuesday: 3-6 p.m., Divide Wellness Center, 6065 Highway 193, Georgetown.

• Jan. 10: 12-3 p.m., El Dorado Hills Community Services District gymnasium, 1021 Harvard Way, El Dorado Hills.

• Jan. 14: 1-3 p.m., Pioneer Bible Church, 6851 Mount Aukum Road, Somerset.

Tags: , , , , , , , , , , , , , , , , , , ,

Read Users' Comments (0)

H1N1 vaccination clinics

Some area counties are offering free H1N1 vaccination clinics. The clinics below are open to all county residents.

Sacramento County

• Monday: 10 a.m.-2 p.m., First Baptist Church, 4401 San Juan Ave., Fair Oaks.

• Tuesday: 4:30-8 p.m., Elk Grove High School, 9800 Elk Grove-Florin Road, Elk Grove.

• Wednesday: 3-7 p.m., Grant Union High School, 1400 Grand Ave., Sacramento.

• Thursday: 10 a.m.-2 p.m., Sunrise Mall drive-through, 6041 Sunrise Blvd., Citrus Heights (no walk-ins, vehicles only).

• Friday: 3-7 p.m., Inderkum High School, 2500 New Market Drive, Sacramento.

• Jan. 11: 4-8 p.m., Valley High School, 6300 Ehrhardt Ave., Sacramento.

• Jan. 12: 10 a.m.-2 p.m., Sacramento Japanese United Methodist Church, 6929 Franklin Blvd., Sacramento.

• Jan. 13: 10 a.m.-2 p.m., Christ Community Church, 5025 Manzanita Ave., Carmichael.

• Jan. 14: 1-5 p.m., Chabolla Center, 610 Chabolla Ave., Galt.

• Jan. 15: 10 a.m.-2 p.m., County Administrative Center, 700 H St., Sacramento.

El Dorado County

• Tuesday: 3-6 p.m., Divide Wellness Center, 6065 Highway 193, Georgetown.

• Jan. 10: 12-3 p.m., El Dorado Hill Community Services District gymnasium, 1021 Harvard Way, El Dorado Hills.

• Jan. 14: 1-3 p.m., Pioneer Bible Church, 6851 Mount Aukum Road, Somerset.

Tags: , , , , , , , , , , , , , , , , , , ,

Read Users' Comments (0)

Better habits can help trim bloated health care system

We’ve resolved to eat better, lace up the running shoes, shed a few pounds, quit smoking and lead healthier lives.

If we could keep our promises beyond the first weekend of the new year, perhaps our health care system wouldn’t be as bloated as it is.

Indeed, some of the responsibility for health care costs sits squarely on the shoulders of consumers who make unhealthy choices – by supersizing meals, quenching thirst with sugar-laden sodas, filling lungs with tobacco and taking a less active role in maintaining their overall fitness.

“As important as health reform is, the real answer in reforming America’s health care system is to empower individuals to make better choices about what we eat and how we live,” said Daniel Zingale, a senior vice president at the California Endowment, a health foundation.

While debate remains in Congress over health care legislation, wellness advocates are hopeful that less controversial provisions promoting healthy living will remain in any bill that reaches the president’s desk.

“As preventable illnesses and injuries are the most significant drivers of increasing health care costs,” the Oakland-based Prevention Institute said in a letter to the White House, “it is essential that we reorient our health care system from an after-the-fact approach to one that focuses on keeping people healthy in the first place.”

The House bill includes $34 billion for a public health investment fund, including $15.4 billion for prevention and wellness programs.

The Senate bill is less generous, providing $15 billion for a prevention and public health fund, some of which could be used for so-called community transformation grants to fund parks and urban trails and to promote access to nutrition.

The Senate bill also would establish a national council that takes a broad approach to drafting a health care strategy that integrates transportation, agriculture, education and employment policies. And it would adopt California’s pioneering law requiring fast-food outlets and chain restaurants to provide nutrition information.

“This is the first time in recent history that community and government strategies will align to help support us in the resolutions we make on New Year’s Day,” said Larry Cohen, the Prevention Institute’s executive director.

Wellness and prevention have been “totally lost in the discussion over the health care bill,” Cohen said, “because it’s … been recognized by both sides as being worthwhile.”

Wellness programs spread

By 2017, U.S. health care could account for $4.3 trillion in annual spending, or a fifth of every dollar spent in the overall economy, according to the National Coalition on Health Care. Much of that could go to preventable conditions linked to obesity, smoking, diabetes and heart disease.

Indirect and direct costs of smoking are now $193 billion a year, about half spent on medical expenses, according to the U.S. Centers for Disease Control and Prevention.

In 2007, diabetes accounted for $116 billion. In 2009, heart disease was expected to cost the country $305 billion for care services, medication and lost productivity, according to the CDC.

Obesity costs the nation as much as $147 billion annually, according to a government study released in July.

In California, the national symbol for healthy living, one in every four people is now considered obese. In 1985, when the CDC began measuring the nation’s expanding girth, 9 percent of the state’s residents were classified as obese.

“Sugar-sweetened beverages are the single-biggest culprit in the obesity epidemic,” said Harold Goldstein, executive director of the Davis-based California Center for Public Health Advocacy.

“The simplest thing people can do is drink water instead of soda. It would save everybody money in these hard economic times … and it would have a dramatic impact on the obesity epidemic.”

For years, experts have preached healthy living to reduce the rates of chronic conditions.

To save on costs and boost productivity, employers and insurers over the years launched wellness programs to promote healthy habits.

The California Public Employees’ Retirement System, the nation’s second-largest purchaser of health care, has long promoted so-called wellness programs.

Last year, CalPERS posted the lowest increases for health premiums in 14 years, part of which it attributed to reduced use of health care services by its members.

“The effect of lifestyle decisions on health do matter in the overall control of health care costs,” said Patrick Johnston, president of the California Association of Health Plans. “What works financially for the individual also works for health plans. … Lower health care costs mean health insurance coverage can be more affordable, and if insurance is more affordable, more people can be covered.”

‘A nation of sick care’

Ellen Wu, executive director of the Oakland-based California Pan-Ethnic Health Network, isn’t about to let the health care industry off the hook.

“Our health care system shares some of the responsibility for our increasing health care costs,” Wu said, noting that profit-minded industries make it difficult for people to access routine health care. “It’s a shared responsibility. We cannot expect individuals to be healthier without an environment that promotes health. … I think you have to give people the opportunity to live healthy.”

Communities need access to healthy food and safe public parks in which to exercise, she said.

“We are a nation of sick care. We don’t do health care,” she said. “Because we do sick care, that’s reflected in how we set everything up.”

Gaining health insurance will allow those who are now uninsured access to doctors for regular checkups and routine care that in the long run could relieve the need for expensive emergency room visits.

Even so, people will have to take a more active role in maintaining good health, Wu and others acknowledge.

Healthier lifestyles could reduce health care spending, but on a personal level folks will reap the benefits, too, in the form of fewer trips to the physician – meaning fewer co-pays and other out-of-pocket expenses – and less time away from work, said Dr. Lisa Liu, a physician at Kaiser Permanente’s Elk Grove medical offices.

“There is a linkage there between health care utilization and cost. As individuals, there are ramifications associated with bad habits. People need to take personal accountability for their health,” she said.

Setting goals is a good start, said Liu.

But “making them and keeping them are totally different. The challenge is picking the right resolution,” she said. “Simply saying ‘I’m going to lose weight,’ is just a wish and not an active plan. …

“New Year’s resolutions need to be reasonable and achievable.”

Tags: , , , , , , , , , , , , , , , , , , ,

Read Users' Comments (0)

H1N1 vaccination cinics

Some area counties are offering free H1N1 vaccination clinics. The clinics below are open to all county residents.

SACRAMENTO COUNTY

• Monday: 10 a.m.-2 p.m., First Baptist Church, 4401 San Juan Ave., Fair Oaks.

• Tuesday: 4:30-8 p.m., Elk Grove High School, 9800 Elk Grove-Florin Road, Elk Grove.

• Wednesday: 3-7 p.m., Grant High School, 1400 Grand Ave., Sacramento.

• Thursday: 10 a.m.-2 p.m., Sunrise Mall drive-through, 6041 Sunrise Blvd., Citrus Heights (no walk-ins, vehicles only).

• Jan. 8: 3-7 p.m., Inderkum High School, 2500 New Market Drive, Sacramento.

• Jan. 11: 4-8 p.m., Valley High School, 6300 Ehrhardt Ave., Sacramento.

• Jan. 12: 10 a.m.-2 p.m., Sacramento Japanese United Methodist Church, 6929 Franklin Blvd., Sacramento.

• Jan. 13: 10 a.m.-2 p.m., Christ Community Church, 5025 Manzanita Ave., Carmichael.

• Jan. 14: 1-5 p.m., Chabolla Center, 610 Chabolla Ave., Galt.

• Jan. 15: 10 a.m.-2 p.m., County Administrative Center, 700 H St., Sacramento.

EL DORADO COUNTY

• Tuesday: 3-6 p.m., Divide Wellness Center, 6065 Highway 193, Georgetown.

• Jan. 10: 12-3 p.m., El Dorado Hills Community Services District gymnasium, 1021 Harvard Way, El Dorado Hills.

• Jan. 14: 1-3 p.m., Pioneer Bible Church, 6851 Mount Aukum Road, Somerset.

Tags: , , , , , , , , , , , , , , , , , , ,

Read Users' Comments (0)

 Page 6 of 6  « First  ... « 2  3  4  5  6