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

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CDC: More babies are being breastfed

April 2013 • Issue 160

Dense Breasts

New law requires mammogram providers to inform if woman has dense breast tissue

Old Blood The blood you’re getting at the hospital may be too old and not as good, says a study

Nearly 70,000 people in CNY have Alzheimer’s

CNY’s Healthcare Newspaper

WATER BIRTH Water birth is becoming a more popular option for home birthing moms. The National Center for Health Statistics reports that using water for laboring and birthing has increased by 50 percent nationwide. A Syracuse mom shares her experience in giving birth in the water.

Page 14

Wanted: Primary Care Physicians Report: Persistent shortage of primary care physicians will make it difficult for hospitals to comply with new national legislation that makes insurance available to the masses, warns a medical association Page 12

New app Fighting Cancer with Your Fork.... and iPhone

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Goodbye Asperger’s Syndrome When the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) comes out in May, Asperger’s syndrome will no longer be listed as a diagnosis. Despite that, families like the Southards and Cittadinos, are going strong with their Asperger’s support group. Page 20 April 2013 •

Edwa rd R. Cook

Meet the Doctor Background helps pediatrician deal with refugee population, language barrier

Arthrit is and Mariju ana

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

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April 2013 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

April 10

Joint pain seminar held at Cicero Library St. Joseph’s Hospital will facilitate a discussion on joint pain at 6:30 p.m. at Cicero Library Wednesday, April 10. Presented by board-certified orthopedic surgeon Brett Greenky, participants will learn what causes joint pain and what treatment alternatives are available. In addition, attendants will find out about rehabilitation options and review the benefits of preparing for surgery. Space is limited. Register with St. Joseph’s Hospital Health Center at 315-744-1244 or email community.programs@sjhsyr. org. Light refreshments will be served. The library is located at 8686 Knowledge Lane.

opens Feb. 1 for five-person teams, with choice of flights: noon – 2:30 p.m. or 3 - 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 and information, contact OCO at 598-4717 or visit the agency’s website at www.oco.org.

April 13

Event: ‘Learn how to avoid sports injuries’

for all attendees. For more information about SportsCare Express, call 315-474OUCH (6824), or visit crouse.org/ sportsmed. SportsCare Saturday is free and open to the public; no registration required.

April 15

Transplant group holds meeting in Pittsford Transplant Awareness Organzation (TAO) is inviting the public to attend its April 15 and learn more about transplant-related issues. Aside from a speaker, the meeting will feature a pizza dinner and a reiki demonstration. It will take place from 6 – 8 p.m. April 15 at Christ Episcopal Church, the fellowship room, 36 S. Main St., Pittsford. For additional information, contract Deb Yendrezeski at auggieday@aol.com.

April 17

Elder law seminar held in Auburn

Syracuse University All-American and Pro Football Hall of Fame running back Floyd Little will sign copies of The Law Firm of Karpinski, his new autobiography, “Promises to Stapleton, Galbato, & Tehan, P.C. in Keep: My Inspired Run from Syracuse cooperation with the Cayuga County to Denver to the Hall,” during SportsApril 12 Office for the Aging will present an Care Saturday, presented by Crouse elder law seminar from 6:30–9 p.m. on Hospital’s Sports Medicine program Wednesday, April 17 at Cayuga Ononfrom 9 a.m.–1 p.m., April 13, at Sportsdaga BOCES on West Genesee Street Care Express, 5823 Widewaters Pkwy., Road, Auburn. This free seminar will Dewitt, near Home Depot. Mr. Little present a comprehensive overview of will sign books from 10 a.m.– noon. The American Red Cross of Cenissues facing seniors and their loved Crouse sports medicine experts will tral New York will hold its 11th annual ones. Topics covered will include share advice on how to avoid common silent auction to benefit the Madisonestate planning, empowering othsports injuries and how to get back in Oneida branch from 5:30 p.m. until all ers to act, the benefits of trusts, asset the game safely after being injured. of the items are sold, April 12 at the preservation planning and long term In addition, SU athletics head team Vernon Downs Hotel Event Center, 4229 care insurance. Space for the program physician Irving Raphael and assistant Stuhlman Road, Vernon. Oneida Savis limited. Registration is required and ings Bank has been the premier sponsor team physician for the Orange, Bradley will be accepted through April 16. Call Raphael, will be joined by Syracuse of the popular event since it started in the Office for the Aging at 253-1226 to 2003. This year, the Mardi Gras-themed Crunch team physician Dan DiChrisregister or visit www.co.cayuga.ny.us/ tina, orthopedic surgeon Michael event falls on opening day at the races. aging/events.htm. Wiese, and concussion management Mardi Gras beads will be available, and expert Paul Klawitter, who will provide visitors can get into the spirit by wearApril 18 information on signs and symptoms ing hats and masks. After the auction, and how to prevent concussion. Sports Vernon Downs will celebrate the start of medicine staff members will provide its 60th season with a spectacular fireworks show. Among the items that will information on proper knee and ankle bracing and effective warm-up exercisbe included in the auction are handes to prevent sports injuries, including made furniture, jewelry, needlework, “Total Recall: Memory Enhancewine, assorted theme baskets and sports those of the anterior cruciate ligament (ACL). Participants can receive an asment Strategies,” is the topic of a semimemorabilia. Two of the featured prizes sessment for ACL injury prevention, nar that will take place at 10 a.m. April are a VIP trip for two to the final two 18 at Cicero Library, 8686 Knowledge rounds of the Masters Golf Tournament as well as free heart health screenings in Augusta, Ga., in April 2014 and two VIP tickets to the 2014 Country Music Awards. Tickets for the silent auction April 13 are $30 for adults and $20 for children 6 to 10 (5 and under are free). The cost includes a buffet dinner with gluten-free Crouse Hospital and the Milton J. Rubenstein Museum of Science and Techoptions starting at 6:30 p.m. For more information or to purchase tickets, place nology (MOST) are partnering to present “Let’s Operate!,” a two-day exhibit to an ad in the program book or donate an provide both kids and adults with a unique, insider’s view of how surgeons are item, call the branch at 315-363-2900 or using advanced robotic technology to perform minimally invasive surgery. email paulette.loomis@redcross.org. The exhibit will run from 10 a.m. to 5 p.m. Saturday, April 13, and Sunday, April 14, in the main exhibit hall of the MOST, located at 500 South Franklin St. in Armory Square, downtown Syracuse. The “Let’s Operate!” exhibit will be on April 13 display adjacent to the new spring 2013 traveling exhibit at the museum called Robots. The centerpiece of the exhibit will be the da Vinci surgical robot from intuitive surgical. Crouse surgeons will be on hand to provide demonstrations using the equipment, including the system’s simulator and robotic arms. Participants All bowlers, from gutter dusters to will get to sit behind the system’s console and actually operate the robot’s four high rollers, are invited to help strike extending arms, while practicing their hand-eye coordination, instrument maback against homelessness by gathernipulation and other surgical skills. Crouse surgeons will also share information ing a team and registering for Oswego about the various surgical procedures performed using robotic technology as County Opportunities’ “Lucky 13” well as treatment options within their respective subspecialties. Bowl-A-Fun. OCO’s 12th annual bowl“We’re excited to partner with Crouse and its surgeons on this exhibit,” ing tournament fundraiser is set for states Tony Ortega, executive vice president of the MOST. “Healthcare technolSaturday, April 13, at Lakeview Lanes ogy, which is advancing so rapidly, is an important part of our lives and to be in Fulton. This year’s event was dubbed able to help explain and show how it works fits in perfectly with our mission.” the “Lucky 13” Bowl-A-Fun because For more information, call 315-425-9068 or visit the MOST’s website at www. it is taking place on on April 13, 2013. most.org. It will take place from noon–6 p.m. at Lakeview Lanes in Fulton. Registration

Red Cross, Oneida Savings team up for auction

Seminar in Cicero to discuss memory issues

Kids, parents invited to explore world of robotic surgery

Bowling competition to help the homeless

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

Lane in Cicero. Join MVP Community Health Educator Chris Britton as he discusses the mechanism of memory, explore easy techniques to improve memory, and stimulate the brain to keep it sharp now and in the future. To register, visit www.nopl.org or call 315-699-2032.

April 27

‘Autism Awareness Walk’ takes place in Liverpool The annual “Autism Awareness Walk” will be held April 27 at Longbranch Park in Liverpool. Registration begins at 9:15 a.m. and the walk will start at 10 a.m. The event is sponsored by the Central New York chapter of the Autism Society of America and is supported by the Kohl’s Autism and Related Disorders Program of Upstate’s Margaret L. Williams Developmental Evaluation Center. The walk is free and its primary purpose is to raise awareness about autism and other related disorders. Autism now affects one in every 88 children. There will be familyfriendly activities following the walk, including a bounce house and refreshments. If you would like to learn more about this event or to make a financial pledge, visit www.kohlsautism.com. Any funds raised at the Walk will be used to support recreational programming for children with a autism and other related disorders.

April 30

Autism and bullying to be addressed at conference The Kohl’s Autism and Related Disorders Program of Upstate’s Margaret L. Williams Developmental Evaluation Center will present a conference about bullying. Barbara Coloroso, internationally recognized author, consultant and speaker, will present “The Bully, the Bullied and the Bystander “from 9 a.m –3:30 p.m. April 30 at Drumlins Country Club in Syracuse. Early registration by April 5 is $85 for professionals and $55 for parents. After April 6, registration will be $95 for all participants. The conference fee includes lunch, refreshments, and lunch. Continuing education course will be available for speech, occupational and physical therapists. For more information or to register, visit www.kohlsautism.com or call 472-4404.

May 7, 14, and 21

‘Living Alone’ seminar for those who live alone Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own,” is a three-part workshop offered for women who want to gain the know-how to forge a meaningful and enriching life on their own. You’ll discover how to think differently about living alone and learn practical strategies to overcome loneliness and other emotional pitfalls, rediscover your true self, and socialize in a couples’ world. The workshop takes place from 7 – 9 p.m. at House Content Bed & Breakfast in Mendon on three consecutive Tuesdays: May 7, 14, and 21. The workshop fee of $125 includes a Living Alone manual, empowerment exercises, and lots of helpful resources. To register, contact Gwenn Voelckers at 585-624-7887 or e-mail gvoelckers@rochester.rr.com.

‘Shelf Life’ of Blood? Shorter Than We Think

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The blood you’re getting at the hospital may be too old and not as good

small study from Johns Hopkins adds to the growing body of evidence that red blood cells stored longer than three weeks begin to lose the capacity to deliver oxygenrich cells where they may be most needed. In a report recently published online in the journal Anesthesia & Analgesia, the Johns Hopkins investigators say red cells in blood stored that long gradually lose the flexibility required to squeeze through the body’s smallest capillaries to deliver oxygen to tissue. Moreover, they say, that capacity is not regained after transfusion into patients during or after surgery. “There’s more and more information telling us that the shelf life of blood may not be six weeks, which is what the blood banks consider standard,” says study leader Steven M. Frank, an associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. “If I were having surgery tomorrow, I’d want the freshest blood they could find.” Frank acknowledges that blood banks do not have enough fresh blood

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for everybody, and that shorter storage periods would result in diminished inventory. But he says that the current practice of transfusing blood stored up to six weeks may need to be reconsidered. According to the research report, the average age of the blood given in the study was more than three weeks. Only three samples in the study were two weeks old or less. One reason for the lack of availability of fresher bloods for adults, Frank says, is the routine practice of giving pediatric patients priority for the freshest units. In fact, he notes, blood banks dispense the oldest blood first so that it doesn’t exceed its shelf life before it can be used. “As a colleague said, it’s like how they sell milk in the grocery store — they put the oldest cartons out front so they can sell them before they expire,” Frank says.

NEED HEALTH

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Call a Community Health Advocate at the Syracuse Northeast Health Community Center Call a Community Advocate at for free,theconfidential support Community and advice at Syracuse Northeast Center for free, conﬁdential support and 472-6343, ext 227.

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

Health CNY’s Healthcare Newspaper

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

In Good Health is published 12 times a year by Local News, Inc. © 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.

Positions for afternoons, evenings, and/or week-ends are available throughout Onondaga County. Call C. Davia @ 478-1462, fax résumé to 478-1467, or e-mail: cdavia@contactefr.org. EOE

UPSTATE NURSES MAKE A DIFFERENCE! As the region’s only Level-One Trauma Center, we are a fastpaced academic medical center with modern technology and up-to-date interventions in caring for the critically ill or injured. Serving 17 counties, we support a population throughout the central New York region. We currently have part-time and full-time positions available in our Operating Room and Emergency Department for RNs. Shadowing opportunities are available. • Tuition Assistance • Membership in the NYS Employees' Retirement System • Excellent Wages and Benefits

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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a year, they get discharged from the program, so we don’t have an interpreter. Most insurances won’t cover their visits. It’s really hard.

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Q: What affect do you see the Affordable Care Act having on your practice? A: I hope it will help because we have a lot of problems with medication coverage. We have a hard time getting patients the right medications. Medications that treat ADHD and bipolar disorder, for example. We have a hard time getting insurance to cover those.

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

Q: What got you interested in pediatrics? A: When I was in rotations, it was the specialty I really liked. I’d rather see a child than an adult. Q: How do you go about diagnosing children when they’re not great at communicating what’s bothering them? A: We have to be able to speak to the parents and get the child’s medical history. Q: Are you the only pediatrician at

Compassionate Family Medicine? A: It’s a group practice, but my partners are family practice. I see all the children. Once my patients reach 18, I try to transition them to one of my partners. Q: You said you work with a lot of the Spanish-speaking population. What health issues do you see in that population? A: I’d say a lot of asthma. A lot of ADHD. It’s a mix of genetics and a lot of the old housing in Syracuse. There’s a lot of mold that can affect asthma. Smoking. With ADHD, it’s mostly genetics. Q: Do you see a lot of the migrant worker population? A: We get some from Oswego County. We get patients from Hannibal, Mexico and Cleveland. Q: What do you do when you can’t prescribe ideal medications? A: We have to do whatever we can and then go from there. We have a hard time getting them in to see a psychiatrist. There’s a long waiting list. Urging families to make the appointments can be difficult. Q: Can you talk about your experience with the National Health Service Corp.? A: It’s a loan repayment system where you work in an under-served community for two years and they’ll help repay your student loans. That was back when I was working at the health center. Q: You founded the Vision Latina Group at the Sophie Davis School of Biomedical Education. What educational challenges did you run into as a student that precipitated the creation of the group? A: We started an organization to help Latino medical students. There weren’t too many Hispanic students at the medical school to talk to. There weren’t too many role models to reference, especially being a woman and Spanish-speaking. In my family, I was the only one who actually went to college. My mom never finished elementary school; my dad never went to high school. My siblings finished high school and that was it. A lot of my friends didn’t finish high school. Q: How did you wind up in Syracuse? A: I was matched in Syracuse through the Sophie Davis program. I did my clinical rotations at SUNY Upstate. I went down to Long Island to do my residency and then ended coming back up for work. Q: You teach medical students now? A: Yes, second year students will sometimes rotate through. We had a lot when I worked at the medical center as well.

Lifelines Hometown: Brooklyn, NY Practice: Compassionate Family Medicine; 311 Green St, Syracuse Education: Sophie Davis School of Biomedical Education at City College of New York, SUNY Upstate Medical University Organizations: American Academy of Pediatrics; Onondaga Medical Society Family: Married, one daughter Hobbies: Watching movies, church activities How to reach the physician: 315-4251431.

Fighting Cancer with

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ana-Farber Cancer Institute has launched a free, easy-to-use iPhone app that provides recipes and nutrition information that can be searched by cancer patients in accordance with their needs. The recipes are also helpful to anyone who wants to have a healthy diet. “We developed Ask the Nutritionist: Recipes for Fighting Cancer to encourage and empower cancer patients, and others, to explore and enjoy healthy eating habits,” says Steven R. Singer, senior vice president for communications at Dana-Farber. “Studies have long shown that good nutrition is tied to good health, and, for those with cancer, treatment side effects can make eating well a real challenge.” Ask The Nutritionist: Recipes for Fighting Cancer contains over a hundred easy-to-prepare recipes ranging from nutritious snacks to good-foryou main dishes to delicious desserts. Users can access a list of ingredients, directions on how to prepare the dish, a shopping list to use at the grocery store, nutrition tips, and nutritional analysis information in a standard USDA label format. New recipes are added each month. “Nutrition information is one of the most popular sections of the DanaFarber website, and we wanted to share the expertise of our terrific nutritionists with a wider, mobile audience,” Singer said. The app curates many of the frequent questions and responses to Dana-Farber’s nutrition staff, and allows users to ask a direct question. The app, developed with Dana-Farber’s staff of registered and board-certified dietitians, is designed to help find the optimal diet for any type of cancer. It also offers users the ability to search by common symptoms (such as nausea or mouth sores), helping to customize dietary needs while going through treatment. There also are recipes and healthy eating tips for cancer survivors.

“Eating a well-balanced diet is one of the best ways to lower the risk of cancer,” says Stacy Kennedy, a nutritionist at Dana-Farber. “Our hope is that this app will not only be a useful tool for cancer patients and their families but will also make choosing the healthiest foods easier and more fun for everyone.” Some unique features of Ask the Nutritionist include: • On-the-go access to over a hundred healthy recipes with an evidencebased approach. • Nutrition tips and information on cancer-fighting nutrients. • Innovative option to search by symptom management. • Specialized diet section for those who require foods that are gluten-free, are high-fiber or provide immune support, etc. • The ability to create a shopping list to take to the grocery store and never forget a key ingredient. • An “ask the nutritionist” function. Dana-Farber’s nutrition department will respond to questions from the app’s users. • An extensive searchable database of frequently asked questions (FAQs) and archived questions and responses about nutrition. The app is available for all iPhone users with IOS 5 or higher. It is free and can be downloaded by going to the Apple iTunes store. Ask The Nutritionist: Recipes for Fighting Cancer was designed and developed in partnership with iFactory, a Boston-based interactive agency.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Living alone doesn’t mean being alone: Online dating can open up possibilities

’ve said it before, but it bears repeating: Living alone doesn’t mean being alone. And getting good at living alone doesn’t mean mastering the art of isolation. On the contrary. The men and women who have found contentment on their own typically enjoy active, vibrant social lives. They are involved in their communities, they enjoy the company of friends and family, they entertain, and . . . they date. While traditional methods of meeting people still work for some, others are finding more success with online dating sites such as Match.com, eHarmony, and OkCupid. While I haven’t dipped my toe into the pool of potential online suitors, several of my single friends have and most report good results. They are meeting new and interesting people, trying new things, and seeing new places. Below is an interview I conducted with my brave friend “Sarah,” who was courageous enough to share her story, but not her real name. It’s my hope that her experience might inspire you (and me!). First, could you share a little bit about your personal circumstances? I was married for 25 years when we discovered we had grown apart, wanted different things. We separated, then divorced two years later. What got you interested in dating again after your divorce? Being single at 60 was a blow and not what I expected to be doing when most of my friends were buying retirement homes. After grieving the loss of my marriage for almost two years, friends encouraged me to “get out there” and start living again. It was time to finally put myself first.”

Did you consider traditional dating methods or did you pursue online dating from the start? Traditional methods are practically non-existent. People are reluctant to “fix you up” in case it doesn’t work out. And online dating is becoming more socially acceptable — even for men and women my age. There are many love stories with happy endings that began with online dating. How did you decide which dating service to enroll in? I chose Match.com cause my single friends had chosen that one, as well. But many people are on multiple sites. Tell me about creating your profile. What was that like? It was daunting until I came up with a fun process. I got together with three of my best women friends to write our profiles. Only, we wrote them for each other because we do not see ourselves the way others do. It was a fun afternoon resulting in profiles that we were happy with and represented our unique personalities and interests What do you look for in the guy’s profile? What piques your interest? After reading many profiles, they all start to sound alike. I am always interested in a guy who has hobbies and who enjoys being outdoors as much as I do. A sense of confidence and playfulness is important to me. Smoking is a huge turnoff. I have received interest from a wide variety of men of all ages from 35 to 77. A big age difference is hard to

take seriously. I am not about to get my cougar on! Could you describe a typical first encounter? I usually like to meet for coffee on a Saturday morning. It’s casual and not a big investment of time or money, and the lighting is good. People rarely look like their photos and it’s easier to spot them in a coffee shop rather than a dimly lit bar, which I did once. People often worry about personal safety. Could you describe the precautions you took? Since I always have the guy’s cell phone number, I text it to a girlfriend, along with the location and time of the meeting. We always check back with each other after the meeting. When I meet a guy, I explain that I am very cautious and do my “homework” (i.e., Google searches). Many give me a business card to prove they are legitimate, but I always check ‘em out. Can you give me a sense for how frequently you were meeting new people? Did it get to be too much at any point? I have a very demanding job and some family responsibilities, so I tend to meet one guy at a time. If he was a dud, I would bury my head in the sand for a few weeks then try again. I take it slow, but some of my friends are on a mission and are really active online. Could you share a story or two about your experience — perhaps one positive one and one disappointment? Sam, one of the first guys that really pursued me with emails and

phone calls, was very persistent and finally I agreed to meet him for coffee. At the end of the coffee date, he told me I could do better than him! Exactly what I had been thinking. The next guy I met, Todd, was fun and interesting and we dated for two months. I felt like a teenager, since it had been 28 years since I had gone out to dinner with a guy other than my husband. It’s funny how dating insecurities have not changed much since high school: “Will he call? Should I call him? What does that text mean?” Sometimes it’s difficult to know how to act, but it was wonderful to feel like a desirable woman again. Things were going well, until he canceled a date at the last minute via a text (How rude). I realized he was playing games and had commitment issues. Good-bye. What advice would you give to someone who’s considering online dating? Have a nice photo taken, even if it’s by a friend. Every guy I have met is so pleased that I actually look like my photo. In fact, they always tell me that I look better than my picture, then go on to tell me horror stories about going to meet a woman and not recognizing her because her photo was so old. I might also add, it’s difficult to really tell about a person from their profile and even a first meeting. It can be worth it to give them a second chance. Have you found someone online who makes your heart go pitter-patter? No, not yet. But, I will say, that I have met some very nice men, each one so different, but I was able to relate to them from past experiences in my life. Each one of them brought out something different in me and it has been nice getting to know myself again. Online dating has helped restore my confidence. 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. Columnist Gwenn Voelckers is conducting a workshopin May. See ad on page 21.

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

REPORT 1 in 3 seniors dies with Alzheimer’s or another dementia

FDA Wants to Relax Approval Process for Alzheimer’s Drugs

Nearly 70,000 people in CNY have Alzheimer’s A

new report issued by the Alzheimer’s Association — “2013 Alzheimer’s Disease Facts & Figures” — shows one in three seniors dies with Alzheimer’s or another dementia in the United States. The new report shows that while deaths from other major diseases, such as heart disease, HIV/AIDS and stroke, continue to experience significant declines, Alzheimer’s deaths continue to rise, increasing 68 percent from 20002010. “New York is home to more than 320,000 people living with Alzheimer’s disease. With deaths from this disease continuing to rise, it is clear that urgent, meaningful action is necessary,” said Catherine James, chief executive officer for the Alzheimer’s Association, Central New York chapter. “Our community needs to come together to fight against this disease, particularly as more and more people age into greater risk for developing a disease that today has no cure.” Alzheimer’s disease is the sixth leading cause of death in the United States and is the only leading cause of death without a way to prevent, cure or even slow its progression. Based on 2010 data, Alzheimer’s was reported as the underlying cause of death for 83,494 individuals — individuals who died from Alzheimer’s. The Alzheimer’s Association “2013 Facts and Figures” reveals that in 2013 an estimated 450,000 people in the United States will die with Alzheimer’s. Among 70-year-olds with Alzheimer’s disease, 61 percent are expected to die within a decade. Among 70-year-olds without Alzheimer’s, only 30 percent will die within a decade. A supplemental report by the Central New York chapter shows that

Estimated Population with Alzheimer’s Disease in CNY Cayuga ........................... 3,367 Chenango ....................... 2,171 Cortland .......................... 1,708 Herkimer ......................... 2,982 Jefferson ......................... 3,478 Lewis .............................. 1,125 Madison .......................... 2,658 Oneida .......................... 10,838 Onondaga ..................... 18,633 Oswego .......................... 3,948 St. Lawrence .................. 4,131 Tioga ............................... 2,111 Tompkins ........................ 2,932 14-county total ........... 69,549 at least 38,403 and as many as 69,549 people have Alzheimer’s disease. The chapter’s report bases its findings on three different mathematical formulas that utilize age — identified by the Alzheimer’s Association as the leading risk factor for developing Alzheimer’s disease — as the primary variable in its calculation. While the 2013 “Facts & Figures” prevalence data is weighted state by state for various demographic factors, the data published in the supplemental report is not. Instead, it applies a ratio to three age groups — 65 to 74, 75 to 84, and 85 and older — as counted in the 2010 U.S. Census. The report reveals that within the 14-county territory of the Central New York chapter, Onondaga County has the highest number of people living with Alzheimer’s disease. As many as 18,633 people countywide live with the disease.

More Than 110,000 people Caring for Alzheimer’s Patients in CNY

here are at least 119,351 Alzheimer caregivers in the 14-county Central New York region under the jurisdiction of Alzheimer’s Association, Central New York chapter. According to a new study, the the care they provide is valued at more than $1.6 billion annually. The Alzheimer’s Association estimates that 3.1 people provide care to every one person with Alzheimer’s disease at a per-person average of 1,193 hours per year, or nearly 136 million hours regionwide. When multiplied by the mean caregiving wage ($11.93 according to the National Caregiving Alliance), the total value of the region’s Alzheimer caregiving was more than

Agency points to need for medications that could prevent, slow disease in an aging population

$1.6 billion. If Alzheimer’s caregiving were a company, it would be the largest employer in the region and its economic value would be eighth in the region behind Verizon, Lockheed Martin, Time Warner Cable, Bank of New York Mellon, National Grid, Wegmans and Cornell University. “The demographic picture in Central New York continues to get grayer,” said Catherine James, chief executive officer for the Alzheimer’s Association, Central New York chapter. “We know that age is the No. 1 risk factor for the disease, so what we must do now as a community is ask ourselves how prepared are we to deal with the Alzheimer’s crisis?”

New Program Seeks Caregivers of Alzheimer Patients

ome Aides of Central New York recently received a $150,000 grant to assist caregivers of individuals with Alzheimer’s disease. The award — one of only four given nationwide — was given by the Rosalynn Carter Institute for Caregiving based in Americus, Ga., with funding provided by Johnson & Johnson. The grant is for the implementation of an “evidence-based” program over a three-year period. Known as REACH (Resources for Enhancing Alzheimer Caregiver Health), the program supports the caregivers of those suffering from Alzheimer’s disease. The focus is to provide education, support and skill building opportunities to help caregivers manage challenging patient behaviors, therefore decreasing their own stress. Results of similar programs have shown an improvement in caregiver health and depression. In addition, studies have shown that, by enabling caregivers to better cope with the every day challenges of caregiving, the quality of care provided improves and the length of time the patient is able to remain in their own homes is extended. “Home Aides of Central New York is honored to be a part of this elite group of organizations given the opportunity to work with the Rosalynn Carter Institute of Caregiving on the REACH project,” said Sandra H. Martin, president of Home Aides of Central New York. “We are equally proud to have the opportunity to pull together our partners in the non-profit and government sectors to take on the critical need to support Alzheimer’s caregivers in our community. These caregivers, who work tirelessly behind the scenes, deserve our support. Their unpaid assistance to those with this devastating disease provides an unrecognized benefit to our community.” Caregivers seeking assistance should contact Home Aides of Central New York at 315- 476-4295 and ask for the REACH program. April 2013 •

n an effort to quickly develop drugs that could prevent or slow Alzheimer’s, the U.S. Food and Drug Administration said it plans to relax the approval process for experimental medications for the memory-robbing disease. In a proposal published online in the March 14 issue of the New England Journal of Medicine, the FDA said clinical trials of people in the early stages of Alzheimer’s would only need to show improvement in tests of thinking and memory. The FDA’s goal is to speed development of drugs to treat a disease that has no cure, so that the millions of aging baby boomers at risk for Alzheimer’s might be able to prevent or slow the degenerative disease. The FDA is taking comments on the proposal, and will possibly make revisions, but the plan is going forward, officials said. Drug companies would still be required to do post-marketing studies on any approved drugs, to confirm their benefits and safeguard against any potential harms from long-term use of these medications. More than 5 million Americans are living with Alzheimer’s, according to the Alzheimer’s Association, which translates into one in eight seniors. And those numbers are expected to swell in the next 20 years, according to the U.S. National Institute on Aging (NIA). The 65and-older population is expected to double to about 72 million in two decades, and the number of people with Alzheimer’s doubles for every five-year interval past age 65, studies have shown. The number of the very elderly, age 85 and older, is estimated to triple by 2050, the NIA added. By HealthDay News

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

My Turn

By Eva Briggs

What’s in Your Stool White, red, black stool. Why all the different colors?

“D

octor,” my patient said, “I don’t know how it happened, but when I went to the bathroom this morning, this fell out of me!” She held out a shiny pipe about 12 inches long and half inch in diameter.

It was pretty clear to me that such an object couldn’t have been in my patient’s stool, at least not without causing some pain and damage. I tactfully suggested that perhaps the pipe had come from someplace else, like her bathroom plumbing. After

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a thorough exam (normal), I reassured her that no damage had been done. Later that day the patient returned, saying I had been right, the pipe was from something in her bathroom. But sometimes people do see weird things in their stool. Like ghosts, for example. Ghosts? Yes, ghost tablets. Some extended-release tablets are designed to release the active ingredient, while the shell remains intact. So what appear to be undigested medications are simply the shell, or ghost, of things passed. Some common offenders include Allegra-D, Concerta, Glucotrol XL, Procardia XL, and Sudafed 24 hour. Other drugs can leave behind a mass that looks like a pill. Examples include Glucophage XR, Glumetza, and Pristiq. Ghostly white colored stools are another matter. Stool gets its characteristic color from bile, digestive juices made in the liver and stored in the gall bladder. When a diseased liver stops making bile, or the ducts are blocked by a stone or tumor, the resulting stool may appear white or clay colored. What if you are seeing red? It could be blood, but it might be something else. The most common dietary cause of red stools is beets. Your doctor can perform an occult blood test on red stools to determine whether blood is present which is especially helpful when the story doesn’t fit. Other foods that can cause red to maroon stools are licorice, tomatoes, and blueberries. Black stools may be due to blood that has been in the digestive tract for a while. But other common causes of black stools are pepto-bismol and iron supplements.

Worms are a creepy thing to find in your stool, but in the US, many or perhaps most “worms” aren’t actually parasites. They’re often “macroscopic mimics’ — items big enough to look like worms but actually formed from benign items. Mucus, for example, can be excreted in long strings. Undigested components of vegetables can look worm-like: onion skin, tomato skin, strings of seeds from dates, shredded carrots, and bean sprouts, for example. Chewing gum can resemble a parasite. And finally, sometimes worms are nonpathogenic species that have been ingested. How could this happen? It can be an accident, as part of a dare, or a disorder called Munchausen syndrome (a psychiatric disease where those affected feign disease to draw attention to themselves.) And some worms aren’t human parasites, but parasites of other animals from contaminated food stuffs that pass through to be excreted in recognizable form. An experienced pathologist can distinguish true parasites from these imposters.

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

Marijuana & Arthritis Baldwinsville man writes about how he found relief for his arthritis by using marijuana and following a special diet, exercise By Aaron Gifford

aldwinsville resident Edward Cook was 46 years old when the pain began. He was a runner and a recreational basketball player and a landscaper. “I worked hard,” he says, “and I played hard.” Arthritis had set in deeply in his left knee to the point where he had to give up his most cherished physical activities as well as his livelihood. Desperate for some relief and always searching for a better solution than prescription drugs, he started rolling joints to relieve the pressure on his joints. After years of experimentation, Cook, now 53, found three key components that worked for him. He said that recipe can actually heal arthritis, and he felt strongly enough about that proclamation that he wrote a book about it – “Arthritis and Marijuana: How marijuana, diet, and exercise can heal arthritis.” “I truly believe in my heart and soul that this writing can, and will, help many millions around the globe,” Cook said in the book’s preface. The Mayo Clinic defines arthritis as the inflammation of one or more joints. The pain and stiffness typically worsens with age. Of the two most common types of arthritis, osteoarthritis is caused by normal wear and tear on the joints over time, while rheumatoid arthritis is an autoimmune disorder. As for treatments, the Mayo Clinic lists a variety of over-the-counter and prescription medications and some alternative remedies like acupuncture, glucosamine, electrical nerve stimulation and yoga or tai chi. Cook, who grew up in the Finger Lakes area and served in the Army before starting his own landscaping company, is a certified group exercise trainer, a certified over-50 trainer and a certified exercise and arthritis trainer. He advocates “body rolling,” where different types of balls are used to rub out arthritis pain in the joints, and has produced a YouTube video known as “bodyrolling1.” He self-published the book via Amazon.com and has distributed to a handful of independent book retailers throughout the Central New York region, including the river’s end

bookstore in Oswego. So far, it has been promoted on a variety of medical marijuana advocacy websites and in “Skunk,” a Canadian magazine for marijuana enthusiasts. “They’re doing cartwheels over it,” he said in a recent interview. “I haven’t heard any negative feedback yet.” For Cook, marijuana is applied in moderation with exercise. He typically smokes a small amount of it before beginning his routine, which includes stretching and body rolling activities. He says the pot allows him to concentrate “introspectively” and focus on certain body parts. “Your attitude toward pain is more rational,” he wrote. “The analgesic effect helps your body feel more fluid, less achy. You can feel your body more intrinsically.” “Marijuana works for my arthritis because it is optional, quick acting, and reliable,” Cook wrote. “It makes my body feel better while giving me a heightened state of awareness and a more pleasant attitude. It has a noticeable effect and a no-doubt efficacy.” Cook said while he also uses marijuana recreationally and did so before he developed arthritis, he does not smoke every day. He also took an extended break from the drug around the holidays as he needed to pass a drug test in order to qualify for a temporary package delivery job. He said he continued with his therapeutic exercise routine during that time, but without smoking he didn’t feel as good and couldn’t do as much exercise. Cook also acknowledged that his public advocacy of illegal drug use could hurt future job prospects. His book advocates growing marijuana for personal use. New York is not among the states that have legalized marijuana for medical use, though leaders have discussed the issue and it may be debated at great lengths in the years to come. “Nothing worthwhile,” he said, “is without risk or trade-offs. I want to improve the health care system and I really think this is a good solution for arthritis.” In the book, Cook is somewhat critical of America’s health care system,

primarily the administration of it. He says there is widespread overmedication and inefficiency, and that the insurance companies take a disproportionate share of health care money away from doctors, nurses and other healing professionals. People, he wrote, are sometimes steered into unnecessary testing and procedures just to cover the cost of doing business. Cook goes to the Veteran’s Administration Hospital in Syracuse and said he’s generally satisfied with the care he receives, though he has not been there for procedures directly related to his arthritis. As his arthritis developed he did have moderate success with overthe-counter anti-inflammatory medicines, but he has avoided prescriptions and is not interested in discussing joint replacement devices. “With prosthetics, I think they [doctors/health care companies] are a little too casual about offering that as an option so early on,” he said. While Cook credits pharmaceutical companies for their work in fighting disease, illness and injury, he also says those companies, which he refers to as “Big pharm,” are threatened by medical marijuana. “Big pharm can’t match the marijuana’s safety and effectiveness,” he wrote. “Marijuana is a green, renewable commodity that Big Pharm can’t control or profit from. It does not want people to know how easily it can be grown or how effective it can be.” Despite Cook’s highest praises of marijuana, he still refers to swimming as “the holy grail” of arthritis relief. This is because your buoyancy in water takes weight off of the joints and allows for more movement and a better range of motion. He cites body-rolling activities as the best land-based exercises for arthritis and has detailed descriptions and photos of himself using

“Body rolling” exercise helped Edward Cook rid of arthritis pain. He has produced a YouTube video about his exercise regimen known as “bodyrolling1.” April 2013 •

At age 46 Baldwinsville resident Edward Cook had to give up his landscaping business, his running and basketball playing because of arthritis. He said marijuana, a special diet with fruits and vegetable and exercise have given him the relief he was looking for. tennis balls, softballs, basketballs, yoga balls, pulleys, cables and the hand grip of a bicep exercise machines to get to the areas of aches, pains and pressure in the legs, knees, ankles, hips, back, feet and hands. “You can do it on your own time,” he wrote, “when you are aching and need it the most. It is the best, most self-satisfying, easily accessed, affordable, effective therapy that I have found in coping with arthritis.” As for the third component of Cook’s arthritis care plan — diet — the author recommends eating fruits and vegetables first when you are really hungry before you move onto the main course or snacks and treats. He routinely eats apples, bananas, green peppers, chocolate milk, juices and water. “I try not to fry things,” he says, “but I also like my pizza, my cheeseburgers.” Cook said publishing the book was a positive experience, and he’s joined a writer’s group to share his ideas and learn from others. He aspires to move to Washington state to produce a cable television show about arthritis and marijuana. In the meantime, he is working on a second book, which will be about his experience as a single father of a teen-age son.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

Wanted: Primary Care Physicians Persistent shortage of primary care physicians will make it difficult for hospitals to comply with new national legislation that makes insurance available to the masses, warns a medical association By Aaron Gifford

state health care advocacy agency warns that the persistent shortage of primary care physicians will make it difficult for hospitals to comply with new national legislation that makes insurance available to the masses.

Central New York hospital officials maintain that while they can always use a few more doctors, they will remain focused on maintaining a high standard of care as their patient loads increase. They have had some success in recruiting: Oswego Health hospital,

for example, added 17 new physicians to its staff in the past two years. St. Joseph’s Hospital Health Center in Syracuse added five primary care doctors last year. Still, staffing levels will be a heavily debated topic in the months and years ahead as the reform is aimed at making low-cost health insurance available to individuals and small businesses. The federal program also provides low- and middle-income families tax credits that cover a significant portion of their costs for coverage. The Healthcare Association of New York State (HANYS) recently released the results of its 2012 physician advocacy survey, called “Doctor Shortage: Condition Critical.” It said 1,200 physicians are needed statewide, not counting New York City. That figure includes a primary care shortage of about 400 physicians. “As thousands of New Yorkers are expected to gain health insurance coverage during the implementation of the Affordable Health Care Act, HANYS President Daniel Sisto said in a press release, “our hospitals and health systems already indicate a dramatic need for primary care physicians through-

out the state. New York must have a comprehensive strategy to address this shortage and ensure all New Yorkers have access to health care.” The agency reported that, for the portion of facilities outside of New York City, 110 hospitals participated in the survey, resulting in a 73 percent response rate. The HANYS report also touched on the shortage of specialists, and said that in the past year 32 percent of health care facilities in the state have had to reduce or eliminate services due to the shortage, and that 75 percent of the survey respondents in New York City indicated that at times their emergency rooms had to transfer patients to other hospitals at times due to gaps in coverage for certain specialties. As for the breakdown of specialties in emergency rooms statewide that are most likely to lack 24-hour coverage in the emergency department, neurosurgery, orthopedics and general surgery were reported as among the most common areas where services were in short supply. The report reaffirmed the need for retention: While 2,400 physicians were recruited in 2011, 2,500 left practices in New York state to work elsewhere or retire. Nationally, the Association of American Medical Colleges predicts a shortage of 46,000 primary care physicians by 2020. That agency says high debts for student loans coupled with declining insurance reimbursement rates are key factors in that trend. These days, medical school residents are more interested in the higher-paying specialties. About 32 percent of all doctors in the United States are primary care providers. The ideal number for that field of medicine — given the nation’s aging population – should be closer to 40 percent, the HANYs report said. The report also broke down the shortage by region. For Central New York, the total number of primary care doctors needed in hospitals totaled 42. By contrast, the number for the Rochester area was 44 and Buffalo/Western New York was 27. As for the barriers to recruiting, 88 percent of those surveyed listed geographic location as the most significant deterrent. The other barriers were listed as lack of qualified candidates, lack of opportunity for spouses, and competition from other health care facilities. Meanwhile, 89 percent of those surveyed indicated that they are hiring more non-physicians clinicians, like physician assistants or nurse practitioners, to cover the staffing gap. And a third of those surveyed indicated that they have also had trouble recruiting physician assistants and nurse practitioners.

continued on page 19 Page 12

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

Women’s issues More mothers are breastfeeding

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cross all groups, the percentage of mothers who start and continue breastfeeding is rising, according to a report released in February by the Centers for Disease Control and Prevention (CDC). From 2000 to 2008, mothers who started breastfeeding increased more than 4 percentage points. During that same time, the number of mothers still breastfeeding at 6 months jumped nearly 10 percentage points, from 35 percent in 2000 to nearly 45 percent in 2008. In addition to increases among all groups, gaps in breastfeeding rates between African American and white mothers are narrowing. The gap narrowed from 24 percentage points in 2000 to 16 percentage points in 2008. “Breastfeeding is good for the mother and for the infant — and the striking news here is, hundreds of thousands more babies are being breastfed than in past years, and this increase has been seen across most racial and ethnic groups,” said CDC Director Tom Frieden, a physician. “Despite these increases, many mothers who want to breastfeed are still not getting the support they need from hospitals, doctors, or employers. We must redouble our efforts to support mothers who want to breastfeed.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

Women’s issues Water birth: a popular option for home birthing moms By Deborah Jeanne Sergeant

ou breathe air — why would you want to give birth in a small pool of water? Apparently, many women want to. The National Center for Health Statistics reported that using water for laboring and birthing increased by 50 percent nationwide from 1996 to 2006. The trend is also seen in Central New York, according to several sources interviewed for this story. “I have seen an increase in interest,” said Christine Goldman, DONAcertified birth doula and co-owner of Doulas of CNY. “People ask all the time where they can go for water birth.” Local proponents of water birth say it offers plenty of advantages to baby and mom over standard “land birth.” Instead of fighting gravity by pushing with her feet in stirrups and the birth canal horizontal, women birthing in a pool are positioned with the birth canal closer to vertical. “I know that it takes the stress off the contractions and makes them less uncomfortable,” Goldman said. “Most moms believe it’s more relaxing and less stressful. It gives a woman buoyancy so the mother feels lighter. She can allow herself to concentrate on birth. It increases blood flow. It can reduce vaginal tearing and reduce the need for pain medication. Moms want these things.” Some people raise concerns about

Goldman

bodily fluids and feces in the tub’s water; however, while attending water births both at home and hospital, Goldman said, “they remove everything out of the water when it happens. They’re prepared. They’re birth certified midwives and come with everything.” Babies don’t aspirate in the tub because they will not breathe until they are exposed to air. The baby’s oxygen source, the umbilical cord, is not cut until after he is taken out of the water. “Moms bring the babies right out of the water onto their chests and the care providers are right there with the same tools they have in the hospitals,” Goldman said. “They’re prepared for anything that can happen. The umbilical cord is their lifeline.” The tubs are about the size of a plastic children’s pool but waist high. The attending midwife keeps adding warm water and monitors its temperature to keep everyone comfortable. Most hospitals do not offer water birthing; some offer water laboring, but transfer moms out of the water once hard labor starts. “A lot of women are interested in it, but are told they cannot birth that way in a hospital, so they don’t push the issue,” said Sarah Oakley, owner of MamaBirth Yoga in Syracuse. “I think that keeps a lot of women from doing it. A lot of the women in my class who have birthed at home have done a water birth.” Oakley also co-leads International Cesarean Awareness Network (ICAN) of Syracuse and is a steering committee member with BirthNetwork CNY, which is working on water birth access for local women. Coinciding with April’s designation as Caesarian Awareness Month, the group is also sponsoring “Cesarean Stories,” an art exhibit at Basic Babies at Shoppingtown Mall April 13. The exhibit will share art photography of women’s post-cesarean scars to raise awareness of the prevalence of cesarean-section surgery. Some providers allow women to labor in water, barring any complications. “I love to watch women labor in a hot tub,” said Richard Waldman, a gynecologist and president of Associates for Women’s Medicine in Syracuse, Fayetteville, North Syracuse and

Liverpool and privileges at St. Joseph’s Hospital. “Just as athletes get a soothing relief in hot water so do laboring women,” Waldman said. Since most area hospitals don’t offer water labor or birth as options, most water births take place at home. “If you’re well-monitored, as with any birth you’re in, that’s the key,” Goldman said, “not doing this by yourself at home. That’s where there’s more risk. You need to do this assisted. Find a good midwife, care provider, doctor, someone to help you. If you have a hospital that doesn’t have it, write to them. that will produce change.” Waldman added, “It is also very important to plan for a sudden or emergency trip to the hospital in case a problem arises.” Preeclampsia, breech presentation, or transmittable infections would all be problems that would rule out water birthing, along with twins, pre-term or other high risk pregnancies. Women need to discuss their desire to try water birth with their OB-GYN or certified midwife.

Cowherd

For Fayetteville Mom, Giving Birth in Water Was a Positive, Unique Experience

arah Cowherd, a doula and steering committee member of BirthNetwork CNY lives in Fayetteville. In January 2012, she gave birth in water to her third child, Story. She had previously labored in water in hospitals, but with her third birth, she opted for home birth with a midwife trained in water birth. “It was incredibly different to give birth in a tub compared with a bed,” Cowherd said. “It was so peaceful and comfortable. It makes your body buoyant and it relaxes your whole system. I had no tearing, which I’d had with my previous deliveries. The recovery is better because there’s a reduced risk of tearing. I joke that I had an ‘aquadural’ and I feel it was just as helpful than an epidural or any kind of pain management.” With her previous births, she had to leave the water when she was ready to push and subsequently gave birth on a bed. With her third birth, she delivered in the water. “We had no problems,” Cowherd said. “The baby came out with perfect Apgar scores and she is perfectly healthy.” The Apgar score assesses newborn health and helps show how well the baby is adjusting to life outside the womb one minute and five minutes after birth, focusing on the baby’s heart rate, respiration, cry, muscle tone, reflex, and color. Cowherd’s husband, Bob “was incredibly supportive,” Cowherd said. “We were pretty well informed and had done our research. We knew what we wanted out of our birth experience. I had always been an advocate of water birth. We weren’t set on having our baby in the water but wanted to have that as an option.” Even her then 4-year-old daughter, Ruby, participated in the home birth by climbing into the tub in her swimsuit. Cowherd also has a son, Clayton. Cowherd advises women interested in water birth to plan well in advance and make sure that their health care providers are on board with the idea. “Women can’t just show up and say, ‘I want a water birth,’” she said. She said that about 90 percent of her midwife’s clients ask about water birth. “My water birth experience was incredibly empowering and peaceful and I am passionate about women having access to choice and freedom in their birth plans,” Cowherd said.

Crouse Receives $48,700 Grant for Breast Health Services

rouse Hospital was recently awarded a $48,700 grant from Susan G. Komen for the Cure Central New York to increase awareness of the availability of free and reduced-cost breast health services, particularly among underserved, underinsured and uninsured women in Onondaga County. The overall goal for the project this grant is funding is that all women in Onondaga County, including 30 to 40-year-olds, receive mammography screenings, as well as follow-up Page 14

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appointments with a medical professional if an abnormality or problem is detected. Early detection is the best defense against breast cancer and thanks to regular screenings and improved treatment methods, people have a greater chance of survival than ever before. With the help of the Komen grant, Crouse aims to increase the number of women who get tested for breast cancer through community outreach and Crouse Breast Health Center programs. The hospital has been and will con-

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

tinue to work on lessening the impact of the barriers of poverty, as well as the lack of education about and the access to healthcare with projects like this. “At the Crouse Breast Health Center, we are dedicated to providing the best possible screening and treatment services to all women,” said physician Stephen Montgomery, medical director of the Crouse Breast Health Center. “Unfortunately, a lack of education about the services we provide or a lack of access to healthcare prevents many women from getting an annual

mammogram, even though it can save lives.” The Crouse Breast Health Center was the first area program to be designated a breas timaging center of excellence by the American College of Radiology. Crouse recently introduced breast tomosynthesis, a new 3D imaging system that provides a more detailed picture of the breast than the traditional 2D digital mammogram, to detect even the most subtle signs of early cancer.

Women’s issues

New Law Requires More Information After Mammograms By Deborah Jeanne Sergeant

s of Jan. 19, the breast density inform law requires mammogram providers in New York to notify their patients if they have dense breast tissue. Before the law went into effect, women typically were not informed of the density of their breast tissue. “It’s not uncommon to have dense breast tissue,” said Carolyn Handville, program director for Breast, Cervical and Colorectal Cancer Screening for Cancer Services Program of Oswego County. “About 40 percent do.” It doesn’t mean patients have breast cancer or necessarily that they have a predisposition to developing cancer. Experts disagree as to whether dense tissue increases the chances of developing breast cancer, but it does hamper technicians’ ability to spot it using mammography. Benjamin McDaniel, radiologist with CNY Diagnostic Imaging Associates in Syracuse, said that the point of the law is to “encourage discussion between a patient and doctor about screening. Mammography is imperfect. It does better with women who have less dense tissue.” Breasts are comprised of fat and glandular tissue that enables nursing. Breast cancer often masquerades as glandular tissue, so the more glandular tissue that is present, the tougher it is to find cancer. In a woman with non-dense breasts, a mammogram can miss a detectable cancer up to 20 percent of the time. For women with dense breast tissue, the percentage rises to 35 percent. Making women more aware of their breast density can encourage them to discuss with their doctors their other health factors relating to breast cancer, such as family history, lifestyle, and other detection methods. Breast ultrasound or MRI may be recommended. Women should also ensure their annual check-up includes a physi-

cal exam of the breasts; however, women with dense breast tissue should be especially vigilant. “Hopefully, [the notifications] will spur greater compliance with mammography and breast exams,” McDaniel said. “It can be difficult to do the exams. I stress to women that they should feel for change and not get preoccupied with ‘Is this mobile or squishy?’ but ‘Is this changing?’ I don’t want women to feel intimidated.” Assessing other factors is also essential. Deepa Masrani, a physician who directs the Upstate University Hospital’s Women’s Imaging, encourages women to “ask their primary about their lifetime risk of breast cancer. If it’s more than 20 percent, they’re eligible to have a bilateral breast MRI as a supplemental screening. If it’s between 15 to 20 percent, then insurance doesn’t approve breast MRI. “Screening breast ultrasound may be offered, however, screening breast ultrasound is not the standard of care because it has a lot of false positives and it increases the number of unnecessary biopsies and follow-ups.” Regardless of her breast density, any woman who has a concern about an abnormality in her breasts should see her doctor.

Self-breast Examination

he National Breast Cancer Foundation (www.nationalbreastcancer.org) gives the following directions for performing a self-breast examination: • “In the shower, using the pads of your fingers, move around your entire breast in a circular pattern moving from the outside to the center, checking the entire breast and armpit area. Check both breasts each month feeling for any lump, thickening, or hardened knot. Notice any changes and get lumps evaluated by your healthcare provider. • In front of a mirror, visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead. Look for any changes in the contour, any swelling, or dimpling of the skin, or

April 2013 •

changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match—few women’s breasts do, so look for any dimpling, puckering, or changes, particularly on one side. • When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently in small circular motions covering the entire breast area and armpit. • Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.”

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Women’s issues Safe Medication During Pregnancy Some are OK to take, some not. Another factor to consider is the stage of pregnancy By Deborah Jeanne Sergeant

f you’re pregnant, you likely already know to be careful of taking medicine for the effect it can have on your baby. In addition to prescription drugs, over-the-counter medication can also harm your baby. At Pine Hill Pharmacy in Cato, pharmacist Walt Coolbaugh often answers questions about over-the-counter medication from pregnant women. “It’s one of the more common questions about safety,” he said. Pharmacists can help you avoid the standard no-nos, but your OB-GYN knows more about your health and caring for babies before birth. Nearly every medication states on the back that if you’re pregnant you should contact your doctor. When you take medication can also make a difference. Generally speaking, the most serious complications in the first four weeks include miscarriage, between the fourth and 10th weeks, birth defects, and between the 10th week and delivery, functional or developmental delays. About half of all US pregnancies

are unplanned, so it’s important to use reliable contraception or ceasing risky medications well in advance of when trying to conceive. Once pregnant, contacting your doctor is the best, safest choice, but sometimes, a minor malady strikes when the office is closed. If you can’t reach anyone through the on-call system, keep these tips in mind. Pharmacist Coolbaugh recommends acetaminophen (one brand name is Tylenol) for minor aches and pains. Beyond that, talk with your OB-GYN regarding pain relief, unless you’ve been prescribed to take aspirin for a different health issue as directed by your doctor. “Common over-the-counter medications like ibuprofen, Motrin, Advil, naproxen and Aleve have been found to increase the risk of miscarriage as well as heart problems for the baby when taken during pregnancy,” said Allison Loi, obstetrician with Community General Hospital. For cold symptoms, you have a few options beyond chicken soup, fluids

and rest (though those will help you feel better). Coolbaugh recommeds Claritin decongestant. If you’re in the second or third trimester, Sudafed should be OK. Loi added that for the aches and pains of cold or flu, 650 mg of acetaminophen every four hours is fine. “Use plain Sudafed 30 mg, every six hours for congestion,” she said, “Benadryl, 25 to 50 mg every four hours for congestion at night, plain Robitussin as directed for cough; and cough drops or throat lozenges as needed. Saline nasal drops or sprays as well as salt water gargles are also safe.” Loi added that severe symptoms such as a fever greater than 101, nasal drainage that is yellow or green, and severe sore throat warrant calling your doctor. Trusty Pepto-Bismol and the like may seem a dependable choice for indigestion, upset stomach, and diarrhea, but since it comes from the same medical family as aspirin, choose Maalox for upset stomach, and Kaopectate or Immodium for diarrhea.

As your pregnancy nears its end, the baby’s larger size will likely cause heartburn. Loi recommends calciumbased antacides such as Tums, Rolaids, Mylanta and Maalox for short-term relief. Pepcid or Zantac may offer long-term help. Many nonprescription drugs combine different ingredients, making it more confusing to women trying to avoid drugs that can harm their babies. Read labels to make sure that these medications do not contain an ingredient you’re trying to avoid. When taking any drug, prescription or non-prescription, make sure you follow the dosage correctly. Taking too much of any drug can be harmful, even if you’re not pregnant. Talk to your doctor about vitamins and natural supplements, too. “Even common nutritional supplements could be harmful,” Loi said. “For instance, some multivitamins contain high levels of vitamin A, which has been shown to cause severe birth defects if taken in large doses during pregnancy. “While prenatal vitamins are safe and important to start prior to conception and continue throughout pregnancy, most other herbal remedies and supplements have not been proven to be safe,” Loi added. “In general, you should discuss the use of all medications and supplements with your doctor.”

CANCER DOESN’T TAKE A YEAR OFF. NEITHER SHOULD YOU. When it comes to your breast health, it’s important to stay a step ahead of any potential issues. That means going in for a mammogram at least once a year. Together with education, regular mammograms are essential to early detection and positive outcomes. So be sure to receive an annual mammogram – and if your results ever come back abnormal, we’re here for you. We’ve been around for more than 25 years with advanced diagnostics including breast MRI, and we don’t plan on taking a year off anytime soon.

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For scheduling, call 315-454-4810, or for our St. Joseph’s Hospital location, call 315-423-6833. Visit www.mdrcny.com for a free personal breast cancer risk assessment. Page 16

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

More Young Women Diagnosed with Breast Cancer

n analysis of breast cancer trends in the U.S. finds a small but statistically significant increase in the incidence of advanced breast cancer for women 25 to 39 years of age, without a corresponding increase in older women, according to a study appearing in the February 27 issue of JAMA. “In the United States, breast cancer is the most common malignant tumor in adolescent and young adult women 15 to 39 years of age, accounting for 14 percent of all cancer in men and women in the age group,” the authors write. “The individual average risk of a woman developing breast cancer in the United States was 1 in 173 by the age of 40 years when assessed in 2008. Young women with breast cancer tend to experience more aggressive disease than older women and have lower survival rates. Given the effect of the disease in young people and a clinical impression that more young women are being diagnosed with advanced

disease, we reviewed the national trends in breast cancer incidence in the United States.” Physician Rebecca H. Johnson of Seattle Children’s Hospital and University of Washington, Seattle, and colleagues conducted a study in which breast cancer incidence, incidence trends, and survival rates as a function of age and extent of disease at diagnosis were obtained from three U.S. National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) registries. Since 1976, there has been a steady increase in the incidence of distant disease breast cancer in 25- to 39-year-old women, from 1.53 per 100,000 in 1976 to 2.90 per 100,000 in 2009. The researchers note that this is an absolute difference of 1.37 per 100,000, representing an average compounded increase of 2.07 percent per year over the 34-year interval, a relatively small increase, “but the trend shows no evidence for abatement and may indicate increasing epidemiologic and clinical significance.”

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We would like to welcome Martin K. Weitzel, DO, as Medical Director of the Fulton Urgent Care Center. The new Medical Director has 26 years of primary care experience, having owned and operated his own medical practice for many years. He also has urgent care experience. Dr. Weitzel is a familiar face at the Fulton Urgent Care Center, as he provided care there part-time for the past two years.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

Parenting By Melissa Stefanec melissa@cnyhealth.com

Discipline: Should corporal punishment be an option?

may have spent my younger days pondering great theoretical questions like “To be or not to be?” These days, however, my noble mind is suffering from vastly different turmoil. Parenting has brought me down roads that are more concrete, but full of more difficult questions. One of the most difficult scenarios parents face is discipline. In our earlier parenting years, my contemporaries were kicking around the all-important question of “To hit or not to hit?” Hitting. I must admit there are times I have thought about it. According to the American Academy of Pediatrics (AAP), about 90 percent of American parents use corporal punishment as a means of discipline. The AAP defines corporal punishment as hitting, slapping, pushing or grabbing in an attempt to curb a certain behavior. When you love someone so much, he or she can really get to you and it’s only human nature to want to lash out. Toddlers have a way of pushing your buttons. My daughter Stella steamrolled her way into the terrible twos long before her second birthday. She has ignored me, defied me, hurt me, and even put herself in mild danger. Even so, my husband and I have vowed not to use corporal punishment as a means of discipline. Before you write us off as new-age subscribers to the school of fee-goodery, hear me out. Our choice is rooted in science. We have the goods to back it up. Time magazine recently reported on a study published in Pediatrics, the official journal of the AAP. The Time article quoted the study as saying, “harsh physical punishment increases the risk of mental disorders — even when the punishment doesn’t stoop to the level of actual abuse.” My immediate take-away from this study is that if I hit my child, she will be at increased risk for mental disorders. In other words, I might scar her for life if I hit her. The same study found people who experienced physical punishment were more likely to experience numerous types of mood disorders. For example, a child subjected to corporal punishment is 1.5 times more likely to suffer from depression or mania, 1.4 times more likely to suffer from depression or anxiety, 1.6 times more likely to abuse alcohol and 1.5 times more likely to abuse drugs. (Yikes. That is a checklist of some of my worst parenting fears.) Not only is hitting dangerous for the psyche, it also has many unintended consequences. According to the AAP, here are some of them. Spanking children under 18 months increases the chance of physical injury to the child. The child is also unable to draw a connection between the spanking and the

punishment. Repeated spanking may cause agitated and aggressive behavior, up to and including aggression toward parents. Spanking teaches children that aggression is an effective way to solve conflicts, and that lesson follows them to the playground and beyond. The AAP also finds two other faults in using spanking as discipline. First, spanking begets more spanking. Hitting a child often relieves anger for the parent. This means the parent is more likely to spank again and again. Secondly, spanking typically stops at some point. Most people don’t spank their 17-year-old children. When the time for spanking ends, typically during adolescence, other forms of discipline are harder to implement. In other words, parents and children aren’t well-versed in other more effective forms of conflict resolution. The effects of corporal punishment also follow children into other aspects of their adult lives. According to the AAP, adults who were spanked as children are more likely to spank their own children, approve of hitting a spouse and experience increased marital conflict. They also experience an increased risk of physical aggression toward others, substance abuse, and engaging in crime and violence. The bottom-line recommendation from the AAP is as follows: “Because of the negative consequences of spanking and because it has been demonstrated to be no more effective than other approaches for managing undesired behavior in children, the American Academy of Pediatrics recommends that parents be encouraged and assisted in developing methods other than spanking in response to undesired behavior.” Not only does hitting condone conflict resolution through violence, it also creates an environment where children fear being hit. The fear of being hit might keep a child from doing certain things, but if that fear is gone (for example if Mommy isn’t in the room) the child will probably engage in unsafe or undesirable behavior. Hitting as an effective form of discipline just doesn’t make sense. Not engaging in corporal punishment seems like a no-brainer. If I use effective discipline on Stella, I won’t place her at an increased risk for mental illness, substance abuse, aggression and a host of other negative repercussions. Not hitting is the easy part. Finding effective and practical ways to discipline her is another story and the topic of my next column. To read more about the reference materials used in this article and the AAP’s Guide to Effective Discipline visit http://pediatrics.aappublications. org/content/101/4/723.full.pdf.

SmartBites

By Anne Palumbo

The skinny on healthy eating

Little Farro Packs Big Nutritious Punch

ometimes I’m aghast at how long it’s taken me to incorporate whole grains into my diet: whole wheat, barley, oats, brown rice, wheat berries and more. Although I’m well aware of their nutritional benefits, and have been for years, I’ve been shamefully slow to the whole-grain gate. I guess ol’ white-bread-white-rice habits die hard. But now that I’ve embraced whole grains with gusto, I’m forever discovering new ones that floor me with their goodness. My latest find is farro, an ancient grain belonging to the wheat family that has a roasted, nutty flavor and a distinctive chewy texture, reminiscent of barley. I’ve grown fond of this whole grain because it has a higher protein and fiber content than common wheat; it’s rich in magnesium, iron and B vitamins; and it contains specific phytonutrients that may boost the immune

system and help reduce inflammation. Plus, it’s fairly low in calories (about 100 per ½ cup cooked) and cooks up relatively quickly. I remain smitten with whole grains in general because studies show that eating whole grains instead of refined grains (which are stripped of critical nutrients) lowers the risk of many chronic diseases, such as heart disease, some cancers, diabetes, and obesity. What’s more, the carbohydrates in whole grains are “complex,” which means they take longer to digest and provide a steadier stream of energy. This leaves us feeling fuller longer and less likely to overeat later. Does eating whole grains contribute to weight loss? Scientists at the University of Copenhagen seem to

think so. According to a recent study, women eating the diet with whole grains lost more weight and saw a more significant decrease in body fat compared to those who ate refined grains. Also worth noting: Cholesterol levels increased 5 percent in the refined group, which further highlights the heart benefits of choosing whole grains instead of refined.

Helpful tips Whole farro, which has an intact hull, will need to be soaked overnight and then cooked for up to two hours. Semi-pearled and pearled farro, on the other hand, do not need to soak and take about 30 minutes to cook. Although the pearled versions have slightly less fiber, they maintain the same high protein level. Most farro sold in the U.S. is hulled to some degree.

Farro with Spinach Pesto and Cherry Tomatoes (Serves 4 – 6) 2 ¼ cups water 8 oz box of farro 2 cloves garlic, peeled ¼ cup chopped walnuts, toasted ¼ cup grated Parmesan cheese 1/2 teaspoon salt 1/4 teaspoon pepper 2 cups packed spinach leaves, stems removed

½ cup flat leaf parsley (or fresh basil) 1 tablespoon red wine vinegar or fresh lemon juice 1 tablespoon water 2 tablespoons extra virgin olive oil 1 cup (or more) cherry tomatoes, halved Parmesan cheese, shredded (optional) Bring 2 ¼ cups water and contents of package to a boil in a medium saucepan; stir. Reduce heat to low; cover; simmer for 35 minutes. Remove from heat and let stand covered, 10 minutes. Fluff with fork. While farro is cooking, make pesto. Pulse garlic in a food processor until finely chopped, then add nuts, cheese, salt, pepper, and a large handful of spinach. Process until chopped. Add remaining spinach and parsley, one handful at a time, pulsing after each addition, until finely chopped. With motor running, add vinegar, water, and oil and blend until incorporated. Toss warm farro with pesto and cherry tomatoes; top with shredded Parmesan cheese. This dish is equally tasty at room temperature. 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.

Wanted: Primary Care Physicians from page 12

Rural areas are the hardest hit by this trend, the report said. Statewide, hospitals that were well outside of population centers lost 76 physicians in 2011 and are currently in need of 309 physicians (76 in primary care). Many hospital officials attribute the shortage to retirements; doctors are aging out and younger ones aren’t interested in moving to small towns. Moreover, younger doctors are more interested in larger communities because of higher pay and more job opportunities for their spouses. Central New York Hospital officials said physician recruitment will continue to be a challenge as the Affordable Health Care Act is rolled out. Physician John McCabe, chief executive officer of Upstate University Hospital in Syracuse, called it a “never-ending quest.” “Hospitals already have problems with access for patients today,” he said. “With more people insured at the Medicaid [reimbursement] rates, the issue will be compounded because the reimbursement is so low. Specialists were already hard to come by, and regionally [outside of Syracuse and its suburbs], the need is going to be even greater. It’s going to put a lot of pressure on hospitals and physicians and communities.” The 17 new physicians hired at Oswego Health hospital within the last two years include several primary care doctors and hospitalists in addition to a cardiologist and an orthopedic surgeon. To prepare for higher patient

volumes, the organization recently completed a medical staff development plan, and is working with two nationally-acclaimed physician recruitment firms, said Marion Ciciarelli, the hospital’s public relations manager. While St. Joseph’s added five primary care doctors last year, it is still looking to hire eight to 10 more, said Fred Letourneau, senior vice president for physician enterprise. “We’re seeing a lot of competition from hospitals in North Carolina,” he said. “Maybe the money here is less, but candidates are interested in Central New York because the facilities are reputable and there is a good health care system. I think the challenge here is to focus on getting those who are from New York state and go to medical school here.” The challenge ahead involves more than just treating a higher volume of sick patients, Letourneau explained. Under preventative care standards, patients are seen by primary care physicians and certain specialists more often to avoid trips to the emergency department or operating room. “People already came to the hospital [emergency room] for care whether they had insurance or not,” he said. “With the new model, we reach out to patients – and there will be a lot more of them – to make sure they get a mammography or colonoscopy. To deliver that locally, hospitals need to have networks in their town. We need to develop systems with physicians and work together.”

How to Attract More MDs to CNY The report “Doctor Shortage: Condition Critical” by The Healthcare Association of New York State includes a few suggestions for meeting the growing need of primary care doctors in New York state: • Increase the number of primary care residency slots • Increase the involvement of current primary care physicians in medical training • Require student participation in areas that are medically underserved • Change the medical school admission process to foster interest in primary care • Involve community collaboration in medical resident training • Financially reward teaching hospitals for producing more primary care physicians • Boost the salaries of primary care residents. April 2013 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Goodbye Asperger’s Syndrome In May Asperger’s syndrome will no longer be a diagnosis but local support groups remain strong and plan to grow By Matthew Liptak

ome May, when the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) comes out, Asperger’s syndrome will no longer be a listed diagnosis. Instead the condition will come under the umbrella term “autism spectrum disorder.” So what is [or was] Asperger’s syndrome exactly? According to psychologist Kevin Antshel, an associate professor of psychology at Syracuse University, “Asperger’s syndrome is an autism spectrum disorder characterized by (1) social interaction impairments such as very poor eye contact, poor social reciprocity (conversations lack typical back and forth), failure to make friends, etc. and (2) a restricted range of interests or behaviors such as a preoccupation with something that is unusual in its focus (street signs) or intensity (amassing a tremendous information about dinosaurs, for example). “Unlike individuals with autism, individuals with Asperger’s syndrome do not have language or intellectual delays. Due to this, individuals with Asperger’s syndrome often function at a higher level and are more independent than individuals with autism.” But, whether they’re labeled as “Aspies” or not, there are those in Central New York devoting their spare time to helping those with the condition. In particular, local advocates have started social groups for children, young adults and women who have the disorder as well as a support group for the parents of those who have it. The Aspie Network of Central New York began in 2011 after the mother of one young man with Asperger’s syndrome wrote an article for The Post-Standard. Sandy Cittadino told the story of the challenges she and her son Joe faced in Joe’s diagnosis with Asperger’s syndrome. She expressed

Lonnie Chu started CNY Asperger’s Women through Meetup.com. Chu is self-diagnosed with Aspergers. Page 20

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The group picture shows, from left, Ryan Southard, Jackie Southard, Joe Cittadino, Sandy Cittadino. The mothers med after sons were diagnosed with Asperger’s syndrome. They founded the Aspie Network of Central New York. how she hoped there could be a place of support for her and her son, and others like them. The public responded with 200 emails to her. Cittadino and her friend Jackie Southard now know there was a need. Southard is the mother to Joe Cittadino’s friend, Ryan, who also has Asperger’s syndrome. They, with some of those who responded to the newspaper article, started two groups. One was a support group for parents and the other was a social club for young people with Asperger’s syndrome. “When both of our sons went to college and we realized when they went off to college they lost their friends from high school that took years to get and we felt badly,” Sandy said. “They had no social interaction with people so Jackie and I thought ‘Gee, wouldn’t it be great if we could get them together with other young people with Asperger’s with things in common.’” It turned out to be a common challenge that faced those with Asperger’s syndrome after high school. How do you find friends and socialize without the social structure? The social club has been one solution. “We have 30 of them that are active and a lot of them will come to activities,” Jackie said. “Every month we have an activity. It could be bowling. It could be laser tag. They could go to the movies. Games, they like to have games. I get close to 10 to 20 people every time.” Sandy Cittadino said she was impressed with the impact the group seemed to have almost immediately with the young adults. Parents reported being elated that their sons or daughters were going to their first

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

How to Find Local Support Groups To find more information on the Aspie Network of Central New York visit www. aspienetworkcny.org. To find the CNY Asperger’s Women group at Meetup. com go to www.meetup. com/CNY-AspergersWomen/. birthday parties in their lives. The new members of the group couldn’t wait for the next scheduled event. “It is key,” Cittadino said. “I see it. The more my son makes friends, the more he socializes, the more confident he gets and I see a definite improvement in him too. The parents that have written me emails saying the change in their son or daughter since this group started has been great.” By all accounts the Aspie Network of Central New York has been a success. Cittadino and Jackie Southard are not resting though. They want the network to become a full-fledged nonprofit organization with a regular place for Aspies to meet at. “Down the road we would love to have a building where we could call home base,” Southard said “We could have meetings there.”

Other than scheduled meetings the women see potential for regular speakers and maybe even an employment service for Aspies. Lonnie Chu heads up CNY Asperger’s Women at Meetup.com. She said she is self-diagnosed as having Asperger’s syndrome and has a family history of the disorder. “I’m finding the best support I get is from other Asperger’s people,” she said. “There’s only two meetup [.com] groups in the United States that are for Asperger’s women and we’re one of them. When I’m alone with my Aspie women we all understand the difficulties we’re dealing with and it’s like ‘Ah, finally I can talk to people, be in a social situation and relax at the same time,’ We usually don’t get that.” Meetup.com is a website that helps people with shared interests form offline groups. The Aspie Network of Central New York has a presence there too. However they see themselves, whether with the old diagnosis of Asperger’s syndrome or the new diagnosis of being on the autistic spectrum, local advocates are finding ways to help those in need. They’re helping them find common ground with others like them—helping them find a place in the world. “There’s as much diversity in the Asperger’s world as there is in the neurotypical world,” Chu said. “You think you’re from another planet. You wonder why nobodies brain works like yours until you find there are Asperger’s. Then when you hang with them suddenly you feel like you are where you belong. That you’re on a planet that you belong to. You’re in a tribe that you belong too.”

HOUSEMATES

What They Want You to Know:

Chiropractors

Have you ever considered living with a person with a developmental disability in their home? In return for your support and companionship, you will receive free rent, utilities, and basic phone. You would be able to maintain your current life style such as work, school or volunteerism and still MAKE A DIFFERENCE in a person’s life. You must be caring, committed and responsible. If this sounds like something you may be interested in, give us a call to learn more. (315) 434-9597 ext. 210.

By Deborah Jeanne Sergeant

ew York Chiropractic College’s Doctor of Chiropractic Program equips graduates to “perform patient management and conduct diagnoses, giving special emphasis to neuromusculoskeletal conditions. Instruction in natural healthcare emphasizes the human body’s inherent ability to heal.” To earn a Doctor of Chiropractic degree from New York State Chiropractic College requires a clinical internship and the equivalent of five academic years. • “People think it will be a visit or two to get the results they’re looking for. Considering the length of time they’ve had that problem, it’s not going to take a visit or two. We compare it with braces on your teeth and having those braces tweaked. [We’re] trying to change the alignment in someone’s spine to take press off the nerves between the vertebrae. • “People think that when their pain has subsided that the problem has subsided but that is not often true. The pain is typically the last thing to appear, so it’s the first thing to disappear. • “Being a weekend warrior can cause problems. • “Those in the younger generation are getting ‘text neck’ because they look at their phones so much and it creates problems similar to whiplash. They’re starting to do studies on it because it’s so prevalent. • “Obesity is a big problem. We’re eating too much food and we’re not as active. When I was kid, I’m 56 now, kids were out of the house playing. These days, they grow up playing videos games and texting. They’re not going to the park and they’re not as active. That leads to a lot of obesity and diabetes in children, let alone the stress they’re putting on their bodies from a chiropractic perspective. They’re not using their muscles and they’re getting reconditioned. • “In the workplace, if they’re working at a desk, this isn’t necessarily geared towards that person. They’re thrown into a situation where they’re working at a desk that may not be at a right height. • “We’re seeing a lot of carpal tunnel problems. The computer has created a lot of problems with people’s necks, and lower backs, too. Michael A. Stirpe, Stirpe Chiropractic Center, Syracuse • “Chiropractic focuses on fine tuning the brain. We use the spine to keep healthy patterns in the brain going. We want to reduce patterns of weakness and reinforce patterns of strength. • “If you have pain for any reason,

the body may not heal properly and reinforce an unhealthy pattern. “I come from a wellness philosophy. Coming on a regular basis is very helpful. When people come regularly, they see improvements in their health in ways they don’t expect. • “Stress weakens the body. Our own habits contribute, as well as an accumulation of injuries over time. We look at someone’s entire health history to see the type of stress they endured and how that has created a pattern of stress the body can’t erase. • “A positive attitude increases effectiveness of the immune system. • “We’re not looking for a cure, but what the body needs to enhance the nervous system. The body does the rest. Lisa Homic, Homic Advanced Chiropractic, Auburn • “When you have neck or back pain, you want to think of it similarly to as how you would think of knee, ankle or wrist pain. If you’re ever hurt any of these, it’s usually diagnosed as a ligneous problem. People never say they pull a muscle in the knee. We always think of muscle pulls when it comes to the spine, but 80 to 90 percent of the time, it is a ligament or disc. You compromise the disc usually when treating it like a muscle strain. Stretching out when you have neck or back pain can make it a lot worse. • “When treating neck or back pain, consider inflammation as a factor. Exercising it will only create more inflammation. Ice and rest will help for a few days. Try not to heat it. If it’s a lower back problem, sitting puts more pressure on it. It’s like an ankle sprain where people won’t stop walking on it. • “If you reduce disc strain, your motion will get better. I use the MacKensie approach, in which I’m certified, where you apply sustained positions, you can get a very clear idea of what you’re dealing with. That will help direct your treatment strategy.

For over 40 years, Pediatric Cardiology Associates, LLC has been providing cardiovascular services throughout the Central New York region, to children and young adults with congenital heart disease. PCA performs noninvasive services, including fetal, transthoracic and transesophageal echocardiography, EKG services, stress/exercise testing and MRI/MRA. Accepting referrals from pediatricians and primary care physicians. 725 Irving Suite 804, Syracuse, NY 13210 Phone (315)-214-7700 | Toll Free (877) 404-5868 | Fax: (315) 214-7701 ❤ Marie S. Blackman, M.D., Director Emeritus ❤ Matthew Egan, M.D. ❤ Nader H. Atallah-Yunes, M.D., FACC ❤ Daniel A. Kveselis, M.D., FACC ❤ Craig J Byrum M.D., FACC ❤ Frank C. Smith, M.D., FACC

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In the workshop led by Gwenn Voelckers — a women who’s “been there” — you’ll discover how to overcome loneliness and other emotional pitfalls, rediscover your true self, and socialize in a couples’ world. $125 fee includes manual, empowerment exercises and book.

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.

For more information, call (585) 624-7887 or visit www.aloneandcontent.com April 2013 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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The Social Ask Security Ofﬁce

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

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Preference given for veterans or spouses of veterans. Page 22

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

Column provided by the local Social Security Office

Your Number Is Your Card Do you really need a new card? Knowing your number is usually all you’ll ever need

specific documents you need to provide. Each situation is unique, but in most cases you simply need to print, complete, and either mail or bring the application to Social Security with the appropriate documentation (originals or certified copies only). In almost all cases, though, an application for your newborn’s Social ftentimes, people decide they Security card and number is taken in need to apply for a new Social Security card because they can’t the hospital at the same time that you apply for your baby’s birth certificate. find their old one. As long as you have There are a number of reasons a all of the required information and docbaby or child may need a Social Secuumentation, it’s not difficult to obtain rity number, but the main one a replacement Social Security is so that you can claim your card. But here’s even better child as a dependent on your news: you probably don’t need tax return. Your child also the card. will need a Social Security When you think about it, number to apply for certain your Social Security number government and social service is your Social Security card. benefits. That is, knowing your number Whether you need a Sois usually all you’ll ever need. cial Security card for yourself Know your number by heart, or your child, it’s easy to apand you’ll never leave home ply for one. But remember: if without it. you already have one and just In the event that you really Banikowski can’t find it, in most cases all you really do want or need to get a replacement need is to know your number. Memocard, either for yourself or for a child, rize your Social Security number, and you can find all the details at www. you’ll never leave home without it. socialsecurity.gov/ssnumber. The “Get Learn more about your Social SecuOr Replace a Social Security Card” rity card and number at www.socialsepage provides information on how to curity.gov/ssnumber. obtain a replacement card and what

Q&A

Q: I applied for a replacement Social Security card last week but have not received it. When should I expect to receive my new card? A: It takes approximately 10 to 14 days to receive your replacement Social Security card. We’re working harder than ever to protect you, prevent identity theft, and ensure the integrity of your Social Security number. To do that, we have to verify documents you present as proof of identity. In some cases, we must verify the documents before we can issue the card. For more information about your Social Security card and number, visit www.socialsecurity.gov/ssnumber. Q: What can I do if I think someone has stolen my identity? A: You should do several things, including: • File a report with the local police or the police department where the identity theft took place, and keep a copy of the police report as proof of the crime; • Notify the Federal Trade Commission (1-877-ID-THEFT or 1-877-4384338); • File a complaint with the Internet Crime Complaint Center at www.ic3. gov; and • Contact the fraud units of the three major credit reporting bureaus: Equifax (800-525-6285); Trans Union: (800-680-7289); and Experian: (888-3973742). If your Social Security card has

been stolen, you can apply for a replacement card. But you usually don’t need a new card as long as you know your number. To protect yourself in the future, treat your Social Security number as confidential and avoid giving it out. Keep your Social Security card in a safe place with your other important papers. Do not carry it with you. Learn more by reading our publication, “Identity Theft And Your Social Security Number”, at www.socialsecurity. gov/pubs/10064.html. Q: What can Social Security do to help me plan for retirement? A: Social Security provides great financial planning tools that can help you make informed decisions. Visit www.socialsecurity.gov and open a my Social Security account to access your online Social Security Statement. The statement lists your earnings and the Social Security taxes you paid over the years. It also estimates the Social Security benefits you (and dependent family members) may be eligible to receive. The statement can help you plan for your financial future. Also, use Social Security’s online retirement planner and our online Retirement Estimator. These will give you estimates of your future Social Security retirement benefits. They also provide important information on factors affecting retirement benefits, such as military service, household earnings, and federal employment. You can access our retirement planner at ww.socialsecurity.gov/retire2.

Come Smile With Us! Bruce Stewart, DDS

By Jim Miller

Simplified Smartphones for Boomers and Seniors Dear Savvy Senior, Are there any smartphones specifically designed for seniors that you know of? I’m interested in getting one, but at age 69, I want to find one that’s easy to see and use. Semi-Smart Senior Dear Semi-Smart, There are actually several manufacturers who are now making simplified smartphones with features designed primarily for older users who have limited experience with modern gadgetry. Here’s a rundown of what’s currently and soon-to-be available. Pantech Flex

One of the best and most affordable age-friendly smartphones on the market today is the Pantech Flex (see pantechusa.com/phones/flex), sold through AT&T for only $1 with a twoyear contract. This Android-powered touch screen phone has a bright 4.3-inch screen, with a fast 1.5GHz dual-core processor and 8 megapixel camera. But what makes this phone ideal for seniors is its easy experience mode which provides a simple, clean home screen with large fonts, clearly marked icons, and quick access to the phone’s most essential features — your phone, camera, messages, menu, Web, contacts, along with shortcuts to your favorite apps. It also offers convenient features like voice dialing and voice commands, and SwiftKey technology that predict the next word you want to type to make texting faster and easier. Individual monthly service plans for AT&T start at $30 for 200 minutes of talk time (for customers 65 and older), $20 for unlimited text messaging, and $20 for 300 MB of data.

Jitterbug Touch

Offered by GreatCall Wireless — the same company that makes the Jitterbug big-button cell phone — the Touch is actually a Kyocera Milano smartphone that’s been rebranded and loaded with GreatCall’s simplified user interface software. It offers a 3-inch touch screen, and a full slide-out keyboard with raised, backlit buttons that makes it easier to type messages. And when you turn the phone on, you get a simple menu list with large fonts that let you access often-used features like the phone, camera, messages and pictures, along with your contacts and apps. This Android phone also offers voice dialing, a 3.2 megapixel camera, and optional features like medication

reminders, 5Star personal security service, a live nurse service to answer your health questions, and more. Available at greatcall.com or 800-733-6632, the Touch sells for $149 with a one-time $35 activation fee, no contract, and calling plans that cost $15 per month for 50 minutes, up to $80 per month for unlimited minutes, text messages, operator assistance, and voicemail. And their data plans run between $2.50 per month for 10 MB up to $25/month for 500 MB.

Samsung Galaxy Note II If a bigger screen is the most desired feature, the Samsung Galaxy Note II (samsung.com/galaxynoteII) has a huge 5.5-inch touch screen display and can be used with a stylus, which makes it easy to see and maneuver. It also offers an easy mode feature which simplifies the home screen providing access only to key functions like the phone, messaging, Internet, contacts and your favorite apps. Available through AT&T, Sprint, Verizon, T-Mobile and U.S. Cellular for $300 to $370 with a two-year contract, the monthly service plans for talk, text and data start at around $80.

Doro PhoneEasy 740

If you don’t mind waiting, the Doro PhoneEasy 740 (dorousa.us/experience) is another excellent option, but it won’t be available in the U.S. until later this year. This Android slider phone has a 3.2-inch touch screen and a numerical slide-out keypad with raised buttons for easy operation. It also offers a largetext, clearly labeled menu to frequently used features like the phone, email, messages, Internet, photos, games and apps. Expected to cost around $99, other age-friendly features include a 5 megapixel camera which can double as a magnifying glass, and an emergency call button that will dial and text five preprogrammed numbers when pressed. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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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April 2013 •

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H ealth News George Popp joins United Way board George Popp of Central Square, vice president of information systems and chief information officer at Laboratory Alliance of Central New York, was appointed to the board of directors of United Way of Greater Oswego County. United Way works with 20 local partner agencies and supports 34 human service programs in five areas: emergency services, children and family services, health and special needs, senior services, and youth development. Popp has been with Laboratory AlliPopp ance since its inception in 1998. He is a member of several professional organizations, including the American Society of Clinical Pathologists, the Health Information and Management Systems Society, and the College of Healthcare Information Management Executives. Laboratory Alliance provides clinical and anatomic pathology testing

services and performed more than 10 million medical tests last year. Laboratory Alliance employs 440 Central New Yorkers and operates four laboratories and 11 patient service centers in the region.

Cayuga County’s Red Cross has new manager Pamela Baker Gratton has been named branch manager of the American Red Cross Cayuga County Branch. The Cayuga County branch at 11 State St., Auburn, is part of the Red Cross Central New York Chapter, which covers Cayuga, Onondaga, Madison and Oswego counties. Gratton was selected from a talented and experienced group of candidates by a committee that included Cayuga County branch advisory council members, volunteers, community leaders and American Red Cross Central New York region senior staff. Gratton “It is an honor and

VNA Launches Managed Long-Term Care Plan Plan to help chronically ill or disabled individuals VNA Homecare has announced that March 1 marked the launch of member enrollment in its new Managed Long Term Care Plan (MLTC), VNA Homecare Options, LLC. The Medicaid plan assists chronically ill or disabled individuals who require health and long-term care services. MLTC plans receive a monthly risk-adjusted capitation payment from New York State Medicaid to pay for a range of home and community-based services. The benefit package includes home care, personal care, social supports, and transportation services. The costs for skilled nursing facility services are included in the capitation payment, providing financial incentive for the plans to keep members healthy and living in the community. VNA Homecare Options will manage the delivery of all services and care. “We are 100 percent committed to proactively and quickly meeting marketplace needs and changes. Maintaining continuity of care is one of the essential components of the plan, making it possible for members to remain healthy, safe and independent in their homes. Having a local organization with a proven track record and the benefit of already having strong working relationships with resources throughout the community is the best course of action for achieving that,” said M. Kate Rolf, President and CEO of VNA Homecare. “It’s incumbent Page 24

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upon us to make certain that the community has access to a local organization that can readily manage and care for their needs. Our presence will ensure consistency and continuity of care for patients.” Managed long-term care is part of New York State’s Medicaid Redesign Initiative of transitioning the Medicaid system from a fee-for-service environment to a managed care environment requiring mandatory patient enrollment (MRT-90) in a managed, long-term care plan. The five-phase implementation of MRT-90 is slated for completion in 2014. The transition began in New York City and will continue throughout the state as plan capacity is developed. More than 85,000 New Yorkers are currently enrolled in MLTC plans. A report issued by the New York State Department of Health shows that 90 percent of statewide enrollees improved their condition or remained stable. VNA Homecare Options, LLC is the newest and one of five entities that comprise VNA Homecare, the d/b/a for Home Care of Central New York. VNA Homecare’s eldest division, the Visiting Nurse Association of Central New York was founded in 1890 and is the oldest certified home care agency in Onondaga County. Information about VNA Homecare Options or enrollment is available by calling 315-477-9500.

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

privilege to be part of an organization that touches so many lives in Cayuga County through emergency response, blood services, health and safety training, and military and international support services,” Gratton said. “I’m excited to be the voice for the Cayuga County Chapter and bring my years of experience to the Red Cross mission.” Gratton, a Cayuga County resident, has more than 20 years of professional experience in program management, public relations/marketing and community relationship development for SUNY Upstate Medical Center in Syracuse, Bryant & Stratton College in Liverpool, and Junior Achievement of Central New York. Most recently, she served for seven years as owner/president of TroubleTree Enterprises, which helped Central New York companies understand how to implement traditional marketing, actionable content marketing, and emerging social media projects. A native of Western and Central New York, Gratton earned a Masters of Administration degree from SUNY Buffalo, and a Bachelor of Science degree in communications and psychology from SUNY Fredonia.

Upstate gets $1.54 million bequest from alumnus Upstate Medical University has received a $1.54 million gift from the estate of alumnus Stanley A. August of Brooklyn, which will help establish an endowed professorship in pediatrics and scholarships for students in Upstate’s College of Medicine. August earned his medical degree from Upstate in 1969 and became a board-certified pediatrician. Ten years later, he enrolled in Brooklyn Law School and became a lawyer to better understand the relationship of law to the medical professions. He was in private practice in Brooklyn for nearly four decades, earning a reputation as an excellent diagnostician. “We are grateful for the living legacy Dr. August has created that will ultimately improve the health of children in this region and support the next generation of physicians in New York,” said Upstate President David R. Smith. “His generosity is a testament to the support of our alumni.” The gift comes in the form of a bequest through Upstate’s Medical Alumni Foundation. August died Aug. 14, 2011. The contribution will be used to establish the Stanley A. August, MD, Endowed Professorship in Pediatrics, and two scholarships: The Nathan and Ada August Memorial Award and the Stanley A. August, MD, Memorial Award. Details of the professorship and scholarships are still to be worked out. “I first learned about Dr. August’s generosity several years ago, during the capital campaign for the children’s hospital,” said Thomas Welch, professor and chairman of the department of pediatrics and medical director of Upstate Golisano Children’s Hospital. The gift from August, while supporting Upstate clinical education mission, represents the final contribution to the children’s hospital capital campaign. Welch added.

Franciscan expands agency to cortland county Franciscan Companies, a company that specializes in respiratory therapy, medical equipment and home care, is expanding services to include the patients and employees of Home Care of Cortland County. After operating for nearly 40 years, the Cortland-based agency has ceased operations due to the changing economics of the home care industry. The licensed home care arm of Franciscan Companies, Franciscan Health Support, formed a partnership with the agency as a way to avoid a gap in home care services in the Cortland area. “We are very comfortable transitioning our patients to Franciscan based on our mutual philosophy of taking excellent care of our patients,” said Michael Pizzola, president of the Home Care of Cortland County board of directors. Franciscan hired most of Home Care’s aides and nurses, who will continue to provide service to nearly 200 patients. Many of the employees worked for the agency for 10 to 15 years, and it was important to the board of directors and Franciscan Companies’ leadership that these staff members are retained during the transition. “A key element of the board’s decision to work with Franciscan was the establishment of a local office in Cortland, and a seamless transition of our employees to Franciscan. What a wonderful way for patients to continue to receive high quality services,” said Pizzola. “It’s a win-win for everybody,” said Megan Hollister, executive director of Franciscan Health Support’s Licensed Agency. “We were able to keep the same people in place — local people who know the community and the patients.”

St. Joe’s has new VP for development St. Joseph’s Hospital Health Center has appointed Douglas G. Smith to the position of vice president for development. He replaces Margaret R. Martin, who retired at the end of 2012. Smith is a senior level fundraising executive with more than three decades of experience in positions of leadership, both in health care and higher education. Most recently, he served as vice president of development and foundation president at Greater Baltimore Medical Center in Towson, Md. He held similar positions at Pittsburgh Mercy Health System and Vail Valley Medical Center, as well. A native of northern New Jersey, Smith received a bachelor’s degree in English from Ohio University and a master’s degree in public management from Carnegie Mellon University’s H. John Heinz III School of Public Policy and Management. He has been an active member of the Association of Smith

H ealth News Healthcare Philanthropy for more than 25 years.

Jason Cherry joins Victory Sports Medicine Jason Cherry has joined Victory Sports Medicine & Orthopedics as director of physical therapy. He will lead a growing team professionals at the Skaneateles practice that provides physical therapy as a key component of integrated healthcare model. “We are extremely fortunate to have Jason as a part of our team,” said Marc Pietropaoli, who founded Victory Sports Medicine in 1999 and leads the practice. “His training, education and experience will be a Cherry great addition to our integrated healthcare model,” he added. Prior to joining Victory Sports

Medicine, Cherry owned and operated a very successful physical therapy practice in Lakewood, Col. He is specifically trained in working with sports injuries and helping patients return to active lifestyles following injury or accident. He is an expert in the rehabilitation of all types of sports injuries. Among his areas of focus Cherry and his team will support the gait and balance program, targeted for patients over 55 or who are at risk of frequent falls. Gait and balance disorders are among the most common causes of falls in older adults and often lead to injury, disability, loss of independence, limited quality of life and even death. Cherry earned his Doctor of Physical Therapy degree from Regis University in Denver. He received his Master of Science in physical therapy from Boston University and his Bachelor of Arts in kinesiology from California State University. He also received a certification in orthopedic manual therapy through the International Academy of Orthopedic Medicine – U.S.

Central New York Chapter Earns Accolades at Alzheimer’s Association National Conference Jared Paventi, chief communications ofﬁcer at Alzheimer’s Association— Central New York chapter, was a co-presenter on the topic of “Online Advocacy” at a recent gathering in Dallas.

St. Joseph’s Hospital Honors Supporters

St. Joseph’s Hospital Health Center presented St. Joseph the Worker awards on the feast of St. Joseph March 19 at the Genesee Grande Hotel. From left to right are Kathryn Ruscitto, president and chief executive ofﬁcer of St. Joseph’s, with the awardees: physician Thomas Aiello, medical director of Pulmonary Health Physicians, PC; Kenyon Craig, executive director, Housing Visions; and physician A. John Merola.

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Ann Walsh, chief development ofﬁcer at Alzheimer’s Association—Central New York chapter, was a featured speaker at a recent gathering in Dallas. She discussed the topic “Key Metrics: Tips to Lead Your Staff and Volunteers.” The Alzheimer’s Association, Central New York chapter was honored for its achievements during the past year at the 2013 Alzheimer’s Association Leadership Summit in Dallas. The annual conference gathers association chapters from throughout the country for educational and training programs, and an awards celebration. During the awards ceremony, the Central New York Chapter was presented an award for Outstanding Achievement in Increasing Concern and Awareness for accumulating the most media impressions among chapters of its size (overall population of 2 million people or less). Its board of directors was honored for having 100 percent participation in the Walk To End Alzheimer’s, the signature

national event of the Alzheimer’s Association. In addition to its awards, the chapter also had two staff members present to their peers in the national network. Toni Ann Walsh, chief development officer, was a featured speaker on a session on data analysis called “Key Metrics: Tips to Lead Your Staff and Volunteers.” Walsh’s session taught other staff from the Alzheimer’s Association how to mine and analyze data to improve their fundraising performance. Jared Paventi, chief communications officer, was a co-presenter on the topic of “Online Advocacy.” His topic focused on tools and tips for motivating advocates of the Alzheimer’s Association. Paventi lives in Camillus. Walsh resides on Onondaga Hill.

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