In Good Health

in good

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Doctor’s Orders

A physician explains what’s best to order at a fast food restaurant

Will you be mine?

Dating tips for finding that special someone

Oneida Healthcare Now Offers Robotic Surgery

Good Oil, Bad Oil Shared Decisions Utica doctor now helps patients make better decisions Meet Your Doctor Chief medical officer at Finger Lakes Health, Dr. Jason Feinberg

February 2012 • Issue 146

CNY’s Healthcare Newspaper

New Study Shows Americans’ Heart Health Needs Improvement

Cardiovascular diseases still account for one in every three deaths in the US. Learn how to get your heart in shape.

Ted Long, a Big Loser: 100 lbs Down and Counting Taking Control of Rochester Heart Your Life in 2012 Institute’s Big Star Ted Long of ‘Ted and Amy’ fame underwent bariatric surgery Sept. 22 as the first patient at Crouse Hospital’s new weight loss program. He has lost 100 pounds as of Jan. 25. His goal is to lose 50 pounds more. A conversation with Long about his surgery, his new diet and his new attitude toward eating and activity.

February 2012 •

Lynette M. Loomis, a certified life and business coach, discusses steps you can take to lead a more productive life this year.

“Step over those preconceived notions about yourself and dig into life with both hands,” she says in a special article for In Good Health.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 1

WHEN YOUR HEART IS ON THE LINE, GETTING HELP FAST CAN MAKE ALL THE DIFFERENCE. Chest pain isn’t the only sign of a heart attack.

Shortness of breath; back, arm or jaw discomfort; severe nausea; or heavy sweating also may indicate a problem. As the first Accredited Chest Pain Center in Syracuse, St. Joseph’s knows just how important it is to diagnose and treat these symptoms quickly and accurately. Seeking medical help right away can help protect you from serious heart damage and create a more positive outcome from a potentially dangerous situation. So, don’t hesitate to call 9-1-1.

Your heart—and your life—may depend on it.

HEART ATTACK? EVERY SECOND COUNTS. CALL 9-1-1.

St. Joseph’s Hospital Health Center 301 Prospect Ave. Syracuse, NY www.sjhsyr.org St. Joseph’s Resource Line (Physician & Program Information): 315-703-2138 St. Joseph’s is sponsored by the Sisters of St. Francis.

Franciscan Companies is a member of the St. Joseph’s Hospital Health Center network.

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

SYRACUSE’S FIRST ACCREDITED CHEST PAIN CENTER

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February 2012 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Feb. 3–5

Tennis tournament to benefit AIDS Community AIDS Community Resources is sponsoring its 13th Annual Heart-toHeart Mixed Doubles Tennis Event Feb. 3–5 at Tennis-n-Gear of Liverpool and Gold’s Gym in DeWitt. Registration is $60 per team; $30 per person.

All ages and skill levels are welcome.

The United States Tennis Association sanctions the Open Division. Highlight includes awards for winners of each division, equipment and instructions for beginners free of charge and refreshments. Proceeds benefit AIDS Community Resources. For more information or to register call Chris Galle, 451-5050 or Carrie Large, 475-2430 or AIDSCommunityResources.com.

luncheon from 12–1:30 p.m., Wednesday, Feb. 15 at the Rochester Riverside Convention Center in rochester. The event celebrates Susan B. Anthony’s life, work, and legacy, and is held each year near her February birthday—this year on the date itself, the 192nd anniversary of her birth. Maestro Remmereit is scheduled to speak at our luncheon. “We are excited about his leadership of the RPO and especially his enthusiasm for women in music,” said Deborah Hughes, executive director of the Susan B. Anthony House. “He is celebrating his new home in Rochester and its great history as the home of Susan B. Anthony and center of the women’s rights movement by featuring women composers in all of his concerts this year.” For more information, visit www.susanbanthonyhouse.org.

March 17

First ‘Run For Dennis’ 5K run/walk is held in Oswego

Feb 15

Susan B. Anthony House luncheon to feature RPO Arild Remmereit, 11th music director of the Rochester Philharmonic Orchestra, will be the keynote speaker for the Susan B. Anthony annual birthday

The first Run For Dennis 5k Run/ Walk is scheduled for 10 a.m., March 17 to honor the memory of Oswego resident Dennis Pacheco, a victim of bladder cancer who died in March last year.

“This run/walk will be chip timed and

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Meet your

USA Track & Field (USATF) certified,” said Jessica Newson, race director and Pacheco’s daughter. All proceeds of the race will go to bladder cancer advocacy and research. This year’s recipients are Strong Memorial Hospital Cancer Center, Rochester, and the Bladder Cancer Advocacy Network (BCAN).

Prizes will be awarded to winners in all age groups—including last place.

“Before learning he had cancer, Dennis was always quick to lend others a helping hand. We would like to honor his giving ways by helping to continue the fight against bladder cancer, the fourth most common type of cancer among men in the US. More than 69,000 cases were diagnosed in 2011 alone. Registration for the race, which begins and ends at Gibby’s Pub on Lake Street, Oswego, is $20 per person by Feb 17, $25 after that date, and $30 on race day.

Registration is open at www.EZRaceReg.com. The website for the race is www.runfordennis.com and the event is also on Facebook at www.facebook. com/runfordennis.

how to forge a meaningful and enriching life on their own. Participants will discover how to think differently about living alone, overcome loneliness and other emotional pitfalls, rediscover their true selves, and socialize in a couples’ world. The workshop takes place at House Content Bed & Breakfast in Mendon from 7–9 p.m. on three consecutive Wednesdays: March 7, 14, and 21. The workshop fee of $125 includes a Living Alone manual, empowerment exercises and lots of helpful resources. To register, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@rochester.rr.com

Clarification In the December issue of In Good Health, Dr. E. Mark Levinsohn, radiologist with Wellspring Breast Center of Upstate Medical University at Community General Hospital, referred to breast MRI, not mammograms, when he said, “A patient needs a 20 percent or greater risk factor to be covered by most insurance companies.” He referred to mammograms when he further stated that for women between the ages of 40 and 50, “some insurance companies only pay for every two years.”

March 7, 14, and 21

Living Alone: Survive and Thrive on Your Own Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own” is a three-part workshop offered for women who want to gain the know-

Yoga For Those Recovering From Illness or Medical Treatment Upstate Yoga Institute in Syracuse announced it is now offering a “Restorative Yoga” class on Mondays.

The class is designed to bring the therapeutic benefits of yoga to individuals who are dealing with or recovering from illness, injury or medical treatments. It is also for anyone whose energy is so diminished by stress that they do not have the stamina for a regular yoga class.

David Jacobs, a certified yoga teacher in the therapeutic tradition of Krishnamacharya, leads the class. He said each class begins with attention directed on the breath before body movement is added. “Various gentle postures are done while sitting on a chair, then standing, and, finally, lying on the floor. This approach relaxes, realigns, and restores the student on

the physical and energetic levels. There is never a requirement to do anything that does not feel appropriate or safe,” Jacobs said.

Each class concludes with a quieting and centering experience, which provides more effective recuperation than normal sleep or other typical means of relaxation.

Jacobs has extensive training in the Krishnamacharya / Desikachar yoga tradition, He has also received certification from Nischala Joy Devi, who was instrumental in developing the yoga portion of both The Dean Ornish Program for Reversing Heart Disease and the Commonweal Cancer Help Program in California. In addition, Jacobs has trained at the Center of Mindfulness at the University of Massachusetts Medical Center in the Mindfulness Based Stress Reduction (MBSR) model developed by Jon Kabat-Zinn and teaches this program to students through the counseling center at Syracuse University.

Upstate Yoga Institute is located on 4863 East Genesee St. For more information, visit www.upstateyogainstitute.com or call 445-4894.

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At Auburn Memorial Hospital, we respect that you have a choice of medical facilities. The decision is not one you take lightly…neither do the physicians who overwhelmingly refer their patients to us. When you are our patient, our highly qualified Care Team focuses on one thing: YOU. We take the time to understand your medical history and we personalize a care plan just for you. We strive to minimize your waiting time and give you priority treatment for acute conditions. AMH has invested in a state-of-the-art, ultra secure Electronic Medical Records system to seamlessly, instantly share your information among all members of your Care Team. That means you only tell your story once and your Care Team stays up-to-date on all aspects of your care. We are 800 staff members and 230 clinicians strong. We perform thousands of inpatient and outpatient procedures each year…focusing on one patient at a time. When you choose AMH, your Care Team provides professional excellence and compassionate care….close to home.

Auburn Memorial Hospital 17 Lansing Street, Auburn, New York 13021 P:315-255-7011

www.auburnhospital.org About the Care Team: The AMH Care Team of 800+ employees and 230+ clinicians perform thousands of inpatient and outpatient procedures each year. Our physicians are Board-certified in one or more specialties, including: Anesthesiology, Emergency Care, Medicine (including Allergy, Cardiology, Dermatology, Endocrinology, Family Practice, Gastroenterology, Internal Medicine, Nephrology, Neurology, Oncology/Hematology, Pulmonary Diseases), Oral Surgery, Obstetrics and Gynecology, Pathology, Pediatrics, Psychiatry, Radiology (MRI & Nuclear Medicine), and Surgery (Bariatric, Ear, Nose & Throat, General, Orthopedic, Ophthalmology, Plastic Surgery, and Urology).

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

Fast Food:

Upstate Yoga Institute

What The Doctor Orders

Sharing yoga since 1983

C

ounting calories doesn’t have to end when facing a fast-food menu. Between shopping excursions to the mall, juggling school activities or taking long car trips, swinging into a convenient burger or taco joint doesn’t have to mean you are entering a nutritional wasteland.

“The average American consumes close to 50 percent of his or her meals outside of the home and fast-food restaurants are abundant,” said Jessica Bartfield, internal medicine who specializes in nutrition and weight management at Gottlieb Memorial Hospital, part of Loyola University Health System. “By following a few rules, you can keep any fast food meal in calorie check.”

Bartfield likes sandwich shops that allow customers to load up on vegetable toppings, which adds nutritional value, and also pass on higher-calorie ingredients like cheese and dressings.

“I am also a fan of fast-food places that offer soup or even chili as soup can be a terrific option, particularly ones loaded with veggies, lean meats and beans,” she said. “Be careful to avoid the cream- or cheese-based soups and beware the bread bowl, which can increase the calories by up to 1,000.”

Bartfield’s Fast-Food Favorite Five

1 — “Select grilled rather than fried. A fast-food grilled chicken sandwich has 470 calories and 18 grams of fat while the fried version has 750

Yoga classes at all levels, Restorative Yoga, Yoga Philosophy, Vedic Chanting, and Yoga Nidra.

Visit our new center at 4863 East Genesee Street www.upstateyogainstitute.com 445-4894

calories and 45 grams of fat.”

2 — “Hold off on cheese, mayonnaise and salad dressings unless lowfat options are available. Cheese can add an additional 100 calories or more per serving, as does mayonnaise and, often, you won’t miss the taste when ordering the plainer versions.”

3 — “Order the smallest size available. Go for the single burger rather than the double and for the small fry rather than bonus-size.”

4 — “Skip sugar-sweetened drinks, which are usually absent in nutritional value and don’t make you feel more satisfied. These calories quickly add up leading to excessive calorie consumption, especially at restaurants offering free refills on drinks.”

5 — Save half of your order for your next meal. You save calories, save time and also save money.”

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

Health CNY’s Healthcare Newspaper

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

In Good Health is published 12 times a year by Local News, Inc. © 2012 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: (315) 342-1182 • Fax: (315) 342-7776.

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, Deborah Jeanne Sergeant, Anne Palumbo, Aaron Gifford, Chris Motola, Melissa Stefanec, Mary Beth Roach, Lynette Loomis • Advertising: Jasmine Maldonado, Tracy DeCann • Layout & Design: Chris Crocker • Proofreading: Shelley Manley • Office Manager: Laura J. Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

Meet

Your Doctor

By Chris Motola

Dr. Jason S. Feinberg Chief medical officer at Finger Lakes Health discusses recruiting efforts, hospital branding and the importance of computerized physician orders Q: Can you tell me a bit about your background and how you came to your position as VP of Medical Affairs at Finger Lakes Health?

A: I went to medical school in Syracuse and I did my residency in San Francisco at University of California at Stanford. I was in the Navy for active duty from 1993 to 1999 and was last with them in Beaufort, South Carolina. I came up here and worked as a primary care physician until 2006.

In 2006, I left primary care to start the hospitalist program in Geneva, taking care of hospitalized patients only. Then about two years, I stepped into an interim role as chief medical officer here at Finger Lakes Health. Last year I was asked to take on the role as a permanent position. I still run the hospitalist program in addition to my role as chief medical officer.

Q: With Syracuse immediately to east and Rochester to the west, is it difficult to attract physicians to a more rural hospital like Geneva’s?

A: It’s definitely an effort to attract physicians to a rural hospital. The challenges associated with that are physicians having to be on call. You really need to establish enough physicians to share calls if you want to have someone available 365 days a year, 24 hours a day. The number of physicians required to maintain a reasonable call schedule and available is, at a minimum, three. Ideally it’s as large as your volume allows. You can imagine being one of two surgeons, being on call every other day for 36 hour shifts is a lot. When you recruit someone here, the first thing they ask isn’t necessarily how much money they’re going to make, but how often they’ll be on call.

It’s a real quality of life issue.

and fellowships. With the establishment of a good call schedule, they feel a lot better sharing the bigger cases amongst them. If you were a surgeon that didn’t have a lot of support and you were on call all the time for your patients, you wouldn’t want to take a case that requires a lot of phone calls and a bunch of visits to the hospital.

But now they can take on bigger cases because they’re more rested. I also see big growth in orthopedics. Our joint center will be open in January [2012], which is a dedicated unit for joint replacement. We anticipate significant growth in that department. We’re also seeing growth in cardiology services.

Q: Do hospitals need to create a brand for themselves nowadays? Do you need to be the “heart care hospital” or the “joint replacement hospital?”

A: I think to a certain extent the smaller area hospitals may need to consider that.

We don’t do

Q: What kinds of solutions have you come up?

A: You can recruit enough physicians in that specialty to provide that service or bring existing physicians in those specialties together. Most recently that occurred here with two orthopedic groups coming together into one call group. It’s bringing people together to provide the service.

Q: What services do you see as growth areas?

A: I see growth in general surgery. Newly trained physicians that we have are much more likely to take on bigger cases as they’re closer to their residency Page 6

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

cancer treatment at our hospital, so that could be a niche for a smaller hospital in our region. I think Geneva General is bigger than a really small hospital and it’s growing. It’s somewhere between a rural hospital and a small city hospital. It’s pretty much a medium sized hospital. So our brand would be doing what small hospitals should be able to offer, a wider range of service that can be safely done in a small hospital supported by a threshold of volume. By threshold of volume, I mean that if you do a procedure once a year, you probably don’t want to be branded that way and advertise it in that way. But a lot of generalized care can be at a community hospital, and that’s what we want to be. Whereas a lot of the other facilities, because of affiliations, a lot of patients hit their doors and they get shipped off to Rochester or Syracuse. I think our brand would be to provide the services that a hospital should be able to do here and do them better than the city hospitals.

Q: What does Geneva, the city, have to offer physicians? How do you sell it to recruits?

A: Number one, it’s central Finger Lakes. That means four distinct seasons, a lot of great, beautiful lakes. It means outdoor opportunities like skiing, fishing, hunting, boating, sailing, all of those things are at your finger tips. You don’t have to commute far or spend much. It’s a very affordable place to live and a very comfortable place to live. It’s a great place to raise children. I think the opportunities my kids have are more diverse, in many aspects, than they would have growing up in a big city.

Q: What is it like being in medicine in the Navy compared to being a civilian physician?

A: That’s a great question. I can sum it up really quickly: it’s about leadership. The military immediately asks you to assume a leadership role.

You get trained on leadership really early on and they have ongoing leadership courses. They have this chain of command that means being responsible for x amount of people and x programs. They basically toss it in your lap and you have to perform. I think it’s allowed me to take the role I have today. Not all physicians in the civilian world are leaders. I don’t mean that in a bad way. A lot of people just didn’t get that training. In the military, you really don’t have that option.

Q: Can you talk a bit about the Computerized Physician Order Entry (CPOE) system, of which you’ve been an advocate.

A: One thing I learned in the Navy; we were completely electronic at that point. It’s a way you order medications electronically, which provides a higher level of accuracy than written orders. It translates to improved safety.

You know the saying about physicians’ handwriting? Not just physicians’ but handwriting in general, can be hard to interpret. When we’re using handwriting to interpret important things like the type of medication, the dosage and the frequency with which it should be taken, the way medical language is built, a lot of names look and sound alike. Punctuation can make a difference. You might get 50 mg when you want 5.0. In CPOE, these are preformed strings that doctors type in and then choose a dose, so it’s not as open to interpretation. It’s a driving force towards safety.

Lifelines Name: Jason S. Feinberg, M.D. Position: Named vice president, medical affairs & chief medical officer for Finger Lakes Health in Geneva in February 2011.

He is also the medical director of Seneca Lake Terrace and Finger Lakes Visiting Nurse Service, and also served as Ontario County Coroner from January 2008 to December 2010.

Education: A native of Miller Place, NY, he received an undergraduate degree in chemistry from Hobart and William Smith Colleges in Geneva, He attended medical school at Syracuse Health Science Center in Syracuse, and completed his internship at Naval Hospital in Oakland, Cal. He completed his internal medicine residency at the University of California San Francisco Medical Center, and is certified by the American Board of Internal Medicine. He served in the U.S. Navy from 1990-1999, where he achieved the rank of Lieutenant Commander.

Family: Married, three children Associations: American College of Physicians, American College of Physician Executives, Society of Hospital Medicine Hobbies: Fishing, Hunting, Skiing

He’s a Big Loser! and it absorbs fewer calories “People that think this is an easy way out,” Long said. “That drives me crazy. There’s absolutely nothing easy about it. You pretty much have to retrain yourself on how to eat.”

Long said he had been a big eater and a fast eater. “This doesn’t give you a choice but to eat slow,” he explained.

The last option

Then Ted of ‘Ted and Amy’ fame uses surgery to shed excess weight

By Mary Beth Roach

W

hat a difference a year makes! As he marked his 50th birthday last January, local radio personality Ted Long began to take stock of his life.

With his children older, he figured that they’ll be starting families of their own, and he wanted to be around for them and for his wife, Bobbie.

“I was huge. I had high blood pressure. I was on blood pressure medication. Cholesterol. I had sleep apnea, and it’s all weight related. My doctor said, ‘You keep going the way you’re going and it’s just a matter of time before you’re going to be diabetic.’ So I had to do something drastic,” Long said.

On Sept. 22, 2011, he underwent Roux-en-Y gastric bypass-laparoscopic surgery and has the distinction of being the first patient at the new weight-loss surgery program at Crouse Hospital in Syracuse.

The team performing the procedure included Jeffrey DeSimone, who heads up the program, and Kenneth Cooper.

And now—as of Jan. 25—he is down about 100 pounds and is still working to achieve his goal of dropping 150 pounds.

Long struggled with his weight for years, but with little success, he admitted.

“I’ve had problems in the past. I’ve tried losing weight a bunch of different ways. It hasn’t worked. I haven’t been able to stick with it,” he said.

The Roux-en-Y surgery seemed to be the best option for Long.

In this procedure, a small pouch is created for the stomach, and doctors reestablish the connection with the small intestine, bypassing a large percentage of the stomach and several feet of the small intestine, according to DeSimone. By creating a smaller stomach, the patient will feel fuller quicker, he said, and by circumventing such a large portion of the small intestine, its digestive and absorption functions are altered,

DeSimone concurred in that it is not the easy way out. “It is the exact opposite,” he said.

Bariatric surgery is the last option that many people have, he noted. It is for patients in excess of 100 pounds who need to lose the weight because they have significant medical conditions or because of their weight, they are prone to develop these conditions.

Referring to it as the biggest single lifestyle change, DeSimone pointed out that extensive physical and emotional preparation is critical.

To assist in that preparation, Crouse, for example, holds free informational sessions several times a month that allows potential patients to meet with the surgeons to discuss the different options and whether they are physically able to have the procedure.

Patients are also required to meet with psychologists to talk about what motivates their eating, what situations they find themselves in when they’re eating, how they handle stress and how they will handle it post-operatively.

Some patients, DeSimone said, will even grieve the loss of food.

Upcoming sessions are scheduled for Feb. 7; Feb. 16; Feb. 25; March 6 and March 15 at the Marley Education Center at 765 Irving Ave., Syracuse.

Those interested can call 315-4722464 or visit crouse.org/weight-losssurgery to register.

The hospital also has support groups that meet once a month, and it is working on developing online support groups well, according to Robert Allen, vice president of communications at Crouse.

It’s game time

After six months, Ted was ready.

“I was really psyched about having this done. I just kept telling myself how much better my life was going to be afterwards. I just kept picturing myself going shopping for smaller clothes, which is huge for me because I’ve had to shop in the big and tall department for over a decade now,” he said.

Long’s wardrobe isn’t the only thing changing.

His attitude, his activ-

ity level, and his fast-food habits are all different, as well.

Amy Robbins, who has co-hosted “The Morning Show” with Ted on 93Q for the past 23 years, loves his new attitude. And in an effort to help Ted, she even stepped in a few weeks ago and took home a plate of Christmas cookies so he wouldn’t be tempted.

And instead of going for pizza or ice cream, Ted and wife Bobbie, who had the same procedure in late fall, go for walks.

“I’m surprised some pizza places haven’t gone out of business in Baldwinsville,” he joked.

What are Ted’s expectations now after the surgery? He remains realistic.

While he works toward losing a total of 150 pounds, he knows that to get there will take initiative.

“Looking at this overall, you have to treat it just like a tool. This isn’t the be-all and end-all,” he said. “I will be working out regularly. I will be watching what I eat. It is a tool, along with diet and exercise. But in my situation, it was a must-have tool. I was at that point in my life where it wasn’t the easy way out; it was the only way out.”

Long urged those serious about doing the procedure to talk with their doctor, to take advantage of the free seminars and to seek out support groups to get others’ advice.

DeSimone has seen a large increase in the number of bariatric surgeries, estimating that they are about 10 times more common as they were 10 to 20 years ago, and he noted the improvements the procedures have made in patients’ health, with many recovering from type 2 diabetes and lowering cholesterol and hypertension levels.

And he believes that the new program with Crouse Hospital will allow them to grow exponentially, emphasizing that the hospital’s commitment of resources, both financial and staff, only serves to enhance the level of care for patients.

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A leaner Ted Long with radio partner, Amy Robbinns February 2012 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Will you be mine? Dating tips for finding that special someone

I

’m often asked by readers and those who attend my “Live Alone and Thrive” workshops whether I ever date. My answer is unequivocally “yes,” and more often than not, people are surprised by my answer.

I like the question, because it gives me a chance to remind everyone that being successful at living alone doesn’t mean one needs to abandon the idea of building and sharing a life with someone special.

I’ve said it before and it bears repeating: Living alone doesn’t mean being alone. Many people satisfy their need and desire to be with people by developing a great group of friends, including family members.

Others want more, and long for romance and the exclusive domain of a loving relationship. It is to this latter group that I dedicate this column.

If the idea of dating in mid-life following the loss of a long-term relationship or marriage seems daunting, know that you are not alone. I’ve talked with many older women and men who have resigned themselves to “terminal single-hood,” after having tried unsuccessfully to enter the dating scene. It only takes a few disappointments and rejections to send people running for cover. But like any challenge, if you approach dating with thoughtfulness and

care, a satisfying and lasting relationship is possible at any age.

Below are a few tips I’ve assembled from my own experience and the experiences of others that may help you jump-start your search for a loving companion: Define what dating means to you. If you haven’t dated in years (perhaps in decades), the term “dating” may suggest the first step in a predictable path to marriage. These days, dating is, well, dating.

And you can define it anyway you like. Maybe you just want a date for a work event. Perhaps you’d be happy with a number of companions with whom you could enjoy movies, dinner, intimacy, etc. Or you may be on a serious quest to find a new life partner. Your definition — your dating goal — will shape the style and pace of your search.

Know what you’re looking for. I remember reading a magazine article recently in which the author detailed her experience of writing down 100 things she wanted in a man, and then — lo and behold — having the man of her dreams stroll right into her life. Was it coincidence? Magic? Who knows, but the exercise has merit. Thinking about what you want as well as what’s

KIDS Corner Feelings of Depression and Binge Eating Go Hand in Hand in Teen Girls

By Laura Kennedy

T

eenage girls who feel depressed are twice as likely to start binge eating as other girls are, according to a new nationwide study. The reverse is also true: Girls who engage in regular binge eating have double the normal risk of symptoms of depression.

The findings suggest that young women who display signs of either depression or binge eating should undergo screening for both disorders.

“Binge eating prevention initiatives should consider the role of depressive Page 8

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symptoms … and incorporate suggestions for dealing with negative emotions,” reports the article, which appears in the current issue of the Journal of Adolescent Health.

This study could provide important new opportunities to address the nation’s obesity epidemic, according to senior author Alison Field, an epidemiologist at Harvard Medical School and the Harvard School of Public Health.

The new study is the largest to

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

Find out more about a new “Live Alone and Thrive” empowerment workshop for women, which will be held in March. Check the calendar page in this issue of In Good Health. unacceptable will help you refine your search and improve your chances of finding a compatible partner.

Be yourself. This is no time to try and become the person you wish you were or you think others will find attractive. One of the advantages of being a little older is increased self-awareness and the confidence to be who you truly are. Accept and embrace yourself “as is.” Pretending to be otherwise will only compromise your chances of meeting someone who loves you just the way you are.

Spread the word. If you want to meet someone, make your search a priority and let friends and family know you’re looking. Don’t be apologetic about expressing your desire to find a companion. It might sound like this: “You know it’s been a while, and I’m feeling ready to meet someone. May I ask a favor? Would you keep me in mind if you run into someone you think might be a good fit for me?” Other ways to initiate your search include joining a matchmaking website or by subscribing to a dating service. Having had no

look at the relationship between binge eating and depression during adolescence, when most eating disorders surface. The study authors defined binge eating as eating a large amount of food in a short amount of time and feeling a lack of control over eating during the episode. The study labeled girls who ate large amounts of food but did not feel out of control “overeaters.”

The findings rely on surveys conducted as part of the nationwide Growing Up Today Study. The authors focused on girls because eating disorders and depression are more common in females than in males. The researchers analyzed data from nearly 5,000 girls aged 12 to 18 who answered questions in 1999, with follow-up surveys in 2001 and 2003.

Teens and young women who reported in the first survey that they always or usually felt “down in the dumps” or “depressed” were about twice as likely as others were to start overeating or binge eating during the following two years.

“The most common approach to obesity has been to focus on eating better and exercising more, but many

experience with these methods, I can only offer this bit of cautionary advice: It’s potentially risky, so take precautions. There’s a lot written on this subject, so look for books and articles, or conduct a Web search to learn how best to protect yourself.

Put yourself with like-minded people.

Do you like to dance? Are you an athlete? Is reading your passion? We all like being with people who share our interests and one way to kick-start your dating adventure is to attend social functions that attract the kind of partner you are looking for. Now’s the time to join clubs and groups whose members include potential partners. It could be a book club, a hiking group just for singles, dance lessons that don’t require partners, or support groups or organizations that cater to divorced or widowed men and women. To be successful, you need to get out of the house.

Have fun and keep your expectations in check. We’ve all suffered the occasional bad date or rejection. Try not to let that stop you from meeting new people and pursuing that special someone. Dating, just like networking for a new job, can put you in the company of interesting, stimulating people. Even if your heart doesn’t go pitter-patter, you’ll be out in the world and expanding your experiences and circle of friends. So give it a whirl. Muster your courage, pick up the phone and enjoy finding your very own Valentine!

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 March workshop, check out the Calendar of Health Events in this issue, call 585-624-7887 or email: gvoelckers@rochester.rr.com.

pathways can lead to being overweight,” said Marian TanofskyKraff, a clinical psychologist at the Uniformed Services University of the Health Sciences in Maryland.

“There is a group of people where it may be more psychologically driven. Targeting some of these psychological factors might help prevent obesity.”

“Binge eaters or overeaters can be very secretive, so parents may be unaware that there’s a problem.

That’s a really important message for clinicians,” adds Field. “If they have patients who are depressed, they need to ask about disordered eating patterns and vice versa.”

The authors note that survey respondents include few youths belonging to ethnic minorities or lower socioeconomic groups, so the study findings might not apply to all populations. In addition, the surveys did not include information on use of medications, such as antidepressants, which might affect outcomes.

Laura Kennedy is a contributing writer with Health Behavior News Service.

Upstate Makes Health Records Digital, Accessible

I

n a first for the region, Upstate University Hospital outpatients will be able to access their own health records, request medical appointments and help to manage their own care from their home computer or smartphone through a new, confidential electronic medical records (EMR) and practice management system. The program was launched in January in the hospital’s family medicine practice and will expand incrementally to cover all Upstate ambulatory patients by the end of the year.

An EMR is a paperless, digital system that integrates all of a patient’s records across all components of Upstate Medical University and can be accessed through Upstate MyChart.

“Launching Upstate MyChart, our patient-driven EMR access platform, creates convenience for patients, but also promotes consistency for healthcare providers,” explains Neal Seidberg, Upstate University Hospital chief medical information officer.

“The EMR creates one standardized record of all of that patient’s information. For instance, when determining a prescription a physician can see any other medications that patient may be taking, allergies or related complaints without having to access additional files.”

To access records, patients can choose to create a free account with Upstate MyChart. This secure, password protected account will be accessible exclusively to the patient, around the clock. The information in MyChart is encrypted, meaning that it can only be unscrambled and displayed when the proper username and password have been entered. MyChart is not intended for urgent medical issues or to resolve health-related issues. A patient should contact their provider directly with these concerns.

John McCabe, senior vice president for hospital affairs, Upstate Univer-

Patients can now access their health records through a secure Web portal or smartphone app sity Hospital, recognizes this program as a natural addition to the Upstate offering. “Upstate is committed to embracing opportunities like this that further empower our patients and help to build them a personal network of health information. This is directly in line with our focus on quality and patient safety,” he said.

Immediate benefits include: •Security. The Web portal and smartphone applications of this software have been developed by Epic to meet stringent security standards, which protect patient data at all times.

•Access. All of a patient’s medicines, immunizations and flu vaccines and medical history, as well as any physician’s notes from recent medical appointments, are accessible within the EMR for secure reference. Notes can include recommendations for preventative care and other information discussed in the medical appointment.

•Convenience. Patients can make appointments or submit messages to their physician’s office directly from the Web portal or smartphone applications.

•Access for parents. Parents will be able to access immunization records needed for school children directly through the portal. An additional visit to the physician’s office or fax forms will no longer be necessary.

•Prescription help. Physicians will send e-prescriptions directly to the pharmacy at the conclusion of a visit.

Patients can request refills from their physician using the portal as needed.

St. Joseph’s, SOS to Form Orthopedic Institute

S

t. Joseph’s Hospital Health Center announced it will collaborate with Syracuse Orthopedic Specialists to become the region’s health care provider of choice for orthopedic services.

“This move is a natural progression in the ongoing relationship between SOS and St. Joseph’s,” said Kathryn H. Ruscitto, president and chief executive officer of St. Joseph’s.

“Our mutual commitment is to join resources to achieve excellence in orthopedics.”

With patients as the first priority, the collaboration concentrates the collective efforts of both organizations, forming a comprehensive orthopedic institute comprised of the exceptional talent of SOS surgeons with St. Joseph’s award-winning nursing care and supportive services.

“As the provision of orthopedic care has evolved, we believe we can best work to continue to enhance quality and patient outcomes, increase operational efficiency and lead to a

superior patient care experience by bringing the vast majority of surgeons and patients together into one program,” explained Perry Cooke, orthopedic surgeon, and president of SOS. Cooke explained that hospitals that provide joint replacement, spine care and surgery, and fracture care in high volumes have been able to establish treatment protocols that streamline care and improve outcomes.

“As an integrated team, we will consolidate volume for key orthopedic procedures where the facility, the health professionals and the support structure are 100 percent focused on the best possible orthopedic patient outcomes,” said Kimberley Murray, RN, MS, CNOR, service line administrator for orthopedic and spine services at St. Joseph’s.

The surgeons who currently perform surgeries at the Community General campus are expected to begin scheduling surgical cases at St. Joseph’s beginning in late February.

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Page 9

My Turn

By Eva Briggs

When Snakes and Spiders Attack

M

y husband and I just returned from a two-week visit to Australia. The first or second question that every one asks is, “Weren’t you afraid of the poisonous snakes and spiders?” Since we spent most of our time in Brisbane, an urban area, I didn’t spend too much time worrying about critters. Not even when my daughter told me that she had killed a family of redbacked spiders (a toxic relative of the black widow) in her kitchen cabinets the week before we arrived.

Now that I am safely back home to midwinter, I thought it might be

interesting to write something about venomous Australian creatures. The largest family of snakes in Australia is the “Elapidae.” This group includes the majority of venomous Australian snakes. Elapids have relatively small heads and closed-canal fangs on their upper jaws. They’ve evolved to fill various environmental niches on the continent, and are more closely related to a family of sea snakes than to terrestrial snakes found on most other continents.

It’s a mystery why so many venomous snakes devolved in Australia. It turns out that it takes a lot of energy for

The two most common toxic spiders in Australia are the redback spider and the Sydney funnel-web spider. Shown is a golden orb weaver, which is nontoxic to humans.

snakes to manufacture and maintain venom. Apparently it pays off in terms of being able to subdue larger prey, requiring the snake to spend less energy hunting. Fast-acting toxins that rapidly immobilize the prey also reduce the likelihood that the snake will be injured during a hunting accident.

Subduing the prey so that it can’t escape helps ensure that the snake will be successful in the harsh and arid climate of Australia. Elapid snake venom actually consists of a laundry list of chemicals that attack the prey, at least mammalian prey, with many mechanisms of action. These chemicals include neurotoxins (interfere with nerve transmission), myotoxins (damage muscles), procoagulants (cause bleeding), anticoagulants (cause clotting), hemolysins (break down blood cells), and phospholipases (digest tissues).

The effects on humans include flaccid paralysis, muscle breakdown, disordered blood clotting, secondary renal damage or renal failure, heart damage and hemorrhage into the brain.

Yikes! With that arsenal of effects, it’s amazing that anyone bitten by a snake in Australia survives. Fortunately, only 25 percent of Aussie snakebites are serious enough to require emergency treatment and antivenin. But the onset of symptoms may be delayed, and if a snake in Australia bites you, you’ll need to seek emergency treatment and be observed for 18 to 24 hours.

First aid measures begin with applying a compression bandage, like an ace wrap, as if you were bandaging a sprain, and splinting the limb to keep it

as motionless as possible. Do not give the victim alcohol, food, or stimulants.

Don’t apply a tourniquet, cut, or wash the wound.

The two most common toxic spiders are the redback spider and the Sydney funnel web spider. Only the bite of the female is toxic, and usually the spider must be provoked (as by sticking your hand into its web) before it bites. Most people react only with itching, which may be severe, and is treated with ice. There is an antivenin available.

Male Sydney funnel-web spiders are the most toxic of Australian spiders.

This is unusual in the spider world, as typically female spiders are more dangerous. This spider is large (the body alone is up to 4.5 cm, about 2 inches), black, and aggressive. Most bites occur in the summer or fall when the makes wander into houses in search of mates.

Not every bite results in envenomation.

Symptoms include pain, mouth numbness, abdominal pain, vomiting, sweating, and salivation. If bitten, apply a pressure bandage and splint the bitten limb, then seek emergency medical care. Fortunately there is an antivenin, although only 10 percent of those bitten require it, and there is usually plenty of time to administer it.

Fortunately I didn’t encounter any of these dangerous fauna on my trip. I did see and photograph many golden silk orb weavers, a large and impressive species with magnificent webs visible from a distance.

Eva Briggs is a medical doctor who works at the Fulton Urgent Care operated by Oswego Hospital and at Immediate Medical Care of CNY in Manlius.

Health Apps May Do Little to Change Eating Habits

W

ith more people online and using smart phones, health applications or “apps” as they are popularly known are being promoted to help with everything from exercising to quitting smoking. A new review suggests that apps designed to change and improve eating habits may not make much of a difference.

Recent developments in communication technology have sparked a new way to present information, known as “e-learning.” With e-learning, users can learn skills and receive professional advice on their own time and at their own pace through interactive programs delivered on the Internet, television, CD-ROMs as well as mobile telephones.

“E-learning is a relatively new development in self-management and we were very interested to see what its effect on dietary behaviors might be,” said Phil Edwards, a senior lecturer in statistics at the London School of Hygiene & Tropical Medicine and member of the team of British Page 10

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reviewers.

The systematic review, which appears in the current issue of Health Technology Assessment, looked at whether e-learning to improve dietary behaviors is effective compared with getting the same advice directly from a health care professional, or in some cases getting no advice at all.

The reviewers evaluated 43 research trials, most of which studied e-learning interventions that aimed to reduce participants’ fat intake and increase their fruit and vegetable consumption.

Other interventions focused on weight loss.

Of the 43 studies, 32 presented nutritional and healthy lifestyle information to the user, and 25 required entering what foods were consumed daily. The e-learning programs in 14 studies mostly aimed to change behavior by having the user set dietary goals and then provided feedback on performance and prompts on how to

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

reach those goals.

For example, one study done at a community center in the U.S. had 1,071 participants use an online program once a week for 10-minute sessions over a 12-week period. The program gave goals with specific strategies, plus meal planning and general nutrition information.

The reviewers concluded that the e-learning interventions did not produce significant changes to dietary behaviors, except for a small increase in the intake of fruits and vegetables.

Participants in all studies consumed an average of only 0.24 more servings of fruits and vegetables and 0.78 fewer grams of total fat per day.

The reviewers surmised that other outside factors might have a bigger role in influencing participants’ eating habits. Factors such as the local availability of healthy foods at affordable prices, marketing of energy-dense foods by the food industry, as well as habits learned from family and peers can influence dietary and eating patterns, explained Edwards.

“These wider determinants of dietary behavior are unlikely to be changed by individually targeted interventions such as e-learning,” he added.

Tom Baranowski, professor of pediatrics and specialist in behavioral nutrition at Baylor College of Medicine in Houston, said that while electronic interventions are not likely to work completely by themselves, it “seems premature to close off developing such interventions.”

“We are just beginning to learn how to design electronic interventions and how best to use them,” said Baranowski, who has done his own research in designing video games to promote diet and physical activity behavior change in children.

He added that primary care providers often “do not want to be bothered with dietary change, in part because they don’t get reimbursed for it,” but electronic interventions can be developed for use with patients to encourage behavior change.

Edwards and his team, however, concluded that further research is needed to explore whether there are particular groups of people who might benefit from these programs.

“E-learning may have potential as one approach within a package of interventions to tackle poor diet and obesity in the population,” said Edwards.

Parenting

By Melissa Stefanec

For Parents, It’s Impossible to Agree on Everything

I

t’s been half of a year. It doesn’t feel possible. Life before her seems like a less-than-optimal, vague recollection. Thus far it has been one amazing and challenging ride.

Now that my little one is no longer a nearly immobile mass who is merely capable of bodily functions, eating and sleeping, discretionary parenting decisions are on the rise. In honor of these decisions, big and small, I dedicate this month’s column to the great compromising (and mistake-making) mom and dad.

Agreeing on how to raise a child can be a real challenge for two new parents. It’s your first try at doing things and you don’t have any triedand-tested knowledge to help you. My husband and I are two hearts with the same goal. We want our daughter to be safe, healthy and happy. However, we are also two minds with some differing ideas on how to get there. There is a clear right and wrong when it comes to putting her to sleep on her stomach or back (back to sleep!), but there’s no professional consensus on whether to use teething gel, caplets or whiskey (wait, maybe the jury is in on one of those). So when there’s no black and white, how should parents navigate the

gray?

Let me start by saying my husband and I agree on most of the big things.

We have similar views on religion, discipline, diet, television, vaccination, materialism, tolerance and the like. We talked about these things long before we conceived.

However, we don’t always see eye-to-eye on the small stuff and this has caused some disagreements.

Does mom or dad always know best?

The truth is most days we are guessing. We read a lot and talk to other parents, but there’s no way to know if we are really doing the right things. When we don’t agree, there isn’t often a way to decipher who is wrong or right. Letting one parent have his or her way can mean failure, but we have to be ready to accept that.

I’m sure all new parents go through this. It’s impossible to agree on everything. So we’ve had to find ways to agree to disagree. We’ve decided the most important thing to agree on is working together. We have to stick by each other in the face of our daughter and take disagreements offline. We believe children thrive off unity between parents, so we have to back each other up even when we disagree about the little things.

This is going to be hard, but it’s something I feel all good parents have to learn to do. It’s hard to take a step back when you love someone so much.

As a new parent you don’t want your child to suffer the slightest discomfort.

One of the most difficult things about parenting is the inevitable failures. As adults, we aren’t hard-wired to deal with failing, yet parenting involves frequent failures.

Sometimes our daughter is going to bump her head because we weren’t paying attention. One of her meals is going to be ruined because of an outdated nipple. One of these times one of her tiny fingers is going to get stuck in a zipper. Sometimes my husband and I are going to forget or disregard our game plan and be (gasp) less than unified in her presence. We are going to have to get used to the idea of failing in front of her. Also, we will have to come to grips with the fact that sooner or later she will start recognizing it.

One of the hardest things about growing up is coming to grips with your parents’ own humanity. Realizing your parents make mistakes — big and small — and are far from perfect can be earth shattering. What you don’t realize when you are a child is one of the hardest things about parenting is realizing this very thing. You fail your child sometimes, because you aren’t perfect. These failures hurt far more than failures in other areas of your life, but as parents you have to allow yourself and your partner to fail. That’s how we learn. When those failures happen, you have to offer your support, understanding and forgiveness, not only for your partner, but for yourself as well.

So we have decided that what is best for our little one is to fail together.

Then, when we do things right, we get to succeed together (and celebrate with some whiskey on our gums). In the end we hope our daughter will love us despite everything we did wrong.

Since I’m getting old, I’ll use one of my mother’s lines, one I used to hate hearing. She will understand, someday, when she has her own children.

IN GOOD HEALTH

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Page 11

Taking Control of Your Life in 2012

By Lynette M. Loomis

Step over those pre-conceived notions about yourself and dig into life with both hands

W

e often look for quick fixes, potions and pills to make us happy or content. In truth, our level of contentment with our life is a conscious choice, a purposeful decision, our responsibility. How we deal with a disappointment in a relationship, an economic downturn or a dream not realized is a matter of choice. We can feel like a victim and let it dictate our sense of self and our future or we can decide to be in control of our reaction and choose our own path forward.

So for 2012, let’s make a resolution to practice some new ways of thinking about and reacting to the events in our life and regain control. We will practice them until they become habits. And when we falter and return to familiar, albeit ineffective, patterns, we won’t despair. We’ll say “Next time I will…”

Re-Phrase Our Inner Messages

We will eliminate the phrases “If only…” and “I just wish that…” from our vocabulary. “If only” is a trap that weighs us down and makes us feel ineffective and powerless. It is the sense that a child has that someone else has to make it all better. “I just wish that…” creates a helpless frame of mind that really says “I want it to be my way without me having to do anything.” So this year, we will take charge. We will do everything we can to be creative and resourceful to fix a situation directly. We will rephrase our self-talk to be positive. “If I do this, then I can…”

Failing that, we will change our view of the situation.

Shifting How We Choose to View Our World

This brings us to one of the most important keys to our satisfaction with life — how we view our world. Each of us is the product of everything we have experienced in our life. We likely hold onto some beliefs that hold us back from being the best person we can be.

We unconsciously harbor negative selftalk “I could never do this...” or “I will never be good enough for…” and “If I fail I will die.” Our negative self-talk stops us in our tracks and convinces us not to even try. If we don’t try, we cannot possibly succeed. In 2012, we will identify our negative inner messages that stem from childhood, carried us through gawky adolescence, or moved us through a failed relationships or financial turnaround. We will replace those messages with realistic, positive phrases that will inspire us to move ahead with confidence and optimism.

Accepting and Adapting to Change with Optimism and Grace

Generally, we are creatures of habit and find comfort in routine. But change is inevitable. Sometimes the world around us shifts and thrusts us into an unwelcome place such as the loss of a family member or close friend, elimiPage 12

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Lynette M. Loomis is a certified life and business coach and may be reached at www.yourbestlifecoaching.com. nation of a job, or a change in health status. We go through predictable, and painful, stages of grieving and most of us come out the other side eventually, saddened but whole. We can’t plan for the loss of a relationship we cherish.

We can do everything we can to remain healthy. And we can plan for a change in our employment status by keeping abreast of trends in our field, anticipating what could happen, figuring out how we will react to possible changes, maintaining our networking, and living below our means and setting money aside “ just in case.”

Another type of change involves us changing the way we think or behave.

We often fear that if we change we won’t be successful or we might fail. (If Thomas Edison let that hold him back we would be probably reading this by candlelight.) We might be concerned that if we change, our friends and family won’t accept our changed behavior and we will be lonely. Or perhaps we fear the loss of control when we step outside of our familiar patterns.

Yes, we might need to add some new friends who share our new views or aspirations. And some of our greatest life lessons and insights come from our failures. When I pass, I don’t want one of my last thoughts to be “I had all of these opportunities in front of me and I wasted every one of them.” In our own way, let us be able to say “I went for it.”

Healing Ourselves by Forgiving Others

And in 2012, we will tackle one of the hardest things to do — forgive. Forgiving someone for hurting you is not to suggest you approve of or condone what they did. (In this article we are not taking about crimes against you but those inevitable hurts and disappointments that accompany family or

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

work life or friendship.) Forgiving does not mean forgetting.

We mistakenly believe that if we harbor anger we can make another person feel guilty. We might snub them or be curt in our conversations. (Mind you, a goodly portion what we let hurt our feelings is unmemorable to the other person.) But holding onto a hurt is emotionally exhausting for us — it hurts us more than it hurts our offender! Holding onto a hurt forever can prevent us from moving ahead, being open to new experiences, or trusting again. It negatively impacts our physical and emotional health. It can isolate us from the world. (Bitter people are not particularly engaging conversationalists.) It lets us feel like a victim, all the time.

Mahatma Gandhi has been quoted as saying “The weak can never forgive. Forgiveness is the attribute of the strong.” Forgiveness is not about the offender. It’s about us. It’s about letting go of something that eats away at us. Forgiving allows us to take back control and regain our personal power.

It doesn’t mean we have to invite a person back into our life or trust them the way we once did. It does mean allowing ourselves to move on.

How do we forgive? Compassion.

Consider what circumstances, life experience, insecurities or carelessness that may have led a person to offend or betray you. Forgiveness requires that we look at the situation more broadly and with greater imagination and empathy.

It is not easy, but it is possible.

In 2012, let’s think of a grudge we may have been holding on to, or some anger or resentment we have been harboring, and just let it go. Yes, simply let it go. Let us each free up a negative thought and replace it with greater inner peace. The surge of energy we will experience will be remarkable.

Doctors, Nurses Often Use Holistic Medicine for Themselves

By Milly Dawson

U

.S. health care workers, especially doctors and nurses, use complementary and alternative medicine (CAM) far more than do workers in other fields, according to a new study.

CAM includes diverse therapies outside the realm of conventional medicine. Overall, 76 percent of health care workers report CAM usage, compared with 63 percent of the general working population.

Health care workers use chiropractic treatment, massage and acupuncture for conditions that conventional medicine does not address well, said study co-author Lori Knutson, executive director of the Penny George Institute for Health and Healing with Allina Hospitals and Clinics in Minneapolis.

While conventional providers often treat common issues such as back pain with pain medication, holistic providers address root causes, she said.

The researchers used data from the 2007 National Health Interview Survey, analyzing responses from 14,329 working adults.

Their findings appear online in the journal Health Services Research Among respondents, 1,280 worked in health care and fell into four categories: (1) providers including doctors and nurses; (2) technicians, for instance, sonographers; (3) support workers such as nursing assistants and (4) administrative personnel not providing patient care.

The study looked at practitioner-based CAM, such as acupuncture; self-treatment with CAM, such as practicing Pilates; and any CAM usage such as following a vegetarian diet, meditating and taking certain herbs.

Doctors and nurses had more than twice the odds of having used a practitioner-based CAM method during the prior year and nearly three times the use of selftreatment with CAM than support workers.

“As insiders, health care workers understand what’s missing in our medical system. They’re more educated than others about orthodox and alternative medicine,” said Joya Lynn-Schoen, a psychiatrist by training who instead practices alternative medicine, offering patients homeopathy, nutrition and chelation therapies.

“Mainstream medicine will say, ‘Here’s a pill’ or ‘Have an operation” or ‘There’s nothing wrong with you. You’re just tired.’

“We may be opening Pandora’s box by disclosing utilization of CAM by conventional providers,” Knutson said. “I prefer to believe that this will create an opening for both provider and patient in optimizing health for the whole person.”

Milly Dawson is a contributing writer with Health Services Research Health Behavior News Service.

Which Oil Is Good For You? With all the labels’ various claims, it can be confusing to know what kinds of oil are healthy for the heart and which aren’t

By Deborah Jeanne Sergeant

Y

ou’ve probably seen heart icons and the term “heart-healthy oil,” “no trans fats” or “no hydrogenated oil” on products lately. With all the labels’ various claims, it can be confusing to know what oil is healthful for the heart and what’s not.

Understanding the difference is important.

Saturated fat and trans fat are increase total cholesterol and the lowdensity lipoprotein (LDL), which raises the risk of cardiovascular disease and other health problems. The high-density liporoprotein (HDL), is the healthful kind.

Exercise and maintaining a healthful weight may seem like the solution to combat the impact of saturated and trans fat; however, even slim, fit people can impact their heart health by consuming too much of the artery-clogging fats.

Beyond reading labels for saturated fat, remember that any sources of fat that are animal-based contain saturated fat, including eggs, animal fat (such as in bacon, sausage, and chicken skin), and whole dairy items. Any fat source that is solid at room temperature, such as butter and lard, contain saturated fat, too.

Trans fats, which are manmade, also harm the body since they “affect our cholesterol level by raising the LDL cholesterol and increasing inflammation in our blood vessels, putting us at greater risk for coronary heart disease,” said Matthew Kertesz, registered dietitian at Your Health Your Choice, a private practice in Syracuse.

“If any trans fats are listed on the label and since we are most likely to consume more than the serving size recommended, the general consensus is to avoid all products containing trans fats or in the ingredients section listing

‘partially hydrogenated or hydrogenated fat.’

“Hydrogenated oils means the item contains trans fat but if one serving contains less than 0.5 grams per serving than the label can read 0 grams of trans fat.”

Check labels for words like coconut oil, palm oil, and palm kernel oil, too. Many commercial items such as pastries, cookies, and crackers contain these oils because they are inexpensive and enhance the flavor and texture of the foods. Meal “helpers” such as noodle and rice side dishes and many prepared “heat-and-eat” frozen entrees contain high levels of saturated fat.

Since the unhealthful effects of these foods have become widely publicized, some manufacturers, fast food chains and restaurants are eliminating “bad” oils in favor of heart-friendly ones. Some labels say “Zero grams of trans fat per serving.” This means that the product contains traces of trans fat if you consume only the package-recommended portion size.

Just as trans fat and saturated fat harm the body, other oils can benefit it. Incorporating more healthful oil in your diet to raise HDL levels can be easy if you use the right oil for the right food. Of course, any type of oil has lots of calories, so it’s wise to use them in moderation.

“Olive oil, which is often used in sauces, dressing and marinades, contains more monounsaturated fats and antioxidants than any other oil,” said Maureen Franklin, registered dietitian with Community General Hospital. “It is also contains polyphenols, which offer anti-inflammatory and anti-clotting properties.”

Dipping crusty bread in olive oil infused with garlic and herbs can be a tasty and more healthful substitute for

garlic bread slathered in butter.

“We recommend olive oil for salad dressing,” said Travis Hance, general manager of Syracuse Real Food Co-Op. “Avocado oil and walnut oil have become more popular in the past few years. Avocado oil can be used in a lot of ways and is rich in flavor. Walnut oil is classic in salad dressings and is very, very good for you.”

Roast vegetables in olive oil with herbs and seasonings and sauté meats and vegetables in oil. These would be good alternatives to using butter.

“Sesame oil, which is used as a condiment and cooking oil, contains vitamins B and E, magnesium, copper, calcium and iron,” Franklin said. “The sesamin and sesamolin found in sesame oil lower cholesterol levels and work to protect the liver.

“Peanut oil, used mainly in dishes with nuts, contains an antioxidant called resveratrol.”

Sesame and peanut oil work well in high temperature such as stir frying in a wok because they holds up well to the heat. As a bonus, their flavor enhances sautéed vegetables.

Franklin uses canola oil as an allpurpose oil.

“It is cholesterol-free, has the lowest amount of saturated fat compared to other oils, and has a high percentage of monounsaturated fatty acids,” she said.

Canola oil may be used in a variety of baking and cooking recipes where a bland tasting fat source is desired such as in cookies.

Decrease the amount of oil you use in baked goods by a quarter since oil contains more liquid than butter. Otherwise, the texture may be a little off.

Hance also recommends using soy products for baking.

“We’re seeing a lot of growth in that area,” he said. “The flavor is fantastic. You can’t tell the difference.

It won’t work the same with pie crust or items like sugar cookies where you want the butter flavor. It is not a lowerfat product, but some people indicate it’s more heart-healthy.”

Fat is calorically dense, so it’s easy to consume too many calories when eating fatty foods. Keep daily intake of any kind of fat within 20 to 30 percent of your total food consumption. Keep saturated fat less than 7 to 10 percent of your fat intake and trans fats less than 1 percent (2 grams).

Franklin recommends swapping oil for lower-calorie items when possible.

“For example, applesauce, mashed banana or prune puree can be used for half of the amount of butter, shortening or oil called for in the recipe,” she said.

“Butter spreads or shortenings that have zero trans fats can also be used.”

Report: 3.9 Million Calls to Poison Centers Nationwide A

merica’s 57 poison centers fielded 3.9 million calls in 2010, an average of nearly 11,000 per day, according to the recently published 2010 Annual Report of the American Association of Poison Control Centers’ National Poison Data System.

According to the report, poison experts at the nation’s poison centers treated 2.4 million human poison exposures and handled 1.5 million information calls in 2010. Children younger than 6 accounted for about half of all the poison exposure calls; however, adults 20 and older accounted for 92 percent of all deaths reported.

A total of 1,730 deaths were reported in 2010; of those, 139 were younger

than 20, including 55 younger than 6.

Sedatives/hypnotics/antipsychotics, cardiovascular drugs, opioids, and acetaminophen combinations were most frequently associated with poison-related deaths.

Poison exposures with serious outcomes increased 4.5 percent over the previous year. Eighty-one percent of poisonings were unintentional, and 15 percent were intentional. Of the 15 percent, 9 percent were suspected suicides.

“Poisonings continue to be a significant cause of illness and death in the U.S.,” said Alvin C. Bronstein, lead author of the report. “The NPDS provides a nationwide infrastructure for public health surveillance of poison exposures, including drug, consumer product, environmental and food poisoning. This report supports the value

of poison centers and the need for specialized medical toxicology expertise across the country.”

The 2010 report also highlights the vital role of poison centers in the nation’s public health system. For example, poison centers tracked the health impact of the 2010 Gulf of Mexico oil spill and raised the alarm about the emerging public health threats of designer amphetamines (bath salts) and designer marijuana (spice and variants).

Other findings in the report include: • About 75 percent of all calls to poison centers originated in people’s homes.

• About 71 percent of the 2.4 million people who called with poison emergencies were treated at home, saving millions of dollars in medical February 2012 •

expenses.

• The top five substances most frequently involved in human poisonings were analgesics (11.5 percent), cosmetics/personal care products (7.7 percent), household cleaning substances (7.3 percent), sedatives/hypnotics/antipsychotics (6 percent) and foreign bodies/toys/miscellaneous (4.2 percent).

“This report comes at a time when poison centers across the country are facing budget crises and underscores the valuable service poison centers provide,” said Deborah Carr, AAPCC executive director. “America’s system of 57 poison control centers is one of the most successful and cost-effective public health programs in the nation.

Poison centers save countless American lives and millions of American taxpayer dollars every year.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

SmartBites

By Anne Palumbo

The skinny on healthy eating

Lots to Love About Lentils

L

ong before I became acquainted with lentil’s nutritious ways, I was smitten with the little legume. Cheap, easy to prepare, and possessing a shelf life that suited my lackadaisical single life, lentils were my constant dining companion.

Since then, I have continued to consume lentils on a regular basis — for all of the above and a whole lot more.

Though small in size, lentils pack a powerful protein punch, yielding 18 grams per cup. For most, this supplies nearly a third of our daily protein requirements.

In addition, lentils are loaded with folate, a B vitamin especially important to women of childbearing age because it reduces the risk of birth defects. Just how loaded? We’re talking a whopping 90 percent of our daily needs in one cup. Benefits to new moms notwithstanding, folate helps the rest of us by producing and maintaining new cells, along with preventing changes to DNA that may lead to cancer.

Like most beans, lentils are rich in dietary fiber, both the soluble and insoluble kind. Soluble fiber helps to stabilize blood sugar levels and lower cholesterol, while insoluble fiber promotes regularity. Both contribute

al value of canned lentils versus those you cook yourself is negligible.

Hearty Lentil and Escarole Soup Adapted from Cucina Rustica cookbook (Serves 4 to 6) oil

to a full feeling that helps curb snacking between meals.

More good reasons to befriend this tiny bean? Lentils are easy to digest and have no saturated fat or cholesterol.

They’re relatively low in calories (only 230 per cup). And, they’re an excellent source of iron, providing about as much per ounce as spinach. Do you hear that Popeye?

All things considered, it’s no wonder “Health” magazine included lentils in its top five healthiest foods on Earth.

Helpful Tips

Lentils are a snap to cook and, unlike dried beans, do not need to be presoaked. Rinse, check for debris, and then boil until tender, about 20 to 30 minutes. Lentils placed in already boiling water will be easier to digest than those brought to a boil. Store dry lentils in an airtight container in a cool, dark place and they will keep for up to 12 months (some say longer). Prefer canned? The difference in the nutrition-

1 tablespoon extra-virgin olive

1 small onion, finely chopped 2 carrots, peeled and cut into small dice 3 to 4 garlic cloves, minced 1 14-ounce can diced tomatoes with juice ¼ teaspoon red pepper flakes (optional) 1 teaspoon each: thyme; parsley (or basil; parsley) 1 cup lentils, washed and picked over 6 cups water 6 cups escarole, roughly chopped Salt and coarse black pepper to taste

continue cooking at a simmer until the lentils are soft and the escarole is tender, about 20 minutes more. Add salt and pepper to taste. Optional: Top with shredded Parmesan cheese.

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.

On the newsstands now

Heat the olive oil over medium heat in a large soup pot. Add the onion and carrots and sauté until soft, about 6 to 8 minutes. If vegetables start to stick to pot, toss in a little water. Add the garlic and sauté for 1 minute more.

Add the tomatoes and spices and cook, stirring frequently, until the tomatoes have cooked down slightly, about 6 minutes.

Add the lentils to the tomato mixture and stir. Allow the lentils to absorb the juices of the vegetables for 1 to 2 minutes, then add the water. Bring the soup to a boil, turn down the heat to a simmer, cover, and cook for 20 minutes.

Stir in the escarole, cover, and

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New Stats Show Americans’ Heart Health Needs Improvement Cardiovascular diseases still account for one in every three deaths in the US

A

merica’s heart and blood vessel health is far from ideal, according to new data in the American Heart Association’s “Heart Disease and Stroke Statistical Update 2012,”published in Circulation: Journal of the American Heart Association.

The update provides insight into our less than ideal cardiovascular health.

For example, obesity continues to be a major problem for many Americans. More than 67 percent of U.S. adults and 31.7 percent of children are overweight or obese. Over the past 30 years, the prevalence of obesity in children has increased from 4 percent to more than 20 percent.

The American Heart Association defines ideal cardiovascular health based on seven health factors: smoking status, weight, physical activity, healthy diet, cholesterol, blood pressure and fasting glucose levels, as well as the absence of a diagnosis of heart or blood vessel disease.

Based on that definition, the new data shows that 94 percent of U.S. adults have at least one and 38 percent have at least three of the seven factors at “poor” levels. Half of U.S. children 12 to 19 years old meet four or fewer criteria for ideal cardiovascular health.

Between 1971 and 2004, our average calorie consumption has increased by 22 percent in women (from 1,542 to 1,886 kcal/d) and by 10 percent in men (from 2,450 to 2,693 kcal/d). Many

of these increased calories come from consuming more carbohydrates, particularly starches, refined grains and sugars; larger portion sizes and calories per meal as well as consuming more sugar-sweetened beverages, snacks, commercially prepared meals (especially fast food) and high-calorie foods.

Burning those calories is also an increasing challenge — 33 percent of adults engage in no aerobic leisuretime physical activity.

Furthermore, in 2009, among adolescents in grades nine through 12, 29.9 percent of girls and 17 percent of boys had not engaged in 60 minutes of moderate-to-vigorous physical activity — the recommended amount for good health — even once in the previous seven days.

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

There is some good news in the update — the death rate from cardiovascular diseases (CVD — all diseases of the heart and blood vessels) fell 30.6 percent from 1998 to 2008, possibly due to better treatments for heart attacks, congestive heart failure and other acute conditions.

The stroke death rate fell 34.8 percent during that time period, dropping it from the third to the fourth leading cause of death. While the drop in ranking is mostly driven by decreases in the number of stroke deaths, likely due to better treatment options for acute stroke, reclassifying some respiratory diseases into one category also played a role.

For example, deaths from chronic obstructive pulmonary disease (COPD), bronchitis and pneumonia are now grouped under the larger category, “respiratory diseases.”

Unfortunately, other statistics in the update illustrate America’s continued cardiovascular disease burden: • Cardiovascular diseases accounted for one in every three deaths in the United States in 2008; more than 2,200 Americans die of cardiovascular diseases every day an average of one death every 39 seconds.

• The cost of cardiovascular care and treatment increased over $11 billion from 2007 to 2008.

• The direct and indirect cost of CVD and stroke in the United State for 2008 was an estimated $297.7 billion.

“By monitoring health, as well as disease, the update provides information essential to public health initiatives, patient care and for people to take personal responsibility for their health and for their lives,” said Dr. Véronique L. Roger, lead author of the update and professor of medicine and epidemiology at the Mayo Clinic College of Medicine in Rochester, Minn.

The American Heart Association has set a goal for America — to improve the cardiovascular health of all Americans by 20 percent and reduce deaths from cardiovascular diseases and stroke by 20 percent by 2020. “If we’re to reach this goal, we’ll need to engage every segment of the population to focus on improved health behaviors,” said Donald Lloyd-Jones, an author of the statistical update and chairman of the department of preventive medicine, Northwestern University Feinberg School of Medicine in Chicago.

“In particular, more children, adolescents and young adults will need to learn how to improve and preserve their ideal levels of health factors and health behaviors into older ages. Moving people who are at poor health to make small changes in their behavior and reach intermediate health is a step in the right direction that can make a big difference,” said Lloyd-Jones.

RA and Heart Disease Linked If you have rheumatoid arthritis, beware of heart problems

By Deborah Jeanne Sergeant

F

or years, people with rheumatoid arthritis (RA) have been identified as at twice the risk for cardiovascular disease as the general population.

Typically, rheumatologists screen patients for cardiovascular disease because the increased risk is so high.

Onset of RA is usually in the 40s and women are disproportionately more prone than men. That patient profile — a 40-year-old woman — is atypical for cardiovascular disease.

Many of the medications used to treat RA, an oftentimes aggressive autoimmune disease, have numerous side effects.

Experts had blamed the medication.

“While it still is true that some medications, such as Cox-2 inhibitors —Vioxx for example — have shown to lead to increases cardiac events, the risk goes up even without treatment,” said Robert Carhart, cardiologist with Upstate University Hospital. “The main factor does seem to be the chronic inflammation.”

Rathika Martyn, rheumatologist with Oneida Medical Associates, agrees that “studies have shown that RA increases inflammation and puts you at higher risk for coronary artery disease.

Controlling inflammation is the key.”

Chronic inflammation is such a problem because it can alter or damage cells that line blood vessels. That can lead to more plaque forming inside the arteries.

“Chronic inflammation also makes existing plaques in the arteries more prone to rupture or break open,” Carhart said. “This is the process, plaque rupture, that leads to most heart attacks.”

Chronic inflammation can also promote clot formation in blood vessels, which can increase the risk of heart attack.

“The ‘good’ cholesterol, HDL, which normally protects against the development of atherosclerosis [commonly known as “hardening of the arteries”], may be altered in RA and loses some of its protective effect,”

IN THE RIGHT PLACE, AT THE RIGHT TIME

Upstate Heart Surgeon Charles Lutz MD

Tashiko Melendez was eight months pregnant with her second child when she woke up with chest and back pains. At that moment, she had no idea that Baby Joseito’s birth was just hours away and that an Upstate heart surgeon would save her life.

As the day wore on, Tashiko’s pains grew worse. The ER became her only option.

While initial tests showed a normal heart beat and no problems with the baby, a sonogram revealed the source of her pain… a life-threatening tear in her aorta, the main artery to her heart.

Upstate Heart Surgeon Charles Lutz was summoned to consult with Tashiko’s doctors.

All agreed that Tashiko first needed an emergency C-section to be followed immediately by open-heart surgery. Both procedures were done at Upstate, and a few days later an exhausted but thankful Tashiko was reunited with her son.

“Aortic tears are not uncommon,” said Dr. Lutz, but they are rare during pregnancy.

They always need urgent surgical treatment, and,” he emphasized, “they are often associated with uncontrolled high blood pressure.”

Tashiko Melendez and her son, Joseito

In a matter of hours, a baby was born, a heart was repaired and a mother was given a new lease on life. Just one week after that harrowing day, Mom and baby were home with Dad and big brother. And Tashiko began a new routine of monitoring her blood pressure.

“I feel like a celebrity when I go to Upstate for follow ups,” said Tashiko. “People are fascinated by the woman who had a baby and open-heart surgery on the same day.

Heart & Vascular Center

“I’m just grateful that we were in the right places at the right time.”

Knowing changes everything.SM Carhart said.

Some RA drugs may help mitigate the risk for heart disease, such as methotrexate, possibly because they help control RA well.

The relationship between RA and elevated risk of heart disease could also stem from other factors related to RA. The autoimmune disease causes swelling in the joints and fatigue among its symptoms.

www.upstate.edu/hvc

Some people with untreated RA are more sedentary because of the stiffness and swelling around the joints and fatigue caused by the disease. Sedentary lifestyle contributes to heart disease.

A diagnosis of RA doesn’t guarantee you will have heart problems, just as the absence of RA doesn’t guarantee you will be free of heart problems.

Other underlying predispositions to developing heart conditions — famFebruary 2012 •

Syracuse, NY ily history and lifestyle choices — make a big difference.

If you have RA, controlling it is one key to reducing the risk of heart disease and the other problems it causes. Ideally, treat RA as early and as effectively as possible. Don’t skip doses or keep silent if a particular drug is not working to control inflammation. Numerous

continued next page

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 17

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RA and Heart Disease Linked from previous page RA drugs are available and what works for one person may not work as well for another.

Keep regular appointments with

your rheumatologist and primary care physician. Follow doctor’s orders.

Lower your other heart disease risk factors.

“Patients with RA can help lower their risk by controlling traditional risk factors such as not smoking, keeping blood pressure under control and keeping cholesterol levels down,” Carhart said.

Engage in regular exercise. View it as a vital part of your wellness such as eating well and visiting the doctor.

“RA patients do not exercise as much as the regular population and there is some belief this also may contribute to the increased risk,” Carhart said.

Exercise can promote joint range of motion, weight management and cardiovascular fitness. Aim for at least 30 minutes of aerobic exercise daily as a minimum. Try brisk walking, using an elliptical machine or taking a fitness class you enjoy.

Aquatic exercise can be easier on days when joints are achy. But don’t neglect weight-bearing exercise. Its bonebuilding ability is especially important

since some RA drugs inhibit the body’s absorption of calcium (talk with your doctor about all your prescriptions’ side effects).

Incorporate stretching into your fitness routine to keep your body limber and strength training to help support your joints and build calorie-burning muscle. A yoga or tai chi class or DVD may help, along with light hand weights or resistance bands.

Eat a well-balanced diet rich in fruits and vegetables, whole grains, lean sources of protein and low-fat dairy. Stick with plant-based sources of fat with oils such as canola, olive or corn, not butter, lard or other animalbased fat for cooking.

Avoid processed foods which tend to be high in sodium and artery-clogging fat. Anecdotally, some RA patients say reducing their sugar and processed food intake helps reduce inflammation, along with following their physicians’ advice and taking their RA medication.

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

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Stress contributes to heart disease

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By Deborah Jeanne Sergeant

E

veryone knows that stress can impact one’s emotional state. But unmanaged stress can also damage heart health. Someone stressing over a failed relationship could have a physically “broken heart.”

Robert Carhart, cardiologist with Upstate University Hospital, said, “Stress absolutely impacts the heart both directly and indirectly.

“Sudden, significant stress with its associated hormone release can lead to heart attacks by an increased sudden demand on the heart, especially in people who may already have coronary artery disease or a limitation of blood flow to the heart.

“It also can cause sudden changes in the heart rate and rhythm, which can lead to irregular heartbeats and even sudden death.

“In certain individuals, a sudden increase in stress levels can cause something that has several names: broken heart syndrome, Tako-tsubo cardiomyopathy or catecholamine induced cardiomyopathy.

“This leads to a sudden dilation in heart muscle and loss of function or pumping function. This can lead to acute heart failure.”

Both physical and emotional stress “causes an increase in stress hormone levels,” he added.

“Chronic exposure to stress hormones, including catecholamines (epinephrine or adrenaline), can damage heart muscles.

“Adrenaline also causes effects on the heart rhythm leading to increased heart rate and abnormal heart beats,” Carhart said.

Cardiologists aren’t entirely certain how stress impacts heart health since it’s hard to single it out as a factor in cardiac disease and difficult to measure stress levels scientifically to study its effect.

Matthew Gorman, cardiologist with Cardiology PC in Syracuse, agrees that “stress causes a lot of problems.

It exacerbates high blood pressure and [makes you] more prone to arrhythmia, and statistically increases your risk of having heart attack and cases of acute stress causing a Gorman cardiomyopathy. We see it several times a month.”

Indirectly, these hormones can harm the heart because they increase the risk factors for heart problems.

“These hormones cause blood pressure to go up which can ultimately lead to damage to the blood vessels, including those supplying the heart muscle, the coronary arteries,” Carhart said.

“This can lead to the development of or worsening of atherosclerosis.

“The chronic stress response can also cause an increase in cholesterol levels as well as an alteration in the cholesterol particles through a process called oxidation, which makes them more toxic to the blood vessels increasing plaque build-up.”

Of course, everyone experiences stress of some sort. Work, relationships, illness and disappointments cause stress. Even positive changes such as a promotion or cheering for one’s favorite sports team can be stressful.

It’s impossible to eliminate all stress from life, and considering the positive sources of stress, such as holidays, entertaining and vacations, doing so would be undesirable.

The difference between someone whose stress causes physical problems and one whose stress doesn’t seems to be how much stress they experience and how they deal it.

Just as negative emotional responses to stress harm the heart, positive emotions can be good for the heart. It won’t reverse damage, but Gorman said relieving stress can prevent more damage.

“If you have had a heart attack it’s very important to get your stress controlled to help prevent the risk factors involved with having another heart attack,” he said. “Unfortunately, it is very hard to get people to deal with the stress in their lives.”

Seek relaxation and tranquility through receiving massage therapy, petting a dog or cat or participating in an enjoyable activity.

Regularly engaging in exercise, getting outdoors, engaging in a satisfying hobby or recreational activity, and occasional massage therapy helps relieve stress. Get up a little early to work out before your day becomes too busy. Or slip in mini workouts throughout the day.

Take a walk midday or after work.

The change of pace and fresh air will help you minimize the day’s stress.

If you can’t remember the last time you’ve done something you enjoy just for fun, it’s time to pick up on old hobbies, tweak favorites or try new ones.

Pull out that box of hobby items you’ve kept in storage to see if you still enjoy them. If you loved to sled as a kid, perhaps you’d like snowshoeing as an adult. Or if you’ve always wanted to try martial arts, dance or cabinet making why not take a short-term class to see if you like it before making a commitment?

Many people find massage therapy melts away their tension. If you can’t afford a professional, just lying still in a quiet, dimly lit room for a few minutes or exchanging foot rubs with your spouse may help.

When sudden stressors strike such as the unexpected death of a loved one, turn to positive means of relieving stress, not alcohol, drugs or other destructive mechanisms.

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Page 20

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

More Therapy May Help Some Stroke Patients

By Deborah Jeanne Sergeant

T

he medical community used to accept that stroke patients’ opportunity for improvement was a relatively short time period, a few months at best.

Any recovery of their ability function in daily life activities would not improve after that point.

However, more and more studies are showing that longterm physical therapy can give some patients greater chances for better recovery.

“The research is prevalent on stroke patients five years down the road,” said Karen Kemmis, physical therapist with University Hospital.

“They can still see improvement.”

A study from the University of Florida released this year showed that many patients who continue with physical therapy for up to a year show greater improvement than those who have a brief physical therapy time frame.

“I agree that seeing patients longterm helps,” said Lisa McGork, physical therapist at Oneida Healthcare.

“I’ve seen some patients off and on over a year and it works. They used to think that the window of recovery was six months, but more studies are showing that it’s longer.

“You have to practice a movement or activity the way you want it done, and it takes a lot of repetition and time.

Intrinsically, it makes sense these patients would do better. Practice is what drives plasticity in the brain.”

As hopeful as the studies sound, not everyone shows marked improvement over the long haul. For some, a few months of physical therapy will bring them to their maximum level of recovery, which may not be as close to their previous abilities as they might like.

Unfortunately, some people who could benefit from a longer-term physical therapy regimen may not be able to afford it because their insurance companies will pay for only a certain number of visits.

“The longer term therapy is difficult from an administrative standpoint,” said Jason Pratt, physical therapist at Oswego Hospital. “Some insurance companies restrict patients from further visits unless patients show they have more room for improvement which may be difficult for physical therapists to prove even if they see potential. The gains are sometimes very slow. It’s hard to show on a month to month basis but that’s where insurance companies live.”

Proving the need isn’t something that patients can do. It’s up to their physical therapists.

“A lot of it comes back to us to document it well,” McGork said. “We have to be really careful about our documentation about patients who need longer term therapy.”

For patients on fixed incomes, the co-pays themselves may make physi-

cal therapy hard to afford. At $20 to $40 per visit, paying for two to three visits a week for a couple of months can be difficult. An older patient who may not believe he will make much improvement may resign himself to a marginal recovery and not bother pushing for additional therapy even if it could help improve their quality of life.

When more therapy is not possible, following through with exercises at home is especially important (although most patients must do “homework” and all are encouraged to get back to normal activities. Recovery is any patient’s full-time job.

McGork tries to train the home health aide or family in guiding specific exercises or activities the patient can do at home to help reach the maximum recovery.

Some patients who need more care may also have additional opportunity once the calendar year is over and a new year begins if their policy gives them a certain number of visits per year.

Since most patients typically have plateaus in their recovery, many are discharged during these times and return in a few months when they’re ready to make more progress.

“I’ve had a patient after a stroke whose goal was to walk,” McGork said. “I might work with them for six months until they can walk with a walker, but their goal is to walk with a cane or with nothing.

“I may discharge them from therapy so they can practice and get stronger and more confident and six months later, they may be ready for a cane.”

Working with patient’s natural flow of recovery doesn’t always fit into an insurance company’s ideal pattern.

It’s vital for patients to speak up if they will struggle to pay the co-pays or for additional therapy that their insurance won’t cover. Therapists can suggest resources to help patients in paying out-of-pocket expenses. Charitable organizations, grants and other resources may help.

Local support groups may offer moral support and keep patients and their families abreast with community resources that may further aid them.

“Certain gyms do a really nice job of one-on-one workouts, as long as it’s a person who’s certified and knows what the patient should or should not be doing,” said Amy DeBlois, physical therapist at University Hospital.

If they are capable, some patients may find additional assistance through taking Pilates or yoga.

“We see a lot of people one, two, even 10 years after their stroke and they can make progress,” DeBlois said.

“We do a re-assessment and if we think there’s some progress to be made, we put them on a restorative therapy program again.”

What They Want You to Know:

Cardiologists

By Deborah Jeanne Sergeant

T

he American College of Cardiologists defines a cardiologist as “a doctor with special training and skill in finding, treating and preventing diseases of the heart and blood vessels.”

The ACC describes cardiologists’ training as completing “a minimum of 10 years of clinical and educational preparation [and they] must pass a rigorous two-day exam given by the American Board of Internal Medicine. This exam tests not only their knowledge and judgment, but also their ability to provide superior care.”

• “The most important message that I constantly find myself reminding patients of is that most of the conditions we treat in cardiology aren’t timelimited, short term problems. They are chromic and time-consuming.

• “Patients have to make a commitment to lifestyle changes. With heart health you talk about diet and exercise and they are long-term things. If you are in the hospital for a heart condition and you go home and avoid cheeseburgers for a month that’s great, but this is a life-long issue.

• “Once people recover from an acute problem, they think they’re all better and slip back into the lifestyle that got them into that problem. Many of these things can’t be cured but controlled. If they have had coronary artery disease, heart failure or an arrhythmia problem, it requires long term management just like a diabetic.

• “Many times, unfortunately, we have gotten so good at getting patients feeling better that they think they are all better and there is no need to make changes.

• “Patients should feel comfortable asking questions. I want them to use the Internet or read magazines. The more they understand their problem, the easier the problem is to manage.

They ‘buy into it’ so to speak and it’s easier to motivate them if they understand the purpose as to why they are making these changes.

• “We can’t give them a pill and they’re cured and they go on their way.

It’s an overwhelming problem. There are a lot of things people can do about the amount of stress they have but we can’t make it go away. We can’t write a prescription for a quiet six-year hiatus on a tropical island. The insurance won’t pay for it! If you have underlying heart disease, you have to manage the stressors. It can take a toll on some-

one with pre-existing heart disease and cause problems for anybody. You have to learn to adapt or cope with that.

• “The message to patients is that many problems that we deal with in cardiology are chronic. We want to manage them so patients are not limited by symptoms.

• “You don’t want to get into a situation where you’re in an adversarial situation with your doctor. If we’re late we want to let patients know.

• “Don’t wait until the last pill in your bottle to call for a refill.

• “Ultimately, as with choosing a primary care doctor, choose someone you’re comfortable with. It’s a longterm relationship usually.

• “People get feeling so good they say ‘Why am I taking this medicine?’

But the medicine is why they’re feeling good. Some treatments and tests can determine if medicine can be taken away sometimes. But we can be a victim of our own success because as patients feel better, they think that they no longer need treatment.”

Robert Carhart, cardiologist with Upstate University Hospital

thing that interacts with something else you’re taking.

• “You have to be a participant in your own health care.”

Cardiac Rehab Can Save Lives

Michael Gabris, cardiologist with New York Heart Center in Syracuse, St. Joseph Health Center

ardiac rehabilitation is important for heart health. St. Joseph’s Hospital offers the only program in Central New York that’s certified by the American Association of Cardiovascular and Pulmonary Rehabilitation. The program includes monitored exercise for diabetics and those with risk of cardiac disease.

In a recently published report, the hospital states that it has found that “patients who participate in a cardiac rehab program not only lower their risk of cardiac-related death by 25 percent, but also may experience the following positive outcomes: • 25 percent reduction in risk of death for patients who walk at a moderate intensity (or perform similar aerobic exercise) for more than 2.5 hours per week • 45 percent reduction in risk of death for patients who improve their dietary habits by following the changes recommended by the clinical specialists in the program • 30 percent reduction in risk of death for patients who lower their blood pressure below 140/90 (or less than 130/85 if they have congestive heart failure and less than 130/80 if they have diabetes) • 24 percent reduction in risk of death for patients with diabetes who maintain a HbA1c of less than 7.0 • 15 percent reduction in risk of death for those who reduce their body mass index to less than 30.

• “Heart disease kills more people than anything in this country. A lot of what we see is preventable.

• “It’s a matter of common sense and taking care of yourself and not spending five to 10 years away from your doctor. High blood pressure and high cholesterol don’t present with immediate symptoms.

• “Don’t let your weight get out of control.

• “We also see people ignore symptoms that they should get seen sooner.

It’s always better to get checked out than to ignore things.”

Matthew Gorman, cardiologist with Cardiology, PC in Syracuse

Deborah Jeanne Sergeant is a writer with In Good Health. “What They Want You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.

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• “It’s easier to prevent a problem than to pick up the pieces after something happens.

• “Risk factor modification prior to an event or illness is the No. 1 thing that drives down the incidences of heart disease. It’s not the high tech toys. It’s the prevention that’s the No. 1 thing that improves heart health.

• “Diet and exercise.

• “Weight and obesity is the No. 1 reason people develop adult onset type 2 diabetes, hypertension and other problems. Instead of going on medication, lifestyle is better at treating and preventing those kinds of conditions.

• “It needs to be regular exercise.

Most people, if they do three days of 20 to 30 minutes of aerobic exercise per week will have enough as a minimum.

Most people don’t do that.

• “As for diet, portion sizes are the No. 1 thing. Unless they’re a diabetic, I don’t restrict any item. Everything is super sized at restaurants these days and people eat way more than the energy they expend during the day and that’s where weight gain comes from.

• “When they see me, they’re generally seeing other doctors. Always bring your medications with you and a list of all of your doctors so we know what things are being done elsewhere.

If I don’t know, I could prescribe someFebruary 2012 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

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Doctor-turned-adviser aims at helping patients Dr. Steven Kussin wrote a book and now launched a new business, Shared Decision Center.

The goal: help patients make informed decisions and navigate the complicate healthcare system

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Page 22

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matic as it was, inspired him to help others make the most informed decisions possible about their own medical care.

A car accident six years ago nearly destroyed the gastroenterologist’s right hand and limited the use of his feet.

He sustained 14 broken bones. After several months of recovery, Kussin attempted to resume his hugely successful practice in Utica, but quickly realized that he no longer had a surgeon’s steady touch and felt he would be putting his patients at risk if continued to perform procedures. Starting as a sole practitioner, he had expanded the business to three locations and employed 60 people. It was heartbreaking to leave a career that spanned 30-plus years.

“I felt I was really good at what I did,” said the 57-year-old New York City native, who completed his undergraduate degree at Colgate University in Hamilton, Madison County. “There’s nothing about being a physician where you ever have to question yourself. You make a wonderful income, people look up to you and you help them.”

During Kussin’s hospitalization, he worried about his future as a physician.

But he also had the unique opportunity to experience medicine as someone who already knew the doctors, the facilities and the choices.

“I knew the doctors, their lives, their wives and their strengths,” Kussin said. “I also saw that my care was so much better than everyone else around me. I got better care because I was so much more informed. I started to think about that. You shouldn’t have to be a doctor to be treated like one.”

That was the premise for Kussin’s book, “Doctor, Your Patient Will See You Now.” He stayed busy writing when he was unable to practice. The writing took three years and was difficult at first, but after several months Kussin got the hang of it. It received rave reviews from the New York Times and is on track to be published in paperback this August.

The first half of the book provides an insider’s analysis of doctor’s offices, medical groups, hospitals and emergency rooms, while the second half deals with empowering the patient, whether it’s questioning a physician’s decision, selecting a new provider or taking steps to prevent acquiring infections while hospitalized.

Dr. Christopher M. Johnson, author of “How Your Child Heals: An Inside Look at Common Childhood Ailments,” called Kussin’s book an excellent guide to “patienthood.”

“The American medical system is a vast, sprawling, complicated thing,” Johnson said. “It is barely understandable to the physicians who work in it, and totally bewildering to the majority of patients who must use it. Dr. Kussin’s book is a hard-headed, practical

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

helpful to men who are considering prostate removal or cancer patients who need to weigh their best- and worst-case scenarios with the quality of their remaining life. Kussin’s business also includes an insurance consultant, Linda Lovrim, who advises clients on what procedures are covered and how much they could potentially pay for care out of pocket.

In this practice, Kussin’s tools are digital and interactive. He has a vast library of online manuals and articles, and he uses a software program that allows clients to rate how they feel about each option as they narrow down their choices toward establishing a plan of care. He also role plays with the clients, challenging them to scrutinize a care plan, bargain over co-payment amounts and bring a “healthy skepticism” toward provider recommendations. Kussin likens the process to buying a car, asserting that patients should still consider themselves as a customer and recognize that they have power to make a deal with their physician or take their business elsewhere.

Kussin enjoys his new career but

user’s guide for people who want to know how our complicated and messy system works day-to-day in doctor’s offices and hospitals. It shows readers how to be savvy, how to be their own best advocate in getting care and avoiding bad care….”

Kussin used the momentum from his book to get back into seeing patients. But this time it was in the role as an adviser, not a physician. Three months ago, he established the Shared Decision Center in a revitalized multistory building in Utica. He says it is the only freestanding independent facility of its kind in the nation. He promotes the center on his website, medicaladvocate.com.

Professional consultants in other regions or states charge upward of $300 an hour for patient advocacy services and most of their work is performed by telephone or in the office of a group practice.

Kussin’s service is priced at $165 per visit, which can last more than two hours and includes followup telephone calls if necessary. Right now he’s just hoping to cover operation and facility costs.

“The others [in Kussin this field], their only overhead is their telephone bill,” Kussin said. “I have an office, but it does maintains it is still not as satisfying as not look like a doctor’s office on the practicing medicine. He hopes to “beoutside or the inside. The only differcome saturated” with clients and long ence between me and having a doctor days, but in its infancy stage the pracin the family is with me, you have to tice sometimes serves only one or two cough up the $165.” people a day. During his opening week, Still, Kussin does not consider Kussin actually had more calls from himself a patient advocate. His main local physicians looking for jobs than function is to make a patient informed he had from prospective clients. The about all of their choices. That would doctor believes his business will grow include discussions about the costs of as more people become dissatisfied procedures, recovery time and quality with their health care choices, largely of life — the risks, the benefits, the full because of insurance company policies spectrum of what’s ahead. He will not that dictate medical practices. endorse any option, and every client is “There will be longer lines, shorter required to sign a waiver that acknowl- visits, more complexity to care,” he edges that Kussin would not testify in said. “The divide will be worse than it any malpractice lawsuits against medi- is now.” cal providers.

Kussin still has many good friends “This is supposed to be a comand respected colleagues in the local pletely neutral place for them to learn,” medical community, but because his he said. “The point here is not to get a services are often perceived as a threat second opinion, but to fully understand to health care businesses “they won’t the first one. When you do this, you go near me with a 10-foot pole,” he become a different kind of patient. You said. can’t make a wrong decision if it’s your “But in time,” he added, “I hope decision.” they realize that I’m just here to make This type of service is especially patients better patients.”

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Get Organized

The first step in getting your affairs in order is to gather up all your important personal, financial and legal information so you can arrange it in a format that will benefit you now, and your loved ones later. Then you’ll need to sit down and create various lists of important information and instructions of how you want certain things handled when you die or if you become incapacitated. Here’s a checklist of areas you need to focus on.

Personal Information

• Contacts: Make a master list of names and phone numbers of close friends, family, clergy, doctors, and professional advisers such as your lawyer, accountant, broker and insurance agent.

• Personal documents: Include such items as your birth certificate, Social Security card, marriage license, military discharge papers, etc.

• Secured places: List all the places you keep under lock and key or protected by password, such as safe deposit boxes, safe combination, security alarms, etc.

• Service providers: Provide contact information of the companies or people who provide you regular services such as utility companies, lawn service, etc.

• Pets: If you have a pet, give instructions for the care of the animal.

• End of life: Indicate your wishes for organ, tissue or body donation including documentation (see donatelife. net), and write out your funeral instructions. If you’ve made pre-arrangements with a funeral home include a copy of agreement, their contact information and whether you’ve prepaid or not.

Legal Documents

•Will: Include the original copy of your will and other estate planning documents you’ve made.

• Power of attorney: This names someone you trust to handle money

matters if you’re incapacitated. If you don’t have a will or power of attorney, do-it-yourself resources like legalzoom. com can help you create them for a few dollars.

• Advance directives: These documents — a living will and medical power of attorney — spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself.

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Meals can be home delivered or available at one of six senior meal sites. (There is a suggested donation)

Financial Records

• Income and debt: Make a list of all income sources such as pensions, Social Security, IRAs, 401Ks, interest, investments, etc. And do the same for any debt you may have — mortgage, credit cards, medical bills, car payment.

• Financial accounts: List all bank and brokerage accounts (checking, savings, stocks, bonds, mutual funds, IRAs, etc.) and their contact information. And keep current statements from each institution in your files.

• Company benefits: List any retirement plans, pensions or benefits from your current or former employer including the contact information of the benefits administrator.

• Insurance: List the insurance policies you have (life, long-term care, home, auto, Medicare, Medigap, prescription drug, etc.) including the policy numbers, insurance agents and phone numbers.

• Credit cards: List all credit and charge cards, including the card numbers and contact information.

• Property: List real estate, vehicles and other properties you own, rent or lease and include documents such as deeds, titles, and loan or lease agreements.

• Taxes: Keep copies of tax returns for seven years and the contact information of your tax preparer.

Keep all your organized information and files together in one convenient location — ideally in a fireproof filing cabinet or safe in your home.

Also be sure to review and update it every year, and don’t forget to tell your loved ones where they can find it.

Savvy tips: To help you get organized, Nolo (nolo.com, 800-728-3555) offers a great resource book called “Get It Together” for $18.50. You can also purchase helpful guides at organizemyaffairs.com.

If you know someone who could benefit From a hot noon meal, call the: Cayuga County Office for the Aging Senior Nutrition Program 253-1427

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

February 2012 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 23

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P.O. Box 276, Oswego, NY 13126 Page 24

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By Deborah Banikowski, District Manager in Syracuse.

Be In The Know Before You Go

W

e’re in the dead of winter. In many areas of the country, that means that we could be in for some rough weather. When severe weather strikes, parents of young children are well aware that they need to check for school closings as they prepare for the day.

But sometimes inclement weather can be severe enough to close down government buildings and offices as well — including Social Security.

If the weather outside is frightful, you should check our website before Banikowski making a trip to your Social Security office. The place to go to find out about emergency office closings is www.socialsecurity.gov/ emergency.

Social Security’s office closings and emergency page provides information on specific offices that are closed due to weather and emergencies, as well as reminders about upcoming federal holidays during which government offices are closed.

The website also offers a link to a comprehensive list of federal holidays

Q&A

In Good Health

In Good Health

The Social Ask Security Office

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

Q: We adopted a baby girl overseas and brought her home with us to the United States. We need to get a Social Security number for her. What do we do?

A: In general, to apply for a Social Security number for your child you must: Complete an Application for a Social Security Card (Form SS-5) for your child, which you can find online at www.socialsecurity.gov; show us documents proving your child’s: U.S. citizenship or immigration status; adoption; age; and identity. Also, show us a document proving your identity show us evidence that establishes your relationship to the child if your name is not listed as the parent on the child’s evidence of age. The adoption decree or the amended U.S. birth certificate will suffice.

You can take your application and original documents to your local Social Security office, or you can mail them to us. All documents must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies of documents. If you do not yet have proof of your child’s citizenship, we can assign a number based on documentation issued by the Department of Homeland Security upon the child’s arrival in the United States. When you do receive documentation of your child’s citizenship, you can bring it to us, and we will update your child’s record. .

throughout the year.

To the right side of the page, you’ll find helpful resources from other government agencies, such as the Federal Emergency Management Agency (FEMA) and the National Weather Service. They can help you to prepare for weather emergencies before they happen.

We also provide information about alternatives to visiting an office, helpful even when offices are open. For example, many of our most popular services are available online at www. socialsecurity.gov.

Find out what types of benefits you may be eligible for by using our benefits eligibility screening tool and then apply online. If you are already getting benefits, you can use our website to sign up for direct deposit so that your payments won’t be interrupted during weather emergencies. You can learn about these and other services available on our secure website by visiting our Online Services page at www.socialsecurity.gov/onlineservices.

If you’d like to be alerted to office closings, that’s easy to do. Just visit www.socialsecurity.gov/emergency and subscribe to the page by selecting the “Get email updates” link next to the red envelope. Then you’ll get an email alert any time there is a change, such as an office closing.

Q: How long do I need to work to become eligible for retirement benefits?

A: Everyone born in 1929 or later needs 40 Social Security credits to be eligible for retirement benefits. You can earn up to four credits per year, so you will need at least 10 years to become eligible for retirement benefits. During your working years, earnings covered

by Social Security are posted to your Social Security record. You earn credits based on those earnings. If you become disabled or die before age 62, the number of credits needed depends on your age at the time you die or become disabled. Learn more at www.socialsecurity.gov.

Q: My grandfather, who is receiving Supplemental Security Income (SSI), will be coming to live with me.

Does he have to report the move to Social Security?

A: Yes. An SSI beneficiary must report any change in living arrangements within 10 days after the month the change occurs. If the change is not reported, your grandfather could receive an incorrect payment and have to pay it back, or he may not receive all the money due. Just as importantly, your grandfather needs to report the new address to Social Security to receive mail from us. You can report the change by mail or in person at any Social Security office or call Social Security’s toll-free number at 1-800772-1213 (TTY: 1-800-325-0778). You can get more information by reading the booklet “Understanding SSI,” at www. socialsecurity.gov/ssi.

Depression Among Seniors Local experts say problem is more prevalent than what figures show

By Deborah Jeanne Sergeant

D

epression is just as common, if not more, among older adults as younger ones.

“From our experience with the elderly population, it is extremely common,” said Dean Bellefeuille, owner of At Home Independent Living in Camillus, which provides non-medical home assistance.

Many times, the adult children of the agency’s clients live too far away or have other circumstances that prevent them from helping the senior. In some cases, the adult children may have had no idea that their parents are not properly caring for themselves.

“We get a lot of calls right after the holidays because people may not have seen their mom since summer and can’t believe the house is such a mess or the parent hasn’t bathed in months, Bellefeuille said. “They’re depressed. That’s why they’re living this way.”

Sometimes, the disconnection from familiar routines and faces contributes to the depression the senior is experiencing. Many friends and family members have passed away or moved.

Seniors have finished rearing families and have retired, so they have lost much of their identity and purpose for life, both of which can trigger depression.

Statistics show that depression is equally as common among younger people and seniors; however, because statistics on depression are usually gathered by surveys of mental health care providers, the numbers may be skewed if seniors don’t treat their depression.

Members of the stoic silent generation and older baby boomers often feel that depression exhibits character defect or weakness. Their stigma surrounding depression can make them less likely to seek help.

Retirees may not have the same health coverage they had while they were working so mental health care may be an out-of-pocket expense.

Many people think depression is normal for seniors. Mary Gualtieri, who earned a Master of Science in counseling and psychological services and works as an elder care specialist with Franciscan Companies’ Embracing Age program, said that “depression often goes undiagnosed or unrecognized in elderly individuals because some of the common symptoms of depression may be viewed as being a natural part of the aging process.”

The signs of depression include change in appetite and sleep habits;

decreased interest in socialization and previously enjoyed hobbies and lasting sadness. Depressed seniors may have more medical problems and physical pain. They may isolate themselves from others.

It can be hard to tell if a senior is depressed. Medical problems and pain may also be some of the causes of depression in older adults. Physical issues such as diminished vision, hearing and mobility can contribute to isolation.

“Some elders have multiple medical issues to deal with, which can overshadow their emotional struggles,” Gualtieri said, “causing symptoms of depression to be overlooked or dismissed by the seniors themselves, or by others. Furthermore, senior citizens may be more susceptible to depression due taking new or multiple medications or because of not taking them as directed.”

Although many factors that contribute to depression among seniors can’t be altered, seniors’ outlook can make a big difference, said Ronald W. Heilmann, licensed clinical social worker and licensed marriage and family therapist in private practice in Syracuse.

“We can focus Heilmann on what we’ve lost or what we still have,” he said. “That seems to be the context we bring to aging. We can cultivate a better attitude towards our lives when we accept the aging processes and the losses that come with it.

“When we accept it, we can turn

our attention to maintaining our health as best we can and making adaptations to help us to retain control and an active lifestyle.”

Bellefeuille encourages family members to directly address areas of loss or limitation to help seniors control how they want to solve the problem.

For example, state, “You’ve having trouble seeing well at night, as evidenced by your fall last week. We’re concerned you may get seriously hurt.

What do you want to do to be safer when you get up at night?”

Or, suggest a few options from which they can select, such as automatic night lights and hand rails and non-skid flooring in the bathroom.

Friends and family can offer support, companionship and transportation.

“The biggest thing we push for with this generation is getting them outside of their homes and moving,” Bellefeuille said.

He recalled an extreme case in which a client had not left her home for two and a half years, ever since her husband died. Of course, grieving loss is natural and healthy, but enduring sadness can mean clinical depression.

If you see signs of clinical depression, refer the person to a mental health professional or contact your local agency on aging or New York Connects. Many of the silent generation may resist a direct suggestion for mental health care.

“If you ask someone if they’re depressed, it means you think they’re sick,” Heilmann said. “Ask what they’re unhappy about. There are people who are feeling sad and hopeless for no good reason. It may be clinical depression and that needs professional help.”

February 2012 •

Recommend that they ask their primary care doctor for suggestions since many of the symptoms of depression manifest physically. But the symptoms that appear to be depression could be the sign of another illness such as Alzheimer’s disease. If the problem is lack of comprehension, not lack of interest, it could be memory impairment.

They may purposefully isolate themselves if hearing loss makes conversation difficult. Or, the senior could have depression along with a different health issue. Depression can also exacerbate other unrelated health problems, so it’s important to treat depression for that reason, too.

Linking the impact of mental health with physical health may convince some seniors to visit their primary care doctor to talk about how they’re feeling.

“We strive to look at the mental aspects of home care because we know it has a big impact on physical health,” Bellefeuille said. “Unfortunately, that’s the aspect no one remembers.”

Solo seniors who are depressed may quit exercising, skip doses of medication, eat poorly and not get enough fluids.

Bellefeuille said his organization has helped seniors who were previously subsisting on crackers instead of balanced meals. Many seniors could benefit from programs such as Meals on Wheels, not just for the nutritional benefits but also because it means that someone will regularly check in on them.

If your senior parent shows signs of depression, you may also contact the senior’s primary care doctor before a visit to request a depression screening.

It’s better to seek professional help for depression.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 25

Plantar Fasciitis More Common Among Older Adults This foot problem is also seen in pregnant women, runners or people who are on their feet for work

By Deborah Jeanne Sergeant

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mong all types of heel pain plantar fasciitis (PLAN-tur fase-I-tis) is the most common.

Plantar fasciitis involves inflammation (thus the “-itis” suffix) of the fascia that runs from the heel and across the bottom of the foot to the toes.

“Older people are more prone to plantar fasciitis because the tissues of the body weaken as we age,” said Douglas J. Dickson, podiatrist at Lyncourt Foot Care in Syracuse.

Plantar fasciitis is also more common among pregnant women, runners and people who are overweight, abruptly increase the intensity of their exercise, engage in a new sport or have certain other medical conditions such as lupus.

Some people believe that heel spurs cause plantar fasciitis, but the opposite may be true.

When the fascia tissue tears, it usually happens near the heel bone, which is the weakest area of the tissue. The inflammation and pain that follows should encourage Dickson the patient to rest; however, continued activity will reinjure the area.

To re-enforce the fascia, the body grows more bone. That new growth is a heel spur. Heel spurs may form unrelated to plantar fasciitis, too, and may or may not cause pain.

As with many bodily strains and pains, initially treat undiagnosed foot pain with RICE: Rest, Ice, Compression and Elevation.

“Try RICE for a couple weeks,”

said Chad Rounds, a podiatrist boardcertified in foot surgery by the American Board of Podiatric Surgery, who practices at Westside Podiatry Center in Camillus, Liverpool and Skaneateles.

“Try over the counter supportive inserts or a heel pad and see if it helps.

If it’s not resolving, it’s time to see someone.”

Plantar fasciitis pain tends to manifest in the heel or arch, but occasionally in the ball of the foot. When the pain strikes also helps indicate it’s plantar fasciitis, but a doctor’s diagnosis should make the final determination.

“The classic symptom is pain after rest,” Rounds said. “They have the most pain when they first get up in the morning but after it stretches out, it feels a little better.”

If they spend a significant amount of time on their feet, the more severe pain returns by evening. Wearing unsupportive shoes also exacerbates the condition.

If a patient is able to rest enough to allow the body to heal the heel, the pain sometimes goes away completely within nine months. But if treatment is necessary for a more severe tear, the earlier treatment is administered, the better.

It’s also important for a doctor to treat lasting heel pain because of the rare chance it could be something else.

“The pain associated with plantar fasciitis can be mimicked by other conditions such as infection, stress fracture, arthritis, calluses, foreign body, nerve entrapment, and bursitis,”

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R

uth Simpson Schwartzwalder, known to her family and friends as “Reggie,” celebrated her 100th birthday Jan. 18 at Loretto’s The Nottingham senior living community in Jamesville.

Schwartzwalder was born in Pine Grove, West Virginia, Jan. 18, 1912. She attended West Virginia University, where she received a degree in women’s physical education. She moved to Syracuse in 1949 with her late husband, Floyd “Ben” Schwartzwalder, who was the legendary football coach at Syracuse University.

A party in her honor was celebrated with her family including daughters Susan Walker and Mary Scofield, five grandchildren, eight great-grandchildren, as well as many friends and

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

Dickson said.

Most doctors order X-rays to rule out other causes.

About half of Rounds’

patients’ plantar fasciitis are effectively treated by RICE and the other half by interventions such as stretching exercises, night splint therapy, or physical therapy.

“Stretching is the most important initial course of treatment for this, but relief of symptoms may be slow,” said Catherine McNerney, podiatrist with CNY Foot Surgery and Podiatry Care in Syracuse. “If symptoms do not significantly improve with conservative treatment in six months then surgery is indicated.”

Surgery manually stretches the fascia. Typically, the pain subsides within 10 days and patients are back at normal activities within a month.

Rounds said that surgery has an 85 to 90 percent success rate. Most patients can immediately begin bearing weight and see a full recovery in three months.

“The success rate for surgical treatment of plantar fasciitis is very high, with low risk of complications,” McNerney said.

relatives.

She has always been an active sports fan and bridge player and is a longtime member of First English Lutheran Church. She volunteered for the Cerebral Palsy Auxiliary and as a Girl Scout leader. Over the years, she has knitted many beautiful items for her family. She says her secret to a long life is “physical activity” and “keeping busy!”

H ealth News Nottingham Senior Living has new executive director Jennifer Ingerson of Baldwinsville has been promoted to the position of executive director of The Nottingham Senior Living Community in Jamesville.

Ingerson’s professional experience in residential long-term care includes more than 20 years with the Loretto family of care where she has served as director of administration and residential services at The Nottingham (198991), director of Loretto North (1991-94), director of operations for Brighton Management (1994-1998), and as development market research specialist (1994-98).

Ingerson briefly left Loretto to work for Hospice of CNY as director of research Ingerson for the Central New York office for sudden infant death syndrome.

She returned to The Nottingham in 2001 and was promoted to associate executive director in 2009. Most recently, Ingerson received certification as a Lean Six Sigma Greenbelt from the Rochester Institute of Technology.

Ingerson is a summa cum laude

graduate of SUNY Cortland where she earned a bachelor’s degree in health science/health administration. She subsequently received her master’s degree in health services management from The New School of Social Research in New York City.

Ingerson resides in Baldwinsville with her husband and three children.

“Jennifer has distinguished herself over the years as a resourceful professional and an excellent leader,” said Steve Volza, senior vice president of Loretto Housing.. “I have great confidence in Jennifer’s potential and future here at The Nottingham. This is a wonderful opportunity for Jennifer and our staff, residents and their families.”

Tully Hill awarded CARF accreditation CARF International announced that Tully Hill Chemical Dependency Treatment Center in Tully has been accredited for a period of three years for its detoxification, inpatient treatment, intensive outpatient treatment and outpatient treatment programs. The latest accreditation is the third consecutive three-year accreditation that the international accrediting body, CARF, has awarded to Tully Hill.

This accreditation decision represents the highest level of accreditation

that can be awarded to an organization and shows the organization’s substantial conformance to the CARF standards. An organization receiving a three-year accreditation has put itself through a rigorous peer review process. It has demonstrated to a team of surveyors during an on-site visit its commitment to offering programs and services that are measurable, accountable, and of the highest quality.

Loretto launches new website Loretto announced the launch of its new website www.loretto-cny.org.

The new website is a complete redesign, featuring improved navigation, design and content. Some of the website’s new features include a resource section for visitors complete with comprehensive long-term care information, a news section and a care and communities section for users to better understand Loretto’s continuum of care.

As people continue to live longer, the need for elder care services will continue to grow. Loretto invites the community to visit the “For Our Family and Friends” section on the website, which features frequently asked questions, choosing care, elder care defini-

tions, obtaining services, suggested readings and other resources.

Website visitors are also invited to tell Loretto what they think of the new site.

Design is by Pinckney Hugo Group.

News from

CEO Kronenberg Recognized — Dr. Paul Kronenberg, president and CEO of Crouse Hospital, has been named a recipient of the 2012 SURE Award for Excellence in Supply Chain Leadership.

The SURE award is presented annually by Healthcare Purchasing News, the leading publication for healthcare supply chain management, to those healthcare executives who ‘Support, UnderKronenberg stand, Recognize and Empower’ supply chain management initiatives within their organizations.

Rochele Clarke Named Stroke Program Administrator — Rochele

Aurora’s Excellence Awards Announced Aurora of CNY, Inc. presented its excellence awards recently at its annual meeting at the Mulroy Civic Center in Syracuse. The awardees are: • Nasser Fitwi: Blind since he was 8 years old, Fitwi came to Syracuse almost two years ago from a refugee camp in Ethiopia. Without the help of any vision at all, he had to learn his way around and adjust to a new culture, country and climate.

Aurora helped with mobility training, assistive devices such as tape recorders, and advice on handling the reams of paperwork that face a new immigrant. Fitwi learned quickly and now he is working to give back and help others. At Aurora he tutors consumers in English as a second language.

He lives in Syracuse.

• Timothy Conners: Conners, an 11th-grader at G. Ray Bodley High School in Fulton, says he’s up for the challenge of dealing with both cancer and blindness. It’s a relatively new challenge for him. He became legally blind just over a year ago due to the cancer, and he had a bone marrow transplant last year. Conners is still a member of G. Ray Bodley’s varsity football team, and wears his jersey when he goes to games to root for his team. Conners, who lives in Fulton, said he plans to attend college after graduation.

• Lindsay Ryan Anthony: Anthony, who has been deaf all of her life, has a long history with Aurora.

She worked in Aurora’s summer education program and then joined Aurora’s deaf employment services staff.

During her time at Aurora, Anthony held lunchtime sign language classes

for staff, took part in the agency’s deaf awareness week activities, and was always willing to do whatever was necessary to represent Aurora and educate the community about deaf culture. Anthony is a member of the Deaf Advocacy Council of Central New York and now works for Project Emerge, a collaboration between Arise and Vera House, where she advocates for people with disabilities who experience domestic and sexual abuse. Anthony lives in Syracuse.

• Breanne Kisselstein: Kisselstein, who is a senior at CiceroNorth Syracuse High School, is dealing with the dual challenge of being hard of hearing and legally blind. She maintains a 90 GPA and her plans include college and a career in science. An active volunteer at her church —Assembly of God in Brewerton — she works in the nursery, belongs to the youth group, and helps out wherever there is a need.

She also spent this past summer working at the Aspen Athletic Club and recently enrolled in the explore your future program at the National Technical Institute for the Deaf in Rochester. Her NYS Commission for the Blind and Visually Handicapped counselor, Beth Bigness, says Kisselstein is devoted to her family and friends and calls her a “positive, forward-looking, caring, personable, down-to-earth young lady.” Kisselstein lives in North Syracuse.

Affordable Cleaning Service: Affordable Cleaning Service, based in Hastings, is Aurora’s employer of the year. The service specializes

In back, from left, are Travis Glazier, Onondaga County Director of Intergovernmental Relations; Laura Smith; Timothy Conners; Nasser Fitwi; Breanne Kisselstein, and Lindsay Ryan Anthony. In front, from left, are Deb Chaiken, Aurora executive director; Rosemarrie Stone, owner of Affordable Cleaning Service, and Rosemarrie’s son Joe. in general home, business and office cleaning as well as waxing, stripping and buffing of floors. Owner Rosemarrie Stone has hired some of Aurora’s deaf clients to work for a variety of customers, including a post office, an apartment complex and an office building. Stone is flexible about their transportation schedules and is also eager to learn about deaf culture and the deaf community.

Laura Smith: Smith was awarded Aurora’s Mattie Letham Community Leadership Award. Diagnosed with macular degeneration in 1997, she is the president of the Oswego County Visually Impaired (OCVI) organizaFebruary 2012 •

tion. Along with members of the Vision Network, she advocated with the Oswego County legislature to reinstate funding for transportation for OCVI members. She founded the Oswego County Book Club and continues to draw Oswego County residents who have vision loss into the network of support and social opportunities provided through OCVI. “Laura has been a tremendous support to me personally and professionally, and she is a strong and loyal advocate for the people we serve,” said Debra Chaiken, Aurora’s executive director. Smith lives in Oswego.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 27

H ealth News Clark has been appointed stroke program administrator.

Clark will coordinate the clinical processes of the hospital’s stroke center through data collection, quality improvement initiatives and education to ensure the highest level of stroke care Clark across the continuum, including prevention, acute hospitalization and rehabilitation. Crouse’s stroke program was the first in the area to earn Gold Plus-designation from the American Heart/Stroke associations.

Clark, who has more than 25 years of nursing leadership experience, most recently served as vice president, clinical services for REACH Call Inc., where she was responsible for providing clinical expertise and education to develop and sustain telestroke programs at a national level. She served as the stroke program coordinator at Upstate Medical University from 2006 to 2008 and also served as co-chairwoman of the CNY Stroke Task Force, responsible for coordinating a multi-media campaign for improving stroke awareness in conjunction with the American Heart Association.

Clark holds a bachelor’s degree in nursing from Upstate Medical University. In 2008, she was awarded the American Heart Association’s quality award for outstanding nurse leader.

Michael Allain Receives Excellence in Research Award — Michael Allain, a clinical nurse specialist at Crouse Hospital, has received the Excellence in Research Award from the Omicron Alpha Sigma Theta Tau International Honor Society of Nursing.

The award recognizes the accomplishments of an active member of Allain Omicron Alpha in the

area of nursing research. The recipient must meet one or more of the following criteria: conducts distinguished research in nursing; communicates nursing research findings through publications, presentations at conferences/ workshops/seminars, consultation, or teaching; gives evidence of a history of nursing research activities. Allain currently serves as a clinical nurse specialist in the hospital’s intensive care unit and emergency department. Allain recently replicated a study related to the use of a specialized dressing used prophylactically to prevent pressure ulcers for high-risk patients who meet specific criteria in the intensive care unit. Through his leadership and collegiality, he enlisted staff members to perform routine ‘skin rounds’ in the ICU, identifying and implementing interventions that have significantly decreased nosocomial pressure ulcers in the ICU. Omicron Alpha is committed to advancing nursing leadership, scholarship and research in clinical practice and in public policy.

News from

New ER Chief — James Tucker has been appointed to the role of chief of emergency and hospitalist medicine.

In this role, he will provide physician oversight of the emergency department (ED) and hospitalist services.

Working with the medical directors of each service, Tucker will ensure quality of care, including sentinel event review, physician and patient complaints and analysis of quality metrics. He also will work to expedite patient flow between the ED and hospitalist Tucker services and assist in

Executive director of Oswego County Opportunities, Diane Cooper-Currier (left) presents Cindy Seeber with a longevity award for 25 years of service to OCO. Seeber joined OCO in 1986 in a support services role and has advanced over the years to her current position of human resources director.

Page 28

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

Auburn Memorial and Rochester General to Explore Potential Affiliation The board of trustees of Auburn Memorial Hospital (AMH) has voted unanimously to explore an exclusive affiliation with Rochester General Health System (RGHS), a nationally recognized integrated healthcare delivery system based in Rochester with a satellite hospital in the Finger Lakes.

In August 2011, AMH began the process of exploring the potential for an affiliation with a larger health system to further enhance its 120-year tradition of providing compassionate, quality acute and long-term care services. AMH and RGHS will now enter into discussions and due diligence which will likely span the next four months to determine the viability and exact nature of an affiliation, including consideration of legal, regulatory, financial, clinical and operational factors.

In making its decision to pursue further discussions, the AMH board cited RGHS successful track record of developing processes for direct admits and transfers from other facilities.

Tucker has served as director of St. Joseph’s family medicine residency program since 1987, and director of medical education since 2003. He is a professor at SUNY Upstate Medical University and a practicing family medicine physician at Heritage Family Medicine, part of St. Joseph’s Physician Health, P.C. He earned a Bachelor of Arts degree as a distinguished graduate of The Virginia Military Institute, and his medical doctorate from Boston University School of Medicine. He also studied at the USAF Medical Center at Wright-Patterson in Ohio.

A resident of Syracuse, Tucker is a team physician for the Syracuse Chiefs baseball team, and head medical team physicians for Syracuse University’s Athletic Department. He is a member of the American Academy of Family Physicians, Society of Teachers of Family Medicine, Association of Family Practice Residency Directors and New York Academy of Family Physicians.

Mark Murphy Promoted To Senior Vice President — Mark Murphy has been promoted to the newly created position of senior vice president for system development and ambulatory care. In this role, he will work closely with Kathryn Ruscitto, president and chief executive officer, on system development, and with Frank Smith, Jr., vice president for corporate development and president of Franciscan Companies, to further develop home care, wound care, sleep labs Franciscan, Murphy dialysis and cardiac rehabilitation services at St. Joseph’s.

In addition, he will focus on developing primary care center-based mental

collaboration with smaller standalone hospitals, its reputation for innovation, a sterling record of patient safety, and a national reputation for quality.

“We plan to explore how an affiliation will provide for greater access to local care, physician recruitment and retention, facilities support and best practice sharing. However, it’s premature to delve too deeply into those elements until due diligence is complete,” said Scott A. Berlucchi, president and CEO of AMH. He continued, “What we can definitively share is our unwavering belief that our employees and physicians are among AMH’s and the community’s greatest assets, and that any affiliation with RGHS would include their ongoing involvement.”

AMH and RGHS plan to provide the next public update at the conclusion of the due diligence process in approximately four months.

health services and medical homes.

Murphy will continue to concentrate on care coordination and readmission prevention.

Murphy has worked for St. Joseph’s since 1989. He is working toward a master’s degree in business administration from Le Moyne College.

He holds a Master of Science degree in nursing from Boston College and a bachelor’s degree in nursing from SUNY Plattsburgh.

A resident of Liverpool, he is a member of several community boards, including PACE of Central New York, the New York State Home Care Association, Rosewood Heights Skilled Nursing Facility and the Liverpool Little League.

New Director of Enterprise and Ambulatory Systems Named — St. Joseph’s Hospital Health Center has appointed Michael A. Spurchise director of enterprise and ambulatory systems.

In this newly created role, Spurchise will be responsible for providing strategic direction and oversight of supporting information technologies and processes necessary to integrate St. Joseph’s network of services. Spurchise has 30 years of healthcare IT experience, including strategic planning Spurchise for large efforts, such as health information exchange, public health and Y2K. Most recently, he led a technical team in the implementation and roll-out of HealtheConnections, the Regional Health Information Organization of Central New York of which St. Joseph’s is a part. A resident of Oswego, Spurchise holds a Bachelor of Science degree in mathematics/education from SUNY Oneonta.

New Vice President For People — Deborah Welch has been named vice president for people. While her title is new, she replaces Sister Rose Ann Renna, who served as vice president for mission integration for more than eight years. Welch will be responsible for mission integration, as well as organizational development. Sister Renna will remain at the hospital assisting with curriculum developWelch ment and education at the college of nursing.

A 32-year employee at St. Joseph’s, Welch has been responsible for the overall operation, administration and management of mental health services for 22 years. Under her leadership, St. Joseph’s mental health services has grown exponentially and has led the way in providing mental health services to those most in need in the Central New York community.

Recently, she added director of organizational development to her areas of responsibility. In this role, she has been applying her knowledge of Baldrige principles and quality and employee development to help advance the organization’s readiness to meet the challenges of tomorrow.

A resident of Skaneateles, Welch holds a bachelor’s degree in psychol-

ogy from Le Moyne College and is an alumnus of Leadership Greater Syracuse, Class of 2003. She also is a member of the board of directors of the New York State Council for Community Behavioral Health and Catholic Charities of Onondaga County.

St. Joseph’s Awarded $2.5 Million Grant From New York State — St. Joseph’s Hospital Health Center was awarded $2.5 million in economic development grant funding from New York State through the Empire State Development Corporation. The funding will be used toward the hospital’s Phase Two B expansion project, which will build a new patient tower, including operating room suites, private patient rooms and intensive care units.

Design is under way for Phase Two B, which will include a 104,000 sq. ft. patient tower with 110 private patient rooms including medical and surgical intensive care units, a 73,000 sq. ft. state-of-the-art surgical suite with 14 operating rooms, a 25-bed postanesthesia care unit and a greenway corridor to North side businesses.

The tower will also contain space for support services, staff education and family waiting areas.

The $2.5 million in grant funding was part of a larger award of more than $103 million to the Central New York region as part of the governor’s Regional Economic Development plans.

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Oneida Healthcare Acquires the da Vinci Si Surgical System Oneida Healthcare has acquired the da Vinci Si Surgical System.

“This advanced level of technology takes surgery beyond the limits of the human hand and this acquisition complements our goal of extending minimally invasive surgery to the broadest possible base of patients,” said President and CEO Gene Morreale.

“Our new surgical suite was designed with this kind of technology in mind and this [approximately $2 million] investment will help us provide the best possible outcomes for our patients and surgeons,” he added.

Morreale also noted that Oneida Healthcare’s da Vinci system is the only one between Syracuse and Albany and will be available to physicians and patients in Madison and Oneida counties, as well as the Utica-Rome area and entire Mohawk Valley region.

Dr. Alberto Del Pino of the Oneida Surgical Group explained that so-called “robotic surgery” can be used for a

multitude of gynocological and general surgical procedures, including his specialty, colorectal surgery.

“The da Vinci Si has several unique features designed to provide additional clinical benefits and efficiency in the operating room, many of which translate to patient benefits,” he said.

He cited several major benefits, including enhanced 3D, high-definition vision of the operative field with up to 10 times magnification, superior visual clarity of tissue and anatomy, and surgical dexterity and precision far greater than even the human hand.

Del Pino was quick to emphasize, however, that robotic surgery doesn’t replace the surgeon. “It’s still our hands and skill performing the surgery but the unparalleled precision, dexterity and control of this system will now enable a minimally invasive approach for many complex surgical procedures.

It’s simply the best tool available,” he concluded.

February 2012 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 29

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

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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