Igh cny 171 mar14 by In Good Health: CNY's Healthcare Newspaper

CAT BITE

Why getting a bite from a cat is much worse than getting one from a dog

Supplements: Waste of Money?

Editorial: supplements are a waste. Local experts disagree

in good March 2014 • Issue 171

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CNY’s Healthcare Newspaper

Trying to understand why the Amish have a significantly lower cancer rate

What’s Their Secret?

RV Travel Tips for Beginners

Men’sHealth Page 7

TeleCare

Local program connects the elderly and those who feel isolated with friendly voice

Open Letter From a Sexual Abuse Survivor Meet Your Doctor Oneida Healthcare doctor on how the da Vinci system aids in gall bladder and other surgeries

Upstate’s Life Teacher 22-year-old volunteer overcomes limitations one step at a time March 2014 •

• Many Start Testosterone Therapy Without Medical Need Study finds increased testing among men with normal hormone levels

• Circumcision Rate Drops Fewer baby boys in the US are being circumcised while some countries are banning the practice outright. IN GOOD HEALTH – CNY’s Healthcare Newspaper

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ccording to the National Golf Foundation, 29 million Americans play golf. That puts a lot of people outdoors for each game that they play, and if they want to get good at the game they are playing more than one round per year. What many of these golfers may not realize is the increased risk for skin cancer they have by being avid golfers. Skin cancer, according to the Skin Cancer Foundation, is the most common form of cancer in the country, with 2 million people being diagnosed with it each year.

Risks. While many people brush off the idea of skin cancer, assuming it is not dangerous, it is actually one of the three types of cancer that is experiencing an increase in mortality rate for men. Roughly 9,500 people died from skin cancer in 2013.

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Time. The average time to play a round of golf is four hours, putting golfers in the sun for extended periods of time. In fact, the Skin Cancer Foundation reports that professional golfers end up getting an average of 217 times more ultraviolet (UV) radiation than is needed in order to cause a sunburn over the course of a year.

Age. Research shows that the majority of people who are diagnosed with skin cancer are over the age of 40, which also coincides with the typical ages of golfers.

Gender. On average, 78 percent of avid golfers are males, which is another skin cancer factor. The majority of people diagnosed with melanoma are white men over the age of 50.

Action. Rather than forget about playing golf, people can take steps to reduce their risks of getting skin cancer while playing the game. In addition to wearing a wide-brimmed hat and avoiding peak sun times, they can wear sun sleeves, which will protect their arms and hands from the harmful UV rays.

IT’S ONLY SUPER IF YOU TAKE IT. According to the National Institutes of Health, up to 20 percent of patients fail to fill new prescriptions, and 50 percent of people with chronic health conditions discontinue their medication within six months. If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember: If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/ TakeAsDirected.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

When Cats Bite: 1 in 3 Patients Bitten in Hand Hospitalized, Infections Common Middle-aged women most common cat bite victims

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ogs aren’t the only pets who sometimes bite the hands that feed them. Cats do too, and when they strike a hand, can inject bacteria deep into joints and tissue, perfect breeding grounds for infection. Cat bites to the hand are so dangerous, one in three patients with such wounds had to be hospitalized, a Mayo Clinic study covering three years showed. Of those hospitalized, two-thirds needed surgery. Middle-aged women were the most common bite victims, according to the research, published in the Journal of Hand Surgery. Why are cat bites to the hand so dangerous? It’s not that their mouths have more germs than dogs’ mouths — or people’s, for that matter. Actually, it’s all in the fangs. “The dogs’ teeth are blunter, so they don’t tend to penetrate as deeply and they tend to leave a larger wound

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after they bite. The cats’ teeth are sharp and they can penetrate very deeply, they can seed bacteria in the joint and tendon sheaths,” says senior author, Brian Carlsen, a Mayo Clinic plastic surgeon and orthopedic hand surgeon. “It can be just a pinpoint bite mark

that can cause a real problem, because the bacteria get into the tendon sheath or into the joint where they can grow with relative protection from the blood and immune system,” Carlsen adds.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

March 8

Sports Injury prevention symposium The area’s leading sports medicine experts from Crouse Hospital’s sports medicine program will discuss injury prevention and treatment in high school and college student athletes during Crouse’s Winter Sports Med/ Injury Prevention Symposium 2014. The event will take place Saturday, March 8, at the OnCenter – War Memorial in Syracuse. Registration begins at 3:30 p.m., with presentations from 3:45 – 6:15 p.m., followed by complimentary pizza and wings, networking and two free passes for each attendee to that evening’s Syracuse Crunch game against the Rochester Americans. High school and college coaches, trainers, athletic directors and medical professionals are invited to participate. Continuing education credits are available. Dan DiChristina, head team physician at Syracuse Crunch and partner in Orthopedics East, will moderate the program. Space is limited, and registration is requested by calling 315-472-2464.

March 8

Band performance to benefit American Red Cross The Baby Boomers Band will perform a benefit concert at 7 p.m. March 8 at May Memorial Unitarian Church in Syracuse to raise awareness and funds for the American Red Cross of Central New York. The seven-member band performs popular Rock and Roll songs from the 60s, 70s and 80s by artists such as the Beatles, Rolling Stones,

Billy Joel, Eagles, Simon & Garfunkel, Mamas & Papas, Supertramp and other famous acts. The band features two male and two female vocalists, creating a four-part harmony that gives the band its signature sound. All proceeds from the concert benefit the American Red Cross mission of alleviating human suffering. Tickets are $15 and include food and drinks. To reserve a seat, call 315-234-2225, email angelina. morimanno-boungou@redcross.org, or send a check payable to the American Red Cross of Central New York, in care of Benefit Concert, 344 W. Genesee St., Syracuse, 13202.

March 12

Unbiased Medicare workshop held in Auburn Learn about the basics of Medicare at a free workshop to be held from 2 – 4 p.m., Wednesday, March 12 at the basement training room of the Cayuga County Office Building. This session is geared toward Cayuga County residents only who are approaching Medicare enrollment and for those already enrolled who are overwhelmed or confused by the information and the options available. This is not a meeting during which sales efforts will be made, and no insurance vendors will be present; this program will contain unbiased information only. Information included in this program will be: the basics of original Medicare; Medicare Advantage and Medicare Part D prescription coverage; Medicare Preventive benefits; Medicare supplemental insurance and EPIC; costs, co-pays and deductibles; and information about available assistance to help those beneficiaries of a low-income status.

William A. Graber, MD, PC Weight Loss Surgery

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Given by William A. Graber MD, FACS March 11, 2014 at 6:00 PM Medical Office Centre – St. Joseph’s Hospital Campus 104 Union Ave., Suite 809, Syracuse NY Call to register 477-4740 or toll free 877-269-0355 Parking will be validated drgrabermd.com or Visit us at www.facebook.com/dr.graber1 Page 4

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

Registration is required and will be accepted until such time as the seating limit has been met. Additional classes expected in the near future. For more information or to register, please call the Cayuga County Office for the Aging at 315-253-1226.

Alzheimer’s Association announces support group dates

March 12

The Alzheimer’s Association, Central New York Chapter invites local caregivers to join a community of their peers in March and April, by attending a support group. Caregiving for someone with Alzheimer’s disease or another form of dementia can be a stressful endeavor surrounded by anxiety, worry and guilt. Caregivers may feel as if they are alone in their journey. The reality is that a community of their peers exists to support one another. Caregiver support groups promote an open forum of sharing and discussion among people facing many of the same issues. All support groups are free of charge to attend and facilitated by trained individuals. For more information, call 1-800-272-3900 or email cny-programs@alz.org. Upcoming meetings include:

Role of GEM Care to be discussed Emeritus at East Side Manor in Fayetteville will feature physician James Ciaccio, director of GEM Care, affiliated with SUNY Upstate Medical Hospital. Ciaccio will discuss emergency services to those over 65 years at the new GEM Care unit. GEM Care is part of Upstate’s Community Campus Emergency Department and offers a comfortable, quiet, and calming environment especially conducive to seniors. The event will take place at 6 p.m., March 12 at the East Side Manor, 7164 E. Genesee Street. It’s free and open to the pubic. For more information, call For more information, call 315-637-5127

March 17

Seminar discusses frontal lobes and ADHD, autism Andy Lopez-Williams, licensed psychologist and clinical director of ADHD & Autism Psychological Services and Advocacy, will present a lecture on the brain and its impact on neurodevelopmental disorders, such as ADHD and autism. The event will be held from 5:30 – 7 p.m., March 17, at Onondaga Free Library at 4840 W. Seneca Turnpike in Syracuse. Lopez-Williams will explain how the dysfunctions of the frontal lobes create many of the symptoms of ADHD and autism, and what can be done to improve them. Licensed providers, educators and families alike are invited to attend this educational seminar. Andy Lopez-Williams received his PhD from the SUNY Buffalo and completed his residency in psychology at the University of Washington, School of Medicine. He founded ADHD & Autism Psychological Services and Advocacy, and has been assessing and treating neurodevelopmental and neurocognitive disorders for more than 15 years. For registration and more information, contact Angela Verenich by emailing angela@aapsa.net or calling 315-7323431. Visit www.AAPSA.net for more information on the agency.

Oneida County CLINTON Clare Bridge Clinton 115 Brookside Rd. Last Wednesday of the month, 3 p.m. Dianne Mahanna and Laura Wratten: 315-859-1947 March 26 and April 30

Onondaga County BALDWINSVILLE Baldwinsville Methodist Church 17 W. Genesee St. Second Tuesday, 6:30 p.m. Eileen Krupka: 315-638-0814 March 11 and April 8 LIVERPOOL Keepsake Village at Greenpoint 138 Old Liverpool Road Second Saturday, 10 a.m. Florence Felt and Skip Collins: 315-849-2140 March 8 and April 12 MANLIUS Manlius Public Library 1 Arkie Albanese Way Fourth Tuesday, 7 p.m. Claire Duffy: 315-47-1775 March 25 and April 22 continued on page 10

Waste of Money? Editorial in The Annals of Internal Medicine says consumers are just wasting money on multivitamin supplements. Local expert disagrees By Matthew Liptak

well-regarded medical journal took the position in its December issue that spending money on multivitamin and mineral supplements is huge waste of money. That just isn’t so, says Upstate University Hospital registered dietitian Maureen Franklin. “I have a differing opinion,” Franklin said. “I guess when I read the article it came across as in terms of there is no benefit whatsoever to supplements. I think supplements have a value depending on each individual case. I think there are people that possibly need supplementation. That’s something they need to talk to [about] with their medical provider.” The journal, Annals of Internal Medicine, published a blunt editorial titled “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.” It cited three separate studies it said shows that supplements are not helpful in prolonging life, preventing cancer, heart disease and cognitive decline. The editorial concludes stating that “although available evidence does not rule out small benefits or harms or large benefits or harms in a small subgroup of the population, we believe the case is closed — supplementing the diet of well-nourished adults with most mineral of vitamin supplements has no clear benefit and might even be harmful. These vitamins should not be used for chronic disease prevention. Enough is enough.” The editorial has caused controversy and widespread debate. Many think supplements can be helpful. They cite conflicting studies they say show that supplements can be beneficial. Franklin believes taking a multivitamin can be a good thing. She takes one herself. She believes each individual should do the research themselves to make their own decision on taking supplements and also consult their medical provider. “I think we’re looking for quick fixes sometimes or I think we’re looking for something that’s going to improve our health,” she said. “I think

that’s important. They want to improve their health. I just think they need to do the research if they’re going to take a supplement. Why? Because somebody down the street went to take it? Or, do they actually need it?” Franklin cited three supplements that some people might need because they have a deficiency: vitamin B12, vitamin D and calcium. But, she noted, people should get tested by their doctor to see if they actually have a deficiency before buying them. Studies sometimes conflict and sometimes multiple studies need to be done before the truth can come out about a certain supplement, Franklin said. There have been occasions where the medical community advised taking a vitamin or mineral supplement and then that changed. “For a while vitamin E was treated like miracle, heart-healthy type vitamin supplementation so we were recommending that,” she said. “Then there were enough studies that said ‘OK, it’s probably not the best thing that we need to be recommending to people.’” A Gallup poll conducted in December showed that Americans take more supplements as they get older. More than half of Americans aged 50 to 64 take supplements, and that figure climbs to 68 percent if they’re over 65. More adults also take them if they have a higher income. “As people get older they get more concerned in terms of their health and they’re looking at what can I do as far as preventive,” Franklin said. “As we get older we start to think about ‘Well, I’d like to live a little bit longer. I’d like to be able to enjoy my retirement. What can I do to help myself?’” Franklin said people are better off getting vitamins and minerals from what they eat and drink rather than taking supplements. A nutritious diet should be the goal. Some people can’t get the needed amount through food if they have a deficiency so they need supplementation. Getting your nutrition through food also has added benefits like introducing important antioxidants and other nutrients to your diet.

Onondaga, Oswego, Cayuga and Madison Counties A monthly newspaper published by Local in good

Health CNY’s Healthcare Newspaper

News, Inc. Distribution: 35,000 copies. To request home delivery ($15 per year), call 315-342-1182.

In Good Health is published 12 times a year by Local News, Inc. © 2014 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Matthew Liptak, Mike Costanza Advertising: Jasmine Maldonado, Marsha K. Preston, Jim Maxwell, Jean Clarke • Design: Chris Crocker • Office Manager: Laura J. Beckwith

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

Meet

Your Doctor

By Mike Costanza

Nannette M. Dowling, DO Geriatric psychiatrist talks about mental problems linked to aging By Mike Costanza Q. What kinds of psychiatric problems do older adults experience? A. Approximately 20 percent of older adults have a mental illness — and by older, that’s usually 65 and older. One group is that of adults who have been diagnosed with a severe and persistent mental illness early in their lives. Then, there’s a group that experienced the onset of mental illness in their later years, with depression spectrum and anxiety spectrum disorders being the most common. Q. Why might an older adult develop depression or an anxiety disorder? A. There are a number of factors. Many folks who will experience new-onset symptoms do so in relation to the aging process and what I call “stage of life” issues, with loss being a common problem. Death of a spouse is one of the biggest risk factors for depression and anxiety. Also, deaths of loved ones, loss of function, loss of status, retirement, changes in life transition, and in family relationships.

folks are at higher risk for developing depression or anxiety disorders. If they go untreated or unrecognized, those folks have poorer health outcomes. It takes them longer to recover. They have longer hospitalizations. Q. Why is that? A. That’s a great question. I don’t know that we have a clear understanding of why. There are a number of complexities here, and that’s one of the things that appeal to me about geriatrics. It’s so closely involved with medical issues as well as how that impacts our overall health. Q. Could part of the problem be the ways that some older adults view psychiatric problems?

Q. What are some of the other factors? A. With time, there are changes physiologically and biologically that might put some people at greater risk for anxiety and depression. Then, there is the interaction of mental illness and physical illness — diabetes, heart disease cancer etc. And then, there are the social factors. Some of these things are coping with just getting older, dealing with, perhaps, a lot of stigma, or changes in how one feels integrated in their community. Q. You appear to be saying that the body and mind are linked in some important way. A. Inextricably linked. This has been well studied in the literature. We know, for example, that many folks who have had a heart attack are at greater risk for or have higher rates of depression. There’s a higher percentage of folks that have a myocardial infarction — a heart attack — that go on to develop depression. Stroke—those Page 6

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

A. Culturally, older folks have barriers to seeking treatment — a stigma against going to a psychiatrist, for example. It results in denial, as well as a reluctance to self-refer. It also leads to an inability to even recognize the need for help. There isn’t a context or necessarily an awareness of changes. Problems with sleep, lack of energy, tearfulness, difficulty with attention and concentration, you might not associate them with having depression, yet these are hallmark signs. When a number of them are present, they [seniors] may not have the language and the context to understand that that’s something else that could be treated. Q. Can older adults depend upon their health care providers to detect and treat such problems? A. Most older folks that have mental health issues are treated in a primary care setting. My argument is these issues are unique, and it may take a deeper understanding in order to flesh things out. Mental health problems in older folks are under-recognized, as well as undertreated. Q. Can you give us an example of how these issues are unique? A. The unique issues of biological changes, which influence treatment in a variety of ways — medication, for example. Older folks in general have more medical co-morbidities. They’re also on more medications, like for hypertension and diabetes, though the major ones are for pain, arthritis and chronic pain. How the body metabolizes medications as we get older changes, so folks are more prone to side effects, and might have more negative experiences. Q. Is ageism part of the problem? A. Ageism, for me as a doctor, is rampant. I work with medical students or even residents and my colleagues comment, like, “Well, of course that person is depressed — they’re 80 years old.” Or, folks chalk it up to that the person is demented or senile, when that’s not the case. They could have a number of things that could give the appearance of impairment. Depression is not a part of normal aging. Q. Can you tell us of some of the ways we can deal with such problems in treatment settings? A. Having geriatric psychiatrists or geriatric sub specialists in with primary care physicians to offer what I like to call it “onestop shopping,” to provide a full continuum of care. We will have about 15 million adults within the next 15 years living with a major mental illness. If that goes under-recognized and undertreated, they decline much more rapidly and they are more likely to develop other issues like heart disease or cognitive decline. Many of these issues are preventable if you address them earlier, get folks involved with coun-

seling and specific types of therapy, which have been demonstrated to be very successful in older folks. Many times, it’s the talk therapies that are most effective in working with older adults, because of medication side effects. Folks don’t want to be on another medication. If there’s another way of treating this or addressing it, that’s their preferred choice. Q. You have mentioned a new program at the Rodney and Marjorie Fink Institute at Menorah Park for Applied Research on Aging, where you are research director, that might help address the mental health issues that some senior citizens face. Could you tell us about that? A. We’ve just initiated a program called “PEARLS,” which is a program that was developed at the University of Washington. People are screened for depression, If they are screened positive, then we are sending counselors and interns into their homes, or where they reside, every week to do a problem-solving therapy, which is an activating therapy that encourages folks to be more independent in their own problem-solving. In the process of doing that, their depression scores actually improve. It’s preventive, but it’s also an early intervention. That’s critical juncture in the aging process. People might be on a trajectory to just rapidly decline, or we can intervene early and make a huge difference if they’re facing change-oflife stage issues. Q. Why did you decide to focus upon geriatric psychiatry? A. I’ve always been drawn to working with older folks. I was born in a small rural community in Montana. The common model there is close knit families, and grandparents are often involved. There’s an ease in talking with folks as well, a respect for the wisdom of the years. That influenced me tremendously. I also had a very close relationship with my grandparents. It was mutual interest—I was interested in them and they took an interest in my upbringing and education. Q. What keeps you coming to the office day after day? A. I love being a physician. There’s such a great need for improved geriatric care, and…it’s very gratifying in many ways to be able to hopefully help people get better and improve their quality of life. It’s fascinating, it’s challenging, and yet it’s rewarding on multiple levels.

Lifelines: Current Positions: Assistant professor of psychiatry and behavioral sciences, SUNY Upstate Medical University, Syracuse; research director, Rodney and Marjorie Fink Institute at Menorah Park for Applied Research on Aging, Syracuse. Education: BS, psychology; BS, biology and genetics; MHPA, health policy and administration, Washington State University, Wash.; DO, (Doctor of Osteopathy) Touro University College of Osteopathic Medicine, Vallejo, Calif. Residencies/Internships: Psychiatry residency, SUNY Upstate Medical University; Fellowship, geriatric psychiatry, Columbia University, New York. Personal: Born in Montana, lives in Cazenovia. Enjoys spending time with family and friends, playing basketball, backpacking, backcountry skiing, birding and cycling.

Smart Contact Lenses May Help Diabetics New lenses being developed will measure blood glucose level continuously By Deborah Jeanne Sergeant

hat if measuring blood glucose level were as easy as wearing a pair of contact

lenses? That’s the goal of GoogleX researchers. The company behind Google Glass are now an estimated five years away from launching (with FDA approval) “smart” contact lenses that can measure blood glucose level based upon the user’s tears. Brian Otis and Babak Parviz, project co-founders, announced their ambitious project via the Google blog Puskas Jan. 16. They could be onto something big, thinks Gerianne Puskas, a regional director for the American Diabetes Association. “I think that diabetics are always looking for a better method of tracking their blood sugar,” she said. “It’s im-

portant we have more research to help. If I had to prick my finger several times a day, I’d want something better, too.” Without accurate glucose levels, diabetics can experience any of a host of life- and function-threatening health crises. Many current monitors reflect a 30-minute delayed reaction because it takes that long for the glucose to travel to other fluids of the body. Continuous glucose monitors require an electrode inserted under the skin and frequent recalibration via finger sticks. Many patients still must prick themselves a few times per day. But if GoogleX’s contacts work, the lenses would offer a less invasive solution. Otis and Parviz describe the sensors embedded in the lenses as looking like “bits of glitter, and an antenna thinner than a human hair.” Most ordinary contact lenses have the manufacturer’s name printed on it. The print is invisible while the lens is worn. Novelty contact lenses with visible colors and patterns have been available for years, so it’s easy to imag-

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ine successfully embedding sensors. Currently, Otis and Parviz’s prototypes generates one reading per second. “We’re also investigating the potential for this to serve as an early warning for the wearer, so we’re exploring integrating tiny LED lights that could light up to indicate that glucose levels have crossed above or below certain thresholds,” their blog entry stated. “It’s still early days for this technology, but we’ve completed multiple clinical research studies which are helping to refine our prototype. We hope this could someday lead to a new way for people with diabetes to manage their disease.” The two are also discussing the forthcoming technology with the Food & Drug Administration. Before the

product can go to market, the FDA must approve it. The researchers will also need to develop apps that will show the lens’ readings to patients and their doctors via smart phone or some other type of display. Along with his doctor’s input, a diabetic would have to be both comfortable with wearing a contact lens and with the technology necessary to display its readings. “It’s going to be right for some people, but not other people,” Puskas said. “As long as people work very closely with their doctor to find the right device, that’s what’s important.” She is excited about the possibility of the contact lens and the other devices on the horizon listed at www. diabetesforecast.org.

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March 2014 •

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Page 7

My Turn

By Eva Briggs

The Hepatitis C Virus

n October 2013, New York state passed a law that requires emergency care and primary care providers to offer a screening blood test for hepatitis C to all patients born between 1945 and 1965. The need for such a law stems from several factors. First, there is the scope of the problem. Three quarters of all people infected with hepatitis C virus (HCV) are unaware of their infection. And 75 percent of hepatitis C infections occur in baby boomers born between 1945 and 1965. That translates to about 150,000 people in New York state living with an undiagnosed hepatitis C infection. HCV is transmitted by blood contamination, most often by IV drug use. The initial infection usually causes no symptoms. Only 15 percent of patients develop acute symptoms such as decreased appetite, fatigue, nausea, muscle or joint pains that resolve spontaneously. Usually these symptoms are sufficiently mild and vague that the diagnosis of hepatitis C isn’t made. Acute

hepatitis C rarely causes jaundice or liver failure and there is no preventive vaccine. The majority of infected patients become chronically infected with hepatitis C. They may go years without symptoms, but eventually progress to cirrhosis and, in some patients, liver cancer. Hepatitis C is the most common reason for liver transplantation. A second reason the new law was passed is the development and availability of a rapid screening test for hepatitis C. This test allows screening from a finger stick or a venous blood draw and provides results in 20 minutes. Because it is a screening test, all positive tests must be confirmed with additional blood testing. A third reason that screening for hepatitis C is useful is the availability of effective treatments. Standard treatment combines interferon, ribavirin and possibly a third drug called a protease inhibitor; the correct combination depends on which subtype of hepatitis C is causing an individual’s infection.

Interferon is a naturally occurring substance that stimulates the immune system to fight infection. Scientists learned to synthesize interferon in the 1980s. Man-made interferon, combined with another molecule (pegylation) to make it stay in the body longer. Pegylated interferon not only must be administered via weekly injection, it can cause many side effects. Adverse reactions include flu-like symptoms, anemia, low white blood cells (which fight infection) low platelets (needed for blood coagulation) and psychiatric symptoms (depression and moodiness.) Ribavirin is a type of medicine called a nucleoside analog and is taken by mouth. It’s exact mechanism of action remains unknown, and it’s not effective against hepatitis C when used alone. But combined with pegylated interferon, it boosts cure rates. Protease inhibitors block an important step in the reproduction of the hepatitis C virus. The virus replicates itself by first making longer strands of RNA, its genetic material, and then using proteases to snip out the unnecessary bits. The two protease inhibitors available until now, boceprevir (Victrelis) and teleprevir (Incivek), have many side effects. Recently a new oral protease inhibitor has been approved. Simeprevir (Olysio) has the advantage of being dosed once a day rather than two or three times daily, has fewer side

effects, and fewer interactions with other drugs. But it is effective only against some of the strains of HCV. It is also a sulfonamide and can’t be used in patients who have had a life-threatening allergic reaction to other sulfonamides. Another new drug, sofosbivir (Sovaldi), is a polymerase inhibitor that blocks different enzymes the virus used to reproduce itself. Sofosbuvir combined with ribavirin, the first oral-only regimen, is effective against HCV genotypes 2 and 3. Not only does this regimen avoid injections, it’s better tolerated and of shorter duration than treatments with protease inhibitors. It does cost more ($84,000 for 12 weeks vs. $40,000 -$70,00 for a course of a protease inhibitor). More new drugs for HCV are under development, meaning future treatment for HCV should become easier and more tolerable.

Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

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xcellus BlueCross Blue Shield in February launched a community engagement campaign that encourages people to take their medications as directed by their health care providers. The campaign was introduced at a press conference attended and supported by representatives from the Onondaga County Health Department and the Onondaga County Medical Society. “The number of people who don’t take medications as prescribed by their health care providers is astounding,” said physician Arthur Vercillo, regional president, Excellus BlueCross BlueShield. The American Heart Association estimates that as many as three out of four Americans don’t take their medication as directed. “Failing to take medications as they are intended can exacerbate health conditions, increase the chances of being hospitalized, cause health care costs to skyrocket and even lead to death,” continued Vercillo. Poor medication adherence annually claims the lives of 125,000 Americans and costs the health care system nearly $300 billion, according to the American Heart Association. The centerpiece of the Excellus BlueCross BlueShield campaign is a stylized prescription bottle called TAD (for “Take As Directed”). It appears as a superhero in ads, billboards and posters that convey simple messages

about the importance of medication adherence. “When it comes to fighting chronic conditions, a prescription drug can be a superhero, but it only works if patients let it,” explained Vercillo. A key message of the campaign is, ‘If you’re not taking your prescriptions as directed, you’re taking a chance.’ “Physicians work in partnership with their patients. When medication is indicated, we trust that the patient will fill the prescription and take the medication as instructed,” said physician David Halleran, president of the Onondaga County Medical Society. “It’s important for patients to discuss with their physicians any barriers they may encounter.” Cynthia Morrow, commissioner of health, Onondaga County Health Department, notes that people offer a variety of reasons, ranging from ‘I forgot’ to ‘It’s too expensive,’ for not taking their medication as directed. “If you have any problems taking your medicine as prescribed, talk to your doctor,” she said. “Together, you can solve any medication-related problem.” The public education campaign highlights a website, ExcellusBCBS. com/TakeAsDirected, which offers information and suggestions on ways to overcome any barriers to taking medications as directed. The website is free and open to the public. Join the conversation on Twitter using hashtag #TakeAsDirected.

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ometimes all you need is a reminder and a little friendly conversation to brighten your day. That is what Contact Community Services offers aging and disabled Central New Yorkers with its unique and free TeleCare program. “It’s designed to reach out to vulnerable individuals in the community,” said Cheryl Giarrusso, the organization’s telephone and Web services director. “They might be isolated and they have no supports in the form of friends or family or neighbors. It’s primarily for the elderly and people with disabilities. We just give them a friendly phone call either daily or at whatever interval they request. We also do medication reminders.” Calls can last from a quick two-minute medication reminder to a 15-minute conversation to check up on how the recipient’s day is going. The call can be a help to families who may be concerned about a loved one who is on their own. It is often something to which the recipient looks forward. “Frankly I think there are some folks in the demographic that we serve in this program who really feel they want someone to touch base with them daily in the event that something happened,” Giarrusso said. “They don’t want to be left alone without a support. It’s really very reassuring that someone will be checking on this person on a daily basis in the event that something happens and they are unable to get help.” TeleCare started in 2011 and currently serves 12 clients, but it is looking to grow. Contact Community Services started out in 1971 as a 24-hour telephone hotline, serving those in crisis or who needed some counseling. According to program officials, the service is going strong and has expanded to include referral and other services. “This was our foray into calling out,” Giarrusso said. “We’ve never called out before. This is our very first effort at calling out and it’s been a real success.” Fifteen part-time staff members participate in the program, said Michele Anson, the organization’s crisis intervention services program manager. They often have mental health backgrounds and do at least 45 hours of training in the reflective listening model. “It’s nondirective and it’s nonjudgmental,” Giarrusso said of the model. “We’re not looking to give them advice. We’re not looking to tell them how we feel about whatever is on their minds. We’re just looking to help them to know that we understand. We want to communicate our understanding and we want to communicate our care, compassion and concern. We want to let them know that we’re very interested in what they have to say. We’re not making any judgments and we’re not going to tell them yes, no, maybe or give them advice about what to do. We’re there just to listen to what it is that’s important to them on that day.” TeleCare is not funded directly,

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East Side Acupuncture Michele Anson though it did receive a $1,000 grant in 2013 from Excellus BlueCross BlueShield to promote the program. The costs of the program are absorbed into the larger budget of the organization, Anson said. Family members of TeleCare recipients and the clients themselves have given positive feedback. One even brought in a plate of cookies this past Christmas to thank the employees. It was a thrill for both the caller and client to actually meet the person on the other end of the line, Giarrusso said. Usually though the caller and client don’t meet, but that doesn’t mean the appreciation isn’t there. Florence Saleh enlisted the program to help her father when she and her husband weren’t available to help him. “TeleCare calls to tell him that it is time to take his pill,” Saleh said. “Since he knows his call is coming he prepares himself by having what he needs at hand and looks forward to the ring of the phone. Beyond the importance of the pill reminder, the call has become an important part of his day, giving him some additional structure and responsibility to the otherwise free flow of time that the elderly can experience.” TeleCare is aptly named. It’s a call of comfort at a time when many find they are living a life of increasing isolation. It’s a reminder to them that they are not forgotten. “I think the biggest thing we want them to come away with is the feeling in a sense that they matter and that they’re important to us.” Anson said. “We do that by building that relationship and by using that model, validating them, letting them feel heard. That’s really what our goal is, just to foster a healthy emotional support and let them feel like they’re part of something. They love to hear that voice on the other end of the line. It’s just that human connection. It just enriches their life. That’s what we want—enrichment.”

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More on TeleCare? For more information on the TeleCare program call Contact Community Services at 315-251-1400, extensions 110 or 116.

March 2014 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

Live Alone & Thrive

Alzheimer’s Association announces support group dates

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

‘Beware the Ides of March’ . . . or not! N

o thanks to Shakespeare, the month of March has gotten a bad rap. Sure, it’s cold, it’s gray, it’s damp. But it need not be death knell of your contentment. If the month of March is stretching out in front of you as a big, dreary void to fill, you are not alone. For many, our winter wonderland is not so wonderful when cabin fever sets in. That’s when anxiety can make an unwelcome visit. You might feel yourself spiraling down, questioning the past and second-guessing your decisions. And that’s when you could be tempted to grab for the TV remote, a bag of cookies and head for the couch — or worse — for bed. Sounds familiar? I can remember many nights after my divorce, coming home after work to an empty apartment with hours on my hands and a heavy heart. The prospect of a long, lonely evening ahead was almost unbearable. I was fine during the day, but when the sun started to set or the weekend rolled around, I would start to panic. I was also fine when I was busy or in the company of friends or family. It was that uncomfortable time alone — when I was all by myself at home — that tested my resolve. After way too many nights on the couch watching mind-numbing reruns, I had finally had enough and started making better use of my “me time.” I am now thoroughly comfortable spending time by myself and have come to enjoy my own company. In fact, it’s not unusual for me to pass on an invitation out, in favor of spending a nice quiet evening at home — relaxing or fully engaged in something I love to do. If you’re challenged by time alone this time of year, consider the suggestions below. You might even clip this column and put it on your refrigerator as a handy reminder. Read. In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely evening. Don’t know where to start? Ask a friend for a suggestion or select a book from The New York Times’ best- seller list. Snuggle up in a comfy, well-lit place and let a good book introduce you to new people, new places, and new ideas. We are never alone when reading. Write. Marcel Proust wrote, “We are healed of a suffering only by expressing it to the full.” Even if you never look back at what you write, the act of committing thoughts and feelings to paper is therapeutic. Consider starting a journal, if you haven’t already done so. A few minutes in the evening or on the weekend is a perfect time to write. As you work through some of the issues associated with living alone, and you become more content, you will find that reading and rereading your journal entries will be a great way to see how

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much progress you are making. Clear Out The Clutter. I know this might sound silly, but clearing out the clutter can be very satisfying and a great way to spend a few hours alone. I spent one recent Tuesday night sorting out my closet and filling two bags for Volunteers of America. It felt terrific. I not only lightened my load, I did something for a good cause. As a result, I felt part of something bigger than myself and less alone. Pursue a passion. This can sound daunting, especially if you’ve yet to identify your passion, but hang in there. Many men and women in long-term relationships often sacrifice their own interests in favor of attending to the needs of others. The pursuit of your own passions can be lost in the process. Now’s a good time to rediscover your “loves” and to dedicate your time alone to those pursuits. Do some digging and identify the things you loved as a child or young adult and make a conscious decision to pursue them now. Evenings or weekends spent doing what you love can be very fulfilling. Loneliness can dissipate and you can feel alive again. Reach Out. With time on your hands, you are in a great position to reach out and make connections

from page 4 NORTH SYRACUSE Andrews Memorial Church 106 Church St. 3rd Tuesday, 1 p.m. Mary Ann Laubacher: 315-450-4431 March 18 and April 15

with others, especially with long, lost friends. This can be a very meaningful way to spend an evening. Just yesterday, I received a hand-written note from a friend I hadn’t seen in a while. I was very touched and inspired to do likewise with my own old friends. Pick up the phone, send an email or send a “snail mail” note to someone with whom you’ve lost touch. “Veg out.” That’s right, veg out. Grab the TV remote, a bag of cookies, and head for the couch — or better — for bed. Again, sound familiar? But this time, do it without guilt, do it without beating yourself up. Everyone is entitled to an occasional night when they just hang out, do nothing and eat junk food. Indulge yourself and tell yourself you deserve it. Wake up the next morning — free of remorse — and ready to take on the day: alone at home and “at home” with yourself, even in the ides of March. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops or to invite Gwenn to speak, call (585) 624-7887 or e-mail: gvoelckers@rochester.rr.com.

SYRACUSE The Hearth on James 830 James St. First and third Thursday, 1 p.m. Chapter Staff: 315-472-4201 March 6 and 20, and April 3 and 17 THE CENTERS AT ST. CAMILLUS 813 Fay Rd. Third Tuesday, 5:30 p.m. Ellen Somers: 315-488-2951 x406 March 18 and April 15 SYRACUSE V.A. HOSPITAL 800 Irving Ave. First and third Wednesday, 1 p.m. Louise Choroser and Eileen Welch: 315425-4400 March 5 and 19, and April 2 and 16

Oswego County CENTRAL SQUARE Divine Mercy Parish Center (St. Michael’s) 592 S. Main St. Fourth Monday, 7 p.m. Gail Lauricella: 315-676-7533 March 24 and April 28 OSWEGO The Manor at Seneca Hill 20 Manor Dr. Fourth Wednesday, 7 p.m. Dianne Morrisette: 315-349-5341 March 26 and April 23

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SmartBites

By Anne Palumbo

The skinny on healthy eating

Bowled Over by Barley

ntil I jumped on the whole-grain bandwagon a few years back, I never gave barley a second thought. Heck, I didn’t even know it was a whole grain. As far as I was concerned, it was a squishy white thing floating around in my canned soup. But knowledge is a beautiful thing, and now I can’t get enough of this tasty stuff. Barley, like other whole grains that have their nutrient-rich kernels intact, bursts with documented health benefits. Studies show that eating whole grains helps to lower the risk of many chronic diseases, such as diabetes, heart disease, and those associated with high blood pressure. While benefits are most pronounced with at least three servings daily, some studies show reduced risks from as little as one. On the fiber front, barley takes top billing among grains, delivering more fiber per serving than any other whole grain (one cup provides about a fourth of our daily needs). Fiber keeps us regular, helps with weight mainte-

nance by promoting a full feeling and stabilizes blood sugars. It also helps to lower blood cholesterol levels by ferrying cholesterol-containing bile out of bodies, a benefit that reigns supreme for those concerned about cholesterol. Of course, barley’s high fiber content is just the tip of the nutritious iceberg. Whole grain barley brims with antioxidants — powerful compounds that mop up free radicals linked to a host of age-related diseases. It’s also a good source of niacin, an important B vitamin that helps convert food to energy, and an excellent source of manganese, a mineral that is essential to healthy metabolism and the formation of connective tissue, cartilage and bone. A toothsome grain with a slightly nutty flavor, barley is naturally low in

fat, sodium and cholesterol, clocks in at only 190 calories per cooked cup, and even serves up some protein: 4 grams.

Helpful tips If possible, buy hulled barley over pearl barley. Although pearl barley still boasts many health benefits, it has been polished or “pearled” of its outermost layer, has fewer nutrients than the hulled version, and is not considered a whole grain. Nonetheless, pearl barley, like its hulled sister, teems with fiber because the fiber in barley is distributed throughout the entire kernel.

Lemon Barley Pilaf with Pesto Adapted from Bon Appetit Serves 4 1 tablespoon olive oil 1 medium onion, chopped ¾ cup barley 2 cups low-salt chicken broth 1 large carrot, peeled and chopped 1 red bell pepper, chopped 2 cups kale (chopped) or baby spinach 2 tablespoons pesto 1 teaspoon grated lemon peel Salt and pepper to taste Heat olive oil in heavy medium saucepan over medium heat. Add

onion; sprinkle with a little salt and pepper. Sauté until onion is beginning to soften, about 5 minutes. Add barley; cook 3 minutes, stirring constantly. Add chicken broth and bring to boil. Reduce heat to low, stir once, and cover. Cook until barley is almost tender, about 30 minutes for pearl barley and 45 minutes for hulled. Add carrot, bell pepper, and kale; cover and cook until vegetables are tender, about 8 minutes. Remove pilaf from heat and stir in pesto. Cover and let stand 10 minutes. Season to taste with salt and pepper. Stir in lemon peel and serve. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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Page 11

Paige Larioni, Upstate’s Life Teacher 22-year-old volunteer overcomes limitations one step at a time

By Matthew Liptak

aige Larioni takes life one smile at a time. She gives them out generously to almost everybody she meets during her rounds as one of Upstate University Hospital’s dedicated volunteers. She overcomes the limitations put on her by a rare condition called lissencephaly one step at a time. “I wouldn’t trade it for anything,” said Paige’s mom, Lisa Larioni. “When she was diagnosed at 7 months old I remember looking at my husband and saying, ‘We were given Paige. Paige was given to all of us.’ He was like ‘What do you mean, given to all of us?’ I just remember saying ‘She’s going to be here to teach each and every one of us how to appreciate life.’” Lissencephaly literally means “smooth brain.” It is a gene-linked malformation characterized by an absence of folds in the cerebral cortex. It develops in the embryo during pregnancy. Symptoms of the disorder are pronounced in Paige. The 22-year-old has the cognitive ability of an 18-monthold. She has spastic quadriplegia, the most severe form of cerebral palsy. She is deaf, nonverbal and has a seizure disorder. She has gastrointestinal problems and has been hospitalized multiple times. Her condition may have drastically changed what her life path might have been had she not had lissencephaly, but Paige’s personality shines through the barriers of her daily life. “She is appreciative of everything, thankful for everything,” her mom said. “Paige is wonderful,” said Rhonda Butler, Upstate’s manager of volunteer services. “She is so cute and friendly and smiling. She always has this positive energy. She loves being with the people. If it’s a chance to deliver flowers or balloons she’s there. She loves being in the hospital and she’s truly developed over the time she’s been here.” Paige has use of some sign language and understands more signs than she can do herself because of her motor problems. Thankfully, because of two orthopedic surgeries Paige can walk independently for periods with leg braces. She has put them to good use. With her mentor, Karen Mcclenthan, another 22-year-old, she has put in 545 volunteer hours since July of 2010. Mc-

Paige Larioni, left, with Karen Mcclenthan, a friend and mentor. “You can’t be around Paige and not feel inspired,” Mcclenthan said. “Inspired to do better, to be better, to help someone in need, or even just inspired to appreciate all that you have and all that life has given you. clenthan takes care of Paige’s physical needs and facilitates communication between Paige and others. She is also her friend. “She is so awesome,” Mcclenthan said. “She has become so independent, especially at her job at Upstate. She thinks she owns the place. I have been able to watch her overcome so many challenges and do it so whole-heartedly. She is the epitome of hard work. She has made me appreciate life’s smallest moments, the ones that are so easy to overlook.” “There really isn’t anything that Paige doesn’t do,” her mom, Lisa Larioni said. “This’ll be her second year now with Special Olympics. She’s going to participate in the 5K run on May 4—the Rad Race. She has a Facebook and if anybody ever goes on her Facebook and asks to be her friend you can see her whole world on there—her whole entire world. At Gigi’s Playhouse she does fundraising. She does cookie baking for Saint Lucy’s. She’s involved in an organization called Cookies for a Cause with Advocates. She was helping at Helping Hounds, but she wanted to bring every puppy

than looks past her lissencephaly and sees her as a normal 22-year-old girl. “Strong. Funny. Genuine. Stylish. Loving. Paige is so much more than a diagnosis,” Mcclenthan said. Her friend and mentor called Paige a fashionista with intelligence beyond her years. Paige is a girly-girl who likes to get her nails done every two weeks. The two shop together and Mcclenthan gives Paige her views on her outfit choices. And Paige has plans. She is currently going to a facilitated communication program at Syracuse University, where she is learning to type. These half-hour session with the staff often ends up being an hour because Paige is so devoted to her work. Mcclenthan said Paige will be going to the university next semester, entering a pilot program that offers education to those with disabilities. She will be SU’s newest coed. Paige is sure to bring even more smiles to campus where she will teach her fellow students and faculty about life. “You can’t be around Paige and not feel inspired,” Mcclenthan said. “Inspired to do better, to be better, to help someone in need, or even just inspired to appreciate all that you have and all that life has given you. She has a way of altering perspectives. Even the worst of days is a good day with Paige.”

home so we had to stop that.” Larioni gives much of the credit of Paige’s full life to her service agency Advocates Inc. She called them her family. They were the ones responsible for connecting Paige with Mcclenthan. Paige also has another facilitator, Aimee Hammond, who works with her on alternate days of the week. Communication for Paige is made easier through technology like the use of an iPad. Mcclenthan said that working with Paige has taught her that language is more than just verbal. “Conversation isn’t always verbal,” Mcclenthan said. “Conversations can start and end at the heart. Learning how to communicate with Paige, through the use of sign language, computers, iPads, iPods, has been something that has opened my eyes and allowed me to look deeper into Paige and who she really Paige sits in front for a picture while brother Gregory, is.” mother Lisa and father Greg (left to right) pose in the So who is Paige? Mcclen- background.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

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New pulmonary health center opens in Syracuse

WOMEN’S ISSUES Don’t miss the April edition of In Good Health—CNY’s Healthcare Newspaper. Call 315-342-1182 to advertise.

Healthy You Wellness Center is first of its kind in the region

ulmonary Health Physicians, PC, Kinney Drugs, and Franciscan Companies, an affiliate of St. Joseph’s Hospital Health Center, observed the opening of the Healthy You Wellness Center Feb. 10, at the new center, located inside the Kinney Drug Store at 104 Lafayette Road in Syracuse. Healthy You Wellness Center is the first of its kind in New York state. Patients with a sudden onset of a pulmonary problem or who need follow-up after being discharged from the hospital no longer need to wait for a doctor’s appointment or go to the emergency room. “Healthy You is positioned to allow patients timely, convenient access to pulmonary health professionals who will assist and support them, offer education, and manage their respiratory condition to improve or maintain their quality of life and help to decrease or eliminate the burdens of their disease,” said physician Thomas Aiello, pulmonologist with Pulmonary Health Physicians, PC. Staffed by specialists from Pulmonary Health Physicians, PC, the Healthy You Wellness Center will focus on patient care for respiratory disease management. Services include assessment, treatment and management for chronic conditions such as COPD, emphysema, bronchitis and asthma, as well as additional preventive health services such as the common cough and cold, flu, allergies and sinus infections. “Access to convenient and affordable health care is a growing concern for the communities that we serve. We expect this problem to only worsen as millions of more patients gain medical coverage under the Affordable Care Act without a corresponding increase of medical providers available to treat them,” said Mike Duteau, vice president of business development and strategic relations for Kinney Drugs. “The Healthy You Wellness Center at Kinney Drugs is a collaborative effort designed to address the need for greater access to affordable health services in the Syracuse market, bridging the gaps in care coordination among healthcare providers and ultimately resulting in improved patient health outcomes.” As part of this initiative, Kinney’s

and Franciscan are stocking respiratory/pulmonary-related medical equipment and supplies in the store including nebulizers, CPAP equipment and other popular items. In addition, Franciscan respiratory therapists and nurses will conduct educational seminars and screenings on-site, with a focus on disease prevention and education. The goal is to advance patients knowledge on topics such as flu prevention, smoking cessation and proper use of prescription inhalers. “We are excited to offer this multi-disciplinary approach to healthcare with nurse practitioners, pharmacists, respiratory therapists, and physician pulmonologists,” said Frank L. Smith, Jr., president and CEO of Franciscan Companies. “Together, we are advancing patient care in the community with convenient access to an advanced level of care. We want patients to live home and live well, and Healthy You accomplishes that.”

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Page 13

St. Joe’s doc pens article on robotics in the cath lab

WOMEN’S ISSUES Don’t miss the April edition of In Good Health—CNY’s Healthcare Newspaper. Call 315-342-1182 to advertise.

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Physician Michael Jorolemon.

ER care at Crouse highlighted in new book Crouse Hospital’s ongoing efforts to improve efficiencies and effectiveness of patient care in its emergency department are highlighted in the very first edition of the American College of Emergency Physicians’ “Emergency Department Management” textbook, just published by McGraw Hill. Crouse’s focus on living the hospital’s mission, vision, values and culture is showcased in the book as one of two national case studies contained in the leadership and strategic planning chapter of the book. “It validates the work our entire team has been engaged in for more than three years to improve the overall experience of patients who come through our emergency services department,” said Michael Jorolemon, a physician, who serves as senior quality officer for emergency medicine. Crouse’s door-to-provider times are the lowest in Central New York, and among the lowest in the U.S.

St. Joseph’s Hospital Health Center’s Ronald P. Caputo, interventional cardiologist and medical director for the interventional cardiology service line, recently authored an article about the CorPath System for Cardiovascular News. The CorPath System is the first and only FDA 510(k) cleared robotic-assisted technology to aid interventional cardiologists in placing stents and balloons in patients with coronary artery disease (CAD). Developed by Corindus Vascular Robotics, CorPath is designed to enhance coronary angioplasty procedures with added precision and accuracy. St. Joseph’s is the first hospital offering robotic-assisted angioplasties outside metro New York City.

Ronald P. Caputo, interventional cardiologist

12/19/2013 12:03:37 PM

AUBURN COMMUNITY HOSPITAL 2013 ACHEIVEMENTS

providing another year of

Quality Community healthCare

VA CLINIC-We are proud to continue our service to local veterans through our contract renewal with the Veterans Administration to maintain a primary care clinic. Our VA clinic now offers telemedicine for a broad array of specialty services for our veterans. Their care is now kept close to home. LABORATORY- Joint Commission has re-accredited the laboratory. This accreditation assures you that we meet high quality standards. NEW PHYSICIANS-We welcomed 48 new active and courtesy practitioners to the medical staff in 2013. Our dedication to bringing you a highly qualified medical staff is a continual process. PRIVATE PATIENT ROOMS-We have converted many of our patient rooms into private rooms to enhance your comfort and care while you are with us.

CPOE, COMPUTERIZED PHYSICIAN ORDER ENTRY- A state-of-the-art CPOE information technology system has been implemented in order to ensure patient safety. Physician orders are now placed electronically. NEW EMERGENT AND URGENT CARE PROVIDERS-Eastern Fingerlakes Medical Care has assumed the medical leadership of our Emergency Room and our two Urgent care centers. This group of ER physicians and assistants is comprised of experienced and dedicated providers who live and practice in our community. URGENT CARE HOURS-You asked for longer hours and we listened. Both Auburn and Skaneateles urgent care facilities new hours are Monday thru Friday 8:00am-8:00pm and weekends 8:00am-6:00pm.

THE PATIENT EXPERIENCE INITIATIVE Quality Assurance has begun a new initiative to continually improve the quality of your stay.

NEW OB/GYN OFFICE IN SENECA FALLS-Auburn Obstetrics and Gynecology is offering their great care to women in Seneca Falls at their new location, 24 Main Street in Seneca Falls.

STATE-OF-THE-ART CT SCANNER-The newest technology is now available to you at Auburn Community Hospital now giving the highest quality images available to aid in diagnosis and treatment of illness. Due to the community’s need, Saturday hours have been added for CT and MRI scans along with general Radiology exams.

ONGOING COMMUNITY OUTREACH PROGRAMS-We continue to educate our community through programs such as, Medically Speaking, Women’s Health Institute, Heart Expo and the patient education module on our website, www.auburnhospital.org.

www.auburnhospital.org Page 14

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

Open Letter From a Sexual Abuse Survivor By Jennifer Nadler to work through, though the number is far greater than five. Working through each stage of healing was excruciating. At times it felt daunting. At times it felt unbearable. At times it felt impossible. But I did not do it alone. It would take two in-patient psychiatric hospital stays, one top-notch psychologist with the patience of a saint, one talented and compassionate peer counselor, a group of three unforgettable women with unforgettable pasts like mine, the unconditional love and unwavering support of my husband and three long, grueling, arduous years of heavy labor to put the pieces of my life back together. And today, 24 years later, there is no more sorrow in my heart and no more silence from my lips. Twentyfour years later, I am nothing but proud to say that I am a professor, a wife, a mother and, yes, a sexual abuse survivor. I no longer focus on the words sexual abuse. I focus on the word survivor.

am a professor I am a wife. I am a mother. And I am a sexual abuse survivor. It has taken 24 years to be able to say this without embarrassment or shame, without guilt or regret, without fear or self-loathing. It has been 24 years too long. The truth may be ugly. The truth may be hurtful. The truth may be devastating. But the truth is the truth. Today, I speak my truth. Over and over I was sexually abused by a family member when I was 12 and 13 years old. I did not tell. I could not tell. I would not tell a soul. Frequently, children don’t tell. They believe it is their fault. I believed it was mine. I carried around a suitcase full of guilt and shame. And with every passing year, that suitcase became heavier and heavier. In my mid-20s, I was no longer able to lug that thing around. My suitcase was bursting at the seams, and so was my life. Bit by bit, my life unraveled, until there was nothing left of me but that scared, ashamed, broken little 12-year-old girl. Each survivor has his or her way of dealing with the trauma and emotional pain of sexual abuse. For some, it’s drugs. For others, it’s gambling. And for some it may be an eating disorder. For me, it was drinking and binge eating, among several other destructive behaviors that got me through my darkest of days. It’s what we do. It’s the way we cope. It’s how we survive. The abuse only lasted two years, but I have spent the past 24 trying to clean up the mess my relative made. I would be lying if I said that there aren’t still times, in the dark and quiet stillness of the night, that I feel as though I

Jennifer Nadler was sexually abused by a relative when she was a kid. She will discuss sexual abuse at 7 p.m., April 2 at Le Moyne College. will never be clean enough. The effects of sexual abuse are devastating and can last a lifetime. It is hard to undo the damage of what has already been done. It is hard. But it is not impossible. When someone dies, the loved one’s survivors have to work through what’s known as “the five stages of grief.” Sexual abuse is a sort of death. It is the death of a child’s innocence, the death of a child’s trust, the death of a child’s voice. As a survivor of sexual abuse, there are also stages of healing

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Jennifer Nadler is a member of both the RAINN (Rape, Abuse and Incest National Network) and the OVC (Office for Victims of Crime) speakers’ bureaus. She is also an adjunct professor in the English Department at Onondaga Community College, teaching English as a second language. She earned her bachelor’s and master’s degrees at Le Moyne College. She has been married for 12 years and has a 6-year-old son. She will present “No More Sorrow, No More Silence: The Voice of a Survivor.” This presentation chronicles her experience of abuse, its long-term effects and her journey to healing. The presentation will take place at 7 p.m. April 2 in Grewen Auditorium, Le Moyne College. The event is open to the community. For more information on how to book Nadler for a speaking engagement, send her an email at thevoiceofasurvivor@gmail.com

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Parenting By Melissa Stefanec melissa@cnyhealth.com

Signs you are in the full-body throes of the terrible twos

hey are fabled for a reason. The terrible twos are a tough time for toddlers, and a very tough time for parents and those charged with caring for those toddlers. My daughter Stella is a prime specimen of a strongwilled, defiant, demanding and loud toddler. Sometimes she makes me feel as though I may actually go crazy. Sometimes I am convinced she is actually going crazy. I love her to pieces, but toddlerhood is a tough, albeit rewarding, time. One of my favorite medical websites — mayoclinic.com — sums it up a lot nicer than that saying, “While the terrible twos can be difficult for parents and caregivers to navigate, keep in mind that 2-year-olds are undergoing major motor, intellectual, social and emotional changes. Their vocabularies are growing, they’re eager to do things on their own, and they’re beginning to discover that they’re expected to follow certain rules. However, most 2-yearolds still aren’t able to move as swiftly as they’d like, clearly communicate their needs or control their feelings.

This can lead to frustration and misbehavior — in other words, the terrible twos.” The recommended reaction to a toddler tantrum is to comfort, ignore or use humor. I am going to try the last approach for this column. I am going to share five humorous (yes, I took my hands off the keyboard and did air quotes after I typed that) anecdotes about my experience with the terrible twos. Hopefully you can laugh with me. I hear it’s the best medicine (or what people do a lot of on the way to the nuthouse). Daily Scenario 1: Rise and Shriek — “Oh mommy,” I hear bellowed from Stella’s bedroom. I open the door to her room to say good morning. She is sitting up in bed and all smiles. I relax a little. We are actually going to have a good morning. I ask her if she wants to wear her kitty or guitar shirt. “Kitty,”

she says enthusiastically. I reach into her bed to lift her out. “No touch me. I want Daddy,” is shrieked into my ear. I call to my husband, who stumbles into the hallway with only one leg in his pants. He lifts her out of bed and starts to get her dressed. He tries to put the kitty shirt over her head; she rips it out of his hands and tosses it on the floor. “No kitty, no daddy. Mommy!!!” She’s been up for three minutes. It starts. Daily Scenario 2: What’s so Amazing About Daycare? – I pick Stella up every day from daycare. When I pick her up, one of two things happen, either she is so engrossed in cartoons that I don’t exist or she runs into my arms exclaiming, “Mommy! I watch Elmo at home?” Whatever the predecessor, what follows is the same. The coat, boot and hat battle; the occasional timeout in my daycare provider’s garage; the strapping of an arching back into a car seat; and lastly, the tantrum on the way home, which I will affectionately refer to as Scenario 3. Daily Scenario 3: Driving Miss Stella – We are on our way home from daycare. I am tired from a long day at work. “Mommy I’m hungry,” she says. “That’s ok, we are going home to eat dinner,” I say. Two seconds later, “Mommy, mommy, mommy, mommy.” “What honey?” I ask. “I’m hungry.” This goes on for about five minutes. Then the hungry tears start in and then the screaming. Sobs of I’m hungry combined with the demands for a snacky cup radiate from the backseat. She is inconsolable. She begs for my hand. I spend the rest of the way home with one hand on the wheel and one hand contorted into the backseat to hold hers. When I give her a pre-dinner snack at home, she looks at it and walks away. Daily Scenario 4: Who’s Training

COMPLEMENTARY MEDICINE Yoga Can Lower Fatigue, Inflammation in Breast Cancer Survivors In study, the more women practiced, the better their results

racticing yoga for as little as three months can reduce fatigue and lower inflammation in breast cancer survivors, according to new research. The more the women in the study practiced yoga, the better their results. At the six-month point of the study — three months after the formal yoga practice had ended — results showed that on average, fatigue was 57 percent lower in women who had practiced yoga compared to the non-yoga group, and their inflammation was reduced by up to 20 percent. The participants had completed all breast cancer treatments before the start of the study and only yoga novices were recruited for the randomized, controlled clinical trial. Participants practiced yoga in small groups twice a week for 12 weeks. Women making up the control group were wait-listed to receive the same yoga sessions once the trial was over. During the study, they were instructed to go about their normal routines and not to do yoga.

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“This showed that modest yoga practice over a period of several months could have substantial benefits for breast cancer survivors,” said Janice Kiecolt-Glaser, professor of psychiatry and psychology at The Ohio State University and lead author of the study. “We also think the results could easily generalize to other groups of people who have issues with fatigue and inflammation,” said Kiecolt-Glaser, also an investigator in Ohio State’s Comprehensive Cancer Center and the Institute for Behavioral Medicine Research. Though many studies have suggested that yoga has numerous benefits, this is the largest known randomized controlled trial that includes biological measures, Kiecolt-Glaser said. Researchers recruited 200 women for the study. The study is published in the Journal of Clinical Oncology.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

Who? – Potty training has to be one of the cruelest aspects of the terrible twos. If your child was fully potty trained before 2, please keep that piece of hurtful information to yourself. You might as well brag to a fast food employee about your vacation in Fuji. As I assume most good parents do, once Halloween passed, all of her candy became potty treats. She knows if she goes on the potty, she gets a treat from her pumpkin. Once we walk in the house, the requests for said pumpkin start rolling in. “Pumpkin, pumpkin,” she says. “Let’s go potty, so you can get a treat from your pumpkin,” I say. “No!” she shrieks as she stiffly crosses her arms against her chest. (Where do they learn these things?) The night goes on, sometimes with successful potty time and sometimes with shrieks for a pumpkin and no potty time to be had. Daily Scenario 5: Scream Tight, I Mean Sleep Tight – Bed time is a challenge for any kid. The obstacles that lead up to it are daunting. There’s the tooth brushing gauntlet, the rinsing of shampoo out of hair, the terrible prospect of hearing only one story. It’s the toddler equivalent of a bad dentist visit. Once we accomplish the unthinkables and lullabies are sung, it’s time to turn out the light. “No dark,” she yelps. I remind her that she has a nightlight and a projector machine. She cries for our cat and a book to read in the dark. She cries for the felt squirrel that hangs from her doorknob. She cries for her working lullaby toy. She cries for the broken one. I pack her in with all her requested items; after all, it’s been a long day for everyone. As I look back at that little face packed in all that stuff, I can’t help but breathe a sigh of relief and fall a little bit more in love. So laugh with me folks. The terrible twos are one heck of ride.

Why Do the Amish Have Significantly Lower Cancer Rates? Doctors discuss the significantly lower-thanaverage rate cancer among the Amish population By Deborah Jeanne Sergeant

mish people live simple, separated lives to benefit their souls. As it turns out, this lifestyle seems to benefit their bodies, too. A study stunned Ohio State University researchers when they found that their Amish subjects experienced 40 percent fewer incidences of cancer compared with Englishers (non-Amish) in Ohio and 44 percent fewer than the national rate. The figures are age-adjusted so that the comparison takes into account the age difference between the Amish people the researchers studied and the average age of the general population. Researchers had anticipated higher rates of cancer among the Amish because they do not marry outside their faith community, which limits their genetic pool. Amish don’t seek to convert people. The few outsiders who join their population do so through adoption. Researchers theoKohman rized that cancer-related gene mutation would increase cancer rates. Instead, it appears their conservative lifestyle and, perhaps, their restricted genetic pool may lower their cancer risks. The study, conducted from 1996 through Gold 2003, studied 24 types of cancer. The journal Cancer Causes & Control recently published the results. The population of the study comprised 9,992 Amish: 90 percent of the population of Holmes County, Ohio. Most of these descended from the same 100 settlers who moved to the area 200 years ago. This helped researchers delve into family health information three or more generations back. The researchers confirmed information they gathered by comparing it with death certificates and cases reported to the Ohio Cancer Incidence and Surveillance System. Physician Joseph Gold, founder of Syracuse Cancer Research Institute, thinks that the Amish lifestyle has a lot to do with why their cancer rates are markedly lower than the general population’s. “They aren’t drinkers and smokers for the most part,” he said. “Smoking, of course, is associated with a lot of lung cancer, and drinking with breast cancer and various other types of cancer. People who avoid that, I would say their incidences of cancer would be much less.” Most Amish homestead, raising their own vegetable gardens, chickens, and pasture-fed livestock. Living independently is part of Amish teachings and culture. Without electricity, Amish complete all their daily chores through manual labor and rely on bicycles or horses for transportation. “I would think that physical labor

is pound for pound definitely higher among Amish,” said Erik Wesner, who operates www.amishamerica.com and wrote the book “Success Made Simple: An Inside Look at Why Amish Businesses Thrive.” “The traits of engaging in more physical activity and maintaining and eating from home gardens are certainly replicable among English, but since our occupations and places of living are often quite different from the Amish, it may take some work and dedication to do so.” Wesner said that in the past 10 to 20 years, Amish have begun consuming more processed foods than they used to; however, it’s still probably a lot less than most non-Amish eat. Other lifestyle habits influenced the study’s findings. Leslie Kohman, medical director of SUNY Upstate Cancer Center, thinks that Amish tenants of marital fidelity and forbidding promiscuity affect their rate of cancers caused by sexually transmitted diseases. STDs may be causal factors with some types of cancer, such as genital human papillomavirus causing cervical cancer, and cancer of genital areas. Despite their many hours in the sun farming, incidences of melanoma

are also much lower among Amish. “They wear long-sleeved shirts and large-brimmed hats,” Kohman said. Their garments also have high necklines and women’s dresses are long. Their dark colors also block harmful UV rays better than lighter colors. Kohman also attributed their lower breast cancer rates with the large families most Amish people have. “Numerous pregnancies, five or six average per Amish family, reduces the risk of breast cancer, as does nursing at a higher rate and for longer.” Simple living — not keeping up with the Jonses — represents a tenant of Amish faith. Church bishops mandate the rules by which they live. Their dress is ordinary. They do not own electric devices or cars (though in some districts, use of such devices or ownership and use for business only is permitted). All of these rules and more are meant to evoke humble demeanor and stamp out pride among church members. By eschewing materialism, Amish

Acu-Care Acupuncture

cu-Care Acupuncture provides personalized preventive and therapeutic health care with the goal of enhancing the quality of life of its clients and to integrating traditional Chinese medicine with western medicine. Acupuncture is a deep-rooted therapy that has been practiced for more than 3,000 years. Clinically proven, it a safe, effective and drug-free therapy. Acu-Care Acupuncture specializes in pain management, but also treats obesity, migraine headaches, menopause syndrome, depression and anxiety, chemotherapy induced nausea, depression, insomnia, vomiting, fatigue syndrome, ADHD, autism, mild to moderate Alzheimer’s disease, etc. “We use integrated medicine to develop a personalized treatment plan for each individual patient,” says acupuncturist Rui Wang, the practice’s owner. As the seventh generation in her family to practice acupuncture, Wang has her family inherited skills. She is also well trained academically in

both western medicine and traditional Chinese medicine. Wang says, “My goal is to bring Chinese acupuncture to America to better benefit my patients.” Her favorite part of the work is seeing the success that acupuncture has brought to patients who come in after they have tried many other forms of medicine and therapies to help their

families also avoid many stressors. “As far as I know, stress accounts for increasing incidences of both diabetes and cancer,” Gold said. “A person can have marked psychological or physical stress and six weeks to six months later can have cancer. We see that a lot. People who decrease stress will have a lesser risk of these diseases. “We tend to focus on the genetic aspects of cancer, but I’m not sure that factor outweighs the physical habits,” Gold said. “To think that cancer incidence is mostly due to genetic make-up is a mistake. It’s the lifestyle.” New York is home to more than 12,000 Amish and 92 Amish church districts. It ranks as the nation’s fifth-largest Amish population. According to AmishAmerica.com, the Empire State boasts the fastest growing population of Amish, including groups in the Mohawk Valley, Lowville, and in Seneca, Yates and Wayne counties. In Oswego County there is a high concentration of Amish in the Pulaski-Williamstown area. condition without results. “Acupuncture is a safe, natural alternative to Western medicine. It can be used in conjunction with or as a supplement to medication and physical therapy,” she says. Acu-Care Acupuncture will soon expand to larger quarters. Wang will continue to increase her patients quality of life while managing their pain or other symptoms. “I hope to see Western medicine and acupuncture work together in collaborative treatment and for acupuncture to be more generally accepted by insurance companies,” she says. Submitted article Acu-Care Acupuncture Owner: Acupuncturist Rui Wang Northeast Medical Center, Suite 108 4000 Medical Center Dr., Fayetteville Phone: 329-7666 Website: www. AcuCareAcupunctureCenter.com .

Dr.Rui and patient, Dick Abar

March 2014 •

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Men’sHealth Grooming Tips for Men: Cleanse, Moisturize and Exfoliate Men can have skin that’s more sensitive to ultraviolet exposure than women’s skin, which makes it more prone to skin damage like skin cancer

ontrary to popular belief, a growing number of men are requesting recommendations for skincare products, says physician Natalie Semchyshyn, assistant professor of dermatology at Saint Louis University. Even so-called tough guys can have skin that’s more sensitive to ultraviolet exposure than women’s skin, which makes it more prone to skin damage like skin cancer or brown spots. “We tend to think of male skin type as tougher, thicker, but actually it’s more sensitive,” says Semchyshyn. “Compared to women, their skin loses moisture faster, is more prone to dryness and doesn’t exfoliate as much.” She offers five grooming essentials for men that could make their skin healthy and glow.

The Basics  You can usually find several different skincare products on a woman’s dressing table, but that may not be a guy thing. Semchyshyn recommends a basic regimen for men. “A six-step program doesn’t work for men. They’re not used to putting on

layers of different things,” she says. Whether it is a shaving gel or a moisturizer, looking for products that have some antioxidants and therapeutic ingredients is a good start. Antioxidants such as phloretin, ferulic acid and vitamins C and E help protect the skin against damage from UV rays and pollution. Colloidal oatmeal helps to soothe sensitive skin and sunscreen helps guard against skin cancer and aging changes. “An all-in-one product that combines moisturizer, antioxidants and sunscreen is a good way to go.”

No Sweat  Men who work out or regularly play sports should take extra care of themselves, as sweating can clog and irritate the skin. “The first step is to wash your skin to get the sweat off,” Semchyshyn suggests. “A gentle cleanser is excellent because it doesn’t strip the skin, it just cleans. After washing the face, using a moisturizer can make up for the loss of moisture from washing.” Sweating can also cause the skin to

become more acne-prone. “Sweating clogs pores. So, along with washing, it’s important to use products with benzoyl peroxide on the chest, back and shoulders to unclog the pores as well as cleanse the skin,” she says.

Oil-free zone  For oily skin, Semchyshyn recommends using a cleanser with glycolic or salicylic acid. “These help exfoliate and balance the skin.” Moisturizers with oil control and sunscreen are great for this skin type. And a gel that combines benzoyl peroxide with oil absorbing ingredients is good for very oily skin.

Exfoliate some more  Most men exfoliate while shaving, but that still doesn’t exfoliate the entire face. “Dead skin cells can give the face a dull look,” Semchyshyn says. “Sonic cleansing brushes can help exfoliate the skin and are great for deep cleansing. They can be used daily and can even

help with flaky body skin.”

Fight dryness  Winter can be ruthless on the skin, more so if you shower multiple times a day, says Semchyshyn. “It’s important to moisturize the skin and use a cleanser that doesn’t dry your skin,” she says. “Using a product that has natural oatmeal will moisturize and soothe sensitive skin. Moisturizers with glycolic or lactic acid in it will keep the skin hydrated and also exfoliate.”

Many Start Testosterone Therapy Without Medical Need Study finds increased testing among men with normal hormone levels

lthough testosterone use has sharply increased among older men in the past decade, many patients appear to have normal testosterone levels and do not meet the clinical guidelines for treatment, according to new research accepted for publication in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism. Testosterone is a key male sex hormone involved in maintaining sex drive, sperm production and bone health. Since testosterone levels tend to

naturally decline as men age, lower levels of the hormone do not necessarily mean that an individual has hypogonadism, a condition that results from low testosterone. As the population ages and an increasing number of men struggle with obesity and diabetes, more men may experience low testosterone levels without meeting diagnostic criteria or displaying symptoms of hypogonadism. “Over the past decade, older and middle-aged men are increasingly being tested for low testosterone levels and being prescribed testosterone

medications, particularly in the United States,” said one of the study’s authors, J. Bradley Layton, a doctor of philosophy of the University of North Carolina at Chapel Hill. “While direct-to-consumer advertising and the availability of convenient topical gels may be driving more men to seek treatment, our study suggests that many of those who start taking testosterone may not have a clear medical indication to do so.” To study testosterone trends, the retrospective incident user cohort study analyzed commercial and Medicare insurance claims from the United States

and general practitioner health-care records from the United Kingdom during the period between 2000 and 2011. The study identified 410,019 American men and 6,858 U.K. men who began taking testosterone during this period. The analysis also found more than 1.1 million U.S. men and 66,000 U.K. men who had their testosterone levels tested during this time. The study was funded by the National Institute of Health’s National Institute on Aging.

Prostate cancer vaccines receive a boost in funding

of being “too small to be convincing,” explains MVI’s scientific co-founder, Douglas McNeel. In addition, the funding will enable safety studies of another of the company’s DNA vaccines (MVI-118) to go ahead. The MVI-816 vaccine is designed to treat prostate cancer patients who have undergone initial surgery or radiotherapy but have found that their prostate-specific antigen (PSA) level, a biomarker for prostate cancer, is on the rise again after treatment. Men who have rising PSA levels despite having undergone these initial therapies are at a particularly high risk of the cancer spreading beyond the prostate to other areas of the body. Currently, their only choice is to

“wait and see” whether their PSA continues to rise or to undergo a form of castration, either surgical or chemical. This castration, also known of as androgen deprivation therapy (ADT), deprives the body of testosterone, the hormone that prostate tumors rely on for their growth. The MVI-816 vaccine is hoped to provide a means of reducing prostate cancer growth that avoids the need for castration. “Our goal in developing MVI-816 is to significantly delay both the onset of metastases and the initiation of [castration] for these patients,” explains president of Madison Vaccines, Richard Lesniewski. “This $8 million financing will allow [us] to advance our efforts to establish a safe and approvable immune activation therapy for men with

early malignant prostate cancer.” The drug is a plasmid DNA vaccine comprising small pieces of modified bacterial DNA designed to induce the body’s immune system to mount an attack against prostate cells that display the prostatic acid phosphatase (PAP) antigen. “When the plasmid gets inside a professional antigen-presenting cell, it stimulates immune T cells that are responsible for killing tumor cells,” explains McNeel. McNeel also highlighted the significance of developing the start-up’s second vaccine, MVI-118, which targets androgen receptors, molecules that are critical in the progression of prostate cancer and also in the resistance of many current therapies.

he development of two new vaccines that are hoped to offer an alternative to castration therapy for men with recurring prostate cancer, is due for an $8 million boost in funding. The pharmaceutical company Madison Vaccines Incorporated (MVI) recently announced the success of a finance round led by Venture Investors, LLC, that has secured the funds to expand a Phase II trial of the MVI-816 vaccine that was otherwise in danger

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

Men’sHealth Circumcision Rates on the Decline Fewer baby boys in the US are being circumcised while some countries are banning the practice outright By Deborah Jeanne Sergeant

he European Union is considering banning circumcision except for religious reasons. Norway’s Health Ministry in November pushed legislation to regulate circumcision in boys while some political parties in the country are calling on a complete ban of the practice on minors. In 2012 in Germany a court decreed that the practice is a form of “bodily harm” against boys who are “unable to give their consent.” Although the procedure has seen little legislative action in the US, except for a proposal in California that would block laws banning circumcision, American parents represent of mix of people who adamantly support or oppose circumcision and those who could go either way. Anti-circumcision groups — such as Intact America (www.intactamerica. org), Mothers Against Circumcision (www.mothersagainstcirc.org), and

National Organization of Circumcision Information Resource Centers (www. nocirc.org) — may explain the decrease in circumcision compared with 30 years ago. A report by The Centers for Disease Control’s National Center for Health Statistics shows that two out of three baby boys born in the West were circumcised in the past. By 2010, the figure plummeted to 58 percent, or a bit more than one in two. The nation’s overall rate decreased by 10 percent in 32 years. Stuart Trust, pediatrician with Pediatric Associates of Fulton, said that it’s becoming a “controversial issue influenced by culture, tradition and religion.” He said that “some number of years ago, the American Academy of Pediatrics guideline stated that they felt there’s no medical need for it so they didn’t condemn it but they didn’t promote it. They left it up to the individ-

KIDS Corner Teens’ Stress Levels Rival Those of Adults, Survey Finds Top worries include post-graduation choices, financial concerns

f paying the bills and putting food on the table put adults’ nerves on edge, just imagine how today’s overscheduled, frequently tested teenagers must feel. Adolescents reported stress levels during the school year that surpassed those of adults, according to the American Psychological Association’s latest Stress in America survey. The survey, based on an August

2013 Harris Interactive poll, is thought to be the first to focus on how stress is affecting the nation’s adolescents. It included more than 1,000 teens and nearly 2,000 adults. The findings suggest that teens’ sleeping and exercise habits feed into their stress levels and the stress affects their health habits, creating a vicious circle, said Norman Anderson, CEO and executive vice president of the

ual’s feelings. In the last three to five years they’ve changed that position. They’re not recommending it, but are talking about some advantages.” Among those advantages, Trust lists a reduced risk of penile infections, which he has never seen among circumcised boys, but has observed among those left intact. He also said that uncircumcised boys might develop phimosis, the inability to retract the foreskin. “The urine can’t come out and it goes back in and it balloons up,” Trust said. “These kids need an emergency circumcision. It’s relatively commonly seen by pediatric urologists. Bottom line, if they’re circumcised you don’t have any of those issues.” He said that it’s rare for parents to say “no” when asked if they would like their newborn son circumcised. Doctors performing circumcisions use local anesthetic, and oral medication may help with pain as well. Prematurity or illness can delay circumcision to a later date, but most baby boys’ circumcision takes place before leaving the hospital for the first time. Georganne Chapin serves as executive director of Intact America, a national organization headquartered in Tarrytown, N.Y. She asserts that circumcision is not only unnecessary, but also harmful. “There are hundreds of men who have very sad stories of penises that were damaged from circumcision, not to mention every penis is damaged from it,” she said. “You’re inflicting a wound on a perfectly good body part. It is utterly unnecessary. It’s a violation of a child’s rights to amputate a fully functional, sensitive area of a body.” One argument in favor of cir-

American Psychological Association. “Those who experience high levels of stress tend to report that they exercise less and they don’t sleep as well, which feeds back into increasing their stress,” Anderson said during a recent news conference. “Conversely, those who say they exercise on a regular basis and get a good night’s sleep show a decrease in stress.” Another “alarming” finding: “Teens don’t appear to realize the impact stress has on their physical and mental health,” Anderson said. More than half of teens think stress has a slight or no impact, yet many reported symptoms of stress, the survey found. Forty percent said they feel irritable or angry and 36 percent said they feel tired. What’s more, the survey suggested that teens are poised to become even more stressed as they enter adulthood. Katherine Nordal, the APA’s executive director for professional practice, said during the news conference that school was the most common source of stress for teens. “Getting into a good college and deciding what to do after high school was also a significant stressor for about 69 percent of teens,” she said. Teens’ financial concerns for their families also ranked among the top stressors. “Children learn what they live, so I think that when there’s a lot of stress in the household in regard to financial concerns that certainly it bleeds down to children as well,” Nordal said. March 2014 •

cumcision purports that circumcised men have a lower likelihood of becoming infected with STDs; however, Chapin likens that to “amputating a little toe because of the chance of an ingrown toenails later.” “People in favor of it want us to prove it’s a bad thing to cut a body part off of a baby, someone who cannot consent.” She added that general anesthesia is never used and sometimes local anesthesia isn’t even used. “Then there’s a wound that takes at a minimum of several days to heal and the baby’s urinating into the open wound and defecating into a diaper where there’s an open wound,” Chapin said. She believes that the foreskin is part of male anatomy for a reason, and that removing it reduces protection for the penis and a degree sexual pleasure as an adult. Several organizations support men who wish to restore their foreskins, such as The National Organization of Restoring Men (www.norm.org), and My Foreskin Restoration Experience (blog.myforeskinrestoration.com). The process usually involves no surgery but stretches intact skin on the penis to form a new foreskin.

ing:

The survey also found the follow-

• Teens reported sleeping just 7.4 hours on school nights and 8.1 hours on non-school nights — far less than the 8.5 to 9.25 hours recommended by the National Sleep Foundation. • One in five teens reported exercising less than once a week or not at all. • Nearly a third of teens said they eat to manage stress, while 23 percent reported skipping a meal due to stress. Anderson said parents can help teens by recognizing their stress levels and modeling good stress-management behaviors, such as eating a healthy diet and taking time to exercise. Parents also need to stay plugged in to their teenagers’ lives by taking every opportunity to communicate with them, Nordal said.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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The Social Ask Security Office

What They Want You to Know: Oncology Nurses By Deborah Jeanne Sergeant

ncology nurses care for patients who have cancer. Their specialty enables them to provide greater comfort and care for their patients and their families. • “I have been an oncology nurse for 13 years and love what I do. Caring for someone with a cancer diagnosis goes beyond the assessments and tasks involved in caring for a patient; it is an expression of love and incredibly rewarding. • “Sitting with a patient, holding their hand, answering questions the patient and family members may have take on the same importance as physical assessments.” Marla Rodas, R.N., with the oncology unit at University Hospital • “The support of family and friends is important to the cancer patient’s journey and cannot be over emphasized. • “If the patient is in the hospital, bring in pillows and blankets from home, family pictures and provide soft lighting. • “Also, bring favorite foods if they are able to tolerate them. • “Listening to someone with cancer is critical, although may be uncomfortable for a family member. Allow the patient to express their thoughts. Respect a loved one wanting to be alone at times. And most importantly, tell them you love them and when appropriate remember that humor can also be a great medicine. • “A common myth is that people believe that the use of narcotics means the end is near or that if they take pain medication they will become addicted. This is not true, narcotics help to improve the quality of life during their journey and help them enjoy precious time with family and friends.” Lisa Bonnlander, R.N. with the oncology unit at University Hospital • “I have seen more love in my day to day work that most will ever see. The littlest things we do for patients could mean the world to them. This work truly grounds you and makes you realize what is important in life. • “We laugh with our patients, a lot. Humor is great medicine. I have had patients even joke about their own demise. • “I had a patient say to me once that she didn’t mind being in the hospital with us anymore because that’s where she was treated more like a person. She went on to explain how a lot of her friends didn’t know what to

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say to her and she felt like no one saw her anymore, just the disease. • “We do have patients beat their cancer, go into remission and they never come back as a patient to the hospital. I remember after a particularly tough week I was called to the front desk because there was a young man looking for me. I immediately recognized him. He had leukemia, so he was with us for over a month at the start of his treatment. He was pretty quiet and withdrawn in the beginning, then his mood turned angry but by the end of his stay he had warmed up to all us. He came up to me and gave me hug. He showed me the leukemia bracelet he had on his wrist that I had given to him. He said, ‘See, Amanda, I still have it years later, it reminds of how positive you were and how my experience changed me.’ He went on to tell me that he wanted to come up to let me know that there are good stories too and to let me know he now is a volunteer and speaks with newly diagnosed cancer patients. He came at the right time. I am spiritual person and I believe God knew I was struggling with loss that week.” Amanda Slifka, RN, clinical coordinator, Oncology Unit at St. Joseph’s Hospital Health Center

• “Be open, honest and call with problems when they begin. Do not wait. Be honest about the obstacles that cancer care may create in your life, be it your ride to treatment, meals, finances, or support. All are part of your care, not just the treatment of your cancer. Lastly, you can decide where you get your cancer care. You do not have to go where your doctor tells you. If you want care in a particular place, then you need to advocate for that.” Denise Tyler, nurse manager at Finger Lakes Hematology & Oncology, Clifton Springs

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

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

Provided Deborah Banikowski, Social Security OfficeSocial Security Office

In Iditarod and Retirement, Prep Is Key

he Iditarod Trail Sled Dog Race, terrain, you want to make sure you held each March in Alaska, is one have prepared for a number of difof the harshest, most challenging ferent possible obstacles on the trail. races known to man (or dog). Mushers For retirement planning, you’ll want embark on a race from Anchorage to to test out the Retirement Estimator Nome that takes between nine and 15 to see how changes in your income, days. Contestants bear sub-zero temretirement age and other variables peratures with gale-force winds that may change your overall plan. Use our can cause wind chills as low as negative Retirement Estimator, where you can 100 degrees Fahrenheit. It takes endurget a personalized, instant estimate of ance, preparation and careful planning your future retirement benefits using to make it from start to finish. different retirement ages and The same can be said for scenarios. Visit the Retirement your race toward retirement and Estimator at www.socialsecuriSocial Security. No one would ty.gov/estimator. hit the trail without being ready Out in the cold, you’ll be for the challenges. Similarly, no thankful for the provisions worker today should be navigatyou’ve brought along. In retireing toward retirement without a ment, you’ll understand why little bit of preparing, planning, it was so important for you to and stick-to-itiveness. save early on. The sooner you Choosing your steps is as begin your financial planning, important as selecting the right Banikowski the better off you will be. Social sled dogs. Your first step in Security replaces about 40 planning for a comfortable retirement is percent of the average worker’s pre-reto look at your Social Security Statetirement earnings, but most financial ment, which you can do online easily advisers say that you will need 70 perwith a my Social Security account. The cent or more of pre-retirement earnings online Statement is easy to use and to live comfortably. You also will need provides estimates you should considother savings, investments, pensions or er in planning for your retirement. It retirement accounts to make sure you provides estimates for disability and have financial security to live comfortsurvivors benefits, making the Stateably when you retire. Visit the Ballpark ment an important financial planning Estimator for tips to help you save. tool. Your Statement allows you to You’ll find it at www.choosetosave. review and ensure your earnings are org/ballpark. accurately posted to your Social SecuUse our online library of publicarity record. This feature is important tions as your trail map or guidebook to because Social Security benefits are help you when it comes to planning for based on average earnings over your retirement. Check out When To Start lifetime. If the information is incorrect, Receiving Retirement Benefits. It and or you have earnings missing from many other useful publications can be your record, you may not receive all of found at www.socialsecurity.gov/pubs. the benefits to which you are entitled As you mush, mush, mush toward in the future. Visit www.socialsecurity. retirement, remember that it’s not gov/myaccount to set up a my Social about the destination, but all about Security account and get started. the journey. Spending a little time to Before heading into the snowy prepare along the way will make all the difference when you cross the finish line into retirement.

Q&A

Q: My neighbor said my kids, 8 and 15, might be eligible for survivors’ benefits since their mother died. Are they? A: Maybe. Their mother must have worked and earned the required number of Social Security credits. If she did, both you and your children may be eligible for benefits. Apply promptly for survivors benefits because benefits are generally retroactive only up to six months. You can apply by calling Social Security’s toll-free number, 1-800-7721213, between 7 a.m. and 7 p.m. on Monday through Friday. People who are deaf or hard of hearing may call our toll-free TTY number, 1-800-325-0778. Q: I’m expecting a baby this June. What do I need to do to get a Social Security number for my baby? A: Apply for a number at the hospital when you apply for your baby’s birth certificate. The state agency that

issues birth certificates will share your child’s information with us, and we will mail the Social Security card to you. Q: My mother receives Supplemental Security Income (SSI) benefits. She may have to enter a nursing home later this year. How does this affect her SSI benefits? A: Moving to a nursing home can affect your mother’s SSI benefits but it depends on the type of facility. In some cases, the SSI payment may be reduced or stopped. Whenever your mother enters or leaves a nursing home, assisted living facility, hospital, skilled nursing facility, or any other kind of institution, you must tell Social Security. Call Social Security’s toll-free number, 1-800772-1213 (TTY 1-800-325-0778). We can answer specific questions and provide free interpreter services from 7 a.m. to 7 p.m., Monday through Friday. We also provide information by automated phone service 24 hours a day.

Come Smile With Us! Bruce Stewart, DDS

By Jim Miller

RV Travel Tips for Beginners Dear Savvy Senior, Can you write a column on RV travel for beginners? My husband and I will be retiring in a few years and have always thought it would be fun to spend some of our time traveling around the country in an RV. What can you tell us? Ready to Retire

different types of RVs available today, along with various videos and other RV information.

Dear Ready, The affordability, combined with the comfort, convenience and personal freedom it offers has made recreational vehicle (RV) travel immensely popular among retirees over the past decade.

With around 14,600 public and privately owned RV parks or campgrounds across the country (see gocampingamerica.com and trailerlifedirectory.com), RVers can roam coastto-coast with no shortage of places to stop, or options to choose from.

According to the Recreational Vehicle Industry Association, there are approximately 35 million RV enthusiasts in the U.S., including a growing number of baby boomers. Some of the reasons RVing has become so popular is because of the freedom and flexibility it offers to come and go as you please. If you like where you’re at, you can stay put. Or, if your feet get itchy you pack up and move on. Another popular aspect among retirees is following the seasons. Snowbirds, for example, like to travel south for the winter, while southerners migrate north during the hot summer months. RVing is also a very affordable way to go. Even considering ownership or rental costs, RV travel is cheaper than traveling by car, plane or train — especially when you factor in lodging and restaurant costs.

RV Options Most people, when they think of RVs, think of huge motorhomes, but RVs run the gamut from folding camping trailers and truck campers, to travel trailers and large motorized RVs. Cost, too, will range from as little as $4,000 for pop-up campers all the way up to $1.5 million for luxurious motorhomes. To learn more about RV options, check out gorving.com, a resource created by the RV travel industry that breaks down all the

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The best way to ease into RV travel and find out if you like it is to rent. Renting can also help you determine which type of RV best suits your needs. Rental costs will vary greatly depending on what you choose, but you can expect to pay anywhere from $30 up to $300 per day. To locate one of the 500 or so RV rental outlets around the country check your yellow pages under “Recreation Vehicle” or search The National RV Dealers Association website at rvda.org.

Camping Options

Most RV parks are open to all comers and rent spaces on a nightly or weekly basis, much like a motel or hotel, with rates typically ranging from $15 to $50 per night, however some in city and country parks may be $10 or even free. RV parks can also range from rustic facilities with limited or no utility hookups, as are more often found in state and national parks, to luxury resorts with amenities that rival fine hotels. To research RV campgrounds, get a copy of the “Good Sam RV Travel Guide & Campground Directory” for $10 at goodsamclub.com/publications, or call 866-205-7451. This guide breaks down what each campsite offers, along with their policies and costs, and a rating system. Also see rvbookstore.com for dozens of books and DVDs about RVs and the RV lifestyle. There are also a number of RV clubs you can join, like the Good Sam Club (goodsamclub.com), that provide member discounts on parks and campgrounds, travel guides, fuel and propane, roadside assistance and more. Passport America (passportamerica. com) is another popular club that gives 50 percent discounts on more than 1,800 campsites across the U.S., Canada and Mexico. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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H ealth News St. Joe’s has new head of financial services Tracy T. Frank, a certified public accountant, has recently been appoint director of financial services for St. Joseph’s Hospital Health Center. Frank brings more than 25 years of financial services experience in both the public and private sectors. Most recently, she served as chief financial officer for Manlius Pebble Hill School in DeWitt, where she also served as interim head of the school for 15 months, providing stable leadership and positive morale after Frank the sudden loss of the school’s longtime head. Frank’s healthcare financial experience includes positions at St. Luke’s Memorial Hospital Center, as well as MedBest Medical Management, Inc. This marks a return to St. Joseph’s for her, as she served as director of financial services in the 1990s. “We are pleased to have Tracy return to our organization,” said Meredith Price, chief financial officer. “She will help us navigate the future healthcare environment in which quality, productivity and finance will be more

connected. Her financial acumen combined with her knowledge of systems design and implementation will help propel us forward as we further develop as a healthcare organization.” A graduate of Clarkson University, she holds a Bachelor of Science degree in accounting, and she is a certified public accountant in New York state. She is co-chairwoman of the CNYCF future fund steering committee, and a communicant of Holy Cross Church in DeWitt. Frank and her family reside in DeWitt.

G. Bozeman

A.M.P. Urology expands into Oswego County Associated Medical Professionals of NY, PLLC (A.M.P. Urology) a large multispecialty medical practice of nearly 50 providers, has expanded into Oswego County. Physicians Gary D. Bozeman and Elizabeth W. Bozeman are both board-certified urologists and have joined A.M.P. Urology to work exclusively in the Oswego and Fulton area. These urologists specialize in all areas of urology, including female urology, male urology, stone disease, benign prostate enlargement (BPH), prostate cancer, kidney cancer, bladder cancer, erectile dysfunction, voiding

E. Bozeman

dysfunction, urinary incontinence, recurrent urinary infections and interstitial cystitis. The physicians are husband and wife who have been practicing together since their marriage in 1996. The fun-loving couple has come to Central New York from South Carolina. They will see patients out of a brand new state of the art medical facility, which is centrally located at 806 West Broadway St. in Fulton (Fulton Commons). They will also be attending physicians at Oswego Hospital.

New clinical operations director appointed Julianne Duffy has been appointed director of clinical operations at St. Joseph’s Physicians. In her new role, Duffy will oversee clinical operations for St. Joseph’s Physician Enterprise including all practices at the Liverpool and Fayetteville campuses along with

the practices located in Baldwinsville, Syracuse and Cazenovia. Most recently, Duffy served as in a leadership role as SJLinked’s director of ambulatory EMR implementation. “Julianne brings to the position knowledge of St. Joseph’s PhysiDuffy cians goals and clinical operations, said Derrick Murry, chief operating officer, St. Joseph’s Physicians. “We believe her direct patient care experience and fervent commitment to patient-centered care will further enhance our ability to meet the needs of our patients.” Duffy worked as a physician assistant in emergency medicine for Crouse Hospital as well as a physician assistant in general surgery for St. Joseph’s Hospital. Duffy was an adjunct instructor in the department of physician assistant studies at Le Moyne College in Syracuse from May 2011 to August 2013. A graduate of Le Moyne College, Duffy earned a Bachelor of Science in biology, and a Master of Science in physician assistant studies. She is licensed in New York state, and certified by the National Commission on Certification of Physician Assistants. Dedicated to delivering patient-centered care, Duffy

UroNavIGH.half_Layout 1 2/24/14 12:53 PM Page 1

NEW TECHNOLOGY TARGETS PROSTATE CANCER Upstate is among the first in the country to introduce the UroNav. This technology fuses MRI and ultrasound images to give doctors greater accuracy in finding and targeting prostate cancer. UroNav uses a technology similar to GPS navigation to direct the biopsy. “UroNav helps locate hidden and often aggressive prostate cancer. Its precision helps patients avoid unnecessary, repeat prostate biopsies,” reports Gennady Bratslavsky, MD, chair of Urology.

To learn more, call or visit 315.464.1500 WWW.UPSTATE.EDU/PROSTATE Page 22

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014

Drs. Bratslavsky and Vourganti

Upstate announces new staff, promotion Physician Paul Aridgides has joined Upstate as assistant professor of radiation oncology, seeing patients at Upstate University Hospital and Oswego County Radiation Oncology. Aridgides earned his medical degree at Upstate. Following an internship at St. Vincent’s Hospital in New York, he completed residency training in the field of radiation oncology at Upstate, where he served as chief resident. Aridgides recently completed a pediatric radiation oncology fellowship program at St. Jude Children’s Research Hospital. He is Aridgides published in the areas of lung cancer and Hodgkin’s lymphoma. Aridgides lives in Fayetteville. Mary Knepper has joined the Foundation for Upstate Medical University as director of the College of Health Professions and College of Nursing Alumni Associations. Knepper was grants manager at St. Joseph’s Hospital Health Center for 12 years where she helped secure $28 million through more than 200 awarded grants. Her expertise was included in nationally known grants consultant Jana Hexter’s 2012 book, “Grant Writing Revealed — 25 Experts Share Their Art, Science and Secrets.” She will be working with the nursing and health professions alumni boards to engage graduates in ongoing support of the colleges and to secure funding for scholarships and other projects. Knepper lives in Dewitt Physician Andrea Intartaglia Berg has joined Upstate’s department of medicine as an assistant professor, specializing in geriatric medicine. Berg received her medical degree from George Washington University School of Medicine in 2007 and completed her medical internship and residency at Yale New Haven Hospital’s Primary Care program in 2010. She then completed the Harvard Fellowship in Geriatric Medicine in 2012 and served as an attending primary care provider at the Newton Wellesley Hospital in Massachusetts prior to moving to Cazenovia and joining Upstate faculty. Berg has been inducted into the Gold Humanism Honor Society and has received two Hartford Center of Excellence in Geriatric Medicine Research Awards. As a clinician educator, she is particularly interested in fostering awareness

and interest into the unique needs of older patients and our aging population. Her clinical interests include comprehensive geriatric assessments with a special interest in cognitive evaluations, memory disorders, and primary care for frail elders. Berg resides in Cazenovia. Registered nurse Ann Markle has been named director of nursing for adult inpatient services at Upstate’s Downtown Campus. Since joining Upstate in 1991, Markle has held both staff and leadership positions within nursing and case management. Prior to taking on these additional responsibilities she served as the director for the Inpatient Surgical Services. Markle is board certified in case management by the American Nurses Credentialing Center. Markle lives in Liverpool.

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Physician Michael Iannuzzi, chairman of Upstate Medical University’s department of medicine, has been named one of the world’s top experts in the field of sarcoidosis research and treatment by Expertscape, an organization dedicated to helping consumers find health professionals with extensive expertise in their specific area of concern. Expertscape uses objective algoIannuzzi rithms to identify the most knowledgeable and experienced physicians, clinicians and researchers across more than 26,000 specific topics, stratified by geography. Expertscape defines an expert as someone who has published peer-reviewed research in the science, therapies and complications for a specific medical topic. Iannuzzi lives in Fayetteville.

St. Joseph’s receives ‘magnet’ recognition St. Joseph’s Hospital Health Center has achieved magnet recognition as a reflection of its nursing professionalism, teamwork and superiority in patient care, according to a news release issued by the hospital. It’s the only hospital in the Syracuse region to hold the recognition, determined by the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program, which ensures that rigorous standards for nursing excellence are met. With this credential, St. Joseph’s joins the magnet community—a select group of 378 healthcare organizations out of nearly 6,000 U.S. healthcare organizations.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2014