Central New York In Good Health

in good 14 Gifts NOT to Give This Holiday PLUS: Gifts that will get your kids to exercise and thoughtful gifts for those who live alone

Stay Flu, Cold Free

Experts share some simple steps that will help you keep the flu (or cold) away

Gingerbread Gallery Local seniors have helped put together this year’s Gingerbread Gallery on display at Erie Canal Museum in Syracuse

Dr. Eva Briggs: Five Common Reasons Your Doctor May Misdiagnose You

December 2011 • Issue 144

FREE FREE

DRUG SHORTAGE

CNY’s Healthcare Newspaper

Problem is not related to Third World countries. It’s affecting pharmacies and patients right here in CNY. Page 21

Health Advice Multifaceted on theAirwaves Doctor

The radio show HealthLink On Air, which airs from 9–10 a.m. on Sundays at WSYR, is in its sixth year and it’s reaching up to 6,000 households per week. It’s consistently been the No. 2 rated program based on listenership in the Syracuse metropolitan area. The program, produced by SUNY Upstate, has an infinite wealth of knowledge to draw from institutionally — physicians, specialists, professors and researchers. “We consider what’s topical, what’s timely,” said Executive Producer Melanie Rich. “There is always a rhyme and a reason for the guests we invite.” Page 7 December 2011 •

G. Randall Green is a man who wears many hats. The cardiothoracic surgeon at St. Joseph’s Hospital Health Center in Syracuse is also a business owner (he is the founder of two medical device companies in New Jersey and Massachusetts) and a lawyer. Page 11

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 1

WHEN YOUR HEART IS ON THE LINE, GETTING HELP FAST CAN MAKE ALL THE DIFFERENCE. Chest pain isn’t the only sign of a heart attack.

Shortness of breath; back, arm or jaw discomfort; severe nausea; or heavy sweating also may indicate a problem. As the first Accredited Chest Pain Center in Syracuse, St. Joseph’s knows just how important it is to diagnose and treat these symptoms quickly and accurately. Seeking medical help right away can help protect you from serious heart damage and create a more positive outcome from a potentially dangerous situation. So, don’t hesitate to call 9-1-1.

Your heart—and your life—may depend on it.

HEART ATTACK? EVERY SECOND COUNTS. CALL 9-1-1.

St. Joseph’s Hospital Health Center 301 Prospect Ave. Syracuse, NY www.sjhsyr.org St. Joseph’s Resource Line (Physician & Program Information): 315-703-2138 St. Joseph’s is sponsored by the Sisters of St. Francis.

Franciscan Companies is a member of the St. Joseph’s Hospital Health Center network.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

SYRACUSE’S FIRST ACCREDITED CHEST PAIN CENTER

A Higher Level of Care

FDA: 35 New Drugs Approved in a Year Report shows quick approvals of safe and effective medicines happening in the U.S.

O

ver the past 12 months, the U.S. Food and Drug Administration approved 35 new medicines.

This is among the highest number of approvals in the past decade, surpassed only by 2009 (37).

Many of the drugs are important advances for patients, including two new treatments for hepatitis C; a drug for late-stage prostate cancer; the first new drug for Hodgkin’s lymphoma in 30 years; and the first new drug for lupus in 50 years.

In a report released in November, “FY 2011 Innovative Drug Approvals,” the FDA provided details of how it used expedited approval authorities, flexibility in clinical trial requirements and resources collected under the Prescription Drug User Fee Act (PDUFA) to boost the number of innovative drug approvals to 35 for the fiscal year (FY) ending Sept. 30, 2011.

The approvals come while drug safety standards have been maintained.

The report shows faster approval times in the United States when compared to the FDA’s counterparts around the globe.

Twenty-four of the 35 approvals occurred in the United States before any other country in the world and also before the European Union, continuing a trend of the United States leading the world in first approval of new medicines.

“Thirty-five major drug approvals in one year represents a very strong performance, both by industry and by the FDA, and we continue to use every resource possible to get new treatments to patients,” said Margaret Hamburg, commissioner of food and drugs. “We are committed to working with industry to promote the science and innovation it takes to produce breakthrough treatments and to ensure that our nation is fully equipped to address the public health challenges of the 21st century.”

Among the new drugs approved in FY 2011, a number are notable for their advances in patient care and for the efficiency with which they were approved: • Two of the drugs — one for melanoma and one for lung cancer — are breakthroughs in personalized medicine. Each was approved with a diagnostic test that helps identify patients for whom the drug is most likely to

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bring benefits; • Seven of the new medicines provide major advances in cancer treatment; • Almost half of the drugs were judged to be significant therapeutic advances over existing therapies for heart attack, stroke and kidney transplant rejection; • Ten are for rare or “orphan” diseases, which frequently lack any therapy because of the small number of patients with the condition, such as a treatment for hereditary angioedema; • Almost half (16) were approved under “priority review,” in which the FDA has a six month goal to complete its review for safety and effectiveness; • Two-thirds of the new approvals were completed in a single review cycle, meaning sufficient evidence was provided by the manufacturer so that the FDA could move the application through the review process without requesting major new information; • Three were approved using “accelerated approval,” a program under which the FDA approves safe and effective medically important new drugs quickly, and relies on subsequent post-market studies to confirm clinical benefit. For example, Corifact, the first treatment approved for a rare blood clotting disorder, was approved under this program; and • Thirty-four of 35 were approved on or before the review time targets agreed to with industry under PDUFA, including three cancer drugs that FDA approved in less than six months.

The Prescription Drug User Fee Act was established by Congress in 1992 to ensure that the FDA had the necessary resources for the safe and timely review of new drugs and for increased drug safety efforts. The current legislative authority for PDUFA expires on Sept. 30, 2012.

but prefer to do it gradually?

If you want to quit but prefer to do it gradually, you may be interested in a study which is being conducted to evaluate an investigational drug that may help you to stop smoking by reduction.* You may be eligible for this study if: ■ You are 18 years of age or older and are in good health, ■ You have been smoking an average of 10 ciga-rettes or more a day for the past year, including the past month, and ■ During the last year, you have been unable to quit smoking for longer than 3 months.Qualified participants will receive study drug or placebo (inactive substance), smoking reduction and cessation counseling, and all study-related physical exams and laboratory tests at no cost. *Gradually reducing the number of cigarettes smoked per day

For more informatino, please contact:

CNY Clinical Research

Rt. 92 The Market Place, Manlius, N.Y. 13104 315-682-3263 khawke@cnycr.com

ONONDAGA, OSWEGO, CAYUGA AND MADISON COUNTIES in good A monthly newspaper published by

Health CNY’s Healthcare Newspaper

Local News, Inc. Distribution: 35,000 copies. To request home delivery ($15 per year), call 342-1182.

In Good Health is published 12 times a year by Local News, Inc. © 2011 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: (315) 342-1182 • Fax: (315) 342-7776.

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Suzanne M. Ellis, Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, Deborah Jeanne Sergeant, Anne Palumbo, Aaron Gifford, Chris Motola, Melissa Stefanec, Mary Beth Roach, Ami Setright Longstreet • Advertising: Jasmine Maldonado, Tracy DeCann • Layout & Design: Chris Crocker • Proofreading: Shelley Manley • Office Manager: Laura J. Beckwith 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.

December 2011 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 3

CALENDAR of

HEALTH EVENTS

Dec. 1

Program to focus on eating and the holidays “Mindful Eating & Holiday Joy” is a free wellness program for the public, including breast cancer survivors, their families and friends, that will take place from 6:30 – 8 p.m. Thursday, Dec. 1, in the Community Room at Panasci Chapel, Le Moyne College. The evening will include an introduction to mindful eating, gratitude meditation, and suggestions for mindful, joyful living during the holiday season and New Year. Program leader is Marnie BlountGowan, mind body wellness advocate and member of the Crouse Hospital Integrative Health Alliance. Sponsored by the Wellness Center for Health and Counseling at Le Moyne College and the Mind Body Health Alliance with funding from Susan B. Komen for the Cure CNY. For more information, email Blount-Gowan at marnie@twcny. rr.com.

Dec. 1

World AIDS Day celebrated AIDS Community Resources will commemorate World AIDS Day,

Thursday, Dec. 1, with a service of Hope and Remembrance at Panasci Chapel at LeMoyne College. The World AIDS Day service begins at 7:30 a.m. and lasts about 30 minutes. Refreshments will follow. The public is invited to attend. Music will be provided by the Syracuse Gay and Lesbian Chorus. AIDS Community Resources is a nonprofit, community-based organization, supported by both public and private funds, bringing information and education, direct services, referrals, and advocacy to everyone in our nine county region who needs help with HIV/AIDS. For more information, call 475-2430.

Dec. 10

Upstate gala to support scholarships, renovations The 2011 Upstate Gala combines two galas, that of Upstate Medical University and of the former Community General Hospital, with proceeds to benefit both campuses. The event will be held beginning 7 p.m. Saturday, Dec. 10, at the Nicholas J. Pirro Convention Center, 800 S. State St., Syracuse. According to Eileen Pezzi, the partnership is the result of Upstate’s acquisition of Community General Hospital early this

summer and the subsequent creation of Upstate University Hospital at Community General. “We are very excited to merge our efforts in presenting our 2011 gala fundraising event,” said Pezzi, Upstate vice president of development and executive director of Upstate Medical University Foundation. “Gala attendees will enjoy a memorable evening of dance, delicious treats and fun while raising funds for programs that will benefit our students and our community.” 2011 Upstate Gala proceeds will provide seed money for a longterm scholarship program for students in Upstate’s four colleges (graduate studies, health professions, medicine and nursing). The proceeds will also support the hospital entrance renovation at Upstate University Hospital at Community General.

John and Bonnie McCabe, and Tom and Julie Quinn, are 2011 Gala cochairs. John McCabe is chief executive officer of Upstate University Hospital and Upstate University Hospital at Community General. Quinn is senior vice president for health system development at Upstate Medical University.

He served as president and chief executive officer of the former Community General Hospital.

For reservations, call 464-4416.

Dec. 13

Leukemia & Lymphoma Society hold support group In response to the needs of Syracuse patients, the Western & Central New York Chapter of The Leukemia & Lymphoma Society offers a monthly support group open to adults diagnosed with myeloma, their family and

friends. The next meeting will be held from 6 – 7 p.m. on Dec. 13 at The Oaks in Dewitt. The group is free but preregistration is required for new members. The group. which meets the second Tuesday of each month, includes education on topics such as dealing with the stress of diagnosis, communicating with your health care team and complementary therapies. Participants will learn the latest information and have an opportunity to discuss the unique issues faced by those who have myeloma. Family members and friends are welcome. Light refreshments will be served. For more information or to register, contact Coleen Jones via email at coleen.jones@lls.org or at 1-800-7842368 ext. 4667.

Dec. 15

Aurora of CNY offers free vision screening Aurora of CNY, Inc. is offering free vision screening from 10 a.m. – 2 p.m. Dec. 15 at its offices at 518 James St. in Syracuse. Vision screening is a non-medical test that evaluates a person’s visual acuity and checks for color-blindness, field-of-vision defects and other conditions. If the screening reveals a possible problem, a visit to a physician is recommended. Each screening takes approximately 15 minutes; appointments can be scheduled by calling Aurora at 422-7263. Aurora, the only non profit that works exclusively with people in Central New York who are deaf, blind, visually impaired or hard of hearing, is a United Way agency of Central New York and Oswego and Cayuga counties.

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THE INFUSACARE DIFFERENCE • Minimal referral requirements • Immediate patient scheduling • Physician on site at all times

• Continuous medical supervision by nursing staff • Follow-up treatment documentation • Comfortable, pleasant environment ensuring patient satisfaction

QUALITY CARE FOR PATIENTS OF ALL AGES Page 4

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

TRANSPLANTS

Recipients at increased risk of 32 types of cancer

P

eople who receive an organ transplant have an increased risk of developing 32 types of cancer, a new study finds.

Some of the most common cancers in transplant recipients include kidney, liver and lung cancer and non-Hodgkin lymphoma, the results show.

Transplant recipients have double the risk of developing any cancer, compared with people who have not had a transplant, the researchers said.

The increased risk of cancer comes, in part, from the medications transplant recipients must take to avoid rejecting the transplanted organ. These medications suppress the immune system, and may elevate the risk for infection-related cancers, said study researcher Dr. Eric Engels, of the division of cancer epidemiology and genetics at the National Cancer Institute. In some cases, immune-suppressing medications may act as carcinogens and directly contribute to cancer’s development, the researchers suggest.

“Clearer understanding of the pattern of cancer risk associated with solid organ transplantation may help future patients have better, healthier outcomes,” Engels said.

including 16,899 kidney, 6,291 liver, 2,333 heart and 1,770 lung transplants.

Previous studies have suggested that transplant recipients are at a higher risk for cancer than the general population. However, these studies focused mainly on those who received kidney transplants, and some studies were too small to accurately estimate risk for all but the most common cancer types.

In the new study, Engels and colleagues evaluated medical data from more than 175,700 U.S. transplant recipients, accounting for about 40 percent of all people who received transplanted organs from 1987 through 2008. The data came from the U.S. registry of transplant recipients and 13 state or regional cancer registries.

About 14 percent of transplant recipients developed non-Hodgkin lymphoma, a cancer of the white blood cells. The risk of this cancer was seven times higher in transplant recipients than in the general population, and was highest for lung recipients. NonHodgkin lymphoma is known to be related to immune suppression and infection with Epstein-Barr virus, the researchers said.

In 2010, a total of 28,664 organ transplants were performed in the U.S.,

Lung cancer was the second most common cancer, found in 12.6 percent

Meds reduce risk of organ rejection

Lung, liver and kidney cancers

of recipients. This may be because the patients already had smoking-related diseases, the researchers said. In cases involving a single lung transplant, lung cancer typically arises in the recipient’s remaining diseased lung rather than the transplanted one.

Liver cancer occurred in 8.7 percent of recipients. The increased risk for liver cancer may be due to recurrent hepatitis B or C infection in the transplanted liver.

And 7.1 percent of recipients had kidney cancer. Recipients of kidney

transplants have damaged kidneys, frequently including multiple kidney cysts, which can become cancerous.

“We wish to understand how medical conditions, and individual immunosuppressive medications, may contribute to cancer risk. In addition, we hope our findings will stimulate other research into the carcinogenic mechanisms associated with organ transplantation,” Engels said.

The study was published Nov. 2 in the Journal of the American Medical Association.

Knee Replacements Up Dramatically for Adults

W

omen and men aged 45 to 64 were 2.5 times more likely to be hospitalized for knee replacement surgery in 2009 than in 1997, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ).

AHRQ’s analysis of hospital stays for knee replacement surgery from 1997 to 2009 found that: • The rate for women aged 45 to 64 jumped from 16 to 42 stays per 10,000 people, while for men the same age,

the rate climbed from 11 to 28 stays per 10,000 people.

• The rates for women and men 65 to 84 rose by 69 percent and 55 percent, respectively — from 72 to 122 stays and from 58 to 90 stays per 10,000 people.

• Among those aged 85 years and older, rates increased by 23 percent for women (from about 27 to 33 stays per 10,000 people) and 36 percent for men (from about 27 to 36 stays per 10,000 people).

CONFUSED BY MEDICARE? DO YOU UNDERSTAND ALL YOUR OPTIONS? ARE YOU TURNING 65 SOON? ARE YOU A VETERAN AND WOULD LIKE LOCAL CARE? ARE YOU DISABLED?

WE CAN HELP ……… CALL, WRITE, FAX OR EMAIL US

December 2011 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

Meet

Your Doctor

By Chris Motola

Dr. Shawn Mills New orthopedic surgeon at Oswego Health talks about minimally invasive procedures, arthritis treatment and why he moved to Oswego Q: How long have you been doing involved in the orthopedic field?

A: I’ve been in orthopedic practice for going on 14 years. With my residency, I’ve been in orthopedics almost 20 years.

Q: What brought you to Oswego and the Oswego Health system?

A; I had been practicing in southeastern Massachusetts. I was employed in a hospital where the health care pressures and dramatic changes in the market led to the hospital going from a nonprofit organization to a forprofit hospital system. As the hospital changed to a for-profit system, they completely lost their direction and scope with regards to the care of the local population, in favor of doing elective surgeries with maximal reimbursing patients with good insurance. Part of my practice has always involved treating traumatic injuries regardless of the patient’s ability to pay, because it’s the right thing to do. Ethically, I could never turn away someone in need. My hospital system made that decision and actually discouraged me from treating and following patients I had treated in the past because they felt they did not reimburse the hospital sufficiently to warrant their being cared for. I couldn’t stomach that, so I started looking at my options, where I could find a community and hospital system to help patients in need. I found that need in Oswego, so that’s how I ended up here.

Q: What’s the typical profile of your patients? What kinds of injuries or diseases do they present with?

A: My practice has never been limited in scope despite the fact that I dropped doing spine, neck or back work seven years ago. I used to have a very busy spine practice, however, in southeastern Massachusetts, there was such high competition between neurosurgeons and orthopedic surgeons for those patients, it was kind of an ugly market. I was already so busy with the other aspects of my practice, I found it was in my best interest to stop treating neck, spine and back problems and focus on extremities. Orthopedic malpractice insurance is based on the types of surgery we do. If you’re doing spine surgery, the malpractice cost can be as much or more than the average orthopedist’s malpractice cost for everything else.

So I dropped spine seven years ago. Aside from that, my only limitations are the limitations of the system. For example, serious medical co-morbidiPage 6

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ties or trauma-related complications that the facility could not care for. As such, those patients get sent off the major trauma centers.

Q: But you’re still treating skeletal injuries outside of the spine?

A: I do not see neck or back complaints, that is correct. Orthopedic surgery includes everything and anything to do with bones, joints and peripheral nerves.

Q: What kinds of nerve-related conditions do orthopedists treat?

A: Carpal tunnel surgery, the ulna nerve at the elbow, or the common peroneal nerve at the knee. In addition to fractures, dislocations and degenerative changes like advanced arthritis in the hip, knee and shoulders that may require joint replacement.

Q: It seems like the public understands arthritis from a symptomatic perspective, but what’s actually going inside the body?

A: The first thing that’s helpful to understand is the pathology. Arthritis has 12 or 13 recognized causes. It’s simply describing the degeneration of the joint, which usually involves the thinning and decay of the articular cartilage which

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

lines the joint and allows them to move freely, as well as inflammation of the joint capsule, which provides the lubricating and nutritional fluid to the cartilage cells and the joint itself.

When I say there are as many as 13 causes, we’re talking about wear-andtear arthritis, or osteoarthritis, there’s rheumatoid arthritis, psoriatic arthritis, there are arthritis conditions related to infections like syphilis, gonorrhea, or Lyme disease. Early arthritis is usually activity-related pain that is usually dull and achy in quality and continues to worsen as we are more active throughout the day.

addition to metal and plastic, we now have the ability to use ceramics as well for high activity patients.

Q: What kinds of treatments are available?

A: The most common treatment for arthritis that can be very effective is simply non-steroidal medications like ibuprofen or naproxen need to only be taken once or twice a day, but can lead to significant improvement by decreasing the inflammatory process going on inside the joint as well providing direct pain management. The second step in treatment is physical therapy and flexibility programs to help combat the losses of motion. We also employ injections from time to time. Injection therapy will often start with a steroid or local anesthetic injected into the joint that oftentimes provides 100 percent relief. The unfortunate truth is that injection is unpredictable in terms of how long it will last. I’ve had patients with severe arthritis who didn’t come back to see me between nine months to a year and patients with minor arthritis whose relief only lasted a week or two. After that, we have the ability to perform another series of injections called ‘viscosupplementation’ injections which inject a gelatin into the knee that are so dense and large that they actually provide cushioning and lubrication and the joint space. Lastly, if we’ve failed all those measure, patients may want to proceed to a joint replacement. With a joint replacement we actually go into the joint and remove the decayed surfaces and replace those surfaces with a metal covering and use a plastic liner or interface as a bearing surface.

In

Q: How invasive are these procedures?

A: I’ve been an advocate and innovator of minimally invasive surgery since my training in residency. Typically when someone came in with a femur fracture, they would end up with major surgery and wounds that were five to seven inches in length.

Through the course of my work since residency, I’ve typically minimized the size of the wound to two or three incisions less than the size of a quarter. By minimizing the damage to the underlying muscle and connective tissue, we greatly reduce the pain and speed the recovery from the surgery.

ies?

Q: How successful are these surger-

A: When we talk about surgeries and whether they are successful or not, of all the surgeries we’ve come up with in orthopedic or general surgery, surgeries like hip and knee replacements are considered to be two of the most successful surgeries. They routinely achieve their goals of alleviating pain and improving functional use of motion.

Q: Any orthopedic health advice for patients?

A: During my training, I was involved with what was called the Blizzard of Worcester in December of 1992. During that snowstorm, we had the largest number of patients present with snow blower-related injuries to UMass Medical Center. Every year, I see far too many patients who are injured due to momentary lapses in judgment when the chute to the snow blower becomes clogged with wet or heavy snow and they stick their hand in to clear it. The impeller can jump and they end up with fractures, amputations and often lifelong deformities to their hands. Never under any circumstances, whether the snow blower is on or off, never stick your hands inside the chute; use a stick or something else. It used to be all snowblowers had chain or gear driven impellers. These were replaced by quieter, rubber belt drives that can store enough kinetic energy, even when they’re turned off, to tear a finger or hands off when the chute is cleared.

Lifelines: Name: Shawn Mills, MD Training: University of Massachusetts Medical Center. Board certified by the American Board of Orthopedic Surgery since 2001 Career: Most recently practiced at Saint Anne’s Hospital in Fall River, Mass. Also served as director of orthopedic rehabilitation at both the Royal Nursing and Rehabilitation Center in Falmouth, Mass, and at the Catholic Memorial Home and Rehabilitation Center in Fall River, Mass.

Current: Operates Advanced Orthopedic Group located adjacent to Oswego Hospital in Oswego Hobbies: Enjoying the outdoors, sailing

HealthLink: Spreading Health Advice Through the Airwaves SUNY Upstate’s radio show HealthLink now in its sixth year

Organ • Eye • Tissue Donation To Enroll in the NY State Registry

www.fletb.org 1.800.568.4321 Finger Lakes Eye & Tissue Bank

By Aaron Gifford

I

t’s a little after 9 on a rainy October morning in the basement of Upstate Medical University’s Weiskotten Hall. Four women with laptop computers focus on the details. They grimace with concentration for a few minutes but are ready to roll when the first guest, a pediatrician, speaks into the microphone.

“So just say what you had for breakfast,” Linda Cohen, the show’s host, tells Dr. Robert Cavanaugh during the sound check.

“Let’s see,” he replies. “Filet mignon, lobster…”

Everyone in the studio laughs, Cavanaugh relaxes, and the show begins.

Cavanaugh discusses his new book, “Dying to be Perfect: How Teens Can Stay Happy, Healthy and Alive.”

That interview and others that followed were each concluded in 14-minute segments. An hour later, another week of Upstate’s HealthLink On Air radio program was wrapped up in a single take.

HealthLink originated as an educational lecture series for the public and later expanded to a radio program broadcast on WSYR so a larger audience could be reached. Now in its sixth year, HealthLink reaches up to 6,000 households per week. That does not include those who listen from their car or elsewhere, or those who access previous shows via podcast from the show’s website. For the 9 –10 a.m. Sunday time slot, it’s consistently been the No. 2 rated program based on listenership in the Syracuse metropolitan area.

“The seminars were great,” said Melanie Rich, the show’s executive producer. “We wanted to broaden the message and make this information more accessible.”

The program has an infinite wealth of knowledge to draw from institutionally — physicians, specialists, professors and researchers. Most guests have been affiliated with Upstate, but that is not a requirement. Onondaga County public health experts, for example, have been on, as well as New York Times health columnist Jane Brody. They have also featured world-renowned medical experts who visit Upstate for meetings, seminars or conferences, but acknowledge that they don’t feature guests from competing hospitals. Bill Corr, deputy secretary of the U.S. Department of Health and Human Services, is on the list of future guests.

“We consider what’s topical, what’s timely,” Rich said. “There is always a rhyme and a reason for the guests we invite.”

And every episode features the “Checkup From the Neck Up” commentary from Dr. Richard O’Neill, a psychologist at Upstate.

Upstate pays WSYR to air the program, and show promos produced by the radio station are included in the cost. The tapings are completed several weeks before the air dates, usually on a Tuesday or Wednesday morning. All of the employees involved with the show have additional roles at Upstate.

Rich is the director of marketing. Show Coordinator Becky Cerio works on

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2717 Bellevue Avenue 1st Floor Syracuse, NY 13210 (315) 437-1304 Randy Stetson, LCSW-R rstetson@bienestar-bcc.com www.bienestar-bcc.com

Upstate’s HealthLink On Air host Linda Cohen interviewing pediatrician Robert Cavenaugh in October. The show, produced by SUNY Upstate and aired 9–10 a.m. on Sundays at WSYR, reaches up to 6,000 households per week. It’s consistently been the No. 2 rated program based on listenership in the Syracuse metropolitan area.

planning special events and producing content for Upstate’s website. Much of the information obtained from program interviews are included in Upstate publications written by staffer Amber Smith, who also helps with producing the show.

“We’re very resourceful here,” Rich said. “None of this good information goes to waste. And sometimes, the guest will mention something that might turn into another topic for a future interview.”

That proved to be the case with the Oct. 26 interview with Cavanaugh.

He only scratched the surface on the topic of the adolescent brain during the 14-minute time slot. Everyone in the studio agreed to have him back in the near future to expand on teen suicide or bullying.

What Cavanaugh did discuss will probably appeal to parents and teens alike. He began by noting that he initially pursued pediatrics because he wanted to work with babies and young children. But over the course of 30 years he became fascinated with adolescents.

“I see them as a very unique population,” he said. “They are not children, they are not adults. They really have many, many unmet needs from a medical perspective.”

He explains how teens can look more like an adult but act more like a child. Cohen interjects: “You can have an 18-year-old physically, but a 10- or 12-year-old psychologically?”

Just before the break, Cavanaugh touches on his metaphor that compares adolescence to a space mission: The launch phase is in that 10–14 year-old range, when children are starting to show more interest in spending time with their friends or even alone instead

of with their family. Then there’s the orbit stage, from 14 or 15 up, where kids can do many things without supervision “but still need help from home base.” And lastly there’s re-entry, where the young person is ready to rejoin society as an adult. Some are in a hurry to get to that point, while others slowly hang glide back or even resist coming back for awhile.

“One of the messages we try to give parents is, they do come back most of the time,” Cavanaugh said.

The next guest was James Alexander, a gynecologist affiliated with University Hospital. He talked about heavy menstrual bleeding, its causes and the observations that should be made before seeking treatment. He discussed a variety of procedures, but at no point did he make any recommendations or promote his practice.

“You need to tailor the medical treatment to the problem,” he said.

Afterward, Cohen explained that the show’s purpose is not to promote Upstate’s hospital or medical school.

“I see its purpose as educational and informational,” she said.

Cohen also works as a patient service coordinator for Dr. Paul Cohen’s (her husband) internal medicine practice. She worked as a speech and language therapist for 25 years before stepping into the communications realm. She previously hosted the Time Warner cable television program “Families in Focus.” As the host of HealthLink, she serves as a layperson who can translate medical terminology into terms the general public can understand.

“What’s the bottom line we want to get across? What are the issues that need to be discussed? That’s what we think about ahead of time,” she said.

December 2011 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

My Turn

By Eva Briggs

Five Common Reasons Your Doctor May Misdiagnose You

M

y oldest daughter is a philosopher. As I write this, she probably is sitting on a rock in a remote corner of the world, wearing a toga, doing what philosophers do: trying to solve the world’s enigmas through logic. Seriously, when she was a teenager, her arguments with parents were not the typical teenage drama.

Instead, she would listen quietly when my husband or I explained our position, and then she’d carefully point out which fallacy we’d made in our reasoning. For example, the straw man, ad hominem, no true Scotsman, ad ignorantium, and more!

Because my daughter taught me all the various ways thinking can run amok, I read with interest a recent article titled “Flaws in Clinical Reasoning: A Common Cause of Diagnostic Error” (“American Family Physician,” November 2011 issue). The authors described five common flaws in clinical reasoning doctors make, estimating that diagnostic errors occur 5 –10 percent of the time in emergency room visits.

Below I’ll try to describe these types of errors, and show examples.

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Anchoring means sticking with a diagnosis. Suppose a lamp won’t turn on. You decide to change

Heart Disease, Cancer and Trauma the Most Costly Conditions for Men

the bulb. It still won’t turn on, so you replace that with another bulb. That’s anchoring: you decided that the bulb is bad even when a replacement bulb didn’t solve the problem. A common medical example occurs when a patient has a cough, and is repeatedly treated with a changing spectrum of antibiotics for a diagnosis of sinusitis. By failing to consider new or different diagnoses, the physician might miss other causes for the persistent cough: allergies, asthma, reflux, tuberculosis.

notice several insects on the plant, and conclude that they are killing it. Even though there might be other causes, you blame the insects because they are so obviously visible. Doctors can make the same type of error. Suppose a patient with back pain thinks he has a urine infection. The physician may conclude that the patient has a urine infection because the urine dipstick is positive for white blood cells, even when other evidence fails to fit the diagnosis.

Availability refers to whatever comes most easily to mind. You come home and find a broken window. So you assume someone was trying to break into to your house. That could be the case, but there are other possibilities: a stray baseball, a punch from an angry teenager, a collision from a misguided bird. For a medical example, consider an itchy rash around a patient’s waist that appears to be scabies. But there are other possibilities that must be considered: hives or contact dermatitis from nickel in a jeans snap, and more.

Framing is assembling elements that support a diagnosis. This is a type of decision-making biased by subtle cues and irrelevant information.

You are driving your car, and as you pass through deep puddle the “check engine” light turns on. So you begin looking for problems that are caused by moisture, like a bad spark plug wire. But the puddle might have been pure coincidence, and the true problem may have no relationship to wetness.

Medical examples include assuming that a patient with a fever has malaria because he just returned from Africa, or that an opioid addicted patient’s abdominal pain is due to narcotic withdrawal. In both cases it’s important to look for other causes so as not to miss serious alternative diagnoses. The first

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Confirmation means assigning preferences to findings that confirm a diagnosis. Imagine that a plant in your garden is dying. You

I

The federal agency also found that cancer was the second most costly disease to treat ($34 billion), followed by trauma-related disorders ($33 billion) and osteoarthritis ($23 billion).

On a per-patient basis, the average annual treatment cost ranged from $4,873 for cancer to $838 for high blood pressure.

In New York state since 1994, only the Medicaid recipient’s probate or intestate estate was subject to recovery

by Medicaid.

A probate estate consists of assets passing by virtue of a valid will.

An intestate estate differs in that the owner of the estate dies owning a property without having made a valid will. In such cases, state law determines who receives the assets and property.

Before The Law

What Changed

Under the new definition, the term “estate” for Medicaid recovery pur•

With so many ways for diagnostic error to occur, how can the risk be minimized?

Evidence suggests that teaching residents (and perhaps by extension other medical professionals) about the types of erroneous reasoning may help. After all, thanks to my daughter’s tutelage, I am less likely to commit the types of fallacious reasoning she explained to me.

Diagnostic checklists also appear to reduce the risk of error.

Eva Briggs, a board-certified physician, works on the staff at Cayuga Medical Center in Ithaca, in its two urgent care centers: one in Ithaca, and the other in Cortland.

By Ami Setright Longstreet

T

Page 8

5

Premature closure refers to failure to seek additional information after reaching a diagnostic conclusion. Perhaps your car is leaking oil.

Upon discovering that the plug is loose, you fail to notice a second cause like a leaking valve cover gasket. The same thing happens in medicine. For example, a doctor detects a broken bone in the foot and then fails to notice a second broken bone next to the first one.

Medicaid Recovery Regulations Changes the Definition of ‘Estate’ n an effort to seek further reimbursement for Medicaid expenses incurred during a recipient’s lifetime, New York introduced new Medicaid recovery regulations on Sept. 8.

The new law and regulations completely redefine the meaning of “estate” by expanding the number and types of assets from which New York state can collect after the death of a Medicaid recipient, and reducing what the appointed beneficiaries are eligible to receive.

he cost of treating men for heart disease topped $47 billion in 2008, leading a list of the 10 most expensive conditions for men age 18 and older, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.

4

patient could have pneumonia, and the second could have appendicitis. Not to mention a myriad of other possibilities.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

poses now encompasses jointly owned bank accounts, jointly owned real property, interests in a trust, life estates, and “other arrangements.”

With the inclusion of life estate in the new regulations, real property can now be sought for recovery by Medicaid.

The value of one’s life estate will be determined immediately before the recipient’s death based on the actuarial life expectancy of the recipient.

Those Medicaid recipients who have turned over their property through a deed with retained life use to specified beneficiaries, including their children, will likely be affected by the new regulations.

Along with the changes of recoveries against life estates, Medicaid can also look to interests in revocable and irrevocable trusts for recovery of benefits paid.

While the grantor of a revocable trust may modify or terminate the trust at any time, the grantor of an irrevocable trust effectively forfeits ownership of the property and assets transferred to the trust.

With the new legislation, assets and accrued income in a revocable trust can now be recovered at death by Medicaid.

Any trust income placed in an irrevocable trust rather than distributed to the Medicaid recipient during his or her lifetime is now also eligible for recovery if that income was directed to be paid to the recipient pursuant to the terms of the trust.

The new policy applies to those Medicaid recipients who die on or after Sept. 8, 2011.

Any recovery for property transfers, joint property, trusts or deeds with retained life use will be governed by the new regulation.

Ami Setright Longstreet is a trusts and estates and elder law attorney, and partner at the law firm of Mackenzie Hughes LLP in Syracuse. She can be reached at 315-233-8263 or at alongstreet@mackenzieh ughes.com.

Stay Cold and Flu Free This Season Who wants to sniffle and sneeze his way through the holidays?

By Deborah Jeanne Sergeant

W

hile no precautions to avoiding colds and flu are foolproof, taking a few steps to protect yourself can improve your chances of enjoying the happiest season of all without being sick.

If it seems that many people get sick during the holidays compared with other times of the year, you’re right.

“Just one person at a holiday gathering who is in the early stages of flu can spread mysery to all those in attendance,” said Patricia Briest, a registered nurse at St. Joseph’s Hospital. “This is partially the reason why this time of the year is called ‘flu season.’ If you are elderly or have an ongoing health concern and catch the flu, you can become very sick.”

Onondaga County Health Department Program Coordinator Kathy Mogle explained that “practicing good health habits like getting enough Mogle sleep and exercise are important because it can help the immune system.”

During the holiday season, sleep and exercise become low priorities in light of decorating, shopping and festivities.

“People are traveling around and are in malls or in church and their risk is higher,” she added.

Diane Oldenburg, senior public health educator Oswego County Health Department, said that sleep “is always an important part of staying well. It helps the body recover and rest.

It seems like everyone is burning the candle at both ends during the holidays.”

She added that over time, stress can also weaken the immune system.

During the summer, people tend to spend more time outdoors. The air is moister then, too. The lower humidity inside many heated homes and businesses tends to dry out nasal passages.

Using a humidifier at night may help.

To help ward off flu, get your flu shot. The notion that obtaining a flu shot puts you at risk for getting the flu is simply not true.

“The flu vaccine cannot give you the flu,” Mogle said. “The flu shot contains a killed virus and the nasal spray has a weakened virus. Some people could get an ache in the arm from where they received the shot or a low-grade fever can happen but it’s not a result of the flu shot.”

If you come down with the flu after receiving a vaccine, you’re either very, very unlucky (since the vaccine is extremely effective), or you were exposed to the virus between the time that the vaccine was administered and when it became effective, which is usually seven to 14 days.

Don’t think that it’s “too late” to receive a flu shot because winter has begun.

“It’s never too late to get your flu shot,” said Judy W. Sokolowski, a registered nurse and nurse manager of employee health services for St. Joseph’s Hospital Health Center. “Get it as soon as the vaccine becomes available. Flu season can last until May. It is absolutely fine to get the flu shot now.”

Since flu season peaks in January or February, obtaining a vaccination in December can still help. You don’t even have to face a needle. A nasal mist vaccine may be used by anyone 2 to 49 years old who is not sick or pregnant.

Even if you “never” get the flu, be considerate of others by obtaining a vaccination.

“There are hundreds of thousands of people in this country, many of whom are children and the elderly, who can’t be vaccinated against the flu due to weakened immune systems due to disease or medications…,” Sokolowski said. “These people depend on those around them to be vaccinated because they’re the ones who are most likely to get the flu which is a vaccinepreventable disease and are most likely to suffer with the illness or die.

“Receiving the flu vaccine not only helps protect the safety of the patients, it also benefits the health care workers and their families.”

Briest Stay away from sick people. Viruses are spread by direct contact with infected individuals or when they have left germs behind on commonly used objects or surfaces, such as a doorknob, shared computer station, or countertop. If you share a workspace, wipe it down with disinfectant wipes before you start your shift.

Keep surfaces clean at home, too.

“Make sure you wash your hands often,” Mogle said. “It stops the spread of germs.”

Oldenburg agreed.

“It’s one of those every day preventive actions, she said. “If you’re a mother or had a mother, these are things you’ve heard a million times.”

Wash up before touching your face, inserting contact lenses, eating, or handling food. Wash up after using a facial tissue, using the bathroom, and completing a chore such as cleaning the bathroom, changing the litter box or changing a diaper.

“If you’re out shopping at malls where there’s a high volume of people, you’re more likely to come into contact with people,” Oldenburg said.

So when you get home, wash your hands.

Wet the hands, lather with soap and scrub palms, backs, between

fingers and under nails for 20 seconds, about the time it takes to sing the “Happy Birthday” song twice.

Then rinse and dry with a clean towel.

Consider using paper towels or designate a “sickie” towel if a member of the household is sick. If soap and water aren’t available, use alcohol-based hand sanitizing gel.

Help your children decrease spreading germs, too. Teach them to sneeze or cough in the crook of their arms, not their hands, since they’re more likely to spread germs by touching objects and others’ hands with their contaminated hands than with their elbows.

Decrease your stress level and get enough rest. Though not much research directly links a lack of rest and excessive stress with illness, Randy Sabourin, owner Personal Fitness, Inc. in Syracuse, said that too much stress is one way to deplete the immune system and make you more susceptible to Sabourin colds and flu.

Do you really need to make the perfect gingerbread house, buy so many presents or write cards to people you barely know? Dial back your expectations.

Take time to relax with a bath, book or exercise. Engage only in holiday activities that you want to do and let the rest go.

Eat right, but don’t go crazy with over-hyped supplements or particular foods.

“Enrich your diet with antioxidants which are found naturally in foods, the produce section of your grocery, and are available as supplements,” Sabourin said. “Antioxidants help your immune system by removing harmful oxidants from the bloodstream.”

While there are no “super foods” December 2011 •

that guarantee your immune system will make you impervious to colds or flu germs, it does make sense to supply your body with nutritious foods, “particularly foods that have high antioxidant content, such as deeply-colored vegetables,” Briest said. “Staying hydrated is important as well.”

If you feel your diet frequently lacks adequate nutrition, talk with your doctor about taking a daily multivitamin.

Reducing stress, eating right and exercise are all important for staying healthy; however, Sabourin puts exercise at the top.

“Exercise has the capacity to protect and even enhance the immune response,” he said. “Fortunately, the intensity and duration of exercise needed to support the immune system is less than that needed to provide the best cardiovascular training. Thus, even relatively low levels of aerobic exercise can protect your immune system.

Twenty to 30 minutes of brisk walking five days per week is an ideal training program for maintaining a healthy immune response.”

Revel in the season: power walk through the store while shopping, walk around your neighborhood after dinner to enjoy the lights, play with the kids in the snow, or take the whole family ice skating.

Any time you are sick, do everyone else a favor and stay home until you are better.

“Don’t go to work, the mall or church,” Mogle said. “It can cause other people to be ill. If you have flu symptoms, call your healthcare provider because there are medications that can relieve symptoms and perhaps shorten the length of the flu. If your child is ill, don’t send them to school.”

Don’t just mask your symptoms with medicine and slog through the day because you are sharing the cold or flu germs with others. The world won’t implode without your presence for a few days and the extra rest will help you get well sooner.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

‘Tis the Season: Thoughtful Gift Ideas for Those Who Live Alone This column is for all of you who have friends or family members who live alone.

While the holidays can be a joyous time filled with laughter, cheer and gift giving, this time of year can also generate feeling of loneliness and anxiety. In my experience, those on their own are especially susceptible to the “holiday blues.”

What can you do to add a little “merry” to the holidays for those who live alone? You can give the gift of time together — probably the most welcome and cherished gift of all. You can also give a thoughtful present to lift a spirit and warm a heart.

Below, I’ve compiled a list of gift ideas for you — some practical, some personal, all guaranteed by me to put a smile on the face of someone who lives alone:

For fun

• An invitation to join you on New Year’s Eve. This can be a challenging night for those who are newly divorced or widowed. I popped the cork with my sister and her husband after my divorce and was deeply grateful for their invitation to spend the evening together. It got my new year off to a great start!

• Tickets or gift certificates to movies, concerts, art openings or the theater. Include an invitation: “Be my guest.” And insist on doing the

driving.

• Dancing, cooking or art lessons.

Do you have a single friend with two left feet? Dancing lessons might be in order. A widowed father who eats supper directly from the container?

Consider a cooking class. Or a divorced sister who’s been looking for a creative outlet? A course in jewelry making might delight her. There are so many possibilities!

For safety

• An American Automobile Association (AAA) membership. I don’t leave home without it. A flat tire, an empty tank, a lost key — been there!

This is a gift worth its weight in gold.

• Handy tools for emergencies or life’s unexpected moments. Consider a compact size “no-battery” magnetic LED flashlight that is shake activated.

This is one of my prized possessions!

How about a Swiss Army knife, complete with screwdrivers, scissors, toothpick, and tweezers?

It even comes with a nail file and a highly coveted corkscrew.

Or, consider a motion-sensor that activates a chime or alarm when a visitor (or new suitor?) arrives. Those of us who live alone need to be prepared for whatever life offers up!

• A gift certificate for car washes.

While not necessarily a “safety gift,”

KIDS Corner Children’s Use of Asthma Controller Drugs Has Doubled

T

he proportion of children who used a prescribed controller drug to treat their asthma doubled from 29 percent in 1997–1998 to 58 percent in 2007–2008, according to the latest News and Numbers from the Agency for Healthcare Research and Quality.

Asthma controller drugs such as cortisteroids, control inflammation thereby reducing the likelihood of airway spasms; asthma reliever drugs, such as short-acting beta-2-agonists, make breathing easier; and leukotrienes help prevent asthma symptoms from occurring.

AHRQ also found that during the Page 10

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1997–1998 and 2007–2008 timeframes: • Use of inhaled corticosteroids, a type of controller drug increased from 15.5 percent to 40 percent. Use of other controller drugs also increased: beta agonists (from 3 percent to 13 percent); and leukotriene (from 3 percent to 34 percent).

• Use of reliever and oral corticosteroid drugs declined from 44 percent to 30 percent and from 17 percent to 9 percent, respectively.

• Average annual total spending for all asthma drugs more than quadrupled from $527 million to $2.5 billion. Specifically, spending for con-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

I know I feel better when my car’s clean (and that can’t help but make me safer on the road). Who doesn’t enjoy a clean, sparkling car? Choose a car wash near your recipient’s home or work place.

For pampering

• An opportunity to be “treated like royalty.” How many of your friends who live alone indulge themselves in luxurious services? My guess is not many, if they’re like me. Who has the time or money? But that’s what makes this the perfect gift!

Why not surprise her with spa certificate for a facial, manicure, pedicure or aromatherapy? Or make his day by with a certificate for a sports massage, fitness facial, or appropriately named MANicure.

• For women in particular who live alone — fresh flowers delivered. Do you know a single woman who lives by herself? When’s the last time she got flowers? Right, years can go by . . . don’t I know it.

So, delight her with a bouquet of roses or tulips — preferably yellow, a color known to evoke the feelings of warmth and happiness associated with friendship.

• And speaking of deliveries, check out Gift of the Month clubs. Coming home alone at any time of year can feel a little empty, but it can really feel lonely during the holidays. Discovering a package on the door stoop can change everything.

Go online and check out www.

AmazingClub.com. Unbelievably,

troller drugs grew from $280 million to $2.1 billion and for reliever drugs, the increase was $222 million to $352 million (all in 2008 dollars).

• Spending for oral corticosteroids fell from $25 million to $8 million (2008 dollars).

Low Birthweight Infants Have Five Times Rate of Autism Autism researchers at the University of Pennsylvania School of Nursing have found a link between low birthweight and children diagnosed with autism, reporting premature infants are five times more likely to have autism than children born at normal weights.

The children, some born as small as about a pound, were followed for 21 years making this study, published in the journal Pediatrics, one of the most remarkable of its kind.

The infants were born between September 1984 through July 1987 in Middlesex, Monmouth, and Ocean counties in New Jersey at birthweights from 500 to 2000 grams or a maximum of about 4.4 pounds.

“As survival of the smallest and most immature babies improves, impaired survivors represent an increas-

you’ll find 36 different monthly clubs to choose from: chocolate, hot sauce, cheese, tea, cigars, wine, beer, pastas, olive oil, popcorn, candles, you name it. I love this idea so much, I might treat myself!

For inspiration

• A gift of charity. Making a donation in someone’s name is a gift you can both feel good about. Think about your friend or family member who lives alone. What do they care about?

Choose an organization that supports their values.

• An invitation to join you in a volunteer activity. Helping others is a great holiday tradition. Early on in my solo journey, a dear friend invited me to join her for a holiday gift-wrapping event to support the humane society.

It felt wonderful to be out of the house and surrounded by other volunteers and staff who embraced the spirit of giving.

• Tibetan prayer flags. One need not practice an Eastern religion to embrace the beauty and blessings embodied in these colorful flags. I have my flags strung between two trees and am filled with warmth when I see them gently fluttering in the breeze.

The Tibetans believe that the prayers will be scattered by the wind, spreading the good will and compassion into the surrounding area.

• A subscription to “In Good Health.” I couldn’t resist. Send inspiration and trusted health information to your friends and family who live alone. Your holidays and theirs will be healthier and happier for it!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, you can call her at (585) 624-7887, email her at gvoelckers@rochester.rr.com.

ing public health challenge,” wrote lead author Jennifer Pinto-Martin, director of the Center Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) at Penn Nursing. “Emerging studies suggest that low birthweight may be a risk factor for autism spectrum disorders.”

Links between low birthweight and a range of motor and cognitive problems have been well established for some time, but this is the first study that establishes that these children are also at increased risk for autism spectrum disorders (ASD).

“Cognitive problems in these children may mask underlying autism,” said Pinto-Martin. “If there is suspicion of autism or a positive screening test for ASD, parents should seek an evaluation for an ASD. Early intervention improves long-term outcome and can help these children both at school and at home.”

The researchers, including a team at The Children’s Hospital of Philadelphia, followed 862 children from birth to young adulthood finding that five percent of the children were diagnosed with autism, compared to one percent of the general population in what researchers called “the first study to have estimated the prevalence of ASD using research validated diagnostic instruments.”

G. Randall Green: MD, JD, MBA St. Joe’s doctor holds degrees in medicine, law and business administration, founded two medical device companies in two different states

By Suzanne M. Ellis

G

. Randall Green was born in June of 1968 in San Francisco.

From the time he entered kindergarten five years later until the spring of 2011, Green would spend 35 of his next 38 years in school.

By May of this year, Green, a cardiothoracic surgeon at St. Joseph’s Hospital Health Center, would hold four undergraduate and graduate degrees, two board certifications, and a head-spinning number of honors, awards, publications, research grants to his credit, and invitations on the lecture circuit.

Those degrees include a bachelor’s degree (1989) in biology from LeMoyne College, a graduate degree (1990) from Oxford University, a doctor of medicine (1994) from Northwestern University Medical School, a juris doctorate (2009) from the Syracuse University College of Law, and a master’s degree in business administration (2011) from The Johnson School at Cornell University.

“With the exception of three years that I spent in Rochester, I’ve been going to school for 38 years,” said Green, 43, of Manlius. “I guess I’m crazy, but I do love learning.”

Indeed.

“Dr. Green is the first and only heart surgeon in the United States to have a Doctor of Medicine, a juris doctorate and a master’s in business administration,” said Kerri Ganci, director of public relations and marketing for St. Joseph’s Hospital Health Center.

In August, the prestigious Center for Healthcare Innovation (CHI) announced that Green had become a member of its strategy group.

CHI, according to its website, is a “nonprofit, non-partisan, independent international organization whose mission is to support and stimulate global life sciences innovation by encouraging collaboration among academia, corporations, entrepreneurs, professional firms, governments, investors and non profit organizations.”

Green “perfectly fits the elements we seek for the strategy group: excellent leadership skills, entrepreneurial passion and business owner, (he is) comfortable with moving seamlessly between for-profit and non profit sectors … and he has a strong commitment to education,” CHI officials said in an Aug. 26 news release. “He also adds expertise in the medical device field, which is important to CHI. [He] is a practicing surgeon, completing heart operations most days of the week, so he adds the physician’s perspective, too.”

Planning Ahead

Green said he knew at a young age that he wanted to be a surgeon.

“It’s always been planned, and I don’t think you get anywhere in life if you don’t have plans and goals,” he said. “Being in cardiothoracic surgery was goal No. 1 from the time I was in high school, when I scrubbed for my first case.”

He had the opportunity to be in that operating room, he said, because his mother was a cardiothoracic nurse.

“I just plain loved surgery and

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This photo of Dr. G. Randall Green, his wife and children was taken last summer at a family wedding. Next to Green is his wife, Meg, and their children, from left, are Casey, Hope and Nate. Green, a cardiothoracic surgeon at St. Joseph’s Hospital Health Center, holds a number of academic degrees including medical, law and business. He is also the founder of two medical device companies.

I loved the challenges associated with it,” he said. “I love the technical challenges and the intellectual challenges that go along with caring for the sickest patients in the hospital.”

As time passed, Green said, earning law and business degrees seemed a natural route in his educational journey.

“I had always been interested in medical device innovation, but you can’t innovate medical devices unless you start a business,” he said.

“And the licensing of patents is a very complicated legal exercise. To be successful, one needs to understand its complexities.”

In 2006, Green began his study at SU’s College of Law, graduating in 2009. Less than two months later, he was enrolled in Cornell’s MBA program, graduating in May of 2011.

“Business is all about management, understanding how to run a company, what goes into a company, how to grow a company,” he said. “You can spend money hiring a business consultant. You can spend money hiring a lawyer. You can talk to a physician about these ideas regarding medical innovation, but there is a disconnect there.”

“The reason to do business, law and medicine all at once is because those are the three things one needs for any new medical venture to be successful. My opinion was that all of those in one place creates the kind of efficiency that will allow my businesses to be more successful.”

Green is also the founder of two

medical device companies: Secant Therapeutics in New Jersey and Vapsys Corp. in Massachusetts. Secant seeks to commercialize a “catheter-based mitral ovalve repair devices,” and Vapsys is developing a “ventilator-associated pneumonia prevention devices,” said Green.

John Cannizzaro, the cardiac service line administrator responsible for all cardiac-related programs at St. Joseph’s, said Green is “a tremendous asset” to anything in which he’s involved.

“Randy is extremely enthusiastic, extremely motivational, and he really shows tremendous leadership abilities and communication skills,” Cannizzaro said. “He is focused on the team concept, and he’s very down to earth. Randy is always open to new ideas, he listens extremely well, and he has the brilliance to incorporate ideas generated by the whole surgical team.

He relates well to everybody and as brilliant and bright as he is, he doesn’t ever take the ‘I-know-it-all’ approach.”

However, the thing that impresses Cannizzaro most about Green, who has been married for 20 years and is a father of three, has little to do with medicine, law or business.

“From hanging out with Randy so much, I honestly don’t know when he finds time to sleep,” Cannizzaro said.

“Even with everything he has going on, he is a deeply devoted family man, and I have always felt that family comes first for him. To me, that is what makes him a truly special individual.”

December 2011 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 11

Parenting

By Melissa Stefanec

Yes to Vaccination If it weren’t for the bombardment of vaccines we received as children, some of us wouldn’t have made it into adulthood

I

t’s been four months since my wonderful daughter entered this crazy world. She has made my life a lot busier, but somehow she has also made it less hectic. How can a sane new mother possibly say that having an infant makes her life less hectic? Let me explain.

The world we are living in today is crazy. Rebellion and crackdowns in the Middle East, natural disasters, famine, disease, hunger, war, abuse and depression rack the headlines. Debt, default, deadlock and distress are plaguing political systems and economies. This constant stream of depressing information is broadcasted into our everyday lives and it becomes contagious.

All of a sudden everything in life can start to feel a lot worse than it really is. As a mother I stress about paying the bills, keeping my home and car in working order, insurance policies and mortgages. Keeping everything current and organized can be a nightmare.

The pressure might be oppressive,

but there is something in my life that lightens the load and that something is my family.

My daughter is a daily reminder that life is pretty darn awesome.

These people are all host parents in the Treatment Foster Care Program at Cayuga Home for Children

What does that mean?

It means they have big hearts,

How can I pay attention to the headlines when my daughter is roaring with laughter? How can I think about the debt crisis in Greece when her perfect face is looking at me with awe and wonder?

The answer is I can’t.

She has a way of making me forget about the bad stuff in life and slowing down my brain. She makes me live in her wonderful moments. She reminds me the important things in life aren’t the big things, they are the little things.

In my case, she is the little thing that keeps me sane and puts some awe and wonder back into my days.

Since my daughter is not sitting next to me while I write this column, my practical side is kicking into high gear and insisting I put something other than personal sentiment in this month’s column.

So here is some other stuff that is playing out in my life as a parent.

Next week my daughter is going in for a well child visit and getting her second round of vaccines. I got off the hook easy last time and had grandma bring her. This time my husband and I are both going. With my fear of needles and his fear of anything the least bit unpleasant ever happening to his daughter, this visit is sure to be a riot.

One of the big issues many parents discuss is whether or not to vaccinate their child.

If you follow the Centers for Disease Control’s vaccine schedule your child can receive up to 23 vaccines in the first year. Although I’m not looking forward to her next round of shots, I realize they are necessary. If it weren’t for the bombardment of vaccines we received as children, some of us wouldn’t have made it into adulthood.

Some people worry about vaccines having a link to autism and others about the presence of mercury. Others worry about serious side effects from vaccines. I’ve done my homework and know better. All of the authors from the study involving linking autism to vaccines have rescinded their work.

The article drawing the connection first appeared in 1998 in the British Medical Journal. That article has not only been removed, but at the beginning of this

year the journal labeled Wakefield’s (the lead author of the study) work as down-right fraudulent. I’m not going to base decisions about my child’s health on fraudulent work and I urge other parents to look at the data and scientific research instead of listening to non-medical professionals and parents on the playground.

Serious side effects from vaccines are very rare. The DTaP vaccine, which most babies get three times by the age of 6 months, is very safe. The vaccine protects against diphtheria, tetanus and pertussis.

According to the Centers for Disease Control (CDC), a severe allergic reaction happens in less than one out a million children vaccinated. Other severe problems like permanent brain damage or coma occur even less than this and the CDC states, “These are so rare it is hard to tell if they are caused by the vaccine.” (For a complete list of vaccine side effects from the CDC visit: www.cdc.gov/vaccines/vac-gen/sideeffects.htm).

Compare that with actually contracting tetanus. That disease kills 20 percent of the people who contract it.

That tells me I’d better take my chances on the vaccine. My daughter may feel a little junky next week, but whatever she will go through has to be easier than suffering from the serious diseases vaccines protect against.

I’m not a doctor and most parents I know aren’t medical professionals, but we owe it to our children to go out and do our homework.

We should do this not only for vaccines, but on any topic affecting our children.

We live in an era where seemingly endless information is available in seconds. We can certainly take the time to sift through some of it. Talk to doctors and do some reading of your own.

Don’t be afraid to ask tough questions of doctors or of fellow parents.

As Americans we are so fortunate, we have the means to educate ourselves.

I resolve to keep doing just that and not for selfish reasons, but so my daughter has the very best chance of growing up to be a happy and healthy smartypants.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

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SmartBites

E. Syr

By Anne Palumbo

The skinny on healthy eating

TICKETS MAKE GREAT STOCKING STUFFERS!

sprouts are low in fat, calories and cholesterol, and moderately high in fiber.

But unlike most vegetables, Brussels sprouts deliver an unexpected nutrient: about 2 grams of protein per serving.

Helpful tips

Choose firm, compact sprouts — from bulk displays vs. packaged containers — that are bright green in color. Select sprouts that are similar in size, as this will allow for more even cooking. Before storing sprouts in refrigerator, remove yellow or wilted outer leaves, but do not wash. Fresh sprouts will keep for 3 – 5 days.

Nature’s Cancer Warrior:

Brussels Sprouts

E

ver since I read that “up to 30 percent of all cancer is related to diet” (Dr. Mitchell Gaynor, Weill Cornell Medical College), I have been on a mission to avoid foods associated with an increased risk and consume those linked with cancer prevention.

Topping my list of cancer-fighters?

Cruciferous vegetables such as broccoli, cauliflower, cabbage, and Brussels sprouts.

According to research published in the “Journal of the American Dietetic Association,” one of the phytochemicals found in cruciferous vegetables — sulforaphane — can stimulate enzymes in the body that detoxify carcinogens before they damage cells. Lucky for all of us who adore Brussels sprouts, this mini cabbage teems with sulforaphane.

Detoxification benefits notwithstanding, I also reach for Brussels sprouts, especially during flu season, because they’re super high in vitamin C. We’re talking 80 percent of our daily needs in half cup. A vital nutrient, vitamin C helps the body maintain

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Oven-Roasted Brussels Sprouts with Garlic and Parmesan healthy tissues and a strong immune system. What’s more, this powerful antioxidant may also help the body fight off cancer by stabilizing free radicals.

Another reason to bag the Brussels: This vegetable may keep inflammation at bay through its impressive concentration of vitamin K: nearly 140 percent of our daily needs in half cup. According to a study published in the “American Journal of Epidemiology,” higher intake of vitamin K may decrease the incidence of inflammation that has been linked to a variety of diseases: cancer, Alzheimer’s, atherosclerosis, and more.

Like so many vegetables, Brussels

1 ½ pounds Brussels sprouts, trimmed and halved 3 ½ tablespoons olive oil 1 tablespoon balsamic vinegar 2 minced garlic cloves ½ teaspoon red pepper flakes (optional) Salt and pepper 3 tablespoons shredded Parmesan cheese (or more) Adjust oven rack to middle position and heat oven to 400 degrees.

Toss Brussels sprouts, 2 tablespoons oil, 1 tablespoon balsamic vinegar, ¾ teaspoon salt, and ¼ teaspoon pepper in large bowl until sprouts are coated.

Transfer sprouts to baking sheet and ar-

range, cut side down. Roast in oven for 15 minutes, then flip the sprouts to cut side up and roast for about 10 minutes more or until gently browned. Transfer to serving bowl.

While Brussels sprouts roast, heat remaining 1 ½ tablespoons olive oil in small skillet over medium heat until shimmering. Add 2 minced garlic cloves and ½ teaspoon red pepper flakes; cook until garlic is golden, about 1 minute. Remove from heat.

After transferring sprouts to bowl, add garlic oil, gently toss, then season with salt and pepper to taste. Sprinkle with shredded Parmesan cheese before serving.

Anne Palumbo is a lifestyle columnist, 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.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

Seniors Help Build the Gingerbread Gallery at the Erie Canal Museum A delicious holiday tradition for more than 25 years

M

ix together a little gingerbread, some royal frosting, pretzels, marshmallows and a variety of other tasty treats. Stir in a large scoop of ingenuity, and a few tablespoons of good-natured joking among family and friends, and what do you get?

A collection of creative and colorful confections that make up the Gingerbread Gallery at the Erie Canal Museum in downtown Syracuse, a delicious holiday tradition for more than 25 years.

The museum invites bakers to compete in one of five categories — youth; family/group; senior; confectioners and corporate. Ribbons, cash prizes or trophies are awarded, depending on the category. Museum visitors are also invited to choose their favorite entry.

When the 26th Annual Gallery opened in November, one of the displays was of an Erie Canal village, built by the staff and residents of Emeritus at West Side Manor Assisted Living in Liverpool.

Sue D’Onofrio-Ansaldo, life enrichment director at Emeritus, leads a group of about six residents in their work.

She tries to keep the group small, she said, so that everyone can have a hand in it.

Layers of marshmallows form the ground and hills, covered with

royal frosting and green-dyed coconut.

While Nancy Jones, Jane Tremont, and “Stoney” Stonesifer work on the job of frosting, Anna Mae Selley mixes coconut into the frosting, to give the illusion of grass, and Fred Owen is busy assembling fences out of pretzel sticks.

He doesn’t need a ruler or any special tools to do the measuring and cutting; he just nibbles off the ends of each stick to make sure they are all the same length. Exacting work, but someone has to do it.

Lining the marshmallow banks of the blue gel canal will be four buildings, which the residents decided should be a saloon, a jail, a general store and a church, in that order. They jokingly decided that it would be most appropriate that the saloon and jail be next to each other.

One design from last year has the museum development and marketing director, Natalie Stetson, still raving this year. It isn’t one’s traditional gingerbread structure.

When one thinks gingerbread, perhaps images of chalets or little houses from the Hansel and Gretel storybooks or come to mind. But an Airstream trailer?

Well, Carol Ann Cook, 62, and her granddaughter, Eloise Smith, now 15, both of Skaneateles worked on the project. The pair has done many things

together over the years, including knitting and quilting classes, Cook said, so they decided to join in the fun last year and enter.

“I have this thing for Airstream

trailers,” Cook said. The daughter of an IBM executive, she remembers being fascinated by the metal briefcase her father had.

Her husband, Stuart, suggested

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

Nancy Jones, left, a resident of Emeritus at West Side Manor Assisted Living in Liverpool and Sue D’Onofrio-Ansaldo, life enrichment director at organization, work on frosting the marshmallow layer of their Erie Canal gingerbread village. one day they take a ride and asked her where she’d like to go. They ended up visiting an Airstream factory in the Midwest, and when the two sold their 40-foot sailboat, she wanted to buy an Airstream trailer and travel.

“I have wanderlust,” she said.

Until then, Cook and Smith created their own version. Perhaps it was a little smaller and not as aerodynamically correct as the real thing, but it sure was sweeter and still very detailed, right down to a license plate and the silver ball rivets.

The pair worked on it for a few hours every Sunday through November last year—“a month of Sundays,” Cook joked.

Since everything in the display

has to be edible, the vignette, with the trailer decorated for the holidays set in a winter camping scene, included gingerbread and royal icing, of course, black licorice tires, marshmallow tanks and a snowman, upside-down ice cream cones with green icing for trees, chocolate stones, fruit strips for the campfire, a picnic table that her husband, a skilled woodworker, made out of pretzels, and chewy Swedish fish in their blue frosted stream.

Icing and other remnants were all over her kitchen, Cook said.

“It was a mess, and it was wonderful,” she said, smiling.

Sounds like a great recipe for holiday fun. The gallery will be open until Jan. 8.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

“I had cancer.

Cancer never had me.”

Yesterday, I got out my fishing rod. I couldn’t help thinking of everyone at HOA. It was last spring when I found out. I was overwhelmed, distraught - and scared. I thought my fishing days were over. Then I went to HOA. My medical team all said, “We have the technology to fight this thing!” and showed my the CyberKnife. It sounded scary, but when I learned how it worked and how safe it was, I had hope for the first time.

Your attitude really inspired me, your staff always encouraged me and your plan of action worked. I may have had cancer, but cancer never had me. Today, my kids and I are heading up to the lake.

Happy Holidays What to Give: Healthful Food Gifts for the Holidays

By Deborah Jeanne Sergeant

Y

our children may have visions of sugar plums dancing in their heads on Christmas Eve, but giving more healthful food gifts this season will benefit your recipients’ health. While sweet treats are fine in moderation, healthful foods can be treats, too, if they are delicious and presented well.

Homemade gifts can help you stretch your gift giving budget and help you give healthful presents, too.

Put together a DIY mix in a large Mason jar and tie a raffia ribbon around the top. The layers of dry ingredients not only look pretty, but are also good for one, too.

“There are a lot of different nutrients in dried soup and chili mixes like protein and fiber,” said Laurel

Sterling Prisco, registered dietitian and wellness educator for Natur-Tyme in Syracuse. “You could put in oatmeal, spices and raisins, it could be makeyour-own energy bar mix, offering good oils and proteins. Or make bread or scone mixes. Using oatmeal, hemp, rice protein or garbanzo bean protein, makes it healthier with the good oils and protein, plus other vitamins and minerals.”

Add a wooden mixing spoon and potholders to the gift and perhaps tuck it all in a large pot or bowl. Wrap the whole gift with cellophane and tie it off at the top with a bow.

Nestle in a pretty basket a few small bottles of olive oil and balsamic vinegar, a small ceramic dish and add some garlic and herbs you dry your-

14 Gifts NOT to Give Janel Welch, registered dietitian and clinical nutrition manager at a Rochester hospital ( Unity Health), offered 14 food gifts not to give this season: 1. “Don’t give sugar-free candies or chocolates to someone with IBS (irritable bowel syndrome) or other intestinal issues. The sugar replacement often used in these products is maltitol, which is only partially digested and absorbed. The part that isn’t digested tends to ferment in the intestinal tract and attract water. To someone with diarrhea-predominant IBS, having a few pieces of these sugar-free goodies can cause some ‘intestinal issues.’ As someone who has IBS, I can speak from sad experience. We’ll leave it at that.

2. “Pay attention that you don’t give tea with special properties to someone whom it might offend. The Republic of Tea, for example, makes ‘Get Lost’ tea, described as ‘herb tea for weight control’; ‘Get it Going’ tea for regularity; and ‘Get Gorgeous’ tea for clear skin.

3. “Be sure you don’t give alcohol to someone who doesn’t or shouldn’t drink. Even if someone has consumed alcohol in the past, they may now be avoiding it for a number of possible reasons.

4. “Don’t give those tins of stale popcorn to pretty much anyone. If it isn’t fresh, it isn’t worth the calories.

5. “Don’t give fruitcake as a food gift, because all the fruitcake jokes known to man are bound to ensue moments after it is unwrapped.

6. “Don’t give a gift assortment of dark chocolates to someone who is passionate about milk chocolate or vice

versa. The same goes for giving creamfilled chocolates to someone who is wild about nuts and chews.

7. “Don’t give alcohol or anything with caffeine to a member of the Church of Jesus Christ of Latter-Day Saints. These items are not in line with their beliefs.

8. “If you don’t know the gift recipient all that well, avoid holiday processed meat gift packs such as those from gourmet catalog companies or other foods containing meat, in case your recipient is a vegetarian. Give Vegan Dark Chocolate Bars, Andean Dreams Vegan Cookies, GoRaw Flax Snacks, Mrs. May’s Vegan Snack Mix, 3 Betty Lou Fruit Bars, Dr. Lankin’s Awesome Almonds flavored almonds, or Sensible Foods Dried Fruit.

9. “Don’t give food gifts that include chocolate, peppermint or spearmint, garlic and onions, coffee, caffeinated tea, citrus, tomato products, or chili peppers, to someone who suffers from acid reflux.

10. “Don’t give any food containing pork or pork products, or that combines dairy with meat products, to someone who keeps kosher or observes Muslim dietary laws.

11. “Don’t give peanut brittle, caramel apples, or candy canes to people with braces.

12. “To that friend of yours who is working hard to lose extra pounds, don’t give a gift card to The Cheesecake Factory.

13. “Don’t give chocolate-covered insects to people who might be ‘bugged’ by it. This actually happened to an acquaintance’s mom, and she was definitely not amused.

14. “If you’re giving to someone with dentures, make sure it’s a food they can chew, not something hard like nuts or apples.” (IGH Rochester)

Want to give healthful food gifts from local sources? Shop here: ■ Central New York Regional Market (2100 Park Street, Syracuse, 422-8647, cnyrma.com) carries local goods, home décor and gifts.

■ Natur-tyme (5898 Bridge St., East Syracuse, 488-6300, www.natur-tyme.com) sells an amazing array of bulk goods, natural and healthful foods and supplements of all sorts.

■ Ontario Orchards (7735 Route 104, Southwest Oswego, 343-6328, www.ontarioorchards. com) offers gift baskets, locally-grown produce and locally-made products, and fresh-pressed cider.

■ Sauders Store (2168 River Rd., Seneca Falls, 568-2673) carries bulk foods, perfect for making big batches of homemade soup mix. Pre-made mixes are also sold in bulk.

■ Spring Lake Bulk Foods & Fabrics (4250 Wolcott Spring Lake Road, Savannah, 594-8485) also carries bulk food, pre-made mixes of all sorts and an impressive array of fabrics and craft items. Just walking the aisles will inspire many unique gift ideas.

■ Taste of CNY (tasteofcny.com) looks like it was started to offer former Central New York dwellers an online portal for finding local brands; however, the site can also give you ideas more local items and you can also ship items or gift certificates to far-away friends and family, too.

self. (A few tea towels will cushion the bottles nicely.)

Mash garlic and dry on a baking sheet at 250 degrees with the oven door open until it’s no longer moist. Pack in a small, decorative jar with some dried Italian seasoning herbs. The recipient can combine the ingredients in the bowl for dipping the bread.

“This could introduce people to oils that they may have never tried and it can promote heart-healthy oils,” said Maureen Franklin, registered dietitian with Upstate University Hospital at Community General.

If you’re not handy in the kitchen, buy the wares of those who are. Especially considering the movement toward locally-sourced foods, many people would welcome the gift of local honey, jam, maple syrup or other “putup” goods. Add some whole-grain crackers, whole wheat pancake mix or other closely associated food.

Even “snacks” can make a healthful food gift.

“Package together salsa, hummus and chips — your own or [storebought],” Sterling Prisco said. “Hummus has protein. Some chips have protein and good fats and whole grains.”

Select unusual or gourmet varieties to provide interest and a touch of luxury. A cute little dish for the salsa and hummus adds a nice touch.

Consider your recipients’ healthful interests. An outdoorsy type might appreciate a backpack full of portable snacks: dried fruit or fruit chips (no sugar added), unsalted nuts and seeds, and low-fat granola bars.

“Trail mixes or bags of nuts and December 2011 •

dried fruits offers nutrients and beneficial oils and protein,” Sterling Prisco said. “A little bit of 80 percent cacao dark chocolate is good, too.”

Many busy business people keep snacks on hand in their desks to fight the mid-afternoon slump. Why not provide some special snacks for them to munch?

“I always like seeds or nuts because they have some good nutritional value, last for long periods of time, and can be presented in a festive jar,” said Caroline Jacobus, a certified diabetes educator and program coordinator for the Central New York Diabetes Education Program. “For example, pumpkin seeds are a concentrated source of numerous health benefiting minerals, vitamins and anti oxidants and can be a great snack.”

Think about the go-getters on your gift list. For those morning larks, feed their need to rise and shine.

“A breakfast basket with steel-cut oats, a variety of dried fruits, Greek yogurt and/or local pancake mix with a variety of butters, such as pumpkin or apple promotes breakfast as an important meal and promotes good fiber intake,” Franklin said.

Families might enjoy a gift basket with a movie or family game night theme.

“This could include healthy snacks such as low-fat popcorn, graham crackers, rice cakes, nut butters, and flavored waters,” Franklin said. “This would promote family time and an opportunity for parents to educate the family on nutritious snacks and nutrition.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 17

Happy Holidays Teen Tech Toys Can Improve Fitness Teens’ fixation on portable technology can be the catalyst for launching new fitness efforts

By Deborah Jeanne Sergeant

I

t seems like teens are constantly plugged in, logged on and sitting down. While modern technology has enhanced our lives, it has also helped fatten our young people.

Instead of engaging in physical activity, many lead virtual lives online while their bodies become flabby and unfit.

But technology can also help teens get active and in better shape.

Teens’ fixation on portable technology can be the catalyst for launching new fitness efforts. Consider putting some of these items under the tree to help your teens improve their health.

Consider applications for their iPod Touch, iPhone or iPad. “Everybody likes MP3 players and smart phones,” said Andy Venditti, owner of Syracuse Fitness Store. “They all have music as motivation. Apple has workout apps where you more or less download a different workout daily and play it through your iPad or iPod.” Many apps target teen boys or girls or anyone with fitness goals. Some offer workout ideas based upon specific equipment, such as: • “iPump & Fitness Builder,” including weights, kettle bells, BOSU balls, and many more.

Users can also search for workouts based upon their location, their fitness objectives, or by keyword. Videos of each exercise make sure they’re performing the movements correctly and users can customize the workouts, too.

For teens who want to improve their fitness level to participate in sports or enhance their appearance but aren’t sure where to start, “iPump” can nudge them in the right direction.

■ “Authentic Yoga with Deepak Chopra” gives examples of yoga poses and workouts to improve balance, flexibility, and muscle strength with instructional videos and photos of each pose accompanied by audio directions.

Girls who want to have a llean, strong body would likely benefit from this app.

■ “iPump Lean” for teen girls emphasizes workouts to tone muscles and get fit. Both video and audio directions guide users through workouts based upon strength training movements, Pilates/yoga movements and cardiovascular activities. Users can also track their progress, too.

■ “Navy SEAL Fitness” app will enthrall any teen who is glued to action movies. He will make it his mission Page 18

•

to complete the app’s exercises that emphasize muscular strength, flexibility and cardiovascular fitness.

■ “MotionTraxx Radio” for iPhone, iPod Touch and iPad, can get idle feet moving to their favorite beat. Teens can choose the intensity of their workout or walking/running pace, all based upon the pace of the music. For teens who love tunes, “MotionTraxx” can get their heart rate up.

■ “iMapMyFitness” is like a high-tech pedometer. Using the device’s GPS, “iMap” helps the user track more than just milage. It also records where the user has hiked, for how long, pace, speed, elevation. A social media element is built in, too. Users can compare their stats with their friends at MapMyFitness.com. For teens who used to be more outdoorsy, this app might motivate them to get back outside. And for those who enjoy social media, the website will add more motivation to get moving.

If your teens’ bicycles have been cluttering the garage, a bicycle GPS may renew their interest.

■ “The bicycle GPS computer can track heart rate and measures speed, distance, time, calories burned, altitude, climb and descent,” said Randy Sabourin, owner of Personal Fitness, Inc. in Syracuse. “The most popular electronic fitness gadget I’ve seen over the past few years has to be the pedometer.”

A traditional pedometer that only tacks the distance walked or run won’t likely impress teens much, but Sabourin said some now have built-in MP3 players or radios, which will add to their appeal for teens who love their tunes.

Digital health monitors, available in sporting goods stores may encourage teens to challenge themselves to keep active.

“You’ll see them wear these on the show, ‘Biggest Loser,’” Sabourin said.

“The body monitoring armband is a fitness gadget promoting weight loss.

Sensors on the armband electronically track activity, calories consumed and

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

burned, and physical changes indicating weight loss progress. They come with a USB plug-in that will download all of the information collected onto your computer. They’re also very popular.”

Teens who are fans of the show will likely know how they work and want to try one out for themselves to.

Teens who love their mobile devices may also enjoy using the GPS to participate in geocaching. Give a $30 year’s membership to the world’s largest geocaching organization by visiting www.geocaching.com.

Geocaching involves using GPS technology to guide hikes outside.

Teens will enjoy following the GPS coordinates to find the hidden “treasure,” earning bragging rights online by finding it first, and hiding the cache in a new location. The caches are usually plastic boxes containing a log book and an item of nominal value. Thousands of people worldwide participate in locations in rural to suburban areas.

Nintendo Wii

The Nintendo Wii and Microsoft Kinect game consoles continue to interest teens and adults in fitness activities. If your teens love video games and are disinterested in outdoor activity, a game console with a few games may be your best bet.

“Games or activities with the Wii or Kinect console get you up and moving,” said Diane Oldenburg, senior public health educator with the Oswego County Health Department.

“There are a variety of levels so you can engage the whole family, whether simple balance activities for Wii Fit or something more competitive like tennis or bowling to go head to head. They have Zumba and dance, too. You’re more likely to hit something to catch their interest.”

Of course, the fitness-based games are an obvious pick; however, they would probably interest teen girls more than boys, who would likely prefer action-based and sports games.

Some of the newer titles based upon games with which teens may already be familiar. These games incorporate players’ bodily movement to play can cajole them off the couch. Players of “The Legend of Zelda Skyward Sword” use the Wii remote as a sword to battle their opponents onscreen, for example. “Zumba Fitness 2” may be a fun choice for teens who love to dance.

Another bonus of these game consoles is that it can help families get active together. Your teens may not admit they like spending time with you and their younger siblings; however, if you meet teens on their terms and with an activity they like, you can increase your family’s fitness and togetherness.

While giving a fitness gadget to teens may seem the sure-fire way to get them moving, select a gift with care.

If the gadget or app ties into something they already like—music, dance, sports, bicycling, etc—it’s much more likely to engage teens.

Happy Holidays Host a Fit Holiday Get-together How about a Christmas Zumba dance party to say “Feliz Navidad” to loved ones?

By Deborah Jeanne Sergeant

D

oes it seem like all you do during the holidays is get with other people to eat?

The holiday buffet for your work party, big family meals, church potluck and cookie baking parties can all add up to a whole lot of calories.

But you can host get-togethers that focus on activity instead of eating.

It may seem counterproductive to launch a fitness campaign during the holidays; however, “most people tend to be more sedentary during the holidays, so anything we can do for physical activity is a great idea,” said Diane Oldenburg, senior public health educator with Oswego County Health Department. “When we do it with other people, we are more apt to do it than if we do it ourselves. We often think exercise is work or we make it seem like work when it can be a social thing and not drudgery.”

Instead of hunkering down indoors over a spread of rich foods, invite friends, family and coworkers to get outside and get moving with you.

Ice skating, snow shoeing, sledding and skiing can provide outdoor fun families can enjoy together. But these activities are not just fun ways to bond.

“Ice skating helps with balance and coordination and using large muscle groups,” Oldenburg said. “There’s some cardiovascular benefit too if you’re not too worried about falling, like I am!”

If your children don’t have skates, you can find used ones inexpensively at a store such as Play it Again Sports or online on eBay. The same goes for

Meet your

snowshoeing and skiing equipment.

These activities offer many of the same benefits of ice skating.

Instead of cruising in your car to look at the Christmas lights displays, bundle up and walk around your neighborhood (or drive to a well-lit neighborhood and park the car). Lights on the Lake offers a few opportunities to walk or run through the lit displays (visit www. lightsonthelake.com for times). A brisk walk burns calories and gives you time to chat with friends.

“If it’s safe to, neighborhood walking or mall walking can be a great activity,” Oldenburg said.

“The lights and decoration take your mind off the physical part of it so it doesn’t seem like exercise.

There’s no cost involved if you don’t take your purse in with you to the mall.”

Before engaging in an activity, warm up by gently stretching and stretch afterwards, too.

“It minimizes any aches and pains afterwards,” Oldenburg said.

You can also burn some calories helping others. Sign up your family to help at a soup kitchen (which may be understaffed during the holidays), go caroling for your church or civic group or take turns ringing the bell for the Salvation Army.

Performing any of these seasonal activities keep you on your feet and reduce stress because you’re doing a good deed.

If you want to warm up with a hot drink afterwards, go easy on the cocoa

or fancy coffee drinks. Many of these are loaded with sugar. Try hot tea or warm cider instead, which offer antioxidants and are lower in calories than many sweetened drinks.

If you really dislike the cold, don’t just hibernate on the couch in front of your favorite holiday movies with friends and family.

Randy Sabourin, owner of Personal Fitness, Inc. in Syracuse, recommends hosting a Christmas Zumba dance party to say “Feliz Navidad” to loved ones.

“Everyone can watch ‘The Christmas Story’ together after,” he added.

Oldenburg suggested throwing a

Wii party.

“Having people over to play a game you already have won’t cost anything,” she said.

Grab a friend you’ve been meaning to spend time with and try a new indoor activity. Since the holiday season is a slow time for most recreation venues, you can likely get a reduced rate at a fitness center or gym that offers classes. Most offer a free trial class and it can be good way to spend some time with a friend during the season.

Who knows? Maybe you’ll both find you like it so much you’ll continue as part of your fitness routine for a more healthful new year.

care team… Professional Excellence, Compassionate Care…Close to Home.

At Auburn Memorial Hospital, we respect that you have a choice of medical facilities. The decision is not one you take lightly…neither do the physicians who overwhelmingly refer their patients to us. When you are our patient, our highly qualified Care Team focuses on one thing: YOU. We take the time to understand your medical history and we personalize a care plan just for you. We strive to minimize your waiting time and give you priority treatment for acute conditions. AMH has invested in a state-of-the-art, ultra secure Electronic Medical Records system to seamlessly, instantly share your information among all members of your Care Team. That means you only tell your story once and your Care Team stays up-to-date on all aspects of your care. We are 800 staff members and 230 clinicians strong. We perform thousands of inpatient and outpatient procedures each year…focusing on one patient at a time. When you choose AMH, your Care Team provides professional excellence and compassionate care….close to home.

Auburn Memorial Hospital 17 Lansing Street, Auburn, New York 13021 P:315-255-7011

www.auburnhospital.org About the Care Team: The AMH Care Team of 800+ employees and 230+ clinicians perform thousands of inpatient and outpatient procedures each year. Our physicians are Board-certified in one or more specialties, including: Anesthesiology, Emergency Care, Medicine (including Allergy, Cardiology, Dermatology, Endocrinology, Family Practice, Gastroenterology, Internal Medicine, Nephrology, Neurology, Oncology/Hematology, Pulmonary Diseases), Oral Surgery, Obstetrics and Gynecology, Pathology, Pediatrics, Psychiatry, Radiology (MRI & Nuclear Medicine), and Surgery (Bariatric, Ear, Nose & Throat, General, Orthopedic, Ophthalmology, Plastic Surgery, and Urology).

December 2011 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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When you need laboratory tests, we’re in your neighborhood Experienced professional staff • No appointments necessary • Many locations open on Saturdays • Most medical insurance plans accepted

In Syracuse

North of Syracuse

Crouse Hospital PromptCare in CNY Medical Center (315) 470-2951

BALDWINSVILLE Village Commons (315) 857-0329 CICERO Lakeshore Professional Bldg (315) 752-0077 LIVERPOOL North Medical Center (315) 452-2280

Crouse Hospital Patient Preadmission Center (315) 470-7942 St. Joseph’s Hospital Health Center Medical Office Centre (315) 703-5004 Upstate University Hospital at Community General Physician Office Building (315) 492-5428 FAYETTEVILLE Northeast Medical Center (315) 329-7047

PULASKI North Jefferson Street (315) 298-4743 In the suburbs

CAMILLUS Medical Center West (315) 468-0501

EAST SYRACUSE Medical Center East (315) 656-9560

Maps and directions online at www.laboratoryalliance.com

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FREE with your paid subscription: the 2011 CNY Healthcare Guide.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

What They Want You to Know:

Nurse Manager

By Deborah Jeanne Sergeant

HealthCarePathway.com describes nurse managers as “basically nurse administrators who oversee nurses, assistant managers, and who are responsible for running their department or ward. Their duties involve hiring, training, evaluating staff, scheduling work shifts, and ensuring that the patients are receiving the best care. They also must stay abreast of changes in nursing and advancements in technology and incorporate that into their work setting for their staff.” They must have a bachelor’s degree in nursing and experience. Certification with The American Organization of Nurse Executives may be required.

• “As a nurse manager, we are continuously juggling multiple priorities at any one time. Patient safety, quality of care and the patient’s satisfaction with that care, is always at the forefront.

• “On any given day I may meet with a patient, a family member, a staff person, a physician, attend meetings, review charts, review staffing, research new practices to put into policy, provide staff education or just help out clinically in time of need.

• “There is always one more thing to do before going home and it is difficult to put a ‘stop time’ on our day.

• Nurse managers are also mentors to staff and we are there to offer them guidance, support and to promote their professional growth.

• “I would say a primary responsibility is to continue to grow professionally ourselves and never stop looking for ways to improve patient care and their perception of that care from a customer service standpoint. We depend on the patients and their families to let us know how we are doing and they need to know we value their input.”

Jan DeRocker, nurse manager, executive director of critical care at Oneida Healthcare Center • “Hospital health care is an extremely complex, every changing environment.

• “Nurse managers balance the requirements of this environment to ensure staff nurses are able to practice effectively and with compassion, and that the organization is successful in meeting its goals.

• “Everything a nurse manager does is focused on quality care and satisfaction of patients and families. We must be ever passionate about constant improvement and inspiring our staff to do the same.

• “Managers attempt to remove barriers in order for staff nurses to give very good care consistently. We talk

to patients to find out their experience so we can apply it to others or make things right when we have not met someone’s expectations.”

Ryan Clapper, manager of Unit 2-8 at St. Joseph’s Hospital Health Center • “Knowing is everything, which is part of our slogan. As a manager and a nurse, it’s about knowing, typical middle management. The patients and families are first. I need to know them first to know the kind of care I’m providing. I need to know my staff. I need to know the doctors who work here.

• “It’s a lot about providing the resources everyone needs or smooth the way so they can get the resources they need.

• “We’re all here because this is what we want to do. It would be wonderful for families and patients to know we’re here because we want to make a difference.

• “Sometimes, in a time a crisis, we expect families to feel distraught and upset but we want them to know we want the best outcome for the patient.

• “We really have family-centered care. We have places for family members to sleep over and we want them to feel they’re part of the care. It’s best for the patients.

• My nurses need to be able to safely hand off care to a new nurse. To make it safe, it’s good it you step back a little and let them do that. It’s important for the nursing staff to communicate to the families, but during the shift change time, we need a half hour for the new ones coming in to get a feel for what’s going on.

• If people ask questions that would help. They should keep a journal of what they’ve learned through research and write down their questions. People think of things after the moment.”

Catherine Stephens, patient service supervisor/nurse manager, Neuroscience Intensive Care Unit at Upstate University Hospital Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.

DRUG SHORTAGE Problem affecting patients, pharmacies in CNY

By Deborah Jeanne Sergeant

P

rescription drug shortages seem like a problem for underdeveloped countries; however, within the past few years, it has become a pressing issue for American pharmacists who cannot supply their patients with the drugs they need.

“It’s nationwide,” said Steven Ciullo, the director of Upstate University Hospital Pharmacy Services. “It’s been getting much worse. This year it’s out of control. We usually see 200 drug shortages a year and we’re over 300 already.

“It’s affecting critical medications: controlled substance pain relievers like morphine sulfate, paralytic agents, chemotherapy agents. They’re essential. The list goes on and on and on.

Some are injectable medications which are critical to patients in dire need.”

Many patients who rely upon the medication to treat cancer cannot simply wait until a new supply comes in. While they wait, the cancer grows and grows. Many of the drugs involved Dick are generic, injectable drugs used in hospitals, but it’s never the same specific drugs.

“It could be a blood pressure drug this week, a surgical medication next week, and a pain medication the next,” said Michael Dick, Oswego Hospital pharmacy director. “Drugs for cardiovascular, emergency care, surgery and anesthesia use are affected the most; however maintenance medications for diabetes, blood pressure, and other disease states are also affected.

“Whenever you begin to receive a medication which was previously unavailable, the next day there seems to be another notice for a different drug in short supply.”

Simply switching to a drug from another manufacturer isn’t easy within an institutional setting. It takes time to locate the alternative, ensure it is suitable, and possibly train staff, too.

An alternative drug may have different packaging, dosing or other usage issues that necessitate a staff in-service

session to ensure that the drugs are properly administered.

It may seem strange that any company with a guaranteed demand for its product such as a drug manufacturer would not eagerly meet the demand should a competing company not produce enough; however, many factors make supplying prescription drugs much different from supplying other consumer goods.

Mergers and acquisitions among drug companies represent two reasons for shortages, since these changes mean fewer companies are available to produce drugs. Some companies simply quit making certain drugs.

“Fewer manufacturers are producing generics as a business decision, as the process of making them is complex and less profitable than newer drugs,” Dick said.

Ciullo agreed that “many of the shortages are related to manufacturer goal of maintaining profitability,” he said. “More and more, the shortages are related to their attempt to maintain profitability.”

For those who remain in business and are trying to manufacture drugs, production problems, caused by several factors, can result in shortages. If a drug production facility does not pass an FDA inspection, the government may shut it down, even if it is the only US-based manufacturer of the drug.

Drugs imported from other countries may not meet US standards. Or the raw materials may not be available.

“A large amount of the raw materials used in pharmaceuticals comes from outside the United States,” Dick said. “Availability problems can arise during armed conflict or political issues, or when weather and other conditions affect the growth of plants used to produce raw materials.

“In recent years, natural disasters in our own country, fire, flood, tornado, hurricane, have caused damage to manufacturing facilities, hampered mass transportation, and compromised the ability to obtain supplies and manufacture product,” he added.

It would seem an ideal time for other drug companies to produce more of the drugs; however, that’s not a

feasible solution to the shortage most of the time.

Their facilities may not be equipped to make that particular drug and if they are, they may not have the capacity or access to raw materials to produce more.

Manufacturers, suppliers and pharmacies don’t typically stockpile these drugs because the formulation may change, the drugs usually bear expiration dates and it’s expensive to maintain a large inventory.

“As soon as Oswego Hospital identifies a shortage of a drug, we immediately attempt to obtain a supply of a backup alternative,” Dick said. “However, everyone else knows about the substitute and is attempting to obtain the drug as well, thus creating another shortage.”

It’s also tough for hospitals to prevent possible shortages.

Ciullo “When hospitals receive notice that a drug is either in short supply or unavailable, it’s often too late to do anything about it,” Dick said. “Economics prevents you from stocking large quantities of drugs on the shelves just in case.”

The shortages are not just a hospital-based pharmacy problem, either.

Some medication dispensed at local and chain drugstores are in short supply such as those used for pain management and ADHD. When shortages happen, patients need to be proactive and willing to try something different.

“Sometimes there are other drugs out there that often work just as well, have been out on the market for years, and have simply been replaced by the newest and best,” Dick said. “These are some of the options that we attempt to provide physicians when we have to alert them of a drug shortage to enable them to alter their prescribing and provide save alternatives for their

December 2011 •

patients.”

Sometimes the patient can transition seamlessly from one drug to another, but not always. It pays to ask about side effects and contraindications with other drugs, food, drinks and lifestyle.

For prescription drugs, Ciullo advises patients to “try various pharmacies,” he said. “One may have a greater supply than another. Very often, if they use mail order programs, they may have more of an inventory than a local retail pharmacy.”

Do not use a mail order or online pharmacy unless recommended by your doctor, pharmacist, insurance company or a trusted friend.

“Many of those sites are selling counterfeit drugs so you never know what you’ll be getting,” Ciullo said. “I know it’s attractive to people to go that route but there’s enough documentation that it’s a major public health issue.”

Obama Takes Actions on Drug Shortage President Barack Obama signed an executive order Oct. 31 to address an escalating shortage of life-saving medicines. Obama instructed the Food and Drug Administration to get better advance warning of impending supply problems and speed up its review of applications from companies that want to change or ramp up production to address shortages.

The order reflects a proposed law on the shortages that has been stuck in Congress, despite bipartisan support.

However, the order lacks the authority of legislation and U.S. health officials cautioned that its impact could be limited.

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The Social Ask Security Office

Ultra Modern Dentistry Backed by Old Fashioned Values

Bruce Stewart, DDS • Most advanced Laser Periodontal therapy available.

• Implants placed and restored • CEREC Crowns - beautiful, strong, done in one visit • Dental low radiation x-rays • Root Canal therapy • Natural tooth colored fillings • Complete Smile makeovers • Complete recare services including periodontal and oral cancer screenings Extended Payment Plans through Care Credit

By Deborah Banikowski, District Manager in Syracuse.

Save Some Time During The Holidays — Online 321 Main St., Oneida, NY 13421

(315) 363-4940 www.brucestewartdds.com

Susama Verma, MD PLLC General Neurology Dr. Susama Verma, MD PLLC is proud to announce her new location at:

1816 Erie Blvd. East, Ste. B Syracuse, NY 13210 Phone: 315-469-2700 Dr. Susama Verma is offering the recently FDA approved Botox treatment for Chronic Migraine as well as non pharmaceutical treatment for uncontrolled Epilespy.

Now offering DigiTrace Home Monitoring System (Ambulatory EEG) at this office

Dr. Verma is currently taking new patients.

Major insurances accepted. Please feel free to speak with your Primary Care Provider for referral.

T

he holidays are here and that means busy days ahead for families across the nation: gift shopping, preparing for guests, sending out holiday greetings, looking up recipes for favorite traditional dishes, checking those credit card and bank account balances.

Many people have found an easier way to manage many of their activities of the holiday season by going online.

Some shoppers have eliminated the need to go to crowded shopping malls for holiday gifts by taking care of it over the Internet.

Some even look up recipes on the Internet and send holiday greetings by email.

You’ll find that these types of convenient, secure transactions can also be found in places you may not ordinarily think to look — for example, at www.socialsecurity.gov.

You can apply online for benefits, Banikowski obtain information, plan for retirement, and request a replacement Medicare card, even apply for extra help with your prescription drug costs all at www.socialsecurity. gov.

You can handle much of your Social Security business quickly and

Q&A

Q: When a person who has worked and paid Social Security taxes dies, are benefits payable on that person’s record?

A: Social Security survivors benefits can be paid to: • A widow or widower — unreduced benefits at full retirement age, or reduced benefits as early as age 60; • A disabled widow or widower — as early as age 50; • A widow or widower at any age if he or she takes care of the deceased’s child who is under age 16 or disabled, and receiving Social Security benefits; • Unmarried children under 18, or up to age 19 if they are attending high school full time. Under certain circumstances, benefits can be paid to stepchildren, grandchildren or adopted children; • Children at any age who were disabled before age 22 and remain disabled; and • Dependent parents age 62 or older.

Even if you are divorced, you still may qualify for survivors benefits. For more information, go to www.socialsecurity.gov.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2011

securely from your home or office computer. If you visit our website at www.socialsecurity.gov you will find that you can: • get an instant, personalized estimate of your future Social Security benefits; • apply for retirement, disability, and spouse’s benefits; • check the status of your benefit application; • change your address and phone number, if you receive monthly benefits; • sign-up for direct deposit of Social Security benefits; • use our benefit planners to help you better understand your Social Security protection as you plan for your financial future; • find the nearest Social Security office; and • request a replacement Medicare card.

Looking for more Social Security information? You can go online to find out almost anything you need to know about the Social Security program. Information is available on subjects ranging from how to get a Social Security number for a newborn to how to go back to work while receiving disability benefits.

This holiday season, do you want to have more time to visit with friends and family? If so, take care of your Social Security business at www.socialsecurity.gov.

Q: I lost my Social Security card.

Should I get a new one?

A: You may not need to get a replacement card. Knowing your Social Security number is what is important.

However, you can replace your Social Security card for free if it is lost or stolen. Remember, you are limited to three replacement cards in a year and 10 during your lifetime. Learn more at www.socialsecurity.gov.

Q: If both my spouse and I are entitled to Social Security benefits, is there any reduction in our payments because we are married?

A: No. We calculate lifetime earnings independently to determine each spouse’s Social Security benefit amount. When each member of a married couple meets all other eligibility requirements to receive Social Security retirement benefits, each spouse receives a monthly benefit amount based on his or her own earnings. Couples are not penalized simply because they are married. If one member of the couple earned low wages or failed to earn enough Social Security credits (40) to be insured for retirement benefits, he or she may be eligible to receive benefits as a spouse. Learn more about Social Security at www.socialsecurity.gov.

Santa Paws is Coming to Town!

Have your pets photo taken with Santa at the CNYSPCA

December 10 & 11 • 10am-3pm All kinds of Pets welcome!

By Jim Miller

Receive a digital photo in a frame.

Funeral Planning On a Budget With the average cost of a “full-service” funeral running around $10,000, it’s worth shopping around Dear Savvy Senior, I just turned 75, and have been thinking about getting my funeral and burial arrangements taken care of so my kids won’t have to. What funeral preplanning tips can you offer a senior with little money?

Not Dead Yet Dear Not, Planning your funeral in advance is a wise move. Not only does it give you time to make a thoughtful decision on the type of service you want, it also allows you to shop around to find a good funeral provider, and it will spare your kids the stress of making these decisions at an emotional time. Here are some tips to help you find affordable services.

Compare Providers

Choosing a quality funeral home is your first step and most important decision in preplanning your funeral. No matter what type of funeral or memorial service you envision for yourself, it’s wise to talk with several funeral homes because prices and services can vary.

Websites like funeraldecisions.com and funeralpricefinder.com can help you compare.

When comparing, be sure you take advantage of the “funeral rule.” This is a federal law that requires funeral home directors to provide you with an itemized price list of their products and services so you can choose exactly what you want. Be sure to ask for it.

Money Savers

With the average cost of a “fullservice” funeral running around $10,000, there are ways to save that few people know about. For example, if a traditional funeral and burial is what you’re interested in, you can save big — at least 50 percent — by purchasing your casket from a store vs. the funeral home, and your funeral provider must accept it. Two good casket shopping resources that may surprise you are Walmart (visit walmart.com and type in “casket” in their search engine) and Costco (costco.com) who offers its members a large variety of caskets and urns at discounted prices.

Another way to cut your funeral bill is to request a “direct burial” or “direct cremation.” With these options your body would be buried or cremated shortly after death, which skips the embalming and viewing. If your family wants a memorial service they can have it at the graveside or at later without the body. These services usually cost between $1,000 and $2,000, not counting cemetery charges.

Should You Prepay?

Be aware that preplanning your funeral doesn’t mean you have to prepay too. But if you are considering paying in advance, be cautious. Prepaid plans are not regulated by federal law and state regulation is uneven. Before you sign anything, here are some areas you need to be very clear on: • Be sure you know exactly what you’re paying for before committing.

• Are the prices locked in or will an additional payment be required at the time of death?

• What happens if you move to a different area or die while away from home? Some prepaid funeral plans can be transferred, but often at an added cost.

• Are you protected if the funeral home goes out of business or if it’s bought out by another company?

• Can you cancel the contract and get a full refund if you change your mind?

• If you do decide to prepay, get all the details of the agreement in writing, have the funeral director sign it, and give copies to your family so they know what’s expected.

Other Payment Option

There will be vendors, crafts and great gift ideas! Fun for the whole family! www.cnyspca.org (315) 454-4479 5878 East Molloy Rd Syracuse NY 13211

Get Back to Your Life When recovering from a hip or knee replacement, stroke or other medical condition, you want to get back to your life and home as soon as possible.

The road back home starts at The Centers at St. Camillus.

The team of rehabilitation experts in the RehabPathTM Subacute Program provide comprehensive short-term inpatient rehabilitation to help you build strength and independence for a successful and speedy recovery.

For more information about the RehabPathTM Subacute Program at The Centers at St. Camillus, call 488-1500.

813 Fay Road • Syracuse, NY 13219 • www.st-camillus.org

Stressed, Overwhelmed, Worn Out, Inattentive?

Train your brain to better function

There are other ways to set aside money for your funeral, rather than giving it to a funeral home. You can set up a payable-on-death, or POD account at your bank, naming the person you want to handle your arrangements as the beneficiary. With this type of account, you maintain control of your money, so if you need funds for medical expenses or something else, you can withdraw it at any time. This type of fund is also available immediately at the time of your death without the delay of probate.

Neurofeedback, A medication free alternative Neurofeedback is a specialized form of biofeedback that improves mental performance, emotional control and physiological stability.

Enhance the quality of your life: exercise your ability to self-regulate.

Racing thoughts quiet down, mind & body relax, energy increases, mood lifts, sleep and behavior improve, chronic pain lessons…

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

Call today for your free consultation Syracuse Neurofeedback Barry Bates (315) 492-3789 Priscilla Young (315) 350-8816 170 Intrepid Lane Syracuse, NY 13205 www.syracuseneurofeedback.com

December 2011 •

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H ealth News Menorah Park celebrates a century of caring Menorah Park recently hosted a reception Nov. 30 in its Grody Auditorium honoring the Jewish Home’s 100 years of service to the community.

The reception was the beginning of a year of events celebrating a century of caring.

Dr. Irving H. Goldman, grandson of a Jewish Home co-founder, presented his insights on its history as seen through the eyes of his grandfather who he honors with a contribution of the lead gift for this centennial celebration.

One hundred years ago, the Jewish community in Central New York was called to action when an elderly man was found lying sick, helpless and alone in a synagogue basement. In November 1912, the doors of the first Jewish Home for the Aged opened in Syracuse.

The community had purchased, furnished and provided caretakers for a 17-room home on Irving Avenue.

In 1925, residents were moved to the current location on East Genesee Street where space and services have been added to accommodate the changing needs of the community. Among the additions are apartments with supportive services, rehabilitation therapy and independent senior housing.

In 2003, the name Menorah Park was officially adopted to encompass

the variety of services provided on the campus. These services continue to grow and now include an adult day program, a home for developmentally disabled young adults, a research initiative and Syracuse Jewish Family Service.

Crouse appoints bariatric program administrator Tammy Holbert has been appointed administrator of Crouse Hospital’s new bariatric (weight loss) surgery program.

Holbert, who is currently pursuing a master’s degree in nursing from Upstate Medical University, has most recently worked as a surgical registered nurse in the hospital’s OR. In her new role, she will provide dayto-day administration of Crouse’s bariatric surgical program and will oversee growth strategies consistent Holbert with the hospital’s mission, vision and values.

As a regional leader in surgical services, Crouse has committed to building a bariatric surgical center of excellence and recently welcomed bariatric surgeons Jeffrey DeSimone, and Kenneth Cooper to the hospital family.

Partners in the Syracuse-based

Oneida Healthcare Hospital Radiology Staff Raises Over $2500 for Free Clinic

Representatives from the Oneida Healthcare radiology department present a check to the Mary Rose Center Free Health Clinic for the Uninsured. Pictured from left are Radiology Manager Barbara Gerow, Technologist Aid Jackie Hoffmeister, Technologists Stacey Radley and Amanda Mullenax, and PACS Administrator Adrienne Blaszak.

The Oneida Healthcare radiology department recently presented a check for $2,520 to the Mary Rose Center, Oneida’s free health clinic for the uninsured. The hospital’s radiology department raffled off a basket as part of National Radiology Technologist Week Nov. 7-11.

The basket included Vera Bradley handbags as well as a variety of gift certificates for local businesses and $100 cash. The winner of the basket, valued at over $700, was Sue Bajek Page 24

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of Camden. The Mary Rose Center, which is located in the North Side Medical Building in Oneida, exists to provide primary healthcare services to low-income, uninsured adults within Madison County and the surrounding areas. Local physicians and clinicians volunteer their services. According to clinic co-founder, Dr. Rathika Martyn, the money will be used to help patients in need of medication.

IN GOOD HEALTH – CNY’s Healthcare Newspaper •December 2011

CNY Surgical Physicians medical practice, the two surgeons had previously worked at Community General Hospital. Crouse is now the preferred hospital for all surgeons affiliated with CNY Surgical Physicians.

faction in areas such as agency training, communication, overall quality of care, caregiver performance, caregiver morale, response to problems and recommendation of services to name a few.

Physician assistant joins Advanced Orthopedic

News from

Physician assistant Dan Birklin has joined orthopedic surgeon Shawn Mills and the Advanced Orthopedic Group, located in the Oswego Health Services Center (HSC), adjacent to Oswego Hospital.

Birklin, a Central New York native, earned his physician assistant degree from LeMoyne College. In addition to his physician assistant training, Birklin is well-versed in sport injuries as he earned his undergradBirklin uate degree in athletic training from SUNY Cortland.

After a successful career as a professional athletic trainer, he wanted a more active role in healthcare and the management of athletes and their injuries and became a physician assistant specializing in orthopedics and sports medicine.

Since joining Advanced Orthopedic Group, Birklin has been assisting Mills in the practice’s office and at Oswego Hospital’s seven-suite surgery center.

At Home Independent Living gets award At Home Independent Living has been recognized with Home Care Pulse’s “Best of Home Care” distinction, according to the company.

Awarded to the top 25 percent of agencies in client and employee satisfaction scores from Home Care Pulse, At Home Independent Living is now ranked among a select few of the best agencies in the country.

“We know that sometimes it is difficult to make care decisions when you don’t have specific experience with an agency. It was our goal to provide families with the ability to make an informed decision, have tangible ways to measure quality and help them find a comfort level when choosing an agency to work with,” said Aaron Marcum, founder of Home Care Pulse.

Home Care Pulse, a company which measures client and employee satisfaction, created the award to identify those agencies in the private duty home care space that demonstrated a passion for client and employee satisfaction. Home Care Pulse believes that honoring such companies can both educate and help families to make better care decisions for their aging loved ones.

Dean Bellefeuille, president and owner of At Home Independent Living, said: “We could not be more pleased with this designation and we will continue to strive for excellence in all our services. ” The selection process for the “Best of Home Care” distinction includes the evaluation of client and employee satis-

Medical Director Achieves Board Certification in Medical Management — The Certifying Commission in Medical Management (CCMM) recently designated Dan J. Vick a certified physician executive (CPE). Vick is the vice president for medical affairs and chief medical officer at Oneida Healthcare.

Vick received the CPE status based on educational achievements, demonstrated stature as a physician, and experience in the field of medical management.

Vick The CPE designation indicates that a physician has achieved superior levels of professional excellence and management education, while also demonstrating effective knowledge and leadership skills. The Certifying Commission in Medical Management currently lists more than 700 certified physician executives.

The national certifying body for physicians specializing in medical management, the Certifying Commission in Medical Management is a nonprofit corporation chartered by the American College of Physician Executives (ACPE) to establish and maintain the high standards required for physician executive certification. The ACPE is the nation’s largest organization of physicians in health care leadership. The college is recognized by the American Medical Association as the specialty society representing physicians in management and holds a seat in the AMA House of Delegates.

Hospital Joins Infection Prevention Initiative — Oneida Healthcare announced that it has joined the Institute for Healthcare Improvement’s Project JOINTS initiative, a federallyfunded program designed to speed adoption of proven methods to prevent surgical site infections (SSIs) after hip and knee replacement surgery. New York is one of five states participating in the first stage of this three-year project. Project JOINTS stands for “Joining Organizations in tackling SSI”.

Launched in April of 2011, the initiative is focusing on hip and knee replacement surgery because infections following these procedures can be catastrophic for the patient and those caring for them. Treatment can mean multiple surgeries, months of medical and physical therapy, prolonged periods of recuperation, and often considerable pain and sizeable out-of-pocket expenses. For some, permanent disability and long-term financial problems

H ealth News are the results.

With over 1.1 million procedures done in 2008 (the most recent numbers available), knee and hip replacements are two of the most commonly performed surgeries in the US. Depending upon patient risk, it is estimated that between 6,000 and 20,000 SSIs occur annually after these types of surgeries.

“And that number is predicted to rise substantially in coming years due to an aging population staying more active,” said Mary Manfredo, a registered nurse who oversees Oneida Healthcare’s infection prevention efforts.

Health care facilities that choose to participate in Project JOINTS commit to implementing the IHI Enhanced Surgical Site Infections Prevention Bundle, a set of five evidence-based practices designed to prevent SSIs in patients undergoing hip and knee replacement surgery: • Patient bathing or showering with a special antibacterial soap for at least three days before surgery • Screening patients for the presence of Staph prior to surgery and treating those testing positive • Preparing skin at the surgical site with an antiseptic solution that contains alcohol • Reliably giving the appropriate antibiotics to the patient before starting surgery • Avoiding shaving hair at the surgical site Manfredo explained that Oneida Healthcare has implemented all five of the infection prevention practices and actually received “Exemplar” recognition for their success in initiating the staph screening process. “It was a team effort”, she said. “Staff worked together to develop and implement the new process, and then shared that success with others.”

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St. Joseph’s awarded $26,850 educational grant from Pfizer — St. Joseph’s Hospital Health Center has been awarded a $26,850 educational grant from Pfizer to enable the purchase of disease registry software that will help establish quality of care benchmarks for diabetes and other chronic diseases.

The software will work with the electronic health record in St. Joseph’s Family Medicine Center. Family medicine resident physicians and faculty will use the software to regularly assess patients with chronic diseases. The information will be entered into the electronic health record so it can be used not only to manage the patients’ care but also for benchmarking and information sharing among health care providers caring for those patients.

“St. Joseph’s Family Medicine Center has the opportunity to dramatically improve the health of the community through implementation of a disease registry to support the management of disease risk factors in the diabetic population we serve,” said Matthew Picone, physician leader for the project.

“Such a registry would help to unite the fragmented care the chronically

ill so often receive. Even in the best of circumstances — when these patients are fortunate enough to have a primary care physician — they may still find themselves shuttling between the offices of medical specialists and the hospital emergency room for treatment of an acute exacerbation of their illness.”

Picone added that oftentimes patients’ medical information is not shared between the providers of their chronic disease care, resulting in treatment gaps and duplication of diagnostic studies. This initiative will help prevent unnecessary testing and delays in patient care.

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New Chief Quality Officer at Upstate — Louise Prince, SUNY Upstate’s associate professor of emergency medicine and quality officer for the department of emergency medicine, has been named chief quality officer for Upstate University Hospital.

As chief quality officer, Prince will oversee the hospital quality care initiatives, including the reporting of hospital quality data to various agencies and organizations.

“Dr. Prince has developed quality enhancement initiatives Prince for our emergency department that have helped strengthen the level of care in this very busy patient care setting,” said John McCabe, chief executive officer of Upstate University Hospital.

“Her leadership and vast knowledge of hospital quality issues, make her well suited to lead Upstate’s quality team.”

Prince completed her residency at Upstate University Hospital in 1995.

She earned her medical degree from Pennsylvania State University.

Prince succeeds David Duggan, who has been named interim dean of the College of Medicine.

New Social Media Editor at SUNY Upstate — Susan Cole has been named to the new position of social media editor At SUNY Upstate’s department of public and media relations.

As social media editor, Cole will develop strategy, content and communications for the university as it expands its communications through emerging social channels like Facebook, Twitter, Google+ and others.

Cole’s background is in agency marketing communications and Cole public relations. She most recently served as senior account executive for Text 100 Global Public Relations in Rochester, where she led the development and implementation of social media programs for numerous

Donor makes $500K pledge to YMCA in Lysander The YMCA of Greater Syracuse announced that it has received a $500,000 pledge to help build the Northwest Family YMCA in Lysander.

The money would be in addition to the millions of dollars already pledged and donated to help build the new Y. The pledge is contingent upon the Northwest Family Y being built on a 22-acre site at the corner of state Route 31 and Drakes Landing Road, land the Y has owned since 2006.

The donor, who wishes to remain anonymous, said that site provides an ideal location: It’s connected by safe walking paths to a large number of children and families and it’s on a state highway that connects it to the population centers of Baldwinsville and Clay. That combination will ensure the facility’s success in serving the greatest number of people, the donor said.

Earlier this year, the Y submitted plans to build a $17 million facility clients, including Xerox. Through her agency experience, Cole has worked in all areas of communications including media relations, collateral development, event management, content creation, project management, digital media and social media.

Cole earned a bachelor’s degree from SUNY Oswego. She resides in Fulton.

New Faculty Appointments — Upstate Medical University has announced the addition of the following doctors to its staff: • Sam Benjamin has joined the department of medicine as assistant professor. Benjamin earned his medical degree from Masaryk University in Brno, Czech Republic, in 2002. He completed his internal medicine residency training in 2009 at Upstate Medical University, where he also served as chief resident. He completed a medical oncology fellowship at the University of Manitoba in Winnipeg, Manitoba, this past summer. His areas of interest are breast and genitourinary cancers.

Benjamin resides in Syracuse.

• Avrille George has joined the department of medicine as assistant professor. George earned a bachelor’s degree in chemistry from Brooklyn College in 2001 and a medical degree from Ross University School of Medicine in the West Indies in 2006. She completed an internship and residency in internal medicine at SUNY Downstate in 2009. This year, she completed a fellowship in infectious diseases, also at SUNY Downstate. George resides in North Syracuse.

• Haider Khadim has joined the department of medicine as assistant professor. Khadim received his MBBS (bachelor of medicine and bachelor of surgery) from King Edward Medical College in Lahore, Pakistan, in 2002.

He completed his residency in internal medicine at Upstate Medical University in 2008, where he also completed a fellowship in hematology/oncology in 2011. Khadim, who is fluent in several December 2011 •

on the site. The plans enjoyed support from the vast majority of town residents. However, the Lysander Planning Board determined that the Y would negatively affect the character of the community and voted 5-0 against the plans.

The donor hopes the new pledge will encourage the Town of Lysander and the YMCA to find a way to move the project forward.

For Bob Jokl, chair of the Metropolitan Board of the YMCA of Greater Syracuse, the gift is a sign of the depth of support the Northwest Family YMCA enjoys. “The YMCA is committed to meeting the needs of the community,” Jokl said.

“That’s why we’re so grateful that this donor has stepped forward to help us meet the needs of northwestern Onondaga County. We welcome all forms of support.”

For more information on the Y, visit www.NWFY.org. languages, conducts research on basic cancer biology, general hematology and benign and malignant hematology, including leukemias and lymphomas requiring bone marrow or stem cell transplant. Khadim resides in Cicero.

• Rakesh Vijay Khanna has joined the department of urology as assistant professor. Khanna earned his medical degree from McGill University, Montreal, in 2003, where he also completed a residency in urology in 2008. He completed a fellowship in minimally invasive and robotic surgery at the Cleveland Clinic in 2011. Khanna resides in Jamesville.

• Kris Kitisin has joined the Upstate Cancer Center as assistant professor of surgery, with specialty in hepatobiliary surgery and liver tumors. Kitisin received his medical degree from Georgetown University Medical School in 2002, where he also completed internships and residencies in general surgery. He completed a fellowship in surgical oncology and hepato-pancreato-biliary at the University of Pittsburgh Medical Center in 2011, where he also served as a clinical instructor. Kitisin resides in Manlius.

• Barbara Robinson has joined the Upstate Cancer Center as assistant professor of surgery, specializing in thoracic malignancies, including lung and esophageal tumors. Robinson comes to Upstate from Brigham and Women’s Hospital in Boston, where she was an advanced fellow of cardiac surgery, specializing in adult congenital, and minimally invasive surgery. She also served as an instructor of thoracic surgery at the hospital and Harvard Medical School. Robinson received her medical degree from Stanford University Medical School in 1990 and her master’s in physiology and biomedical sciences at the Mayo Clinic in 2000, where she completed her residency in general surgery. Robinson resides in Syracuse.

• Rajan Khanna has joined the department of medicine as a hospitalist. Khanna earned his MBBS (bachelor

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of medicine and bachelor of surgery) at the Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences in Rohtak, India, in 2003, where he also served as a house officer in the intensive care unit in 2004. Khanna was a physician in the department of internal medicine at Deep Medical Center in Fairdabad, India, from 2005 to 2006 and a physician in the department of cardiology at Fortis Escorts Hospital and Research Institute in Faridabad, India, in 2007. He completed his residency in internal medicine categorical program at Lincoln Medical and Mental Health Center in New York in 2010, where he also served as chief resident in internal medicine. Khanna resides in Camillus.

• Dorothy C. Pan has joined the department of medicine as assistant professor. Pan received her medical degree from Weill Medical College of Cornell University in 1995. She completed her residency in internal medicine at Montefiore Medical Center, Albert Einstein College of Medicine in 1998 and a fellowship in medical oncology and hematology at Memorial Sloan-Kettering Cancer Center at Weill Medical College of Cornell University in 2001. Her research interests have included non-Hodgkin lymphoma. Pan resides in Syracuse.

Michael Poiesz has joined the department of medicine as assistant professor. Poiesz earned his medical degree from Upstate Medical University in 2005. He completed his internal medicine residency training in 2008 at Tufts Medical Center and a hematology/oncology fellowship at New York University Medical Center in 2011.

Poiesz’ research is in gastrointestinal, breast cancers and viral-related malignancies. Poiesz resides in Tully.

• Tasaduq Fazili has joined the department of medicine as clinical assistant professor, specializing in infectious diseases. He served previously as a clinical assistant professor of medicine at Oklahoma University Health Sciences Center in Oklahoma City. He also served as an infectious disease physician at Texas County Memorial Hospital in Houston, Mo., and at Phelps County Regional Medical Center in Rolla, Mo., from 2002 to 2007.

Fazili earned his medical degree from the University of Kashmir in Srinagar, Kashmir, in 1994. He completed his

residency in internal medicine at SUNY Buffalo in 1999 and a fellowship in infectious diseases at Albany Medical Center in 2001.

• Bhaskara Reddy Madhira has joined the department of medicine as a hospitalist and clinical assistant professor. Madhira an MBBS degree (bachelor’s degrees in medicine and surgery) at Rangaraya Medical College in Kakinada, India, in 2004. He is pursuing a master’s degree in biology at Missouri State University, in Springfield, Mo. He was a research fellow in kidney transplant at the University of California, Los Angeles, from 2007 to 2008, and completed his residency in internal medicine at Rochester General Hospital in 2011.

• Birendra Prasad Sah has joined the department of medicine as clinical assistant professor, specializing in pulmonary and critical care. Sah earned a medical degree from P. Koirala Institute of Health Science in Dharan, Napal, in 2001. He completed his residency in internal medicine (2008) and a fellowship in pulmonary and critical care (2011) at Upstate Medical University. Previously he worked as a resident in the emergency department and intensive care Unit at Patan Hospital in Lalitpur, Nepal, and as a resident at Kathmandu Hospital Pvt. Ltd, in Kathmandu, Nepal.

Clinical Assistant Professor Clinical Assistant Professor at SUNY Upstate Medical University (Syracuse, NY): Perform clinical care in the Pulmonary/Critical Care Division.

Perform and teach the evaluation of patients and procedures. Offer clear and effective instruction within areas of expertise to students and medical residents in the College of Medicine and Graduate Studies. Contribute to medical scholarship by supporting clinical research through participation in clinical trials and contributions to medical literature, including educational, ethical or research reports.

Reqs: M.D. or Foreign Equivalent and three (3) years of experience as a Medical Resident.

Completion of a ACGME residency program in Internal Medicine. Completion of Fellowship in Critical Care and Pulmonary Disease. Board certification/Board eligibility in Internal Medicine; Board certificaton/Board eligibility in Pulmonary/Critical Care Medicine; and License/Permit to practice medicine in the State of New York. Please send CV to: Stacy Mehlek, Faculty Affairs & Faculty Development, 750 E. Adams Street, Syracuse, NY 13210.

SUNY Upstate Medical University is an AA/EO employer engaging excellence through diversity.

Women and minorities are encouraged to apply.

EMPLOYMENT SUPPORT

We are growing again! Exceptional Family Resources is looking for you if you have experience in employment supports or working with people with developmental disabilities. Provide prevocational & vocational services to persons enrolled by developing work-related behaviors in service recipients. Ability to work independently in an individual’s home and community setting necessary. High School Diploma/GED, reliable transportation, flexibility to work less than 40 hours/week to consisting of days, evenings or weekends. Please call Carolyn Davia @ 478-1462, ext. 329; fax resumè to 478-1467, or e-mail: cdavia@contactefr.org.

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EMPLOYMENT Advertise your services or products and reach your potential customers throughout Central New York for under $100 per month.

35,000 copies distributed through more than 1,000 locations. Call 342-1182 for more info.

Step Up to the Challenge!

Join Upstate’s Nursing Teams!

As the region’s only Level-One Trauma Center, we are a fastpaced academic medical center with modern technology and up-to-date interventions in caring for the critically ill or injured.

Serving 17 counties, we support a population transported by ground or air from throughout the central New York region.

We currently have part-time, full-time and per diem positions available in our Operating Room and Emergency Department for: RNs and Nursing Assistants. Shadowing opportunities are available.

• Tuition Assistance • Membership in the NYS Employees' Retirement System • Excellent Wages and Benefits

For professional nursing opportunities, call (315) 464-4810 or 1-800-274-4810 or apply on-line www.upstate.edu/hr/jobs/ Upstate Medical University/Upstate University Hospital is an AA/EEO/ADA employer engaging excellence through diversity.

Smoke-free campus since 2005

Upstate University Hospital Upstate University Hospital at Community General Upstate Golisano Children’s Hospital www.upsatate.edu I Syracuse I State University of New York

Much More!

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