in good Pam Hunter’s Mission: Raise Awareness of Epilepsy, Help Those Affected by it
March 2013 • Issue 159
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CNY’s Healthcare Newspaper
The
Why You Should Wear Them
Milk: Your Bones’ Best Friend
Forgotten Gender
Compare the few initiatives for men to the vast array of women’s health promotions, and it’s easy to see that men are left in the dust when it comes to health care efforts.
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Syracuse north side food pantries struggle in face of chronic shortages
Cancer Rates Still Decreasing Despite trend, an estimated 1.6 million Americans will receive a cancer diagnosis and 580,000 will die of the disease in 2013
INSIDE: Teen Births Hit Record Low
It Runs in the Family Medicine is all in the family for the Farahs with five doctors spanning two generations. Physician and patriarch Fuad Farah and his wife, Mona, have four children—Richard, Ronald, Joyce and Ramsay. All of them are doctors. Fuad, Ramsay and Joyce, who share an office together, share the story of the family’s immigration from Lebanon, the founding of their private practice, the different paths they took into medicine, and what it is like to be in business together. Page 22 March 2013 •
All About Urology David Albala, Crouse Hospital’s chief of urology who specializes in robotic surgeries, talks about the daVinci, prostate cancer, PSA and his experience hiking the Appalachian Trail
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Compassionate Family Medicine/FCMG
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# 301 Prospect Ave., Syracuse, NY Visit our website: 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.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
in New York state
March 2013 •
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CALENDAR of
HEALTH EVENTS
March 5, 6
Auburn seminar discusses the basics of Medicare
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Learn about the basics of Medicare free workshops will be held from 3–5 p.m. on Tuesday, March 5 at the sixth floor caucus room No. 1 of the Cayuga County Office Building and from 10 a.m.–Noon p.m. on Wednesday, March 6 at the basement training room of the Cayuga County Office Building. Classes have also been scheduled for April, May and June. These sessions will be geared toward Cayuga County residents only, who are approaching Medicare enrollment, and for those already enrolled who are overwhelmed or confused by the information and the options available. These are not meetings during which sales efforts will be made, and no insurance vendors will be present; these presentations will contain unbiased information only. Call the Cayuga County Office for the Aging at 315-253-1226, or visit the News & Activities section of website www. co.cayuga.ny.us/aging/events.htm.
March 7, 14, 19
Home Aides hosts employment open houses Home Aides of Central New York, a local nonprofit organization, will offer several employment open houses designed to find caring individuals who can assist seniors with household tasks including laundry, shopping and errands, and personal care ( including dressing and bathing). The schedule is as follows: • Thursday, March 7; 8:30–10:30 a.m. Home Aides of CNY, 723 James St., Syracuse • Thursday, March 14; 8:30 –10:30 a.m. Home Aides of CNY, 723 James St., Syracuse • Tuesday, March 19; 1– 4 p.m. DeWitt Community Library, ShoppingTown Mall, 3649 Erie Boulevard East, DeWitt. For more information, call 315-4764295.
March 9
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Free yoga classes offered in N. Syracuse library The Northern Onondaga Public Library in North Syracuse is sponsoring free sessions of yoga every Saturday beginning March 9 and following on March 16, 23 and 30. The classes will take place at 11 a.m. at the North Syracuse Library, 100 Trolley Barn Lane and will be led by a certified yoga instructor, Linda Haverlock. No walls of mirrors, no prerequisite fitness level or performance expectations. Just bring your own yoga mat or you may purchase one for $12 courtesy of “Yoga with Linda.” For more information about the instructor, visit www. yogawithlindah.com Registration
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
required. Visit www.nopl.org or call 315-458-6184.
March 16
Whole food nutrition to be discussed in Cicero A whole food nutrition class will take place at The Northern Onondaga Public Library in Cicero at 11 a.m., March 16. Did you set a New Year’s resolution to lose weight and look great? Do you want to sleep better and have more natural energy? Meet certified holistic health, nutrition and fitness counselor Paula Youmell for a personal wellness and nutrition class. “Paula’s Whole Food Nutrition” class will help you improve your diet, learn how to shop for health food and learn the positive impacts of eating locally, seasonally and organically grown food. Event will take place at the Cicero Public Library, 8686 Knowledge Lane. Free. Registration required by visiting www. nopl.org or calling 315-699-2032.
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 ext. 106.
April 13
Bowling competition in Fulton to help the homeless All bowlers, from gutter dusters to high rollers, are invited to help strike back against homelessness by gathering a team and registering for Oswego County Opportunities’ “Lucky 13” Bowl-A-Fun. OCO’s 12th annual bowling tournament fundraiser is set for Saturday, April 13, at Lakeview Lanes in Fulton. This year’s event was dubbed the “Lucky 13” Bowl-A-Fun because it is taking place on on April 13, 2013. It will take place from Noon–6 p.m. at Lakeview Lanes in Fulton. Registration opens Feb. 1 for fiveperson teams, with choice of flights: Noon–2:30 p.m. or 3:00– 5:30 pm (first come, first served). Businesses and individuals are invited to donate door prizes for the raffles and silent auction, and major sponsors are being solicited as well. This year’s proceeds will benefit services for the homeless. For registration or sponsor information, or to donate a door prize, contact OCO at 598-4717 or visit the agency’s website at www.oco.org.
OASIS health classes to feature stem cell, therapy, keeping bones strong
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ASISI, an educational program for mature adults who want to continue to grow, learn and be productive, is sponsoring two healthrelated classes in March. They area: • “The Hope For Stem Cell Therapy,” presented by Gregory L. Eastwood, a physician and professor of bioethics and humanities and past president of Upstate Medical University. What are stem cells? Are all stem cells alike? What lies in the future for stem cell research and treatments? March 28 from 1:30–3:30 p.m. Class fee is $5. • “Keeping Bones Strong,” presented by Arnold M. Moses, a physician and professor of medicine division of endocrinology / department of medi-
cine, director of metabolic bone disease program at the Joslin Center. Teresa Koulouris, RN, program coordinator and nurse educator, Osteoporosis prevention and education program the Joslin Center. This program will provide an overview of the different ways to prevent osteoporosis as one ages, and a review of home hazards with effective ways to reduce the risk of falls and how to develop a plan for you in your home. March 29, from 1–2:30 p.m. Class fee is $5. OASIS is located at 6333 St. Rt. 298, next to the Double Tree Hotel off Carrier Circle. Free membership is open to anyone 50-plus. For information call 464-6555. OASIS is sponsored in part by Upstate Medical University.
Record Number of Children Covered by Health Insurance in 2011
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record number of U.S. children were covered by health insurance in 2011, mostly due to substantial increases in the enrollment rates of public insurance, according to new research from the Carsey Institute at the University of New Hampshire. The new research is presented in the Carsey Institute brief “Record Number of Children Covered by Health Insurance in 2011” conducted by Michael Staley, a research assistant at the Carsey Institute and a doctoral candidate in sociology at the University of New Hampshire. “The increase in children covered by health insurance likely stems from policies enacted to increase participation in government-sponsored health insurance programs. In addition, we continue to see significant declines in private insurance and increases in public insurance, which reflects the economic and job market of 2011, four years after the beginning of the Great Recession,” Staley said. According to Staley, between 2008 and 2011, the rate of private coverage among children decreased by more than 5 percentage points across the United States, while public rates increased by more than 9 percentage points. “While unemployment rates have declined since 2008, research shows that some individuals are taking jobs with no health benefits, with health
benefits that are not available to dependents, or with unaffordable premiums. Thus, many parents have turned to public programs such as Medicaid, the State Children’s Health Insurance Program (SCHIP) or other state programs,” he said. The key findings are as follows: • Rates of insurance coverage for children under age 18 increased from 90 percent in 2008 to 92.5 percent in 2011. • With the exception of the Midwest, all regions experienced a modest increase in children’s health insurance coverage between 2010 and 2011. • Rural places and central cities in the South and West experienced the greatest increases in rates of coverage since 2008. • The proportion of children covered by public health insurance increased substantially for the fourth consecutive year in every kind of place — rural, suburban, and in central cities. • Rates of private insurance coverage among children decreased for the fourth consecutive year. “As more families turn to public insurance to provide coverage for their children, costs are likely to increase, despite cost-reducing measures required by the Affordable Care Act that go into effect in 2014. Some proposed policy changes would shift a greater proportion of the cost of care back to families, which could be particularly burdensome for low-income families, who may choose to forego care because of higher costs,” Staley said.
Health Tip Why Wear Sunglasses? They block sun’s ultraviolet rays
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ell-made sunglasses do more than make you look like a movie star. They can protect your eyes from many problems, including those caused by the sun’s harmful rays. The American Optometric Association says you should always don sunglasses during the daylight hours because: • They protect your eyes against the sun’s UV rays, which could otherwise lead to cataracts. • They protect against “blue light” from the solar spectrum, which could increase your risk of macular degeneration.
• They lead to improved and more
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comfortable vision from not having to squint. • They can make it easier to adapt to darkness. Exposure to bright light can make it more difficult to adjust to driving at night. From HealthDay News March 2013 •
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Meet
Your Doctor
By Chris Motola
Dr. David Albala Urologist who specializes in robotic surgeries talks about the daVinci, prostate cancer, PSA and his experience hiking the Appalachian Trail Q: You are a urologist? A: Yes. I have been for about 22 years. Q: What kinds of conditions do you see and treat? A: A lot of my work is kidney stone work, where I’ll take a scope, go up the ureter and use a laser to break up the kidney stone. The majority of my practice is robotic surgery, where I use a robot to help with surgical procedures that allow patients to get out of the hospital quicker. They return to work a lot quicker. The blood loss from prostate surgery is a lot less, for example. I had a very good role model when I was a resident. The diversity of the practice was very appealing to me. Q: You were a pretty early adapter of the daVinci robot. How has that been for your practice? A: I’ve been using the daVinci since 2003. I was a professor at Duke and the head of robotic surgery there for 10 years. The daVinci has really revolutionized how we think of surgical procedures. The robot doesn’t make the surgeon better; the surgeon has to be skilled with the robot to do the surgical procedures, but you can be a lot quicker and a lot more accurate.
incontinence in my practice, that’s not really my specialty. My practice is starting to practice in sub-specialties. For example, we have a dedicated physician who just does female incontinence work. We have another partner who just does erectile dysfunction. My contribution to the process, primarily in men’s health would primarily be the prostate. Q: Why is the prostate so prone to infection and cancer? A: That’s the million dollar question. We know a few things about prostate cancer. If you’re African American, you have a higher risk. If it runs in your family, you have a higher risk. So there’s clearly a genetic component. We’re starting to understand that’s an important factor. There’ve been studies on diets and envi-
ronmental components that are a little softer than the genetic components. We see infections in younger men. As men age, the prostate continues to grow under the influence of testosterone and we start to see frequent urination, which is common as we age. And we see a small percentage of patients develop prostate cancer. Every year about 230,000 men in the United States get diagnosed and 20,000 men die from it. There’s a disconnect between developing prostate cancer and dying from it. I think our job as urologists is to inform patients, make the diagnosis and make recommendations for treatment. Right now there’s a fair amount of controversy around that. Q: How so? A: It’s in both the literature and the lay press. The United States Public Health Task Force just came out with a recommendation that men not get a PSA (prostate specific antigen) test. The way we detect prostate cancer is with a rectal exam and a PSA test. Together, that helps us form a basis for treatment. If you come to us and say, “Doc, I’m getting up three or four times a night with a lot of urgency and frequency.” We do a rectal exam, measure the PSA. If it’s normal for your age, we may place you on some therapy to relax the muscle in your prostate. That will help relieve your symptoms. If the PSA comes back elevated, or if we feel a nodule on your prostate, we would recommend a biopsy to rule out prostate cancer. The recommendation the task force put together, I believe, was based on flawed information. The question they wanted to ask was, “Is prostate screening worthwhile.” Much like how, a number of years ago, they sought to address something similar with women and mammograms by recommending a blood test instead. The cost of a mammogram is
Q: How has that technology evolved? A: There are a couple new prototypes being developed, but right now daVinci is the only approved robotic system. The Japanese, the Canadians and the Germans are all developing robotic systems that are fairly far along in their development. It’s kind of like how Ford was around for awhile before Mazda and Toyota showed.
significantly higher than the cost of a blood test. The blood test is not specific for prostate cancer. The PSA can be elevated in an enlarged prostate, an infection or prostate cancer. The PSA test helps us sort all that out and make a recommendation. The task force recommended against that based on a couple of studies that claimed it wasn’t cost effective to do PSA testing. tor?
Q: Was cost the primary motiva-
A: Yeah. That it’s not cost effective. There were two studies quoted in the New England Journal of Medicine. One was an American trial that showed that PSA screening does not save lives. In other words, it doesn’t affect the death rate. The problem is the data was contaminated. They had a group that had testing and a group that didn’t, but a lot of the patients of the second group had actually had PSA testing done at some point in their life. A European study, on the other hand, found that it was effective in cutting mortality by about 25 percent. The difference between the studies is that the European study was carried out a lot longer. Prostate tumors are some of the most slowly growing tumors there are, so if we’d followed the American patients longer, we may have found that there was a benefit. Secondly, the test is a simple blood test. It helps us get information about the patient. There’s a Scandinavian study that’s currently studying the issue. But the recommendation was made based on those two studies: one said yes, one said no. The bottom line, I think, is that we need to follow these patients a lot longer. As a urologist, I feel like it’s a very reasonable, not very expensive test to do. Q: I understand you’ve hiked the Appalachian Trail. How hard was that? A: You know, I’ve always been attracted to the outdoors. Before medical school, I got my degree in geology, of all things. I was seriously contemplating forestry school. I ultimately decided I wanted to work with people. My father was a physician and my mother was a nurse, so there was some family influence there. So when I got accepted to medical school, I decided to quit my job and pursue one of my dreams, hiking the Appalachian trail. Four and a half months later, I’d done it.
Lifelines Name: David Mois Albala, M.D. Hometown: Chicago, Ill. Education: Michigan State, Dartmouth (residency), Washington University (fellowship) Affiliations: Crouse Hospital, Community Campus, St. Joseph’s Medical Center. Partner of Associated Medical Professionals of NY, PLLC (A.M.P.), based in Syracuse. The practice focuses on urology and radiation oncology Organizations: American Neurological Association; Society of Robotic Surgeons; Endo-Urology Society, American Medical Association Family: Married (Francine), Son (Jack) Hobbies: Hiking, skiing, cooking
Q: Besides kidney stones, what procedures do you do? A: Prostate problems are probably number one. Enlarged prostates, prostate cancer. So those and kidney stones are the procedures I’m most skilled at. But I also see some general urology things. I don’t see much
l l A d a “Re In Good ” ! t I t One ad, working all month. u Abo Health Reaching health providers and consumers in the region
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
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Millions of Americans Have an STD: Report And half of new infections each year are among young people, CDC says
H
ere’s a new and sobering government statistic to ponder: Experts estimate that the number of sexually transmitted infections among Americans now totals more than 110 million. In two studies published online Feb. 13 in the journal Sexually Transmitted Diseases, estimates of the prevalence and cost of treating STDs are tallied. The numbers are not good. One of the more concerning findings was that there are nearly 20 million new infections each year, and half of those occur among young people (aged 15 to 24). And the cost of treating STDs is substantial: The lifetime cost of treating 20 million infections a year comes close to $16 billion, the report showed. Eight STDs were included in the analysis, conducted by researchers at the U.S. Centers for Disease Control and Prevention. They included chlamydia, gonorrhea, hepatitis B virus
(HBV), herpes simplex virus type 2 (HSV-2), HIV, human papillomavirus (HPV), syphilis and trichomoniasis. Some of these infections can cause serious health problems that range from infertility to chronic pelvic pain and cervical cancer, the researchers noted. While women tend to suffer greater health consequences from STDs, just as many young men are infected as young women, the report showed. “Sexually transmitted infections are a significant risk to people of any age who are sexually active, with some [infections] capable of transmitting through skin-to-skin contact,” said Kaitlin Doyle, women’s health coordinator at the Long Island Jewish Medical Center in New Hyde Park. “We have to take measures to protect ourselves,” she said. The findings highlight the need for greater prevention and screening efforts, and young people should be the first target of such efforts, the researchers noted.
Alzheimer’s Disease Cases May Triple by 2050
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he number of people with Alzheimer’s disease is expected to triple in the next 40 years, according to a new study published in the Feb. 6 online issue of Neurology, the medical journal of the American Academy of Neurology. “This increase is due to an aging baby boom generation. It will place a huge burden on society, disabling more people who develop the disease, challenging their caregivers, and straining medical and social safety nets,” said co-author Jennifer Weuve, assistant professor of medicine, Rush Institute for Healthy Aging at Rush University Medical Center in Chicago. “Our study draws attention to an urgent need for more research, treatments and preventive strategies to reduce this epidemic.” For the study, researchers analyzed information from 10,802 AfricanAmerican and Caucasian people living in Chicago, aged 65 and older, between
1993 and 2011. Participants were interviewed and assessed for dementia every three years. Age, race and level of education were factored into the research. The data were combined with US death rates, education and current and future population estimates from the US Census Bureau. The study found that the total number of people with Alzheimer’s dementia in 2050 is projected to be 13.8 million, up from 4.7 million in 2010. About 7 million of those with the disease would be age 85 or older in 2050. “Our detailed projections use the most up-to-date data, but they are similar to projections made years and decades ago. All of these projections anticipate a future with a dramatic increase in the number of people with Alzheimer’s and should compel us to prepare for it,” said Weuve.
ONONDAGA, OSWEGO, CAYUGA AND MADISON COUNTIES in good A monthly newspaper published by
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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, Melissa Stefanec, Matthew Liptak, Aaron Gifford, Mary Beth Roach • 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.
Women’s Health Services in LaFayette Syracuse Community Health Center is Now Offering OB-GYN Services at LaFayette Family Health Center.
Your Health Care Home of Choice. Call for an Appointment Today 677-3186. 2561 Route 11, LaFayette
Clinical Assistant Professor
jobs jobs jobs
Clinical Assistant Professor at SUNY Upstate Medical University (multiple locations in Syracuse, NY): Engage in clinical care, research and teaching in the area of Gastroenterology with specialization in hepatology. Requirements: MD or foreign equivalent; Board certification in Internal Medicine; Board certification in Gastroenterology; and Eligibility for License/ Permit to practice medicine in the State of New York. Must also be eligible to sit for Transplant Hepatology Boards through demonstrated expertise and a primary focus in hepatology, as defined by ACGME, through at least one of the following: a liver society member (e.g., American Association for the Study of Liver Diseases, European Association for the Study of the Liver, etc); has a record of scholarship in liver disease; is ABIM certified in transplant hepatology; is a United Network for Organ Sharing recognized transplant hepatologist; or has completed a transplant hepatology fellowship. Please send CV to: Stacy Mehlek, SUNY Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210. An AA/EEO/ADA employer committed to engaging excellence through diversity.
Clinical Investigator/Clinical Assistant Professor Clinical Investigator/Clinical Assistant ProfessorIN(multiple open positions) at GOOD HEALTH - MARCH Research Foundation of the State University of New York (Syracuse, NY): Provide 1/16post-doctoral PAGE V clinical and research training to medical, graduate, and students in the $169.42 at appropriate clinical College of Medicine and Graduate Studies. Conduct presentations departmental rounds, perform clinical research, maintain updated lecture series and material, and publish in peer-reviewed journals. Serve as preceptor for house staff and students in caring for patients on the Neuroradiology service. Perform clinical care in the Neuroradiology Division, including provision of primary care and consultant responsibilities for private patients and those being followed in public clinics. Develop clinical activities that promote excellence in clinical care. Assist in coordinating clinical image care and referrals with specific emphasis on new clinical programs, as well as those currently established. Develop clinical research plans and potentially expand the range of patient-based radiological resources. Participate in college governance, curriculum development, and other forms of academic service. Requirements: M.D. (Doctor of Medicine) or foreign equivalent. Completion of Medical Residency (US or Foreign accepted). Eligible for License/Permit to practice medicine in the State of New York. Some travel required. Please send CV to: Stacy Mehlek, Faculty Appointments Specialist, 750 E. Adams St., Syracuse, NY 13210. An AA/EEO/ADA employer committed to engaging excellence through diversity.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
It’s Never Too Late to Get Comfortable in Your Own Skin
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t took me some time to get comfortable in my own skin. It took some growing pains, some setbacks as well as successes, and some aching losses — but it has all been worth it. The reward has been a life filled with more peace, freedom and joy. Now, in the happy third chapter of my life, I am comfortable expressing my true self. I am steering clear of “shoulds” or other people’s agendas and opinions, and I am enjoying being me in these ways and more: • I drive a stick shift. • My guilty pleasure is a fine French Bordeaux. • I love to write. • I find my spiritual bearings in nature. • I enjoy all kinds of music, but I keep coming back to the Great American Songbook. • I practically live by candlelight, loving the warm, cozy ambiance it creates. Plus, I look much younger in dim light. Ha! • My all-time favorite movie is To Kill a Mockingbird. • Sitting around my backyard bonfire with the people I love is a favorite pastime. • I prefer relating to people in person vs. through technology. • I ride a motorcycle (in daylight only and on back roads.) I know, I know . . .
• I’ve kept every one of my mother’s beautifully written thankyou notes. • Cutting for Stone is on my bedside stand. • An honest-to-goodness listener (not a pretend listener) melts my heart. • I love working with my hands and using good tools. Thanks, Dad! • Planting and harvesting my own garlic and other vegetables makes me incredibly happy. (Email me for my delicious roasted garlic soup recipe.) • Paris is my favorite travel destination. • I’m a dog lover. Big time. • I’m a “practical” romantic, hopelessly moved by the everyday nuances of life and relationships — the good, the bad, and the silly. • I’ve retired my wardrobe of blacks and grays for vibrant pinks, oranges, and greens. • My passion is helping women embrace their independence and adjust to living alone. I’ve discovered that the key to living alone successfully is to determine who you really are and what you
KIDS Corner Can Breakfast Make Kids Smarter?
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ew research from the University of Pennsylvania School of Nursing has found that children who regularly have breakfast on a near-daily basis had significantly higher full scale, verbal, and performance IQ test scores. In one of the first studies to examine IQ and breakfast consumption, researchers examined data from 1,269 children six years old in China, where breakfast is highly valued, and concluded that children who did not eat breakfast regularly had 5.58 points lower verbal, 2.50 points lower performance, and 4.6 points lower total IQ scores than children who often or always ate breakfast after adjusting for seven sociodemographic confounders. “Childhood is a critical period in which dietary and lifestyle patterns are initiated, and these habits can have important immediate and long-term implications,” said lead author Jianghong Liu, associate professor at Penn Nursing. “Breakfast habits appear to be no exception, and irregular breakfast Page 8
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eating has already been associated with a number of unhealthy behaviors, such as smoking, frequent alcohol use, and infrequent exercise.” At age 6, a child’s cognitive ability as both the verbal and performance levels is rapidly developing. Both the nutritional and social aspects of breakfast play a role. After a whole night of fasting, breakfast serves as a means to supply “fuel” to the brain. Meanwhile, social interaction at breakfast time with parents may promote brain development. Mealtime discussions may facilitate cognitive development by offering children the opportunity to expand their vocabulary, practice synthesizing and comprehending stories, and acquire general knowledge, noted the authors. The researchers suggest that schools play a role in stressing the importance of eating breakfast by delaying start times and/or providing breakfast to allow students to profit from the cognitive benefits of eating before a morning curriculum.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
really want for your life — to be your best, true, most aware self. It may sound simple, but for those coming out of a long relationship, determining or rediscovering “who you really are” can be daunting. After years of focusing on the needs and desires of a spouse and family, many discover that, somewhere along the way, they have disappeared around the edges and lost their own sense of self. Rediscovering yourself and identifying those things that bring joy and meaning into your life can turn living alone into an adventure of the spirit. Once you establish your individual interests and means of self-expression, you may find that time alone and the silent moments between events no longer feels empty. Below is an exercise to help you get back in touch with your true self. Spend some time with these questions: 1 – Search back. What were things you did or pursued as a child that gave you joy? What did you do particularly well, or that you secretly took pride in? What did you just love doing as a kid? 2 – More recently, when do you
completely lose yourself in something? What activities consume you and make you feel complete, as though nothing is missing? These are your “loves.” These pursuits can reveal your true self. 3 – What are the kinds of things you do when you have time to yourself, perhaps on vacation? How do you spend your time, when no one is watching, when you’re just being you? 4 – And finally, when you open a newspaper or magazine, what article interests you most? This may help to define areas that pique your interest. Then, take action: Based on the answers above, identify one step (even a small step) you can take now to reconnect with a past pursuit or to delve more deeply into an existing interest. Write down your step. Share it with another person who can help hold you accountable. Do it today. Those of us who live alone have the gift of abundant time to ourselves. Use it wisely. Use the time to get to know yourself all over again. When you identify the things you love to do, and do them, you will feel more integrated and in touch with your true self. You’ll be spending your time pursuing activities that bring you personal satisfaction — activities that reinforce who you are and who you want to become. With each passing day, I am confident you’ll find yourself getting more and more comfortable in your own skin! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, you can call her at 585-624-7887, email her at gvoelckers@rochester.rr.com.
Teen Births Hit Record Low, CDC Reports Preterm and low-birth-weight babies also down, researchers add
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een birth rates have dropped yet again, reaching a historic low, and the number of babies being born early or with a low birth weight has also declined, a new U.S. government report shows. Many factors may account for the improvement, experts say. “We talk more about teen pregnancy, the responsibility of having a child and how difficult it is to be a teen mom. We also talk about contraception and abstinence more,” said physician Jill Rabin, chief of ambulatory care, obstetrics and gynecology at Long Island Jewish Medical Center, in New Hyde Park. “Adults have to remember we’re fighting the adolescent sex drive that developed as a matter of survival of the species,” Rabin said. “It’s important to remember the three I’s when you’re working with teens. They think they’re immortal, invincible and infertile. We have to convince them otherwise and dispel the myths, and the message
needs repetition.” As for the decrease in preterm and low-birth-weight babies, Rabin noted that “prenatal care is getting better, and the message of the importance of prenatal care is getting out there.” The report, from the National Center for Health Statistics branch of the U.S. Centers for Disease Control and Prevention, documented declines in the three areas: • The teen birth rate fell to 31.3 births per 1,000 women aged 15 to 19 in 2011. Twenty years ago, that rate was 61.8 per 1,000 teenage girls. • For the fifth straight year, the preterm birth rate dropped, to 11.7 percent in 2011 from 12.8 percent in 2006. • The rate for low-birth-weight babies also declined, from 8.15 percent in 2010 to 8.1 percent in 2011. The report was published online Feb. 11 and will appear in the March print issue of the journal Pediatrics.
Upstate Now Offers 3D Mammography Technolgy enables doctors to get more detailed look at breast tissue
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pstate University Hospital now offers 3D mammography, called tomosynthesis, which may appeal especially to women with dense breasts. Taken just like a regular mammogram, tomosynthesis takes several 1-millimeter image slices of the breast, giving radiologists a more detailed look at breast tissue. Upstate becomes the first facility in Upstate New York that offers tomosynthesis. It is available through Upstate’s Breast Imaging Center of the Women’s Health Network, located at 550 Harrison Center, Syracuse. The acquisition of this technology is timely, according Upstate. A state law that took effect Jan. 19 requires mammography centers to notify women with dense breasts, alerting them that this condition may put them at increased risk for breast cancer and that cancers are difficult to spot in dense tissue on a mammogram. The letters will advise women with dense breasts to talk to their primary care providers about whether additional imaging is appropriate. “With our new technology, dense breasts can be evaluated,” says physician Deepa Masrani, section chief of women’s imaging at Upstate. Women with 20 percent or greater lifetime risk are advised to undergo a bilateral breast MRI. Those with less than a 20 percent lifetime risk who, nonetheless, remain apprehensive are advised to undergo screening breast ultrasound. “The downfall to [additional
My Turn
Physician Deepa Masrani, section chief of women’s imaging at Upstate and assistant professor of radiology, reviews images from a mammogram.
testing] is that there are a lot of false positives,” says Masrani, which means some women may undergo procedures such as biopsy that turn out to be unnecessary. A woman cannot tell by touch whether she has dense breasts. And, breast density can change over time, influenced by her weight, age, hormone
mammogram by going to the same mammography center, or making sure they bring previous images when they go to a new center. Radiologists like to have older images to compare with the newer, to help spot changes. Willer also supports patients doing their own monthly breast exams. “I’ve seen a number of patients who have palpated their own cancer.”
Electric toothbrushes and manual toothbrushes are equally effective at removing plaque. Power models may be easier for people with manual dexterity problems. Don’t forget to replace your toothbrush every month. Toothpaste seems to come in a million combinations of abrasives, colors, detergents, flavors, fluoride, whiteners, artificial sweeteners and more. Fluoride strengthens tooth enamel and inhibits bacteria. Other ingredients combat bacteria are triclosan and metal salts (which appear in the ingredient list as stannous which means tin, and zinc.) Peroxide and baking soda have a whitening effect but aren’t antibacterial. Mouthwash, like toothpaste, comes in assorted varieties. Chlorhexidine is an antimicrobial mouthwash available only by prescription. It reduces plaque and gingivitis. When my daughter wore braces, her orthodontist advised it. Listerine, a popular brand, is a mixture of various essential oils. It was named after Joseph Lister, a pioneer of antiseptic surgery, and in fact was first marketed as a surgical antiseptic. Cetylpyridinium is another antibacterial found in brands such as Scope and Cepacol. Some brands contain fluoride. Many mouthwashes contain alcohol and should be kept away from children. Flossing cleans between teeth in places that your toothbrush can’t reach.
Yet only about 1/3 of people floss their teeth regularly. There are many varieties of dental floss, varying in thickness, waxed vs. unwaxed, flavor, and shredproofness. If you smoke, quitting is one of the best things you can do to promote periodontal health. Smoking is a downward spiral for your teeth, contributing to decay and oral cancer, and burning up money that could be spent on dental cleanings and check-ups. You may be wondering by now whether you should be brushing your dog’s teeth or buying them dental health treats. In fact while writing this article, Petsmart emailed a sales flyer filled with dog dental health items. They will help your dog’s oral health, but I don’t think anyone has yet studied whether that will make any difference for the owner. So you still have to take care of your own mouth.
By Eva Briggs
Is it Safe to Kiss Your Dog or Other Pet? Several factors can help keep germs away from your mouth
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levels and alcohol usage. Regardless of breast density, experts stress that mammograms are still the best screening tool against breast cancer, and they are recommended annually for women 40 and older. Katherine Willer, an Upstate radiologist based on the community campus who specializes in breast imaging, says patients can help get the most accurate
or years, the Peanuts comic strip character Lucy shrieked in terror whenever Snoopy planted a kiss on her lips. “Blech! Dog germs!” The Internet has been echoing Lucy’s fears with dire warnings that kissing your dog could cause gum disease ever since the “Archives of Oral Biology” published a study by Japanese researchers in 2012. Was Lucy right? Should we panic whenever a dog can’t hold its licker? No. The study never looked at dog kisses, just routine contact with pets. It’s true certain plaque-forming bacteria typically found in canines are more common in dog owners’ mouths than in the general population. But these bacteria are colonizing rather than infecting the owners. In other words, they’re living there, but they’re not causing disease. How can this be? For starters, we are all exposed to all manner of dis-
ease-causing bacteria and viruses every day, and many of them live on or in our bodies. Mere colonization doesn’t cause disease. Host defenses (our ability to fight disease), dose (how many pathogens are present), and virulence (how nasty the germs are) all interact to determine whether infectious organisms cause disease. Good oral hygiene — or lack thereof — is more important in determining whether those dog germs cause gum disease. How then should you care for your mouth to prevent gum disease? For starters, there’s diet. Eat less sugar less frequently — avoiding between-meal snacks — and brush your teeth after eating. This takes away the fuel that plaque-causing bacteria feed on. Regular tooth brushing is more important that which toothbrush you use. Choose one with soft bristles, which are more effective at rooting out bacteria hiding in tooth crevices, but gentler and less likely to harm your gums.
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Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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Cry for Help Syracuse north side food pantries struggle in face of chronic shortages By Matthew Liptak
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ood. We all need it. But sometimes we don’t pay too much attention unless we don’t have it. Many people on the north side of the city of Syracuse don’t have it and increasingly they rely on their neighborhoods’ food pantries to supply it. The Franciscan Church of the Assumption located at 808 N. Salina St. feeds 400 families a month through its pantry and 600 people a day through its soup kitchen. “I think the food pantry itself here is vital because we’ve become a regular part of people’s lives,” said Franciscan Brother Nicholas Spano, director of the pantry and kitchen. “The government likes to say food pantries should be there to augment people’s regular grocery budget. I don’t think we do that. I think we are a critical part of some families’ grocery budgets.” Scott Brown, president of All Faiths Food Pantry Inc., which covers the rest of the area north of James Street, agrees. “It’s an ongoing problem,” he said. “Unfortunately food pantries are no longer truly emergencies. They have become a means for people that have to on a regular basis use them to get through the month. That’s a function of the economy and the fact the price of food just keeps going up.” Last December, Assumption looked like it might have given out its last sandwich to the hungry. “I was extremely concerned,” Spano said. “I was downright scared we were going to have to close. We made our press release on Dec. 3 and at that point we were telling the public we would have to close Jan. 1. The reality is we probably didn’t have enough food to get through [the following day]. We definitely would have been closed within a couple days. That’s just how dire the situation was.”
Community stages huge rally
The food shortage at Assumption hit the press right around Christmas. CNYCentral and other media organizations from the Syracuse area led the news with the story. There was a groundswell of public support for Assumption, a church that has fed the poor since the 1860s. To date, the campaign to refill the shelves with food has raised $215,000, Spano said. Billy Fuccillo, the car dealership owner, offered to match up to $50,000 in donations. The money raised went well beyond that and is enough to run the pantry operations for two years. “I think it’s great,” Spano said. “It’s nothing that we expected. We never expected that type of support. We didn’t have any reason to think Mr. Fuccillo was going to support us. We never met Mr. Fuccillo until we actually received a check from him. We never expected people would support us like that. I think it’s great because it affirms for our volunteers and clients that people do care. “Sometimes I think we can get extremely negative about life and say, ‘OK, nobody cares about the poor. Nobody cares about the disenfranchised.’ I don’t know if that’s fair. I think a lot of people do care. I think a lot of people really showed they cared by making a donation.”
Continual demand
“Our appeal to people is ‘That was a great appeal,’” he said “Unfortunately in February we’re still going to need your support. In June we’re still going to need your support. In August we’re still going to need your support. When we come back around to Thanksgiving, we’re still going to need your support. It is a constant, constant ministry that never stops.”
Franciscan Brother Nicholas Spano shows off a sweatshirt with the logo of his bakery, Fat Friar. The bakery sells shortbread cookies and candy to raise money for the Assumption food pantry and soup kitchen on the north side of Syracuse.
Spano said Assumption’s fundraising committee is looking into efforts to keep the momentum going. He said the pantry and kitchen is without an advertising budget and they make the most efficient use of the food they do receive. He and Brown both encourage donors to give money as opposed to food if they can. “Any support that people can give to their local pantry is greatly appreciated,” Brown said. “You don’t have to be able to donate $100 but if you could send in $5, $25 or a couple bucks every month, it goes a very long way to helping us meet the needs of our clients. We continue to try and educate the public that the best donation you can give us is a few dollars as opposed to a couple
cans of something. We can stretch that.” In the meantime, Assumption has gotten creative in finding ways to fundraise. It started Fat Friar Bakery, selling gourmet shortcake cookies and candy in Skaneateles and at the farmers’ markets in the summer. It has raised over $10,000. “It’s definitely a chronic situation,” Brown said. “Over the last 20 years, food pantries have gone from, ‘I just don’t have enough food to get through this particular couple of days’ to ‘I don’t have enough food to make it every month.’” For more information on the food pantries, go to www.assumptionchurchsyracuse.org.
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Cancer Death Rates Still Decreasing Despite lower numbers, the American Cancer Society estimates that 1.6 million Americans will receive a cancer diagnosis and 580,000 will die of the disease in 2013 By Deborah Jeanne Sergeant
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ecent reports from the American Cancer Society indicate that the rate of death for all cancers continues to decline from previous decades, from 215.1 per 100,000 in 1991 to 173.1 in 2009, a 20 percent decrease. Cancer deaths among men and children decreased about 1.8 percent per year and 1.5 percent among women. The death rate among the four main cancer types — lung, colon/rectum, breast and prostate — have been steadily decreasing. “To see over the course of 20 years that mortality rates are going down, it shows the ‘war on cancer’ is working,” said Jason Warchal, community mission manager for the Eastern Division of Warchal the American Cancer Society, Inc. in East Syracuse. “I think that there is a lot of work to be done but it’s a tremendous step in the right direction.” He attributes the decrease in lung cancer deaths largely because of smoking cessation efforts. Tobacco usage impacts not only the chance of developing lung cancer, but also cancers in other parts of the body. Better awareness and screening have helped decrease deaths from colon cancer, skin cancer and breast cancer. Benjamin McDaniel, radiologist with CNY Diagnostic Imaging Associates in Syracuse, said that advanced equipment may be skewing Kohman the statistics somewhat. “We’re detecting smaller cancers that won’t ever cause someone to die,” he said. “That will increase your denominator so the percent of fatal cancers goes down. We find more thyroid cancer now than ever.” Improved equipment and detection methods also saved lives, as does improved treatment methods, especially for the top cancer killers: breast, colorectal and lung cancer. “About 90 percent of all breast cancer patients now are basically cured of their cancer,” said, Leslie J. Kohman, a physician who directs Upstate Cancer Center at Upstate Medical University. “Colorectal cancer, it’s not as much improvement and with lung cancer, we’ve made a little progress.” Though decreasing cancer death rates is good news, the disease is far from eradication. The American Cancer Society estimates that 1.6 million Americans will receive a cancer diagnosis and 580,000 will die of the disease in 2013. Many types of cancer have no proven screening technique, but for those that do, regular doctor visits can help keep those screenings on schedule.
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Kohman stressed the importance of HPV vaccine to prevent cancers associated with human papillomavirus (HPV): cervical, cancer of the anus and penis, and some types of head and neck cancer. “It’s recommended for girls and boys in the 13- to 15-year-old age group,” she said. She added that the vaccination rate in the US is less than half of girls receiving just one of the three recommended doses and even fewer boys. “Two-thirds of cancers are preventable with what we know now,” Kohman said. “Tobacco cessation is the single most important thing, then obesity, for a very large number of cases of cancer. The third is exercise. If you even take a brisk daily walk for 30 minutes per day, it can lower your risk.” Exercise should include both aerobic exercise, such as bicycle riding, skating, or swimming and anaerobic exercise, such as resistance bands, lifting weights and calisthenics movements. Jason Warchal of he Eastern Division of the American Cancer Society fears that cancer McDaniel rates may see an uptick in the future if obesity is not adequately addressed as a health problem among today’s children and young adults. “Understand what you eat, what your diet consists of,” he said. “Improve the choices you make in healthful foods that are consumed and increase physical activity. They go hand in hand with exercise.” A diet rich in whole grains, fruits and vegetables, and low-fat diary with few processed and fatty foods help support a healthy body and control weight. For more information, visit the American Cancer Society’s website, www.cancer.org.
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Pam’s Mission: Raise Awareness of Epilepsy, Help Those Affected by it Syracuse resident Pam Hunter was recently appointed executive director of the Epilepsy Foundation of Rochester-Syracuse-Binghamton By Aaron Gifford
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pilepsy is a disease that may be under-diagnosed and is rarely discussed or thought about. And yet it affects more people than autism, multiple sclerosis, cerebral palsy and Parkinson’s disease combined, Pamela Hunter explains. “It’s an unknown, she said, adding that in 2012 the U.S. Centers for Disease Control and Prevention increased its estimate of Americans with epilepsy from one in 100 to one in 26. A lot of people don’t want to talk about it or just don’t know much about it.” Hunter, of Syracuse, is making it her mission to talk about it at every possible community health fair she can attend between Rochester and the Mohawk Valley. As the recently appointed executive director of the Epilepsy Foundation of Rochester-SyracuseBinghamton, Hunter is prioritizing outreach, which was a big part of her job since she began working for the nonprofit agency as its Syracuse area director in 2010. “My goal has been to grow this business to make sure that people know we’re around and available to help people with epilepsy.” Epilepsy, also called seizure disorder, is a medical condition that affects a variety of mental and physical functions. The diagnosis is confirmed after the person has two or more unprovoked seizures. A seizure occurs when a cluster of nerve cells in the brain produce abnormal signals, affecting the person’s consciousness, movements or actions. The disease itself is not known to be fatal but continued seizures can affect a person’s achievements at school, work and in various activities. The CDC estimates that epilepsy affects 2.2 million Americans, including more than 300,000 children under the age of 15 (90,000 of which cannot be adequately treated). It is the fourth most common neurological disorder in the United States behind migraine, stroke and Alzheimer’s disease. It is also a condition that can be developed at any age, though it disproportionately affects the very young and the very old. And recent studies indicate that military veterans who have suffered a traumatic brain injury have an increased risk of developing epilepsy. Locally, Hunter estimates that more than 5,000 people in Onondaga County have epilepsy. “But,” she added, “we aren’t seeing most of them.” That’s because too many of them are not getting treatment for the condition, or just seeing a primary physician, getting medication and going on their way. But epilepsy is a condition that could involve up to 20 different types of seizures. Those who suffer from it should be seeing a neurologist, Hunter said. “A clear sign is someone walking around dazed and confused,” Hunter said. “But that’s not uncommon these days, and they could be mistaken for someone who is drunk or on drugs. And many people don’t have seizures Page 12
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in front of their doctors, so they [doctors] don’t know what’s going on.” Those who contact the Epilepsy Foundation are educated about the disease, the proper course of treatment and the right types of medication. The agency also helps clients obtain the proper medication through its pharmacy assistance program, runs the Camp EAGR summer vacation program for children with epilepsy, and offers support groups. The Epilepsy Foundation of Rochester, Syracuse and Binghamton previously merged with Pralid Inc., a Rochester-based nonprofit that helps those who suffer from traumatic brain disorders as well as those with development disabilities; some functions of those two agencies are shared. Their combined budget is about $14 million. Hunter oversees 20 employees and a countless number of volunteers who specifically work on the agency’s epilepsy program. A significant chunk of the budget is raised locally through fundraisers like the Epilepsy Walk in July. Even though Hunter is the boss, she travels more than anyone else in the agency. She’s in Rochester at least once a week, and on any given day she’ll go to a school or community institution in a small town where people have been traumatized by epilepsy and where those who suffer from it are stigmatized. The task may include explaining the medical condition to school children and their teachers, and educating them on a plan of action should they ever witness a seizure again. “It’s heart-wrenching, some of the stories you hear every day,” she said. “Whether its kindergarten, first grade, high school or college, education is key. When you know what to do, it’s less scary.” Some of the instructions she provides during these outreach sessions are published on the agency’s website (www.epilepsyuny.org). The proper first aid in the case of a seizure is to keep calm and reassure other people who may be nearby, and not to hold the victim down or try to stop his or her movements. Clear the area around the person of anything hard or sharp, and loosen ties or anything around their neck that may make breathing difficult. Turn the person gently onto one side but do not try to force the mouth open with your fingers. Don’t attempt artificial respiration except in the unlikely event that the person does not start breathing after the seizure has stopped. Stay with the person until the seizure ends naturally. Offer to call a taxi, friend or relative to get the person home if he seems confused or unable to get home by himself. In additional to outreach and education work, Hunter is also accustomed to fighting people’s battles. A typical scenario is where an epilepsy patient cannot get the best available prescription from a local pharmacy.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
“There’s always a problem with the insurance companies,” she said. “Fighting those battles for individual patients — we do that every day.” Hunter is also involved with working on state legislation that would benefit epilepsy patients, particularly those who rely on Medicaid, and she’s always lobbying or encouraging institutions to dedicate more time and money to epilepsy research. She has experience in the political arena, having served a short stint on the Syracuse Common Council in 2011 and as a member of the city’s Democratic committee for the past decade. She said she finds similarities between her roles in government and the human services industry. “It’s the ability to advocate for the people who need it the most by building a solid network and a solid formation of relationships.” The daughter of a minister, Hunter grew up in the Lake George area and served in the U.S. Army before em-
barking upon a career in human resources, where she worked for large companies like Arthur Andersen and Price Waterhouse Coopers. She eventually settled in Syracuse with her husband and son and worked at Syracuse Community Health Center, Inc. for several years before taking a job with the Epilepsy Foundation. She said the work ethic and sense of teamwork that she learned in the military helped her to be successful, but it was the work of her father — who marched for civil rights in the 1960s and went on to work with domestic violence workers — that inspired her to pursue a career in human services. “It’s always been engrained in me to be someone who helps others,” she said. The Epilepsy Foundation is always looking for those who are interested in helping others in the Central New York region. Anyone interested in volunteering with the agency can call 477-9777.
Men’sHealth Men: The Forgotten Gender Compare the few initiatives for men to the vast array of women’s health promotions, and it’s easy to see that men are left in the dust when it comes to health care efforts By Deborah Jeanne Sergeant
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reastfeeding support, pink ribbon campaigns for breast cancer, free mammogram and PAP smear programs, women’s heart health awareness: all of these are important efforts of modern medical personnel to improve health. But in the zeal to promote women’s health, it seems like someone has been forgotten. What about men? Where’s the health support for them? It’s more like a whisper drowned by the shouts for women’s health. Men’s health seems to have taken a back burner to women’s health. The US Department of Health and Human Services reports that men are 25 percent less likely than women to have visited a health care provider in the past year. Men’s health is also endangered by their dominance in industries such as transportation and warehousing; construction; and agriculture, forestry, fishing and hunting, as reported by the US Department of Labor Bureau of
Labor Statistics in September 2012. In general, men tend to undertake riskier hobbies than women. Motorsports, bull riding and using power equipment for woodworking represent just a few of the dangerous interests that are dominated by men. Especially as young men, guys undertake dares and stunts more than their female counterparts, too. The US Department of Health launched a “Real Men Wear Gowns” campaign in 2008 to spur men to schedule and follow through with annual physicals and to obtain their age- and gender-appropriate screenings. Few other men’s health initiatives exist on either the national or local level, even though men could probably use more health promotion. The US Department of Health and Human Services reports that men are 1.5 times more likely to die from heart disease, cancer and lung disease than women, for example. Most of men’s
health initiatives center on only sexual health. Compare the few initiatives for men to the vast array of women’s health promotions, and it’s easy to see that men are left in the dust when it comes to health care efforts. “Women tend to be more in tune with their bodies,” said physician David Albala, chief of urology at Crouse Hospital. With an attitude of “if it ain’t broke, don’t fix it,” men typically skip annual physicals, screenings and, in some cases, minor but necessary medical care. As a result, few organizations exist to address men’s health issues. However, Albala has seen some improvement in men’s health initiatives. “Men are getting more aware of health,” he said. “Healthcare does have a bigger role to men than it used to.” Crouse has offered men’s health seminars and prostate cancer seminars to the public and 200 people have
March 2013 •
shown up. Rob Kiltz, a medical doctor who operates CNY Fertility in Syracuse has observed the same shift between emphasis on men’s and women’s health care. “I think it’s a little bit of the pendulum swinging back and forth, that women were overlooked for so long,” Kiltz said. “As that trend moves, it grows bigger. Maybe it’s a marketing issue. Women tend to be the consumers more than men are, so maybe that is a little bit of it.” From birth and breastfeeding onward, women are usually the family guardians of health. Their general necessity to nurture others and themselves tends to make them more interested in preventative health and wellbeing. Because of anatomy, women’s health also is more complex. For example, men’s contribution to conception and childbirth is pretty limited. Women’s physical involvement, from conception through weaning, can last more than two years. “There’s not a lot in men’s health you need to test for,” Albala said, “and what you need to test for is pretty inexpensive. To develop an effective men’s health program is not that expensive.”
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Men’sHealth The PSA Question: Should Men Be Tested or Not? Retired Madison County doctor says no, it’s just a waste of time and money; other doctors disagree By Aaron Gifford
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ark Sicherman, a retired physician who lives in Erieville, Madison County, is now in his late 70s. He has no intention of ever getting a PSA test. In fact, he cautions men of any age to avoid them. “Statistically, they don’t save lives,” he said, adding that as he avoids PSAs, his wife, Dani Riposa, 77, never had a mammogram. Sicherman was a pediatrician in the Camillus area before retiring from a career in alternative medicine. He had already publicly denounced the PSA (prostate-specific antigen, an enzyme in the prostate gland) blood test before the U.S. Preventive Services Task Force in 2011 recommended against routine screening for prostate Sicherman cancer in most men. But he alleges that the vast majority of providers locally and nationally has rejected the task force’s findings and continues to routinely prescribe and conduct unnecessary PSA tests because those procedures are big money makers “in the standard of care” model and allow physicians to appear as if they are making the safest decisions. “In my opinion,” Sicherman said, “it’s at the point where doctors don’t even think about it — they just do it. It’s a safer path for doctors. There’s less liability if they err on the side of extreme caution. The problem with PSAs, if it’s high there’s no question that they are going to do a biopsy and say, ‘what would happen if we didn’t stop the cancer?’“ He recalls a patient in his early 60s whom he saw 10 years ago. The test noted elevated PSA levels and, following a biopsy, the patient’s prostate
was removed. The man complained to Sicherman about being impotent and having difficulties controlling his urination. “This guy was a construction worker,” Sicherman said. “He lived for his manhood. He was devastated. He thought he might as well be dead. No one explained to him first what his chances of survival would be if he didn’t have the surgery. Would they be 50 percent? He should have been able to base his decision on that.” According to the task force’s report, PSA tests commonly result in false-positive results that cause patients to persistently worry about cancer. The false-positive tests result in additional tests and unnecessary biopsies. In many cases where the biopsies indicate evidence of tumors, the prostates are removed even though the slow rate of the gland’s growth is not potentially fatal during the patient’s lifetime. The report said PSAs have caused over-diagnosis of prostate cancer and has resulted in “over-treatment” when in fact most prostate cancer is asymptomatic for life. The American Cancer Society and the American Society of Clinical Oncology quickly responded to task force’s findings, maintaining that the PSA test has saved many lives and should always be part of the conversation when physicians talk about prevention, screening and treatment with their patients. Physicians from Upstate Medical Center, Crouse Hospital and several large medical groups that include internists, urologists and radiologists did not respond to inquiries to weigh in on the PSA debate for this story, but in recent years local specialists have submitted well publicized op-ed pieces to local newspapers defending PSA tests. In an October 2011 piece in the
Syracuse Post-Standard, Gennady Bratslavsky, a urological oncologist at Upstate Medical University, advised the public not to underestimate the value of PSA tests. “Early diagnosis of cancer in any form is some of the best advice medical practitioners can offer, because it saves lives,” he wrote. “Therefore any recommendation that devalues this simple advice is worthy of closer scrutiny. “There is no doubt that PSA screening is less than an ideal test, as its results may be affected by the conditions other than prostate cancer, such as benign enlargement or inflammation of prostate. Nevertheless, since the PSA test was introduced in the United States more than two decades ago, there has been a steady and significant reduction — more than 30 percent — in prostate cancer deaths. Such a trend cannot be explained away by citing healthier lifestyles and better eating habits of men. The only explanation for this reduced mortality is the introduction of prostate testing.” David Albala, urology department chief at Crouse Hospital, published a July 2012 commentary that said that the overgeneralization that prostate cancer is a slow-growing disease is a mistake. At a time when prostate cancer is the second-leading cancer death in American men (one in six men diagnosed with the disease during their lifetime), and until a better alternative test is made available, Albala wrote, “forgoing prostate cancer screening by way of the available methodologies — as suggested by the USPSTS (task force) — could be extremely harmful to many men.”[see related story on page 6]
Anthony Scalzo of Hematology Oncology Associates of Central New York, in a brief response to the inquiry for this story, noted that his practice generally follows the guidelines of the American Society of Clinical Oncology, the American Urological Society and the American Cancer Society. After the task force’s report was released, the American Cancer Society noted in its guidelines that PSA tests for men should generally be offered at age 50, and even to men in their 40s if they have increased risk for prostate cancer (African-Americans or family history). The American Urological Association recommends screening to begin at 40 and cease when patients reach their early 70s. But Sicherman and those organizations agree that screening does not necessarily mean PSA tests in every case. Sicherman advises men to discuss prostate health with their physicians annually, to learn about symptoms of prostate problems and to monitor them. “If you have the symptoms, then do the tests. Go over the symptoms once a year. But that’s not always the way medicine is practiced,” he said.
Learn more at one of our informational sessions and meet Drs. Jeffrey DeSimone and Kenneth Cooper.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2013
Men’sHealth Saturated Fat Decreases Male Fertility
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ou know saturated fat isn’t good for you. But men who want to start a family should be aware that saturated fat impacts their health in yet another way: it may hamper male fertility. A Danish study appearing in The American Journal of Clinical Nutrition implicated saturated fat intake as a factor for decreasing sperm count. The study subjects who ate the most saturates fat had 38 percent lower sperm concentration and 41 percent lower sperm count in their semen compared with men who consumed the least fat. “By changing the amount of saturated fats and adding more polyunsaturated fat, you Kiltz can improve the sperm count,” said Rob Kiltz, a physician who owns CNY Fertility Center in Syracuse. “It’s a combination of reducing the bad things we do and improving your diet with more poly unsaturated fats.” The study is among a growing body of work that underlines the importance of men’s health for increasing the chances of conception. “Many studies have found that dietary fats can impact pregnancy outcome in women,” Kiltz said. “More recent data has even helped differentiate that some fats can improve fertility. But very little of the nutritional intervention has been directed toward men.” Kiltz said that there is a “contributing male factor” in at least one-third of couples struggling with fertility. For another third of couples, the woman’s health impedes conception. The final one-third is either unknown or a combination of male and female factors. Improving the diet to boost sperm count isn’t complicated. Kiltz said that most men resist taking supplements or eating foods such as salmon and flaxseed to obtain healthful polyunsaturated fatty acids. “Now a group of researchers has found a practical solution,” Kiltz said. “They had a group of men begin eating 75 grams of walnuts per day. After
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only 12 weeks, they demonstrated an improvement in sperm count, better sperm motility and increased sperm vitality. “Better still, they did not experience any increase in body weight or body mass index proving that this recommendation is practical with no identifiable drawbacks. In fact, eating walnuts has also been shown to be heart healthy and may reduce the risk of prostate problems as well.” For general health, not just improving the chances of conception, he also encourages men to reduce alcohol intake, eliminate tobacco, and eat more fresh fruits and vegetables, whole grains and fewer processed foods. “Make this a habit not something you do from time to time,” Kiltz added. To help tell the difference between saturated fat and more healthful sources of fat, Branning remember that fat sources solid at room temperature, such as butter, shortening and stick margarine are saturated fat. Susan Branning, registered dietitian at St. Joseph’s Hospital Health Center, said many men’s diets that are high in saturated fat include favorites like “ribs, chicken wings with blue cheese, cheeseburgers, and ice cream. “Saturated fat is found in higherfat cuts of meat,” she said, “such as ribs and chuck, poultry skin, full-fat dairy products, such as whole milk, cheese, cottage cheese, ice cream, some processed meats such as bacon, sausage, salami, and bologna, and other products such as regular butter/ stick margarine, sour cream, and cream cheese.” Swapping these out for better alternatives: low-fat or fat-free diary, leaner cuts of meat (remove the skin from poultry and trim visible, white fat from other meat), reduced-fat bacon, burger, sausage and deli meat. When eating out, “choose sandwiches or subs make with lean deli meat such as turkey or ham instead of salami or bologna,” Branning said.
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Men’sHealth Caffeine Worsens Urinary Incontinence in Men A mere two cups of coffee can increase risk of urinary incontinence incidences in adult men with existing moderate to severe urinary incontinence By Deborah Jeanne Sergeant
M
en who experience urinary incontinence may have their coffee habit to blame for worsening the problem. Though not always the case, the urge to go may be exacerbated by caffeine consumption. A study published in the Journal of Urology links caffeine consumption — a mere two cups of coffee — to increased risk of urinary incontinence incidences in adult men with existing moderate to severe urinary incontinence. The findings don’t surprise David Albala, a physician who serves as chief of urology at Crouse Hospital. “Caffeine can be an irritant to the bladder,” he said. “That may be what we’re seeing here. Caffeine is both a bladder stimulator and a diuretic.” Caffeine can cause the bladder to contract so that the urge to urinate
becomes too strong to subdue in time to make it to the restroom. Men who notice that it’s getting harder and harder to get to the bathroom in time should try cutting back on caffeine. In addition to the morning cups of java, other caffeinated culprits can worsen urinary incontinence. Jeffrey Draves, registered dietitian at St. Joseph’s Hospital, warns people monitoring their caffeine intake to limit the obvious offenders — coffee and cola — but other items as well. “The amount of caffeine varies from 35 mg. in a 12-oz. cola to 80 to 150 mg. in 6 ounces of brewed coffee, up to 350 mg. in a 16-oz. serving of some energy drinks,” Draves said. “Other sources of caffeine include black tea and chocolate. Check reputable websites such as Web MD for caffeine content of selected items. Generally
speaking, consumption of greater than 400 to 500 of caffeine may be considered excessive. For a person with urinary incontinence, it is probably best to let your symptoms be your guide.” If cutting back to three cups of coffee per day doesn’t help, reducing caffeine intake further might. “Although decaf coffee, tea, and soda still contains a small amount of caffeine, it is not likely to aggravate your symptoms,” Draves said. While tea offers a healthful alternative to soda, all colors of tea — black, green and white — contain caffeine and even some fruit and herbal blends do, too. Caffeine is also found in pain relievers such as those meant for headaches or for menstrual pain, which some guys might “borrow” in a pinch. Alcohol and spicy foods may also irritate the bladder and contribute to urinary incontinence. Some prescription medication may contribute to urinary incontinence by irritating the bladder, too. It’s important to read labels and discuss possible side effects with a pharmacist or primary care physician.
If avoiding these possible triggers and cutting back on caffeine doesn’t make much of a difference, men should see their primary care doctor or a urologist. It may be a sensitive bladder issue or even “a bladder tumor,” urologist Albala said. “There could be any number of things. Enlarged prostate, neurological issues, bladder sensitivity: these can all cause urinary incontinence. Conservative measures usually work.” The doctor typically perform a few tests to see if it’s a bladder storage problem or obstruction problem, such as an enlarged prostate or scar tissue in the urethra. Injury or previous surgery can cause scar tissue in the urethra. The treatment plan usually starts conservatively with medication. If there is an obstruction, surgery may be warranted. “The outcome for men with urinary incontinence is usually good,” Albala said.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
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DIABETES
Growing Up with Diabetes
By Aaron Gifford
Mom: More schools need to be equipped to deal with an increasing number of kids who have diabetes
C
hip Moynihan was just a child when he discovered that “juvenile diabetes” was an outdated and inaccurate term Chip Moynihan was diagnosed with Type 1 diabetes in 1978 at the age of 5. His father, meanwhile, was diagnosed with the same disease three years later at the age of 35. The notion that Type 1 only occurred in children was the first of many misnomers the Moynihans dealt with in an era when too many people also assumed that all diabetes patients suffered from the disease because of unhealthy lifestyles. According to the Mayo Clinic, Type
1 diabetes is a chronic condition where the pancreas is unable to produce insulin, the hormone that allows sugar, or glucose, to enter cells and produce energy. There are various factors that contribute to Type 1, including genetics and exposure to certain viruses. Though Type 1 is far more common to first appear during childhood, it can develop at any age. Type 2, by contrast, occurs when the body doesn’t produce enough insulin or becomes resistant to the effects of it, according to the Mayor Clinic. Type 2 is far more common than Type 1, and is often caused by unhealthy diets and lack of exercise. As a child, Moynihan spent many Saturday mornings at a diabetes management education program at Loretto. He was the only young Type 1 diabetic among a large gathering of middleaged or elderly Type 2 diabetics. “They just kind of put everyone together,” he recalled. “The people used to say you ate too much sugar as a kid. When I was a kid, a diabetic was a diabetic. But Type 2 is really more of a fight about weight.” But Moynihan, who was the only Type 1 diabetic child during his years at elementary and high school, always maintained a can-do attitude,
Frankie Palladino, 9, of Manlius was diagnosed with type 1 diabetes a little more than a year ago. His mother, Patty Palladino, explained that the boy’s first year in school with the disease was difficult. and succeeded in school, martial arts bodybuilding and water skiing. He now works as a chronic care consultant and runs a Type 1 diabetes support for the entire Syracuse area. He’s helping parents to drive change in the way area schools respond to the needs of diabetic children. Frankie Palladino, of Manlius, 9, is among the children that Moynihan has
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helped. Frankie was diagnosed with Type 1 diabetes a little more than a year ago. His symptoms included constant thirst, lethargy and frequent urination. He also lost 15 pounds in one month. None of Frankie’s immediate family members are diabetic, but he does have two cousins with the disease. Continued on page 24
It’s a fact:
Research shows that kids who shop at stores with tobacco marketing two or more times a week are 64% more likely to start smoking than their peers who don’t. Source: Henriksen, Schleicher, Feighery and Fortmann. Pediatrics: The Official Journal of the American Academy of Pediatrics, July 19, 2010. DOI: 10.1542/peds.2009 3021
Our kids have seen enough. Take action to protect them at
IN GOOD HEALTH mag 10.25”w x 5”h • March 2013
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DIABETES
Controllable, Not Curable By Deborah Jeanne Sergeant
M
any websites and articles offer “cure” recipes for diabetics saying all they need to do is adopt certain lifestyle changes. That’s not the case, according to several people interviewed for this story. “Behavioral modification can eliminate or minimize the factors that lead to diabetes, obesity, physical inactivity, and reverse the lab work to normal or near normal levels,” said Susan Rioux, clinical nurse specialist and certified diabetes educator for St. Joseph’s Hospital Health Center. “If lifestyle changes Rioux produce improvement in blood sugar or A1C levels, discuss the possibility of reducing or discontinuing medication with your primary care provider,” Rioux said. [The A1C test provider a picture of the average blood
glucose control for the previous two to three months]. “However, the non-modifiable factors remain: genetic component, and progression of the disease. This may eventually lead to resuming medication, especially if the positive self-care behaviors don’t continue.” The term “cure” should not be taken literally. Jody Kearns, certified diabetes educator with the Joslin Diabetes Center at Upstate Medical University, doesn’t use the term “cured” even for the most compliant patients. “The person still has diabetes but is controlling it,” Kearns said. “It’s ‘well controlled diabetes.’ People still have diabetes.” The genetic predisposition to diabetes cannot be changed; however, the environmental effects can. Kearns helps patients learn how to lose weight, for example. “That can improve their blood sugar control,” she said. “If they lose
SmartBites
By Anne Palumbo
The skinny on healthy eating
Your Bones’ Best Friend: Milk
Page 18
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most Type 2 diabetics control blood sugar. “Monitor portion sizes of all foods and carbohydrate intake,” Kearns said. “Weight loss is accomplished by cutting back on everything.” Simple carbohydrates can spike blood sugar. They can come in many forms, including table sugar, white flour, fruits and white rice. Simple carbohydrates may be found in foods thought of as healthful such as 100-percent juice, pretzels, baked snack chips and raisins. Diabetics should generally focus on more whole grains, lean meats like fish, chicken and turkey, low-fat dairy, and vegetables, both for weight loss and for controlling blood sugar. Reliable sources of information include the American Association of Diabetes Educators, American Diabetes Association, American College of Endocrinology, and your doctor and certified diabetes educator.
healthy skin. You might be wondering: Will consuming more than the daily recommended amount of milk (three cups) protect my bones even more? Recent studies at Harvard suggest not. Also: Will drinking warm milk make me sleepy? Drinking warm milk before bed may help you relax, but there is not enough tryptophan (a precursor to melatonin) in a normal serving of milk to cause any real drowsiness.
2 cups low-salt chicken broth 1 teaspoon salt ½ teaspoon coarse black pepper 2 cups low-fat milk Shredded Parmesan cheese, for garnish
Helpful Tips Consume low- or no-fat milk over whole. It’s slightly higher in protein and significantly lower in saturated fat, cholesterol and calories. For example, an 8-ounce glass of whole milk has 146 calories, whereas skim has only 86. If possible, choose milk that is free of antibiotics, bovine growth hormone and pesticides.
M
ilk consumption falls by the wayside for many adults. Although we drink it as kids and encourage our own kids to drink it, many of us seem to lose that loving feeling for milk as we grow older. It’s unfortunate: milk is loaded with nutrients that aging bodies need. Milk is an excellent source of calcium, an important mineral that builds healthy bones and teeth, maintains bone mass, regulates heart rhythm and facilitates nerve transmissions. One cup of milk provides about 30 percent of our daily needs, which equals as much calcium as 10 cups of raw spinach. Vitamin D is equally important for bone health, and milk’s a winner in that department, too, providing about 25 percent of our daily needs. Simply stated, vitamin D promotes calcium absorption, which is essential for strong, healthy bones. According to Georgia Gianopoulous, a dietician at the Weill Cornell Medical Center, “Consuming adequate calcium and vitamin D helps
10 percent of their body weight even, it makes a difference.” She wants patients to pick an activity they like and incorporate both strength training and aerobic movement into their fitness plan. “It’s something you’ll need to do for the rest of your life,” she said. Choosing an activity that is too strenuous or uninteresting will make it hard to stick with. By lifting weights, the patient can build muscle tissue that will burn more calories even while at rest. Elevating the heart rate for 30 minutes or more most days of the week is a good goal, but staring out with five to 10 minutes is more realistic for most people. Before starting an exercise regimen or making dietary changes, anyone should consult with their doctor and certified diabetes educator. Although a nutrition expert may have good advice, he isn’t a specialist in diabetes. Adopting better eating habits helps
protect against osteoporosis and lowers the risk of bone fractures.” More good reasons to down this nutrient-dense drink: Milk teems with protein (about 8 grams per cup) and phosphorous, two additional nutrients that, among other benefits, contribute to strong bones. And, it’s a very good source of riboflavin, a B vitamin that helps convert food to energy. Last but not least, milk has as much potassium as one small banana (good for regulating blood pressure) and a good amount of vitamin A, a powerhouse vitamin essential for growth, eyesight and
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
CREAMY TOMATO SOUP (serves 4-6)
2 tablespoons canola oil 1 medium onion, thinly sliced 2 carrots, peeled and chopped 3 cloves garlic, minced 2 tablespoons tomato paste 2 28-ounce cans whole Roma tomatoes 1 teaspoon sugar ¼ cup chopped fresh basil leaves (or 3 teaspoons dried)
Heat the canola oil in a large soup pot over medium heat. Add the onions and carrots and sauté for about 10 minutes. If vegetables start to stick to the pot, add a little water and continue stirring. Add the garlic and cook for 1 minute more. Slightly increase heat and add tomato paste. Continue cooking, stirring often, until paste has begun to caramelize in spots, about 5 minutes. Add one whole can of tomatoes with juices and ½ of other (save rest for future use), sugar, basil, chicken broth, salt and pepper. Stir well. Bring the soup to a boil, lower heat, and simmer, uncovered, for 15 minutes. Carefully puree soup in pot with handheld soup blender. Stir in the milk and simmer until flavors meld, about 10 minutes longer. Garnish with a tablespoon of shredded cheese. Note: Before adding tomatoes, cut off tough ends and discard. 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.
Parenting
if you’re eligible for medicaid and you need long-term care
By Melissa Stefanec melissa@cnyhealth.com
A plea to nonparents and parents with older children
B
aby-proof (noun \bā-bē prüf\) — The achievement of having one’s home and surroundings so secure that the parents of babies are lulled into a false sense of security. A status that is unrealistic and unobtainable, even after ridiculous amounts of time, money and energy are spent trying to acquire said status. OK, so maybe the editors at Merriam Webster wouldn’t be on board with this definition, but I know there are a lot of parents behind me when it comes to this practical definition of baby proof. What is babyproof anyway? Almost everything is baby-proof; it’s toddler proofing that lays down the gauntlet. Some days I feel like I achieved it, then my daughter comes running up to me with a candle lighter or dish of cat food. Stella is getting smarter, quicker, and (dare I say it) mischievous. (As a parent, I’m just coming to the point where I recognize Stella is a very real person, whom possesses positive and negative qualities alike). Minus the isolated flammable object and pet food mishap, I think my house is as baby-proof as it is going to be. I’m not going to make this column about baby proofing for parents with young children. We are all so sick of worrying about baby proofing. We don’t need it crammed down our throats anymore. However, I would like to take this opportunity to gently nudge a different demographic with some baby proofing advice. I want to preach to two demographics, the childless and parents with (much) older children. When we hit the road with our tot in tow, things get a bit hairy. This column is a crash course in baby proofing for the unbabied. So, if you’re a relative, childless friend or parent with older children, continue reading. If you want to get more than three uninterrupted, coherent sentences out of your visitors, you will set aside a few minutes to help out us frazzled parents. When we travel, my husband and I keep a good eye on Stella, but she is lightning-fast. On the other hand, I am getting older, slower and driven to distraction. (By distraction, I mean I try to speak a sentence that doesn’t contain the phrases, ‘we don’t put that in our mouths’ or ‘that hurts the doggie’.) Toddlers will be toddlers and taking a few precautions to baby proofing can help keep everyone involved sane. Here is my crash course in baby proofing. • Hide your treasures and break-
ables — Your great grandmother’s antique candy dish, your framed wedding picture, your oil diffusers, your vintage fishing rod hanging precariously low, you need to temporarily relocate these objects. • Create a makeshift baby cage — This isn’t as cruel as it sounds. I’m just requesting that you restrict access to most of your home. Shut the doors to all of your rooms and keep them shut. If you have some gates, use them. If you can use furniture as a barricade, do it. We’re talking toddler warfare here! • Put out some toys — I’m not requesting that people go out and buy toys. I’m suggesting that finicky toddlers love playing with new stuff. In many cases, “new” items can be as simple as wooden spoons and pie tins. Toddlers love making forbidden material into toys, so put out some safe forbidden material. • Keep your toys away — Your tablet, phone, laptop, remotes, all these things should be safely stowed somewhere. I don’t want to chase down an as-seenon-TV knock-off remote for your next birthday, and you probably enjoy your original remote. • If your pets don’t like kids, lock them up — If you refuse to lock up your kid-hating pet, then don’t invite my toddler over. Stella loves animals. I’m pretty certain her first word was “meow.” When she’s excited, she pants like the Pomeranian at daycare. Most toddlers will find a way to play with your pet, so let’s make sure your pet is willing. If not, let’s not turn our visit into a cage match between your furry baby and my baby. • Prepare yourself for a lot of touching — Be prepared that items in your home will be touched. By items, I mean everything. If you can’t handle this, things are going to go less than well. This is why I request you put untouchable items out of reach. Unless the only phrase you want to hear out of my mouth is “please don’t touch that.” Make sure some stuff is okay to explore. • Take a deep breath and relax — Now that I am done totally freaking you out; let me remind you that your visit with my family will go just fine. By taking a few easy precautions, you can actual sit back and enjoy our visit. After all, I’m not bringing a 21-pound tornado into your home (she’s more like a hurricane).
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SUNY Upstate leads the state in enrolling New York’s own U
pstate Medical University’s College of Medicine’s incoming class for fall 2012 had a higher percentage of New York residents than the other 12 allopathic medical schools in the state. The data was shared by the Association of American Medical Colleges. Upstate’s College of Medicine received 4,730 applications for admission for the class of 2016. Of the 156 enrolled students, 87.8 percent of them were from New York state. That percentage bested SUNY Buffalo (82.6), SUNY Downstate (80.5) and SUNY Stony Brook (73.4). “This is no accident,” said Upstate President David R. Smith. “We have been making a concerted effort to attract and enroll New Yorkers over the last seven years. While our applicant pool was only 42 percent New Yorkers, I challenged our admissions committee to look closely at our own. We have an excellent class and the state has a strong chance of retaining them. It’s the right thing to do for Upstate and New York state.” The ranking also bears out the importance of maintaining a strong Upstate University Hospital in Central New York. “The College of Medicine and our Upstate University Hospital move as one and serve as a large interactive classroom for all our students,” said Hospital CEO John B. McCabe. Imbedded in the class of 156 are some 29 students from rural New
York counties. These students are being encouraged to seek a career that would include service in a rural setting. A special Rural Medical Scholars Program has been designed for those students and special opportunities are extended, according to James
Medical Schools Incoming Class of 2016
College Applications # Class % NYS Residents SUNY Upstate ................... 4,730 .................... 156 ..................... 87.8 SUNY Buffalo .................... 4,192 ................... 144 ..................... 82.6 SUNY Downstate ............... 5,543 ................... 185 ..................... 80.5 SUNY Stony Brook ............ 4,918 ................... 124 ..................... 73.4 Hofstra-North Shore .......... 5,043 .................... 60 ...................... 53.3 Albert Einstein ................... 7,784 ................... 183 ..................... 44.3 Rochester .......................... 5,055 ................... 102 ..................... 37.3 Albany ............................... 7,953 ................... 138 .......................37 New York Medical ............. 11,422 .................. 195 ..................... 34.9 New York University .......... 8,351 ................... 158 ..................... 34.2 Mount Sinai ....................... 6,309 ................... 139 ..................... 30.9 Columbia ........................... 7,378 ................... 166 ..................... 30.7 Cornell-Weill ...................... 5,886 ................... 101 ..................... 23.8 Source: US Medical School Applications and Matriculants by School, State of Legal Residence and Sex, 2012 (Association of American Medical Colleges Report 12/17/2012)
Sleep Specialists By Deborah Jeanne Sergeant
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• “Sleep apnea can be a problem that can be missed. Most people feel that they may be sleepy because they’re working late and fatigued because of the life obligations they have. Treating sleep apnea is not just to get rid of Page 20
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• the presence of a dedicated mission, committed leaders and a rural training program at the medical school • inclination of the student toward public service
Matriculated Students Fall 2012
What They Want You to Know:
leep specialists are medical or mental health professionals whose further course of study and certified, board-regulated sub-specialty is sleep disorders. These include professionals in sleep technology, behavioral sleep medicine, and sleep medicine specialists.
Greenwald, professor of family medicine and director of the program. Greenwald says that rural practice actually correlates best with four factors: • rural origin of the students • interest in family practice
fatigue or snoring but also because it’s associated with other medical conditions. Sleep apnea can make those conditions worse. The conditions that have a high association with sleep apnea include systemic hypertension, irregular cardiac rhythms, and congestive heart failure. People who have to be put to sleep for surgery are more likely to have complications if they have untreated sleep apnea. • “When people talk to their doctor about sleep, they should bring their bed partner with them if possible. Many of these problems are picked up
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2012
by the bed partner, including snoring, movement, talking or sleep walking. These can be a problem and the only way to know is to have the bed partner there. • “Keep a log of how much sleep someone is getting is important. The most common cause of excessive daytime sleeping and fatigue is insufficient sleep at night. It may have nothing to do with sleep apnea. It’s not a matter of insomnia, but that they’re not devoting enough time for sleep. • “Sometimes people are afraid they aren’t going to sleep in the sleep lab when undergoing a study. The sleep lab is made to be comfortable to get people to sleep. Others worry that if they get diagnosed with sleep apnea, they won’t be able to comply with the therapies. People tolerate things differently. They should just try the therapy, even if they’re not sure it will work for them. Sherif El Bayadi, sleep specialist and pulmonary specialist with the Sleep Laboratory at St. Joseph’s Hospital Health Center. • “One misconception that patients often have is that sleep apnea is all that we treat. We treat people for many other sleep disorders. Many of them are very effectively treatable. • “Many patients can have symptoms that manifest as sleep disorders, but may not be because of true sleep disorders. Some patients say, ‘I sleep fine,’ but are unaware of how poorly they are sleeping.
• “We look at symptoms that appear in the daytime and overall health. Feeling tired in the daytime is one of those. That is a common sign of a sleep disorder. • “Getting older or feeling bored doesn’t make you have naps and feel sleepy in the daytime. If you have adequate sleep, you should be able to stay awake during the daytime. • “You spend about one-third of your life sleeping and that part of your life can be neglected. It would be beneficial for people to seek treatment for their sleeping disorders and often has a very immediate and dramatic impact on quality of life. • “Bring all your records if you’ve had any testing before for sleep issues. • “Know the medication you’re on. That is very helpful.” Jacob Dominik, neurologist with a sub-specialty in sleep disorders, is affiliated with Sleep Insights Medical Service, with several offices in Central New York.
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.
Excellus Awards Hospitals $26 Million for Quality Improvements
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ifty-four upstate New York hospitals and health centers last year earned $26 million in quality improvement incentive payments from Excellus BlueCross BlueShield as part of the health insurer’s hospital performance incentive program. In the past nine years, quality performance incentives from Excellus BlueCross BlueShield have exceeded $145 million. “Our many years of working with our hospital partners to drive improvement in quality of care and patient safety by linking payments to improvements in health outcomes provides a strong foundation for the new models of collaboration anticipated with health care reform,” said Carrie Frank, vice president of quality and health informatics at Excellus BlueCross BlueShield. Participating in this program in 2012 were eight Central New York hospitals: Cortland Regional Medical Center, Crouse Hospital, Massena Memorial Hospital, Oswego Hospital, Samaritan Medical Center, St. Joseph’s Hospital Health Center and Upstate University Health System (two hospitals). “For several years, Crouse and other hospitals have partnered with Excellus BlueCross BlueShield to improve the care of patients,” said Derrick Suehs, chief quality officer at Crouse Hospital in Syracuse. “This partnership has played a key role in helping Crouse identify, prioritize and implement care improvement initiatives that make a real difference in the patient experience and care outcomes.” Suehs cites as examples Crouse Hospital’s 57 percent reduction in acquired pressure ulcers in its intensive care unit over the past year, a decrease in the number of hospital-acquired infections and improvements in patient satisfaction scores and timeliness of services. “Excellus BlueCross BlueShield’s
hospital performance incentive program provides a supportive structure for continuous improvement in both clinical and service outcomes. It has been a win for our patients at Crouse,” said Suehs. Launched in 2004, the hospital performance incentive program evaluates participating hospitals on more than 300 performance measures. In 2012, hospitals achieved 87 percent of all target quality levels. Target outcomes are jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, the Leapfrog Group, the Joint Commission on the Accreditation of Healthcare Organizations, the Institute for Healthcare Improvement and others.
Four areas are targeted for improvement:
• Clinical outcomes — Focused on improvements in heart attack care, heart failure and pneumonia care. • Patient safety — Focused on reductions in hospital-acquired infections, improved medication reconciliation processes, surgical care and National Quality Forum Safe Practices. • Patient perception of care and patient satisfaction — Focused on a hospital’s use of a national survey tool. • Efficiency — Focused on generics utilization, length of stay and readmissions.
Relevance in Upstate New York
According to the most recent data on hospital-acquired infections available from the Centers for Medicare & Medicaid Services, there were an estimated 24,000 hospital-acquired infections in upstate New York in 2010, and more than 1,000 deaths were likely to have occurred as a result.
Upstate studying use of FaceTime to observe medical students in clinical settings
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edical schools are always interested in finding innovative ways to monitor a student’s interaction with patients, especially without the faculty member also being in the room. The iPad, together with its FaceTime application, might be just what the doctor ordered to make that happen. Funded by a $25,000 SUNY Innovative Instruction Technology Grant, Upstate Medical University will study the use of the FaceTime application on the iPad to observe students in clinical settings. “We know how convenient and useful FaceTime and the iPad are at connecting families, especially when they are great distances from each other,” said Ann Botash, professor of pediatrics and one of the study’s principal investigators. “We want to see if the same technology can be helpful in how faculty observe and respond to students as part of the educational process.” Under the study, faculty will use FaceTime on the iPad to observe the student’s patient encounter in real time and provide immediate feedback to the student. Once inside the exam room,
the student will place the iPad in the corner of the room so that the faculty member, who will be at another location, can observe the student and patient interaction. When the session with student and patient is over, the faculty member can provide the student with immediate feedback, also using the FaceTime application. About 60 students and faculty are part of the study. The students involved in the study represent a variety of education programs, from medical students in family medicine and pediatric clerkships, to students in Upstate’s family nurse practitioner (College of Nursing) and physical therapy programs (College of Health Professions). While iPad use is growing as a teaching tool in many institutions, the benefit of its use with its FaceTime application, is less known. “This study will address whether the iPad and FaceTime can help us bridge time and distance barriers to observing students,” Botash said, “as well enhance the students’ clinical skills by improving the quality and consistency of the faculty’s immediate feedback.” Upstate will present the study’s findings in May.
These six women are now performing at healthcare institutions around town as part of their internship in Upstate’s therapeutic music practitioner program. From left: Laura Jordan of Baldwinsville, Victoria Krukowski of Cicero, Libby Joyce of South Onondaga and Mary Tolone of Mattydale, are among the first class of students in Upstate’s Music for Health and Transition Program. To fulfill their certificationr requirements, the will play for patients at area healthcare institutions.
First class of music practitioners set to play for patients
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ix musicians, including a clarinetist who played for the Syracuse Symphony Orchestra, are poised to be among the first Syracuse-area residents certified as music practitioners through the national music for healing and transition program, now offered at Upstate University Hospital. As a final step to full certification, the six embarked on a 45-hour internship program, beginning in January, to providing healing music to patients at Upstate University Hospital and other area healthcare facilities. Upstate’s music for healing and transition program, which enrolled its first class in March, trains musicians on how to use live music to create a healing environment for those with acute and chronic illness. Each musician has already had more than 100 hours of classes taught in Syracuse by certified music practitioner instructors from across the country. Their internships, which began in January, marked the first formal therapeutic musical encounter they have with
patients. Harpist Laura Jordan said the training reaffirmed what she had known from her days as an educator, that music has the power to change the environment. “Music can fill more than a room; it has the power to promote a healing environment, and that will be our roles as music practitioners,” she said. Music practitioners are not music therapists. Music practitioners use their training and talent to create a healing environment that may reflect changes occurring in the patient. Music therapists are part of a patient’s clinical care team and often engage patients in a music-related activity to meet a therapeutic goal. All of the students agree that being a music practitioner is less about performing than it is about creating that healing environment. Classes for the spring program begin in March. For more information contact Dona Wonacott at 315-303-4015.
Letter to the Editor Music therapy: Story misstates name of profession To the Editior Dona Wonacott, our harpist, and I have read the article about the harpist at St. Joseph’s published last month in In Good Health. We noticed that the article’s author has given the title “therapist” to Dona Wonacott. There are several instances she is referred as therapist, including in the photo caption. Dona, Sister Rose Ann and I were all in the room during the interview. We repeatedly wanted to make sure that Dona’s receives the correct title: certified music practitioner. March 2013 •
We even gave the interviewer Dona’s brochure and explicitly stated that Dona is not a therapist, that she is a certified music practitioner. Sister Laura Hackenberg Chaplain, Spiritual Care Services St. Joseph’s Hospital Health Center Editor’s note: We regret the mistake.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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All in the Family: Love of Medicine Skin Deep In Dr. Fuad Farah’s family, all his four children are physicians By Mary Beth Roach
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edicine is all in the famdiverse, you need a background ily for the Farahs with that’s not just one-dimensional,” five doctors spanning he said. two generations. He graduated from SUNY Physician and patriarch Fuad Upstate Medical University, Farah and his wife, Mona, have completed his internship in New four children—Richard, Ronald, Hampshire, and his residency Joyce and Ramsay—who are all and a fellowship in St. Louis. doctors. In 2000, he returned to CenAll four siblings earned their tral New York, joined his father medical degrees from SUNY Upin private practice and began state Medical University. The two teaching at Upstate. youngest siblings—Ramsay and In 2003, Ramsay became the Joyce—joined the practice of Farchief of dermatology, a position ah Dermatology and Cosmetics, a once held by his father. practice their father founded. He is also an associate proLike their father, Ramsay and fessor of medicine and pathology Joyce also teach at Upstate. and laboratory director of the Meanwhile, Richard is an anuniversity’s Mohs surgery unit. esthesiologist in Alaska. Ronald, Most recently he was inthe second oldest, is a radiologist stalled as president of the Onat the Syracuse Veterans Adminondaga County Medical Society. istration Medical Center. Ramsay, at 43, has distinguished From their main offices at himself by becoming the youngthe Hill Medical Center near est president of that organization. Upstate, Fuad, Ramsay and Joyce Daughter follows suit shared the story of the family’s Joyce Farah came to the pracimmigration to the United States tice through a different route. from Lebanon, the founding of “I had always wanted to go their private practice, the differinto medicine or be a teacher,” ent paths they took into medicine, she said. So she has done both. and what it is like to be in busiShe had been a French ness together. teacher in Homer and then at While there may be many East Syracuse-Minoa. While she fathers and sons or fathers and was on maternity leave, she dedaughters in practice together, to cided it was the opportune time have a father-son-daughter team, to enter medicine. especially in dermatology, is She graduated from Upstate unique, they said. in 2001. She went on to do a felMona is the office manager. lowship at Roswell Park Can“She has an honorary doctorate,” cer Institute and a residency at All in family: Seated are Mona and her husband, physician Fuad Farah. Standing are son Ramsay and quips Ramsay. SUNY Buffalo. It was the mid-1970s, and the daughter Joyce, both physicians. In the portrait on the wall is the graduation photos of sons Richard, While she is part of the famFarahs were living in Lebanon, a Ronald, Ramsay and daughter Joyce Farah — all medical doctors. The center photos are of Fuad and ily’s private practice, she hasn’t country being torn apart by civil Mona Farah left the classroom. She is an aswar. Concerned for the safety of sistant professor of medicine at the family, the Farahs fled to the career choices; for example, the actual the division of dermatology until 2003. Upstate, and is considered an expert in United States. practice of medicine, research, adminis- In 1980, he founded Farah Dermatolthe field of photodynamic therapy. “He didn’t really have much of a tration, or teaching. ogy and Cosmetics. The doctors not only share a pasplan other than to get the family out of Fuad knows well of this diversity. That all four children have gone sion for medicine, research and teachLebanon,” recalls Ramsay, the youngDuring his 52-year career, he has been into medicine might not be as much a ing, and not only do they share the est, who was 7 at the time. “It was a involved in many aspects of the medimatter of genetics as it is the example name on the door of their medical pracchallenging time. We just left with cal field. set by their father. tice, but they also share a single office. six suitcases and no job prospects in Although the Farah family moved Dad showed the way Their suite includes a reception hand.” here in 1976, Fuad had been to the U.S. “Imitation is the highest form of area, treatment and examination “We immigrated with almost noth- years earlier. As a recipient of a Rockflattery,” said Ramsay. “I think I speak rooms, a laboratory, and one room ing except what was in my head,” Fuad efeller Foundation Scholarship, Fuad for all of my siblings. We’ve watched where the desks for the three doctors— said. trained at Barnes Hospital in St. Louis, my dad and the life he’s been able to and one for Mona—line two walls of The family landed in Boston and Mo., learning research techniques in lead as a physician; it’s been a very that space. They also have offices in visited Syracuse because they had rela- immunology. inspiring life. It’s been a scholarly Watertown, Camillus, and Fulton. tives there. One relative is cardiologist Upon returning to Beirut, he life; he’s been a teacher and he’s been The Farahs enjoy this sense of toDaniel Fuleihan of the New York Heart began his own immunology lab at healer. Every day he comes back home getherness, and see it as being benefiCenter and past president of the Onon- the American University there. In the from his work with great satisfaction cial to their patients’ care. daga County Medical Society. early 1970s, he was approached by the “I can’t imagine a better situation,” Fuad went on to join the staff at World Health Organization to establish that he’s made a real and tangible difference. What better way to lead one’s said Joyce, adding the arrangement alSUNY Upstate Medical University in a WHO Immunology Research and life than to heal and to teach? It’s been lows for an easy flow of information. the late 1970s and continues to teach Training Center at the university, and very gratifying for Dad and we wanted Ramsay said patients benefit from there. in 1975, he was a visiting professor in to do the same.” the wisdom and experience of their Bern, Switzerland. ‘Testament to Dad’ Although Ramsay always knew he father, while he and his sister can bring He is recognized as one of the “It was testament to my dad,” wanted to follow in his father’s foota high level of energy and enthusiasm. pioneers in research on leishmaniasis, Ramsay said. “He was in his 40s. A steps and go into medicine, he maIt’s this enthusiasm that continues a parasitic disease prevalent in the family of four, two kids in college with to fuel their love of learning in such an Middle East and one that has affected a jored in history at Syracuse University no assets. [He left Lebanon] just to get ever-evolving field. number of Gulf War soldiers upon their during his undergraduate years. He them out of danger.” thought it was important and ben“It’s what makes it fun,” said Ramreturn from that part of the world. Fuad encouraged his children to eficial, he said, to meld scientific and say. “It’s part of what makes it a great After settling in Syracuse in 1976, get their degree in medicine. A major humanities backgrounds. job.” Fuad joined the staff at Upstate Medireason is the flexibility it can offer in “As the world becomes more cal University and served as chief of Page 22
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
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Do You Need To File a Tax Return This Year? Dear Savvy Senior, My income dropped way off when I retired early last year, and I’m wondering if I fall into the so called “47 percent” of Americans who won’t have to pay any income taxes this year. What can you tell me? Curious Senior Dear Curious, The percentage of seniors, age 65 and older, who won’t have to pay income taxes this year, is actually around 56 percent, according the Tax Policy Center. Here’s a breakdown of the 2012 filing requirements along with a few other tax tips to help you determine if you need to file. IRS Requirements Whether or not you’ll need to file a federal income tax return this year will depend on your filing status, your age, and your gross income. If your gross income falls below the IRS filing limits, you probably won’t have to file. Gross income includes all the income you receive that is not exempt from tax, not including Social Security benefits, unless you are married and filing separately. You probably don’t have to file this year if: • You are single and your 2012 gross income was less than $9,750 ($11,200 if you’re 65 or older). • You are married filing jointly and your gross income was under $19,500. If you or your spouse is 65 or older, the limit increases to $20,650. And if you’re both over 65, your income must be under $21,800 to not file. • You are head of household and your gross income was below $12,500 ($13,950 if age 65 or older). • You are married filing separately and your income was less than $3,800.
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• You are a qualifying widow(er) with a dependent child and your gross income was less than $15,700 ($16,850 if age 65 or older).
Special Situations Be aware that there are some special financial situations that require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had net earnings from self-employment in 2012 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file. To figure this out, the IRS offers a resource on their website called “Do I Need to File a Tax Return?” that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. You can access this page at www.irs.gov/uac/Do-I-Need-toFile-a-Tax-Return%3F, or you can get help over the phone by calling the IRS helpline at 800-829-1040.
Check Your State Even if you’re not required to file a federal tax return this year, it doesn’t necessarily mean you’re also excused from filing state income taxes. Check on that with your state tax agency before concluding you’re entirely in the clear. For links to state and local tax agencies see taxadmin.org — click on “Links.”
Tax Aide If you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low income taxpayers, age 60 and older. Call 800906-9887 to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at nearly 6,000 sites nationwide. To locate an AARP TaxAide site call 888-227-7669 or visit aarp. org/findtaxhelp.
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.
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George S. Kornfeld, O.D. for a FREE telephone consultation call: 585-271-7320 or 866-446-2050 www.IALVS.org March 2013 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Growing Up with Diabetes Continued from page 17 and the times for insulin administraHis mother, Patty Palladino, explained that the boy’s first year in tion. She said that while the prevalence school with the disease was difficult. of Type 1 diabetes has increased in In one instance, a bus driver told him recent years, the technology for monihe could not eat on the bus. In another, toring and treating it has improved. Frankie had to blatantly disobey a One of the newer devices is an insulin teacher’s order not to leave the classpump that provides the user a conroom to use the tinuous source of bathroom. Graduinsulin through a ally, the staff besmall tube inserted came more aware into the abdomen. of the boy’s condi“Another tion and made major change has allowances for been the diet of dihis required care, abetics,” she said. Patti explained. “They are allowed “It’s a difficult to eat whatever balance,” she said. they want within “As parents, we reason, and are want to teach him not restricted from to be respectful. eating sweets. Of But he also has course, a nutritious to keep himself meal is preferred.” safe. With this Belton added [disease], when that every faculty you have to eat, member in a school you have to eat. should be aware of Luckily, he had any diabetic stua vigilant school dent in the school, nurse.” and nurses should Karen Cofino, The Palladicomplete training president of the NYSASN nos learned that for administering the school did not emergency gluhave a set policy or guidelines for deal- cose injections in the event that a child ing with diabetic students, but they ap- should ever become unconscious due plaud the nurses for going out of their to low blood sugar. Moreover, faculty way to look after Frankie’s well being. and students are instructed in recognizHe can administer his home fingering the symptoms of very high or low prick tests to check sugar levels, but blood sugar in case the diabetic student the nurses administer the insulin shots will need help getting to the health twice a day. Frankie brings a supply kit office. to school, including an emergency pen Karen Cofino, president of the that is used if sugar levels drop danger- NYSASN, said school nurses have ously low. many responsibilities when it comes In late September, Patty discussed to helping diabetic students. Students the importance of Type 1 diabetes edu- who test their blood sugar often during cation at a meeting with the state eduthe school day may need to learn how cation reform commission at Mohawk to properly discard their lancet after Valley Community College in Utica. each test. Students new to diabetes Moynihan said some schools in the may need assistance learning how to region are very receptive to the needs do their tests independently. And a of diabetic students, while a handful student who is transitioning from daily of others are still “tough as nails.” He’s injections to an insulin pump will need advising districts to include at least help learning how to count carbohybrief diabetes awareness training in drates in foods and calculate them into the teacher training or development the device. Often, nurses will have to workshops that occur throughout the advocate for diabetic students at lunch academic year. time by making sure they aren’t wait“It could be built into the rest of ing in the cafeteria line too long. the training,” he said. “Even if it’s just Cofino was quick to point out that quickly going over a binder that they students also have the right to keep can reference later.” health issues to themselves if that’s Representatives from the New York their prerogative. State Association of School Nurses “If a child feels he or she is com(NYSASN) said they have made fortable sharing information about his significant strides in recent years to or her diagnosis with his or her classbetter accommodate diabetic students mates that is totally up to them,” Coand educate staff and faculty members fino said. “Some students do not want about the disease. to talk about it and want to maintain Diane Belton of the Cazenovia Cen- privacy. School nurses are to maintain tral School District noted that the first student confidentiality and are not step is to maintain specific parent and allowed to disclose medical informaphysician orders for glucose testing tion.”
“Some students do not want to talk about it and want to maintain privacy. School nurses are to maintain student confidentiality and are not allowed to disclose medical information.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013
The Social Ask Security Office Column provided by the local Social Security Office
Spring Into Retirement
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ere are a few important items about Social Security retirement benefits and how to apply for
The decision of when to retire is personal and depends on a number of factors. To help you weigh the factors, them. we suggest you read our online fact When you work and pay Social sheet, “When To Start Receiving ReSecurity taxes, you earn credits totirement Benefits,” available at www. ward Social Security benefits. If you socialsecurity.gov/pubs/10147.html. were born in 1929 or later, you need 40 You may want to consider your credits (10 years of work) to qualify for options by using our “retirement retirement benefits. estimator” to get instant, personalized We determine the amount of your estimates of future benefits. You can benefit by both how long you work and plug in different retirement ages and how much you earn. The higher your scenarios to help you make a more lifetime earnings, the higher informed retirement decision. your monthly benefits. If there Try it out at www.socialsecuwere some years when you did rity.gov/estimator. not work or had low earnings, You also can set up an your benefit amount may be online “my Social Security” lower than if you had worked account. You can use your steadily or earned more. “my Social Security” account Your age at the time you to obtain a copy of your Social start receiving Social Security Security statement to check retirement makes a difference your earnings record and see in your benefit amount. The future estimates of the retirefull retirement age (the age at ment, disability, and survivor which 100 percent of retirebenefits you and your family Banikowski ment benefits are payable) has been may receive. Visit www.socialsecurity. gradually rising from age 65 to age gov/myaccount. 67. You can take “early retirement” as When you decide to retire, the easiearly as age 62, but if you start collectest and most convenient way to do it is ing benefits before you reach your full right from the comfort of your home or retirement age, your monthly payment office computer. Go to www.socialsecuwill be reduced. You can find out what rity.gov where you can apply for retireyour full retirement age is by referment benefits in as little as 15 minutes. ring to the convenient chart at www. In most cases, there are no forms to socialsecurity.gov/retire2/retirechart. sign or documents to send; once you htm submit your electronic application, Just as you can choose an early that’s it! You’re done! retirement and get a reduced payment, Be sure to have your bank account you also can choose to keep working information handy so you can receive beyond your full retirement age to take your payments electronically. Electronadvantage of a larger payment. Generic payment of federal benefits is now ally, your benefit will increase automat- mandatory, with few exceptions. ically by eight percent each year from Spring is a great time to turn a new the time you reach your full retirement leaf. Spring into retirement now! Learn age until you start receiving your benmore by reading our publication, “Reefits or until you reach age 70. tirement Benefits,” at www.socialsecurity.gov/pubs/10035.html.
Q&A
Q: I need to get something from Social Security to verify my income. How can I do that? A: We provide three types of income proof: 1 – A Benefit Verification Letter shows your monthly benefit amount. You can get your Benefit Verification Letter online at www.socialsecurity.gov/myaccount. It often is used as official proof of income to: • Apply for a loan; • Give to a landlord; • Obtain housing assistance, or other state or local benefits; • Verify Medicare coverage; or • Verify retirement status, disability, or age. 2 – An SSA-1099 shows your annual income for income tax purposes. We mail the SSA-1099 by January 31 each year. You can request an SSA1099 online, or you can call us at 1-800-
772-1213 (TTY 1-800-325-0778) between 7 a.m. to 7 p.m., Monday through Friday, or visit a local office. Go to www. socialsecurity.gov to locate an office. 3 – An annual cost-of-living adjustment (COLA) notice is sent to all beneficiaries at the end of each year providing the amount of the monthly benefit for the following year. Q: What is the earliest age I can begin receiving retirement benefits? A: The earliest age you can begin receiving Social Security retirement benefits is 62. If you decide to receive benefits before your full retirement age, you will receive a reduced benefit. Keep in mind you will not be able to receive Medicare coverage until age 65, even if you decide to retire at an earlier age. Check out our “retirement estimator” to get fast, personalized estimates of future benefits. You can find them at www.socialsecurity.gov/estimator. For more information, go to www.socialsecurity.gov.
H ealth News New chief nursing officer at Crouse Ann Sedore has been named chief nursing officer for Crouse Hospital. She had previously served as director of the Crouse Hospital College of Nursing for five years, and prior to that as chief operating officer and chief nursing officer at University Hospital in Syracuse. In her new role, Sedore will provide strategic and operational leadership for the hospital’s nursing division, which includes more than 900 registered nurses. “Ann is an energetic, engaged and mission-focused leader with a solid grasp of both strategic Sedore and operational issues,” says Crouse CEO Paul Kronenberg. “Her proven nursing leadership experience, both at Crouse and in her prior positions, coupled with her passion for the profession of nursing, made her the overwhelming choice from the candidates we reviewed. Her values match our organizational values.” Sedore, who holds a Ph.D. in nursing, is a member of the Central New York Nurses Collaborative to Advance Research and Evidence-based Practice (CNY-NCARE) and of Sigma Theta Tau, Omicron Alpha Chapter. She also serves on the Onondaga County BOCES health advisory board and the advisory board of Keuka College of Nursing, and is a consultant on legal matters related to nursing care in acute care settings to law firms throughout New York state.
Eye doctor inducted into College of Surgeons Physician Patrick Costello has earned the right to use the designation FACS — Fellow, American College of Surgeons — after his name. The Oneida native has been an eye and eyelid surgeon in the Mohawk Valley for nearly nine years. He was among 1,377 initiates from around the world who became fellows of the American College of Surgeons (ACS) during convocation ceremonies at the College’s 2012 annual Clinical Congress held recently in Chicago. Costello was nominated by his colleagues for the distinction, which was followed by Costello an ACS review of his personal, educational and surgical history and an invitation for an oral interview before the board. “Physicians cannot apply for this distinction, but rather have to be recommended by another fellow, which makes it a very select honor,” said Costello. Costello is in practice with his brother John at Costello Eye Physicians and Surgeons located in New Hartford, Oneida, Rome and Hamilton. He is an adjunct faculty member at SUNY Upstate Medical University. In 2012, Costello joined other area eye surgeons
and Rome Memorial Hospital to open the Griffiss Eye Surgery Center, where he performs all of his surgeries. He received a medical doctorate in 2000 from Albany Medical College and served on the faculty at Albany Medical College. He is a fellow of several other professional societies and academies including the American Academy of Ophthalmology, American Academy of Cosmetic Surgery and the American Society of Cataract and Refractive Surgeons.
Chelsea Doyen joins North Medical Family Physicians Physician Chelsea Doyen has recently joined North Medical Family Physicians at North Medical Center in Liverpool. The practice is an affiliate of St. Joseph’s Hospital Health Center. Doyen is certified by the American Board of Family Practice and completed her residency at St. Joseph’s Hospital Health Center family medicine program in Syracuse. Doyen worked as a physician technician at Arlington Emergency Medical Associates in Arlington, Texas, and was a member of the Surgery Club at St. George’s University and a volunteer at Children’s Doyen Hospital of Dallas. Prior to pursuing her medical degree, Doyen received a bachelor’s degree in business administration from Texas A&M University and worked as the director of traffic at Ackerman Queen Advertising in Irving, Texas. In 2009, Doyen received her medical degree at St. George’s University School of Medicine in Grenada, West Indies, and a bachelor’s degree in biology from University of Texas at Arlington in 2004.
Markessinis joins North Medical Urgent Care Physician Paul Markessinis recently joined North Medical Urgent Care at Northeast Medical Center in Fayetteville. Markessinis is certified by the American Board of Internal Medicine and completed residencies at Albany Medical Center Hospital and Rhode Island Hospital. Markessinis has years of experience as owner and president of First Stop Medical Care, P.C., in Albany, where he was responsible for all clinical, operational and financial aspects of an urgent care practice. Markessinis is also Markessinis the owner and president of Lite-Touch Cosmetic Skin Care, a part-time medical practice offering various non-invasive and minimally invasive cosmetic skin care treatments in the Albany area. Markessinis received his medical degree at University of Massachusetts Medical School in Worcester, Mass., in 1983. He received his bachelor’s degree in chemistry and biology from
New Dean At Upstate College of Nursing Joyce P. Griffin-Sobel, who has education at Weill Cornell Medical more than 30 years of experience in College, for ITEACH—Integrating academic nursing, has been named Transdisciplinary Education Across dean of the College of Nursing at Cornell-Hunter. Upstate Medical University. As acting dean, and assistant The appointment is effective dean of curriculum and technology, April 1. She succeeds Elvira Szigeti, Griffin-Sobel oversaw curricular who is retireting after serving as activities and academic quality in dean of Upstate’s College of Nursthis school of 800 students, and led ing since 1998. the incorporation of techGriffin-Sobel, who is nology into curriculum, known for her leadership with special attention to and innovation in teaching the use of simulation and with technology and interinformatics. During this professional education, is a time, she created a CUNYprofessor in the Hunter-Belwide consortia of faculty levue School of Nursing at development in teaching Hunter College, City Univerwith technology. sity of New York, where she Griffin-Sobel’s impact has served as acting dean, has been felt as an author, assistant dean of curriculum Griffin-Sobel editor and contributor to and technology (2008-2011), numerous scholarly works, and director of undergraduate proand books including, “Gastrointesgrams (2004-2011). tinal Cancers” (Oncology Nursing Says Griffin-Sobel: “My goals Society, 2007), and “Hematology & are to develop interprofessional Immunology: Concepts for Nurseducation experiences, broaden the ing“ (Appleton Century Crofts, college’s online course offerings, 1986) which won an AJN Book of build strong relationships with our the Year Award. stakeholders such as health care Griffin-Sobel is a much soughtand community agencies, corporaafter speaker, having lectured tions and alumni, and to deepen across the globe on issues related the research mission of the college.” to technology in health care and Upstate’s College of Nursing, cancer care. She has received nuenrolls more than 400 students merous honors for her teaching and in a variety of programs, offering research including the 2012 Excelbachelor’s, master’s, post-master’s lence award in Academic Mentorcertificate. It will begin offering the ing from the International Nursing doctor of nursing practice degree Association for Clinical Simulation, this fall. The college is accredited and was named a Fellow of the by the American Association of Academy of Nursing Education in Colleges of Nursing’s Commission 2008. on Collegiate Nursing Education. Her clinical career has been At Hunter, Griffin-Sobel is in oncology, particularly care principal investigator for New York of those with gastrointestinal City Nursing Education Consormalignancies. She earned her PhD tium in Technology (NYCNECT) at New York University in nursing which is a HRSA-funded faculty (1987), her master’s degree in nursdevelopment grant in teaching ing as a clinical nurse specialist at with technology. HRSA stands for Hunter-Bellevue School of Nursing Health Resources and Services (1981) and her bachelor’s degree in Administration. She is co-principal nursing at Herbert H. Lehman Colinvestigator, with Carol Storeylege (1975). Johnson, senior associate dean for She is married to Donald Sobel.
Union College in Schenectady in 1978. Markessinis currently resides in New York’s Capital District.
HealtheConnections transitioning platform HealtheConnections, the Regional Health Information Organization (RHIO), is partnering with Mirth Corporation to upgrade and expand its capabilities and reach. Since launching its efforts in 2010, HealtheConnections has become one of the nation’s fastest-growing RHIOs, connecting 17 hospitals, six independent regional diagnostic centers, and more than 100 physician practices and other health care organizations. Thanks to a new partnership with Mirth, HealtheConnections will add statewide patient record lookup, public March 2013 •
health reporting and information exchange services with the Veterans Health Administration. The HealtheConnections HIE has patient health records on 85 percent of the region’s population, with more than 700 providers accessing or receiving health information services. All information in the exchange and all current capabilities will be migrated to Mirth’s platform and applications.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2013