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

in good February 2013 • Issue 158

Music to Patients’ Ears Harpist brings healing to St. Joe’s Hospital

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CNY’s Healthcare Newspaper

More Kids Having Heart Problems Just one among several indicators: Boys aged 5 to 14 show increase of 51.6 percent for ischemic stroke

Pages 9 & 10

Is Gluten-free For You?

Problems, solutions for ill-fit dentures

New ER Chief at Oswego Hospital Jerry Emmons just took over the position Page 6

Immediate Care in Manlius: 5 Years Serving Patients ER doctor who started center plans to open other facilities in Onondaga County Physician Tom Chmelicek knew he was taking a significant risk when he left his job in the emergency department of St. Joseph’s Hospital Health Center in January 2008 to start Immediate Medical Care of CNY in Manlius. He said his practice has been so successful, he plans other ones in Onondaga County. Page 17

February 2013 •

Reasons Why Diets Fail

The battle of the bulge is on — any movement on the scale yet? Page 5

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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FACT:

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

Excellence, taken to heart. 301 Prospect Ave., Syracuse, NY www.sjhsyr.org St. Joseph’s Resource Line (Physician & Program Information): 315-703-2138 Follow us on Facebook and Twitter: stjosephshealth

St. Joseph’s is sponsored by the Sisters of St. Francis. Franciscan Companies is a member of the St. Joseph’s Hospital Health Center system.

AUBURN COMMUNITY HOSPITAL

�� COMPREHENSIVE DIAGNOSTIC IMAGING SERVICES With accreditation by the American College of Radiology for Mammography and MRI. � REHABILITATION SERVICES A complete range of inpatient and outpatient including: Physical Therapy, Occupational Therapy, Hand Therapy, Speech Therapy

��7 BLOOD DRAW STATIONS call 315-255-7023 for locations and hours ��COMPREHENSIVE SURGICAL SERVICES, INPATIENT AND OUTPATIENT Orthopedic, General Surgery, OBGYN, Bariatrics � STROKE CARE A New York State Department of Health designated Stroke Center ��SLEEP SERVICES A nationally accredited center with a range of services in a private, hotel-like setting �� BARIATRIC PROGRAM Finger Lakes Bariatric Program, nationally accredited, designated Bariatric Center of Excellence ��OBSTETRICS-GYNECOLOGY Including our brand new Stardust Birthing Center

FOR MORE INFORMATION ON THESE SERVICES:

www.auburnhospital.org

17 Lansing Street, Auburn NY, 13021 - 315-255-7011

SHHH...

Silent Hospitals Help Healing

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Podiatry

316 South Main Street North Syracuse, NY 13212 315-452-1314

PROVIDING HEALTHCARE AUBURN COMMUNITY HOSPITAL PROVIDING HEALTHCARE EXCELLENCE EXCELLENCE ��24/7 EMERGENCY CARE ��URGENT CARE Walk-in for non-emergent care, seven days a week -Finger Lakes Medical Care 303 Grant Avenue - 258-7100 -Urgent Medical Care of Skaneateles- Route 20 - 685-(WELL)9355

Dr. Lynda Kreitzer

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

Featuring LightPod Neo Medical Aesthetic Laser

LightPod Neo is used for a wide range of treatments on the feet and ankles. Including but not limited to Fungal Nails, Wound Care and Warts

Pedorthist on site specializing in diabetic shoes. Maureen Kaljeskie, C. Ped.

Why People See a Doctor Skin problems, joint disorders top the list

new Mayo Clinic Proceedings study shows that people most often visit their health care providers because of skin issues, joint disorders and back pain. Findings may help researchers focus efforts to determine better ways to prevent and treat these conditions in large groups of people. “Much research already has focused on chronic conditions, which account for the majority of health care utilization and costs in middle-aged and older adults,” says Jennifer St. Sauver, primary author of the study and member of the Population Health Program within the Mayo Clinic Center for the Science of Health Care Delivery. “We were interested in finding out about other types of conditions that may affect large segments of the population across all age groups.” The research team used the Rochester Epidemiology Project, a unique, comprehensive medical records linkage system, to track more than 140,000 Olmsted County, Minn., residents who visited Mayo Clinic, Olmsted Medical Center and other Olmsted County health care providers between Jan. 1, 2005, and Dec. 31, 2009. Researchers then systematically categorized patient

diagnoses into disease groups. The top disease groups included: • Skin disorders • Osteoarthritis/joint disorders • Back problems • Cholesterol problems • Upper respiratory conditions (not including asthma) • Anxiety, depression and bipolar disorder • Chronic neurologic disorders • High blood pressure • Headaches/migraine • Diabetes “Surprisingly, the most prevalent non-acute conditions in our community were not chronic conditions related to aging, such as diabetes and heart disease, but rather conditions that affect both genders and all age groups,” says St. Sauver. For example, almost half of the study population was diagnosed with “skin disorders” — acne, cysts, dermatitis — within the five-year period. St. Sauver says that this finding presents an opportunity to determine why these skin-related diagnoses result in so many visits and if alternative care delivery approaches that require fewer visits are possible.

Hold the Diet Soda?

ew research suggests that drinking sweetened beverages, especially diet drinks, is associated with an increased risk of depression in adults while drinking coffee was tied to a slightly lower risk. The study was released in January and will be presented at the American Academy of Neurology’s 65th Annual Meeting in San Diego, March 16 to 23. “Sweetened beverages, coffee and tea are commonly consumed worldwide and have important physical — and may have important mental health consequences,” said study author Honglei Chen, a physician with the National Institutes of Health in Research Triangle Park in North Carolina and a member of the American Academy of Neurology. The study involved 263,925 people between the ages of 50 and 71 at enrollment. From 1995 to 1996, consump-

tion of drinks such as soda, tea, fruit punch and coffee was evaluated. About 10 years later, researchers asked the participants whether they had been diagnosed with depression since the year 2000. A total of 11,311 depression diagnoses were made. People who drank more than four cans or cups per day of soda were 30 percent more likely to develop depression than those who drank no soda. Those who drank four cans of fruit punch per day were about 38 percent more likely to develop depression than those who did not drink sweetened drinks. People who drank four cups of coffee per day were about 10 percent less likely to develop depression than those who drank no coffee. The risk appeared to be greater for people who drank diet than regular soda, diet than regular fruit punches and for diet than regular iced tea.

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. © 2013 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, Pat Mailin, Melissa Stefanec, Matthew Liptak, Aaron Gifford, Bruce Frassinelli • 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.

REGISTERED NURSES

Our Home Care Agency is a partnership between Oswego Health and St. Joseph’s Hospital. Our services continue to grow in Oswego County and we have a variety of RN positions available. For more info and to apply online visit our website at hh-homecare.org. If you have any questions call (315)458-2800 ext 124 or fax resume to (315)458-1193.

Rated one of the Top 25% Home Care Agencies from HomeCare Elite.

ASSISTANT PROFESSOR - RADIOLOGY Assistant Professor at SUNY Upstate Medical University (Syracuse, NY) Perform clinical care in the Interventional Radiology Division, including provision of primary care and consultant responsibilities for private patients and those being followed in the public clinics. Serve as the preceptor for house staff and students in caring for patients on the Interventional Radiology Division service during assigned periods. Develop clinical activities that promote excellence in clinical care. Develop strong clinical working relationship with referring physicians and colleagues within the Interventional Division. Look to develop and enable interventional techniques that are not currently performed or offered within the department. Offer clear and effective instruction within expertise to students in the College of Medicine and Graduate Studies and serve as preceptor/mentor for house staff. Evaluate students and residents. Maintain updated lecture series and material. Perform research in area of expertise. Reqs: M.D. (Doctor of Medicine) or foreign equivalent and five (5) years of postgraduate experience in interventional radiology. Completion of Medical Residency (US or Foreign accepted). Completion of Interventional Radiology Fellowship. License/Permit to practice medicine in the State of New York. Interested candidates apply to: Stacy Mehlek, Faculty Appointment Specialist, 750 E. Adams St., Syracuse, NY 13210.

An AA/EEO/ADA employer committed to engaging excellence through diversity.

February 2013 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

IN GOOD HEALTH - FEBRUARY

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CALENDAR of

HEALTH EVENTS

Feb. 7

Medicare basics workshop takes place in Auburn Learn about the basics of Medicare at a free workshop from 10 a.m. — Noon, Feb. 7 at the basement training room of the Cayuga County Office Building, 160 Genesee St., Auburn. This session will be geared toward those who are approaching Medicare enrollment and for those already enrolled who are overwhelmed or confused by the information and the options available. This is not a meeting during which sales efforts will be made and no insurance vendors will be present; this presentation will be unbiased information only, according to organizers. Information included in this program will be: the basics of original Medicare; Medicare Advantage and Medicare Part D prescription coverage; Medicare Preventive benefits; Medicare supplemental insurance and EPIC; costs, co-pays and deductibles; and information about available assistance to help those beneficiaries of a low-income status. Registrants may park on the street where two-hour, metered parking is available, or in the municipal parking garage on Loop Rd off South Street. Parking lots adjacent to the County Office Building are for the use of county employees only. For more information or to register, call the Cayuga County Office for the Aging at 315-253-1226, or visit the News & Activities section of its website, www.co.cayuga.ny.us/aging/ events.htm. Future classes will be held March 5 and 6.

Feb 9

AIDS group sponsors cardboard sledding derby AIDS Community Resources will hold its third annual Sled for RED Cardboard Sledding Derby at Four Seasons Golf & Ski Center in Fayetteville on Feb. 9. Registration begins at

4 p.m. The event kicks off at 5 p.m., followed by a tubing party and a hot chocolate, food and drink sampling party. The Sled for RED Derby begins promptly at 5:15. Each team (up to five members) may use only regular cardboard, tape, and paint to construct the cardboard sleds. Each sled team needs to fundraise a minimum $250 to enter the derby. Raise more and earn more incentives. The tubing party following the competition is $10 per person. The fee to attend the hot chocolate, food, beer and wine sampling event is also $10 per person.

Feb. 12, 26

Weight loss surgery seminar at St. Joe’s St. Joseph’s Hospital Health Center will host a free informational session on “Weight Loss Surgery: When is it the Best Option?” at 6 p.m. on Tuesday, Feb. 12, at St. Joseph’s Medical Officer Center, suite 809-810, located at 104 Union Ave. in Syracuse. Free parking is available in the medical office center parking garage. A second session will be held at 6 p.m. Tuesday, Feb. 26, at the Onondaga Free Library, located at 4840 West Seneca Turnpike in Syracuse. William Graber, a board-certified surgeon specializing in weight loss surgery, will explain what qualifies as obesity, how obesity affects health, when surgery is the best option and review what can be expected after surgery. Space is limited. To register, call St. Joseph’s at 315-744-1244 or e-mail community.programs@sjhsyr.org.

Feb. 13

Crouse offers free bariatric support group Crouse Hospital will provide a free support group for those about to have or who have had bariatric (weight loss) surgery. The support group, which is also open to family and friends, will meet from 4 – 6 p.m. Feb. 13 and on the

second Wednesday of every month at the Marley Education Center. Registration is required by calling 315-470-8974. The Marley Education Center is located at 725 Irving Avenue, Syracuse; parking is free in the Marley garage. Facilitated by Crouse Hospital’s team of specialists, the support group offers attendees the opportunity to discuss concerns, share experiences and gather information in a safe, friendly environment that will help them achieve physical and emotional success. In addition, each session will feature a guest speaker who will present on relevant topics.

Feb. 19

Healthcare bootcamp for veterans in Chittenango Theresa Cangemi, president of Medicare Made Simple, a business that helps retirees understand Medicare system and their options, will host a seminar that explains how Medicare can help cover the gaps in VA coverage for those eligible for Medicare. The seminar will help guide veterans looking for dental coverage. It will also focus on a savings program for prescription drugs, vision care, hearing care and alternative medicine. This program is for veterans of all ages and Cangemi will cover how to obtain this inclusive package for veterans and their family for a low monthly cost. The event will be held from 10 a.m. to Noon Feb. 19 at Clear Path for Veterans Inc., 1223 Salt Springs Road in Chittenango. For more information, call 315-687-3300 or visit www.ClearPathForVets.com.

Feb. 21

Aurora of CNY offers monthly vision screening Aurora of CNY, Inc. is offering free vision screening at its office at 518 James St. in Syracuse. Screening will be held from 11 a.m. – Noon on Feb. 21. Each screening takes approximately 15 minutes; appointments can be scheduled by calling Aurora at 422-7263. Vision screening is a non-medical test that evaluates a person’s visual acuity and checks for color-blindness, field-ofvision defects and other conditions. If the screening reveals a possible problem, a visit to a physician is recommended. Aurora, the only nonprofit that works exclusively with people in Central New York who are deaf, blind, visually impaired or hard of hearing, is a United Way agency of Central New

Taking Charge of Chronic Illness Individuals suffering from chronic illnesses, such as heart disease, asthma, arthritis, diabetes, bronchitis or emphysema, now have a new resource to help them learn how to manage their disease and improve their health. The Living Healthy Workshop is a six-session program developed and tested at the Stanford University Patient Education Center. The program is being offered at no charge through collaboration between Upstate’s OASIS program, Onondaga County Department of Aging and Youth and The Centers at St. Camillus. Page 4

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The sessions are facilitated by two peer leaders certified in CDSMP by Stanford University and are open to adults of all ages. Living Healthy workshops help attendees to feel better, increase their energy and get relief from pain, fatigue and difficult emotions. This allows participants to take control of their life and do the things they want to do each day. It also offers them the opportunity to learn from others who have similar health issues. Class size is limited to 20. All facilities offer free parking and wheelchair access. Two classes took

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

place in January. The two remaining classes will be as follows: • Class No. 332. Free. Wednesdays from Feb. 6 through March 13. Six sessions from 1 – 3:30 p.m. Fayetteville Free Library, 300 Orchard St., Fayetteville. • Class No. 333. Free. Thursdays from March 21 through April 25. Six sessions from 1 – 3:30 p.m. The Centers at St. Camillus, 813 Fay Road, Syracuse. To register for any of these locations call 315-464-6555.

York and Oswego and Cayuga counties. Other screenings will take place March 21, April 24, June 19 and Aug. 21.

March 16

Run For Dennis’ 5k Run/ Walk to be held in Oswego The second annual Run For Dennis 5k Run/Walk is scheduled for 10 a.m., March 16 to honor the memory of Oswego resident Dennis Pacheco, a victim of bladder cancer. This run/ walk will be chip timed and USA Track & Field (USATF) certified. All proceeds of the race will go to Strong Memorial Hospital Cancer Center, Rochester, and the Bladder Cancer Advocacy Network (BCAN). Prizes will be awarded to winners in all age groups—including last place. Registration for the race, which begins and ends at Gibby’s Pub on Lake St., is $20 per person by Feb 16, $25 after that date, and $30 on race day. Registration is open at www.EZRaceReg.com. The website for the race is www.runfordennis.com and the event is also on Facebook at www.facebook. com/runfordennis. Last year’s race raised more than $14,000 for bladder cancer advocacy and research.

April 7

Alzheimer’s group recruiting “Indoor Warriors” The Alzheimer’s Association, Central New York chapter is seeking a new type of hero in its fight against Alzheimer’s disease: indoor warriors. The chapter debuts its newest event, the Indoor Warrior Triathlon, on April 7 at Gold’s Gym, 7455 Morgan Road, Liverpool. This all-ages, all-abilities indoor triathlon is a fitness challenge for all of Central New York to get involved in the fight against Alzheimer’s. It is Syracuse’s only indoor triathlon and the only such event in the nation conducted by an Alzheimer’s Association chapter. Registration is open to the first 100 entrants at www.alz.org/cny. The $60 entry fee includes an athlete gift, participation award, and a training program — including workout and dietary suggestions — designed by Gold’s Gym. Indoor triathlons take a different format than traditional outdoor timed run/bike/swim events. Participants in the Indoor Warrior Triathlon will have 10 minutes to swim, 30 minutes to bike and 20 minutes to run as far as they can. A seven-minute transition period between each event allows athletes to prepare for the next discipline. Overall event, gender and age-group standings will be based on the total combined miles accumulated from each discipline. Event rules and details are available at www.alz.org/cny or by calling Grant Fletcher at 315-472-4201 x106.

Advertise With In Good Health Reach thousands or health consumers, providers. One ad working all month long. editor@cnyhealth.com

Top Four Reasons Why Diets Fail T

he battle of the bulge is on — any movement on the scale yet? “Losing weight is one of the top resolutions made every year, yet only 20 percent of people achieve successful weight-loss and maintenance,” says Jessica Bartfield, internal medicine who specializes in nutrition and weight management at the Loyola Center for Metabolic Surgery & Bariatric Care. Despite the fact that two-thirds of Americans say they are on a diet to improve their health, very few are actually decreasing in size. “Dieting is a skill, much like riding a bicycle, and requires practice and good instruction,“ says Bartfield. “You’re going to fall over and feel frustrated, but eventually you will succeed and it will get easier.” According to Bartfield, here are the top four reasons why many dieters fail to lose weight.

1. Underestimating Calories Consumed “Most people, even experts, underestimate the number of calories they eat per day. Writing down everything that you eat — including drinks and “bites” or “tastes” of food — can help increase self-awareness. Pay attention to serving sizes and use measuring cups and spoons as serving utensils to keep portions reasonable. Food eaten outside of the home tends to be much larger portion sizes and much higher in calories. Try to look up nutrition information of your favorite take-out meal or restaurant and select a healthy meal before picking up the phone or going out to eat.

2. Overestimating Activity and Calories Burned “Typically you need to cut 500 calories per day to lose 1 lb per week.

This is very difficult to achieve through exercise alone, and would require 60 minutes or more of vigorous activity every day. A more attainable goal would be to try to increase activity throughout the day and get a total of 30 minutes of moderate to vigorous exercise most days of the week. Buy a pedometer and track your steps; try to increase to a goal of 10,000 steps per day. But be careful: exercise is not an excuse to eat more.”

3. Poor Timing of Meals 4. Inadequate Sleep “You need a steady stream of glucose throughout the day to maintain optimal energy and to prevent metabolism from slowing down. Eat breakfast every day within one hour of waking up, then eat a healthy snack or meal every three to four hours. Try not to go longer than five hours to keep your metabolism steady.”

“Studies have shown that people who get fewer than six hours of sleep have higher levels of ghrelin, which is a hormone that stimulates appetite, particularly for high carbohydrate/high calorie foods. In addition, less sleep raises levels of cortisol, a stress hormone, which can lead to weight gain.”

Enjoy Your Life. After All, the World Hasn’t Ended By Bruce Frassinelli

hen the world did not end, as the Mayans allegedly predicted in December, I came back from the mountaintop with my suitcase. If I were to be one of the chosen few when the end came on Dec. 21, I at least wanted to have a fresh change of clothes and some toiletries. Not knowing if I were one of the chosen ones to make the journey to another, happier place, I didn’t know how long this Mayan journey might take. After all, I didn’t want to be disheveled and unshaven when I arrived. Well, as we now know, just as Harold Camping had miscalculated in May 2011, the end-of-the-world predicted by the Mayan calendar also was a bust. Camping is the 90-year-old retired civil engineer who built a multi-million-dollar nonprofit ministry based on

his end-of-the-world predictions. Later, Camping said he miscalculated and that the world would end in October 2011. Well, that didn’t happen either. OK, let me pinch myself: Yep, I’m still here. No earthquakes, check. No tornadoes, check. No volcanic eruptions, check. No tsunamis, check. No plagues, check. No super meteors hurtling toward earth from secret hiding place, check. Yes, there was Hurricane Sandy, but, heck, that was nearly four months ago. And, most annoying, no Mayan sightings. Before my trek to the mountain — I wanted to be in a location that was clearly visible if the Mayan god were seeking me out, because I knew he wouldn’t have much time — I set my wristwatch to U.S. Naval Observatory Time. I wasn’t sure what timepiece the Mayan god is using these days. (I

secretly hoped it wasn’t an hourglass, because those damn things are so imprecise.) While I was on the mountaintop, it was dark and cloudless, and the wind was brisk and biting. Off in the distance, I could hear a chorus of voices shouting, “Hela, hela” — Mayan for “we’re here.” I realized others must be seeking visibility, too. They must have seen the winds as signs that the prophetic beginning-of-the-end was imminent. I saw a plane, which had taken off moments earlier from the local airport, pass on its ascent to cruising altitude. I briefly wondered whether the Mayan god might have chartered an airliner to pick up the faithful believers. If he had, I didn’t get the message. I silently cursed myself for not having friended him on Facebook or tweeted him to

February 2013 •

confirm my whereabouts. As the big and little hands of my Mickey Mouse watch hit the 12, I held my breath and strained my ears. Nothing. Friday, Dec. 21 had come to an end, and it was now officially Saturday morning. A couple of minutes went by. “Hela, hela,” came several voices in the distance, not quite as loud this time, probably because there were fewer of them; the others had left. Confused but relieved, I got into my car and drove home. Now, I had to figure out how to get the suitcase back into the house without my wife seeing it. No such luck. “Where were you?” she asked with much annoyance. When I told her, she looked at me incredulously. “Are you serious?” she asked. “I’m going to bed.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Dr. Jerry Emmons Oswego County native becomes the ER chief at Oswego Hospital Q: What kinds of services do you oversee in the Oswego emergency department? A: I oversee the emergency medical staff, so the physicians who work in the emergency department, scheduling, recruitment, quality measures, and things like that. Q: How did you end up in the position? A: I was actually doing a travel position for a group that staffs St. Joseph’s Hospital Health Center as well as some hospitals in Rome and Utica. When I signed for that job a year and a half ago, my life was very different. Now I have a son who was born a few months premature, so I wanted more time to spend with my family. I didn’t want to have such a long commute. I wanted to be able to spend more time with my wife and son without spending 30 hours a month on the road. The position at Oswego Hospital allows me some flexibility in scheduling and I’m responsible to only one facility instead of three or four. It’s also a community I feel is home. I’m from the Phoenix area [in Oswego County] and I worked on ambulances in this area in year past. Q: How is your son doing now? A: He’s doing incredibly well. He doesn’t really have any residual problems. He’s gaining a ton of weight. He’s amazing. Q: How much of your job is administrative vs. practice? A: I’d say about 80 percent of my job is clinical and maybe 20 percent is administrative. At this point, I’m the only full-time ER physician, so they need me more on the clinical schedule than administratively right now. I’ve got wonderful backup from Dr. [Michael] Boyle. He’s handling a lot of the responsibilities during a slow transition over the next couple of months. Port City Emergency Physicians also provides us with coverage 24 hours a day when I’m not here. We also have 18 hours of mid-level coverage per day, which includes physician assistants and nurse practitioners. in?

Q: What kinds of shifts do you put

A: I do work clinically four days a week and the rest of my time is admin-

istrative. I do a couple weekend shifts every month and a couple of night shifts every month because I find it very important to be familiar with the challenges of the off-hour shifts. We’re a 24-hour business.

group of well-trained emergency physicians. No. 2 is to maintain and improve the level of care we’re offering. We can actually handle and look after a variety of emergency complaints. I would like to encourage more of our community to utilize the services we’re offering and coming to our department. Q: Given that you’re the only ED in the county, who are your major competitors? A: Mainly the Syracuse hospitals. It really depends on the complaint. The pediatric services at Golisano Children’s Hospital, the VA hospital for veterans. Since we’re the only

Q: What are the challenges of running Oswego Health’s ED? A: I think the biggest challenge so far has been recruiting local talent, getting physicians who are trained in emergency medicine to want to practice here. Not a lot of doctors know about our facility. I think that part of that has been the departure of our last medical director. I think Dr. Boyle would agree with me. Q: What kinds of conditions do you typically treat? A: It’s a very satisfying community practice in that it’s classical medicine, all ages, all comers, traumatic injuries, cardiovascular complaints, strokes. You’re basically seeing the entire spectrum of emergency medicine here. We’re the only emergency department in the county, so we see a lot of patients who prefer to seek care closer to home. Q: A few years ago, there was a lot of concern over losing A. L. Lee Memorial Hospital’s emergency department in Fulton. How well has Oswego Health been able to absorb the overflow? A: Very well, I think. I know that volumes for every emergency department in the region have gone up. I can’t tell you how much of that is because of Lee Memorial closing, but I can tell you that we’re definitely accommodating the patients who choose to come here. We also have Fulton Urgent Care there, which provides a lot of care for the citizens of Fulton. Q: What are your goals for the Oswego Health ED? A: I’d like to recruit a stable

community hospital in the area, it’s kind of an apples to oranges comparison. Patients may choose to go to a tertiary center, but that’s because they’re looking for something specific. Q: Oswego County is geographically large and weather is obviously an issue when it comes to getting people to critical services in a timely manner. How well do you feel Oswego Health is addressing those challenges? A: We’re very blessed to have a very active and well-staffed EMS [emergency medical services] system and I’ve been involved with that for several years. Certainly the bad weather taxes the EMS system, but I think the bad weather usually sends more patients our way since making that long trip to Syracuse may take over an hour during a bad storm. But we have excellent EMS service. Q: Do you feel the local community is behind the hospital as an institution? A: I think so. I see a lot of clinics available for patient referrals. Oswego County Opportunities offers a lot of services and resources. I think so. I think so. Q: What effect has the Affordable Care Act had on your department, if any? A: By virtue of being in emergent care, not really, but I do know it’s more challenging to get patients into the hospital, and by that I mean in terms of hospital reimbursement. So patients might need to meet more criteria for the hospital to be reimbursed for their stay. So more of our documentation may be geared toward that than before. Q: What’s something the community should know about the Oswego Health Emergency Department? A: That we are here. We can provide a lot of services close to home. There are a lot of acute and emergent care issues that we can handle right here. We have a brand new facility, one of the newest in the greater Syracuse area. Also, if there’s anything they’d like to see in the emergency department, they can contact me at jemmons@oswegohealth.org.

Lifelines Name: Jerry Robert Emmons, director of Emergency Services at Oswego Health Education: SUNY Upstate Medical University; University of Sydney (Australia); Cornell University Afﬁliations: Oswego Hospital Organizations: American College of Emergency Physicians; American Medical Association; Onondaga County Medical Society Family: Married, one son Hobbies: Renewable energy (including waste vegetable oil as fuel); housing and food cooperatives; downhill skiing; ﬁshing; camping

l l A d a “Re In Good ” ! t I t u One ad, working all month. Abo Health Advertise in

Reaching health providers and consumers in the region

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

Reflexology Maps Out Pain Relief

William A. Graber, MD, PC Weight Loss Surgery

By Deborah Jeanne Sergeant

or some people accustomed to Western medicine, reflexology sounds a little too “out there” to try. But driven by desperation for pain relief, they give it a try and are surprised to find that the gentle to firm pressure a therapist places strategically at points on their hands, feet or ears does, somehow, dispel their pain. In general, reflexology, a modality of ancient medicine, is said to work because the nervous system’s connections can be stimulated on the hands, feet and ears. Practitioners have mapped which locations impact what parts of the body so that prodding a specific place on a foot can relieve pain in the back, for example. Claire Blum-DeStevens, an occupational therapy practitioner at a local rehabilitation center, completed a course in reflexology. “People think it’s voodoo, but it’s a great tool to help people,” she said. “You can send messages to that part of the body to decrease stress and increase circulation. What’s really important is it helps to relax the person. It releases endorphins, Friedberg which are good for healing the body.” Anna Friedberg, a registered nurse who’s certified in reflexology and practices the modality at Belladerma Wellness Spa in Brewerton, said that sometimes people ask for reflexology thinking it is a type of massage, but actually, it’s closer to acupuncture. “Our body works so well together that there are pressure points on the feet that correspond to organs and glands,” she said. When she locates a tender point, some clients say they feel a “good pain” but the twinge dissipates within a moment. Typically, practitioners push on the points with a finger or use a stroking motion, the same way practitioners did thousands of years ago. The ancient practice is based upon stimulating the nervous system. “With some patients, I’ll find the point sensitive to the technique and I tell them what it correlates to and they’ll say, ‘I’ve had problems with my heart’ or gall bladder or what have you,” said Camille McNally, licensed massage therapist at North Star Natural Health Center in Baldwinsville and Massage Studio 151 in Auburn. She

Community Information Seminar

Bariatric Surgery

Given by William A. Graber MD, FACS February 12, 2013 at 6:00 PM Medical Ofﬁce Centre – St. Joseph’s Hospital Campus 104 Union Ave., Suite 809, Syracuse NY

also operates her own business, Workplace Wellness Solutions. “Energy does flow through your body and go to your feet and hands,” McNally said. “Your feet have more nerve endings than any other part of the body. I think some patients have found relief from work done on their feet and that’s why they continue to get these treatments. If you work with those pressure points, you can facilitate healing.” The mapping on the hands and feet is pretty similar, though more spread out than that of the ear. Some people receive pain relief from a single treatment and the effect lasts hours, days or weeks. Others require more sessions and benefit from reflexology treatments cumulatively. Since reflexology causes no side effects except, possibly, discomfort on tender points, patients can choose it as a means of complementary medicine. It is important to talk with the practitioner about your current and past health issues, however. “There are points that you don’t want to work during pregnancy,” said Nikki Hai, licensed massage therapist owner of Hai Energy Massage in Auburn. “It should also be avoided shortly after a meal. Drink water after the session and extra water if you have kidney disease. For people with kidney or heart issues, the sessions should be short.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Touch: One of Life’s Essential Ingredients

kiss. A hug. A gentle touch. No, this is not a column about romance in anticipation of Valentine’s Day. I am writing instead, about a related matter: the importance of touching and being touched. Both are essential to our sense of well-being. This subject is especially relevant for those who live alone, because — on our own — we can be susceptible to touch deprivation. When that happens, we miss out on all the benefits of healthy human contact. I’m no expert in this area, but others are, and their research has shown that touch is absolutely essential for emotional and physical health and development. Studies conducted by the University of Miami’s Touch Research Institute revealed that touch can do so much good: it can help reduce pain, anxiety and depression; lower heart rate and depression; and even promote immune function and healing. But I don’t need a study to convince me of the value of touch and affection. I have my own “proof,” and it is revealed to me whenever I am touched or touch another. A friend’s warm hug can lift my spirits, a reassuring hand on my shoulder can hold the demons at bay, even a handshake can be affirming. Those who live alone can often unwittingly, almost unconsciously, ne-

glect this vital component of a happy, healthy life. It’s easy to do, especially if you have a tendency toward isolation or are without a significant other in your life. If that’s the case, I encourage you to take notice. Is touch absent in your life? Has it been weeks or months since you enjoyed the warmth of an embrace? When was the last time you felt the comfort of a soothing caress? Or, exchanged backrubs with a friend? Below are a few tips to “keep in touch.” They have worked for me, and it’s my hope that you, too, will benefit from incorporating positive, loving touch into your life. Become a hugger. It’s not for everyone, but if you’re not a hugger, consider becoming one. A little practice is all it takes. Hugging wasn’t natural for me. It wasn’t something I grew up with, so it felt awkward at first. I was forever bumbling the embrace, leaning left, when I should have been leaning right, knocking heads, or sending glasses askew. So years ago, I made a deliberate

decision to become a hugger. Intuitively, I knew I was missing out on this natural form of human expression. The good news? I got better at it over time, and life is sweeter, as a result. Volunteer to touch. The benefits of “loving touch” are not just for the ones receiving it. Those who deliver it also reap great personal rewards and satisfaction. If you look around, there are plenty of opportunities to administer positive, healthy touch to someone in need. Many hospitals have volunteer “rockers” for newborns, and nursing homes are often looking for volunteers to make personal connections with residents who may not have family nearby. Just an hour talking to a resident, while applying hand lotion, could improve someone’s day. To volunteer in this way can be a healing act of kindness, one that says we are in this life together. What soothes one soothes us all. Own a pet. Study after study has shown that petting a dog or gently stroking a cat can have a calming effect

KIDS Corner T

on people by lowering blood pressure and reducing anxiety. Again, I don’t need a study to validate my own experience. Petting my beloved springer spaniel Lillie (rest her soul) or snuggling with her on the couch had an immediate and relaxing effect. After a long day at the office, almost nothing was as grounding as a few minutes with my affectionate pooch. Owning a pet can help you feel connected, soothed, and joyful. Boy, do I miss her. Get in touch with yourself. Selfgratification for pleasure or with the goal to sooth, heal, or relieve tension is natural, and can be a healthy expression of self-care and an act of self-affirmation. When you “love the one you’re with,” something profound and restorative can result. Splurge for a massage. I read recently that, “Massage is to the human body what a tune up is for a car.” Among its many benefits, therapeutic massage can bring relief from anxiety, reduce stress, fight fatigue, and increase your capacity for tranquil thinking and creativity. If you are touch-deprived, this form of safe, non-intimate touch can refocus the body’s natural ability to heal and regenerate itself. You can make a conscious effort to bring more touch into your daily life and more happiness to yourself and those around you. Touch enhances bonding and gives us a sense of belonging and well-being important essentials for everyone, but especially for those who live alone. 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 workshop schedule, call 585-624-7887 or email Gwenn at gvoelckers@rochester.rr.com.

Flu Vaccine Rates in Children Remain Lower Than Expected

When Should You Keep Your Child Home Sick from School

hildren are bound to come down with the occasional cold or other viral illness, especially when cold weather keeps a whole class cooped up inside all day. Whether or not to keep your sick child home from school or daycare can be a difficult decision to make, and may also depend on your child’s school or daycare policies. A Mayo physician offers tips on how to decide. “Young children’s immune systems haven’t learned to recognize and resist most common viruses,” explains Robert Key, family physician at Mayo Clinic Health System in Prairie du Chien. “That’s why, until they’re 8 or so, kids seem to bring home everything that’s making the rounds at school. Children can typically have six to 10 colds per year.” “In general, children should stay home when they don’t feel well enough to participate in normal daily activities Page 8

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and lack sufficient alertness to learn or play,” Key says. He suggests that kids should stay home when they experience: • Vomiting twice or more over a 24hour period or being unable to tolerate normal food and drink, or both. • A temperature of 101 or higher. • Severe coughing or difficulty breathing. • Repeated bouts of severe diarrhea for at least a day. • Persistent abdominal pain (more than two hours). • Open sores on the mouth. • A skin rash or red eye from an undetermined cause. • Head lice or scabies. • Other contagious conditions such as strep throat, chicken pox, impetigo, etc. According to Mayo Clinic, the top four infectious illnesses that keep children home from school or daycare

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

his year’s flu season is in full swing with 41 states now reporting widespread illness. Unfortunately, not enough children are getting the flu shot even though health officials recommend that all children 6 months and older get the vaccine. According to a new study by researchers at Wake Forest Baptist Medical Center, less than 45 percent of children were vaccinated against the flu during a five-year study period. “Our research showed that one in six children under age 5 who went to an emergency department or clinic with fever and respiratory symptoms during the peak flu seasons had the flu,” said Katherine Poehling, associate professor of pediatrics and epidemiology at Wake Forest Baptist and lead author of the study, published in the online edition of the February issue of Pediatrics. “Many of those illnesses

could have been prevented by vaccination, the best known protection against the flu.” The researchers found that children less than 6 months of age had the highest hospitalization rates with flu. “Parents should include a yearly flu shot to protect themselves and their children,” Poehling said. “The best way to protect infants too young to receive the influenza vaccine is for pregnant women, the infant’s family members and contacts to get the shot, too.” The study, funded by The Centers for Disease Control and Prevention (CDC), reported population-based data on confirmed flu cases in children younger than 5 years old in three counties in Ohio, New York and Tennessee. More than 8,000 children seen in inpatient, emergency department and clinic settings were included during five flu seasons from 2004 through 2009.

are colds, the “stomach flu,” pink eye and strep throat. If your child’s illness seems to be more than just a common cold or flu, you may want to contact his or her regular health care provider to see whether the symptoms could indicate something more serious. The single most important thing

your child can do to prevent illness is to wash his or her hands thoroughly and frequently. The Centers for Disease Control and Prevention recommends that people wash their hands with soap and warm water for 15 seconds — about as long as it takes to sing the “Happy Birthday” song twice.

The Bad News?

More Kids Having Heart Problems Doctors: No such a thing as typical cardiology patients any more By Aaron Gifford

here is no such thing as a typical cardiology patient any more. In decades past, patients who saw specialists for heart problems tended to be over 55, obese, smokers, heavy drinkers or all of the above. That description may still make up half or more of the patient loads for area cardiologists, but on any given day there will also be men and women in their 20s and 30s as well as middle-aged and even elderly adults who are still in good health. This shift is attributed to several factors, explains, Andrew Weinberg, a clinical cardiologist with the Cardiovascular Group of Syracuse, which has practices in Fayetteville and Liverpool and is affiliated with St. Joseph’s Hospital Health Center. He said primary care physicians are increasingly referring their patients to cardiologists based on family history of heart problems and other factors. Secondly, patients who were part of the childhood obesity epidemic within the past several years are now, as young adults in their 20s and 30s, seeing heart doctors. In addition, a stronger emphasis on preventive care has patients with problems like sleep apnea seeing cardiologists for problems that are not yet linked to the heart but could be in the future. “Nowadays we look at multiple risk factors,” Weinberg said. “People do walk in and say, ‘I feel fine. I don’t know why I’m here.’ You can’t put people in a box. They could be a 35-yearold, a 65-year old or even an 85-year-old who works out at the Y six days a week.” Many primary care doctors feel blood pressure monitors and cholesterol tests don’t tell them enough about patients at risk for heart disease. In turn, those patients may be seen Weinberg by specialists who perform ultrasounds or stress tests that monitor the heart when the patient is exercising. Weinberg, who has been practicing for about 10 years now, said on most days he sees at least a few patients under the age of 55; his older colleagues told him that in their early days of cardiology they might go weeks without seeing a younger patient . On a weekday last month he treated a 19-year-old with a heart arrhythmia that was likely caused by heavy drug use. A few days before that he saw a 21-year-old who was born with a hole in his heart. That patient, who has a patch on his heart, spent 13 minutes on an incline treadmill with no difficulties what so ever. Major medical advances in the field and improved technology,

Jennifer Kowal’s third child, Claire Elizabeth (right), was diagnosed with hypoplastic right heart syndrome four months before being born. “It’s devastating when you hear something like this,” said Kowal. The mother later turned her pain into creating Mended Little Hearts, a group that meets weekly inside the Children’s Heart Center at Golisano Children’s Hospital at the University of Rochester Medical Center. Weinberg says, are allowing people who were born with congenital heart disease (birth defects of the heart) to live much longer. Valve replacements are much more durable than they were a decade ago, requiring fewer replacement surgeries to the patients and less wear and tear on their bodies. “Usually they didn’t survive past their 40s,” Weinberg said. “The technology has come a long way.” Weinberg’s evidence of younger cardiology patients is based only on his and his colleague’s observations; they did not have a breakdown by age readily available. Still, state and federal health care sources indicate that the cardiology spectrum covers the young and the old. According to its website, the Mayo Smith Clinic in Rochester, Minn., has been treating heart disease in children for half a century now. Annually, Mayor Clinic heart specialists record 5,000-6,000 visits by children and adolescents for congenital heart problems, performing 350 to 400 operations each year to repair defects.

Stroke on the Rise Among Children Story on next page

The National Institute of Health reported in 2010 that women are developing heart diseases at young ages — with significant increases in the number of women in their 30s and 40s who die of heart disease — and that trend correlates with increasing obesity rates. In its 2012 Statistical Fact Sheet Update, the American Heart Association reported the frequency of high blood pressure in children between the ages of 8 and 17 decreased from 1963 to 1988 but has increased in the past 24 years due to the prevalence of obesity. Between 1997 and 2004, hospitalization rates for that age group increased by 28.5 percent for cardiac and circulatory congenital abnormalities. The American Heart Association also reported that in 2012, 23.1 percent of adolescents surveyed (29 percent of girls, 17 percent of boys) indicated that during a seven-day period they had less than 60 minutes of physical activity that increased their heart rate and made them breath hard. Nationwide, February 2013 •

24.9 percent of adolescents used a computer for activities other than school work (video games or socializing) for three hours per day on an average school day. Last year, the obesity rate for children between the ages of 2 and 5 was more than 20 percent. That rate increased to more than 35 percent for kids between 6 and 11 and remained at above 30 percent for youngsters between 12 and 19, according to the American Heart Association. Weinberg said while it’s disappointing to see young adults in poor health due to the overeating and lack of exercise they had growing up, he’s happy to help them make lifestyle changes while their hearts are still strong. “There’s a huge correlation between weight, blood pressure, sugar level and cholesterol,” he said. “If you are 30 to 40 pounds overweight, you are going to develop blood pressure problems earlier in life. I tell them to make the lifestyle commitment. I don’t want to see you on meds or in the hospital for surgery.” Physician Frank Smith of Pediatric Cardiology Associates in Syracuse said Central New York has had pediatric heart doctors since the 1950s, and the advances in the field since then have been staggering. The majority of his group’s patients are treated for congenital heart disease, but there is still a significant number of patients who are treated for heart muscle infections, side effects caused by medications on the heart (certain types of chemotherapy used in cancer treatment, for example), pulmonary disease, blood disorders, obesity and high blood pressure. “A large number of children who have symptoms that may indicate heart disease (chest pain, dizziness, fainting, fluttering of the heart) are evaluated by us, and fortunately the majority will be found to have no heart disease at all.” Smith said nearly every heart condition can be diagnosed with ultrasound exams, and major birth defects of the heart can often be detected before birth. Nearly every heart condition can be treated with medication or with a specific operation or series of procedures. Open heart surgery on infants and young children has been replaced with the use of catheters. Children with particularly significant risk factors are referred to Smith’s group for cardiac evaluation. Obesity, high blood pressure, high cholesterol levels and the metabolic syndrome — all risk factors for development of early coronary artery disease, are “increasingly common” in children and adolescents, Smith said. “Sometimes they will demonstrate the early signs of coronary heart disease,” he said. “The challenge for all of us remains how to treat them. We are confronted with the difficult dilemma of getting children and their families to adopt a healthy lifestyle that includes a prudent diet, adequate exercise and avoidance of smoking.” “We would like to think that our ability to show the child and family that the child’s heart is already suffering from obesity and hypertension would immediately lead to a change in attitude and a willingness to change,” Smith added. “Unfortunately, it often does not. The solution is as complicated as the problem itself, and, at best involves the family, the pediatrician or family doctor, the school, and nutritionists as well as the pediatric cardiologist. This is perhaps the next horizon to reach in the field of pediatrics as well as pediatric cardiology.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

Stroke on the Rise Among Children

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Creating Smiles With a gentle touch

Boys aged 5 to 14 show increases of 51.6 percent for ischemic stroke By Deborah Jeanne Sergeant

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

ypically, most people picture older adults when they visualize a stroke patient; however, children and teens represent a growing population of stroke patients. By tracking hospitalizations for stroke between 1995 and 2008, researchers with the Centers for Disease Control found that boys aged 5 to 14 showed increases of 51.6 percent for hospitalization due to ischemic stroke and increases in subarachnoid hemorrhage for girls of the same age range. Other studies around a similar timeframe estimate that stroke among children and teens has increased by about 30 percent. Although the overall number of children experiencing stroke is small, a jump this dramatic indicates a serious problem. “In the past 15 years, the data show that cardiovascular risk factors are impacting younger people for predisposition for problems that can lead to stroke,” said Tarakad Ramachandran, medical director of the Crouse Stroke Program. “Among the younger people, we’re seeing more high blood pressure, obesity, cholesterol-related disorders and increase in tobacco and alcohol abuse.” Lisa Paul, founder and leader of Cope with Stroke, a nonprofit educational and support group in Liverpool, said that she has noticed more and more younger stroke patients instead of the typical retiree-aged stroke patients. Although changes in the way hospitals track and report stroke incidences could account for some of the increase, lifestyle factors likely contribute a far bigger share of the blame. “Getting kids active for an hour a day is good,” Paul said. “It’s so hard for some people, like parents who work a lot of hours and the kids are latchkey kids. Though it’s a computer game, the Wii can help.” Since many neighborhoods aren’t safe for even older children to play in unsupervised these days, “you have to look for alternatives,” Paul said. Parents need to lead the way by taking charge of their kids’ health, both for their own sakes and for providing a good example to their children by staying active and eating right. Instead of declaring a moratorium on screen time, offering a positive alternative can generate more enthusiasm for getting and staying fit. Enrolling children in school sports, community sports leagues and active extracurricular activities such as dance or martial arts lessons can get them moving, but informal, everyday exercise such as brisk walking, performing physically taxing chores and playing

games in the back yard can also help. “Obesity is a big issue with kids,” Paul said. In her former profession as a social worker, Paul saw firsthand the difficulty low-income families have in providing nutritious food to their families. “The food we gave them from the food pantry and on food stamps budget they wanted to go as far as it could, but it’s usually not so healthful,” she said. “It’s a diet that’s canned, has lots of pasta, and has few fruits and vegetables. You’re not intentionally increasing your children’s risk but eating that way is increasing it.” Generally, the more processing and preparation a food has undergone the greater chance that it is not healthful, and the closer it is to its natural state, the more nutrients a food retains. Youngsters with sickle cell disease have a 10 percent higher risk of stroke. Lipid disorders can also raise the risk, as can certain medications such as oral contraceptives. Some teen girls take them for controlling menstrual bleeding and not for preventing pregnancy; however, their impact on stroke risk remains the same regardless of why they are taken. Know the side effects of any medication your children take and discuss them with your healthcare provider.

Sign of Stroke The signs of stroke are the same in children as in adults. The National Stroke Association (www.stroke. org) offered the acronym “FAST” to help identify stroke and treat promptly, which helps increase the chances of a good outcome. Face: ask the person to smile. Does one side of the face droop? Arms: ask the person to raise both arms. Does one arm drift downward? Speech: ask the person to repeat a simple phrase. Is their speech slurred or strange? Time: If you observe any of these signs, call 911 immediately. “Note the time when any symptoms first appear,” sates the National Stroke Association site. “If given within three hours of the first symptom, there is an FDA-approved clot-buster medication that may reduce long-term disability for the most common type of stroke. There are also two other types of stroke treatment available that might help reduce the effects of stroke.”

What They Want You to Know:

Orthopedic Surgeons By Deborah Jeanne Sergeant

he American Academy of Orthopaedic Surgeons (www.aaos.org) states that the specialty is called orthopedics because “its specialists have treated children suffering from spine and limb deformities. The Greek roots of the word ‘orthopedics’ are ortho (straight) and pais (child). Early orthopedists often used braces or other forms of treatment to make the child ‘straight.” Today, orthopedic surgeons use a variety of treatments to help musculoskeletal patients of all ages. • “As spring sports start up — lacrosse, baseball, tennis — so too can shoulder pain. Shoulder injuries are common in overhead athletes [who participate in] swimming, tennis, baseball, [and] football, but can also occur

in overhead workers. This is especially true with heavy laborers or jobs, which require repetitive activities at work. • “It is important to remember to perform appropriate warm-up beforehand in order to prevent these injuries. • “You should also include hip and core strengthening exercises to alleviate stress on your shoulder with your local physical therapist or athletic trainer. • “Additionally, it is imperative to follow Little League pitching guidelines at young ages (littleleague.org) to prevent problems evolving in adolescence. • “Off-season season and conditioning programs vary between sports, but all programs should include an appropriate amount of rest regardless of the sport. Many of the youth injuries

are a result of overuse and can be prevented with an appropriate amount of shoulder ‘shut down’ in the off-season. • “They can still continue endurance and conditioning cardiovascular exercise while resting their upper body. The program should then offer a mix of gradual intensity and endurance build up to prepare for the season and conclude with sport specific drills. These can be prepared by your coach, physical therapist, or strength and conditioning expert. • “Please see your doctor if you start having shoulder pain that doesn’t go away with rest or becomes worse with daily activities. This could be the sign of something that can be treated with therapy, rest or temporary activity modification.” Bradley S. Raphael, Crouse Hospital orthopedic surgeon and partner at RSM Medical Associates, where he specializes in shoulder and knee problems. He is also a team physician for Syracuse University Athletics and many local high schools and colleges. • “I am frequently asked...what it takes to become a surgeon, or more specifically, an orthopedic surgeon... The stage is usually set in high school. Excellent academic standards, a high motivational level, perseverance, and boundless energy serve as the fuel to begin the rigorous process that will consume the next 14 to 15 years of your life. • “For some, my brother Brett and I included, the undergraduate years are not spent in the traditional pre-medicine track. A wrestling injury experienced by Brett during our undergraduate years at North Western was the catalyst sparking our interest both in medicine in general, and in orthopedics

more specifically. It was at that point that we initiated the process that led us to medical school. • “Even more frequently today, medical school students are often from diverse backgrounds that steered them later in life to medicine rather than following the traditional pathway that originates in high school. • “Two of my sons are examples of the more nontraditional entry into medicine having completed undergraduate programs outside the science domain. • “Regardless of the path that led to the medical profession, the road to orthopedics is filled with years upon years of education, countless hours in the clinical setting, endless studying, and myriad examinations intended to result in survival of only the fittest and best suited for the profession. Reflecting back on the more than 20 years of my orthopedic practice, in addition to the 14 years I spent in education, residency, studying, and examinations, I am glad that I chose the road to orthopedics because the harvest I have reaped is far greater than that which I have sewn.” Seth Greenky, orthopedic surgeon with Orthopedic & Spine Services at St. Joseph’s Hospital Health Center Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.

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My Turn

By Eva Briggs

Watch Out for Red Flags What your back pain is trying to tell you

hen doctors talk about red flags, they’re not referring to something that you wave around to incite a bull. They’re referring to history or exam findings that suggest a potentially serious condition. In the last month I’ve seen several patients with these red flag symptoms suggesting that their back pain was more than a typical back pain. Back pain is very common, and sprains, strains and minor nerve pinches are the predominate causes. While these conditions can be severe and limit activity, they usual are not associated with life-threatening conditions and are treated with measures to control the pain and time to permit healing. But what symptoms constitute red flags that something more serious could be happening? One way to think about red flags is to organize them by the serious conditions no one wants to miss.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

If you’ve ever had cancer — especially of the breast, prostate, kidney, lung, or thyroid — back pain could be due to metastatic spread to the spine. Age is important, too. Kids younger than 17 and adults over 50, especially in the absence of a typical history for back injury, could have more something serious going on. Pain that gets worse when you rest is worrisome, because typical sprains and strains improve with rest. Unexplained weight loss is a red flag because, in our society, few people lose significant weight without altering their diet or activity. Pain that doesn’t improve after four to six weeks of treatment can also be a danger sign.

Infection

Although infection of the spine and adjacent tissues is uncommon, it does happen. Fever, elevated blood count, and spine surgery within the previous year are risk factors. Recently an outbreak of fungal meningitis from contaminated spinal injections has been in the news. Infections can spread to the back from other sites: urinary tract infection, skin infections such as pressure ulcers over the low back or lung. And sometimes pneumonia or kidney infections start with back pain, and the back itself is OK. Immune system suppression by chemotherapy, cortico-

steroids or other immune suppressive drugs, or diabetes, places you at higher risk of infection.

Cauda equine syndrome

This is a rare condition caused by compression of a bundle of nerve roots in the lowest portion of the spine. This bundle resembles a horse’s tail, the literal meaning of “cauda equine.” It requires urgent surgery to prevent permanent nerve damage. Symptoms include incontinence, the loss of ability to control the bowels and/or bladder. There may be a loss of sensation, called saddle anesthesia, that affects the genital area and inner thighs, the parts of the body that contact a saddle when riding a horse. Both lower legs may become numb and/or weak.

Fractured vertebrae

Significant trauma — motor vehicle accidents or falls from a height — can break bones in the spine. In a person with osteoporosis, age over 70, or prolonged steroid use, even minor trauma can fracture vertebrae.

Abdominal aortic aneurysm

Your aorta is the large blood vessel from the heart that serves as the major pipeline distributing blood throughout the body. If it is weakened by high blood pressure, atherosclerosis (hardening of the arteries), or certain connective tissue diseases, it can leak blood or even rupture. The first symptom of a leak can be back pain. If an aneurysm ruptures, it may produce back pain but can turn into a catastrophic illness very quickly. Fortunately most back pain isn’t due to these serious conditions, but be sure tell your health care provider if you experience any of these red flags.

Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

Flu Season is Not Over Yet Here are some extra precautions for older people

e’ve all read about the severity of the current flu season. Boston declared an emergency, hospitals across the country are seeing patients in tents outside their emergency departments and we all probably know someone who has been laid up for a week with fever and aches and generally feeling lousy. But the flu could be especially severe for the 39.6 million older adults in the United States. Defined as 65 years or older, the group makes up almost 13 percent of the total population. Add

to that the number of people who care for an aging person — patient, parent or friend — and the impact on older people is even greater. What’s an older person or a caregiver to do? The three biggest rules, according to Andrew Duxbury, a geriatrician at University of Alabama at Birmingham (UAB) School of Medicine, are: • Get a flu shot — it’s not too late and it could help reduce severity of an illness. • Wash your hands regularly • Avoid crowds

Harpist Brings Healing to St. Joe’s Hospital By Matthew Liptak

he soothing sounds of the Celtic harp now resonate every Tuesday in the rooms of patients who are ill or dying at St. Joseph’s Hospital in Syracuse. The introduction of the instrument and its owner, Dona Wonacott, are the result of the work of two Franciscan sisters, Sister Laura Hackenberg and Sister Rose Ann Renna, who believe in the healing power of music. “It is pretty neat,” Hackenberg said. “We’re just thrilled. I have heard her play, not as a patient. She played for the chaplains and it really is just very soothing. Just something about the harp. Something about the tonal qualities of the harp.” It’s not only the three women at St. Joseph’s who believe in the positive results that music can bring to patients. The therapeutic value of music is well documented and the leadership at the hospital was eager to bring a new program to the hospital. It started late last year. “It really started with our CEO who at the end of 2012 said to me ‘I want you to start a music therapy program,’” Renna said, who is also a musician. According to harpist Wonacott, research proves that music can help reduce blood pressure, stabilize heart rate, reduce need for pain relievers and anesthesia, relieve anxiety and stress and even accelerate surgical recovery

and physical healing. “The harp has a particular resonance to it,” Wonacott said. “It’s an acoustic instrument so when you pluck the strings the vibration of the harp kind of works with the resonance and vibration of the human body. It has a very special effect.” Wonacott said she comes in for two hours each Tuesday and the list of patients for her to play to is already provided. Patients have the ability to refuse but most have welcomed her musical company. “Many of them have been very, very appreciative,”Hackenberg said. “Many of them have given comments that ‘Oh, I feel peaceful,’ or they’ll say ‘Oh, can you come back?’ All wonderful and positive responses. “We wish that we could serve every patient in that capacity of providing therapeutic music but...there’s three areas of focus. One is end of life care, if a patient desires or a family desires some soothing music at the bedside. The second area would be if the patient is experiencing pain issues. They’re very much distracted by their pain and the music can be a way of distracting them from that. It changes a little bit of their situation. The third one is if a patient has some dementia and agitation that might go along with that.” Though the St. Joseph’s program may be new, Wonacott’s involvement with the harp isn’t. She has a Welsh

Dona Wonacott plays to patients at St.Joe’s every Tuesday. She is a certiﬁed music therapist. background and used to attend highland games with her family. That is where she first learned of the instrument. She began playing it as an adult in 1990 and now plays both as a soloist and in a group. The harpist became a certified music therapist by studying through

February 2013 •

the music for healing and transition program. The program teaches the use of music as a therapeutic service to the patient and not as entertainment. Wonacott emphasized that she practices therapeutic music and not music therapy.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

SmartBites

By Anne Palumbo

The skinny on healthy eating

Beat the Blues with

Spinach

of vitamin A (a workhorse vitamin essential for growth, eyesight and healthy skin); it’s super low in calories, fat and cholesterol; and it’s a very good source of fiber, iron and calcium. The downside of spinach? It contains oxalic acid, which, when consumed regularly by some people, can lead to irritation of the digestive system, stomach and kidneys — as in, stones, gallbladder problems and gout. Also, this acid may interfere with the absorption of calcium. For the majority, however, oxalic acid poses no problem.

Helpful tips

lthough I adore winter, I confess to wilting in February. As the snow piles higher, the sky grows grayer, and the indentation on my couch becomes permanent, I know I’m not my usual chipper self. Aware of this personal lull, I make a concerted effort during this time to eat foods that are particularly high in folate and vitamin B12, two B vitamins linked to mood. Studies have shown that low blood levels of these vitamins may play a role in depression, especially since both are precursors to serotonin. Serotonin, as many know, is the “feel-good” neurotransmitter that keeps us happy. That said, I cover my B12 base with salmon, fortified breakfast cereals and dairy products; while I take care of folate with beans, lentils, asparagus, and spinach, a personal favorite. I’m keen on this green for its high concentration of folate (and so much more). But let’s begin with folate. In

a word, spinach is a folate superstar, providing more folate per cup than any other dark leafy green. Whether consuming fresh or frozen, you can fulfill over half of your daily needs with a single serving, which, according to some research, is enough to boost serotonin. Spinach is also loaded with vitamin K, a vitamin that helps blood clot, prevents calcium build-up in tissues (a condition that can lead to cardiovascular disease), and promotes bone health. Go, Popeye! More good reasons to saddle up to this superfood: It’s an excellent source

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Store fresh spinach (wrapped tightly in a plastic bag) for up to 5 days in the refrigerator. Wash fresh spinach just prior to consumption, but not before. Although bagged spinach is pre-washed, another rinse is recommended. To get the most nutritional bang from your spinach, steam it and then combine it with a food high in vitamin C — such as garlic, lemon or mandarin oranges — since this combination promotes the optimum absorption of iron.

Healthy Spinach Gratin Serves 4 to 6

2 10-oz. pkgs. of frozen chopped spinach, thawed and drained 1 tablespoon olive oil 1 small onion, chopped 3 garlic cloves, minced 1 8-oz. pkg. sliced mushrooms 1 tablespoon whole wheat flour 2 tablespoons low-fat milk 2 teaspoons fresh lemon juice 1 teaspoon dried basil

½ teaspoon each: salt, pepper ½ cup shredded cheddar cheese (low-fat, if desired) 2 tablespoons whole wheat bread crumbs or chopped nuts Preheat the oven to 375 degrees. Lightly oil an 8 x 8-inch baking dish. Sauté onion and garlic in olive oil, over medium heat, until soft – about 5 minutes. Add mushrooms and sauté 5 minutes more, stirring occasionally. In a large bowl, toss together the spinach, mushroom mixture, flour, milk, lemon juice, basil, salt, pepper, and shredded cheese. Spoon into the prepared dish in an even layer. Sprinkle the bread crumbs or nuts over the top. Bake until heated through, about 25 to 30 minutes. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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So many products feature “gluten-free” labels that some wonder whether gluten is unhealthy By Deborah Jeanne Sergeant

oticed so many food packages labeled “gluten-free,” along with “fat-free” or “cholesterolfree” that you wondered what’s so wrong with gluten? Actually, nothing, say area experts. Wheat, rye and barley naturally contain the protein gluten and most people have no problem eating these grains. Some people blame gluten intolerance, also known as celiac disease, for stomach upset after consuming a grain product; however, a true diagnosis may be reached only by a blood test and endoscopies administered by a gastroenterologist. Some people have varying degrees of sensitivity to gluten, but not celiac disease. Wyman Celiac disease isn’t an allergy, but “is definitely an autoimmune disease,” said Ruth Wyman, a retired public health nurse for the City of Syracuse and president of the Central New York Celiac Support Group in Syracuse. “People with it cannot tolerate eating wheat, barley and rye.” The symptoms of celiac disease include intestinal distress, bloating, diarrhea, cramping, skin irritations, ear pain, joint pain and fatigue. “People with celiac must avoid eating gluten to avoid these symptoms,” Wyman said. National Digestive Diseases Information Clearinghouse estimated that about two million Americans have celiac disease. It’s not entirely clear why celiac has become so widespread. Unlike a food allergy, celiac disease does not cause reactions from casual contact with the food, only consumption. Non-celiac gluten sensitivity has no genetic or autoimmune connection, but it does involve damage to the small intestine. People sensitive to gluten have some symptoms like celiac, but there is not a test that can confirm it. By trial and error, these patients discover that by limiting or eliminating gluten, their symptoms diminish. Avoiding gluten is not as easy as it would seem because some processed

foods use wheat flour as a binder: salad dressing, marshmallows and ice cream. Oats processed by a company that also processes wheat may be contaminated by gluten because of their shared facility. “It can be a very difficult diet to follow,” Wyman said. “You have to be so careful about everything.” Her husband was diagnosed with celiac 15 years ago, which complicated both home cooking and eating out. Some people believe that going gluten-free is a good way to lose weight; however, Wyman disagrees. “It’s gotten crazy,” she said. “I hear this a lot. Following a gluten-free diet is not a healthful diet for most people. It’s not necessary for people in general to eat gluten-free. You lack a lot of vitamins you don’t get in regular food.” Many celiacs take vitamin and mineral supplements to help replace those they miss in wholesome foods like bread. “Gluten-free” does not necessarily mean healthier. Many gluten-free goodies for celiacs have little nutrition and many fatty, high-calorie foods are gluten-free. “A lot of gluten-free foods have more fat content,” Wyman said. “If you don’t have to be on the diet, don’t be.” Though some people do lose weight on a gluten-free diet, it is not because gluten is fattening. “If well people replace glutenbased flour with corn starch, potato flour and rice flour, they won’t lose weight because it’s swapping one carbohydrate for another,” said Nikki Hai, who heads the Auburn branch of Raising Our Celiac Kids, a national organization. “But if they switch gluten products for more fruits and vegetables, they may lose weight. It is difficult to maintain, so people who aren’t celiac tend to go right off it.” Hai’s daughter was diagnosed with celiac at 17 months old, which has given her first-hand knowledge of the challenges of living with celiac disease. “As a fad diet to lose weight, I don’t see it working unless they’re completely cutting out the white starches,” Hai said. “If they cut out processed foods, I can see it as helpful to lose weight.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Less than 25% of Americans Walk for More Than 10 Minutes

any people in the U.S. do not walk, bike or engage in other forms of active transportation, missing an important opportunity to improve their cardiovascular health, concludes a new study in the American Journal of Preventive Medicine. Active transportation refers to any form of human-powered transportation, most commonly walking and cycling, but also using a wheelchair, in-line skating or skateboarding. The study’s researchers suggest active transportation is “an untapped reservoir of opportunity for physical activity for many U.S. adults.”

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Using cross-sectional data from the 2007–2008 and 2009–2010 cycles of the National Health and Nutrition Examination Survey (NHANES), Gregg Furie, a physician with the Yale School of Medicine and his colleague, Mayur M Desai, were surprised to find that less than one quarter of U.S. adults in a nationally representative sample reported walking or bicycling for transportation for more than 10 minutes continuously in a typical week. “That’s a pretty low rate,” said Furie, “and we need to increase that level.” People who engaged in active transportation on average had lower

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

body mass indexes and lower odds of hypertension, compared to those who didn’t. The study identified reasons why government policies and infrastructure, along with “built environment interventions,” should allow and encourage active transportation. Communities that do so may promote dedicated bicycle lanes and routes, educate residents about bike and motor vehicle road-sharing, provide bicycle storage, and integrate public transportation for both pedestrians and cyclists. The U.S. has one of the lowest rates of active transportation in the world,

said James F. Sallis, chief of the division of behavioral medicine at the University of California, San Diego. “This is not an accident. U.S. transportation policies and funding prioritize travel by car, unwittingly discouraging active travel,” said Sallis, who is also director of active living research at UCSD. “This situation is made worse by land use and zoning policies that separate residential and commercial zones to the extent that it is not feasible to walk for daily needs. These new findings point out how transportation policy is health policy.”

Immediate Care in Manlius: 5 Years Serving the Community

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ER doctor who started center plans to open other facilities in Onondaga County By Aaron Gifford

om Chmelicek knew he was taking a significant risk when he left his job in the emergency department of St. Joseph’s Hospital Health Center in January 2008, but his vision was too exciting to ignore. The physician wanted to run a business that was unlike any other practice in the Syracuse metro area. “When I was thinking about the idea, there was this empty strip mall,” he said of the southern Manlius location at the intersection of Cazenovia and Enders roads. “When that plaza got built, it became too much of a coincidence not to put something there.” Just before its fifth anniversary in January, that business, Immediate Medical Care of CNY in Manlius, tallied 13,500 patients. Chmelicek says it is the only walk-in doctor’s office Chmelicek in Onondaga County that is not affiliated with a hospital or large group practice. He set up shop in direct competition with the Northeast Medical Urgent Care in Fayetteville and immediately met families who traveled there from Madison County. The staff regularly sees patients from Fayetteville, Manlius and DeWitt as well as more rural places like Pompey, Fabius, LaFayette, Cazenovia, DeRuyter and Chittenango. “There’s a lack of primary care doctors,” he explained. “I’m not sure how many of them around here are accepting new patients. For the flu and other ailments, where are you supposed to go?” In the beginning, Chmelicek was almost always on the job as Immediate Care operated from 9 a.m. until 8 p.m. Monday through Saturday and 1 p.m. until 7 p.m. Sundays, but he has since been able to trim his hours slightly with the help of one additional fulltime physician and three part-timers, all of which have their own practices on the side. All told, counting nurses and clerical workers, the facility employs 25 people. “I’m happy to say much of the staff has been here from day one,” he said. “It is a true family atmosphere,” added Patty Palladino, the office manager. The business sees around 35 patients a day who have non-life threatening illnesses or injuries, with the monthly average at 800-1000 patients, Palladino said. At least one doctor, one nurse and one technologist are on site at all times. The facility is also equipped to perform X-rays and lab work, including blood work, at all times. Chmelicek said his practice is different than other walk-in facilities in that he does not have physician assistants on staff; every patient is seen by a doctor. “I’m old school in that regard,” he said. Chmelicek was born in Canada and attended medical school there before his career led him to practice in

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Immediate Care of CNY is different than other walk-in facilities in that it does not have physician assistants on staff; every patient is seen by a doctor. “I’m old school in that regard,” said Tom Chmelicek, the physician who started the business ﬁve years ago. Mississippi and Louisiana. He’s lived in Central New York for 14 years now. While he certainly respects the work emergency room doctors do, he never had long-term plans for that kind of a career and said it’s not as exciting as most people think. “I don’t regret leaving,” he said. “It can be satisfying, but you spend a lot of time getting people through red tape. People without insurance, they don’t have anywhere else to go and they’ll have to wait all day. The ER is 95 percent boredom and 5 percent sheer terror.” He added that many patients and other providers enjoy engaging him on his experiences in Canada and socialized health care. While it’s an interesting topic, he steers clear of anything too political, stressing that the health care systems in both counties have pros and cons. Here we have a sizeable chunk of the population waiting all day in an emergency room for basic care, while there most people wait six to nine months to see a specialist, he said. “I get it all the time — people ask about it or want to debate it,” he said with a laugh. “I tell them, in general, Canadians are trained to wait.” Chmelicek said walk-in places like his are fairly common in the south but still relatively sparse in Upstate New York. Still, he believes they will increase in numbers as the number of patients continues to outpace the number of available primary care physicians and family doctors. Nationally, there will be 45,000 “too few” primary care physicians by the year 2020, the U.S. Department of Health and Human Services reported

in a 2011 study on the shortage of health professionals. It said more than 65 million Americans live in communities where there are not enough doctors to accommodate basic medical needs (Primary Care Health Professional Shortage Areas). And 43 percent of Americans who do have regular physicians reported not having access to same-day or next-day appointments. Moreover, 63 percent of Americans who do have regular physicians indicated that they had difficulties getting medical care on nights, weekends or holidays without going to the emergency room. In 2010, 20 percent of Americans waited six or more days to see a doctor when they were sick, according to the study. Those statistics show there are growth opportunities for places like Immediate Care of CNY. According to the Urgent Care Association of America, there are 8,700 urgent care facilities in the United States, and that number is increasing by about 300 per year. The association estimates that between 71 million and 160 million people visit these types of medical care offices annually. “Just in Fayetteville and Manlius,” Chmelicek said, “there are more than enough patients for all of us [urgent care centers].” If business remains strong at Chmelicek’s 3,000-square-foot facility, he’ll set his sights on opening other locations in Onondaga County, possibly one in the city of Syracuse. “I love the niche that we have and I’m hoping that we’ll be celebrating anniversaries 25 years from now,” he said. February 2013 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 17

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

Parenting By Melissa Stefanec melissa@cnyhealth.com

Mommy’s Resolutions I

’m a little behind on my resolutions, but I am also a little behind on laundry, home repairs, paper work and, well, everything. As we all bravely venture into 2013, I would like to take time to project. Reflecting doesn’t change anything, but projecting does. What sort of mother can I be in 2013? Here are my parent pledges for the coming year of child rearing.

I pledge to be busy This is more of an inevitable acknowledgement than a pledge. Since becoming a mother, I have so little time. I’m constantly frustrated by this. To be frustrated by the inevitable is like crying over lobbed toddler food. I know I will be busy and not have enough time to do it all, but this year I pledge to be all right with that. It’s not changing, so I will have to accept it and manage.

I pledge to sit and sleep See the above pledge. I know I will be busy, but no one wins when you burn the candle at both ends. I need to continue my commitment to sleep (sweet, beautiful sleep), but I also need to learn when to sit down and call it quits. The dishes aren’t going anywhere, but my patience and disposition often are.

I pledge to be patient Speaking of patience, I need to exercise more of it. Being a parent demands a lot of patience. I’m typically very patient with my daughter Stella, but a little less patient with others. I need to exercise more patience with people that I didn’t birth. When you put so much into one person, it’s a real challenge to find more to give. However, exercising more patience will pay me back in kind.

I pledge to only potty train if she is ready I promise that 24 months is just a number. She may be ready before or after that age, but I will listen to her cues, not my internal ones that want to stop buying and disposing of diapers.

I pledge to stick to my guns Timeout is going to be my new best friend. I never thought punishing

my own child would be so difficult. Watching her get worked up hurts me, but it has to hurt less than a burnt hand on the stove or her poking my eye out with her brute baby strength. I will not threaten. I will follow through, and I will tell myself it gets easier after a little legwork.

I pledge to drop the guilt Yeah right. Fine. I pledge to drop a minuscule amount of mommy guilt. That’s all any mother’s mind can part with. I will stop worrying that my daughter is going to recess on the spot when I am too tired to provide constant enrichment. I will convince myself that a half hour of television isn’t going to stunt her for life. I will recognize that occasionally losing my temper isn’t going to end up as fodder on some expensive therapist’s pad.

I pledge to count to 10 This mommy is going to work on her own temper tantrums. That means raising my voice less, talking to Stella in a respectful tone, and being the person I want my daughter to be. This pledge will likely be broken, but I will pledge, and pledge again, until I have it almost right.

I pledge to set aside time for goofiness I already started this one. I made my husband promise we would set aside 15, uninterrupted minutes each evening to play together as a family. This means no one is doing dishes, folding laundry, checking email or distracted. We will all play as though we are 18 months old.

I pledge to be a great mom, wife, family member and friend If I can’t do these things, everyone loses. I want to make 2013 my most positive year yet. This means I will forgive myself, my daughter and everyone else in my life. Fail, amend and move on people!

SUNY Upstate’s NEALS: Groundbreaking Work to Find Cure for ALS Worldwide consortium based at SUNY Upstate conducting various trials to cure ‘Lou Gehrig’s Disease’ By Matthew Liptak

eremy Shefner, professor and chairman of neurology at Upstate Medical University in Syracuse, saw a need almost 20 years ago that desperately needed to be filled. The physician saw there wasn’t a viable outlet for clinical trials of drugs that could potentially treat ALS in the United States, except through pharmaceutical companies. He, with his colleague Merit Cudkowicz, responded in a big way. They started the Northeast ALS Clinical Trials Consortium (NEALS), now the largest ALS consortium for clinical trials in the world. It is administered jointly out of Upstate Medical University in Syracuse and Massachusetts General Hospital in Boston. Amyotrophic lateral sclerosis (ALS) — also known as “Lou Gehrig’s Disease” — is a degenerative disease that affects nerves in the brain and spinal cord. Degeneration of these nerves leads to loss of control of muscle movement in the arms and legs as well as those that control speaking, breathing and swallowing. ALS usually leads to death within three to five years. “When I was a resident I took care of a number of ALS patients and I thought it was just a really devastating disease,” Shefner said. “The patients were very compelling and there was just so much unmet need that it became, first, one of the things that I was interested in; and, as it’s gone on, it has really become the main focus of my career. “My partner Merit Cudkowicz, we were both at Harvard Medical School at the time in the mid-90s and felt that a network of academic neurologists committed to finding better treatments could increase the speed of the trials as well as the number of drugs that could be tested. Such a network could evaluate drugs that it might not be profitable for a pharmaceutical company to test. We started with seven New England sites and as we became more successful we just gradually added more sites. Now most of the ALS clinical centers in the U.S. are members.” Now NEALS has more than 100 member sites in North America, Ireland and Israel. It wasn’t easy building such a thriving medical consortium, Shefner said. “It was a lot of hard work,” he said. “First to get people motivated to be in a group like this and then we got our first NIH [National Institutes of Health] grant. That was in the late-90s and once we got our first project going we kept building on projects since they came up. We’re participating in five or six clinical trials right now. We just get busier and busier.” Those clinical trials involve millions of dollars, hundreds of people, and drugs that carry the hopes of both doctors and patients. But despite so much riding on the outcome, there is no guarantee of success. The results for a clinical trial of a drug dexpramixole looked promising just recently before the results were revealed.

“I’m very hopeful about that trial,” Shefner said before the results were released. “I think it’s very possible that that will be a significant advance, but if not we keep on trying.” The results — negative, as it turned out — were released to the disappointment of everyone involved. One woman whose husband was in the study wrote on an online forum that they had hoped dexpramixole was “an answer to their prayers.” Shefner said, “The results were very disappointing. My main reaction is that we just have to keep working, and that with every failed trial we learn something that will help us in the future.” This is just one example of the up and downs that those involved with clinical trials have to deal with. But with medical advancement comes new trials and new hopes. And not all of these trials involve drugs. Kirsten Gruis, an associate professor of neurology at Upstate Medical University, is working on an electronic pacemaker for the diaphragm of ALS patients. “It’s an implanted electrical device to provide electrical stimulation to the diaphragm muscle in an attempt to keep the diaphragm muscle stronger longer,” Gruis said. “The main reason most patients succumb to the disease is impaired breathing function. They just lose the ability to breathe well enough to move enough air to sustain their life. It is happening because the breathing muscles get weak and the diaphragm muscle is one of the main breathing muscles. If we can keep the diaphragm muscle stronger longer it’s a really good potential way of improving a patient’s survival.” Gruis said that within a month or two a clinical trial will start on the pacemaker involving 20 different sites, the main one being Upstate Medical University. The trial is funded by the ALS Association and the Muscular Dystrophy Association and Synapse Biomedical, the manufacturer of the device. “Relative to other therapies that have been studied with preliminary proof-of-concept studies, no other pill or device has demonstrated as much benefit in initial studies as the diaphragm pacer,” she said. Positive or negative outcome, the work goes on. Shefner hopes that five to 10 years from now NEALS will have several positive trials behind it and the 20 to 30 thousand ALS patients in America (and more around the world) will be that much closer to a cure. Certainly failure will come, too, but the researchers at NEALS will make the best use of the silver linings that they can. “It is hard, but we learn from negative trials as well, and try to put that to good use in new trials,” Shefner said. “Our patients are very involved and push us to keep trying as well.” For more information on NEALS go to www.alsconsortium.org/.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Golden Years Preventive Health Helps Seniors Stay Healthy Doctors: Early detection is key in successfully treating many diseases By Deborah Jeanne Sergeant

f you live by the adage, “If it ain’t broke, don’t fix it,” you could be endangering your health. Preventive medicine can help seniors stay healthier as they age. Many in your parents’ generation took it for granted that they would experience mental decline as they aged, but times have changed — early interventions can help treat problems that were once untreatable. Sharon Brangman, gerontologist with SUNY Upstate, encourages seniors to have a “mini, mental status examination to do a quick screening of memory and establish a baseline so if there are any memory problems developing in subsequent years, you can compare,” she said. “Memory loss that is associated with a problem such as dementia can start very subtly. It’s important to look for changes over time.” Many changes in health that could be Alkins perceived as “old age” disorders, such as memory problems, could really be prevented or minimized with proper health care. This starts with an annual physical to make sure your body is functioning as it should and to address any concerns you may have. It’s also important to receive vaccinations for tetanus every 10 years, flu every fall, pneumo vaccination every five years, and shingles around age 60 to 65.

“All of these prevent diseases that can be very debilitating to an older person,” Brangman said. “Pneumonia, for example, can be harder to fight if you’re older, especially if you have chronic lung disease, heart disease or diabetes.” Screening can also help maintain your health, including colonoscopy for detection of colon cancer, bone density scan (especially for women), PAP smear for cervical cancer, and mammogram for detecting breast cancer. Blood work can ensure the right levels for cholesterol, sugar, thyroid function, vitamin D and B-12. Follow your doctor’s advice for the necessity and frequency of screenings and exams and for taking any extra steps for caring for your health. Brangman “Have a medication review annually,” Brangman said. “Every single medicine, whether prescription or over-the-counter, bring it in to your physician to review it. Many get started on prescriptions and no one looks at whether they continue to need it.” Ask your physician about screening your vision and hearing during your annual physical. If your hearing doesn’t seem to be as sharp as it used to be, you may not need hearing aids. “Sometimes, hearing can be decreased by ear wax blockage,” Brangman said.

Doctors should clear deep blockages. If you try to do so at home, it’s easy to push the wax farther into the ear canal and damage year ear. Vision changes can happen gradually. As you compensate for changes, such as not driving at night, you may not realize how poorly you see. “If you can’t see well, you might fall, not drive well, not give yourself medication safely,” Brangman said. “You might become isolated socially if you can’t hear well and it can lead to feelings of depression.” Even if your vision seems fine, an eye test can screen for diabetes or hypertension, glaucoma, macular degeneration, all conditions that may not manifest readily observed symptoms. If you feel you’re unstable on your feet, ask your doctor about an annual fall assessment. “A lot of older people are admitted to the hospital because of a fall,” Brangman said. During a fall assessment, your doctor may ask about any falls you have experienced and how steady you feel as you stand, walk and climb stairs. You may also discuss your prescriptions, as many medications can make you dizzy or change your blood pressure when you stand up. This can make you more prone to fainting and falling. Day to day, you can do plenty to maintain your health at home, such as exercise. You don’t have to run marathons. Just start walking for a few minutes a day until you’re walking for 30 minutes. Or try picking up an active hobby like ballroom dancing.

Making sure you eat a balanced diet is important, with plenty of fruits and vegetables, whole grains, and lean sources of protein and calcium. Get enough quality sleep. Disturbances in sleep plague many older adults, either not enough sleep, or nonrestful, fragmented sleep. Lack of proper sleep can contribute to a host of health problems and diminish the quality of life. “In order to make sleep better one needs to know what the cause of the sleep disruption is,” said physician Stephan Alkins, who specializes in pulmonary and sleep medicine at Crouse Hospital. He pinpointed poor sleep behaviors, such as excessive napping during the day, drinking alcohol or caffeinated beverages in the afternoon or evening, sedentary lifestyle, and doing activities such as watching television or paying bills in bed. “Elderly individuals often take multiple medications for their medical problems,” Alkins said. “Many medications can cause sleepiness which lead to napping during the day. “Sometimes changing the time of take these medications can help with daytime alertness. Some medications, such as diuretics, will fragment sleep and these medications should be taken during the day to minimize the need to get up at night to use the bathroom.” Pain from conditions such as arthritis can also hamper good sleep. Try taking analgesic medications before going to bed to promote better sleep.

Medicare Preventive Services: What’s Free, What’s Not By Jim Miller

edicare covers a wide array of preventive services to help you stay healthy, but it’s important to know which services are totally covered, and which ones will generate some out-of-pocket costs.

Free Services

Thanks to the Affordable Care Act, original Medicare now offers many preventive health services completely free to beneficiaries. Preventive services include various exams, lab tests and screenings that help find health problems in their earliest stages when they’re easier to treat. They also include a number of vaccinations and programs for health monitoring, as well as counseling and education to help you take care of your own health. Here’s a quick rundown of the different Medicare preventive services that won’t cost you a cent, along with the eligibility requirements you’ll need to meet to get them. • Wellness visits: All Medicare beneficiaries are eligible for two types of Page 20

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preventive wellness visits — one when you’re new to Medicare and one each year after that. But don’t confuse these with full physical examinations. These are prevention-focused visits that provide only an overview of your health and medical risk factors and serve as a baseline for future care. • Colorectal cancer screening: The fecal occult blood test, flexible sigmoidoscopy or colonoscopy is available to all beneficiaries aged 50 or older. • Mammograms: All women with Medicare aged 40 and older can get a free breast cancer screening mammogram every year. • Pap tests and pelvic exams: These cervical and vaginal cancer screenings are available every two years, or once a year for those at high risk. • Prostate cancer screenings: Annual PSA blood tests are available to all male beneficiaries aged 50 and older. • Cardiovascular screenings: Free blood test to check cholesterol, lipid and triglyceride levels are offered every five years to all Medicare recipients.

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

• Diabetes: Screening available twice a year for those at risk. • Bone mass measurements: This osteoporosis test is available every two years to those at risk, or more often if medically necessary. • Abdominal aortic aneurysm screening: To check for bulging blood vessels, this test is available to men aged 65 to 75 who have ever smoked. • Vaccinations: An annual flu shot, a vaccination against pneumonia and the hepatitis B vaccine are all free to all beneficiaries. In addition, Medicare also offers free smoking cessation counseling; medical nutrition therapy to help beneficiaries with diabetes or kidney disease; depression screenings; alcohol screening and counseling; obesity screening and counseling; annual cardiovascular risk reduction visits; sexually transmitted infection screening and counseling; and HIV screenings.

Cost-Sharing Services

Medicare also offers several other preventive services that require some

out-of-pocket cost-sharing. With these tests, you’ll have to pay 20 percent of the cost of the service (Medicare picks up the other 80 percent), after you’ve met your $147 Part B yearly deductible. The services that fall under this category include digital rectal exams for prostate cancer, glaucoma tests and diabetes self-management training services. For detailed information on all Medicare preventive services see medicare.gov/share-the-health, or call Medicare at 800-633-4227 and ask them to mail you a free copy of “Your Guide to Medicare’s Preventive Service” (publication 10110).

Medicare Advantage

If you have a Medicare Advantage plan, you’ll be happy to know that all Advantage plans are also now required to cover the same free preventive services as original Medicare. Jim Miller writes the column Savvy Senior for In Good Health.

Upstate Plans ER Just for Seniors When it opens at Upstate University Hospital’s Community Campus, the senior emergency department will be the first of its kind in the area By Matthew Liptak

magine having an emergency and instead of coming to a place that is loud, bright and frenetic for help you find yourself in a peaceful space where the sound-absorbing ceiling tiles and curtains keep the noise down, lights are adjusted to the time of day and a staff trained specifically in geriatrics is there to see to your needs. It is the vision of Jamie Ciaccio, the chief and director of the department of emergency medicine at Upstate University Hospital’s Community Campus. If all goes well the new senior emergency department will be a reality by the late spring or summer of this year at Community Campus, the first of its kind in the area. He is supported in the endeavor by his boss, the hospital’s chief administrative officer, Meredith Price. “One of the things we’re focusing on in our emergency medicine [is] creating a special subset for seniors who do come through or visit the emergency room,” said Price. “We want to make sure that they are treated in a way that gets them sent back out as functioning at the right lifestyle that they came in at,” Price said. “Oftentimes the elderly do come to a hospital...they tend to quickly decline in terms of their abilities. Discharging them becomes difficult because they are not able to quickly return to the lifestyle they are used to.” Says Ciacco: “What happens is the person comes into the senior emergency department, as we call it. I don’t like the word geriatric because geriatric implies old and presently 65 to 70, 72 is not necessarily old. These people are still climbing high peaks and golfing and swimming and sailing and doing tons of things so we call it the senior ED.” The change is a paradigm shift, Ciaccio said. Before the new senior emergency department, older patients were routinely admitted to the hospital because it was easier, faster and got the patient out of the department quicker. Now, because of cost savings and a growing recognition that the hospital isn’t necessarily the best place for a senior to recuperate, the emergency staff works with the patient’s primary care physician and others to see if recuperation at home is possible. “The physicians and nurses will all have specialty training in geriatrics so that we’re more in tune to the special problems of the geriatrics,” Ciaccio said. “We will have social workers and case managers that will help to coordinate outpatient

care. “An example I commonly use is the 72-yearold woman whose mild diabetes, mild high blood pressure, mild dementia, she’s capable of living at home with some family assistance. She comes in. Rather than admit her [for pneumonia] and have her go down hill we give her IV antibiotics in the ER. We set up two more doses of IV antibiotics at home through visiting nurses. We have the pharmacy deliver her medication so she doesn’t have to go out and get it. We talk to her primary care physician. We discharge her with an appointment in hand rather then say ‘oh just call your doctor and get an appointment.’ This patient is returned to her home environment where she is comfortable. The country saves money. Her quality of life is improved and it’s sort of a win-win all the way around.” Ciaccio didn’t invent the idea of an emergency room just for seniors. The idea had its genesis from a journal article done around 2007 by a doctor who happened to specialize both in emergency medicine and geriatrics. Ciaccio is the first to bring the concept to Central New York though. “This has been an initiative that’s been going on for about the last five to seven years. After her article came out a number of these began to spring up around the country. Now they’re springing up everywhere because we are realizing the benefits. With the new provisions in the Affordable Care Act this dovetails perfectly into that. We’re going to try and save the country money and at the same time deliver quality care and help provide for quality of life.” Ciaccio is excited about the prospects for the new department. When he originally came across the concept he thought it was geared for those elderly who were infirmed or in nursing homes but when he saw that it expands services for all seniors, even the more active, he became enthusiastic about the project. “There’s a large nursing home population and they require some special care and then when I realized that this is about targeting the functioning, independent, relatively healthy seniors and that they can stay at home, that’s what really got me going on this because it can save the country money at a time when we need money saved and, two, it can help people really enjoy their retirement years,” he said.

Jamie Ciaccio, the chief and director of the department of emergency medicine at Upstate University Hospital’s Community Campus, is a proponent of a new ER for seniors that will look for their care more carefully. “This has been an initiative that’s been going on for about the last ﬁve to seven years.

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The Social Ask Security Ofﬁce Column provided by the local Social Security Office

New to Electronic Payments?

Many Options for Ill-fitting Dentures By Deborah Jeanne Sergeant

f your dentures feel sloppy, cause pain or don’t work right, you don’t have to put up with it. Though these problems may have been commonplace for denture wearers years ago, dentists can help make them fit much better now. And it may not mean buying a new set of dentures. Many times, a denture adjustment can help. Jeff Stannard, dentist with Specialized Dentistry Syracuse, said that if dentures don’t fit right in one particular place, disclosing paste can pinpoint where they are rubbing so an adjustment — adding or removing material — can fix them. “The upper jaw may shrink upwards and backwards,” he said. “The lower jaw has the appearance of shrinking down and forward. That’s how people’s bite wears. A study shows dentists said 75 percent of dentures weren’t fitting right and only 10 percent of people said that they didn’t fit.” Stannard said that dentures should be replaced about every seven to 10 years, but since the changes in the jawbone take place so slowly, many people don’t notice. “See a dentist and preferably, a prosthedentist,” Stannard said. “We are the true experts with these dental prosthetics. Stay away from denture mills. They take short cuts on the impressions, the quality of the dentures, and how they’re set up. Dentures should be made for the individual and each tooth should be set individually.” A laboratory reline uses heat and pressure to repair dentures, and the resulting denture is less porous. “The more porosity you have in the acrylic, the more the denture can pick up odors and stains,” Stannard said. Even the best-fitting dentures can cause problems now and then. And some denture wearers never feel as confident about their dentures’ fit as they want to. Implants can provide a solution. “Implants are state of the art today,” said Michael J. Romano, dentist with Summit Dental, PC in Liverpool. “It’s very stable.” These titanium screws help anchor dentures in place. The screw is embedded into the bone and the gum tissue grows over it. A cap above the gum line is attached to the screw and the denture snaps on to the cap. The wearer would no longer need denture adhesive to secure their dentures. Page 22

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Some dentists give patients place the dentures in right away and others wait four months for the bone to grow around the screws while the patients wear a relined denture. “It lasts a lifetime,” Romano said. “It’s like a wood screw you’re screwing into a bone. People think it’s a very painful procedure, but remarkably, it’s not. A lot of people have minimal discomfort. It’s not near like a deep filling or root canal. The recovery time is very quick. People don’t need to be afraid of them.” People who are poor candidates for dental implants (where individual false teeth permanently cap implanted screws) may do well with mini implants to secure dentures, since it’s not necessary to graph bone to support the tiny titanium screws. The mini implants cost about half to one-quarter the expense of larger, older-style implants and are less invasive. Talk with your dentist about what option will work best to help make your dentures fit and function better.

Is a reline right for you? A reline will save money over buying a new set of dentures for sure, but not everyone is a good candidate. Barbara L. Panko, a dentist practicing in Oswego, gave the following contraindications for a reline: • “An excessive amount of bone loss has taken place. At that time, new dentures would be indicated because the denture would get too thick if they were relined. • “If there are sores in the mouth, those must heal before a reline is done. • “When the patient complains of temporal mandibular joint pain, that must be resolved first. • “If the dentures have poor aesthetics or if there is unsatisfactory jaw relationships between the upper and lower. • “If the denture creates a major speech problem. • “If the shape of the bone has to be re-contoured.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

eginning March 1, with few you may want to know about your exceptions, all federal benefits, future payments. including Social Security and • Electronic payments are safer: Supplemental Security Income (SSI) there’s no risk of checks being lost or benefits, are to be paid electronically. stolen; For years, Social Security has • Electronic payments are easy and stressed the convenience, security, reliable: there’s no need to wait for the and safety of getting benefit payments mail or go to the bank to cash a check; electronically, offering peace of mind • Electronic payments are good that your payment will arrive on time, for the environment: they save paper even in the event of natural disasters or and eliminate transportation costs; and being away from home when the check finally; is in the mail. • Electronic payments Electronic payments (direct save taxpayers money to the deposit or Direct Express) are tune of $120 million per year: not only the best way to rethere are no costs for postage, ceive federal benefit payments paper, and printing; and — for most people, starting in • Electronic payments March, they are the only way. could save you money on The truth is, for most check-cashing and bank fees. people getting monthly benPlease visit www.GoDiefits, this isn’t really a change rect.org today to learn more at all. That’s because more than about getting your Social nine out of 10 individuals who Security and SSI payments the receive benefits from Social safe, easy, inexpensive, and Banikowski Security already receive paygreen way — electronically. ments electronically. And rest assured that on payment deIf you get your payments the oldlivery day, you won’t have to wait for fashioned way and electronic payments your money; your money is already in are new to you, here are some things the bank and ready for you to use.

Q&A Q: What’s the easiest way to apply for retirement benefits? A: The easiest way to apply for retirement benefits is online at www.socialsecurity.gov/applyonline. It’s easy and secure. You can complete it in as little as 15 minutes. In most cases, once your application is submitted electronically, you’re done. There are no forms to sign and usually no documentation is required. Social Security will process your application and contact you if we need more information. You also can apply by calling our toll-free number, 1-800-772-1213 (TTY 1-800-325-0778), between 7 a.m. and 7 p.m., Monday through Friday. Our representatives will make an appointment to take your application over the telephone or at a local Social Security office. Q: How can I get an estimate of my retirement benefits? A: Use our online Retirement Estimator at www.socialsecurity. gov/estimator. There, you can enter certain identifying information about yourself, including your name, date of birth, Social Security number, place of birth, and mother’s maiden name. If the personal information you provide matches our records, you can enter your expected retirement age and future wages. The online application will combine your earnings data Social Security has and provide you a quick and reliable online benefit estimate. You can even enter different “what if” scenarios to find out what your benefits

will be in different situations. A Spanish-language Retirement Estimator is available at www.segurosocial.gov/ calculador. In addition, you can obtain your online Social Security statement, which provides estimates of future benefits as well as a record of your earnings to make sure your past earnings are reported correctly. Find the online statement at www.socialsecurity. gov/statement. Q: How do I report a change of address if I’m getting Supplemental Security Income (SSI)? A: A person receiving SSI must report any change of address by calling our toll-free number, 1-800-772-1213 (TTY 1-800-325-0778), or by visiting a local office within 10 days after the month the change occurs. You cannot complete a change of address online. You should report your new address to Social Security so you can continue to get mail from Social Security when necessary, even if you get your benefits electronically by direct deposit or Direct Express. Learn more about SSI at www.socialsecurity.gov/ssi. Q: Is Supplemental Security Income (SSI) taxable? A: No. SSI payments are not subject to federal taxes, so you will not get an annual form SSA-1099. To learn more about SSI, read our publication on the subject, What You Need To Know When You Get Supplemental Security Income (SSI) at www.socialsecurity.gov/pubs/11011.html. If you receive Social Security benefits, they may be taxed.

Lakeside Family Dentistry Barbara L. Panko DDS

35 East 1st Street, Oswego across from the Best Western Hotel By Jim Miller

How to Find and Hire a Good Home Care Worker Dear Savvy Senior, What’s the best way to find a good in-home caregiver for my elderly mother? Looking for Care Dear Looking, Finding a good in-home caregiver who is dependable, likeable, trustworthy and affordable can be challenging, to say the least. Here are some tips and resources that can help. Know Your Needs

Before you start the task of looking for a caregiver, your first step is to determine the level of care your mom’s needs (see www.NCLneedsassessment. org for a checklist). If, for example, she only needs help with activities of daily living like preparing meals, doing laundry, bathing or dressing, a “homemaker” or “personal care aide” will do. But, if she needs health care services, there are “home health aides” that may do all the things a homemaker does, plus they also have training in administering medications, changing wound dressings and other medically related duties. Home health aides often work under a nurse’s supervision. Once you settle on a level of care, you then need to decide how many hours of assistance she’ll need. For example, does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or perhaps bathe? Or does she need more continuous care that requires daily visits or a full-time aide? After you determine her needs, there are two ways in which you can go about hiring someone. Either through a home health agency, or you can hire someone directly on your own.

Home Health Agencies

Hiring a certified home health agency to supply and manage your mom’s care is the easiest but most expensive option of the two. Costs run anywhere from $12 up to $40 an hour depending on where you live and the qualification of the aide. This is also usually a better way to go if your mom requires a lot of in-home health care. How it works is you pay the agency, and they handle everything including an assessment of your mom’s

needs, assigning appropriately trained and pre-screened staff to care for her, and finding a fill-in on days her aide cannot come. Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may change or alternate, which can cause a disruption in care and confusion. You also need to know that while Medicare does cover some in-home health care services if it’s ordered by a doctor, they don’t cover homemaker services, nor will they cover personal care services, such as bathing and dressing, provided by a home health aide if that is the only care required. But if your mom is low-income and qualifies for Medicaid, some services are covered. To locate and compare Medicareapproved home health agencies visit www.medicare.gov/hhcompare, and call 800-633-4227 and request a free copy of the “Medicare and Home Health Care” publication (#10969) that explains coverage and how to choose an agency.

Hiring Directly

Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $10 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom. But be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any worker-related injuries that may happen. If you choose this option make sure you check the aide’s references thoroughly, and do a criminal background check. To find someone, ask for referrals through friends, doctor’s offices or hospital discharge planners, check online job boards like craigslist.org, or try carelinx.com or carescout.com. Some states even offer registries (PHImatchingservicesmap.org) to help you locate good caregivers. Or, for a fee, a geriatric care manager (caremanager.org) can help find someone.

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.

Seniors over 65 always receive a 20% Discount Phone (315) 312-0339 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

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Home Care by Seniors for Seniors There’s a huge difference in the kind of home care you can receive from someone who really understands what your life is like as a senior. The concerns you have. The need for independence. Someone who, like you, has a little living under his or her belt. Our loving, caring, compassionate seniors are there to help. We offer all the services you need to stay in your own home, living independently. • Transportation • Shopping • Doctor Appointments • Companion Care • Housekeeping services • Meal preparation/cooking • 24-Hour Care • and more Call us today. Like getting a little help from your friends.

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H ealth News Anne Marie Mullin joins hospice board

Liverpool nurse joins Home Aides of Central New York

Anne Marie Mullin, senior vice president at Laboratory Alliance of Central New York, was recently appointed to the operating board of Hospice of Central New York. Hospice of Central New York is an independent, communitybased, nonprofit agency committed to providing a compassionate, dignified alternative for people with an incurable illness and limited Mullin life expectancy. HCNY operates Hospice of Central New York (HCNY), the Hospice Grief Center, The Hospice Foundation of CNY, and The Auxiliary to Hospice Foundation. Mullin is a long-time volunteer at HCNY and previously served as secretary and president of the board of the Hospice. The Baldwinsville resident is an active volunteer with several local nonprofit organizations.

Jeffrey M. Emlaw, a licensed practical nurse of Liverpool, has joined Home Aides of Central New York as a clinical coordinator. Emlaw will be responsible for providing phone triage and home health aide orientations and also participate in quality assurance activities and serve as an agency liaison, proEmlaw viding the public with information regarding services offered by Home Aides of Central New York. Emlaw achieved his LPN degree through Onondaga-Cortland-Madison County BOCES and is currently working toward a registered nurse degree. He has more than 17 years of experience in the healthcare field.

Syracuse YWCA has new executive director

Stephanie Heffner, a certified public accountant, has joined Tully Hill Chemical Dependency Treatment Center as controller. Heffner was previously employed at Aspen Dental Management, Inc. where she held the position of corporate accounting Heffner manager since 2007. Prior to 2007 Heffner worked for Ernst & Young, LLP as a senior auditor.

Fanny Villarreal has recently been appointed the new executive director of the YWCA Syracuse and Onondaga County. In the last two decades Villarreal has served the Central New York community in various roles. She was the family and community development director at P.E.A.C.E Inc., and executive director at Spanish Action League. Villarreal Villarreal is the founder of Nosotros Radio Inc., “Your Latino Voice,” and co-founder of Latino Networking Professionals. Villarreal replaces longtime Executive Director Joan Durant, who retired at the end of the year after 16 years of service to the YWCA.

Tully Hill Chemical has new controller

St. Joe’s nursing school granted accreditation St. Joseph’s College of Nursing at St. Joseph’s Hospital Health Center has been granted accreditation by the Middle States Commission on Higher Education based in Philadelphia.

Hematology-Oncology Associates Cofounder Appointed to ASCO Panel Physician Jeffrey Kirshner, Silver awards were presented to physicians Jeffrey Kirshner, Anone of the founding partners of thony Scalzo, Tracy Alpert, Stefania Hematology-Oncology AssociMorbidini-Gaffney and the research ates of CNY (HOA) and principle staff. investigator of the practice’s robust HOA currently participates clinical research department, has been appointed as an expert in over 100 clinical trimember of the American Soals. Kirshner is actively ciety of Clinical Oncology’s involved in several of the guideline panel addressing cooperative group committhe treatment of women tees and is currently serving with advanced HER2 posias a member of the National tive breast cancer. Cancer Institute’s Symptom “It will be an ongoing Management and Quality of project as new drugs become Life Clinical Trials Steering available,” said Kirshner. Committee. He is also the The guidelines established co-chair of the Community by this group become the Oncology Committee for the treatment recommendations Kirshner Alliance, a national cancer set forth by ASCO that will be utiresearch consortium. lized around the globe. ASCO is the HOA’s research program world’s leading professional organi- provides opportunities for clinical zation representing physicians who cancer research because they have care for people with cancer. With been a part of a large network that more than 25,000 members, ASCO is enables patients and physicians to committed to improving cancer care participate in clinical trials across through scientific meetings, educathe United States for over 25 years. tional programs and peer-reviewed The CCOP allows HOA patients to journals. access investigational cancer drugs HOA officials said this appoint- and treatments for patients in our ment is just another example of how community. As the saying goes, Hematology-Oncology Associates “Today’s clinical trials are tomoris committed to cancer patients and row’s treatments.” The program dedicated to clinical research. Last not only allows patients to accrue year, the National Cancer Institute to treatment trials but there is a awarded HOA with four awards for substantial prevention and symptom management component to the physician accrual to clinical trials research. For more information, sponsored by the National Cancer Institute’s Community Clinical visit www.hoacny.com. Oncology Program (CCOP). The commission is recognized by the U.S. Secretary of Education as an accreditor of degree-granting colleges and universities in the Middle States region, which includes Delaware, the District of Columbia, Maryland, New Jersey, New York, Pennsylvania, Puerto Rico, the U.S. Virgin Islands and several locations internationally. The commission is a voluntary, non-

governmental, membership association that defines, maintains and promotes educational excellence across institutions with diverse missions, student populations and resources. It examines each institution as a whole, rather than specific programs within institutions. “Accreditation by Middle States is evidence of the quality and excellence of the nursing education program of-

Auburn Community Holds Thirds Annual Gala

Physicians Americo Santillo (from left), Donald Delahanty and Richard Freeman with G. William Ryan, Scott A. Berlucchi (Auburn Community Hospital president and CEO), Pamela Kirkwood, Eric Allyn, Nance Rifanburg and Michael Rifanburg Page 24

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

On Jan. 19 Auburn Community Hospital held its third annual New Year New Life, Operation Excellence — “A Stitch in Time” — gala, in support of the New Life Begins Initiative. This initiative’s goal is the continued support of hospital services to provide compassionate, high quality care to the patients of the Auburn area. The celebration, held at Holiday Inn, honored three outstanding community members with ACH’s Lifetime Leadership Award for longstanding dedication to the hospital

and our community. Those honored were Donald Delahanty and Richard Freeman, both decade-long ACH physicians, and G. William Ryan, former ACH board member whose impacts on the hospital and community were recognized. “The people of our community have always been very generous, giving freely to worthwhile endeavors, and we at ACH were once again overwhelmed by the generosity of the night’s gala,” said Scott Berlucchi, the hospital’s president and CEO.

H ealth News fered at St. Joseph’s College of Nursing,” said Marianne Markowitz, dean of St. Joseph’s College of Nursing.

St. Joe’s echocardiography lab receives accreditation

Haris Mobeen joins Oswego as full-time hospitalist

St. Joseph’s Hospital Health Center’s echocardiography laboratory (Echo Lab) has been granted a threeyear term of accreditation in echocardiography in the area of adult transthoracic by the Intersocietal Accreditation Commission (IAC). Established more than 30 years ago, St. Joseph’s Echo Lab employs five cardiac sonographers and two echo technicians. Accreditation by the IAC means that St. Joseph’s Echo Lab has undergone a thorough review of its operational and technical components by a panel of experts. The IAC grants accreditation only to those facilities that are found to be providing quality patient care, in compliance with national standards through a comprehensive application process including detailed case study review. IAC accreditation is a “seal of approval” that patients can rely on as an indication that the facility has been carefully critiqued on all aspects of its operations considered relevant by medical experts in the field of echocardiography. Echocardiography provides early detection of life threatening heart disorders and other diseases. Echocardiograms are noninvasive tests that use sound waves to produce detailed images of the heart’s size, structure and motion. It also can measure blood volume and the speed and direction of blood flow through the heart.

Physycian Haris Mobeen has joined Oswego Hospital as a full-time hospitalist. Mobeen originally provided care at Oswego Hospital as a hospitalist on a per diem basis. He recently completed a critical care medical fellowship at Dartmouth Hitchcock Medical Center. Mobeen earned his Bachelor of Medicine and Surgery (MBBS) degree at Rawalpindi Medical College, the University of Punjab, loMobeen cated in Pakistan. Before he immigrated to the United States, he worked at Holy Family Hospital, at a private medical practice and served as an anatomy instructor at Foundation Medical College in Pakistan. After his arrival in the U.S., he completed an internship and residency in internal medicine at Penn State University’s Hershey Medical Center, in Hershey, Pa. During his residency, he served as chief medical resident and was a clinical instructor. Mobeen has also fulfilled a fellowship in nephrology at Upstate.

Survey: Syracuse Orthopedic Specialists ranks second in the nation in customer satisfaction Syracuse Orthopedic Specialists (SOS) announced that it ranked second in its debut on a Press Ganey Customer Satisfaction Survey review of 24 OrthoForum participants. The customer satisfaction survey measures patient satisfaction in a variety of aspects of their interaction with SOS staff, including their initial phone call to the office, their wait time at their appointment, the care and concern of the provider, and cleanliness of the facility and friendliness of staff, among others. The current review was based on more than 2,800 surveys Press Ganey sent to SOS patients who received services from August 2011 to July 2012. “This demonstrates the care and respect we strive to provide patients everyday,” said physician C. Perry Cooke, president and co-founder of SOS. Press Ganey is a consulting firm that provides services to health care organizations to help them with performance improvement. The OrthoForum is an association of the largest, privately-owned orthopedic practices in the US, all individually selected to participate in activities that advance each group’s position in its local market through benchmarking, business ventures, networking discussions and best practices. SOS is the only ortho-

pedic practice in Central and Western New York to be a member of the OrthoForum. Pamela Hilliar, director of customer service and patient access, SOS, works closely with Press Ganey to review customer feedback and respond appropriately — whether to share a compliment or investigate a concern. She has found that Press Ganey’s partnership has been extremely helpful. “Press Ganey has given advice on how to improve customer interaction,” sadi Pamela Hilliar, director of customer service and patient access, SOS. “Our staff welcomes the input and survey comments are well-received.” She is pleased with the survey results because it proves something she has long believed, “that SOS is more than great doctors, but also a great patient experience.” SOS established its own patient satisfaction program, SOS Cares, in 2009 as part its leaders’ commitment to area patients. “This is one reason for SOS being ranked so high among Ortho Forum members,” according to Scott Springer of Press Ganey. “SOS is trending really well now in customer satisfaction.” SOS will continue to work with Press Ganey to survey patients and develop programs to improve the patient experience.

From left, Don Weber, DCI local administrator; Sri Narsipur, chairman of Upstate’s division of nephrology; Upstate President David R. Smith; Upstate Professor Emeritus Edward Schroeder; and Karen Hansen, DCI corporate administrator, gather at the Upstate gala Nov. 30.

Dialysis Clinic, Inc. Contributes $1M to Upstate Upstate Medical University has received a $1 million gift from the Dialysis Clinic, Inc. (DCI) of Nashville to establish the Edward T. Schroeder/DCI Inc. Endowed Professorship in Nephrology, named in honor of Upstate emeritus faculty member, scientist, administrator and clinician. “We are tremendously grateful to DCI for this extraordinary gift,” said Upstate President David R. Smith. “This kind of corporate philanthropy is rare and demonstrates a culture of giving that is simply inspirational.” According to Eileen Pezzi, vice president for development at Upstate, the gift is the largest ever received by Upstate’s department of medicine. The Foundation for Upstate Medical University will raise an additional $500,000 to cover the entire cost of the endowed professorship. “The generous contribution will certainly inspire others to give to the endowment and we are already beginning to receive additional gifts,” said Pezzi. “Thank you, DCI.” The endowed professorship will be used to attract and retain a full-time professor/researcher with a specific interest in dialysis and end stage renal disease to Upstate’s division of nephrology, providing support to the university’s tripartite mission of education, research, and patient care. The professorship will February 2013 •

carry the name of fund. Schroeder served the university for more than 35 years, beginning in 1965. He retired from Upstate in 2003. During his tenure, he served as chief of the division of nephrology and interim acting chairman of the department of medicine, among other roles. He was an early developer of dialysis and dialysis programs in the region, and continues to volunteer with the National Kidney Foundation. In addition to the $1 million gift, DCI has in the past provided more than $200,000 in research grants to nephrology and other departments. DCI is the largest nonprofit dialysis provider in the United States and it was founded in 1971. It operates more than 210 dialysis clinics, not including the acute facilities within hospitals. DCI employs more than 5,000 people and serves over 13,000 patients within 27 states. Over the last 40 years, DCI has given more than $188 million in support of research and education to its programs and affiliated institutions. University Dialysis Center, located at 1127 E. Genesee St., in Syracuse, serves as the local DCI outpatient clinic. DCI officials were honored for their gift at the Upstate gala, held Nov. 30 at the Nicholas J. Pirro Convention Center at Oncenter Complex in downtown Syracuse.

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Excellus BCBS doctor to help transform nation’s end-of-life care

NEW ISSUE

Celebrating life after 55.

The Institute of Medicine has selected an Excellus BlueCross BlueShield physician to serve on a committee of national experts charged with helping to transform the nation’s endof-life care. Patricia Bomba, a physician who lives in Pittsford, serves as vice president and medical director, geriatrics, Excellus BCBS. She will serve on the Institute of Medicine’s Committee on Transforming End-of-Life Care. Bomba Bomba is a nationally recognized palliative care and end-of-life expert who designs and oversees the implementation of community projects throughout New York state. At Excellus BCBS, Bomba serves as a geriatric consultant on projects and programs affecting seniors. “New York state is ahead of the curve when it comes to ensuring patients’ wishes are honored at the end of life,” Bomba said. “I hope to parlay the successes of New York state into a new national standard that empowers patients, their families and physicians to make and share sound decisions.” Bomba was the driving force behind a 2008 New York state Medical Orders for Life Sustaining Treatment (MOLST) law which

helped to ensure that a person’s end-of-life wishes were followed, whether the person was at home, in a nursing home or in any other non-hospital setting. Bomba earned a bachelor’s degree from Immaculata College in Pennsylvania and graduated from the University of Virginia School of Medicine. She completed her residency in internal medicine at the University of Rochester and is board certified in internal medicine, with added qualifications in geriatric medicine. Bomba serves as New York’s representative on the National POLST (Physician Orders for Life Sustaining Treatment) Paradigm Task Force and is chairwoman for New York’s MOLST Statewide Implementation Team. The Institute of Medicine is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision-makers and the public. The Committee on Transforming End-of-Life Care will conduct a consensus study that will produce a technical report on ways to advance end-of-life care, among many others goals.

• Utica couple: 50-year partners in marriage and on the dance ﬂoor • Destiny USA’s Bob Congel: At 77, he is not done yet • 50-year partners in marriage and on the dance ﬂoor • Hearing: Not your grandma’s hearing aid • Write the story of your life • Income: The main reason older people hold a job • Americans pessimistic about retirement • Mentoring: It helps both seniors and youth • Should you ditch your land line?

LOOKING BACK

• 1963 vs. 2013. What a difference 50 years makes

....and many other interesting stories

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013

Brenda Walpole, medical assistant, and Amy Conzone, a registered nurse, earned certiﬁcation.

Oswego Health Orthopedics Staff Earns Certiﬁcation Two staff members from Oswego Health’s Advanced Orthopedic Group have become certified as registered orthopedic technologists by the American Society of Orthopedic Professionals. Amy Conzone, a registered nurse, and Brenda Walpole, medical assistant, who work in the office

of orthopedic surgeon Shawn Mills took part in a two-day training workshop. The pair then took and passed the required 190-question multiple choice examination. During the hands-on workshop, the staff members learned casting techniques, as well as other skills to benefit their orthopedic patients.

New Screening Program Now Available to Smokers at Oneida Healthcare Oneida Healthcare has introduced a new screening program aimed specifically at current and former smokers. A recent study by the National Cancer Institute showed low-dose CT screening of high-risk current or former smokers can cut the death rate from lung cancer by 20 percent. “The objective of the hospital’s new lung cancer screening program is to detect lung cancer at its earliest stage, when it’s most curable, even if there are no obvious symptoms,” said Barbara Gerow, Oneida Healthcare’s manager of radiology services. Gerow said that under the program participants receive: • A low dose CT scan that can be scheduled Mon-Fri 7:30am-6pm. • A professional reading and interpretation of the CT scan by a highly trained chest radiologist. • A report automatically sent for review to a specialized surgeon who will personally contact the patient to discuss the findings. A duplicate report will be sent to your primary physician. • A CD with the images for your

personal records. • Free smoking cessation counseling by a certified smoking cessation counselor is available. • Reminder in one year to schedule another scan if you so desire. Gerow noted that the $235 cost for the screening is payable at the time of service and that this kind of testing isn’t currently covered by insurances, although she said that could change in the future as it becomes more widely used. Screening candidates must be 55-74 years of age; be a current or former cigarette smoker of at least one pack a day for 30 years or two packs a day for 15 years; or have a family history of lung cancer. Acknowledging that some people might prefer not to know if there’s a problem, Gerow stressed the importance of catching lung cancer as early as possible. “If there is something, hopefully we’ve found it in time and it’s treatable, or if everything looks good, I guess you can look at it as pretty inexpensive peace of mind,” she concluded. Anyone interested in Oneida Healthcare’s lung cancer screening program can get more information or schedule an appointment by calling 361-2035.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013