In Good Health by In Good Health: CNY's Healthcare Newspaper

in good Born At Home

Births taking place outside of the traditional hospital setting increased 29 percent between 2004 and 2009

Auburn Memorial Now Auburn Community

March 2012 • Issue 147

CNY’s Healthcare Newspaper

The Vegan Diet

Special Food & Nutrition Issue

Cancer: When should you get a second opinion

Scoring His Dream on Dad’s Team

Feeling SAD?

Bob Natoli

The weather may have something to do with it

Orthopedic surgeon Brad Raphael joins his father, Irv, as physician for SU teams

Your Nails Fungal nail infection is one of the several problems that can affect your nails

FREE FREE

For Syracuse University fan and Fayetteville native Brad Raphael, the men’s basketball team’s recordbreaking start to the 2011-2012 season was just icing on the cake. To him, what’s really special about this season is finally working alongside the man he idolizes—his father, Irving (“Irv”) Raphael, head team physician for SU athletics. March 2012 •

The Secret to Breaking a Guinness World Record Oswego resident Bob Natoli, 56, recently achieved his sixth Guinness World Records’ fitness milestone. He broke the record for the most weight lifted by barbell upright in a one-hour period. He talks about his exercise regimen, food, nutrition, sleep and his motivation.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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FACT:

More hearts are cared for at St. Joseph’s than any other hospital in the region. St. Joseph’s Cardiovascular Care

Excellence, taken to heart. 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 • March 2012

Brittonﬁeld

FREE PARKING

Home Births Rise Nearly 30 Percent The rise in home births is attributed to personal preference, lower cost

here’s no place like home—when it comes to giving birth. According to a report from the Centers for Disease Control and Prevention, the rate of home births in the United States has risen dramatically since 2004. Births taking place outside of the traditional hospital setting increased 29 percent between 2004 and 2009,

from 0.56 percent of all births, to 0.72 percent, or almost 30,000 births. For non-Hispanic white women, the increase was most pronounced, with a 36 percent increase. The rise in home births is believed to be attributed to personal preference, although some experts point to the lower costs of giving birth at home. Highlights in the report include:

Binge drinking: problem bigger than previously thought U. S. adults binge drink more frequently and consume more drinks when they do

ore than 38 million U.S. adults binge drink an average of four times a month and the most drinks they consume on average is eight, according to a new “Vital Signs” report form the Centers for Disease Control and Prevention. While binge drinking is more common among young adults aged 18–34, of those age 65 and older who report binge drinking, they do so more often — an average of five to six times a month. Binge drinking is more common among those with household incomes of $75,000 or more, but the largest number of drinks consumed per occasion is significantly higher among binge drinkers with household incomes of less than $25,000 — an average of eight to nine drinks, the report said. Binge drinking is defined as consuming four or more drinks for women and five or more drinks for men on an occasion.

Drinking too much, including binge drinking, causes more than 80,000 deaths in the United States each year, making it the third leading preventable cause of death, and was responsible for more than $223.5 billion in economic costs in 2006. Over half of these deaths result from injuries that disproportionately involve young people. “Binge drinking causes a wide range of health, social and economic problems and this report confirms the problem is really widespread,” said CDC Director Thomas R. Frieden. “We need to work together to implement proven measures to reduce binge drinking at national, state and community levels.” For more information about binge drinking and how to prevent this dangerous behavior, visit the CDC’s Alcohol and Public Health website at www.cdc.gov/alcohol/index.htm.

• Among white women, home births increased 36 percent, from 0.80 percent in 2004 to 1.09 percent in 2009 • For white women, home births account for one in every 90 births • In other racial and ethic groups, home births are less common • Home births are more common among women aged 35 and over, and among women who have had other children. Births that occur in the home more often involve lower risk pregnancies, with fewer among teenagers or unmarried women, and fewer pre-term, low birth weight or multiple births. In 2009, home births varied from a low of 0.2 percent in Louisiana and the District of Columbia, to a high of 2 percent in Oregon and 2.6 percent in Montana. Some of the benefits of home

birth are privacy, comfort and more personalized continuing care. The biggest objection to home births are concerns about safety for both the mother and the infant.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

March 14

Free workshop in Auburn on the basics of Medicare Learn about the basics of Medicare at a free workshop from 1 – 2:30 p.m., Wednesday, March 14 at the basement training room of the Cayuga County Office Building, 160 Genesee St., Auburn. This session will be geared toward those who are approaching Medicare enrollment and for those already enrolled who are overwhelmed or confused by the information and options available. Information included in this program will be the basics of original Medicare; Medicare Advantage and Medicare Part D prescription coverage; Medicare Preventive benefits; Medicare supplemental insurance and EPIC; costs, co-pays and deductibles; and information about available assistance to help those beneficiaries of a low-income status. Metered on-street parking is available and also the municipal parking garage is located two blocks away on Loop Road. Due to limited seating, registration is required. Tuesday, March 13 will be the last registration date. For more information or to register, please call the Cayuga County Office for the Aging at 253-1226.

March 14, April 27

Aurora to offer free vision screening in Syracuse Aurora of CNY, the only non-profit that works exclusively with people in Central New York who are deaf, blind, visually impaired or hard of hearing, is offering free vision screening at two Syracuse locations: Beauchamp Library, 2111 S. Salina St., from 1 – 3 p.m., March 14, and Mary Nelson Youth Center, 2849 S. Salina St., from 11 a.m. – 2 p.m. April 27. 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. For more information, call Aurora at 422-7263.

March 17

‘Run For Dennis’ run/walk taking place in Oswego More than 200 people have registered to participate in the first Run For Dennis 5k Run/Walk, scheduled for 10 a.m., March 17 to honor the memory of Oswego resident Dennis Pacheco (May 28, 1959 March 17, 2011), a victim of bladder cancer. Registration fee is $25 up to race day, and $30 on March 17. Registration is open at www.EZRaceReg.com. The website for the race is www.runfordennis.com and the event is also on Facebook at www.facebook. com/runfordennis. The run/walk will be chip timed and USA Track & Field Page 4

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(USATF) certified. All proceeds of the race will go to bladder cancer advocacy and research. This year’s recipients are Strong Memorial Hospital Cancer Center, Rochester, and the Bladder Cancer Advocacy Network (BCAN). Prizes will be awarded to winners in all age groups—including last place. “Before learning he had cancer, my dad was always quick to lend others a helping hand,” said Jessica Newson, race director and Pacheco’s daughter. “We would like to honor his giving ways by helping to continue the fight against bladder cancer, the fourth most common type of cancer among men in the US. More than 69,000 cases were diagnosed in 2011 alone.” Donations can be made to ‘Run For Dennis’ and sent to Oswego County Federal Credit Union, P.O. Box 310, Oswego, NY 13126. Anyone who would like to sponsor or donate goods or services to the race can contact jessican ewson@runfordennis.com.

April 10, 17, 24

Living Alone: Survive and Thrive on Your Own Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own” is a three-part workshop offered for women who want to gain the knowhow to forge a meaningful and enriching life on their own. Participants will discover how to think differently about living alone, overcome loneliness and other emotional pitfalls, rediscover their true selves, and socialize in a couples’ world. The workshop takes place at House Content Bed & Breakfast in Mendon from 7 – 9 p.m. on three consecutive Tuesdays: April 10, 17, and 24. The workshop fee of $125 includes a Living Alone manual, empowerment exercises, and lots of helpful resources. To register, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@rochester.rr.com.

April 14

Elder law free seminar in takes place in Auburn The Law Firm of Karpinski, Stapleton, Galbato, & Tehan, P.C. in cooperation with the Cayuga County Office for the Aging will present an elder law seminar from 6:30 9 p.m. on Wednesday, April 4 at Cayuga Onondaga BOCES on W. Genesee St. Road, Auburn. This free seminar will present a comprehensive overview of issues facing seniors and their loved ones. Topics covered will include estate planning, empowering others to act, the benefits of trusts, asset preservation planning and long term care insurance. Space for the program is limited. Registration is required and will be accepted through Tuesday, April 3. Call the office for the aging at 253-1226 to register, or visit the office for aging website’s News & Activities page at www.co.cayuga. ny.us/aging/events.htm.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

March 19

Dr. Brangman to discuss memory loss in Liverpool Geriatrician Sharon A. Brangman is scheduled to be the guest speaker during an event sponsored by Keepsake Village at Greenpoint Premier Memory Care. The SUNY Upstate professor, who directs the Geriatric Medicine Fellowship Program and the Central New York Alzheimer’s Disease Assistance Center, will talk about memory loss and Alzheimer’s disease — the myths and the facts. It will take place from 5:30-7 p.m., March 19, at Santangelo’s Restaurant, 673 Old Liverpool Road in Liverpool. Dinner will be provided during the event. For more information or to register, call Lisa Merrill, Keepsake Village’s community relations director at 416-9627.

Sept. 29

Alzheimer’s group announces big event The Alzheimer’s Association’s Walk to End Alzheimer’s, a united movement to reclaim the future for millions, will take place Sept. 29 at Long Branch Park. More than 1,000 people are expected at this year’s event to raise awareness and funds to fight Alzheimer’s disease. Participants will unite in a three-mile walk along a scenic trail and will learn more about Alzheimer’s disease, advocacy opportunities, clinical trial enrollment, and support programs and services of the Alzheimer’s Association. Each walker will also join in a meaningful tribute ceremony to honor those affected by Alzheimer’s disease. To join the event or for more information, visit alz.org/ walk or call 472-4201.

April 26, 28

Events aim at raising awareness of autism The Central New York Chapter

CNY Eye and Tissue Bank Supports National Eye Donor Month The Central New York Eye and Tissue Bank (CNYETB), committed to enhancing and saving lives through eye and tissue donation while maintaining respect for those who give the Gift of Life, will be promoting the many benefits of eye donation throughout March 2012, designated as National Eye Donor month, in 12 Central New York hospitals at which it recovers donated eye tissue. CNYETB will distribute its ‘Gift of Sight’ eye donation material in high traffic locations at three Syracuse-area hospitals (Upstate University Hospital, Crouse Hospital, Syracuse VA Medical Center) and hospitals in Oswego, Cortland, Chenango, Carthage, Star Lake (Clifton-Fine Hospital), Hamilton (Community Memorial Hospital), Massena, and Binghamton. Included in the information to be available to hospital staff, patients, and visitors will be NY State Organ and Tissue

of the Autism Society of America will host two events designed to increase awareness of autism. A conference for professionals and parents of children with autism will take place from 9:30 a.m. – 5 p.m. April 26 at Sheraton Syracuse University Hotel & Conference center, 801 University Ave., Syracuse. Titled “Children with Social, Emotional & Behavioral Challenges Including Autism Spectrum Disorders: The Collaborative Problem Solving Approach,” the conference will feature presenter Ross Greene. On April 28, the chapter will host “Autism Awareness Walk — One Piece at a Time,” at 10 a.m. at Long Branch Park in Liverpool. The events are sponsored by the Margaret L. Williams Developmental Evaluation Center in conjunction with CNY Coalition for Young Children with Special Needs. Online registration is available at AutismSyracuse.com. Professionals pay $85 (by April 6) or $95 (after April 6); parents pay $55 (by April 6) or $65, after that date. For more information go to AutismSyracuse.com or call 4724404

Seasonal

Getting organic food direct from local farms The local community supported agriculture program — or CSA — is taking subscriptions for the 2012 growing season. The farms are organic farms that obtain subscriptions from ordinary consumers, who then receive a weekly basket (more likely bag or bags) of produce for every week of the season. Local farms say this is a great way to get consumers closer to the earth and familiar with new veggies, and a method of building autonomy and resiliency into the local food supply. These CSA programs vary a great deal in cost, length of season, work requirements (if any) and available pick-up points. For more information, check with the Northeast Organic Farming Association of New York (on the Web at nofany.org) or Local Harvest (on the Web at localharvest.org).

Donor Registry forms that, when completed and submitted to the state’s Department of Health, represent an individual’s legal consent to the donation of his or her eyes (and if he or she chooses, also his or her organs and other tissue) at the time of death. “The more people we can educate and inform about eye donation and its many benefits, the more they will understand about the indisputable value of giving the Gift of Sight,” said CNYETB community relations coordinator Jessica Duffy, who is overseeing the organization’s efforts at promoting eye donation. “Current statistics show that only 17 percent of New Yorkers age 18 and older have enrolled in the New York State Donate Life Registry as organ, tissue, and eye donors, compared to a nationwide average of 42%. Our goal in March will be aimed at helping raise that low New York State percentage.” CNYETB will supplement its inhospital education, information, and donor enrollment March 2012 effort with a variety of public service announcements and related publicity.

Extended-Wear Contact Lenses Not Capturing the Market Despite convenience, less than 8 percent of contact lens prescriptions are extended wear

fter more than a decade on the market, extendedwear (EW) contact lenses still haven’t caught on among patients and eye care professionals, reports the February issue of Optometry and Vision Science, official journal of the American Academy of Optometry. espite their advantages, EW contact lenses—which can be worn continuously for up to a month— account for less than 8 percent of contact lens prescriptions. The study was based on an analysis of worldwide prescribing data, led by Nathan Efron, BScOptom, of Queensland University of Technology, Australia. The researchers analyzed 14 years of data (1997 through 2010) on contact lens fittings by eye care professionals in 39 countries. They analyzed trends in EW contact lens prescribing, including patient and characteristics and fitting patterns. Extended-wear contact lenses made of an oxygen-permeable silicone hydrogel material first came on the market in the late 1990s. Modern EW lenses are designed to be left in the eye day and night for up to a month, without the need for daily removal and cleaning. The data suggested that use of EW lenses peaked in 2006, when they accounted for 12 percent of all soft contact lens prescriptions. However, the rate decreased in more recent years, falling to 7.8 percent in 2010. The rate varied between countries, ranging up to 27 percent in Norway. Certain groups of patients were more likely to receive EW lenses, including men, older patients, and those not receiving their first contact lens prescription (“refits”). Efron and coauthors speculate that EW lenses are more likely to be prescribed for older patients who are experienced with contact lenses—and perhaps better

able to afford the higher cost of EW lenses. Some men may prefer EW lenses because of their convenience for sports participation. Most patients with EW lenses used some form of lens care solution. That suggested that they remove and store their lenses at least occasionally, rather than wearing them full time for the entire month. Nearly 30 percent of EW lens prescriptions were for conventional hydrogel lenses—possibly because they are less expensive than newer silicone hydrogel lenses designed specifically for 30-day extended wear.

Safety Concerns Are Key Issue “Despite the obvious benefits of lifestyle convenience” associated with EW lenses, “it seems that practitioners still prefer to prescribe, and patients prefer to wear, contact lenses for daily wear,” Efron and coauthors write. The drop in EW lens prescriptions during the mid-2000s may partly reflect the introduction of silicone hydrogel lenses designed for daily use. But safety concerns are probably the key factor behind the limited acceptance of EW lenses, Efron and colleagues believe. The first EW lenses introduced to the market were associated with high complication rates. The problems were mostly eliminated by the current generation of oxygen-permeable silicone hydrogel lenses. The rate of severe keratitis with modern EW lenses is low, around 20 cases per 10,000 lens wearers per year. However, that’s higher than the 4 per 10,000 annual rate for daily contact lens wearers. Efron and coauthors conclude, “EW prescribing…is unlikely to become a mainstream lens-wearing modality until the already low risks of ocular complications can be reduced to be equivalent to that for daily wear.”

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

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In Good Health is published 12 times a year by Local News, Inc. © 2012 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: (315) 342-1182 • Fax: (315) 342-7776.

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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, Deborah Jeanne Sergeant, Anne Palumbo, Aaron Gifford, Chris Motola, Melissa Stefanec, Steven Joao, Joyce Gramza, Ernst Lamothe • 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.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Dr. Neal Seidberg Doctor discusses the introduction of new electronic medical records system at Upstate University Hospital Q: What’s your specialty? A: My formal title at Upstate University Hospital is chief medical informatics officer (CMIO). I also take the lead on installing some of the larger medical record systems. My specialty area is pediatric critical care. Q: Do you have to get technologically adept in addition to being a doctor to be a CMIO? A: I’ve always been interested in using computer systems to improve patient care. I actually wrote a medical records software program and similar things like that. When I was a resident here, I recognized that there was a hole and potential safety problem with patient hand-offs. So I’ve always kind of been involved in it. The CMIO is such a new position within institutions that there really isn’t a single formula for it yet. Q: Can you talk about the medical records system Upstate is working on? A: We are in the middle of implementing a new electronic medical record system. Now, we’ve had bits and pieces of a system before now, but this is the first time we’ve fully integrated lab results, electronic prescribing, best practice advisory and unifies records into one patient, one chart. One of the neat pieces to this is that it doesn’t just end when you walk out of the clinic. Patients can sign up to become what we call MyChart users.

MyChart is a way that patients can electronically access their records through a secure Web portal or through a mobile device app. Patients will receive an after-visit summary that tells them why they were here, their medication list, a to-do list, medical goals like losing weight. Q: Does this complicate things when it comes to HIPAA compliance? A: No, it has what’s referred to in the industry as “bank-level security.” Nothing is stored in your device or computer. So if you lose your device or walk away from your computer, it will lock back up and there’ll be no information there to see. It’s not like sending an email where the message sits on your computer.

When you’re messaging back and forth on our system, the message stays on our system, you just view them. You might get an email saying that you got a message, but you’d have to log onto the system to read it. Q: Are these systems just catching on or have they been around for a while? A: Full EMRs are a very new field. Some of these have been out there for a while, but really only in parts and pieces. The more complete systems have been around, but the marketplace is only starting to mature. The driver for a lot of places now is the meaningful use requirement from the American Recovery Act part of the stimulus package. The patient being able to access their file from outside the office is still pretty rare. Very few systems have the capability to support this. We’re partnering with a vendor named Epic Systems out of Madison, Wis. They’re considered to be the best EMR system in industry right now. At the moment, they’re the only ones providing patient access features until General Electric releases theirs. To become an Epic institution, you need to either be an academic hospital or a children’s hospital, or a very large institution. We are the only institution that will be able to implement this in our 17-county area in the near future. Rochester General is the closest hospital to offer this. Q: How will this help patient-doctor communications? A: If you think back just a year ago, every clinic in our area had its own charts for a patient. I didn’t know what the guy down the hall in a different specialty clinic was doing with that patient. It made it really difficult to provide the highest level of care. If you asked the patient what medications they’re on, they might only have told you the medications they thought were important. With a system like this, it provides a much higher capability of doing integrated care and partnering with our patients. Q: Do you see the system making patients more familiar with their medical charts? A: Totally, totally. We can set goals, for example, that their blood pressure will be lower. They can now see how their blood pressure is tracking over time. As the system matures a little bit further, we’ll add capabilities to send information back through here, so the patient could take their blood pressure at home and send it to us for review. We reply back, tell them they’re doing a good job or tell them they need to come in. It gives the patient a little bit more of a partnership with the physician.

Lifelines Name: Neal Seidberg, M.D. Hometown: Syracuse Education: SUNY Upstate Medical Center, Children’s Hospital (Pittsburgh) Afﬁliations: Upstate University Hospital Organizations: Society of Critical Care Medicine, Healthcare Information and Management Systems Society (HIMSS) Family: Married, two children Hobbies: Photography, Sailing

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

Uplifting Effort Area entrepreneur shatters world fitness record By Steven Joao

swego entrepreneur Robert Natoli is living proof that one’s age should not be a deterrent from challenging themselves to their extreme limits. Natoli, 56, achieved his sixth Guinness World Records’ fitness milestone recently at his own business site, Timebuyer in Oswego. He broke the record for the most weight lifted by barbell upright in a one-hour period. Natoli lifted the 40-pound barbell for a total of 51,640 pounds in one hour, shattering the previous record of 40,752.5 pounds held by Eamonn Keane of Ireland. This was Natoli’s third fitness record in nine months. “I trained so long to break this record and it was definitely the hardest one so far because it involved the whole body,” Natoli said. “I love challenges because they motivate me to stay in shape while also hopefully helping me extend my life a little longer.” Natoli spent eight weeks intensely training in order to prepare for the record. He stays in shape year round, working out six days a week. His training includes running to keep his endurance up and lifting all different kinds of weights to improve his muscular strength and endurance. “As much as you prepare yourself beforehand, it doesn’t completely prepare you for it because the real thing is the real thing,” Natoli said. “I was definitely tired, but for me the hardest part was just showing up.” Natoli’s wife, Peggy, and their son, Bobby, were in attendance at the event.

They could be heard cheering and motivating him throughout the entire event.

great respect for what these veterans have done thousands of miles away to stop terrorism.”

Bobby holds the record for the most chin-ups in one minute with 53, a record his father previously owned with 44. “What my dad has been able to accomplish is amazing and aspiring,” Bobby said. “For him to complete such a difficult goal speaks for itself and his hard work.” Three of Natoli’s Guinness World Records have since been broken, including the chin-up record that his son owns. He owns the record for most weight arm-curled in one hour with 60,019 pounds and most weight lifted by front dumbbell raises in one hour with 39,720 pounds. The record was dedicated to veterans at the Syracuse Veterans Affairs Medical Center in Syracuse. Natoli donated $2,000 to VA voluntary services, which support numerous programs. These areas include nursing, recreation, the community care center, community living center and more. Natoli asked for pledges of a penny per pound he lifted to help improve the quality of life for veterans treated at the medical center. “I wanted to dedicate this record to these injured veterans because I admire their sacrifices protecting this country, as well as the sacrifices their families have made,” Natoli said. “They are an incredible organization and I have

He hopes the donations will help veterans to purchase new wheelchairs, televisions and other items for disabled veterans. Natoli is owner of the chain Timebuyer, which deals automobiles on an independent basis. “I did one rep at a time, one minute at a time,” Natoli said. “But this is how anyone can tackle anything. People in debt can eliminate it $1 at a time, pay off one credit card at a time. People losing weight can lose one pound at a time. It’s a very similar thing.” Natoli was the former owner of Rentavision, one of the largest inde-

Proud son

Worthwhile cause

pendently owned rental companies in the United States. Natoli helped grow Rentavision from one store in Oswego to 250 stores. He eventually sold his chain after 15 years of operation for approximately $99 million. Natoli said he believes Timebuyer has the potential to surpass the success achieved by Rentavision. Natoli recently authored a book titled, “True Vision 4 Success.” The book focuses on helping people create life goals that help them achieve lasting success. Natoli is an Oswego native and resides in Oswego Town. He graduated from Oswego High School and the SUNY Oswego with a degree in communications.

Secret to breaking a Guinness World Record Q: How often do you exercise a week? A: I normally train six days a week. I rest on every seventh day in order to let my body repair itself. Q. How many hours do you work out each time? A. It might surprise many people, but I don’t work out that long at a time.

Bob Natoli, 56, achieved his sixth Guinness World Records’ ﬁtness milestone recently in Oswego. He broke the record for the most weight lifted by barbell upright in a one-hour period.

I usually work out for about 45 to 60 minutes. I believe it can be detrimental to the body to work out any long. I train intensely during that time. You can’t work out both hard and long, it’s either one or the other. Q. Where do you exercise? A. I have an exercise room located right in my house. I train in solitude with no distractions. I may have a CD on and am focused on what has to be done. Q. How many hours of sleep do you try to get at night? What time would you say your day starts and ends? A. I always try to get eight hours of sleep a night. I wake up at around 7 a.m. and am asleep by no later than 11 p.m. The eight hours keeps my body feeling relaxed and focused. People who don’t get the appropriate amount of sleep are causing their body harm by not resting them properly. do?

Q. What types of exercises do you

A. I do everything. I do all the major weight lifting movements, as well as free weight movements. I believe in doing a lot of natural exercises, such as chin-ups and push-ups, as well as biking and swimming. I do lots of sprints and jogging, as well as hiking with a backpack. I’ll go for a hike and will do all kinds of exercises on the hike. For instance I’ll start out jogging and if I see a branch I will go over and do some chin-ups on the branch or I’ll stop and do some sit-ups or push-ups. There’s nothing like the fresh air. People who don’t exercise are missing out on an important and exciting aspect of life. Q. What do you do in terms of cardio exercises? A. Well, weight lifting is a good way to work on your cardio. I don’t

Continued on page 8 March 2012 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

Uplifting Effort

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

Q. How often are you putting fluids into your body? A. I’m not a fanatic about putting fluids constantly into my body. It doesn’t make sense to me why people are constantly drinking from plastic jugs because they contain estrogen which is not something you want to put in your body. If you’re eating the appropriate amounts of vegetables and fruits than you shouldn’t have to be drinking all day. I eat nine fruits and vegetables all day. Q. What would you recommend to people trying to get back in shape? A. I have a saying, “inch by inch Robert Natoli, left, goes for a Guinness World Record at anything’s a synch.” People try to do too Timebuyer in Oswego. At his side is Mike Janela, Guinness much too fast, which World Records adjudicator. leads to two things: injury and illness. rest more than 45 seconds to a minThey should start off slowly by going ute in between reps and that’s how to the doctor and getting a complete I trained to break my last record. physical with them. My advice would Strength endurance can be gained by be to take it one step at a time and not doing natural movements, such as try to do too much. If all you can do is push-ups help a person work their core walk around the block a few times than muscles better than a bench pressing. that’s progress. Bench pressing can cause injuries to your shoulders. I don’t do the same Q. Do you believe age should not exercise more than three weeks in a be considered a deterrent to people row because the body will adapt to a staying in shape? certain exercise or movement because it A. I believe life gets in the way. gets used to it. That causes it to become They get a job, start to make money, get less beneficial. I only won’t change it married, and start having kids and they up if I’m training for a new record. I’m find it hard to make time to exercise. currently not training for anything, so I Training becomes a lower priority and will be changing it up. they forget how to prioritize properly. It doesn’t take as much time as people Q. What’s your diet like? What do think. If a person intensely works out eat for breakfast, lunch and dinner? for 20 minutes, three days a week they A. I try to eat natural foods because can get back into shape. they are more focused. I like to call it Gods food plan. If man made it then Q. Do you believe staying healthy it’s probably garbage. That’s not to say and in good shape is the best way to everything man makes is garbage, but live a longer life? if you don’t want your body to look A. Studies have proven it increases like garbage than don’t put garbage in the good and quality years of person’s it. I like to have oatmeal with raisins life. Exercise will help a person experiand banana’s in the mornings. I like ence the years that are most important to add different fruits to it regularly. I to them if they are in good shape. It is like to make my protein shakes, mixed certainly my goal to have those imporwith berries and other fruits. If you put tant years. No pills or vitamins will good things in your body then it makes help your body physically like exercise it easier to stay healthier and exercise does. better. Q. What is your over all motivaQ. Are there any types of food you tion? What drives you to stay in peak try to avoid? physical shape? A. Yes, I stay away from things like A. Feeling good. I feel great after doughnuts. I believe too many Ameria workout. It is a great way to start off can today are into fast food because it the day and it gives me the energy to is cheap and convenient. That’s not to take on whatever life has to throw at say all fast food is bad for you. They me. I feel good the whole day after I do have salad choices and things that workout. By the end of it I’m usually aren’t all bad. A person that eats it thinking about the next exercise I will once in a while is not going to die from do the next day. it. I eat meat and have red meat once a week but I like to focus on eating things that are natural that come from

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Flying solo and feeling great: See the glass half full!

“

Every one of us has been given a great gift: the cup of life. It is half full and half empty. We choose which half to focus on, at every moment.” — Marc Allen, triathlon coach. Seeing the glass as half full rather than half empty is all about focusing on what’s positive in our lives, regardless of what comes our way. It’s about being thankful, appreciative, and grateful. It’s about concentrating on our strengths rather than our weaknesses. I’m convinced that our thoughts and attitudes determine the life we have. And experience has taught me that seeing the glass half full can make all the difference for those who live alone. We have a choice. We can choose to see the positive or we can choose to wallow in the negative — to close our eyes to possibilities and to begrudge what life has offered up. So, how do you view the cup of life? Take a look at the list below, which contains actual quotes from divorced or widowed women and men I’ve encountered along my journey. Do you find yourself identifying with one perspective over another? NOT BEING MARRIED HALF EMPTY “Something must be wrong with me. All my friends are married, and here I am alone and miserable.” HALF FULL “Not in a million years did I expect to be divorced at my age, but I am resourceful and persistent. I’ve always wanted to travel and try

new things, and now I have that opportunity — to create a life that’s rewarding and full of new people and experiences that bring me joy.” DECISION-MAKING HALF EMPTY “Are you kidding? I don’t know enough to buy a house or a car. Those are the big decisions my husband used to make. I wouldn’t know where to begin.” HALF FULL “Finally, I get to make all my own decisions! No one’s around to secondguess my choices. I just purchased my first car all on my own: a new Honda Civic. I did the research and was completely prepared when I went to the dealership. My color choice? Cool mist metallic!” IN A CRISIS HALF EMPTY “I’m no good in a crisis. I go to pieces. When I hear bad news, I’m embarrassed to admit that I long to be taken care of and protected, as if I’m a child. Living alone makes all this worse. There’s no one to turn to.” HALF FULL “Being alone in a crisis isn’t the end of the earth. In fact, some of my most significant growth has been during tough times. When I got the call that my father had had a heart attack, I took charge, made calls, and brought the family

KIDS Corner Study: Spanking Produces Troubled Kids

dding more fuel to the controversial topic of children and spanking, two Canadian child development experts have published a new analysis warning that physical punishment poses serious risks to a child’s long-term development. In the paper, published online Feb. 6 in CMAJ, the Canadian Medical Association Journal, the authors analyzed

two decades of research and concluded that “virtually without exception, these studies found that physical punishment was associated with higher levels of aggression against parents, siblings, peers and spouses.” While studies show that spanking has declined in the United States since the 1970s, many parents still believe it’s an acceptable form of punishment.

together. I learned I could take care of myself and others, too.” DATING HALF EMPTY “I can’t imagine dating at my age. What could anyone possibly see in a middle-aged, grey-haired retiree with grandchildren?” HALF FULL “Warm friendships, even romance, can happen at any age! I met my second husband when I was 72, after my dear Larry passed away. We met in a grief support group and the rest is history. Next year, we are celebrating our fourth anniversary.” FINANCES HALF EMPTY “He took care of all the finances, the bills, the taxes, everything! I feel helpless and, honestly, I fear dying alone and penniless.” HALF FULL “I knew it wouldn’t be easy, but I knew I could do it. Getting help with my finances was one of the first things I did after my divorce. I picked up the phone and asked for help, did my homework, and now enjoy peace of mind. I think it’s the thing I’m most proud of. COOKING FOR ONE HALF EMPTY “Why would I go to any lengths to create a special meal for just myself? It hardly seems worth it. I can fill up on chips and salsa and call it a night.” HALF FULL “Creating a pleasant ‘table for one’

A 2010 University of North Carolina study revealed that nearly 80 percent of preschool children in the United States are spanked. “Our paper is a prompt to medical professionals to apply the compelling findings of research on physical punishment in their guidance of parents,” said co-author Joan Durrant, a child clinical psychologist and professor of family social sciences at the University of Manitoba in Winnipeg. In addition to the substantial evidence that children who are spanked are more aggressive, the authors note that physical punishment is linked to various mental health problems, including anxiety, depression, and drug and alcohol abuse. What’s more, recent neuroimaging studies have shown that physical punishment may alter parts of the brain that are linked to performance on IQ tests and increase vulnerability to drug or alcohol dependence, they write. Many parents are skeptical of published findings on spanking, and question whether the aggressive behavior prompts the spanking, rather than the other way around. But the paper’s coMarch 2012 •

makes me feel good about myself. It means I’m nourishing my body as well as my spirit. When I prepare a nice table setting and sit down to a healthy, home-cooked meal, a sense of serenity comes over me. I feel at home with my own good company.” DISCOVERING YOUR TRUE SELF HALF EMPTY “I’m a creature of habit, too old to re-invent myself. And, what’s the point anyway? There’s no one to share my life with. HALF FULL “It’s never too late. Today, I have an opportunity to fashion a life that reflects my dreams, my style, my true self. Just recently, I signed up for piano lessons, a lifelong dream of mine. My niece is also coming into her own, and I love being a role model for her. TIME ALONE HALF EMPTY “Living alone is for the birds! I just want to stay in bed and pull the covers up over my head. HALF FULL “Living alone need not be a time of diminished opportunities. It can be a time of expanding possibilities. Used wisely, the time can be an adventure in self-discovery and reveal opportunities for personal growth and fulfillment.” If you don’t like the results you are getting in your life, consider changing the attitudes that are producing those results. Who knows what great adventures and joy await those who focus on gratitude and embrace the wisdom of seeing the glass half full. Drink up and enjoy life! 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 April workshop, check out the Calendar of Health Events in this issue. You can also call Gwenn at (585) 624-7887, email gvoelckers@rochester.rr.com., or visit www.aloneandcontent.com.

author says researchers have been able to tease this relationship apart. “It is the case that children who are more aggressive do tend to get hit more, but the punishment does not reduce those children’s aggression; rather, it exacerbates it,” said Ron Ensom, who worked as a social worker at the Children’s Hospital of Eastern Ontario, in Ottawa, when the paper was written. “When parents of aggressive children are instructed in how to reduce their use of spanking, and they do indeed reduce it, the level of their children’s aggression declines,” Ensom said. “And when children who all have the same level of aggression when the study begins are followed over a period of years, those who are spanked tend to get more aggressive over time, while those who are not spanked tend to get less aggressive.” The authors urged physicians to help parents learn nonviolent, effective approaches to discipline, but one child psychologist in the United States said the paper fell short in providing examples of such approaches.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

My Turn

By Eva Briggs

Conditions that Can Affect Fingernails Psoriatic fingernail, fungal nail infections are some of the problems that can affect your nails

but switched to jazz because he had psoriasis that prevented him from growing the requisite long fingernails. Psoriasis is one of many diseases that can affect the finger- (and toe-) nails. Psoriatic fingernail changes occur in 10-15 percent of the 7 million Americans with psoriasis, and even occasionally affect people who don’t have skin lesions. Manifestations include the salmon patch, a reddish yellow discoloration beneath the nail plate that resembles a drop of oil under the fingernail. Other changes can weaken the nail so that it crumbles easily, cause pits and lines in the nail, or cause the nail to separate from the nail bed. No cure exists for psoriasis, but dermatologists have an arsenal of treatments that include topical treatment, UV light, and even systemic drugs for severe cases. One of the most common disorders affecting fingernails is onychomycosis, a fungal infection, which affects toenails much more often than fingernails. Moisture, as in prolonged Nail fungus is the most common problem affecting nails. immersion from dishwashBecause nails grow slowly, some medicines must be ing (think especially of taken for weeks or even months. Unfortunately relapse those who do this for a living) increases the risk. is common. here are some things that you don’t expect you’ll have to do as a parent. For example, did I ever imagine that I would bring my son, when he was a teenager, to a nail salon for artificial nails? Of course not. But when he decided to become a serious classical guitar student, his instructor suggested that he have artificial nails placed on his right hand, to jump start his studies, because classical guitar players need long fingernails on their picking hand. My brother studied classical guitar,

Other risk factors include skin fungal infections, other nail disease or deformity, suppressed immune system, and exposure to contaminated manicure equipment. Fungal nail infections cause the nails to thicken, change their shape, become brittle and crumbly, develop white or yellow streaks, and accumulate debris. Over-the-counter topical medicines usually aren’t helpful. Oral antifungal medicines help some people. Because nails grow slowly, these medicines must be taken for weeks or even months. The results won’t be known until the fingernail grows out which may take three to six months. Unfortunately relapse is common. Often fingernail changes indicate underlying systemic disease. In the case of my own father-in-law, he developed ridging and brittleness of all 20 of his nails. In retrospect, I wonder if this wasn’t an example of a paraneoplastic syndrome, a disease or symptom by products secreted into the bloodstream by tumor cells, not related to the presence of cancer cells in the affected area. My father-in-law was diagnosed with metastatic lung cancer several years after his fingernail changes began; perhaps he had acrokeratosis paraneoplastica of Bazex. Had I known about this condition I would have insisted that his doctor obtain a chest CT due to

his heavy smoking history. One of the best-known fingernail changes associated with systemic disease is clubbing. The soft tissues at the base of the nail plate become thick and spongy, causing deformity. While lung disease is the most common cause, clubbing can also be due to heart disease and cancer. Beau’s lines, transverse linear depressions, can occur in all nails due to any systemic illness severe enough to disrupt normal nail growth. They will grow out over time, as the patient recovers from the initial illness. A Beau’s line may affect a single nail due to injury. You might be wondering, what is the importance of fingernails? They assist in the ability to grasp and manipulate fine objects. One measure of finger sensitivity is the ability to perceive two pinpricks as separate stimuli. This two-point discrimination is measurably improved in a finger with an intact fingernail compared to a finger missing its nail. Fingernails also protect against trauma. The conditions that I’ve discussed above are only a few of dozens that can affect fingernails. If your primary care doctor isn’t able to diagnose a fingernail problem, the correct specialist to see is a dermatologist. Eva Briggs is a medical doctor who works at the Fulton Urgent Care operated by Oswego Hospital and at Immediate Medical Care of CNY in Manlius.

The Doctor is Not In Today

Shortage of doctors in rural Upstate expected to worsen as more physicians retire or leave the area

ospitals across the state are facing a serious physician shortage that is expected to worsen as the pace of physician departures and retirements accelerates, and hospitals are having problems recruiting new doctors, according to a new report by the Healthcare Association of New York State (HANYS). “The 2011 Physician Advocacy Survey,” which focused on the physician shortage outside of New York City, found 34 percent of hospitals had to reduce or eliminate services in the past two years due to a lack of doctors. Sixty-six percent reported there were times when the shortage left their emergency department without coverage for certain specialties, such as orthopedics and neurology, requiring a transfer to another hospital for treatment. The shortage is particularly acute in rural areas, with the added recruitment challenges of geographic location, weather, and professional isolation. More than half of the rural counties in New York state reported a decrease in one or more categories of crucially needed physicians, and six rural counties (Chemung, Chenango, Greene, Page 10

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Herkimer, Seneca, and Ulster) saw a decline in the number of primary care physicians. “Every patient deserves a doctor,” said HANYS’ President Daniel Sisto. “We must have policies in place to motivate and recruit physicians to practice in New York state, particularly in the communities that need them the most.” In 2010, nearly 2,300 physicians left or retired from hospitals, compared to 1,600 in 2009, and an estimated 510 are expected to retire in 2011. With the average age of practicing physicians at 52, and 16 percent over the age of 65, the pace of retirements is expected to accelerate in coming years, exacerbating the shortage. Sisto noted the importance of preventing cuts to successful training and recruitment programs such as Medicare Graduate Medical Education and Doctors Across New York (DANY), a state-funded initiative to help train and place doctors in underserved areas. He also emphasized the need for programs such as DANY to be implemented in an easier-to-access manner so that funds can be utilized effectively, as well as for New York state to seriously address the workforce recommendations of the

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

Medicaid Redesign Team. Statewide, hospitals reported that they had the most difficulty recruiting psychiatrists, urologists, orthopedics, internal medicine sub-specialists, obstetrics/gynecology and primary care doctors. The survey found key recruitment barriers continue to be the lack of competitive salary, lack of candidates, geographic location, and lack of opportunity for spouse. National reports estimate the average medical student debt at around $160,000. The report also showed some areas of the state are experiencing a much

greater shortage than others. In the Rochester area, 59 percent of hospitals reported they had to reduce or eliminate services in 2010, compared to a statewide average of 26 percent. In Western New York, 82 percent responded there were times their emergency department did not have specialty coverage, requiring patient transfers, compared to 66 percent statewide. A total of 109 member hospitals outside of New York City responded to the survey, with 90 percent of the state’s rural hospitals responding.

Cancer

When to Seek a Second Opinion By Deborah Jeanne Sergeant

eceiving a cancer diagnosis is Cherny, oncologist with Crouse Hosdifficult. In addition to learning pital. “If you’re sure about treating they face a serious illness, papatients appropriately and you want to tients usually must decide about treatdo the best for the patients, that should ment options quickly before the disease never factor in. If it does, it’s a red flag spreads. They have a lot to process in a for the patient and family if the doctor short period of time. is reluctant to have them get a second Some patients, however, should opinion. Maybe it’s time to look for consider obtaining a second opinion. It another doctor.” helps them make peace with Many doctors will also the diagnosis. help make the arrange“The most important ments, too, especially if indicator a second opinion is they are aware of a specialneeded is a patient’s unist in that type of cancer or certainty or dissatisfaction a center where the patient with the original opinion,” could receive more up-tosaid Leslie Kohman, medidate treatments. cal director of the Upstate Desiring a second Cancer Center. “Patients opinion is especially wise in have a more critical attitude, cases where the patient has leading to a more consumer been diagnosed with a rare type of attitude.” type of cancer or when it’s Especially considering unusual for a person of that the cost and side effects of patient profile. Although many cancer treatments, it’s today’s lab work and other important to know for sure diagnostic tools are betTrisha Torrey of that the diagnosis is correct ter than ever, they’re not Baldwinsville was and that the treatment plan diagnosed as having a perfect and neither are the is on target before moving professionals who interpret rare cancer. A second forward. their results. opinion conﬁrmed the Some patients seek a While it’s rare for test diagnosys. It turned second opinion hoping for results to indicate a false out she never had the better news, but this isn’t negative—showing that likely to happen. someone has cancer who is disease. “If the doctor is trusted, actually cancer-free, misinthe patient can say, ‘Do you think a terpretation of medical results happens second opinion can give me other more frequently than doctors like to information?’” Kohman said. “I always admit, according to Trisha Torrey. She say, ‘You can do that if it will make you knows from personal experience. feel better, but the second opinion will “You need a second opinion if you almost always be in agreement with are at all suspect the first opinion could the first opinion.’ If it’s a rare type of be wrong and/or the treatment recomcancer, we may send them to another mended by your doctor will be invaspecialist.” sive—surgery, chemo, radiation, will If the second opinion contradicts require a long time to work, like taking the original diagnosis or treatment a drug for more than a few weeks, or plan, getting a third opinion is always will be expensive such as more than a an option. Kohman also recommends few hundred dollars, even if insurance contacting each oncologist and the covers it,” she said. primary care physician to review the “If your research or your second findings. opinion produces something different, “It occasionally happens if that then…you need a third opinion.” the first place makes a mistake in the She advises seeking subsequent pathology or there’s a different opinion opinions from doctors who have no on what they see under the microaffiliation with any of your previous scope,” she said. “But this is extremely doctors or their facilities. rare. Usually, it’s not the diagnosis but In 2004, Torrey was working as a the treatment. The patient has to evalu- marketing consultant and felt that her ate the institution and the setting. If it’s health was fine, except for her newly a physician working by him- or herself, discovered, golf ball-sized lump on her the physician may not be aware of all torso. It didn’t hurt, but she dutifully the options.” had it checked out. Upstate offers a multidisciplinary Weeks later, the doctor told her approach to cancer treatment to give that she had a very rare subcutanepatients a broad perspective and opous panniculitis-like T-cell lymphoma portunities unavailable at non-teaching (SPTCL). It’s so rare, that a second lab hospitals. had been tapped to offer its opinion Don’t worry about hurting your and the second lab confirmed the first health care providers’ feelings. lab’s findings. “I would hope my ego would The soonest she could see an onnever get in the way,” said Richard cologist was two weeks. In the mean-

time, Torrey researched all she could find and the news was grim. Most patients with this type of cancer died quickly. But oddly, Torrey’s intuition told her she was fine. She did not feel sick. Once she saw the oncologist, her CT scan and blood work he ordered indicated no presence of cancer. But he wanted to proceed with chemotherapy right away, telling her that without it, she would die in months. The rarity of this type of cancer made it hard for Torrey to find an expert in it. A friend tipped her off to a doctor treating someone with SPTCL and Torrey made an appointment right away. Torrey felt unsure about the interpretation of the lab results and wanted the SPTCL expert to review her case. By now, she had also determined that an additional test had been run, but no one had reviewed the results. In fact, those results had been misplaced for weeks and had not been considered as part of her original diagnosis. Through her research and working with a new doctor, “it became very clear to me that I did not have cancer, no matter what those labs and oncologists thought,” she said. A specialist at the National Cancer Center finally confirmed she never had cancer. The initial recommendation for chemotherapy was also misguided. Even if she had been sick, her second opinion oncologist told her radiation would have been a preferred option for her treatment, not chemotherapy. To this day, Torrey has never received a confirmed diagnosis, nor has she ever had any form of treatment for anything related to that original lump. Because of her experience, Torrey, who lives in Baldwinsville, has become a nationally-known speaker and writer on patient advocacy (www.everypatientsadvocate.com) and has been seen on or quoted by National Public Radio, MSNBC, The Oprah Magazine, Wall Street Journal, CNN, Fox News, U.S. News & World Report, USA Today and Health Magazine. Educating yourself and being your own advocate is the “gospel” Torrey preaches. Make sure you research reputable sites such as The Mayo Clinic (mayoclinic.com), The American Cancer Society (cancer.org), or National Institutes of Health (nih.gov). “If you’re not comfortable, get a second opinion,” Kohman said. “If your doctor doesn’t want you to get a second opinion, get a second opinion. Make sure the second opinion comes from a larger facility and make sure it’s a legitimate medical source, not from an alternative medicine provider who offers hope without evidence.” March 2012 •

9 Million U.S. Adults Lost Health Coverage During Recession

n estimated 9.3 million American adults lost health insurance coverage as a result of increased unemployment during the recession of 2007-09, according to a newly published study by researchers at Cornell, Indiana and Carnegie Mellon universities. The study, titled “The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession,” was published online by the National Bureau of Economic Research. The paper can be viewed at: www.nber. org/papers/w17600. The study finds that roughly nine times as many Americans lost health insurance coverage in the recession of 2007-09 as in the previous recession of 2001. It also estimates that 4.2 million children under the age of 18 gained health insurance coverage during the recession, supporting the idea that government health insurance programs work counter-cyclically, as intended as part of the social safety net. As parents lose jobs and income, more children qualify for coverage through Medicaid and State Children’s Health Insurance Programs. Other findings include: • Men were much more likely than women to lose insurance coverage as a result of increases in the unemployment rate, and the effect was strongest for men who were white, older and well educated. Of adults estimated to have lost coverage, 7.1 million were men and 2.2 million were women. • For men, an increase in the unemployment rate of 1 percentage point was associated with a 1.67 percentage-point decrease in the likelihood of being insured. • Even for men who didn’t lose their jobs, increases in the unemployment rate were associated with a decreased probability of health insurance coverage. This may be because employers dropped coverage, cut workers’ hours to where they no longer qualified for health insurance, or increased employee premium contributions leading to workers declining the offer of coverage. • For children under 18, a 1 percentage-point increase in the unemployment rate is associated with a 1.37 percentage-point increase in the likelihood of being insured. The paper concludes with a “thought experiment” that examines the impact of the 2010 Patient Protection and Affordable Care Act on the relationship between unemployment and insurance coverage. The results imply that, because of the act’s expansion of Medicaid coverage for adults, a higher unemployment rate would not have a significant impact on insurance coverage with the law in place.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

Parenting By Melissa Stefanec

Caring for my 7-month-old daughter Returning to work and putting my most-beloved possession in the care of a stranger not an easy decision

t’s been seven months since I became mother. Since every mother needs an adjective in front of her name, this month I’m proclaiming myself a working mother. Being a working mother comes with its own special set of mommy guilt and plenty of that was felt when my little lady entered daycare five months ago. There is a great deal of debates revolving around the best option for childcare. Every parent I know had

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thoughts, second thoughts and third thoughts about how his or her child should be looked after when he or she wasn’t available. Every option comes with associated guilt, resentment and reservation. Choices seldom come by easily and even after choices are made, many of us are left with gnawing echoes in our ears. Did we make the right choice? Can we live with the choice we’ve made? As luck would have it, lots of my friends are somewhere in the procreation process. It’s nice to be going through this monumental life change together (and equally nice to see other parents as lost and as confused as I am). One thing I’ve watched all of us struggle over is finding childcare. It’s hard to know if you are making the best choice for your child. Is it better for a parent to stay at home and raise his or her own child? Are you depriving your child of something important by having someone else cater to most of his or her waking hours? Are you a bad parent if you can’t stay at home? Are you an even worse parent if you simply don’t want to stay home? I say we stop and put all the questioning and self doubt aside for a moment and take a step back. If your child is well-fed, (mostly) clean, loved, safely supervised and in a safe environment then you are doing this whole parenting thing pretty well. Stop being hard on yourself and remind yourself of how awesome you are. If only I could have believed in my own awesomeness five months ago.

When it came to returning to work and putting my most-beloved possession in the care of a stranger, I was a basket case. There may be a lot of childcare options out there, but most of us are limited by financial or personal restrictions. Staying at home wasn’t an option for my husband, or me unless the mortgage fairy was going to visit with more regularity than the tooth fairy. Some parents may have the means to stay at home, hire a nanny or have a family member provide care, but we were not those parents. Most parents I know use some combination of the following options. They place their child in a daycare center, home-based daycare, use an independent provider or telecommute and work from home. It’s one of the most difficult parenting decisions you make, no matter what the final decision is. After exploring our options, my husband and I chose a NYS-certified home daycare provider. This means each day my daughter goes to a provider’s house and is cared for with a handful of other children. A NYS-cer-

tified provider goes through a lengthy accreditation process and is monitored and regulated by the state. State-sanctioned or not, my reservations could have filled a kiddy pool. I secondguessed myself and second-guessed my second guesses. When I first brought her to daycare I was racked with guilt. Surely she would somehow be crippled by the

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fact she had to attend daycare. Surely, if my husband or I could stay home with her, we would enrich her life in a way no third-party caregiver could. I pictured her being ignored while other children’s needs were being looked after. I pictured her under stimulated and emotionally neglected. Looking back these worries were all pretty ridiculous. My husband and I may love our daughter more than anyone else in the world, but we aren’t scarring her by placing her in loving and capable hands. In fact, I soon came to realize that we are helping her. At the tender age of seven months, our daughter already has some great little friends who she looks up to and who adore her. She’s getting a crash course in socialization and learning valuable life lessons. She’s learning that her needs are important and will be looked after, but that she can’t always comes first. She’s also learning to trust and care about people outside of her family. Most of all, she’s having fun, and the happy baby I pick up each night is giggling proof. It took me quite a while to drop the guilt and realize I made the right decision. This wasn’t through any fault of my chosen daycare provider; it was a result of outside pressures, perceived mommy wars and good old-fashioned worried mom brain. The great childcare debate has been beaten to death ever since women entered the workforce. As parents, we all have to respect each other’s choices and situations. Instead of worrying about what choice is better, we should be focusing on how our choices affect our children. If our children are healthy and happy, we are making the right choice. There is no need for debate. Dual incomes are a necessity for most parents, so feeling guilty about necessity is an exercise in futility. Of course it’s hard to say goodbye to her each day. Some days I miss her so much it hurts, but having a job is a personal and financial necessity for me. Most days I don’t feel like I’m cheating my daughter. I don’t feel cheated by the fact that I grew up in a household where both of my parents had to work. I went to a daycare provider who took good care of me. I’m glad I had a safe place to spend my parents’ working hours and even more grateful that I had parents who were good role models and taught me to work hard and provide for my family. At the end of the day, parents need to believe in themselves and their choices. If your child is being well cared for, drop the guilt. There are many children in this world whose parents can’t afford that luxury. There will be ups and downs no matter what childcare option you choose, but trust that you are doing right by your family. There is no universal best choice for childcare, only the best choice for you and your child.

Scoring His Dream, On Dad’s Team Orthopedic surgeon Brad Raphael joins his father, Irv, as physician for Syracuse University teams By Joyce Gramza

or Syracuse University fan and Fayetteville native Brad Raphael, the men’s basketball team’s record-breaking start to the 2011-2012 season was just icing on the cake. To him, what’s really special about this season is finally working alongside the man he idolizes—his father, Irving (“Irv”) Raphael, head team physician for SU athletics. After 15 years away, Brad, 34, returned home to Syracuse in September to become a partner in his father’s orthopedic and sports medicine practice and join Crouse Hospital’s trauma team, as well as to serve as assistant physician for the Syracuse teams. The 15 years were spent pursuing the intensive education and training he needed to follow in Irv’s footsteps. “Growing up, kids either love or hate what their parents do,” Raphael says. “All of my life growing up, I would admire what my dad was doing.” “He loved his job. I saw the gratitude patients had towards him whenever he was out in public. And I saw him do some surgeries as a kid—at 13, 14, when I was very impressionable, but not so young as to get grossed out at the sight of blood.” Brad Raphael witnessed the outcomes as well. Irving Raphael was assistant team doctor since 1987, becoming head team physician in 1992. “Seeing him treat these high-level athletes and get them back from injuries” — Brad Raphael shakes his head in undiminished astonishment — “I’m a huge SU fan. That’s my team. It made a huge impression on me.” “The first surgery I saw was an ACL reconstruction, and seeing him doing this major surgery through a small incision and six months later, the player is back playing basketball, I thought it was the coolest thing,” Raphael says. “I still think it’s the coolest thing.” So when Raphael graduated from Fayetteville Manlius High School in 1996 and headed for college at the University of Rochester, he wasn’t “like

most students who say, ‘I want to be a doctor’ and go to medical school to figure out what kind,” he says. “For me, I always wanted to be a sports medicine team doctor, so I worked backwards— ‘how do I get there?’” Raphael earned his medical degree from his father’s alma mater, Yale Medical School, in 2005. Then he then headed to New York City, completing a surgical internship at New York Presbyterian Hospital/Weill Cornell Medical Center, followed by an orthopedic residency at the renowned Hospital for Special Surgery from 2006 to 2010. “That was such a great place to be a resident,” he says. “I got to cover everything from trauma, pediatrics, tumor, hand and foot surgery,” he says. In 2010, he moved to Los Angeles for a yearlong sports medicine fellowship at the Kerlan Jobe Orthopedic Clinic. “It was my dream fellowship,” says Raphael. “I was assistant team physician for the Lakers, the Dodgers, the Angels— but the highlight of the year was I ended up meeting my fiancée.” “That kills your social life,” he jokes. “Here I’m thinking as Lakers team doctor I’m going to be having fun, but…” Ironically, Raphael’s fiancée, Rebecca Bronfein, had also just moved to LA from New York, for a job at the Museum of Contemporary Art. “We were both in New York City for five years and never met,” he says. “We met my first week out there at the birthday party of a mutual friend.” Bronfein just moved here and the couple plans to wed on Labor Day weekend in her hometown of Baltimore, and to establish “permanent roots” in Syracuse, he says. “I’m finally at the point where I’m doing sports medicine, working with my dad, being a team doctor doing orthopedics and it’s great. I’m living my dream right now.” And he says being on his father’s team has only strengthened his bond with his dad. “I couldn’t put into words how amazing of a relationship it

is working with him—the admiration, the respect,” says Raphael. Raphael says he’s learning every day from Irv’s 35 years of orthopedics experience, but he also brings new knowledge to the partnership. “He’d be the first to tell you that orthopedics is changing every day,” he says. “He has a lot more to teach me, but there are still things that I’ve learned—new techniques and technologies from LA and New York.” One example is the state-of-the-art MRI facility in their East Syracuse office, Elite Health Care Medical Associates. “Ten years ago, that didn’t exist in orthopedic offices.” Another major change is in biomaterials. “We’ve been moving from metals to bio-absorbable equipment we put into patients,” Raphael says. He notes that surgery in general has become less and less invasive, recalling when arthroscopy, using fiber optic cameras to see inside of joints, was new to his dad. “We went from it being a diagnostic tool when (Irving) was getting started. Now we can do arthroscopic rotator cuff repair.” But he says perhaps the biggest change is the use of what he calls “interventional techniques”— “ways to hopefully prevent surgery when we can.” Those include platelet-rich plasma injection. “PRP is the hot topic in sports medicine news because it’s been used by athletes like Kobe Bryant and Alex Rodriguez,” Raphael says. “We can take a patient’s own blood, take out the growth factors and healing stimulants, and inject them back into an injured tendon or a joint” to promote healing. Another new technique that can avert surgery for chronic wear or damage to joints, tendons and ligaments is viscosupplementation, replacing or supplementing the fluids that naturally cushion and protect the cartilage. “The original stuff was rooster combs — chopped up and made into an injection. Now,” he says, biotech companies “use processes to grow the components in bacteria.” March 2012 •

But Raphael says the most impressive cases are not necessarily confined to sports medicine. “Taking call at Crouse Hospital is fun, because with fracture care, you get to see the most dramatic improvement where someone who comes in on a stretcher with a hip fracture can walk out of that hospital.” He adds that his work at Crouse is “an opportunity to give back to the community.” “There are patients who don’t have doctors, or as much access to healthcare resources, but when they come into the ER, we take care of them.” Another way he tries to give back is by spending as much time as he can doing orthopedic research, publishing and presenting in the medical literature and at professional meetings. “I want to continue to advance the field, and to basically bring recognition to Central New York as a location for orthopedic research,” Raphael says. Raphael is also quick to acknowledge that living his dream isn’t all glory. He played lacrosse and basketball growing up, used to ski, and “try to play golf,” but now “I don’t have time to play sports.” And some of what he’s learned is painful. “Unfortunately, the more we know, the more we find out we don’t know,” he says. “You can do a perfect operation and perfect rehabilitation and there can still be complications that are unavoidable that make you feel terrible.” And as much as he loves the SU teams, Raphael says covering them as “Dr. Brad” — since there is only one “Dr. Raphael”— is not as fun as being a fan. While he gets to sit right on the sidelines, “You’re actually stressed out because you never want to see someone get hurt.” “In fact,” he adds, “the more you get to know the SU athletes, the bigger a fan you become because they’re really great kids.” He claims to have no favorite player. “That wouldn’t be fair,” he says, “I love all SU athletes.” For more information: www.raphaelmd.com.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

SmartBites

By Anne Palumbo

The skinny on healthy eating

Praise for the Potato

h, the poor potato. It gets such a bad rap. Long feared by many as unhealthy — too starchy! too caloric! — it has fallen by the plate-side. I can’t tell you how many times I’ve tossed perfectly good potatoes down the drain after a dinner party. But I won’t give up on the humble spud and here’s why: potatoes are good for you! Sure, they have more carbs than your average vegetable, but the carbs in potatoes are the “good” ones that nature makes, the ones with heart-healthy fiber and other valuable nutrients. Good carbs — vs. the “bad” ones found in refined foods that zip through us lickety-split — are harder to digest and thus get absorbed more slowly into our systems. The benefits? Our blood sugar levels remain more stable, we feel fuller longer, and our energy is longer lasting. Potatoes are impressively high in vitamin C, with one medium potato providing more than a fourth of our daily needs. Although no studies confirm that vitamin C prevents colds, it

may shorten the length of a cold. Beyond its immune-boosting capabilities, vitamin C helps the body maintain healthy tissues and is essential for healing wounds. This tasty tuber is also an excellent source of potassium, especially when consumed with the skin. A powerhouse mineral, potassium is crucial for key body functions and also helps to control blood pressure. According to findings from a recent study published in the Archives of Internal Medicine, increasing your potassium intake may be the key to a longer life. Still worried about the calories? Potatoes themselves are not all that caloric, averaging around 130 calories per spud. What’s more, they’re sodium-, fat- and cholesterol-free. Add a table-

spoon of butter, however, and you not only add about 100 calories, but you add fat and cholesterol, too.

Helpful tips Select firm potatoes (individually, when possible) that do not have sprouts or green coloration, since this color indicates that they may contain high levels of a toxin, solanine, which can cause nausea, headaches and other health problems. Store potatoes in a cool, dark place, away from onions, as the gases that they each emit will cause mutual degradation. Don’t refrigerate raw potatoes because it turns the starch to sugar and ruins the flavor. Stored properly, most potatoes last about a month.

Healthy Oven-Roasted “Fries” Adapted from Emeril Lagasse 2 large potatoes, scrubbed (recommend red- or yellow-skinned potatoes) 1 to 2 teaspoons vegetable oil 1 large egg white Seasoning blend of ¼ teaspoon each: salt, pepper, garlic powder, thyme, paprika Adjust oven rack to lower middle position; preheat oven to 425 degrees. Line a large baking sheet with parchment paper, then grease with the veg-

etable oil. Scrub and dry potatoes, leaving skin on. Slice lengthwise into ½-inch thick slices, then turn each slice flat and slice again lengthwise into even fries, ½-inch thick. In a medium mixing bowl, whisk the egg white to a light froth and then mix in seasoning blend (or seasonings of choice). Add the potatoes and toss to coat evenly. Spread the coated potatoes on the prepared baking sheet, not touching. Bake for 15 minutes. With a spatula, turn the fries over and continue baking for another 10 minutes or until they are brown and crispy. Season with additional salt and pepper to taste. Serve warm. 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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Food & Nutrition

Healthful Vegan Eating By Deborah Jeanne Sergeant

ick Ryan, co-owner of the allvegan menu Strong Hearts Cafe in Syracuse, began his journey toward the vegan lifestyle during high school. Concerned about animal welfare, he became vegetarian and later transitioned to vegan. Vegetarians avoid meat and meatbased foods. Vegans avoid all animalbased foods. Both groups promote consumption of grains, nuts, seeds, fruits and vegetables. Ryan and his wife, Sarah, don’t eat animal-based foods for their health’s sake, too, especially as they approach 30. Ryan attributes his overall good health to eating vegan. “I eat a lot of whole fruits and vegetables and whole grains and I think that goes a long way,” he said. Sarah Ryan has been vegan for six to seven years. Upstate University Hospital at Community General registered dieti-

tian Maureen Franklin said that the vegan diet’s potential benefits include “a lower body weight, improving cholesterol levels, and reducing the risk of developing certain cancers and medical conditions such as heart disease, and diabetes,” she said. “This is because a vegetarian diet can typically be lower in fat, higher in fiber, and plant based vs. animal based.” Reina Apraez, produce and deli clerk at Syracuse Real Food Co-Op, has eaten vegan for off and on for the past several years. She won’t cook meat for herself but accepts meals offered to her that contain meat. For Apraez, the source of the meat is important. She feels more inclined to eat grass-fed beef or venison harvested by a hunter friend and eschews meat grown “where an animal is locked up,” she said. She also began exploring eating vegan because of the health aspects.

“I felt like my system would be cleaner...” she said, “but I needed to eat more often to get the nutrients I needed. At one point, after being vegan eight months, I got sick. I was working and in school. It made more sense to eat food I was offered.” Unable to afford eating a balanced vegan diet, Apraez hopes to be able to do so someday. She’s not alone in her interest in veganism. In response to public health concerns, more companies have added vegan foods to their product list or menus, including Wegmans. Beyond the vegetarian and vegan offerings on the shelves, the regional grocery store chain added a ready-to-eat vegetarian and vegan food bar in its Pittsford store

(in the Rochester area) last summer and found it was so successful that Wegmans has since added one in each of its “hub” stores in each division. “If customer feedback continues to be positive, we will look to introduce vegetarian bars in more of our stores,” said Jo Natale, spokeswoman for Wegmans. The vegetarian bars offer both vegan and vegetarian hot and cold dishes, including almond crusted tempeh, vanilla glazed carrots, and citrus carrot and chickpea salad to go or to eat at the Market Café seating area. In the Syracuse area, the Dewitt Wegman’s store includes a vegetarian/vegan bar. Ryan opened Strong Hearts nearly four years ago. The restaurant, located

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So what do vegans Nick and Sarah Ryan eat on an average day? They shared a typical day’s meals and snacks: • Breakfast: Whole grain cereal like toasted oats or whole wheat bran flakes with soy milk and coffee. • Snack: banana or another fruit • Lunch: Salad or sandwich from Strong Hearts Cafe • Dinner: Chili with lots of beans, a tofu dish or polenta. “We use brown rice all the time. During the summer, we go to farmer’s markets and stock up on inseason fruits and vegetables. “I sometimes indulge in chocolate. I probably eat too many sweets but I haven’t notice any weight gain. I like vegan brownies and every now and then, I’ll have vegan cupcakes.” at 719 E. Genesee St., offers a soup of the day, side dishes, salad, and breakfast items all day long. “Business is going well,” Ryan said. “It seems like there’s at least an interest in veganism. I’m not sure if it’s interest in adopting the vegan lifestyle or they’re just becoming more open to eating a healthful lunch. We don’t want to necessarily cater only to vegans. Our goal is to introduce eating plant-based foods to the general public, including delicious, decadent desserts and sandwiches similar to things like a chicken salad sandwich.” Eating plenty of fruits, vegetables and legumes is part of eating healthfully as a vegan. Chelsey Wallace, registered dietitian with St. Joseph’s Hospital Health Center, said that “these foods are associated with several health benefits because they generally have high contents of fiber, folic acid, vitamins C and E, potassium, magnesium, and contain less saturated fat. “In addition, vegan diets are cholesterol free because they do not contain any animal products. As a result of the nutrition content of vegan friendly foods, eating a vegan diet has been shown to lower ones risk for obesity, type-2 diabetes, cardiovascular disease, hypertension, and diverticulosis,” Wallace said. One of the potential pitfalls is becoming a “junk food vegan,” a phrase coined to describe vegans who — out of busy lifestyles or culinary ineptitude — rely upon convenience foods that are technically vegan but low in nutrients like microwave popcorn, candy, packaged vegan snack foods and soda pop. But vegans who eat right still have a few dietary challenges. “Anyone who restricts their diet from major food groups can drift toward processed foods and can turn to sugar and high-fat items,” said Kerry Dal, registered dietitian with Upstate Medical Center. “When you’re planning on being vegan, do a lot of meal planning. Shop regularly if you want those fresh fruits and vegetables and soak those dry beans. “You may not find everything you want when you’re out and about. You’ll have to pack foods. You’ll potentially spend more money and time.” Some vegan “convenience” foods aren’t as good choices as others. Dal said that canned fruit is “better than no fruit at all. If it’s a convenience item, that’s okay. Fresh fruit should be the first choice, though.” Vegan canned beans can be high in sodium, but Dal said that rinsing them can help lower the sodium content for

vegans who need to watch their salt intake. Another caveat is that some nutrients are hard to obtain from only plantbased sources. “By eliminating dairy and meat, they can eliminate calcium and protein and that is often a challenge,” Dal said. “They can lack iron, because meat sources of iron are more readily absorbed. Plant sources are harder.” To make sure they get enough iron, vegans must find plant-based sources, including dried fruits, iron-fortified breads and cereals, wheat germ, blackstrap molasses, nutritional yeast, tofu, and seeds, such as pumpkin and sesame. Wallace, the dietitian with St. Joseph, said, “Legumes such as garbanzo beans and black beans, green leafy vegetables such as Swiss chard and kale, and fortified cereals are iron sources. “In addition, consuming vitamin C foods such as citrus fruits at the same time as the iron sources above will help to increase iron absorption,” Wallace added. Dal expressed concern about protein intake since people need about 50 grams daily. “I’ve had vegans gain weight because they eat more food to get their protein,” she said. Some grains contain protein, but in small enough amounts that excessive amounts must be eaten to get enough. “People don’t need to go overboard on protein like the Atkins diet, but they need to meet their basic needs,” Dal said. In addition to whole grains, beans are good sources of protein in place of meat, eggs and dairy. Since animal-based foods are most Americans’ source of vitamin B-12 in the diet, excluding them completely can put them at risk for vitamin B-12 deficiency. “With careful meal planning and possible vitamin supplementation one will be able to consume a nutritionally balanced vegan diet,” Wallace said. She recommends fortified foods such breakfast cereals, soy milk, and meat substitutes such as veggie burgers or possibly taking a supplement. Since not everyone is able or willing to entirely give up on animalbased foods, reducing consumption of the worst offenders can help improve anyone’s health. These would include processed meats (including salami, bacon, cured ham), chicken with the skin still on, and fatty cuts of meat. Opt for modest portions of lean cuts of meat instead. Low-fat or fat-free dairy can help reduce one’s saturated fat intake and reduce caloric intake, too. “If you are thinking of making changes to your diet and the idea of being vegetarian appeals to you, why not start slowly?” Franklin said. “Investigate the types of vegetarian diets. Start by having one meatless meal a week.

Study: 5 Percent of Population Follow Diet How popular is veganism? Vegetarian Resource Group commissioned an independent study in 2008 which indicated about 5 percent of Americans are vegetarian and half of those are vegan. March 2012 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

The Mainstreaming of Vegan Diets Once the purview of a small group of devotees, more people are embracing plant-based eating plans

egan diets are considered by some to be extreme, a strict way of eating that exists on the radical fringes of vegetarianism. But today, a growing number of people are giving vegan diets a second look, and nutritionists now believe that a well-thought-out vegan eating plan could be the most healthy way to live for most people. “Properly planned vegan diets are healthy, nutritionally adequate and may provide health benefits in the prevention and treatment of many diseases,” said Vandana Sheth, a registered dietitian and nutrition educator and a spokeswoman for the American Dietetic Association. Vegan diets are plant-based and exclude all animal products, even items like milk, cheese and eggs that are allowed in some forms of vegetarian diets. Veganism drew added attention in 2011 from a pair of U.S. notables. Former President Bill Clinton — long famous for McDonald’s runs and barbeque lunches — announced in August that he had converted to a vegan diet. And domestic doyenne Martha Stewart dedicated an hour-long episode of her TV show in March to the vegan lifestyle.

Research has found that people who follow a vegetarian or vegan lifestyle enjoy a number of health benefits, Sheth said. These include: • Lower cholesterol levels. • Lower blood pressure. • A healthier body mass index. • Decreased risk for heart disease. • Decreased risk for cancer. • Better control and prevention of diabetes. “They don’t have to worry about cholesterol because cholesterol is only found in animal products,” Sheth said. “And as you would expect, vegan diets are much higher in fiber.” Sheth added that research has found vegan diets to be appropriate for people at all stages of the life cycle — even people at crucial stages, such as growing children, pregnant or lactating women, and highly active athletes. One of the long-standing criticisms of a vegan diet has been that people will miss out on many essential nutrients that are in rich supply in animal products. Nutritionists say that is no longer a serious concern, although people in a vegan lifestyle do need to pay careful attention to their supply of certain nutrients. Interestingly, protein is not one of

the nutrients that vegans need to worry about, even though plants are not the best sources because their proteins do not break down into the full range of amino acids that the human body requires for healthy functioning. “It’s true that most plant foods don’t contain all the essential amino acids needed by our bodies, while animal proteins do,” said Andrea Giancoli, a registered dietitian in Los Angeles and a spokeswoman for the American Dietetic Association. “But a grain plus a bean makes a complete protein. As long as you’re getting a variety of those, you are fine — and they don’t need to be consumed at the same time.” Sheth and Giancoli also noted that certain vegan “super foods” like soy products and quinoa have been found to contain proteins that break down all the essential amino acids. “It is absolutely possible to get enough protein from beans, lentils, tofu, soy products and other plant sources like seeds and nuts,” Sheth said. “As long as you’re getting a varied amount throughout the day, your body can mix it up and get what it needs.” Nutrients that vegans do have to keep careful track of in their diets, according to Sheth and Giancoli, include vitamin B12, a key nutrient in cell metabolism, nerve function and blood production, and calcium, which is needed for healthy bones. Animal products are rich in vitamin B12, and dairy products contain loads of calcium. However, vegans can get B12 and calcium from fortified cereals and fortified dairy substitutes such as soy or rice milk. “You need to be a smart consumer and read labels to make sure you’re buying products that are fortified,” Giancoli said. Dark green leafy vegetables like broccoli, collard greens or kale also are good sources of calcium. Vegans also have to make sure they get enough iron, which is essential in the creation of hemoglobin, the protein in red blood cells that delivers oxygen to cells and tissues throughout the body. Again, animal products are much more rich in iron, although plant foods such as dried beans, dark green leafy vegetables and fortified dairy substitutes are good sources. “Keep in mind that our bodies are able to absorb more iron from food if the meal is also rich in vitamin C,” Sheth said. “If you’re having spinach, you might have tomatoes or a citrus dressing with it to increase absorption.” Omega-3 fatty acids probably represent the greatest nutritional challenge for vegans, the two nutritionists said. Thought to be critical for cognitive function and healthy cardiovascular function, omega-3s appear in large amounts only in fatty fish such as salmon — a dietary no-no for vegans. Some plant sources — flaxseeds, soybeans, pumpkin seeds and walnuts, for example — contain a type of omega-3 fatty acid, but it’s not the same type found in fish and has not been proven to have the same level of health benefits, Giancoli said. “There’s some concern that vegans may be missing out,” she said. Finally, vegans need to keep in mind that it’s just as easy for them to indulge in an unhealthy diet as it is for omnivores, Sheth said. She recommends that her vegan clients follow the federal government’s “My Plate” guidelines for eating, the same as everyone else should. “You’re basically just replacing the protein source,” Sheth said. “Otherwise, it’s the same meal.” By HealthDay News.

Food & Nutrition Sweet, Sweet Stevia

How it has become the hottest trend in sweeteners By Deborah Jeanne Sergeant

s a society, we Americans love our sweets. Sugar or high fructose corn syrup are the sweetening agents of choice for many manufacturers of sweetened baked goods, drinks and candy; however, both of these are high in calories and offer no nutrients. Many low- or no-calorie sugar substitutes have been approved by the FDA as food additives. These include aspartame, sucralose, neotame, acesulfame potassium, and saccharin. Stevia (STEVE-ee- uh) is one of the substitutes more recently gaining use in the United States. Since stevia has been in use for centuries in other countries and US-based studies have shown it to have no side effects, the FDA gave it a “Generally Recognized As Safe” status and approved it as a food additive in 2008. “When something is ‘generally recognized as safe’ by the FDA, it means that experts have agreed that it is safe for use by the public in moderate amounts,” said Caroline Jacobus, certified diabetes educator and program coordinator for the Central New York Diabetes Education Program. Known scientifically as “stevia rebaudiana,” stevia, in its refined form, can be 200 to 300 times sweeter than sugar at the same volume. Its leaves are so sweet the shrub is also called “sweetleaf.” A member of the chrysanthemum family, stevia is found in numerous varieties indigenous to Paraguay and Brazil. In America, stevia is commonly known by several brand names. Truvia was created by Coca-Cola and Cargill. As of August 2011, about 20 products made by Coca-Cola worldwide use Truvia as their sweetener. PureVia, created by Whole Earth Sweetener Company, is used by Pepsico in beverages such as Trop50, a reduced-calorie juice drink. Wisdom Natural Brands makes SweetLeaf Stevia as a tabletop sweetener and ingredient for manufacturers. For diabetics, dieters or anyone looking for a sweetener that isn’t sugar or chemically-based, the rising popularity of stevia is a boon. “It is safe to use if you have diabetes and it does not appear to affect blood sugar levels,” said Maureen Franklin, registered dietitian with Upstate University Hospital at Community General. “It is important to remember that if it is used in a baked product, the total carbohydrate needs to be addressed as well as portion control.” Unlike some sugar substitutes, stevia doesn’t give a strong aftertaste. Some liken it to a mild licorice taste. “Many people describe [the aftertaste] as less than other sugar substitutes,” Jacobus said. “Sweetness is a very personal thing. Some people may like it while others prefer something else.”

Some sugar substitutes do not taste good as a tabletop sweetener; however, for most people, this isn’t the case with stevia. “I do think it’s great,” said Laurel Sterling Prisco, registered dietician and wellness educator for Natur-Tyme in Syracuse. “We have tons of people in here who use it. We use it in protein drinks when we’re trying to keep the sugar content down.” People new to stevia will also need to use it more sparingly than what they might think. “Stevia is several hundred times sweeter than sugar,” Jacobus said. Some sugar substitutes break down when used in baked goods. Stevia may be baked up to 400 degrees. It will not caramelize or crystalize like sugar, so desserts like crème brulee or meringue won’t work with stevia. “Replacing sugar in cooking and baking is more of an art than a science,” Jacobus said. “Stevia as well as other sweetener substitutes does not have the same properties of regular March 2012 •

sugar and will not behave the same way during baking. “The most helpful tip would be to follow the package label on how to substitute Stevia for regular sugar. This will produce the greatest success.” Although stevia is derived from a plant, it is processed to achieve the form that can be used as a food sweetener. Its source is natural, not chemical-based, but it has been processed. In addition to its use as an ingredient, it’s available in liquid or powdered form. “When you look at white table sugar, the bleaching processes and extraction process isn’t good,” Sterling Prisco said. “The majority of sugar comes from beets and almost all are genetically modified. You start out with something genetically modified and the extraction processes strips it down of nutrients.” Before consuming stevia, consult with your doctor. People allergic to ragweed or chrysanthemums may have a problem with stevia because the plants are related.

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Food & Nutrition Food at Children’s Hospitals?

Pretty bad, study says Officials at Golisano Children’s Hospital react to research showing that food served at children’s hospitals is unhealthy By Deborah Jeanne Sergeant

ne would think that food offered at a children’s hospital would include a large variety of healthful options since in general children usually do not make wise food choices. A recently published study in “Academic Pediatrics” found that only 7 percent of entrees served at 14 of California’s children’s hospital cafeterias were classified as healthful. “As health professionals, we understand the connection between healthy eating and good health, and our hospitals should be role models in this regard,” said Lenard Lesser, primary investigator and a physician in the Robert Wood Johnson Foundation Clinical Scholars Program, David

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Geffen School of Medicine at UCLA. “Unfortunately, the food in many hospitals is no better — and in some cases worse — than what you would find in a fast food restaurant.” Although all of the facilities offered low-fat or skim milk and diet soda, 81 percent sold highcalorie, sugary items near the register, which can prompt impulse purchases of these unhealthful items. Only 25 percent offered whole wheat bread, which is largely considered more healthful than white bread. Branning Nearly half of the hospitals did not offer low-calorie salad dressings and half lacked signs promoting healthful entrees. Since the study was conducted in July 2010, some of the surveyed hospitals have begun to improve their food. At Golisano Children’s Hospital

at Upstate, Susan Branning, registered dietitian and clinical nutrition manager, said, “We’re always looking to make our meals healthier, both those that are in the cafeteria and delivered to patients. We have a wide variety of options available like fresh fruit, vegetables without added fat or sodium, and whole grains instead of refined.” The hospital is offering more vegetarian options and, in the cafeteria, the hospital has an extensive salad bar and an optional “Small Bites” desserts. Nutrition information posted at many points of sale helps cafeteria diners remain conscious of how what they eat impacts their health. “We’ve tried to increase the amount of information we’re providing to our customers as far as calories, fat,

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and sodium and the nutrients people are interested in,” Branning said. The hospital also includes several healthful entrees on the menu at all times. “We try to have different promotions through the months where we focus on fruit and vegetable intake or decreasing fat and sodium intake,” Branning said. “We’re always trying to have signage to promote healthier eating.” She said that the menu always includes whole wheat rolls instead of refined, white-four rolls, and skim milk. A centrally-located filtered water station attracts many visitors who can fill their own containers or provided cups for free, which can encourage people to decrease their intake of calorically-laden beverages. Since hospital’s main focus is helping its patients get well, young patients may order what they wish from the menu (unless they have specific dietary restrictions). “What patients receive is driven by the diet ordered by the physician,” Branning said. “In general, for patients not on any kind of diet restriction, many facilities are making efforts to provide a healthier diet. “Probably, the biggest challenge we face particularly with children is when they’re in the hospital and sick, we want to get them to eat. The better nourished they are and better they eat, the faster they’ll get better. If they come from a family where they don’t eat particularly healthy, it can be a challenge to get them to eat. We want healthful options available but there are a lot of people out there who don’t eat that way at home.” Those are the types of foods when you’re sick you want something you like that you’re used to eating. Comfort foods like chicken nuggets (along with a side of vegetables, of course) may help a sick or hurt child feel more at home.

Food & Nutrition Cooking at Home Helps Manage Diabetes Learning to cook from scratch can help diabetics control their carbohydrate intake and understand food better when they dine out By Deborah Jeanne Sergeant

ype 2 diabetics need to watch what they eat and when to help control their blood sugar. But if you’re not handy in the kitchen, this can be more challenging. Home cooks are more accustomed to what goes into recipes and that makes dining out easier. Eating out can be a minefield. “Often we have no idea of what has been added to foods and we also have an inaccurate concept of a serving size,” said Susan Rioux, clinical nurse specialist and certified diabetes educator for Crouse Hospital. “This combination can result in an unawareness of extremely unhealthy eating habits.” Cooking at home from scratch can help. But sometimes meal helpers and other prepackaged shortcuts can sneak more carbohydrates and unhealthful elements into the diet than people are aware. Many are high in fat, sodium and calories—a recipe for dietary disaster. Although convenient, partially made food can be nearly as bad or worse than restaurant foods because of the additives and stabilizers; however, since they have labels, it can be easier to track nutrition as long as the portion size is the same the amount that he manufacturer specified on the package. If a packaged item contains 6 grams of fat per serving and it should feed four, the fat content per serving doubles if a diner eats two servings. “A registered dietitian can help educate you on your calorie requirements, nutrition requirements and

dietary restrictions needed for multiple medical issues,” Rioux said. Learning to cook from scratch can help diabetics control their carbohydrate intake and understand food better when they dine out. “Cooking for oneself is important for everyone, not just people with diabetes,” said Jody Kearns, registered dietitian and certified diabetes educator with Upstate Joslin Diabetes Center. “It gives you more control over what you eat. Food doesn’t cause diabetes. Just because you eat junk food doesn’t mean you’ll get diabetes; you must have some type of genetic predisposition to diabetes. Eating junk food can aggravate your weight which can make controlling your diabetes difficult. I think that many people do not understand how food relates to their blood glucose which is why education is so important.” It’s also helpful for type-2 diabetics to test their blood sugar before and after meals to help them determine how a particular dish or meal impacts their blood sugar. Investing in a few diabetic cookbooks can make it easier to prepare low-carb meals at home that the whole family can enjoy. “For cookbooks to be utilized to their fullest the person with diabetes needs to know a little about foods,” Kearns said. “For example if the recipe has the nutrient analysis at the bottom but the person has no idea what a carbohydrate is that information is

useless.” She advises diabetics to use cookbooks with “real life recipes” that are easy to understand since most people aren’t nutrition experts. Many cookbooks offer nutrition information, including sodium, fat and carbohydrate content. “If you go to the American Diabetes Association website, www.diabetes. org, there are several healthy recipes as well as cookbooks you can purchase,” Kearns added. Rioux likes The American Diabetes Association’s “Month of Meals” series of cookbooks “that not only provide recipes, but also helps with meal planning based on your carbohydrate or calorie meal plan,” she said. “It has sections that can be flipped back and forth to make a menu, and gives you the recipe for what foods are on that menu.” Another of Rioux’s favorites is the ADA’s “Diabetic Meals in 30 Minutes” series, “which is great for working people that are strapped for time, and also a book called “Diabetes and Heart Healthy Cookbook” for those who have existing cardiac conditions or are at risk for developing them. “The ADA also has several ethnic cookbooks available, ‘Concinando para Latinos con Diabetes’ and ‘The New Soul Food.’” Susan Callaway, Oswego Health certified diabetes educator, recommends the ADA’s “Recipes for Healthy Living” resource, which is available

free on the organization’s website. “This resource offers free access to meal plans as well as recipes,” Callaway said. “The ADA site not only provides recipes but also the nutritional information, most importantly the carbohydrate content of the foods prepared as well as suggesting side dishes and even dessert recipes. “There is a section which also offers suggestions for either increasing or decreasing the amount of calories or carbohydrates in your meal plan. The site allows you to plug in your numbers to determine the appropriate meal plan for you.” Cheryl J. Smith, registered dietitian, and certified diabetes educator with St. Joseph’s Hospital, likes the following cookbooks because they “do not use too many ingredients and the recipes are easy to prepare,” she said: “Diabetes and Heart Healthy Menus for Two” (American Heart Association and American Diabetes Association), “Fast and Simple Diabetes Menus” (Betty Wedman-St. Louis), “4 Ingredient Diabetes Cookbook” (Linda Coffee and Emily Cale), “15 Minute Diabetic Meals” (Nancy Hughes), and “Healthy Calendar Diabetic Cooking” (Lara Rondinelli and Jennifer Bucko). “A good way to decide what books you would like is to go to the bookstore or library, find a comfortable chair and browse through the many selections available,” Smith said. “The cookbooks do not have to be specific to diabetes; they can be heart healthy, low-fat or vegetarian. Just make sure that the nutritional information is available with the recipes.” Food TV’s website (www.foodnetwork.com/healthy) offers a free diabetic recipe section under its “Special Diets” tab. Each recipe includes a photo and sometimes a video, step-by-step directions, nutritional information, and reviews by users who oftentimes suggest ways to enhance and improve recipes. Learning how to cook can help a diabetic tweak recipes of any cookbook to make them more healthful and fit into their dietary requirements. “Many of the small changes can be made in the way you prepare your food, for example, cooking with less fat, broiling or baking instead of frying, and using less sauces and gravies,” Rioux said. “For those that love to cook, learning how to prepare foods that are still delicious but better for you can be fun and rewarding.”

Breads top list of saltiest foods M

ost of the salt in American diets doesn’t come from the salt shaker; it comes from the foods they purchase and restaurant meals. Surprisingly, bread and rolls are the No.1 source of salt in Americans’ diet, accounting for more than twice as much sodium as potato chips. According to a report released in February by the Centers for Disease Control and Prevention, the salty junk foods you would expect to see on the

top of the list, such as chips, pretzels and popcorn, occupy the No. 10 spot. The CDC said that bread and rolls are not really saltier than many other foods, but people tend to eat a lot of them. According to the CDC, breads and rolls account for about 7 percent of the salt the average American eats daily. Taking the No. 2 spot were cold cuts and cured meats, followed by pizza; fresh and processed poultry; soups; fast food hamburgers and sandwiches;

and cheese. Rounding out the list, accounting for about 3 percent each, are spaghetti and other pasta dishes; meatloaf and other meat dishes, and snacks such as potato chips and pretzels. Dietary recommendations for most Americans are no more than 2,300 milligrams of sodium per day, which is the equivalent to about a teaspoon of salt. Certain people, such as those with high blood pressure, should consume even less. The average sodium intake in the United States is around 3,000 milliMarch 2012 •

grams. Just one in 10 Americans meet the teaspoon guideline. Excess salt intake has been linked to a host of health problems. Salt reduction has become a recent focus of public health campaigns, and some major food makers have taken steps or announced plans to gradually reduce the amount of sodium in their products. Health experts say that consumers should read labels carefully and look at sodium content. Preparing food at home and eating more fruits and vegetables are other ways to reduce sodium intake.

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SAD ATTACK Seasonal Affective Disorder (SAD) has more to do with the lack of sunlight than with temperatures or snowfall By Aaron Gifford

n Central New York, many people are less happy when the days get shorter and the winter weather sets in. But the winter blahs, experts say, should never be confused with a type of depression known as “Seasonal Affective Disorder.” Seasonal Affective Disorder — or SAD — is fairly common around here, said Richard O’Neill, a psychologist at SUNY Upstate Medical University, and it actually has more to do with the lack of sunlight than it does temperatures or snowfall. Nationally, it affects 3 to 5 percent of the overall population. “Lack of sun affects the brain,” O’Neill, he said, adding that it’s natural for living things to seek and desire sunlight. “But some people’s brains are more in need of sunlight for their mood to stay positive.” According to the National Alliance on Mental Illness, SAD is far more common in women than in men, and

most patients first notice it in their 20’s. It can occur in children and adolescents, however, and in most of those cases symptoms are first notices by parents or teachers. It’s not unusual for someone with the condition to report at least one close relative with a psychiatric condition, including severe depressive disorder (55 percent) or alcohol abuse (34 percent). Naturally, this type of depression typically sets in around winter and disappears in the spring. Some patients have reported that their psychological condition has worsened from one winter to the next, O’Neill said. Symptoms can include low energy, weight gain, loss of pleasure, guilt, difficulty sleeping, difficulty with memory and concentration, and thoughts of suicide. But O’Neill cautions that those who suddenly find themselves depressed at any point during the winter should not assume that it’s SAD. He recommends getting a standard checkup to rule out any physical problems. If none are found, then it’s time to contact a mental health professional who will determine whether the apparent depression is connected to any other issues or events in your life or simply as

a result of too little social contact with others or physical activity. About 10 percent of SAD patients report annual relapses that occur in the summer, possibly as a response to high heat and humidity, according to the National Alliance on Mental Illness. This condition has been called “Reverse SAD.” In those cases, depression is more likely to be characterized by insomnia, decreased appetite, weight loss and anxiety or agitation. There have also been a few reported cases where patients regularly experience winter and summer depression while feeling fine every spring and fall. Whether this type of depression is a brain chemistry issue is still under debate. Research on SAD is ongoing, but mental health experts so far have found a variety of ways to treat the condition. “There’s also some new research that says if you give those people psychotherapy that treats the way they think and behave during the darker months of the year, they can improve their depression,” O’Neill said. O’Neill has had some success with that approach. He challenges SAD patients to notice their thoughts and how

Holly Maxwell: Suffering from SAD By Ernst Lamothe

s a freshman at Penfield High School in the Rochester area, Holly Maxwell had enough to worry about. She tried to fit in and be social but the start of every school year brought deep despair and depression. When the sun went down, so did Maxwell’s mood. She became a loner and a recluse for much of the early months of the school year because of her Seasonal Affective Disorder. When the problem worsened during her junior year, she started seeing a psychologist and then a psychiatrists, needing to take Prozak to even out her temperament. “I had no friends,” said Maxwell. “There were days that I just didn’t want to get out of bed and there were days that felt even worse than that.” Her depression usually starts after Labor Day when the sun comes down earlier and earlier. She occasionally takes vitamin D as a supplement throughout the winter, a suggestion encouraged by physicians. “Our winter season is so long here in Upstate New York and even turning back the clocks is doing a number on my body because it starts getting dark at 5 p.m. and you feel like you never get to see the light.” A decade ago, Maxwell turned to light box therapy to revitalized her spirits, using it 30 minutes at a time. The therapy includes a special lamp with a bright, fluorescent light that Page 22

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impersonates sunlight. Doctors advise taking long walks during the daylight; however, in the region sun light during the winter is a rarity even in the daytime. While nothing is full proof, the light therapy occasionally boosts her from her doldrums. “I put the lights right next to me when I am sitting on the computer and it does give me a little extra energy,” said Maxwell, who also has a prescription for Pristiq, used to treat major depressive disorders in adults. “It feels like having the sun in your face in the summer time Holly Maxwell: “Our winter season is so long here in and I do all of a sudden Upstate New York and even turning back the clocks is doing start feeling better.” a number on my body because it starts getting dark at 5 p.m. Those who sufand you feel like you never get to see the light.” fer from the disorder believe it’s more far her feelings without being ridiculed or reaching and prevalent than reported. dismissed. Since there are no physical signs like “A lot of people don’t know that cancer or liver disease or because most this is a major hindrance. It’s looked cities don’t experience similar five upon lightly by some people as not months winters like Rochester, the con- serious at all but it is,” said Maxwell. dition is sometimes dismissed. Seeing “There is a large population of people a psychiatrist helped Maxwell discuss who are not saying anything.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

those thoughts influence their mood. The idea is to confront those negative thoughts, undo the negative thinking process and “engage in reality in a way that is gratifying.” “You know what really feels good in your life. What do you typically do, and what can you do more of?” Taking in any available sunlight is an additional treatment option. Researchers have found improvements in patients who manage to get outside on winter afternoons for a walk. Even those who stand near a window during the brightest time of the day have also reported improvements. Doctors have also prescribed lamps that mimic the same light spectrum as sunlight. These lamps are encased in a box that filters out ultraviolet radiation. According to the National Alliance on Mental Illness, more than 50 percent of those who use these lamps have reported complete remission of SAD symptoms after using these lamps. According to the Center for Environmental Therapeutics, SAD can also be treated with “dawn therapy” where the patient receives light exposure during the final period of sleep. A timer gradually turns on a lamp with a diffuser, simulating the real light of an outdoor springtime dawn. The light, which is weaker than the light delivered in the special light boxes SAD patients use, affects the body’s biological clock, suppresses melatonin secretion and may produce an anti-depressant effect. This is an option for people who decide against purchasing the light box or don’t have the ability or motivation to get outside and expose themselves to any available light in the winter. Physical activity and social interaction are also key to improving mood, O’Neill said. Patients are encouraged to make a better effort during the darker months to stay connected with others via email or Facebook. With SAD, mental health professionals might be very cautious about prescribing anti-depressant medications due to side effects, withdrawal symptoms and patient fear of what might happen if they stop taking them. In the most serious cases of depression where prescriptions are given (about 12 percent), the medication is issued in conjunction with counseling. According to the National Organization for Seasonal Affective Disorder, tricyclics and other traditional antidepressant drugs are not helpful for SAD because they can exacerbate lethargy and sleeplessness. Psychotropic drugs like lithium and benzodiazepines have also not been proven useful in treating SAD. However, non-sedative drugs like paroxetine (Seroxat), sertaline (Lustral) and fluoxetine (Prozac) have been effective in treating the depressive symptoms of SAD. The National Alliance on Mental Illness reports that very few SAD patients have required hospitalization, and even fewer have been treated with electroconvulsive therapy.

Most Diabetic Patients in NYS Not Receiving Necessary Tests New Report Highlights Missed Opportunities to Improve Diabetes Patient Outcomes, Encourages Successful Strategies

nly 37.7 percent of diabetics in New York state received all three recommended medical tests in 2009, with 12.8 percent not receiving any, despite being more likely to see their doctors on a regular basis than the rest of the population, according to a new report by the Healthcare Association of New York State (HANYS) and funded by the New York State Health Foundation (NYSHealth). The report, “Managing Diabetes Care: Moving an Underlying Chronic Condition to the Forefront,” outlines the missed opportunities to educate diabetes patients within hospital and primary care settings, and highlights the successful strategies of integrated patient care. “A diabetes patient will see his or her primary care physician to address an acute symptom, not to address chronic disease prevention,” said HANYS President Daniel Sisto. “It is increasingly clear that the coordination of services for chronically ill patients, such as diabetics, is crucial and that providers and patients must work

together for successful outcomes.” Hospitals across the state have been implementing comprehensive disease management programs, such as participation in the patient-centered medical home model, which allows for coordination between different care sites and all members of the care team. Also, some hospitals have begun using electronic medical record systems and disease registries that remind providers about the need for best practice standards, such as standard diabetic blood tests and eye exams. “Hospital admissions and readmissions are key cost drivers for the care of patients with diabetes,” said James R. Knickman, president and chief executive officer of NYSHealth. “Improving diabetes care management for patients across the health care system can lead to lower readmission rates, better patient outcomes, and a reduction in health care costs.” Patients with diabetes were 2.4 times more likely to be readmitted to the hospital for any reason than patients without diabetes.

The report found that diabetics need a transition plan between the hospital and primary care provider to ensure the stability and management of diabetes after being discharged. While the benefits of more fully integrating diabetes care into primary practices is well established, in many hospitals, such programs are not part of routine discharge plans. For example, an inpatient hospital stay could provide diabetic selfmanagement education and make certified diabetes educators available to complement clinical care. The study found patients who had a diagnosis of diabetes for more than 20 years showed improvement after one year of diabetes education. There was statistically significant improvement in self-care knowledge, quality of life and self-management behavior, including monitoring blood glucose and good foot care. EDITOR’S NOTE: See related story — Cooking at Home Helps Manage Diabetes — in this issue.

Drinking black tea may reduce your blood pressure B

lack is the new green---when it comes to tea. According to a new study from the University of Western Australia, people who drink black tea throughout the day may reap the benefit of a reduction in blood pressure. While the study was not able to identify the specific component of the tea that might lead to a drop in blood pressure, past studies have shown the flavonoids, compounds found in many plants and green tea, long touted for its healthy benefits, are good for the heart. For the study, published in the Archives of Internal Medicine, 95 Austra-

lians with normal blood pressure were randomly divided into two groups. One group drank black tea and another drank a beverage similar in taste and caffeine content. Each group drank their assigned beverages three times a day for six months. To account for potential influences from other foods, the researchers had the participants in both groups cut back of foods rich in flavonoids such as apples, grapes, dark chocolate and wine for four weeks prior to the study and all throughout the study After the six month, the tea drinkers’ systolic blood pressure, fell about 2 mm Hg for both the upper and lower number. The placebo group’s systolic blood

pressure (the upper number) went up about 1 mm Hg, and their diastolic (lower number) also increased about 0.55 mm. The increase could be attributed to the group’s overall reduction in foods abundant in flavonoids, the scientists noted. Before the study, the participants blood pressure throughout the day averaged 121/72 mm HG. Blood pressure readings less than 120/80 are considered normal. The decline in blood pressure readings for the black tea drinkers were subtle and not nearly the kind of decline you would see in a person taking blood-pressure-lowering medication. But, the results are encouraging and warrant more research, health experts say. March 2012 •

Upstate wins $100,000 grant for vision research The grant will enhance research studies in Upstate’s Center for Vision Research, including ongoing work into the causes of congenital degenerative eye diseases

he ophthalmology department at Upstate Medical University has received a $100,000 grant from Research to Prevent Blindness (RPB), a leading voluntary health organization supporting eye research. The grant will be directed by physician John A. Hoepner to support research conducted at the department’s Center for Vision Research (CVR). “The support of Research to Prevent Blindness has allowed us to build a world-class research group dedicated to preserving and restoring sight,” said Hoepner, professor and chairman of Upstate’s department of ophthalmology and administrative director of the Center for Vision Research. Since 1998, the department has received more than $2.4 million from the RPB. Included among RPB-funded studies is one that involves an innovative use of technology that shows promise in better understanding the causes of congenital degenerative diseases of the eye, such as retinitis pigmentosa. Findings from another RPBsupported study could offer new possibilities for preventing or reversing the disabling vision loss caused by age-related macular degeneration, diabetes retinopathy, retinitis pigmentosa, glaucoma, and other diseases that damage the retina. Upstate’s ophthalmology department has attracted $19 million in peer-reviewed funding from the National Institutes of Health, National Science Foundation and other agencies and lists among its funding sources $1.2 million from the Grateful Patient campaign of the Upstate Medical University Foundation and $250,000 from the Lions Clubs of District 20-Y1. CVR scientists collaborate with each other and with colleagues around the world as they work at the molecular, cellular, systems and perceptual levels to understand the origin of diseases that lead to severe vision loss and blindness. CVR’s distinguished scientists have made important discoveries on the possible causes of retinitis pigmentosa, glaucoma, diabetic retinopathy, and age-related macular degeneration.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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By Deborah Jeanne Sergeant

he American Dental Association states that dentists are doctors who specialize in oral health. Their responsibilities include: diagnosing oral diseases, promoting oral health and disease prevention, creating treatment plans to maintain or restore the oral health of their patients, interpreting x-rays and diagnostic tests, ensuring the safe administration of anesthetics, monitoring growth and development of the teeth and jaws, performing surgical procedures on the teeth, bone and soft tissues of the oral cavity, and managing oral trauma and other emergency situations.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

• “Why doesn’t the government give the students enough time to brush after they eat in the school cafeteria? I don’t understand why it’s not a policy. It only takes five to 10 minutes to go to the bathroom and brush their teeth. I don’t understand why they don’t implement it at school. They teach that it’s important and ask them to take a report from the dentist to see if their hygiene is good. They have PE for exercise, but they don’t allow them time to brush their teeth at school. • “I have a son and I received a letter saying if he doesn’t bring sneakers, he’s not ready for PE. But they wouldn’t spend a letter saying he must bring a brush, paste and floss. Many eat breakfast and lunch at school. Why can’t they keep a toothbrush in the locker room to brush one time a day? • “Go to the dentist for a checkup every six months. People take a shower once or sometimes twice a day. Home care of your teeth is equivalent to that. I can’t take a shower just once in a while and expect to be healthy. • “Home care has to be implemented from when people are little. The ‘real’ dentist is the parent who supervises and keeps them doing this as a habit. If people would do this, it would eliminate much of what dentists do. It starts at home with the parent or legal guardian. That’s where the prevention starts. People can have beautiful, healthy teeth for a lifetime.” Jin Song, dentist with Accurate Dental Care, Syracuse • “I don’t think [visiting the dentist every] six months is adequate for some people, especially if they’re not flossing and thoroughly brushing

twice a day. • “In general, people don’t understand the link between gum diseases and systemic health and between gum disease and heart disease and general health. • “People don’t generally realize that losing a tooth causes more teeth to be subject to loss and increased incidences of loss. You have the same forces from your muscles placed on the remaining teeth. They’ll take more abuse from the muscles. Replacing teeth when you lose them is key. Bridgework and partial dentures don’t support the teeth they have. Implants are a better recommendation. • “When it hurts, it’s too late. You want to take the dentist’s recommendations to heart and deal with them sooner than when it starts to hurt. When it hurts, it’s into the pulp of the tooth and it’s more difficult to resolve.” James E Richardson, dentist with Clinical Dental Group, PC, Fulton and Liverpool • “What people eat is very important. Sodas, power drinks and sweetened supplements are not good for teeth. • “There’s an increase in use of methamphetamines in Oswego County and there are significant oral effects. It’s dangerous and can kill. And it damages teeth almost irreparably with cavities. The side effects orally are of course not as important as the fact that it kills. Meth is bad for the mouth because the people who use it aren’t nourished well and eat lots of junk foods and sodas. Meth dries out the mouth and is acidic, which damages the teeth.” Robert Schaefer, dentist practicing in Oswego

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.

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Dear Savvy Senior Is there an age limit on being an organ donor? At age 73, I’m interested in being a donor when I die, but am wondering if they would still want my organs. What can you tell me, and what do I need to do to sign up? Willing But Old Dear Willing, There’s no defined cutoff age for being an organ donor. In fact, there are many people well up into their 80s who donate. The decision to use your organs is based on health, not age, so don’t disqualify yourself prematurely. Let the doctors decide at your time of death whether your organs and tissues are suitable for transplantation. Donating Facts In the United States alone, more than 112,000 people are on the waiting list for organ transplants. But because the demand is so much greater than the supply, those on the list routinely wait three to seven years for an organ, and more than 6,500 of them die each year. Organs that can be donated include the kidneys (which are in the greatest demand with more than 90,000 on the waiting list), liver, lungs, heart, pancreas and intestines. Tissue is also needed to replace bone, tendons and ligaments. Corneas are needed to restore sight. Skin grafts help burn patients heal and often mean the difference between life and death. And heart valves repair cardiac defects and damage.

istry. You can do this online at either donatelife.net or organdonor.gov. Both sites provide links to all state registries. If you don’t have Internet access, you can call your local organ procurement organization and ask them to mail you a donor card, which you can fill out and return. To get the phone number of your local organization, call Donate Life America at 800-355-7427.

Identify yourself Designate your decision to become an organ donor on your driver’s license, which you can do when you go in to renew it. If, however, you don’t drive anymore or if your renewal isn’t due for a while, consider getting a state ID card — this also lets you indicate you want to be a donor. You can get an ID card for a few dollars at your nearby driver’s license office.

Tell your family Even if you are a registered donor, in many states family members have the ultimate say whether your organs may be donated after you die. So clarify your wishes to your family. It’s also a good idea to tell your doctors and include it in your advance directives. These are legal documents that include a living will and medical power of attorney that spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself. If you don’t have an advance directive, go to caringinfo.org or call 800-6588898 where you can get free state-specific forms with instructions to help you make one.

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Q&A Q: I lost my Social Security card, should I get a new one? A: If you know your Social Security number, you may not need a replacement card. You can replace your Social Security card for free if it is lost or stolen, but you are limited to three replacement cards in a year and 10 during your lifetime. Learn more at www. socialsecurity.gov/ssnumber.

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f you didn’t sign up for Medicare Part B medical insurance when you first became eligible for Medicare, you now have an opportunity to apply — but time is running out. The deadline for applying during the general enrollment period is March 31. If you miss the deadline, you may have to wait until 2013 to apply. Medicare Part B covers some medical expenses not Banikowski covered by Medicare Part A (hospital insurance), such as doctors’ fees, outpatient hospital visits and other medical supplies and services. When you first become eligible for hospital insurance (Part A), you have a seven-month period in which to sign up for medical insurance (Part B). After that, you may have to pay a higher premium — unless you were covered through your current employer’s group health plan or a group health plan based on a spouse’s current employment. You are given another opportunity to enroll in Part B during the general enrollment period, from Jan. 1 to March 31 of each year. But each 12-month period that you are eligible for Medicare

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

Q: I worked for the last 10 years and I now have my 40 credits. Does this mean that I can stop working and get the maximum Social Security retirement benefit when it’s time to retire? A: The 40 credits are the minimum number you need to qualify for retirement benefits. However, we do not base the amount of the benefit on those credits; we base it on your earnings over your working lifetime. To learn more about Social Security retirement benefits and how your benefit amount is figured, read our online publication, Retirement Benefits, at www.socialsecurity.gov/pubs/10035.html. Q: I want to estimate my retirement benefit at several different ages. Is there a way to do that? A: Use our Retirement Estimator at

Part B and do not sign up, the amount of your monthly premium increases by 10 percent. There are special situations in which you can apply for Medicare Part B outside the general enrollment period. For example, you should contact Social Security about applying for Medicare if: • you are a disabled widow or widower between age 50 and age 65, but have not applied for disability benefits because you are already getting another kind of Social Security benefit; • you worked long enough in a government job where Medicare taxes were paid and you meet the requirements of the Social Security disability program and became disabled before age 65; • you, your spouse, or your dependent child has permanent kidney failure; • you had Medicare medical insurance (Part B) in the past but dropped the coverage; or • you turned down Medicare medical insurance (Part B) when you became entitled to hospital insurance (Part A). You can learn more about Medicare by reading our electronic booklet, Medicare at www.socialsecurity. gov/pubs/10043.html. Or visit the Medicare website at www.medicare. gov. You may also call Medicare at 1800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048).

www.socialsecurity.gov/estimator to get an instant, personalized retirement benefit estimate based on current law and your earnings record. The Retirement Estimator, which also is available in Spanish, lets you create additional “what if” retirement scenarios based on different income levels and “stop work” ages. Q: I currently receive Social Security disability benefits. Is there a time limit on how long you can collect Social Security disability benefits? A: Your disability benefits will continue as long as your medical condition has not improved and you cannot work. We will review your case at regular intervals to make sure you are still disabled. Learn more by reading our publication, “Disability Benefits,” at www.socialsecurity.gov/pubs/10029. html. Q: Is it true that a person can own a home and still be eligible for Supplemental Security Income (SSI) benefits? A: Yes. A person who owns a home and lives in that home can be eligible for SSI benefits. Although there is an asset limit for people to qualify for SSI, some things don’t count toward that limit, such as a house, a vehicle, and some funds set aside for burial expenses.

H ealth News Excellus medical director named to national panel Frank J. Dubeck, chief medical officer and vice president for medical policy and clinical editing at Excellus BlueCross BlueShield, has been selected to serve on the executive committee of the editorial panel of the American Medical Association’s Current Procedural Terminology (CPT) Codebook, representing health insurers and other third party payers. CPT codes are the vocabulary physicians use to report their services to insurance companies. The editorial panel reviews code Dubeck changes to improve claim processing efficiency and to accommodate breakthroughs in medical practice. Dubeck has been the representative for the National BlueCross BlueShield Association on the panel since 2009. A nationally recognized expert on clinical coding and editing, Dubeck has been chief medical officer for Excellus BlueCross BlueShield’s Utica region since 1998. An internist with 20 years of clinical experience, Dubeck practiced locally at Slocum Dickson Medical Group prior to joining Excellus BlueCross BlueShield.

Community relations person named at ARC Lyndsay Frank has joined Oswego Industries, Inc. and its sister agency ARC of Oswego County as director of communications and community relations. Frank will be responsible for fundraising, donor relations, communications, special events, public awareness and media relations for both organizations. Frank comes to Oswego Industries, Inc. from Communities In Schools of Pennsylvania, a dropout prevention

organization, where she served as executive director of the capital region affiliate based in Harrisburg. Prior to that, she worked in the public relations division in the Harrisburg office of Tierney, a fullservice agency, based in Philadelphia, where she worked on a variFrank ety of clients including Verizon Wireless, Pennsylvania Department of Community and Economic Development, FELD Entertainment, Jack Welch MBA program and the ACES Train, to name a few. Frank received her bachelor’s degree from Pennsylvania State University and currently resides in Fulton.

John Riccio is Auburn’s new chief medical ofﬁcer John A. Riccio has been appointed chief medical officer at Auburn Community Hospital. Riccio joined hospital medical staff in 2000. Since 2003, he has been the director of the medical laboratory and chief of pathology at the hospital. He received his undergraduate degree from Thomas A. Edison College, Trenton, N.J, and his medical degree from the University of Medicine and Dentistry of New Jersey. He completed his internship in internal medicine and residency in pathology and laboratory medicine at Geisinger Medical Center, Danville, Pa. In Riccio. addition, he completed a Fellowship in cytopathology at the Medical College of Pennsylvania in Philadelphia. Riccio is board certified and a diplomat of the American Board of Pathology. He is a member of the Medical Society of the State of New York, and

CENTENARIANS Loretto resident Filomena “Fanny” Garofalo celebrates 100th birthday Filomena “Fanny” Garofalo, a resident of the Loretto Health and Rehabilitation Center in Syracuse, celebrated her 100th birthday Feb. 15 with family members from Central New York and Union City, Cal., along with fellow Loretto residents and staff. Garofalo was born in Compobasso, Italy, Feb. 15, 1912, and has two sons. She worked in the real estate field and also operated her own floral decorating business creating special arrangements of artificial flowers to rent to area businesses. Garofalo’s favorite activity is, “going out with her sons for dinner and having a glass of wine.” When asked about her secret to living a long life, she replied, “To be careful!”

Auburn Memorial Hospital Changes Name to Auburn Community Hospital Auburn Memorial Hospital, Inc. recently announced it has changed its name to Auburn Community Hospital effective immediately. This change reflects the stronger connections, which the hospital is developing through the communities in the Finger Lakes region. “Our local community is a critical part of the life of this hospital,” said Scott Berlucchi, president and CEO. “We want our name to reflect a sense of that ownership by the population we serve,” he added. Auburn Community Hospital will continue to offer the same programs and services. The name

of the Cayuga County Medical Society. He served as the president of the Auburn Community Hospital medical staff from 2008 to 2010 and is currently a member of the Auburn Community Hospital board of trustees. In his role as chief medical officer, he will direct the hospital’s quality management and performance improvement initiatives. Riccio resides in Auburn with his wife Sharon.

Internist Associates adds primary care doctors Two physicians have joined the medical practice of Internist Associates of Central New York. Barzaga Hazrati was most recently in private practice in New Jersey and also worked at Finger Lakes Medical Associates in Geneva. Prior to that, she served as diabetes care coordinator for Northeast Valley Health Corp. in Los Angeles. Hazrati received her medical degree from Ruprecht-Karl University in Heidelberg, Germany, and completed her residency in internal medicine at Albert Einstein College of Medicine and Flushing Hospital Medical Hazrati Center in New York. Jane Hudson most recently was an assistant professor in the department of medicine at SUNY Upstate. She received her medical degree from University of Pittsburgh School of Medicine and completed her residency Hudson in internal medicine at SUNY Upstate. Hudson also served many years as a hematology/oncology attending physician at the Syracuse VA Medical Center. March 2012 •

change has no impact on any hospital operations and is unrelated to the organization’s exploration of a possible affiliation with Rochester General Health System. “We are continually grateful to our employees, medical staff, and volunteers for their tremendous dedication and commitment to service,” said Eric Allyn, chairman of the hospital’s board of trustees. “They are the heart of this hospital and our real connection to the community.” The hospital is in process of changing signs, stationery, and forms that will transition to the new name.

Excellus promotes Thomas P. Tiernan Excellus BlueCross BlueShield has announced the promotion of Thomas P. Tiernan to regional director of sales. In his new position, Tiernan will oversee Excellus BlueCross BlueShield’s midmarket segment sales, strategy and retention in the company’s Central New York and Utica regions. Tiernan has been with Excellus BlueCross BlueShield for 12 years and most recently served as regional manager of sales for the Watertown market. Before joining Tiernan Excellus BlueCross BlueShield in 2000, Tiernan was an account executive with Key Bank Insurance in Watertown for two years. He also spent 16 years as a district agent and regional sales manager with Prudential Insurance, also in Watertown. A graduate of Herkimer County Community College, Tiernan is a member of the National Association of Insurance and Financial Advisors and the Carthage Basketball Club.

Gift to help drive aide recruitment at Home Aides The Eldercare Foundation recently donated $10,000 to Home Aides of Central New York to help put a fresh spin on the agency’s home health aide recruitment efforts. Among other plans, the gift will help Home Aides of Central New York explore the potential benefits of social media marketing. Home Aides of Central New York is the largest non-profit provider of home health aide services in Central New York. Despite this fact, the agency faces an ongoing shortage of home health aides, turning away an average of 50 to 100 service requests

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H ealth News each month. This trend is unlikely to change, as the region’s elderly population continues to grow at an unprecedented rate. Historically, Home Aides of Central New York has utilized traditional recruitment methods, relying on newspaper “help wanted” advertisements, employment websites, targeted mailings and job fairs to attract applicants. Now, thanks to the funds provided by the Eldercare Foundation, it hopes to tap into the wealth of recruitment opportunities offered by online technologies including Facebook, Twitter and LinkedIn.

Upstate raises $650,043 for United Way campaign Upstate Medical University employees have raised $650,043 for its 2011 United Way/Community Giving Campaign, exceeding the goal of $650,000. That’s a 6 percent increase over Upstate’s 2010 United Way/Community Giving Campaign that raised $609,270. The four-month campaign concluded in early January. The campaign supports hundreds of community programs and services, including those offered at Upstate. “We are extremely grateful for the support the Upstate community provides to these important human service agencies,” said Community Giving Campaign co-chairs John McCabe and Wanda Thompson. “Each year, the need in our community grows and Upstate’s spirit of caring soars.”

McCabe is senior vice president for hospital affairs and chief executive officer for Upstate University Hospital. Thompson serves as senior vice president of operations. McCabe and Thompson said that helping to make the 2011 campaign a success was the addition of Upstate’s newest members from Community General (Upstate acquired Community last July); the efforts of Upstate’s more than 200 campaign department representatives and campaign committee members; and an online method to donate. A comprehensive incentive program, and inspiring testimonials from employees about why they support the campaign, featured on Upstate’s Community Giving Campaign website, also helped to exceed the campaign goal, was also cited for the record-breaking campaign. Over the last five years, Upstate employees have contributed more than $2.6 million through the United Way/ Community Giving Campaign, earning the United Way’s Spirit of Caring Award in 2010.

Simply Prescriptions earns top marks from Medicare The prescription drug plan Simply Prescriptions is the only standalone Medicare Part D plan in New York state to earn the highest quality rating from the federal agency that administers the Medicare program. The plan is offered locally and throughout the state.

Oswego Hospital Lab Receives Joint Commission Accreditation Oswego Hospital’s laboratory has been accredited by the Joint Commission (JC) following a thorough three-day inspection process. During the JC visit in November, a team from JCAHO observed how lab workers conducted various tests, reviewed the control measures the department has in place and examined how test results are recorded. In addition, the team conducted similar observations at Oswego Health’s Urgent Care Center in Fulton. Laboratories are mandated to be inspected by the JC every two years. According to Patricia Main, Oswego Hospital’s laboratory administrative director, between 75 and 80 percent of the diagnostic information for a patient comes from the lab. “The laboratory plays an invaluable and enormously significant role in healthcare,” said Main. “Our lab staff works very hard and I am proud of our accreditation.” Joint Commission accreditation involves evaluating a health care organization’s performance in areas that most affect patient health and safety. These areas are defined in Joint Commission standards. By achieving accreditation, a health care organization makes a commitment to follow Joint Commission standards, which provide the framework for safe, quality care. The Joint Commission is a private agency endorsed by the federal government. Oswego Hospital’s laboratory has been During 2010, the last full accredited by the Joint Commission (JC) year that statistics are availfollowing a thorough three-day inspection able, the Oswego Hospital lab process. In the photo from left are Patricia performed 603,569 tests, while another 110,812 tests were done Main, the lab’s administrative director, and at the Urgent Care Center in Ed Hale, assistant administrative director. Fulton. Page 28

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

St. Joseph’s held a ribbon cutting and blessing ceremony for its new Ralph and Christina Nappi Emergency Services Building Jan. 30. The building ofﬁcially opened for business Feb. 1. Pictured are Sam Nappi and his mother, Christina Nappi, cutting the ribbon while family members look on. Pictured left is Kathryn Ruscitto, president and chief executive ofﬁcer of St. Joseph’s.

St. Joseph’s Holds Ribbon Cutting For New Emergency Services Building St. Joseph’s Hospital Health Center held a ribbon cutting and blessing ceremony of its new Ralph and Christina Nappi Emergency Services Building Jan. 30. The $80 million expansion project includes a newly expanded, 54-bed emergency department, psychiatric emergency program, clinical observation unit and chest pain center, and a “green” data center. Consistent with Syracuse’s national identity as one of the top 10 green communities in the nation by the U.S. Environmental Protection Agency, the project used sustainable design principles to build a “healthy” hospital while seeking LEED certification. This marks the completion of the first phase of St. Joseph’s expansion on the north end of its campus. The Centers for Medicare and Medicaid Services (CMS) rated the quality of standalone Medicare Part D plans on a scale of one to five, with five stars representing the highest quality. Only Simply Prescriptions and three other standalone Medicare Part D plans nationwide earned a five-star rating for 2012. Simply Prescriptions is a division of Excellus Health Plan, Inc., the largest nonprofit health insurer in Upstate New York. The plan provides drug coverage for Medicare-eligible individuals in New York state who are eligible for Medicare Part A (hospital coverage) and/or enrolled in Medicare Part B (physician and medical coverage). Usually, Medicare beneficiaries can only switch Part D plans during the fall open enrollment period, but eligible beneficiaries can switch to a five-star drug plan at any time during the year. CMS rated standalone Part D plans on a variety of measures, including customer service, member complaints, responsiveness and management of chronic conditions. The ratings were posted to the Medicare website to help beneficiaries select the best drug plan. Beneficiaries will see the star ratings when using Medicare’s Plan Finder at www.medicare.gov/find-a-plan/questions/home.aspx.

The second phase includes a 104,000 sq. ft. patient tower with 110 private patient rooms, including medical and surgical intensive care units, a 73,000 sq. ft. state-of-the-art surgical suite with 14 operating rooms, a 25-bed post-anesthesia care unit and a greenway corridor to North side businesses. The tower will also contain space for support services, staff education and family waiting areas. Estimated to cost $140 million, the second phase is expected to be complete in 2014. St. Joseph’s has launched a capital campaign to help raise money for the new expansion. To make a pledge to the Generations Campaign, visit St. Joseph’s Hospital Foundation website at www.sjhsyr.org or call 315-703-2137.

News from Respiratory Care Department Awarded National Quality Care Designation — Crouse Hospital has again earned Quality Respiratory Care Recognition (QRCR) from the American Association for Respiratory Care (AARC). The QRCR designation ensures quality respiratory care in a hospital and helps patients and families make informed decisions about the quality of the respiratory care services available at the facility of their choice. “This recognition is another example of our staff’s superior skills and dedication to their profession and, above all, their commitment to providing the best possible care to our patients,” said Rob Pikarsky, director of respiratory care, cardiac and sleep services at Crouse Hospital. About 700 hospitals in the United States, or approximately 15 percent, have received the QRCR designation, which places Crouse among the elite for respiratory care in the nation, reflecting the high level of respiratory expertise at the hospital. This is the eighth consecutive year Crouse has earned this designation.

Hospital Joins CMS’ Partners for Patients Program — Crouse Hospital has joined a national initiative of The Centers for Medicare and Medicaid Services (CMS) called Partners for Patients to encourage and support hospitals across the U.S. to reduce hospital-acquired conditions by 40 percent, reduce hospital readmissions by 20 percent, and save $35 billion in healthcare costs nationally over the next three years. Crouse will work with a consortium of 170 other hospitals across New York state that is being co-facilitated by the Hospital Association of New York State (HANYS) and the Greater New York Hospital Association (GNYHA). In this consortium, hospitals will work collaboratively with HANYS/ GNYHA to address the 11 focus areas defined by CMS. The focus areas include adverse drug events, catheter-associated urinary tract infections, central line-associated bloodstream infections, injuries from falls and immobility and adverse obstetrical events, among others. As part of its initial participation in the program, Crouse will focus efforts on reducing and preventing patient falls in the hospital. Partners for Patients is in the beginning stages and is expected to last up to three years, says Crouse Director of Quality Improvement Jennifer Watkins. “This important initiative supports Crouse’s ongoing commitment to improving the quality of care we provide as well as the overall patient experience.”

News from

New Officers and Members-AtLarge — St Joseph’s Hospital Health Center has elected new officers to its

medical staff leadership: President, Balasubramaniam Sivakumar (general surgery); vice-president/presidentelect, Richard Waldman , (OB/GYN); secretary/treasurer, Cristian Andrade (family medicine/hospitalist); members-at-large: Angelo DeRosalia, (surgery/urology); Seth Greenky, (surgery/orthopedics); and Ahmad Nazem, (surgery/cardiac surgery). Medical staff leadership officers were voted on Jan. 25 by the members of the medical staff. The new representatives assumed their offices immediately, and will hold their leadership roles for two years. New Members Join St. Joe’s Medical Staff — The following medical doctors have joined St. Joseph’s active medical staff: Justin B. Bertrand, family medicine. He lives in Fayetteville; Clarissa Del Rosario, internal medicine / nephrology. She lives in Baldwinsville; Katherine J. Dunham, pediatrics, of Cicero; Vanessa R. Gibson, thoracic surgery, of Sandusky, Ohio; Peter P. Huntington, internal medicine / cardiology, of Tully; Carri A. Jones, anesthesiology, of Syracuse; and Christina M. Yambo, emergency, of Cicero. New Director Of Supply Chain Management — Steven (Steve) Fondario has been appointed St. Joseph’s Hospital Health Center’s director of supply chain management, a newly created position that addresses the product cost, quality, supplier and delivery challenges in today’s complex hospital and healthcare environments. Fondario has more than 30 years of experience in various operational, supply chain, and business roles, including leadership positions at General Electric, Apple Computer and Cisco Systems, Inc. He holds a Bachelor of Science degree in economics and business from Le Moyne College and a Master of Science degree in systems and business management from the University of Denver. Fondario

Fingerlakes Bariatric Program Designated Bariatric Center of Excellence Auburn Community Hospital announced that the Fingerlakes Bariatric Program has been accredited by the American Society of Metabolic and Bariatric Surgery (ASMBS) as a Bariatric Surgery Center of Excellence, the highest level of recognition. The ASMBS, a leader in research and development of weight loss surgery, promotes the delivery of bariatric surgical care with the highest levels of efficiency and patient safety. In order to qualify for this designation, the surgeon and hospital must meet stringent requirements. The Fingerlakes Bariatric Program, under the direction of physician Carl A. Weiss III has demonstrated its commitment to providing the highest quality of care for its bariatric patients. Accredited bariatric programs provide the support and resources necessary to address the entire spectrum of care for bariatric patients from the pre hospital phase through the early postoperative care

and long term follow up to ensure the greatest opportunity for success. “Since the initial development of the Fingerlakes Bariatric Program in 2005, it has been my primary goal to obtain this prestigious designation” stated Weiss, “The staff has worked diligently and the entire team deserves high praise for this accomplishment.” Through the ASMBS designation, the Centers for Medicare & Medicaid Services now recognize the Fingerlakes Bariatric Program which will allow expanded coverage for Medicare patients who are eligible for bariatric surgery. “The Bariatric Surgery Center of Excellence recognizes both the surgeon and the hospital as having demonstrated unparalleled commitment and the ability to consistently deliver safe, effective, evidencebased care to our community,” stated Scott A. Berlucchi, President/ CEO at Auburn Community Hospital.

Health in good

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

“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.

March 2012 •

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Autism Awareness Programs supported by Kohl’s Autism and Related Disorders Program

CONFERENCE Children with Social, Emotional & Behavioral Challenges Including Autism Spectrum Disorders: The Collaborative Problem Solving Approach PA R E N T S & P R O F E S S I O N A L S - YO U A R E I N V I T E D ! Sheraton Syracuse University Hotel & Conference Center • 801 University Ave.

April 26, 2012 from 9:30 a.m. - 5 p.m. Presenter Ross Greene, Ph.D. Online registration at AutismSyracuse.com Professionals: $85 (by April 6) $95 (April 7-16) • Parents: $55 (by April 6) $65 (April 7-16) For more information go to AutismSyracuse.com or call 472-4404.

Sponsored by Margaret L. Williams Developmental Evaluation Center in conjunction with CNY Coalition for Young Children with Special Needs.

AUTISM AWARENESS WALK Saturday, April 28th 10:00 am Long Branch Park in Liverpool.

“one piece at a time”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012

hosted by CNY ASA Central New York Autism Society of America