Dancer Alma Concepcion grew up in Puerto Rico, where her father was a lawyer and a politician. She was a soloist with Ballets de San Juan and performed in Spain with the famous dancer Antonio. She has been been teaching Spanish dance and ballet at Princeton Ballet School for more than 20 years. She also teaches children’s dance in a grass roots organization, Taller de Danza, that she founded for Hispanic children and their parents in Trenton, and she works in a literature outreach program (People and Stories – Gente Y Cuentos). Her husband, Arcadio Diaz, is a professor at Princeton University, and they have two grown children – their daughter is a New York-based dancer.

`In 1989 I was having trouble with my feet. It was very painful. I went to a podiatrist who told me that I should not try to dance any more. My time with dance was over, he said, and he thought I should do something else with my life. This doctor did not explain. He just told me, `You have danced long enough.’

"But I could not accept that. I had been dancing since I was six years old. I was choreographing and writing about dance, I was dancing and teaching, and I depended on my feet. I could not see myself not using my feet.

"One colleague, Ze’eva Cohen, at Princeton University, said, `Alma, I can see you with some pain in your life, but I cannot see you not dancing. I don’t see how you can not dance.’

"Another colleague told me about Dr. Ricketti and assured me that he could help me.

"At my first visit. Dr. Ricketti asked me what I did. `I am a dancer,’ I said. `You think I am crazy, right?’

"`No, I don’t,’ he said, `I am going to put you at 100 percent of what you do.’ I couldn’t believe my ears. I had just come from this other doctor who had said the exact opposite.

"Dr. Ricketti told me I had fallen arches, and made special orthotics for me. And that was it. He also prescribed special shoes and said that I should use just those shoes. And as time has gone by, it has gotten better. I can use any shoes. I don’t need to use the orthotics all the time any more.

"He was very positive about what he was going to do. He is a specialist in sports, and he had worked with dancers before. There was no doubt in his mind. The orthotics were $250 which at the time was pretty expensive, and medical insurance did not pay for podiatrists.

"For many years I have continued to dance – to take class, and teach, and perform. I did stop performing – it is better to stop at your peak rather than too late – but I dance when I am demonstrating for my students. I can’t teach sitting down. I have to engage myself.

"He also helped my friend, who had pain, he thought, from doing a lot of walking, and who thought it was something wrong with his feet. It was Dr. Ricketti who, watching him walk, told him that something was wrong with his spine. My friend went to the neurologist and learned he had a spur on his spine and needed an operation. Had he not had the operation, he would have become paralyzed."

James C. Ricketti DPM does podiatric medicine and surgery and sports medicine; he has privileges at Robert Wood Johnson Hospital at Hamilton and the New Jersey Surgical Center in Mercerville. He grew up in Mercerville, the son of an accountant and a housewife who had four sons – the others are now the co-owner of a steel company, an allergy/pulmonary specialist, and a vice president of the Federal Reserve Bank.

After graduating from Rider University, Class of 1977, he earned his DPM degree from the Ohio College of Podiatric Medicine and did a residency at the James C. Giuffre Medical Center in Philadelphia. He and his wife Maria, who teaches in the Mercer County Vocational-Technical program, have two sons, one at Rider and the other at Steinert High.

An early injury influenced Ricketti’s career choice. "I stubbed my toe in high school, and it got infected. I went to my brother’s former college roommate, who was a podiatrist, and he impressed me," he says.

Ricketti had his first experience designing orthotic shoe inserts for dancers soon after he graduated from podiatry school; he consulted to the Cleveland Ballet. To help Concepcion, he watched her perform. He saw that for flamenco, a type of Spanish dance, the balls of her feet pound the floor to make percussive rhythms. "I had her dance for me," says Ricketti, "and then I knew what the problem was and how to control it." He designed a special orthotic that is made of different material from the usual prescription inserts.

Also in Cleveland Ricketti had his first brush with major league sports players. After he helped loosen the hamstrings of Len Barker, a pitcher for the Cleveland Indians, Barker pitched a perfect game against the Toronto Blue Jays. As a result of that success Ricketti did some work for the Red Sox in 1985, developing a shoe appliance for Roger Clemens that led to Clemens’ 24-4 record and that helped the team get to the World Series.

"I still have quite an extensive sports practice, but now I treat high school athletes," says Ricketti. "When I fix a high school or college athlete’s foot, and they go back and play and are all-state, it gives me gratification – they thank me. The pros are a bunch of babies, more aggravation than they are worth."

– Barbara Fox

James C. Ricketti DPM, 2273 Route 33, Golden Crest Corporate Center, Suite 204, Hamilton Square 08690; 609-587-1674; fax, 609-587-2206.

In a Long Battle, A Doctor Listens

Teacher Kathy Ritz, 38, lives with her husband, David, an industrial engineer, and her son, Michael, 7, in the Hamilton house she grew up in. She runs the science lab for grades 3-8 at St. Paul’s School in Princeton, teaching three days a week. Her father, now retired, owned a liquor store, and her mom helped him in the store. Today her parents live just three blocks away from Ritz, one brother lives around the corner, and her in-laws also live in West Trenton. Her other brother lives in Burlington (Ritz says her mother wonders aloud, "Why would he want to live so far away?").

`In 2001 I found a lump in my right breast during a self-exam. I was 33 years old, and my son was about a year and a half. I had a lumpectomy at Fox Chase in Philadelphia. The cancer was Stage II. Following the surgery I had six months of chemo followed by six weeks of radiation at St. Francis in Trenton.

"I had regular check-ups for four years. In February, 2005, a Stage I recurrence was detected in a mammogram; I had been having a mammogram every six months on the right side, and every year on the left. Shortly before the diagnosis, the doctor who I had been seeing at Fox Chase decided to get married and go back to her family in Chicago. I called the Cancer Institute of New Jersey Hamilton (affiliated with RWJ University Hospital Hamilton) because it was so close and because I wanted a second opinion.

"When I met Dr. T [oncologist Deborah Toppmeyer] I just clicked with her. She’s very positive. I knew she was listening to me – that’s important when you’re not feeling well. Toppmeyer [who, as associate professor of Medicine at UMDNJ/Robert Wood Johnson Medical School in New Brunswick, spends the bulk of her time in New Brunswick, where the Cancer Institute of New Jersey headquarters are located] had been coming to Hamilton only sporadically filling in until an oncologist who had left had been replaced. When they told me she would only be here occasionally and she really wasn’t keeping her patients, I begged her to keep me as a patient.

"She’s not only interested in my medical health, she interested in my whole being. Dr. T. was the one who encouraged me to go back to work after my treatment. She is a very positive listener; she kind of reads between the lines. I feel like I could have her over to my house for tea.

"I had a mastectomy with the same surgeon I had had at Fox Chase, Ellen Sigurdson, followed by 12 weeks of chemo at Hamilton. The first time was harder, the second time I knew what to expect, and it was a different drug combination, not as harsh on the system as the first time. The infusion area looks out on a landscaped garden with sculpture and a rock waterfall called Grounds for Healing. All the chairs face windows so you’re looking outside at plantings, benches, and bird feeders. They give you lunch, they bring in musicians who play harp music or guitar, they bring in petting dogs, and there are social workers checking on you all the time.

"They all know you by name, even the receptionist. Trish Tatrai, who runs the breast consultation program and is Dr. T’s right-hand person, is so excellent. If I had a problem I could call her and she would call right back. If she couldn’t answer the question, she would find out and call me back.

"I asked Dr. T about the survival rate for a second occurrence. She doesn’t give you numbers. She said, `I have a large patient base who has survived a second occurrence.’

"I have a strong supportive family and a lot of good friends. I’m strong-willed; most people can’t even believe what I’ve been through. I go to church every week and my faith has been tested. You try to get through and rely on whatever you can."

Breast cancer oncologist Denorah Toppmeyer, 47, was born in New York City and grew up in Manhasset Hills, Long Island. Her father was an electrical engineer, and her mother owned a marketing research company. She earned her bachelors in chemistry/psychology with a minor in math from Ohio Wesleyan University in 1981 and her M.D. from Albany Medical College in Albany, New York, in 1985. She completed her internship in internal medicine at the University of Pittsburgh School of Medicine and fellowships in medical oncology at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston.

`I fell in love with Dr. Kildare when I was 10. I always wanted to do `save the world’ type of work and be in some sort of health-related field. When I got into medicine, I was drawn to the uniqueness of the oncology patient, the holistic approach of how you manage patients – the comprehensive medical care, and the many psycho-social issues that you address in their treatment. The biology of breast cancer and the continued scientific discoveries is what really attracted me. I also enjoy the interpersonal relationships you form on many different levels in medicine.

"I am particularly interested in the treatment of young women with breast cancer, and the unique challenges they have. We have a program at Hamilton called the Life Center, which provides counseling, risk assessment, and risk-reduction strategies to young women at high risk for breast cancer. Younger women (with breast cancer) have a very different set of issues (than older patients) – the financial considerations, how they interact with their own colleagues, fertility. Kathy (Ritz) is among that group: she is young, and the struggles she’s had to deal with included having a young child at the time of her first diagnosis."

Cancer Institute of New Jersey – Hamilton, 2575 Klockner Road, Hamilton 08690; 609-631-6960; fax, 609-631-6888. Michael Eleff MD, medical director. www.cinj.org

Family Atmosphere; No Long Waits

Executive assistant Diane Dell, 66, was born in Trenton and currently lives in Ewing. Her father built custom homes, and her mother was a realtor. She is a graduate of Villa Victoria Academy in Ewing, and is currently an executive assistant in human resources for a large pharmaceutical firm.

`Dr. Fernando – I call her Dr. Cha, almost everyone who knows her does – has been my doctor for 20 years and has become a trustworthy friend. I do not hesitate to recommend her, and at least 15 of my friends go to her, including my two daughters and son-in-law.

"Her office is not like a doctor’s office – it feels like you’re visiting a person’s home. Dr. Cha is warm and welcoming and there is no white-coat anxiety. There are never a lot of people in her waiting room. They keep their appointments on schedule with minimal wait-time. I’ve gone during the work day, and they know people have demanding jobs; they see you right away. You can get an appointment in a minute, and you can even walk in without an appointment. Her husband, Bruno Cole, is a cardiac surgeon at RWJ University Hospital, and helps with the practice. You can get your X-rays taken and your blood work done there so there is no need to make multiple stops.

"Dr. Cha is wonderful, almost like an old-time doctor. When I have needed specialists she recommend someone right away. I feel that she’s always there for me. She’s someone you can call and run over to see, when you have your doubts about something.

"Because of my confidence in her abilities, I recommend her. Every time I turn around I feel like I’m saying, `Isn’t Dr. Cha your doctor?’"

Internist Chandani Fernando grew up in Sri Lanka, the daughter of a deputy governor in the central bank (the equivalent of our Federal Reserve) and a Swedish mother, who worked in the Swedish Embassy. She completed medical school in Sri Lanka, then did her residency in internal medicine and her fellowship in infectious diseases at RWJ University Hospital in New Brunswick, finishing in 1996. She worked as an assistant medical director at a major pharmaceutical firm from 1996 to 2001 before opening her own practice with her husband, Bruno Cole, a surgeon specializing in cardiac, thoracic, and vascular surgery at RWJ University Hospital.

`My uncle is a physician, and my mom’s sister is a dentist. It was always something I liked to do. (In medical school) I became interested not only in the part where you interact with people but also the academic part, the fact that the medical field is always changing – it’s an ongoing process, and you never stop learning.

"At that time new knowledge about HIV was coming out and that field was changing, and that interested me. I also became fascinated with infectious disease. It is one of the specialties where, if you found a reason for an illness, such as something that would respond to antibiotics, you could help someone with quick results."

Princeton Primary & Urgent Care Center LLC, 707 Alexander Road, Suite 201, Princeton 08540; 609-919-0009; fax, 609-919-0008. Chandani D. Fernando MD, medical director. wwwppucc.com

Alternative Approach To Chronic Back Pain

Story teller Susan Danoff has had chronic problems with muscle spasms for most of her life. "When I was a little girl, it was a stiff neck," she says. "I couldn’t turn my head." The attacks came on with no warning, and were triggered by the simplest thing – bending down to pick something off the floor, catching a falling pot.

Her first health practitioner was her mother, who gave her asprin and a compress. When she was a child, the spasms lasted for a few days. "When I got older, they hung on longer," she says. "It could be totally debillitating."

The worst attack came in the fall of 2004. "That bout lasted five months," she says. Unable to tolerate drugs, she was in pain all of the time. The spasm sapped her of energy, and made her favorite physical activity – walking her two dogs – completely impossible. Driving was difficult and uncomfortable, but Danoff did continue with her work.

A native of Wilkes-Barre, Pennsylvania, Danoff earned a degree in East Asian studies from Princeton University in 1975 – with the third class to include women. She then spent a year teaching in Taiwan with Princeton in Asia. Quickly deciding that teaching was the career for her, Danoff earned a teaching certificate at the University of California at Berkeley and then a master’s degree in English at Rutgers.

But it was a chance encounter at the Princeton Public Library that set her career course. "I saw a story teller there in 1979," she recalls. She knew right away that she wanted to combine story telling with teaching. "I was interested in it as a teaching art," she says. She worked on her story telling skills and repertoire while teaching writing part time at Princeton University for nine years. All the while, she was looking for work as a story teller.

"When you’re developing a career no one has heard of, it’s hard to get work," she says. But she persevered, first getting work from the New Jersey Council on the Arts, where she worked for five years in the early 1980s, and also performing on her own and making tapes. "In the process," she says, "I learned that story telling is an incredible vehicle for teaching urban children."

She began to pursue contracts with urban schools for year-long story telling programs, and in 1996 founded Storytelling Arts, a non-profit that now has enough work to keep 10 contract employees busy in schools around the state.

Danoff was able to keep Storytelling Arts going during her latest – and possibly last – bout with muscle spasms, but it wasn’t easy. "I was at my wits end," she says. A chiropractor she had been seeing was out of town, so she went to another chiropractor. Her condition got no better. Then her trusted chiropractor returned. She thought she would get relief at last, but he was unable to help her. The spasm lifted, but quickly came back.

Next she turned to her primary care physician, suggesting that it was time for tests – perhaps a CAT scan or an MRI. But her doctor was quite sure that the problem was not skeletal, but was indeed muscular. He gave her the name of an alternative medicine practitioner, Lucero Mejia, a Lawrenceville resident who performs MAT – muscle activation techniques.

With nothing to lose, Danoff went to see Mejia, and is sure that she will never have serious problems with spasms again. Explaining just what MAT is, Danoff says "It’s totally different from chiropractic. That’s bones, this is muscles. It’s not massage. It’s very scientific. She locates where the muscle is weak and contacts that muscle." Each muscle is tested to see just where the weakness is. Practitioners of MAT believe that spasms occur because the muscle is no longer communicating properly with the brain. They restore the connection through muscle manipulation.

"It’s totally pain free," says Danoff. It is also meant to be permanent. "This is not therapy where she wants you to come back," she says. "She wants you to be healed, and not come back." The therapy generally occurs over about four sessions, but Danoff’s treatment took longer because she had had such severe spasms for so long. She was also given isometric exercises to do at home, and, as a next step, she says that she will probably go back to Mejia, who is also a personal trainer, for a course of strength-building exercises.

At the moment, Danoff is enjoying her new pain-free life, her work, and her family. Her husband, Neal Tolchin, is an English professor at Hunter, and her son, Jonah Tolchin, just graduated from the eighth grade at the Princeton Friends School. Her dogs, a golden retriever and a Cavalier King Charles spaniel, are getting a lot more walks now, and she is full of energy as she prepares to promote her first book, "The Golden Thread: Storytelling in Teaching and Learning."

In her own life, the golden thread was the one that led her, after a lifetime of pain, to Lucero Mejia.

Lucero Mejia, MAT therapist, says that Susan Danoff is the most challenging person I have ever had," says Lucero Mejia. "I put stress on individual muscles," she says of the muscle activation technique (MAT) she practices, "but I couldn’t put much stress on her. She was too weak." When Danoff first came to her, Mejia recalls thinking "I don’t know how she’s getting better."

A case of mononucleosis Danoff suffered while in her 20s contributed to the weakness, in Mejia’s opinion. "With mono – and with Lyme disease – you become weak," she says.

But Danoff, after a five-month seige with muscle spasms, did respond to the MAT therapy, and now, nearly two years after working with Mejia, is confident that she will no longer be bothered by the condition.

Mejia speaks about MAT just three days before she is due to fly to Denver for further training in the technique. To become certified she completed a 17-month internship in 2003, spending one week each month in Denver, learning the technique developed by Greg Roskoph, biomechanics trainer for the Denver Broncos, Denver Nuggets, and Utah Jazz pro sports teams.

MAT, as explained on www.resistancetrainingspecialist.com/mat, is "a unique and practical approach to evaluating and dealing with neuromuscular imbalances that contribute to dysfunction and ultimately to injury. The MAT system provides trainers with the necessary skills needed to treat neuromuscular inhibition and the resulting tension/protective mechanisms in the antagonists that will restrict range of motion."

Like Danoff, Mejia has crafted her own career. A native of Colombia who immigrated at age 18, her first job in this country was fielding directory assistance calls for AT&T. Her reaction to her first job was: "I can’t take the abuse of these customers. I have to get an education." She first attended Mercer County Community College, and then earned a finance degree summa cum laude from Rider University. By furthering her education, she was able to move up in the ranks of AT&T, specializing in marketing, and coming within a stone’s throw of upper management. But after some 15 years with the organization she began to question her life’s work.

"In 1995 I realized I had a house, a car, materialistic things, and I asked `Should I climb the ladder, or do something else?’ I asked `If I had all the money in the world, what would I do?’"

The answer went back to a life-long pre-occupation. "A little on the heavy side" as a youngster, Mejia had been interested in fitness and nutrition all of her life. At a career crossroad, she decided that "by 2000 I will be a fitness guru." She began holding personal training sessions in her home gym, and doing fitness career research.

When AT&T offered her a buy-out in 1998, she quickly decided to "take the money and run." She then earned a fitness and nutrition diploma from the International Correspondence School in Scranton, Pennsylvania. Next was an ohashiatsu certificate from the Ohashi Institute in New York City.

As her personal training and nutrition practice grew, Mejia was frustrated to find that her clients were getting hurt, and were having trouble healing and getting back to their sports. It was then that she heard about MAT, which preaches that biomechanical imbalances lead to injuries. She now incorporates MAT into her practice.

The mother of two sons, one about to become a Lawrence policeman and the other a senior at Harvard, Mejia, who is married to Jorge Mejia, a chemical and environmental engineer about to start a new job with Merck, says she is "super fit."

And while Danoff’s case presented her biggest challenge, perhaps the best advertisement for her brand of alternative medicine is her father. Along with her mother, he had business and real estate interests in Colombia, and worked as an accountant after immigrating. "I changed his nutrition, and he is very healthy," says Mejia of her dad, who is close to his 94th birthday.

– Kathleen McGinn Spring

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