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An Interview with Dr. Mascolo

ACUTE Denver Health - Dr. Mascolo1. What made you want to become a physician? When you first started off your career, where did you want to end up?

While growing up, my mother was very ill and back then, in Italy, doctors still made house calls. I was fascinated by their ability to comfort the sick and strive to alleviate their suffering. This has resonated with me my whole life and lead me on this incredible journey. When I decided I wanted to be a doctor I thought I wanted to become a pediatrician however, during my first clinical rotation of third year I realized my calling wasn't in pediatrics. Clearly my path was a different one. I had never even thought about eating disorders however during my last year of residency, Dr. Philip Mehler was my attending and first exposed me to severely malnourished patients. Subsequently, when I joined the faculty at Denver Health and he wanted to open a unit dedicated to the care of such severely ill patients I jumped at the opportunity. It's been a huge learning curve and an incredible journey and privilege to learn how to proprerly care for such ill and underserved patients.  Life is funny, eating disorders found me, not the other way around!

2. You are also an associate professor at the University of Colorado. How has teaching helped your ability to treat and see patients?

Teaching allows me to better care for patients on two levels. First it's an opportunity for me to keep up with current literature in an effort to teach my students and residents the latest evidence-based care.  Secondly, it allows me to educate the next generation of physicians regarding the care of severly malnourished patients which is unfortunately lacking in the medical field.

3. What makes ACUTE Center for Eating Disorders different from other eating disorder facilities?

ACUTE Center for Eating Disorders is the only medical stabilization unit of its kind in the US. At the center of everything we do are our patients, their care is individualized and completely dependent on their needs and goals.

In order to care for them we've put together a multidisciplinary team that is devoted to serving such a fragile population; from our specially trained Internists to our supportive psychotherapy, our dedicated nurses and nursing assistants, physical and occupational therapists, dietitians, and personalized discharge planning, we support patients through the beginning of their road to recovery.

4. What Internet resources would you recommend for individuals looking for medical information about eating disorders?

Unfortunately, I'm not familiar with any site that is dedicated to medical information regarding eating disorders. There are however, a few sites that offer a wealth of information, as well as support and resources for those struggling.

-NEDA

-The Alliance for Eating Disorders

-ED Hope

-ED Referral

5. Does your team utilize any type of employee wellness programs to help them perform at such a high level?

We have a dedicated nurse educator that assiduously perfects protocols and ensures nurses and nursing assistants are comfortable and facile in the care of our fragile patients. We strive to keep our team engaged through social activities such as our summer picnic, our holiday party, and various other yearly activities. We also encourage recognition of outstanding team member via use of "shout outs" and star awards.

6. What are some typical stereotypes about eating disorders and how would you educate the public about the reality of the disease?

Sadly, there are so many. Let's debunk a few...

Eating disorders are a female problem...

Absolutely not true. In the us, there are 20 million women and 10 million men suffering from eating disorders and in western countries, the prevalence of eating disorders is 0.1% of the male population.

Eating disorders only affect certain ethnic and socioeconominc populations...

Not true, eating disorders affect all classes and all ethnicities and the spectrum of illness is broad ranging from anorexia nervosa to binge eating disorders. Sadly, at times, cultural barriers lead to even more shame, denial, and missed opportunities to diagnose and treat these vulnerable patients.

Eating disorders only affect teenagers...

Sadly, although the majority of eating disorders manifest themselves during adolescensce, only about 50% of struggling patients are diagnosed leading to missed opportunities to intervene which leads to prolonged struggles with this disease well into adulthood and beyond.

7. What are some signs and symptoms to look for if an individual isn't sure if they have an eating disorder?

A very quick and easy screening tool is the scoff questionnaire. It comprises of 5 questions and answering yes to at least 2 questions has a high specificity and sensitivity for diagnosing an eating disorder.

- website for scoff

8. What type of organizations are out there that bring awareness to eating disorders?

- National Eating Disorders Association (NEDA)

- The Alliance for Eating Disorders Awareness

- Binge Eating Disorder Association (BEDA)

9. Why have medical flights been so important to your patient population (is ground or commercial travel contraindicated)?

Our partnership has been crucial to meeting the needs of our patients around the country. We are physically located in Denver but serve patients across the globe. Prior to our partnership such patients were unable to access our care and our expertise. Having Angel MedFlight as part of our team allows patients that are too critically ill or weak due to their illness to safely be transported to our doorstep for life-saving care.

10. Can you describe the partnership your organization has with Angel MedFlight?

Angel MedFlight is our preferred critical care transport provider. We've been so fortunate to be able to develop this partnership. Thanks to the time and dedication of your staff we've been able to create protocols that allow the safe transport of critically ill patients from facilities across the country. From turning schedules to management of glucose and fluids enroute, your vigilant care makes us feel confident that our patients will arrive to us safely.

11. Can you talk about the anticipated growth of ACUTE and how this will help your patient population?

In a little over a month, ACUTE will move to a brand new beautiful unit with bigger patient rooms, more therapeutic space, a dedicated area for physical and occupational therapy, and a zen room. In the next year and a half we will grow from a 15 bed unit to a 30 bed unit in order to accommodate the growing need for medical stabilization in the eating disorder population.

 

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