Cny igh 190 oct15

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in good

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CONTROVERSY Coca-Cola Controversy: Is Exercising More or Eating Less Better for Weight Loss?

Menstrual Cups Anyone?

October • Issue 190

cnyhealth.com

CNY’s Healthcare Newspaper

ACL Injury Epidemic

Method seen as substitute for tampons, pads

Low-Fat vs. Low-Carb Diets

Number of injuries to anterior cruciate ligaments nearly tripled in the last 25 years. We talk to local experts

Which Trims More Body Fat?

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Greetings From Guatemala Forty-eight healthcare workers from Central New York went to Guatemala in late August to help poor orthopedic patients walk again. Operation Walk Syracuse has helped patients both here and abroad with joint replacement therapy. Page 14

URGENT!

Understanding one’s way through emergency, urgent care options

Little pumpkin seeds are big on nutrition See SmartBites column on page 13

Meet Your Doctor New Crouse’s VP of medical affairs, Mickey Lebowitz, explains changes he has seen in medical field since he wrote “Losing My Patience — Why I Quit the Medical Game” Page 6 October 2015 •

Texting and Driving: It’s Getting Worse Page 3

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 20 •

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Texting and Driving Habits Hard to Change

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ou know you shouldn’t, but the temptation is great. Your phone has chirped you have a new text message and, more than anything, you want to take one hand off the steering wheel and check the message. Texting while driving not only takes one hand off the wheel, but it takes manual skill to tap the screen and mental attention to read the message. In the mere five seconds it takes to check a message, your car will have traveled 440 feet if you’re driving 55 mph, far too long to maintain adequate attention on the road. The texting and driving problem is only worsening. Steve Adkisson, a registered nurse and pediatric trauma program coordinator for Upstate Medical University, believes that it’s not just a teenaged problem. “This is a problem that spans all ages,” he said. “It’s not just limited to young people. You see more aggressive use in young people, but everyone is attached to their phones. Use spans all generations.” The problem lies in the excuses people tell themselves. Adkisson believes each age group dreams up rationalizations. “Younger people are convinced of their immortality and older people feel like they’re experienced drivers and they won’t have a bad outcome,” he said. “I’ve been in ER trauma medicine over 20 years and they all say they don’t think it will happen to me. That’s classic.” Younger drivers boast faster reaction time than older drivers, but less experience behind the wheel. And texting distracts any driver too much, regardless of age. Adkisson believes that penalties work and are making a difference. But some people learn only by experience, and those errors in judgment may cause lifelong disabilities or even cost lives. “I don’t favor legislating behavior,” he said. “The technology is developing so fast. How can you keep up with it? For me, for my program, the key is to go out there and educate people on the dangers and what can happen.” Adkisson leads a variety of programs that meet teens at schools and

over venues to raise awareness of the dangers of texting and driving. He has also offered a program in conjunction with area hospitals that show teens the likely consequences of driving while texting. “It has to be a thing with cultural pressure,” Adkisson said. “When I skied back in high school, nobody wore a ski helmet. Now, there’s a stigma attached to not wearing one. As with smoking, you’ll need to see a cultural change.” Part of his message is helping teens understand that texting accidents can affect victims and survivors for years. Death isn’t the only outcome. Some survivors endure painful recoveries and sustain lifelong impairment and disfigurement. Though many teens at first display flippancy, “by the end of the session, they’re serious and focused on what we’re saying,” Adkisson said. “More than a couple kids come up and thank us. It’s very powerful stuff.” Some parents turn to prevention apps that shut down the phone if it travels faster than 12 mph; however, savvy teens may simply borrow a friend’s phone or figure out a way around the app. Parental involvement and behavioral modeling still makes a huge difference on whether or not teens text while driving. John McCann, training director for National Tractor Trailer School, Inc. in Liverpool, said he ranks texting while driving right up there with other driving distractions and means of impairment. “It’s a habit most people engage in,” he said. McCann knows whereof he speaks. From his viewpoint in large trucks, he has good visibility into passenger cars and sees people texting routinely. “Most people have done it,” he said. “For many people, it’s a normal thing to be driving down the road and texting.” He hopes more parents will set the example to not text while driving, both for their safety and to influence the next generation to set aside or turn off their phones while they’re behind the wheel.

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. 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, Brenda Lotito • 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.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Diabetes support groups announced in Oswego Residents can learn more about how to treat their diabetes during two free support groups held each month. A group meets the first Thursday of the month from 10 – 11 a.m., Oct. 1, at Springside at Seneca Hill located halfway between Fulton and Oswego on Route 45A. A representative from the Oswego County Office of the Aging will adiscuss and answer questions about Medicare’s updated insurance plans. The Oswego area group meets the third Wednesday of the month from noon to 1 p.m. and will hold its next meeting on Oct. 21 in the lower level JPC conference room of the Oswego Health Services Center, which is adjacent to Oswego Hospital. Participants are encouraged to bring their own lunch. For more information on the support groups, please call 349-5513

Oct. 8

Spirit of Women presents Ladies Night Out Crouse Hospital’s Spirit of Women program, in partnership with Community Memorial Hospital in Hamilton, will present a glamorous evening just for ladies from 6 – 9 p.m. on Thursday, Oct. 8, at Traditions, 5900 N. Burdick St. A feature of the evening is a fashion show highlighting local ladies shining brightly as they win the fight against

breast cancer, emceed by 93Q’s Amy Robbins. The reservation-only event for the first 300 women who register also includes a twinkling serenity suite, a selfie station, makeup applications and door prize drawings. The evening’s event will be dessert with Crouse doctors. Tickets for the event are $25 per person and include a free gift, one sparkling signature cocktail and hearty hors d’oeuvres. Call 315-470-5777 or visit crouse.org/sparkle to make reservations.

Oct. 12

JCC offers Columbus Day vacation camp for children The Sam Pomeranz Jewish Community Center of Syracuse will hold a Columbus Day vacation camp for children in grades K-6 from 9 a.m. – 4 p.m. on Monday, Oct. 12, at the center on 5655 Thompson Road, DeWitt. The camp will be filled with lots of fun activities such as arts and crafts, sports and more for children to enjoy during their day off from school. Half-day options and early/late care to extend the day from 7 a.m. – 6 p.m. are also available. The morning activities will include create your own Nina, Pinta and Santa Maria ships, play ships and sailors in the JCC gym, and more. The afternoon will feature fall-themed crafts, Ga-ga (Israeli dodgeball), football frenzy and dancing games. Full-day campers are asked to bring a non-meat lunch. An

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Coca-Cola Controversy: Is Exercising More or Eating Less Better for Weight Loss?

C

oca-Cola has given $1 million to a new research organization that has pushed a message that lack of exercise is a bigger factor in the obesity epidemic than is calorie consumption. Science, however, still counts calories as the main driver of weight gain for most people. Although exercise makes people healthier, cutting calories usually plays a bigger role in weight loss, experts say. “There’s an overwhelming amount of research demonstrating that, from an individual perspective, the key is decreasing calories modestly to successfully lose weight over time,” said physician Pieter Cohen, an assistant professor of medicine at Harvard Medical School. “It’s certainly great to add exercise, but to suggest that it’s the solution to the obesity epidemic … is ridiculous,” Cohen said. The new nonprofit organization, called the Global Energy Balance Network (GEBN), received $1.5 million from Coca-Cola last year to help launch the organization, according to The New York Times. In a statement, Steven Blair, a professor of exercise science at the Univer-

sity of South Carolina Arnold School of Public Health and a member of GEBN, said that although the media have focused on “blaming fast food” and sugary drinks for the obesity epidemic, “there’s really virtually no compelling evidence that that, in fact, is the cause.” On its website, the GEBN does not deny that good health involves both eating a healthy diet and doing exercise. But the organization’s website also says there is “strong evidence that it is easier to sustain at a moderate to high level of physical activity (maintaining an active lifestyle and eating more calories)” than it is to be sedentary and eat fewer calories. In an editorial published in 2014, several members of GEBN wrote that increasing physical activity “may be more achievable than reducing [calorie] intake” for energy balance. However, Cohen disagreed with this message. An exercise program by itself typically doesn’t lead to much, if any, weight loss, Cohen said. One reason for this is that exercise increases appetite, which can lead people to eat more, Cohen said. Exercise also causes the body to produce more muscle, which is

heavier than fat tissue. In addition, it’s usually easier to cut calories out of the diet than it is to exercise at the levels needed to burn enough calories for weight loss. For example, in general, experts say a person needs to cut 500 calories a day from his or her diet to lose 1 lb. (0.45 kilograms) a week. In theory, it would be possible to burn 500 calories through exercise instead of caloric re-

striction, Cohen said. But this would be difficult, because burning this amount of calories through exercise takes time, and in order for the strategy to work, people could not consume a single calorie more than they do already, despite their increased activity. “It would be much easier to eliminate those 500 calories [from our diet] than to find the time to exercise enough to burn 500 calories a day,” Cohen said.

Healthcare in a Minute By George W. Chapman Price transparency Hospitals are just getting around to making their charges for procedures available to the public, but few if any will make what various insurers actually pay them available to the public. Confidentiality agreements between hospitals and insurers prevent this. Transparency in what insurers pay hospitals for procedures is touted as a way of increasing competition among both insurers and hospitals, thereby keeping costs under control. A recent study by the Center for Studying Health System Change estimates that a transparent all-claims database could save $100 billion a year. Mega insurance mergers It remains to be seen if recently announced insurance mergers, not yet approved, will lower or increase premiums. Both the American Hospital and American Medical associations have expressed concerns over the pending merger of insurance giants Aetna and Humana and Cigna and Anthem. Their fear is that one huge insurer will dominate the market and will be far less willing to negotiate payments to hospitals and physicians in the marketplace. If the mergers are approved, the Department of Justice will be vigilant for unfair pricing and monopolistic activity. Massachusetts update Industry observers consider the Bay State as a harbinger of healthcare to come for the rest of the country. “RomneyCare,” or its version of “ObamaCare,” has been law since 2006. So what has been the impact on costs and health after nine years? Ninety-nine percent of all residents are insured, so the mandated universal coverage is successfully in place.

Overall costs increased 4.8 percent last year. This sounds pretty good relative to the rest of the country, but it was actually deemed to be disappointing by authorities and consumer advocates. The good news regarding future costs is that insurers are aggressively moving away from fee-for-service reimbursements to alternative models designed to control costs and improve outcomes. Fraud and abuse Congress has approved another $378 million in funding to combat Medicare fraud and abuse. Last year, Healthcare Fraud and Abuse Control recovered $3.3 billion. The return on investment is very good, with $7.70 recovered for every $1 spent on detection. Accountable Care Organizations Despite the fact that 75 percent of ACOs didn’t save money, Centers for Medicare & Medicaid Services data shows that overall, there was a savings of $411 million. Savings are calculated by what CMS would have paid to the ACO under normal fee-for-service reimbursement versus alternative payments received by the ACO. ACOs are a new concept, so it is not surprising that 75 percent are not saving money. The 25 percent that are prove it can be done. Advocates continue to point out that ACOs may be the best way to control costs, eliminate unnecessary care and emphasize team-based care that focuses on prevention versus just treatment. But, if CMS truly believes in population management through ACOs, it will have to loosen overly stringent formulas for risk adjustment and quality benchmarks. CMS will also have to eliminate the “penalty only” quality scoring system. In other words, there is no reward

for improving quality; there is only a penalty for not hitting quality benchmarks. The transition from fee-for-service to fee-for-quality is hard enough for most providers. Advocates of ACOs are saying if CMS continues to set the bar too high too soon, there will be more failures and the ACO business model will be doomed to early failure. Interstate insurance sales This has been discussed recently by virtually everyone running for president. It is not new. A bill to allow insurers to cross state lines was introduced in Congress 10 years ago. Proponents believe by eliminating the red tape associated with different state regulations, insurers would increase the size of their risk pools — more covered lives — and lower their per unit administrative costs which would give consumers more choices with lower premiums. But simply opening up the borders, so to speak, won’t necessarily create more national insurance plans. Insurers would have to set up their provider networks with thousands of physicians, hundreds of pharmacies and dozens of hospitals before attempting to sell insurance in a new state, all of which is expensive and time consuming. Cadillac tax. No, not the car It takes effect in 2018. A “Cadillac” tax will be imposed on employers that offer “overly rich-expensive” plans which typically result in employees having to pay more out of pocket. The tax will be imposed if the premium for an individual exceeds $10,200 for an individual. The purpose of the tax is to provide an incentive for employers to shop plans and for insurers to control premium prices. Plans that offer unlimited access October 2015 •

to hundreds of physicians and several hospitals may have to be narrowed (less choice) to keep costs and premiums down. It is estimated that by 2018, 16 percent of employers could be offering an individual plan that costs over $10,200. Community Health Centers Odds are you reside in the service area of a federally funded CHC. Since the passage of the Affordable Care Act, more than 700 new sites have opened. There are 1,300 CHCs that operate 9,000 sites for an average of 180 sites per state. The CHCs provide care to 20 million people. Both sides of the aisle in Congress favor the program that supports providers in underserved rural and urban areas. Telemedicine Thanks to technology and changing reimbursement to physicians, virtual (video) primary care doctor-patient consults are expected to double to 5.4 million over the next five years. Easier access to primary care physicians means less postponement of seeking care and better compliance with treatment plans. It is estimated that failure to seek care and failure to follow a physician’s advice costs $100 to $289 billion a year.

GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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changes he has seen in medical field since he wrote “Losing My Patience — Why I Quit the Medical Game” Q: I’m not sure if you remember, but you spoke with us back in 2010. At the time you were planning to leave medicine. What turned things around? A: I left private practice Oct. 31, 2007 at 4 o’clock in the afternoon. That’s when I started writing my book, “Losing My Patience: Why I Quit the Medical Game.” I finished writing it nine months later or so. I, happily, found an editor and publisher. The book came out in 2009. After writing the book, I worked with the VA as a hospitalist. It was an opportunity to go back to basics and sort of rediscover why I went into medicine in the first place. It allowed me to remove a lot of the things that challenged me in private practice and just take care of patients and teach medical students without worrying about the billings, malpractice, referrals. I also felt a bit of that guilt, that Jewish guilt, about having never served in the military. Around that time, we had a lot of men and women coming back from the Middle East and Afghanistan, so it was an opportunity to give back. I really liked the VA. I liked the system, the patients, the staff, the students, the residents. It was a really good time. And as a hospitalist, you’d work 14 days on, seven days off. It was nice to have that week off to recover. Q: What brought you to Crouse? A: In 2010, out of the blue, I received a call from Paul Kronenberg, who was CEO at the time. I grew up at Crouse. I did my rotations, internships and residency here. I did my endocrine fellowship here. Then in 1991, I came here as an attending with Internist Associates and was stationed here until 1998. Then from 1998 to 2004, I started the Endocrine and Diabetes Center, which was also a great time, but there were some challenges. I was on call 24-7 and the hospital was going through some rough times. I left to join the CNY Family Group. So in 2010, Paul Kronenberg asked me if I’d like to be a quality director at Crouse, which was a new position. The beauty of that position was that it really gave me an

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015

opportunity to fix some of the things I thought were broken in our little world of health care. It’s one thing to complain about things, but another to try to fix them. So Paul gave me this great opportunity to do that.

In the News Crouse Appoints Mickey Lebowitz, M.D. as Vice President of Medical Affairs and Clinical Quality

Crouse Hospital recently named physician Mickey Lebowitz as vice president of medical affairs and clinical quality. He will provide oversight, mentoring and performance assessment of all physicians and practitioners and will work closely with the quality improvement division on patient safety and process improvement initiatives and will partner with physician leaders to help lead system-wide efforts for clinical quality, safety and cost of clinical care. He also oversees infection control, care coordination, physician quality and medical affairs. In 2007 he quit his private practice and wrote a book about the medical field.

Q: So health care has changed a bit since you last spoke to us. Have the changes addressed some of concerns? A: You’re absolutely right that things are changing. In the old days we had what’s called “volume care,” which is something I wrote about in my book. When I was in private practice, I wasn’t willing to compromise the quality of care. The practice was financially challenged at the time, but I didn’t feel like it was safe to take on more patients. For me, it’s not a matter of how many patients I was seeing, but how many patients I was seeing well. I wanted good outcomes, and I didn’t think I was going to get them if I saw more patients more quickly than I was seeing them. And I was seeing a lot of patients. So the new health care paradigm has caught up to what I was saying, which is that outcomes are the most important. So we’re looking at high quality, low cost and patient satisfaction. So in some respects I’m happy that there’s this new emphasis on outcomes. The challenge is defining outcomes, defining quality and then measuring them.

Lifelines

Q: What do you think the state of Crouse’s medical care is now? A: I think Crouse is a great hospital, but we can be greater. So my motivation is to make us as good as we can possibly be and give patients what they want. And what patients want is safe, high-quality, cost-effective care. And they want good communication with and between staff. A big part of my position is figuring out what I can do to help our docs function at their maximum level, give them maximum support and remove the barriers to their job.

Name: Mickey Lebowitz, M.D. Position: Senior Medical Quality Director at Crouse Hospital Hometown: Brooklyn, NY Education: SUNY Upstate Medical University Affiliations: Crouse Hospital Organizations: Endocrine Society, American Association for Physician Leaders Family: Married, two children Hobbies: Family activities, writing/ screenwriting, songwriting, synagogue activities

Q: Do you see a move toward consolidation in the medical world, where physicians join larger institutions that act as more of a support system? A: So what’s happening is a lot of the financial risk is moving from the payers to the providers. So providers have developed integration networks to help deal with that. What physicians will have to adjust to is moving from a more competitive environment to a more collaborative one. Q: Are you still practicing, or are you mostly administrative at this point? A: I’m probably about 90 percent administration at this point. I still do consultations at the hospital though and try to be a part of the team, especially since everyone has to live with the things I put into place. They’ll see me dealing with the results of them too. Q: Are we overworking doctors? A: So years ago when you were asked, “who is the best doctor?” the answer was pretty subjective. You’d say you like this guy or that guy, patients seem to like him, he seems like he gets good outcomes. Now everything is going to be measured. The best doctor is the doctor with the best measured outcomes, weighted for risk adjustment so that we’re not comparing apples to oranges. That’s going to be a challenge, so they’re going to have to rely on support staff, supportive technologies and a collaborative environment.


ACL Injury Epidemic Number of injuries to anterior cruciate ligaments (ACL) nearly tripled in the last 25 years By Deborah Jeanne Sergeant

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as your child or a classmate experienced an anterior cruciate ligament (ACL) tear? She is not alone. “The rate of ACL reconstruction per 100,000 population aged 3 to 20 years has been increasing steadily over the past 20 years, from 17.6 in 1990 to 50.9 in 2009,” according to the New York Statewide Planning and Research Cooperative System (SPARCS) database census. Of those, the peak age for reconstruction was age 17, usually a teen’s junior or senior year of high school. Elizabeth Cohen, physical therapist with CNY Physical Therapy & Aquatic Centers in Cicero, said that some of the reason for more ACL injuries is that student athletes start at a younger age. Few ACL injuries occur before age 12; however, it’s unclear if that is because of a physical or developmental difference or because so few children under age 12 participate in sports at the level of junior high and high school students. Many teams participate in pre-season practices and scrimmages, travel to events and encourage off-season play as well. Another factor in the puzzle is that more young women are playing sports and their favored sports Jenks tend to be the ones at higher risk for ACL injuries. “Girls are eight to 10 times more likely to suffer an ACL injury than boys,” Cohen said. “Their hips are wider, which causes excess pressure on their knees. Their hormones can cause ligaments to loosen, and that also puts excessive pressure on knees.” Since 80 percent of ACL injuries involve non-contact sports, it’s not necessarily the football linemen that get laid up with a bum knee. It’s the pivoting soccer player or gymnast or the jumping volleyball player or basketball player getting hurt. Girls do not participate in as many non-contact sports as boys. Cohen said that generally, coaches emphasize performance-oriented training over the conditioning exercises

that keep athletes safer, such as proper body mechanics. “Ask coaches about ACL prevention,” she advised parents. “Working muscles together is so important, not in isolation. They need general strengthening and polymetric movement, which is learning things like landing right. Make sure kids are performing warmup exercises. If you start a player cold, you have a greater chance of injury.” Many coaches don’t want to waste practice time to prevent an injury that may not even happen, even though few extra minutes a few times a week can make a big difference. “Even a pre-season workshop would help,” Cohen said. Coaches could continue working with students throughout the season to stick with the program with at-home exercises also. Drew Jenks, physical therapist at Sports PT in Syracuse, agrees. “It could help raise awareness,” he said. He added that his organization has tried to offer ACL injury prevention training at several schools, but “it’s a fairly hard task to get into programs because many coaches don’t want to cut back on practice time. Some may be unaware of what resources are available. Many [medical] people are willing to donate their time. “There’s definitely a benefit of knowing, and even a one-time lecture helps. No program is 100-percent, though.” Some of Sports PT’s therapists have trained in sports metrics so they could help athletes prevent injuries. “We’re learning a lot more about the science as to why ACL injuries occur,” Jenks said. “It started at what’s happening at the knee. then it became the ankle, hip, core and trunk. It’s the whole body training.” It’s also important for student athletes to branch out into different sports. Focusing on just one sport can over stress areas of the body, including the knees. “Most of our young athletes won’t go on to play in college, yet we emphasize specializing in one sport,” Jenks said. “By being a multi-sport athlete, you train your body in different ways. You can handle different situations better than if you played one sport.” Though only a handful of students ever receive sports scholarships, about 50 percent of ACL patients who have their injury surgically corrected become arthritic by midlife.

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October 2015 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 7


Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Setting goals can help restore your confidence

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s I’ve shared in the past, my self-esteem took a real nosedive after my divorce. I felt exposed and embarrassed. It was as if my personal and private failure at a relationship had become very public. I just wanted to hide. And hide I did! I hid in my work, in my home, and in my self-help books. I also hid from my friends. Divorce — even a fairly amicable divorce — can really knock the wind out of your self-confidence. If you are suffering from the fallout of a failed marriage and are in hiding, as I was, know that you are not alone. Regaining my self-confidence was a slow process and painful at times, but ultimately very rewarding. The process started with baby steps. While I am a huge believer in positive thinking, I intuitively knew I wouldn’t be able to think myself into more confidence. I knew it would require work and that I would have to build my confidence back up one success at a time. And that’s when I discovered the incredible power of goal setting. During the dark days following my divorce, I found the simple act of

writing down mini-goals and checking them off the list actually helped me get through my day. At the time, my list was pitifully basic: get dressed, make my bed, water the plants, etc. That list looks pretty pathetic now, but anyone who has endured a painful divorce knows just what I’m talking about. The simplest tasks can seem insurmountable. But I kept at it, adding more items to the list as the days wore on. Remarkably (thankfully!), this process of writing down and accomplishing my goals began to have a real and positive impact on my day and on my self-esteem. Committing things to writing seemed to have miraculous power. My “to do” list was motivating me. It held me accountable. And it enabled me to see and track my progress and success. It wasn’t long before one good day was followed by the next and the next and the next. My sense of accomplishment was as energizing as it was fulfilling. I began to feel better about myself. To this day, I create a “to do” list on a daily basis and still get a confidence boost when I complete a goal

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015

and check it off the list. This practice has been so rewarding and self-affirming that I now employ a goal-setting process for my bigger life plans and projects. In fact, I created a “Goal Worksheet” for myself that captures what every good goal should be: written down, specific, time bound and achievable. Below is an example of a travel goal you might adopt for yourself this fall. I chose this example because traveling solo is a great way to get to know yourself better, expand your universe, and have some fun! Your goal statement: I will get out of my comfort zone and take a first-ever weekend trip alone — a mini-retreat of sorts to recharge my batteries, rediscover my center, and enjoy some quiet time to think, reflect and dream. Your timetable and action steps: 1 – By Oct. 9: I will share my goal with a few friends and ask for suggested retreat destinations within easy driving distance. (I highly recommend the Roycroft Inn in East Aurora, NY) 2 – By Oct. 14: I will review my options, make a decision, and reserve my hotel room for the weekend of Oct. 23, 24 and 25. 3 – By Oct. 15: I will inform my family members (and, if appropriate,

neighbors) of my plans, including my travel destination and how to reach me. 4– By Oct. 16: I will make arrangements for pet care, if necessary. 5 – By Oct. 20: I will spend a few days researching restaurants, checking out things to do, and finding a spa for a much-anticipated massage! 6 – By Oct. 21: I will pack light, including emergency supplies, a journal and a good book, which may come in handy as a pleasant diversion while eating alone. 7 – By Oct. 22: I will prepare healthy snacks for the road, carefully review my driving directions, check my tire pressure, and fill my gas tank. 8 – By Oct. 23: I will take off early, excited and proud to be leaving on my mini-adventure! Goals can give your life direction and purpose. And they can put passion into your everyday existence, which is especially important for those of us who live alone. It may take some time before you regain your footing and self-esteem. Chances are, you’ll take some detours and encounter some bumps along the way. But I have found that setting and accomplishing mini-goals — and eventually larger life goals — is key to regaining self-confidence. Actually doing (vs. wishing and hoping) has worked for me, and it may work for you, too . . . wherever life takes you. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her October workshop, check out the events calendar in this issue, or contact Gwenn at 585-624-7887 or email at gvoelckers@rochester.rr.com.

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Women’s issues Menstrual Cups Offer Women Third Option Method seen as substitute for tampons, pads By Deborah Jeanne Sergeant

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adies, you have another choice instead of tampons and sanitary pads. Meet the menstrual cup. Made of soft, surgical-grade silicone, a menstrual cup collects rather than absorbs menstrual flow. Instead of emptying your pockets and filling landfills, a cup may be reused. Not many women have heard of it or are interested in it, according to David Kurss, an OB-GYN with Suburban Obstetrics and Gynecology at Women’s Wellness Center of Western New York in Williamsville. “I haven’t had any patients ask about this,” he said. “I asked every patient in my office for a day — and I saw a lot of patients — and I didn’t have one person say, ‘I’m interested in trying that.’” “Most people are used to the absorptive nature of the tampon or pad. I’m sure there are some patients who work a long shift or go hiking and don’t have access to restrooms. I think some may want to be made aware there is an alternative.” The cup is shaped like an inverted bell with a stem at the closed end. It collects flow and, according to man-

ufacturers, as long as it’s correctly, it cannot leak regardless of the user’s activities. “You would have to place it perfectly so it wouldn’t leak,” said Michele Frech, doctor of osteopathic medicine in the OB-GYN at Neighborhood Health Center, in Buffalo. “It can be mortifying especially for a teenager. You have to be careful to not spill it after you take it out. Most women use tampons you’d have to be comfortable with your own body.” After washing her hands, the user folds the cup into a “c” shape and inserts it inside her vagina. The cup pops open inside and forms a seal. Only a small portion of the stem remains outside the body. Every 12 hours, the user must remove and empty the cup. Squeezing the cup while it’s inside breaks the seal and the user may pull it out by the stem. After emptying the flow into the toilet, the user washes the cup with mild soap and warm water to clean it. At a multi-stall public restroom, the user may wipe the emptied cup with tissue paper and wash it the next time; however, since most women need to empty it only every 12 hours, it’s not

difficult to time emptying the cup in private at home. After the period ends, the user boils the cup for use next month. No research has shown a connection between toxic shock syndrome (TSS) and using menstrual cups. TSS has been linked with using tampons and other items inserted into the vagina. Though rare, TSS can be fatal. It is caused by strains of the staphylococcus aureus bacterium. Proper hygiene while using a cup greatly reduces the already minimal chance of contracting TSS. “Follow manufacturer directions,” Frech advises any woman trying a menstrual cup. “As long as you have a way to adequately clean it, it should be safe.” She added that TSS is “a theoretical risk, but pretty rare. It’s probably less risky with a cup because silicone is not reactive. The question is, can women keep it clean? How does it degrade and withstand repeated use?” Most cups have measurement markings on the side which could be useful for women who need to measure their flow, since absorbent products cannot offer a consistent means of

measuring. Examples of brands include DivaCup (www.divacup.com), Mooncup (www.mooncup.co.uk), Lunette (www. lunette.com) and SoftCup (www.softcup.com). Though the initial cost is a little high — $32 to $39, compared with around $5 to $8 for a package of disposable products — the cup pays for itself in less than eight months and lasts for years. One exception is the Soft Cup, available at Walgreen’s, which is disposable. Odor isn’t a problem since as long as the cup is inside, the flow is not exposed to air, unlike when using a pad. Virgin women run the risk of tearing the hymen if the opening to their hymen is small. For some cultures, this defines losing virginity, but the medical definition of virginity is if a woman has never experienced intercourse. Most cup makers offer a size for women who have never had a baby and another for mothers who have delivered, whether vaginally or surgically. Manufacturers recommend not using a cup for post-partum bleeding, while using topical medication, and whenever a vaginal infection is present.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 9


Women’s issues The Gianna Center offers family planning the natural way Syracuse clinic positions itself as an alternative to Planned Parenthood By Matthew Liptak

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hether you are just looking to be greener in your medical care or have concerns about the conventional use of birth control, the Gianna Center at 127 Chapel Drive in Syracuse might be for you. The small medical office is part of the Pope Paul VI Institute and was formed as an alternative to Planned Parenthood, an organization that supports practices like birth control and abortion that are contrary to the Roman Catholic church’s teachings. But you don’t have to be Catholic to use Gianna Center services. All those who are interested in an alternative method to managing fertility are encouraged to make an appointment. “My dream was to create an alternative to Planned Parenthood,” Joan Nolan, the center’s executive director said. Though her views on women’s reproductive health may not be in the mainstream, the methods behind the center are based on modern science. “I practice a form of women’s health,” said physician Karen Dalton, Gianna’s medical director. “It’s called naprotechnology which helps women who are having any kind of women’s health issues in general with a form of medicine that’s based on a form of natural family planning called the Creighton method.” Dalton helps women with family planning, but she also helps patients with conditions such as menstrual cycle abnormalities, PMS, endometriosis, polycystic ovarian syndrome, hormonal abnormalities and general gynecological care. She is opposed to prescribing birth control for both ethical and medical reasons, she said. “We want organic,” Dalton said. “We want healthy, but we will take an artificial hormone that shuts down the way your system works and that’s considered perfectly fine. There are ramifications to doing this and our world is suffering because of it.” She said she has had a patient in

her 20s have a stroke due to birth control pills. The pills caused a blood clot that led to a pulmonary embolism that caused the stroke. She also said she had a patient who developed a swollen liver due to a cyst she attributes to birth control pills. There is also a correlation between taking birth control and getting breast cancer, Dalton said. “I don’t care what other people say, the evidence is out there and people are ignoring it,” she said. “We’re definitely seeing an increased rate of aggressive breast cancers in young women — 2 percent per year since the 1970s.” On ethical grounds both Dalton and Nolan believe that giving birth control pills to women and girls is sending a bad message. That message is that there is something wrong with the way the female body works and it must be treated with a medication. Instead, the pair proposes teaching women and girls how their body works and letting that knowledge enable them to direct their reproductive life. It is less convenient and takes more work and discipline than using birth control, but they believe it is preferable. “What we offer is an approach that says your fertility is not a disease,” Dalton said. “It’s a gift and you deserve to know how your body works and when there are problems we can help you using natural methods.” The Creighton model, which the center follows, was developed by Thomas Hilgers, a practicing physician and clinical professor in obstetrics and gynecology at Creighton University School of Medicine in Nebraska. Dalton said the model was 99.5 percent effective in preventing pregnancy. It revolves around a woman learning how to monitor her body on a daily basis to observe when she is fertile. Somewhere in the middle of a woman’s menstrual cycle she will see a discharge called cervical fluid, Nolan said. It is a sign of her impending ovulation for that month. “What this system does is it trains

Gianna Center Executive Director Joan Nolan (left), and Gianna Center medical director, physician Karen Dalton. a woman to read the signals her body is telling her so she knows when she’s fertile,” Dalton said. Those using the Creighton method may also choose to use a basal thermometer to understand their cycle. When the temperature goes up a half degree and stays there it means the woman is in the second half of her cycle, Dalton said. It takes about a year for a woman to learn and fully incorporate the natural family planning method into her routine, the doctor said. “It does take a little bit of work and

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015

a little bit of education,” she said. “It may be challenging for some.” “We absolutely want to get the word out because we believe that women deserve to understand how their bodies work,” Dalton said. “Every medical problem that a girl might come in with—irregular periods, acne, painful periods, PMS—the birth control pill has been given as the answer for everything.” To contact the Gianna Center call 585-369-6803 or go to www.giannasyracuse.com.


Meet Your Provider

CNY Healing Arts Finding a Place of Balance: ‘Fall Should Be a Time of Reflection and Relaxation’ By Donald Clarke With summer behind us our days become shorter and nights become longer. Added to our already full schedules, back to school activities and last minute outside projects and we can easily become overwhelmed, a situation that can lead to increased stress and anxiety. Fall should be a time of reflection and relaxation. Small changes in diet and lifestyle can have big impacts on our quality of life. Stress reduction has a tremendous effect on helping reverse weight gain, physical and mental fatigue, insomnia and low sex drive. So many times we get caught up in our routine and forget that places exist solely to help us reduce stress and improve our quality of life. As an acupuncturist at CNY Healing Arts located in Syracuse, Rochester and Latham I often treat clients who have waited much longer than they should have. In our centers alone we staff acupuncturists, massage therapists, estheticians, yoga instructors and nutritional advisers. Here are some areas to pay close attention to this fall: Diet: With Halloween and the holidays fast approaching,

the temptation to eat sweets and carbohydrates (empty calories) increases substantially. Stay away for these types of foods, such as breads, chips ,cookies, soda, candies and cakes. These foods are often referred to as empty calories. Meaning that these foods are high in calories and low in nutrients. Essentially they are doing very little to help maintain a healthy body and mind. Nutrient deficiency leads to a whole host of health conditions and disease. Acupuncture: Acupuncturists have the unique ability to gently move the body energy, reducing pain, stress and anxiety. Massage: The art of touch is as old as the human race. Massage therapists have a special skill to relieve pain and induce a sense of deep relaxation. Esthetics: Many people are unaware that the skin is the largest organ of the body. Facials and Microderm help keep pores open letting the skin breathe. Healthy oxygenated cell development equals healthy skin. Yoga: Yoga is the practice of movement combining physical, mental and spiritual aspects. Yoga has been shown to reduce stress and improve heart health. We often race through our days taking care of everyone except ourselves. We are loved and needed. We owe it to ourselves, our friends and our families to stay healthy and live a long productive healthy life.

Donald Clarke, a licensed acupuncturist, has been practicing Chinese medicine in CNY for over 15 years. He studied at the prestigious Bastyr University in Seattle, where he specialized in acupuncture and Chinese medicine. If he is not writing or speaking about health or health related topics he is at home in his garden. He can be reached at 315671-5755.

CNY Healing Arts • www.cnyhealingarts.com • 315-671-5755 • 195 Intrepid Ln, Syracuse

Parenting By Melissa Stefanec melissa@cnyhealth.com

Finding the Unexpected in No. 2

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here are a seemingly endless parade of parenting clichés. Many of them are trite, but ultimately, true. One such cliché is that no one is ever ready to be a parent. I think everyone believes that, but I wasn’t expecting the same to be true for having a second child. When we started planning our second kid, I felt like I was already in the parenting majors. I thought I knew what to expect. As with so many of my parenting expectations, I was dead wrong. My son, River, was born a year ago. Although that doesn’t seem possible, it is, and he is already, literally, running away from babyhood. This month, I am going to reflect on lessons I have learned from my second-born. The whole process will be just as amazing as it was the first time It doesn’t get old. Carrying, delivering and meeting your child is amaz-

ing. The pregnancy itself was easier, because I wasn’t so worried about everything. I just tried to enjoy the ride. Having two children is five times the work I don’t care what logic says. I was ready for twice the work, but I was woefully underprepared for what the actual amount would be. The mess, the errands, the appointments and the obligations, they proliferate as though I had 16 children. My house will never be clean and the laundry will never be done Seriously, never again. My house will look like it’s been raining toys, clothes and general disorder for the foreseeable future. Cleanliness won’t be achieved until they leave for college. And then, I will start lamenting parenting clichés like, “the house is too quiet” and, “I’m bored and lonely.” The percentage of my brain falling victim to mom brain has tripled

My two-kid mom brain metaphorically resembles an overstuffed filing drawer. It runs like a computer that has used up all of its disk space. It’s not that I am cloudy, it’s that there is way too much to do and remember. As such, things that once got my attention and thoughtfulness have been replaced by only vital day-to-day operations. May I offer my apologies in advance for any slights? (They were completely unintentional.) I will not be punctual or early for something until I am in my 50s I used to be so punctual. I even regained punctuality at some point after baby No. 1. That was short-lived. I will be late, it’s just a question of how late. There will always be a hold-up, like when my 4-year-old left her milk box where her brother could get to it and he locked himself in his room and painted for two minutes. I have to accept that I will be late and probably be accompanied by some sort of lingering odor or stain when I get there. Having two children is like a perpetual summer My nights got shorter and my days got longer. After a full day of work, I get the kids fed, cleaned and in bed. I then clean the house to a roach-free level. When I look at the clock, it’s 8:45 p.m. Eight hours until I plot the alarm clock’s death. The days are very long, and the nights are too short. I find myself asking, “Is No. 2 getting the shaft?” Every joke you’ve ever heard about second children is (at least partially) true. The second kid just doesn’t get the same treatment as the first. I pureed organic food for my first born, and I buy discounted, partially tampered with jarred food for my second-born (I kid). Seriously though, I feel guilty about October 2015 •

not being able to dote on my second baby like I did on my first. It’s simply a matter of logistics and practicability, but that doesn’t make me feel any less guilty. At the end of the day, I tell myself it’s a good thing. My second-born will be so independent and self-managed. When you are stressed, savor the tender moments The tender moments are everywhere, you just have to take a step back and tune into them. It’s easy to slip into the routine of reacting to crises and going on autopilot for the mundane. I try to dwell on the tender moments with my children. It helps me stay saner. My kids are incredibly different I knew my children wouldn’t be carbon copies of one another, but I had no idea how different they would be. I had to learn, early on, to throw all my expectations and natural tendencies to compare out the window. No two people are alike or growing in the same way. I had to realize that I was on a new and totally separate journey. I love No. 1 just as much as No. 2 From talking to other parents, this is a very real concern. Parents wonder how they will ever be able to love their second child as much as their first child. Personally, I never had this concern, but I know it’s out there. So let me try to alleviate that fear. You will love this second child like no other. You will love it differently from your first, but that love will be immense. When you think about it, you don’t love any two people in your life the same way. The relationship with No. 2 will be just as deep and beautiful as it is with No. 1; it will just be wonderfully different.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 11


My Turn

By Eva Briggs

Asymmetry Wonder why some people have eyes of different colors or one side of the face different than the other?

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umans prefer symmetry. People find symmetric faces more attractive than asymmetric faces. At least, up to a point; completely symmetric faces are perceived as unnatural and disconcerting. But there are many medical conditions that affect the symmetry of the face or body. One fairly common condition is heterochromia iridis. That means that the eyes are different colors. This can vary from a subtle difference in shade, or a section of an eye that differs from the main eye color. Or the two eyes can be completely different, such as one brown and one blue. The color of one’s eyes is determined by the amount and distribution of melanin pigment in the irises. Most of the time people with heterochromia are born with the condition. Sometimes is a benign genetic quirk. Sometimes it is evidence of an underlying genetic disease. One example is Waaardenburg syndrome. Affected people may have one eye lighter than the other, or light sections in one or both eyes. There may be a white forelock, widely spaced eyes, and hearing impairment. It turns out that the cells that produce melanin (melanocytes) are closely related to cells of the inner ear that allow for nor-

mal hearing. One abnormal gene can alter both eye color and hearing. The same condition can occur in ferrets, rendering many ferrets with white on their heads deaf. Differences in eye color can be acquired. For example trauma, certain eye drops, and tumors. For the curious, a Google search will turn up a long list of famous people with heterochromia iridis. Another common cause of facial asymmetry is Bell’s palsy. This is a paralysis of the seventh cranial nerve, which controls facial muscles. Most of the time the cause is unknown, although some theorize that viruses are at the root. Lyme disease can cause Bell’s palsy. With the current surge in Lyme cases, it’s important to test patients with Bell’s palsy for Lyme disease. The condition can be mild, causing slight asymmetry, or severe, rendering one side of the face pretty much immobile. Severe cases can interfere with the ability to completely close the eye. So some patients will need to protect the affected eye with eye drops or ointments. They will also need to tape the eye shut at night so the cornea won’t dry out or be accidently injured

during sleep. Many cases of Bell’s palsy diminish or resolve over time. Sometimes it’s not merely the face, but the entire body that is asymmetric. Several years ago, one of my friends was changing the diaper of her first grandchild. She discovered something that neither the new mother or the child’s pediatrician had noticed — one of the baby’s legs was larger than the other. It’s called hemihypertrophy or hemihyperplasia, meaning one side is larger than the other. Fortunately they live in a big metropolitan area with access to all sorts of specialists who pretty quickly diagnosed the baby with Beckwith-Weidemann syndrome. It’s due to an abnormality in the regulation of genes on chromosome 11. People with this disorder often have other associated conditions such as abdominal wall abnormalities, abnormally large tongues, or low blood sugar during infancy. There’s also an increased risk for various childhood tumors. Fortunately my friend’s granddaughter is now 8 years old and hasn’t had any complications, needing only a lift in her shoe. So if you look in a mirror and appear a little asymmetric, don’t worry, that’s the norm.

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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Page 12

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015


SmartBites

By Anne Palumbo

The skinny on healthy eating

Little pumpkin seeds are big on nutrition

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ately, my husband and I have been sprinkling shelled pumpkin seeds on everything: salads, cottage cheese, roasted vegetables, cereal. They’ve reached “staple status” in our kitchen because they’re delicious and convenient and chock full of nutrients we need and benefits we care about. Now that we’re eating less meat, we’re always concerned about protein. A handful of pumpkin seeds gives us about 8 grams of this powerhouse nutrient, which accounts for a decent chunk of our daily protein needs. Protein — a.k.a. “the building block of the body” — is needed to build and maintain all kinds of body components, from hair to bones to muscles. Protein also makes up the hemoglobin that carries oxygen in our blood. In other words, without it, we’d probably never get off the couch! Pumpkin seeds are one of the best plant sources of zinc, an important mineral that boosts our immune system and aids in speedier wound healing. In addition, zinc may protect against age-related vision loss; and, according to the “Journal of International Medical Research,” may help prevent osteoporosis in women, especially those who have gone through menopause.

Sleepy? Grumpy? Pumpkin seeds may be your ticket to restful shut-eye and a better mood, as they are teeming with tryptophan — an amino acid that your body converts into serotonin, the “feel-good” chemical that promotes sleep and overall well-being. Low in both sodium and cholesterol, pumpkin seeds have about 150 calories and 5 grams of fat per handful. Do know that most of the fat is the good, unsaturated kind that can help lower cholesterol.

Helpful tips

Shelled pumpkin seeds are available in prepackaged containers as well as bulk bins. Make sure the seeds are not shriveled and show no signs of moisture or insect damage. If possible, smell the pumpkin seeds to ensure they are not rancid or musty. Store seeds in an airtight container in the refrigerator for up to two months (they may last longer but they lose their fresh taste). Roasting seeds (stove-top or in the oven) brings out their flavor and adds some crunch. Thinking about babies? Zinc is vital for normal fetal development and the maturation of sperm. Getting a daily dose of pumpkin seeds is good for hearts. In part, this is due to their high concentration of magnesium, a mineral that regulates heart rhythm and helps relax blood vessels. Since low dietary levels of magnesium have been linked to increased rates of hypertension and heart disease, this little gem may promote cardiovascular health. Pumpkin seed’s diverse mixture of antioxidants — those free-radical-gobbling compounds that have been shown to thwart age-related diseases — may also keep our tickers in tip-top shape.

Whole Wheat Quick Bread with Pumpkin Seeds

plus a handful for topping the bread 1 ½ cups low-fat buttermilk 2 large eggs 4 tablespoons butter, melted and cooled coarse salt, for sprinkling Preheat oven to 350F. Lightly oil a 9 x 5” loaf pan and set aside. In a large bowl, mix flours, sugars, salt, baking powder, and baking soda. Stir in 1 cup of the pumpkin seeds. In a separate bowl, mix buttermilk with eggs and cooled butter, whisking to combine. Pour wet mixture into dry ingredients and stir, just until combined. Batter will be thick and sticky. Spoon batter into loaf pan and spread out evenly with a spatula. Top with additional pumpkin seeds and coarse salt. Bake for 50 minutes, until loaf is browned on top and sounds hollow when tapped. Cool in pan for 10 minutes before removing. Great toasted!

Adapted from Amanda’s Cookin’ 2 cups whole wheat flour 1 ½ cups all-purpose flour ¼ cup granulated sugar ¼ cup packed light brown sugar (or honey) 1 teaspoon salt 4 teaspoons baking powder 1 teaspoon baking soda 1 cup roasted, shelled pumpkin seeds,

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.

Low-Fat vs. Low-Carb Diets: Which Trims More Body Fat?

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ollowing a low-fat diet may help dieters lose more body fat than following a low-carb diet, according to a new study. Researchers found that people in the study lost 3.1 ounces (89 grams) of fat per day, on average, when they followed a low-fat diet for six days. In comparison, the same people lost 1.9 ounces (53 grams) of fat per day while follow-

ing a low-carb diet for the same amount of time. “A lot of people have very strong opinions about what matters for weight loss, and the physiological data upon which those beliefs are based are sometimes lacking,” study author Kevin Hall, a metabolism researcher at the National Institute of Diabetes and Digestive and Kidney Diseases,

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said in a statement. “I wanted to rigorously test the theory that carbohydrate restriction is particularly effective for losing body fat, since this idea has been influencing many people’s decisions about their diets.” The new study was published Aug. 13 in the journal Cell Metabolism.

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October 2015 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 13


Forty-eight members of the Central New York medical community went to Guatemala in August to help poor orthopedic patients walk again. Operation Walk Syracuse has helped patients both here and abroad with joint replacement therapy.

Operation Walk Syracuse steps in to help disabled around the world Volunteers from CNY making a difference in the lives of people in Guatemala, other parts of the world By Matthew Liptak

A

group of Central New York healthcare workers went to Guatemala in late August and as a result many more citizens of that country are now walking. “Forty-eight people that are in sync, who have a passion for what they’re doing and as a result of them working in such a collaborative way we were really able to impact the lives of a lot of people who otherwise who would not have been able to have the surgery and get back to living a normal life,” said Kim Murray, an registered nurse and clinical director of Operation Walk Syracuse. Operation Walk is a nonprofit 501c3 medical mission program that includes an all-voluntary team that travels around the world to do free hip and knee replacement procedures on individuals who otherwise wouldn’t have access to that care. According to the latest federal statistics there were 719,000 knee replacements in the U.S. in 2010 and 332,000 hip replacements. Joint conditions are regularly treated in America and hundreds of thousands of people, if not millions, are walking because of modern technology. But it’s a different story in other countries. Third world countries often provide poor health care and that includes treatment to people with chronic joint problems. A group of medical workers in Central New York recognized this and is determined to do something about it. They started a chapter of an organization called Operation Walk in Syracuse. So far, they change the lives of up to 85 people each year in foreign countries by providing operations. The Syracuse chapter started in 2010. It is one of 13 chapters in the U.S. and Canada. They’ve been to Panama twice and once to Katmandu, Nepal. Their trip to Ghana was postponed due to the Ebola outbreak. In August the team — formed mostly by professionals from Syracuse Orthopedic Specialists, Crouse and St. Joseph’s hospitals — went to a mission

Page 14

hospital in Antigua, Guatemala, where Murray said there were more hip replacements than usual for a younger population that was ravaged by arthritis cases. But she said the hospital there was like a “well-oiled machine” with different teams coming in from around the world on a weekly basis to help the poor. The surgeries went so fast and smooth that extra patients were screened to do additional procedures. Two memorable patients that Murray recalled were sisters who both needed hip replacements. They wanted to go into surgery side-by-side. “They were in their 20s,” Murray said. “They both needed bilateral hip replacements. What was kind of neat, they went through everything together. We put them on the OR schedule for the same date so that they could be prepped together, so they could go into the OR at the same time, so they could do their rehab together afterward.” The trip was just one in a line of journeys that has led Central New York health-care workers to help people walk around the world. “We are going to be going to Ghana next year. I’m in conversations with India to possibly go to India the year after.” Brothers Seth and Brett Greenky, both orthopedic surgeons in Syracuse, along with Murray, originally wanted to become involved with the Operation Walk chapter in Boston. Lawrence Dorr, a physician who founded the umbrella organization in 1995, decided there was enough interest and skill for Syracuse to start its own chapter. Each trip costs the organization up to $275,000 depending on the condition of the host medical center. The Guatemala trip cost between $160,000 and $175,000. That doesn’t include the millions of dollars of medical supplies donated by corporations. “The donated goods that we get from all of our very generous supporters and companies, the donated supplies are in excess of $2 million. What they see is that there’s just people around the world who are much,

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015

Orthopedic surgeon Tim Izant with a patient during recent trip to Guatemala. much more needy in terms of joint replacement than here. This is the only chance to really impact the lives of those people.”

Organization helps in Syracuse as well

When Operation Walk Syracuse goes to a country it takes about 50 people in two teams. That includes surgeons, anesthesiologists, physicians assistants, surgical techs, floor nurses, recovery room nurses, instrument specialists, implant specialists, physical therapists and translators. It ships out the 16,000 pounds worth of medical supplies it needs two months ahead of time, Murray said. Their goal is to get the operations done in about four days and be back home in eight or nine. “The first day after surgery is my favorite time,” Murray said. “The first day in the OR it’s long hours from sun up to sun down...taking care of different elements of the activity that we have going on, but the next morning when I come in for rounds at 6 o’clock in the morning and walking through the ward and seeing people up and walking and smiling and happy— that’s really the single best thing.”

While there the team does some education too, teaching the local doctors how best to see to the rehab of the patients. After Operation Walk returns to Syracuse it continues to keep an eye on its patients from a distance. Murray said they keep in touch with the patients through email or telephone and help guide the local native medical team in their treatment. Operation Walk Syracuse hasn’t forgotten about the needs of its home city either. Each December it has run a program to give joint replacement surgery to those in Central New York who have fallen through the cracks of the health care system. There’s been less demand for Operation Walk work in Syracuse recently, probably because the Affordable Care Act is providing coverage for more residents, Murray said. “Once a year there’s a very rigorous application process and a vetting in terms of people’s financial need,” she said. “We’ve been doing that for the last three years locally.” To learn more about Operation Walk Syracuse go to OperationWalkSyracuse.com or call 315-883-5875. .


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Understanding one’s way through emergency, urgent care options Attention all snow birds! By Brenda Lotito

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he rise in patient demand for medical services, an aging population and the growing burden of chronic diseases is placing stress on the primary care system. Doctors’ office waiting rooms are packed during the short work days, leaving others frustrated with no appointment time in sight for days, weeks or even months. Providers with short evening and weekend hours still find themselves overextended. Individuals who may need reassurance are unable to receive a phone call from office nurses in a timely manner. Still, your primary doctor is the best place to start when you are sick or hurt. “The most important advice is for patients to have an established relationship with a primary care physician. Their doctor has a good understanding of the patient’s history and any conditions. If the condition is chronic, the primary care physician should be called first,” said Norma Cooney, department of emergency services chairwoman and medical director at St. Joseph’s Hospital in Syracuse. The Centers for Disease Control and Prevention reports that nearly half of the population has visited an emergency room at least once. But with more choices of care popping up, how do individuals make a choice they feel good about? Many hospital emergency rooms house a “fast track” area in between the waiting area and the actual emergency room. This helps the sicker patients receive faster access to a higher level of care while those who may be able to be treated relatively quickly, shorter wait times. The questions and the answers are not all that simple but can be used as a guide: Q.: When should someone seek emergency room care? Cooney: “There is not a clear line or easy answer for when patients should seek emergency room care. However, there are some important conditions that often warrant a visit to the ER, and that is when the patient experiences a rapid onset of symptoms or an acute deterioration from their baseline health. Complaints that warrant an emergency evaluation include chest pain, shortness of breath, intractable abdominal pain, a change in neurologic status, or a life-threatening condition such as choking, seizures or severe burns.

“It can be difficult for patients to determine what a life-threatening emergency is. Therefore, a “split-flow” model in an emergency department that allows for placement of the patient in the appropriate care area is critical for effective and efficient care.”

When do I go to urgent care? Q.: What types of illness or symptoms would lend themselves to an urgent care facility? Julianne Duffy, director of clinical operations: “If the problem is non-life threatening or doesn’t risk disability, if the patient can drive himself or herself and they cannot see their primary care doctor, then they should go to urgent care. If necessary, an urgent care center can transfer a patient to the hospital or an emergency department.” Individuals who choose either an urgent care or emergency room will be met with a similar team — most often a physician, nurse practitioner, or physician’s assistant along with nurses and other ancillary staff. “Simply put, they (urgent care and emergency room) both provide exceptional quality. It is the level of acuity that is different. The physicians who work in urgent care centers are experts in their own area. The providers in urgent care are a mix of emergency physicians and family practitioners that have had years of experience and are extremely efficient at treating minor emergencies. Cooney: “While there are more resources in an emergency department, a patient can certainly receive the same quality of care at an urgent care. And, typically they can receive more expeditious care for their minor emergency. There is capacity and opportunity for the urgent care centers to see and treat more patients. Urgent care facilities are expanding to other locations and increasing the hours available to accommodate the community at large.” While practitioners, nurses and ancillary staff continue to work to care for the sick and injured in these facilities, both Duffy and Cooney agree that it all goes back to the primary care physician and the importance of having one. “Continuity of care and follow-up after an emergency department visit are also crucial for appropriate care and coordination of care,” Cooney said.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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October is Down Syndrome Awareness Month

Local Down Syndrome Association: Two Decades of Advocacy By Matthew Liptak

O

ne Manlius woman, with help from others, created the Down Syndrome Association of Central New York 23 years ago to help those with the chromosomal abnormality and their families. The woman, Shari Bottego, the organization’s president and founder, is a hands-on leader who has kept the group going for over two decades. “The Down Syndrome Association of Central New York’s mission is to support one another in the challenges we face; to educate the community both in its knowledge and perception of Down syndrome; to advocate for our children and to be available to other parents,” she said. The outlook was a little different in the 1990s when Bottego moved to Syracuse with her family, including her son, David, who has Down syndrome. She found the head of the local advocacy group packing up and heading out of town. “My family moved to this area when my son was 2 months old and we knew nothing about Syracuse or Down syndrome,” she said. “A year or 9/23/15 4:34 PM sobreast.IGH_3.16.qxp_Layout later I was approached1 by someone

when my son and I were out shopping. She was originally from the same part of the country as I was and we started talking. She said she wanted to start up the support group again. I said I would be interested but we would do it the proper way and become a 501 (c) (3) not-for-profit organization so what happened before would not happen again.” About 400,000 Americans have Down syndrome, according to the National Down Syndrome Society. One in 691 babies in the U.S. is born with the condition. Individuals with Down syndrome have a full or partial extra copy of chromosome 21. Chromosomes are the structures genes are aligned along in the nucleus of every cell in the human body. Those with Down syndrome may have physical signs of the condition and cognitive impairment, but it doesn’t prevent them from living full and often extraordinary lives. Bottego’s son is now 26 years old. The program he’s in encourages him to live an active and fairly independent life. He volunteers, takes classes, exercises daily, works on life skills and Page 1

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015

socializes with friends, she said. “Other individuals take college classes, drive cars and work in the community. If an individual has a particular interest, they can work with their broker to develop a plan that meets their wants and needs,” Bottego said. “None of this would have been possible 10 years ago.” Down Syndrome Association of Central New York serves 147 families in Onondaga and surrounding counties. It is an all-volunteer organization made up of parents who have a child or adult with Down syndrome. They are self-supporting. Membership dues are $25 a year, depending on the ability to pay. A major event of the group is the National Down Syndrome Society’s “Buddy Walk.” The walk has grown across the country from 17 events in 1995 to almost 300 walks this year. The Down Syndrome Association of Central New York sponsored the local walk, which took place in late September. Unlike other Buddy Walks, the local event was not a public fundraiser. It was free for participants to attend and

expected to attract almost 2,000 people. Area businesses provide some financial support, Bottego said. The nonprofit had raised $11,400 by September. Bottego is uncertain of the future of the organization. She said she hopes for additional support for the organization from the Down syndrome and surrounding community. She said she has had trouble filling board positions and is reluctant to take a lesser role even after 24 years, because of concerns Down Syndrome Association of Central New York would go into decline without leadership. “Without a strong leader the group will fall as it did before I got involved,” she said. “We supply a great service to the community by not only supporting our members but also providing the new parent packets at the area hospitals; help families find services in the area who are new to the Syracuse area and the Buddy Walk, just to name a few.” For more information on the Down Syndrome Association of Central New York go to www.dsaofcny.org or call 315-682-4289.

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Adjusted Flu Vaccine Options Available to Seniors This Year Dear Savvy Senior, What can you tell me about this year’s flu shot? Last year’s vaccine was ineffective at preventing the flu, especially among seniors. What options are available to me this year? Seeking Protection Dear Seeking, You’re right. Last season’s flu shot was not very effective at preventing the flu. In fact, according to the Centers

for Disease Control and Prevention (CDC), people who got the shot were just 19 percent less likely to visit the doctor for flu than people who did not get the shot. In good years, flu shot effectiveness is in the 50 to 60 percent range. The reason for the shot’s ineffectiveness last year was because the vaccine was mismatched to the circulating flu viruses, which can genetically shift from year-to-year. This year, U.S. health officials have tweaked the flu vaccines to include last year’s missing strain, which will hopefully provide better protection. But a flu shot is still your best defense against the flu. So, depending on your health, age and personal preference, here are the flu vaccine options (you only need one of these) available to older adults this year. Standard (trivalent) flu shot: This traditional flu shot has been around for more than 30 years and protects against three different strains of flu viruses. This year’s version protects against two A strains (H1N1 and H3N2), and one influenza B virus. Quadrivalent flu shot: This vaccine, which was introduced two years ago, protects against four types of influenza — the same three strains as the standard flu shot, plus an additional new B-strain virus. High-dose flu shot: Designed specifically for seniors, age 65 and older, this trivalent vaccine, called the Fluzone High-Dose, has four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. Howev-

er, note that the high-dose option may also be more likely to cause side effects, including headache, muscle aches and fever. FluBlok vaccine: Created for adults 18 and older who have egg allergies, this is a trivalent flu vaccine that does not use chicken eggs in its manufacturing process. Intradermal flu shot: For those who don’t like needles, the intradermal flu shot uses a tiny 1/16-inch long micro-needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shots. This trivalent vaccine, however, is recommended only to adults, ages 18 to 64. To locate a vaccination site that offers these flu shots, visit vaccines. gov and type in your ZIP code. You’ll also be happy to know that if you’re a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot, as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays. Private health insurers are also required to cover standard flu shots, however, you’ll need to check with your provider to see if they cover the other vaccination options.

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Two other important vaccinations the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. Around 1 million Americans are hospitalized with pneumonia each year, and about 50,000 people die from it. The CDC is now recommending that all seniors, 65 or older, get two vaccinations –Prevnar 13 and Pneumovax 23. Both vaccines, which are administered just once at different times, work in different ways to provide maximum protection. If you haven’t yet received any pneumococcal vaccine you should get the Prevnar 13 first, followed by Pneumovax 23 six to 12 months later. But if you’ve already been vaccinated with Pneumovax 23, wait at least one year before getting the Prevnar 13. Medicare Part B covers both shots, if they are taken at least 11 months apart.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015

I

nternational Skeptics Day falls in tures of “my Social Security” that will October, making it a month of secstave off that skepticism. You can: ond-guessing and, hopefully, getting • Keep track of your earnings and to the truth of the matter. At Social verify them every year; Security, we believe that a healthy bit • Get an estimate of your future of skepticism encourages you to get the benefits if you are still working; facts. • Get a letter with proof of We have created an easy way your benefits if you currently to cast aside doubt about Social receive them; and Security, and you can access this • Manage your benefits: resource any time of the year, – Change your address; day or night. You can clear any – Start or change your amount of skepticism you might direct deposit; have about your Social Security – Get a replacement Mediearnings by creating a safe and care card; and secure “my Social Security” – Get a replacement account at www.socialsecurity. SSA-1099 or SSA-1042S for tax gov/myaccount. season. Banikowski With a “my Social Security” If you do find a discrepanaccount, you can instantly check your cy on your statement, you will need to Social Security statement. Financial collect the proper documentation from experts have said that your statement is your employer to correct any misinfor“… probably the most crucial financial mation and submit it to Social Securiplanning document for every Amerity. For detailed instructions, you can can.” access the publication “How to Correct By thoroughly checking your Social Your Social Security Earnings Record” Security statement, you can make sure at www.socialsecurity.gov/pubs. each year that your work was correctly Join the over 20 million people who documented. This will ensure you get are accessing their personalized aca correct Social Security benefit when counts from the comfort of their home you start collecting. or office at www.socialsecurity.gov/ There are many other valuable feamyaccount.

Q&A

Q: I applied for my child’s Social Security card in the hospital but have not received it. How long does it take? A: In most states it takes an average of three weeks to get the card, but in some states it can take longer. If you have not received your child’s card in a timely manner, please visit your local Social Security office. Be sure to take proof of your child’s citizenship, age, and identity as well as proof of your own identity. And remember, we cannot divulge your child’s Social Security number over the phone. Q: Is it illegal to laminate your Social Security card? A: No, it is not illegal, but we discourage it. It’s best not to laminate your card. Laminated cards make it difficult — sometimes even impossible — to detect important security features and an employer may refuse to accept them. The Social Security Act requires the Commissioner of Social Security to issue cards that cannot be counterfeited. We incorporate many features that protect the card’s integrity. They include highly specialized paper and printing techniques, some of which are visible to the naked eye. Keep your Social Security card in a safe place with your other important papers. Do not carry it with you.

Q: I have two minor children at home and I plan to retire this fall. Will my children be eligible for monthly Social Security benefits after I retire? A: Monthly Social Security payments may be made to your children if: • They are unmarried and under age 18; • Age 18 or 19 and still in high school; or • Age 18 or older, became disabled before age 22, and continue to be disabled. Children who may qualify include a biological child, adopted child or dependent stepchild. (In some cases, your grandchild also could be eligible for benefits on your record if you are supporting them.) For more information, see our online publication, “Benefits For Children,” at www.socialsecurity. gov/pubs. Q: I just got a notice from Social Security that said my Supplemental Security Income (SSI) case is being reviewed. What does this mean? A: Social Security reviews every SSI case from time to time to make sure the individuals who are receiving payments should continue to get them. The review also determines whether individuals are receiving the correct amounts. You can learn more about SSI by visiting our website on the subject at www.socialsecurity.gov/ssi.


H ealth News Urologist joins Auburn Community Hospital Physician Ryan C. Sidebottom has joined the Auburn Community Hospital Medical Staff and is opening his practice, Upstate Urology of Auburn. Sidebottom did undergraduate studies at Purdue University and received his Doctor of Osteopathic Medicine degree from the Texas College of Osteopathic Medicine. He was the chief resident in urologic surgery at the Sidebottom Albert Einstein Medical Center in Philadelphia. He is a member of the American Urological Association (AUA), the American Medical Association (AMA), the American College of Osteopathic Surgeons(ACOS), and the American Osteopathic Association (AOA).

Carlos Dator Jr., Joins Oswego hospitalist team Oswego native Carlos Dator, Jr. is returning to his hometown to provide medical care as a member of Oswego Hospital’s hospitalist team. He will also provide care alongside both his physician parents at their respective Oswego practices. Dator recently completed his family medicine residency at St. Joseph’s Hospital in Syracuse. He earned his medical degree from the American University of the Caribbean School of Medicine, located on the island of St. Maarten. His bachelor’s degree was obtained from Loyola College, where he graduated cum laude. Dator He spent his junior year abroad at Newcastle University upon Tyne, located in the United Kingdom. While at Loyola College, he was presented the ALANA Academic Achievement Award and the freshmen sociology award. Both of Dr. Dator’s parents are local physicians, which he said helped to spark his interest to become a medical professional himself. When he was about 6 years old, his father, Carlos Dator Sr., would occasionally bring his son to the hospital when he conducted his patient rounds. “I have fond memories of my Dad taking me on rounds and I remember how pleasant and nice the staff was,” Dr. Dator Jr., said. Dator Jr., said he was excited to return to his hometown, where he wants to have a positive impact on the

community. “I hope to bring to Oswego some of the vast experiences I have had during my college and medical school years,” he said. “I would like to promote and, of course grow, the opportunities in the community where I enjoyed a very positive upbringing.”

B’ville native doctor joins ClearPath Diagnostics Physician Brian T. Pavlovitz has joined ClearPath Diagnostics, a regional, tissue and cytopathology group, headquartered in Syracuse. Pavlovitz, a Baldwinsville, native, is board certified in anatomic and clinical pathology. He was fellowship-trained in cytopathology at Virginia Commonwealth University after serving his pathology residency at SUNY Upstate Medical University. Pavlovitz has expertise in surgical pathology and cytopathology. He was most Pavolvitz recently staff pathologist at Rochester General Hospital and laboratory director at Clifton Springs Hospital & Clinic. “It’s wonderful to bring a talented Syracuse-area native such as Dr. Pavlovitz back home,” said ClearPath Diagnostics’ medical director Michael T. Mazur. “As ClearPath continues to grow both geographically and in the area of women’s health, Brian will be a valued addition to our clinical team.” Physician owned, ClearPath Diagnostics provides anatomic pathology, cytology and dermatopathology services to referring providers and their patients in the northeastern United States.

St. Joe’s psychiatric program has new director Physician Ahmed Raslaan Nizar has been appointed St. Joseph’s Health’s medical director for the comprehensive psychiatric emergency program (CPEP). In his new role, Nizar serves as the senior medical leader responsible for provider oversight and the development of policies and procedures to ensure delivery of medical care consistent with St. Joseph’s mission. “This new role allows me to bring my passion for patient-centered, psychiatric care to a new level,” Nizar noted. “I look forward to working with Nizar our team of pro-

fessionals to deliver the highest quality care to our patients using innovative methods and technologies.” Nizar received his Doctor of Medicine degree from St. Georges University School of Medicine in Grenada in 1995 and completed his residency in psychiatry at SUNY Downstate Medical Center in Brooklyn. He is board certified in psychiatry and neurology, and is a member of the American Medical Association, American Psychiatric Association. Prior to his appointment, Nizar was a practicing psychiatrist with St. Joseph’s Hospital outpatient services and comprehensive psychiatry emergency program (CPEP). Before joining St. Joseph’s he practiced family medicine in Sri Lanka for three years and was the only physician running a hospital in the war torn area. Nizar worked in Chenango County Mental Health Center and Greater Binghamton Health Center for eight years and is on faculty at SUNY Upstate.

Oneida Healthcare awarded hospital accreditation Oneida Healthcare announced it has earned The Joint Commission’s Gold Seal of Approval for Hospital Accreditation by demonstrating continuous compliance with its performance standards. The Gold Seal of Approval is a symbol of quality that reflects an organization’s commitment to providing safe and effective patient care. The hospital underwent a rigorous, unannounced on-site survey in June. During the review, a team of Joint Commission expert surveyors evaluated compliance with hospital standards related to several areas, including emergency management, environment of care, infection prevention and control, leadership and medication management. Surveyors also conducted on-site observations and interviews. The Joint Commission has accredited hospitals for more than 60 years. More than 4,000 general, children’s, long-term acute, psychiatric, rehabilitation and specialty hospitals currently maintain accreditation from The Joint Commission, awarded for a three-year period. “Oneida Healthcare is pleased to receive accreditation from The Joint Commission, the premier health care quality improvement and accrediting body in the nation,” said Oneida Healthcare CEO Gene Morreale. “Staff from across the organization continue to work together to develop and implement approaches that have the potential to improve care for the patients in our community. Our accreditation is the result of an outstanding team effort.” October 2015 •

Crouse Hospital appoints surgeon to medical staff Benjamin Sadowitz has joined Crouse Hospital as a board certified general surgeon. He is also a partner in Central New York Surgical Physicians, P.C. Sadowitz earned his medical degree from SUNY Upstate Medical University, where he also completed his general surgery internship and residency. He Sadowitz also completed a fellowship in advanced gastrointestinal and hepatopancreaticobiliary at Florida Hospital Tampa. Prior to joining Crouse, he was the advanced trauma life support director at SUNY Upstate Medical University. Sadowitz is a member of the American College of Surgeons.

Crouse Hospital names new director of finance

 Kevin Randall is Crouse Hospital’s new director of finance. He previously served as the hospital’s manager of finance. Prior to his employment at Crouse, Randall worked as an audit associate for PricewaterhouseCoopers in Rochester, where he performed audit, review and compilation services for diverse clients, such as Corning Randall and Kodak, and as an audit assistant for the Bonadio Group in Syracuse, where he was accountable for reviewing and verifying records, external financial statement auditing and compliance with policies, procedures and standards. Randall earned his Bachelor of Science degree in accounting from SUNY Oswego.

Pensero is Crouse’s new 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 recruit-

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 19


Auburn Nurses Meet for 50th Year Reunion

The Auburn Memorial School of Nursing, class of 1965, recently held its 50th reunion. Part of the celebration entailed a tour of Auburn Community Hospital, that was followed by a reception. Pictured in the photo are: front row, Kathleen (Gnau) Stillwell, Martha (Miller) Cole and Brenda

(Wright) Parker; second row: Pamela Seamans, director of staff development; Dorothy (Fitts) Ireland; Suzanne (Bush) Baran; Dolores (Burns) Salerno; Marcia (Addington) Liddiard; Marilyn (O’Dell) Warner; Pamela (Byron) Heffernan; and Tammy Sunderlin, vice president for nursing

Oswego Hospital Installs New State-of-the-Art MRI

Oswego Hospital officials were recently pictured in the facility’s new state-ofthe-art MRI suite. From left are Erin Clinton, MRI technologist; Bob Pompo, executive vice president for finance; Kim Watts, CT/MRI supervisor; David Ruel, director of imaging; Megan McManus, senior MRI technologist; Eric Campbell, chief financial officer; Jim Marco, interim human resources director; and Jeff Coakley, vice president for communications and government affairs. Seated from left physician Allison Duggan, Oswego Health executive vice president and interim administrator; and radiologist Gerald Black, along with Margaret Glass, associate administrator and Jason Santiago, chief operating officer of The Manor at Seneca Hill. A new state-of-the-art fixed 1.5 tesla magnetic resonance imaging (MRI) scanner with the ability to carry out more complex diagnostic procedures has been unveiled at Oswego Hospital. This cutting-edge technology depicts and clarifies diseases of the brain, spine, liver, pancreas, kidney, uterus and other soft-tissue organs. It is also often invaluable for many orthopedic diagnoses such as knee meniscal tear or shoulder rotator cuff injury. As part of its equipment purchase, Oswego Hospital has also installed the most advanced breast MRI coil. This technology is able to create consistently high-quality, high resolution images regardless of breast size or density — often Page 20

revealing lesions that could go unnoticed with conventional imaging. Oswego Health Chief of Radiology James Sherwood said the new MRI has very impressive image quality. “The improved resolution increases diagnostic accuracy and confidence, and the exam times are shorter,” he said. “The new MRI utilizes state-of-the-art technology.” Sherwood added that the MRI also provides a larger field of view, so that he is able to see a wider area in a scan. This is particularly useful in orthopedic imaging. Along with providing better scans, the new MRI is now located within the hospital. Previously, patients underwent an MRI scan in a trailer connected to the hospital.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015

ment; contract management; and physician referral relationship development. In this new role at Crouse, she will be responsible for providing leadership, staff development and financial and operational oversight to the Pensero following areas/ departments: ED providers; hospitalists, GI hospitalists; neurology; and the Community Memorial Hospital ED/ hospitalist program. Pensero earned an MBA from Columbia College and is a 2011 graduate of Leadership Greater Syracuse. She resides in Baldwinsville. “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.

RMS hires healthcare transformation specialist Danielle Park has joined Research & Marketing Strategies, Inc. (RMS) as healthcare transformation specialist. She will provide analytical and programmatic support to the RMS healthcare transformation team. Park aids in the Baldwinsville-based firm’s healthcare transformation activities, including assisting clients with individual project needs in preparation for the National Committee for Quality Assurance (NCQA) Park approval and Patient-Centered Medical Home (PCMH) recognition, as well as being involved in quality improvement initiatives relating to the Patient-Centered Medical Home (PCMH) program model and patient-centered care. With over 10 years of experience in the medical field, Park was previously a home health aide with a vast knowledge in healthcare management and medical office systems. Her strong background in patient advocacy, medical terminology and billing and coding prove to be an exceptional skill set for propelling the RMS healthcare team forward. Park earned two associate’s degrees — in liberal arts and sciences, from Cayuga County Community College, and in medical administrative assisting from Bryant & Stratton College. Park will receive her bachelor’s degree in health care administration at the end of 2015.

Upstate announces appointment, honors Upstate Medical University has announcemed the following honors and

appointments: • Michael Jurbala has been appointed director of internal audit and advisory services. Jurbala, a certified public accountant, most recently served as a consultant on Sarbanes-Oxley compliance with JC Jones and Associates Jurbala LLC, in Pittsford, near Rochester. He also served at EveryWare Global (Oneida LTD/ Anchor Hocking Inc), from 2004 to 2013, as vice president of finance and corporate controller for the $400-million business, where he oversaw financial operations, corporate reporting, Manocha control environment and shared services at corporate offices in the United States and abroad. In addition, he also served in positions including director of Foodservice and International operations and director of internal audit during his 10 years with Everyware. He Bisen has also held audit positions with Dannible & McKee, LLP and Ernst & Young and has been past president of the board of directors for Meals on Wheels of Syracuse. A graduate of St. Bonaventure University, Jurbala is a member of the American Institute of Culebras Certified Public Accountants and the New York State Society of CPAs. • Divey Manocha has joined the department of medicine as a clinical assistant professor, specializing in gastroenterology. Manocha earned his degree in medicine and surgery from Maulana Azad Medical College, New Delhi, India, in 2000, and served as registrar of internal medicine from 2005 to 2008. He competed his residency at Upstate Medical University in 2011, where he also completed a fellowship in internal medicine in 2012 and a fellowship in gastroenterology and hepatology in 2015. His work has been published in numerous peer-reviewed publications. • Physician Nabamita Bisen has joined the department of medicine as a clinical assistant professor in the pulmonary division. Bisen earned her degree in medicine and surgery in 2006 from Calcutta Medical College, Kolkata, India. She completed a residency in internal medicine (2008 to 2011); a fellowship in pulmonary and critical care medicine (2014) and a fellowship


in geriatric medicine (2015) at Upstate Medical University. • Physician Antonio Culebras, professor of neurology, was inducted as an honorary member of the Royal Academy of Medicine of Valencia, Spain. Honorary membership is awarded by the academy to medical doctors who are practicing physicians with academic merits, including publications, books and national/international presentations, and who have significantly advanced the medical sciences. Culebras lends his expertise in many ways, from his service as co-chairman for the annual World Sleep Day for nearly a decade to being lead author of a 2014 guideline from the American Academy of Neurology that recommended oral anticoagulants for stroke prevention in some people.

Embracing Age now manages Baldwinsville’s Silver Fox Embracing Age, an affiliate of St. Joseph’s Health and Franciscan Companies, announced a new management and marketing agreement with Silver Fox Senior Social Club in Baldwinsville. Embracing Age is a nonprofit organization that enables older people to

remain living independently at home. Silver Fox enriches the lives of this same group of people with daily activities that challenge the mind and body. “The entire staff at Silver Fox Senior Social Club is very pleased with our new association with Embracing Age,” says Richard Elander, owner of Silver Fox Senior Social Club. “We believe the management and marketing capabilities of the Franciscan network will result in great opportunities for the growth of Silver Fox.” “Silver Fox addresses a very important need in our community – the need for a stimulating and safe place for seniors to go to during the day, while their caregivers are working,” says Susan Clancy-Magley, executive director of Embracing Age. “In addition, so many of our caregivers need a bit of respite. With Silver Fox, they can rest assured that their loved one is in a caring and nurturing environment.” As part of the Franciscan and St. Joseph’s Health family, Silver Fox participants will have increased access to a variety of services to help them live home and live well. This includes home health care, transportation, educational workshops, Lifeline Medical Alert, a medication dispensing service, and more. In turn, existing Franciscan and St. Joseph’s Health patients will benefit from attending Silver Fox Senior Social Club.

New Oswego Health CEO Takes Over Charles Gijanto, who possesses more than 32 years of healthcare leadership experience, started Sept. 14 as the new president and CEO of Oswego Health. In that position, he will provide strategic, executive and operational guidance for the Oswego Health System, which includes Oswego Hospital, The Manor at Seneca Hill, Springside at Seneca Hill, Oswego Health Home Care, Physician Care, P.C., and other supporting affiliates that provide health services to approximately 120,000 people in the Oswego County region. Gijanto was appointed by members of the Oswego Health Board during Gijanto a meeting held Aug. 31. Gijanto began his healthcare career with the U.S. Department of Health, Education and Welfare in New York City. Since then, he has served in a variety of prominent positions providing him with broad-based community hospital experience, a strong emphasis on quality, services and efficiency, as well as a consistent focus on service excellence, engagement and culture. He most recently served as the president of Baystate Regional Markets, which is a division of Baystate Health, Springfield, Mass. Baystate Regional Markets includes two hospitals and 18 physician practic-

es that provide health services in central Massachusetts. Together, the hospitals and practices combined for an annual budget of approximately $150 million. Prior to his role as a CEO, Gijanto served in several leadership roles at Champlain Valley Physicians Hospital Medical Center (CVPH) in Plattsburgh, including executive vice president/ chief operating officer and chief financial officer. He also served as the chief financial officer at both Fanny Allen Hospital in Colchester, VT and at Moses-Ludington Hospital in Ticonderoga. In addition, he is experienced in business development. While working at CVPH as the vice president of strategic business development, Gijanto earned his master’s degree in health systems administration from the Rochester Institute of Technology. Gijanto previously earned a bachelor’s degree in business administration from Siena College. Throughout his career, Gijanto has been active with various healthcare associations, as well as in the communities in which he has lived, serving on both business-related boards and as a member of services clubs. Gijanto is married and has two children

Members of St. Joseph’s Physicians Family and Internal Medicine offices with Kathryn Ruscitto, president and CEO of St. Joseph’s Health. (Seated left to right) Maria Demko; Jacquelyn Cage; Brittnie Beachel; Karin Kurtz; Kathy Pawlikowski and Meaghan Roberts, both licensed practical nurses. (Standing left to right) Tanya Enigk; hospital CEP Ruscitto; Millie Raab; physician Alberto Del Pilar Jr.; Patti Poletto; Julianne Duffy, chief operating officer for St. Joseph’s Physicians; and Betsy Bedigian.

St. Joseph’s Physicians Earns National Recognition For Patient-Centered Care St. Joseph’s Health announced that St. Joseph’s Physicians six primary care practices received Level 3 recognition from the National Committee for Quality Assurance (NCQA) Patient-Centered Medical Home (PCMH) program for using evidence-based, patient-centered processes that focus on highly coordinated care and long-term participative relationships. The Patient-Centered Medical Home (PCMH) is a transformative model of health care delivery that aims to improve the quality and efficiency of care. PCMH identifies practices that promote partnerships between the patient and their personal clinicians, instead of treating

patient care as the sum of several episodic office visits. Each patient’s care is tended to by clinician-led care teams, who provide for all the patient’s health care needs and coordinate treatments across the health care system. “The active, ongoing relationship between a patient and clinician in medical homes focuses on helping the patient stay healthy and preventing illness,” said physician Lynne Humphrey, medical director for the Heritage Group. “PCMH Recognition shows that St. Joseph’s Physicians has the tools, processes and resources to provide its patients with the right care at the right time.”

Upstate Cancer Center Gets Award Upstate University Hospital has received the 2015 Outstanding Achievement Award by the Commission on Cancer (CoC) of the American College of Surgeons (ACS). Upstate is one of a select group of only 20 U.S. health care facilities with accredited cancer programs to receive this national honor for surveys performed Jan. 1 to June 30, 2015. Upstate is one of only three institutions nationwide to have received the award for four consecutive surveys. The award acknowledges cancer programs that achieve excellence in providing quality care to cancer patients. “We’re grateful to our entire cancer team, because their dedication to the treatment of our patients and care of their families is what earns us accolades like this one,” said physician Leslie J Kohman, medical director, of the Upstate Cancer Center. “The Commission on Cancer honor is important to us because it October 2015 •

recognizes the quality and breadth of our cancer program, including patient education, research and clinical care.” Upstate’s cancer program was evaluated on 34 program standards categorized within one of four cancer program activity areas: cancer committee leadership, cancer data management, clinical services, and quality improvement. The cancer program was further evaluated on seven commendation standards. To be eligible, all award recipients must have received commendation ratings in all seven standards, in addition to receiving a compliance rating for each of the 27 other standards. “Continuing recognition from the Commission on Cancer is a reflection of our team’s dedication to constant improvement and high quality care,” said Richard Kilburg, administrator of the Upstate Cancer Center. “Our commitment to our patients drives everything that we do, and this award is an affirmation of that.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

Page 21


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from page 4 afternoon snack will be provided. The camp’s half-day options run from 9 a.m. to noon and 1 – 4 p.m. Early registration pricing and a discount for siblings is available through Oct. 5. Registration is discounted for JCC members, however membership or JCC program enrollment is not necessary for a child to attend the Columbus Day vacation camp. For more information and to obtain a registration form, call 315-445-2360 or visit www.jccsyr.org.

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Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own,” is a three-part workshop offered for women who want to rediscover joy and contentment, and to gain the knowhow to forge a meaningful life on their own. You’ll meet others in similar situations and learn practical strategies to overcome loneliness, rediscover your true self and socialize in a couples’ world. The workshop takes place from 6:30 – 8:30 p.m. at House Content Bed & Breakfast in Mendon on three consecutive Wednesdays: Oct. 14, 21 and 28. Light refreshment is provided. The workshop fee of $145 includes a Living Alone binder, empowerment exercises and helpful resources. To learn more, contact Gwenn Voelckers at 585-6247887 or email gvoelckers@rochester. rr.com. Voelckers is the author of the column “Living Alone,” published every month in this newspaper.

315-483-9118 Oct. 20 www.blossomview.com Class to Help Improve Balance offered in Oswego

For comprehensive, quality care from physicians you can trust, turn to University OB/GYN Associates All general and specialty women’s services are provided by our group

Certified instructors at Bishop’s Commons in Oswego will again lead the popular weekly class designed to help participants improve their balance and avoid falls. Titled “6 Steps To Better Balance,” the class will follow a six-step approach to better balance developed by Betty Perkins-Carpenter

at Senior Fitness Productions. It will be led by certified better balance program instructors and will meet once a week beginning Tuesday, Oct, 20 and continue through Tuesday, Nov. 24. Classes will run from 1 – 3 p.m. each week. As a member of the Oswego County Falls Prevention Coalition, Bishop’s Commons will make this six session class and accompanying instructional material available free of charge to class participants. Registration is required and space in the class is limited. To register for the class, or for more information about the “6 Steps to Better Balance” program, please call 349-0799 or 592-0827.

Oct. 23

St. Luke Health Services to celebrate 40 years St. Luke Health Services in Oswego and affiliates are set to host a “Cheers To 40 Years” Wine and Beer Tasting Celebration on Friday evening, October 23rd and the public is invited. The celebration will mark the nonprofit, community-based healthcare provider’s 40th year of serving the greater Oswego County community. The “Cheers to 40 Years” event will feature a number of local wineries and local distilleries each providing tastings of their most delicious offerings, food pairings from local establishments, and a variety of seasonal beer samplings courtesy of Eagle Beverage. A silent auction with prize packages, raffles and live music by The Billionaires will add to the excitement. The event will take place from 6 – 10 p.m. on Friday, Oct. 23, at the Lake Ontario Event and Conference Center, 26 E. First St. in Oswego. Tickets are $30 each for adult/general admission and $15 each for special designated driver tickets. To purchase tickets, stop at St. Luke Health Services, Bishop’s Commons or St. Francis Commons in Oswego, or Michaud Residential Health Services in Fulton. Tickets are also available online at www. stlukehs.com, or www.ticketleap.com. For more information call 342-3166 or visit The St. Luke Family of Caring website at www.stlukehs.com.

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Our physicians are faculty of the Upstate Medical University We are the only group with the Academic Difference Most insurances accepted www.upstate.edu/obgyn Page 22

IN GOOD HEALTH – CNY’s Healthcare Newspaper • October 2015

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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