In Good Health: CNY #263 - November 2021 by In Good Health: CNY's Healthcare Newspaper

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NOVEMBER 2021 • ISSUE 263

TIPS TO IMPROVE YOUR HEALTH TODAY

• Get your probiotics • Practice a healthy mindset • Reduce sugar consumption • Get the flu vaccine • and more. P. 12

INSIDE: GOLDEN YEARS SPECIAL. P. 22

Doctor Hits Streets to Treat Homeless Patients CUTTING-EDGE SURGEON Orthopedic surgeon Michael R. Diaz brings cutting-edge technology to Oswego Health. He discusses better ways to perform total joint replacement, treat arthritis and more. P. 4

PARTNER VIOLENCE:

WE ALL KNOW A GABBY Gabby Petito’s disappearance and death reveals that partner violence is epidemic in this country; we just don’t always recognize it by name. P. 21

Physician David Lehmann is part of a Upstate Medical University program called HouseCalls for the Homeless. He often sees homeless patients on street corners, under a bridge or in the back of a van. P. 16

$156,000,000,000

That’s right: Cancer care costs U.S. $156 billion per year; drugs a major factor

rivate insurers paid out about $156.2 billion in 2018 for U.S. patients with the 15 most common cancers. Medication was the largest expense and drugs for breast, lung, lymphoma and colon cancers accounted for the largest chunk of those costs, according to a Penn State College of Medicine study. “The public often hears that the U.S. spends an inordinate amount of money on health care, but no one has quantified exactly how big that number is and how that number [is] broken down for exactly what types of services,” said study author Nicholas Zaorsky, a physician. He’s an assistant professor of radiation oncology and public health sciences at Penn State Cancer Institute in Hershey, Pennsylvania. “We wanted to look at what private insurances are paying for each kind of cancer and for each type of services,” Zaorsky said in a college news release. The researchers analyzed a nationwide database that included more than 402,000 privately insured cancer patients under age 65. The patients were treated in 2018 for lymphoma, melanoma and cancers of the breast, prostate, colon, lung, uterus, head and neck, bladder, kidney, thyroid, stomach, liver, pancreas and esophagus. In all, the patients received 38.4

million types of procedures and services. Breast cancer led the way with about 10.9 million, followed by colon cancer with about 3.9 million. Breast cancer was the most expensive type of cancer ($3.4 billion), followed by lung cancer and colon cancer, both about $1.1 billion. The $4 billion spent on drugs was the most expensive treatment category — double the cost of cancer surgeries, according to findings published Oct. 6 in JAMA Network Open. The study didn’t assess whether treatments provided were cost-effective, but the findings may help guide future research into that area. “It’s hard to say like what is a reasonable price for a drug or service, but I think it’s fair to say that they make up the plurality of our health care spending in the U.S., then some would argue that this money may be better spent elsewhere in other services,” Zaorsky said. “These figures basically just show you how much the medical system spends on certain types of cancers versus another one.” He said one might ask if the costs are justified. For example, pancreatic cancer is one of the deadliest, Zaorsky said, but the total cost of care devoted to it is relatively low compared to something like indolent prostate cancer, which may exist for a long period without causing problems.

When it comes to learning your risk of cancer – including breast cancer – knowledge is power. That’s why Hematology-Oncology Associates of CNY is proud to offer comprehensive Cancer Genetics Testing and Counseling with specially trained experts. Available to anyone – not just HOA patients – Cancer Genetics Testing and Counseling: • helps you and your family make better-informed decisions about your healthcare • is covered by most insurance plans • begins with a simple blood sample To see if Cancer Genetics Testing and Counseling is right for you, talk with your doctor and take our five-minute survey at hoacny.com/cancergenetics or by scanning this code.

Page 2 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

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November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 3 SJH10128_US_News_In_Good_Health_9.75x13.75_V1.indd 1

10/19/21 3:46 PM

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Q: Tell us a bit about your orthopedic practice. A: I was trained classically as a general orthopedic surgeon. As the years progressed, I streamlined down to a total joint practice. I was the first person at [Cooperstown-based] Bassett Hospital to utilize the NAVIO robotic-assisted total joint program. So I had the expertise to bring that here. So over the last couple years we’ve been performing robotically assisted total joint arthroplasty at Oswego Health. It’s pretty new in the sense of cutting-edge technology. One of my goals is to bring cutting-edge technology to rural institutions where these advanced techniques aren’t usually available. So we’ve done very well with that. We’re currently upgrading our robot to the CORI robot, which is a little bit faster and more precise. It’ll help us deliver the very latest care when it comes to total joint replacement at Oswego Health, for our population. Q: You’re also looking into something called platelet rich plasma treatments (PRP). What is that and how would it be used? A: It’s something I’ve been interested in for more than 30 years. It’s something called a biological agent. If you think about what joint replacement could look like 30 years from now, joint replacement will probably be an obsolete procedure altogether. We’ll be more adept at healing cartilage and taking care of arthritic problems where we can treat them before they really present themselves. So, we use these biological agents, bone marrow concentrate, which has stem cells in them and PRP. I’ve been using PRP for about 10 years now to try and stop the arthritic processes and perhaps even heal or regrow cartilage over time. Q: What’s that process been like over the last 10 years? A: I pioneered a program where I came from where I performed a novel surgery to try to help joints preserve their cartilage, which included harvesting bone marrow and isolating

Page 4 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

the stem cells in it. I had some very nice results. I didn’t publish anything, but I got some good anecdotal results. So I wanted to bring that here. I don’t believe there’s much of that going on here, and that includes in Syracuse. I’m interested in starting a joint preservation and restoration clinic. That’s been my goal for many years and if this appears to be my last stop on my tour of jobs, I’m very interested in doing that. So basically I’m interested in starting a clinic where we can comprehensively treat a patient who has early arthritis or moderate arthritis before they need a joint replacement. Q: Are these procedures covered by insurance companies? A: Unfortunately, a lot of these processes are not yet accepted by insurance companies, but I do foresee a time where the PRP injection becomes the new cortisone injection of the future. So, why PRP? If you think about any kind of injury, one of the first components that will come to the area is platelets. And these platelets have all of these growth factors. One of them is TGF-B (transforming growth factor beta), a cell growth and proliferation enzyme or protein that will make cells grow faster and more prolific. You have a blood vessel growth factor. You have a stimulus growth factor and a host of other things that will go ahead and stimulate cells and perhaps repair them. One of the other things it does is reduce catabolic enzymes that come in and degrade things. So if you hurt your knee, there are enzymes that will actually hurt your cartilage. So PRP increases the growth factors and decreases the harmful enzymes. Q: How new are PRP treatments? A: Athletes

around the world and sports teams around the world are routinely using these for joint injuries, ligament injuries. So it’s nothing new on the market, we’re just looking at utilizing it with newer techniques. I think it could really be used to great extent in some kind of clinical setting. We have a machine in the office that will harvest PRP. Q: How is PRP harvested? A: It’s not all that complex, which is nice. So the patient comes to the office, they come to a room, a nurse draws a vial of blood. The blood will be put into a centrifugation system and the PRP will be separated out of the other plasma. And at the end you’ll be left with an injection that can be put into the area of involvement, whether that be a shoulder, ankle, knee, etc. to help the healing process. Unfortunately, since insurances don’t cover it, it costs about $600 to do this, which can be prohibitive for some people, but it’s worth the investment. Q: I remember stem cells being all the rage a couple decades ago, but a lot of that died off when they didn’t live up to expectations. Are we finally working the kinks out and homing in on the mechanisms? A: Absolutely, yes, that’s a super question. Years ago everyone was excited about stem cells and were using them for corneal issues and even deafness, because they’re cells that can differentiate into almost anything. I think the question has been “how do you get them to differentiate?” Some of the latest studies out of Japan suggest that we may be able to start pushing the stem cells to differentiate. The real issue over the last 10 years, unfortunately, has been the FDA. Not to harp on the FDA, but the rest of the world is so much farther advanced on this issue. We have such strict criteria on what we can do with what comes out of the body. It has to be done in the same office, on the same day and you cannot manipulate the cells in any way. There was a company out of Utah that was taking stem cells and growing them. They were having some nice results, but the FDA came in and said if you manipulate the cells it becomes a drug. So they were shut down. So we’re pretty far behind. A lot of athletes go to Europe or elsewhere to receive these treatments. Q: What kind of results have you seen? A: Back where I used to work, I was able to recover some specimens that did show some cartilage response. But, as far as regrowing the cartilage in the joint, probably not yet. That will be the next great advancement, whether through genetic manipulation or manipulating the stem cells.

Lifelines

Name: Michael R. Diaz, D.O. Position: Senior attending orthopedic surgeon at Oswego Health Hometown: Ringwood, New Jersey Education: Philadelphia College of Osteopathic Medicine; Muhlenberg College Afﬁliations: Oswego Health Organizations: American Osteopathic Association; New York Medical Society; American Osteopathic Academy of Orthopedics Family: Wife, two adult sons Hobbies: Skiing, travel

November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 5

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Healthcare in a Minute By George W. Chapman

Cost, Confusing Technology, Poor Provider Information: Telehealth Dissatisfaction

ndoubtedly, the pandemic fostered a surge in virtual care or telehealth. In 2019, 7% of patients reported using it. In 2020, 9% of patients availed themselves of it. This year, 36% of patients reported using telehealth for their care. A recent survey of 4,700 consumers by J.D. Powers revealed underlying dissatisfaction among telehealth users. On the positive side, 57% of respondents cited convenience; 47% cited

quicker care; 36% cited safety. On the negative side, 24% said services were too limited. Cost, confusing technology and poor provider information were each cited by 15% of respondents. The take here is the demand for telehealth services will continue beyond the pandemic. Providers and insurers need to accept the new reality and work to improve this new and popular service line.

No “Surprise Billing” Ruling

These commercially administered plans, versus the traditional Medicare plan administered by CMS, have seen their enrollment double over the past decade. 42% of eligible seniors have opted to drop their traditional Medicare plan and enroll with a MA plan. There are currently 33 different MA plans offered by commercial giants such as BCBS, United, Anthem, Cigna, Aetna, etc. Premiums may actually decline next year, which could mean less being deducted from a senior’s Social Security check. All of these MA plans offer extra services beyond traditional Medicare to both entice enrollees and improve their care, including: transportation, dental, optical, auditory, mental health, home visits, food delivery and even pest control. All of the major insurers are expanding their footprints and markets to capture more seniors.

The intent of this law is to protect unwitting consumers from exorbitant/surprise out-of-pocket costs for services provided by out of network providers. A typical example would be when a consumer goes to an in-network emergency room and then gets a “balance due after insurance payment” from the out of network emergency room group, specialist or radiology group. A recent ruling requires that disputed bills between the out-of-network provider and the commercial payer be settled by an independent arbitrator. Each party submits their preferred dollar amount to the arbitrator. The arbitrator will reward the party that is closest to a national qualified payment amount. The AHA and AMA argue it favors commercial insurers and it is a form of price setting. (Congress actually DOES set prices for Medicare.) Consumer advocates laud the ruling which should mitigate surprise outof-pocket expenses.

Medicare Advantage (MA) Plans Open enrollment started Oct. 15.

Fake C19 Cards Two VA employees in Detroit have been charged with theft, fraud and conspiring to sell fake proof of vaccination cards. One has been charged with theft of government property, (actual vaccination record

Page 6 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

cards). The accomplice has been charged with theft of government agency seals to commit fraud and trafficking in counterfeit goods. Ironically, the fake cards were to be manufactured in China. Beware of scams where a link is sent to a phone requesting personal information (name, Date-of-birth, SSN and picture of your NYS driver’s license) to validate your vaccination status.

ACA Updated For those who do not get health insurance from their employer or Medicare, the exchanges have been improved. Commercial plans must pay a user fee every year. It is about 2.5% of their premiums for next year. It goes toward consumer information, outreach and navigation programs. The number of navigators has been increased to 1,500 thanks to an $80 million grant from CMS. Open enrollment starts Nov. 1 and ends Jan. 15, 2022. Navigators can now help enrollees with how to appeal for financial assistance and reconciling premium tax credits. The previous administration had reduced the number of navigators, allowed states to reduce benefits via a waiver and to offer short-term plans. CMS rescinded the aforementioned in order to broaden assistance, maintain decent coverage and further strengthen health insurance for more than 20 million consumers.

Drug Prices Granting Medicare the ability to negotiate drug prices seems like a no-brainer. Literally tens of billions can be saved. Not surprisingly, fear mongering ads by drug manufacturers have increased significantly. Medicare would simply be given the ability to NEGOTIATE (not SET) drug prices. Negotiating is a twoway street, so claims by the drug lobby that fewer drugs will come to market or your particular drug may

no longer be available are totally specious. The proposed legislation is now buried in the $3.5 trillion human infrastructure bill. Because there is no control on drug prices like there are on physician and hospital prices, investing in drugs is a safe bet. For example, Walgreens is putting up $970 million for a 71% share in Shields Health Solutions to expand its specialty pharmacy business. Meanwhile, in the hospital world where Medicare sets, not negotiates prices, a survey by Kaufman Hall of 900 hospitals predicts hospitals will lose a collective $54 billion this year. Without COVID-19 relief, it is estimated the loss would be $92 billion. As a result of the pandemic, patient acuity levels are way up, services are delayed and adding insult to injury, drug costs have sky-rocketed.

NYS Vaccine Mandate Just days after the vaccine mandate deadline, NYS climbed to a 92% vaccination rate among hospital and nursing home healthcare workers. It is one of the highest in the country. This achievement has alleviated fears of massive staff shortages and delays in services. NYS is being sued by a small group claiming a religious exemption based on the fact that cell lines derived from fetuses aborted years ago were used in the development or production of test vaccines. More than 700,000 people in the US have died as a result of COVID-19. 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.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

This Thanksgiving: Be Grateful for Goals

y self-esteem took a real nose dive after my divorce. It was years ago, but I can still recall how empty, exposed, and embarrassed I felt. It was as if my personal and private failure at a relationship had become very public. I just wanted to hide. And hide I did! I hid in my work. I hid in my home. I hid in my books. Divorce — even a fairly amicable divorce — can really knock the wind out of your self-confidence. If you are suffering from the fallout of a failed marriage and are in hiding, as I was, know that you are not alone. Regaining my self-confidence was a slow process and painful at times, but ultimately very rewarding. The process started with “baby steps.” While I am a huge believer in positive thinking, I intuitively knew I wouldn’t be able to talk myself into more confidence. Nor could my morning meditations cure my emotional ails. I knew I would have to work at it. I knew I would have to build my confidence back up one success at a time. And that’s when I discovered the healing power of goals and a “to

do” list. During the dark days following my divorce, I found the simple act of writing things down and checking them off the list actually helped me get through my day. At the time, my list was pitifully basic: get dressed, make my bed, water the plants, feed the cat, etc. That list looks pretty silly now, but anyone who has endured a painful loss knows just what I’m talking about. The simplest tasks can seem insurmountable. So, I would pick an item on my list, do it, check it off, and then go on to the next item. Remarkably, this process of articulating and accomplishing my mini-goals began to have a real and positive impact on my day and on my self-esteem. Committing things to writing had amazing power. To this day, I create a “to do” list on a daily basis and still get a confidence boost when I accomplish my mini-goals and check them off the list. This practice has been so rewarding and self-affirming that I now employ a goal-setting process for my bigger life plans. In fact, I created a “no excuses goal worksheet” for my larger projects, plans, and dreams. My

Many Incidents of SUID Can be Prevented

The Academy of Pediatrics recommends babies be placed on their back to sleep

By Kathleen M. Dermady

udden unexpected infant death (SUID) is the leading cause of death in babies younger than 1 year. For most, the cause of death is unexplained by illness, anomaly or trauma and is most frequently attributed to an unsafe sleep setting. About 90% of the deaths occur before 6 months of age. Each year about one in 1000 babies die of SUIDS; the incidents in Black and Native American children is two to three times higher than white. In the last 10 years, 56 babies have died in Onondaga County. For parents and caregivers, fatigue is a common factor. Holding a sleeping baby is one of the most

rewarding warm feelings. While it is tempting to fall asleep with your baby or place baby in a lush and cozy chair or bed, this can be a fatal mistake. Grief and guilt overwhelm most families. In 1992 The Academy of Pediatrics, recommended babies be placed on their back to go to sleep. The number of infant deaths decreased by 50%. Studies have found “back to sleep” improved cerebral (brain) oxygenation compared with lying face down. Some caregivers place babies on their sides, often propped with pillows or blankets. All babies move, and it is more common for a baby to roll face down than face up. Items

Page 8 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

worksheet captures what every goal should be: written down; expressed in positive, affirming language; assigned specific steps and deadlines; achievable; and, when met, rewarded. Below is an example of a goal I set for myself one difficult November, when I had no plans for Thanksgiving. My life circumstances had changed and I knew I needed a change of pace and time to myself to think and reﬂect on my life and my future.

Goal Statement I will (gulp) make plans to spend Thanksgiving on my own. Specifically, my goal will be to enjoy a solo three-day getaway over the Thanksgiving holiday. Action Steps and Timetable • Day 1: I will share my goal with my best friend and ask her for feedback, support and suggestions. • By day 5: I will research and identify an Adirondack lodge that serves a home-style Thanksgiving meal with all the fixings. • By day 10: I will select my destination, ask about community-table options in the dining room, and make a reservation. • By day 16: I will make arrangements for pet care, stop my mail and the newspaper, and schedule a tire-rotation and ﬂuid check for my car. • By day 24: I will hit the road with a full tank of gas, map, an audio book and snack pack. • Later that same day: I will check into the lodge, unpack, and head down to the lounge to relax and unwind in front of the stone fireplace.

• Thanksgiving Day: I will embrace the day with an open heart, ready to enjoy my own company and the company of those around me. I will take a nature walk, write letters (perhaps one to myself) and focus on all the things and relationships for which I am thankful. I will cherish the day in front of me.

Reward I will feel extraordinarily good about myself when I accomplish my goal and I’ll reward myself with a ... (fill in the blank!). My reward was a walnut picker-upper. True. I wanted one. My house is surrounded by walnut trees. Goals can give your life direction and purpose. And they can put passion into your everyday existence, which is especially important for those of us who live alone. It may take some time before you regain your footing and self-esteem. Chances are, you’ll take some detours and encounter some bumps along the way. I sure did. But I kept moving forward and soon discovered that setting and accomplishing minigoals and eventually larger life goals was key to regaining my self-confidence. Actually doing (vs. wishing and hoping) worked for me, and it can work for you, too. For that, we can be very grateful. Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite Voelckers to speak, visit www.aloneandcontent.com

In the last 10 years, 56 babies have died of sudden unexpected infant death in Onondaga County. Kathleen M. Dermady used to prop a baby can become deadly if the baby rolls into them and suffocates. More than half of infant deaths are found to be caused by accidental suffocation and strangulation in bed (ASSB). After a baby dies, teams of professionals evaluate the infant through examination and autopsy, review any medical or known risk factors and perform re-enactment, asking parent(s) and caregivers to replay the last hours and moments of the infant’s life. For some, a cause is not determined, but unsafe sleep and risk factors that may have contributed to an unsafe environment for the baby are evaluated. Grandparents and caregivers are in a unique role to provide support and guidance to new and exhausted

parents. Recognizing parental fatigue and offering to care for a new baby to allow parents to recover from birth and the demands of a newborn can be lifesaving. A newborn feeds every two to three hours and should not be expected to sleep through the night. Many new parents are aware of the back to sleep recommendations, but are often easily inﬂuenced by family or friends who provide alternative advice. The evidence has shown that the sleep-wake pattern of a baby is more arousable positioned on their back and that this may be protective against infant death. Kathleen M. Dermady is a member of the Onondaga County Child Fatality Review Team. She holds certiﬁcation in midwifery, obstetrics and gynecology.

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November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 9

My Turn

By Eva Briggs, MD

Sepsis: A True Medical Emergency It is an overwhelming, haywire response by the body to an infection

ne spring day in 1990, my father got out of bed and started for the bathroom. He only made it a few steps before collapsing in a heap on the floor. My mother called an ambulance. He wound up in the ICU with sepsis. That’s the same condition leading to former president Bill Clinton’s October hospitalization. Sepsis is an overwhelming, haywire response by the body to an infection. This reaction is called a systemic inflammatory response syndrome (SIRS). SIRS can also arise from noninfectious causes such as severe trauma, cancer, blocked circulation and others. Bacterial infections are the most common triggers of sepsis. Common sites are lung, urinary tract, skin or gastrointestinal tract. In Clinton’s case it was a urinary tract infection; in my father’s case a previously unsuspected gallbladder infection. Viral infections such as COVID-19 and influenza, fungal infections and protozoal infections are also capable of causing sepsis. A combination of the infectious organism’s characteristics and the host’s factors produce sepsis. Infectious bacteria make substances to colonize the body, evade the immune system and establish disease. They manufacture chemicals that trigger the body’s inflammatory response. The body’s inflammatory system then spirals out of control, damaging immune cells, blood cells, blood vessels, as well as the tissues of the lung, brain, liver and kidneys.

An estimated 1.7 million adults in the United States develop sepsis each year and 270,000 of them die. The following groups are at highest risk: – Adults older than 65 and children younger than 1. – Immunosuppressed people. – Those with chronic medical conditions such as diabetes, chronic lung disease, cancer and kidney disease. – Anyone with a recent severe illness or hospitalization. – People who have survived a previous episode of sepsis. Sepsis is a true medical emergency. Signs and symptoms of sepsis can be cardiac, such as a racing rapid heart rate or low blood pressure. Neurologic signs are confusion and disorientation. Respiratory symptoms include shortness of breath. The patient can also have a fever, shivering, chills, or extreme pain. If you suspect that someone has sepsis, seek medical care immediately. Sepsis can damage multiple organs in the body: • Lungs — acute respiratory distress syndrome. • Brain — encephalopathy leading to agitation and confusion. Blood clots can form in the small blood vessels of the brain. Multiple small micro abscesses can take root in the brain. • Liver — an injured liver fails to produce blood clotting factors leading to widespread bleeding. The liver fails to remove metabolic waste products such as bilirubin and the

COVID-19 Booster & the Flu Vaccine

Excellus BlueCross BlueShield vice president of medical affairs for clinical services discusses the COVID-19 booster vaccine

lu season is here again, and the COVID-19 pandemic is still with us. Vaccines offer crucial protection against each of these diseases, but many people have questions about the COVID-19 booster and this year’s flu vaccine. Excellus BlueCross BlueShield’s physician Nicholas Massa has some answers. Q. Can I still get my flu shot this year if I get a COVID-19 booster shot? A. Yes! Getting your yearly flu shot reduces your risk for flu-related illness and potentially serious complications. Likewise, if a COVID-19 booster is recommended for you, getting it may help shore up your

protection against severe COVID-19 illness and death. The good news is that you don’t have to pick between the two types of vaccines. You can get both. Q. Do I need to wait for a certain period of time between the two vaccines? A. There’s no need to space them out. In fact, if you are due for both shots, you can get them at the same visit. Just don’t delay your ﬂu shot too long if a COVID-19 booster isn’t recommended for you at this time. Ideally, you should get your ﬂu shot by the end of October.

Page 10 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

Former President Bill Clinton was hospitalized in October after developing sepsis that was triggered by a urological infection. He was discharged from the UCI Medical Center in Orange, California, a few days later.

patient becomes jaundiced. • Kidney — damaged kidneys produce little or no urine output and permit toxins to accumulate. • Cardiovascular — the heart muscle may fail, depriving the body of oxygen. Dilated blood vessels cause the blood pressure to drop. When a physician suspects sepsis, they will attempt to determine the underlying cause and treat it with antibiotics, antivirals or antifungals. But most care is supportive. Oxygen, ventilator or other respiratory support. Medication to improve blood pressure and assist heart function. Dialysis for kidney failure. Transfusions of needed blood components. As I write this, I don’t know what former president Clinton’s outcome is. In my father’s case, he somehow miraculously survived his

episode of sepsis. He experienced lung failure, kidney failure and a bleeding ulcer. He walked out of the hospital weak, but mentally intact several weeks later and lived three more years. All thanks to the excellent care of the intensive care staff at Albany Medical Center.

Q. Will the side effects be worse if I get both shots at the same visit? A. This is a new situation, but we have lots of experience giving other vaccines together. That experience has shown that the side effects are generally about the same whether the vaccines are given alone or at the same time. If you have concerns, speak with your health care provider.

COVID-19 at the same time. The highly contagious delta variant that is going around might make this even more likely—and it’s something you want to avoid. There Nicholas Massa is growing evidence that having COVID-19 and the ﬂu together increases the risk for severe illness and death. That’s a compelling reason to get vaccinated against both.

Q. But flu season wasn’t bad last year. Do I really need a flu shot this year? A. You’re right—the level of flu virus activity was unusually low last flu season. That may have been partly because people were wearing masks, social distancing, and staying home a lot due to COVID-19 restrictions. This year, people are mingling more, which means that flu viruses have more chance to circulate. Getting your flu shot remains very important. Q. How will the delta variant of COVID-19 impact this flu season? A. It is possible to have flu and

Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.

For further COVID-19 resources visit us at ExcellusBCBS.com/ covid19. Submitted by Excellus BlueCross BlueShield

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Big Rise in Injuries From E-Scooters, Hoverboards

overboards, electric scooters and electric bikes are the transportation of choice for a growing number of Americans, but they’re taking many straight to the emergency room. Injuries associated with these socalled “micromobility products” skyrocketed 70% between 2017 and 2020, according to a soon-to-be-released report from the U.S. Consumer Product Safety Commission (CPSC). That increase dovetails with greater use of these transportation alternatives as Americans return to work, school and other activities. Between 2017 and 2020, injuries related to micromobility products resulted in more than 190,000 visits to U.S. emergency departments. The numbers rose steadily — from 34,000 in 2017 to 44,000 in 2018, 54,800 in 2019 and 57,800 last year, according to a CPSC news release. E-scooters accounted for much of the surge: 7,700 ER visits in 2017; 14,500 in 2018; 27,700 in 2019; and 25,400 in 2020. The injuries often involved arms

and legs, as well as the head and neck, the findings showed. The commission said it’s aware of 71 deaths associated with micromobility products during the study period, but noted that reporting is incomplete. Hazards associated with e-scooters, hoverboards and e-bikes mainly owe to mechanical, electrical and human factors. To reduce these hazards, CPSC is working with ASTM International (formerly known as American Society for Testing and Materials) and Underwriters Laboratories (UL) to improve voluntary product standards. Meanwhile, the CPSC called on users to take several steps to protect themselves. When using micromobility products, always wear a helmet. And before riding an e-scooter, check it for any damage. This includes examining the handlebars, brakes, throttle, bell, lights, tires, cables and frame. Damage can cause a loss of control and lead to a crash.

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Wednesday, November 17th at 5:00-6:00PM

ONONDAGA, OSWEGO, CAYUGA & MADISON COUNTIES A monthly newspaper published by Local News, Inc. 33,500 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. © 2021 by Local News, Inc. All rights reserved. P.O. Box 276, Oswego, NY 13126 Phone: 315-342-1182 • Fax: 315-342-7776 • Email: editor@cnyhealth.com Editor & Publisher: Wagner Dotto • Writers: Deborah J. Sergeant, Jim Miller, Gwenn Voelckers, Kathleen M. Dermady, Anne Palumbo, Chris Motola, Melissa Stefanec, Eva Briggs (MD), Mary Beth Roach, Ken Sturtz, Barbara Pierce • Advertising: Amy Gagliano, Cassandra Lawson Layout & Design: Joey Sweener • Ofﬁce Manager: Nancy Nitz

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.

Register: sosbones.com/jointseminar | Questions? 315-703-3442 November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 11

10 Tips to Improve Your Health Today By Deborah Jeanne Sergeant

ou know the drill: eat right and exercise. But you can do many other things to improve your health also.

1. Reduce processed sugar. “What’s made the biggest difference in my energy and sleep is that I stopped eating processed sugar. I use Monk fruit, maple syrup or honey for sweetening. I don’t have dips and dives in energy and I sleep better. Our taste buds last 10 to 15 days. They re-grow based on what we’re feeding them. 2. Hydrate, but not too much. “Hydration seems like an all-ornothing mindset: one gallon of water a day or not drinking anything. Really, we don’t need a gallon of water a day. Over-hydration is a thing. Every couple hours have a cup of tea or some water. Don’t guzzle it but keep sipping throughout the day. Five to six glasses a day is reasonable and healthy. We sometimes overshoot goals and it’s draining because we make it so complicated.” 3. See your primary care provider. “Be honest with your provider and work with them to find ways to improve your health. Some people tell me they’re doing things when they’re not. Having a primary care provider is so important. We need a partner to help manage our health. We need to take proactive steps that aren’t reactive. I’m here to identify things early and coordinate care and get you in the right direction so we can manage it. People are scared to get colonoscopy and mammograms. But not knowing is scary.” 4. Get your ﬂu vaccine. “Flu vaccine is important every year,

especially if you’re a senior citizen. When they go to their providers or the pharmacy, we call it the ‘high dose’ ﬂu vaccine. At any age, anyone should have their vaccines, like whooping cough every 10 years. 5. Practice a healthy mindset. “My emphasis is having a healthy mindset. It’s just as important and having a positive mind to keep your body healthy. Don’t just focus on your body. Keep your mind and emotions healthy as well. Have a good social life and someone to talk with or reach out when you’re stressed. Those things make the body healthier as well.” 6. Try strength training. “Strength training isn’t just for young males. It’s for females and for the elderly. When you’re doing strength training, you use your cardiovascular system. It improves bone density to prevent osteoporosis. It also makes you more limber. Activities of daily living are more difficult than if you do strength training. It helps reduce body fat and increases muscle mass. Strength training helps reduce blood pressure and cholesterol.” 7. Aim for more monosaturated fats in your diet. “Not all fats are created equal. According to the American Medical Association, we need fats to help keep the body warm, to nourish our brains, give us energy, and help with the production of some hormones. The good fats are monounsaturated like olive oil, peanut butter, avocados, and even animal fats though

Page 12 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

these should ideally be from pastured beef, pork and chicken. Polyunsaturated fats are found in oils such as sunflower, soybean, and corn oils and in nuts and seeds like walnuts and flaxseed. 8. Get your probiotic intake with yogurts and other fermented foods. “A healthy digestive system is important for healthy living. We hear so much about the water we drink and the air we breathe being filled with pollutants. Antibiotics kill good bacteria, too. Sugar helps grow the bad bacteria. The resulting bacterial imbalance can really throw us off. It’s a delicate balance between good and bad bacteria. This is why we have the recent push for fermented foods such as sauerkraut, kimchi, yogurt, apple cider vinegar, and others. They are filled with good bacteria and the more the merrier. When these aren’t available or appealing, there are supplements to help balance your gut called probiotics.” 9. Pick your soy products carefully. “If you are consuming soy products as protein sources, I would recommend them to be USDA organic or non-GMO verified. I also recommend free-range or organic animal protein sources. I typically recommend rBST-free (bovine growth hormone) or organic dairy sources (cow, goat or sheep) that are at least 1%-2% milkfat. Research has shown that at least 2% dairy products contain anti-inflammatory properties. 10 Increase magnesium-rich foods like avocados, black beans and almonds into your diet. “Magnesium is a

very important mineral that oversees more than 350 enzymatic processes in our bodies. It has been seen to assist in immunity, insomnia, depression, irritability, anxiety, rapid heartbeat, regulating blood pressure, relaxing smooth muscles, regulating blood sugar and so much more.”

Sources

• Tips 1 and 2 by Lacey Roy, lead nutrition coach and owner Full Bodied Health, Fayetteville. • Tip 3 by Nathaniel Farden, family nurse practitioner with Lakeview Primary Care, Oswego. • Tip 4 by Jiancheng Huang, public health director, Oswego County. • Tip 5 by Chiheon Yi, licensed acupuncturist, Holistic Practitioners Acupuncture Syracuse. • Tip 6 by Brandon Anderson, personal training manager at Blink Fitness in Syracuse. • Tips 7 and 8 by Sadieann Zogby Spear, owner A Strong And Healthy You, New Hartford. • Tips 9 and 10 by Laurel Sterling, registered dietitian, nutritionist and educator with Carlson Laboratories in Canastota

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November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 13

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The Power of Honey There’s a difference between raw honey and the kind typically found in stores

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• From Bee Honey starts as flower nectar collected by bees, which gets broken down into simple sugars stored inside the honeycomb. The design of the honeycomb and constant fanning of the bees’ wings causes evaporation, creating sweet liquid honey. Honey’s color and flavor vary based on the nectar collected by the bees. For example, honey made from orange blossom nectar might be light in color, whereas honey from avocado or wildflowers might have a dark amber color.

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So how is honey made?

tirred into tea, spread on toast, blended into a smoothie or drizzled on plain yogurt, honey provides sweet ﬂavor to meals. In addition, the ancient sweetener provides many other benefits. “Honey is filled with antioxidants and can boost your overall health and immune system,” said Jillian Barrett, co-owner of BeeKind, LLC, a home décor and local goods shop in Syracuse that carries local honey from Hiwire Honeybees in LaFayette. “Honey has antibacterial and antiseptic properties making it beneficial to be ingested or be used topically.” Barrett recommends it for sore throats, as does The World Health Organization and American Academy of Pediatrics. Compared with medicinal-tasting cough syrup, honey is pleasanter for children to take. However, children less than 1 year old should not ingest honey because of the risk of botulism because of traces of bacteria in honey. It poses no risk for children older than 1 or pregnant women. Raw honey and the type typically found in grocery stores are different, as the latter is pasteurized. Raw honey still has pollen traces in it and that has been found beneficial. Buying honey explicitly labeled as

raw can ensure those properties are intact. “Local, raw honey, like that from Hiwire Honeybees, can help with seasonal allergies,” Barrett said. “This is due to ingesting honey containing pollen found in your area making you less sensitive to it.” Though honey does offer many benefits, since it is a sweetener, eating it in moderation is important. Honey’s topical uses have been well-known for millennia—and it is still in use that way today. Raw manuka honey is said to be especially beneficial for pressure ulcers and wounds because of its ability to promote healing. It is made by bees gathering nectar from manuka plants, which are native to New Zealand. “Honey does have some significant therapeutic benefits for the skin,” said Ramsey Farah, dermatologist with Farah Dermatology & Cosmetics in Syracuse. “In our practice, we often use it for chronic wounds and a part of our treatment strategies for healing.” In addition to its wound healing capabilities, honey is gentle. In fact, Nancy Samuel, RN and managing partner at Sedora Spa in Syracuse, said some of her spa’s products contain honey for its ability to calm and hydrate the skin. “It’s definitely great for healing and anti-inﬂammatory properties,” she said.

• To Hive On average, a hive will produce about 65 pounds of surplus honey each year. Beekeepers harvest it by collecting the honeycomb frames and scraping off the wax cap that bees make to seal off honey in each cell. Once the caps are removed, the frames are placed in an extractor, a centrifuge that spins the frames, forcing honey out of the comb. • To Home After the honey is extracted, it’s strained to remove any remaining wax and other particles. Some beekeepers and bottlers might heat the honey to make this process easier, but that doesn’t alter the liquid’s natural composition. After straining, it’s time to bottle, label and bring it to you. It doesn’t matter if the container is glass or plastic or if the honey is purchased at the grocery store or farmers’ market. If the ingredient label says, “pure honey,” nothing was added from bee to hive to bottle.

The Top 6 Raw Honey Beneﬁts From www.healthline.com

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A good source of antioxidants Raw honey contains an array of plant chemicals that act as antioxidants. Some types of honey have as many antioxidants as fruits and vegetables. Antioxidants help to protect your body from cell damage due to free radicals. Free radicals contribute to the aging process and may also contribute to the development of chronic diseases such as cancer and heart disease. Research shows that antioxidant compounds in honey called polyphenols may play a role in preventing heart disease.

Antibacterial and antifungal properties Research has shown that raw honey can kill unwanted bacteria and fungus. It naturally contains hydrogen peroxide, an antiseptic. Its effectiveness as an antibacterial or antifungal varies depending on the honey, but it’s clearly more than a folk remedy for these kinds of infections.

Page 14 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

Heal wounds Manuka honey is used in medical settings to treat wounds because it’s been found to be an effective germ killer and also aids in tissue regeneration. Studies show that Manuka honey can boost healing time and reduce infection. Keep in mind that the honey used in hospital settings is medical grade, meaning it’s inspected and sterile. It’s not a good idea to treat cuts with honey you buy from a store. Phytonutrient powerhouse Phytonutrients are compounds found in plants that help protect the plant from harm. For example, some keep insects away or shield the plant from ultraviolet radiation. The phytonutrients in honey are responsible for its antioxidant properties, as well as its antibacterial and antifungal power. They’re also thought to be the reason raw honey has shown immune-boosting and anticancer benefits. Heavy processing destroys these valuable nutrients.

Help for digestive issues Honey is sometimes used to treat digestive issues such as diarrhea, though there isn’t much research to show that it works. It’s proven to be effective as a treatment for Helicobacter pylori (H. pylori) bacteria, though, a common cause of stomach ulcers. It’s also a potent prebiotic, meaning it nourishes the good bacteria that live in the intestines, which are crucial not only for digestion but overall health. Soothe a sore throat Have a cold? Try a spoonful of honey. Honey is an old sore throat remedy. Add it to hot tea with lemon when a cold virus hits you. It also works as a cough suppressant. Research has suggested that honey is as effective as dextromethorphan, a common ingredient in over-the-counter cough medication. Just take one or two teaspoonfuls, straight.

SmartBites By Anne Palumbo

Roasted Sweet Potatoes with Parmesan, Garlic and Thyme Adapted from Cooking Classy Serves 4

The skinny on healthy eating

The Superfood to Eat Year-Round: Sweet Potatoes The problem with sweet potatoes is this: Many people think of sweet potatoes only when Thanksgiving rolls around. That’s a problem because we should really be thinking about this nutritious tuber all year long! A few points to ponder: They’re considered a superfood by many; they’re widely available for a decent price; and, they’re delicious. What makes them worthy of the esteemed superfood title? Put simply, they’re loaded with nutrients and antioxidants that do a body good. While we can’t list them all, we can focus on a few standouts. Sweet potatoes are super rich in vitamin A (in the form of beta-carotene), which is important for eyesight. Numerous studies demonstrate that eating adequate amounts of vitamin A promotes healthy vision, prevents the development of night blindness, and may help slow age-related macular degeneration, a leading cause of blindness. What’s more, vitamin A helps fight off infections and contributes to building strong, healthy bones. A great source of fiber, sweet potatoes deliver about a fourth of our average daily needs in one cup. Fiber contributes to good health by stabi-

lizing blood sugar levels, promoting regularity, and ferrying bad cholesterol out. Some studies suggest that increasing fiber reduces our susceptibility to diseases such as heart disease, colon cancer, and diabetes. Sweet potatoes brim with antioxidants—powerful compounds that mop up free radicals linked to a host of age-related diseases. They’re also a good source of potassium, an essential mineral for maintaining normal blood pressure, and an excellent source of both manganese, a mineral that promotes a healthy metabolism, and vitamin C, a workhorse vitamin that’s necessary for the growth, development, and repair of all body tissues. Although sweet potatoes are low in fat, sodium, cholesterol and calories (180 per baked cup), they are high in carbs (46 per baked cup). The good news is, they’re the complex kind that takes longer to digest, which keeps our engines running longer.

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Helpful tips Select small to medium sweet potatoes that are firm and do not have cracks, soft spots or moldy ends. Large ones can be tough and tasteless. Store sweet potatoes in a cool, dark place for up to 10 days. Preparing sweet potatoes with a little fat, such as olive oil, can help boost the absorption of beta-carotene. While topping sweet potatoes with marshmallows and brown sugar is a Thanksgiving tradition for many, there are healthier ways to prepare them.

1½ lbs sweet potatoes (about 3 medium) 2½ tablespoons olive oil, divided 2 cloves garlic, minced 1 teaspoon dried thyme ½ teaspoon salt ¼ teaspoon coarse black pepper ¼ cup grated Parmesan Preheat oven to 400 degrees F. Wash potatoes thoroughly and then cut into 1-inch chunks. Place in a large bowl. In a small bowl, stir together 2 tablespoons olive oil, garlic, thyme, salt and pepper. Pour mixture over sweet potatoes, mix with hands (or spoon), and then spread into an even layer on one to two baking sheets. Roast in preheated oven until tender, tossing once halfway through, about 30 minutes total. Remove from oven, move rack to broiler position (about 6 inches away) and turn on broiler. While broiler is heating up, drizzle potatoes with remaining ½ tablespoon olive oil, then sprinkle with Parmesan. Return to broiler for about 1 minute. Adjust seasonings and serve.

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Upstate Doctor Hits Streets to Treat Homeless Patients The program is one of a growing number of street medicine initiatives By Ken Sturtz

ost doctors today don’t make regular house calls; it’s been decades since patients traded the convenience of a home visit for the formality of the doctor’s office waiting room with its bland décor and outdated magazines. But physician David Lehmann is an outlier; he has no waiting room and every patient he sees amounts to a house call whether he treats them on a street corner, under a bridge or in the back of a van. Lehmann and Mia Ruiz-Salvador operate a program through Upstate Medical University called HouseCalls for the Homeless. The goal is to provide direct medical care to homeless individuals throughout Onondaga County by meeting them where they are on the streets. The program is one of a growing number of street medicine initiatives across the country. By all accounts the program has been successful at providing medical care to a vulnerable and often difficult to treat population. HouseCalls for the Homeless works with a variety of organizations and programs to provide medical care to the homeless, wherever they are. They routinely go out on the street with outreach workers and make periodic visits to shelters. Lehmann also volunteers at several free clinics in Syracuse and brings medical students with him to learn and help out. “I think the success is based on collaboration, on how well the collaboration efforts work well together,” said Ruiz-Salvador, the program coordinator for HouseCalls for the Homeless. For such a program to succeed, she said, buy-in and support are necessary from the constellation of government agencies and nonprofits that

play a role in serving the homeless, from the city and county to hospitals and the organizations that run homeless shelters and do outreach work. The program might never have happened if Lehmann hadn’t made a simple observation and decided to do something about it. Lehmann joined the faculty of Upstate in 1994 as an internist and clinical pharmacologist. In addition to teaching, he sees patients. In 2013, he switched primarily to inpatient work, seeing patients at the hospital and emergency room. He soon noticed that homeless individuals accounted for a fraction of his total patients, but tended to make repeated trips to the ER. Under normal circumstances, a patient with issues such as uncontrolled high blood pressure, breathing problems or a skin infection would go to their doctor to receive care and medication long before it snowballed into an emergency. But by the time Lehmann was seeing them at the ER, they had gone untreated so long that their conditions were often severe enough for them to be admitted, sometimes requiring lengthy hospital stays to recover. About 75% of homeless patients had insurance through Medicaid, but the cost of hospitalization was much higher than treating the condition when it appeared and the quality of life for the patient was far worse. Lehmann knew that the constant trips to the ER and hospital stays could be reduced and quality of life improved if homeless patients received medical care sooner. Case managers from human service agencies had plenty of experience meeting the homeless on the streets and connecting them to needed services. They could sign them up for Medicaid, connect them

Page 16 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

with mental health and substance abuse services, and begin the process of finding housing. When it came to medical care, however, Lehmann said he realized there was a disconnect in how services were provided for people living on the street. “They were trying to fit these guys into an existing health infrastructure of the clinic,” Lehmann said. “Go to the doctor’s office and sit in the waiting room for an hour.” Homeless individuals usually don’t have a doctor or transportation, Lehmann noted. And the environment can make it extremely difficult for them to receive care. For example, someone struggling with mental illness might be unable to handle the anxiety associated with sitting in a crowded waiting room. And a drug addict is unlikely to wait an hour to

be seen. Patients in need of medication would receive something to tide them over short-term, but often ended up back in the ER because they had no doctor to prescribe them medication long-term. “It’s just a completely unworkable sort of situation,” Lehmann said. The problem angered Lehmann to the point that he decided to do something. He and Ruiz-Salvador put their heads together and worked with Upstate to find a solution. The result was HouseCalls for the Homeless. In 2018, Lehmann opted to stop seeing patients at the hospital and devote most of his time outside teaching to street medicine. But he knew he needed help connecting with the homeless and began attending meetings that included

From left: With van parked, physician David Lehmann puts his “bread and butter medicine” to work as he treats various homless individuals (photos 1–4); Mia Ruiz-Salvador is the program coordinator for HouseCalls for the Homeless. “I think the success [of the program] is based on collaboration, on how well the collaboration efforts work well together,” she says (5). Center Image: Physician David Lehmann: He has no waiting room and every patient he sees amounts to a house call whether he treats them on a street corner, under a bridge or in the back of a van.

nonprofits working with the homeless. It was there that he met John Tumino. “I basically would have been cold-calling these guys walking around on the street,” Lehmann said. “And John already had a very robust sort of relationship with the street homeless folks.” Tumino, a former chef and restaurateur, founded In My Father’s Kitchen a decade ago to provide street outreach. He was sitting in the same meetings with Lehmann, the county and other nonprofits trying to decide how best to get medical care to people on the streets. “We were in a meeting one day and nothing was transpiring,” Tumino said. “After the meeting I said ‘Doc, I’m already going out, why

don’t you just come out with me, bring your bag, let’s just go try it.’” Things clicked and Lehmann began riding along when Tumino did outreach. Although they had different backgrounds, both men shared a faith component that helped fuel their work. To Tumino, who is also a minister, they weren’t doing work. “It’s not a job; it’s my life’s mission,” he said. “I think he feels the same way.” Lehmann grew up in a suburb of St. Louis and, after pharmacy school and residency, decided to join the Order of St. Camillus, a religious order in the Catholic Church. He spent three years as a brother, including a year in Kenya running the pharmacy at a remote bush hospital. He met his future wife while in Kenya and later left the order and went to medical school. During his initial outings with Tumino, Lehmann carried a bag with a stethoscope, blood pressure cuff and other medical equipment. He also brought along things like wound care supplies. The inpatient pharmacy at Upstate provided a prefilled box with medications such as painkillers, antibiotics, inhalers and blood pressure pills. Lehmann rides shotgun as Tumino winds his way around in a van, making stops at locations he knows homeless individuals congregate. During a typical outing Tumino might visit an average of 15 people, handing out food and supplies. Of those, Lehmann might meet three people in need of medical attention. He usually treats them where they are. There’s also a table and bench available in the outreach van. He comes across a variety of people on the streets, though most of his patients are men between 20 and 30 years old. He sees a lot of chronic conditions; even homeless patients in their 30s tend to have conditions typically associated with older people. The work is pretty straightforward for Lehmann, who refers to most of what he does as “bread and butter medicine.” He has gone on post-disaster relief trips to Haiti and Ecuador in the past and said those experiences proved helpful when treating patients on the streets. When he sees a homeless patient Lehmann will do an assessment and decide what care is needed. Skin infections, often caused by drug use, are common. He spends a good deal of time draining abscesses and fighting infections. He stitches up cuts, provides foot care and handles any

other ailments a patient might have. When possible, he follows up a day or two later. If a patient needs medication he’ll usually provide it on the spot even if he plans to write them a prescription for the pharmacy. Since so many of his patients are also dealing with addiction or mental illness, they typically want immediate help with their medical issues, Lehmann said. So, he’s found it helpful to have medication on hand so he can start treating them immediately. During the pandemic he has spent time providing COVID-19 tests and vaccinations. He’s also helped patients who had COVID-19, but didn’t require hospitalization or who were being quarantined at hotels by Social Services. For those quarantining, he has provided medications and made follow-up visits to check on them. Lehmann has experienced very little pushback to the help he provides. That may be due in part to the program’s collaboration with organizations that already have relationships with the homeless. “There’s not a stigma to the medical guy out there seeing them. They want you especially if they know you have treatment at arm’s length,” Lehmann said. “I don’t have that sort of resistance that in some ways the psychiatric providers do.” Tumino said when he and Lehmann began working together he recognized Lehmann was eager to help the homeless, but also that there would be a learning curve working with that population. “I think the thing for him was learning to get out of that clinical mindset,” Tumino said. It takes more than simply meeting the homeless where they are. It takes time to learn how to work with nontraditional patients such as the homeless, Tumino said, especially in the case of people dealing with addiction or mental illness. He said Lehmann has become skilled at providing the best care possible to his patients under challenging circumstances, often repeating the phrase “Don’t let perfect be the enemy of good.” “He’s always about thinking outside the box and finding ways to get them care,” Tumino said. “Are we doing perfect work, perfect medicine? No. But it’s good work.” Lehmann recalls a patient who was suffering from severe schizophrenia and had lost both his feet. He was staying at a shelter, but case

managers got him housed. The man developed a significant infection in one of his legs and had a growing abscess that needed to be drained. Lehmann started the man on antibiotics and referred him to the wound clinic. But when the nurse took him in, the man acted up, refused to wear a mask and got kicked out, Lehmann said. With the likelihood that the condition would worsen if left untreated, Lehmann reluctantly opted to treat the man at home as best he could, draining the abscess and trying to fight the infection. “The frustrations that I have is trying to get them linked into the system because it’s kind of like a round peg square hole,” Lehmann said. “This guy is a round peg; the square hole is the office-based wound clinic and they’re just not going to fit. At some point you can only do so much.” Among the challenges of street medicine is the knowledge that the longer a person remains homeless, the more likely they are to die. Lehmann points to a statistic from the Street Medicine Institute: when you engage with a person on the street you’ve got an average of 2.7 years before they die. That adds a sense of urgency to get them treated and off the streets, Lehmann said. But after several years caring for the homeless Lehmann knows the importance of soaking in the victories, such as getting a patient treated and off the street, even if they’re the minority of cases. “For every five of these that you’re really spinning your wheels you get one that’s a real success story and you just hang your hat on that,” Lehmann said. “And you just get a lot of gratification from that; that really puts gas in your tank.”

HouseCalls for the Homeless Fund The Upstate Foundation maintains a donation fund to provide medications, medical supplies and equipment, and other items to aid in the care of homeless individuals. Charitable contributions can be made online at www.upstatefoundation.org/ HouseCalls or via check made payable to the Upstate Foundation (750 E. Adams St., Syracuse, NY 13210). Make a notation for HouseCalls for the Homeless.

November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 17

Q A &

with Gary Fitzgerald

“Biggest challenge is workforce,” says CEO and president of Iroquois Healthcare Association and Iroquois Healthcare Alliance about healthcare industry By Mary Beth Roach Q: What is the Iroquois Healthcare Association and what is its mission? A: We’re a health-care association of 50-some hospitals in 32 Upstate New York counties. We were created when the Central New York Hospital Association and the Northeastern New York Hospital Association got together and decided to merge. The reason we gave it the Iroquois name is it’s the same kind of territory as the Iroquois nation. The Iroquois nation was one of the first groups of tribes that got together and worked together. And that’s what the hospitals are trying to do. We mostly do advocacy for hospitals in our membership. We have hospitals, both small and large, rural areas, big cities. We make sure what Washington and Albany do, when it comes to regulations, financing, Medicare and Medicaid, that hospitals in our membership are treated fairly. We do educational programs for our membership and staff. We collect data and we give the data back to the hospitals on certain

things so they can compare themselves to each other and see how they’re doing. We have a for-profit subsidiary that does purchasing for hospitals. Right now, we’re really deep into the healthcare workforce shortage. We’ve been working on that for a long time, but it’s gotten worse with the pandemic and the vaccination issues. A lot of our hospitals are right on the edge of trying to get more staff and we’re trying to help with that. Q: Can you give us an idea of how extensive your coverage area is? A: We have 32 counties. We go from Columbia County, which is just south of the Capital Region, up to Plattsburgh, and over to Watertown and down to Binghamton. We don’t go into the city of Rochester. Q: In what ways have you helped healthcare institutions navigate through the COVID-19 pandemic? A: They [the healthcare institu-

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tions] are the ones doing all the work. We’re collecting data and we talk to the Health Department and the Governor’s Office. During the height of the pandemic, we were on calls almost daily, seven days a week, trying to make sure that the department of health and the governor’s staff knew how things were going in the hospitals, where there were bed shortages and where there were supplies of PPEs, where there were shortages. That was a pretty intense time. And the COVID pandemic was different because it started in New York City downstate and we really weren’t experiencing it at that level upstate. Then, all of a sudden, a few months later, we started to get a surge upstate. While they were scrambling downstate, we were furloughing staff off in our hospitals. We’re communicating all this to the Department of Health on a regular basis, so they understand what’s going on out there. We just made sure, if there was a hospital that had a staffing problem or a PPE problem, we communicated that and we tried to locate stuff to help them out. We are a go-between between the Department of Health and the hospitals themselves. We also had the hospitals talk to each other. Q: How do you interface with the state government regarding these healthcare issues and concerns, especially during the pandemic? A: We do it in a number of ways. We work with the Department of Health. We work with the governor’s office — there are people in the Governor’s office who are healthcare deputies – and we also inform the State Legislature –— the Senate and the Assemblypeople. We communicate with them on a regular basis. When they’re in session, we usually make visits down there to their offices or in their regional offices. We have an agenda for the session, like our workforce and how to make it easier for hospitals to recruit and retain workforce. The upstate hospitals that we represent have different needs than the downstate hospitals. Q: What are some of the biggest challenges that you see in your role facing the healthcare industry today? A: I think the biggest challenge is workforce. It takes a while to get healthcare workers certified and educated and trained. We’re working with educational organizations so we can get more healthcare workers into the system. It’s also finances. There are three ways hospitals get paid — insurance companies, Medicaid and Medicare. If Medicaid and Medicare aren’t paying their fair share, that

causes hospitals to really have a problem financially. The future is trying to make sure we have adequate financing and adequate staff. Q: Are there any speciﬁc programs or initiatives that you’re doing or planning to do in the near future to combat some of these issues. A: The Caring Gene — we have a campaign on social media, on TV and radio basically saying if you have the “caring gene,” you should be working in healthcare. Certain people have that gene. We made a whole campaign, trying to generate more interest in people wanting to get into healthcare. Q: How has the response been? A: We have a lot of people that are interested. But the one piece we’re trying to figure out is how many people actually got hired. It generated a lot of interest. It’s very difficult because the hospitals and nursing homes are recruiting on their own. It is very difficult to know if it was our campaign or it was their ability to get the word out there. We’re trying to figure out ways to better document that. Q: Your organization has sponsored some job fairs currently. Will you be extending those job fairs into November? A: Yes, because I think for whatever reason, we’re not getting enough people participating who are looking for jobs. We’ve got a number of vacancies at all our providers and yet we’re not generating enough interest in some of these job fairs. I think this is a national debate why people aren’t looking for work right now. We’re going to continue to do the job fairs because we believe there’s a group of people that would be interested in working in a healthcare environment. Q: The job fairs are virtual. If someone would be interested in knowing more, are the job fairs posted on your website? A: They’re on the Iroquois.org website and the Caring Gene.org website. Q: What do you see for the future for the healthcare industry in Upstate New York? A: There will be consolidation of healthcare services. The workforce will have to be rethought because we don’t enough that are in the pipeline. There’s going to be more telehealth. It’s really moving in that direction. Hospitals are going to be working with each other in a more efficient way.

Non-Surgical Ways to Improve Skin’s Appearance By Deborah Jeanne Sergeant

ou have many more options for regaining a youthful appearance to your skin than going under the knife. Area medical spas offer an array of means for improving how your skin looks. While acknowledging that his office provides “so many options” for non-surgical improvements to the skin, Ramsey Farah, dermatologist with Farah Dermatology & Cosmetics, emphasizes prevention with all patients. “It’s so much harder to reverse aging from sun damage issues,” he said. Farah Dermatology operates offices in Syracuse, Watertown, Rome, Fulton, Camillus and North Syracuse. “We have two reasons why our skin ages: intrinsic factors—the genetic programming of cells we can’t do anything about and we also have a lot of sun-induced damage.” For the latter, he recommends sunscreen and sun avoidance. “If you can minimize at least this form of aging, you’re one step ahead of the game,” Farah said. At home, using dermatologist-recommended topicals can help skin look its best. Some are prescriptions and some are over-the-counter products. “There’s a whole class of retinols and retinoids,” Farah said. “Almost everyone with facial aging issues should be on one of those as part of their regimen. There’s a whole universe of cosmeceuticals. Some offer

vitamin C, fruit acids, and the list goes on and on. Focus on the concept of using topical therapy to maintain your skin health.” Resurfacing methods can include mild and aggressive peels, but Farah prefers lasers because of their precision in reaching the epidermis and dermis. Lasers can improve the evenness of pigmentation and stimulate the production of collagen, which can minimize lines, pore size and wrinkles. Lifting procedures do not necessitate the use of surgical methods. Farah said that lasers can be used to cause a controlled contracture of the skin’s deeper tissues, which can improve areas that have begun to sag. Another option is thread lifts. “Threads are dissolvable surgical sutures that are inserted into the skin in various locations,” Farah said. “They can then be pulled up a little bit. Once you put them in, they engage the collagen and connective tissue, and you can pull them up for a non-surgical lift effect.” While a surgical procedure gives a more dramatic result than lasers and threads, Farah said that lasers are “getting close” to them. Nancy Samuel, register nurse and managing partner at Sedora Spa in Syracuse, said that microderm abrasion, chemical peels and micro needling are popular techniques her spa offers. Microderm abrasion uses physical means of removing the top layer

of skin and chemical peels use the application of products to do so. “Anything that causes a breakdown in the skin causes new collagen production,” Samuel said. “At menopause, we’re almost living off of our savings, similar to calcium. At that point the only way to create new collagen is to create new light trauma to the skin.” Micro needling offers anti-aging results. Also called collagen induction therapy, it uses thin, sterile needles to repeatedly pierce the skin and deliver the patient’s own platelet rich plasma (PRP) deep within the skin. The PRP contains growth factors that help the skin improve in appearance. Micro needling causes tiny injuries to the skin to stimulate production of collagen to improve skin’s appearance. “Micro needling goes even deeper than peels or abrasion,” Samuel said. “It has to do with affecting different levels of trauma to create different levels of stimulation.” Injectable approaches include Botox and fillers. Botox is effective for the upper half of the face and works by relaxing the muscles so they do not contract. That provides the effect of minimizing the appearance of

lines. Used with filler, the patient can have a smoother, less lined appearance afterwards. Filler can also help in areas of the face that have lost volume over time, such as the lips. How long the procedures last varies based on the individual’s appearance, lifestyle habits like smoking diet and hydration, and the procedures themselves. Laser treatments can cause a couple of days’ downtime, but provide results that last for months. The effects of chemical peels can last for a few weeks and may cause redness that lasts a day. Microderm abrasion has no downtime and its effect lasts for about a week, making it a good choice before a special event. It takes a few weeks to see the effects of micro needling. Its effects can last for as long as a year, which has helped make the treatment popular. Botox’s line-smoothing effects last about four months. Fillers last for three months to a year. Threads can last nine months to two years. Both Farah and Samuel encourage people interested in anti-aging techniques to seek an experienced practitioner who is either trained in medicine or is supervised by someone with medical training.

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For a personal tour, call 315-685-1400. 150 E. Genesee St., Skaneateles www.peregrineseniorliving.com November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 19

Parenting By Melissa Stefanec

MelissaStefanec@yahoo.com

Finding Beauty in the Madness

omewhere between all the obligations, parents lose something really important. We spend our days caught up in a whirlwind of things to do. The responsibilities are many and the breathing room is scarce. We worry about our immediate family, our extended family, work, school activities, homework, exercise, social obligations, bills, mortgages, budgeting and meal planning. Not to mention actively parenting our children. In that mess of busyness, we rarely have time to savor the moment or reﬂect on the important things. The time we spend worrying robs us of the joys of simple things. Paradoxically, enjoying a simple moment is one of the best ways to put gas in our tanks. So, how can busy parents make room for enjoying the small and beautiful moments in our lives? I don’t have the perfect answer, but I think we have to force ourselves to slow and savor some moments. This is hardly a novel concept, but it’s incredibly hard. This month, I’m going to reﬂect

on some of the tiny moments that make me immensely thankful for being a parent. Some of them are mundane. Some are silly. But it’s my hope that finding beauty in my ordinary life might help someone else do the same. • Driving past the cows — Our route to school passes a small beef farm. The cows and bulls are very close to the road. There are often babies wandering about the pasture. My kids and I are always cooing at the babies. We compete to see who can spot the calves first. We marvel at how quickly the calves grow. Sometimes, we roll down our windows and moo. It’s great to be silly. • Giving the kids a beater — A lot of baking happens in my home. I like to roll the dice and let kids lick batter (and a little bit of raw egg) off the beaters. I love bellowing across the house, “Who wants a beater?” and having them run up saying, “Me, me, me.” I like watching them make a mess. There is a beautiful innocence to it. • Walking behind my family — When we are out and about on a

family hike or walk, sometimes I lag behind my family. I love to watch them walk ahead of me. Sometimes they are hand in hand. Sometimes they are being goofy. There is just something so beautiful and ephemeral about watching my husband walk with one of my kids on each side. One day, they might be taller than him. But I will always remember the days when they were small. • Getting schooled on action ﬁgures — My 7-year-old son is a master of invention. If I sit down with him when he’s playing with his toys, he regales me with wildly creative backstories. The details in the stories rival legal documents in their intricacy. His imagined plotlines warm my heart. They are a much-needed break from the grown-up talk of finances and the state of the planet. • Watching the stars — If there is anything that can make gazing into the starry heavens better, it’s doing so with my children. When we have evening fires, they often ask me to come stare at the skies with them. I’m thankful for every time I oblige their requests. Listening to their questions and thoughts about the constellations and planets makes me feel a little more alive. • Watching my kids play in the yard — There is a mysterious beauty to watching children play when I can’t hear what they are saying. It’s fun to imagine what their narratives might be. Watching kids get along with each other, no matter how different they might be, gives me a hope that I carry with me throughout the day. • Being read to — On my luckiest days, my children offer to read to me. I love that we all share a love of reading. It may be tricky for me to follow plot lines without proper phrasing, but what they lack in diction, they

make up for in heart. I could linger in those little literary moments for hours. • My kids giving me food from their garden — This year, my kids had their own little garden. They grew peppers, tomatoes and pumpkins. On summer and early fall days, they would make me come and marvel at their garden close up. When I was working, they would bring me treats from their garden. They wanted me to be impressed and share their little bounties with me. I won’t soon forget the adoration and pride in their eyes or their willingness to give what little they had. • Chalking the driveway — One of our favorite family activities is to chalk our driveway. Sometimes we make it pretty. Sometimes we make it silly. Sometimes we make it about schoolwork. Whatever the topic, it calms all of souls to get our emotions out on the pavement. The fact that it will wash away only makes it more valuable. That way, we always have another chalk session to look forward to.

Conclusion Each day is full of hundreds of moments. Some are frustrating. Some are maddening and some are trite. The amazing moments are hard to come by. However, I just need to follow my kids’ leads. I need to stop being too busy to find the beauty in a pepper, starry sky or driveway doodle. I need to stop doing and take moments to live.

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Partner Violence: We All Know a Gabby By Barbara Pierce

he story of Gabby Petito has blown up in the media: the attractive 22-year-old who went on a cross-country road trip with her fiancé and never returned home. The young couple set off from Long Island in July in their converted van — documenting their travels on Instagram. Her remains were recovered in Wyoming in September. It appears that she may have been murdered by her boyfriend or that there was ongoing abuse in their relationship. Partner violence is epidemic in this country; we just don’t always hear about it. One in three females are victims of domestic violence in their lives, and one in 12 males, say experts. We think it happens to other people, but it can happen to anyone. It may be happening to someone you know. Maybe even to you. Partner violence, or domestic violence or abuse as it’s often called, is usually not obvious. A lot of folks think it’s physical: hitting, punching, bruises on the face, things that we can see. But often the most intense and damaging harm happens behind closed doors: emotional abuse, controlling behavior, verbal abuse, things like that. As a counselor, I worked in an organization that helped victims of domestic abuse. I was stunned, day after day, as woman after woman, and the occasional man, shared their

horrific stories. I learned much about abuse from these brave people. Some of the things I believe are important for us to learn from Gabby’s story: — In a healthy relationship, both people feel respected, supported and valued, decisions are made together, both have friends and interests outside of the relationship, and disagreements are settled with open and honest communication. — Both have the right to their own feelings and ideas and to share them without worrying about how their partner will react. Their privacy is respected, including the rights to private conversations, phone calls, text messages, social networking. — While there isn’t a sure way to spot an abuser, most abusers share some common characteristics. This list of warning signs means the person may have the potential to be abusive: • Quick involvement: Many victims knew their abuser only for a short time before being pressured to live together or get married. The abuser comes on like a whirlwind saying things like: “You’re the only person I can talk to;” “No one else ever understood me before.” The abuser needs someone desperately and pressures the victim to commit. • Controlling behavior: The

abuser tries to control your life: what you do, who you see, what you think. The abuser will be angry if the victim is “late” coming back. The abuser will question the victim closely about where the victim went, and who they spoke to. • Blames others for problems and feelings: Abusers are very good at making victims think they deserve the abuse and will blame the victim for almost anything that goes wrong. The abuser will say: “You made me mad,” “You made me do it. The abuser blames the teacher for a failed class, blames the cop for a traffic ticket, blames the boss for getting fired. • Unrealistic expectations: The abuser is very dependent on the victim for everything. The abuser will say things like: “If you love me, I’m all you need. No one will love you like I love you.” • Isolation: The abuser cuts the victim off from all resources and support. The abuser gets jealous of the other people in the victim’s life. The abuser does not “allow” the victim to make decisions or have friends. • Verbally abusive: In addition to saying things that are meant to be cruel and hurtful, there is an element of degradation, cursing, and criticiz-

ing any of the victim’s actions. The abuser may call the victim stupid; no one else would ever want them. • Past history of abuse: The abuser may say that a victim was only abused because they made the abuser do it. The victim may hear from the relatives or friends that the partner was abusive in past relationships. • Threats of violence: Any threat of physical force meant to control the victim. “I’ll slap you,” “I’ll kill you,” “I’ll break your neck.” At Gabby’s funeral, her father, Joseph Petito, had a lesson for the world: “If there is a relationship that might not be the best for you, leave it now.”

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November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 21

Golden Years

For people still working and with health insurance through their employer, a letter stating they have coverage will waive the penalty. “They have to provide a letter every year stating that their coverage is comparable to Medicare,” Chamberlain said. Private insurance companies administer Part C for the government. Part C is also called a supplement plan, or Medicare Advantage, which pays what A and B do not cover. Medigap is another optional plan administered by an outside insurance company. The Advantage plans combine the benefits of A and B, and usually offer other benefits such as better medical coverage, hearing exams, vision coverage, dental cleanings, transportation and fitness benefits. Parts A, B and sometimes C do not cover prescriptions. Part D is the

prescription drug program, which is offered through a private insurance company. “The bulk of the business we do is with Advantage plans because they take A, B and D and roll them into one plan that’s managed by a private insurance company,” Chamberlain said. “They have the ability to offer additional benefits that aren’t part of original Medicare.” Some even cover over-the-counter medication. “Most people look at a Medigap policy to supplement that 20% that Medicare doesn’t cover,” Chamberlain said. “It’s different from Advantage. It’s managed by a private insurance company. You show the card from that vendor and everything happens behind the scenes. With a Medigap, the claim goes to Medicare first, they pay what they pay and the claim has to go on a secondary basis to whenever pays the supplement. You have to buy a separate, D plan if you get the supplement. They don’t cover part D.” The Part D plans vary on the cost of different medications and which medications are covered. Chamberlain warns clients about the prescription drug “doughnut hole,” which places a greater burden upon policyholders for the cost of their prescriptions. Policyholders should carefully consider their Part D insurance coverage and look at Elderly Pharmaceutical Insurance Coverage (EPIC), a senior program that helps minimize the cost of medications for income-eligible seniors. While going for the most expensive Advantage Plan or what someone else likes seems like the best option, Chamberlain said that’s not always best. He advises clients to carefully examine their healthcare needs to determine what plan suits them. A Medicare expert can provide help in figuring out the best plan. “The key to any of this is talking with someone who has knowledge of what they’re doing,” Chamberlain said. “The biggest thing is people see ads on television and don’t realize that when they call that number, it’s a salesperson and those products may not be available in New York.” He encourages people to work with an independent agent who receives a ﬂat amount regardless of the plan chosen, whether a basic or not. Clients pay nothing for their consultation.

The investigators assessed patients’ neighborhoods based on 17 factors that reﬂected education, income, employment and household characteristics. The researchers discovered that Black patients from poorer neighborhoods were 19% more likely to die within five years of their heart attack than their white neighbors. But five-year survival rates for Black patients in wealthier neighborhoods were similar to those of white patients from the same neighborhoods.

“These findings may be of particular interest to health systems, since most health systems invest heavily to improve the quality of care provided to heart attack patients within the medical system,” Lee said in a Kaiser Permanente news release. “However, what this study shows is that a patient’s post-discharge environment also matters when it comes to long-term health outcomes,” she added. The findings were recently published in the Journal of the American College of Cardiology.

Medicare Parts

Here’s what you should consider when picking a plan By Deborah Jeanne Sergeant

he various “parts” of Medicare may seem confusing; however, learning a few principles about how they work can make it much easier to understand. Medicare is for people 65 and older or those receiving disability benefits for two years or more. Most people pay about $150 per month, depending upon income. Parts A and B cover 80% of the costs for care. Part A covers hospice and hospitalizations. For nursing home care, it pays for 20 days. After that, patients owe a co-insurance of $185.50 a day up until 100 days. From day 21-100, the patient will have a co-pay. “Once they determine skilled care is no longer needed and can be managed in the home or someone plateaus, at that point Part A ends at the nursing home,” said Brianne Barr, director of social work at Seneca Hill

Manor. Part B covers outpatient services after an annual deductible of $203 for things such as doctor’s visits, laboratory tests, x-rays, diagnostic tests, therapy and other services. It also pays toward durable medical goods. Some eligible people also skip signing up for Medicare because they do not have chronic health issues or take prescription drugs. But they face consequences later if they sign up late. Signing up for Medicare within the period of three months before or three months after the 65th birthday is important. “If they don’t sign up and don’t have coverage, they have to pay a penalty every month forever for each month they didn’t have Medicare,” said Bill Chamberlain managing partner of The Finger Lakes Group in Auburn, Binghamton and Elbridge.

Where You Live Could Predict Your Survival After Heart Attack

here are many factors that affect your longevity after experiencing a heart attack. And now, new research finds that your neighborhood could play a key role in your long-term survival. The researchers found that patients in poorer neighborhoods had a lower chance of survival over five years, and that Black patients in those neighborhoods had a lower chance than white patients. “This study suggests that social

and environmental factors can affect a person’s outcome after a heart attack, and where a person lives can have a powerful impact on health outcomes,” said senior study author Ming Sum Lee, a cardiologist at Kaiser Permanente Los Angeles Medical Center. For the study, Lee’s team looked at records from more than 31,000 people treated for a heart attack at the same hospital between 2006 and 2016.

Page 22 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

Golden Years

How to Choose a Quality Nursing Home Each facility can be very different, which is a big factor By Deborah Jeanne Sergeant

bout half of people will need long-term care eventually. Of those, some will receive care in a nursing home. If you are planning for your own care or for that of a loved one, how can you know if a facility provides quality care? The New York State Department Christine Sanford of Health licenses and inspects nursing homes, examining metrics including quality of care received, quality of life achieved, safety of residents, preventive care practices, and inspections and complaint information. Information on specific nursing homes is available at their website. Medicare’s website also lists nursing homes with ratings based upon health inspections, staffing and quality of resident care measures. Consumers can also look for

third-party quality accreditation such as by Joint Commission. The independent nonprofit is the oldest healthcare accreditation body in the nation. Organizations must successfully submit copious documentation and complete a rigorous on-site survey by a Joint Commission team every three years to maintain their accreditation. “A lot of people like to select a facility near their location so they can visit more often,” said Christine Stanford, senior director of operations and finance at Loretto. She encourages touring the nursing home under consideration and visiting the ﬂoor where their loved one would live. “Understand staffing ratios,” Stanford said. “Meet the staff. Selecting a nursing home is a combination of things. Use the resources from the state Department of Health. Ask about staff continuity and longevity. That person develops a relationship with the resident and the family to learn their preferences. Being a CNA or nurse in long-term care is a calling. It’s typically someone who finds purpose in improving an elderly person’s life.”

Stephen Hanse, president and CEO of The New York State Health Facilities Association, Inc. in Albany, also thinks it is a good idea to visit nursing homes in person (if permitted) or at least virtually. Reporting sites “are not always up-to-date and accurate,” Hanse said. “The best barometer determining the best facility is to choose a facility that is close to where you live so you can visit.” While visiting, observe how the residents appear. Are they clean and content? Look for a bulletin board listing activities and events. Does the facility look and smell clean? Visit during a mealtime. Does the food appear appetizing? Do residents who need help receive help in eating? “It really is what feels right to you?” Hanse said. “You may be able to have a virtual meeting with the facility and talk with the administrator and staff. Talk about your loved one’s needs and find the fit. It’s similar to a process in anything in life where you’re choosing something important like choosing a college.” Ask about any specific medical or clinical needs and if the facility can meet those needs.

While friends’ recommendations can be part of the decision, Hanse warned that everyone has a different experience and one bad experience with a particular staff member may not warrant writing off a facility. A good nursing home would follow through with further training and possible disciplinary action after an incident. “A lot of people write down a list of the questions they want to ask,” Hanse said. “Understand the needs and priorities and concerns of your loved one. Have a candid, open conversation. That’s critical.” In crisis situations, when the family and patient have little time to plan, they may need to select a nursing home in just a couple of days. Current staffing constraints and a limited number of beds available also make the options fewer. By planning together beforehand, families can make more informed decisions.

Resources to Find the Right Nursing Home Medicare: www.medicare.gov/care-compare/? providerType=NursingHome&redir ect=true NYSDOH: https://proﬁles.health.ny.gov/ nursing_home/#5.79/42.868/-76.809 Joint Commission: www.qualitycheck.org NYS Department of Health: https://proﬁles.health.ny.gov/ nursing_home/#5.79/42.868/-76.809

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November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 23

Golden Years

Long-term Care Can Sap Assets Start planning now for your later care By Deborah Jeanne Sergeant

ome people assume that Medicare or their health insurance will entirely cover their cost of nursing home care or at-home care. It will not. Medicare only covers full-time rehabilitation for a short period of time, but not long-term care. Other people think that their children will be capable of caring for them in their old age without considering their children’s responsibilities and health. Caregiving full-time is difficult and stressful. Many assume they will likely not need long-term care at all. “I’ve been doing this for 15 years and I could probably count on two hands the number of long-term care policies I’ve seen,” said Brianne Barr, director of social work at Seneca Hill Manor. “A lot of people don’t anticipate how long they’ll live or the medical issues they could have.” About 50% of people will require long-term care for an average of two

and a half years or six months, if they use home help and assisted living for a couple of years. For those with any type of dementia, their need for full-time care could be up to 10 years, as they can experience good physical health but still need full-time care. Most financial advisers recommend planning a means to cover the costs of long-term care for at least two years—about $200,000 a person—whether at home or within a facility. The cost of long-term care insurance has increased dramatically in the past 15 years, with many insurers no longer issuing new policies. Barr said many people on a fixed income cannot afford the premiums. For those with the means, long-term care insurance can protect their assets. For people who want to protect their assets for a younger spouse or heirs, long-term care insurance may make sense. Long-term care policies kick in once a person cannot perform

two of the six activities of daily living: eating, bathing, toileting, dressing, transferring and continence. “Typically, these policies have a daily maximum benefit,” said Christine Stanford, senior director of operations and finance at Loretto. “It is important to make sure any policy purchased has an inﬂation rider to keep up with the rising cost of health care.” People who purchased policies decades ago without the rider have been shocked to find their policies cover just $50 of care daily, far less than the median $340 per day. Typically, long-term care coverage includes home care, assisted living services and nursing home care. Assisted living costs about 40% of the cost of nursing home and helps conserve resources longer. Stanford said that unlike with Medicaid coverage, which covers only nursing home care for indigent individuals, longterm care policies help people stay independent longer. Living in a nursing home has become especially unfavorable because of the pandemic. The pandemic has underscored the challenges of curtailing outbreak of infectious diseases in facilities compared with living at home. Because nursing homes are regulated by the Department of Health—unlike assisted living facilities—residents must accept changes to their living environment such as living with residents who have COVID-19. To qualify for Medicaid while still protecting assets, people must transfer assets five years before applying for long-term care, although a spouse is permitted to continue living in a house worth $700,000 or less. Some people choose to self-insure by including the cost of the long-term care into their legacy planning. That way, if they end up not needing long-term care, they can leave more assets to their heirs. It can be important to look at family health history. Were many of the previous generation long-lived? What health issues do you currently face? Those applying for long-term health insurance must have good health to be approved for a policy. A shared care policy can provide coverage for whichever spouse needs long-term care. Hybrid life insurance

VA Awards $1.8 M in Grants to Fight Homelessness in Syracuse Region

he Department of Veterans Affairs has awarded $1,895,000 in the form of two grants to the Altamont Program, Inc. of Schenectady, a community organization primarily focused on combating homelessness. The grants are part of the VA’s Grant Per Diem Program and will be used to improve transitional housing and supportive services for veterans in the greater Syracuse area. The program provides funding to community organizations that provide transitional housing and

supportive services for veterans experiencing homelessness, with the goal of helping them achieve residential stability, increase their skill levels and income, and obtain greater self-determination. “The Grant and Per Diem program is integral to VA’s continuum of services and resources to help Veterans exit homelessness,” said Frank Pearson, Syracuse VA Medical Center director. “The newly awarded grants allow VA to continue to tailor transitional housing and case management services to the unique needs and circumstanc-

Page 24 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

es of individual veterans facing housing crises, which helps put them on the pathway to permanent housing faster.” The GPD funding will support two different types of grants to address the unique needs of veterans who are experiencing homelessness: Capital grants provide funding for community organizations through the Coronavirus Aid, Relief, and Economic Security Act of 2020. The funding supports capital improvements to transitional housing facilities. The improve-

policies can also cover the cost of care or else it pays a death benefit. Annual premiums for long-term health insurance can range from $2,000 to $5,000 per person, depending on coverage level and health. New York will offer a 20% income tax credit and for some people, the federal government will offer a small deduction. Some people manage homecare by relying on family members living in the home for things like socialization, housekeeping and cooking and a visiting professional for help with monitoring health, bathing and dressing. People with $2 million or more of assets can likely self-fund about three to four years of care without lowering their spouse’s lifestyle. Someone with less should consider coverage. Although the costs of long-term care insurance may be high, compared with the cost of care, it is still a good deal for many people. The insurance offers peace of mind and relieves the family of the challenge of providing care. “Another option to secure a longterm care insurance policy is to check with life insurance companies,” Stanford said. “Some life insurance companies offer long term care insurance riders.” These “hybrid” life insurance policies with a critical illness rider may be used for long-term are needs, but if it is not used, it becomes a death benefit for the policyholder’s heirs. The premiums are usually more affordable. Care does not have to be through a professional home healthcare agency. With a hybrid plan, the policyholder can cash in the policy for a qualified claim and pay someone for providing care—even a family member—and/or pay a home care agency. “Deciding to purchase a longterm care policy is a comprehensive decision which includes an assessment of your current health status, income, assets and your service delivery preferences for care as you age,” Stanford said. “Although I am not an attorney, I have worked in the healthcare industry for more than 20 years. It is always a best practice to meet with an attorney who specializes in estate planning prior to making any decisions.”

ments result in less congregate and more individual unit style housing, thereby improving personal safety and reducing risks associated with close quarters living for Veterans. Case management grants are used to support case manager positions within community organizations. These positions provide services to help veterans retain housing stability, adequate income support and self-sufficiency. The GPD program has provided community-based transitional housing and supportive services since 1994. The number of veterans experiencing homelessness in the U.S. has declined by 50% since 2010 resulting from the GPD program and other VA efforts.

By Jim Miller

Simple and Inexpensive Final Farewells Immediate or Direct Burial If you’re interested in being buried, an immediate or direct burial is the most basic and low-cost option. With an immediate burial, your body would be buried in a simple container shortly after death, skipping the embalming, viewing and use of the funeral facilities. If your family wants a memorial service, they can have it at the graveside at your place of worship or at home without the body. These services usually cost between $1,800 and $3,500, not counting cemetery charges, which can run you an additional $1,000 to $3,000. All funeral homes offer direct burial.

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Direct Cremation If you and your husband are interested in cremation, a direct cremation is the simplest and least expensive way to go. It includes picking up the body, completing and filing the necessary paperwork, the cremation itself and returning the cremated remains to the family. There’s no embalming, formal viewing or casket. A simple cardboard box called an “alternative container” is used to hold the body. Depending on where you live and the funeral home you choose, the average cost for a direct cremation runs between $1,000 and $3,000. If you want additional services beyond what a direct cremation offers, ask the funeral home for an itemized price list that covers the other services cost, so you know exactly what you’re getting. All providers are required by law to provide this. To locate nearby funeral homes, look in your local yellow pages, or Google “cremation” or “funeral” followed by your city and state. You can also get good information online at Parting.com, which lets you compare prices from funeral providers in your area based on what you want.

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Q: I need proof that I receive Medicare benefits. Where can I get a letter proving that? A: If you need proof that you get Social Security benefits, Supplemental Security Income (SSI), or Medicare, get an instant benefit verification letter online by using your personal my Social Security account. If you don’t receive benefits, your letter will serve as proof that you don’t receive benefits. If you recently applied for benefits, the letter will make that clear as well. The information on your benefit verification letter will include information that applies to your situation. You can set up your secure, personal my Social Security account at www.ssa.gov/myaccount. Q: I was incarcerated for two years. Before I was imprisoned, I received SSI benefits. Will my SSI payments start automatically when I am released? A: No. You must contact your local Social Security office and provide them with information regarding your release dates. In some cases, it may be necessary to reapply for SSI benefits. For more information, visit www.ssa.gov/reentry or contact your local Social Security office.

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Q: Will my retirement benefits increase if I wait and retire after my full retirement age? A: Yes. You can increase your Social Security retirement benefit in two ways:

ing point to request a review of the determination we made. Please visit www.ssa.gov/benefits/disability/ appeal.html. • Supplemental Security Income (SSI) — SSI is a federal income program funded by general tax revenues, and helps people who have little or no income and who are age 65 or older, blind or have disabilities. If you meet certain requirements, you may apply online at www.ssa. gov/benefits/ssi. If you are not able to apply online, call your local Social Security office to apply. • Medicare — Medicare is a federal health insurance program for people age 65 or older, some people younger than 65 who have disabilities, and people with end-stage renal disease. If you are not already receiving Social Security benefits, you should apply for Medicare three months before turning age 65 at www.ssa.gov/benefits/medicare. • Extra Help with Medicare Prescription Drug Costs — People who need assistance with the cost of medications can apply for Extra Help at www.ssa.gov/i1020. • You can increase your retirement benefit by a certain percentage if you delay receiving retirement benefits. We will add these increases automatically from the time you reach full retirement age until you start receiving benefits or reach age 70. • If you work, each additional year you work adds another year of earnings to your Social Security record. Higher lifetime earnings may result in higher benefits when you do retire. For more information, visit www. ssa.gov/pubs to read, print, or listen to our publication, “When to Start Receiving Retirement Benefits.” You also can use our “Retirement Estimator” at www.ssa.gov/estimator to determine your estimated future benefits. Q: I was speaking with my sister and she told me that she receives half of her spouse’s benefit. Why am I not eligible for benefits from my spouse? A: If your spouse is eligible for Social Security benefits, you could be eligible for one-half of their benefit at your full retirement age. However, if you worked and are eligible for Social Security benefits on your own record, your own benefit may be higher than what you could be eligible for on your spouse’s record. If you have questions regarding your eligibility for benefits, please call 1-800-772-1213 (TTY 1-800-325-0778) between the hours of 7 a.m. and 7 p.m. Monday through Friday.

Golden Years

The Medical Power of Attorney It’s not always deciding whether to ‘pull the plug’

By Deborah Jeanne Sergeant

s part of end-of-life planning, it is important to complete a healthcare proxy. Named in this document is the medical power of attorney (POA), a person who has the legal authority to make healthcare decisions for you should you be incapable of making them because of an illness or injury. Selecting this person is a decision to make with care. “People tend to think that they have to automatically assign their spouse or a son or daughter or family member,” said Brianne Barr, director of social work at Seneca Hill Manor. “That’s not really the case. I always advise people to choose people as their medical POA who will adhere to their wishes when they’re not able to make decisions for themselves. Sometimes, it’s too hard for a spouse or child to follow those wishes as it’s a very special person. It’s their loved one.” The medical power of attorney may also be called a durable power of attorney for healthcare or a healthcare agent. But the role is different from a financial power of attorney, which is someone who can make

financial decisions and pay bills for a person who is incapacitated. “If they’re close by it’s helpful but you don’t necessarily have to pick someone who’s local as long as there’s way to get a hold of them,” Barr said. Although it can be helpful, the individual does not have to possess medical knowledge. Trust and a thorough understanding of your wishes is much more important. Christine Stanford, senior director of operations and finance at Loretto, encourages people completing a healthcare proxy form to discuss in detail end-of-life care, including artificial supports, resuscitation and quality of life issues.

Some Diabetes Meds Might Also Lower Alzheimer’s Risk

Study ﬁnds people taking the drugs have fewer biomarkers, slower cognitive decline

eople taking certain drugs to lower blood sugar for Type 2 diabetes had less amyloid in the brain, a biomarker of Alzheimer’s disease, when compared to both people with Type 2 diabetes not taking the drugs and people without diabetes. The new study, published in the Aug. 11 online issue of Neurology, the medical journal of the American Academy of Neurology, also found people taking these drugs, called dipeptidyl peptidase-4 inhibitors, showed slower cognitive decline

than people in the other two groups. In people with Type 2 diabetes, the body no longer efficiently uses insulin to control blood sugar. Dipeptidyl peptidase-4 inhibitors, also known as gliptins, can be prescribed when other diabetes drugs do not work. They help control blood sugar when combined with diet and exercise. “People with diabetes have been shown to have a higher risk of Alzheimer’s disease, possibly due to high blood sugar levels, which have been linked to the buildup

“We always encourage our residents to have discussions with their health care proxy while they are still capable of decision making,” Stanford said. “Discussions should include whether they want to be intubated, receive hydration and nutrition (feeding tubes), receive antibiotics for infections.” While most people think of medical power of attorney agents as deciding to “pull the plug” or not, they may also be called upon as a point of contact in case of a hospitalization or out-patient surgery for organizing post-discharge or postoperative care or in case of complications. “The healthcare proxy only acts when you’re able to act or make deci-

sions on their own,” Stanford said. She also encourages residents to complete a medical order for life-sustaining treatment (MOLST) form that has been completed with a healthcare provider’s input. “This document is subject to review and change as the individual’s healthcare needs change,” Stanford said. In addition to the medical power of attorney, a back-up person is also recommended. Younger people tend to choose their spouse and parents; older adults tend to select their spouse and a child. But selecting more than one child can cause rifts if the plans are not made clear.

of amyloid beta in the brain,” said study author, physician Phil Hyu Lee of Yonsei University College of Medicine in Seoul, South Korea. “Not only did our study show that people taking dipeptidyl peptidase-4 inhibitors to lower blood sugar levels had less amyloid in their brains overall, it also showed lower levels in areas of the brain involved in Alzheimer’s disease.” The study involved 282 people with an average age of 76 who were followed up to six years. All had been diagnosed with either pre-clinical, early or probable Alzheimer’s disease. Of the group, 70 people had diabetes and were being treated with dipeptidyl peptidase-4 inhibitors, 71 had diabetes but were not being treated with the drugs and 141 did not have diabetes. Those without diabetes were matched to those with diabetes for age, sex, and education levels. All had similar scores on cognitive tests at the start of the study. Participants had brain scans to measure the amount of amyloid in the brain. Researchers found that people with diabetes who took the drugs had lower average amounts of amyloid plaques in the brain compared to people with diabetes who did not take the drugs and compared to people who did not have diabetes. All participants took a common thinking and memory test called the Mini-Mental State Exam (MMSE) on average, every 12 months for 2.5 years. Questions include asking a person to count backward from 100

by sevens or copying a picture on a piece of paper. Scores on the test range from zero to 30. Researchers found that people with diabetes who took the drugs had an average annual decline of 0.87 points on their MMSE score, while people with diabetes who did not take the drugs had an average annual decline of 1.65 points. People without diabetes scored an average annual decline of 1.48 points. When researchers adjusted for other factors that could affect test scores, they found that the scores of the people taking the drug declined by 0.77 points per year more slowly than the people who did not take the drug. “Our results showing less amyloid in the brains of people taking these medications and less cognitive decline, when compared to people without diabetes raises the possibility that these medications may also be beneficial for people without diabetes who have thinking and memory problems,” said Lee. “More research is needed to demonstrate whether these drugs may have neuroprotective properties in all people.” A limitation of the study was that data were not available to show the accumulation of amyloid in participants’ brains over time. This study does not show cause and effect. It only shows an association. The study was supported by the Korean Healthy Industry Development Institute and the Korean Ministry of Health & Welfare.

November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 27

Health News Samaritan and Roswell Park announce medical oncology partnership

Samaritan Medical Center in Watertown and Buffalo-based Roswell Park Comprehensive Cancer Center in Buffalo have announced a new affiliation, linking medical oncology services provided at Samaritan’s Walker Center for Cancer Care with the Roswell Park Care Network. The new affiliation will offer cancer patients in the North Country region access to the latest approaches and best practices in cancer treatment to enhance the quality of medical oncology services available locally. Beginning Oct.18, the care of medical oncology cancer patients in the Watertown region will have access to leading cancer research, education and prevention services overseen by experts from Roswell Park, the only facility in Central and Upstate New York designated by the National Cancer Institute as a comprehensive cancer center. Two full-time medical oncologists at the Walker Center — physicians Florence P. Arnold and Ihsan U. Haq — will become employees of the Roswell Park Care Network and will continue to provide care for their patients at the Walker Center location. Patients at the Walker Center will benefit from enhanced capabilities and resources offered by the expanding Roswell Park Care Network, which is the most expansive community cancer, supportive and specialized care affiliation across New York state.

systems. Every year, Healthgrades evaluates hospital performance at nearly 4,500 hospitals nationwide for 31 of the most common inpatient procedures and conditions. The hospitals that have achieved the Healthgrades America’s 50 best hospitals for cardiac surgery and America’s 100 best for spine surgery have demonstrated exceptional quality of care. From 2018-2020, patients treated at hospitals receiving the America’s 50 best hospitals for cardiac surgery award have, on average, a 52.8% lower risk of dying than if they were treated in hospitals that did not receive the award. “Consumers can feel confident in the America’s 50 best hospitals for cardiac surgery for their commitment to quality care and exceptional outcomes. The recognition helps provide peace of mind when selecting a place for care,” said physician Brad Bowman, chief medical officer and head of data science at Healthgrades. “As the number one hospital for heart care in the region, we are extremely proud to be named a best hospital for cardiac surgery for the fourth year in a row,” said Leslie Paul Luke, president and CEO at St. Joseph’s Health. “On top of that, to be awarded a Top 100 designation in spine surgery and coronary intervention is a testament to our amazing colleagues here at St. Joseph’s Health. It is truly impressive that, even amid the COVID-19 pandemic, our incredible surgical teams have once again delivered outstanding patient outcomes.”

St. Joseph’s College of St. Joe’s named best for has new dean cardiac, spine surgery and Nursing Lenore Boris has been named coronary intervention dean of St. Joseph’s College of Nursing. St. Joseph’s Health is one of America’s 50 best hospitals for cardiac surgery and one of America’s 100 best for spine surgery and coronary intervention, according to new research released by Healthgrades, the leading resource that connects consumers, physicians and health

In her new role, she will oversee the daily operations of the college, faculty development, curriculum design and research, and clinical services. “Dr. Boris brings with her more than two decades of teaching, research and management experience

Local residents featured on 2022 “Syracuse 60 Strong” calendar Twelve Syracuse residents in their 60s have been chosen to be featured as “pin ups” on an exclusive 2022 calendar that highlights events and activities around Syracuse and serves as a roadmap to good health. A panel of celebrity judges from Syracuse selected the 60 Strong Ambassadors because they have competed in world championships for their sport, overcome major health issues, served as leaders in their community or dedicated their lives to helping others. Each one has a unique story to tell. They all exemplify how life after 60 can be a positive, vibrant and active time. In addition to being photographed to appear in the 2022 Syracuse 60 Strong calendar, winners received “celebrity treatment,” and were paid for their time to participate in a professional photo shoot. The winners are as follows: Page 28 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

in higher education to our College of Nursing,” said Leslie Paul Luke, president and CEO of St. Joseph’s Health. “We are confident that she will provide outstanding leadership and counsel to faculty, staff and strive to provide an excellent student experience.” Prior to this appointment, Boris taught in nursing and medical programs at several colleges across Upstate New York. She spent more than 15 years as an associate dean at the Binghamton Campus of SUNY Updste Medical University’s College of Medicine. Her responsibilities included oversight of daily operations and managing the budget. She also played an active role in the school’s community relations including supervising a free clinic that provided primary health care to uninsured adults at no cost to the patient. Boris began her nursing career as a nurse in the U.S. Air Force. She served as a clinical nurse on active duty and later as a ﬂight nurse and eventually administrator of a clinic. In 2007, Boris retired as a colonel after 28 years of service. Boris earned her bachelor’s degree in nursing from California State University in Hayward, her master’s degree in nursing from Syracuse University, and Ph.D. in nursing from the University of Wisconsin-Milwaukee. Boris also holds a law degree from Lenore Boris University of Wisconsin. Boris succeeds Susan Berger, who has served as interim dean since April 2021. Berger will resume her role as the chairperson of the governing board of St. Joseph’s College of Nursing. “We are incredibly grateful for Dr. Berger’s leadership at the College during this transitional phase,” Luke said. “Dr. Berger was instrumental in

maintaining the school’s well-known standard for excellence and leading the next generation of nurses while we searched for a permanent dean.” Boris assumed her role in mid-September. She lives in Ithaca with her son, Aaron, and 20-yearold cat. In her spare time, she enjoys hikes, reading and home projects.

Interventional cardiologist joins St. Joseph’s Health

Physician Suhayb Kadura has recently joined St. Joseph’s Health’s medical staff. Kadura is a board-certified cardiologist who grew up in and began his medical education in Upstate New York. He did his residency in internal medicine at the University of Rochester as well as a threeyear fellowship Suhayb Kadura in cardiovascular disease at SUNY Upstate Medical University in Syracuse. Kadura completed his subspecialty training in interventional cardiology at the University of Connecticut in Hartford, Connecticut, where he trained in coronary and structural heart disease. Prior to joining St. Joseph’s Health, he worked as a hospitalist in Rochester at Highland Hospital and University of Rochester Medical Center, and as a hospitalist at the VA Medical Center in Syracuse. He will be continuing these roles. A board-certified physician in cardiovascular disease and internal medicine by the American Board of Internal Medicine, Kadura is also an active member of the American Heart Association and American College of Cardiology. He is also board certified in nuclear cardiology as well as cardiac CT imaging.

Deborah Reinhardt-Youmans, Donna Dunn, George Kilpatrick, Jim King, Joseph Cambareri, Liz Malcolm Scheibel, Mary Jensen, Mary Lou Balcolm, Pat Floyd-Echols, Vicki Brackens, Elliott Bruton and Kevin Maier. The winners were nominated by family members and friends. They will each appear in front of a Syracuse landmark and the calendar will also feature health tips for seniors and provide information about Medicare information sessions and open enrollment. The Syracuse 60 Strong calendars are available for purchase online at www.Syracuse60Strong.com. The cost is $15 for each calendar and all proceeds will benefit the Alzheimer’s Association, CNY Chapter. Syracuse 60 Strong is a celebration of grit and resilience, sponsored by FamilyCare Medical Group in conjunction with the launch of Salt City Senior Care Advantage IPA, a new program designed to keep seniors active and help them navigate the complexities of Medicare coverage and other healthcare decisions.

Health News Nurse joins the Center for Wound Healing at Oswego Health

Lorraine A. Ladd-Falanga recently joined The Center for Wound Healing at Oswego Health. Ladd-Falanga will see patients at the center which offers leading-edge treatments including hyperbaric oxygen therapy, negative pressure therapies, bioengineered tissues and biosynthetic to reintroduce the body’s innate ability to heal. Ladd-Falanga brings over 20 years of experience to the job and is no stranger to Oswego Health. Throughout her career, she held various positions at Oswego Hospital, including being a nurse practitioner in Ladd-Falanga the emergency department and serving as a hospitalist. She’s worked throughout Central New York at the major healthcare systems and most recently was a nurse practitioner at Delph Health Care where she provided medical care to patients requiring admissions. By joining The Center for Wound Healing at Oswego Health, a member of the Healogics network, Ladd-Falanga will collaborate with a network of academic medical centers, hospitals and thousands of professionals committed to advancing wound healing by creating, sharing and activating wound prevention and care expertise. This center along with only 15 others around the country recently received the President’s

Farnham Family Services Expands to Mexico Farnham Family Services recently marked the opening of its new clinic in Mexico with a ribbon cutting ceremony. Located at 111 Hamilton St., the new clinic expands Farnham Family Services’ reach and allows for easier access to Farnham’s many services and programs aimed at reducing and

Circle Award, for outstanding clinical outcomes for 12 consecutive months, including patient satisfaction higher than 92%, and a minimum wound healing rate of at least 92% within 28 median days to heal. Ladd-Falanga is a New York licensed registered nurse, registered vascular technologist and cardiac sonographer. She earned her Master of Science and bachelor’s degree in nursing from SUNY Upstate Medical University.

Nurse practitioner joins Lakeview Primary Care

Oswego Health’s brand-new primary care practice, Lakeview Primary Care, recently welcomed experienced family nurse practitioner Nathaniel Farden. Licensed in 2010 as a registered nurse, Farden earned his nursing degree in 2012 from Western University. Farden joined Oswego Health as a registered nurse in the emergency department in 2015, then later transitioned Nathaniel Farden as a utilization registered nurse in case management in 2016 while continuing his schooling. In 2019, Farden received licensure as a family nurse practitioner and worked per diem with the Oswego Health hospitalist team as an nurse practitioner. “By regularly seeing a primary care practitioner, you can identify and control health risk factors before they become problems,” said medical director for Lakeview Primary Care,

eliminating the abuse of alcohol and other drugs in Oswego County. Above from left are board member and first vice-president, John Zanewych; community services board member Larry Schmidt; Farnham Senior Director of Services Sandie Waldron; Farnham Executive Director Eric Bresee; Farnham Board President Mike Dehm; Director of Community Services for Oswego County Nicole Kolmsee, and Farnham Director of Operations Penny Greene.

physician Micheal Stephens, who also serves as associate chief medical officer for Oswego Health. “As we look to provide more access to care in Oswego County, we are fortunate to have experienced providers such as Nathaniel here ready to care for our community,”

Pain medicine doctor joins New York Spine

Physician Adrianne Monaco O’Quinn recently joined New York Spine and Wellness Center and will see patients in East Syracuse, North Syracuse and Camillus locations. O’Quinn is a fellowship-trained pain management physician, and is board-certified in both pain management and physical medicine and rehabilitation. She specializes in treating spine, hip, knee and other musculoskeletal disorders, as well as chronic pain conditions, including arthritis and diabetic neuropathy. O’Quinn joins New York Spine and Wellness Center with over seven years of experience practicing in the Syracuse area. O’Quinn completed a fellowship in pain medicine through the

anesthesiology department at SUNY Upstate Hospital, where she also completed a residency in physical medicine and rehabilitation and was selected as chief resident. She completed O’Quinn an internship at St. Joseph’s Hospital in Syracuse, and received her medical degree from SUNY Upstate Medical University. She graduated summa cum laude with a bachelor of science degree from the University of Massachusetts, Amherst, where she was also the captain of the field hockey team. “New York Spine and Wellness Center plays an important role in our community by caring for individuals with painful conditions. They offer compassionate care and an array of treatment options from conservative therapies to advanced and innovative technologies. I am happy and honored to join this excellent team,” she said.

Crouse Health Named Age-Friendly Health System Crouse Health is one of just 37 New York state healthcare facilities — and the only one in Central New York — to be designated an age-friendly health system by the Institute for Healthcare Improvement (IHI). The Healthcare Association of New York State (HANYS) recently announced the hospitals, ambulatory practices, post-acute care facilities and federally qualified health centers that earned this designation after participating in the first cohort of the HANYS-led New York State Age-Friendly Health Systems Action Community. “Crouse is proud to be recognized as an age-friendly hospital,” said Chief Operating Officer/Chief Medical Officer Seth Kronenberg. “This recognition reﬂects our commitment to improving outcomes for older adults.” The IHI designation compliments the recognition Crouse had previously received from the American College of Emergency Physicians for best practices in treating geriatric patients in the hospital’s emergency department. With support from the New York State Department of Health, the program launched in November

2020 and ran through August 2021; the designation of 37 participants to date has nearly doubled the number of New York facilities IHI has recognized for adopting evidence-based interventions to improve care for older adults. “This action community kicked off at the height of the global COVID-19 pandemic, but our cohort was undeterred,” said Bea Grause, president, HANYS. “COVID-19 has had a disproportionate impact on older adults, magnifying the importance of using practices tailored to that population.” The members of HANYS’ initial New York State Age-Friendly Action Community cohort learned to identify and address common risks during hospitalization, discharge planning and care transitions, while optimizing their patients’ physical function and independence, supporting caregivers and strengthening coordination between settings and providers. Age-Friendly Health Systems is an initiative of The John A. Hartford Foundation and IHI, in partnership with the American Hospital Association and the Catholic Health Association of the United States.

November 2021 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 29

Health News

NYS Attorney General Visits Pomeroy Treatment Center at Crouse Health State Attorney General Letitia James brought her statewide Heal New York tour to Syracuse in October, delivering nearly $37 million to the region to combat the opioid epidemic. The nearly $1.5 billion being distributed statewide comes from different settlements negotiated by her office following the March 2019 lawsuit against manufacturers and distributors of the painkillers. James says it’s time to turn the tide on the opioid drug crisis. “Right now in America, someone somewhere is unfortunately misusing a painkiller for the first time. Someone is dying of an overdose. Somewhere in this state, we are burying a child. Someone is in the throes of drug addiction, and they’re seeking help. We’re living with broken communities and broken families, and people are sinking further into despair.”

Onondaga County is set to receive $9.4 million and Syracuse $3.7 million for prevention, education, treatment, and recovery. The Attorney General James made her announcement at the recently relocated and expanded $17 million Crouse Health Pomeroy Treatment Center on Erie Boulevard East. Physician Tolani Ajagbe, Crouse Addiction Treatment Services medical director, says a major issue is access to treatment. But he says it’s improved in recent years where patients don’t have to wait a long time for care. “A lot of places, including our treatment center, are able to take patients for treatment the same day they show up at our door. So, access to treatment is very important. The damage is already done. We’re just trying to figure out how to stop the bleed.” Ajagbe said 2020 was the deadliest year for opioid overdoses in Onondaga County, with 156 lives lost. This year is on pace to surpass that number.

CALENDAR of HEALTH EVENTS

Nov. 2, 3

Tap dance classes held at JCC Adult tap dance classes are returning to the JCC of Syracuse after a two-year hiatus due to the pandemic. The JCC’s Neulander Family Sports & Fitness Center will hold weekly adult tap dance classes on Tuesday and Wednesday evenings this fall starting Nov. 2 at the center on 5655 Thompson Road in DeWitt. The advanced tap dance class will be offered from 6:30–8 p.m. on Tuesdays starting on Nov. 2. It will be taught by longtime JCC tap instructor Barry Shulman. On Wednesdays

starting Nov. 3 Angela Saturno will teach a beginner tap dance class from 6:30–8 p.m. followed by an intermediate tap dance class from 8–9 p.m. The cost is $5 per person each night. The classes are scheduled to run through at least December, although there is no set end date yet. All classes are taught “New York City” style. Students do not need to commit to every class and can attend as much as they’d like. A limited number of tap shoes are available to borrow at no cost each night on a first come, first served basis. The JCC’s tap classes are open to anyone age 12 and older. No prior dance experience is necessary. Proof of COVID-19 vaccination and

Page 30 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2021

Nascentia Health Raises $100K for Charitable Foundation

dated and unsafe beds. Nascentia Health CEO Kate Rolf presented awards to three local individuals who have significantly contributed to the well-being of the community. County Executive Ryan McMahon received the Civic Engagement Excellence Award, which is given to recognize a person or group that excels in addressing public concern and making a difference in the lives of those in the community. McMahon was chosen for his leadership and commitment to making Onondaga County a safe and thriving place to live and work. Adam and Clover Weitsman received the Community Champion Award, which is presented in honor of persons or organizations who have made an outstanding contribution to the community. They were selected for their significant philanthropy efforts through their CNY Tuesdays give-back campaign, in addition to the many other charitable donations they have provided in support of local organizations.

County Executive Ryan McMahon received the Civic Engagement Excellence Award from Nascentia Health CEO Kate Rolf.

Adam and Clover Weitsman received the Community Champion Award from Nascentia Health CEO Kate Rolf.

wearing a mask is required to attend. Maximum 25 people per class and registration is required for every class meeting by calling 315-445-2360. Plenty of free parking is available. Tappers are asked to arrive early to sign in. For more information about the JCC’s adult Tap Dance classes, contact Patrick Scott at 315-445-2040, ext. 144, or pscott@jccsyr.org.

Appointments are required by calling 315-472-7504. Walk-ins are not allowed. Each patient will require a COVID-19 precautionary screening and must comply with safety protocols, including wearing a mask. The screening is available for people at high risk for lung cancer, meaning they must meet all the following criteria: • Are 50 to 80 years old • Are currently smoking or have quit within the last 15 years • Have a history of heavy smoking. “Lung cancer screening is a regular preventive health check, like a mammogram or a colonoscopy, and most people who get screened do not have cancer” said physician Nicole Taylor of CRA Medical Imaging. “The low-dose CT checks your lungs while you are healthy and looks for any changes from year to year. With that information we can intervene with any necessary medical care as soon as possible.”

Nascentia Health recently celebrated its annual Raise A Glass event, which raises funds for the organization’s charitable entity, the Nascentia Health Charitable Foundation. Held at Lakeshore Yacht & Country Club, the event drew over 200 people and raised more than $100,000 for the foundation. The Nascentia Health Charitable Foundation is focused on improving the lives of the organization’s home-care patients through grants of life-changing health-related items to those who are uninsured or under-insured. Recent donations include a generator for a rural patient so frequent power outages don’t affect his oxygen machine, equipment to allow a mother to safely get her disabled child in and out of the bath, and new beds and mattresses for patients who were sleeping on the ﬂoor or dilapi-

Nov. 13

Free lung cancer screening offered in E. Syracuse, Auburn To celebrate Lung Cancer Awareness Month in November, Hematology/Oncology Associates of CNY and CRA Medical Imaging are offering free lung cancer screenings from 9 a.m. to 1 p.m., Saturday, Nov. 13, in two locations: HOACNY office at 5008 Brittonfield Parkway, E; Syracuse, and Diagnostic Imaging Center, 37 W. Garden St., Auburn.

ConnextCare Expands School Based Health Center Services in Mexico School District

From left: Reception area; dental exam room (top); general exam room (bottom).

onnextCare is opening of a new School Based Health Center location in the Mexico Elementary School. The new site will offer medical, mental health and dental services to enrolled students who are in both the Mexico elementary as well as the Mexico High School. The SBHC is a full-service health center operated by ConnextCare and partially funded by New York state. The site will provide prompt, quality and convenient primary and acute medical services, counseling services as well as preventive dental services. This service comes at no

Elementary School supports ConnextCare’s ongoing mission to provide accessible, comprehensive and premier health care and support services to Oswego County residents and surrounding communities. The opening of the Mexico Elementary marks ConnextCare’s eighth schoolbased site in the county with other locations in the Sandy Creek, Pulaski, APW and Fulton districts. To take a virtual tour of the new site, please visit connextcare.org or visit the ConnextCare Facebook page.

cost to the students and their families. “The school-based health center program is an invaluable and rewarding element of the ConnextCare organization. The school-based health centers are unique because they allow students to be seen for services without leaving the school itself and at no out-of-pocket cost to the student’s family, thus breaking down barriers to care that some families may otherwise face,” said Tricia Peter-Clark, president and CEO of ConnextCare. “We are proud to provide this service to the local school

districts and we are excited to partner with the Mexico schools again to add our second school-based health center to their district. This offers continuous access to health services for students of Mexico elementary and middle school through their high school years.” All school-aged children (elementary, middle and high School) are eligible to enroll in the program, parents may request enrollment forms from the school, at a ConnextCare location or online at www.connextcare.org. This expansion to Mexico

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