SUNSCREENS Dermatologist explains new FDA requirements and the latest advancements in sunscreens
in good July 2014 • Issue 175
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CNY’s Healthcare Newspaper
Fertility:
U.S. Dogs, Too, Are Overweight
Just over half of dogs in the United States are overweight or obese, according to a survey
High Season for Food Poisoning
EGG Freezing
Recent advances in cryogenics have improved success rates to the point where egg freezing has become more commonplace, say fertility experts
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Chicken is the top offender
FAT WORLD Lymphatic massage anyone? Meet Your Doctor
— Auburn surgeon David Okolica discusses bariatric surgery
Sit-Stand Workstations Saying that sitting for long periods is detrimental to health more people — like Bruce Simmons, SUNY Upstate director of employee and student health — are choosing to work standing.
In the past three decades the number of overweight and obese people worldwide climbed from 857 million in 1980 to 2.1 billion in 2013, according to a major study. Most of these people are based in 10 countries. Yes, you guessed it: the United States leads the pack.
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Number of Cancer Survivors Will Reach 19 Million in Next Decade: Report Meeting their medical needs will become even more important in coming years, researcher says
T
he number of cancer survivors in the United States will rise from the current 14.5 million to nearly 19 million by 2024, a new report predicts. Cancer rates have been falling for 10 years, but the number of cancer survivors is rising due to factors such as earlier detection and better treatments, the American Cancer Society said. “The growing number of cancer survivors in the U.S. makes it increasingly important to understand the unique medical and psychosocial needs of survivors,” report author Carol DeSantis, an American Cancer Society epidemiologist, said in a cancer society news release. “Despite the fact that awareness of survivorship issues has increased, cancer survivors face numerous, important hurdles created by a fractured health care system, poor integration of survivorship care and financial and other barriers to quality care, particularly among the medically underserved,” she said. In 2014, the most common cancers among female survivors are breast (41 percent), uterine (8 percent) and colorectal (8 percent). Among male survivors, the most common cancers are prostate (43 percent), colorectal (9 percent) and melanoma (8 percent).
Sign of skin cancer
Lung cancer is the second most commonly diagnosed cancer in Americans, but is only the eighth most common among cancer survivors due to its low survival rate. Among cancer survivors, 64 percent were diagnosed five or more years ago and 15 percent were diagnosed 20 or more years ago. Only 5 percent of cancer survivors are younger than 40, while 46 percent are 70 and older. Survivors’ age ranges vary substantially by cancer type. For example, 62 percent of prostate cancer survivors are 70 and older, while only 32 percent of melanoma survivors are in this age group. The findings were published online June 1 in CA: A Cancer Journal for Clinicians.
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High Season for Food Poisoning One out of six Americans gets sick every year from some sort of foodborne illness By Deborah Jeanne Sergeant
“S
ummer complaint” is an antiquated term for severe bouts of diarrhea common during the warmer months of the year. In the very young, elderly and sick, the illness could be fatal. Symptoms can include vomiting, diarrhea, abdominal pain, fever and chills and they can last from an hour to more than a week. Though our grandparents and great-grandparents didn’t fully understand what caused the illness, linking it to warm weather was apropos. “People need to be aware summer’s a time for fun and being outdoors, but one out of six Americans gets sick every year from some sort of foodborne illness, usually from poor food handling,” said Beth Smythe, registered dietitian with the New York State Dietetic Association. Food should remain within the window of 40 degrees to Smythe 140 degrees for only two hours and, in 90-degree temperatures, one hour. The number of bacteria in food that temperature doubles every 20 minutes. Nesting bowls of cold foods in bowls of ice may help improve its safety a little as can keeping food out of direct sunlight. Hot foods that are covered and in insulated containers such as slow cooker crocks may also be warmer than those transferred to non-heated containers. If in doubt, “stick with things that are non-perishable like rolls, chips, and peanuts,” Smythe said. “Fruit salad would take longer to spoil than a potato salad.” Susan Branning, registered dietitian and manager clinical nutrition at St. Joseph’s Hospital Health Center, said that during the summer months, “food is more likely to be kept in the danger zone at these functions,” she said. “When food sits out, cold foods are often not kept cold enough and hot foods are often not kept hot enough to prevent foodborne illness. Note the danger zone is 40 degrees F to 140 degrees F. During the summer, indoor or outdoor temperatures are considered the danger zone. And that’s how food becomes contaminated to the point where it can cause illness.” Keep hot foods hot and cold foods cold and outside
Insist
on the
Best Care
of the 40 to 140-degree range. Smythe added, “Hopefully, most of what you cook right away you eat right away. They do have hot packs you can microwave before you leave and you can help keep food at a warmer temperature. But if you can’t keep it warm enough, err on the side of caution and get rid of it.” You can also help guests to curtail illness by using smart food handling strategies. Bring raw and cooked foods in separate coolers. Don’t serve cooked foods in the same containers that held them while they were raw. Don’t reuse ice in the cooler to cool drinks since it could be contaminated with bacteria. Thoroughly clean the picnic table and benches with hot, soapy water ahead of time or use a tablecloth. Offer hand sanitizer if soap and water aren’t readily available. Use different cooking utensils and plates for handling raw and cooked meat at the grill. Use a meat thermometer to check for doneness. Relying upon color or cooking time isn’t as accurate. It may seem like a lot of fuss for a picnic, but “small children, elderly or people with a compromised immune system or allergies can be more susceptible to foodborne illness,” Smythe said. “And healthy people get sick, too.”
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Bariatric surgeon: Long-term success rate of bariatric procedure is now 75 to 80 percent
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Q: What percentage of your practice is bariatric? A: It’s about 50 percent bariatric, 50 percent general. Q: What surgeries make up the majority of your general surgeries? A: It’s generally minimally invasive gall bladder surgery, hernia repairs, appendicitis and laparoscopic surgery for acid reflux. Q: Bariatric surgery has been around for a while now. What is the long-term outlook for patients who undergo the procedure to treat their obesity? A: Overall they’re very good. The long-term success rate is 75 to 80 percent. The reason the success rate is that high now is because patients are involved in a multidisciplinary program before and after the surgery that helps them maintain a healthy lifestyle. Q: Have the surgical techniques evolved? A: Twenty years ago, the procedures were done as open surgeries. The techniques have evolved considerably and are done laparoscopicly with small incisions. The visualization for the procedure is done with a fiber optic camera, which allows us to see very well inside the abdominal cavity. We can do more with small incisions. Q: You mentioned the importance of lifestyle changes for long-term effectiveness, but what effect does the procedure alone have on body? A: It’s the most powerful metabolic tool we currently have at our disposal. It’s much more powerful than medication or lifestyle
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
changes alone. As far as appetite suppression, the degree to which the patient feels hungry after surgery is markedly decreased. The reason for this is that you are either removing a large piece of the stomach, which secretes hormones that induce hunger, or you are dividing the stomach and reconnecting it to the intestines, bypassing a portion of the small intestines, which also secretes hunger-stimulating hormones. So bariatric operations do a lot to decrease appetite, change the metabolism of the body and have positive effects on conditions like diabetes, sleep apnea and cardiac disease. Q: How quickly can a patient expect to recover from bariatric surgery? A: For the most part, it’s expected that patients will be sore the first few days after the surgery. They should be back to their regular activities within one to two weeks. They will have to adjust their diet and relearn how to eat, advancing their diet from a liquid, to a semi-solid, to a solid food diet over the following month. Q: Can you describe what a good candidate for bariatric surgery looks like vs. a bad candidate? A: There’s an extensive screening process for candidates. For the most part, patients need to meet the BMI requirements for the surgery and we need to review their medical history, medications, etc. If they meet the criteria and have appropriate insurance coverage, we look at compliancy with instructions, good family support and express interest in a long-term solution. Patients have to be seen by our dietitian. They have to make dietary modifications to show that they can make lifestyle changes. They need to not have any unmanaged psychiatric conditions that would disqualify them. They have to lose a small amount of weight prior to the surgery. Q: Is that to prove commitment or medical reasons? A: Both, really. It demonstrates compliance and commitment, but it also makes performing the surgery easier as well. It decreases the size of the liver, which makes the surgery easier to perform.
Q: What are the risks of the procedure? A: All surgery has risks and bariatric surgery is no exception. The risks are best grouped into immediate surgical risks that can occur during or slightly after surgery and long-term risks. The immediate risks would be things like bleeding, infection, injury to other organs and leakage of a staple line. In the first couple weeks, there’s still a concern for wound infection and hernia formation. Another shortterm risk would be an unindenting narrowing of the procedure that was performed. Long-term, there’s a risk of gall stones, vitamin deficiency, protein malnutrition and, of course, weight regain. Avoiding weight regain requires compliance from the patient and lifestyle changes to make sure that doesn’t become a problem. Q: You mentioned psychiatric issues disqualifying patients. Can you elaborate? A: I would say it’s twofold. Patients who have active, untreated or unresolved psychiatric would have contraindications. So patients who have schizophrenia, bipolar disease, a history of suicide attempts, anorexia or bulimia are not usually good candidates. The other side is non-compliant patients, patients who don’t take their medication, for example. The psychiatrist would essentially assess that the patient fully understands the procedure and how it will change them and whether or not they can be compliant with the lifestyle changes they’ll have to make. Q: Do you, as the surgeon, get to see the progress the patients have made down the road? A: Long-term follow-up is very important. We see patients two weeks after the surgery and then several more weeks or months later to see how they’re doing. And then even after that, we check on the patients annually to see what their quality of life is, if they’re maintaining their weight or experiencing complications and collect data on their progress. Doing this is part of the accreditation process for bariatric programs. Q: A lot of times, surgeons don’t get to know their patients very well. Due to the rigorous screening and follow-up, do you get to know your patients better than surgeons typically do? A: I think you end up knowing more about a bariatric surgical patient than a general surgical patient. They may rely on you more to be your doctor than another specialist. The support they need is ongoing and lifelong, so I would say, yes, that is the case.
Lifelines: Hometown: Fair Lawn, N.J. Education: University of Pennsylvania (undergrad). Graduated from general surgery residency at Brookdale Hospital in Brooklyn. In 2009, graduated from a Bariatric Fellowship at Hershey Medical Center in Hershey, Pa. Also completed a minimally invasive fellowship at Lehigh Valley Hospital in Allentown, Pa. Career: Previously worked as medical director of bariatric surgery at the Hospital of Central Connecticut; practiced bariatrics and general surgery for three years at Sacred Heart Hospital in Allentown, Pa. Affiliations: Auburn Community Hospital Organizations: American Society for Metabolic and Bariatric Surgery Hobbies: Winter sports, travelling
Study: Obesity rates climbing worldwide
W
orldwide, there has been a startling increase in rates of obesity and overweight in both adults (28 percent increase) and children (up by 47 percent) in the past 33 years, with the number of overweight and obese people rising from 857 million in 1980 to 2.1 billion in 2013, according to a major new analysis from the Global Burden of Disease Study 2013, published in The Lancet. However, the rates vary widely throughout the world with more than half of the world’s 671 million obese individuals living in just 10 countries — the United States (more than 13 percent), China and India (15 percent combined), Russia, Brazil, Mexico, Egypt, Germany , Pakistan, and Indonesia. Over the past three decades, the highest rises in obesity levels among women have been in Egypt, Saudi Arabia, Oman, Honduras and Bahrain, and among men in New Zealand, Bahrain, Kuwait, Saudi Arabia, and the United States. In high-income countries, some of the highest increases in adult obesity prevalence have been in the USA (where roughly a third of the adult population are obese), Australia (where 28 percent of men and 30 percent of women are obese), and the UK (where around a quarter of the adult population is obese). The findings come from a comprehensive new analysis of the global, regional, and national prevalence of overweight and obesity in adults aged 20 years and older and children and adolescents aged 2–19 years between 1980 and 2013. The authors warn that the study presents a worrying picture of substantial rises in obesity rates across the world and say that concerted action is urgently needed to reverse this trend. Led by Professor Emmanuela Gakidou from the Institute for Health Metrics and Evaluation at the University of Washington in the United States, a team of international researchers performed a comprehensive search of the available data from surveys, reports, and the scientific literature to track trends in the prevalence of overweight (body mass index of 25kg/m² or higher) and obesity (BMI of 30kg/ m² or higher) in 188 countries in all 21 regions of the world from 1980 to 2013. Key findings include: • In the developed world, men have higher rates of obesity than women, while the opposite is true in
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developing countries. Currently, 62 percent of the world’s obese people live in developing countries. • The greatest gain in overweight and obesity occurred globally between 1992 and 2002, mainly among people aged between 20 and 40. • Especially high rates of overweight and obesity have already been reached in Tonga where levels of obesity in men and women exceed 50 percent, and in Kuwait, Libya, Qatar, and the Pacific Islands of Kiribati, Federated States of Micronesia, and Samoa where most (more than 50 percent) of women are obese. • The prevalence of overweight and obesity in childhood has increased remarkably in developed countries, from 17 percent in 1980 to 24 percent in 2013 in boys and from 16 percent to 23 percent in girls. Similarly, in developing countries, rates have risen from roughly 8 percent to 13 percent in both boys and girls over the three decades. • In 2013, the proportion of obesity in girls reached 23 percent in Kuwait, and 30 percent or more in Samoa, Micronesia and Kiribati, the highest levels calculated. Similar trends in obesity were found in boys, with the Pacific Islands of Samoa and Kiribati showing the greatest obesity prevalence. • Within Western Europe, levels of obesity in boys ranged from 14 percent in Israel and 13 percent in Malta, to 4 percent in The Netherlands and Sweden. Levels of obesity in girls were highest in Luxembourg (13 percent) and Israel (11 percent), and lowest in the Netherlands Norway, and Sweden (4 percent). • In developed countries, the rate of increase in adult obesity has started to slow down in the past 8 years, and there is some evidence that more recent birth cohorts are gaining weight more slowly than previous ones.
Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by Local
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In Good Health is published 12 times a year by Local News, Inc. © 2014 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 • Advertising: Jasmine Maldonado, Marsha K. Preston, Jim Maxwell • 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.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
On Your Own? Do the ‘Happy’ Dance! “Can’t nothing bring me down. My level’s too high.” Pharrell Williams
Y
ou’ve no doubt heard it: the beloved “Happy” song from the movie Despicable Me 2, written and performed by Pharrell Williams. I downloaded a copy on my iPhone. Whenever I’m feeling a little blue, I play it. My mood changes almost immediately. Early on, it was hard for me to get comfortable with the idea of living alone, especially in a world that glorifies “couplehood.” I clung to an old belief: that I could only be happy if I were married or had a significant other on my arm. Is that same “tune” playing in your head? If so, you’re not alone. It takes discipline of thought, determination, and sometimes an inspirational song to challenge preconceived notions about what contributes to happiness. These days, I’ve thrown away negative, outdated beliefs about being single, and have instead adopted a philosophy of living that enhances my well-being. I choose to be happy. You can, too. Here are some tips: 1 — Take stock. Be on the lookout for negativity. When you start spiraling down about living alone, don’t go there. Stop the old tape and replace it with something more positive and
reinforcing. Try this: “I’m doing this. I’m making this work. I’m reinventing my life and myself and I’m okay. I’m becoming more independent and resourceful and — at the end of the day — I’m a survivor and proud of myself.” 2 — Don’t fake it. If you are having a tough day, admit it. Share it. We’re all human. Sharing your challenges with close friends and family will only bring you closer together. Feeling connected and loved . . . isn’t that what makes our lives and relationships worthwhile? And real? It happens best with honest communication and mature and mutual sharing. 3 — Give yourself a break. Getting good at and ultimately enjoying life on my own didn’t happen overnight. It took practice. Years of practice. Give yourself time to adjust to the single life. After all, this is foreign territory if you’re coming out of a long marriage. 4 — Cherish your newfound independence. This can be a time of self-discovery, no matter what your age. Striking out on your own will expand your horizons and build self-confidence, whether you’re 34 or 84. Don’t be afraid to travel, relocate, or try something new. Identifying those
KIDS Corner Baby gate-Related Injuries Nearly Quadrupled Since 1990 Researchers call for advances in gate design, increased caregiver education
I
f you are a parent, chances are you have used or will use a baby gate at some point. Baby gates are designed to help protect young children from stairs and other dangers around the home. If you use these in your home, take note. A new study from researchers in the Center for Injury Research and Policy at Nationwide Children’s Hospital has found gates can lead to injury if used incorrectly. The study, published in the MayJune print issue of Academic Pediatrics,
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is the first nationally representative study to examine injuries associated with these gates. From 1990 through 2010, emergency departments in the United States treated an estimated 37,673 children younger than 7 years of age for baby gate-related injuries. That is an average of 1,794 per year, or about five injured children per day. More than 60 percent of the children injured were younger than 2, and they were most often injured by falls down stairs after a gate collapsed or
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
things that bring meaning and joy into your life can turn living alone into an adventure of the spirit. 5 — Find (or deliver) something joyful every day. Be purposeful about this. Bright spots are everywhere and can be found every day. Notice and appreciate them. Share them. Be the one who creates a joyful moment for others. 6 — Don’t wait for happiness to find you. I’ve made this mistake. It’s a big one: waiting for the phone to ring, waiting for the invitation, waiting for some wonderful thing to happen to lift me out of my doldrums. Instead, make your own happiness. And make someone else happy along the way. 7 — Stay current. No excuses, now. We live in a technologically sophisticated world. It’s how we communicate these days. It’s how we entertain. And when you live alone, it can be a godsend. If you’re technologically challenged, know this: It’s not that hard! Resolve to be an open-minded student, and invite a friend or family member to show you the basics: texting, email, Facebook, Instagram, or Twitter. Stay connected; it’s a key to happiness. 8 — Give it up. The stereotyped
when it was left open, leading to soft tissue injuries like sprains and strains and traumatic brain injuries. Children aged 2 to 6 years old were most often injured by contact with the gate itself after climbing on it, which can lead to cuts. “Baby gates are essential safety devices for parents and caregivers, and they should continue to be used,” said Lara McKenzie, the study’s co-author and a principal investigator in the Center for Injury Research and Policy at Nationwide Children’s Hospital. “It is important, however, to make sure you are using a gate that meets the voluntary safety standards and is the right type of gate for where you are planning to use it.” McKenzie recommends parents think of pressure-mounted gates as products that should only be used as room dividers or at the bottom of stairs because those kinds of gates are not designed to withstand much force and will not prevent a fall down stairs. For the top of the stairs, only gates that have hardware, which needs to be screwed into the wall or railing, will be strong enough to prevent a child from falling down the stairs. The fact that the rate of injury associated with this safety product nearly quadrupled during the time period covered by the study, going from 3.9 per 100,000 children in 1990 to 12.5 per 100,000 children in 2010, shows more can be done to prevent these types of
image of single men and women as desperate and miserable is exaggerated and just plain untrue. Recent studies on the subject bear this out. Loneliness is not a “state of being” reserved for people who live alone. Were you ever lonely while you were married? 9 — Choose to treat yourself well. It builds esteem. Prepare and eat decent meals at home. Get enough sleep. Exercise. Indulge in “guilty pleasures:” a nap, a piece of chocolate, a good book (Have you read The Year of Pleasures by Elizabeth Berg?). 10 — Avoid isolation. Isolating on holidays, birthdays, Sundays, etc. is no good. Solitary confinement is punishment for criminals, not for people who live alone. Make plans. Pick up the phone! 11 — Expand your definition of love beyond “romantic love.” This will stand you in good stead, if you are not ready to find another mate. Embrace “passionate friendships” — those relationships in which you can be yourself and feel completely comfortable. I’ve said it before and I’ll say it again: living alone doesn’t mean being alone. 12 — Embrace happiness. Living alone can be wonderful, meaningful, and — dare I say it — for some people, preferable to being married. Embrace your singlehood. Being on your own just might prompt a “Happy” dance! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops or to invite Gwenn to speak, call 585-0624-7887 or email her at gvoelckers@rochester.rr.com.
injuries. Study researchers recommended a combination of efforts to educate families on correct ways to use gates and changes in gate design to reduce these types of injuries.
Tips to help reduce gate-related injuries • Use hardware-mounted baby gates at the top of stairways. Gates that only press against walls, called pressure-mounted gates, are not secure enough to prevent falls. • Install gates in homes with children between 6 months and 2 years of age. • If possible, remove the gates when the child turns 2, or when the child has learned to open the gate or climb over it. • If removing a gate is not possible because of other children in the home, use a gate without notches or gaps that could be used for climbing.
Growing New Trend: Sit-Stand Workstations Saying that sitting for long periods is detrimental to health more people choosing to work standing By Matthew Liptak
S
tudies have shown that sitting for long periods is detrimental to health. It increases the likelihood of disease, disability and an earlier death. Some have even said that sitting is the new smoking. A workstation may be one of the solutions to the persistent problem of a modern sedentary lifestyle. Stand-up workstations have been around for many years now, allowing users to conduct work on their computer while standing up. It is a less sedentary way to conduct business. More recent sit-stand workstations enable the user to alternate between sitting or standing at their work. The sit-stand models can be cheaper and some even clamp on to the outside of existing desks. They are the first choice of many at locations such as SUNY Upstate Medical University. “I don’t think they should be used exclusively because while sitting long term is a risk factor, standing has its own cons, its own perils as well if you’re just standing,” said Valerie Beecher, an ergonomics specialist at Upstate. “I think employers, managers and everyone should be cognizant of that to see if they can get the appropriate person for the sit-stand workstation. I don’t think they’re for everybody. Somebody who as part of their job is up and moving and not at their desk all the time is probably fine. On the other hand, for someone who has a chronic back problem and pain, it would be good to give them the option to stand. Based on making sure it’s the right fit, it can be a great benefit.” Bruce Simmons is the director of employee and student health at the university. He moved to a sit-stand workstation about two years ago. “It was offered to me and I had kind of transitioned into a position where I was sitting much more than I was earlier in my career,” Simmons said. “I noticed that my life, at least at work, had become very sedentary. I was very enthusiastic about finding a way to at least be on my feet a bit more while I was at work. I was offered the sit-stand workstation and immediately found that it was something that made my day at work quite a bit more tolerable. In fact today I had gotten into work at about 8:45 and it was 11:45 and I had yet to sit down because I had e-mails and other documents to work on. “I had been on my feet all morning. That was not necessarily the plan; it just turned out that that’s where I ended up.” At the least, standing burns 50 more calories an hour than sitting. Those at Upstate have also found that they tend to have more energy carrying
Dr. Bruce Simmons at a SitStand Workstation into the end of the day. They say they have become more productive because of their sit-stand workstation.
Energy booster
“I’m definitely more alert in the afternoons,” said Karen Wentworth, director of guest services and patient relations at Upstate. “You don’t get tired like two, three o’clock in the afternoon so, yeah, I think I’ve been more productive and I have produced more work.” Beecher said standing causes more stress on the circulatory system and legs. People should work into standing at work incrementally, she said. That is another reason sit-stand workstations can be good. They allow the flexibility of alternating between sitting and standing. Offices with people in it who may be sitting for several hours at a time may be good candidates for the workstations, Beecher said. An example she gave was that of the main phone line call center at Upstate. Workers there are at their phone for eight to 10 hours a day without a chance to change position or an excuse to get up. There are also three shifts of workers at the call center who use the same areas to work. The sit-stand workstations can be individually adjusted for each employee’s height so the same equipment can be used for workers
coming in for different shifts. Standing can cause problems too for some, so sit-stand workstations may not be appropriate for all employees. A company or organization needs to target individuals or departments to see what their specific needs are. “There’s people who have orthopedic problems already, with their knees, hips or ankles, and they may not be able to tolerate the standing,” Beecher said. “To just put them everywhere, a company wouldn’t get their money’s worth.” The sit-stand workstations have changed the way many do work today and may help solve the problem of what is now called “sitting disease.” Studies have shown that too much sitting can contribute to many health problems. They have also concluded that sitting can lead to an earlier death by one to two years. Standing up to the disease may be in the future for many employers. Simmons said he’s at his workstation about 40 percent of the time and would not go back to a desk. It has changed the way he conducts his business. “I’m not sure I can do without it now,” he said. “Now that I’ve had it, I think I’d really miss it if I didn’t have it. I’ve become much more accustomed to working while I’m up on my feet than I was before.” July 2014 •
Some ways to stand more • Walk more at work. Park your car farther away from your building; use stairs not elevators; take a long route to the restroom or mail room. • While computing, set a timer to remind you to stand up and stretch every half hour; take this time to pick-up and clean your work area. • Stand up when you talk on the phone. • Don’t send emails if the recipient is near; walk over and talk to him or her. • Avoid long sitting commutes by standing on the bus, subway or train. • When watching TV, lose the remote; get up to change the channels. • Stand or exercise while you watch TV, or just stand and move around during pesky commercial breaks. • During intense video gaming, stand up in between sessions and screen loads. Sources: JustStand.org
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New Requirements for Sunscreens Dermatologist explains new FDA requirements and the latest advancements in sunscreen
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onsumers stocking up on sun care products may be seeing some unfamiliar terms and others might be unable to find the types of products they have used in the past. That’s because this is the first season in which new sunscreen standards and requirements from the U.S. Food and Drug Administration (FDA) are in effect. Accounting for nearly half of all cases of cancer in the U.S., skin cancer is the most common type and more than 3.5 million Americans will be diagnosed with this potentially disfiguring, costly and deadly disease in 2014. The best way to lower the risk of skin cancer is to practice effective sun safety year round. Physician Adam Friedman, director of dermatologic research at Montefiore Medical Center, explains what the FDA changes mean and offers tips to help people choose products that feature the latest advancements in sunscreen.
Water-resistant
Sunscreens claiming to be waterproof and sweat-proof are no longer on the shelves. In their place are 40- and 80-minute water-resistant sunscreens. “What was once called water/sweatproof is now thought of as water-resistant because these products only offer successful sun protection for a limited amount of time when they are exposed to water,” said Friedman. “Choose an 80-minute water-resistant sunscreen,
and reapply after getting out of the pool, ocean or even toweling off from a good workout.”
Sun Protection Factor (SPF)
A common misconception is that SPF measures the length of time users can be in the sun before getting sunburned. SPF defines the amount of ultraviolet B (UVB) radiation needed to cause a sunburn, even while sunscreen is on. • Sunscreens with SPF 2–SPF 14 can prevent sunburn, but they provide no protection against skin cancer or premature skin aging. Such sunscreens must now carry a warning label stating, “Spending time in the sun increases your risk of skin cancer and early skin aging. This product has been shown only to help prevent sunburn, not skin cancer or early skin aging.”
What They Want You to Know: Osteopath By Deborah Jeanne Sergeant
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ew York State Osteopathic Medical Society (www.nysoms.org) states that doctors of osteopathic medicine (DOs) and medical doctors (MDs) “are complete physicians. They are both licensed by state and specialty boards to perform surgery and prescribe medication.” • “When I decided to go to medical school, I always knew it would be osteopathic. We look at the whole picture and that’s what I was interested in, especially since I was going into primary care. That really resonated with me, not to just look at a person as a gall bladder, but looking at the whole situation to find the root cause. • “As it turns out, I enjoy doing manipulation. Most MDs don’t do any manipulation. I see a lot of people with muscular and skeletal problems. Many people don’t want to take medications. When you can structurally adjust a
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muscular skeletal problem, it does patients good. It’s something I can relate to and find patients love it. • “I prescribe medications and can do injections, too. If someone comes in with neck pain, I may be able to readjust them, do acupuncture and not just do pain medication. Or do all three if that’s what’s needed. I feel good about having more to offer patients than just writing a prescription. • “A lot of people ask if it’s the same as chiropractic, and some techniques are similar, but the philosophy is a little different. I think from an osteopathic perspective, it’s not just the spine but the circulatory system and lymphatic system. • “A lot of the osteopathic techniques address mobilizing tissues and treating the whole body. There is such a wide variety of techniques within osteopathic medicine. Muscle ener-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
• The FDA has yet to rule on whether products with SPF values higher than 50 provide additional protection compared to products with SPF values of 50. • In order for a sunscreen to reach its listed SPF, a full ounce needs to be applied. Recent research shows that in real life situations, people only apply 20-25 percent of this amount, unknowingly lowering the protection factor of their sunscreens. “Skin cancer does not discriminate — regardless of skin type, everyone should apply a healthy amount of a sunblock that is SPF 30 or higher,” said Friedman.
Broad spectrum
Until the final FDA requirements took effect, sunscreens were only evaluated and regulated for their ability to protect against UVB radiation, as measured by SPF. Now, sunscreens also are evaluated for their UVA protective capacity. Those containing ingredients that protect against both UVA and UVB radiation are labeled as “broad spectrum” sunscreens. “UVA penetrates deeper into the skin where it can accelerate skin aging and cause skin cancer. I call UVA the silent killer, because unlike UVB, it does not cause sunburns so it is hard to tell if you are getting harmful exposure,” said Friedman. “Broad spectrum sunscreen use should not be limited to beach outings or summer months. gy techniques used to move lymph, cranial sacral, and many I’m sure I’m not even aware of within osteopathic manipulation. • “Patients need to be a little bit more open. A lot of times, what patients come in for isn’t the real reason. One of the attributes of osteopathic medicine is the tendency to get people to open up and say what’s really going on. It’s not just, ‘Here, take this pill.’ It’s trying to go beneath the surface a little bit and go beneath the surface. It’s not just because you lifted this box wrong. What is going on at home? Are you stressed? Because the answers to these questions can shed more light on why you have this pain.” Scott Treatman, DO and director of employee health at Crouse Hospital • “Osteopathic training is much better than what MDs study, in my opinion. I help teach medical students and residents. We’re taught to see the person as a whole person. There’s a hands-on approach, so from the first week of DO medical school, students are putting their hands on real patients. They have better diagnostic skills. • “MDs learn all the same facts, but that doesn’t prove their ability to palpitate an abdomen. I’m a physical medicine and rehabilitation physician for people with life altering health issues like traumatic brain injury or stroke. Physiatrists are the docs that do that. • “I’m boarded in physical medicine and rehab thru the MD and DO world and boarded in the hands-on approach and boarded in nueromuscularskeletal medicine/osteopathic manual medicine. • “My hands are a tool that have been trained to work. I can help a person when I’m nowhere near a hospital.
Recent research demonstrated that the skin aging process is significantly slower among people who apply broad spectrum sunscreen daily, year-round.”
Read the ingredients
Sunscreen manufacturers use different combinations of ingredients. Choose products that have a variety of sun-blocking agents. • Friedman recommends selecting a sunscreen that contains several organic sun-blocking agents such as ecamsule, cinoxate, octyl salicylate, and benzophenones (i.e. oxybenzone). The different chemicals work in synergy to create greater sun protection than any one ingredient individually. Additionally, combining multiple agents allows manufacturers to use less of each, thereby decreasing the risk of any associated irritation. • The best products will also contain mineral, physical sun-blocking agents like zinc oxide and titanium oxide. In the past, these ingredients appeared chalky and left skin greasy, but newer products deliver “micronized” thinner, sheerer formulations. Products containing talc and bentone gel prevent these ingredients from clumping, and improve cosmetic appearance. • Look for pH stabilizers to hydrate and fortify the skin, like dimethicone, cyclomethicone and sodium phosphate. When the skin is hydrated, its can heal and repair itself much more quickly.
I can evaluate a kid’s arm if we’re at a campsite nowhere near a hospital. I can say, ‘It’s most probably not fractured and you shouldn’t break any speeding laws getting there. It can wait until morning.’ • “We can engage a person about spiritual health without making people feel like you’re judging them. Sometimes people are spiritually wounded. We’re trained to at least go there. • “I bring more to the table. I had a real life before I became a doctor. I’m not God. I’m here to facilitate your recovery. If you don’t quit smoking, I’m not going to pick on you. • People come in and say, ‘My rotator cuff is partially torn and I want a cortisone injection.’ How do they know that? They looked it up on the Internet! “I tell patients, ‘I’m so glad you came here with an Internet diagnosis, and since you believe it, why don’t you let the Internet fix you?’ • “Don’t fake pain or range of motion during your exam. We can tell. • “The doctor/patient relationship is a work in progress and there may be divorces.” Patricia Hart, DO at Hope Medical Care, PLLC, Manlius. Not currently taking new patients. Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.
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Lymphatic massage, unlike other types of massages such as Swedish, has a very gentle touch, like petting a cat. By Deborah Jeanne Sergeant
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any people have received or are aware of Swedish massage techniques. The deep, kneading pressure brings stress relief and comfort. But a lighter touch is just what some need. Lymphatic massage may not seem like massage at all, but its gentle strokes can make a big difference. The body naturally generates lymph. This clear fluid contains white blood cells, plasma and waste. The lymph system includes tissues and organs such as the spleen, tonsils, bone marrow and thymus. The parts of the lymph system work together to filter and transport lymph throughout the body Korosec and to the heart where it enters the blood stream. Barbara Korosec, a registered nurse, completed training in manual lymph drainage therapy and practices in Syracuse. “We stimulate the movement of the lymph through more efficient pathways,” Korosec said. “A lot of times you can prevent swelling or post-op work on people to resolve some of that swelling. The touch is a very extremely light touch. It’s about the weight of one nickel.” She has found that ill patients benefit from the immune system boost lymphatic massage offers. “Some people who are undergoing chemotherapy find that lymphatic massage helps the therapy work better,” Korosec said. “There are many different indications for the therapy.”
She listed detoxification, better surgery outcome, breast issues, pain control and healthier skin and organs. “There’s an increase in the number of white blood cell production by 30 percent with lymphatic massage,” she said. “It facilitates the body’s own ability to improve its health.” Jill St. John, a registered nurse and licensed massage therapist at Relax & Restore Massage Therapy in Oswego, said that athletes benefit from lymphatic massage. “It helps with bruising and swelling,” she said. “You can do some massage once it’s past the acute stage and help it heal faster. Anyone just coming out of the hospital [benefits] because it helps support them getting well again.” Unlike some other forms of massage, lymphatic massage employs a very light touch. The practitioner begins at the extremities and always toward the heart. For cancer patients, a therapist typically starts on the untreated side of the body. Massages last about an hour. Not all clients are good candidates for lymphatic massage. Those with low platelet count or history of blood clots may be excluded. Clients with generalized edema may see their condition worsen with lymphatic massage if their condition is caused by liver, kidney or cardiac problems. Clients typically receive a thorough screening regardless of the cause of their edema. It’s also important to consult with a primary care physician or oncologist before seeking lymph massage to prevent contraindication. “We typically won’t work on people who don’t have a doctor’s prescription,” Korosec said.
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My Turn
By Eva Briggs
Virus, Bacteria and the ‘Threat Net’
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ntibiotic overuse remains a tricky situation to navigate. When someone has a bacterial illness, the correct antibiotic can be a lifesaver. The same antibiotic is worthless against viral illnesses. Antibiotics, like any medicine, are not risk-free. First is the problem of allergic reactions, which occasionally are life threatening. Antibiotics can upset the delicate balance of the normal bacteria that colonize our bodies. This causes problems ranging from yeast infections to diarrhea due to Clostridium difficile, a nasty disease that produces misery, hospitalization and, sometimes, death. Then there’s the problem antibiotic resistance. Within a single species of bacteria, individuals vary in their sensitivity to a particular drug. Suppose someone has pneumonia caused by a bacterium that’s sensitive to penicillin. In reality, perhaps 1 percent of the germs are resistant to penicillin. When the patient receives penicillin, 99 percent of the bugs are killed. That’s enough for the patient to recover. But the 1 percent that are not killed remain in the body. They’re not causing any disease, at least not yet. But the patient can spread those germs
Doctors’ Use of E-Records More Than Doubles
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lmost 80 percent of doctors in the United States have switched from paper to electronic health records, new government statistics show. By 2012, almost 72 percent of physicians had made the change, compared to just under 35 percent in 2007, according to the report from the U.S. Centers for Disease Control and
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to others and eventually conditions become right for those resistant germs to cause pneumonia in someone else. Now penicillin won’t work against the resistant “super bug.” Most of the time when someone is sick with a fever or a respiratory illness, the cause is a virus. But we don’t yet have simple, widely available tests that quickly distinguish between a patient with a bacterial illness who truly needs an antibiotic to recover, from someone with a viral disease for whom antibiotics provide no benefit and might cause harm. But sick people often want antibiotics because they feel miserable and hope that something, anything will help. The problem is compounded because people who have received antibiotics for past viral illnesses and got better erroneously attribute their recovery to the antibiotic, not to their body’s immune system. Also, we live in a busy society and everyone is too busy to be sick, citing an upcoming vacation, special event or visit from relatives as reasons for wanting antibiotics. And we doctors worry, too. What if this time it is a bacteria, not a virus, and I fail to treat the patient correctly? Will he or she get sicker, have serious
complications or die? The good news is that there is technology on the horizon to allow rapid identification of pathogens. These new biosensors identify genetic material from disease-causing organisms in a patient’s blood stream. Of course most of the genetic material (which is composed of nucleic acids) in human blood comes from the patient, and only a small fraction arises from the disease-causing microbe. Special techniques are required to ferret out the tiny portion arising from foreign invaders. Scientists began by analyzing the sequence of nucleic acids in various disease-causing microorganisms. Using this knowledge they synthesized special segments — or snippets — of nucleic acids called primers. Primers seek out and combine with foreign nucleic acids from the bacteria, virus or other invaders in the patient’s blood stream. Any bits of microbial genetic material detected are next amplified. A technique called polymerase chain reaction (PCR) makes multiple copies. The mass of the amplified material is measured via a mass spectrometer. Sophisticated algebra determines how much of each of the five possible nucleic acids
Prevention. Since then, the number of doctors using electronic health records has increased even more, added lead researcher Esther Hing, a statistician at CDC’s U.S. National Center for Health Statistics. “In 2013, 78 percent of physicians were using electronic health record systems,” Hing said. “We are reaching nearly all the doctors.” Hing noted that the progress is largely the result of the federal government’s financial incentives to help doctors change to electronic recordkeeping. “These incentives have had a large part in the increased adoption of these systems,” Hing said. However, many doctors (about 40 percent) aren’t using the full capabilities of their system, Hing noted. Once the system is installed, there is a steep
learning curve before doctors and other staff are able to use it efficiently, she said. Basic systems keep track of patient data, prescriptions and lab test results, Hing explained. More advanced features can graph patient tests to note trends and keep track of changes in the patients’ health over time. Hing noted that the real goal of these systems is to improve patient care. However, whether or not they do is still unknown. “We are still evaluating the results. We think it improves the care provided to a patient. Anecdotally, in certain settings, it’s been demonstrated that these systems have improved health by improving coordination of care, reducing medication errors and overuse of tests,” Hing added. Of the doctors who turned to elec-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
combine to form the detected microbial genetic material. Finally this result is matched to a database that, so far, contains information from more than 1,000 known disease-causing organisms. With such a device, doctors could learn the cause of a patient’s illness within hours, rather than the days currently required for standard bacterial cultures. Because standard bacterial blood cultures are cumbersome and don’t detect viruses, currently doctors draw blood cultures for the sickest patients. They don’t help the typical outpatient. A prototype detection device was used in 2009 to identify the first two known swine flu patients. Scientists have calculated that by establishing a network composed of 200 carefully chosen hospitals with biosensors machines — tentatively dubbed the Threat Net — disease outbreaks can be identified days or weeks earlier than is currently possible. Earlier detection could translate lives saved by containment of disease outbreaks or bioterror attacks.
Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
tronic health records by 2012, 39.6 percent used a basic system, up from 11.8 percent in 2007, the researchers found. And 23.5 percent had a fully functional system, up from 3.8 percent in 2007, according to the findings published May 20 in the CDC’s National Health Statistics Reports. Hing also noted that in 2007 larger practices (11 doctors or more) were more likely to have an electronic record system (just over 74 percent) than smaller practices (about 21 percent), but by 2012 that gap had narrowed. As more doctors adopted electronic record systems, however, the gap between those who used a basic system and those who took advantage of all the features of their system widened from an estimated 10 percent in 2007 to about 31 percent in 2012, Hing said.
SmartBites
By Anne Palumbo
The skinny on healthy eating
Boost Your Health with Bananas
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hen it comes to healthy snacks, I don’t monkey around. They need to be convenient, tasty and nutritious. They need to fill me up and give me energy. They need to withstand being tossed into my purse. For me, bananas fit that bill, beautifully. Nutritionally, bananas have a lot going for them. Super rich in potassium, an essential mineral for maintaining normal blood pressure and heart function, bananas help keep the hardest working muscle in our body beating strong. In fact, the American Heart Association has certified bananas as a heart-healthy food when eaten as part of a low-fat balanced diet. What’s more, according to a fouryear study, men who ate diets higher in potassium-rich foods, as well as foods high in magnesium and cereal fiber, had a substantially reduced risk of stroke. Bananas are also good sources of other nutrients that promote heart health: fiber and vitamin B-6. Fiber does a heart good by helping people maintain a healthy weight (crucial to
sustained and substantial boost of energy. It’s why athletes often reach for bananas. And because it comes with fiber, which slows digestion, it gives the body time to use it as fuel instead of storing it as fat. At only 105 calories a pop, with no sodium or cholesterol and next to no fat, it’s no wonder bananas are the world’s most popular fruit!
Helpful tips
heart health); while B vitamins help break down homocysteine—an amino acid that at high levels is related to a higher risk of cardiovascular disease. Feeling blue? Reach for a banana. Bananas contain tryptophan, an amino acid that helps our body produce serotonin, a natural substance that can improve our mood and make us relax. The healthy dose of vitamin B-6 in bananas, which regulates blood glucose levels, can also put a bounce in our step. The natural sugar in bananas — about 14 grams per banana — gives a
Don’t put unripe bananas in the fridge: it will halt the ripening process. If you need to hasten the ripening process, place bananas in a brown paper bag, adding an apple to accelerate the process. Ripe bananas that will not be eaten may be placed in the fridge. Although the peels will darken, the bananas themselves will not be affected. Bananas can also be frozen (peel first) and will keep for about two months.
2 bananas (peeled and frozen) 12 strawberries (fresh or frozen) 1 cup low-fat yogurt (Greek plain or vanilla) ¾ to 1 cup low-fat milk 2 teaspoons honey 1 tablespoon ground flaxseed (optional) Place ingredients in a blender and puree until smooth. If smoothie seems too thick, add more milk.
Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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Women’s issues Egg Freezing More Commonplace Most fertility centers no longer consider egg freezing experimental and classify it as elective. Cost of banking eggs ranges from $5,000 to $6,000, plus medication and storage fees By Deborah Jeanne Sergeant
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ancer patients used to be the primary patients seeking egg freezing to preserve fertility before undergoing radiation, chemotherapy or removal of the ovaries. Recent advances in cryogenics have improved success rates to the point where egg freezing has become more commonplace. Physician Rob Kiltz, founder of CNY Fertility in Syracuse, said that the primary candidate for egg freezing remains young women under 30 at risk for losing ovarian function. “Secondary clients, which I think we’re beginning to see more, are young women who want to bank their eggs because they’re not Kiltz currently interested in having children but want to increase their odds of having children later,” Kiltz said. Once women reach their late 30s, the probability of conceiving decreases because of the quantity and quality of their eggs. Frozen eggs have a 60 to 85 percent survival rate of eggs and 40 to 50 percent pregnancy rate. These rates nearly rival that of embryo freezing. “Embryo freezing is the best for women who have a partner,” Kiltz said. “Egg freezing is here for those who don’t.”
One reason for the improved success rate of egg preservation is that newer technology enables fertility experts to quickly freeze eggs, which minimizes the formation of ice crystals, which can damage them. Kiltz believes greater awareness has driven interest in egg freezing. “We’re helping them understand the potential,” he said. “People are talking about it and it’s something people can do. “I think it is going to grow and the success will improve the technology. Costs will go down and more and more women will pursue this. If we can make it affordable in their early 20s, when women are just finishing college and starting careers and they don’t have the money, most of those women will rather use this than lose their fertility. If you can create a sysElguero tem where they can provide those eggs for themselves or to donate for future use, you can spread the cost out.” In other areas in the state, the demand for egg freezing among non-cancer patients is growing. Sonia Elguero, board certified OB-GYN at CWR Partners in Albany, said that she has seen increased interest in the procedure.
Elguero is completing training in endocrinology and reproduction. She thinks that the improved technology has helped. “The technique is important to minimize damage to the egg,” she said. “We’re doing ultra rapid cooling to minimize ice crystals. There’s no time for them to form. That increases the survival to comparable to buying fertilized eggs if we compare them head-on.” Another factor is using a method of injecting a single sperm into the egg, which has resulted in “significant improvement in pregnancy rates,” Elguero said. Because of the procedure’s previously dismal success rates of around 5 percent, harvesting eggs used to mean more sessions for the woman seeking to preserve eggs. Now up to half of the eggs harvested make good embryos, so providers obtain less than 10 normally. Vitek Because the success rate has become so high, most fertility centers no longer consider egg freezing experimental and classify it as elective. This reclassification, along with greater awareness of the procedure, has helped make egg freezing
become more mainstream. The cost of banking ranges from $5,000 to $6,000, plus medication and storage fees. Donor eggs are $15,000 to $20,000. But the cost of long-term storage can equalize the cost. The best chances for success rely more heavily upon the age of the eggs used than on the mother’s age. Although healthier women make healthier moms and healthier pregnancies, fertility isn’t as effected by her health. “They think their body is the factor but it’s really their eggs,” said Wendy Vitek, an OB-GYN at the University of Rochester Medical Center. “Once you freeze an egg, it’s frozen in time relation to its health.” Leftover eggs may be donated for research or possibly donated if the donor passed tests proving her health at the time of donation. Donors’ medical history is recorded for any future children. Fertility centers anonymously label the source of donated sperm and eggs so the children resulting from donations don’t end up getting married, for example. “The recipient knows the donor identification number, so they don’t know the identity of the donor, but women who use donor sperm know the number from the cryopreservation bank,” Vitek said. “Offspring of donors can get together through that donor number.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
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Women’s issues Early Menopause Effects More than Fertility By Deborah Jeanne Sergeant
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ost women experience the onset of The Change at some point in their mid-40s. But when that happens before 40, that’s early menopause. The classic menopausal symptoms are the same — disruption of the cycle and hot flashes, night sweats and vaginal dryness, the other traits associated with the change in hormonal levels — except it happens at a younger age. Laurel Sterling, registered dietitian and wellness educator for Natur-Tyme in Syracuse, said that early menopause “can be due to stress, estrogen dominance, xenoestrogens, toxic substances in the environment, medications, food choices, genetics or how early you started menstruating.” Smoking may also cause earlier menopause as can medical procedures such as removal of the ovaries, hysterectomy, chemotherapy, radiation or uterine artery embolization. The last of these may decrease the blood supply to the ovaries. A hysterectomy with the ovaries still intact usually moves menopause two years earlier. Younger women treated with chemotherapy or radiation may experience early menopause. Some women believe that they experience early menopause when they cease taking oral contraceptives; however, that’s not the case. Oral contraceptives tend to minimize menstrual flow and other symptoms, along with preventing conception. Premature ovarian insufficiency (POI) mimics premature menopause in many ways, making it difficult to diagnose. POI occurs in about one in 250 women under 35 and one in 100 younger than 40, so it’s not uncommon. Women with premature ovarian insufficiency experience a disruption in menstrual cycles for at least four months and the presence of certain changes in hormone levels. Both POI and women with early menopause have higher levels of FSH, a hormone that reflects ovarian function, and low levels of estradiol, the estrogen
produced by the ovary. But ovarian function returns intermittently to 5 to 25 percent of women with POI, unlike those with early menopause. Because they may still ovulate occasionally, they should use contraception. About 5 to 10 percent of women with POI who don’t use contraception become pregnant and can successfully carry a baby. Beyond the bothersome symptoms of menopause all women experience, early menopause has been identified as associated with an increased risk of low bone mineral density, which may lead to osteoporosis. It may also increase risk of heart disease and impaired mental ability in older age. Some physicians recommend that women receive hormone therapy until age 50 when they would normally experience menopause. Younger women don’t experience the risks of hormone replacement therapy. In addition to discussing with their doctors the pros and cons of hormone replacement, women experiencing early menopause should commit themselves to a healthful lifestyle to mitigate the other effects of early menopause. Maintaining a healthful weight and diet, along with seven to eight hours of sleep per night can help, along with avoiding tobacco. Sterling encourages women to use supplements and a healthful diet to support post-menopausal health. These include a vitamin-B rich multivitamin. “A good quality multi-vitamin-mineral can help prevent depletion of important vitamins and minerals when a less than desirable diet or extra stressors are taking place,” Sterling said. “An essential fatty acid supplement is also necessary for...help with mood and memory... omega 6 fatty acids nourish dry skin, hair, and mucous membranes, as well as aid in natural hormone production.” She added that a vitamin D supplement, about 2000 international units, helps the body maintain its stores in the winter months when little sunlight
Neuropathy & Pain Expert
is available to generate it. “Vitamin D helps with moods and the immune system,” Sterling said. “Probiotics — beneficial bacteria — are very important as 70 to 90 percent of the immune system lies in the gut. Probiotics also help detoxify harmful estrogens. Make sure the probiotic you choose has over 1 billion CFUs with a combination of lactobacillus and bifidobacterium.” Performing weight-bearing exercise strengthens bones. Simply put, weight-bearing exercise is any movement where the body functions upright, such as walking, jogging, gardening or dancing. Swimming, using an elliptical machine, or canoeing represent a few non-weight bearing exercises. Women experiencing early menopause should also remain vigilant about their physicals. Jamil Mroueh, an OB-GYN with a specialty in reproduction endocrinology and infertility with Rochester Fertility Care, said that if the early menopause were caused by damage to the ovaries, “it could damage other glands like the thyroid
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Carrying a Purse Can Be a Pain By Deborah Jeanne Sergeant
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ching shoulders, neck pain, strained back — but you haven’t worked out in a couple days. What’s the matter? Try checking your bag. Purses or laptop bags can cause several types of injuries. Lindsay C. Groat, physician assistant for Walter Short, MD at Syracuse Orthopedic Specialists, PC, said that injuries from carrying purses and bags can include muscle strain, shoulder strain and injuries to the rotator cuff. “Poor posture can develop from accommodating the weight of the bag and circulation and vascular flow can also be affected by a heavy bag,” she added. “Patients most often report neck and back pain from carrying heavy bags. Excessive pressure where the strap rests could even lead to diminished strength and sensation in the affected arm.” It seems like the pain of this kind of injury would deter people from carrying bags that hurt, but initially, the pain doesn’t seem like it’s all that serious. In addition to learning about good posture and how to carry their bags, some patients need physical therapy and strengthening exercises to ease their painful symptoms. “Home exercises, such as stretching, seated rows, deltoid flies and shoulder press can help as well,” Groat said. For some, chiropractic treatment can help. Some patients don’t understand how it relates to muscle strain. Jennifer Condon, chiropractor at High Point Chiropractic Wellness in Syracuse, said that “part of it is people don’t completely understand how the body works. It is complex. If you get a pulled muscle on your shoulder from carrying a heavy purse, it’s never just the muscle or just the shoulder. The muscles, when they’re tighter pull the spine, and pull on the ligaments. There’s always going to be an element of that tight muscle pulling on the spine. Think about it as the whole muscular skeletal system.”
Groat suggests:
• “Bags with wider straps tend to distribute the weight along a greater area and create less point compression of the anatomic structures. • “Straps that cross the body will create less downward force on the shoulder itself. • Bags with two straps, such as backpacks, will cut the strain on each shoulder by 50 percent when worn evenly on both shoulders.”
Condon suggests:
• “Keep it as light as possible. Go Page 14
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
through your purse and decide if you really need all this stuff all the time. If you can get it down to a smaller size, you’ll be more likely to keep the weight lighter, too. • “The more you can keep it evenly distributed, the less stress and strain and tightness and pain you’ll have from it. Choose a structured bag. • “Alternate shoulders. Carrying a heavy purse on one shoulder only is a repetitive micro-trauma. • “If you carry a large bag, have a little smaller bag in it holding your essentials so you don’t always have to bring the whole big bag. • “Don’t let backpacks hang down too far. Keep them higher on the torso to avoid putting extra pressure on the lower back. • “Children should carry only 10 percent of their body weight. Adults can carry more.”
Participants of the single and parenting course at North Syracuse Baptist Church. The group meets once a week for 13 weeks and discusses a wide variety of topics concerning raising kids alone. Organizers say the group can accommodate more participants.
Program in N. Syracuse Helps People Raising Kids Alone By Matthew Liptak
T
he new single and parenting course offered at North Syracuse Baptist Church is a Christian-based program, but it offers practical parenting advice for those looking for some guidance on how to raise their children alone. The program was created by North Carolina-based Church Initiative Inc., a nondenominational, nonprofit ministry serving more than 16,000 churches worldwide. The organization also came up with the popular DivorceCare and GriefShare courses that run at churches and organizations throughout the country. Ellen Jones runs the course at North Syracuse Baptist Church along with two other instructors. “This program though has a focus not only for divorced parents but also widowed or it’s even for people whose husband or spouse is stationed far away and they’re raising their kids by themselves, or even never married,” Jones said. The program has seven students now and is looking for more. They are from a wide variety of backgrounds, including moms in their 50s to their teens. Jones said she hopes single dads will come to the classes, too. There are 13 classes in the course, one class per week. Each class is centered around a topic for that week. The topic is included in both a 30 to 45 minute video that the students watch and then discuss in a group format. “There’s a workbook that goes along,” Jones said. “You would follow it along. It has all the topics that they’re going to touch on during the video. During the week it has what they call hopework instead of homework. I really love that idea. It’s giving you hope during the week. It’s not hard. It just goes along with the topic itself.” Jones said the single and parenting program is an improvement over the older DivorceCare and GriefShare classes in that it offers more online support for students. There is an online help center that includes videos, tips
and devotions. “It goes right along so they get a whole other dose of what’s offered in the class,” she said. Class topics are varied. The first week was about being tired and overwhelmed as a parent. The second week had to do with addressing your fears. Other classes include budgeting and finances; parenting goals and expectations; suffering and adversity; emotions and stability; parenting approaches and God’s love; talking and listening; conflict and resolution, and dating and singles’ sexuality. So far feedback has been positive from students, Jones said. “I like the single and parenting program a lot,” said 39-year-old North Syracuse resident Dicsia Dorta. “I think every church should offer this training because it teaches us as parents how to teach our children values, discipline and respect. I have learned about strategies and ideas about how to handle different situations with my son that normally I wouldn’t have any clue how to handle.” Along with Jones the two other instructors have a diverse background: One instructor was a divorced and widowed mother while the other was a teen mom. “I think that’s one of our biggest fears as a single parent is that we’re never going to do it right or do it good enough that they’re [the children] going to be all right,” Jones said. Jones is proof that with a little help you can raise happy and healthy children as a single parent. She herself had two sons and a daughter she raised alone. In the seventh grade her daughter was flunking out of school. “It was a big mess,” Jones said. Today that daughter is 23 and instructing kids on her own as a school teacher. For more information on the Single and Parenting program call Jones at 315-699-9195 or go to www.SingleandParenting.org.
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Making a Strategic Move into Travel Nursing RN expects to see higher demand for travel nurses By Brenda Lotito
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oday’s nurses must take an active role in the implementation of a strategic plan to overcome the future of the profession. According to 2012 figures from the US department of Labor Bureau of Labor Statistics, registered nurses constitute the largest healthcare occupation with 2.7 million jobs. Sixty one percent of these jobs are in hospitals. Figures also show that the largest health care industry — hospitals — will grow slower than that of long-term care, home health care and outpatient facilities due to early discharge and more outpatient procedures. In addition, the number of individuals who have access to healthcare services will increase as a result of the federal health insurance reform. As baby boomers get older, so does the nursing population, leading to a nursing retirement boom that began in 2010 and is slated to last until 2020. The average age of the registered nurse population documented by the National Sample Survey of RNs by the Federal Division of Nursing was 46.8 years in 2004, determining that 40 percent of registered nurses will be well over 50 years old by 2020. Because of this exodus, employment of registered nurses by hospitals is slated to rely on temporary employment to fill staffing needs. As the demand for nurses grows, temporary nurses will be needed more often, leading to a growth in the employment
services industry. The American Hospital Association reports current vacancy rates in some hospitals as high as 19 percent for full-time registered nurses. Travel nursing began as a seasonal substitute from the increase in population in the winter months in the Sunbelt states. As individuals escaped from the frigid winds and heavy snows of the Northern states, hospitals in those areas saw a sharp spike in care. As the beds filled, the hospitals needed a plan to have nursing staff increase at those peak months as well. Hospitals began to hire nurses for temporary employment, a few months out of the year, until the seasonal citizens returned to their permanent residence back north. Recruiting nurses wasn’t all that bad either. Nurses who signed up for the jobs may be from the same northern areas and welcomed the “break” from the drudgery of snow and slush. Although the work was challenging, the nurses became tourists on their days and hours off. Nevertheless, history has changed the travel nursing industry over the past few decades. Nursing shortages have hit hard and staffing needs are high. Hospitals now look to staffing agencies to bring in temporary nurses to fill the gaps and prevent unsafe workloads for the permanent staff. As the demand for nursing grows and the amount of trained nurses continues at its slow pace, hospitals
Parenting By Melissa Stefanec melissa@cnyhealth.com
A guide to pre-natal tests and screenings
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arenting is one of the toughest and most rewarding gigs on the planet. Like any other life event, it changes you forever. The decision to have a child is a momentous one. The decision to have another child is just as momentous. Apparently, my husband and I were feeling rather ambitious when the yuletide came around this year, because we decided it was time for another momentous event. We are expecting baby No. 2. There is a lot of joy and excitement surrounding pregnancy, and I have been more than happy to bask in that. However, there is also a lot of worry, stress and questioning that goes on during pregnancy. For me, the scariest thing about being pregnant is the fact I can’t be certain about the health of my developing baby. So many things can go awry, and it’s frightening to have something that is so important be [mostly] out of my control.
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One of the things I am certain every pregnant woman looks to with apprehension is fetal testing. No mother wants to get bad news back from a testing or screening. In order to check your health and the health of your unborn child, you are poked, examined and prodded so much during pregnancy. I have to admit sometimes I’m not even certain what they are poking or prodding for. The tuberculosis, HIV and sexual transmitted disease tests are self-explanatory, but the others are a bit more mysterious. So, this month, I am going to describe some of the most common prenatal tests and screens that are available to a pregnant woman in the United States. Hopefully, it will take a little mystery out of an anxiety-filled and emotional time. I for one feel better when I am armed with knowledge, so I sought out information from the March of Dimes Foundation.
First Trimester
• Early ultrasound — Some providers do an ultrasound during the first trimester to confirm the pregnancy and
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
are beginning to poise themselves to recruit nurses for temporary employment, filling in for short staffing needs. Besides their own recruitment efforts, the healthcare systems and organizations are now exploring third party recruiters. Company size varies greatly, from only a few nurses to hundreds. Karen Hart, past senior vice president of health care division at Bernard Hodes Group in New York, states that the top nationwide recruitment tactics for healthcare professionals are “employee referral programs, college recruitment programs, on-site education offerings and career development (as attractors), flexible scheduling, on-site job fairs with CEUs, and excellent career websites with easy online application/ resume submission.” With all these factors in mind, travel nursing could be an opportunity for any nurse who becomes restless with tenure, has a yearning for travel, and has excellent clinical skills. All 50 states have now joined in — and use — recruiting agencies to find travel nurses. “Travel nurses are nurses that have made their work business,” said Marilyn Garner, a Rochester-based RN travel nurse who just finished an assignment in Pennsylvania. “You must seek and talk to a number of agencies in order to know who treats you best and who pays you well. It is business savvy. Travel companies want the applicant with the most time and
qualifications (many specialties such as ER, ICU, neonatal and pediatrics) for positions that lead to greater opportunity and growth for the nurse.” Finding a travel company that suits you is the first step into the travel field. Healthcare industry trends show us that travel nursing is here to stay and, with the nursing shortage not abating any time soon, health care traveling may be the wave of the future. The current state of affairs in nursing is being characterized as unlike those of the past. As we have seen throughout time, there has been a cycle of nursing shortages and gains. Strategies and efforts of the past may not be enough for the healthcare system to endure this projected alarming devastation of nursing workforce. New ideas, creative focus and innovation will need to embody the industry’s response to stressed hospital, outpatient, homecare, skilled nurse and rehabilitation facility nurses.
make sure it’s not an ectopic pregnancy (a pregnancy not located in the uterus). • Chorionic villus sampling (CVS) — This test takes a sample of tissue from around the baby to see if it has a genetic condition. The test is typically done between 10 and 12 weeks of pregnancy. This test is more invasive than an ultrasound or blood screen and carries some risk to the baby. Providers typically recommend CVS to some women who are older than 35, if genetic problems run in a mother’s family, or if a first-trimester screening shows a baby is at an increased risk of birth defects. • Cell-free DNA testing (also called noninvasive prenatal testing) — This new blood test examines a baby’s DNA by taking a sample of the mother’s blood. The test is actually a screening for certain genetic conditions, such as Down, Edward and Patau syndromes. A mother can have the test after 10 weeks of pregnancy, and it’s thought to be extremely accurate and result in few false positives. The test is typically given to women in high-risk groups or those over the age of 35. • Cystic fibrosis (CF) carrier screening — This blood screening looks to see if a mother has the gene that causes CF. If you have the gene, your partner should be tested. • First-trimester screening — This blood test is done between weeks 11 and 13. It tests for conditions such as Down syndrome and heart defects.
ing may lead your doctor to recommend an amniocentesis. • Amniocentesis (also called amnio) — This tests the amniotic fluid from around the baby. It can detect genetic conditions such as Down syndrome. The test usually is done at 15 to 20 weeks of pregnancy. Providers conduct amniocentesis for many of the same reasons as CVS. • Ultrasound — Most practitioners will perform a routine ultrasound between 18 and 20 weeks of pregnancy. This ultrasound scans for birth defects and provides a picture of how the baby is growing. The anxiety on this test is knocked down a peg, because it can reveal the sex of the baby. • Glucose screening — This blood test reveals if you have gestational diabetes. The test is done between 24 and 28 weeks. It includes two blood draws and chugging a drink so sugary most 5-year-olds would find it too sweet.
Second Trimester
• Maternal blood screening — This screen measures for four substances in a mother’s blood to see if her baby is at an increased risk for certain birth defects such as Down syndrome and heart defects. The results of this screen-
Brenda Lotito is a registered nurse of 27 years. She received her Bachelor of Science in Nursing (BSN) at Empire State College and is currently enrolled in the college’s Master of Science degree in nursing. She is also a freelance writer and an avid traveler.
Third Trimester
• Group B Strep (also called GBS) – This test checks fluids from a woman’s cervix to see if she carries the Strep B virus, which can be passed from mother to baby during birth. The test is done between weeks 35 and 37. If a woman tests positive, she will be administered antibiotics during delivery to protect her baby. So there’s the basic rundown of some of the ways women and their developing fetuses can be tested during pregnancy. I feel slightly less anxiety than I did before writing this (that is until I go for my next test or screen). If you want to alleviate some anxiety or just want more information on prenatal testing, visit: www.marchofdimes.com/ pregnancy/prenatal-tests.aspx
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he provides companionship to a lonely elder in our community. He helps prepare meals and straightens up the home. She makes sure her patient’s basic needs are met. They are caring, compassionate and helpful. They are home health aides. It takes a special kind of person to be able to provide this level of care to patients. “We look for people who are sympathetic and understanding,” says Stacey Gingrich, director of patient services at Franciscan Health Support. “They also need to be reliable, responsible, have strong communication skills and a good work ethic.” Kristen Kelly has been serving as a home health aide with Franciscan for more than three years. “I really enjoy Kristen Kelly, Franciscan home health aide, sits with a resident helping people,” she said. “Once their basic of Park Rose Retirement Estates. needs are met, I like fit.” spending time with my patients beFranciscan is one of the few local cause I know many of them get lonely.” companies with paid training on site. In fact, one of Kelly’s home care During the two-and-a-half week propatients has made such an impact on gram, employees learn through classher life that she goes to see him every room work and hands-on field training single day. to ensure they are fully prepared to be a “I want to take care of him,” she said. “He has dementia but it’s not very home health aide. “The training program is strong,” noticeable until you get to know him. Kelly said. “It makes us feel comfortHe gives you the impression that he’s able to handle what we find in the on top of everything but he may forget to take his medication or fall and forget field.” Aides assist with personal care, about it.” light housekeeping, meal preparation Kelly’s concerned that if she’s not and medication reminders. But that there, another home health aide may social engagement role is also very not pick up on the subtle signs that important. something’s wrong with his health. So, “We play a huge role in our pashe visits him at least once, if not twice, tients’ lives. We may be the only person every day. they see that entire day,” Gingrich said. “Had I never been a part of this “I want our aides to really listen to company, I would never have met what the patients’ needs are and make him,” Kelly said. “He’s always a part sure we’re meeting those needs.” of my day. I don’t look at it like work; Franciscan recently implemented I can do puzzles with him when I have incentives to attract the high quality time. I’ll bring my lunch with me, then candidates they need. These incenI make him lunch and we’ll eat togethtives include tuition reimbursement, er.” quarterly productivity incentives, a Kelly’s experience has led her to competitive wage, and medical and encourage friends to apply to be a dental benefits. For more information home health aide at Franciscan. on becoming a home health aide, or if “I have to see certain qualities in you need a home health aide, call 315people,” she said. “If they really like 458-5600. working with people, or they want to go into a field like nursing, being a Submitted by Franciscan Health Support home health aide may be the perfect
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Study: Many Pets Are Too Fat Control food portions, provide daily exercise to keep your furry companions in shape, vet advises
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uch like their human companions, many of America’s pets are overweight. Just over half of dogs in the United
States are overweight or obese, and 58 percent of cats are carrying too many pounds, according to a survey from the Association for Pet Obesity Prevention. And, like people, animals can face health consequences from excess weight. “Overweight animals also have certain health issues,” said Susan Nelson, clinical associate professor in the department of clinical sciences and veterinarian at the Kansas State University Veterinary Health Center, in a university news release.
Excess weight “can aggravate joint disease. It can lead to Type 2 diabetes. It can aggravate heart conditions, and it can lead to skin diseases as folds in the pet’s skin get bigger. It can even shorten their life span,” noted Nelson. How can you know if your pet is overweight? You may not be able to tell by appearance alone, since pets can appear to be in good shape even when they aren’t. At the appropriate weight, Nelson said, pets should only have a thin layer of fat over their ribs and show an hourglass shape from above. If you have a long-haired pet, it may be best to look when your dog is wet. Nelson also recommends using a measuring cup to figure out how many calories your pet is eating each day. It’s also important to re-check that information every time you switch brands or types of food since calories may vary
as much as 200 to 300 per cup between different brands or types of food, she said. Calorie information should be available via the bag or can of pet food. If you can’t find calorie details on the packaging, contact the manufacturer. Be cautious about the suggested amount of food for your pet, Nelson said. “In the testing facilities, these animals are typically mandated to have a certain amount of exercise per day because they are research animals,” she said. “In reality, a lot of the pets that we own don’t get as much exercise as those dogs and cats in the research facilities.” Nelson suggests cutting back on treats too, keeping them to no more than 10 percent of your pet’s diet. And exercise your pet 20 to 30 minutes per day, if possible.
Center for Spiritual Care at Upstate publishes book, Open the Eyes of My Heart
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eventeen Upstate University Hospital spiritual care volunteers share their special moments with patients when they most strongly felt the presence of the spirit in an inspiring book, “Open the Eyes of My Heart.” The book is newly published by Upstate’s Center for Spiritual Care through a grant provided by the Friend in Deed campaign of the Foundation for Upstate Medical University. It is written by Walt Wasilewski with Imani Shabazz and designed by Susan Keeter. “Something in these special moments either simply or profoundly changed the lives of these volunteers when they offered spiritual compassion to these patients,” said the Rev. Terry Culbertson. “This book tells their stories in a personal, compelling way.” Culbertson is Upstate’s manager of spiritual care and supervisor of its clinical pastoral education program. Spiritual care volunteer Steffany Thomas, one of the 17 volunteers who share their moments, uses reiki
to connect with patients. Reiki assists in marshaling life energy to support a person’s natural inclination to health. Thomas speaks of her moments with a woman in her late 30s who was battling acute onset leukemia. Thomas, also in her 30s, had mostly ministered to older patients. Thomas speaks of the woman looking young and of feeling an instant kinship with her. Culbertson hopes that “Open the Eyes of My Heart” will inspire others to become spiritual care volunteers at Upstate. “Our program includes a full spectrum of faith traditions,” she said. “There are so many ways our volunteers offer spiritual care, whether it is through prayer, reiki, music, a gentle touch or merely just by spending quiet moments with patients. Offering spiritual care as a volunteer can add a fulfilling dimension to life,” she said. Culbertson also believes that “Open the Eyes of My Heart” is the first book of its kind in the nation, saying that she will share the book with other facilities that would like to
publish one of its own. “Open the Eyes of My Heart” is the third book published by Upstate’s Spiritual Care program. The first book, “A Second Set of Hands,” written by parents and caregivers and complied by on-call clergy volunteer Rev. Wes Fleming, was published in 2007. The second book, “In Their Own Voices,” by Syracuse University Professor Eric Kingson, Ph.D., is based on interviews with 14 Upstate pediatric patients. It was published in 2009. Culbertson says that a fourth book is planned for release next May. This book will include stories of hope by psychiatric patients. “Open the Eyes of My Heart” is available for $5 through Upstate’s Office of Spiritual Care. Proceeds will be used toward book re-
prints. To purchase a copy of the book or to learn more about becoming a spiritual care volunteer at Upstate University Hospital, call 315-464-4687.
Cynics at Higher Risk for Dementia? Yeah, Right Study suggests they may be three times more likely to develop brain disease than more trusting folks
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ynical, distrustful people may be more prone to dementia, a new Finnish study contends. Those traits have been linked with other health problems, such as heart disease, the researchers noted. “Our personality may have an impact on our brain health,” said study author Anna-Maija Tolppanen, from the University of Eastern Finland in Kuopio. Tolppanen cautioned that this study finding only shows an associa-
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tion between cynicism and dementia, not necessarily a cause-and-effect link. “This is the first study showing the link, so it is not possible to say yet whether this is causal or if the association is explained by something else,” she said. One explanation could be that people who are more wary of others may be less socially active, which in turn may increase their dementia risk, she said. There are many ways personality
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
may affect brain health, Tolppanen said. People with different personality traits may be more or less likely to engage in activities that are beneficial for mental health, such as a healthy diet, mental or social activities, and exercise. Another suggestion is that personality may cause physical changes in the brain, she said. “These findings suggest that in addition to established lifestyle-related risk factors, such as exercise or diet, our attitude or personality may be a modi-
fiable risk factor,” Tolppanen said. The report was published online May 28 in Neurology. Sam Gandy, director of the Center for Cognitive Health at Mount Sinai Hospital in New York City, said the new study “addresses the issue of whether dementia underlies the development of an outlook characterized by negative, cynical, sometimes paranoid mistrust that can develop in the elderly.”
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How to Make an Online Memorial for a Departed Loved One Dear Savvy Senior, What can you tell me about online memorials? My uncle recently passed away, and some of the family thought it would be neat to create an online memorial to pay tribute to him, and accommodate the many family and friends who are scattered around the country who couldn’t attend his funeral. Grieving Niece Dear Grieving, It’s a great idea! Online memorials have become increasingly popular over the past decade, as millions of people have created them for their departed loved ones as a way to recognize and remember them. Online Memorials? An online memorial is a website created for a deceased person that provides a central location where family and friends can visit to share stories, fond memories, photographs, comfort one another and grieve. The memorial can remain online for life (or a specific period of time) allowing people to visit and contribute any time in the privacy of their own space. Online memorials started popping up on the Internet in the late 1990s, but were created primarily for people who were well known. But now, these sites are for anyone who wants to pay tribute to their departed family member or friend, and ensure they will be remembered. Content typically posted on an online memorial includes a biography, pictures, stories from family and friends, timelines of key events in their life, along with favorite music and even videos. Another common feature is the acceptance of thoughts or candles offered by visitors to the site who want to send their condolences and support to the
grieving party. An online memorial can also direct visitors to the departed person’s favorite charity or cause to make a donation, as an alternative to sending funeral flowers.
How to Make One To make an online memorial, you can either create an independent website, or use an established memorial site, which is what most people choose to do. Memorial websites are very easy to create and personalize, and can be done in less than 30 minutes. There are literally dozens of these types of sites on the Internet today. To locate them, do an online search for “online memorial websites.” In the meantime, here are a few good sites to check into. The biggest and most established site in the industry is Legacy.com, which also publishes about 75 percent of the obituaries in North America each year through its newspaper affiliations. Creating an online memorial through this site (see memorialwebsites.legacy. com) will run you $49 for the first year, plus an annual $19 sponsorship fee to keep it visible. Some other popular sites to check out are ForeverMissed.com, which offers a free barebones option, along with a premium plan that runs $35 per year or $75 for life; and iLasting.com, which runs $49 per year or $99 for permanent display. If you’re on a tight budget consider LifeStory.com, which is completely free to use, but requires you to log in through Facebook to get to it. And iMorial.com, which is free if you allow ads to be posted on your uncle’s page, or it costs $50 without ads. Or, if your uncle used Facebook, you can also turn his profile into a memorial for free when you show proof of death. Once his page is memorialized, his sensitive information will be removed and his birthday notifications will stop, but (depending on his privacy settings) it still enables family and friends to post memories and condolences. In addition, you can also request a Look Back video, which is a short video created by Facebook highlighting your uncle’s pictures and most liked status messages. 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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The Social Ask Security Office Provided Deborah Banikowski, Social Security OfficeSocial Security Office
Medicare Is Here To Stay
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not enroll when you are first eligible, edicare went into effect 48 also known as your initial enrollment years ago on July 1, 1966. Earperiod. There also is a Medicare Part B lier that same year, Medicare workers went door to door trying to get deductible of $147 in 2014. • Part C (Medicare Advantage) seniors to sign up. Medicare was not the cornerstone then that it is today and allows you to choose to receive all of your health care services through a propeople did not know whether it was vider organization. This plan includes going to work for the long haul. all benefits and services covered under Now, nearly half a century later, Part A and Part B, usually includes Medicare remains one of the most Medicare prescription drug coverage, popular government programs in the and may include extra benefits and sernation. vices at an extra cost. You must We can’t see the future, but have Part A and Part B to enroll one thing’s for sure: Medicare is in Part C. Monthly premiums here to stay. vary depending on your state, Medicare provides health private insurer, and whether insurance to more than 50 you select a health maintenance million Americans. Forty-two organization or a preferred million are people age 65 and provider organization. older and the other 8 million are • Part D (Medicare preyounger and have disabilities. scription drug coverage) helps Most people first become cover the cost of prescription eligible for Medicare at age 65. drugs. Many people pay a The four parts of Medicare Banikowski premium for Part D. However, are parts A, B, C, and D. people with low income and re• Part A (Hospital Insurance) helps sources may qualify for extra help from cover inpatient hospital care, skilled Social Security to pay the premium and nursing care, hospice care and home deductible. To see if you qualify for exhealth care. Most people get Medicare tra help visit www.socialsecurity.gov/ Part A premium-free since it is earned prescriptionhelp. by working and paying Social Security Will you be age 65 soon? Even if taxes. you decide not to retire, you should • Part B (Medical Insurance) helps consider applying for Medicare. You cover services from doctors and other can apply in less than 10 minutes using outpatient health care providers, outour online Medicare application. Do it patient care, home health care, durable today at www.socialsecurity.gov/medimedical equipment and some preventive services. Most people pay a month- careonly. To learn more about applying ly premium for Part B. In 2014, the premium for most people is $104.90, the for Medicare when you plan to delay retirement, read our publication “Apsame as it was in 2013. Some high-inplying For Medicare Only—Before You come individuals pay more than the standard premium. Your Medicare Part Decide,” available at www.socialsecuriB premium also can be higher if you do ty.gov/pubs.
Q&A
Q: I can’t find my Social Security card. How can I get a new one? A: First, consider whether you really need a new card. You only need to apply for a replacement Social Security card if you don’t know your Social Security number or if you need to show your card to a new employer or other entity. If you decide that you do need a card, follow these three easy steps. • Step 1: Complete an Application For a Social Security Card (Form SS-5). • Step 2: Show us documents proving your: – Identity; and – U.S. citizenship or immigration status. • Step 3: Take your completed application and original documents to your local Social Security office or your local Social Security Card Center. Q: How can I calculate my own retirement benefit estimate? A: We suggest you use our Retirement Estimator at www.socialsecurity. gov/estimator. Our Retirement EstimaPage 20
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tor produces estimates based on your actual Social Security earnings record, so it’s a personalized, instant picture of your future estimated benefit. Also, you can use it to test different retirement scenarios based on what age you decide to start benefits. For example, you can find out your estimated monthly payments if you retire at age 62, 70, or anytime in between. Visit www.socialsecurity.gov/estimator. Q: How do I earn Social Security credits? A: “Social Security credit” (sometimes referred to as a “quarter of coverage”) is the measure of your work under the Social Security program. We use your total covered yearly earnings from both wages and/or net earnings from self-employment to compute Social Security credits. The amount needed for a credit increases automatically each year as average wages increase. For example, in 2014, you earn one credit for each $1,160 of wages or self-employment income. You can receive a maximum of four credits for any year. Generally, you need 40 credits to be eligible for retirement benefits. Leran more at www.socialsecurity.gov/ pubs.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2014
Sharing Crouse Cardiac Excellence Catherine Braudrick (left), and Colleen Wolford, electrophysiology nurses who work in Crouse Hospital’s Miron Cardiac Care Center, represented the hospital recently with a poster presentation at the 35th annual meeting of the Heart Rhythm Society in San Francisco. This is an international meeting for electrophysiologists, cardiologists,
researchers and allied professionals working with patients who have arrhythmia disorders. More than 13,000 professionals attended this year’s conference. Crouse electrophysiologists Jamal Ahmed and Kwabena Boahene provided important data and information for the poster presentation.
The Upstate Sleep Center located at Medical Center West in Camillus was recently reaccredited by the American Academy of Sleep Medicine. From left (back row) patient service clerk Michelle Berkey, director Dawn Leadley, technical manager Ron Waldron, co-medical director, physician Dragos Manta. On the ffront row from left are business manager Lisa Vigliotti-Bane, keyboard specialist Jennifer Yattaw, and secretary Yetta Williams.
Upstate Sleep Center receives re-accreditation The Upstate Sleep Center recently received a five-year re-accreditation from the American Academy of Sleep Medicine (AASM). The Upstate Sleep Center has been accredited by the AASM for more than 25 years. The accreditation process is based on the AASM Standards for Accreditation of Sleep Disorders Centers, and requires a survey of the facility. According to AASM, “The continued quality of these requirements has made AASM center accreditation the gold standard by which the medical community and the public evaluate sleep medicine facilities. “We are proud to announce the re-accreditation of the Upstate Sleep Center,” said co-medical director and physician Robert E. Westlake. “The center has a long history of serving its patients with the highest standard of care, and this re-accreditation reaffirms
our dedication to their sleep health.” “The Upstate Sleep Center has been accredited by the AASM for more than 25 years,” said co-medical director Dragos N. Manta, a physician. “The accreditation process reviews the center’s staff and training, policies, equipment and more, to ensure that we operate at the highest standard set by the AASM.” The Upstate Sleep Center, the only sleep study facility in Central New York to care for children, is located in Medical Center West in Camillus. Its staff includes four administrative staff, 14 sleep technicians and a team of seven physicians who specialize in sleep medicine, pediatrics, neurology, pulmonary disease and otolaryngology. The facility has 12 sleep study rooms, which operate seven days and nights a week to help diagnose sleep disorders.
H ealth News Acu-Care Acupuncture moves to larger offices Rui Wang, a seventh-generation acupuncturist and owner and operator of the Acu-Care Acupuncture Center, announced the expansion of her practice to new offices at Northeast Medical Center in Fayetteville, suite 209. Wang utilizes her skills to alleviate pain of many kinds, including back pain, reduce inflammation and has successfully treated many difficult OBWang GYN cases, which are difficult or sometimes limited by current Western medicine treatment methods. Both new and old patients are welcomed to the newly expanded offices. For more information visit www. AcuCareAcupunctureCenter.com.
Danlee Medical Products marks 20th anniversary Danlee Medical Products is celebrating its 20th year of business. Founded in 1994 by Joni Walton, Danlee Medical Products, Inc. is a medical supply distributor and manufacturer who specializes in cardiac testing supplies such as electrodes, chart paper, customized hook-up kits, cables and lead wires serving the needs of more than 4,000 health-related professionals and their patients globally. In addition to being a full line distributor of medical supplies, Danlee Medical Products, Inc. Walton is a certified women-owned business enterprise, a FDA regulated manufacturer and a globally recognized industry leader in the production of customized hook-up kits for Holter monitor testing. The company has recently been appointed to the Women’s Business Enterprise National Council (WBENC). Through the past 20 years, the company has worked to expand its customer base by developing new and innovative products and by quickly and efficiently responding to the ever-changing demands of the marketplace. The company prides itself on providing the customer with unmatched buying experience. “We view each customer as a valued member of the Danlee family, as our associates enjoy establishing and maintaining actual relationships with them,” said Walton. “This same philosophy is also practiced internally as our employees operate in an atmosphere of congeniality, teamwork, and some light-hearted fun in a family-type atmosphere. Solidifying our base with controlled, steady growth, Danlee’s future plans include facilities expansion, personnel additions, innovative
product development, investment in further employee training, and increased catalog inventory items.”
Widewater Gynecology to move larger quarters Widewaters Gynecology will move to new offices at 5844 Widewater Parkway in July. The new location will provide more space and even free parking. Physicians Navpriya Oberoi and Melanie Ramachandran will continue to provide OB-GYN services at the new location. Ramachandran is a board certified gynecologist and diplomate of American Board of Obstetrics & Gynecology. The physician completed undergraduate education at Syracuse University with honors in biology and anthropology. She earned her medical degree from SUNY Upstate Medical Center and had her residency in the ER at Oberoi SUNY Upstate, where she also served as chief residency in the department of obstetrics and gynecology. She is a fellow of American College of Obstetrics & Gynecology. Ramachandran brings 30 years of Ramachandran gynecological experience to her practice, which ranges from adolescence to menopause. Special interests include preventive care, contraception, HPV vaccines, abnormal PAPS, colposcopy, laser surgery, LEEP, novasure uterine ablation, abnormal menses, menopause, bioIdentical hormone therapy, vaginal dryness and vaginal local estrogen therapy. Physician Oberoi is board-certified in gynecology and a fellow trained in minimally invasive gynecologic surgery. She was the recipient of 2009 SUNY Upstate Outstanding Resident award. Her special interests include laparoscopic and robotic surgery, endometriosis, prolapse and incontinence treatment. For more information on the practice, visit www.widewatersgyn.com.
St. Joe’s primary care center gets recognition St. Joseph’s Hospital Health Center announced its primary care center west pediatric services, has received level 3 recognition from the National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home 2011 (PCMH-2011) program for using evidence-based, patient-centered processes that focus on highly coordinated care and long-term participative relationships. Nurse practitioners Beth Currado and Joanne Lavigne and physicians Catherine Curry and Jose Vargas are linked to the recognition.
Oswego Health Auxiliary Makes Generous Donation to Health System The Oswego Health Auxiliary has once again made a generous $50,000 donation to the health system. Each May, as Oswego Health celebrates May as healthcare month, members of the Auxiliary make a large donation to the health system, which ensures that exceptional healthcare programs and services will remain available locally. The Auxiliary raised the donated funds from their annual fall bazaar and various other fundraisers, as well as the sales from the Oswego Hospital snack bar and the Fulton Medical Center’s 510 Café.
Seated in the photo from the left are Oswego Hospital Chief Nursing Officer Valerie Favata, Auxiliary President Barbara Handley-Place, Oswego Health President and CEO Ann C. Gilpin and Terri Smith, of the Auxiliary. Standing from left are, Oswego Health Director of Volunteers and Auxiliary Sarah Weigelt, along with Auxiliary members Mary Roman, Noreen Zuccolotto, Diane Jones, Treasurer Julia Burns, Mary Margaret Restuccio, Linda McQueen, Mary Borte, MaryLou Kritzman, Secretary Marion Duplessis and Sheila Gurdziel.
The recognition is valid for three years. The patient-centered medical home (PCMH) is a model of care emphasizing care coordination and communication to transform primary care into “what patients want it to be.” Research shows that medical homes can lead to higher quality and lower costs, and improve patients’ and providers’ reported experiences of care. The PCMH identifies practices that promote partnerships between individual patients and their personal clinicians, instead of treating patient care as the sum of several episodic office visits. Each patient’s care is tended to by clinician-led care teams, who provide for all the patient’s healthcare needs and coordinates treatments across the healthcare system. Medical home clinicians demonstrate the benchmarks of patient-centered care, including open scheduling, expanded hours and appropriate use of proven health information systems.
on its quality improvement projects with local emergency medical services providers to engage in active performance improvement activities using Lean Six Sigma principles. The hospital formed a learning collaborative with EMS providers in 2010 to identify ways to improve patient care processes and hand-offs between the hospital and EMS providers. The collaborative was expanded in 2013 to include Welch Allyn as a partner. The results and outcomes of this learning partnership have significantly improved the processes and quality of patient care provided by EMS professionals in 11 New York State counties, improved EMS operational efficiency, advanced the quality of care within the hospital setting and strengthened Crouse’s relationship with its EMS partners. In addition, results of many of the collaborative projects have been shared regionally, state wide and nationally at various professional conferences.
Crouse Hospital gets ‘Best Performance Award’
St. Joe’s named to list of 100 great hospitals
Crouse Hospital has been honored with the 2014 CNY Best Learning and Performance Practices Award by the CNY Chapter of the American Society of Training and Development. Crouse received the award based
St. Joseph’s Hospital Health Center’s has been named to the 2014 edition of “100 Great Community Hospitals,” a list based on community hospitals’ accolades, quality and service to their communities by Becker’s
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H ealth News Hospital Review. According to the Becker’s Hospital Review article, the hospitals that made the list have fewer than 550 beds and have continually worked to provide the quality of care and the experience patients deserve and expect. “On behalf of our staff, physicians and leadership, we appreciate this recognition for our accomplishments. St. Joseph’s has worked closely with key partners Centerstate CEO, Catholic Charities, The Northside Urban Partnership, Home Headquarters, Housing Visions, Near Westside Initiative, Nojaim Brothers Supermarket, and the Lerner Center for Public Health Promo-
tion in an effort to make a difference in our Community Initiatives. We share this recognition with them,” said hospital CEO Kathyrn Ruscitto. For its 2014 Top 100 list analysis, Becker’s editorial team has chosen organizations based on rankings and awards from iVantage Health Analytics, Truven Health Analytics (formerly Thomson Reuters), CareChex, and the American Hospital Association. The Becker’s Hospital Review 2014 edition of “100 Great Community Hospitals” article, including the complete list of the top 100, can be found at bit.ly/ 2014beckerstop100.
Sarah Minor, the sister of Syracuse Mayor Stephanie Minor, has recently being recognized by the Home Care Association of New York State. A nurse in Rochester, she has worked with the refugee population in that city.
Sister of Mayor Stephanie Minor honored by Home Care Association of NYS
Ladies Ancient Order of Hibernians Donates to Catholic Charities. The Ladies Ancient Order of Hibernians (LAOH), Dean Michael Barry Division 1, partnered with the Catholic Charities of Oswego County recently, by gathering and donating non-perishable food items. Shown pictured at the Ancient Order of Hibernians in Oswego recently are from left to right: Evelyn Thurlow, Corine Bateman, Dee Mulcahey, Dawn Abtey, and Donna Roman.
The Ancient Order of Hibernians (AOH) is an international Irish-Catholic fraternal organization, founded in New York City in 1836. The Dean Michael Barry Division 1 was founded in Oswego in 1903. The LAOH was established for practicing Roman Catholic women of Irish descent and meets at the AOH clubhouse at 22 Main St. in Oswego. For additional information please call 343-9815.
AIDS Walk/Run raises nearly $200K The 22nd Annual AIDS Walk/ Run, presented by Empower Federal Credit Union and UPS June 1, raised $181.860 and celebrated 22 years of fundraising for youth sexual health education programs delivered by ACR Health. Since it began in 1992, the AIDS Walk/ Run has been the mainstay funding for ACR Health’s now extensive adolescent health initiatives. Since its inception, the event has raised more than $2.3 million and positioned ACR Health as a state leader in youth education.
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The Home Care Association of New York State (HCA) has recognized Sarah Miner of HCR Home Care in Rochester with one of its highest honors for caregivers. Miner, a registered nurse, recently received the 2014 Caring Award at its annual conference. This award recognizes individuals for exhibiting compassion, skills and service that set their contribution apart, and whose actions over a period of time exemplify outstanding compassion in caring. Miner was honored for her tireless work to help Rochester’s refugee population access health care services. Specifically, she identified health disparities and lack of access to community resources among refugee adults with chronic health
conditions, and she proposed and successfully implemented a sustainable refugee program within HCR Home Care. “All of us at HCR Home Care are very proud of Sarah for receiving this prestigious honor,” said Elizabeth Zicari, president, HCR Home Care. “Sarah’s compassion and her commitment to serving the refugee population were instrumental in creating our refugee program, and she has contributed tremendously to the successful outcomes this program has achieved.” A Ph.D. candidate working toward her doctorate degree in nursing, Miner resides in Rochester. She is the sister of Syracuse Mayor Stephanie Miner.
FDA Releases Proposed Regulations for E-Cigarettes By Patricia Briest
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an addictive substance as well, and uch discussion and media caffeine is not regulated. The differhype have surrounded the marketing and use of electron- ence might be in the harm that may be caused by product use. ic cigarettes (e-cigs). The Federal Drug Unlike caffeine, nicotine is not a Administration has researched the “stand alone” product as used in either product and developed recommendatobacco products or in e-cigs. The additions that they would consider impostives that allow nicotine to be absorbed ing on the product once they achieve as well as the tar and other dangerous regulatory control of the product content and use. substances in tobacco, and carcinogenLegislation has also been drafted ic chemicals found in e-cigs could be that would give the FDA regulatory considered a “game changer.” control of other tobacco products, such Research on tobacco products as cigars, pipe tobacco and dissolvable consistently shows numerous lifelong products. health problems with use, including The regulations being proposed death. Research on e-cigarettes reveals include prohibiting: the sale of these cancerous causing chemicals thus far; products to minors, free samples, other studies are pending. People have introduction of new products without been harmed as the battery has been FDA approval, claims of modified risk known to ignite vaporous fumes, imwithout FDA approval, and producposing another major concern. Many in the medical community ers would have to register with the agree with the FDA. Products that FDA. In addition, product ingredients potentially cause great harm need to be would need to be listed, and health kept out of the hands of our youth, and warnings would need to be included in advertisement. Proposed regulations regulated so that users know exactly what they are risking should they currently do not include regulation of decide to use any of flavors that may be attractive to youth, these products. product marketing or Internet sales. There are bound to be a variety of Patricia Briest is a reactions from the public regarding board-certified family the FDA proposals, particularly the nurse practitioner question of “how much government regulation is too much?” and nurse manager Considering that nicotine, which is for cardiopulmonary a significant ingredient in these prodrehabilitation, wellness and outpatient diabetes ucts, is a highly addictive substance, management at St. some would argue that the products Joseph’s Hospital. should be regulated. However, a counter argument could be that caffeine CAncerIGHhalf_Layout 1 6/18/14 4:46 PMisPage 1
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