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FAMILY PRACTICE: Varacallo brothers work together as doctors at PH Orthopedics and Sports Medicine

DuBOIS — Brothers Chris and Matt Varacallo – orthopedic doctors at Penn Highlands Orthopedics and Sports Medicine – have returned home to care for the community they love as much as their beloved late father did.

Chris Varacallo, DO, a sports fellowship-trained and board-certified orthopedic physician, moved back to the DuBois area in June 2015 to work with University Orthopedics. About a year ago, he had discussions to join Penn Highlands Orthopedics, and those talks included his brother, Matt Varacallo, MD, a fellowship-trained sports medicine orthopedic surgeon.

“I’ve been practicing here (in DuBois) since July of 2015 in preparation for Matt to come over here so we could work together,” said Chris Varacallo, noting Matt joined the practice in August 2019.

“The real interesting element of us working together is that we’re brothers, we’re both natives,” Matt Varacallo said. “We grew up here, went to school here and now we’re both fellowship-trained. He’s in non-operative primary care sports medicine and I’m in operative orthopedic medicine.”

A lot of times, patients can’t even tell them apart because they look so much alike.

“They confuse us all the time, but it’s just come to us and we can manage pretty much anything,” Matt Varacallo said. “Yes we do sports medicine. Yes we care about athletes, but I have this conversation all the time with patients. If you’re an athlete on Friday night at the football game, okay, obviously you’re an athlete, but some people, their sport is gardening or their sport is just moving around without pain or they want to get down and play with their grandkids. That’s still, in my mind, sports medicine because we’re trying to do what we can in the field of orthopedics and sports medicine to get you functioning optimally.”

“The goal is for surgeons, in general, is that you’re in the operating room more often,” Chris Varacallo said. “And that’s where my specialty comes into play, I’m very comfortable evaluating anything, fractures, surgical things and I can call him and say, ‘Hey, I have an ACL tear that needs a surgery’ or ‘I have this fracture that needs a surgery.’ And so what I typically tell people is, ‘You don’t have to figure it out, what’s under Matt and what’s under me. You just send it to us and we’ll figure it out and go from there.’”

And with fellowship training, Chris Varacallo said there are cutting edge treatments happening at Penn Highlands that they don’t do in Altoona or State College.

“They maybe do a little bit in Pittsburgh, they maybe do a little bit in Philadelphia, but there’s cutting edge things that he and I do and we (every doctor in the system) work together to do that,” he said. “Before knee replacements, we do a nerve block or I do a nerve block for the knee that controls pain after a knee replacement. All the staff orthopedists here are brought into that. We do that here, but they don’t do that anywhere else.”

“Some of the surgeries I’m doing here now ... the one specific to the ACL, I don’t think it had been done here probably for like 15 years or something like that,” Matt Varacallo said. “We’re both open to to bringing the newest technologies back to this area. And it does give us a niche.”

He said it’s interesting to sit back and look at how the two of them working together fell into place.

“And now it’s the evolution of how where one patient comes to see him and then they’ll see me or I need him to do something first and then they come back to see me and then I book them for a surgery,” Matt Varacallo said. “It’s a constantly evolving process, but it’s nice. I can tell you that with the other systems that I trained there’s nothing like this.”

The brothers are the sons of Luanne Varacallo, of DuBois, and the late Dr. Albert Varacallo, who was a prominent and well-loved family practice physician from DuBois who passed away in a bicycle accident in 2010. They have four other siblings, Natalie, Albert, Dom and Tricia – all but Natalie still live locally.

Being close to family was an important part of why both of the Varacallo brothers made the decision to come back to their hometown and practice medicine.

Chris Varacallo went to Ohio University College of Osteopathic Medicine in Athens, Ohio, for medical school, then the Cleveland Clinic for his residency and Palmetto Health/University of South Carolina, Columbia, South Carolina, for his fellowship. During his second year of residency, he married his wife, Elissa, also a native of DuBois, and they are now raising their three young children together.

“I was in those bigger cities and I had the opportunities in Cleveland and in Columbia to stay there,” he said. “And my dad had passed away my third year of medical school ... that also played a part in terms of being close to family, being home. My mom’s here. And so being available for her if she needed it was a pretty important thing.”

“There was a good support system in medical school and we really, as a family ... with the six of us, we really developed a closer bond,” he said. “Right now it’s awesome because out of the six of us, five of us are here.”

“Family is a huge component to it,” said Matt Varacallo, who attended medical school at Pennsylvania State University College of Medicine in Hershey, his residency at Drexel University College of Medicine in Philadelphia and his sports fellowship at the University Kentucky, Lexington, Kentucky.

“It was interesting, because when I was in Philly the city grew on me, although in the back of my mind I was always thinking about coming back here,” he said. “But when my dad passed away, I was between my first and second year of med school. And I totally agree with Chris, where it was that family support system that we really got closer out of that tragedy, and the healing process. I know we’re closer than we ever were before that. I just think that that reinforces the family bond that we have.”

The opportunity to help those in their community was another reason of wanting to return home.

“Initially when I was growing up, I did not want to be a doctor because we never saw our dad, he was always working,” Chris Varacallo said.

But in high school, he started to consider becoming a doctor.

“We’d go out to eat ... and we’d be sitting there and our dinner would take probably two to three hours because my dad would get stopped by multiple patients,” Chris Varacallo said. “And that really had a big impact on me because I’m like, ‘Wow, these people see him in the community, they talk to him, they treat him like one of their own and he treats them the same way and he has a friendly conversation with them.’ I saw the impact that he would make on their lives and I thought that would be pretty cool to be able to do that.”

He eventually mentioned to his father that he wanted to be a doctor and his father advised him to work at the hospital.

“If you want to be a doctor you got to start at the ground level and make sure you like it,” Chris Varacallo recalled his father saying. “So I worked as a nurse’s aide on the floor over in the hospital the summer after my junior year cleaning bed pans, getting water, putting water in a bucket for people and that kind of stuff. I really liked the patient interaction at that point. That experience really solidified my passion for medicine and my desire to go to medical school.”

“I was kind of the same way where I realized how hard my dad worked and how much he really put everything into establishing his practice and creating it in his own ideal fashion,” Matt Varacallo said. “But he was on call 24/7, he was on the grind 24/7, he really established such a high standard of care for patient ... and really I think it was the trickle down effect with us.”

“Like Chris was mentioning where he was at a very young age, taught that you got to work and appreciate how it is at the bottom and then that builds up,” Matt Varacallo said. “You build on the solid foundation. He instilled the same thing to me, so I think that that translates nicely and it’s interesting to see how it ties in because with sports medicine, I tell a lot of these patients is that I’m your surgeon yes, but I’m partnering with you. You’re going to become like family because I see them so often.”

“I feel a great responsibility to the people of this community ... to be able to educate them and give them access to high quality care so they don’t have to travel to Pittsburgh, Altoona or State College,” Chris Varacallo said.

“There’s so much pride in bringing that high quality comprehensive sports medicine care to the people in this community,” Matt Varacallo said. “I mean we were both involved heavily in athletics and our name was always in the papers. Then that ties into what our dad established while we were growing up. And then we continue it and bridge on.”

Over the last four-plus years practicing in DuBois, Chris Varacallo said he still sees patients who were his dad’s patients.

“He delivered them or delivered their children, or he was the doctor for their parents or something like that,” he said. “I get stories pretty much every day. It’s really cool to hear that and it kind of keeps his memory alive, taking care of patients.”

The brothers believe their father would be proud of the foundation he laid for them.

“He’d be beaming,” Chris Varacallo said. “I think about that often, about what he would say or what he would do, or being able to talk to him about things. And I try every day just to practice, to make him proud. To not let the people that just automatically trust the last name of Varacallo, because of him, to not let those people down and not give them cause to second guess what we’re doing.”

“My father really held himself to such a high standard,” Matt Varacallo said. “Not only in establishing a relationship and going above and beyond the clinical aspect of it. He was personable with them, too. And that’s a big thing for patients. I always saw that growing up and that set that framework for me. That’s something I go out of my way to do. I’m going to partner with my patients, be personable with them. Not only give them good clinical care, from my brother and me, but also having a vested interest in them as a person, too.”

Every single day since he became a physician, Chris Varacallo said he says a prayer on his way into work.

“I pray for my dad to intercede on my behalf, as a physician, to help treat people in the best way I can,” he said.

Sergeants Curry and Panebianco take charge

CLEARFIELD — Sergeants Crystal Panebianco and Julie Curry of the Lawrence Township Police Department show that women can not only make a career as police officers but flourish.

Nationally, less than 13 percent of full-time police officers are women. In small to medium sized police departments it is between 6 and 8 percent.

And for women in leadership positions the percentages even smaller with about 9.5 percent of first line supervisor positions being held by women and about 2.7 percent of police chiefs being women, according to Law Enforcement Management and Administrative Statistics data.

But the Lawrence Township Police Department with 10 full-time police officers, has two female sergeants with only Chief Douglas Clark above them in rank.

Curry said police departments nationally are having difficulty recruiting new officers, not just female officers. She said part of the reason is the stringent requirements. In Pennsylvania for example, those who want to become police officers have to pass rigorous physical fitness tests, two psychological examinations, have a clean criminal record, and pass 720 hours or about six months of police academy training to work in the high stress, profession that has difficult hours.

“It takes a unique person to do this job,” Panebianco said.

Panebianco said she decided to become a police officer somewhat later in life. She was 26 years old when she became a police officer. A Clearfield native, she started out at the Petersburg Police Department before joining the Lawrence Township Police Department in 1997.

“I wanted to make a difference and help people,” Panebianco said of why she wanted to be a police officer.

Curry said she always wanted to be a police officer and attended junior police academies as a child. Like Panebianco, she said she wanted to make a difference and help people.

“And I just love working in the law,” Curry said. “And I love studying human behavior.”

In addition to having a bachelor’s degree in criminology she has a master’s degree in social work.

Curry joined the Lawrence Township Police Department in 2003 after completing her academy training.

When he became chief a couple of years ago, Clark changed the structure of the police department and made each of the two sergeants the supervisors of half of the department’s officers with the chief supervising the sergeants, Panebianco said.

The department has a total of 14 police officers and each sergeant is responsible for supervising five to six police officers.

As supervisors, the sergeants act as the officers in charge when at crime scenes and accidents, write evaluations for each of the officers under their command and offer them assistance and guidance, and discipline and reprimands.

All the police officers in the department from the chief on down perform patrol duty and make arrests, Curry said.

The sergeants also assist in investigations, especially with the younger police officers.

Each of the sergeants also have additional duties. Curry is in charge of the evidence room and filing reports and Panebianco is in charge of the uploading and storage of the dash cam and body cam recordings and the filing of accident reports.

Panebianco is also the department’s Taser expert and conducts the department’s Taser training.

“We both have our own responsibilities,” Panebianco said.

Despite the stress and long hours both women said they love their jobs and don’t regret becoming police officers.

When asked if someday they would like to be a chief of a police department, Panebianco quickly said “no.”

She noted that she is only a few years away from retirement but she said Curry could be chief someday

Curry wouldn’t commit either way.

“I will cross that bridge when it comes,” she said. “Being chief comes with a lot more headaches.”

Learning about making maple syrup

BROOKVILLE — People looking to learn more about tapping trees and making maple syrup gathered Thursday night in Brookville to listen to Penn State Extension educator Scott Weikert, from the Forest County Extension office.

He, like some of the others attending the class, has been making maple syrup as a hobby rather than as a business because of the amount of sap needed to make a gallon of syrup. Weikert says he taps about 50-60 maple trees.

While many people may think that only one type of maple tree produces the sweet sap needed for the maple syrup making process, Weikert listed several trees both in the “hard” maples and “soft” maples categories. These included: sugar maples and black maples, both hard trees, and red and silver maples, which are both soft maples.

One can tell those maple trees with the sweet sap by their leaves and bud positions. The “right” maple trees have “opposite leaf arrangements,” he said. This means if there is a leaf on the right side of the branch, there is a corresponding leaf on the left side. This can still be seen as the tree begins to bud out. Maple syrup sap, however, is collected before the tree begins to leaf out. Once it begins to leaf out, the maple syrup sap collecting season is at an end. The leaves have jagged edges as well. The maples with smooth edges are Norway maples and they are not used for maple syrup.

To get sap from the trees, he noted that the weather conditions have to be right. Those conditions include a freezing and thawing period. Nighttime temperatures must be below freezing while daytime temps must get above freezing, making making the months of February and March ideal for local sap collecting most years.

This timeframe, he said usually begins in mid Februrary and will last anywhere from four to six weeks. However, this process is dependent on the weather and can change yearly.

Tapping trees too early can cause them to stop flowing too early and tapping for too long – after buds break open – can give the syrup undesirable flavors and have an off color.

The sap flows during the freezing and thawing process because it causes changes in the pressure within the tree. As the temperatures rise, positive pressure develops and causes the sap to rise. As temps lower, negative pressure develops stopping the flow of sap.

Even tapping a tree every year is a process. One can not use the same tap hole each year. The tree quickly heals itself when the tap is removed after the sap collecting season ends. The healing process causes a dark wood to form which is not good for sap collection therefore the taps must be moved to the left or right or up or down.

Even how far into the tree hole is drilled for the tapping process is important. The shavings should be light cream in color because it is in the light colored wood that the sap flows. Drill too far into the tree and tap into darker shavings, the sap will be yellow which in turn means dark syrup and off flavors.

Anyone new to the hobby will be happy to note that expensive metal buckets are not necessary to collecting the sap. Weikert stresses, however, that the container used be food safe. Any food safe container with a lid is good just know what was in the container before you use it. He said even it the container is cleaned out, if it wasn’t used for food items, it is best not to use it.

Unless you are using tubing that is connected to each tree tap and empties into the collection container, one will have to empty the buckets attached to each tree into a collection container. From this container, the sap should flow to the evaporator otherwise hobbyists must continue to add small amounts of sap to the evaporator themselves.

Weikert noted that the evaporator does not need to be an expensive piece of equipment either. His handout listed using two 50-gallon metal barrels and a barrel wood stove kit (door, feet and chimney adaptor). What’s important is that there is airflow under the wood and a chimney to carry smoke and ash away from the pan holding the sap.

To know when the sap becomes syrup with 66-68 percent sugar content, one must monitor the boiling temperature. Using a thermometer to check it, the sap should be around 212 when it is boiling and when that temperature rises another 7.25 degrees, it should be syrup. Once the sap hits the boiling temperature begins to rise, it will reach a point, he says, when it will rise quickly and one has to be prepared to remove it from the heat or risk burning the it.

“We pulled it off (the heat) at 5 degrees above boiling point and finished it in a pot on the side burner of a gas grill,” he said, noting that it gave him better control.

Once it has reached the syrup stage, it still must be filtered to remove any impurities that might have been in the sap.

While it is a lot of work as the cooking of the sap takes a long time, Weikert said he believes anyone who tries it will find they enjoy it.

Saying he is not an expert in maple syrup making, he offered three resources for those looking to try their hand at it. The first source is the University of Vermont, Proctor maple Research Center, which he noted is the king of maple research. Vermont is the number one producer of maple syrup. Pennsylvania is ranked 4th. The center can be found online at UVM.edu/extension/maple

Other sources included:

  • North American Maple Syrup Producer’s Manual Ohio State University
  • Cornell Maple Program: https://blogs.cornell.edu/cornellmaple/

File photo by Chris Wechtenhiser 

TJ Wingard, left, uses a blocking pad as he works with a player during a drill on the opening day of training camp prior to the 2018 season. Wingard was named the Beavers’ new varsity head coach Thursday night.

Emergency responders attend Narcan training

NEW BETHLEHEM — Members of the New Bethlehem, Distant and Limestone volunteer fire companies attended a free Narcan training session on Thursday night. Held at the New Bethlehem fire station along Arch Street, the class attracted approximately 25 emergency service personnel and local residents.

The training was provided under the auspices of the Armstrong-Indiana-Clarion Drug and Alcohol Commission. The commission’s representative, who requested anonymity, said that the agency offers support to anyone in the three-county area who wants to quit using tobacco, alcohol or drugs.

Narcan, also known as naloxone, is a rescue drug that can be used to interrupt an opioid overdose, the representative said. The substance interrupts the pathway between an opioid and specific receptors in the patient’s brain, eliminating a drug’s “high.”

“Hospitals now use Narcan when an overdose victim comes in,” the speaker said. “It only works on opioids and nothing else. It is a fast way to determine whether or not the person is on a drug such as fentanyl or something else.”

Opioid deaths have actually been falling in recent years in Clarion County, the presenter said. With its mostly rural population, it experienced 12 related deaths in 2018 and five last year.

“Opioid overdoses can be catastrophic when they happen,” the presenter said. “But most of the overdoses in this area come from methamphetamine, and Narcan cannot fix those.”

During the class, the presenter described fentanyl and related opioids, how they are commonly packaged and what first responders need to look for when responding to an overdose.

“You will often find small bags that are the size of postage stamps,” the speaker said. “Heroin is brown in color, while fentanyl is usually white. Also, burnt spoons and used syringes may be in the area.”

The attendees also learned that several myths about fentanyl are untrue. Breathing in the powder will not get a bystander high, and it is not easily absorbed through the skin.

“You would need to play in a pile of it with your bare hands to maybe absorb it, and then probably only if you had a break in your skin,” the speaker said.

While responders may object to saving a drug user over and over again, the presenter said that multiple efforts are worthwhile.

“Sometimes it takes several encounters with Narcan for a user decide to decide to stop,” the presenter said. “It is not a case of one-and-done. One of my colleagues is a recovering addict and needed to be saved nine times by Narcan before he got clean.”

Anyone can obtain a Narcan kit, especially if he has completed a training session. If a person has to use the contents of a kit, he only needs to contact the AIC officer, fill out a form and then pick up a new kit.

Narcan usually has a two-year expiration date and when it is past its prime, it can be turned in at one of several collection points throughout Clarion County, including the New Bethlehem Police Department along Broad Street. Fortunately, the drug remains effective for a while after expiration if properly stored.

Those who have Narcan kits at home were advised to store them away from bright light, humid areas and temperature extremes.