in good Meet Your Doctor Physician Douglas Tucker explains the goal of PACE CNY and how a team of doctors, nurses, therapists and other professionals keeps as many as 550 frail seniors at home
July 2017 • Issue 211
priceless
cnyhealth.com
CNY’s Healthcare Newspaper
Complementary Medicine
100 on the Rise ‘Deadliest Days’
AAA says more teens die in crashes between Memorial Day and Labor Day than in any other time of the year
PAIN
Practitioners say more people are benefiting from integrative medicine. Over 30 percent of adults and approximately 12 percent of children use nonWestern health care, according to the National Institutes of Health. Page 17
Pregnancy: Week 1
Pregnancy: Week 40
Three weeks after delivery
SUNY Upstate doctor discusses what’s the best over-thecounter painkiller you can take
5
Things You Need to Know About Back and Neck Pain Interview with physician David Moorth
What My Garden Has Taught Me Author of “Live Alone and Thrive” talks about lessons learned while gardening
Kristen Szitar, a personal trainer and fitness instructor at Method 360 in East Syracuse, discusses exercising during and after pregnancy. Inside
Ginger It’s official: ginger can enhance calorie burn and reduce feelings of hunger. Studies have linked ginger to positive changes in cholesterol, blood sugar, blood pressure, inflammatory proteins and liver health. See SmartBites inside
BRAS
Aesthetics and modesty aside, what health benefits do bras provide, if any? We interviewed several experts. Read more inside
WOMENS HEALTH SPECIAL
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17 Lansing Street • Auburn, NY 13021
The Water’s Not Fine: U.S. Pool-Linked Infections Double in 2 Years Cryptosporidiosis can cause weeks of watery diarrhea, CDC warns
F
amilies seeking to cool off don’t expect to pick up a nasty infection. Yet outbreaks of a diarrhea-causing parasitic infection have doubled in recent years at swimming pools and water playgrounds in the United States, health officials warn. At least 32 outbreaks of cryptosporidiosis were reported in 2016, compared with 16 outbreaks in 2014, according to a new report from the U.S. Centers for Disease Control and Prevention. Crypto is the most common cause of diarrhea, the CDC says. It spreads when people come in contact with the feces of an infected person. Otherwise healthy people can be sick for up to three weeks with watery diarrhea, stomach cramps, nausea or vomiting, the CDC warns. The infection can become life-threatening in people with compromised immune systems. The cause? Adults or children sick with crypto-caused diarrhea are swimming in public pools despite their illness and further spreading the parasite, said Michele Hlavsa,
chief of the CDC’s healthy swimming program. During a diarrheal incident, “a typical person who’s sick with Cryptosporidium can release 10 million to 100 million oocysts, which is the infectious stage of crypto,” Hlavsa said. “Swallowing 10 or fewer of these oocysts can make you sick. Looking at a typical-sized pool, even swallowing a mouthful of water can make us sick.” People also can contaminate pool water with Crypto through physical contact, said Lilly Kan, senior director of infectious disease and informatics with the National Association of County & City Health Officials (NACCHO). The findings were published May 19 in the CDC’s Morbidity and Mortality Weekly Report. People should not swim if they are sick with diarrhea, and they should keep children with diarrhea out of the pool, Hlavsa said. If they have been diagnosed with crypto, they should wait two weeks after diarrhea has stopped to go swimming.
urologyIGH.10.25x6.75.qxp_Layout 1 8/19/16 1:12 PM Page 1
MEET THE UPSTATE UROLOGY TEAM Chairman Urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
General urology andrology
GENNADY BRATSLAVSKY, MD ZAHI N. MAKHULI, MD Female and reconstructive urology, urinary incontinence in women, pelvic floor treatment and neurourology
NATASHA GINZBURG, MD Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities
MATTHEW D. MASON, MD
Urologic oncology and endourology, robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal; renal stone disease
OLEG SHAPIRO, MD
Urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
RAKESH KHANNA, MD
General female urologic health
TIMOTHY K. BYLER, MD
General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn.
RYAN SIDEBOTTOM, DO
General urology, female and reconstructive urology
ELIZABETH FERRY, MD
Nephrolithiasis (kidney stones), enlarged prostate, urination problems, voiding dysfunction, bladder and kidney surgery
JESSICA E. PAONESSA, MD
Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities
JONATHAN RIDDELL, MD
Incontinence, urethral stricture disease, pelvic organ prolapse, vessico vaginal fistula, reconstructive surgery
DMITRY NIKOLAVSKY, MD
Male reconstructive surgery, urinary diversions, general urology
STEPHEN BLAKELY, MD
Male infertility, erectile dysfunction, andrology, general urology
JC TRUSSELL, MD
General urology
IMAD NSOULI, MD
FOR QUESTIONS OR TO MAKE A REFERRAL CALL 315.464.1500 UROLOGY
Page 2
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions
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Learn more about Medicare Call today to learn more
Turning 65 soon? You can get medical and prescription drug coverage in one simple plan
John Karatzas 315-766-5290 (TTY: 711) 8 a.m. to 6 p.m., Monday – Friday A licensed sales agent will answer your call. KaratzasJ@aetna.com
Aetna Medicare has plans that work hard for you. Our plans offer you: • $0 monthly plan premiums • $5 copay for primary care physician and $35 copay for specialist office visits • Allowance for eyewear and dental
Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. You must continue to pay your Medicare Part B premium. The Part B premium is covered for fulldual members. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other pharmacies, physicians and/or providers are available in our network. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Aetna complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, free language assistance services are available. Visit our website at www.aetnamedicare.com or call the phone number listed in this material. ESPAÑOL (SPANISH): ATENCIÓN: Si usted habla español, se encuentran disponibles servicios gratuitos de asistencia de idiomas. Visite nuestro sitio web en www.aetnamedicare.com o llame al número de teléfono que se indica en este material. 繁體中文 (CHINESE): 請注意：如果您說中文，您可以獲得免費的語言協助服務。請造訪我們的網站 www.aetnamedicare.com 或致電本材料中所列的電話號碼。 Y0001_4002_9196_FINAL_1 Accepted 01/2017
©2017 Aetna Inc.
July 2017 •
72.12.579.1
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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CALENDAR of
“Destination Chenango�
SEPT. 16
July 4
Walk to raise awareness for ovarian cancer
August 31
Lecture Series
HEALTH EVENTS
(607) 334-1400
Sunday, July 16th from 1-2 p.m.
Reverend Ted Taylor - Retired Minister of the Dewitt Community Church *A Message You’ll Enjoy. THE NEXT LECTURE: August 20th – Dr. Nasri Ghaly – Syracuse Psychiatrist Medical Marijuana Come Visit The Farm! Meet: “Big Bad Ben� the Blond Belgian
Problems???? We have Therapists Jim Marshall Farms Foundation, Inc. 1978 New Boston Road, Chittenango, NY 13037 www.jmfďŹ nc.org Please Call 315.447.6182 for directions and questions
The ninth annual Maureen T. O’Hara “Teal There’s A Cure� run/ walk will be held at 9 a.m. on Tuesday, July 4, at Marcellus Park. Participants will follow the course through the village of Marcellus, along Nine Mile Creek and back to the park. An awards ceremony will follow at 10:15 a.m. The annual event was started in 2009 by the O’Hara family to educate people about ovarian cancer — teal is the official color for ovarian cancer awareness. The race is held in honor of their daughter/sister, Maureen O’Hara, who died from ovarian cancer one week after the 2012 race. The race was officially renamed in Maureen’s honor in 2015. Preregistration for this year’s race is $30. Registration on the day of the race is $40. Registration forms are available throughout the village of Marcellus, including the town hall. For more information, email tealtheresacure@gmail.com or visit www.gracesgarden.org.
July 15
Amyloidosis Support group meets in Rochester The Amyloidosis Support group will hold its annual meeting from 8:30 a.m. to 1:30 p.m., July 15, at the Weiner Conference at Rochester General Hospital, 1425 Portland Ave. in Rochester Amyloidosis is a life threatening, rare illness. According to Mayo Clinic, amyloid is an abnormal protein that is usually produced in the bone marrow and can be deposited in any tissue or organ. Symptoms depend
on which organs are affected. They may include swelling, fatigue and weakness, shortness of breath, and numbness, tingling, or pain in the hands or feet. Depending on the type of amyloidosis, medications, chemotherapy, or a stem-cell transplant may be options. Guest speaker will be hematologist Ron Go from Mayo Clinic. For more information, send an email to MaryAnn Kraft at thumbelinamk@yahoo.com or Muriel Finkel at info@amyloidosissupport.com.
July 29
Walk to Remember to take place in Auburn The Walk to Remember will hold its eighth annual event to raise awareness and support of Alzheimer’s and dementia persons and their caregivers in Cayuga County. This event will take place Saturday, July 29, and will be held in conjunction with The Big 6 at the Ward W. O’Hara Agricultural Museum, 6880 E. Lake Road in Auburn. Registration begins at 9 a.m. The walk starts at 10 a.m. and continues until 12:30 p.m. The events will include raffles, scratch-off display, afghan, $100 Wegmans gift card, MacKenzie-Childs products,, music and more. Refreshments will be available for purchase throughout the events. Registration and payment should be turned in by July 14 at the Office for the Aging, 160 Genesee St. before 4 p.m. to be guaranteed the official Walk to Remember T-shirt. Those wishing to register on the morning of the Walk may do so. For more information, call the Cayuga County Office for the Aging at 315253-1226 or Corinne Ryan @315-2531104.
TO Group, Semi-Private & Private
Swim LeSSonS
in the JCC’S outdoor heated PooL • Ages 6 months to adult. • Everyone welcome! JCC membership not required; discount for members. • Ask about our pool birthday parties.
5655 Thompson Rd. • DeWitt 315.445.2360 • www.jccsyr.org Page 4
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
U.S. Liver Cancer Deaths Have Doubled Since 1980s: Study It’s now fifth-leading cause of cancer death in men and No. 8 among women
L
iver cancer is the fastest-growing cause of cancer deaths in the United States, a new study reports. Liver cancer cases have been on the rise since the mid-1970s, a trend expected to continue through at least 2030. Death rates from the disease have doubled since the mid-1980s — the fastest increase of any cancer, according to the American Cancer Society, which conducted the study. About 41,000 new cases of liver cancer and 29,000 deaths from the disease are projected in the United States this year, the cancer society said. Liver cancer is now the fifth-leading cause of cancer death in men and the eighth-leading cause in women. About 1 percent of people will be diagnosed with the disease during their lives. Only one in five survives five years after diagnosis,
said the researchers led by physician Farhad Islami. Islami is strategic director of cancer surveillance research and health services research at the cancer society. A key reason for the liver cancer surge is a higher rate of hepatitis C virus infection among baby boomers. Among people born between 1945 and 1965, 2.6 percent have hepatitis C, a rate six times higher than among other adults. Rising rates of obesity and Type 2 diabetes have also contributed. Other risk factors for liver cancer include alcohol, which increases risk by about 10 percent per drink per day, and tobacco use, which increases liver cancer risk by about 50 percent, according to the findings. The study was published June 8 in CA: A Cancer Journal for Clinicians.
Now approved for chronic pain
Medical Marijuana now approved for chronic pain
We’re opening the doors to a new era at Crouse Health!
COMMUNITY OPEN HOUSE
W
e invite the entire community to join us for tours of our newly expanded Pomeroy Emergency Services, meet our emergency services team members, and see how Crouse Health is improving access to care for all Central New Yorkers.
Thursday, July 13 7 a.m. – 7 p.m.
Crouse Hospital, 736 Irving Avenue Free parking in the Crouse parking garage
Pomeroy Emergency Services Opens for Patient Care Tuesday, July 18! July 2017 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Meet
Your Doctor
By Chris Motola
Douglas Tucker, M.D. Nearly a Third of Drugs Hit by Safety Issues After FDA Approval Study found serious side effects often arose after medications OK’d for sale
S
afety problems emerge with nearly one in three prescription drugs after they’ve been approved by the U.S. Food and Drug Administration, a new study reveals. Researchers examined data on drugs approved by the FDA between 2001 and 2010, with follow-up through 2017. The investigators found that 32 percent of the drugs had safety issues after approval. “That is very rarely a drug withdrawal, but more commonly a black-box warning or drug safety communication issued by the FDA to let physicians and patients know that new safety information has been determined,” said study leader, physician Joseph Ross. He is an associate professor of medicine and public health at Yale University. Of 222 drugs approved by the agency during the study period, three were withdrawn, 61 received boxed warnings and 59 prompted safety communications, the findings showed. Drugs most likely to have post-approval safety concerns included biologics, psychiatric drugs and medicines approved through the FDA’s accelerated approval process. The report is timely because the FDA is under pressure to accelerate drug approvals, the study authors noted. “It shows that there is the potential for compromising patient safety when drug evaluation is persistently sped up,” Ross said in a university news release. At the very least, the study should inform the ongoing debate about pre-market drug evaluation, the researchers suggested. To assess experimental drugs for safety and effectiveness, the FDA relies on pre-market drug testing and clinical trials. Most of the trials involve fewer than 1,000 patients studied over a period of six months or less. This makes it hard to detect safety issues that might surface once more patients use the drug over a longer time period, the researchers explained.
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Chief medical officer explains the goal of PACE CNY and how a team of doctors, nurses, therapists and other professionals keeps as many as 550 frail seniors at home Q: Give us an overview of your position. A: I’m the medical lead at PACE CNY. My role is to oversee a lot of the administrative functions of PACE [Program of All-Inclusive Care for the Elderly]. I also oversee our clinics and diagnostic treatment center. Q: What is the PACE program? A: PACE is an organization that is charged with caring for frail elders. We essentially take people who are one step away from the nursing home and try to keep them at home. That’s our real goal. We do that by having a team working around them — physicians, nurses, nurse practitioners, and then home care, therapists and nutritionists who all do the work to make sure patients can be healthy at home. We also run a day center that helps people come in and meet their social and medical needs, as well as transportation to and from it. As a doctor who worked in private practice quite a lot in the old days, if I were to have a person with a lot of complicated issues, it would be very difficult to coordinate all of the things they needed in an organized fashion. PACE has the infrastructure set up to take care of that. So, if I have a patient that I notice is having trouble with their knee, I can have a plan to get them to a therapist before they leave the room. It’s kind of one-stop shopping for our elders. So, that’s helpful too. Once you sign up, we cover everything. There’s not extra responsibility for the patient to make any copays. We cover drugs, hospital visits, everything once they’re in the program.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
Q: What are the advantages of keeping a patient in their home as a provider? A: Let me first answer that with a question: have you ever been in a nursing home? Q: Physically, yes, but of course not as a patient. A: If you had the choice between living in your home or an institutional environment, it’s pretty easy. You’d rather be in your own home, with your own stuff around here. There are a lot of medical advantages, too. People are happier there, they have more access to their own family, familiar neighbors. We keep families together, spouses together. It’s not always easy. As people become more and more frail, there are more things we have to do to keep them there. So, that’s another nice thing about the day center: it can give caregivers a break. Q: What are the typical needs of PACE patients? A: It’s really a whole spectrum, but to qualify for PACE you have to have some kind of need. Usually they’re day-to-day things like cooking, bathing, dressing. These are things people often can’t do when they’re debilitated. Even medication. They may have trouble opening a pill bottle due to arthritis, or they may have trouble remembering to take their medications on time. So all those things are important things we can organize and keep on track. Q: How large is the program now? A: We have about 550 people that we manage. Q: Is the demand going up with the baby boomers, or are they
not quite in your demographic yet? A: It’s getting there. You have to be 55 to be in the PACE program. We’ve been growing. We’ve doubled in size over the last 10 years, and we’ll continue to grow. There are other similar programs that are growing as well, even if they usually aren’t as comprehensive as PACE. Q: Do you think institutional settings are becoming obsolete? A: There are a couple ways to look at that. There are some efficiencies to nursing homes that you can’t achieve in the home. One nurse can handle a lot more people in one central location. So there are some things that are economies of scale. I think, in general, we try to get away from that model, but it doesn’t work for everyone. People in the later stages of Alzheimer’s disease, for example, tend to wander and need to be in a situation where they’re constantly monitored. We probably won’t get away from that until we cure Alzheimer’s. There are other people that need really intensive care and need someone around them. Unless you have nearly unlimited resources, which most people don’t, it’s hard to get that outside of an institutional setting. Q: Is it more possible, now, to living a full lifespan without a long-term stay in a nursing home? A: Yeah. Most of our folks are able to stay in their homes until end of life. At any one time, we only have 5 to 8 percent of our population in a nursing home. We feel we do a pretty good job of enabling our people to stay home longer. We’re pretty happy to have accomplished that. Q: One of the challenges of aging is that it’s easy to become socially isolated. How does PACE address this? A: It’s interesting, one of the challenges we have is that people don’t have to participate in our programs. We have, as part of the program, the day centers, which also double as social centers. Our folks spend one to five days a week in the centers. Generally, people are pretty happy doing that. We try to develop close working relationships with the folks as well. Q: What communities is PACE CNY available in? A: Our program is in Onondaga County only right now.
Lifelines
Name: Douglas Tucker, M.D. Position: Chief medical officer of PACE CNY Hometown: New Berlin, Wisc. Currently lives in Camillus Education: University of Wisconsin Medical School, Madison, Wisc., MD degree, 1984; internal medicine residency program, SUNY Health Science Center, Syracuse (1984-1987); chief resident, medicine, SUNY Health Science Center, Syracuse (1987 to 1988) Affiliations: N/A (works closely with Crouse, St. Joe’s, University Hospital) Career: Member, board of directors, Loretto Management Corporation since 2015; attending physician, Van Duyn Home and Hospital (1988-2000); attending physician, Loretto Geriatric Center, 1997 to 2000. Family: Four children Hobbies: Cross-country skiing, biking, camping
Smartphone: How to Tell If It’s Become Your BFF? Cleveland Clinic: Cell phone overuse can be just like any other kind of addiction
A
s great as smartphones are, you can get too attached to the gadgets. According to experts at the Cleveland Clinic’s Center for Behavioral Health, cell phone overuse can be just like any other kind of addiction. And here are two warning signs: your smartphone is interfering with your life, and you get withdrawal symptoms when you try cutting back. Ask yourself these questions to check on the health of your relationship with your phone. • Is using your smartphone getting in the way of work or making it hard to concentrate on tasks? • Do you think about your
smartphone even when you’re not using it? • Do you feel impatient and irritable if you’re not holding it? • Do you check your phone constantly, and for longer than you intended? Do family members say you use it too much? If your smartphone use is in the danger zone, take steps to cut back. Try to set aside a few hours of no-phone time every day. Set goals and keep track of what you’re doing without your phone, such as reading or being with your family. Set aside time at the end of the day for relaxing activities like meditation or listening to music. Turn your phone off during these breaks.
If that’s too stressful, then turn off the alerts. Above all, don’t let your phone interfere with getting enough restful sleep. Stop using it at least an hour before you go to sleep — looking at gadget screens too close to bedtime can interfere with the body’s natural
process of winding down before bed in anticipation of shuteye. And be sure not to charge it in your bedroom if you charge it overnight so that it can’t wake you if you get a message. Editor’s Note: BFF stands for “best friends forever.”
Healthcare in a Minute By George W. Chapman
TrumpCare
The Republican-controlled Senate is planning to vote on a revised American Health Care Act bill by the end of June. (This may or may not have happened by the time you read this.) Congress goes into summer recess July 4. The Senate seems to be rushing this through without much analysis, especially after the Congressional Budget Office projected 23 million people would lose their insurance if the ACHC passes as is. Political insiders think the Senate wants to vote before recess (get it out of the way) so it can concentrate on other issues like tax reform and infrastructure funding when they return to work. If the bill is put up for vote before recess and does not pass the Senate, many believe nothing or little will be done until much later in the year. Consequently, the ACA (ObamaCare) would remain law of the land.
NYS Medicaid
Gov. Andrew Cuomo has proposed to ban any insurer from participating in NYS Medicaid if they exit from the NYS insurance exchange where individuals go to buy insurance, sometimes subsidized depending on income. The ban does not prohibit insurers from selling employer-based health insurance. The ban extends to any contracting with state agencies. Cuomo does not want the state “to go backwards” when it comes to healthcare. Insurers doing business in NYS must continue to provide the 10 essential health benefits and pre-exiting conditions guaranteed under the ACA. The bill currently under consideration in the US Senate (TrumpCare) would allow states to reduce some or all of the 10 essential benefits including hospitalization, mental health, pediatric and maternity services.
NYS Universal Healthcare Bill
Overshadowed by the constant media attention on TrumpCare, on
May 27 the NYS Assembly quietly passed a universal healthcare bill, called the New York Health Act, 92 to 52. The universal health bill would cover the 9.7 million New Yorkers (49 percent of 19.8 million total residents) currently covered through their employer. The remaining 51 percent of New Yorkers are covered by either Medicaid, Medicare, VA or federal employee insurance. Like many states, because of the uncertainty of the AHCA in Washington, NYS is taking matters into its own hands. Proponents estimate it will save New Yorkers money saying the NYHA could be funded by an income assessment averaging 8.1 percent of payroll. Currently, employer contributions to insurance averages 12.8 percent of payroll. Opponents argue it would be more expensive than what employers are paying now. The NYS “normal” budget is expected to be about $82 billion the first year of the NYHA, 2019. Critics figure the NYHA will cost an additional $91 billion and that would prove to be prohibitive. But if the NYS Senate does not pass the bill, all speculation is for naught. To pass, all 31 democrats, virtually half the Senate, would have to vote yes.
New Medicare Fraud
Typically, Medicare fraud is committed by a legitimate provider of care billing for services never provided or by an illegitimate/phony provider billing for services never provided. Now insurance companies can get in on the act. America’s First Choice Holdings of Florida was fined $32 million in a case brought by a whistle blower. Medicare pays Advantage plans a premium for each member enrolled by them. The premium is based on an individual’s claims experience. Basically, the sicker a member (one requiring a lot of services), the higher the premium paid to the Advantage plan by Medicare. In order to maximize premiums received, First Choice “made material
misrepresentations” which means inflating the sickness or utilization score of patients enrolled. United Health Care has also been accused of similar fraud but is fighting Medicare.
Kudos to Crouse Hospital
C-sections are the most common surgeries performed by hospitals. According to the Centers for Disease Control and Prevention, almost a third of babies are delivered via Csection and almost half the C-sections performed are unnecessary. Consequently, Health and Human Services has set a goal of 24 percent C-section rate for low risk births. Only 44 percent of hospitals are currently under 24 percent threshold. Crouse Hospital in Syracuse had the lowest rate in the country at just 6 percent.
Drug prices
Everyone seems to agree drug prices in the US are absurdly high and something has to be done. Both Trump and Clinton campaigned for allowing the US to import cheaper drugs from Canada and other countries. And this would include drugs literally made in the US and imported from other countries back to the US. Drug stocks stumbled when president elect Trump vowed “to bring down drug prices.” This is one of the few things all Americans want and something both parties could agree upon in Congress and get something done. Then the powerful drug lobby reared up. Suddenly, despite reassurances that the FDA would approve imports as it does now, staunch supporters of drug importation developed “real concerns over safety.” One senator had the audacity to proclaim the importation bill didn’t meet his safety standards. Ironically, 40 percent of all drugs sold in the US are already imported from all over the world. The pharmacy manufacturing industry spent over $900 million on lobbying between 1998 and 2005, or well over $100 July 2017 •
million a year. There are about 1,300 registered drug lobbyists which is about 2.4 per members of congress.
Ideas for Change
Physician Jim Weinstein, CEO of New Hampshire-based Dartmouth-Hitchcock Health, has always been an outspoken advocate for redesigning our faulty healthcare system. Some of his ideas, recently presented at a national healthcare symposium are: 1. Mandate the transparency of a procedure cost and expected outcome. You have the right to know both. 2. Focus on top 5 percent of healthcare utilizers who account for a staggering 50 percent of all costs, while half of us account for just 3 percent. 3. Quickly transition from fee for service reimbursement to value-based payments. It’s still all about the almighty buck instead of quality. 4. Require those who make over $100,000 annually to contribute more to their healthcare. Eliminate the maximum taxable earnings for Social Security ($127,200) to shore up Social Security and level the playing field among us. 5. Perform preventive or routine care visits remotely. (Telehealth).The 50 percent of us that consume only 3 percent of costs would be the prime audience. 6. Trump wants to incentivize drug manufacturers to return overseas profits to the US through tax breaks. Drug companies should then establish endowments for people who cannot afford their products. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 7
In Pain?
SUNY Upstate doctor discusses what’s the best overthe-counter painkiller you can take By Matthew Liptak
P
ain is a pain, and when you don’t think there’s a need to see a doctor, there are many overthe-counter pain relievers to treat it. But which one should you get? In Good Health talked to physician David Lehmann, distinguished service professor of medicine, practicing internist, hospitalist and clinical pharmacologist at Upstate Medical University. He supplied the ins and outs of what you need to know about over-the-counter pain medicine. So, let’s get to the basics. What actually is pain anyway? “You can think of it as two big pots.” Lehmann said. “One would be pain from inflammation and then
pain from nerve involvement. The latter would be straightforward headache like brain and pain from back pain, a pinched nerve—that kind of stuff. It’s non-inflammatory pain. The inflammatory type of pain would be injury, any type of injury that a person would have involving a joint or soft tissue. Different over-thecounter pain killers work better for different ailments the doctor said. There are basically four overthe-counter types of pain relievers: acetaminophen, naproxen, ibuprofen and aspirin. Aspirin is no longer a contender as a go-to pain reliever as it’s weaker than the others, Lehmann said.
Acetaminophen:
• The only one of the drugs that is not an NSAID (nonsteroidal anti-inflammatory drug). • Lehmann said this is the safest over-the-counter painkiller with the least side effects. • Great for fever and headaches. • Don’t take as needed (yes, do not take as needed), Lehman advised. Instead take the maximum allowed dose to build up the drug to effective levels in your bloodstream. • Don’t spend more on extra strength. The additional dosage has no recognizable Lehmann impact on treating your body’s pain, Lehman said. “There’s no advantage of two tablets of extra strength, which would be 1,000 mgs over 650 mgs,” he said. “Studies have been done. It’s very well documented.”
Ibuprofen/Naproxen: • Both are nonsteroidal anti-inflammatory drug (NSAIDS). • Good for joint pain and muscle aches. • Don’t underdose yourself. Leh-
mann advises taking the maximum of 800 mgs three times a day to get maximum effectiveness. “You’re behind the eight ball when you’re just taking it for as-needed relief,” he said. • Don’t take with heart-maintenance dose of aspirin. “When you take naproxen or ibuprofen and you take aspirin for your heart, the aspirin does not work,” Lehman said. “That effect to prevent stroke and heart attack is blocked when you take either naproxen and ibuprofen with the aspirin.” Instead, take your aspirin at least two hours before or after taking the ibuprofen or naproxen. • Don’t take enteric-coated aspirin which delays the release of the aspirin, as the naproxen and ibuprofen will counteract its effect. As always if you’re in doubt about using a drug, even over-the-counter, give your doctor a call or ask the pharmacist who is probably right there in the drug store and happy to help.
Prosthetic Surgery for Erectile Dysfunction, Incontinence Implantable medical device helps men maintain erection, control urinary incontinence By Stephen Blakely, MD
M
ost men are aware that there are implantable medical devices used to treat damaged joints or diseased hearts, but many men are unaware that there are also implantable medical devices for treatment of erectile dysfunction (ED) and male urinary incontinence (the unintended leakage of urine). These devices have been around since the 1970s and have been modernized over the past 40 years to become what we use today. ED is a very common problem encountered by men as they age. Some men have ED as a result of prostate surgery, however it can also be the result of common medical problems or even smoking. Medications are commonly used to treat ED. For some men, the medications are either ineffective or unable to be taken. For this group of men, a penile
implant can be surgically placed that allows a man to have an erection when he chooses. The most common penile implant is a system which inflates (to make the penis firm) and deflates (to make the penis soft) with the manipulation of a pump that is contained within the scrotum (near the testicles). Studies suggest that about 90 percent of men will be satisfied with this treatment option. Urinary incontinence, which is the unintentional leakage of urine, is less common in men than in women. It most frequently effects men after prostate surgery. Typically a man will leak a small amount of urine when he coughs, sneezes or exerts himself during work or exercise. There are two devices that are commonly used to treat this problem. The most common is called an artificial urinary sphincter or urinary control system. This is a surgicall
placed system which allows a man to control when he urinates by manipulating a small pump within the scrotum. The second device is called a male sling. It is a plastic mesh material that can be surgically placed under the urethra to apply pressure and prevent leakage. This device does not require any manipulation. ED and urinary incontinence can be very bothersome and can keep men from enjoying life. With the use of surgical implants, many man can return to the quality of life they expect and deserve. Not all men are candidates for these procedures, but most are. It is important the surgical treatment be tailored to the goals of the man being treated. At Upstate Urology there are urologists trained in prosthetic surgery. If you are interested in an evaluation, call Upstate Urology at 315464-1500.
Stephen A Blakely is a urologist with the Upstate Urology group at Upstate University Hospital, where he is also an assistant professor of urology. He received his medical degree from the University of Maryland School of Medicine and completed his residency at SUNY Upstate Medical University.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
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or the second straight year, U.S. pedestrian deaths are setting alarming new records. The number of pedestrians killed on U.S. roads rose a projected 11 percent between 2015 and 2016, the largest year-to-year increase on record, according to a new Governors Highway Safety Association (GHSA) report. During the first six months of 2016, preliminary data show 2,660 pedestrian deaths nationwide, compared to 2,486 for the same period during 2015. The year-long projection is based on those numbers. The report also projects a 22 percent rise in pedestrian deaths from 2014. Both estimates are sharply higher than the 9 percent increase in pedestrian deaths between 2014 and 2015. “This is the second year in a row that we have seen unprecedented increases in pedestrian fatalities, which is both sad and alarming,” said report author Richard Retting, who’s with Sam Schwartz Transportation Consultants. Pedestrians account for about 15 percent of U.S. road deaths. The report cited several possible reasons for the spike. They include Americans driving more due to lower gas prices; more people choosing to walk for health, transportation,
economic or environmental reasons; and widespread use of smartphones, a distraction for walkers and drivers alike. “Everyone walks, and we want to encourage that, but at the same time we want to make sure that we all get to our destinations safely,” GHSA Executive Director Jonathan Adkins said. “Unfortunately, this latest data shows that the U.S. is not meeting the mark on keeping pedestrians safe on our roadways. Every one of these lives represents a loved one not coming home tonight, which is absolutely unacceptable,” he said. One doctors’ group added that prevention — keeping your eyes and ears on your surroundings — is key. “Today’s projected pedestrian fatalities — the highest ever recorded — are an urgent wake-up call that we need to work harder at consistently focusing on where and how we are walking,” said physician Alan Hilibrand. a spokesman for the American Academy of Orthopaedic Surgeons. “Pedestrians need to be mindful of their surroundings,” while walking, Hilibrand said. “Walking while looking at your phone or an electronic device can result in sprains, broken bones, and other serious, even fatal, injuries.”
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Page 9
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
What My Garden Has Taught Me Gardening is ripe with life lessons for those of us who live alone. It has taught me the value of planning, preparation, patience and pleasure — four essential “P’s” for a bountiful garden and … a bountiful life. Fertile ground exists in each of us, and a little tending can produce beautiful results. Here’s what I have learned: Plan: Realizing the garden of your dreams begins in your imagination, followed by careful planning. Diagram your garden and it will help you avoid planting bulbs on top of bulbs or mistaking a poppy for a weed. Likewise, envisioning your life goals and committing them to writing can help you flourish and grow. Cultivate: Good, cultivated soil promotes healthy, deep roots. When you add fertilizer to your garden and mix it up you are rewarded with abundance. Adding essential ingredients to the foundation of your dream garden (and your dream life) will nourish all that follows. You can’t go wrong with good, nutritious food; a walk in nature; a good book; soothing music; or saying
“yes” to a new adventure that’s been tugging at your heart. Plant: So many choices! Revisit your plan and embed your carefully selected seeds or seedlings with a tender, loving touch, being careful not to overcrowd or plant more than you can manage. And remember: We reap what we sow, so follow your dreams. Plant a rose and you get a rose; plant a dandelion and you get a dandelion. Seed your future with healthy choices that promote well-being. Weed: We all need room to breathe and positive space in which to blossom. It holds true for your garden and your life. Gardening is all about consistent caretaking. Slack off, even for a few days, and all things unwelcome show up and take root. Weed out the negativity and any dream-stealing toxins that contaminate your life, dash your hopes, or spoil your fun. When you pull out the bad, you can more easily focus on the good in your life. Prune: When weeding is not enough, a major pruning may be just what the arborist ordered. A job,
relationship or home that no longer satisfies or meets your needs may need a hard look. It may be time to pull out that pair of “life loppers.” Mulch: Mulching keeps weeds at bay and the ground moist, and returns nutrients to the soil. It also adds a finishing touch. Mulch offers a blanket of protection, in the same way that regular doctor appointments, insurances, and safety measures protect our lives. You can learn a lot from mulching. Wait: We all know that “good things come to those who wait” and it’s not just what comes out of the Heinz ketchup bottle. When you exercise patience, go slowly and enjoy the gradual unfolding of a flower, an idea or a friendship, your life can be savored and more deeply appreciated. Each year, I look to my garden to remind me that growth takes time. Enjoy: Before you know it, your labor of love and patience will pay off. Take pleasure in the transformation as the colors, textures, and fragrances emerge. Too often, we fail to “stop and smell the roses” in our gardens and in our lives. So get busy, then step back and take a good look. There’s nothing quite as satisfying as admiring what you’ve accomplished. It’s reason to celebrate! By osmosis, gardening has taught me how to take better care of myself. I have absorbed its rich messages and learned how to nurture my inner garden and growth as a women on her own. I encourage you to grab a spade
and join me. Beauty, growth, and an energizing sense of renewal can be yours, season after season after season.
Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive,” empowerment workshops for women held throughout the year in Mendon, NY. For information or to contact Voelckers, call 585-6247887 or email: gvoelckers@rochester. rr.com.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
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Meet Your Provider Northeast Dental Group
Dentist trained at University of Buffalo joins local dental practice, specializes in sleep apnea, implant work Who wants a stressful day at work? Not Gregory McCraith, a dentist who recently joined the dental care team at Northeast Dental Group. McCraith said that the low-stress environment at Northeast particularly drew him to the practice as an ideal place to work. Though a new face at Northeast Dental, McCraith has three decades' experience in practicing dentistry. A lifelong New Yorker, he grew up in Utica. The artwork in dentistry intrigued him. The dentist who cared for his teeth in childhood encouraged him and allowed him to observe him at work, which further sparked his interest in dentistry. McCraith trained at University at Buffalo. He practiced numerous years in Buffalo and now calls Central New York his home again. "I like all parts of dentistry, but what I like doing the most is sleep apnea and implant work," McCraith
said. Sleep apnea affects 22 million Americans, according to www. sleepapnea.org. Though McCraith makes custom appliances that help people with mild to moderate sleep apnea, he's really helping patients prevent more serious complications. Sleep apnea can contribute to cardiovascular disease and can cause sleep disruption that leads to accidents and injuries. It has also been associated with Type 2 diabetes. McCraith likes how implants can transform a patient's smile while restoring a level of function paralleled only by the natural teeth. McCraith believes that his diversified background has enabled him to develop a broader range of experience and patient empathy. He has worked in private practice, community health center and hospital settings. "You see patients as people and not as numbers or dollar bills," McCraith
said. Working with impoverished patients "brings out the humanitarian element in you," he said. McCraith keeps up with new developments in dentistry through continuing education courses and hands-on workshops. He believes that Northeast Dental's emphasis on preventive care and patient education represents the best way to practice dentistry. Instead of "disease care," the Northeast Dental approach focuses on dental health care to help patients stay healthy. A typical patient visit to Northeast Dental includes examining the teeth and gums, oral cancer screening, and X-rays as necessary. The dental team educates patients on the importance of proper brushing, routine cleanings regular flossing, sealants, and fluoride. Patients also review their medical history, any new medications, and any illnesses that may impact dental health. This kind of
McCraith patient care can help the dentists at Northeast Dental prevent problems instead of simply treating them. Dr. Michael Botty and Dr. David DeVito had enjoyed practicing together for a decade in Fulton when they decided to expand Northeast Dental to more communities in the greater Syracuse area, including Cicero, Central Square and Fayetteville. They currently employ nine doctors and 31 operatories. When he's not chairside at Northeast Dental, McCraith enjoys scuba diving, hunting, sailing, and motorcycling. He's also learning to fly planes.
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‘Deadliest Days’ New teen drivers face triple the risk of a fatal crash
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ewly minted teen drivers in the United States have almost triple the risk of being involved in a deadly crash than adults, a new study finds. The study looked at national data, and also found that drivers aged 16 to 17 are almost four times more likely than drivers aged 18 and older to be involved in a crash. Compared to drivers aged 30 to 59 years old, new teen drivers are 4.5 times more likely to be involved in a crash, and more than three times as likely to be in a fatal collision. The findings were released at the start of the “100 Deadliest Days.” That’s the period between Memorial Day and Labor Day. During that time, the average number of deadly crashes involving teen drivers is 15 percent higher compared to the rest of the year, the study authors said. Over the past five years, more
than 1,600 people were killed in crashes involving inexperienced teen drivers during this deadly period. The study was released June 1 by the AAA Foundation for Traffic Safety. This study “found that that inexperience paired with greater exposure on the road could create a deadly combination for teen drivers,” David Yang, executive director, said in a foundation news release. “Statistics show that teen crashes spike during the summer months because teens are out of school and on the road,” he said. Fatal teen crashes are on the rise and increased more than 10 percent between 2014 and 2015, according to National Highway Traffic Safety Administration data. Three main factors associated with fatal teen crashes are distraction, not buckling up and speeding.
AAA says parents can help reverse this trend by getting more involved and talking to their teens about the dangers of risky driving behaviors. “Parents are the front line of defense for keeping our roads safer this summer,” Jennifer Ryan, AAA July 2017 •
director of state relations, said. “It all starts with educating teens about safety on the road and modeling good behavior, like staying off the phone and buckling your safety belt.”
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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hose who are uninsured or underinsured who need health care, can get it at Amaus Medical Services in downtown Syracuse. Physician Lynn-Beth Satterly is co-founder of the clinic. “It started in 2007 as an outreach of the Cathedral of Immaculate Conception,” she said. “They were looking for ways to ramp up care of the underserved. The pastor approached my husband and I, who are both family doctors, about some help there. We said why don’t we do a needs assessment and see if a clinic could be used. We did a needs assessment in collaboration with some colleagues and, when we looked at the numbers, we realized that there Satterly was a population of people in that area that actually could use an interim primary care clinic.” The clinic is run much like any other primary care office, except that it is all-volunteer staffed. There are a half dozen providers, seven nurses and four clerical staff. There are fourhour clinics at the office on Wednesdays and Thursdays. Providers usually see four to 10 patients a day in four exam rooms, Satterly said. “When they come in they can expect [what looks like] a small private practice,” she said. “We have a commitment that, even if we can’t solve all the problems, we will always advocate and our commitment is always to be kind. We’re there by choice. We’re happy to be there and take care of people. We do our best to follow standards of care. It just feels like being in a regular private practice.” Satterly said her work at the clinic is a function of her faith, but she believes all those in the medical field have a duty to help the underserved. “If you think about it, doctors make a living off people being sick,”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
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she said. “I feel it’s very important to give back to people who might not be able to pay for those services.” Before the Affordable Care Act became available the clinic was seeing about 1,500 patient-visits a year. That number was reduced to 600 or 700 after Obamacare was put in place. She says that includes about 400 unique visitors in 2016. “What we do is we see people as long as they need us and as long as they are economically vulnerable,” she said. “It depends on the day. It depends on the year. It depends on whether or not it’s flu season.” Amaus also has a pediatric clinic and separate dental clinic. The staff’s concern for patients extends to nonmedical issues. They will seek to advocate for them if they have unstable housing or other challenges, often referring them to the appropriate organization that can help. Satterly believes the clinic will be around for the foreseeable future. Whether it grows or not may depend largely on what health insurance law comes about on the national level. “I think [it] will grow as need dictates and as we can find a way to meet that need,” she said. “I think right now what we’re doing is meeting the need that we’re faced with.” These helpers could use your help too. They are funded by private support and small grants. They are always looking for more donations and volunteers. They are particularly in need of a grant writer and website designer at the moment. “In Syracuse at any given time 25 percent of the population meets the criteria for poverty and they have trouble making ends meet,” Satterly said. “When you’re poor, one of the things you have a problem with in addition to stable housing, and stable employment, is health care. Those three factors are related.” To find out more about Amaus Medical Services call 315-424-1911.
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Things You Need to Know About Back and Neck Pain By Ernst Lamothe Jr.
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small tweak to the back and spine can cause pain and affect range of motion for the entire body. Sometimes it occurs from awkwardly picking up an item, while other times you can simply wake up in pain. David Moorthi, an interventional spine care specialist at St. Joseph’s Physicians Spine Care in Syracuse, understands the need for preventive care for the back and spine. However once the problem begins, he intervenes in acute spine pain through development and coordination of treatment plans that seek to prevent unnecessary surgeries. “Eighty-five percent of back and neck pain often goes away by itself,” said Moorthi, who is certified by the American Board of Physical Medicine and Rehabilitation. “It may be painful initially but there are many things the public doesn’t know that could help with conservative treatment of the pain.” Moorthi offers five preventive tips to surgery for spine, neck and back pain.
1.
Visit your primary doctor A primary care doctor has the history of when your pain began and can offer you a solid, clinical evaluation in most cases. They will be able to listen, touch, feel and make decisions based on the examination. “Your doctor can often assess where the pain is coming from and
offer a treatment plan,” said Moorthi. Also, because they know your history, your primary care physician can talk to you about lifestyle choices such as exercise and nutrition that will be beneficial in creating a solid frame. “If you are overweight and the muscles around your body are flabby that doesn’t support the spine as well as it could,” said Moorthi.
2.
Treat it conservatively There was always a debate between physicians if cooling or heating back pain works better. Moorthi prefers the latter. “Warm packs tend to work better for acute back and neck pain,” he said. “It also helps to take some anti-inflammatory medication to make it better.” He also suggests massages as a possible medium for relief. Because muscles tend to stiffen up, having a massage therapist work the body can often make them more relaxed.
3.
Stretching Stretching may take a back seat to your exercise routine, but it shouldn’t. Stretching may help you: • Improve your joint range of motion • Improve your athletic performance • Decrease your risk of injury Studies about the benefits of stretching have had mixed results.
Some show that stretching helps. Other studies show that stretching before or after exercise has little to no benefit. “One of the first things I tell patients is that they should stretch every day,” said Moorthi. “Stretching your neck, back, pelvis, legs and abdominal muscles can strengthen your body. When the muscles are relaxed, they tend to work more efficiently.” Something simple like taking a moment in your office between your eight-hour shifts and just standing up and stretching your arms can make a world of difference. “You want to stay mobile and active throughout the day,” he added. “It is very easy to stiffen up and get yourself in more pain.”
4.
Avoid twisting and turning We have all heard the advice about bending with your knees when lifting heavy objects. However, there is something else that we do that might cause more damage than not bending at the knee. “People don’t realize that when they pick up heavy weight they often twist and turn their whole bodies. That can cause a lot of strain on your back,” added Moorthi. “Because the pelvic joint does most of the work on the lower body, when you twist while carrying something heavy it can cause an awkward motion for the body which results in possible injury.”
Physician David Moorthi, an interventional spine care specialist.
5.
Chiropractic Chiropractic is a health care profession dedicated to the non-surgical treatment of disorders of the nervous system and/or musculoskeletal system. Generally, chiropractors maintain a unique focus on spinal manipulation and treatment of surrounding structures. Many studies have concluded that manual therapies commonly used by chiropractors are generally effective for the treatment of lower back pain as well as for treatment of lumbar herniated disc, neck pain, among other conditions. “A lot of time healthcare professionals demonize chiropractic care. But I do believe that it can be useful,” said Moorthi. “I have seen patients get adjusted by a chiropractor and they all of a sudden hear a pop that loosens something up and they feel better. Modern medicine doesn’t have all the answers so I believe you have to look at all conditions from every angle.”
If you think something is wrong with this picture, you should see what’s being served up in stores. Tobacco companies spend billions on colorful signs, special discounts and promotions in stores where kids can see them. And the more kids see tobacco, the more likely they are to start smoking. It’s time for tobacco marketing to hit the road.
Tobacco companies place most of their advertising in stores where
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% OF
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shop at least once per week
Take action now at SeenEnoughTobacco.org facebook.com/TobaccoFreeNYS July 2017 •
@TobaccoFreeNYS
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 13
My Turn
By Eva Briggs
New Developments in Migraine Treatment About 39 million people in the U.S. have migraines — one in five women suffer from it
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s a migraine sufferer, I was excited to learn about a new treatment under development to treat migraine headaches. Many people incorrectly label any severe headache as a migraine. Migraine is a specific syndrome of recurring headaches, often accompanied by nausea and vomiting, sensitivity to light and sound, with pain typically located on one side if the head, and pulsing or throbbing in character. About one-third of migraineurs have an aura of strange sensory symptoms just before the start of the headache, most often in the form of vision disturbances. Many migraineurs experience a prodrome warning of an impending attack: fatigue, yawning, mood swings, light sensitivity and other vague systems. Egyptian medical documents dating back to 1200 B.C. describe the disorder, making it one of the oldest diseases ever detailed. About 39 million people in the U.S. have migraines — one in five women and one in 16 men. Migraines seem to run in families, and more than three dozen genes have been associated with migraine susceptibility. The exact mechanism leading to
migraines remains unclear. An early theory proposed that distended, dilated blood vessels in and around the skull produce the typical pulsating pain of migraines. In the 1940s neurologist Harold Wolff discovered that administering a drug to constrict blood vessels could alleviate the pain. This led to the first migraine-specific medicine, ergotamine tartrate. Unfortunately, ergotamine has multiple side effects such as nausea and vomiting (already a problem during a migraine), elevated blood pressure and constriction of arteries impairing circulation to the heart or extremities. In the 1970s and 1980s researchers found that during migraine attacks people seemed to be losing serotonin, as the levels of serotonin dropped in the blood and rose in the urine. Administering serotonin could reduce the headaches but, as with ergotamine, produced serious side effects. Scientists searched for drugs that could bind more specifically to serotonin receptors. This led to sumatriptan and similar triptan medicines. While often helpful, triptans completely relieve migraine pain for only 30 percent of people, and the pain may come back later the same
Parenting By Melissa Stefanec
Could’ve, Would’ve, Should’ve (But I Am One Person)
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s a parent, I have acquired something I never had while childless. It’s something I always said I was better than. It’s a thing I never wanted to waste time and energy on. That thing is a frenemy — the classic person that always leaves you wondering if he or she is more friend or enemy. Except, my frenemy isn’t a person, it’s a thing. It’s a thing that I relied on to see me through my formative years and a thing I swore by. It’s my good-oldfashioned to-do list. Me and my todo lists go way back. From a whiteboard in my bedroom in high school, to a notebook in my purse, to trendy peel-and-stick chalkboards in my kitchen, and memos on my phone, my to-do lists have grown with me and helped me keep it together when the demands of life seemed unmanageable. However, being a mother has brought about my friend’s betrayal. My to-do list in no longer my chief aide in conquering tasks; it’s now a reminder of all the things I have Page 14
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failed at. For every item I cross off it, two more jump on. And that’s not being trite or melodramatic; it’s actually a gross underestimate. My to-do list is becoming documentation of my failures, and I don’t like it. I could be that I just need to get it together. I could tell myself to buck up, try harder and focus on productivity. But, like most parents I know, I already work from the moment I get up, which is too early, until the moment I go to bed, which is too late. Unless I quit sleeping, there aren’t ever going to be enough hours in the day. So, instead of beating myself up over things I can’t change, I am going to start a new refrain. Could’ve, would’ve, should’ve (but I am one person). Every time I start stressing about things that are undone in my life, I need to take a deep breath and remind myself that all the important things will get done in time, and the rest will just have to slip through the cracks, because I can’t be anything more than one person.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
day. Triptans, too, have unpleasant side effects, such as chest, tightness, dizziness, drowsiness, tingling, and flushing of the face and neck. Also in the 1980s, Swedish scientist Lars Edvinsson began studying calcitonin gene-related peptide (CGRP), a substance found in the nerves around the blood vessels inside the skull. CGRP potently dilates these blood vessels, and its administration to migraine sufferers triggers an attack. So it seems that if this substance could be blocked, perhaps that could lead to another way to treat migraines. Scientists in Germany succeeded in designing a CGRP antagonist, a molecule that blocks CRGP receptors. It worked to stop migraines when given via IV. But as promising as this seemed, again there was the bugaboo of side effects. In this case the CGRP blocker caused serious liver problems. The next innovation was to build a monoclonal antibody, a protein able to bind and block CGRP receptors while leaving the liver and other vital organs unscathed. But antibodies are too large to pass from the blood into the brain, and so it seemed possible this wouldn’t help. Yet it seems to work. Apparently blocking CRGP in nerves outside the brain helps block pain signals entering the brain through the periphery. Clinical trials studying the monoclonal antibody so far have shown few side effects. It seems reasonably effective, preventing migraines completely in one out of six patients, and cutting the number of headache days by more than half in 70 percent of patients. Although this drug appears more
So here are some of my to-dos and my new refrain. • My kids are tired because I ran errands after piano lessons instead of getting home and getting them to bed on time. We needed milk and bread, and I didn’t want to pay $4 for a half gallon of milk from the convenience store up the road. So, I dropped by the grocery store after lessons, and now my kids are paying the price. I should’ve planned better. Could’ve, would’ve, should’ve (but I am one person). • My son has stains down the front of his shirt from a day of picky eating. We have somewhere to be where a halfway decent shirt would be ideal. I should’ve packed a change of clothes for him. I should’ve finally made those “emergency” bags for my vehicle (the one with a change of clothes, a wipe pack and an extra pullup in it). That way, I could be ready for most of what mom life throws at me. Could’ve, would’ve, should’ve (but I am one person). • I should’ve practiced sight words with my daughter tonight. I should dedicate two nights a week to sight words and another two nights to practicing colors with my son. It’s my job to enrich them. Instead, I made dinner and cleaned up so they had full bellies and a decent home. Still, those sight words are haunting me. Could’ve, would’ve, should’ve (but I am one person). • I shouldn’t have raised my voice at my kids when their bickering became too much for me to bear. I should’ve turned down the
effective with fewer side effects than many currently available migraine medicines, there are drawbacks. It would have to be given via every three-month IV infusions, or by monthly self-injections. The longterm safety isn’t known. Most migraineurs are woman of childbearing age, but the safety during pregnancy isn’t known. Other drugs being developed for migraine treatment include serotonin blockers specific for nerve cells without affecting blood vessels. The aim is to reduce the headache without the side effects of blood vessel constriction. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
heat on the stove and let dinner wait for a few minutes while I calmly confronted them and their problem. Could’ve, would’ve, should’ve (but I am one person). • I should’ve used my lunchtime at work to take the bottles back and stop at the post office. Those books for my sister have been riding shotgun for weeks. I should’ve got my car inspected and brought it in for the hatch release recall. Instead, I skipped lunch because I got to work late after a morning toddler meltdown involving the need for everything to be done by Mommy. Could’ve, would’ve, should’ve (but I am one person). • I should’ve made that potty training chart for my son. Once upon a time, he was so interested in using the potty. Now, the word potty is on par with sitting quietly and doing what he is told. He needs a better motivator than me ordering him to do his duty at a set time and place. I should entice him with a brilliant prize. Could’ve, would’ve, should’ve (but I am one person). My daughter turned 6 on Sunday. I remembered so many things for her party, but I failed to remember to schedule her 6-year well visit. Now, I will be on the waitlist for an evening appointment so I don’t have to take more time off from work. It still counts as long as I squeak the visit in while she is six, right? Could’ve, would’ve, should’ve (but I am one person). Could’ve, would’ve, should’ve (but I am one, amazing person).
SmartBites
The skinny on healthy eating
Relieving Nausea Just One of Ginger’s Powers
D
oes ginger really help you lose weight? Recent research gives it a thumbs-up. The new studies, published in the Annals of the New York Academy of Sciences, suggest that consuming ginger can enhance calorie burn and reduce feelings of hunger, and that it’s associated with weight loss in overweight adults. More good news: Studies have also linked ginger to positive changes in cholesterol, blood sugar, blood pressure, inflammatory proteins and liver health. Although the field is in its infancy, says Marie-Pierre StOnge, associate professor of nutritional medicine at Columbia University, the research is promising. For now, she adds, people should know that ginger is rich in antioxidants and anti-inflammatory properties, and that “including it in their diet certainly won’t hurt—and might even help a great deal.” Ginger’s latest perks seem fitting, especially since so many of us already prize ginger for its health benefits. What are those benefits? Let’s take a look. Of all the spices, ginger seems to be the go-to spice for stomach woes, from nausea to indigestion to motion sickness. Ginger soothes the stomach because it contains the compound gingerol, which helps to relax the
G.I. tract by blocking receptors that cause nausea. I drank ginger tea for morning sickness while pregnant and continue to drink it today whenever I feel queasy. Fresh ginger is a natural anti-inflammatory, thanks again to the gingerol compound. Some studies suggest that ginger may provide symptomatic relief of pain and swelling for individuals with inflammatory health problems like osteoarthritis or rheumatoid arthritis. Additionally, consuming fresh ginger may also help arthritis-related problems with aging knees. Besieged by painful periods? Ginger may be your ticket to a more comfortable day. On the cancer front, ginger is showing some true grit. Researchers from the University of Minnesota have indicated that ginger may inhibit the growth of human colorectal cancer cells. Likewise, Dr. Rebecca Lui and her colleagues from the University of Michigan showed that ginger induces cell death in ovarian cancer cells. In both studies, all roads lead back to its acclaimed gingerols. Must we consume an entire ginger root in one sitting to reap any benefits? Not likely. Because the active substances in ginger are so concentrated, experts say you don’t have to use very much to get the
goods. For arthritis, some people have found relief consuming as little as ¼-inch slice of fresh ginger cooked in food. For nausea, some have had their rumbles righted with a few ½-inch slices of fresh ginger in a cup of hot water.
and pepper and toss lightly. Set aside. In a small bowl, combine the lemon juice, lime juice, red wine vinegar, ginger, garlic, salt and pepper, and sesame oil. Whisk it all together until incorporated. While whisking with one hand, slowly drizzle in the canola oil until well mixed. Pour the dressing over the carrot and edamame mixture. Toss to combine. Top with the chopped avocado pieces. Garnish the dish with more sesame seeds and cilantro if you like.
Helpful tips
Gingery Carrot Salad with Edamame and Avocado (Serves 4-6) Adapted from “The First Mess” cookbook
Salad:
5-6 carrots, peeled and cut into matchsticks 1 cup frozen shelled edamame, thawed 1/4 cup black sesame seeds (optional) 1/2 cup cilantro leaves, roughly chopped (mint or basil also good) salt and pepper, to taste 1 ripe avocado, peeled and chopped
Select fresh ginger roots that are firm, smooth and free of mold and soft spots. Next, take a whiff: it should be pungent and spicy. Fresh, unpeeled ginger can be stored in the refrigerator for up to three weeks. My favorite tip for storing ginger: Peel several large roots with a paring knife, finely grate roots in a food processor, scoop the resulting mixture into an ice cube tray, and freeze. Once frozen, place individual cubes in a freezer bag and then, before you cook with a cube, thaw it at room temperature or for just a few seconds in the microwave.
Ginger citrus dressing:
1/4 cup fresh lemon juice juice of 1 lime 1/2 tablespoon red wine vinegar 1 inch piece of ginger, peeled and finely grated 1 garlic clove, minced salt and pepper, to taste few drops of toasted sesame oil 2-3 tablespoons canola oil
Combine the carrot matchsticks, thawed edamame, sesame seeds and chopped cilantro in a large bowl. Season the whole mixture with salt
July 2017 •
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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Essential Oils. Do They Work? Experts say they are effective for pain treatment, stress relief, relaxation By Deborah Jeanne Sergeant
I
f you don’t use them in your home, you’ve likely experienced essential oils in a diffuser at a business or friend’s home. Extracted from plants, essential oils have become a popular means of freshening the air. But they can also do much, much more. “The market for essential oils is just exploding,” said Wendy Meyerson, owner of Natur-Tyme in Syracuse. She said that one big reason is the rising interest in self-help. According to Meyerson, many people buy oils at Natur-Tyme for making their own skincare products, using as home health remedies and for taking care of their homes. “People are looking for more natural options to combat mosquitoes and ticks, treating sinuses and colds in winter and they want essential oils for use in diffusers and lamps — that is really big,” Meyerson said. Household uses include as
natural air fresheners and household cleaners, both of which would otherwise contain chemicals. Meyerson said many conventional air fresheners and cleaners are toxic and people develop sensitivities to these. “They’re finding they do much better with a natural essential oil,” she said. “People coming in have as many different reasons as to why they want essential oils.” Young Living, a popular brand of essential oils, sells more than 80 essential oil types, plus numerous blends. With all this selection available, it may be difficult to know what to use. Meyerson recommends not taking essential oils internally unless the company specifically states it may be ingested. “We recommend a carrier oil like jojoba oil,” she said. She added that pet owners should store their essential oils away from pets, since some can be toxic to animals. To learn how to use essential oils,
Meyerson recommended “The Essential Oils Book” written by Colleen K. Dodt and published in 1996 by Storey Publishing. She also said “Aromatherapy for Everyone: Discover the Secrets of Health and Happiness with Essential Oils,” by P J Pierson and Mary Shipley, published in 2004, is a great source of information about essential oils. They are both available at Amazon.com. Laurel Sterling, health educator and registered dietitian practicing in
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Canastota, uses many essential oils. She recommended using a patch test for topically applying oils to ensure the user won’t have an allergic reaction. Although essential oils come from plants, people may respond differently to oils because of their concentration. “Carrier oils should be used to avoid skin reactions, like almond oil, avocado oil, or coconut oil,” Sterling said. “With pregnancy, there are oils that should not be used during certain stages.” Physician Az Tahir practices holistic integrative medicine at High Point Wellness in Syracuse. He said that he has seen “a lot of benefits from essential oils combined or alone. It is very, very safe.” Tahir added that people should use essential oils with great care because they’re so concentrated. Most people need only a drop or two in a carrier oil for use topically, for example, or a few drops in water to use in a spray bottle. Carrier oil may include coconut oil or extra virgin olive oil. Like Meyerson, he offered caution to people interested in taking essential oils internally “since it’s very highly concentrated. It can be a problem,” Tahir said. “Too much of anything can be dangerous. Be very, very careful.” He said that another way to use essential oil is in a bath with Epsom salts. Because the FDA doesn’t regulate essential oils, users should seek products from a well-known company to help ensure the product is organic and pure.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
Use of Complementary Medicine
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n recent years, non-Western medicine has grown in popularity and availability. Most insurers cover at least some modalities. According to the National Institutes of Health, more than 30 percent of adults and approximately 12 percent of children use non-Western health care. A few prestigious medical schools have begun offering dual certification programs, which has raised the esteem for integrative practitioners. Well-known medical doctors such as Mehmet Oz, Deepak Chopra, Andrew Weil, and Mark Hyman also use and endorse modalities that originate outside Western medicine. Physician Az Tahir practices holistic integrative medicine at High Point Wellness in Syracuse. In addition to his training as a medical doctor and post-graduate studies that specialized in several areas, he is a licensed massage therapist and has completed training in several types of massage, clinical hypnotherapy and homeopathy. “It has been a slow journey to be accepted,” Tahir said. “Many doctors are seeing the benefits of complementary medicine.” He said that among those who aren’t embracing complementary medicine are doctors who don’t see the connection between lifestyle and health. He recalled a patient he knows who was given a hamburger after colon cancer surgery, even though red meat has been identified as a contributory cause of colon cancer. Tahir said that medical schools provide students with little education about nutrition and the benefits of modalities such as relaxation, aromatherapy and other basics of complementary medicine. “It’s unfair the patients don’t
According to the National Institutes of Health, more than 30 percent of adults and approximately 12 percent of children use non-Western health care. get the benefit of complementary medicine,” Tahir said. “With treating cancer, some of my colleagues are doing a good job in providing all the options and others are just saying, ‘Surgery, chemotherapy and radiation are the only options.’” Tahir hopes that patients continue to push for more approval of complementary medicine so that it will become more accepted. Laurel Sterling, natural health educator and registered dietitian practicing in Canastota, believes that complementary medicine has become more accepted in the 17 years she’s worked in the industry. “Using fish oil as a supplement is more accepted and doctors are recommending probiotics,” she said as just two examples. She said that many nurse practitioners she knows attend integrative health conferences to meet patient demand as patients become more savvy about their own health. Sterling thinks that since insurance drives a lot of the health care
industry, broadening insurance to accept more complementary health will help increase the accessibility to complementary health. “Some people want to take measures to go in a more natural way to help heal their bodies instead of the Band-Aid approach, which what a lot of medications do,” Sterling said. Wendy Meyerson, owner of Natur-Tyme in Syracuse, recalls when her father, Stan Meyerson, a local integrative pharmacist, hosted a radio show about health when she was a youngster. At first, many doctors doubted his approach was helpful. But eventually, many doctors called into his radio show to ask questions. In this example and through others, Meyerson has observed firsthand the shift in patient trust from only conventional to more integrative medicine. She thinks that more people want to become proactive about their health because they discover it helps. “People have found success in using diet, exercise, hands-on modalities and nutritional supplements,” she said. While she said that patients must discuss scaling back or quitting medication with their doctor, healthful lifestyle habits can help them improve their health and possibly reduce or eliminate some medication. She wants the area of non-pharmaceutical pain management to continue to develop, as well as prevention and management of chronic conditions such as high blood pressure and high blood sugar. “People can’t afford to live with the medical system, whether drugs or physicians,” Meyerson said. “[Patients are] looking at other ways to do things that are more effective and economical.”
Experts we spoke with, from left, are physician Az Tahir, High Point Wellness in Syracuse; Laurel Sterling, natural health educator and registered dietitian practicing in Canastota; Wendy Meyerson, owner of NaturTyme in Syracuse.
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Women’s HEALTH
Extreme Workouts While Pregnant
By Deborah Jeanne Sergeant
M
any fit women enjoy extreme workouts to stay healthy and challenge themselves, whether it’s long-distance running, weight lifting, training for “warrior” events, hitting the gym hard or competitive fitness. When they become pregnant, many can continue to work out with a few tweaks to their regimen. “I literally worked out circuit training the day I gave birth,” said Kristen Szitar, personal trainer and fitness instructor at Method 360 in East Syracuse. She said that with a few exceptions, she thinks that healthy, athletic women may continue to participate in sports and activities as long as they’re comfortable and their OBGYN approves. “During the pregnancy, it helped me keep my sanity,” Szitar said. “I can’t just stay on the couch. A lot of pregnant women think they should stop working out, but recovery is harder if you aren’t active for nine months. I started working out two weeks after I gave birth. It gave me energy to keep moving. I wasn’t doing crunches and core work, but moving helped my core.” Szitar also stayed within her OBGYN’s recommended weight gain by eating right and exercising. She said that women who aren’t
fit but become pregnant should stick with low-impact exercise like walking or yoga. “Do what makes you happy so you can stay stress-free,” she said. “If you’re doing something that makes you happy, that’s the most important thing.” She said that after 20 weeks, pregnant women should avoid lying flat on their backs since the baby’s weight can press against a blood vessel called the vena cava, which can restrict the blood flow to the baby and cause dizziness to mom. Pregnant athletes should take a few precautions. Ashlea Youngs, personal trainer at Metro Fitness Club in Syracuse, said that since the pregnant body releases relaxin, a hormone that loosens ligaments for delivery, women should take care to not sprain a joint. Injuries can prove harder to treat during pregnancy. Many types of pain medication aren’t safe for babies. Supportive sport wraps may provide additional stability to joints. Youngs added that fit mamas should also modify their activities to avoid direct contact and falling. This could include inline skating, horseback riding, skiing, martial arts sparring, boxing, football and soccer. Women who lift weights should isolate their movements so they
Bras: Do They Do Anything for Women? By Deborah Jeanne Sergeant
M
ost American women wouldn’t dream of leaving home without wearing a bra, but they unhook — if not remove them — once they’re home for the evening. Most feel culturally obligated to align to the “proper” silhouette and make sure they’re covered up. Aesthetics and modesty aside, what health benefit do bras provide, if any? In the mid-‘90s, a rumor circulated that underwire bras raise women’s risk of breast cancer because they supposedly hamper the body’s lymphatic system and cause toxins to build up, eventually leading to breast cancer. Jayne R Charlamb, an OB-GYN with SUNY Upstate, said that her patients often ask about an increased risk of breast cancer because of wearing underwire bras. “There is absolutely no good scientific evidence showing a causal link between bra-wearing and Page 18
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breast cancer,” said Charlamb, who is associate professor of obstetrics and gynecology and director of the division of breast health and breastfeeding medicine at SUNY Upstate Medical University. While that may let under wires off the hook, women can reduce the risk of breast cancer through a few proactive steps. Charlamb said that alcohol intake and obesity are associated with an increased risk of breast cancer, and that breastfeeding is associated with a lower risk. Home self breast exams, clinical breast exams and mammograms may also help catch cancer while it is still more easily treated. Bras offer few health benefits, according to Nicole Chaffee, physical therapist with Regain Physical Therapy in Pittsford. “They have fair to little tension support for the back muscles and muscles of the chest,” she said. Racer-back and crisscross styles
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
Kristen Szitar pregnancy sequence: From left, photos show her during week 1 of pregnancy, week 40 of pregnancy (full-term) and three weeks after she delivered. She said she continued exercising during pregnancy. “It helped me keep my sanity,” Szitar said. “I wasn’t doing crunches and core work, but moving helped my core.” don’t strain their abdomens. They should also be careful to not allow free weights to strike their abdomen. As always, using a spotter can help improve safety. Pregnant women should avoid working out in very warm environments, such as hot yoga or running outside on a hot day, since that can harm the baby. Szitar also advises pregnant women to stay hydrated while working out and to adjust their diet to ensure they get enough healthful calories. Before engaging in exercise, pregnant women of any fitness level should discuss their health and any
concerns with their OB-GYN. They should also carefully explain the details of their activity to ensure it is safe for themselves and baby. Anytime an activity feels like it’s “too much”, a pregnant woman should listen to her body and reduce her activity level. “Always check with your doctor first,” Youngs said. “Every pregnancy is different and carries different circumstances that need to be taken into consideration.” Overall, pregnancy isn’t a time to make great fitness gains, but to maintain health and nurture both the mother’s and baby’s bodies.
can help users improve posture and provide support for larger breasts; however, they can’t prevent sagging. For more support and greater comfort, Chaffee recommends bras with separate cups and wider straps. Some people theorize that wearing a bra weakens ligaments that support the breasts, but that’s not the case, according to Emese Kalnoki, a new surgeon practicing at Quatela Center in Rochester. She specializes in aesthetic and reconstructive breast surgery and body contouring procedures. But it’s also not true that a bra will prevent natural sagging once they’re removed.
“So, go ahead and wear your favorite bra — or don’t,” Kalnoki said. She listed pregnancy, breastfeeding, weight loss and gain, and aging as contributory causes of sagging breasts, not whether or not a woman wears a brassiere. “The type of collagen that you inherit from your parents also affects the perkiness of your breasts throughout life,” she added. Many women keep wearing the same sized bra despite changes in their breasts. Others don’t have their brassieres adjusted correctly or wear the wrong size. Kalnoki recommends an annual bra fitting.
Women’s HEALTH Cosmetics with SPF: Are They Enough?
By Deborah Jeanne Sergeant
C
oating exposed skin with sunscreen before a day at the beach is part of skincare for many people. But routine sun exposure adds up to cumulative skin damage over time. Many brands of make-up and skin care products boast that they contain sun protection factor (SPF) ingredients as anti-aging properties. Is that enough to safeguard your skin against damaging rays in day-to-day use? For many women, probably not. “You still need sunscreen, even if a cosmetic product has sunscreen in it,” said Ramsay Farah, dermatologist with Farah Dermatology and Cosmetics in Syracuse. Part of the problem, he said, is that many cosmetic products have low SPF — such as 10 — and how indicates the product protects against they’re applied. Instead of the thick both UVA and UVB rays. coating of sunscreen, users apply “Many of these are hypoallermake-up products genic since they such as primer and contain physical foundation thinner blockers,” Drew and blend them said. into the skin more. She recomThey also skip mends brands Elta exposed areas such MD, Color Science, as the ears, neck and, for children, and throat. Blue Lizard. Ramsay Farah, dermatologist with Farah’s sister, One issue for Farah Dermatology and Cosmetics in women is that afJoyce Farah, also Syracuse. a dermatologist ter applying a sunat Farah Dermascreen base and tology, said that then SPF cosmetstarting with a base sunscreen helps ics, they should re-apply a sunscreen provide better protection. Users can product after two hours. add primer and make-up on top of Few women who took the time the base layer of sunscreen. to apply and blend make-up want Sara Drew, board certified adult to pile on a greasy, white layer of nurse practitioner with Geneva sunscreen before heading out for a General Dermatology Associates in walk during their lunch break. Since Geneva, said patients ask a lot about some translucent powders offer SPF the effectiveness of cosmetics with 30, Joyce Farah suggested using a SPF. Though these can help, she said, SPF mineral powder as a touch-up to “It’s even more important to have avoid piling on more sunscreen midsomething on underneath.” day “or wear a hat or both,” she said. Most make-up with SPF rates at “There are some really good make-up least 15 SPF, though 30 is better. SPF lines with minerals and sunscreen for measures the protection that a sunwhen you don’t want to apply more screen provides against the sun. SPF sunscreen on top of make-up.” rated higher than 30 doesn’t offer a After two hours, women with significant advantage. oily skin likely need a touch-up Sunscreen products often bear anyway. expiration dates because their active She suggested tinted sunscreen ingredients can lose effectiveness for a more casual look that’s easier to over time. Most last about three reapply later. years, but if products change in color, Sweating, swimming and towel scent or consistency, throw them out drying the skin all reduce the amount and buy new ones. of time that sunscreen provides proMany products contain titanium tection. dioxide or zinc oxide, both of which In general, seeking shade whenphysically block UVA and UVB rays ever possible, using the car visor, that cause aging and skin cancer. and wearing SPF protective clothing, These become active upon applicasunglasses and broad-brimmed hats tion. Chemical sunscreens must be can also provide physical barriers to applied 15 minutes before sun exsun exposure. posure. The term “broad spectrum”
“You still need sunscreen, even if a cosmetic product has sunscreen in it.” -
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Women’s HEALTH
Safely Eating for Two By Deborah Jeanne Sergeant
A
mid the many changes a pregnant woman makes in her lifestyle to nurture and protect her baby, her diet can be among the most important. What a woman eats can directly affect the baby’s health, both positively and negatively. April Ward, owner of Botanic-Her in Skaneateles, is a nationally board-certified nurse-midwife and state-licensed midwife. She said safe food handling can help prevent listeriosis, a bacterial infection caused by the bacterium Listeria monocytogenes. The infection can cause miscarriage, stillbirth and premature delivery. One surprise to many women is that deli slices of meat can cause problems because of the frequency of Listeria outbreaks with this type of food. “Avoid eating deli meat exposed to open air or salads bars because of the risk of food borne illness which can harm the pregnancy,” she said.
While many sandwich shops lightly toast subs, Ward said that the meat must be heated to steaming hot to kill Listeria. A juicy, grilled steak with a pink center may sound enticing, but it should be well done with a minimum internal temperature of 145 F. (Ground beef should be 160 F and poultry 165.) She listed other foods frequently contaminated with Listeria. They include unwashed produce, soft cheeses and unpasteurized milk and other beverages. “Be careful about Crock-Pots,” said Laurel Sterling, natural food educator and registered dietitian practicing in Canastota. “A friend of mine had food poisoning from eating food that wasn’t heated through.” She warned about raw sushi or raw eggs for pregnant women. She added that pregnant women should make sure grilled meat is cooked all the way through. Other picnics favorites can also cause problems. “Foods should be kept either
What Should Women Eat While Pregnant? • “Cultured foods like yogurt, sauerkraut and kefir helps improve good flora in the vaginal canal so it supports the baby’s immune system. Laurel Sterling, natural health educator and a registered dietitian practicing in Canastota • “In general, avoid highly processed foods with refined flours and sugar. They are empty calories. It’s best to get micronutrients from whole foods instead of supplements. • “Water is really best as the main source of hydration. There’s really no place at all for soda, whether diet or full calorie. it’s worthless and possibly harmful. • “Pregnant women don’t always grasp that 4 to 6 oz. of juice is okay, but it doesn’t deliver the fiber content of fresh fruits and
vegetables. Coconut water is also a good choice as it’s a natural source of electrolytes. April Ward, registered professional nurse, licensed midwife and owner of Botanic-Her in Skaneateles • “Pregnant women need a balanced diet. This should include whole grains, fruits, vegetables, lean protein and low-fat or fat-free dairy. Healthful fats from foods such as avocados, nuts and seeds, as well as vegetable oils including canola and olive oil should be included in the diet. • “Folic acid: Folic acid reduces the risk of birth defects that affect the spinal cord. All women of childbearing age and pregnant women should consume at least 400 micrograms of folic acid each day. Natural food sources of folate include legumes, green leafy vegetables and citrus
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
hot or cold,” Jane Burrell Uzcategui, registered dietitian and instructor of Nutrition, Public Health, Food Studies and Nutrition at Syracuse University’s Falk College. “There’s a two-hour period at room temperature. If it’s out longer, then bacteria start to grow exponentially. Bacteria likes time, temperature, and moisture.” That’s why food left outside on a hot day is at higher risk of spoiling faster than food in an air conditioned environment. Burrell Uzcategui also cautions pregnant women about caffeine. “Research shows the higher caffeine intake increases risk of pregnancy loss, but that’s at high levels,” she said. “If a woman has 200 mg. a day, considered safe.” Portion size matters. She added that for reference, the smallest size coffee offered by Starbucks is 180 mg. Black tea is about 50 to 100 mg. per serving. Kathryn Szklany, registered dietitian at St. Joseph’s Health, advises pregnant women to limit their con-
fruits. Folate also can be obtained through fortified foods such as cereals, pastas and bread, as well as supplements. • “Iron: Maternal iron deficiency is the most common nutritional deficiency during pregnancy. Pregnant women need at least 27 milligrams of iron each day. Foods with high and moderate amounts of iron include red meat, chicken and fish, fortified cereals, spinach, some leafy greens and beans. For vegetarians and women who do not eat a lot of meat, increase iron absorption by combining plant-based sources of iron with vitamin C-rich foods. For example, try spinach salad with mandarin oranges or cereal with strawberries. • “Calcium: During pregnancy, calcium is needed for the healthy development of a baby’s teeth, bones, heart, nerves and muscles. The recommended amount of calcium during pregnancy is 1,000 milligrams
sumption of large fish known to be contaminated with mercury, which can harm baby’s developing nervous system and brain. These include shark, swordfish, king mackerel, marlin, orange roughy, and tilefish. “Some other types of fish can provide an array of nutrients that are important for your baby’s early development,” Szklany said. “Most experts agree that DHA and EPA are difficult to find in other foods.” She listed fish considered safe to eat during pregnancy (2-3 4-oz. servings/week) include salmon, trout, anchovies, herring, sardines, haddock, flounder, and shad. Szklany added that pregnant women must strictly avoid alcohol and tobacco products, as these cross through to the baby and cause abnormal development. Alcohol exposure can cause fetal alcohol syndrome or other problems. per day for women aged 19 to 50. That means at least three daily servings of calcium-rich foods such as low-fat or fat-free milk, yogurt or cheese, or calcium-fortified plantbased beverages, cereals and juices. Kathryn Szklany, registered dietitian at St. Joseph’s Health • “No extreme dieting if you’re trying to get pregnant or are pregnant. • “During the first 13 weeks, there’s no need to eat more food. During the second trimester, then calories needs are 350 more daily. That means one additional serving from each food group, not go have a milkshake. During the last trimester, she should eat 450 additional calories to her pre-pregnancy calorie needs.” Jane Burrell Uzcategui, registered dietitian and instructor of Nutrition, Public Health, Food Studies and Nutrition at Syracuse University’s Falk College.
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Contacts for Kids: How Young is Too Young?
Optometrists report prescribing contact lenses to kids as young as 9 years of age By Deborah Jeanne Sergeant
I
f your glasses-wearing pre-teen begs for contact lenses, claiming “all my friends are getting them,” he may not be exaggerating. For years, optometrists have been prescribing contact lenses for pre-teens. Several factors play into the shift toward younger contact lenses use. Earlier nearsightedness has driven down the age, according to Jane Beeman, president of the Minneapolis-based Contact Lens Society of America and contact lens specialist at the Flaum Eye Institute at the University of Rochester Medical Center “More children are getting more nearsighted at a younger age with every generation,” Beeman said. “The FDA is looking at why this is happening, but it begins this conversation at an earlier age.” Of course, glasses help people see clearly; however, for children engaged in sports or physical activiKrzyzak ties, glasses can get in the way. “For children or adults, glasses work well straight in front of you, but to see the periphery, you have to turn your head,” Beeman said. “I had a patient who’s a competitive skateboarder. For him, he sees great through his glasses, but he wanted to try lenses to see so much better glancing to left or right.”
Some children don’t like how glasses look on them, although the fad of wearing glasses as a fashion statement has diminished their numbers. Cost has also influenced the age at which children switch to contact lenses. Beeman said that they’re not as expensive as glasses on a yearto-year basis. Streamlined care has also lowered the cost. Instead of two solutions plus enzymatic tablets, contact lens wearers use only one daily solution for cleaning lenses. Or, they can choose daily wear lenses. “Parents love [daily wear lenses] because they don’t have to worry about their kids caring for them,” Beeman said. “They’re a little more pricey, but they’re pretty competitive.” Beeman said that establishing good contact lens hygiene habits in pre-teens is sometimes easier than in teenagers. “If the child really wants to give it a try and is committed, you have a much better chance it will work well,” Beeman said. Children must acclimate themselves to the feeling of the lens in their eyes, and get over the urge to blink while inserting the lenses. “Sports are a big factor,” said Mike Gzik, licensed optician and contact lens practitioner with New York Optometric in Syracuse. “When kids participate in sports, a lot of times, parents want to make sure they can
wear helmets or play without glasses getting broken.” Some patients want to wear their lenses only while participating in their activity and wear their glasses otherwise. “With sports, contact lenses offer definitely better visual acuity,” Gzik said. “People feel they see better with contact lenses on.” One-day disposable lenses eliminate the need to clean lenses. For children who may forget to clean lenses, this option Gzik can provide a way to go for contacts. Richard Krzyzak, optometrist with Krzyzak Eyecare in Liverpool, said that the child’s maturity level affects his decision on fitting pre-teens. He also shared that in general, “it is usually due to sports, dance or something where the glasses interfere,” Krzyzak said. “It’s usually not just cosmetic. If all the factors line up and the parents are behind them, it’s
a lot easier.” He has prescribed lenses to kids as young as 9 or 10 years old, which sometimes is actually easier than fitting teens because younger patients may be more compliant with how lenses are cleaned and handled. Patients being fitted for contact lenses may not leave the office unless they can put them in and take them out. Krzyzak pretty much prescribes only daily wear lenses. Otherwise, contact lenses must be removed before sleeping, cleaned properly and replaced on schedule. Patients must commit themselves to washing their hands thoroughly before inserting or removing lenses and using only sterile disinfecting solution for cleaning. Ultimately, the decision is up to the eye care provider since a pair of contact lenses is a prescription medical device.
Four in 10 Don’t Take Medications as Prescribed
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ine out of 10 Upstate New York adults believe that taking medications as prescribed is “very important” or “extremely important,” yet four out of 10 missed one or more doses of medications they were prescribed, according to a new survey commissioned by Excellus BlueCross BlueShield. “It seems obvious that people should take their medications as directed,” said physician Nicholas Massa, medical director of Excellus BlueCross BlueShield’s Central New York region. “It’s particularly important for those individuals who are living with chronic conditions such as high blood pressure, high cholesterol or diabetes, because it may be the best way to manage their disease.” The online survey, administered by the polling firm One Research, contacted 2,000 Upstate New York adults, which is a representative sample of the region’s U.S. Census Bureau demographic profile. More than half of the participants (1,215)
were currently taking a prescription medication for a chronic condition and were asked about medication adherence. About half of the total U.S. population and 90 percent of adults ages 60 and older used at least one prescription drug during the previous month, according to the Centers for Disease Control and Prevention. Age is a factor in medication adherence. About a third of survey respondents in the 18- to 44-year-old age group reported always taking their medications as prescribed. This compared to 67 percent of respondents 65 and older who reported always taking medications as directed. The Excellus BlueCross BlueShield survey revealed that when patients stop taking or change the way they take their prescription medication, it’s usually because they forget or don’t have the medication with them (43 percent), they don’t like the side effects (20 percent), or there’s an issue with the cost (14 percent).
According to a survey released by Excellus BlueCross BlueShield, younger people are less likely to take their meds as prescribed. Chart by Excellus BlueCross BlueShield. Eight percent of survey respondents said they stop taking or change the way they take their medication when they feel they can get by without it. Massa cautions that many diseases have silent symptoms that are not readily apparent until they have caused damage to the body. Among Upstate New York adults who missed a dose of a prescription medication, about three out of 10 reported that their symptoms returned. July 2017 •
“If you don’t take your meds and your symptoms persist, your doctor may think the drug didn’t work for you and prescribe something stronger, and perhaps even more expensive,” said Massa. The World Health Organization believes that getting more patients to take their medications as directed may have a greater impact on the health of the population than any improvement in specific medical treatments.
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Upstate, Crouse: Time-tested Care When it Comes to Stroke By Matthew Liptak
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
hen it comes to speed of treatment of an emerging stroke situation, Crouse Hospital might have an edge on time, but the stroke care programs at Crouse and Upstate Medical University have their strengths in the life-saving mission to care for those with the condition. According to physician Julius Gene S. LaTorre, Upstate’s director of its comprehensive stroke program stroke, patients may receive treatment in as little as 11 minutes from the time they enter Upstate’s ER, though the average is 31 minutes. According to data sup-plied by Crouse’s director of nursing in neuroscience, the median time for a stroke patient to get LaTorre in the door and then receive medical assessment is eight minutes. Officials from St. Joseph’s Hospital declined to offer comments for this story. Both Crouse and Upstate hospitals usually prefer the patient to call an ambulance first so the hospital can be prepared when the patient arrives. “As soon as the patient arrives in the emergency room everybody is ready to take care of the patient,” LaTorre said. “The first thing we do is bring a patient to CAT scan. We have made our protocol to bring the patient directly from the ambulance to the CAT scan to rule out any evidence Deshaies of hemorrhage in the brain. If the patient continues to have symptoms of stroke and we don’t have any contraindication, then we give the patient a clot-busting medication called tPA.” Crouse take the same strategy when admitting a stroke patient. And, like Upstate, it will often go ahead and do a medical procedure called a mechanical thrombectomy. A doctor inserts a catheter into the groin and can navigate a stent through the body to remove a clot. “Nowadays with the new equipment we have it can take 20 to 30 minutes,” said the director of Crouse’s Neuroscience Institute, physician Eric Deshaies. “It’s less than the hours it used to take with the
older equipment. There are windows for everything. The clot-busting drug can only be given within the first three to four and a half hours, and then the other things we do, typically it’s a six to eight-hour window. You do have some patients who will just wake up with a stroke and they don’t know if happens just when they woke up or if it happened hours before so we have a specialized CAT scan where we look at the blood flow in the brain, and based on those results determine an age of the stroke.” Both doctors see reasons to be hopeful about stroke treatment. As time goes on more advancements for better care are being made. LaTorre said stroke interventions are some of the most effective medical interventions there are in medicine today. There are more positive outcomes per case than other conditions. “Treatment for stroke is getting better,” he said. “The time window is expanding. I wouldn’t be surprised if in the next one or two years we will have additional new effective treatments we can use to battle stroke.” Crouse and Upstate offer clinical trials for stroke patients. Deshaies is excited about some of the groundbreaking work being done in neuroscience. “They’re doing research on where they actually interface robotics with little grids on the brain,” he said. “It’s able to take those signals and transmit them and get a functional outcome. There’s a lot of hope in the future. They’re also doing some stem cell transplantation to try to regenerate some of these pathways, but we’re very, very early.” Both doctors were asked by In Good Health why a patient should choose their institution for care. “The most obvious thing is that we’re the only comprehensive stroke center in this region,” LaTorre said. “We have everything that the patient would ever need. There’s a very strict criteria to be accredited as a comprehensive stroke center. We’ve been accredited since 2015.” “At Crouse we’re the only place in the region that has two highly specialized hybrid rooms where we can do both minimally invasive and maximally open surgery to treat the strokes and to treat the aneurisms at the same time,” Deshaies said. “We also are the only place in the region that has three endovascular neurosurgeons. We’re able to treat stroke.” Wherever you wind up for treatment, the doctor’s from Crouse and Upstate agree time is critical in treating the condition successfully. They say patients should be aware of the “FAST” acronym when thinking about yourself and stroke: F for facial drooping; A for arm and leg weakness; S for speech difficulties, and T for time to call 911. If you exhibit these symptoms get to a stroke program at once. If your successfully treated you could be on your feet again and out of the hospital in as little as a few days.
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How to Hire a Home Helper Dear Savvy Senior,
I would like to hire a personal assistant/home helper for my mom to assist with some simple household chores like house keeping, errand running, driving her to the doctor, and keeping her company. But mom doesn’t require personal/ physical caregiving nor does she require any home medical care. Any tips to help us find someone? Looking for Mom Dear Looking,
Getting your mom some help at home to handle some of her household chores can make a big difference keeping her independent longer. Here’s what you should know, along with some tips to help you find someone reliable for your mom.
Home Helpers
For seniors who could use some help at home — but don’t need a caregiving aide for personal care — there are a bevy of personal assistance/home helpers out there that can help make life a little easier. Most home helpers can assist with any number of things like shopping, running errands, transportation, light house keeping, laundry, meal preparation, arranging services (home maintenance, lawn care, etc.) and other household chores, along with providing companionship and support. And, if your mom gets to the point she needs personal physical care like bathing or dressing, they can usually help with this too. Most home helpers are part time workers who work a few hours a day or a few days per week. You also need to know that while Medicare does cover home health care services if a doctor orders it, they do not cover home helper/personal assistant services. There are two ways in which you can go about hiring someone for your mom; either through a home care agency, or you can hire someone directly on your own.
Home Care Agency
Hiring a home helper through a non-medical home care, or non-medical companion care agency is the
easiest, but most expensive option of the two. Costs run anywhere from $12 up to $30 an hour depending on where you live and the qualification of the assistant/aide. How it works is you pay the company, and they handle everything including assigning appropriately trained and pre-screened staff to care for your mom, and finding a fill-in on days her helper cannot come. Some of the drawbacks, however, are that you may not have much input into the selection of the aide, and the helpers may change or alternate, which can cause a disruption. To find a home care agency in your area, Google “non-medical home care” followed by the city and state your mom lives in, or you can use Medicare’s home health agencies search tool Medicare.gov/hhcompare. Most home health agencies offer some form of non-medical home care services too. You can also check your local yellow pages under “home healthcare services.”
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Hiring Directly
Hiring a personal assistant/ home helper on your own is the other option, and it’s less expensive. Costs typically range between $10 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom. But, be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the assistant doesn’t show up. You’re also responsible for paying payroll taxes and any worker-related injuries that may happen. If you choose this option make sure you check the person’s references thoroughly, and do a criminal background check. To find someone, ask for referrals through friends or check online job boards like CraigsList.org, or try Care.com, CareLinx.com, CareFamily. com or CareSpotter.com.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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The Social Ask Security Office By Deborah Banikowski District Manager, Syracuse
Ticket to Work Puts People Back in The Driver’s Seat
S Home Care by Seniors for Seniors There’s a huge difference in the kind of home care you can receive from someone who really understands what your life is like as a senior. The concerns you have. The need for independence. Someone who, like you, has a little living under his or her belt. Our loving, caring, compassionate seniors are there to help. We offer all the services you need to stay in your own home, living independently. • Transportation • Shopping • Doctor Appointments • Companion Care • Housekeeping services • Meal preparation/cooking • 24-Hour Care • and more Call us today. Like getting a little help from your friends.
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ocial Security encourages people to rejoin the workforce when they are able. Ticket to Work is our free and voluntary program that helps people get vocational rehabilitation, training, job referrals and other employment support services. This program is for people age 18 to 64, who are receiving disability benefits and need support re-entering the workforce or working for the first time. While many disabled individuals are unable to work and may never be able to return to work, we know that some are eager to try working again. Work incentives make it easier to work and still receive health care and cash benefits from Social Security while providing protections if people have to stop working due to a disability. Social Security works with employment networks to offer beneficiaries access to meaningful employment. Employment networks are organizations and agencies, including state vocational rehabilitation agencies that provide various employment support services. Some services they may help with include
Q&A
Q: What should I do if an employee gives me a Social Security number but cannot produce the card? A: Seeing the card is not as important as putting the correct information on the worker’s Form W-2. You can verify employee Social Security numbers by using the Social Security Number Verification Service. Just go to www.socialsecurity.gov/ bso. This online service allows registered employers to verify employee Social Security numbers against Social Security records for wage reporting purposes.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
résumé writing, interviewing skills and job leads. Ticket to Work gives individuals the opportunity to choose from several employment networks. Participants are free to talk with as many employment networks as they want before choosing one. If someone signs an agreement with an employment network, they’ll help the individual develop an employment plan. We’ll review their progress toward achieving the goals of their employment plan every 12 months. If they are making timely progress in their return to work plan, we will not conduct a medical review of their disability during the time they’re in the program. Many people have successfully completed the Ticket to Work program. Anyone interested in the Ticket to Work program should call the Ticket to Work Helpline toll-free at 1-866-968-7842 (TTY 1-866-833-2967). More information on the program is available online at www.socialsecurity.gov/work. Remember, Social Security is with everyone through life’s journey, providing resources that can help people reach their work and retirement goals.
Q: Is it true I must now receive my benefits through direct deposit? A: Anyone applying for benefits on or after May 1, 2011, will be required to receive their payments electronically. Paper checks will no longer be an option for most people. If you don’t have a bank account, you can get your benefits through the Direct Express debit MasterCard. Switching from checks to electronic payments is fast, easy, and free at www.godirect.org. You also can call the U.S. Treasury Processing Center’s toll-free helpline at 1-800-333-1795 or speak with a bank or credit union representative or contact Social Security for help.
ONONDAGA, OSWEGO, CAYUGA AND MADISON COUNTIES in good A monthly newspaper published by
Health CNY’s Healthcare Newspaper
Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.
In Good Health is published 12 times a year by Local News, Inc. © 2017 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, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Matthew Liptak, Anne Palumbo, Melissa Stefanec, Chris Motola, Ernst Lamothe Jr. Eva Briggs (MD), Stephen Blakely (MD) • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
H ealth News Crouse Hospital appoints new stroke director Physician Tarakad Ramachandran has been appointed stroke director for Crouse Hospital and the Crouse Neuroscience Institute. Working closely with Crouse’s neuro sciences team, Ramachandran will provide leadership to help build on the hospital’s stroke program, with the aim of achieving comprehensive stroke center certification. HighRamachandra ly regarded nationally and internationally as a clinician and educator, Ramachandran came to Syracuse in 1976 with broad-based training in internal medicine from the United Kingdom. After two years of residency and a year of chief residency in neurology at Upstate Medical University, he advanced his training with a year of fellowship in neuromuscular diseases and electrophysiology from Boston University School of Medicine. He returned to Syracuse in 1980 to pursue his career in neurology at Crouse and University hospitals. Ramachandran served as chairman of neurology at Crouse
from 1984 to 2013. In addition to being a full academic professor in neurology, Ramachandran has also held positions as clinical professor in neurosurgery, internal medicine, family medicine and psychiatry in addition to being a lecturer for the Center of Bioethics and Humanities at Upstate Medical University. He has received numerous awards over the years, including Upstate’s first Gold Award in Clinical Medicine (2008), and has been honored with the SUNY President’s Award for Excellence in Teaching, the SUNY President’s Employee Recognition Award and the SUNY President’s Award for Excellence in Faculty Service. This year he was honored with the Leonard Tow Humanism in Medicine Award from the Arnold P. Gold Foundation. The American Academy of Neurology honored him with its most coveted Ken Viste Award in 2008. Ramachandran has a strong interest in vascular neurology (stroke medicine) and was chairman of Crouse’s operation stroke committee from 1996 to 2000. As chief of neurology at Crouse, he was instrumental in creating the hospital’s stroke unit, which was the first in the region to be designated with “Gold Plus” performance achievement from the American Stroke Association. He also was very active in the creation of the stroke unit at Upstate, from which he retired in 2010 as a professor emeri-
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Remember your life before that wound? Annoucing a state-of-the-art wound healing center in your area Upstate Stroke, Dementia Researcher Wins Prestigious Science Prize Physician Li-Ru Zhao, associate professor of neurosurgery at Upstate Medical University and a research scientist at the Veterans Administration Medical Center in Syracuse, has been awarded the 2017 Bernard Sanberg Memorial Award for Brain Repair from the American Society of Neural Therapy and Repair (ASNTR). The award, presented April 29 at the ASNTR annual meeting, recognizes Zhao’s significant research contributions in acute and chronic stroke, vascular dementia, traumatic brain injury (TBI), and Alzheimer’s disease. Zhao’s extensive investigation into potential treatments for the debilitating effects of stroke in-
cludes the first demonstration of the neuroprotective properties of stem cell factor (SCF), granulocyte colony-stimulating factor (G-CSF) and SCF + G-CSF combinations in treating the effects of acute and chronic stroke. She discovered that these growth factors — naturally occurring substances capable of stimulating cellular growth, proliferation and healing — could be used alone or in combination to reduced brain damage from stroke and improve motor function. Her laboratory is currently studying how the bone marrow stem cell factors repair the brain in Alzheimer’s disease and is working at determining how the bone marrow stem cell factors regulate neuronal process formation, synaptic generation, and stem cell growth and differentiation. Zhao lives in Fayetteville.
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H ealth News tus of neurology and psychiatry. Ramachandran is a fellow of the American Academy of Neurology, which awarded him the A.B. Baker Teaching Award in 2007. Over the years, he has contributed significantly to neurological training and teaching in India as a visiting professor to many of its universities. In the 1980s he helped create a free CT scanning program for the underprivileged in Pune, India. As a delegate of the World Stroke Foundation, he participated in the inauguration of the Regional Asian Stroke Congress and first Indian Stroke Association Meeting, endorsed by the World Stroke Federation, at Chennai, India in 2006. Ever since, he has been a visiting faculty at the Indian Stroke Association’s annual meetings. Ramachandran holds a master’s in business administration from Syracuse University and a master’s in public health from Upstate.
Cardiologists make move to new practice St. Joseph’s Health announced that three physicians from SJH Cardiac Catheterization Associates, P.C. have now joined the cardiology practice of St Joseph’s Physicians. They will see patients from the St. Joseph’s Physicians office at 4939 Brittonfield Pkwy. in East Syracuse and are now part of St. Joseph’s Physicians Cardiology. The three physicians are: • Ali Al-Mudamgha — he received his medical degree from SUNY Health Science Center in Syracuse, where he also completed his internal medicine residency and cardiology fellowship. He then completed his electrophysiology fellowship at Stanford Mudamghu University. He was appointed director of cardiac electrophysiology services at St. Joseph’s Hospital in 2003, and currently focuses on cardiac electrophysiology. He is also a clinical assistant professor in the department of medicine at SUNY Health Science Center in Syracuse. • Ronald P. Caputo — he has been an invasive/interventional cardiologist for more than 20 years. He received his medical degree from Georgetown University Medical School, completed his residency at University of Massachusetts Medical Center, and research and clinical fellowship in cardiology at Harvard Caputo Page 26
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Medical School and the Beth Israel Hospital. He has served as an instructor in medicine at University of Massachusetts Medical School and Harvard Medical School, and is also an assistant clinical professor of medicine at SUNY Health Science Center. He was director of the cardiology service line at St. Joseph’s Hospital for eight years and was involved in the formation of the structural heart program at the hospital. Caputo will direct cardiovascular research for the St. Joseph’s Physicians practice. • Alan Simons — he received his medical degree from New York Medical College. He completed his residency and cardiology fellowship at SUNY Health Science Center. Simons was the medical director of St. Joseph’s catheterization laboratory for eight years, and his areas of focus include Simons interventional cardiology, congestive heart failure and peripheral vascular disease. He is also a clinical instructor and preceptor with the physician assistant program at Le Moyne College. All three cardiologists have been involved in significant medical research, including being among a small group of doctors selected nationwide for new medical technologies and trials over the past 20 years — bringing the latest medical advancements to Syracuse. They have been published numerous times, and recognized with many awards. “Having these three renowned cardiologists formally join St. Joseph’s Physicians and become part of the St. Joseph’s integrated network allows St. Joseph’s Health to continue to deliver the highest level of cardiac care in the region and take our comprehensive program to the next level,” said Leslie Paul Luke, president and CEO of St. Joseph’s Health. “Our comprehensive team approach will provide our patients with access to the latest innovations in interventional and non-invasive treatment options for heart disease.” According to a news release issued by the hospital, St. Joseph’s Health has the most awarded cardiovascular care program in the region, with nearly a dozen different accreditations, certifications and recognitions for cardiovascular care.
Crouse recognized for heart failure treatment Crouse Health has been recognized nationally for the successful way it treats patients with heart failure. It recently received the 2017 Get With The Guidelines-Heart Failure Gold Plus Quality Achievement Award for implementing specific quality improvement measures out-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • July 2017
lined by the American Heart Association/American College of Cardiology Foundation’s secondary prevention guidelines for patients with heart failure. Research shows that those who seek care from hospitals where quality improvement measures are followed have better outcomes. Crouse has earned the Gold Plus designation for heart failure several years in a row. The Get With The Guidelines quality improvement program helps hospital teams follow the most up-todate, research-based standards with the goal of speeding recovery and reducing hospital readmissions for heart failure patients. Many published studies demon-
strate the program’s success in achieving patient outcome improvements. The heart failure team at Crouse earned the award by meeting specific quality achievement measures for the diagnosis and treatment of heart failure patients at a set level for a designated period. These measures include evaluation of the patient, proper use of medications and aggressive risk-reduction therapies.
The Watchman implant device has been approved by the Food and Drug Administration as an alternative to long-term blood thinner therapy for patients with atrial fibrillation (AFib), a common heart rhythm disorder.
Crouse First in Region to Use New Cardiovascular Device That Reduces Risk of Stroke Crouse Hospital is the first hospital in Central New York to use the Watchman device, a minimally invasive implant approved by the Food and Drug Administration as an alternative to long-term blood thinner therapy for patients with atrial fibrillation (AFib), a common heart rhythm disorder. Studies have shown that the Watchman device offers these patients as much protection from stroke as blood thinners, such as warfarin. About five million people in the United States suffer from AFib, which occurs when the upper and lower chambers of the heart stop beating in harmony. Instead, the upper chambers beat irregularly and stop moving blood through and out of the heart. When this occurs, blood clots are likely to form in an area of the heart called the left atrial appendage (LAA). The LAA is the size of a thumb and looks like a small pouch near the top of the heart. Blood clots can break loose from the LAA and travel to the brain, lungs and other parts of the body, causing a stroke. The Watchman implant is designed to stop clots from leaving that area of the heart. AFib is the cause of about 20 percent of strokes, which can be devastating and costly to individuals and families, according to physician Joseph Battaglia, medical
director for Crouse’s cardiac care services. “The Watchman implant provides physicians with a breakthrough stroke risk reduction option for patients with non-valvular AFib, especially those who are poor candidates for long-term anticoagulation medication,” says Battaglia. This new alternative to strokerisk reduction involves the small, parachute-shaped device being implanted in the heart rather than medication therapy. The Watchman is implanted by accessing the heart through a vein in the leg using a non-surgical approach. The device changes the internal shape of the heart, making it resistant to clot formation, according to Battaglia. According to a hospital news release, the procedure takes one to two hours, is painless, and the majority of patients are discharged from the hospital the following day with immediate return to full function. Scar tissue forms around the device over time, permanently closing off the left atrial appendage. “This new therapy can lower the risk of stroke to benefit many patients in Central New York who are not considered optimal candidates for blood thinners and we are pleased to be the first in the area to be able to offer this advanced treatment,” adds Battaglia.
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