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

in good Enlightening news about onions

Magnet Ingestion

November 2012 • Issue 155

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CNY’s Healthcare Newspaper

Meatless Monday ‘Meatless Monday’ movement gaining ground in the CNY area. Page 18

SUNY Upstate sounds alert to new emergent health issue among kids. Page 8

$9 BILLION That’s the amouint spent annually in the U.S. on knee operations. Page 5

A Life Taken by Bath Salts — and a Mom’s The Flu & Seniors Determination to Prevent If you’re one of the unlucky seniors who catches the flu, Future Tragedies your risk for complications is greater than that of a younger person. Page 22

Tragedy that claimed the life of a young man in Oswego in August shook the community; mom now vows to fight to make synthetic drugs illegal in NYS. Page 19 November 2012 •

For kids, battling epilepsy not an easy task

Ira Williams, 10, had his ﬁrst seizure the day he was born. To control it, he takes several pills plus a shot for an underdeveloped pituitary gland. Grandmother and caretaker Pat Williams says: “The worst thing is other kids being afraid of him and looking at him as being different.” Page 9

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

“With their help, I can still live at home.” Johnnie Drake, Syracuse, NY

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The Auxiliary of St. Joseph’s Hospital Health Center Inc., and Liquor City, Wegmans Plaza, DeWitt, will present the 16th Annual Holiday Wine Tasting. The event takes place from 6 – 9 p.m., Friday, Nov. 2, at the Holiday Inn at Electronics Parkway, Liverpool. Guests may enjoy hundreds of wines, fabulous food and tempting desserts. Proceeds from the wine tasting will benefit St. Joseph’s Westside Family Health Center’s patient waiting room, creating a comfortable, family-friendly atmosphere featuring children’s play scapes, wall art and furniture. Regular tickets are $50, patron tickets are $75. Guests must be 21 or older to attend. Accommodations at the Holiday Inn are available. For more information, visit www.sjhsyr.org/auxiliary or call 315-448-6100.

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Parkinson’s disease support groups announced Co-sponsored by the Onondaga County Department of Aging and Youth and the Parkinson’s Group of Syracuse, Inc. two new support groups have been formed to help people suffering from Parkinson’s disease and their families. The first meeting will take pace from 6 – 7 p.m. Nov. 13 and Dec. 11 at The Villas of Summerfield, 100 Summerfield Village Lane, Syracuse; the second, will take place from 1 – 2:30 p.m. Nov. 5 and Dec. 3 at The Hearth at Greenpoint, 150 Old Liverpool Road, Liverpool. For information or to sign up, call Cynthia at 435-2362 x140

Nov. 7

Research conference spotlights Alzheimer’s cure Researchers from around the world have set their sights on defeating Alzheimer’s disease, which is the sixth leading cause of death in America. The Alzheimer’s Association, Central New York Chapter will focus on the local and national efforts to defeat this disease at its first Alzheimer’s Research Conference, Nov. 7 at the DoubleTree By Hilton Hotel Syracuse. Admission to the conference, which

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begins at 8 a.m., is $40 per person or $250 for a table of seven, and includes breakfast and handouts. The conference will feature a keynote from Dean Hartley, director of science initiatives for the national Alzheimer’s Association, focusing specifically on the current state of Alzheimer research. Before joining the Association, Hartley was an associate professor in the department of neurological sciences at Rush University Medical Center in Chicago, one of the leading Alzheimer research centers in the world. His speech will be followed by presentations from local researchers and a panel discussion. Register by visiting the www.alz.org/ cny, or by calling 315-472-4201 ext. 108.

Nov. 7, 8

Free Medicare seminars in Oswego, Fulton Individuals who are turning 65 or shopping for Medicare coverage can attend a free Medicare seminar and learn more about their health insurance options. The seminars will detail Excellus BlueCross BlueShield Medicare options, including Medicare Advantage and Medicare Supplement Plans. The events will take place from 10 a.m – 1 p.m. Nov. 7 at Oswego Public Library, 120 E. Second St., Oswego, and from 10 a.m. – 1 p.m. Nov. 8 at Riverside Inn, 930 South First St., Fulton. Medicare’s annual enrollment period ends Dec. 7. To register for a Medicare seminar, go to ExcellusMedicare.com or call toll-free 1-888-834-1408 (TTY/TDD users call 1-800-421-1220) from 8 a.m. to 8 p.m., seven days a week. For a complete list of upcoming seminars, visit ExcellusMedicare.com.

Nov. 27

Epilepsy group to hold ‘Dinner with the Doctor’ The Epilepsy Foundation of Rochester-Syracuse-Binghamton will hold its ‘Dinner with the Doctor’ that will bring a neurologist and other experts to discuss issues related to epilepsy. People suffering from the disease, their families and friends are invited for the free dinner. The event will take place at 6 p.m., Tuesday, Nov. 27, at 1045 James St., second floor large conference room, in Syracuse. The epilepsy foundation estimates there are nearly 5,000 people living with epilepsy in Onondaga County. For more information and for registration, call 315-477-9777, extension 102 or visit ww.epilepsy-uny.org.

Health in good

ONE AD, WORKING ALL MONTH • editor@CNYhealth.com

Reach Health Professionals & Consumers.

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

U.S. Sees a Run on New Knees Since 1990s Over $9 billion spent annually on the operation, researchers say

he number of Americans getting knee replacement operations has jumped more than 100 percent over the past two decades, keeping many more older adults active and independent, a new study finds. At about $15,000 an operation, however, the costs to Medicare and other insurers have also ballooned. But experts analyzing fees associated with the procedures say that added productivity and mobility may offset the initial outlay. Knee replacement is cost-effective, said Matthew Hepinstall, an orthopedic surgeon at Lenox Hill Hospital in New York City. “This is a surgery that can actually pay for itself in the increased productivity of the person who goes from disability to return to work,” said Hepinstall, who was not involved in the study. There are also savings in disability payments and the costs of ongoing care, he said. According to background information in the study published in the Sept. 26 issue of the Journal of the American Medical Association, roughly 600,000 knee replacements are done each year in the United States. The total cost of all these knees is $9 billion, the researchers noted. Among Medicare beneficiaries — patients 65 and older participating in the government’s health insurance program — first-time knee replacements jumped 162 percent between 1991 and 2010, the study found. Revisions (replacement of an artificial knee) increased about 106 percent in that time period. Lead researcher Peter Cram, an associate professor of medicine at the University of Iowa Carver College of Medicine in Iowa City, credits the burgeoning baby boom generation and better success rates with the procedure’s popularity. “We are doing more procedures as the population ages,” Cram said. In addition, a higher proportion of that aging population wants the surgery, he

said. With many years of practice, the operation is very safe and the rate of complications remains low, Cram added. For people with severe knee damage, a knee replacement can relieve pain and restore movement. To examine the effects of knee replacements on health costs, Cram’s team collected data on almost 3.6 million Medicare patients who had a knee replacement or a revision of an initial knee replacement in the previous 20 years. The investigators found initial knee replacements rose 76 percent and revisions increased 99 percent. While success rates were consistent over the period, the number of hospital readmissions within 30 days inched up from 4.2 percent to 5 percent in initial knee replacement patients and from about 6 percent to almost 9 percent among revision patients. That rise in readmissions is largely related to shorter initial hospital stays today, Cram said. After an initial knee replacement, patients now leave the hospital in 3.5 days vs. 7.9 days in the mid-1990s, the study found. Wound infections were one reason for readmissions, but the authors weren’t certain of the cause. Cram said knee replacements last 15 to 20 years, which means many patients may live long enough to need a second operation. However, the newer implants may last longer than the earlier models, he said. “Implants we are implanting today are different than the one we used 10 to 15 years ago,” Cram said. “Hopefully, they’re newer and better, but we don’t really know that.” Recovery from a knee replacement takes about three months and requires patients to undergo physical therapy. Results depend on the surgery itself and the patient’s willingness to work on moving the knee, said Hepinstall. The study also found that more obese and diabetic patients get new knees nowadays, and more patients are getting outpatient rehabilitation than two decades ago.

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

Health CNY’s Healthcare Newspaper

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

In Good Health is published 12 times a year by Local News, Inc. © 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. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, Deborah Sergeant, Anne Palumbo, Chris Motola, Melissa Stefanec, Matthew Liptak, Avery Galek, Kevin DeValk, Ken Sturtz, Aaron Gifford • Advertising: Jasmine Maldonado, Tracy DeCann • Design: Chris Crocker • 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.

November 2012 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Dr. Paul Klawitter Doctor talks about the most injury-prone sports and what people can do to help prevent problems Q: What is considered a sports injury? A: It’s kind of a smaller term to describe orthopedic injuries that were the result of a sporting event, but the truth is whether you twist your ankle playing football or twist your ankle slipping on the ice, it’s a very similar injury. So it’s not isolated to injuries from sports. It can be any orthopedic injury. I’m specifically in primary care sports medicine, so I don’t do any surgery. If a patient does eventually need surgery, I refer them to an orthopedic surgeon with Crouse’s sports medicine initiative. I take care of sprains, arthritis and chronic conditions related to sports injuries. So in addition to being available to the athletes Crouse has made arrangements with, I’ll see referrals from primary care doctors for any orthopedic injury. Q: What are typical sports injuries? A: The three most common are injuries to the knee, shoulders and ankles. That’s probably true of both sports injuries and the general population. Q: What makes those joints more vulnerable to injury than, say, your thigh or forearm? A: We have a large range of motion there, but they’re only supported by soft tissue structures like muscles, ligaments and tendons. A lot of force is transmitted to the joint. It’s not true of all joints—the hip socket is deep enough to get some stability from the bone—but most are supported by soft tissues. Q: What can be done for injuryrelated arthritic conditions? A: Arthritis certainly is a difficult problem because there’s not much in the way of reversing it. It’s most common in weight-bearing joints like the knee, so weight loss can be one of the best things you can do to avoid arthritis or minimize its impact. Try to keep the muscles around your joint strong to help protect it. There are some medications that can be injected into the joint. Steroid injections can cut down on inflammation and help with the pain, but they don’t really cure the problem and, if you use them too much, they can have a negative effect. There’s a newer class of medications that simulate the lubricants in the joint; you can think about it like an oil change. Some people take glucosamine and believe it helps them, although there’s no medical evidence right now that it does. Beyond that, there are surgical options up to and including joint replacements.

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

Q: Knee joint replacements are way up in the country right now. What’s responsible for this increase? A: That’s a difficult question for me as I don’t perform the operation. I would guess it’s a combination of the population being both more overweight and more active, so there’s more stress being placed on the joint. The surgeons may also be more comfortable with the operation. But again, I may not be the best person to ask. Q: Can you explain why the weight placed on load-bearing joints like the knee is an order of magnitude more than the person’s actual weight? A: The reason is that when you’re standing still, you’re bearing that static weight, so that 150 pounds of weight is 150 pounds of weight on your knees. When your walking up the stairs or running, your whole weight is coming down from the air, so that’s 150 pounds moving maybe 10 miles per hour, so your knee has to resist that force and momentum. That’s why one pound of body weight means a lot more than one pound to your knees. Q: Crouse’s sports medicine program is the youngest among Syracuse’s hospitals. Why has Crouse chosen to launch a program now? A: I’m actually not sure when they first started talking to Syracuse University and the Raphaels [Irving and Bradley, team physician and assistant team physician at SU, respectively]. In terms of the part I play, primary care and concussion man-

agement, I contacted them at a certain point while working somewhere else and joined the team when I was able to. Q: What would you suggest in terms of injury prevention? A: Proper weight control. Listen to your body. As you get older, what you’re able to do is going to change. You don’t have to stop, but you should have realistic expectations about what you can do. And just maintain total overall fitness, strength training, endurance training, flexibility training, etc. stands the best chance of allowing you to continue the activities you enjoy. People are able to continue at high levels well into an advanced age; people are running marathons into their 70s and beyond. It’s rare that people have to stop, they just need to be aware of what’s going on. Q: Stretching before working out: good or bad? A: Yes and no. There’s evidence that being too flexible exposes your joints to injury, but on the other hand a lot of physical therapy treatments rely on flexibility exercises to restore normal ranges of motion, particularly if their having problems with their gait. Obviously if someone wants to be a gymnast, ballet dancer or martial artist, you’ll need flexibility to perform the particular maneuvers. But there’s evidence that if you stretch too much, you can expose your joints to injury since the natural protection to your joint that tightness provides into there. Q: What appeals to you, personally, about this specialty? A: I had been an emergency room doctor for a long time and enjoyed taking care of muscular-skeletal injuries. When I was a student, I’d thought about doing it but decided to go into emergency medicine instead. I’ve always been involved in athletics as a soccer player, hockey player and runner. So I had a personal interest it. Also, one of the areas of research I did for my PhD was in muscle fatigue and how to make people perform better. I decided I’d rather do this full time and ended up doing a fellowship in that area. Q: What activities have the highest potential for injury in your experience? A: Football clearly has the most, partially because there are a lot of people involved in it and also because people are running into each other. Soccer, you’ll see a lot of lower extremity injuries, lots of knee-to-knee contact. Those are probably the two biggest from organized sports. In the general population, running produces a lot of overuse injuries, people ramping up faster than they should. Proper play is very safe, I’m not saying your destined for injury, but those activities carry a higher risk.

Lifelines: Name: Paul Klawitter, M.D. Position: Member of Crouse Hospital’s new sports medicine program Certiﬁcation: Board-certiﬁed specialist in primary care sports medicine, including sports-related concussion management. Hometown: Hamburg, NY Education: Clarkson (undergrad), SUNY Upstate (medical), Ohio State University (graduate) Organization: American Medical Society for Sports Medicine Family: Married, two children Hobbies: Running, hockey, guitar, coaching son’s hockey team

If It’s Flu Season, Why Are Health Centers So Empty?

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s communities prepare for the oncoming flu season, one may wonder why their local health centers are not overflowing with people getting this season’s vaccination. “The proliferation of places where people can get flu vaccinations [has] increased dramatically over the last couple years,” said Kathleen Cuddy, deputy director of health services for the Cayuga Health and Human Services Department. Flu vaccinations have become increasingly accessible to the public in recent years, readily supplied at franchise pharmacies such as CVS, Rite Aid and Walgreens. The trend has made its way to supermarket chains as well, including Walmart and Safeway. “In Cayuga County for example, as a health department, we do still provide public flu clinics and flu vaccinations,” Cuddy said. “But our numbers dwindled considerably at our public clinics, I think because of the ability for people to access it elsewhere.” Studies estimate that more than 30,000 people die from the flu each year in the United States, and put more than 200,000 people in the hospital. Awareness of this has created efforts to battle this issue. The New York State Department of Health opened regulations so pharmacists can offer vaccines. Anyone 3 years of age and older is entitled to an influenza vaccination. If a location chooses to immunize on its site, it must send a protocol to a doctor willing to sign off on its practices. Recent trends have made flu vaccinations available in numerous locations other than pharmacies. “In New York state, if a pharmacist wants to do it in a church, they’d have to get a protocol signed by a doctor basically overseeing their practices, so they can do that location,” said Dan Rajca, pharmacy district manager at Kmart. Although pharmacies have had the greatest increase, vaccinations are now available at community centers, public schools, the YMCA and churches, according to Cuddy. Other options include teacher unions and social services. “Fire halls will have safety weekends where immunizations are given,” Rajca said. “It’s basically word of mouth and the cooperation of the neighborhood.” Early autumn months are prime time to get the flu vaccine and it usually remains available until early spring.

“The vaccine itself is good for six months,” said Eric Faisst, director of public health for Madison County. “It takes about two weeks to kick in once you get the shot. We try to encourage people the shot in the fall so it lasts through flu season, which goes to about April or May.” There are no restrictions on who can get the shot besides some supermarket age policies and cases of health conditions and allergies, where the vaccine is not recommended. The majority of the population is given a traditional flu shot. “It’s fairly safe,” Rajca said. “The flu vaccine is actually inactive. So contrary to popular belief, you can’t get the flu from the flu shot.” Other options include a nasal spray flu vaccine, well known by the trademark name FluMist. This is recommended to very young children under the age of two. For seniors aged 65 and older, Fluzone High-Dose is offered. This vaccine has four times the amount of antigen, which creates a stronger immune response for better protection. For those who are squeamish of needles there is the Fluzone Intradermal shot. This vaccine uses a shorter needle and injects the vaccine under the skin rather than deep in the muscle. The pneumococcal vaccine for pneumonia and meningitis is also recommended for seniors 65 and older. Most healthcare providers such as Medicare, Medicaid and private health insurances cover the charges. Medicare Part B will cover all the costs of any flu shot. The federally funded Vaccines for Children program provides vaccines for children at no cost for those who may not have the ability to pay. “As I know now, most health insurance [plans] cover this so called ‘preventive services,’” said Jiancheng Huang, public health director for Oswego County. “But the start of 2014, probably, all health insurances need to carry preventive services.” For those who pay out of pocket, most pharmacies charge for cost of the vaccine and round up to cover administrative costs. Average prices range from $25 to $35 for a regular or intradermal shot, and $50 to $60 for a high-dose shot. “Flu season sometimes comes with what they call pandemic flu,” Huang said. “So [vaccines] protect your respiratory system, enhance your overall immunity and it will help prevent other diseases.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

My Turn

By Eva Briggs

Keep Rodents Where They Belong: Outside Your Home

like wild animals, including rodents, as long as they stay where they belong: outside of my house. While out of town recently to visit family, I saw a TV show (scarily titled “Monsters Inside Me”) about a rodent-borne disease. Hours later, I saw a newspaper article about a different rodent-borne disease. Those two stories confirmed my opinion. But first a true tale from my own family about a possible rodent-related illness. Years ago we took a family vacation to the Lake Tahoe area and stayed in a cabin in the woods. Upon arrival, we were greeted by some cute friendly chipmunks who eagerly accepted tidbits of food from my three children. The very next day we went for a hike, and at the trailhead was a large sign warning: “Do Not Feed Chipmunks. They May Carry Bubonic Plague.” Naturally I felt guilt-stricken; how could I have exposed my children to a dread disease? We stopped feeding the chipmunks and enjoyed the rest of our vacation. Every night my son complained that something was running around his room at night and we told him, “It’s just some mice, go back to bed.” On the last morning we saw the culprit — a chipmunk! The day after returning home, my son awoke with a fever of 105 degrees, shaking chills, headache, and body aches. Was it bubonic plague? And how

would I know? I’d never seen a patient with bubonic plague. And I didn’t think it likely that our family doctor would be familiar with it either. So I called the California Health Department. They listened to my tale, and located the placed we had stayed on their map. “Hmmmm…..the man said. We haven’t seen any bubonic plague there. But we’ve had some cases of tick-borne relapsing fever, contracted in rodent-infested cabins.” The disease is spread by soft-bodied ticks that bite people at night while they are sleeping and drop off before they get out of bed, unlike our local deer ticks which hang on for a few days while they feed. As it turns out, there are two ways to make the diagnosis. One way is to draw blood to look for antibodies to the disease: an acute specimen at the time of the illness (which should be negative if the patient has never had the disease before) and a second specimen six week later to look for newly acquired antibodies. The second way is to draw blood and look for the bacteria under the microscope, but that is most likely to be positive if the specimen is obtained when the patient is experiencing the shaking chills. Fortunately the treatment is an antibiotic called doxycycline. I spoke to

KIDS Corner Magnet Ingestion Upstate sounds alert to emergent health issue among kids

ediatricians at Upstate Golisano Children’s Hospital are joining their colleagues across the nation in alerting the public to an emergent health issue—magnet ingestion among children and adolescents. Ingested magnets can stick together and trap and compress portions of the bowel wall between them, potentially leading to perforation, ischemia, sepsis, and bowel obstructions. According to physician Manoochehr Karjoo, director of pediatric gastroenterology at the Upstate Golisano Children’s Hospital, magnets are among the most dangerous objects to be swallowed by children. “Magnet ingestion can lead to seriPage 8

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ous, long-lasting damage or possibly death,” said Karjoo. “It is important for parents and caregivers of young children, especially as we near the holiday gift-giving season, to be made aware of the unique risks that these magnets pose if ingested.” According to the American Academy of Pediatrics (AAP), anecdotal reports across the nation have shown that magnet ingestions have led to dozens of surgeries, bowel perforations or fistulas, endoscopies, bowel resections, and other serious gastrointestinal injuries. Reported injuries, according to the AAP, involve products that consist of small, round magnets marketed

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

my family doctor, who examined my son, ordered the tests and prescribed the correct medicine right away. Neither test came back positive, but by the time my son’s blood was drawn he wasn’t having the shaking chills. And the early antibiotic treatment could have blocked the development of antibodies. So did he have tick-borne relapsing fever? I’m guessing yes, despite the negative tests, because he fit the profile, and he responded quickly to the treatment. Also neither of his sisters or parents got at all sick which would have been probably the case if it were an illness that spread directly from person-to-person, since we had been cooped up together during our airplane flight which included a two-hour wait on the tarmac before we took off. A link to the California Health Department’s fact sheet on tick-borne relapsing fever: www.cdph.ca.gov/ HealthInfo/discond/Pages/TickBorneRelapsingFever.aspx Back to the scary TV show. This really was a case of bubonic plague occurring close to home in New York City. The sick couple presented to a travel clinic, where the astute doctor recognized the wife’s giant infected lymph node as a buboe, the hallmark lesion of one form bubonic plague. Although she responded quickly to antibiotics, her husband didn’t fare so

as “stress relief” desk toys for adults. These magnets are generally sold in sets of 100 or more, making it difficult for parents to recognize if a few magnets have gone missing. Although these products are labeled and designed for adults, they can easily find their way into the hands and mouths of children. Pediatricians have been aware of the dangers associated with ingesting magnets for many years. For this reason, the AAP was successful in advocating for new Consumer Product Safety Commission (CPSC) standards for children’s products and toys that contain magnets in 2008. These new standards help keep children safe by ensuring that magnets in children’s products will not fall out of or become unattached from children’s products, or otherwise become available for mouthing or swallowing among young children. Unfortunately, these magnet safety standards only apply to children’s products and do not extend to products that are specifically designed for adults or other

well. His disease spread throughout his body. He spent months in the hospital, and had to have both legs amputated due to the infection. The bacteria that causes plague, Yersinia pestis, lives in rodent fleas, usually rat fleas. It turns out that the couple acquired the disease from fleas on the ranch in the southwest before their vacation to New York City. For more on bubonic plague from the CDC: www.bt.cdc.gov/agent/plague/factsheet.asp The newspaper story told the tale of a man bitten by a mouse while camping in an Adirondack (the story can be found at www.timesunion.com/ local/article/Deadly-virus-link-studied-3941255.php). He became ill with what turned out to be hantavirus, a potentially lethal infection usually spread by inhaling dust or particles tainted with rodent droppings. Fortunately this disease is rare in New York, because it’s a virus, and does not respond to antibiotics. These tales reinforce my opinion that rodents belong outside. Now the challenge: to convince my cats not to bring live rodents home.

Eva Briggs is a medical doctor who works at North Medical Urgent Care in Liverpool and Fulton Urgent Care in Fulton.

products that include loose magnets. “We are encouraging parents and caregivers to take steps to prevent magnet ingestions from occurring in children and adolescents,” said Karjoo. “Parents and caregivers should keep these products away from young children who might swallow them. Also, they should inform older children of the serious dangers associated with using magnets to mimic piercings in their mouths, ears or noses. And, most importantly, they should closely monitor loose magnets and other magnetic products and contact their pediatrician immediately if they suspect a magnet has been swallowed or inhaled.”

For kids, battling epilepsy not an easy task Caretakers say seeking support is crucial for families of those with the disorder By Matthew Liptak

abby Kreis , 8, and Ira Williams,10, are among the many children in Central New York coping with epilepsy. Their stories are of two loving children who have battled almost all of their lives to build a life around frequent seizures, lots of medicines and the social challenges that can come with growing up with epilepsy. Ira had a seizure the night he was born, said his grandmother and caretaker Pat Williams. He had to be rushed to a hospital in Syracuse from Oneida, where he was born. He was in the hospital for six weeks. Gabby was fine, epilepsy-free, for the first two months of her life. Then, Gabby’s legs began to seize violently. “It was scary,” Bonnie Kreis said. “We called a pediatrician and she directed us to go to the emergency room. She thought it was a seizure and she was right. The seizure activity got worse until she was about 3 and then we implanted a device called a vagus nerve stimulator. She was having hundreds of seizures a day.” The implant was a dramatic success. It regulates electrical signals to her brain. Gabby’s seizures went from very frequent and long (up to 20 minutes, which can be life threatening) to only one to five a day. “We truly are very lucky because it could have been a great deal worse,” Kreis said. “We could still be in the situation where we were when she was still seizing uncontrollably, but now we have at least some relief. She still seizes every day.” Ira Williams, who lives in Canastota, doesn’t have an implant but he does have a multitude of medications he takes to help him with his epilepsy and other challenges. He takes eight in all plus a shot for an underdeveloped pituitary gland. Then there’s the helmet. He wears one to prevent any accident or fall that may occur during a seizure. It keeps him safe but it doesn’t protect his grandmother’s heart when she sees him trying to socialize with other kids his age.

“The worst thing is other kids being afraid of him and looking at him as being different,” Pat Williams said. “They won’t include him in anything or try to play with him and that’s sad. It’s very sad. It breaks my heart. He’ll go right up to them and say ‘Do you want to play with me?’ Some of them will just ignore him like they didn’t even hear him.” Both Pat Williams and Bonnie Kreis said the same thing about coping—getting support is essential. “You need to have support groups,” Pat Williams said. “You need to have somebody to talk with to get Ira Williams, 10, had his ﬁrst seizure the day he Gabby Kreis, 8, was diagnosed with epilepsy through it. Those supwas born. He takes eight in all plus a shot for an at 2 months of age. “It was scary,” her mother, port groups are the best underdeveloped pituitary gland. “The worst thing Bonnie Kreis, said. “We called a pediatrician and thing ever.” is other kids being afraid of him and looking at she directed us to go to the emergency room. She She goes to meethim as being different,” said his grandmother and thought it was a seizure and she was right.” Before ings at the Epilepsy caretaker Pat Williams. treatment, the mother said, Gabby was having Foundation of Rochester-Syracuse-Binghamhundreds of seizures a day. Now the number of ton on James Street in Syracuse. There occurrences has dropped to one to ﬁve a day. she broadens her education on epilepsy and also finds support. Sometimes the foundation will bring in an expert on a becomes part of the regular day. the joy they bring to Bonnie and Pat. medicine from the medical companies “This is our normal,” Bonnie Kreis Both the cared-for and the caretakto talk, other times it will be a dinner said “This is part of Gabby and it’s ers offer few complaints. with a doctor. part of who she is. It doesn’t make any “At first it was scary,” Bonnie Kreis Gabby’s mom finds support at the sense going around and being scared said. “You see other people with kids same place. or anything like that. It’s part of her. with allegedly normal lives. You can’t “The epilepsy foundation is huge,” It’s part of her every day life and you just go to the store. You have a wheel she said. “They put me in contact with know it’s scary but it’s our normal and chair and you have to make extra a lot of really amazing people that have we treat it no different then if your plans. In all honesty I prefer our life. become very good friends. It helps to child had bumped his head. We bear It’s chaotic, it’s crazy, but it’s wonderhave somebody who understands.” through it the best we can.” ful, you know?” People with epilepsy and their This November is National Epi“If you’re going to take care of caretakers learn to live with the diflepsy Awareness Month and before the somebody like that...it’s very hard,” ficulties the disorder poses on a daily month is through more caretakers of said Pat Williams “You have to be willbasis. When first confronted with the children with epilepsy will likely be ing to give up. It’s not what I expected seizures of a child or loved one the calling the foundation in Syracuse to my retirement to be but you have no reaction can be one of fear, but in time seek help and answers. It can be a scary choice. You love them.” they learn to cope. Where once a seidisorder, but one that can be treated zure was a dramatic event, managing it and often managed well, depending of the treatment. November is Epilepsy “Epilepsy can be diagnosed and affect someone every single day and Awareness Month there’s not a week that goes by that I do not receive a call from either a mom November is National Epilepsy saying I have a son or daughter, or my Awareness month — the neurological people they care for.” husband, or my mom has developed Hunter said that the goal of the disorder may have special meaning to epilepsy and I don’t know what to do,” foundation is to reduce seizures from many more than once thought. One said Pamela Hunter, regional director epilepsy to zero, not just manage the in 26 people will develop epilepsy at of the Syracuse chapter of Epilepsy disorder. It’s a challenging goal that some time during their lives, according Foundation of Rochester, Syracuse and helps push doctors and researchers Binghamton. “Every week we receive a to a report released in March by the harder. call like that and because of the prevaInstitute of Medicine of the National “It’s being able to advocate for lence of people being diagnosed and Academies stated. those who don’t have anywhere else to developing epilepsy is so high those go, who can’t advocate for themselves More than 150,00 new cases calls always come.” and reducing the stigma in society are diagnosed in this country each For Gabby and Ira the journey of about epilepsy,” she said. “The prevayear. Most of the estimated 2.2 million growing up with epilepsy goes on as it lence is so high.” people in the U.S. with epilepsy have has just about every month since they For more information on the local were born. Perhaps for them life is a onset in their childhood or as an older Epilepsy Foundation chapter go to more difficult process than for other adult. www.epilepsyuny.org or call 315-477children their age, but you wouldn’t 9777. know it from the size of their smiles or

Epilepsy Foundation Celebrating 35 Years The Epilepsy Foundation of Rochester, Syracuse and Binghamton is celebrating 35 years of service in 2012. Pamela Hunter, regional director, said that the local chapter serves about 100 clients a month. Last year, it sponsored educational presentations to about 3,000 people. “We coordinate all of the services,” Hunter said “There is a person who is diagnosed with a developmental disability—we coordinate their services. Sometimes they need occupational therapy. Sometimes they need job coaching. Sometimes they need life coaching. Sometimes they need assistance with transportation. Sometimes they need help with respite with the

November 2012 •

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Are You Facing Thanksgiving Alone?

f you are facing Thanksgiving alone for the first time, you may be anticipating a lonely and depressing fourth Thursday of November. But it doesn’t have to be so. Whether you’re divorced, widowed or just can’t make it home for Thanksgiving, this family-centered holiday can be an opportunity for personal growth and expression. Below are some tips and creative ways to manage and embrace what can be a challenging day in the life of those alone this time of year: Be thankful. And why not start with yourself? Consider making a list of all the things you are thankful for this year: Your health? Your children? Those good friends who have stood by you through thick and thin? A career or volunteer job you love? A beloved pet. Or perhaps even this opportunity in your life to learn and grow? Take the long view. While you may be alone this year, it doesn’t mean you’ll be dining solo on leftover stuffing the rest of your life. This one day doesn’t dictate your destiny. Who knows what the future holds? Over the next year, you may meet someone special or achieve a measure of inner peace and confidence that enables you to really enjoy a holiday on your own. Do good. Helping others this time of year can take your mind off being alone and give you something worthwhile to do. Shelters and food kitchens often

welcome volunteers, but — truth is — many of these agencies fill up fast with regular volunteers. You may need to plan ahead and be creative. As an alternative, many local YMCAs host “Turkey Trots” and need volunteers to register and cheer on runners of all ages. Instead of serving stuffing at the shelter, you could be serving up smiles at the finish line! Throw your own little holiday dinner for fellow strays and disconnected persons. Have some fun! It doesn’t have to be elaborate or even planned far in advance. Sometimes last-minute dinner invitations can turn into the best, most memorable get-togethers. Chances are you know others who may be alone this Thanksgiving. Extend a warm invitation and ask people to bring a holiday side to pass. This gives everyone a chance to make a meaningful (and delicious!) contribution. Beware of “euphoric recall.” When you’re feeling lonely, it’s easy to glorify the past. Did last year’s Thanksgiving live up to the Norman Rockwell ideal? Or did all the

bickering, bad blood, and woozy, overstuffed relatives make you want to run for the hills? Maybe, just maybe, being with your own good company is a blessing. Rent a movie and indulge in a tasty guilty pleasure. Oh, why not? Rent a favorite “feel good” film and make a night of it. You might check out “Tootsie” or “On Golden Pond,” two of my favorite oldies, which never fail to warm my heart. Or find a new movie you haven’t seen and enjoy the novelty of seeing something for the first time. Top it off with a favorite treat. I love pumpkin pie ice cream this time of year! Pick up the phone. I’ve adapted one of Abe Lincoln’s famous lines for my own purposes: Most folks are as lonely as they make up their minds to be. The difference between isolation and engagement can be as simple as dialing a seven-digit phone number. My experience happily tells me that most folks welcome a call on Thanksgiving. An invitation to go for a walk or see a matinee while the turkey is in the oven is often seen as a nice diversion and chance to get out of the house. Others just love opening

their homes, inviting friends in, and expanding the celebration. It can be a beautiful thing for everyone. Nurture yourself. On your own, Thanksgiving can be a great day to do whatever you enjoy doing. Treat yourself to well-deserved time to yourself to read, luxuriate in a warm bath, nap or take a nice walk to enjoy nature. Pamper yourself for at least 30 minutes and take a mini-vacation from your worries, doubts and fears. Write thank-you notes. Now here’s an idea that’s so obvious it often gets overlooked on Thanksgiving. “Build bridges the rest of the year, and cross them during the holidays,” said Craig Ellison, author of “Saying Goodbye to Loneliness and Finding Intimacy.” If you can’t be with friends or family this holiday, pick up a pen and thank them for their support and friendship. Who wouldn’t love to receive a card on the day after Thanksgiving that begins, “I’m sitting here on Thanksgiving morning thinking of you. On this day of thanks, I can’t help but be thankful for our (fill in the blank).” In preparation for this king gesture, purchase cards and stamps in advance. So there you have it: Survival tips for a single-serving Turkey Day. The good news? It will be Friday before you know it and you can be thankful you got out of bed, rose to the occasion, and enjoyed your Thanksgiving. 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 workshops or to invite Gwenn to speak to your group, call 585-624-7887 or email: gvoelckers@rochester.rr.com.

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Experts: U.S. Risks Losing Out to Asia in Medical Research

edical research saves lives, suffering and dollars — while also creating jobs and economic activity. The United States has long led the world, with hundreds of thousands of jobs and marketable discoveries generated by government research funding every year. Top students from around the world come here for training — and often stay to help fuel medical innovation. Now, warns a team of researchers in the New England Journal of Medicine, the U.S. risks losing out to Asia as the hub of medical discovery. The result, they caution, could be a “brain drain” of top young researchers, and the loss of untold discoveries and economic activity. The authors are two physician researchers from the University of Michigan Medical School and VA Ann Arbor Healthcare System, and an American researcher who left the U.S. for better job prospects in Singapore. They compiled data on five Asian countries — China, India, Singapore, South Korea and Taiwan — that are all boosting their government support for medical research right now. All five have a long-term plan for increased support for such research, as part of efforts to boost their national economies and world standing. By contrast, American medical scientists and physician researchers face almost certain cuts to federal research funding.

At best, the authors say, funding for the National Institutes of Health — which supports most U.S. medical research — will fail to keep pace with inflation next year. At worst, if the federal budget falls off the ‘fiscal cliff’ of automatic cuts, American medical research spending will fall by 8 percent, with thousands of researchers cut off from funding. One estimate says this could cost the U.S. $4.5 billion in economic activity. There are also proposals to cut entire health research agencies. By contrast, China has increased spending on medical research by 67 percent, South Korea by 24 percent, India by 15 percent, Singapore by 12.5 percent and Taiwan by 4 percent in the most recent year for which data was available. “In recent years, NIH funding has not kept pace with growth in biomedical innovation, making it harder for scientists to win grants,” says first author Gordon Sun, an otolaryngologist and health researcher who is currently a 2011-2013 Robert Wood Johnson Foundation Clinical Scholar at University of Michigan, supported by the U.S. Department of Veterans Affairs. “Meanwhile, these five Asian countries have pledged long-term increases in funding.” He notes that the number of clinical trials of new medical ideas in the U.S. has fallen, while the number in countries like China has grown.

Abortion Rates Plummet with Free Birth Control

roviding birth control to women at no cost substantially reduced unplanned pregnancies and cut abortion rates by 62 percent to 78 percent over the national rate, a new study shows. The research, by investigators at Washington University School of Medicine in St. Louis, appears online Oct. 4 in Obstetrics & Gynecology. Among a range of birth control methods offered in the study, most women chose long-acting methods like intrauterine devices (IUDs) or implants, which have lower failure rates than commonly used birth control pills. In the United States, IUDs and implants have high up-front costs that sometimes aren’t covered by health insurance, making these methods unaffordable for many women. “The impact of providing no-cost birth control was far greater than we expected in terms of unintended pregnancies,” says lead author and gynecologist Jeff Peipert. “We think improving access to birth control, particularly IUDs and implants, coupled with education on the most effective methods has the potential to significantly decrease the number of unintended pregnancies and abortions in this country.” Unintended pregnancies are a major problem in the United States. Each year, about 50 percent of all U.S. pregnancies are unplanned, far higher than in other developed countries. About half of these pregnancies result from women not using contraception and half from incorrect or irregular use. The Contraceptive Choice Project enrolled 9,256 women and adolescents

in the St. Louis area between 2007 and 2011. Participants were 14-45 years of age, at risk for unintended pregnancy, and willing to start a new contraceptive method. Participants had their choice of birth control methods, ranging from long-acting forms like IUDs and implants to shorter-acting methods such as birth control pills, patches and rings. The women were counseled about the different methods, including their effectiveness, risks and benefits. The extremely low failure rate (less than 1 percent) of IUDs and implants over that of shorter-acting forms (8 percent to 10 percent) was emphasized. In all, about 75 percent of women in the study chose IUDs or implants. From 2008 to 2010, annual abortion rates among study participants ranged from 4.4 to 7.5 per 1,000 women. This is a substantial drop (62 percent to 78 percent) over the national rate of 19.6 abortions per 1,000 women in 2008, the latest year for which figures are available. The lower abortion rates among Choice participants also is considerably less than the rates in St. Louis city and county, which ranged from 13.4 to 17 per 1,000 women, for the same years. Among girls aged 15-19 who had access to free birth control provided in the study, the annual birth rate was 6.3 per 1,000, far below the U.S. rate of 34.3 per 1,000 for girls the same age. While birth control pills are the most commonly used contraceptive in the United Sates, their effectiveness hinges on women remembering to take a pill every day. November 2012 •

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NPs’ Meteoric Rise Nurse practitioners becoming more prevalent on CNY health scene By Lou Sorendo

here is a changing dynamic in the world of healthcare today, and it is being generated by the rise of nurse practitioners. On all levels of health care, NPs are making their presence felt in Central New York and across New York state. An NP is a registered nurse who has earned a separate license as an NP through additional education and experience in a specialty area of practice. According to Tom Nicotera, director of membership and public affairs for the New York State Nurse Practitioners Association, the number of NPs has been increasing and is expected to escalate. Just taking a look at the number of licenses issued by the New York State Education Department shows the upward trend of NPs on the statewide healthcare scene. • 2007—831 • 2008—946 • 2009—917 • 2010—1,102 • 2011—1,163 “There has been a fairly consistent increase,” and projections call for more of the same, Nicotera said. “We haven’t seen anything that will indicate it will do anything else.” Nicotera said employment opportunities for NPs are continuing to grow. “It is a progression for registered nurses wanting to do more,” he noted. He said that factor combined with the impending Patient Protection and Affordable Care Act will result in more increases of NPs. “There will be a lot more people coming into the system. The need is going to grow in general for healthcare providers,” he added. “Nurses as a group are a helping profession,” Nicotera said. “Nurses have the desire to help patients and work with them. They come from a different frame of reference when it comes to patients.” The state has a total of 16,877 licensed NPs and features the secondhighest number of NPs in the nation, second only to California. Currently, there are 16 recognized educational tracts for NPs in the state educational system. Just as physicians have specialty practices, NPs also do. Family practice (6,005) is the top NP practice in the state, followed by adult health (4,941), pediatrics (1,744) and psychiatry (1,307).

Charter member

Ellen Dethloff, who holds a Master of Science in Nursing and is a boardcertified nurse practitioner, works at St. Joseph’s Hospital Health Center in Syracuse. Dethloff is a native of Winthrop, Mass., a suburb of Boston. The Syracuse resident attended Cayuga Community College in Auburn where she was certified as a registered nurse. In 1981, she entered the first NP program at SUNY Upstate. She went back to school in ’93 to obtain her master’s degree. Dethloff was part of the first graduating class of NPs numbering 12. Eight of them, including Dethloff, went on to form the Coalition of Nurse PractiPage 12

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Number of NPs in CNY Onondaga County: 771 Oswego County: 103 Cayuga County: 79 Madison County: 71 Source: New York State Education Dept.

tioners of Syracuse, which eventually morphed into a state organization. “We also had our first nurse practitioner clinical conference for continuing education credits in Syracuse which we did for the first five years until we turned it over to a paid administrative staff to do,” she added. “It was great to bring education to those who are graduating to continue their skills for certification.” In order to remain certified, NPs need to take 75 credit hours of continuing education every five years and must put in more than 20 clinical hours per week. In addition, NPs must precept students and show an effort in their profession to educate student nurses, she said. “I was the first [NP] here at the hospital,” she said. “They didn’t know what to do with me at first and I wasn’t even legal yet. It took us almost four years after that to have Albany sign the nurse practitioners’ bill.” Dethloff was working at St. Joe’s and taking a class in advanced assessment while beginning the pursuit of her master’s degree. “I started listening to the hearts and lungs of patients, and my nursing supervisor noted that,” she said. She was then recommended to participate in the initial NP program at St. Joe’s. “They were looking to have an NP on my unit to take care of patients when the physician was back in his office,” she said. “My interest was I wanted to advance my skills.” She said there are generational differences regarding perception of the NP. Dethloff said older patients prefer to see a physician. “That’s what they grew up with,” she said. “And I think some of the newer generation prefers to see a nurse practitioner.” “I think patients are very happy with us,” she said. She said numerous research studies have indicated that patients say NP care is equal to physician care on a day-to-day primary care level. Patients also trust that NPs are qualified enough to direct patients to the next level of care if necessary, research says. She said challenges of being an NP in an outpatient setting involve being able to handle the volume of appointments in a day. “The demand to see enough patients in a day is difficult,” she said. Also, challenges in an outpatient setting include dealing with insufficient reimbursement from third-party

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

payers and overhead costs.

NPs’ vital role

Dethloff, who is married and has two college-aged children, began to see the upswing in the use of NPs in the 1990s. NPs began playing pivotal roles in providing initial assessment for physicians in an office setting as well as acting as a liaison between the patient and physician in the hospital environment. “We have those advanced assessment skills and can be their eyes and ears at the hospital,” she said. She said those roles became more visible in the ‘90s while reimEllen Dethloff, who holds a Master of Science in Nursing and is a boardbursement certiﬁed nurse practitioner, works at St. Joseph’s Hospital Health Center changed as in Syracuse. She is one of the ﬁrst NPs in Central New York. well. She also NP program at St. Joe’s. She interviews saw an increase in the number of gradprospective students and matches them uates thanks to programs like those ofwith preceptors. “Now I can get the fered at Le Moyne, SUNY Upstate and next generation ready,” she said. SUNY Binghamton. New era of health care “It really expanded. You had more students and more availability,” she Dethloff said the number of apadded. plicants for family practice or internal Dethloff said she enjoys having medicine has declined as physicians sufficient time with patients as an NP. are choosing specialty tracts. “I love it when the light goes on. “Who is going to take care of all A physician might have spoken to the these people in a primary care setting?” patient and they are overwhelmed with she asked. the information. I come in after the She said grants are helping colvisit and ask, ‘Do you have questions?” legiate programs funnel more NPs And they say yes. And I’ll say, ‘What into primary care, and tuition payback he means is he is going to put a chest incentives are available if NPs focus on tube in to drain fluid from your lungs primary care over certain periods of to make it easier for you to breathe betime. cause you are in heart failure. You will “There are certain nurses who wish be able to return to some of the things to go to school but can’t take on the fiyou did before.’ I also tell them it is nancial burden. but with incentives like going to hurt and how to prevent that. that, they will take it,” she said. I give them details that are sometimes That opportunity has been availnot available,” she said. able to physicians as well. Physicians “I love to see them say, ‘Oh, that are able to go to school with the prommakes sense,’” she said. ise that they would devote five years in Dethloff has seen a dramatic the public health spectrum in order to increase recently in the number of NPs receive tuition paybacks. on the healthcare scene. Meanwhile, Dethloff said the “We employ quite a number of NPs Syracuse area has a shortage of mental here,” she said. There are eight NPs health healthcare professionals such as that cover the neonatal intensive care psychiatrists and psychologists. unit with two physicians at St. Joe’s. In Efforts are now under way to the acute care environment, the hosestablish a mental health specialty pital features eight NPs on staff in its for NPs who wish to go further and critical care unit. acquire critical and didactic credits in “In partnership with physicians, mental health in order to care for veterwe are able to see patients, summarize ans in need or those with drug issues. patients and be their link if the physiShe said SUNY Upstate is incorpocian returns to his or her office or is in rating mental health as part of its NP the operating room,” she said. curriculum. “We work in the intensive care unit Dethloff said the region also benright along intensivists,” she said. “If efits from NPs being that they provide there is a physician on, he or she will weekly visits to patients in nursing oversee maybe two nurse practitioners homes. The state requires a health care and their patients, so as a team they provider to be in nursing homes, but can see more patients together.” having a physician there 24-7 would Dethloff is the coordinator of edube cost-prohibitive. “NPs are a great cation and student orientation for the extension that can do that,” she said.

Parenting

Kimberlee Vargas, LCSW, PLLC. 530 Oak Street • Suite 203 Syracuse, NY 13203 • Ph: 459-3714 www.kimberleevargaslcsw.com Individual, Couples and Family Counseling for Children, Adolescents and Adults

By Melissa Stefanec melissa@cnyhealth.com

Meeting Mommies

LAKE REGION UROLOGY William H. Foresman, M.D., P.C. Gerald Ortego, P.A.

Being a new parent only makes meeting new people harder

emember when meeting new people was easy? At one point it was easy as making friends with the kids next door, the person sitting next to you in class, the person in the dorm room down the hall or a person at the bar. Nowadays it isn’t so easy. I haven’t made an actual new friend in over five years. My social sphere is limited to people I already know, people I’m already friends with, family and coworkers. Opportunities to meet new people don’t often present themselves. As the world grows and its people sprawl, geography becomes a social obstacle. Being a new parent only makes meeting new people harder. My daughter Stella is at least a couple of years from activities, school and classes, and until then I feel as though I’m in a mommy no-fly zone. Over the years I’ve made a lot of great friends, but none of them can stop at my house for a glass of wine after their children go to sleep. We all relocated to start adult lives and families. We still see each other, but such visits have to be coordinated far in advance and require at least 45 minutes of travel. I love all my friends, but having one in your own back yard is ideal and seemingly unobtainable. Many of my new mommy friends are having the same problems. We all joke about going up to strangers at the store and asking them to be our friend, but something tells me acting like a creep isn’t going to start a lifelong friendship. Picture the following conversation at your local department store: Me (to a mom with a toddler):” How cute is she? How old is she? Mom with toddler: “18 months. Your daughter is adorable” Me: “Thanks, she’s 15 months. I see you are buying some organic baby snacks. My baby likes organic baby snacks. Do you live around here? We should be friends.” See how quickly that turned creepy? So what is a mom to do? My first thought was looking for a mom group to join. You hear about these things from others or read about them online. There are groups of moms out there who meet up for

dinner and schedule the occasional play date. None of them knew each other before joining the group, but the group allowed them to meet some local people to hang out with. Hearing about stories like this led me to some Internet searches. After searching and finding almost nothing, I broadened my search. When that search failed, I tried some more. Apparently, these elusive mom groups aren’t as commonplace as the urban legends led me to believe. The few groups I found were for stay-at-home moms. They met up in the morning or afternoon. They aimed to help the isolated stay-at-home mom meet some adults in her area and get out of the house. I couldn’t find a group within 20 minutes of my home, and I certainly couldn’t find a group that regularly met on evenings or weekends. I thought about putting out a Craigslist posting. I’ve thought about attending child-themed activities at my local library, but guess what? They all take place during working hours. In moments of desperation, I’ve considered hanging a ‘Friend Wanted’ sign at local stores with my phone number or email address listed on the little torn pieces at the bottom. I’ve thought about starting my own mom’s group, but the thought of the work and time involved is daunting. I just want to show up to some functions and start some mommy networking. So far, this column has been about as effective at addressing how to meet new people as I have been in doing that very thing. I guess that is because there is no easy answer. If you want to make friends when you are a parent and an adult, you really have to put yourself out there. When you meet new people, you have to be friendly and forward. You have to be willing to move out of your comfort zone. You have to strike up conversations with new acquaintances and strangers. You have to go out on a limb and inevitably make a fool of yourself. Let’s hope that the person on the receiving end of our foolishness has a little compassion. So ladies, let’s be understanding, warm and welcoming to our fellow moms; even if they come on a little creepy.

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Several sleep centers in CNY offer treatment for those with sleep disorders By Kevin DeValk

onathan Howell always had problems sleeping. The temperature had to be just right. Increasingly, he had to be completely exhausted to fall asleep — and the problem only seemed to be getting worse. In college, a friend woke him up once, concerned, telling him he was “panting like a dog” in his sleep and even occasionally choking. There’s also a story about a girlfriend sending him home in the middle of the night because of his unusual sleep. Tactfully, she suggested the next day that he take a sleep study, which he had already started considering. He’s glad he did. Howell, a 39-year-old opera singer from Liverpool, underwent his sleep study last October in a hotel room-like atmosphere at St. Joseph’s Hospital’s sleep lab in Fayetteville. He was hooked up to wires one night to monitor his sleep. During a follow-up test a short time later, he underwent the same study, this time with the use of various breathing masks. Howell fits one of the typical profiles of those who seek out Central New York’s sleep centers. They can’t sleep at night, and the drowsiness they feel during the day impacts their job performance or other areas of their life. They go to see their doctor, who refers them to a sleep specialist, who may order them an appointment at a sleep center, said David Wolfe, educa-

More Information on Sleep Problems Check these websites to learn more about sleep disorders: • St. Joseph’s Hospital. Details about the sleep study process, and St. Joseph’s sleep centers in Syracuse and Fayetteville. www.sjhsyr.org/sleeplab#. UH-EgsXA9CI • Crouse Hospital. More information about sleep disorders, including the serious health risks, and information about Crouse’s sleep center. www.crouse.org/services/sleep-center/ • American Sleep Apnea Association. Resources on sleep apnea, articles on proper use for CPAP machines and other pertinent topics. sleepapnea.org/ • Cigna Insurance. Overview on the problem, including types of treatment and information for children. www.cigna.com/individualandfamilies/health-and-well-being/hw/medical-topics/sleep-apnea-hw49127.html#hw49129 • National Heart, Blood and Lung Institute. Information on sleep apnea, and its correlation with numerous chronic diseases. www.nhlbi.nih.gov/health/ health-topics/topics/sleepapnea/

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

tion coordinator at Crouse Hospital, whose modern six-bed sleep center opened in 2009. “Their tiredness brings them to their physician,” said Wolfe. One of the most common sleep disorders is sleep apnea. Affecting an estimated 22 million Americans, sleep apnea causes drowsiness and contributes to a range of health problems by disrupting breathing during sleeping, according to the American Sleep Apnea Association. The disruption is normally caused by temporary airway blockages. Most cases are undiagnosed. These blockages can last from several seconds to several minutes. With some people, it can happen 30 times or more per hour, reports the National Heart, Blood and Lung Institute on its website. Sleep apnea is more common among the overweight, but anyone can have it, including children, the institute reports. Sleep apnea is the most common disorder treated at sleep centers, Wolfe said. Among other things, sleep apnea contributes to: • High blood pressure • Heart disease • Diabetes • Memory problems Treatment often begins with consultation by a doctor followed by a participation in a sleep study, where patients’ sleep patterns are studied during an overnight stay. The results are analyzed by a sleep technician, with recommendations given by a sleep physician during a follow-up evaluation, Wolfe said. One of the more common forms of treatment is use of a breathing assistance apparatus called a CPAP machine. Another is surgery. The number of patients seeking sleep studies was on the rise, but has leveled off in recent years, Wolfe said. There are more than 80 sleep disorders, but the most common, insomnia, is not normally tested at sleep centers, he said. Insomnia is normally treated through lifestyle changes such as medication, and avoiding tobacco and caffeine, according to the Heart, Blood and Lung Institute. Central New York has a number of sleep centers, ranging from two to 10 beds each. Crouse’s center is staffed by a medical doctor and several sleep therapists, Wolfe said. Patients are often treated to a hotel-like experience. At Crouse, patients get a private room with their own bathroom, continental breakfast, free Wi-Fi, and valet parking, Wolfe said. St. Joseph’s Hospital has two eightbed sleep center, seeing about 3,000 pa-

Common symptoms of sleep apnea • Feeling unusually tired during the day. • Waking up feeling unrested, and perhaps with a headache. • Moments of stopped breathing during sleep. • Gasping or choking while sleeping. Source: Cigna Insurance.

tients per year, said Stephen Swierczek, director of sleep labs for the hospital. A third center is planned to open in early 2013, he said. Upstate Medical University operates a lab at Community General Hospital, with a staff of 18, according to its website. Howell said that during his study, the room was comfortable, but the wires on the first night made it hard to fall asleep, as he tossed and turned. “It contained a comfortable bed, a nightstand, a chair, and a large cabinet with lots of wires that looked like a wardrobe,” he said. The second time, with the breathing masks, he still had a hard time sleeping, but was elated to learn that the 45 minutes it had previously taken him to fall asleep was reduced to four. The source of his sleep problems turned out not to be sleep apnea, to his surprise, but an unusually large uvula, the tissue mass suspended in the back from the roof of one’s mouth. He was fitted for a CPAP, and immediately began falling asleep faster, although it was trial and error over the next few months as his body adjusted and finding the right mask, with the help of sleep technicians. Howell said he sleeps through the night now and has more energy during the day. “My energy level was so improved it impacted my singing to the degree that my voice teacher noticed,” he said, adding that now his teacher recommends sleep studies to other students who seem tired. Howell, who is engaged, said it saddens him to think some people give up because their CPAP isn’t helping them. Adjustment takes time and patience, he said, but it’s well worth it.

Healthful Thanksgiving Emphasizing more vegetable side dishes can help increase the nutritional value of Thanksgiving dinner By Deborah Jeanne Sergeant

hanksgiving dinner doesn’t have to be a dietary disaster. Amid the sugar- and fat-laden fare, a traditional Thanksgiving dinner does offer some really nutritious foods. So sample the less-than-nutritious dishes and enjoy a serving of the wholesome bounty Thanksgiving offers. “You have really all the makings of a healthful meal,” said Julie Mellen, registered dietitian with SUNY Upstate. “Turkey is a very lean protein and almost fat free if you lay off the skin. There’s no saturated fat in it. It’s such a healthy meat.” But not all turkeys are equally healthful. Mellen advises against selfbasted birds that are injected with fat in favor of fresh ones you can baste yourself with broth or juice. Many times, how you fix dishes makes a huge difference in their healthfulness, not just what you’re cooking. “Be aware of how you prepare your holiday foods, as you can easily add calories to a very wholesome and nutritious food when adding such things as butter or maple syrup to a squash, for example,” said Maureen Franklin, registered dietitian with Upstate at Community General Hospital. “Look for new ways to prepare foods that maintains the original food without adding excess calories and fats.” Franklin and Mellen like the orange vegetables traditionally served such as squash, sweet potatoes and pumpkin, which are high in fiber, vitamin C and beta carotene. “They’re nutritional powerhouses,” Mellen said. “Squash is naturally sweet; you can just roast them.” Go easy on the sugar-topped sweet potato casserole and butter-topped squash, or try alternatives that lower the sugar and fat. For example, roasting

sweet potatoes and topping with a drizzle of maple syrup and a sprinkle of chopped nuts makes the dish special but more healthful than one swimming in brown sugar, butter and marshmallows. For pumpkin pie, remember that “most of the fat is in the crust,” Mellen said. Modify it or try a pumpkin trifle.” Cranberries are also nutritional superstars packed with fiber and vitamin C, but again, “cut some of the sugar in cranberry sauce or use apple juice to add a little sweetness,” Mellen suggested. Waldorf salad--the apple chunks tossed with raisins, walnuts and salad dressing--offers quite a few nutrients. “Apples are a good source of fiber, flavonoids, vitamin C and beta carotene,” Franklin said. Use a light dressing to reduce the calories and fat and eat a modest portion. The starches of the Thanksgiving meal--potatoes and stuffing--seem to take a beating when it comes to their nutritional information; however, instead of white bread stuffing and peeled potatoes, stick with whole wheat bread and don’t peel the spuds (bonus: you’ll save time and add flavor!). “Mashed potatoes contains vitamin C, potassium and copper, dressing has folate, vitamin K, selenium and fiber, and dinner rolls have thiamin, niacin, riboflavin, selenium and manganese,” said Darlene Beeman, registered dietitian with St. Joseph’s Hospital Health

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Center. These vitamins and minerals support many imporf you still overdo Thanksgiving dinner, tant functions and organs of take heart. It’s just one meal. Burn off the body. Emphasizing more some of those extra calories with extra vegetable side dishes can movement. also help increase the nutritional value of Thanksgiving dinner. While green bean 60 minutes walking – 339 calories casserole in a rich sauce and topped with fried onions isn’t 30 minutes touch football – 287 calories a nutritional powerhouse, a 60 minutes shopping – 157 calories few bites are fine. But adding more healthful vegetable 45 minutes washing dishes – 111 calories dishes such as a tossed green 15 minutes moderate jumping jacks – 74 salad can help. Even a few appetizers are calories pretty healthful. “Pumpkin seeds and Source: www.Healthstatus.com/calculate/cbc, squash seeds contain folate, based upon a 145-lb. adult selenium zinc and fiber,” Franklin said. “Nuts are a saturated fat. Olives are good sources good source of magnesium and vitaof monounsaturated fats and antioximin e, and they have a healthy ratio dants.” of mono-, poly-and omega-fats to

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SmartBites

By Anne Palumbo

The skinny on healthy eating

Enlightening News About Onions

or years, I avoided onions. They made me cry; they gave me bad breath; they upset my stomach. But, these days, onions are a pantry staple, thanks to a few lifestyle changes. In a nutshell: I chill onions right before cutting to reduce tears; I eat parsley afterwards to curb bad breath; and I only eat cooked onions. I reach for this vegetable on a regular basis because, like other sulfurrich alliums (garlic, leeks, shallots), onions are loaded with health benefits. To begin, onions show big promise in fighting cancer. Although scientists are still learning how onions may thwart this disease, researchers at Cornell University have found that members of the onion family with the strongest flavor — particularly New York Bold and Western Yellow — are the best varieties for inhibiting the

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combines with vitamin C and other compounds to inhibit enzymes that generate inflammation. Plagued by gastritis or stomach ulcers? You might want to stock up on onions. Because onions may inhibit the growth of H. pylori, an ulcer-forming microorganism, some medical centers recommend that people with gastritis add onions to their diet. Like many vegetables, onions are low in calories (about 60 per cup), have no fat or cholesterol, and have next to no sodium. What’s more, they’re a decent source of both fiber and vitamin C, and even provide a little protein.

Helpful tips

growth of liver and colon cancer cells. Next, onions may promote longevity. Loaded with flavonoids — beneficial antioxidants that mop up cell-damaging free radicals — onions may prevent or slow down diseases related to aging, such as heart disease, dementia, cataracts and cancer. Make that two bowls of French onion soup, please! Another good reason to befriend this bulb: Onions may deter inflammation. Several studies have shown that quercetin, a particularly powerful flavonoid found in onions,

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

Choose firm, dry onions that have no sprouts or moldy spots. Store onions in a well-ventilated, dark place, away from potatoes (which will cause them to spoil more quickly). Do not store onions in plastic. With proper storage, whole dry onions can last about a month. Cut onions can be stored in the refrigerator in a sealed container for up to seven days.

Spaghetti with Creamy Onion Sauce Adapted from Moosewood Restaurant Low-Fat Favorites Cookbook 3 large yellow onions 2 teaspoons olive oil 2 teaspoons fennel seeds

½ teaspoon red pepper flakes (optional) 1/3 box whole-grain spaghetti 14.5-ounce can petite-diced tomatoes 1 cup 2 percent milk Salt and pepper to taste Shredded Parmesan cheese Slice off the ends of the onions. Cut each onion in half lengthwise and remove the peel. Slice each half lengthwise into strips. Bring a large pot of water to boil. While the water heats, warm the olive oil in a large skillet. Add the onions, fennel seeds, and hot pepper flakes (if using) and sauté over medium heat, stirring occasionally to prevent sticking, for about 10 minutes. Add the spaghetti to the boiling water, stir, and cover. Set timer for 5 minutes. Meanwhile, add the milk and tomatoes to the onions. Cover and gently simmer. When the spaghetti has cooked exactly 5 minutes, drain and add immediately to the onion mixture. Simmer the spaghetti in the sauce for about 5 minutes, stirring constantly, until the pasta is done and the sauce thickens. Add salt and pepper to taste, top with shredded cheese, and serve. 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.

Can Eating Tomatoes Lower the Risk of Stroke?

ating tomatoes and tomato-based foods is associated with a lower risk of stroke, according to new research published in the Oct. 9 print issue of Neurology, the medical journal of the American Academy of Neurology. Tomatoes are high in the antioxidant lycopene. The study found that people with the highest amounts of lycopene in their blood were 55 percent less likely to have a stroke than people with the lowest amounts of lycopene in their blood. The study involved 1,031 men in Finland between the ages of 46 and 65. The level of lycopene in their blood was tested at the start of the study and they were followed for an average of 12 years. During that time, 67 men had a stroke. Among the men with the lowest levels of lycopene, 25 of 258 men had a stroke. Among those with the highest levels of lycopene, 11 of 259 men had

a stroke. When researchers looked at just strokes due to blood clots, the results were even stronger. Those with the highest levels of lycopene were 59 percent less likely to have a stroke than those with the lowest levels. “This study adds to the evidence that a diet high in fruits and vegetables is associated with a lower risk of stroke,” said study author Jouni Karppi of the University of Eastern Finland in Kuopio. “The results support the recommendation that people get more than five servings of fruits and vegetables a day, which would likely lead to a major reduction in the number of strokes worldwide, according to previous research.” The study also looked at blood levels of the antioxidants alphacarotene, beta-carotene, alpha-tocopherol and retinol, but found no association between the blood levels and risk of stroke. To learn more about stroke, visit www.aan. com/patients.

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’ y a d n o M s s e l t a e M ‘ t n e m e v o M Gaining Ground By Deborah Jeanne Sergeant

few restaurants and food service departments at area hospitals and schools have introduced “Meatless Monday” programs to encourage eating more plant-based foods and reduce red meat consumption. St. Joseph’s Hospital Health Center kicked off its Meatless Monday program Aug. 6. “We have done a lot to improve the quality and variety of what we offer our customers,” said Jeffrey Mitchell, executive chef for St. Joseph’s Hospital Health Center. “The overall hospital and medical staff support healthier options and this made sense.” Mitchell makes sure he features vegetarian options each Monday. The staff also created new signs and posters as well as talked about it in daily staff meetings throughout the organization. Though the organization is not promoting it directly toward the patients at this time, “for staff and visitors, we hope it encourages them to eat a more varied diet and healthier foods,” Mitchell said.

Area dietitians agree that excess meat consumption can contribute to many health problems. “By reducing meat consumption, we reduce saturated fat and dietary cholesterol,” said Julie Mellen, registered dietitian at SUNY Upstate. “More importantly, I feel that Meatless Monday as part of the Healthy Monday initiative encourages the public to try something new and different, to think outside the standard meat-potatovegetable meal and Mellen experiment with nontraditional meals: plant based proteins, vegetables, whole grains.” Both Syracuse University and SUNY Upstate operate Meatless Monday programs. Laurel Sterling Prisco, registered dietitiann and wellness educator for

Natur-Tyme in Syracuse, thinks most people eat too much red meat, and it’s not good for their health. “Studies relate less consumption of red meat [with] decreased occurrences of diseases: heart disease, diabetes, cancer, and osteoporosis,” she said. She advises people who eat red meat to stay within two to three servings of red meat per week. If your intake of red meat is too high, swap some out for protein sources such as white meat, eggs, whole grains (such as brown rice, quinoa, and millet), nuts, beans or legumes. Though a good way to boost fruit and vegetable and whole grain intake, Meatless Monday may lead Prisco some consumers to believe that meat is unhealthful in any form or amount. While it’s widely known that certain meats—salami, bacon, and pepperoni, to name a few—are not good for us, area dietitians stress that all meat isn’t bad. “Look at the ingredients,” said Beth Smythe, registered dietitian for the New York State Dietetic Association in Syracuse and Rochester. “The less processed it is, the better it will be. Look at the cut.” She added that many people assume that a turkey burger is automatically lower in saturated fat than ground beef, but if it contains dark meat, skin and other fatty portions of the bird, lean ground sirloin may be much lower in cholesterol.

Beef offers 29 lean cuts. Just ask your store’s butcher or a meat shop for help in identifying them. Bison and venison is often much leaner than many cuts of beef. With other cuts of red meat, look for visible fat as a clue. “If it doesn’t have a lot of marbling and you trim off the white edge, you reduce the saturated fat which clogs arteries,” Smythe said. “Anything from the loin or round is healthiest.” The size of the portion of meat also makes a big difference. Many restaurants serve very large slabs of red meat that measure many times the size dietitians such as Smythe recommend. “Beef can be part of a nutritious diet,” she said. “A 3-oz. portion is 150 calories. It’s very reasonable. Beef gets a bad rap, but it can be part of a healthy diet. “We need at least 5.5 oz. of any protein foods daily. The recommendation within that is 1.8 oz. of meat. Research lately shows we’re getting 5.1 oz. of protein a day and any type of meat is 1.7.” Red meat is rich in iron, which some women of childbearing years lack. My Plate, which replaces the USDA’s Food Guide Pyramid, can help you eat more balanced meals. My Plate depicts one half a plate filled with vegetables and fruits, one-quarter with a lean source of protein and one-quarter with a whole grain. A glass of milk accompanies the meal. Although some people could stand to reduce their meat intake, especially processed meat, eliminating or drastically reducing meat intake “doesn’t mean you’re healthier,” Smythe said. “A lot of people who choose vegetarianism gain more Smythe weight because the types of foods they’re eating.” For example, replacing lean meat with the same volume of whole-fat cheese will add many more calories to the diet. “Cheese is a good food in moderation,” Smythe said, “but if your diet is predominately cheese for protein, could you potentially take in more calories than you can burn? You need a variety of nutrients to be in good health. It’s easy for people to villainize certain foods.”

Who’s Behind ‘Meatless Monday’

St. Joseph’s Executive Chef Jeffrey Mitchell prepares stuffed peppers, a “Meatless Monday” dish for a segment recorded by organizers of the Meatless Monday movement from the Lerner Center at Syracuse University. The Lerner Center was founded by Sid Lerner, a Syracuse University graduate. Page 18

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

“Meatless Monday is a nonprofit initiative of The Monday Campaigns, in association with the Johns Hopkins’ Bloomberg School of Public Health. We provide the information and recipes you need to start each week with healthy, environmentally friendly meat-free alternatives. Our goal is to help you reduce your meat consumption by 15 percent in order to improve your personal health and the health of the planet. “Presidents Wilson, Truman and

Roosevelt galvanized the nation with voluntary meatless days during both world wars. Our intention is to revitalize this American tradition. We’re spearheading a broad-based, grassroots movement that spans all borders and demographic groups. By cutting out meat once a week, we can improve our health, reduce our carbon footprint and lead the world in the race to reduce climate change.” From www.meatlessmonday.com

A Life Taken by Bath Salts Tragedy that claimed the life of a young man in Oswego shook the community; mom now vows to fight to make synthetic drugs illegal in NYS By Ken Sturtz

ragedy struck Teresa Woolson’s life on Thursday, Aug. 9 — her birthday. She learned that her 19-year-old son, Victor Woolson, had nearly drowned swimming in Lake Ontario after using synthetic drugs, known as “bath salts.” He lingered in a hospital before dying the next day. As the details trickled in and Woolson grieved, she was struck by the notion that her son had bought the toxic drugs that contributed to his death legally, at a store in Oswego. “It’s just so upsetting that you can walk into a store and buy something that is so deadly,” she said. With her son ripped out of her life, Woolson vowed to take action. People needed to know about the toxic drugs, she reasoned, and the community needed stricter laws and regulations. If they’d already existed, she said, her son might not have been snared by the destructive drugs. Victor Woolson first got into bath salts at the 420 Emporium around the corner from Cayuga Community College in Fulton, where he was in his second year of college, majoring in criminal justice and psychology, his mother said. Funny, witty and eager to make friends, he befriended a group of people that smoked often. Someone asked if he knew of a place they could

smoke. “And he offered his car,” the mother said. After that he was hooked. Suddenly Victor Woolson — who graduated from Mexico High School with an honor Regents diploma in 2011 and had served Victor Woolson in the school’s Marine Corps Junior Reserve Officers’ Training Corps program for four years — was regularly smoking bath salts, his mother said. “He would say many times ‘It’s legal. If you can buy it in the store, how bad can it be?’” On the drugs, Victor Woolson’s life began to deteriorate quickly, culminating in an incident in March in which he went missing from his family’s home in Scriba. After a nationwide alert, the 19-year-old was eventually found in a motel in Oneonta, surrounded by synthetic drugs. He talked of suicide and was acting erratically when he went on the spree, his mother said. He spent 10 days in a Cooperstown hospital rehabbing and recovering. “That’s when I discovered what the cause was,” Woolson said.

Her son admitted to purchasing Pump It, a white powdered substance, from a smoke shop in Fulton. After the hospital stay, Victor Woolson continued to recover at home in Scriba. He was improving, his mother said, but struggled with severe bouts of panic and rage. He was also having withdrawal-like symptoms, she said. It was around that time that Woolson first began meeting with elected officials and police, urging them to do something about the drugs that were so easy to obtain. Even then, after synthetic drugs had been attracting national attention for months, many people weren’t familiar with them, she said. Police eventually did raid and shut down the 420 Emporium where her son was first introduced to synthetic drugs. Smoke shops in the city of Oswego, however, were still making a mint selling bath salts and other synthetic drugs, especially synthetic marijuana. Many of the products resembled candy. As Victor Woolson struggled with the prospect of no more synthetic drugs, a friend sent him a text message saying that the drugs were still being sold in the city of Oswego, his mother said. On Aug. 9, at around 6 p.m., he and friends bought two packages of Avalanche, a type of bath salts, from a store in Oswego. The group smoked the drugs, and then went for a swim at Flat Rock, near the SUNY Oswego campus. By 8:30 p.m. authorities were pulling Victor Woolson’s body out of the water. “It’s just unbelievable that something like this can happen,” Woolson said. “My son would not have been doing it if he couldn’t buy it in a store.” Police did raid several smoke shops in the city of Oswego over the summer, in part in response to con-

cerns from the public, but police, lawmakers and healthcare providers nationwide have groped for a solution to the dilemma of stores selling synthetic drugs legally. As the drugs, especially bath salts, became widespread over the last few years, one seemingly obvious solution was to make them illegal. Effective legislation and enforcement has proved extremely difficult, however, as officials and companies played an increasingly frustrating cat and mouse game. If one type of synthetic drug was banned, manufacturers simply changed the formula or continued making other varieties. Despite federal and state bans, the drugs have remained persistent and easy to obtain. That’s when Woolson decided she needed to do something about the problem. Although the pain from losing her son remains, she said she wants to prevent something similar from happening again. She has met with dozens of local officials to lobby for tougher laws against synthetic drugs. “It’s a definite crisis in our community and it’s come up so fast,” she said. In September the Oswego County Legislature, in part at the urging of advocates like Teresa Woolson, voted to enhance existing legislation by adding four new local laws to curb use, possession, distribution and sale of synthetic drugs. But the county laws will entail only jail time and fines, she said. What Woolson really wants, she said, is legislation at the state level that will allow for felony charges and lengthy prison sentences, especially for stores that aren’t following the rules. “I’m working constantly to get the word out, educate people on how poisonous and dangerous this stuff is, and make new laws and save lives,” she said. “I just have to use my energy to get the word out and save lives.”

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Climbing the Hillside In its 175th year, Hillside Family of Agencies sees more progress By Matthew Liptak

he Hillside Family of Agencies has been working to serve its fellow man, particularly children, for 175 years. Its commitment to quality has held up well through tumultuous times such as the Civil War and the Great Depression. It holds up today, too. Last year, the nonprofit organization provided human services to 12,636 youth and families in New York state and Prince George’s County, Maryland. That’s under the auspices of seven affiliate organizations that employ 2,298 staff members. In the Central New York region, where it has had a presence since 1986, it helped 2,100 Syracuse-area youth and families last year and employs 620 people. But the CNY region is a wide area. Hillside covers 15 counties there, including Broome, Cayuga, Chemung, Chenango, Cortland, Jefferson, Oneida, Onondaga, Oswego, Madison, Nolan Seneca, Schuyler, Tioga, Tompkins and Yates. The impressive endeavor that is now the Hillside Family of Agencies got its start with just a handful of enterprising women in Rochester in 1837. They formed the Rochester Female Association for the Relief of Orphans and Destitute Children. “Hillside started 175 years ago and was originally begun by a group of citizens in Rochester as an orphanage,”

said Clyde Comstock, chief operations officer of the Hillside Family of Agencies. “I think we’re one of the oldest organizations across New York state. The women who founded Hillside wanted to find a solution to children living in the street. That’s how Hillside started. The organization quickly grew to serve thousands of youth each year. Over time, the people of Hillside learned that disadvantaged youth and their families were best helped by keeping the family unit intact rather than institutionalizing kids. The vast majority of children, about 80 percent, are now aided while in their own families. “It became clear to our organization over the years that kids were better raised in families then being raised in institutions. We started to shift our focus and began working with children who had some sort of behavioral or mental health difficulties,” Comstock said. “We started working with foster homes to provide children with families to live with rather than growing up in an institution.”

A committed effort

Hillside Children’s Center provides specialized services to each child depending on their needs. These include mental health, child welfare, and specialized developmental disability services, among others. Its central region services leader, Liz Nolan, agrees with Comstock in thinking that much of Hillside’s progress has come from its commitment to family driven care. Its ability to put the child’s interest before the agency has kept Hillside at the “head of the pack,” she said.

Medical Students Help Create Community Garden

Hillside Children’s Center Finger Lakes Campus in Auburn. “That is one of the features that Hillside is particularly respected for locally because the government entities in town are very interested in getting kids back into their families. It’s better for kids and also it’s lower cost,” Nolan said. “I know they appreciate the fact that Hillside is in fact doing something which might be counter to business interests. We have meetings in which we talk with them about moving kids out of our residential services and back into the community that could lead us to be at risk financially. But it’s the right thing to do. I think we are respected for really walking the talk.” Growth takes work and Hillside has been busy. In the central region there are five new initiatives designed to help children and their families. One is the GROW program (Gaining Resiliency Through Overall Wellness) which is a residential program for girls who have experienced trauma. It has grown from eight to 18 beds due to constant demand. A second is the family finding pilot program. This program helps children who have been in foster care, developmental disability and mental health systems reconnect with family. It will help about 40 youth. “We reach back through their family histories and will find a targeted number of about 40 family members to try and bring them to the table to see if they can help work out a better future for their child,” Comstock said. A day treatment program has started in Oswego County this school year for an initial number of 24 children. That will quickly expand to 32. The program is run for Oswego County BOCES.

Adoption program underway

Claire Lewkowicz, left, and Kelly Cummings, both second-year medical students at Upstate Medical University, were among the 150 Upstate students who participated in the university’s Day of Service Sept. 8. Lewkowicz and Cummings helped create a community garden for the Brady Faith Center in Syracuse. Page 20

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

Of the other two new initiatives Hillside is taking up in the central region, one is an adoption program to help parents after they have adopted their child and the other is the opening of a facility for six young men who are struggling with behavioral issues. The state-funded adoption program hopes to smooth out any rough

patches the adoptive families are going through. “The kids who are adopted bring a lot of trauma, a lot of pain, hurt, fear as well as hope into that new relationship,” Nolan said. “We’ll be supporting families to ensure that those adoptions remain intact and that the children don’t experience another disruption in their life. We’ll be working with 30 families a year in that program. Another part of that program is to offer training to professionals in the community throughout the year in adoption.” Whether it’s providing adoptive services, working with the behaviorally or developmentally challenged, or one of its many other programs, Hillside has met with success in most of its undertakings. The secret to that success is the family of agency’s commitment to quality and ability to embrace change. And there is one other key ingredient. “Another big part of our success, a huge part, is our staff,” Nolan said “Our staff is incredibly passionate and committed. I think the organization does a good job in providing the support to the staff that they need to be successful. We would be nothing without our staff.” Comstock said Hillside continues to take the lead to meet the challenges the future holds including financial ones. “Now the nonprofit community is really challenged by the state financial structure to be able to achieve their missions,” he said. “I think agencies like Hillside have the depth to help make sure agencies can continue their work. At its core, the family of agencies continues its service by offering relief to local communities one child at a time. “It’s our belief that children are quite resilient and if we are able to intervene early with them, we can turn around an entire life,” Comstock said. For more information on the Hillside Family of Agencies, go to www. hillside.com.

Golden Years

Boom Time!

Most baby boomers in Upstate reporting high life satisfaction, according to a report by Excellus

he first Central New York baby boomers celebrate their 65th birthdays this year, and about three out of four of them and others nearing this milestone self-rate their health as good or better, even though half report having at least one chronic condition, according to a report issued recently by Excellus BlueCross BlueShield. Upstate New Yorkers who are 60 to 65 years old also feel good about their lives, with about 95 percent reporting high life satisfaction. That’s slightly above the 93 percent of 18- to 59-yearolds who reported being satisfied or very satisfied with their lives. “The Facts About Turning 65 in Upstate New York” delves into healthrelated issues facing the oldest of the post-war baby boom generation (Americans born from 1946 through 1964). The report also highlights actions they can take to maintain or improve their health status. “Today’s 65-year-olds can expect to live an additional 19 years, which is about five years longer than was expected for an individual of similar age in 1946, the first year of the baby boom,” said physician Arthur Vercillo, regional president, Excellus BlueCross BlueShield. “But with aging comes a host of acute and chronic health conditions.” Excellus BCBS found that among 60- to 65-year-old Upstate New Yorkers who responded to a Centers for Disease Control and Prevention survey, many reported having been diagnosed with a chronic health condition, including one or more forms of cancer (14.5 percent), cardiovascular disease (20 percent), diabetes (21 percent) and arthritis (51.9 percent). “The cost of treating chronic diseases consumes 95 percent of the health expenses incurred by older adults,” continued Vercillo. A look at health care expenses in New York state shows that 65- to 74-year-olds comprise 6.9 percent of the population, but their per capita health expenses represent 15 percent of the total. “In addition to added expenses, chronic conditions can cause years of pain and suffering and functional decline that can lead to disability and loss of independence,” said Vercillo. He noted that despite widespread perceptions about aging and statistics that depict declining well-being as an inevitable part of it, poor health is not intrinsic to growing older. “It can be tragic when individuals don’t recognize the fundamental link between their personal health behaviors and their risk of illness,” said Vercillo. “For people who make this connection, the health burdens we typically associate with age, while not entirely avoidable, can decrease substantially.” Today’s leading causes of death among older adults often are preventable. Just three behavioral risk factors – smoking, poor diet and physical

inactivity — account for more than a third of chronic disease deaths. All are directly tied to heart disease, cancer, stroke and diabetes. “What else can today’s baby boomers do to avoid disease as they age?” asked Vercillo. “They can assume greater responsibility for their own health by adopting specific practices, many of which are aligned with the CDC’s Healthy People objectives for the population by the year 2020.” Comparing Healthy People objectives to the disease prevention and preventive care behaviors reported by 60- to 65-year-old Upstate New Yorkers who participated in the CDC survey reveals that:

• 31 percent reported colorectal cancer screening according to current guidelines (annual fecal occult blood test), compared to the Healthy People 2020 objective of 70.5 percent. • 35.5 percent reported having had a pneumonia vaccine, compared to the Healthy People 2020 objectives of 60 percent for high risk 18- to 64-year-olds and 90 percent for all adults ages 65 and older. • 43 percent reported having been diagnosed with high cholesterol, compared to the Healthy People 2020 target of 13.5 percent. • 53 percent reported having been diagnosed with high blood pressure, compared to the Healthy People 2020

target of 26.9 percent. • 59.7 percent reported having had the seasonal flu vaccine, compared to the Healthy People 2020 objective of 80 percent to 90 percent for low- and highrisk populations respectively. “These numbers show that boomers in the 60- to 65-year-old age group have many opportunities to take charge of their health as they prepare for the years ahead,” said Vercillo. View the complete report on turning 65 in upstate New York at excellusbcbs.com/factsheets. Submitted by Excellus BlueCross BlueShield

Turning 65 in Upstate New York

November 2012 •

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Golden Years Even Healthy Seniors Should Vaccinate to Avoid Flu Experts say getting vaccinated also helps people around you By Deborah Jeanne Sergeant

ven normally healthy seniors should receive an immunization because it can help decrease the spread of the disease to vulnerable groups, according to Mitchell Brodey, a physician specialized in infectious disease at Upstate at Community General Hospital wants. “These can include the elderly who can get vaccinated but don’t respond as well. The older you get, the worse your immune system gets,” Brodey said. “Those who come in contact with young grandchildren, babies, people older than them, or if they work or volunteer around sick people such as someone getting chemotherapy. It’s not just all about you.” People should Brodey also especially seek immunization if they come in contact with pregnant women or someone with a compromised immune system or chronic medical condition such as asthma, COPD, heart disease or diabetes. Many people say, “I never get the flu.” Why do they still need a flu shot? Brodey said he hears the “I-never-getsick” excuse all the time. “Just because you never had what you thought was the flu before doesn’t mean you’ll never get it,” he said. Some people do not recognize flu symptoms in themselves and have actually had a bout with the flu that they thought was a cold. “You can pass it on to people who will get sicker than you, especially infants under 6 months,” Brodey said. Herd immunity refers to the relative Brangman safety of an unvaccinated person who comes in contact only with those who are vaccinated; however, if too many people do this, the risk of an outbreak rises. If you’re one of the unlucky seniors who catches the flu, your risks for complications is greater than that of a younger person. This is because “the two populations most at risk for a Page 22

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serious outcome after the flu are the very young and the very old,” said Sharon Brangman, gerontologist with SUNY Upstate. “Certain medications can reduce your ability to fight infections so those who take steroids or medication for rheumatoid arthritis is another reason to get a vaccination,” Brangman added. “Usually, with my patients who take multiple medications, it means they have more medical problems and they’re usually more vulnerable to the flu.” Some people feel that vaccination is futile because they have, in the past, caught the flu after vaccination. However, vaccination can lessen the impact of the flu should you still become sick. Other people claim they have become sick because of the flu shot. They received a vaccination and a few days later became sick. But it takes at least two weeks for a vaccination to become fully Briest effective. It’s likely that the person was exposed during this window of opportunity. “The vaccine is made with the dead virus,” Brangman said. “The only thing it can do is help your body make an immune response. There is no association between a flu shot and getting the flu. The worse response is a local response--a little soreness at the

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

injection site--or a little fever because the body is making a response to the dead virus. It doesn’t mean you’re sick. Most people can manage that with some Tylenol.” As a natural immune response, the body builds up antibodies to the “invader” and thus the individual can fight off flu germs when they come. “Flu tends to peak in January and February, but flu has been detected as early as October and as late as May,” said Patricia Briest, nurse manager for cardiopulmonary rehabilitation at Franciscan Health. “There is generally a rush following holiday travel, so we advise people to get immunized at least two weeks before the Thanksgiving holiday. It takes about two weeks to build an immune response to the flu.” For needle phobics, the intradermal shot with the smaller, thinner needle may offer less pain. This vaccination goes into the skin, not the muscle, which some find easier to handle. The

shot is generally not approved for older adults; ask your provider. The inhaled version of the vaccination is available for people two through 49. There’s also a higher dose flu vaccine that may provide better protection, but it causes more pain, redness and swelling at the injection site than the lower dose. It’s important to talk over the options with your health care provider in relationship to your other health concerns. If affordability is holding you back, ask your county’s public health department for a list of sliding scale clinics in your area. Medicare and most health insurance covers flu shots. The quality of the vaccine is the same regardless of where you go. Though the hassle, pain and expense of a flu vaccination may be among your reasons for shirking the shot, it’s worth it.

Golden Years Hospice at Home or Not? Hospice professionals deliver care to patients at home, nursing home, hospital or at comfort care home By Deborah Jeanne Sergeant

f you or a loved one is faced with an incurable health condition and imminent end of life, hospice care can help make the transition easier and more comfortable for everyone. “Hospice is more than just a visiting nurse or a visiting health care home aide. It’s a team of health care professionals,” said Bill Pfohl, communications officer at Hospice of Central New York. Hospice professionals can include a hospice doctor, visiting nurses, social workers who offer companionship, chaplains, music therapists, trained volunteer caregivers and grief counselors. Patients and families may choose hospice care as part of the care they receive as inpatients or at any of the 11 inpatient hospice residences in New York state, which becomes the patient’s home-away-from-home. Or, one may receive hospice care in his home. The levels of care are respite care to “fill in” for the normal caregivers temporarily (such as when the patient’s caregiver is traveling), general care for acute symptoms, routine care to supplement and enhance the daily care given or continuous care. “The decision to accept hospice in the home or in an institutional setting typically depends on the availability of a person or persons to function as

the hospice client’s caregiver in the home setting,” said Lynne Bogart, a registered nurse with Oswego County

Common Misconceptions Many people hold misconceptions about hospice care. Local experts share a few of the most common. • Choosing hospice means that you are giving up hope. “I hear [that] a lot...[Hospice is] reframing hope to quality of life with the time you have left.” • Hospice is just for the last few days you have left. “Hospice is intended to be a sixmonth benefit. It can be longer. The median McMahon length of stay for hospice in New York State is 17 to 19 days. It’s very low. I would like people to take full advantage of this benefit.” • Hospice is for elderly people with cancer. “That’s not true. Hospice is for everybody with a terminal diagnosis of six months or less if the disease runs its

normal course.” Kathy A. McMahon, president and CEO of Hospice and Palliative Care Association. • Hospice is a place where terminally ill people live. “Some hospices do provide residency facilities where hospice clients can stay temporarily or until end of life; however, most hospice care is delivered in a personal residence where the person lives; be it home, nursing home, hospital, assisted living or group home. Bogart My suggestion would be to anyone with questions regarding Hospice care to simply call us. We love to talk with the public about our services and how we can help.” Lynne Bogart, a registered nurse with Oswego County Hospice.

Hospice. “The term caregiver often refers to the person who has the primary responsibility to care for the hospice client whose disease process will inevitably make him or her dependent on another. The dependency can be slight, requiring little help, or total, requiring around the clock supervision and care. “Most often family members assume the role of the caregiver, however the role can be fulfilled by friends, paid hired help, church families and neighbors, even ex-spouses have been known to help in this role.” Waiting for weeks or months by a patient’s bedside isn’t possible for most families, so hospice can offer the comfort of another person’s presence. Hospice care also assures the family that their loved one is as comfortable as possible to increase the quality of their lives. Hospice providers usually offer a 24-hour on-call number so when at patient enrolls, he or the family can reach a nurse anytime they need extra help, which can prevent unnecessary and expensive emergency room visits. Choosing to receive hospice care at a facility often depends upon the patient’s condition. “If they need skilled nursing 24/7, the skilled nursing facility is the better place,” Pfohl said. “If the patient can be sent home, and 80 percent would November 2012 •

rather have their final days at home, but it depends upon the illness and the level of distress. That determination is made by the family and family physician with help from the hospice staff.” Some people prefer non-family members to take care of their personal needs instead of having a son or daughter help them bathe or use the bathroom. But many people prefer their own homes to living in a hospital or nursing home. They want to be surrounded by their belongings and feel more secure in a familiar place. Many factors can help patients and families decide if at-home care will work, such as the number of willing caregivers. Planning ahead can make all the difference in whether or not a patient’s wishes are honored. These can be difficult conversations, but necessary to make sure that the patient and family receive the care they want. “Advanced care planning should take place early, not during a crisis so the patient can make known what they want,” said Kathy A. McMahon, president and CEO of Hospice and Palliative Care Association. “People need to fill out an advanced directive and a health care proxy so someone can make decisions for them if they lose decisionmaking capacity.”

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HOME DELIVERED MEALS ARE A LIFELINE TO MANY FRAIL ELDERLY SENIORS Nutritious, hot noon meals are available throughout Cayuga County for those seniors unable to prepare a meal for themselves. Meals can be home delivered or available at one of six senior meal sites. (There is a suggested donation) If you know someone who could beneﬁt From a hot noon meal, call the: Cayuga County Ofﬁce for the Aging Senior Nutrition Program 253-1427 Page 24

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Social Security Helps Veterans (and Active Duty Military) Every Day

ov. 11 is more than just a namilitary service on or after Oct. 1, tional holiday — Veterans Day 2001, regardless of where the disability is a time to honor the men and occurs. women who risk their lives to Even active duty military protect our freedom. We at Sowho continue to receive pay cial Security ask you to join us while in a hospital or on in saluting the men and women medical leave should consider of the armed forces. Be sure to applying for disability say “thank you” to a veteran benefits if they are unable on this important day. to work due to a disabling For those who return home condition. Active duty status with injuries, it will be our and receipt of military pay turn to help them. If you know does not necessarily prevent any wounded veterans, please payment of Social Security let them know about Social disability benefits. Receipt Banikowski Security’s Wounded Warriors of military payments should website. You can find it at www. never stop someone from applying for socialsecurity.gov/woundedwarriors. disability benefits from Social Security. The Wounded Warriors website A person cannot receive Social answers a number of commonly asked Security disability benefits while questions and shares other useful engaging in substantial work for pay information about disability benefits, or profit. However, the work activity including how veterans can receive is the controlling factor and not the expedited processing of disability amount of pay the person receives or claims. It is important to note that military duty status. benefits available through Social Learn more by visiting www. Security are different than those from socialsecurity.gov/woundedwarriors. the Department of Veterans Affairs and We at Social Security thank all require a separate application. veterans and members of the armed The expedited process is used services for all that they do — not only for military service members who on Veterans Day, but every day of the become disabled while on active year.

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

Q: I applied for a Social Security card for my baby at the hospital, but the card came back with a misspelled name. What should I do? A: Find at least two original documents proving your child’s U.S. citizenship and identity, as well as one proof of your identity as the parent. Then go to your local Social Security office or card center to ask for a corrected card. The documents you show us must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies of documents. To find out more, visit www.socialsecurity.gov/ssnumber. Q: What is Supplemental Security Income (SSI)? A: SSI provides monthly income to people 65 or older, blind or disabled, who also have limited income and financial resources. To be eligible, an individual also must be a U.S. citizen and resident of the United States or a noncitizen lawfully admitted for permanent residence. There are, however, some noncitizens granted a special immigration status who are eligible. To get SSI, an individual’s financial resources (savings and assets) cannot be more than $2,000 ($3,000, if married). For more information,

read our publications, Supplemental Security Income or Understanding Supplemental Security Income. Both are available at www.socialsecurity. gov/pubs. Q: Can I delay my retirement benefits and receive benefits as a spouse only? How does that work? A: It depends on your age. If you are between full retirement age and age 70 and your spouse is receiving Social Security benefits, you can apply for retirement benefits and request the payments be suspended. Then, you can choose to receive benefits on your spouse’s Social Security record. You then will earn delayed retirement credits up to age 70, as long as you do not collect benefits on your own work record. Later, when you do begin receiving benefits on your own record, those payments could very well be higher than they would have been otherwise, because you earned delayed retirement credits. Q: Are Supplemental Security Income (SSI) benefits subject to federal income tax? A: No. SSI payments are not subject to federal taxes. If you get SSI, you will not receive an annual form SSA-1099 from Social Security. However, your Social Security benefits may be subject to income tax. Learn more at www. socialsecurity.gov.

By Jim Miller

Vaccination Options for Seniors This Flu Season Dear Savvy Senior, Are there any new or different types of vaccines being recommended to seniors this flu season? Health Conscious Carol Dear Carol, There are actually several different types of flu shots available to seniors this year, along with a new FDAapproved shot for pneumonia. Here are your options. Flu Shots

Just as they do every year, the CDC strongly recommends a seasonal flu shot to almost everyone, but it’s especially important for seniors who are more vulnerable. The flu puts more than 200,000 people in the hospital each year and kills around 24,000 — 90 percent of whom are seniors. This year, all seniors 65 and older have two flu vaccine options from which to choose. A traditional flu shot or a shot of Fluzone High-Dose. The high-dose vaccine contains four times the amount of antigen (the part of the vaccine that prompts the body to make antibody) as a regular flu shot does, which creates a stronger immune response for better protection. And if you’re under age 65, your two options are a regular flu shot or a shot of Fluzone Intradermal. The intradermal vaccine uses a shorter, thinner needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shots. If you’re squeamish about needles, this is a nice option. You also need to be aware that if you’re allergic to chicken eggs or if you have had a severe reaction to a flu vaccine in the past you should not get vaccinated without consulting your doctor first.

To locate a vaccination site that offers regular, high-dose and intradermal flu shots, ask your doctor or pharmacist, or check the online flu-shot locator at flu.gov. Most chains like CVS, Walgreens, Safeway, Kmart, Walmart and Rite Aid offer all types of shots. You’ll also be happy to know that if you’re a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot. But if you’re not covered, you can expect to pay around $25 to $35 for a regular or intradermal flu shot, or $50 to $60 for a shot of the high-dose.

Pneumonia Vaccine

The other important vaccination the CDC recommends to seniors — especially this time of year — is the pneumococcal vaccine for pneumonia and meningitis. Pneumococcal diseases hospitalize around 300,000 U.S. seniors each year, and kills around 5,000. The CDC currently recommends all seniors 65 or older get a one-time only shot of the vaccine Pneumovax, as well as those under 65 who smoke or have chronic health conditions like asthma, lung and heart disease, diabetes, or a weakened immune system. Pneumovax, which protects against 23 strains of the pneumococcal disease, is also covered 100 percent under Medicare Part B, and you can get it on the same day you get your flu shot. If you’re not covered by insurance, this vaccine costs around $45 to $85 at retail clinics. You also need to know that this year, there’s an alternative pneumococcal vaccine available to people age 50 and older called Prevnar 13. This vaccine, which has been available to children for several years, may provide seniors longer lasting and better protection against pneumonia than Pneumovax. Talk to your doctor to determine which pneumonia vaccine is best for you. Prevnar 13 is also covered by most insurers including Medicare Part B, but if you aren’t covered the shot runs between $100 and $150. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

Public Health Nurses Registered Professional Nurses Oswego County Health Department has excellent nursing opportunities in community-based health care providing skilled nursing care to clients in their homes. Beneﬁts include: • Competitive hourly rate plus incentive bonus package • Health, life, dental and vision insurance coverage • Membership in the NYS Retirement System • Paid holidays and vacation leave • Tuition reimbursement for related education For more information on qualiﬁcations and to download an application, visit our website at http://www.oswegocounty.com/personnel/openings.html or call 349-3548. Please submit application to: Kathryn Caltabiano, Director of Patient Services Oswego County Health Department 70 Bunner Street, Oswego, NY 13126 (315) 349-3548 • kate@oswegocounty.com

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Mammograms Decline

Cancer Practice Celebrates 35 Years

Preventive mammography rates in women in their 40s have dropped nearly 6 percent nationwide since the U.S. Preventive Services Task Force (USPSTF) recommended against routine By Aaron Gifford mammograms for women in this age group, a Mayo Clinic analysis shows. That represents a small but significant n 1982, a cancer diagnosis was decrease since the controversial guidelargely viewed a death sentence. lines were released, the researchers Despite that popular belief, say. Their findings were presented at a few optimistic Syracuse-area the Academy Health Annual Research physicians developed an Meeting in June. oncology practice that “The 2009 USPSTF guidelines focused on treating the resulted in significant backlash mind, body and spirit. among patients, physicians and other Nationally, there organizations, prompting many were major medical medical societies to release opposing breakthroughs in the guidelines,” says co-author Nilay decades that followed. Shah, a researcher at the Mayo Clinic Locally, the physicians Center for the Science of Health Care at Hematology-OncolDelivery.” ogy Associates of CenUsing a large, national tral New York (HOA) representative database of 100 health have played a major role plans, researchers identified the in those advancements number of screening mammograms and find themselves on performed between January 2006 and the cutting edge of cancer December 2010, and compared rates treatment — literally and before and after the task force report. figuratively. The success Comparing mammography rates of their CyberKnife Rabefore and after publication of the new diosurgery will be among guidelines, researchers found that the the topics discussed at the recommendations were associated organization’s 30th Anniversawith a 5.72 percent decrease in the ry Cancer & Wellness Sympomammography rate for women aged sium, scheduled for 5-8:30 p.m. 40-49. Over a year, nearly 54,000 fewer Thursday, Nov. 15 at its 5008 mammograms were performed in this Brittonfield Parkway location in age group. East Syracuse. “For the first year after the The CyberKnife, a robotic tool that guidelines changed, there was a small is unique to HOA, allows surgeons to but significant decrease in the rate of remove tumors from the brain, panmammography for women aged 40– creas and other areas with precision 49,” Shah says. “This is consistent with accuracy, reducing the time of treatthe context of the guidelines change.” ments and number of treatments a “Screening mammography is patient would need. The momentum not a perfect exam, but it is the best of that program and others at HOAC available tool to detect cancer early,” has helped the practice earn national says Sandhya Pruthi, director of Mayo recognition. Clinic’s Breast Clinic. “Early detection “It really is amazing how things can lead to better options and possibly have changed,” Maryann Roefaro, less-aggressive treatments.” HOA chief executive officer, said in a recent interview. “Cancer is more often considered curable, or a chronic disease that you have to manage. There are so many more treatments available.” HOA is the only independent group of its kind in the area; most For the fourth year running cancer treatment practices are affiliated the New York Chiropractic College with research hospitals and have access (NYCC) earned a place on the to more funding. Roefaro credits her Chronicle of Higher Education’s roll of group’s success with its cancer preven“Great Colleges to Work For” alongside tion component as well as its continusuch notables as Duke University, ous involvement with clinical trials. University of Michigan and Notre “That’s the conduit,” she said. Dame. Qualifying marks in more than HOA began with John Gullo, who four categories merited placement on in 1979 became the first board-certified the Chronicle’s select honor roll” for oncologist to open a private practice the third year in a row. NYCC excelled in the Syracuse area. Three years later, in 10 of the 11 available assessment in 1982, he was joined by physician categories — adding collaborative Santo DiFino. At that time, patients governance, teaching environment and in the area either went to a university senior leadership to last year’s seven hospital setting for cancer treatment, winning classifications. or a private practice physician who The program — now one of the may or may not have had some exlargest and most respected workplace- perience with cancer treatment. But recognition programs in the country — it was unusual at that time to find an distinguishes colleges for best practices independent oncology group in Central and policies. After reviewing 46,946 New York. surveys submitted by administrators, “Ultimately,” Gullo says on the faculty members, and professional HOA website, “we felt our patients support staff members from 294 would be better served by a larger, uniparticipating institutions, only 42 make fied, comprehensive cancer program it to the honor roll. than from two smaller, independent “To earn a place on the Chronicle’s practices.” select ‘honor roll’ for three consecutive Additional physicians came on years is truly an outstanding board, starting with Anthony Scalzo distinction! Students unquestionably and Jeff Kirshner. The practice added benefit whenever quality instruction is radiation oncology services, social delivered by satisfied faculty members work, dietary counseling, genetics and a customer-oriented staff,” said counseling and integrative therapy NYCC President Dr. Frank J. Nicchi. programs “so that we are truly taking

Physicians at Hematology-Oncology Associates of Central New York have seen dramatic changes in cancer treatment

NYCC selected as ‘Great Colleges to Work For’

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

Hematology-Oncology Associates of Central New York ia celebrating 35 years in business this year. It gradually expanded to 17 physicians, 20 nurse practitioners and 200 clinical personnel spread out over five locations. In 2013 it plans to become the first certified “Oncology Medical Home” in New York state. care of the whole patient,” Gullo said. Roefaro pointed out that genetics is among the most interesting components of cancer treatment, and HOA physicians and nurse practitioners are trained in that area and keep up with advancements in the field. Some cancer treatments, she said, are known to work or not work based on the patient’s genetics and family history. The practice gradually expanded to 17 physicians, 20 nurse practitioners and 200 clinical personnel spread out over five locations — Syracuse, East Syracuse, Liverpool, Auburn and Rome. They also have a wellness center in Camillus, where patients can participate meditation classes, yoga, pilates, Reiki therapy, healing touch, foot reflexology, even Zumba or belly dancing. All told, the practice serves about 2,500 new cancer patients and 1,300 new blood disorder patients per year. In 2011, HOA logged a total of 99,500 patient visits. As the only nationally recognized Community Clinical Oncology Program (CCOP) in Central New York, and through its affiliation with the National Cancer Institute, HOA allows local cancer patients access to more than 120 clinical research trials, ranging from investigational therapies for various stages and types of cancer, to prevention trials on cancer-related side effects. These tests allow under-insured patients access to high-quality care. In 2008, HOA was one of 10 community oncology practices in the nation to receive honors from the American Society of Clinical Oncology. The year prior, the practice enrolled 300 patients into clinical trials involving 25 different cancer types, including breast, lung, colon and pancreatic. Thanks in large part to the knowledge gained through clinical trials, HOA physicians say, two-

thirds of cancer patients live at least five years past their diagnosis. In the 1970s, by contrast, only half of the cancer patients who participated in clinical trials reached the five-year mark. Roefaro said sweeping changes in recent years, from managed care trends to health care reform and declining insurance reimbursements, has challenged HOA to work harder and smarter. “We’re weathering the storm,” she said. “We just try to do the best thing for patients. We have to be conscious about controlling costs. The secret is to do the right thing and render the best possible care more efficiently and economically.” Roefaro said she plans to create a comprehensive breast care partnership program for woman that covers everything from early detection for patients at a high-risk of breast cancer, to postcancer care for those who survived the disease. The practice also has its sights set on becoming the first certified “Oncology Medical Home” in New York state next year. To obtain that credential, HOA must demonstrate its ability to coordinate patients’ cancer care with their entire medical condition. There are also high benchmarks for obtaining patient satisfaction while providing high-quality care at a low-cost. The intent of this program is to raise the bar and establishes new community standards for cancer treatments. If one group obtains this credential, other practices will strive for the same success. Roefaro said HOA’s focus, no matter how much more the business grows, will never change. “We’re always on the cutting edge,” she said. “But it isn’t always technology — it’s mind, body, spirit.”

H ealth News Community Memorial Hospital earns recognition Community Memorial Hospital was recently named one of the nation’s “Top Performers on Key Quality Measures” by The Joint Commission, the leading accreditor of health care organizations in America. Community Memorial Hospital was recognized by The Joint Commission for exemplary performance in using evidence-based clinical processes that are shown to improve care for certain conditions, including heart attack, heart failure, pneumonia, surgical care, children’s asthma, stroke and venous thromboembolism, as well as inpatient psychiatric services. Community Memorial Hospital is one of 620 hospitals in the U.S. earning the distinction of top performer for attaining and sustaining excellence in accountability measure performance. Community Memorial Hospital was recognized for its achievement on the following measure sets: pneumonia and surgical care. The ratings are based on an aggregation of accountability measure data reported to The Joint Commission during the 2011 calendar year. The list of Top Performers represents 18 percent of accredited hospitals reporting data.

PT to oversee Central Square rehab department Julie Bloom, who holds a doctorate of physical therapy, will oversee the rehabilitation department at Oswego Health’s recently opened Central Square Medical Center. “I am very thrilled to have this opportunity,” Bloom said. “For the past six years I have worked in an outpatient clinic setting and to be responsible for the operation of a new rehabilitation center is exciting.” In addition to her experience, Bloom is Bloom certified in mechanical diagnosis and therapy of the spine (MDT) through the McKenzie Institute. The MDT is a philosophy of active patient involvement and education for those with back, neck and extremity

problems. An evidence-based approach, MDT uses effective assessment tools that lead to an accurate diagnosis and an appropriate treatment plan. “I am able to provide a more effective treatment plan and have found that patients get better much faster using this proven method,” Bloom said. In addition to her MDT certification, she has extensive education in vestibular and balance rehab. Bloom earned her doctorate and master’s degree in physical therapy at D’Youville College in Buffalo. She obtained her bachelor’s degree in exercise science from Bloomsburg College, located in Bloomsburg, Pa; where she also ran track and cross country.

Doctor joins Pathology Associates of Syracuse Physician Mark E. Costaldi recently joined Pathology Associates of Syracuse as a staff pathologist. Costaldi earned his master’s and medical degrees from St. Louis University in Missouri after completing his undergraduate studies majoring in chemistry at Rockhurst University in Kansas City, Mo. Costaldi He did his residency in pathology and fellowship in hematopathology at the University Hospitals Case Medical Center in Cleveland and a fellowship in cytopathology at the University of Rochester. Pathology Associates practices at Crouse Hospital.

Ophthalmologist joins Grifﬁn practice Lawrence Cecchi, a 2003 graduate of Upstate Medical University who specialized in ophthalmology at Geisinger Medical Center in Danville, Pa., recently joined the practice of Dr. John Griffin as a new associate. Cecchi had been in practice at Bassett Medical Center in Cooperstown since 2007. While there, he was attending ophthalmologist and was the first doctor at Bassett to use cataract surgery innovations, including correction

Hematology-Oncology Associates’ Physicians Receive Awards from the National Cancer Institute The National Cancer Institute recently awarded Hematology Oncology Associates of Central New York with four awards for physician accrual to clinical trials sponsored by the National Cancer Institute’s Community Clinical Oncology Program. HOA maintains the highest accruals for adult clinical cancer research in Central New York and has maintained a 25-year partnership with the National Cancer Institute (NCI) through a mechanism known as a Community Clinical Oncology Program or CCOP. There are only two of these programs in New York state. HOA is the only CCOP in Central New York. Silver awards were presented to physicians Jeffrey Kirshner, Anthony Scalzo, Tracy Alpert, Stefania Morbidini-Gaffney and the research staff. HOA currently participates in of astigmatism and presbyopia. He also spearheaded resident education as associate professor of clinical medicine, maintaining affiliations with Albany Medical Center as well as Columbia University. Cecchi is boardcertified in ophthalCecchi mology and licensed to practice in New York state. Besides cataract surgery, he is experienced in eyelid surgery, diagnosis and treatment of macular degeneration, glaucoma and rarer medical conditions affecting the eyes. Family is a large part of what brought him back to the area. His wife is from Skaneateles, and he currently resides in Cazenovia with her and their four children. He practices at Griffin’s office at the Madison-Irving building on Irving Avenue in Syracuse, as well as the

over 100 clinical trials. Kirshner, the principal investigator for the HOA’s CCOP, is actively involved in several of the cooperative group committees and is currently serving as a member of the National Cancer Institute’s Symptom Management and Quality of Life Clinical Trials Steering Committee. Kirshner is also the co-chair of the Community Oncology Committee for the Alliance, a national cancer research consortium. HOA’s research program provides opportunities for clinical cancer research because the CCOP is a large network that enables patients and physicians to participate in clinical trials across the United States. The program allows HOA patients to access investigational cancer drugs and treatments for patients in the community. For more information, visit www.hoacny.com.

EyeCare Center of Oneida on Main Street.

Health center in Oswego earns reaccreditation Mary Walker Health Center, the primary care center for students of SUNY Oswego, has received three-year reaccreditation from the Accreditation Association for Ambulatory Health Care. “We are very proud of it,” said Liz Burns, director of student health services and one of four full-time nurse practitioners that staff the center, along with a registered nurse, a licensed practical nurse and a secretary. “In order to get through the process, we had to show that we follow best practices in our daily business,” Burns said. “This is truly an effort accomplished by all of the staff.” Status as an accredited organization means Walker Health Center has

St. Joseph’s awarded $221,242 grant for nursing education St. Joseph’s Hospital Health Center recently was awarded a $221,242 grant from the New York State Department of Labor’s H-1B Registered Nurse Upgrade Project. The funding, which will be granted over three years, will be used for tuition reimbursement for registered nurses who pursue a Bachelor of Science in Nursing (BSN) degree. Pending legislation in New York State, “BSN in 10,” recommends that all RNs in New York state hold a bachelor’s degree within 10 years of graduation from an associate or diploma program. Additionally, an

Institute of Medicine recommendation calls for 80 percent of RNs to be at the BSN level by 2020. Taking a pro-active stance toward enhancing care for its patients, St. Joseph’s has required all nurse managers to have a BSN since March, 2010. St. Joseph’s also has established an organizational goal requiring that all new RNs hired beginning Jan. 1, 2013, hold a BSN or obtain a BSN within five years. To help make this happen, St. Joseph’s is incentivizing current RNs to obtain BSN degrees, through enhanced tuition reimbursement

benefits made available to employees. Among other enhancements to St. Joseph’s tuition benefits, employees can now access reimbursement money up front rather than having to pay it out-of-pocket and then wait several months until after the course to receive reimbursement. The area’s fourth largest employer, St. Joseph’s employs 415 BSN-prepared nurses, which represents just more than 30 percent of the nursing workforce. These nurses care for thousands of patients every year; the combination of an aging population base plus the Central New York November 2012 •

region’s higher rates of acute and chronic conditions means that St. Joseph’s nurses will continue to treat patients who have more serious and more complex conditions than prior generations. “Studies have shown that better-educated nurses save lives,” said AnneMarie Czyz, chief nursing officer for St. Joseph’s. “With every increase of 10 percent in the proportion of staff nurses with a BSN, there is a corresponding decrease of five percent in mortality rates.”

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H ealth News met the AAAHC’s recognized standards for quality health care. Accredited institutions range from ambulatory surgery centers to medical group centers, from community health centers to managed care organizations. The association made a site visit to Oswego in late April, Burns said. “In particular this year, they were looking at infection control,” she said. “Our surveyor stated we have met all the standards of an office-based surgery center.” Though Walker Health Center does not offer surgery, it provides primary care services during morning walkin clinic and afternoon appointments — from 9,000 to 12,000 patient visits a year — and also offers emergency first aid; makes medical, surgical and dental referrals; provides common medications, immunizations and seasonal flu vaccines; does routine laboratory testing; and offers other health services.

Upstate names pediatric surgery chief Andreas H. Meier, a pediatric surgeon with special interest in minimally invasive pediatric surgery, has joined Upstate Golisano Children’s Hospital as division chief of pediatric surgery and director of the Olivia Louise Pietrafesa Center for Children’s Surgery. He also serves as an associate professor of surgery and pediatrics at Upstate Medical University. Meier resides in Syracuse. His academic interests focus on novel approaches to surgical education, including the use of simulation in surgical curricula and team training. Meier succeeds surgeon Michael Ratner, who retired from clinical practice this summer. Meier comes to Upstate from

Southern Illinois University School of Medicine, where he was an associate professor of surgery and pediatrics, chair of the division of pediatric surgery and medical director of the Surgical Skills and Research Laboratory. He acquired his Meier, medical degree from Ludwig Maximilian University School of Medicine in Munich, Germany, a doctoral degree in medicine from Technical University School of Medicine in Munich, Germany, and a master’s degree from the University of Illinois Urbana/Champaign. His residency in general surgery was completed at Stanford University, where he served as chief resident. He completed a fellowship in pediatric surgery at Emory

University in Atlanta. He also completed two research fellowships in surgical oncology and advanced technology in surgery at Stanford University. Meier has contributed extensively to the scientific literature, writing about numerous surgical specialty techniques for both the pediatric and adult patient. Most recently he was the principal investigator of an educational study, funded by the American College of Surgeons, that assisted surgical educators on ways to establish a team training program through the use of tested simulation scenarios. A member of several professional societies and academies, he has served as an ad hoc reviewer for numerous journals, including the American Journal of Surgery, the Journal of Surgical Research, the European Journal of Pediatrics and the Journal of Pediatric Surgery. He is an associate editor for the Journal of Simulation in Healthcare.

Internist joins Chittenango Health Center

Joseph Murabito, owner/operator and administrator of Morningstar Residential Care Center in Oswego, recently hosted an open house to unveil the facility’s many technological and structural upgrades.

Morningstar Residential Care Center Unveils Improvements Morningstar Residential Care Center recently hosted a reception on to showcase the facility’s recent improvements and upgrades. Joseph Murabito, owner/ operator and administrator of the facility, pointed out that along with the modernization of the center, formerly known as Sunrise Nursing Home, it has grown and improved its warm and people-oriented atmosphere. “We want this facility to be a community resource. This reception was by invite for people who directly or indirectly have a connection with health care in the area,” Murabito said. “We want people to embrace the dynamic Page 28

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atmosphere of our skilled nursing facility.” Murabito said along with the name change, Morningstar has seen many structural and technological improvements over past year or so, citing for examples a new occupational therapy suite; a new private medical exam room; new staff break room; extensive landscaping and the addition of a large, wraparound patio; electronic medical records system and extensive hardware upgrades; the installation of wireless computer access and a video surveillance security system; new computer servers and the launching of a new website to name a few. The 120-

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

bed facility is currently getting a new roof and a full-house sprinkler system with installation scheduled to begin in January of 2013. “We don’t have the grandeur or size of our competition, but we have a highly skilled yet comfortable, warm atmosphere,” Murabito said. “We try to make practical use of our space. Because of the intimacy of our physical space, the closeness of proximity of the team to our residents and families, we have been able to create a highly effective and communicative atmosphere; better than any other place I have worked.” For more information, visit www.morningstarcares.com

Physician Robert T. Freidman has relocated his internal medicine practice from Fayetteville to Oneida Healthcare’s Chittenango Health Center. “We’re delighted to have a physician of Dr. Friedman’s quality and character become part of the Oneida Healthcare system. His practice is an excellent addition to our lineup of services in Chittenango,” said Friedman Mike Fifield, Oneida Healthcare’s practice administrator. Chittenango Internal Medicine provides comprehensive adult and geriatric medicine. It’s located in the lower level of the Chittenango Health Center building at 153 W. Genesee St., across from the Chittenango High School entrance. The upper level is home to the Chittenango Family Care practice, which opened in 2002. Earlier this year, the hospital also opened a new laboratory draw service in a downtown storefront at 201 W. Genesee St. in the village. Fifield said the expansion of services reflects a trend of steady growth. “We’re seeing more and more people from Chittenango, Fayetteville, Manlius and Cazenovia discover that it [Chittenango Health Center] is their portal to an impressive complement of technology, services and personalized care, just 15 minutes down the road in Oneida,” he said.

ClearPath launches new strep detection test ClearPath Diagnostics, a leading anatomical pathology lab serving Upstate New York, has launched a new women’s health molecular assay for the detection of group B streptococcus (GBS) from Meridian Bioscience, Inc. The new assay, named illumigene GBS, is the next generation of technology for GBS testing, replacing the current culture methodology used in most

H ealth News U.S. laboratories today. Sensitivity on the new assay approaches 99 percent vs. a range of 65 percent with the culture method. With over 4.3 million births in the US, GBS is the leading cause of morbidity and mortality in infants, with the most common complication being early-onset neonatal sepsis. Infant mortality is preventable with appropriate diagnostic testing. ClearPath Diagnostics provides anatomic pathology and women’s health diagnostics to over 60 percent of the OB-GYN physician offices in its currently served markets. It has selected the Meridian Bioscience illumigene GBS test not only for its excellent sensitivity, specificity, ease of use, and FDA compliance, but because the test is available nationwide to support the labs expansion plans. “We are excited to begin offering our clients the new Meridian group B strep test,” said Michael A. Jozefczyk, a physicians who is the president of ClearPath Diagnostics. “This test is another example of our commitment to excellence in launching innovative assays in which clinicians are provided more accurate information to diagnose and treat challenging health issues facing women every day. The illumigene test will ultimately help us prevent infant mortality for patients who might otherwise not be accurately diagnosed.”

B’ville practice focuses on psychological services ADHD & Autism Psychological Services and Advocacy PLLC has recently opened a new office in Baldwinsville. The practice specializes in providing state-of-the-science assessment,

treatment, educational and advocacy services for persons across the lifespan with ADHD and Autism Spectrum Disorder. AAPSA offers diagnostic evaluations, parent education and skill building, parent-child conflict resolution, parent-child interaction treatment, individualized Medication Assessments and other services It’s located at 80 Smokey Hollow Road in Baldwinsville. For more information, call732-3431.

Laboratory Alliance opens center in Cazenovia Laboratory Alliance recently opened a new patient service center in Cazenovia at 132½ Albany St., in the Atwell Mill Professional Building. The new Madison County location is one of 11 patient service centers in Central New York that are open to the public for laboratory test draws ordered by health care providers. The center is open from 8 a.m. – 4:30 p.m. Monday through Friday. It is closed for lunch from 12:15 – 1 p.m. Appointments are not necessary and most medical insurance plans are accepted. Free parking is adjacent to the first-floor office. Atwell Mill Professional Building is located east of the village between Riverside Drive and Fenner Street, in the annex building behind New Great Wall Chinese Restaurant and Atwell Mill, across the street from Sunoco. Now in its 15th year, Laboratory Alliance provides clinical and anatomic pathology testing services and performed nearly 10 million medical tests last year. Laboratory Alliance employs 440 Central New Yorkers. For more information, visit www. laboratoryalliance.com.

Oswego Industries program participants take a brief break to pose with the Ronald McDonald statue.

Oswego Industries, Inc. Donates to Local Ronald McDonald House Oswego Industries, Inc. program participants recently dropped off a year’s worth of pop tab donations raised through the organization to the local Ronald McDonald House Charities of Central New York. After the tabs are collected, the local RMHC brings the collection to local recycling centers, where they are weighed to determine their value. The recycling center then sends the local RMHC Chap-

ter a check for the total value. The current value for CNY is 60 cents a pound. Ronald McDonald Houses collect pop tabs instead of entire aluminum cans because it’s more hygienic to store tabs than cans, and collection and storage is easier. The program is an easy way for people of all ages to support RMHC and know they are making a difference for families and children.

Excellus BlueCross BlueShield Aids United Way Campaign Regional President of Excellus BlueCross BlueShield Arthur Vercillo presents Melanie Trexler (center), executive director, and Lois Luber, resource development director for United Way of Greater Oswego County, with a check for $3,500 for the United Way 2012-2013 annual campaign. “Excellus BlueCross BlueShield is pleased to be a $3,500 Leadership Giver / Admiral Society sponsor of the United Way of Greater Oswego County’s 2012 / 2013 Community Fund Campaign,” said Vercillo.

Oswego Hospital Celebrates National ER Nurses Week Oswego Hospital recognized its entire emergency room staff during its celebration of national ER nurses week, which took place Oct. 7 – 13. Among the staff members that work in the department from the left are Kellie White, Liz Dehm, Julie Rice, Phil McKeogh, Heidi Prime, Erica Peterson and Deb Jones. All of them are registered nurses except for Liz Dehm, who is an ER technician.

25 Years on the Job Diane Cooper-Currier (right), executive director at Oswego County Opportunities presents a longevity award to financial assistant, Elaine Briggs for 25 years of service to OCO Health Services.

November 2012 •

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he American Academy of Allergy, Asthma and Immunology defines allergist/ immunologists and related professionals as having “advanced training and experience dedicated to allergy, asthma, immune deficiencies and other immunologic diseases.” This is additional training beyond what they received to become medical doctors. • “We’re a specialist in allergic problems of the respiratory tract and skin. We deal with a host of different problems. We deal with a wide variety of situations. • “Usually before a patient comes to me, they go to a primary [doctor] who refers them. They usually come in with a respiratory problem. “With an allergy, you have to demonstrate they’re making allergy antibody and we correlate that with their history. You need them both. • “Once that’s done, we try to control the problem. We propose a battery of medication and avoidance measures. If that doesn’t control the problem, the question is, ‘Is it bad enough to instigate allergy desensitization?’ By stimulating the immune system, we have success in about 80 percent of cases. • “For allergic reactions, the home environment and especially the bedroom is important, as is the cleanliness. Home should be maintained at 35 to 40 percent humidity. At that range, people are comfortable. At 50 percent, you start to promote dust mite growth and below 35 percent, it tends to be drying and uncomfortable and can make allergies worse.” Dr. Michael Sheehan, Allergy, Asthma & Rheumatology Associates, Syracuse • “Our specialty is unique. People who are board certified are trained in pediatric and adult asthma, allergy and immunology, so we see all ages for a broad array of problems. We get a lot of referrals from primary care physicians. • “There are overlaps in care. We see kids with upper respiratory infections and from ENT [ear, nose and throat] offices. We identify if allergies play a role in why they have recurring upper respiratory problems. Sometimes it does. Treatment for underlying inflammatory patterns is important. We have overlaps with gastroenterologists. When people have chronic reactions, food or environmental allergies could play a role. And we have overlap with dermatologists with patients who have skin conditions and rashes. Because of

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this overlapping, we see a lot of people who don’t think they have allergies. They may not understand why they’ve been sent to see us. • “People have allergies sometimes that make them more prone to infection. We also get run-of-the-mill patients that have allergies that affect them in a variety of ways for chronic, nagging issues. • “To speed up the process of evaluation, come to the office prepared. If you’ve had any tests or lab work done, or if you’ve been seen elsewhere, any diagnosis you’ve had, bring it to us. Don’t assume the person referring you sent it ahead to us. • “The office waiting room is a mix of people of all ages. We see lots of kids. We even have an extra large exam room, which helps for seeing larger families. • “We have a triage system and our nurses can answer a lot of questions for our patients right over the phone. If they’re not a patient, we may need to see them. Or if it’s an existing patient with a new problem, we may need to see them. A lot of what we do with diagnosis is based upon history and what we see and test. • “Most of these conditions won’t kill you outright. Some patients try home remedies or over-the-counter drugs. It would be nice if everyone would come in to see use before problems become bigger problems, especially with asthma. I wish they wouldn’t try an over-the-counter product on the advice of a friend who had similar symptoms but has a different problem. They need a diagnosis first. And they need to let their care providers know what they are taking, how much and when to make sure it doesn’t interfere with what we’re trying to do.” Dr. Stella Castro, Asthma & Allergy Associates, Fayetteville and other locations statewide

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.

Uptick in Cinematic Smoking More onscreen tobacco use in movies aimed at young viewers — “The Help,” “Midnight in Paris,” and “Hugo” some of the movies that showed the most smoking

op box office films last year showed more onscreen smoking than the prior year, reversing five years of steady progress in reducing tobacco imagery in movies, according to a new University of California at San Francisco (UCSF) study. Moreover, many of the topgrossing films of 2011 with significant amounts of smoking targeted a young audience, among them the PG-rated cartoon Rango and X-Men: First Class.” The more smoking young people see in movies, the more likely they are to start smoking, the U.S. Surgeon General has reported. “Hollywood has still not fixed this problem,” said lead author Stanton A. Glantz, a professor of medicine at UCSF and director of the Center for Tobacco Control Research and Education. “The result of the increase in onscreen smoking in youth-rated films will be more kids starting to smoke and developing tobaccoinduced disease.” Altogether, the 134 top-grossing films of 2011 depicted nearly 1,900 tobacco “incidents,” the analysis found. An incident is defined as one use or implied use (such as a lit cigarette) of a tobacco product by an actor. Total tobacco incidents per movie rose seven percent from 2010 to 2011. Among movies rated G, PG or PG-13, smoking incidents per movie soared by 36 percent. The data was obtained by counting tobacco incidents in movies whose box office sales ranked in the top 10 for at least a week. Some of the films that showed the most smoking were “period” movies, such as “The Help,” “Midnight in Paris,” and “Hugo,” which depicted an era when smoking was more common than it is today. But others were fantasy films, including “Cowboys & Aliens,” “Green Hornet” and “The Twilight Saga: Breaking Dawn — Part 1,” which were aimed squarely at the youth market, noted Glantz. “Movies continue to deliver billions of smoking images to adolescents,” the authors reported. In stark contrast to prior years, the three major film companies that have adopted policies designed to discourage smoking in their movies depicted just as many tobacco incidents per youth-rated movie as companies that lack tobacco use policies. Those three studios with tobacco reduction policies are: Time Warner (established policy in 2005), Comcast (2007) and Disney (2004). The three companies with no such policies: Viacom, News Corp. and Sony. The study authors, noting that about two-thirds of subsidies for top-grossing movies are earmarked for productions with smoking, recommended that health departments work with policy makers to correlate

movie subsidies with public health interests in reducing smoking. “These results underscore a need for an industry-wide policy to keep smoking out of films marketed to youth,” Glantz said. “An R rating for

movies with smoking would give film producers an incentive to keep smoking out of movies aimed at young viewers. The exception would be when the movie clearly reflects the dangers and consequences of tobacco

use, or represents the smoking of a real historical figure.” Tobacco, the leading cause of preventable and premature death, kills an estimated 443,000 Americans annually, according to the United States Department of Health and Human Services. Every day in the U.S., an estimated 3,800 young people smoke a cigarette for the first time, the agency reported earlier this year.

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