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GVHEALTHNEWS.COM
APRIL 2019 • ISSUE 164
Understanding the Dramatic Fall in Number of Births
General surgeon Thomas Wormer has practiced at Thompson Health for 30 years — he talks about his profession, changes in medicine and his volunteer work in Haiti
Birthrate in the U.S. is at the lowest level in 30 years.
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Organ Donation Finger Lakes region still lags nation when it comes to number of people registered to donate
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Things You Need to Know About Autism
Hot Flashes 101
Kick the Clutter in 30 Days
The Rochester Minimalists, a group of individuals looking to reduce our environmental footprint and consumerism, formerly is sponsoring a “30-Day Minimalism Game” that challenges people to get rid of clutter Buffalo-based WellNow Urgent We Help Make It All Better at their home or office. Find out how you can Care today has more than 30 participate. facilities in NYS. It will launch 14 Page 7 new locations this year Low Wait Times
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New App to Help Patients Prepare for Medical Visits
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atients often only have about 15 minutes with their doctors during an office visit and they often walk in unprepared for what questions they want their doctor to answer about their medical problem or treatment. To help patients prepare for their medical visits, the Agency for Healthcare Research and Quality (AHRQ) developed a new consumer mobile app that builds off the agency’s “Question Builder” online tool. The Question Builder app, which is available at no charge for smartphones, tablets and laptop computers on iTunes and Google Play, aims to help patients organize questions and other information prior to medical visits. “Consumers liked the ability to have questions and other information at their fingertips during medical visits, while doctors, nurses and other clinicians said that better-prepared patients would lead to more effective and efficient visits and potentially more accurate diagnoses and better outcomes,” the agency said in a release. “Patients can get better care by preparing to ask questions about their care and communicating effectively with their doctors, nurses and other providers,” said physician Jeff Brady, who directs AHRQ’s Center for Quality Improvement and Patient Safety. “Asking questions to make sure patients understand instructions
and other aspects of their care can help reduce the chance of missed diagnoses, identify the right tests that are needed, and avoid unnecessary hospital stays.” Through the app, patients can input details of their upcoming appointments, such as date and reason for the visit, and then choose questions they want to ask their doctor, starting with a list to prompt them with commonly asked questions in different situations. To talk to a doctor about medical tests, the app prompts patients to ask questions such as: How accurate is the test and what do I need to do to prepare for the test? Patients can then use the app to email information to themselves or others for reference or can use the app to make notes during the medical visit. The app organizes content and questions by type of medical encounter, such as a medical visit or preparing for surgery, and offers consumer education materials and videos about the importance of asking questions and sharing information. There’s also a camera option that allows patients to document visual information such as a skin rash, upload insurance or prescription medication information, and other photo-enabled features. To download the free app, go to the app store and type “AHRQ Question Builder.”
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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April 3
Rochester Minimalists to discuss tiny home living The group Rochester Minimalists will present a “Tiny Homes Panel Discussion” from 6:30 to 8:30 p.m., Wednesday, April 3, at Irondequoit Public Library (room 114), 1290 Titus Ave., Rochester. The meeting is free and open to the public. Participants will hear from Erika Guli and Mackenzie and Logan Rockcastle, who currently reside in tiny homes, and Eric Menz, a registered engineer with a nonprofit focused on sustainable housing and workforce development. Rochester Minimalists is a group of individuals looking to explore their relationship with things, what brings value to their lives, to reduce their environmental footprint and question consumerism.
April 4
Support group open to those divorced, windowed Separated? Divorced? Widowed? Ending a significant relationship? Neutral Ground Support Organization, a nonprofit, peer-support group, will hold its spring orientation meeting at 7 p.m., April 4, at Henrietta United Church of Christ 1400 Lehigh Station Road. Participants are encouraged to arrive during coffee time, 6:30-7 p.m. For more than 40 years Neutral Ground has provided groups for people to express and share their thoughts and feelings and to develop a firmer foundation on which to rebuild their lives. Orientation is free but an annual membership of $30 is required to join a closed group. For additional information, visit https://NeutralGroundSupport. org.
April 5 You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org
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Seminar to focus on metastatic breast cancer The Breast Cancer Coalition will host the 16th Annual Cindy L. Dertinger Advanced Breast Cancer Seminar: “Tools for the Journey” from 1 to 6 p.m., Friday, April 5, at the Memorial Art Gallery in Rochester. The theme, “Living with Metastatic Breast Cancer,” will be explored during panel presentations followed by a reception in honor of the panelists. Physicians speaking at the event include Ajay Dhakal of Pluta Cancer Center; Kenneth Usuki of Wilmot Cancer Center; and Michael Krasner, professor of clinical medicine, University of Rochester Medical Center. The moderator will be Pam Polashenski, senior hospitalist, Rochester Regional Health Eastern Region. Discussion topics include: “Emerging Trends in the Treatment of Metastatic Breast Cancer,” “Radiation
Therapy for Metastatic Breast Cancer,” and “Mindfulness, Healing, and Self Care.” The panel will also feature two speakers who are living with metastatic breast cancer: Nancy Gramkee-Cuer and Amy Schnitzler. This regional event is offered to those living with advanced breast cancer and to others concerned about breast cancer issues. Family, friends, caregivers and care providers are also invited. Funding is provided by M&T Bank, Rochester Division, in memory of their friend and colleague, Cindy L. Dertinger. Admission is free, however seating is limited and reservations are required. For more information, call 585-473-8177.
April 14
Vegan group to hold fundraiser event The Rochester Area Vegan Society will sponsor a fundraiser dinner at 6 p.m., April 14, at Brighton Town Park Lodge, 777 Westfall Road, Rochester. Dinner will be catered by Eden Restaurant. Cost to attend is $35 per person. All proceeds will benefit the mission of the vegan society, which is to advocate a diet which is entirely plant-based and avoids the use of all animal products including eggs, dairy, fish, and all flesh. After dinner, physician Ted Barnett, co-coordinator of the Rochester-Area Vegan Society, will give a brief and lively Powerpoint presentation on the many vegan developments in Rochester and beyond. For more information, call 2348750 or visit https://rochesterveg. org. You may send a check by mail to RAVS, PO Box 20185, Rochester NY 14602.
April 26-28
Local artists sponsor show
A group of 14 local artists will sponsor a pop-up arts and craft show with original items ranging from wearable art to ceramics, wood, glass, photography and other items. The event will take place from 4 to 8 p.m., April 26; 10 a.m. to 5 p.m., April 27; and form 10 a.m. to 4 p.m. April 28 at the Clover Center for Arts and Spirituality, 1101 Clover St. in Rochester. The event is free and the location has plenty of parking space. For more information, call 585-5864492 or send an email to jrusitzk@ Rochester.rr.com.
May 7
Audiologists to discuss latest in hearing technology Hearing Loss Association of America Rochester Chapter invites anyone interested in hearing loss to any or all of several events on Tuesday, May 7. All programs are
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
held at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester, across from the George Eastman Museum. • 10 a.m.: “Hearing Other People’s Experiences (HOPE)” will take place at church vestry room. Prospective, new or experienced hearing aid users can share their experiences, questions, and hearing loss journeys in an informal round table discussion facilitated by retired audiologist and hearing aid user Joseph Kozelsky. • 11 a.m. to 1 p.m. Parish Hall. Program begins at noon. “Rochester Academy of Medicine: Its Connection with Hearing Loss” with Allis D’Amanda. She will share the history of the mansion housing the Rochester Academy of Medicine at 1441 East Ave., which was built in 1912 by prominent citizen Edmund Lyon. D’Amanda is a Lyon descendent. • 7 to 9 p.m. Parish Hall. Program begins at 8 p.m. “Cochlear Implant Technology Update: What’s New at UR Audiology? with audiologist Megan Wightman. The world of cochlear implants seems to change monthly with the release of new accessories, implants and sound processors. Wightman will explore the latest implant technology used at UR Audiology and who might benefit from it. All HLAA programs are free. Anyone interested in hearing loss is welcome. For more information, view the organization’s web site at hearinglossrochester.org or telephone 585-266-7890.
June 1
Free dental care offered to 100 people in Greece Dentist Oliver Cabrera of Greece Family Dentistry and Implantology will host Dentistry From The Heart, an event that will provide free dental care to the first 100 patients who show up on his practice. It will take place from 8 a.m. to 4 p.m., June 1, at Greece Family Dentistry & Implantology, 120 Erie Canal Dr., suite 150, Rochester. Last year the practice provided more than $24,000 in free dental care to nearly 70 patients. Services provided range from extractions, fillings and cleaning. “Now more than ever, I know there’s people out there that need dental care, but have no means to afford treatment — whether they’re out of a job, or just don’t have dental insurance,” said Cabrera. “This Dentistry From The Heart event is our way of providing a necessary service to the community, and ‘being there’ for the people who are in need of dental treatment.” Dentist Vincent Monticciolo, based in New Port Richey, Fla., founded Dentistry from the Heart in 2001. Participating dentists have donated over $25 million and helped over 500,000 people since its inception.
Got an event to share with our readers? Send us an email by the 10th of each month.
editor@GVhealthnews.com
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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New Nurses Work Overtime, Long Shifts, and Sometimes a Second Job Nearly half of newly licensed nurses work overtime, while more than one in 10 have a side job
N
ew nurses are predominantly working 12-hour shifts and nearly half work overtime, trends that have remained relatively stable over the past decade, finds a new study by researchers at NYU Rory Meyers College of Nursing. In addition, 13 percent hold a second job, according to the study published in the Journal of Advanced Nursing. Changes in health policy in recent years — from the passage of the Affordable Care Act and increased access to healthcare to the recession, which delayed some nurses’ retirements — have had implications for nurses and the hours they work. “Research shows that nurses’ hours, scheduling patterns, and overtime have been associated with patient safety and nurse well-being,” said Amy Witkoski Stimpfel, PhD, assistant professor at NYU Meyers and the study’s lead author. “However, we wanted to understand what these changes in the global economy have meant for the newest generation of nurses. Stimpfel and her colleagues analyzed surveys from more than 4,500 newly licensed nurses in 13 states and Washington, D.C., collecting information on nurse demographics, education, work attributes, and attitudes. Specifically, nurses were asked about their work schedule, daily shift length, weekly work hours, overtime, and whether they worked a second job. Four different cohorts of nurses — those first licensed in 2004-2005, 2007-2008, 2010-2011, and 20142015—completed the survey soon after being licensed; these cohorts were compared to observe changes over time. The researchers found that newly licensed nurses work an average of 39.4 hours a week, predominantly in 12-hour shifts. More than 13 percent report having a second paid job. New nurses prefer working the day shift, and the preferred shift length is 12 hours. Twelve percent of nurses report working mandatory overtime (an average of less than an hour in a typical week), and nearly half (45.6 percent) work voluntary overtime (an average of three hours in a typical week). The researchers observed nuanced changes in overtime hours during the decade studied: there was a decline in both mandatory and voluntary overtime during the economic recession by about an hour per week, but overtime hours rose in the most recent cohort.
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Meet
Your Doctor
By Chris Motola
Thomas Wormer, M.D. General surgeon has practiced at Thompson Health for 30 years — he talks about his profession, changes in medicine and his volunteer work in Haiti Q: You are a general surgeon at Thompson Health. Can you walk us through what you do in a hospital like Thompson? A: I’ve been practicing here 30 years. General surgery in smaller communities really encompasses gastrointestinal surgery, colorectal surgery, breast cancer, skin cancers, endoscopies, wound care. So, it’s a pretty broad range of areas that we take care of. Q: Have you found that your role has changed over the years with the centralization and networking of hospitals? A: Well, we don’t do as much trauma as we used to when I first got here, which isn’t a bad thing in my opinion. It’s been pretty well-proven that trauma patients do better in specialized trauma facilities. Q: Have the demographics of Canandaigua changed much? Are you seeing different types of patients with different issues than before? A: There have been some changes. I think our patient population has gotten somewhat older, somewhat sicker, with more chronic illnesses. But not any dramatic changes. Q: Your work sometimes takes you outside the Finger Lakes region. Tell us about your missions to Haiti. A: So, I’ve been to Haiti five or six times. We’ve gone to a town called Milot, near Cap-Haitien in northern Haiti. We worked at a hospital there that’s primarily run by the Haitian physicians and administrators, but is affiliated with a hospital in New Jersey called Sacred Heart. Mostly what we’ve tried to do is help the Haitian surgeons, give them a little break and take care of the more routine cases to cut down on their backlog.
very helpful. A cardiologist went with us one time and said, “Haiti is really the place where you need the generals, the surgeons with a broadbase who know how to do a lot of things.” They don’t have the specialists that we do in this country. Q: What kind of impact do you try to have while you’re there, and what impact does it have on you? A: It certainly makes me appreciate what we have in this country more. You find yourself working there with recycled instruments and makeshift materials. You have to be more innovative there. In terms of our impact on Haiti, we’re a pretty small group, and it’s a pretty small hospital, but I guess every bit helps. Q: When you’re training younger surgeons in a small city setting like Canandaigua, what kinds of expectations do they have? A: We’re kind of semi-rural. We pretty much have the full spectrum of specialties here. I think the one thing some of the younger surgeons struggle with is just the amount of night-call they have to take. It’s a smaller pool of surgeons to cover the hospital. On the other hand, I think you really become part of the community in a way you wouldn’t in a larger city. You see your patients on the streets, at Wegmans, at the post office. Over time, you become more and more part of the community itself rather than just working at a hospital.
Q: Do you find being a general surgeon, having that broader base, comes in handy in that environment? A: Yes,
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
Q: Do you find recreation opportunities are a big selling point for the area? I understand you’re a fly-fisher yourself. A: I am, but I haven’t done it in a couple years due to a shoulder injury. I haven’t been able to get out as much.
Q: What procedures do you end up doing most often? A: Like most general surgeons, I do a lot of gall bladders, hernias, things like that. I personally do a lot of breast cancer surgery, colon cancer surgeries, a lot of endoscopies, screening for colorectal cancer, that sort of thing. Q: Having practiced for 30 years in one location, do you find you’re able to have more of a continuum of care with individual patients than surgeons might normally have? A: Yeah, with a 30-year time frame, I’m sometimes getting second generation family members coming through now, which is kind of nice. I think in a lot of ways, it probably makes it more fun for me and more comfortable for them. Q: What kind of impact do you feel you’ve had on the community, and what kind of impact do you want to leave? A: I think that the hospital itself is growing and part of that is because the people who have been here have worked very hard to gain the hospital a good reputation for patient care. I hope the community itself will be a little healthier for us having been here. And going forward, I think there are a lot of great, younger doctors who are coming in and starting to take over. So, we want this to be a place where younger doctors want to come and work. Q: What do you think new doctors are looking for? A: I think up-to-date technologies. We’ve been doing robotic surgeries here for about seven or eight years. I think that, for a small hospital, we’ve been very innovative. We were one of the first hospitals in New York to do routine laparoscopic surgery, and that’s become pretty much the standard of care nowadays. It was a revolution in surgery. When I finished my training, we did almost all our abdominal surgery with open incisions. Recovery was usually several days in the hospital. Back to work was six to eight weeks. Now we’re talking about sometimes being back to work the next day. But when we started it was still pretty radical. We’ve been on the forefront of a lot of those changes. Q: With Upstate New York weather being what it is, do you sometimes end up with cases that would, in normal weather, be referred to a bigger hospital? A: We haven’t recently, but I remember one Super Bowl a driver took out a power line. Everyone lost their television signal. Nobody was happy about that.
Lifelines Name: Thomas Wormer, M.D., FACS Position: General surgeon at Thompson Health Hometown: Portville, NY Education: Albany Medical College Affiliations: Thompson Health Organizations: American College of Surgeons; Canandaigua Medical Society; American Society of Breast Surgeons Family: Wife (Melissa); four children Hobbies: Gardening, photography, fly fishing
Kick the Clutter
Rehabilitation Services
30-Day Minimalist Challenge is a way to get rid of more than 450 items over the course of one month By Amy Cavalier
I
t seems that everywhere you look, minimalism — the “life-changing art of tidying up” — is all the hype. As it turns out, a lifestyle based on “less is more” can actually make you happier. Studies show that clutter can distract us, make it difficult to relax, trigger feelings of guilt and embarrassment, inhibit creativity and productivity and cause us to waste time looking for things we can’t find. A study published in Current Psychology in June 2018 showed that clutter can negatively impact mental well-being, and induce a physiological response including increased level of cortisol, a stress hormone. Well, now is your chance to kick the clutter once and for all!
30-Day Minimalism Game Join the Rochester Minimalists in April as its members take on the “30-Day Minimalism Game.” The Rochester Minimalists is a group of individuals looking to explore our relationship with things, evaluate what brings value to our lives, to reduce our environmental footprint and question consumerism. Created by Ryan Nicodemus and Joshua Fields Millburn, also known as “the minimalists,” the 30 Day Minimalist Challenge is a fun way to get rid of more than 450 items over the course of one month. While it’s good to start on the first of the month, you can really begin the challenge whenever the mood strikes you. Here’s how to play! • On the first day of the challenge, you get rid of one item; on the second, two items; on the third, three items, and so on and so on until you’ve completed 30-days. • How you count items is up to you. While it may seem easy to find enough items to get rid of in the first two weeks, it gets harder as the challenge progresses and the number of items you need to part with climbs. • Whether you trash it, sell or donate it, the goal here is to get the items out of your home by midnight. If that’s not possible, it’s best to put the items somewhere where you will not be tempted to introduce them back into circulation. Set a deadline for getting rid of everything once the challenge is complete. You might want to sell, recycle at the Monroe County EcoPark, or to get rid of some of your items in the Second AnnualFree-For-All on May 4. • Invite a friend to complete the challenge or join the Rochester Minimalists group on Facebook as its members take on the challenge during the month of April! Having a buddy system keeps you accountable, helps you stay inspired and makes it more fun!
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Second Annual Monroe County Buy Nothing Free-For-All So, you completed the 30-Day Minimalism Challenge and now you’ve got a bunch of stuff that you’re not sure what to do with. Save yourself the hassle of selling your goods on Craigslist or in a yard sale. Pass it forward at the Monroe County Buy Nothing Second Annual Free-For-All from 10:30 a.m. to 3 p.m. on Saturday, May 4 at the Thomas P. Ryan Community Center located at 530 Webster Ave. in Rochester. This is an event for the community to share items with one another for free! There will be no cash exchanged or bartering allowed. Bring what you wish to give away. Receive what others may no longer need. Discover the power of neighbors helping neighbors! Be sure to RSVP by emailing amycavalier@hotmail.com if you plan to bring items to give away so we can be sure we have enough space for everyone who participates. Buy Nothing groups are hyper-local, adult-only, gift-based economies on Facebook. Members must live where they give. Once approved, you can give away, ask for or share anything you would like with your neighbors. There are currently more than a dozen Buy Nothing communities in Monroe County. To locate a group in your area, visit https://buynothingproject.org/find-a-group/.
For more information: • Join the Rochester Minimalists for the “30-Day Minimalism Game” in the month of April by visiting www.facebook.com/groups/rochesterminimalists/. • For more information on the Monroe County Buy Nothing Second Annual Free-For-All, visit https://www.facebook.com/ events/374257133316664/. Amy Cavalier is the leader of the Rochester Minimalists Community and a co-administrator of her neighborhood’s Buy Nothing group. April 2019 •
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Serving Monroe and Ontario Counties in good A monthly newspaper published
Health Rochester–GV Healthcare Newspaper
by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations.
In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. P.O. Box 525, Victor NY 14564. Phone: 585-421-8109 • Email: Editor@GVhealthnews.com
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Payne Horning, Sharon Osborne, Amy Cavalier, Daniel Croft, MD, Christine Green • Advertising: Anne Westcott, Linda Covington • Layout & Design: Dylon Clew-Thomas • Office manager: Beth Canale No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Physician Well-being Improving, But Burnout Risk Remains T he good news is that physician burnout appears to be improving, along with indicators for physician well-being. However, physicians remain at high risk for burnout, depression and depersonalization, compared to other professionals. Those are the updated findings from Mayo Clinic researchers and their collaborators that are published in Mayo Clinic Proceedings. “This is good news. It shows that burnout is being addressed nationally and programs are having some impact,” said physician Lotte
Dyrbye, Mayo Clinic researcher and senior author of the paper. “Clearly more organizational change and more research is needed to sustain this trajectory.” Researchers from Mayo Clinic, the American Medical Association and Stanford University collaborated in the national survey of physicians across more than 20 specialties to assess any changes between the previous study in 2014 and the original survey in 2011. While burnout varies by specialist, overall reported levels of burnout and satisfaction with work-life
integration improved between 2014 and 2017 — but only to 2011 levels. The researchers say individual and organizational efforts have improved the situation, but more work needs to be done. Burnout encompasses many aspects but includes the areas of emotional exhaustion, depersonalization, distress and depression. Extreme cases of burnout can lead to medical errors affecting patients, job loss and suicide. Survey responders say the demands of updating electronic health records are a major factor in burnout. These demands
limit the time physicians can spend with patients, and that affects career satisfaction. More than 30,000 physicians were invited to participate in the electronic survey. Roughly 17 percent (5,197) responded, and a second attempt to reach nonrespondents gained 248 more participants. Questions mirrored those on the previous surveys. Researchers say the reason for the change may be due to physicians adapting to the new work environments over the three-year period. Also, much progress may be attributed to interventional programs to stem burnout in hospitals and other facilities. Conversely, they say the indicators may have improved because many distressed physicians have left the profession.
Healthcare in a Minute By George W. Chapman
‘Vaccine Hesitancy’ Among Top 10 Threats to Global Health “Vaccine hesitancy” is the term coined by the World Health Organization to describe the resistance to vaccination due to unfounded safety fears, complacency about infectious diseases or difficulty accessing vaccinations due to supply or price. Vaccine hesitancy is now listed in this year’s top 10 threats to global health. Lately, close to 200 people in New York, mostly children, contracted measles, according to the Centers for Disease Control. An ongoing measles outbreak in Portland, Ore., has sickened 23 people, mostly children. Twenty of them were never vaccinated. Incredibly, despite the overwhelming evidence that vaccines work, the rate of unvaccinated kids has quadrupled in the past 17 years. Thanks to vaccines, smallpox has been completely eradicated and polio soon will be. Some children remain unvaccinated because of choices made by their parents. The American Medical Association is clamping down on providers who flippantly provide feeble excuses for children not to be vaccinated so they can enter school. The CDC is debunking the myths about vaccines. No. 1: Numerous studies have
found no connection between vaccines and autism. People might think the two are linked because the MMR vaccine is administered at the same phase in a child’s development when they may begin to show signs of autism spectrum disorder (not responding to their name, oversensitive to noise). No.2: It is not “safer” to space out the vaccines. The CDC recommended schedule is based on disease risks, vaccine effectiveness at certain ages and vaccine interactions with each other. No. 3. Vaccines do not contain harmful chemicals. Some substances contained in some vaccines do sound harmful, notably formaldehyde and mercury. The former is naturally produced in our bodies and the trace in vaccines is far less. The ethylmercury used in flu vaccines is safe and much different than the toxic methylmercury which most of us should be worried about. No. 4. You cannot rely on everyone else’s immunity/vaccination to protect your unvaccinated children. If an outbreak occurs, unvaccinated children are far more likely to get sick.
Socialized Medicine
would slowly transition the other 50 percent, typically by age, into a single payer system, eventually eliminating commercial insurance. Most physicians now very cautiously back a single payer system because most commercial insurers are paying Medicare based rates, so a single payer would just be easier for them to manage. The American Medical Association’s legitimate concern is once there is a single payer, they are at the mercy of the single payer. Seventy percent of Americans favor universal healthcare, but few are sure how it would work or be paid for. Of course, taxes would go up if the entire cost of universal care is paid for through taxes. But what hasn’t been considered in proposals is, what happens to the amount of care paid for by employers? Will they keep it and then pass the savings along to their
If your definition of socialized medicine means government controlled or paid for medical care, then we are almost halfway there. Within the next few years, the government’s share of healthcare spending will approach 50 percent, according to The Centers for Medicare and Medicaid. Aging baby boomers entering Medicare will drive this. By 2027, CMS estimates about 74 million people will have Medicare and about 83 million will be covered by Medicaid for a combined total of 157 million which will be about 45 percent of the projected population of 350 million in 2027. When you add in those insured/covered by federal employee insurance, Tri-Care (military), the VA and the Bureau of Indian Affairs, the government pays for over half of us. The “Medicare for All” movement Page 8
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employees in higher wages, which would then ameliorate the increased payroll taxes? Or will they continue to pay a percentage of the premium to the single payer? On average, employers cover about 67 percent of the employee’s health insurance.
Rural Hospital Jeopardy
One in five rural hospitals in the U.S. is at risk of closing unless there is direct fiscal relief or they affiliate with a larger, healthier system. Sixty-five percent of the rural hospitals at risk are considered essential because of their trauma status, services to vulnerable populations, isolation and economic impact on the surrounding communities. The states with the most at-risk rural hospitals are: Mississippi, 31 hospitals; Kansas, 29: Montana, 12; and Texas, 12. Ninety rural hospitals have closed since 2010. Left alone, most rural hospitals will close because of poor finances or their ability to attract and retain physicians. Ironically, telemedicine could hasten closures as rural populations get increased access to physicians in urban areas.
More MDs Employed
As of a year ago, 44 percent of practicing physicians were employed by hospitals or health systems. Just seven years ago, only 25 percent of physicians were employed. Over the last two years, hospitals acquired 8,000 more practices and another 14,000 physicians left private practice to become employed, according to the Physicians Advocacy Institute. In the last seven years, hospital-owned practices more than doubled from 36,700 to more than 80,000. The vast majority of physicians completing their residencies will bypass private practice and seek employment. The hassle/risk of running a private practice has become overwhelming and unfulfilling for many physicians. Physician employment is actually encouraged/driven by payment policies that favor integrated health systems where physicians and hospitals work in coordinated and managed unison to improve population health.
Your medical record
Many hospitals and physician offices are still providing only paper copies of records to their patients. Because paper copies are labor inten-
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
sive, you can be charged per page. It can get expensive, especially if a hospital record. HIPAA regulations state you are entitled to a digital copy of your record if the provider has the capability to do so. In response to complaints from consumers about providers blocking/impeding electronic access to their data, the Department of Health and Human services recently made public several rules that would allow consumers easier access to their record via the app of their choice, like a smartphone, at no additional cost. The healthcare industry has been slow to adapt to available technology. In fairness, providers cannot simply raise prices to pay for their investment in information technology because their reimbursement from their party payers is fixed.
Price transparency
Unaware of what a procedure cost, consumers inadvertently can drive up their own premiums by unwittingly using more expensive providers. For example, your insurance benefit summary says you have a $50 copay for an outpatient MRI. So, no matter where you go for the MRI, all you know is you owe $50, regardless of the cost. Your insurance company has different payment schedules per MRI provider. It often depends on the negotiating power of the MRI provider. Larger hospital / health systems can demand higher reimbursement than smaller facilities and private physicians. By inadvertently getting your MRI done where the insurer has to pay more, you increase the expense to the insurer which causes your premium to go up. In the cases where you have a 20 percent copay, you still don’t know the overall cost and may be going to the highest price facility. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
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achary Losee was near death when he learned a donor heart had been found for him. Now, three months after his transplant surgery, he is planning to return to school to continue his sophomore year. “It meant a second chance at life,” he said. Zachary, 15, of Hamlin, doesn’t know where his heart came from, but more New Yorkers are signing up to be organ donors, according to a new analysis of data from Excellus BlueCross BlueShield. “This donor family gave my son the greatest gift of all, which is to continue with life,” said Julie Prest, Zachary’s mother. “He wouldn’t be here now if it wasn’t for that gift.” The rate of registered organ and tissue donors in New York state has increased nearly 60 percent since 2014, according to the Excellus BCBS report. Despite that progress, New York state is still playing catch up. Across the country 58 percent of adults are registered organ and tissue donors. Only 35 percent of New York state adults are in the donor registry — and the need for organs in New York state is third highest among the 50 states, with 9,500 individuals waiting for a transplant. According to the report, most Upstate New York areas perform better than the state, including the Finger Lakes region with 46 percent of adults registered as organ and tissue donors. “The increase in donor registration shows that more people understand that they can give others a lifesaving gift. But there is still work to do,” said physician Lisa Harris, medical director at Excellus BCBS. “Last year, 386 New Yorkers became too sick to remain on the waiting list and another 387 died awaiting a transplant.” “There are so many people waiting, waiting for a heart, a liver, skin…” said Prest. “It is such a selfless act that you can do and yet it’s the greatest thing you can give anybody.” “It’s clear in our state we need to do a better job of communicating the importance and the ease of registering as an organ and tissue donor,”
Need for Donors at a Glance
• New York has the third highest need for organs but has the second lowest donor rate registration rate. • 35 percent of NYS adults are registered organ donors compared with 58 percent of US adults who are registered organ donors. • 9,500 New Yorkers are waiting for an organ • 17,000 Americans have been on the waiting list for more than five years Source: Excellus BlueCross BlueShield said Harris. In 2017 New York state expanded outreach and added legislation to simplify the process to register as an organ and tissue donor. • 16- and 17-year-olds became eligible to join the registry when applying for a driver’s license or permit • New Yorkers became eligible to sign up for the Donate Life Registry when applying for or renewing a health insurance plan on the state’s health plan website • Lauren’s Law was made permanent in NYS, requiring customers to check one of the two boxes related to organ donation in order for their DMV application to be processed. NYS Department of Health data from October 2018 show nearly 38,000 of the new organ registrations in previous 12 months were 16- or 17-year-olds and approximately 91,000 new registrations came from the health insurance marketplace. While in the hospital Zachary had a visit from Lauren Shields, the woman who inspired Lauren’s Law. After receiving a life-saving heart transplant at age 9, she has become a fierce advocate for organ donation. He says she’s his role model and plans to follow her lead. “I don’t always want to be known as the kid with a heart transplant,” Zachary said. “I want to be known as the kid who made a difference.” Submitted by Excellus BlueCross BlueShield.
How to Become an Organ Donor • Sign up through the New York State Department of Motor Vehicles in-person or online at DMV.NY.gov; • Sign up when you register to vote; • Enroll through New York State of Health when applying for health insurance at NYStateofHealth.NY.gov; • Complete a paper or online registration form at DonateLife.NY.gov. April 2019 •
If so, you may qualify for a new investigational eye drop research study! If you have previously been diagnosed with glaucoma or increased eye pressure and are at least 18 years of age, we invite you to participate. The study involves 7 office visits over the course of approximately 11 weeks. You may be compensated for your time and travel.
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2018
Organ Donation: Finger Lakes Region Still Lags Nation
Do you have glaucoma or high eye pressure?
GUIDE INSIDE
You Cannot Have a Healthy Bo dy With a Sick Mouth Survey: Mor e Americans Want to Visit the Dentist
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IN GOOD
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Anne Westcott: 585-421-8109 Linda Covington: 585-750-7051 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 9
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
On Her Own: Up Close and Personal with Ginger Howell
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t was love at first sight. At the ripe old age of 14, Ginger Howell met and was smitten by her future husband-to-be Dick Howell in Saginaw, Mich. They happened to be neighbors — and Ginger was robbing the cradle. Dick was 13. “Even at that young age, he was so good-looking, smart, and athletic — especially at swimming!” Ginger beamed. These childhood chums turned into highschool sweethearts, and then years later got engaged when they were students at the University of Michigan. Ginger got “pinned,” an old-time expression, which signaled the beginning of an exclusive courtship akin to engagement. Dick and Ginger tied the knot following graduation. When Dick was drafted, the couple lived and traveled abroad in post-war Germany for a year, then moved to Rochester where Dick was hired by Eastman Kodak and they started a family. Three kids later, they had nestled into a rustic ranch in Pittsford, where Ginger launched Seasonal Kitchen, a cooking school in their home, while Dick made a name for himself at Kodak. When Dick retired, he joined Ginger in the kitchen and together they taught cooking classes that mixed good-hearted ribbing with lots of laughs, helpful cooking tips and demonstrations. The classes, which included dinner, were (and continue to be) a hit! Sadly, Dick lost his battle with cancer five years ago. As a widow,
Ginger was determined to carry on their cooking legacy and love of life, both the sweet and the savory.
Q: After you lost Dick, what were some of the biggest challenges you faced?
classes.
A: Facing life without someone to lean on was a huge change for me. Dick and I did everything together after he retired. We were inseparable. And he did so much around the house. I wasn’t sure how I was going to stay on top of things. I was also very worried about finances and whether I would be able to hold onto the house and continue the cooking
Q: How did you overcome these challenges?
A: Well, I thank my lucky stars for my daughter Holly. She stepped right in to help me lead the cooking school, which was no small feat. Each class requires lots of preparation, shopping and rehearsal ahead of time, followed by hours of clean-up afterwards. While Holly and I couldn’t sustain the 11 classes per week Dick and I led, she and I kept it going. This was important for financial reasons. I needed to pay the bills. But I also needed and wanted to maintain my social network. Many of my class members became friends and, as such, became my support system after Dick died. I’ll be forever grateful for that. My financial consultant was also invaluable. Thanks to his help,
s d i K Corner
How to Keep Your Kids Safe From Cyberbullying
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o type of bullying is acceptable, but cyberbullying can be harder for parents to spot because it takes place via cellphone, computer or tablet, often through social media. Cyberbullying can be a hateful text message or post of embarrassing pictures, videos and even fake profiles of the victim. Victims are often bullied in person, too, and have a harder time escaping it. But unlike facing a bully at Page 10
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school, cyberbullying can happen 24/7, even when your child is home with you. Messages and images can be posted anonymously and spread in no time. And it can be difficult or even impossible to find the culprit. The consequences of being cyberbullied are far-reaching. Young victims are more likely to use alcohol and drugs, skip school, lose self-esteem and develop health problems. What can parents do? The website Stopbullying.gov recommends
Dick and I had a retirement nestegg I could live on as long as I was careful about my spending. That’s not always easy when you love to entertain, cook and enjoy delicious food! But I made it work. Q: There is a commonly held belief that single women in midlife are inevitably unhappy without a partner. How do you respond to that?
A: I’m bemused by that belief. Perhaps these are women — or men, too, I suppose — who haven’t given themselves a chance to see what they can do and experience for themselves. Living alone can be so empowering. I know this may sound cliched, but I find every day to be an adventure.
Q: Has living alone provided you with any unexpected revelations or opportunities?
A: Oh, so many! For one thing, I can still shovel snow at my age — I’m 90! I know this sounds simplistic, but it’s very symbolic. I’ve learned I can do things for myself. My attitude is that shoveling snow is great exercise! Good for the legs. It gives me a great deal of satisfaction knowing that I am capable on my own; that I can depend on myself. I’ve also learned that if things are beyond me, I can ask for help and rely on the kindness of others. Last month, the UPS guy showed up with a delivery on a very snowy day. I asked if he could help shovel the front porch before he left, which he did so gladly. I don’t see asking for help as a weakness; I see it as a sign of strength and self-confidence.
Q: What does an ideal day look like for you now?
A: On an ideal day, I wake up to a clean kitchen, having washed the dishes the night before. I put away the clean dishes, make my list of chores for the day (which typically includes a trip to the grocery store), and then I get busy trying new rec-
ipes or prepping for a cooking class that evening. After the class and everyone has left, Holly and I clean up and collapse exhausted, but happy, in my living room. We are full of gratitude for the beautiful people and purpose in our lives. Q: What advice do you have for women and men who find themselves living alone in midlife?
A: Keep working at something you love to do — something that matters. Working keeps us young and alive! For me, it’s Seasonal Kitchen. For others it could be hiking, writing, playing an instrument, travel, you name it. I encourage people to stay active and engaged in life. And to be with friends and definitely own a pet, if possible. Oh, and take a cooking class!
Q: And one last question: How do you plan to spend this evening?
A: Mercifully alone (smiles). I adore a quiet evening to myself. As you can imagine, I’m very busy food shopping, prepping and leading classes, going out to dinner with friends, participating in wine tasting events, attending fundraisers, etc. I look forward to an evening alone watching “World News Tonight,” followed by “Jeopardy,” and then snuggling up with a good book. I love reading and re-reading anything by Irwin Shaw and Rona Jaffe. Tomorrow I will wake up rested and eager to take on a new day, on my own and looking forward to what’s to come.
Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon. She is also the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” To purchase her book, learn about workshops, or invite her to speak, call 585-624-7887, email gvoelckers@rochester.rr.com or visit www.aloneandcontent.com.
being proactive — talk with your kids about cyberbullying, including why they should never bully others, and encourage them to tell you about any incident right away. Friending or following your kids on social media may help you know if they become the victims of unwanted postings.
More tips for parents • Teach kids not to share anything that could hurt or embarrass them or others to avoid retaliation. • Regularly check your kids’ social network pages to look for signs of bullying behavior, such as mean images of another child. • Tell your kids to talk to you if an online message or image makes them feel threatened or hurt. • Encourage your kids to speak up if they see cyberbullying happening to someone else, and not to engage in the bullying by forwarding posts. • If your child is cyberbullied, print and save screenshots, emails and texts for evidence. He/she should not react to the bully, but should block and/or delete him/ her from their friends lists. Block the user name, email address and phone
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
number. If your child finds a profile that was created or altered without his/her permission, contact the site to have it taken down. • Report cyberbullying to your online service provider, and go to its safety center to block users and limit who can contact your child. • Report cyberbullying that involves a crime to police. • Contact law enforcement if cyberbullying involves: Threats of violence, child pornography or sexually explicit messages or photos, any photo or video of someone in a place where he or she would expect privacy, stalking and a hate crime. Also report incidents to your child’s school. The school can use the information to help with prevention and response strategies.
Meet Your Provider
Atkin Center for Outpatient Rehabilitation A Conversation with Chad Mapes, Director A Service of Jewish Senior Life
Q: Tell us about the Atkin Center for Outpatient Rehabilitation. A: We offer traditional therapy disciplines – physical, occupational, massage and speech – to help adults recover from an illness, injury, surgery or other medical diagnoses. We support recovery and build patient strength and confidence to get you back to fuller functioning and living. We are conveniently located on the campus of Jewish Senior Life, on Winton Road South near Route 590. We offer free parking, and transportation is available within Monroe County for ambulatory and/or wheelchair-bound clients, if needed. Q: What types of injuries and illnesses do you treat? A: We provide therapies for the treatment of orthopedic, neurological injuries, hand injury, post-concussion rehabilitation, and vertigo and balance assessments. We also treat patients with illnesses caused by stroke, Parkinson’s,
head injuries, general neurological disorders, and more. Q: Are there other therapy services you provide? A: We have staff certified in specialty therapy programs such as LSVT Big & Loud, an intensive physical therapy program for people with Parkinson’s and other neurological disorders. We can help people regain physical strength and improve clarity in their speech. We are one of the only outpatient providers in the area to provide VNG testing, which is a diagnostic tool used to help patients who suffer from balance or dizziness problems. We also offer Orthopedic and Spine Rehabilitation, and Manual Therapy.
and create a customized driver training program to help older drivers maintain their driving independence. Q: What makes your rehabilitation unique? A: Our patients benefit from individualized treatments and 45 minute one-on-one therapy sessions with our highly trained and professional staff. Our team of professionals has more than 30 years of experience in rehabilitation therapy.
Q:What other services are available on the Jewish Senior Life campus? A: Jewish Senior Life is a Continuing Care Retirement Community (CCRC) offering all levels of care on a single campus, from independent living to skilled nursing care. We also have a variety of community programs and services for people living outside of our campus such as physician house calls for the homebound, and companion care. We serve people of all ages, faiths and ethnic backgrounds.
Q: What other services do you offer? A: We partner with Rochester Rehabilitation’s DriveOn program to help seniors drive safely, comfortably and stress-free. Our occupational therapists work with DriveOn’s experienced driver specialists to evaluate driving ability
Atkin Center for Outpatient Rehabilitation
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585-784-6530 n jsloutpatientrehab.org n 2021 S Winton Rd, Rochester, NY 14618 n
Group Urges Tech Companies to Stop Vaccine Misinformation
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he American Medical Association (AMA) has added its voice to those calling on large tech giants to combat the misinformation on vaccines on their sites. The AMA, the country’s largest physician organization, in March sent a letter to the CEOs of six leading social media and technology companies urging them to ensure their users have access to “accurate, timely, scientifically sound information” on vaccine safety and efficacy. The letter went to the CEOs of Amazon, Facebook, Google, Pinterest, Twitter and YouTube. The AMA said while some technology companies
have announced steps to combat the spread of vaccine misinformation, it was urging the leaders of all six companies to act. “At a time when vaccine-preventable diseases, particularly measles, are reemerging in the United States and threatening communities and public health, physicians across the country are troubled by reports of antivaccine-related messages and advertisements targeting parents searching for vaccine information on your platforms,” wrote physician James L. Madara, the AMA’s CEO and executive vice president. He said doctors are concerned the proliferation of this misinformation will further decrease vaccinations and persuade people to make medical decisions that could spread preventable diseases. “With public health on the line and with social media serving as a leading source of information for the American people, we urge you to do your part to ensure that users have access to scientifically valid information on vaccinations, so they can make informed decisions about their families’ health,” Madara wrote, also urging the CEOs to make public their plans to ensure that users have access to accurate information on vaccines. Tech companies have been unApril 2019 •
der pressure and grappling with how to halt the spread of misinformation on their platforms. In mid-March Amazon removed two books available on its website claiming to offer ways to cure autism, according to USA Today. Earlier in the month, news reports indicated Amazon had pulled antivaccination documentaries from Prime Video. Pinterest blocked all searches on its service using terms related to vaccines or vaccinations to stop the spread of misinformation on antivax posts. And Facebook said it was cracking down on false information linked to the antivax movement, USA Today said. The Centers for Diseases Control and Prevention (CDC) has confirmed 228 cases of measles in 12 states as of mid-March, which puts the country on track to surpass previous record years. Six outbreaks, which the agency defines as three or more cases, have occurred in New York, Washington, Texas, Illinois, and California. The CDC said the outbreaks are linked to American travelers bringing measles back into the U.S. from other countries, such as Israel and Ukraine, where large measles outbreaks are occurring. The outbreaks have resulted in national attention and put the spotlight on the antivaccination movement. And a dramatic case has also
drawn national attention: That of a 6-year-old unvaccinated Oregon boy who contracted life-threatening tetanus in 2017 after he cut his forehead while playing outdoors on his family farm. The case was reported in the CDC’s Morbidity and Mortality Weekly Report where doctors who treated the child at the Oregon Health and Science University revealed he spent almost eight weeks in the hospital at a cost of nearly $1 million. His parents declined a second dose of DTaP vaccine, which prevents diphtheria, tetanus and pertussis, and other recommended immunizations. More than 100 doctors and nurses helped the boy survive, but not one of them had ever seen a child with the bacterial disease before. It was the first pediatric tetanus case in more than 30 years in Oregon. “It’s always hard to watch a child suffer. It is harder when we know they are suffering from something that’s preventable and obviously we do everything we can to try to avoid those situations,” Carl Eriksson, a doctor in OHSU’s pediatric intensive care unit, and one of the case study authors, told The Oregonian. “It reminds us that vaccine-preventable illnesses are terrible diseases that are often life-threatening, and we’re not used to seeing them so when a case like this does come along it’s definitely eye-opening to a lot of people,” Eriksson said. Earlier this month, the American Academy of Pediatrics also sent letters to the CEOs of Google, Facebook and Pinterest urging them to combat “the dangerous spread of vaccine misinformation online.”
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Things You Need to Know About Autism By Ernst Lamothe Jr.
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here has been a ten-fold increase of autism prevalence in the last 40 years, according to the Centers for Disease Control and Prevention. There are three million individuals in the United States and tens of millions worldwide who have autism. “Although autism prevalence has increased, this is likely due in large part to increased awareness and assessment for autism spectrum disorders and changes in diagnostic criteria over time,” said Jara Johnson, developmental behavioral pediatrician at Rochester Regional Health. “That is the case rather than an epidemic increase in the incidence of autism.” Here are five key facts you need to know about autism in children. Don’t believe the stereotypes Because autism is still something that is not readily talked about, there continues to be a few myths that continue to stand out. Even in television shows some people with autism are shown in a stereotypical and one-dimensional lens. There are two myths that are very prevalent that Johnson wanted to dispel. “Vaccines do not cause autism,” said Johnson. “Autism likely results largely from genetic factors, though for some there may be environmental factors that impact risk. There have been many large studies that show no link between autism and vaccines.” Secondly, people with autism can show affection. “Those with autism can often give and receive affection, though they may do so on their own terms and it may not be in conventional ways,” said Johnson.
1.
2.
There are key symptoms that people should know. Autism spectrum disorder is a neurodevelopmental condition characterized by differences in social skills and social communication, along with the presence of restricted and repetitive behaviors. Some early signs can often be detected in infants and toddlers, though for some children, their symptoms are more detectable as they age. “Some children with autism may appear to be unaware of those around them, while others may really desire friendships and relationships, though struggle understanding all the complexities of initiating and maintaining those relationships,” said Johnson. “Children with autism may have limited play skills or difficulties sharing in imaginative play. All have varying difficulties with both verbal and non-verbal communication skills.” A few of those skills they struggle with could include understanding spoken language, eye contact, gestures, facial expressions or tone of voice. However, the issue is that because it is a spectrum some children with autism may have limited to no speech, while others may be very talkative. Some children’s autism spectrum disorders co-occur with other conditions, such as attention deficit hyperactivity disorder. Boys are more affected 3. Boys are four times more likely to be diagnosed with autism
than girls. According to research from Autism Speaks, one in 37 boys and one in 151 girls will be diagnosed with autism. This disorder can
Sleep Difficult for Children on Autism Spectrum By Deborah Jeanne Sergeant
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ecent research published in the journal Pediatrics indicates that children with autism spectrum disorders (ASDs) are at double the risk for experiencing difficulties with sleep than children not on the spectrum. Researcher Ann Reynolds, a physician and associate professor of developmental pediatrics at University of Colorado School of Medicine, found that children between the ages of 2 and 5 are more likely to delay bedtime, struggle getting to sleep, feel anxious about sleep, awaken during the night and have night terrors, all of which can mean fragmented sleep. “Children on the spectrum often exhibit behaviors such as aggression, hyperactivity and other behavioral Page 12
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problems — and lack of sleep can be a setting event for these behaviors to be more likely to occur,” said Julie Cenzi, licensed behavior analyst, mental health counselor, and owner of Spectrum Behavioral Counseling Service in Rochester. “Having adequate amounts and quality of sleep are important so that children may function better in school and will help improve academic ability.” Children also need sleep for their own mental health benefits. Cenzi said that otherwise, issues such as depression or anxiety may occur. Sleep issues can also affect the rest of the family. “This leads to decreased patience, increased irritability and depression in other family members as well,” she said.
be reliably diagnosed by 2 years of age, but most children are not actually diagnosed until after the age of 4. “Girls may not fit the stereotypes or their symptoms may be misinterpreted,” said Johnson. “Girls may demonstrate less characteristic restricted or repetitive behaviors or fewer of them altogether. For some, especially those who do not have intellectual impairment, their presentation may be more subtle. They may have more social motivation and some of their social overtures may be less atypical than boys, such as somewhat better eye contact. Their autism symptoms may also be masked or overlooked due to additional struggles, such as anxiety, depression, poor self-esteem, or ADHD.” Eye contact information 4. There is an association with eye contact differences, name-
ly lack of eye contact, and autism. Lack of eye contact can be one of the earliest signs of autism in infants or toddlers. The exact reasons for eye gaze differences are not clearly understood. “Some research suggests that it may even be an unconscious behavior,” said Johnson. “It’s possible that it could be related to the way the brain processes visual information. Most people are naturally wired to use eye contact as a form of nonverbal communication, which often conveys interest and attention. Those who are typically developing not only use eye gaze as a form of communication, but they also coordinate that gaze with gestures, facial expressions, and verbal language.” to see your physician 5.Do notIn wait 2018, the CDC deterSo why do kids on the spectrum experience sleep disturbances? Heidi Connolly, chief of pediatric sleep medicine services at University of Rochester Medical Center, said that it’s not entirely clear, but it’s a common complaint. She said that hormones offer a few clues. Melatonin, a natural hormone produced by the body, helps set the circadian rhythm of waking and sleeping. It’s usually released close to bedtime. “It looks like children with autism aren’t as good at making that nighttime surge of melatonin,” Connolly said. “Giving two to three mg. before bed can be helpful.” What doesn’t help is giving the child attention when awakening at night. “It perpetuates the behavior of getting up in the night,” Connolly explained. She recommends a night time routine illustrated by a picture board or other display, as does Cenzi, since children on the autism spectrum generally do well on routines because they know what to expect next.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
Jara Johnson, developmental behavioral pediatrician at Rochester Regional Health. mined that approximately one in 59 children are diagnosed with an autism spectrum disorder. The American Academy of Pediatrics recommends that all children be screened for autism at their 18- and 24-month well-child checkups. If you’re not sure if your child has been screened, you can ask for a screening. You can also complete the online screener, print the results, and bring them to your healthcare provider to discuss your concerns. Much was not previously known about what causes autism, but research is showing that environmental influences and rare gene changes cause autism, which impacts early brain development. Autism does not discriminate and can affect children of all social classes and ethnicities. Remember to look for the signs and to get your child screened. “If a parent or caregiver is concerned that their child may have an autism spectrum disorder, it is suggested that they speak with the child’s primary care physician sooner rather than later to discuss their concerns,” added Johnson.
“Creating a set routine with calming activities — such as reading books, taking a bath and going to bed at the same time every night — are important,” she said. “Avoiding electronics at least an hour before bed and avoiding food or drinks with sugar or caffeine will help children fall asleep faster and sleep more soundly.” Just before bedtime isn’t a good time for vigorous activity; however, sufficient activity earlier in the day may improve sleep. Cenzi added that environmental factors conducive to good sleep could include white noise in the bedroom, darkened rooms, and a quieter home around bedtime. But these factors are highly individual. Some children find a bath as stimulating, for example. “For some kids, a weighted blanket may be helpful,” Cenzi said. “Sensory concerns may make some bedding uncomfortable so ensuring that the sheets and blankets feel okay to the child is also important.”
Op/Ed
E-cigarettes: A New Form of Addiction By Daniel Croft, MD
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ince the introduction of electronic cigarettes several years ago, it’s been suggested that these electronic nicotine delivery devices could help smokers quit. This claim is incorrect. The most recent example is a study reported in the New England Journal of Medicine that concluded patients in the United Kingdom who used e-cigarettes were twice as likely to quit combustible cigarettes as those who used FDA-approved nicotine replacement therapies. However, that was not all that they found. After one year, 80 percent of study participants who used e-cigarettes to quit were still using e-cigarettes. They had not broken their addiction to nicotine, but rather switched to a different form of inhaled nicotine. Importantly, this would leave them vulnerable to a return to combustible cigarettes. Although the risks and benefits of e-cigarettes are still under intense study, we do know that nicotine alone presents real dangers. It can increase the risk of cardiovascular and lung disease, and it can affect fetal growth and development. We also know that nicotine — especially the concentrated liquid form in e-cigarettes — can be extremely poisonous and potentially fatal if swallowed. In addition, nicotine affects developing brains, a particular concern for adolescents and young adults, age groups that are more likely to try smoking or vaping and that are more susceptible to nicotine addiction. According to the U.S. Surgeon General, e-cigarettes are now the most commonly used form of tobacco by youth nationwide, and nicotine addiction can prime the adolescent brain for addiction to other drugs such as her-
Training • Th erapy • Ed uca tio n•
oin and cocaine. As an increasingly popular method for delivering nicotine, e-cigarettes deserve more scrutiny. Some major medical groups, including the American Cancer Society, have recommended only using e-cigarettes for smoking cessation when a person has failed FDA-approved methods, including nicotine replacement therapies (patches, lozenges or gum) and prescription medications like bupropion (Wellbutrin) and varenicline (Chantix). But those who choose this strategy must switch completely from combustible products (no dual use) and have a clear plan to stop e-cigarette use. Although we do not yet know the long-term health effects of e-cigarettes, we do know that they are not risk-free. The fact that smokers turn to e-cigarettes as a quit strategy should serve as a call for health care providers to improve support for effective cessation efforts. We must do everything we can to help all smokers quit. If you want to quit nicotine, talk to your health care provider and contact the New York State Smokers’ Quitline at 1-866-6978487 or nysmokefree.com. We are here for you. Physician Daniel Croft is assistant professor of pulmonary and critical care medicine at University of Rochester Medical Center.
New Tinder-Style App Aims to Help Parents of Picky Eaters With this new app, kids can help parents identify the foods they like by separating choices into ‘yucky’ or ‘yummy’ categories
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ant a happier, healthier what the group hopes will be several mealtime for your picky digital tools meant to help parents eater? Just swipe left. through early childhood challenges. It’s a scene most toddler parents This first release has two main are familiar with: entire meals disfeatures. The first is a game that carded, stubborn little ones exerting allows children to place various foods what control they have, and frustratinto “yummy” or “yucky” categories ed parents torn between remaining so that parents can then test their firm and wanting to ensure their kids knowledge of their children’s food are getting at least some calories. preferences. The plight of parenting a picky The other is a section with evieater is real. But a new app may help dence-based advice to help parents Newspaper-internet ad for: Improving Well-Being for Older Adult some Family of Dementia Caregivers (RSRB #60901) offer some relief. address the picky-eating Released by the Department issues they may be dealing with. of Child and Adolescent PsycholoTo download the app, go to the gy, in conjunction with researchers app story in your smartphone and from NYU Langone Health, “When to type “When to Wonder: Picky EatWonder: Picky Eating” is the first of ing.”
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Heart Attacks Striking More Young Adults 20 percent of people who have a heart attack now are 40 or younger
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lthough Americans are suffering fewer heart attacks, the rate is dramatically increasing among those under 40. In fact, 20 percent of people who have a heart attack are 40 or younger, a rate that has risen 2 percent a year for 10 years, new research reports. Some of these people are now in their 20s and early 30s, said senior study author Ron Blankstein, a car-
diologist at Brigham and Women’s Hospital in Boston. He said it used to be “incredibly rare” to see anyone under age 40 with a heart attack. “Based on what we are seeing, it seems that we are moving in the wrong direction,” he said. These young heart attack victims also have the same risks of dying from another heart attack or stroke as older patients.
“Even if you’re in your 20s or 30s, once you’ve had a heart attack, you’re at risk for more cardiovascular events and you have just as much risk as someone who may be older than you,” Blankstein said. Risk factors such as diabetes, high blood pressure, smoking, family history of premature heart attack and high cholesterol were the same among older and young people
who suffered a heart attack, researchers found. Younger patients drank less alcohol but were more likely to be substance abusers — 18 percent used marijuana and 9 percent used cocaine. For the study, Blankstein and colleagues collected data on close to 2,100 patients under age 50 admitted to two hospitals for heart attacks. “Many people think that a heart attack is destined to happen, but the vast majority could be prevented with earlier detection of the disease and aggressive lifestyle changes and management of other risk factors,” Blankstein said To protect yourself, he recommends avoiding tobacco, getting regular exercise, eating a hearthealthy diet, losing weight if you need to, managing your blood pressure and cholesterol, avoiding diabetes, and staying away from cocaine and marijuana. In a related study, Blankstein’s team found that one in five patients who suffer a heart attack before age 50 also have diabetes. Diabetics are more likely to have repeated heart attacks and die from a heart attack than other people. These patients need aggressive treatment, Blankstein said. Some diabetes medications can reduce heart attack risk, he added. The findings are to be presented March 17 at the American College of Cardiology’s annual meeting in New Orleans. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
Career: Diagnostic Medical Sonography Career requires only an associate’s degree. It pays about $70K By Deborah Jeanne Sergeant
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ould you like a career in a medical field that requires an associate’s degree but starts at around a $70,000 salary in the Rochester area? Consider becoming a diagnostic medical sonographer — or a technician who takes ultrasound images for physicians. In addition to a healthy return on investment, the career offers a job outlook of 17 percent growth from 2016 to 2026, considered “much faster” than other jobs by the Bureau of Labor Statistics. Chelsea Pino, sonographer with University of Rochester Medical Center, works mostly in the children’s hospital. She had always wanted to work in a medical field and after shadowing a sonographer, she realized it was the right fit for her. “I like the availability of options,” she said. Many people stereotypically picture the sonographer as the person who takes ultrasounds of their baby before birth; however, the career has many other options, too. Sonographers work in hospitals, doctor’s offices, and non-medical Page 14
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boutiques that offer sonography sessions for families to “meet” their new baby before birth (although this sub-specialty isn’t diagnostic in nature). The medical specialties include vascular, ophthalmology, cardiac, pediatric and many more. Pino believes that attention to detail, personal drive and compassion are all “soft skills” that can benefit sonographers. “We have to take it upon ourselves to tell the doctors what we’re finding on the images,” Pino said. “The ‘people’ aspect is a big aspect. Some of that is learned on the job.” She completed Rochester Institute of Technology’s four-year program and completes continuing education credits to keep her credential and stay up-to-date. “I like the interaction with patients,” she said. “If you give them a good experience, that’s a lasting memory.” Hamad Ghazle with Rochester Institute of Technology, sees plenty of demand, “locally, regionally and nationwide” for sonography. “Ultrasound is really becoming widespread in many parts of the
world,” Ghazle added. “The demand is everywhere. The statistics show the demand will continue to increase into the future.” Ghazle is program director, professor and advanced practice sonographer with the Diagnostic Medical Sonography Program at the College of Health Sciences and Technology at RIT. The school offers an ultrasound program accredited by the Commission on Accreditation of Allied Health Programs. It includes a certificate in general and cardiac sonography and a bachelor’s degree in sonography, though in New York, only an associate’s degree is required before sitting for the required certification exam. At RIT, students receive clinical training and classroom instruction. A strong aptitude in science may be helpful. “They use the latest technology and work in an outstanding, vibrant
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
environment,” Ghazle said. “As you work in this field, you’re challenged on a daily basis to provide the best care, best examination and provide high quality diagnostic images.” He believes that the work includes elements of other professions, including medical engineering, industrial engineering, mechanical engineering and medical care. Other related opportunities could include managing, education and working for companies that build and sell the equipment. Ghazle said that repetitive motions when performing ultrasounds can result if technicians don’t use proper ergonomics. Because of the high demand, another challenge is the size of the workload for some people. “The field is increasing all the time,” Ghazle said.
SmartBites
The skinny on healthy eating
Ham: The Good, the Bad, and the Better Choices
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s eating ham healthy? It’s certainly something to ponder, whether ham only makes a holiday appearance at your table or is a regular indulgence. Truth is, compared to other meats, ham — the cut of meat from a hog’s hind leg that’s preserved by curing — gives many nutritionists pause. But with Easter right around the corner and ham being a crowd favorite, let’s say we start with the good! Ham, like all meat, is an excellent source of complete protein, with a 4-ounce portion serving up around 20 grams. An important component of every cell of the body, protein is needed to build and repair tissues, as well as make enzymes, hormones and other body chemicals. And while we often associate greater protein needs with growing bodies, research is increasingly showing that pumping up your protein — no matter
your age — can boost your health and help prevent a decline in muscle mass with aging. Along with thwarting weakness as we head into our twilight years, maintaining muscle mass has another powerful benefit: it decreases the risk of fracture from falls. Ham, especially lean ham with its fat trimmed away, is relatively low in fat and calories, which is good for those watching their weight and fat intake. An average 4-ounce serving, for example, has only 120 calories and about 4 grams of total fat, of which only 1 gram is saturated fat. Three more good reasons to eat ham, notwithstanding its delicious flavor? Ham delivers healthy doses of selenium, niacin and phosphorous. While selenium plays an important role in the health of our immune system, both niacin, which helps
April 2019 •
raise good cholesterol and lower bad cholesterol, and phosphorous, which helps regulate heartbeat and muscle contractions, contribute to heart health. And now for the bad. Ham — versions that are not reduced-sodium, that is — can be loaded with sodium. Loaded! We’re talking around 1,200 milligrams in a 4-ounce serving, which is almost all of the 1,500-milligram recommended daily limit for people with high blood pressure and over half of the 2,300-milligram limit recommended for healthy people. Consuming too much sodium, as many know, increases your risk for high blood pressure and heart disease. Also bad: Processed meats, like ham, can increase your risk for numerous health problems. Studies show that consumption of these cured meats has been linked to a higher risk of heart disease, Type 2 diabetes, and certain cancers. The nitrates used to preserve processed meats and improve the flavor are known carcinogens.
Honey-Balsamic Glazed Ham with Garlic
Adapted from Eatwell 101 (serves 12-15)
1 (5-6 pound) cooked bone-in ham (uncured, if available) 40 garlic cloves (about 4 heads) 2 tablespoons olive oil 3/4 cup water 1 tablespoon balsamic vinegar 1 tablespoon honey 2 tablespoons Dijon mustard 1 tablespoon chopped fresh rosemary or 1 teaspoon dried rosemary, crushed 1 tablespoon chopped fresh thyme or 1 teaspoon dried thyme Coarse black pepper, to taste Preheat oven to 350°F. Score ham in a diamond pattern by making shallow diagonal cuts at 1-inch intervals. Place ham, cut side down, on a rimmed baking sheet lined with foil. Set aside. Meanwhile, soak garlic cloves in
Healthy tips
Eat ham in moderation. Choose lean, uncured (nitrate-free), low-sodium ham whenever possible. Uncured cooked ham is preserved with a celery juice-sea salt mixture that has naturally occurring nitrites, making it less harmful. Many groceries now carry healthier ham versions. When preparing ham, consider using less salt, less sugar, and ingredients that are lower in both. boiling water and simmer for 3 or 4 minutes. Drain from boiling water and rinse under cold water. Remove skin from cloves; it should come off easily. Pat dry, if moist. Heat olive oil over medium heat in small skillet; brown garlic gently for a couple of minutes until golden, stirring frequently to avoid burning. Remove garlic and set aside. In the same skillet, combine water, balsamic vinegar, honey, mustard, rosemary, thyme, and pepper and bring to a simmer. Cook for 5 minutes until the sauce thickens. Add garlic back to the glaze and cook for 2 minutes more. Remove from heat. Brush ham with about 1/3 of the honey-balsamic glaze, tent with foil, and bake for 50 minutes. Remove foil tent, brush with another 1/3 of the glaze, add garlic to the pan around the ham and bake for an additional 50 minutes. Remove from oven and let rest 10 minutes. Serve sliced ham with remaining glaze and garlic on the side.
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 15
Hilton Parma Group Sets Example of How to Fight Addiction Mission of Hilton Parma Drug Intervention Community Education is to educate the public about the dangers and risks of substance abuse, end the stigma associated with drug, alcohol addiction By Christine Green
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ichelle Polatas of Parma didn’t set out to become addicted to heroin. But the cycle of addiction began when an old boyfriend offered 18-year-old Polatas the drug. There were arrests, an overdose, theft and weeks in and out of rehab facilities. Her mother, Laurie Polatas, was emotionally and physically exhausted. “It was beyond my parental knowledge. It took her dad and I by surprise; we just didn’t understand what was going on. We were a normal family,” Laurie said. In the midst of this struggle, Michelle ended up in the Monroe County Correctional Facility. Her family was confused and hurt and “hiding under a rock of shame,” Laurie said. She felt an uncomfortable feeling of embarrassment and self-blame. But she knew this shame wasn’t serving her or her daughter. She needed to climb out from beneath that rock and take action. In October of 2014 she reached out to officials at the Hilton school district, the village mayor and other local citizens. “Maybe we could come together and make our community healthier,” Laurie Polatas recalled telling them. She contacted the National Council on Alcoholism and Drug Dependence-Rochester Area for help in organizing and forming a coalition. It was through its guidance and mentoring that she learned of the Community Anti-Drug Coalitions of America (CADCA). CADCA’s mission is to assist coalitions nationwide as they create and maintain safe and drug-free communities. Polatas and the team she brought together registered as a coalition under CADCA and today they are a 501 (c) (3) nonprofit coalition called Hilton Parma Drug Intervention Community Education (HPDICE).
HPDICE
One of the goals of the HPDICE coalition is to educate the public about the dangers and risks of substance abuse in order to save lives. It provides resources for treatment, recovery and prevention. “I try to be the broker of the information to the community,” said Laurie Polatas. She believes that open discussion is the key to helping young people stay safe. “You have to talk about these things. They [teenagers] think they’re invincible and bad things aren’t going to happen to them.” The 100 percent volunteer group consists of partners from all over the Page 16
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area including school administrators and counselors, students, local towns and villages, a representative from Monroe County Office of Mental Health, and church groups. Parents and family members of those suffering with substance abuse issues also make up the core group. Kathryn Hogan is one of those parents. Her son is addicted to drugs, and she fears he may always be dependent on them. As HPDICE’s communication coordinator she has found great support among the coalition members and believes that the work they do is extremely important. “We’re really trying to make the world better for our children. Everyone is very valued here. This is an exceptional committee,” she said.
No More Shame
Part of HPDICE’s educational mission is to end the stigma associated with drug addiction. “My whole thing when I jumped into this committee was no more shame and no more blame,” said Hogan. “I’m done with this whole stigma.” Both Hogan and Polatas noted that the negative views many in society have against those addicted to drugs, particularly opioids, prevent people from seeking help for themselves or a loved one. This stigma can often make those in the middle of such a situation feel isolated and helpless. Medical professionals agree that alcohol and drug addiction is a disease and that opioid overdose is a nationwide epidemic. The Centers for Disease Control and Prevention (CDC) reports that in the US an average of 130 people die every day of an opioid overdose. HPDICE is working to educate people on these and other substance use statistics locally and nationwide in the hopes that more people will help find practical solutions rather than judging those suffering.
The Heart of Addiction
“Addiction doesn’t come without pain,” Polatas pointed out when asked why some people engage in the risky behaviors that can lead to addiction. Usually, a person who is addicted to drugs is trying to cope with an uncomfortable feeling. This can be stress, anxiety, depression or a traumatic experience. Adverse Childhood Experiences (ACEs) is a scoring system developed by the CDC and Kaiser Permanente to assess a young person’s risk factor for poor physical and mental health in later life. ACEs can include
Laurie Polatas, left, and Kathryn Hogan of the nonprofit coalition called Hilton Parma Drug Intervention Community Education (HPDICE). violence, natural disasters, homelessness or neglect among many other difficult situations. Children with more ACEs are at a higher risk of addiction. “There’s a really pretty complicated emotional and mental health component to this drug stuff,” Hogan said when discussing the multitude of issues that contribute to risky behaviors and addiction. The upside is that schools are now much more aware of childhood risk factors and are actively educating kids on healthy coping skills, said Hilton High School Prevention Counselor Jillian Peer. “I have lists and lists of coping skills that are healthy and not dangerous. It takes time for students to find what might work. What works for me might not work for you. It’s a process that takes time.” Some coping techniques include exercises like deep breathing, journaling and other mindfulness activities.
HPDICE Programing & Initiatives
Michelle Polatas is now 26 and is doing well in long-term recovery. Today she and her mom speak to students about her story of substance abuse and incarceration. They’ve reached at least 8,000 students in Monroe, Ontario and Wayne county school districts.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
“I believe my purpose is to share our story. I get to work side by side with my daughter and we can share where we came from and where we are today, and hopefully it will save one life out there.” Other HPDICE-sponsored events and programs have included a talk for parents about the hazards of vaping. They also hosted a free training on the use of Narcan (an opiate antagonist used to revive a person suffering from an opioid overdose). Last prom season they created a raffle for students who signed a sobriety pledge. Two winning couples were driven to prom in classic cars and other students won smaller prizes. Polatas and the coalition partnered with the Hilton High School marketing class last school year. Students in the class created a comprehensive marketing plan for HPDICE which included the design and distribution of T-shirts to staff and students. Peer said that the bulk of the credit for the coalition’s success goes to Laurie Polatas. “I’m just so happy to be a part of it. HPDICE is an amazing group of people. I’m in awe of Laurie. I’m amazed at her energy and her effort,” said Peer. “She continues to persist and she is so positive and so motivated. It’s just a joy to work with her and honestly it’s an honor to be a part of her team.”
7
Questions to John Radford, MD, owner and founder of Buffalobased WellNow Urgent Care With recent acquisition and new sites, WellNow today has more than 30 facilities in NYS. Owner, who launched the business in 2012, plans to open 14 new locations this year alone, including some around Chicago By Payne Horning Tell us a little about your back1. ground in health care. I am an emergency room doctor
turned healthcare entrepreneur. In my almost 20 years as an entrepreneur, I have been driven to find ways to keep patients healthy and safe in a rapidly changing health care industry. Appropriately, the companies I’ve founded share a common commitment to offering quality care that is accessible, affordable and quick. I’ve always believed that patients come first. How did your experience in 2. the industry contribute to your decision to create a chain of urgent-care
facilities? In my time working in the emergency room, I worked closely with health systems, doctors and patients. This gave me a firsthand appreciation for the challenges faced by healthcare practitioners and patients. It’s an up-close experience, and you truly empathize with the emotional and financial complexities that patients face. I saw an opportunity to provide greater and convenient access to non-emergent care that put patients first. This inspired me to create Five Star Urgent Care, which today is WellNow Urgent Care. Since 2012, your company has 3. quickly expanded its presence in New York state – and continues to grow today. Was that expansion and large footprint always part of the plan? From our earliest beginnings, we have always been committed to serving communities where there is a need for greater access to quality
urgent care. Our growth is a reflection of the rapidly growing urgent care industry across New York state. It connects directly to how we provide our communities’ residents with greater access to quick and convenient medical care for non-life-threatening injuries and illnesses. Today, we have more than 30 locations and are one of New York’s fastest growing urgent care providers. We are very proud of that. WellNow Urgent Care is not currently located outside New York state but we do have plans to expand to the Illinois area with locations in Crestwood and Evergreen — both suburbs of Chicago — in 2019. In October, Five Star rebrand4. ed itself as WellNow. Why the change and what does it represent?
The name “WellNow” ties back to our company’s strong history of putting the needs of our patients first. We believe the new brand best aligns with our mission of providing high quality, quick and convenient urgent care. It also reinforces our focus on empowering every patient when it comes to managing their healthcare decisions about where, when and how they receive treatment. For us, the name is a true representation of our service and our standards of getting patients and their families back to being well. Now. How is WellNow addressing the 5. medical needs of Upstate New York?
The urgent care industry continues to grow, both in Upstate New York and across the country. As a
Physician John Radford during the opening of a WellNow Urgent Care in Vestal. Radford is the founder and owner of WellNow, which has more than 30 locations in New York, mostly Upstate. He’s planning 14 new facilities this year, including in the suburbs of Chicago. He started the business in 2012. Western New York native and longtime healthcare practitioner, I’ve seen it firsthand and saw the need for an urgent care network that can match this region’s growing demands for quality care. This is especially true for smaller communities where it’s common for care to be less accessible. We address this in a few ways. WellNow employs highly talented and experienced urgent care providers. We have more than 600 employees, which include 95 percent full-time staff. This allows us to truly get to know our business, so that we can deliver quality, convenient care with consistency. Our recent growth, which includes Western New York’s MASH Urgent Care joining our network, also means that we are able to serve an even greater number of communities — both in Upstate New York and across the state. What role does urgent care play 6. in the larger health care industry, and has it changed at all in recent years?
As the urgent care industry continues to grow, we are always looking for ways to stay ahead of our field by continually making ourselves available to patients. For example, demand for urgent care clinics is growing rapidly. Patients seeking medical care often don’t want to wait. By offering longer
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plans to open approximately 14 new locations in 2019 which will allow us to further deepen our connections across New York state, while also starting to expand into Illinois. Through it all, our commitment to putting patients first will never change. We deeply value the strong relationships with communities and individuals we serve. This passion is what brings us to work, every day.
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hours, walk-in service and the opportunity to check in online, urgent care centers can fulfill patients’ needs in a way that traditional doctors’ offices often cannot. Financial burden is another consideration. Urgent care centers can sometimes provide an alternative to emergency departments and facility fees. It’s a way to provide middle ground to care for non-emergent needs. We’re cognizant of all of these things — capacity, hours, convenience and more. We don’t take our status for granted and are always looking for new ways to stay connected with patients. Trust is earned, not to be expected.
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Page 17
Women’s Health
Dramatic Fall in Number of Births in the U.S. Local experts: Many factors are believed to cause shrinking birthrate, which is at the lowest level in 30 years By Deborah Jeanne Sergeant
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f it seems that people are having smaller families, you’re right. The Centers for Disease Control and Prevention recently reported that the rate of childbirth dropped for nearly every age group of reproductive-age U.S. women in 2017, reaching the lowest levels in 30 years. According to the U.S. Census, the U.S. birthrate in 2017 decreased to 60.2 births per 1,000 between the ages of 15 and 44, which represents a 3 percent drop from the birthrate in 2016. In 2017, the nation experienced 3.853 million births, approximately 92,000 less than the year before. What’s most concerning is that birth declines tend to happen during times of war or economic hardship, not when unemployment is down and the economy is improving such as in recent years. Since 1971, the nation isn’t producing enough children to replace those who have passed away, a trend also noted by the Census. Numerous factors contribute, both physical and societal. Physician Rosalind Hayes, affiliated with Rochester Fertility Care, said that fewer people are choosing to have babies at a young age, which means smaller families. Waiting to have a baby also shortens the time frame in which women are able to give birth. “I think there are issues related to
student debt, changing family ideas and trends to later marriage,” Hayes said. “People have a juggling act of finishing school, getting a job, paying off loans and finding the right person to have a child with.” Since the women’s rights movement, marrying and having children hasn’t been the expected and main option for women of childbearing years. Pursuing education and career are also options, but they tend to delay childbearing for those who do become mothers. Easier access to contraceptives and abortion, plus fewer teen pregnancies, also play a role in reducing births. For those who want to have children, Hayes said that maintaining overall health is vital to maximizing their chances of fertility, including a healthy weight, healthful diet, regular exercise and eschewing tobacco use and excessive alcohol. Taking those steps “goes a long way,” Hayes said. “A lot of things happening later in life are associated with lifestyle issues. Diabetes, high blood pressure, high cholesterol, obesity: all of those issues creep up as people get older if they’re not maintaining a healthy lifestyle. They all affect fertility.” She recommends seeking professional fertility help if conception isn’t achieved in six months for a couple if the woman is over 35, or a year for a couple if the woman is 35 and
younger. But “it’s never wrong to come in and talk about pre-conception planning,” Hayes said. “There’s a lot of testing to see if you carry any genetic risks.” Tennille Richards, board-certified clinical acupuncturist and owner of LIV Acupuncture, Pain & Fertility in Pittsford, blames infertility issues, in part, on the typically unhealthful American diet and on the use of oral contraceptives, which she said can cause long-term fertility issues after discontinued use. Richards also puts the blame ofinfertility on increasing consumption of soy. “The amount of soy added to the US diet since the 1990s is monstrous,” Richards said. “A lot of boys 23 and 24 today who are getting married were raised on soy-based formula.” She said that since soy raises estrogen levels, it can interfere with male reproduction. She also blames infertility on plastics and pesticides, which she calls “endocrine disrupters.” “They are in and around us everywhere have a corrosive, deleterious effect on a child’s development,” Richards said. “We have men with horrifically low sperm counts. Sometimes in a sample, we don’t see
one good sperm. Men should have good sperm well past 50. The fact that they don’t have one good sperm is ridiculous.” As for women, she said that using contraceptives that are only progesterone without estrogen causes women to become menopausal as far as their egg health goes. Once they discontinue contraceptives with the hopes of conceiving, “for some, the eggs don’t turn on again,” Richards said. “Unhealthy women, who are prone to thyroid issues and other metabolic issues, are at huge risk,” she added. “When they’re put on progesterone, their eggs shrink. Then they’re showing signs of polycystic ovary syndrome by age 25 or 30.” Polycystic ovary syndrome makes conceiving difficult. She urges women to quit using high progesterone oral contraceptives and the progesterone injections that last for up to a year in favor of oral contraceptives that also contain estrogen, unless risk factors prohibit it, such as family history of breast cancer. She also suggested eating organic to avoid any exposure to chemical sprays, which she said also contributes to infertility.
The recently issued report by the Centers for Disease Control and Prevention report also found:
• The rate of births to women ages 15 to 44, known as the general fertility rate, sank to a record low of about 60 per 1,000.
• Women in their early 40s were the only group with higher birth rates in 2017, up 2 percent from the year. The rate has been rising since the early 1980s. • The cesarean section rate rose by a tiny amount after having decreased four years. Studies have shown C-sections are more common in first-time births involving older moms. • Rates of preterm and low birth weight babies rose for the third straight year. • Birth rates for teens continued to nosedive, as they have since the early 1990s. In 2017, they dropped 7 percent from the year before. Providing health care navigation services• Rates for women giving birth in their 20s continued to fall and hit record lows. They fell 4 percent. for persons 55 and older. ■ Providing health■care Scheduling medical appointments. navigation services • Birth rates for women in their 30s fell slightly, dipping 2 percent for persons 55 and older. patients at appointments. for women ages 30 to 34 and 1 percent for women 35 to 39. Birth rates ■ Meeting for women in their 30s had been rising steadily to the highest levels in at ■ Scheduling medical appointments. ■ Health education. least half a century, and women in their early 30s recently became the age ■ Meeting ■ Providing health care navigation services patients at appointments. group that has the most babies. ■ Health education. for persons 55 and older. Call 585-244-8400, The U.S. once was among a handful of developed countries with a ext. 216 to learn more. ■ Scheduling medical appointments. fertility rate that ensured each generation had enough children to replace ■ Providing health care navigation services ■ Meeting patients at appointments. The rate We cannotCall assist585-244-8400, residents of nursing homes andit.assisted living.in the U.S. now stands less than the standard benchmark for for persons 55 and older. ext. 216 to learn more. replacement. It’s still above countries such as Spain, Greece, Japan and ■ Health education. Italy, but the gap appears to be closing. ■ Scheduling medical appointments. We cannot assist residents of nursing homes and assisted living. Supported by A decade ago, the estimated rate was 2.1 kids per U.S. woman. In Call 585-244-8400, ■ Meeting patients at appointments. 2017, it fell below 1.8, hitting its lowest level since 1978. ext. 216 to learn more. Supported by ■ Health education. We cannot assist residents of nursing homes and assisted living. Information based on reports published in USA Today. ■
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019 Supported by
Call 585-244-8400, ext. 216 to learn more.
Women’s Health
Good Night, Sleep Tight: Helping Baby Sleep Better By Deborah Jeanne Sergeant
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ew parents realize that their new baby’s needs will likely curtail their own sleep at night for the weeks and months ahead. Babies’ small stomachs cannot hold enough to last all night. Along with those nighttime feedings, they will require changes as well — they may also simply wake up and need soothing to get back to sleep. Parents can do quite a bit to lengthen the time that a baby sleeps, starting at about three months. Missy Yandow, owner of My Goodnight Train in Rochester, calls the first few months after birth the “fourth trimester” because for one, babies’ sleep cycle hasn’t adjusted to the common circadian rhythm of sleeping at night and remaining awake during the day. During this time, most babies just eat and sleep with little recognition of when it’s bedtime. Yandow said by the end of the fourth month, babies begin to consolidate sleep, meaning they sleep for longer time periods and start to nap more regularly
during the day. “Stop swaddling around eight weeks,” Yandow said. “Then, use a sleep sack to keep them warm.” The cozy nightwear features arms and a neck opening, but is basically a zippered gown that opens at the bottom hemline for changes. Yandow also said that a conducive sleep environment can also help establish good sleep habits. Keep the room dark, at the optimal temperature and quiet. She added that it’s important to establish and maintain the same bedtime routine, such as a bath, feeding, burping and time to cuddle in a rocking chair. Putting babies down immediately after feeding can cause discomfort. They need a little time to digest. “The same routine triggers production of sleep hormones,” Yandow said. “Place the baby down to sleep drowsy, but still awake.” Since babies may awaken for a feeding or soothing, learn to tell the difference. Babies who are rooting — making sucking movements, turning
their head to the side, sucking on their fist — need to feed. “I recommend parents to discuss with their pediatrician or lactation consultant,” Yandow said. Sometimes, a brief check-in is all baby needs. Adriana Lozada, sleep educator and owner of Birthful in Rochester, wants parents to learn about their babies’ personality and rhythm right from the start. Some are just fussier than others. Some become over-stimulated more than others. “Tune into the personality of your child,” Lozada said. “That can help when they’re around 3 to 6 months. Before that, it’s all instinct. Any effort to create schedules or restrict things will backfire.” For instance, a young baby will need more naps and as naps phase out, the timing of the naps will change, too — and that’s developmentally expected, according to Lozada. “Understanding that, you bring all the pieces together of your baby’s temperament, average sleep needs
for that age, pattern and rhythm and how much help they need,” Lozada said. “You can bring a loose structure so you have an idea of what’s up and baby has some consistency that respects their individuality.” While your best friends’ baby may sleep six hours at a time by 3 months (lucky them!), yours isn’t abnormal for waking. Neither baby is “right” but simply different. What you do to soothe the baby makes a difference, as they have preferences, such as rocking, shushing sounds, white noise machines, pacifiers and swaddling; however, teaching self-soothing at around 4 months can help you get more sleep. Laying babies down while yet drowsy helps them learn they don’t have to have you help them transition into sleep. “A good night’s sleep starts in the morning,” Lozada said. “Strengthening the circadian rhythm starts in the morning.” She recommends exposing babies to light at their normal waking time to send signals to their bodies that it’s time to stop sleeping. When it’s time for the night routine, dim the lights and eliminate them until morning. “The biggest thing to focus on isn’t trying to get the baby to sleep longer at night, but keep them awake longer during the day,” said Dr. Heidi Connolly, chief of Pediatric Sleep Medicine Services at University of Rochester Medical Center. She said that newborns nap about three times a day, a few hours after they wake up, afternoon, and in the early evening. If possible, eliminating the early evening nap can help. “Newborns need to eat in the middle of the night, but after a few months old, they don’t really need to nurse in the night,” Connolly said. “Feeding them then encourages them to wake up and feed.” Above all, ensure babies need to sleep safely. The American Academy of Pediatrics states that babies should sleep on their backs, alone, and in a crib with immobile sides containing nothing but a firm mattress and a fitted crib sheet. Babies do not need pillows, crib bumpers, blankets, stuffed animals, bottles or anything else in their cribs. Placing cribs near parents can keep babies safe, yet close by for feedings and comfort.
Are Some Birth Control Methods Doomed to Fail?
W
omen who get pregnant when using certain contraceptives might have their genes to blame, a new study suggests. A gene variant that breaks down hormones in birth control could be the culprit, researchers reported. “When a woman says she got pregnant while on birth control, the assumption was always that it was somehow her fault,” said lead study author, physician Aaron Lazorwitz. “But these findings show that we should listen to our patients and consider if there is something in their genes that caused this.” According to Lazorwitz, an assistant professor of obstetrics and
gynecology at the University of Colorado School of Medicine, “The findings mark the first time a genetic variant has been associated with birth control.” Contraceptives are not 100 percent effective, but the reasons they fail are not fully understood. The new study included 350 healthy women, half older than 22. All had a contraceptive implant in place for between 12 and 36 months. Five percent of the women had a gene called CYP3A7 1C, which is usually active in fetuses and then switched off before birth. But some women with this gene continue to make the CYP3A7 enzyme into adulthood, the study authors noted.
April 2019 •
“That enzyme breaks down the hormones in birth control and may put women at a higher risk of preg-
nancy while using contraceptives, especially lower-dose methods,” Lazorwitz said in a university news release. The gene variant can be found through genetic screening, he added. Pharmacogenomics is a relatively new field that focuses on how genes affect a person’s response to drugs. The study shows how this field could dramatically change women’s health, “especially in light of the social, financial and emotional consequences of contraceptive failure,” the researchers noted. The report was published March 12 in the journal Obstetrics & Gynecology.
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Women’s Health
Cancer survivor Terry Werth, 71, in front of the Erie Canal. She has recently published “Goodnight Spencerport,” a children’s book set in the west side village of Spencerport.
‘Werth’ While Endeavor Cancer survivor, author Terry Werth of Spencerport inspired through her writing By Christine Green
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erry Werth, 71, of Spencerport, fought hard against the stage three triple negative breast cancer she was diagnosed with in 2009. But in 2011 when the physical battle she endured was over, she knew that the deep emotional scars her illness left behind were only just beginning to heal. Werth retired in 2004 from her position as public information specialist at West Irondequoit Central School District. She went on to volunteer at Journey Home in Greece as well as volunteer as a Reach Out Radio reader at WXXI. Unfortunately, her volunteering efforts had to be put on hold when she got her diagnosis. Her struggle with breast cancer was a life-changing experience, and the best way she could cope with the stress of it all was to write about it. Those early poems, essays and letters were a balm to her on the days she felt very alone even amidst the kindness and love of those closest to her. “At the end of the day, it is just you and your pillow; you feel very alone,” said Werth. “It’s like nobody really knows what’s in your head and in your heart and how scared you are and how much of an uphill climb it is not to give into the fear and depression and the anxiety.” After the treatments, her life as a survivor began and she felt like a different person. “Survivorship changes you,” she said. “It’s like background music — it’s never in that sharp focus in front of your face like it was in the beginning, but it is never really gone Page 20
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either.” So she kept writing and processing and soon the essays, the poems, and the letters were numerous enough to compile into a book. In 2011, Werth published “Pink on Pink: Writing My Way Through Breast Cancer” (Creative Energies 2011).
Forever changed
In 2013, Elizabeth Haskins of Wilmington, Ohio, set one of the poems in Werth’s book to music. Haskins, a retired assistant college professor emeritus at Wilmington College, chose the poem, “I Am Forever Changed.” “It just spoke to me,” recalled Haskins. She expressed the truth so beautifully.” Muse Cincinnati Women’s Choir performed the song that year under the direction of Catherine Roma, also of Wilmington College. The chamber choir, Madrigalia, performed the song again in March of 2018 in Rochester during the “Singing our Losses, Singing Our Strength” concert. Hearing both choirs sing the song was extremely moving for Werth, and she noted that it was a distinct honor that these two wellknown choirs performed it. “It was one of the most thrilling things for me, to hear my words sung by the Cincinnati Women’s Choir. They’re world class, and I think Rochester Madrigalia is also world class,” she noted. Werth’s writing efforts continued, and in 2017 she published “Goodnight Spencerport” (Werth 2017) a children’s book set in the
west side village of Spencerport. Because she knew the village and its landmarks so well, the text came quickly to her. What took a little more time and research was the compilation of the extensive glossary in the back of the book. The glossary consists of four pages of detailed historic information about the places shown in the story, including instructions on how to do further research online. The final piece to the puzzle was the addition of colorful photos of the village. After seeing a striking photo of a full moon over the canal in Spencerport, she sought out the photographer. It turned out that educator and photographer Joe Pompili not only lived in the village, but he lived just down the street from Werth. Werth was excited to collaborate with Pompili, who took more than 300 photos for the project. “He had the same love of the community that I did. I felt like it was a great match,” she said.
Sense of history
Phyllis Leathersich of Spencerport was thrilled when Werth released “Goodnight Spencerport.” She purchased a copy for each one of her seven children, “because they all have children and I thought it would be a nice way for them to teach their kids about where they came from. I was really excited about that.” In 2018, Werth read a news story about another Spencerport woman, Maria Delgado Sutton, who was putting together care packages for residents of Puerto Rico affected by Hurricane Maria.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
Werth was eager to help Delgado with the “One Box At a Time” project and donated copies of her books for the care packages. But her assistance didn’t end there. Werth helped Delgado organize a fundraiser at their local library. The event raised enough funds to send 64 boxes directly to residents in Puerto Rico. Werth also accompanied Delgado on a trip there last December. Delgado was impressed with Werth’s determination and willingness to give of herself. “Terry knew that this was not going to be a pleasure trip to Puerto Rico, we would have to foot the bill for our plane fare, baggage, and expenses. This trip was made with a mission in mind,” Delgado said. “We were able to pack four suitcases full of food and school supplies. It was her idea to reach out to Jet Blue Airlines to request a waiver for our suitcases, which they granted,” she added. “Terry is always busy doing ‘something’ and always for the benefit of others. Terry is so thoughtful; she is genuine in wanting to know what others’ concerns are and does her ultimate best to help them. She has a big heart and gives from her soul.” Werth is also a certified funeral celebrant and ordained wedding officiant. She says officiant work is very creative and refers to it as “just another fulfillment of my original dreams.” When asked what project she plans to tackle next, she said that she is working on the “Village Gateway Project” in Spencerport. Project organizers are seeking to remove two deteriorating CSX railroad abutments in the village. “It’s an effort to aesthetically balance the entry from the south end of the business district with all the improvements made over the years on the north end,” she said. She continues to write and hopes to publish more work soon. To learn about Werth and her books, visit goodnightspencerport.com and teresawerth.com.
Women’s Health
Hot Flashes 101
What are hot flashes?
The most common menopause-related discomfort is the hot flash . Although the exact cause still isn’t fully understood, hot flashes are thought to be the result of changes in the hypothalamus, the part of the brain that regulates the body’s temperature. If the hypothalamus mistakenly senses that a woman is too warm, it starts a chain of events to cool her down. Blood vessels near the surface of the skin begin to enlarge, increasing blood flow to the surface in an attempt to dissipate body heat. This produces a red, flushed look to the face and neck in light-skinned women. It may also make a woman perspire to cool the body down. The heart may beat faster, and women may sense that rapid heartbeat. A cold chill often follows a hot flash. A few women experience only the chill.
How long will I have hot flashes?
Most women experience hot flashes for six months to two years, although some reports suggest that
betes and cancer all rise after menopause. Most women visit their primary care doctor or gynecologist once a year for a “well-woman visit,” which insurance now covers with no copay. Even height, weight, and blood pressure checks at your visit reveal a lot about your health risks, and you and your healthcare team can discuss other tests you might need, such as cholesterol measurements, PAP tests, and mammograms. Physical inactivity, obesity, and unhealthy eating, smoking, and excessive alcohol consumption increase the risk of heart disease, stroke, diabetes, and cancer. The evidence continues to grow that getting active, losing excess weight, and healthy habits can reduce these risks.
What are the treatments for hot flashes?
they last considerably longer — as long as 10 years, depending on when they began. For a small proportion of women, they may never go away. It is not uncommon for women to experience a recurrence of hot flashes more than 10 years after menopause, even into their 70s or beyond. There is no reliable way of predicting when they will start — or stop.
I’m having a hot flash. Should I be concerned about what lies ahead?
Menopause is a fact of life for every woman around the world. However, the physical and mental impact of this physiologic inevitability varies both within and across all cultures. While there is no universal menopause experience, it can mark the beginning of an exciting new time of life for all women.
As I mature past menopause, how can I achieve the best possible health?
Get the checkups you need and maintain a healthy lifestyle. The risks of osteoporosis, heart disease, dia-
Although the available treatments for hot flashes do not cure hot flashes, they do offer relief. Hot flashes usually fade away eventually without treatment, and no treatment is necessary unless hot flashes are bothersome. A few women have an occasional hot flash forever. There are a number of low-risk coping strategies and lifestyle changes that may be helpful for managing hot flashes, but if hot flashes remain very disruptive, prescription therapy may be considered. Prescription hormone therapy approved by the US Food and Drug Administration include systemic estrogen therapy and estrogen-progestogen therapy (EPT; for women with a uterus) — are the standard treatment. Another FDA-approved hormone product, for women with a uterus, combines estrogen with bazedoxifene instead of a progestogen. Bazedoxifene is an estrogen agonist/ antagonist, which means that it works like estrogen in some tissues while inhibiting estrogen activity in others. In this case, it helps to protect the uterus from cancer. For women who prefer not to take hormones or cannot hormones, nonhormone drugs approved to treat
depression, called selective serotonin-reuptake inhibitors (SSRIs), have been found to be effective in treating hot flashes in women who don’t have depression. The only SSRI FDA has approved thus far for treating hot flashes is paroxetine 7.5 mg.
Source: The North American Menopause Society.
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Medication Drop Box Locations: Bristol: Town Hall
Farmington: State Troopers
Canandaigua: FLCC (Keuka Wing) The Medicine Shoppe Ontario County DMV Office Canandaigua Police Dept. Thompson Hospital (lobby) Mental Health Clinic
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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How to Save Money on Your Medication By Jim Miller
T
he rising cost of prescription drugs is a problem that stings millions of Americans. While there’s no one solution, there are some different strategies and resources that can help reduce your drug costs, so you can afford what you need. Here are several to consider. • If you have insurance, know your drug formulary: Most drug plans today have formularies (a list of medications they cover) that place drugs into different “tiers.” Drugs in each tier have a different cost. A drug in a lower tier will generally cost you less than a drug in a higher tier, and higher tier drugs may require you to get permission or try another medication first before you can use it. To get a copy of your plan’s formulary, visit your drug plan’s website or call the 800 number on the back of your insurance card. Once you have this information, share it with your doctor so, if possible, he or she can prescribe you medications in the lower-cost tiers. Or, they can help you get coverage approval from your insurer if you need a more expensive drug. You also need to find out if your
drug plan offers preferred pharmacies or offers a mail-order service. Buying your meds from these sources can save you some money too. • Talk to your doctor: Ask your doctor if any of the medications you’re currently taking can be reduced or stopped. And, find out if the ones you are taking are available in generic form. About 80 percent of all premium drugs on the market today have a lower-cost alternative. Switching could save you between 20 and 90 percent. • Ask for a three-month prescription: This can be significantly cheaper for drugs you take long-term. If you use insurance, you’ll pay one co-pay rather than three. • Split your pills: Ask your doctor if the pills you’re taking can be cut in half. Pill splitting allows you to get two months’ worth of medicine for the price of one. If you do this, you’ll need to get a prescription from your doctor for twice the dosage you need. • Find and use online discounts: Start by trying GoodRx.com, BlinkHealth.com or WeRx.org. They will ask for the name of the drug,
Everyone wants to live longer. But nobody wants to get old. So tell me, how does that work? At St. Ann’s Community, we believe that the key to staying young is feeling young. That’s why we provide a full range of senior services designed to keep you healthy, active and enjoying all that life has to offer – no matter what your birth certificate says.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
the dose, the number of pills, and where you live. Then they will show you what you can expect to pay at various pharmacies if you use their discount coupons or vouchers, which you can print out or download to your phone to show a pharmacist. • Pay cash: Most generic medications cost less if you don’t use your insurance. For example, chains like Target and Walmart offer discount-drug programs that sell generics for as little as $4 for a 30-day supply and $10 for a 90-day supply if you pay out-of-pocket. While some insurance companies charge a $10 copay for a 30-day supply. Also ask your pharmacy if they offer a drug discount card program and compare costs with your insurance plan. You can also find free drug discount cards online at sites like NeedyMeds.org, which can be used at most U.S. pharmacies. • Shop online: You can also save by using an online pharmacy like HealthWarehouse.com but be sure to use an online retailer that operates within the U.S. and is licensed. The site should display the VIPPS symbol, which shows it’s a Verified Internet Pharmacy Practice Site. • Search for drug assistance programs: If your income is limited, you can probably get help through drug assistance programs offered through pharmaceutical companies, government agencies and charitable organizations. To find these types of programs use sites like BenefitsCheckUp.org, PatientAdvocate.org, RxAssist.org and NeedyMeds.org.
Laser Gum Treatment in Rochester, NY What is laser gum treatment or LANAP?
Laser Treatment is an advanced technique for your doctor to treat periodontal (gum) disease and save many teeth that were previously considered hopeless. A laser light is used to gently remove harmful bacteria and diseased tissue from the gum pocket.
By Jim Miller
Does Medicare Covers Vision Services? Dear Savvy Senior, I will be enrolling in Medicare in a few months, and would like to know how Medicare covers vision services? I currently have vision insurance through my employer but will lose it when I retire.
Looking Ahead Dear Looking, Many people approaching 65 are unclear on what Medicare does and doesn’t cover when it comes to vision services. The good news is that original Medicare covers most medical issues like cataract surgery, treatment of eye diseases and medical emergencies. But unfortunately, routine care like eye exams and eyeglasses are the beneficiary’s responsibility. Here’s a breakdown of what is and isn’t covered. • Eye exams and treatments: Medicare does not cover routine eye exams that test for eyeglasses or contact lenses. But they do cover yearly medical eye exams if you have diabetes or are at high risk for glaucoma. They will also pay for exams to test and treat medical eye diseases if you’re having vision problems that indicate a serious eye problem like macular degeneration, dry eye syndrome, glaucoma, eye infections or if you get something in your eye. • Eye surgeries: Medicare will cover most eye surgeries that help repair the eye function, including cataract surgery to remove cataracts and insert standard intraocular lenses to replace your own. Medicare will not, however, pick up the extra cost if you choose a specialized lens that restores full range of vision, thereby reducing your need for glasses after cataract surgery. The extra cost for a specialized lens can run up to $2,500 per eye. Eye surgeries that are usually not covered by Medicare include refractive (LASIK) surgery and cosmetic eye surgery that are not considered medically necessary. • Eyeglasses and contact lenses: Medicare does not pay for eyeglasses or contact lenses, with one exception: If you have had a conventional intraocular lens inserted during cataract surgery, Medicare will pay for eyeglasses or contact lenses following the operation. Ways to Save Although original Medicare’s vision coverage is limited to medical issues, there are ways you can save on routine care. Here are several to
check into. • Consider a Medicare Advantage plan: One way you can get extra vision coverage when you join Medicare is to choose a Medicare Advantage plan instead of original Medicare. Many of these plans, which are sold through private insurance companies, will cover routine eye care and eyeglasses along with all of your hospital and medical insurance, and prescription drugs. See Medicare.gov/find-a-plan to shop for plans. • Purchase vision insurance: If you get routine eye exams and purchase new eyeglasses annually, a vision insurance plan may be worth the costs. These policies typically run between $12 and $20 per month. See Ehealthinsurance.com to look for plans. • Check veterans benefits: If you’re a veteran and qualify for VA health care benefits, you may be able to get some or all of your routine vision care through VA. Go to Vets. gov, and search for “vision care” to learn more. • Shop around: Many retailers provide discounts — between 10 and 30 percent — on eye exams and eyeglasses if you belong to a membership group like AARP or AAA. You can also save by shopping at discount retailers like Costco Optical, which is recommended by Consumer Reports as the best discount store for good eyewear and low prices — it requires a $60 membership fee. Walmart Vision Centers also offer low prices with no membership. Or consider buying your glasses online. Online retailers like WarbyParker.com, ZenniOptical. com, and EyeBuyDirect.com all get top marks from the Better Business Bureau and offer huge savings. To purchase glasses online you’ll need a prescription. • Look for assistance: There are also health centers and local clinics that provide free or discounted vision exams and eyeglasses to those in need. To find them put a call into your local Lions Club (see Directory. LionsClubs.org) for referrals. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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A. Perio probe indicates excessive pocket depth. B. Laser light removes bacteria and diseased tissue. C. Ultrasonic scaler and special hand instruments are used to remove root surface tarter. D. Laser finishes cleaning pocket and aids in sealing the pocket closed so new germs cannot enter. E. Healing of gums to cleaned root surface occurs. F. Bite trauma is adjusted. G. Healing occurs.
A. Perio probe indicates excessive pocket depth. B. Laser radiation vaporizes bacteria, diseased tissue, pathological proteins and alerts the practitioner to the presence of tartar. C. Ultrasonic scaler and special hand instruments used to remove root surface accretions. D. Laser finishes debriding pocket and aids in coagulation. E. Healing of gums to clean root surface occurs. F. Light trauma is adjusted. G. Healing occurs.
All these people have gum pockets 5mm or greater, and the higher classes of gum disease correspond to deeper gum pockets and more loss of bone support to the teeth. All classes of gum disease greater than Class I are candidates for Laser Gum Treatment.
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Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. April 2019 •
Learn more at hoacny.com/Cyberknife CyberKnife treats tumors in the brain, spine, lung, liver, prostate and more. IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Ask St. Ann’s
Ask The Social
Why Is Transitional Care Essential After a Cardiac Event?
Security Office
From the Social Security District Office
By Sharon Osborne
A
chieving the best possible outcome after a heart attack or other cardiac event takes time and expert care. Upon discharge from the hospital, a short stay at a transitional care center is the best way to regain the strength and independence you need to return home safely. After a cardiac event or surgery, daily activities that were once second nature are more challenging — and potentially dangerous — when you take on too much, too soon. The rehabilitation specialists at the Transitional Care Center at St. Ann’s Community recommend that you receive education and interventions modified to your needs, to conquer these challenges: • Energy conservation: With a limited amount of energy at your disposal, learning how to use your strength wisely and pace yourself is essential. Sitting on a chair in the shower keeps you from feeling depleted by the heat and steam. After getting dressed, do some breathing exercises or take a two-minute break to recover before going on to the next task. • Activity tolerance: A series of exercises and endurance training can help you increase your standing tolerance so you can do simple things like shaving and brushing your teeth. • Breathing: Instead of allowing a painful sternal incision to impair your breathing, holding a pillow to your chest can make taking deep breaths easier and deliver enough oxygen throughout your body. • Adaptive equipment: Avoid overexerting yourself with the help of adaptive equipment that eliminates the need for you to bend down, reach overhead or walk without assistance while doing daily activities. Examples include using a sock aid for dressing and a wheeled walker for stability and support. Your occupational therapist will recommend equipment based on your condition and help you learn how to use it properly.
Choosing the best place for your needs. Rochester is fortunate to have several transitional care centers, so it’s essential to find the one that will give you the highest likelihood of returning to your prior living situation. Look for: • Interdisciplinary teams of medical, nursing, therapeutic, dietary and social work professionals to manage patient care after cardiac or other health events, including after discharge to home to ensure your safety • Admissions seven days a week • Rehab six days a week for the quickest possible recovery • The latest technology to help you get more out of rehab, faster • Be sure to ask about patient outcomes, too. • Where you go for rehabilitation is up to you. Where you go for rehabilitation is up to you. Having a cardiac event is a wakeup call. A successful rehabilitation experience helps you learn new ways to care for yourself and regain your independence so you can get home as soon as possible. So be sure to include a transitional care stay in your recovery plan.
Sharon Osborne – is executive director of Transitional Care Center and Rehabilitation Services at St. Ann’s Community, a senior community offering a full continuum of care in Rochester. Email her at sosborne@ MyStAnns.com, call 585-697-6483 or visit www.stannscommunity.com.
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How Social Security Decides If You Still Have a Qualifying Disability
S
ocial Security is required by law to review, from time to time, the current medical condition of all people receiving disability benefits to make sure they continue to have a qualifying disability. Generally, if a person’s health hasn’t improved, or if their disability still keeps them from working, they will continue to receive their benefits. These continuing disability reviews help us ensure that only eligible people receive disability benefits. It supports the integrity of the Social Security system while delivering fair services to wounded warriors, chronically ill children and adults and other people with disabilities. To help us make our decision, Social Security first gathers new information about an individual’s medical condition. We’ll ask their doctors, hospitals and other medical sources for their medical records. We’ll ask them how their medical condition
Q&A Q: I usually get my benefit payment on the third of the month. But what if the third falls on a Saturday, Sunday, or holiday? Will my payment be late? A: Just the opposite. Your payment should arrive early. For example, if you usually get your payment on the third of a month, but it falls on a Saturday, we will make payments on the Friday prior to the due date. Find more information about the payment schedule for 2019 at www. socialsecurity.gov/pubs/calendar. htm. Any time you don’t receive a payment, be sure to wait three days before calling to report it missing. To ensure that your benefits are going to the right place, create a my Social Security account. There, you can verify and manage your benefits without visiting your local office. Please visit www.socialsecurity.gov/myaccount to create your account. Q: I suspect that someone I know is collecting Social Security disability benefits when they shouldn’t be. What is the best way for me to report fraud? A: You can report fraud online at www.oig.ssa.gov/report or call the Social Security Fraud Hotline at 1-800-269-0271. Social Security has zero tolerance for fraud and uses many proven tactics to prevent fraud, waste and abuse. Our Office of the Inspector General is relentless in its
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • April 2019
limits their activities, what their medical tests show and what medical treatments they’ve been given. If we need more information, we’ll ask them to get a special examination or test, for which we’ll pay. If we decide their disability benefits will stop, and they disagree, they can appeal our decision. That means they can ask us to look at their case again. When they get a letter telling them about our decision, the letter will tell them how to appeal the decision. You can read more about how we decide if you still have a qualifying disability at www.socialsecurity.gov/ pubs/EN-05-10053.pdf. People can check the status of their disability application with a personal my Social Security account at www.socialsecurity.gov/myaccount. This secure account gives people access to many tools that can save them time. Find out how Social Security is securing today and tomorrow at www.socialsecurity.gov.
pursuit of people who conceal work activity while receiving disability benefits. We investigate and seek prosecution for people who receive benefits for a child or children who aren’t under their care, or who fail to notify Social Security of the death of a beneficiary and continue to receive and cash checks of the deceased. We also depend on you to help stop fraud. Q: I own a small business. How can I verify employees’ Social Security numbers? A: Employers can use our Social Security Number Verification Service to verify the names and Social Security numbers of current and former employees for wage reporting purposes. For more information, go to www.socialsecurity.gov/employer/ssnv.htm. Q: What is the earliest age I can begin receiving Social Security retirement benefits? A: The earliest age you can begin receiving Social Security retirement benefits is age 62. If you decide to receive benefits before your full retirement age, which for most people is age 66 or 67, you will receive a reduced benefit. Keep in mind you will not be able to receive Medicare coverage until age 65, even if you decide to retire at an earlier age. For more information, go to www. socialsecurity.gov/retire.
H ealth News St. Ann’s, Catholic schools to offer tuition assistance St. Ann’s Community will partner with the Diocese of Rochester Catholic Schools to offer family tuition assistance to nursing employees. The four-year pilot program offers significant tuition reimbursement for children of St. Ann’s nursing employees to attend any one of the Catholic schools in the Rochester Diocese. The program is open to any full or part-time benefit-earning licensed practical nurses (LPN) and registered nurses (RN) at St. Ann’s Community’s Irondequoit and Webster locations. St. Ann’s also welcomes new RNs or LPNs to participate in the program. St. Ann’s will provide up to $5,000 of tuition assistance per household. The benefit provides eligible employees up to $3,000 (for elementary and middle school level) or up to $5,000 (for high school level) of tuition assistance. “This new benefit is part of our ongoing effort to attract and retain top nursing talent,” said Bob Bourg, senior vice president of human resources. “We wanted to do something meaningful that could positively contribute to our nursing employees’ lives and their families.” “We know how difficult it can be to send children to private school,” said Michael McRae, President and CEO of St. Ann’s Community. “As an organization founded in the Catholic tradition of excellence, we believe strongly in the value of a Catholic education. If we can help support our nursing employees and defray some of those costs for their families, we see it as a win-win.” St. Ann’s Community has a rich history of investing in their workforce through programs such as college tuition reimbursement, awarding scholarships and giving of grants.
Friendly Senior Living director gets award Vanessa Brookes, director of quality for Friendly Senior Living, has been recognized by McKnight’s as a Women of Distinction award winner in the rising stars category. This national recognition honors women who have demonstrated Brookes an exceptional commitment to the senior care industry. 2019 is the inaugural year of the women of distinction awards program, created to recognize executive-level women at senior living communities. Of the hundreds of nominations received, Brookes was one of only approximately 20 women
nationwide chosen as a rising stars winner, and the only award recipient from New York state in this category. The rising stars category specifically recognizes women aged 40 or younger, or with less than 15 years of experience in the profession. Recipients will be honored at a special event in Chicago in May. Brookes’ commitment to aging services began in her teens, when she volunteered at a local assisted living residence for people with dementia. Her interest in serving those with Alzheimer’s disease and related conditions grew through continued volunteerism and internships at regional Alzheimer’s Association chapters and other aging services agencies. Brookes’ career accomplishments include professional research and presentations focused on aging issues; innovative approaches to process improvements; and being selected into the fellowship programs of the Connecticut LeadingAge Leadership Academy. Brookes currently resides in Greece. “We are very proud of Vanessa and grateful for her commitment and service to our organization. Those we serve greatly benefit from Vanessa’s dedication to addressing the needs of older adults, particularly those living with Alzheimer’s disease,” said Glen Cooper, president and CEO of Friendly Senior Living.
MVP Health has new senior leader for health initiatives Mary Hardy has joined MVP Health Care as senior leader for strategic health initiatives. Hardy comes to MVP Health Care with extensive leadership experience in the health care industry, including more than 20 years in leadership roles at GE Health and positions at several analytics start-ups, such as Philips Healthcare and the Alliance for Better Health, where she worked on predictive modeling in the health care space. In her new role, Hardy will lead MVP Health Care’s new approach on integrated health, taking a member-centric approach to health care by including both medical and behavioral health to ensure health care includes the well-being of the whole person. She is passionate about the role integrated health will have on improving members’ quality of life and the role data and analytics will have on recognizing possible crises and preventing them by determining what kind of help members
may need and reaching out to them proactively. With a business engineering degree, Hardy has been analyzing data and interpreting that data to create solutions from the start of her career. She received a bachelor’s degree in electrical and computer engineering from Clarkson College of Technology.
Highland Women’s Health practice opens new location Highland Hospital has opened a new Highland Women’s Health practice, located at 800 Ayrault Road inside the Perinton Medical Center. An open house celebration was held March 13. Providers at the new location include physicians Carole Peterson and Kara Repich and nurse practitioner Theresa Seguin. The new office features a more spacious and modern environment as well as free parking. Officials at the hospital say that with multiple locations across Rochester, Highland Women’s Health makes it easy for patients to get check-ups and preventive screenings, manage birth control, and receive expert prenatal care. All locations offer comprehensive obstetrical care for low-risk and high-risk pregnancies. They also provide comprehensive gynecological services, from annual exams and family planning to the treatment of menstrual, pelvic organ, and pelvic floor disorders to menopause management.
Expanded adult day program opens in Irondequoit St. Ann’s Community has opened a new adult day program at Durand Senior Apartments. The program provides quality care with both social and medical services for older adults and people with disabilities. This program is the first of its kind in the greater Rochester area that offers both social and medical support in one convenient location. Located at the new Durand Senior Apartments at 4250 Culver Road near Seabreeze, the program is now open to the greater Rochester community. Supported by a grant from the Greater Rochester Health Foundation, the new program and location doubles the number of participants served previously, allowing St. Ann’s to meet the needs of the growing
senior population in Monroe County. St. Ann’s adult day programs are ideal for adults who need medical services or skilled nursing care, have a chronic illness or memory problems, are socially isolated or depressed or have decreased mobility and need rehabilitation support. “We know there is a growing need in our community to serve older adults that want to remain living at home but may need assistance with medications or desire more social activities,” said Michael McRae, president and CEO of St. Ann’s Community. “Adult day programs also offer a much-needed respite for caregivers while providing a safe, supervised, social environment for loved ones during the hours when it is needed most.” For more information on the adult day program at Durand Senior Apartments, contact Rola O’Meally at 585-697-6365 or email romeally@ mystanns.com.
Highland offers new treatment for sleep apnea Highland Hospital is now the first hospital in the Rochester region to offer an implantable device called a hypoglossal nerve stimulator (Inspire) as a treatment for patients who suffer from moderate to severe obstructive sleep apnea. Inspire is an FDA-approved, surgically implanted device that stimulates a nerve in the tongue while patients sleep. This moves the tongue out of the way and helps keep the airway open so they can breathe more easily; the stimulation of the tongue is timed to the patient’s breathing. The implantation procedure is done under general anesthesia and involves three small incisions to place the device. The procedure takes between two and three hours and most patients spend just one night in the hospital after surgery. “Selective upper airway stimulation, or ‘Inspire,’ is different from other procedures for obstructive sleep apnea because it can improve the tone of airway muscles during sleep,” said physician Sveta Karelsky, chief of otolaryngology head and neck surgery at Highland Hospital and associate professor of clinical otolaryngology at the University of Rochester Medical Center, who performs the procedure. “Because of this, patients who are good candidates for Inspire typically have very good outcomes when it comes to treatment for their obstructive sleep apnea.”
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