in good Injury Free Tips for keeping your children injury-free during fall sports season
Do schools start too early for teens? The CDC says yes
September • Issue 189
cnyhealth.com
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CNY’s Healthcare Newspaper
The Pink Pill
FDA approves pill to increase women’s libido, known by some as ‘Viagra for women.’ We get the local reaction Page 21
Fighting to Find a Cure for Ovarian Cancer Founder of nonprofit Hope for Heather on a mission to create awareness of ovarian cancer Many community hospitals will not survive unless they become part of a larger system of care. See “Healthcare in a Minute” inside
Treating Swollen Eyelid
Making an Impact Diagnosed with arteriovenous malformation (AVM) at age 4, 19-year old Manlius resident Kelleigh Gustafson is helping AVM patiens with her efforts ro raise awareness of the condition. She is shown with physician Eric Deshaies from Crouse Page 10
More Reasons to Gobble Up Chicken Page 9
Meet Your Doctor Prostate cancer: Is it a ticking time bomb waiting to explode? Urologist Gennady Bratslavsky tackles that question and talks about prostate cancer prevention
Page 6
September 2015 •
One-third of the about 30 million people struggling with eating disorders are men Page 12
New Law Allows Students to Self-Manage Diabetes at School Page 12
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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We Our Caregivers!
U.S. Infant Deaths at Lowest Rate Ever: CDC But American babies still die at rates that are higher than other affluent countries
T
FREE CLASSES! Fall/Winter 2015-2016 Anyone 18 years or older who voluntarily provides care and assistance to an older or disabled person is a caregiver.
SEPTEMBER
Men Can Cook Caregiver Wellness: A Holistic Approach What To Do When You’re No Longer A Caregiver Powerful Tools For Caregivers 1 Home Is Where The Heart Is Home With Care
OCTOBER
Medicare: An Overview & Changes For 2016 Dementia Conversations Powerful Tools For Caregivers 2 Mindful T’ai Chi Chih Healthy Eating For Successful Living Who Will Take Care Of Me? The Medical System Is Changing Give Me A Break! Respite Can Help
he number of U.S. infants who die before their first birthday continues to decline and is at a historic low, health officials recently reported. Between 2012 and 2013, the rate dropped only slightly, from 5.98 deaths per 1,000 births to 5.96. But that’s part of a long-term trend: Since 2005, when infant mortality stood at 6.86 per 1,000 births, the rate has fallen by 13 percent, according to the U.S. Centers for Disease Control and Prevention. “Every single time an infant dies in the first year of life it is a tragedy for a family,” said report author T.J.
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Mathews, a demographer at CDC’s National Center for Health Statistics. However, “in 2013, we saw the lowest infant mortality rate ever,” he said. “That’s good news. There were many years when the rate was steady and wasn’t declining, then in 2009 we started to see some declines, and we are continuing to see that. It’s not a sharp decline, but it’s going in the right direction.” In 2013, 23,446 infants died in the United States, 208 fewer than in 2012, the researchers found. “Not long ago, we were around 28,000 to 30,000 deaths,” Mathews said. “There are still a lot of infant deaths, but that there are fewer means there have been positive changes.” For most groups, the infant death rate remained stable. However, death rates among Puerto Ricans and Cuban-Americans dropped significantly — 14 percent for Puerto Rican women and 40 percent for Cuban-American women. Mathews noted that the disparity in infant deaths between blacks and whites persists. The infant death rate for blacks is double that of whites. “That sad fact has been constant,” he said. David Mendez, a neonatologist at Nicklaus Children’s Hospital in Miami, said, “Access to care seems to be the driving force behind these disparities.” Most infant deaths occur among babies born early with birth defects. Many deaths are also due to preterm delivery.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
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Over 4 Million Americans Say They’ve Driven Drunk in Prior Month: CDC
A
new study finds that close to 2 percent of adults — about 4.2 million people — admitted to driving while intoxicated at least once over the prior month. The study, based on 2012 data analyzed by the U.S. Centers for Disease Control and Prevention, also outlines the “typical” drunk driver: Young males with a history of binge drinking. Curbing the problem could save countless lives, the CDC researchers said, since “alcohol-impaired driving crashes have accounted for about one third of all U.S. crash fatalities in the past two decades.” One expert agreed. Binge drinking is rampant among the young, said physician Scott Krakower, who specializes in alcohol abuse issues. “Individuals should not be afraid to seek help if they have a drinking problem,” he said. “Bottom line: if one is drinking, they should never drive a motor vehicle. They are putting innocent lives at risk.”
In the new study, a team led by CDC investigator Amy Jewett looked at 2012 data from an annual federal government survey. They found that “an estimated 4.2 million adults reported at least one alcohol-impaired driving episode in the preceding 30 days, resulting in an estimated 121 million episodes [per year].” The profile of the “typical” drunk driver probably won’t surprise many, either — a binge-drinking young male. According to the study, men aged 21 to 34 made up a third of all drunk driving episodes, while men overall made up 80 percent of impaired drivers. The report found that 4 percent of adults fall into the category of “binge drinkers” — men who consume five or more drinks at one occasion, or women who have 4 or more drinks per occasion. This 4 percent of adults are involved in nearly two-thirds of all drunk driving incidents, the CDC researchers noted.
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Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by Local
Health CNY’s Healthcare Newspaper
News, Inc. Distribution: 35,000 copies. To request home delivery ($15 per year), call 315-342-1182.
In Good Health is published 12 times a year by Local News, Inc. © 2015 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776.
Upstate offers the first emergency and urgent care for 55+. Visit our calm, easy-access setting at 4900 Broad Road in Syracuse. (The former Community General Hospital.)
FOR MORE INFORMATION, CALL UPSTATE CONNECT
800.464.8668
UPSTATE.EDU/GEMCARE WWW.UPSTATE.EDU/HOSPITAL/PATIENTS/NICHE
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Matthew Liptak, Chris Motola Advertising: Amy Gagliano, Cassandra Lawson Design: Chris Crocker • Office Manager: Alice Davis 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.
September 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Health in good
CNY’S HEALTHCARE NEWSPAPER
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
EOE/AA Minority/Female/Disability/Veteran
CALENDAR of
HEALTH EVENTS
All Month
Onondaga County offers free classes for caregivers Onondaga County Department of Adult & Long Term Services, Office for Aging is offering a series of classes designed to caregivers. They are free of charge. They are: • “Men CAN Cook” — 10:30 a.m.– 1 p.m., Sept. 2, 9, 16, 23, at United Church of Christ, 215 Blackberry Road, Liverpool; • “Caregiver Wellness: A Holistic Approach” — 5:30 – 7 p.m., Sept 9, at Natur-Tyme, 3160 Erie Blvd. East, Dewitt; • “What To Do When You’re No Longer A Caregiver” — 5:30 – 7 p.m., Sept. 16, at Sage Upstate, CNY Philanthropy Center, 431 E. Fayette St., Syracuse; • “Powerful Tools For Caregivers 1” — 9:30 – 11:30 a.m., Sept. 9, 16, 23, 30 and Oct. 7, 14, at Elderwood at Liverpool, 4800 Bear Road, Liverpool; • “Home Is Where The Heart Is” —
5:30 to 7 p.m., Sept. 21, 28 and Oct. 5, at Liverpool Public Library, 310 Tulip St., Liverpool; • “Home With Care” — 5:30 to 7 p.m., Sept. 24, Liverpool Public Library, 310 Tulip St., Liverpool. Class sizes are limited, so registration is required by calling Cynthia at 435-2352, ext. 4993 or emailing cstevenson@ongov.net. Catalog is online at: www.ongov.net/aging/icare.
Sept. 3
Free yoga for beginners at Yoga Institute Upstate Yoga Institute is offering free yoga classes for beginners from 5:45 – 7 p.m., Thursday, Sept. 3. The studio is located next door to the Dewitt Wegmans, at the corner of E. Genesee Street and Edwards Drive in Fayetteville. According to instructors, this is a perfect opportunity to experience yoga in a comfortable, non-competitive environment. Participants will be gently introduced to the practice of yoga with clear instructions that
respect each person’s own body. The business requests that those interested in in the free classes send an email to info@upstateyogainstitute.com to confirm participation. Space is limited.
Sept. 9
Vedic chanting class held in Fayetteville Free Vedic chanting class will be offered by Upstate Yoga Institute from 7:15 – 8:15 p.m., Wednesday, Sept. 9. Discover the timeless sounds of Vedic chanting with a teacher who has been chanting for more 25 years. According to instructors, chanting is a yoga of sound which makes chanters feel grounded and joyous. It also sharpens their ability to focus, listen and remember, according to instructors. No musical or language ability required. For further information or to sign-up for this free class, email Martine at info@ upstateyogainstitute.com.
Sept. 15
Crouse presents forum on managing joint pain Suffering from hip or knee pain — or know someone who is? Join Crouse Hospital’s board-certified orthopedic experts for more information about the causes and latest treatments and advancements in orthopedic care. Orthopedic surgeons Tim Izant, chief of orthopedics at Crouse Hospital
and partner at Syracuse Orthopedic Specialists, and Rob Sherman, partner at Upstate Bone & Joint Center, will present the latest surgical and non-surgical options in orthopedic care. The event, free and open to the public, will be held from 6:30 – 8 p.m., Tuesday, Sept. 15, at the Marley Education Center, 765 Irving Ave. Free parking is available in the Marley and Crouse Hospital garages. Pre-registration is required by calling 315-472-2464 or visiting crouse.org/jointpain. The panel will discuss the anterior approach to hip replacement surgery; the latest advances in knee replacement surgery; and how to manage hip and knee pain.
Sept. 17
Spirit of Women event to feature Indian theme Crouse Hospital’s Spirit of Women program continues its journey to good health with an Indian-themed getaway from 6 – 8:30 p.m. on Thursday, Sept. 17, at Drumlins Country Club, 800 Nottingham Road, Syracuse. The event — which coincided with Gynecologic Cancer Awareness Month — will provide a relaxed setting that encourages women to care for their wellbeing. A feature of the evening is a presentation led by Mary Cunningham, Crouse GYN oncology surgeon. She
continued on page 22
Healthcare in a Minute By George W. Chapman Telemedicine Mostly due to advances in technology, telemedicine is becoming more commonplace. What has been holding back the proliferation of telemedicine is reimbursement from insurance companies. While some insurance companies have been reimbursing for telemedicine, they have kept it fairly quiet. Slowly but surely, more insurers are paying physicians for telemedicine services. It has been estimated that telemedicine will save over $6 billion annually. This does not take into consideration the reduction in sick time and lost wages for patients. Telemedicine allows physicians and their support staffs to treat and monitor more patients that will alleviate the pending shortage of physicians. Many states are now pushing insurance companies to cover telemedicine. Primary care physicians Not surprisingly, those of us who see the same primary care provider fairly consistently — such as an internist, family physician or OB-GYN — have fewer hospitalizations and emergency room visits than those who do not. A study of 49,000 medical visits published in “Health Affairs” found that the more familiar a physician is with your medical history and chronic conditions, the more successful your overall care will be. As the saying goes, “Too many chefs spoil the broth.” Retail clinics According to The New York Times, CVS is now one of our largest healthcare companies. CVS operates 1,500 clinics among its 7,800 stores. Focusing
on population health, CVS no longer sells tobacco products. CVS actually resigned from the U.S. Chamber of Commerce when it learned the chamber was lobbying against anti-smoking laws. Sixty percent of Americans live near a CVS store, so the ability of CVS to have an impact on population health is tremendous. Despite criticism from traditional providers, consumer satisfaction with retail clinics is high. Healthcare strains state/local budgets An analysis by the Pew Charitable Trusts discovered that healthcare spending accounts for 31 percent of state and local government budgets. But don’t blame expanded Medicaid. The majority of healthcare spending is on public employees and retirees. It has increased 61 percent over the last six years. Medicaid spending has also increased and the federal government pays for most of it. A recent article in the Journal of Health Economics estimates the state liability for retiree health benefits is $1.1 trillion, or about one third of state annual revenues. Ninety-seven percent of this huge liability is unfunded. Premium review According to a study in “Health Affairs,” premiums are lower in states that have review authority over commercial insurers’ proposed rate increases. New York state has this regulatory authority. Big insurers get bigger The merger frenzy among commercial carriers reached a high point last month when No. 2 Anthem announced its intention to purchase No. 4 Cigna
for around $50 billion. This would create the largest health insurer in the United States with about 53 million covered lives. Also last month, Aetna bid $35 million for Humana. Both deals have to be approved by shareholders and federal regulators. If approved, the impact of these mergers on premiums would not take effect until 2017 as most carriers have rates for next year set. Federal regulators will pay particular attention as more seniors opt for rapidly growing Medicare Advantage plans that are offered through commercial carriers. While larger is essential considering the necessary huge investments in technology and health information systems, the reduction in competition could leave many communities with little to no choice when it comes to health insurance. Massachusetts General the “best” For what it’s worth, U.S. News and World Report named it the best hospital out of 5,000 nationwide. The Mayo clinic in Rochester, Minn. came in second. Johns Hopkins in Baltimore and the UCLA medical center in Los Angeles tied for third. Physician shortage The shortage is expected to be felt by 2020 although there is much debate as to degree. In the meantime, medical schools have done their part by expanding enrollment. By 2018, there will be over 21,000 medical students, which is about 4,000 more than now. Teaching hospitals have done their part by voluntarily expanding the number of residency slots. The key word is “voluntarily” September 2015 •
because they have not been reimbursed for the costs associated with the additional slots because the federal government has not done its part to address the shortage. Since 1996, there has been a cap on the number of residency slots to be reimbursed through additional Medicare payments. With more budget cuts on the way, many teaching hospitals will be forced to discontinue the additional slots they have added. As more medical students graduate, there are not enough U.S. residency slots or jobs available to them. They will be forced to find residency jobs abroad. Hospitals must get bigger Stand-alone community hospitals are finding it harder to compete with nearby hospital systems and even harder to negotiate rates with dominant insurers. Many community hospitals will not survive unless they become part of a larger system of care. Consequently, hospital mergers and acquisitions continue on the upswing. Not to be outdone by insurance mergers, the number of hospital merger and acquisition transactions in 2014 increased by 18 percent — 637 to 752 — over 2013. GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
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Meet
Your Doctor
By Chris Motola
Gennady Bratslavsky, M.D. Prostate cancer: Is it a ticking time bomb for men? Chairman of the department of urology at Upstate tackles that question and talks about screening and other ways to help prevent prostate cancer
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Q: This month is our men’s health issue. Why is urology such an important specialty for men’s health? A: It’s probably the only field where physicians routinely ask them about quality of life issues related to that topic, whether they’ve been screened for prostate cancer and how they might benefit from it. These are routinely addressed in the urologist’s office. Q: Would you say urology fulfills, for men, a similar niche that OB-GYN does for women? A: Absolutely. It has a big element that the primary care doctors have, with long-term follow-up that require building a relationship with the patient that will likely last for a number of years. Q: What are some of the key health indicators that a urologist would like for in terms of men’s health? A: So we should start with a disclaimer that, while primary care doctors do an outstanding job screening for many urological issues, I would say that the key indicators include quality of life, which includes as assessment of urinary health, frequency/ difficulty of urination, sexual performance issues and the presence of blood that may be in the urine. Q: The prostate can kind of come across as something of a ticking time bomb for men. What’s the deal with it? How do you head off problems with your prostate? A: So in the United States prostate cancer is the most common form of cancer in men and the second most deadly for them after lung cancer. It has the reputation of a ticking time
IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
bomb in part because over 50 percent of the men who die from it are 75 or older. But “the ticking time bomb” would only be true if we stopped screening for prostate cancer. There’s no question that the prevalence of prostate goes up as men age, but you can develop it much earlier. But it’s wrong to think that nothing can or should be done about it. Now, sometimes those who are old and in frail health might not benefit from treatment and screening, but those decisions need to be made on a patient-by-patient basis. Even though it can be curable, it would be a mistake to say every prostate cancer must be treated. So we’re looking at how
aggressive the cancer is, the patient’s health, available technology. Urologists are usually supportive of prostate cancer screening as a way to avoid the early explosion of that “ticking time bomb.” While we still don’t have a crystal ball, we do have some sophisticated tools at Upstate, including digital imaging, to help us detect prostate cancer and target it if it’s there. Q: There seem to be a lot of rumors that go around about ways to keep your prostate healthy. You hear everything from eating lots of mushrooms to ejaculating more often. Is there any truth to these? A: This is a great question. Some research has found that more frequent intercourse was associated with a lower frequency of prostate detection. And some foods have been looked at and are thought to offer some protection from the development and advancement of prostate cancer. But as of right now, there are no definitive studies that support the specific use of food supplements or vitamins to improve the outcomes of patients with prostate cancer, or to prevent prostate cancer. What we have learned is that vitamins given in excess are actually dangerous. Some of the substances we thought might have been helpful in preventing the development of prostate cancer — selenium or vitamin E, for example — have, in controlled studies, were more likely to have developed prostate cancer than those who didn’t. All we can recommend at this point is a healthy diet, the avoidance of high fat, fried foods. Overall outcomes of prostate cancer patients are highly dependent on their overall health. So I wouldn’t recommend anyone go on a high mushroom diet or to triple their vitamin E. Q: There’s been some push-back on screening. Is it easy to get these tests done and paid for by insurance? A: In the last few years, the United States Preventative Task Force recommended that screening not be done for prostate cancer. Urologists have noticed a higher rate of more advanced prostate cancer. There’s no question that there’s a controversy as to whether there should be screening. The whole controversy arose from the over-treatment of prostate cancer in the past and the side effects from that over-treatment. But the ability to intervene earlier, if necessary, can lead to a much higher quality of life for our patients.
Lifelines Name: Gennady Bratslavsky, M.D. Position: Chairman of the Department of Urology at Upstate Medical University, Professor Hometown: Kiev, Ukraine Education: Albany Medical College (medical and residency), National Cancer Institute (fellowship) Affiliations: SUNY Upstate, Community General, Rome General Hospital Organizations: American Urological Association, Society of Urologic Oncology Family: Married (Katja), three sons (Michael, Mark, Gene) Hobbies: Soccer, fishing, travel, art, guitar
Early Detection Key in Ovarian Cancer Founder of nonprofit Hope for Heather on a mission to create awareness of ovarian cancer By Matthew Liptak
O
varian cancer causes more deaths than any other female reproductive cancer, according to the National Cancer Institute. “In New York state I believe about 1,500 women were affected last year and 900 died,” said Frieda Weeks, the co-founder of Hope for Heather, a nonprofit organization based in Liverpool dedicated to finding a cure for ovarian cancer by funding research and improving survival through education and early detection. September is National Ovarian Cancer Awareness Month. It was created to spread awareness of the disease and hopefully end the deadly trend. According to the American Cancer Society, the risk of a woman developing ovarian cancer in her lifetime is one in 75. Half of those cases are women diagnosed at 63 years of age or older. About 21,000 women are diagnosed with the disease yearly and over 14,000 die from it. “[There’s] probably a 70 percent chance of survival if you detect it early,” Weeks said. “The problem is we can’t [detect early] right now because of the way the symptoms are. We desperately need a test like the pap smear to detect it so that women can live longer.” Weeks with her husband Gary
started the nonprofit Hope for Heather in 2009 to spread awareness of ovarian cancer and raise money for research. The group is named in memory of the Frieda and Gary Weeks’ daughter Heather, who was a passionate voice in the fight against ovarian cancer. Heather Weeks worked for the Ovarian Cancer Research Fund. She died of colon cancer in 2008 at the age of 23. Ovarian cancer symptoms can be vague. They include bloating, pelvic or abdominal pain, trouble eating or feeling full quickly and feeling the need to urinate often and urgently. Because a woman with early stage ovarian cancer can so often be misdiagnosed and sent to a gastroenterologist or some other doctor, Frieda Weeks proposes women give their gynecologists a unique challenge: make them prove you don’t have ovarian cancer instead of making them prove you have it. It may be an essential attitude to have if you want to catch the disease early, Weeks said. Ginger Denny, 64, of Fayetteville, did not catch the cancer early, but was very lucky. She was diagnosed with Stage 3 ovarian cancer in November of 2000. “After two weeks of a nagging discomfort in my left pelvic area I went
Frieda Weeks is co-founder of Hope for Heather, a nonprofit dedicated to finding a cure for ovarian cancer.. to my GP,” she said. “A urinalysis was negative for a urinary tract infection and after a pelvic exam a transvaginal ultrasound was ordered for that same day.” After further tests and a visit to a gynecological oncologist, Denny’s ovarian cancer was confirmed. She received life-saving surgery 15 days later. She went through six months of chemo and hasn’t had a reoccurrence of the cancer. Today she runs a support group for ovarian cancer patients called GRACE’S. “Even with the number of years that have passed since I was diagnosed, I know that the cancer could return,” she said. “I consider myself very blessed. I was fortunate to have a GP who listened and acted on my behalf and the referral to the gynecological oncol-
ogist was essential. Now I listen to my body and I take action if symptoms are persistent. I’ve learned to be my own advocate.” Since early detection is so important Hope for Heather will host the annual Teal Ribbon Run and Walk at Lewis Park in Minoa Sept. 19 (see calendar of events in this issue). Last year the run and walk raised $65,000 and 800 people participated even though it was a rainy day, Weeks said. “Forty percent of what we raise goes to research and 60 percent we raise stays here in the community for our educational efforts,” she said. “We try to keep as much money in the community as possible, but we need the research.” Hope for Heather is an entirely volunteer-driven operation. It also makes many other outreach efforts to spread the word about ovarian cancer. It had 140 volunteers working the state fair last year with two booths. It also runs an Angel Fund at the Upstate Cancer Center. The fund helps women with ovarian cancer pay for out-of-pocket expenses like food and transportation for visiting family members. Overall the nonprofit has donated over $150,000 to ovarian cancer research in the last five years, Weeks said. Weeks said that progress is being made in the fight against ovarian cancer, but more research needs to be done. But Hope for Heather’s leader hopes a test can be found soon to diagnose ovarian cancer at an earlier stage so more women might live. If that break through is made tens of thousands of lives might be saved. For more information on Hope for Heather go to www.hopeforheather.org. For information on the GRACE’s support group call Ginger Denny at 315-637-1417 or email ginger@gracesgarden.org.
The Appraisers Road Show IS COMING TO SYRACUSE ANTIQUES • ART • JEWELRY • COLLECTIBLES Saturday, Sept. 19 | 10 am to 5 pm & Sunday, Sept. 20 | Noon to 5 pm
Everson Museum of Art, 401 Harrison Street, Syracuse, NY 13202 Robert Meringolo, former Sotheby’s Associate, is bringing a team of Nationally and Internationally Recognized Experts, including former Sotheby’s & Christie’s appraisers for a two day Appraisers Road Show at the Everson Museum of Art, Syracuse.
The experts will appraise and purchase (if desired) items such as: • Sterling Silver Flatware sets • Antique Toys • Jewelry & Jewels • Dolls • World Wide Stamps • Antique Crocks & Stoneware
• Collectibles • Folk Art • Antique Motorcycles & Cars • Photography & Cameras • Oriental Carpets • Costume Jewelry
• Glassware • Scrap Gold & Silver • Historical Documents, • Military, Guns & Weapons Books, Musical Instruments • Sporting Goods & Collectibles • Patintings • Chinese & Japanese Antiques • Furniture • Clocks & Watches $5.00 Appraisal Fee per Item
By Popular Request Coins, Silver Flatware & Gold Will Be Purchased
A REPRESENTATIVE WILL MAKE HOUSE CALLS AT NO CHARGE FOR THE NEXT 6 MONTHS. No Appointment Necessary!!
For Information call Robert Meringolo 518-937-4976
Westerlo@aol.com www.RobertMeringolo.com Facebook.com/GoToRoadshow September 2015 •
Do You Have a Treasure in Your Attic?
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Page 7
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
The Healing Power of Forgiveness
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ho wouldn’t be angry beyond words? After 38 years of marriage, two children and a lifetime of memories, she arrived home from work one day to find a hand-written note on her nightstand. He had left her to “find himself.” Completely blindsided, she dropped to the bed stunned in disbelief. He was gone. His clothes closet empty. His home office cleared out. With no word about his whereabouts, she racked her brain, desperate to make sense of his bizarre behavior. Had she missed something? Was he ill? And where in the world was he? Days later, her anguish was replaced by anger when she inspected his computer history and discovered that he had met someone online. He and his newfound “soul mate” had scheduled a rendezvous in Florida. It has been four years now since this nightmare, but to hear her talk about it today is to bring everything immediately to the fore — the deep emotional wound, the humiliation and the loss of life as she knew it. The retelling of her ordeal quickly ignites a seething anger just beneath the surface. How could he have done this to her and the kids? How could he have betrayed them? While my friend’s lingering bitterness is understandable, it is also unfortunate. By dwelling on this hurtful event and hanging onto her anger, she
is allowing her resentment and hostility to fester. Left unchecked, she risks bringing negativity into current relationships and experiences, or worse — letting her anger hurt the connections with the people who matter most in her life. I feel for her. Are you holding onto a grudge? Does an abiding bitterness occupy your thoughts? Nearly all of us have been hurt by the words or actions of others somewhere along the way. The wounds may be deep, but if you don’t practice forgiveness, you might be the one who pays the biggest price. While it can feel almost impossible to let go of a long-standing grudge and feelings of resentment, I can tell you from my own experience that forgiveness can bring a measure of peace that may enable you to move on with your life. It might even make room for compassion and understanding. I’ve also learned that forgiveness doesn’t just happen on its own or overnight. You must choose to forgive. It’s a process of change that requires commitment, courage, and self-reflection: Acknowledge and share your pain. Let it all out. Share your suffering with
KIDS Corner Tips for Keeping Your Children Injury-Free During Fall Sports
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any children return to sports such as soccer, football, cross-country and volleyball when they return to school. Physicians in the division of sports medicine at Cincinnati Children’s Hospital Medical Center say preparation before the first day of practice is critical in helping to reduce the risk of injury. According to the American Academy of Pediatrics, approximately 3.5 million children and adolescents 14 and under get hurt annually playing sports or participating in recreational activities. More than 775,000 children and adolescents 14 and under are treated in hospital emergency rooms
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for sports-related injuries each year. Most of these injuries are traumatic in nature and occur as a result of falls, being struck by an object, collisions, and overexertion during unorganized or informal sports activities. More concerning, say Cincinnati Children’s Sports Medicine physicians, is the exponential increase in the number of overuse injuries experienced by young children today. These types of injuries are often the result of excessive training year-round or a rapid ramp up of activity after a period of inactivity. This scenario is common at the onset of any sports season. Doctors in the Division of Sports
IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
someone you trust, and don’t hold back. When there’s someone there to really listen, your pain can become tolerable and perhaps more likely to dissipate. Empathize with the person who hurt you. I know this may not be easy. But none of us is perfect. The person who hurt you may have been acting out of self-preservation, an unspoken fear or pain of their own. Take a hard look at yourself. We all know that there are two sides to every story. What was your role in the breakdown of your relationship or in whatever has contributed to your resentment? Taking personal responsibility for our words and behavior and, importantly, their results is an essential part of forgiveness — not just of others, but of ourselves. Holding onto a victim mentality may serve to validate an unhappy situation, but it can also keep you mired in anger and thoughts of revenge. Embrace the benefits of forgiveness. Forgiveness can be empowering. It can set you free from the past and release the control the offending person has had in your life. There may be health benefits, as well, when you carry
Medicine at Cincinnati Children’s suggest these tips to ensure children’s safety when they return to school sports: • Four to six weeks prior to the onset of any sports season, children should start exercising regularly to get ready for their season. • Acclimate children to hot weather workouts by gradually increasing time outdoors in the heat and humidity. Acclimatization should occur for about the first 10 days to two weeks of practice to help prevent heat injuries. • Make sure children drink plenty of fluids and take frequent breaks: every 10-15 minutes while participating in sports or physical activity. Also make sure they wear light clothing and limit their exposure to the sun in the hottest part of the day. Applying towels soaked in ice cubes and water to the head and neck helps to stay cool. • When heat illness is suspected, move the athlete into the shade or coolest area nearby. Try to cool them as quickly as possible by exposing the skin to ice/ cold water and cool circulating air. • Young
a lighter emotional load. The more I practice forgiveness, the less stress I experience and the better I feel. Focus on the future. Rather than focus on the past and your wounded feelings, seek out positive, healthy relationships and experiences. Put your energy into finding beauty and kindness around you. When you are ready, actively choose to forgive the person who hurt you. Remember, you can forgive the person without excusing the act. Forgiveness is not about condoning. It’s a gift you give yourself — to release yourself from bitterness and vengeful thinking. Reinforce your forgiveness with a symbolic act. In my Living Alone workshops, participants take part in a “letting go” ceremony, during which they symbolically release anger, negative attitudes and unhealthy behaviors into a fire burning brightly in my fireplace. Many capture their thoughts in writing and find some relief in seeing their past hurts go up in flames. Symbolic acts such as this can help the healing process. As you let go of anger, grudges, resentments, and thoughts of revenge, you may no longer define yourself and your life by your past hurts and grievances. When you embrace forgiveness, you are embracing the promise of renewed compassion, kindness, and gratitude. Even some tenderness. Forgiveness can be healing and set you free. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, N. Y. For information about her upcoming workshop, check out the Calendar of Health Events in this issue or contact me at 585-624-7887 or through my email, gvoelckers@rochester. rr.com.
athletes with asthma should use preventative inhalers 20-30 minutes before exercise, do a gradual warm-up and should have an inhaler available to them during practices and during competition. • Make sure children wear any recommended protective equipment and ensure it is well-fitted. Protective equipment, such as helmets, can help prevent severe injuries such as skull fractures. Many head injuries result from helmets not being fitted or used correctly. Athletic trainers can fit helmets in the sports where they are needed. • Remind children to immediately tell the coach or trainer if they feel dizzy, “foggy,” have a lapse in memory, or have a headache after taking a blow to the head. • Parents need to be mindful that athletes who have symptoms affecting their thought process after taking a blow to the head should not return to the same practice, game or contest and should be evaluated by a physician prior to return to play.
SmartBites
By Anne Palumbo
The skinny on healthy eating
More Reasons to Gobble Up Chicken
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et’s not beat around the chicken coop: Heart disease is the No. 1 cause of death for both men and women in the United States; and high consumption of saturated fats raises our risk for this disease. Many of us are aware of this risk and have decreased our consumption of foods high in saturated fat — such as red meats — as a result. In fact, for the first time in over a century, Americans are eating more chicken that beef. Chicken is loaded with lean protein, serving up about 30 grams per average serving of skinless breast meat and just a tad less for skinless thigh meat. Protein is a powerhouse building block for muscles, cartilage, bones, skin and blood. This essential nutrient also makes up the enzymes that power many chemical reactions in our body, from digestion to metabolism. What chicken is not loaded with is fat, especially saturated fat or calories. It’s why so many doctors and nutritionists recommend its consumption over red meat. An average serving of skinless breast meat has only 1 gram of saturated fat and 165 calories, while the same size serving of skinless thigh meat has about 3 grams and 210 calories. How much saturated fat are we
allowed in a day? The Dietary Guidelines for Americans encourage us to limit our saturated fat intake to less than 10 percent of our total calories. Chicken is super rich in niacin, an important B vitamin that helps keep our skin, hair and eyes healthy and also supports our nervous and digestive systems. In addition, niacin plays a key role in converting food to energy and influences how we process cholesterol. According to the Mayo Clinic, consuming a niacin-rich diet may raise our good cholesterol by 35 percent, while also lowering our bad cholesterol and triglycerides (another type of unhealthy fat). Lastly, chicken is a good source of selenium, a trace mineral that does wonders for our thyroid and immune system. A powerful antioxidant, selenium also helps make special proteins
that may prevent the kinds of cell damage that contribute to age-related diseases.
Helpful tips
Buy chicken that’s well-wrapped and then put the poultry in a produce bag to prevent cross-contamination. After prepping the chicken (the USDA advises not to rinse before cooking), wash everything that touched the meat with hot, soapy water. Whatever cooking method you use, the chicken must reach a temperature of at least 165 degrees fahrenheit to make sure all bacteria are destroyed. Buying chickens raised without antibiotics (look for the “USDA Organic” label) supports farmers who keep their chickens off these drugs and also preserves the effectiveness of antibiotics in humans. No hormones are ever used in the production of any US chicken.
Asian Chicken Salad with Cabbage Adapted from The World’s Healthiest Foods 2-3 boneless, skinless chicken breasts 5 cups Chinese cabbage, sliced thin 1 red pepper, sliced thin ½-1 cup shredded carrot ½ cup minced scallion ½ cup sliced almonds, toasted ¼ cup fresh cilantro 2 tablespoons toasted sesame seeds
pinch of red pepper flakes salt and pepper to taste Preheat oven to 350 degrees F. Tent chicken in foil, place on baking sheet and cook for 45 minutes (or until internal temperature reaches 165). Remove, open foil, and let cool. While chicken is cooling, thinly slice cabbage and pepper and shred carrot. Place in large bowl. Add minced scallion, chopped cilantro, and sliced almonds to this mixture. Using your hands, shred chicken into bite-size pieces and add to bowl. Whisk together olive oil, soy sauce, vinegar, honey, garlic, red pepper flakes, salt and pepper. Toss with cabbage-chicken mixture and then sprinkle with sesame seeds. (Double dressing if mixture seems too dry.)
Dressing 2 tablespoons olive oil 2 tablespoons soy sauce ¼ cup rice vinegar 2 tablespoons honey 1-2 cloves garlic, minced
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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Kelleigh Gustafson’s History Diagnosed with arteriovenous malformation at age 4, 19-year old Manlius resident making an impact on the lives of patiens nationwide By Aaron Gifford
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elleigh Gustafson has no recollection of what life was like before she first heard the words arteriovenous malformation, or AVM. Diagnosed with the disease at age 4, Gustafson has always had plenty on her mind, excelling in school and sports and enjoying as active of a social life as possible in between traveling out of state several days each year for surgeries. The 19-year-old from Manlius has set a positive example of living life to the fullest. But even that, she says, is not enough. So Gustafson took it upon herself to raise awareness about this relatively unheard of disease and money for medical research. Her ongoing efforts recently earned recognition from state Sen. John DeFrancisco, who championed a legislative proclamation declaring July 19 through July 26 “AVM Awareness Week in the state of New York.” AVM is a birth defect that causes abnormal blood vessel growth where blood flows very fast through the vessels and raises pressure in the veins; the capillaries that distribute blood to the tissues, however, are missing. Over time, the blood supply to the skin and tissues around the AVM is reduced. It is typically diagnosed and treated in children. The disease, which manifests itself with blotches on the skin and also affects internal organs, can be life-threatening. In Gustafson’s case, the abnormal blood vessel growth has been detected on her brain, which puts her at risk for stroke, paralysis and blindness. Gustafson grew up in Michigan. She is the youngest of four siblings. For as long as she can remember, she has traveled out of state every three to six months for two weeks at a time for treatments, which has included
tracheostomies. She participated in basketball, volleyball and dance despite constant warnings to take it easy. “As I got older, they kept saying you can’t do it anymore,” she said. “It’s too dangerous.” The Gustafsons moved to Manlius after Kelleigh finished middle school, but she continues to travel out of state for care multiple times per year. She is under the care of world-renowned vascular interventional radiologist Patricia Burrows, who is now based at the Children’s Hospital of Wisconsin and previously worked in Boston, New York and Houston. The Gustafsons followed her to all of those cities in order to get the best care available. “She’s basically a friend of the family at this point,” Kelleigh said. “She’s sort of like a mother figure — always reassuring.” She went on to graduate from Bishop Grimes High School and enrolled at Le Moyne College, where she recently began her sophomore year and is studying psychology and occupational therapy. She aspires to work in the medical field some day. She also plays on the golf team, an experience she calls extremely challenging but rewarding. During the summer, she has worked at the Turning Stone Resort and Casino golf courses. During athletic training, Gustafson must monitor her heart rate, which increases at a faster rate than that of her teammates’. She must also be careful not to get hit on the side of her head, and remains aware of her surroundings at all times. “It’s a lot to take on,” she said, “but I love it.” In 2012, Gustafson established the “Kelleigh’s Cause” website aimed at raising awareness of AVM and outreach opportunities for families affect-
Kelleigh Gustafson posing with her doctor in Syracuse, Eric Deshaies, medical director of endovascular and cerebrovascular neurosurgery at Crouse Hospital. He says, “The effort she has put into AVM awareness — locally and nationally — is outstanding. She’s made an obvious impact. She’s selfless in her passion to educate people about AVM. It’s absolutely amazing to do those things at 19.”
ed by it. Then she took on fundraising efforts, which so far have raised more than $100,000 for medical research through events like the “Color Run” in her native Lansing, Mich., and workplace dress down days where employees donate money to the cause in exchange for being able to wear T-shirts and jeans to the office. None of the money raised was used for her own care. “We didn’t want to do that,” she said. While the medical care and regular trips out of state have had a major financial impact on the family, the generosity of others — both loved ones and strangers — has helped the Gustafsons immensely, Kelleigh explained. “We’ve had friends watching [siblings] for us and making us dinner. A family that didn’t even know us let us use their home,” she said. “We’ve just been supported by so many.” Physician Eric Deshaies, medical director of endovascular and cerebrovascular neurosurgery at Crouse Hospital, said there are a few hundred AVM patients in the Central New York region. It’s rare compared to conditions like cancer and heart disease but more common than most people Kelleigh Gustafson ongoing efforts recently earned recognition from state Sen. John DeFrancisco, might think. He said some who championed a legislative proclamation declaring July 19 through July 26 “AVM Awareness Week cases are genetic and others are spontaneous. in the state of New York.” Picture are, from left, Dan Gustafson (Kelleigh’s father), state Sen. John “A number of people DeFrancisco, Kelleigh Gustafson, Lori Gustafson (Kelleigh’s mother), physician Eric Deshaies of have been diagnosed but Crouse Hospital. Page 10
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
don’t know where to get care or treatment,” said Deshaies, who is enlisted as Burrows’ backup in case Gustafson ever needs emergency treatment. Significant medical advances have been made in treating the disease in recent years, Deshaies said. Patients generally require fewer surgeries than they did a few years ago, and specialists now have the ability to apply an endovascular catheter into an artery to look at it. Tiny coils are used to block blood flow and slow down or stop blood vessels from growing. They can also use the Cyber Knife tool, which applies highly precise radiation doses to surgical areas. Before these methods were available, surgeons had to entirely remove blood vessels, resulting in paralysis or loss of certain functions. Current research, Deshaies explained, is focused on genetics. “We’re trying to understand how AVM develops and grows,” he said. “That’s especially important for [detection and treatment in] the brain. When it’s in the brain, there’s no way of knowing until they have a seizure or hemorrhage. Gustafson’s contribution to this work, Deshaies says, is beyond words. “The effort she has put into AVM awareness — locally and nationally — is outstanding,” he said. “She’s made an obvious impact. She’s selfless in her passion to educate people about AVM. It’s absolutely amazing to do those things at 19.” The “Kelleigh’s Cause Golf Outing” to benefit AVM research is scheduled for Friday, Sept. 18 at Turning Stone. A variety of sponsorship levels are available. For more information, or to register, visit http://kelleigh.org/ golf.
Yawn! School Starts Too Early for Teens, CDC Says M
ost U.S. middle and high schools start the day around 8 a.m., which public health officials consider too early for teens, according to a new report from the Centers for Disease Control and Prevention. School start times that are too early can contribute to lack of sleep among teens, most of whom don’t get the recommended 8.5 to 9.5 hours of shut-eye, the report said. In 2014, the American Academy of Pediatrics (AAP) recommended that middle and high schools start no earlier than 8:30 a.m. “Getting enough sleep is important for students’ health, safety, and academic performance,” Anne Wheaton, an epidemiologist in CDC’s Division of Population Health and co-author of the agency’s new report, said in a statement. “Early school start times, however, are preventing many adolescents from getting the sleep they need.” The researchers analyzed information from a survey of nearly 40,000 public middle and high schools (and combined schools, with both middle and high school grades) given in 2011 and 2012. The average school start time was
8:03 a.m., the study found. Only about one in five middle school students, and one in seven high school students started the school day at the recommended time of 8:30 a.m. or later. However, school start times varied greatly by state. In Hawaii, Mississippi and Wyoming, there were no schools starting at 8:30 a.m. or later, but in Alaska and North Dakota, more than 75 percent of schools started at 8:30 a.m. or later, the report said. Schools started earliest in Louisiana, where the average start time was 7:40 a.m., and latest in Alaska, where the average start time was 8:33 a.m. In New York, the average start time was 7:59 a.m., according to the report. Too little sleep in adolescents is linked with health problems such as obesity, symptoms of depression and not getting enough exercise, as well as poor academic performance, the researchers said. “Among the possible public health interventions for increasing sufficient sleep among adolescents, delaying school start times has the potential for the greatest population impact by changing the environmental context for students in entire school districts,”
the researchers wrote in the Aug. 7 issue of the CDC journal Morbidity and Mortality Weekly Report. Educating parents as well as those who make decisions on school start times about the impact of sleep deprivation on teen health and academic performance “might lead to adoption of later start times,” the researchers said. Other steps that can improve sleep in teens include setting regular bedtimes and waking times (even on weekends), and removing technologies, such as computers, video games and mobile phones, from teens’ bedrooms. Because the study looked at school start times in 2011 and 2012, it was not able to determine whether some schools had changed their start times in response to the 2014 AAP recommendation.
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New Law Allows Students to SelfManage Diabetes At School
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s parents get ready to send their children back to school this fall, the parents of children with diabetes have more than backpacks and school supplies to get organized — they must also plan for how their children’s diabetes needs will be met while they are at school. This year, thanks to a new state law, children will be permitted to carry diabetes supplies and self-manage their diabetes at school and at any school function. In addition, school staff members may volunteer to be trained to administer glucagon in an emergency when a nurse is not present. “The school year is always a stressful time for families of children with diabetes,” said Renee Williams, assistant superintendent of the Honeoye Falls-Lima Central School District and advocacy chairwoman for the American Diabetes Association. “Hopefully this new legislation will reduce some of that stress for families, knowing their children will be able to self-manage their diabetes at school and have emergency back-up care in the event that a
nurse is not available.” Under the new law, students who have obtained parental consent and written permission from a physician or authorized medical provider may carry and use diabetes supplies, equipment and food to treat hypoglycemia during the school day, on school property and at any school function. The new law also allows unlicensed staff in both public and private schools to be trained to administer glucagon when a nurse is not present. Severely low blood sugar is very serious. If it happens, loss of consciousness may occur and a person may be physically unable to eat or drink a rapid-acting source of sugar (glucose) to restore proper glucose levels. A glucagon injection would be necessary in this type of emergency. In a news release, the American Diabetes Association states that it fought hard to have these issues addressed in state law and has posted additional information on its website. For more information, visit www. diabetes.org/nyschools.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
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Men’sHealth Men, Too, Are Affected by Eating Disorders One-third of the approximately 30 million people struggling with eating disorders are men By Deborah Jeanne Sergeant
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ost people think only young women concerned about a slim appearance experience eating disorders. Fact is, one-third of the approximately 30 million people struggling with eating disorders are men, according to the National Eating Disorders Association. “Male eating disorders are often overlooked or underreported,” said Dorothy Dellefave, registered dietitian and clinical nutrition manager at Auburn Hospital. Typically, most eating disorders occur in younger people, although no age is immune. The reasons behind the eating disorders differ between the genders. Among young women, obsession with appearance and low weight drives many to eating disorders. Many men who develop eating disorders do so from involvement in certain sports. While there’s some truth to the fact that a lighter body will result in a faster run time than a heavier one, a competitive person who wants to excel can easily fall into an eating disorder if other factors come into play. “Despite all the negative [side effects], the eating disorder provides them with an important function,” said Clark Pinson, a psychologist practicing in Syracuse. Eating disorders can help people feel like at least one area of their lives is completely in their control, especially if other areas of life seem out of control. “Many people cope with mental disorders by developing eating disorders,” said physician Rich Kreipe, medical director of the WNY Comprehensive Care for Eating Disorders in Rochester. “It’s not a mental illness but a developmental illness. They may feel like they can’t control anything, see ads for weight control products, and say they can do that on their own. It’s a sense of accomplishment that they can-
not eat when everyone around them is eating.” Typically, overweight people trying to drop pounds or athletes who want to perform better feel content once they reach their goals. People with an eating disorder never “arrive” at the ideal body. Males often focus on bulking up, if they’re football players or bodybuilders, so it’s not always about getting light but cutting bodily fat and building muscle in unhealthy ways. This can include excessive protein consumption or eliminating fat from the diet. Eating disorders can cause nutritional deficiencies, lifelong health issues and, left untreated, death. Addressing possible eating disorders in a confrontational manner invites resistance. But urgency may be warranted. “The type of eating disorder makes a difference in the response because some are life-threatening, like anorexia,” said Mitchell Jaffe, a licensed marriage and family therapist practicing in Syracuse. “Purging may not be as immediate.” Jaffe suggested arranging a physical as a subtle approach for a person not in immediate danger. “You can let the physician know ahead of time [about suspicions of an eating disorder] so they know to look for things,” Jaffe. “Most people with eating disorders won’t come out and say, ‘I have an eating disorder.’” Instead of trying to diagnose, express concern about nutrition and observable health indicators, like lack of energy. Suggest that visiting a medical provider can help his sports performance. And reminding the athlete that losing too much weight can actually detract from his performance if he loses too much muscle tissue and nutrients. Asking the coach for help may backfire, as not all coaches are up
Does Your Son Have Eating Disorder? Could your son have an eating disorder? Dorothy Dellefave, registered dietitian and clinical nutrition manager at Auburn Hospital, said that eating disorders can include “many different behavioral, emotional, mental, and physical characteristics” which can include these signs from of www.nationaleatingdisorders.org/ males-and-eating-disorders: • Excessive dieting, fasting, restricted diet • Food rituals • Preoccupation with body building, weight lifting, or muscle toning • Compulsive exercise • Difficulty eating with others, lying about eating • Frequently weighing self • Preoccupation with food • Focus on certain body parts; e.g., buttocks, thighs, stomach • Disgust with body size or shape • Distortion of body size; i.e., feels fat even though others tell him he is already very thin • Intense fear of becoming fat or gaining weight • Depression • Social isolation • Strong need to be in control • Rigid, inflexible thinking, “all or nothing” • Decreased interest in sex or fears around sex • Possible conflict over gender identity or sexual orientation • Low sense of self-worth—uses weight as a measure of worth to speed on nutrition as it relates to health. Some fall into the trap of telling their athletes what to do to get the results they want instead of how to become healthy to perform their best. Seek good sources of nutritional information such as from a registered
dietitian or physician. Many commercial websites offer information that’s stilted to sell a product. Instead, seek academic sites, such as the website of the Academy of Nutrition and Dietetics (www.eatright.org).
Jacquie lost 100 lbs. and found a whole new perspective. Sitting down for storytime with her students was hard. Getting back up was nearly impossible. But since Jacquie had weight-loss surgery, she’s found the energy to keep up with her class. Jacquie also found a compassionate team at Crouse. From trusted surgeons and nutritional experts to an ongoing support group that’s with her every step of the way. Hear Jacquie’s
Is Weight Loss Surgery Right for You? Upcoming Free Seminars: Sept. 8 • Sept. 17 To register: crouse.org/weightloss 315/472-2464
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ASSOCIATED MEDICAL PROFESSIONALS & ZERO - THE END OF PROSTATE CANCER HELPING SAVE LIVES TOGETHER!
Men’sHealth No to Steroids
Incredible bulk or Incredible Hulk?
A
SEPTEMBER IS PROSTATE CANCER AWARENESS MONTH! A.M.P., with the support of ZERO and other local healthcare partners is holding a free community prostate cancer screening for men who are uninsured, underinsured or lack access to healthcare for the wellbeing of our community. For more information call Jason Warchal @ 315.433.5645 “What many men do not realize is that prostate cancer if caught early can most often be successfully treated. So, men should not avoid the topic. When it comes to your health, knowledge is power,”says David Albala, MD, Medical Director of A.M.P. We recommend that men have a baseline Prostate-Specific-Antigen (PSA) blood test and a digital rectal examination test at age 40.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
lot of hard work, practice and dedication can help you sculpt a well-muscled body, but anabolic steroids will get you there a lot faster. What will it cost you, though? To help sort speculation from fact about the side effects, Clarkson University assistant professor of physical therapy and physician assistant studies Ali Boolani and two of his students have just published an opinion paper in Medical Research Archives. The short side of the long story of their research-based conclusion is: Don’t use steroids. “It’s a hot topic, but we can’t do clinically based steroid research. It’s illegal and unethical,” says Boolani. “We started this project last summer to explore what’s known on side effects, and my students spent hundreds of hours each sifting through current information.” The allure of a bigger, stronger, faster body is as enticing as the huge paychecks professional athletes can command, but the use of anabolic-androgenic steroids (synthetic testosterone) also creates some powerful and contradictory conditions, according to
Boolani and students Britni R. Keitz and Holly S. Bronson. Side effects include: acne, increased body hair, aggressive behavior, fluid retention, elevated blood pressure, sleeplessness, increased irritability, feelings of low libido, increased sex drive, increased appetite, sweating, increased feeling of well-being, depressive mood states, loss of head hair, and gynaecomastia (enlarged breast tissue in men). “I found a lot more new research, so I added it and tried to get two sides of the issue but there’s a lot of inconsistent data. Much of the information on steroid use is from questionnaires,” Keitz says. “I found it amazing, though, what psychological changes the studies report — depression and homicidal feelings.” Bronson adds, “It’s sad to risk your health to get ahead. This research can help open people’s eyes to the negative effects of steroids so they can make an informed decision before they take anything.” The paper, “The Effects of Anabolic Androgenic Steroids on Performance and its Adverse Side Effects in Athletes” is published in Issue 1, 2015, of Medical Research Archives.
Community Information Seminar:
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To register call 315-477-4740 or toll free 877-269-0355 Parking will be validated
My Turn
By Eva Briggs
Treating Swollen Eyelid Avoid the heat, just apply an ice pack or cool compress
E
very summer I’ll see a few patients with an impressively swollen eyelid from an insect bite or bee sting. It happens because female mosquitoes — they’re the only sex that feeds on blood — inject you with saliva after poking their proboscis through your skin. The insect’s saliva is full of anticoagulants, blood thinners that allow your blood to flow freely into the hungry mosquito without clotting before she’s finished. Once the female flies off, some of that saliva remains in your skin. Your body recognizes this as foreign material, and sends in the immune system. Your immune system makes antibodies that bind to antigens in the saliva, triggering the release of histamine. This, in turn, makes nearby tiny blood vessels leaky, letting fluids seep out into adjacent tissues. Your eyelid has many blood vessels, so a mosquito bite to the eye can trigger impressive swelling, rather than a mere small bump. The same scenario happens when a bee or wasp injects you with venom during a sting. The best treatment is an ice pack or cool compress, because cold constricts blood vessels, making them less leaky. Heat will just make things worse, allowing more fluid to leak out,
producing more swelling. Your head is elevated above your heart while you are upright. That’s is good for swelling. But when you lie down at night, the elevation is gone, and your eyelid will swell more overnight. That can look terrible in the morning. Sleeping in a recliner chair to elevate your head can help. An antihistamine, like Benadryl, Zyrtec or Claritin relieves itching.
Contact dermatitis and other problems
Another common reason for eyelid swelling is contact dermatitis — a reaction to something that touches the skin. Poison ivy is one example. The triggering substance is often tricky to figure out. Anything you touch with your hands may get onto your eyelids when you inadvertently touch your eyes. The thicker skin on your hands may not react, while the more delicate eyelid tissue turns red, itchy, and inflamed. Because cosmetics are a common cause, eyelid contact dermatitis is more prevalent in women. Infections can cause your eyelids to swell. Because the eyelid is a complex structure with lots of components, there are many types of infections. Viruses or bacteria may infect the skin itself. Shingles, caused by the same virus as chicken pox, can cause blisters,
redness, pain, and swelling. That’s miserable enough, but if the shingles virus affects the cornea of the eye, that’s worse. It can lead to scarring and vision loss. The cornea is more likely to be affected by shingles when the tip of the nose has shingles blisters too. Staph and strep germs are the most common bacteria causing cellulitis or infection of the skin. Behind your eyelids is a layer of tough connective tissue called the septum. It serves as a barrier separating the eyelids and more superficial structures from the orbit (eyeball) and other deeper structures. An infection of the tissues in front of the septum — preseptal or periorbital cellulitis — is unpleasant and potentially serious. But an infection of the tissues behind the septum — orbital cellulitis — is very dangerous because it can quickly destroy the eye or spread to the brain. Orbital cellulitis caused by the bacteria “Hemophilus influenza” used to be something that every doctor caring for young children saw with some regularity, until a vaccine introduced in 1985 made it very rare. Most people are familiar with the
tear glands. They’re located in the upper outer lid. When they are inflamed, it’s termed dacryadenitis. Your tears collect at the inner corner of the lower eyelid in the lacrimal sac and duct. Inflammation of these structures is dacrycystitis. But there are also smaller glands to produce sebum (meibomium glands) and sweat (glands of Zeiss or Moll). While you might not recognize the names of these structures, when they’re inflamed they produce the familiar stye, a nodule along the edge of the eyelid. Another common eyelid problem is blepharitis, inflammation at the base of the eyelashes. One simple treatment that may help is washing the eyelids once or twice a day with diluted baby shampoo. I had to laugh when one patient balked at this suggestion, because he did not want to spend money on baby shampoo. Even though a bottle from the dollar store would probably be a year’s supply. He asked why he couldn’t just use the shampoo he already had at home. Clearly he was not thinking that through! Any benefit from reducing the bacterial numbers on his eyelid margins would have been more than offset by the irritation of getting shampoo in his eyes. Sometimes it doesn’t pay to be penny-wise and pound-foolish. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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FOR MORE INFORMATION OR TO MAKE A REFERRAL CALL 315-464-1500. WWW.UPSTATE.EDU/UROLOGY September 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Women’s Health Special issue of In Good Health coming in October. To advertise, please call 315-342-1182 or email editor@cnyhealth.com
Parenting By Melissa Stefanec melissa@cnyhealth.com
Backstrokes and Back Stories
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
here are the lessons you try to teach your kids and, then, there are the lessons your try to teach yourself. These grown-up lessons are the ones I strive to model for my children. One of those lessons has been running through my mind a lot lately. I will call it the backstrokes and back stories lesson. It was born of a small confrontation I had in a pool. A month or so ago, my schedule and stress level were out of control. My children had been sick, I had been on deadline at work, I was working extra hours, my baby had been refusing to sleep, and my self-nurturing tank was at a record low. I had been eating poorly and skipping exercise. Something needed to give. So, one morning, after minimal sleep, I decided I was going to the gym to swim. I set the alarm extra early and tried to get out the door. After nursing, packing and toddler meltdowns, I was running behind schedule. When I arrived at the pool, there was one spot open in a lane with an elderly woman swimming in it. She wasn’t looking up. Typically, you ask a person if you can swim in the lane with him or her. Every time this woman turned laps, I waved and said excuse me. She gave me no response. She had been swimming in the middle of the lane, but then she moved over to the side. I thought she had seen me. I had less than 15 minutes to swim, so I started swimming. A few laps later, she stopped me and reamed me out. She chastised me like I was child. She told me she didn’t know I swimming next to her and how dangerous that was. I was livid, but I barely responded. I didn’t want to fire off raw emotion at an old lady. I spent the next several laps thinking of what I was going to say to her when I reamed her out. I thought she had seen me and moved to the side for me. Just like it was my job to ask her to share her lane, it was her job to pay minimal attention to the people around her. I shouldn’t have to spend seven of my 15 minutes of exercise time doing a poolside dog and pony show to get her to acknowledge my existence. I hadn’t worked out in weeks, because I had a sick kid. I barely slept. I barely had time for a real meal. I was working two jobs. All I wanted were 15 measly minutes to do something for myself, and her distracted self was robbing me of that. I was going to ask her if she had children and if she remembered what the early years of child-rearing were like. Did she remember the sleepless nights, the self-deprivation, the endless demands? Did she stop to think
about my side of the story? Who died and made her the inattentive pool police? Man, I was going to, respectfully as possible, lay into her. My moment of glory came. We were both at the end of the pool at the same time. She was taking a breather between laps. I was about to lay it on the line for Mabel the Pool Queen, when my rational side kicked in. I knew nothing about this woman, other than she liked doing the backstroke, wasn’t paying attention and liked to chastise people. In all reality, I didn’t know her side of the story. For all I know, Mabel’s mother or sister might have died the day before. Maybe Mabel had an ailment that was robbing her of sleep. Maybe she had an accident in the pool last year and it laid her up and robbed her of her only form of recreation. Maybe Mabel was just a crotchety old lady who felt the world owed her something. Maybe she had been a disrespectful, authoritative jerk all of her life. Maybe she was just in the midst of a really horrible time. The point is, I didn’t know. I was going to lay into her for not knowing where I was in life, when I had no idea where she was in hers. Even my exhausted mind could realize that wasn’t fair. So, I did open my mouth, but what came out wasn’t fire. I simply explained I hadn’t meant to frighten her or endanger her. I tried getting her attention several times, and when she moved to the side of the lane, I assumed she had seen me. Mabel and I apologized to each other and went about our ways. That was the end of it. So back to how this relates to parenting. There are a lot of problems in this world, but I think so many of them could be solved if we extended more empathy to one another. As we go through life, we often get cross with people for not knowing where we are coming from. We get frustrated and want people to walk a mile in our shoes. We focus on us. I want to teach my children to acknowledge that you don’t know most people’s histories. You haven’t walked anywhere in that person’s shoes. You are as ignorant of that person’s story as he or she is of yours. So, before you act, acknowledge that and proceed accordingly. When it doesn’t jeopardize you, give others the benefit of the doubt. We all want that treatment, but the only way we will get it is by extending it to others. I will call it my backstrokes and back stories parable, and my children will think I am lame. I can handle that label. It’s way better than the jerk-who-chastises-old-ladies-in-pools label.
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Medicare Options for Retirees Who Travel Dear Savvy Senior, What are the best Medicare coverage options for retirees who travel a lot? Almost 65 Dear Almost, The best Medicare options for retirees who travel extensively depends on your destination. Let’s start with a quick review of the different coverage choices Medicare offers beneficiaries today.
One option is Original Medicare, which has been around since 1966, and covers (Part A) hospital services and (Part B) doctor’s visits and other medical services. If you choose Original Medicare, you may also want to get a Medicare (Part D) prescription drug plan (if you don’t already have coverage) to cover your medication costs, and a Medicare supplemental (Medigap) policy to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles. Or, you could get Medicare Advantage (Part C) plan, which is sold through private insurance companies, that covers everything Original Medicare covers, plus many plans also offer prescription drug coverage and extra services like vision, hearing and dental care all in one plan. To help you evaluate your options, the National Council on Aging offers an online tool at MyMedicareMatters. org, and your State Heath Insurance Assistance Program (SHIP) provides free Medicare counseling — call 800677-1116 for contact information. You can also shop and compare Medicare health and drug plans and Medigap policies at Medicare.gov/ find-a-plan, or call 800-633-4227. Also note that whatever Medicare plans you choose to enroll in, if you find that they are not meeting your needs or your needs change, you can always switch to a different plan during the open enrollment period, which is between Oct. 15 and Dec. 7.
U.S. Travel
If you and your husband are planning to travel domestically, Original Medicare provides coverage everywhere in the U.S. and its territories (this includes all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands and American Samoa)
as long as the doctor or hospital accepts Medicare. But if you have a Medicare Advantage plan, your coverage may be restricted. This is because most Medicare Advantage plans (which are usually HMOs or PPOs) require you to use doctors, hospitals and pharmacies that are in the plan’s network within a service area or geographic region. So if you’re traveling outside that area, you may need to pay a higher fee, or your services may not be covered at all. Before enrolling in a Medicare Advantage plan, check the benefit details carefully to see what costs and rules apply when traveling outside your service area.
Traveling Abroad
If you’re planning to travel abroad, Original Medicare does not provide coverage outside the U.S. including cruising, except in rare cases, and Medicare drug plans will not cover prescription drugs purchased outside the U.S. either. But, there are some Medigap policies that do provide limited coverage abroad. Medigap C, D, F, G, M, and N plans will pay for 80 percent of medically necessary emergency care outside the U.S., but only for the first 60 days of the trip, and you have to meet an annual $250 deductible first. There’s also a lifetime maximum benefit of $50,000, so you’d need to cover any costs above that amount. If you have a Medicare Advantage plan, your coverage outside the U.S. will depend on the plan. Some plans offer emergency care coverage while others don’t. You’ll need to check your plan for details. If you want additional emergency medical coverage when traveling abroad, some good shopping sites are squaremouth.com and insuremytrip. com, which compare policies from major travel-insurance companies. Prices vary considerably, ranging from under $100 to several hundred dollars depending on your age, what they cover and how long you’ll be away. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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www.seniorshelpingseniors.com
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 17
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Pediatric Cardiology Associates, LLC For over 40 years, Pediatric Cardiology Associates, LLC has been providing cardiovascular services throughout the Central New York region, to children and young adults with congenital heart disease. PCA performs noninvasive services, including fetal, transthoracic and transesophageal echocardiography, EKG services, stress/exercise testing and MRI/MRA. Accepting referrals from pediatricians and primary care physicians. 725 Irving Suite 804, Syracuse, NY 13210 Phone (315)-214-7700 | Toll Free (877) 404-5868 | Fax: (315) 214-7701 ❤ Marie S. Blackman, M.D., Director Emeritus ❤ Matthew Egan, M.D. ❤ Nader H. Atallah-Yunes, M.D., FACC ❤ Daniel A. Kveselis, M.D., FACC ❤ Craig J Byrum M.D., FACC ❤ Frank C. Smith, M.D., FACC Page 18
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
Provided Deborah Banikowski, Social Security OfficeSocial Security Office
This Childhood Cancer Awareness Month: Benefits Abound
C
ancer can affect any one of us, be eligible for SSI. Contact Social Secuat any time. Sadly, thousands of rity right away to find out if the income people under the age of 20 are di- and resources of the parents and the agnosed with cancer every year, and it child are within the allowed limits, and remains the leading cause of disease-re- to start the SSI application process. lated death for children. • Fill out the online child disabilIn September, we honor the ity report. At the end of the strength and courage of children report, we’ll ask you to sign who are battling the many forms a form that gives the child’s of cancer, as well as the young doctor(s) permission to give us Americans who have lost their information about his or her lives to these terrible diseases. disability. We need this inforSocial Security provides mation to make a decision on benefits for children who suffer your child’s claim. You can acfrom many disabling diseases, cess the child disability report including some forms of cancer. at secure.ssa.gov/apps6z/ These benefits could help with i3820/main.html. the additional costs of caring for Banikowski Social Security also has an an ill child. The Supplemental obligation to provide benefits Security Income (SSI) program pays quickly to applicants whose medical benefits to disabled children who have conditions are so serious that they limited income and resources. obviously meet our strict disability If you wish to apply for benefits standards. for your child, you’ll need to complete Social Security’s compassionate both an application for SSI and a child allowances program enables us to idendisability report. The report collects intify diseases and other medical condiformation about your child’s disabling tions quickly that invariably qualify condition, and about how it affects his under the listing of impairments based or her ability to function. on minimal objective medical informaHere are the steps to apply. tion. The compassionate allowances • Review the child disability starter list allows Social Security to identify kit. This kit answers common questions the most seriously disabled people for about applying for SSI benefits for allowances based on objective medical children, and includes a worksheet that information that we can obtain quickwill help you gather the information ly. Compassionate allowances is not you need. You can view the starter kit a separate program from the Suppleat www.ssa.gov/disability/disabilimental Security Income program. You ty_starter_kits_child_eng.htm. can learn more about compassionate • The SSI program is a “needsallowances at www.socialsecurity.gov/ based” program for people who have compassionateallowances. low family income and resources. SSI No matter what month it is, Social has strict limits on the amount of inSecurity is here to provide benefits come and assets you can have and still those with severe disabilities. If you or anyone in your family needs assistance, visit www.socialsecurity.gov/disability.
Q&A
Q: I heard that my disability must be expected to last at least one year to qualify for Social Security disability benefits. Does this mean I have to wait until I’ve been disabled an entire year before applying for disability? A: No. If you believe your disability will last a year or longer, apply for disability benefits as soon as you become disabled. Processing your application can take an average of three to five months. If your application is approved, we’ll pay your first Social Security disability benefits for the sixth full month after the date your disability began. For example, if your state agency decides your disability began on Jan. 15, we’ll pay your first disability benefit for the month of July. We pay in the month following the month for which benefits apply, so you’ll receive your July benefit payment in August. For more information about Social
Security disability benefits, refer to our publication, “Disability Benefits,” at www.socialsecurity.gov/pubs. Q: How do I apply for disability benefits? And, how long does it take to get a decision after I apply for disability benefits? A: You can apply for disability benefits online at www.ssa.gov/disabilityssi/apply.html. To get a decision on your disability application usually takes three to five months to. The time frame can vary depending on • The nature of your disability; • How quickly we can get your medical evidence from your doctor or other medical source; • Whether it’s necessary to send you for a medical examination; and • Whether we review your application for quality purposes. Learn your claim status at www. socialsecurity.gov/claimstatus.
H ealth News Jeff Kirshner appointed to prestigious oncology group
establishing treatment guidelines, providing educational programs and publishing peer-reviewed journals.
Physician Jeffrey J. Kirshner, medical hematologist/oncologist and partner at Hematology-Oncology Associates of CNY, was recently invited to serve as a member of the Clinical Practice Guidelines Committee (CPGC) in June of 2015. In addition, he serves on three breast cancer expert panels and the Practice Guidelines Implementation Network (PGIN) for the American Society of Clinical Oncology (ASCO). The CPGC committee oversees all of the clinical practice guidelines for ASCO, many of which are used worldwide. “These guidelines set the standards for cancer treatment around the globe,” said Hematology-Oncology Associates CEO, Maryann Kirshner Roefaro. “We could not be more proud of Dr. Kirshner’s accomplishments and his contribution to the future of cancer care.” ASCO is the world’s leading professional organization representing physicians who care for people with cancer. With more than 25,000 members, ASCO is committed to improving cancer care through scientific meetings,
Crouse appoints director of provider services Crouse Hospital has named Carleen Pensero to the new position of director of provider services. Pensero comes to Crouse after having spent 15 years at St. Joseph’s Hospital, most recently as patient access director. Prior to that, she served as medical staff services director and business development director for St. Joseph’s. Pensero has extensive experience in physician relations and recruitment; contract management; and physician referral relationship development. In this new role, she will be responsible for providing leadership, staff development and financial and operational oversight to the following areas and Pensero departments: ED providers; hospitalists, GI hospitalists; neurology; and the Community Memorial Hospital ED / hospitalist program. Pensero has an MBA from Colum-
Oswego Hospital Nurses Volunteer at Cub Scout Camp
Oswego Hospital nurses who volunteered with Cub Scouts camp are, from left, Kathryn Pagliaroli, Jennifer Bonning, Brandi Engle, Theresa FitzGibbons and Andrea Pylak-Wehunt, along with Betsy Gazda, district commissioner for the Ontario District of the Boy Scout’s Longhouse Council, who is also an administrative assistant at Oswego Health. Five Oswego Hospital registered nurses each volunteered an evening this summer to help support a local Cub Scout camp. The Cub Scouts, who were from throughout Oswego County and in grades kindergarten through fifth, took part in the weeknight twilight camp held at the Oswego County Airport. The theme for the camp, take flight, included touring a small private airplane along with taking
part in related crafts and science activities each night. The nurses ensured that the Scouts were safe throughout the camp and lent a helping hand when needed. “The Cub Scouts are an important part of our community and I was happy to volunteer my time,” said Kathryn Pagliaroli, Oswego Health director of clinical quality and patient safety.
Happy 103rd Birthday Gladys Rappleye, a resident of Springside at Seneca Hill in Oswego, has recently celebrated her 103rd birthday. Members of her family brought her a birthday cake and she was given a card shower, where she received more than 60 cards. A former longtime resident of Palermo, Rappleye worked as a bookkeeper for 35 years at the now closed Frank G. Wells store in Oswego.
bia College and is a 2011 graduate of Leadership Greater Syracuse. “As we continue to develop the Crouse Health Network — which includes a strategic focus on closer alignment with physicians and other providers, as well as enhanced communication with our physician groups — this position is critically important,” says Crouse Chief Medical Officer Seth Kronenberg.
Oswego has new director for emergency services Oswego Hospital recently welcomed physician Wajeeh Sana as medical director of emergency services. Sana attended medical school in Pakistan and completed his family medicine residency at St. Vincent’s Mercy Medical Center in Toledo, Ohio, where he served as chief resident. During his residency, he was presented the Thomas Clever MD Award for providing comprehensive and compassionate care to patients. He has been Sana providing care in the hospital emergency’s department since 2012. In his new role, among his immediate goals is to reduce patient wait times and ensure that each patient has an excellent customer service experience. Sana arrives at Oswego Hospital with management experience, as he previously served as the medical director for Cayuga Emergency Physicians. He has also worked for Lifetime Health Medial Group’s urgent care center in Rochester. Oswego Hospital’s emergency department provided care to 25,600 visitors in 2014.
St. Joe’s sleep lab receives accreditation St. Joseph’s Hospital Janus Park Sleep Laboratory in Liverpool recently received program accreditation from the American Academy of Sleep MediSeptember 2015 •
cine (AASM). “St. Joseph’s Sleep Laboratory is an important resource to the local medical community and will provide academic and scientific value in addition to the highest quality care for patients suffering from sleep disorders,” said Nathaniel Watson, AASM president. To receive accreditation for a fiveyear period, a sleep center must meet or exceed all standards for professional health care as designated by the AASM. These standards address core areas such as personnel, facility and equipment, policies and procedures, data acquisition, patient care, and quality assurance. Additionally, the sleep center’s goals must be clearly stated and include plans for positively affecting the quality of medical care in the community it serves. “The accomplishment of achieving voluntary accreditation by the American Academy of Sleep Medicine is a direct result of the outstanding sleep program under the medical direction of Dr. Edward Downing, as well as the support provided by the administration of St. Joseph’s Hospital,” said Neil B. Widrick, manager of the hospital’s sleep laboratories. “I’m proud to say the sleep program is staffed by an incredibly talented staff; we have the largest number of registered sleep technologists of all area sleep centers. Our entire focus is to improve life for people with sleep disorders.”
Upstate announces appointment, honors • Physician Leslie J. Kohman, distinguished service professor and medical director of the Upstate Cancer Center, is one of 23 individuals to receive a 2015 St. George National Award from the American Cancer Society. The award recognizes Kohman for demonstrating ongoing leadership in the community to further the society’s mission to fight cancer. Kohman began her volunteer career with the American Cancer Society in 2000 as a member of the Central New Kohman York region’s advi-
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H ealth News sory board. • Physician Wei Song has joined the department of pathology as assistant professor, having extensive experience in molecular pathology and, in particular, Next-Generation Sequencing. At Upstate, he will play a key role in establishing the new Next-Generation Sequencing Laboratory to be located in the Central New York Biotech Accelerator. Prior to Upstate, Song was a surgical pathology fellow at Tufts Song Medical Center in Boston. He received his medical degree and a master’s degree in pharmacology at Shanghai Medical University, Shanghai, China; his doctorate degree at the University of Pennsylvania in Philadelphia. • Kathi Durdon has been named director of operations for the Central New York (CNY) Biotech Accelerator, a division of Upstate Medical University. In this role, Durdon will assist biotech and biomedical for-profit start-up companies become viable businesses in the region; develop and promote grant and venture capital opportunities, service and mentor program process, and implementation of expedient standard operational procedures in management of Durdon a state-of-the-art biotech and biomedical accelerator. She will also serve as an adjunct instructor for SUNY Empire State College. Durdon is a certified clinical research professional (CCRP), and a member of the Association for the Advancement of Medical Instrumentation (AAMI) Human Factors Committee. Durdon previously was employed at Welch Allyn as manager of clinical operations. • David P. Anthony has been appointed assistant vice president for finance and budget for Upstate Medical University, responsible for overseeing the activities of accounting and budgeting, bursar’s office, research accounting and compliance, property management and duplicating. In addition, he oversees Upstate’s tax-exempt auxiliary services corporation and its tax-exempt property-holding corporation. Prior Anthony to joining Upstate’s department of accounting and budget, Anthony spent 18 years at Upstate University Hospital, where he served most currently as financial controller. • Physician Arnold M. Moses received a crystal plaque and a letter of recognition from the American PhysPage 20
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iological Society, honoring him for his 50-year membership. Moses is a SUNY distinguished service professor of medicine and director of the metabolic bone disease program at Joslin Diabetes Center. Moses
Franciscan Lifeline takes over VNA program Franciscan Companies, an affiliate of St. Joseph’s Health, has acquired the Visiting Nursing Association (VNA)’s Lifeline program. The Lifeline Medical Alert system protects people in case of falls. VNA’s 300 customers are now part of the Franciscan Lifeline family. “By merging our Lifeline programs, our organizations are closer together and we can now bring Franciscan’s full range of services to all VNA customers,” said Beverly Lawton, executive director of Franciscan Lifeline. “In the changing healthcare environment, mergers and consolidations are more common. We are reducing costs yet still providing the same high level of care to these customers.” “We’re pleased that we’re working with a community partner that provides high quality service to its clients,” said Andrea Lazarek-LaQuay, chief clinical officer, VNA Homecare. “There was no reason to have two similar Lifeline programs in our community. This allows Lifeline subscribers to still get excellent service through the same provider.” The transition was seamless for VNA Lifeline customers. They received a letter explaining the move over to Franciscan Lifeline but their service continued with no changes or interruptions. Franciscan hired VNA’s Lifeline installer and added him to the Franciscan Lifeline team.
CAC welcomes interns Ogden and Carbonaro Karrie Damm, executive director of the Child Advocacy Center of Oswego County (CAC) has announced that Rachel Carbonaro and Katie Ogden have been accepted as interns at the CAC. Carbonaro, who holds an associates degree in humanities and social sciences from Onondaga Community College and bachelor’s degree in psychology, is currently seeking her master’s degree in mental health counseling at SUNY Oswego. Ogden, also pursuing her master’s degree Carbonaro at SUNY Oswego,
IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2015
earned bachelor’s degrees in psychology and criminal justice at Shenandoah University in Virginia. CAC provides a wide range of free services to children who have been physically or sexually abused and provides a safe, child-friendly site Ogden for the investigation, prosecution and treatment of child abuse.
Visiting Nurse Association Celebrates 125th Anniversary In 1890, three women established an organization that would change the face of health care in Central New York forever — the Visiting Nurse Association. Juliet Hanchett, Laura Bisset Mills and Arria Huntington founded the organization on the principles of commitment, respect and general benevolence. 125 years later, the Visiting Nurse Association of Central New York (VNA), a division of VNA Homecare, reflects on its history of dedicated service to the community. “One of the things that makes the VNA so special to so many is how dedicated the organization is to staying patient-centered,” said VNA Homecare Options Care Manager Supervisor Bill O’Hern. “No matter the obstacle, our patient’s needs come first.” The VNA has played an important role improving the lives of its patients. During the late 1920s, when the Spanish Influenza Pandemic was at its peak, the organization was able to keep the death rate of its patients to 5 percent. While the devastation of the Great Depression ravaged the country during the 1930s, the organization never ceased operation. The organization also played a major role in the reduction of Syracuse’s tuberculosis death rate, which fell from 147 deaths per 100,000 people in 1908 to 48 per 100,000 in 1934 — a rate less than that of any other city in the country. As the health care industry evolved and adapted to new technologies and innovations, the perseverance of the VNA’s employees held strong. As recollected by VNA Homecare’s Clinical Supervisor Cindy Parkinson, “The first year that I worked at the VNA [1981], there was no such thing as 9-1-1,” she said. “I remember performing CPR on a man whose heart had stopped beating while simultaneously trying to tell the telephone operator where to send an ambulance. Thankfully, my patient lived, and I have never seen someone so grateful. It is moments like this that
you remember for the rest of your life.” The VNA now operates as one of eight entities under VNA Homecare’s corporate umbrella. With a reputation as one of the most trusted, respected and widely-known home care systems in this region, VNA Homecare’s other entities include the VNA Foundation of Central New York Inc.; CCH Home Care and Palliative Services, Inc.; Independent Health Care Services, Inc.; Home Aides of Central New York, Inc; Eldercare Social Day Program; the Eldercare Foundation, Inc.; and VNA Homecare Options, LLC, a Medicaid Managed Long Term Care Plan that provides services to 48 counties in New York State. According to VNA Homecare’s Vice President of Patient Services Gail Carmichel, the organization’s ability to adjust to change over the years has been one of the leading contributors to its success. “A huge strength of VNA has always been its ability to seamlessly adapt to the changing times,” said Carmichel, “As healthcare changes, the VNA responds to what the community needs, and always stays patient-centered in everything it does. We work to thrive — not just survive.” Although care is still prominently provided in patient’s homes, advances in technology have made it possible for the VNA’s patients to be “visited” daily through the use of monitoring equipment. This allows a nurse to review a patient’s vital signs and other information from a central station and identify possibly life-threatening changes in health before the patient ever notices any symptoms. “One of the most amazing things about the new technology we have is the opportunity it has given us to keep patients with even the highest acuity in their homes,” said Parkinson. “We have had great success in transforming over the years to be able to treat these patients at home, and teach their families how to care for them.” Technological and medical advances will continue to bring innovation to the work of the VNA, but the idea put into action by the dedication and ingenuity of the agency’s founders will remain at its core. “As the parent company of the VNA, VNA Homecare extends its sincerest appreciation to those who have believed and supported the organization’s mission and values over the years,” said President and Chief Executive Officer Kate Rolf, “We look forward to continually serving this community for many years to come.” To celebrate the 125th anniversary celebration, VNA is holding a Barn “Raise”ing event on Sunday, Oct. 4, from 1to 4 pm at the Mandana Barn in Skaneateles. Tickets are $50 and can be purchased by calling 315-477-9301 or visiting www.reimaginevna.org.
Pink Pill for Women to Hit Pharmacies in October Local doctor cautious about effectiveness of new ‘Viagra’ for woman By Deborah Jeanne Sergeant
D
iminished libido? Now there’s a pill for that. On Aug. 18, the US Food and Drug Administration gave the green light to Addyi (flibanserin) for treating low sex drive in premenopausal women. It’s the first approved libido pill for either gender in the US. “Today’s approval provides women distressed by their low sexual desire with an approved treatment option,” said physician Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research (CDER) in a press release. “The FDA strives to protect and advance the health of women, and we are committed to supporting the development of safe and effective treatments for female sexual dysfunction.” Medically known as generalized hypoactive sexual desire disorder (HSDD), low libido not caused by any other physical or mental health issue or circumstantial issue can be hard to treat. Physician Renee E. Mestad, assistant professor of obstetrics and gynecology and division chief of general obstetrics and gynecology for Upstate University Hospital, said that HSDD is hard to treat because it exhibits no physical traits. Erroneously called “Viagra for women,” Addyi works differently from
male impotence drugs. The purpose of Addyi is to treat sexual desire, not performance. Viagra increases blood flow through a man’s body, including the genitals, which improves sexual performance. Sprout Pharmaceuticals, based in Raleigh, NC, manufactures Addyi, which is available through prescription. It can cause serious interactions with alcohol and other medication. Its side effects include low blood pressure and loss of consciousness. Patients taking Addyi should not consume alcohol or take moderate or strong CYP3A4 inhibitors, a class of prescription medication, because of negative interactions. Because of these elevated risks, the FDA approved Addyi with a risk evaluation and mitigation strategy (REMS). Physicians prescribing Addyi and the pharmacists filling it must be registered with the REMS program to track any problems patients encounter. The prescribers must also strongly caution patients about the contraindications involving drinking alcohol while taking Addyi. Other common responses to the medication include dizziness, sleepiness, nausea, fatigue, insomnia and dry mouth. The FDA’s press release stated
that researchers tested Addyi in three studies consisting of 24 weeks each. Each trial included 2,400 premenopausal women who had HSDD at least five years. Their age averaged 36 years. The drug’s trials were randomized, double-blind and placebo-controlled. Women in the study were followed for at least one year. From the participants’ responses, the researchers said that “on average, treatment with Addyi increased the number of satisfying sexual events by 0.5 to one additional event per month over placebo.” Mestad said she’s “not overly impressed by the results by women using the drug over the placebo patients. I’m not sure that one extra episode [of sex per month] will be significant to the woman.” She added that drug’s minimal effectiveness, saddled with significant risk factors, indicate that the pressure on the FDA exerted by women’s groups may have influenced the drug’s approval. The FDA denied approval of the drug twice in the past five years before its recent approval. “Consumers and health care professionals are encouraged to report adverse reactions from the use of Addyi to the FDA’s MedWatch Adverse Event Reporting program at www.fda.gov/ MedWatch or by calling 1-800-FDA-
1088,” the FDA states. “The FDA is regulating it quite a bit,” Mestad said. “[Viagra] causes possible heart problems, and isn’t regulated. But the pink pill is regulated, which I find interesting.” Sprout, the pharmaceutical company that manufactures the pill, predicts no problems with insurers covering the new drug, which should hit pharmacies by October. The manufacturer foresees its cost as comparable with Viagra, a drug used to treat male impotence. Physicians such as Mestad may not be as eager to embrace Addyi. “I’m waiting to see how it pans out,” she said. “I am waiting for physician credentialing [required to prescribe the drug] to see how it will pan out. I think some women will jump on it and some will wait and see about the side effects. A lot of OBs have patients with this issue and don’t feel like they’re serving their patients well unless they’re pursuing every avenue.” Despite some initial hesitancy from medical professionals, the industry sees big potential for the small, pink pill. On Aug. 20, Valeant Pharmaceuticals International, Inc. acquired Sprout Pharmaceuticals, Inc. for approximately $1 billion.
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will explain the latest information related to gynecologic cancer prevention, detection and treatment, followed by a question and answer session. The event also includes authentic Indian food, music and dance, and guests can also enjoy henna tattoos, yoga and meditation instruction and a fun photo booth. The event is free, but pre-registration is required and can be made by calling 315/472-2464 or visiting crouse. org/passport.
Sept. 19
Event to raise awareness of ovarian cancer Hope for Heather, a nonprofit organization based in Liverpool dedicated to finding a cure for ovarian cancer by funding research and improving survival through education and early detection, is organizing its seventh annual Teal Ribbon Run and Walk at Lewis Park in Minoa Sept.19. The event will highlight the need to fund ways to detect, prevent and treat ovarian cancer. Immediately after the 3K walk and 5M run the village of Minoa will host a community festival.
Last year the run and walk raised $65,000 and 800 people participated even though it was a rainy day. To date, the organization has donated over $150,000 to ovarian cancer research. For more information on Hope for Heather go to www.hopeforheather. org.
Sept. 19
Multi-blood analysis event in Central Square Oswego Health will hold a multiblood analysis event from 6:30 – 9:30 a.m. Saturday, Sept.19, at the Central Square Medical Center, 3045 East Ave. in the village. To make an appointment call 341-0011, lines are open 24 hours a day. This full battery of tests can help prevent potential health problems. The cost of the analysis is $35. Typically these tests can cost more than $340. In addition, this year there are two optional tests that cost $20 each. These tests include a prostate specific antigen (PSA) test, which is recommended to men older than age 50, and a vitamin D test. The analysis screens individuals for various conditions such as anemia, diabetes, and others, as well as for coronary, kidney, and liver diseases. The
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most popular screening at the event is the portion of the analysis that assesses LDL and HDL cholesterol along with triglycerides. A 12-hour fast is required for the blood analysis, but participants can drink water the morning of the testing. Checks to cover the cost of the screenings should be made out to Oswego Health. Credit card payment will not be accepted. Phlebotomists from Oswego Hospital will be on hand to conduct the blood draw. The results of the multi-organ blood analysis will be sent directly from the Oswego Hospital lab to the participant’s home and their physician in an easy to read format.
Sept. 23
Fall prevention program comes with free lunch Seniors aged 60 and above are encouraged to attend a falls prevention awareness day event, which will take place from 10:30 a.m. – 1 p.m., Sept. 23, at the Westcott Community Center, 626 Euclid Ave., Syracuse. This year’s them is “Take a Stand to Prevent Falls.” The Onondaga County Office for Aging, which promotes the event, is a member of the Onondaga County Step Up To Stop Falls Coalition, the sponsor’s event. The coalition is a diverse group of organizations whose mission is to support healthy aging by measurably
IOSWEGO AM HEALTH
reducing the incidence of falls, related injuries and resulting mortality among individuals, aged 60 and above, living in the community. Participants will take a risk assessment that will include falls education, strength and balance screening and exercise class. A free lunch will be served. Registration is required by calling 315-435-2352, ext. 4942; or you may email: ellenmccauley@ongov.net.
Sept. 25
Hospice of CNY plans September Song event September Song is Hospice of Central New York’s signature fundraising event. It will take place at 6:30 p.m., Sept. 25 at Traditions at the Links at Erie Village, 5900 N. Burdick St., East Syracuse. The evening will feature food, dancing and music by Prime Time Horns, decadent desserts, and a chance to mix and mingle with friends. During the event, organizers will celebrate the hospice’s 30 years by honoring the following individuals, who were key advocates in securing Medicare certification, and for their dedicated and continued support to hospice’s mission over the years: Roslyn Bilford, Ronald Hummel, Leo Jivoff, H. Gillis Murray, Maryanna Robinson, Sidney Sadoff, Joanne Zinsmeister-Yarwood. For more information and tickets call 315-634-1100.
“Everyone who wants great health-care close to home needs to support the Oswego Health system. It’s important that area residents understand how much Oswego Health brings to the community.” I am an Oswego Health donor. Ed Alberts Oswego Health Donor & Local Businessman
www.oswegohealth.org
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Crouse Hospital and Excellus BlueCross BlueShield Partner for Enhanced Care Coordination Crouse Hospital is joining Excellus BlueCross BlueShield in an innovative program designed to achieve enhanced care coordination, improve patient satisfaction and outcomes and reduce healthcare costs. The collaboration — known as an Accountable Cost and Quality Arrangement (ACQA) — will benefit Excellus BlueCross BlueShield members who receive care from doctors affiliated with Crouse Hospital. Using Crouse’s integrated network of physicians and outpatient services, the collaboration will provide enhanced healthcare options for patients by: • increasing physician-patient engagement to coordinate care and improve health care experience and outcomes; • improving quality of care; • aligning payment with quality, patient outcomes and value. According to Crouse Chief Medical Officer Seth Kronenberg, the goals of delivering better healthcare quality and avoiding unnecessary costs can be achieved through such efforts as improving access to primary care medical
Third Annual Onondaga County Conference
services (to manage chronic illnesses such as diabetes and reduce the need for emergency room visits), improving medication adherence rates and reducing duplication of services. “We’re pleased to collaborate with Excellus BlueCross Blue Shield on this new and innovative approach, which is the way healthcare will be delivered in the future,” says Kronenberg. “Providing real value will replace the traditional model of fee-for-service that we all have become accustomed to in healthcare. ACQA represents a significant step toward the future.” “Excellus BlueCross BlueShield and Crouse Hospital share a common goal of improving the quality of care and health of the community,” states Jim Reed, regional president, Excellus BlueCross BlueShield. “Our ACQA partnership offers a new approach to achieving the triple aim of improved healthcare quality, enhanced patient experience and lower costs.” Providers must meet quality standards to ensure that savings are achieved through improving care coordination and providing care that is appropriate, safe and timely.
Do you snore? Do you have high blood pressure? Do you wake up frequently during the night?
Reclaim Your Life (and Energy)!
“Living An Active Life with Parkinson’s Disease” Thursday, October 8, 2015 Check-In 8:15 am to 8:45 am Program 9:00 am to 2:30 pm FREE PROGRAM & LUNCH Host: Susan Kennedy WCNY-TV “Cycle of Health” American Legion Post 787 5575 Legionnaire Drive (off Route 31) Cicero, New York 13039 Registration is REQUIRED. To register, call Upstate Connect at 315-464-8668 Deadline for registration Monday, Sept. 28, 2015
The Conference Includes:
Movement for Healthy Aging Chronic Disease Management A Professional Panel Discussion On: • Treatment Advances • New Medications • Innovative Devices & Equipment • Financial & Legal Issues
Support for the Conference from: Onondaga County Office for Aging
Oneida’s Hometown Sleep Center is Accepting Patients • Conveniently located on the hospital campus • State-of-the-art hotel style rooms • Large beds, televisions and air conditioning Oneida Health Support is located on-site to ensure easy access to the therapy and equipment you need.
The Sleep Center at Oneida Healthcare 601 Seneca Street, Oneida Call: (315) 363-4419 Oneida Health Support is a partnership between Oneida Healthcare and Franciscan Companies
For Information: Cynthia Stevenson 315-435-2362 x4993, cstevenson@ongov.net September 2015 •
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