in good Meet Daphne
See how she and other dogs are making a difference in the lives of hospital patients
Neurofeedback Find out more about the technique used to treat ADHD, depression, drug addiction
May 2014 • Issue 173
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CNY’s Healthcare Newspaper
Oswego: Unhealthiest County in NYS
Oswego County is highly regarded for many things, such as its vast natural resources and rich history. It is also the last among all counties in New York state in the area of health behaviors. It ranks 62nd out of 62 counties, according to recent health rankings. Page 7 Page 11
1 Year Old ‘Take Care’ show about health and wellness on public radio marks one year anniversary
3-Parent Babies Recently there’s been a lot of debate about a technique that some dub “three parent babies.” Read more inside
Meet Your Doctor Herbert L. Kunkle Jr., an orthopedic surgeon at Auburn Community
Who’s the Boss at Red Cross?
Page 7
Rosie Taravella, an actress who worked on ‘Who’s the Boss’ and other TV shows, has injected new energy at CNY Red Cross.
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UNDERREPORTED A March study states that Alzheimer’s disease may contribute to more or as many deaths as heart disease or cancer, first and second on the Centers for Disease Control and Prevention’s list of causes of death. Page 17
May 2014 •
CDC: Too Many Younger Teens Still Getting Pregnant Despite a drop in teen birth rates in recent years, too many girls under 18 are still getting pregnant, U.S. health officials said in April.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Lab-Grown Vaginas, Noses Herald New Options for Patients Regenerative surgery takes a leap forward, two studies show
D
octors have successfully implanted laboratory-grown vaginas into four teenage girls suffering from a rare birth defect, creating new organs with feel and function comparable to that of a “natural” vagina, a new study reports. Another research team is reporting the first successful nose reconstruction surgery using laboratory-grown cartilage. In both cases, doctors harvested the patients’ own cells and used them to create new tissue that was then grafted back onto the body. The two studies, published online April 11 in The Lancet, show how years of research into tissue engineering for skin grafts is being put to practical use for other purposes, said physician Samuel Lin, an associate professor of surgery at Harvard Medical School and site director of Harvard’s plastic surgery residency training program. “Perhaps now we’re just seeing the translational products of all that research that has been going on for years,” Lin said. One study involved girls aged 13 to 18 who were born with Mayer-Rokitansky-Kuster-Hauser syndrome, a rare genetic condition in which the vagina and uterus are underdeveloped or absent. Researchers harvested muscle cells and epithelial cells from a biopsy (surgically removed tissue sample) of
each girl’s genitals. Epithelial cells line body cavities and are able to generate or release fluid and detect sensation. In a process that took three to five weeks, doctors grew the cells into larger tissue cultures that were then attached to a biodegradable “scaffold” hand-sewn into the shape of a vagina. The scaffolds were tailor-made to fit each patient and are made of the same type of material used in surgical sutures. Once the new vaginas were ready, surgeons created a canal in each patient’s pelvis and stitched the scaffold to the girls’ reproductive structures. The girls’ bodies proceeded to form nerves and blood vessels into the grafts, and gradually replaced the engineered scaffold with a new, permanent organ. “It’s just like when you’re having plastic surgery and they place a skin graft on you to replace damaged tissue,” said physician and senior author Anthony Atala, director of the Wake Forest Baptist Medical Center’s Institute for Regenerative Medicine in Winston-Salem, N.C. “The graft will re-grow blood vessels and nerves,” he said. In the other study, Swiss scientists harvested nasal cartilage cells from five patients, aged 76 to 88, who had severe defects of their noses following skin cancer surgery. During skin cancer surgery, doctors
often have to cut away parts of cartilage to remove a tumor. Surgeons usually reconstruct the nose using cartilage from the person’s ear or ribs, but the procedure can be very invasive and painful. The researchers at the University of Basel in Switzerland grew the cartilage cells into new tissue 40 times the size of the original biopsy in one month, and then used that tissue to rebuild the noses of the patients. One year after the reconstruction, all five patients were satisfied with their ability to breathe as well as with the appearance of their nose. None reported any side effects. Doctors from the research team said the same technology could be used to engineer cartilage for reconstruction of eyelids, ears and knees.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
Too Many Younger Teens Still Getting Pregnant: CDC Girls aged 15 to 17 account for about one-quarter of teen births, report shows
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espite a drop in teen birth rates in recent years, too many girls under 18 are still getting pregnant, U.S. health officials said in April. Even though births to teens aged 15 to 17 have declined, a quarter of teen births occur in this age group — nearly 1,700 a week, according to the U.S. Centers for Disease Control and Prevention. “There have been noted declines in births to teens, and that’s good news,” Ileana Arias, principal deputy director of the CDC, said during a news conference. “However, we can’t be complacent when we hear about these declines. We still need to make more progress in reducing health disparities and the public health burden related to teen pregnancies and births. Younger teens still account for one in four teen births,” she said. Arias noted that pregnancy and birth can interfere with finishing high school and can lead to sacrificing education, career and income. “The young teen years are a critical time when a teen, especially a young woman, could jeopardize her future if
she cannot complete high school or go to college,” she said. Young fathers may also have to limit their education and defer their plans, Arias said.
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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 Gail Behm, RN, Lynne Scalzo • Advertising: Jasmine Maldonado, Marsha K. Preston, Jim Maxwell • Design: Chris Crocker • Office Manager: Laura J. Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
Just one more way 9,000 New Yorkers taking care of New York. Upstate Medical University
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May 2
Crouse auxiliary presents “Take Me to Vegas” Take a chance on a night of fun at “Take Me to Vegas,” presented by the Crouse Hospital Auxiliary from 6 – 10 p.m., Friday, May 2, at Justin’s Tuscan Grill in East Syracuse. The Las Vegas-themed evening will include a variety of casino style gaming tables, a silent auction and an exclusive jewelry drawing. The evening will also feature delicious food stations and Vegas-style Syracuse Post Standard entertainment featuring Syracuse native Marissa Mulder, a prominent Size: 1/16 page New York City cabaret singer. Issue: April Tickets for the event are offered in packages. The ace highDue: package for $75 includes Cost: admittance for one and$169.42 $500 in gaming tokens. The two pair package for $125 admits two and includes $1,000 in gamThey only have display ads. ing tokens. The royal flush package for $200 includes admittance for two guests plus two raffle tickets, two drink tickets, $1000 in gaming tokens and event recognition. Call 315-470-7123 for more information.
May 3
Kentucky Derby party to benefit cancer patients If you can’t make it to the 140th annual Kentucky Derby in Louisville, consider attending Positively Pink Packages’ 10th annual derby-themed fundraiser to benefit local breast cancer patients. Proceeds from the event will support Positively Pink Packages, a local nonprofit organization that provides free care packages and vital resources to newly diagnosed breast cancer patients, ensuring that no one faces breast cancer alone. Positively Pink Packages has provided more than 5,000 free care packages throughout Central New York. The event will take place from 5 – 9 p.m. May 3 at BAR in Armory Square in Syracuse. Exquisite hats, mint juleps, Kentucky cocktails, a sumptuous buffet and desserts, and a festive attitude will prevail as the crowd cheers on their favorite horses while watching the “Run for the Roses” on giant-screen TVs. Tickets are $50 in advance and $75 at the door. For more information or for tickets, go to www.positivelypinkpackages.org or call Positively Pink Packages at 315-278-0645.
May 6
Animal rights movie to be exhibited in Syracuse People for Animal Rights, a nonprofit organization based in Syracuse, will sponsor the showing of award-winning film — “Minds in the Water” — about surfers who take action to protect dolphins, whales and porpoises. The event will take place at 6:30 p.m., May 6, at Onondaga Free Library, 4840 W. Seneca Turnpike, Syracuse and it’s free and open to the
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
public. For more information, call 488PURR, email ldestefano3@twcny.rr.com or visit peopleforanimalrightsofcny.org.
May 7
Unbiased Medicare basics workshops in Auburn Learn about the basics of Medicare at a free workshop to be held from 3 – 5 p.m. Wednesday, May 7, at the basement training room of the Cayuga County Office Building. This session will be 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. 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.
May 10
Family Tapestry sponsors annual walk to benefit May is children’s mental health awareness month and Family Tapestry, a nonprofit organization that embraces mentally ill youth and youth with serious emotional disorders, is sponsoring its “Hero for Hope” annual walk. The event’s goal is raise awareness of mental and emotional disorders and
raise funds for the organization. It will take place at 9 a.m., May 10, at Willow Bay Saw Mill Creek Shelter (Onondaga Lake Park). May is children’s mental heath awareness month. Suggested donation: $25 (includes T-shirt). Children under the age of 16 must be accompanied by an adult. For more information, call 315-559-2174 or familytapestryinc@ gmail.com.
May 26
Church benefit to help LaFayette Outreach The Columbian Presbyterian Church in LaFayette will host its annual Memorial Day Benefit for LaFayette Outreach from 8 a.m. – 12 p.m., Monday, May 26. The event will be held on the church grounds, located at the intersection of routes 11 and 20. LaFayette Outreach is the local food pantry and service-referral agency, and relies exclusively on grants and donations to help feed neighbors in southern Syracuse. The benefit consists of a silent auction, plant sale, bake sale, ice cream sundaes and a free kid’s craft area. All proceeds will be donated directly to LaFayette Outreach. For more information, contact the church at 677-3293 or send an email to cpresbyt@twcny. rr.com.
June 8
Scleroderma group sponsors annual walk The Scleroderma Foundation / Tri-State, Inc. Chapter will sponsor the 10th annual Syracuse Stepping Out to Cure Scleroderma to raise funds and awareness for scleroderma research and patient support. Walk information and registration can be found at walks. SclerodermaTriState.org. It will take place from 9 – 10 a.m., Sunday, June 8, at the Onondaga Lake Park — Bay View Tent Area Onondaga Lake Parkway in Liverpool. The Stepping Out to Cure Scleroderma walk is an event to raise awareness and money needed to deal with this devastating autoimmune disease. Money raised at this event will be used to help fund research efforts and provide patient support and education. To date there is no known cause or cure. For more information about scleroderma contact the Scleroderma Foundation/Tri-State, Inc. Chapter office at 800-867-0885 or visit www.SclerodermaTriState.org.
St. Joseph’s nursing graduates achieve 100 percent pass rate on national licensing exam St. Joseph’s Hospital College of Nursing Dean Marianne Markowitz reports that 100 percent of the college’s December 2013 graduates have passed the NCLEX-RN (National Council Licensure Examination for Registered Nurses) on their first attempt. The state mean pass rate year to date is 78.14 percent and the national mean is 83.04 percent. “I am proud to announce that St. Joseph’s graduates continue to excel on the NCLEX, scoring far above the state and national means,” said Markowitz. “Our graduates achieved this milestone amid an increase in the passing standard. Continuous changes in health care and nursing practice call for a
greater level of knowledge, skills and abilities than was previously required. “St. Joseph’s College of Nursing graduates demonstrate excellence as registered professional nurses who practice throughout our community as well as nationally,” she added. According to the National Council of State Boards of Nursing (NCSBN): “To ensure public protection, NCSBN member board jurisdictions require a candidate for licensure to pass an examination that measures the competencies needed to perform safely and effectively as a newly licensed, entry-level nurse.” The licensure exam for registered nurses is the NCLEX-RN.
Crouse first area hospital to perform single-site robotic hysterectomy Crouse Hospital is the first hospital in Central New York to perform a single-site robotic hysterectomy. Using the most advanced technology available, GYN surgeon Sargon Bebla uses the da Vinci Surgical System to perform the delicate and complex operation through one tiny incision in the navel. The navel nearly completely conceals any scarring. Hysterectomy is one of the most common surgeries Bebla among women and is often recommended to resolve serious and sometimes painful conditions such as endometriosis, excessive menstrual bleeding or uterine fibroids. In addition to nearly invisible scarring, potential benefits of single-site hysterectomy include minimal pain, faster recovery because of reduced trauma to the anatomy, short hospital stay and high patient satisfaction. The surgery can be performed in about one hour with a typical hospital stay of 24
hours, says Bebla, who has been using the robotic surgical technology for gynecologic and pelvic reconstructive procedures since 2009. “The single-site procedure takes the many benefits of robot-assisted hysterectomy a step further by decreasing the number of incisions from four to one. With just a one-inch incision hidden in the navel, it’s what you don’t see that is so impressive — no visible scar,” says Bebla During the procedure, Bebla sits at a console, viewing a 3D, high-definition image of the patient’s anatomy. The surgeon uses controls below the viewer to move the instrument arms and camera. In real-time, the system translates the surgeon’s hand, wrist and finger movements into more precise, delicate movements of the miniaturized instruments inside the patient. “The robotic technology gives me greater range of motion and precision than with hand-manipulated, minimally invasive procedures.” Crouse’s robotic surgery program is the largest in the region, with more than 650 procedures performed annually. Areas of clinical expertise include general surgical; urology; GYN Oncology; colorectal; and gynecology surgery.
Upstate MIND: New department at Upstate Medical University is focused on innovation Innovation is key to staying competitive in the ever-changing field of health care and Upstate Medical University has developed a focused innovation center—Upstate MIND — that will transform innovative ideas into useful, tangible ways to improve the human condition and the delivery of health care. Physician Robert Corona, who holds a Master of Business and Administration degree, is leading Upstate MIND (Medical Innovation and Novel Discovery), in the newly created position of vice president for innovation and business development. Corona, who will continue to serve as professor and chairman of Upstate’s patholCorona ogy department, is an experienced neuropathologist and a leader in bioinformatics and the application of technology in medicine. In his new position, he will report to Rosemary Rochford, vice president for research at Upstate. Corona says that Upstate MIND is open to anyone who has a good idea and who is looking for collaboration with those who have complementary skill sets. “All ideas are on the table as long as they add value to the practice of medicine,” said Corona. “We are looking for new and creative ways to improve health care practices, whether it is through the discovery of new therapies, devices, or products; to make
the patient experience more satisfying; or to improve patient access. If the idea is of value, we will support the innovator in every way possible to bring their idea to the bedside or to market.” Corona is using targeted strategies to ensure the success of Upstate MIND. “The initial emphasis of Upstate MIND is to develop expertise in next-generation gene sequencing with the goal of collaborating with oncologists for personalized oncology treatments involving patients at our Upstate Cancer Center,” Corona said “and we hope to expand to other disease states.” To assist in the process, Upstate MIND will house a molecular diagnostics reference laboratory as molecular diagnostics and bioinformatics will play leading roles in the development of new therapies. In layman’s terms, he says, “molecular diagnostics involves analyzing the building blocks of tumors as an example… or ‘picking out pieces of the puzzle’ in a tumor.” The bioinformatics “puts the puzzle together.” “The future of medicine is likely going to be driven by the analysis of genetic blueprints of disease, their protein products and personalizing therapies as a result of the analysis,” he says. Corona wants Upstate MIND to pave the way to create what he calls lifelong fearless learners. “We can accomplish this by designing novel education pathways and models for teaching and training future physicians and scientists to become innovators and pioneers in the field of health care,” he said. To discuss your innovative idea or to discuss business partnership opportunities, contact Corona at coronar@ upstate.edu or Kathy Pazaras at 315464-9288.
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FREE PARKING AT REAR OF STORE May 2014 •
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Meet
responses to treatment plans.
Your Doctor
By Lou Sorendo
Dr. Herbert L. Kunkle Jr. Auburn Community orthopedic surgeon: ‘We have to deal with too many middlemen who don’t have the patient’s best interest in mind’ Q.: What inspired you to choose orthopedic surgery as a specialty? A.: I thought I should get a good foundation of general medicine, so I was a general practitioner for five years. I enjoy surgery and enjoyed surgery in training in medical school. A lot of it deals with fracture work and reconstruction, which I enjoy. As a former athlete, I also do sports medicine. I work along the whole spectrum from young to old. Q.: What are some of the more common health issues you encounter in your practice? A.: We see a lot of degenerative conditions, such as aging major joints like knees, hips and shoulders. We see the whole spectrum from soft tissue problems, arthritic joints, ligamitis and tendon tears and disruptions.
of the more rewarding aspects of your profession? A.: Probably just taking people who weren’t functioning optimally and getting them as close to 100 percent as we can. Also, people come in with maybe four to six months of pretty bad pain. Initially, we will give them an injection or do a procedure that lessens the pain considerably. Once a surgery takes place and the patient heals from that, you see them a couple of weeks after surgery and they are walking better, lifting better or moving their shoulder and upper extremities. In orthopedics, unlike some other fields, you can see pretty quick positive
Q.: Why did you choose the Auburn area and Auburn Orthopaedic Specialists as an environment to practice? A.: I knew some of the physicians and administrators in Auburn. I’m from the Philadelphia area where all the hospitals are owned with no small independent hospitals left. What’s appealing about Auburn is working at an independent hospital, in a nice community, with a solid group of referring physicians. There are very good internists, hospitalists and primary care doctors in the Auburn area, which is always nice. Q.: What skills sets are necessary in order to be a successful orthopedic surgeon? A.: In any surgical or proceduralist-type field, you must have a good ability to think through problems from how somebody presents to the different treatment options you can give, whether they be non-operative or surgical. You have to be able to think through that and put together a treatment plan and follow through with people in a proven fashion. In the operating room, a surgeon has to have a good pair of hands. I’ve known bright, compassionate and thoughtful doctors, but some of them didn’t realize they weren’t technically as good as others, so they tended to go into non-operative type fields. Q.: How do you gain gratification from in your practice? What are some Page 6
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
Q.: What characteristics or strengths do you possess which have led to success as an orthopedic surgeon? A.: I am patient centered and still make house calls as a specialist when needed. When people come to the practice, they will find that we as a staff are very considerate and focused on the patient. In this crazy world with all the paperwork and compliance issues, there is not as much time to spend with patients as there used to be. It’s important to spend time with patients, even though you are being pulled in many different ways. I try to listen to patients and engage them in their care. I educate them on different alternatives. As a surgeon, I certainly like to operate but am pretty conservative and try to explore different options and work with patients to come up with a treatment plan. We want to educate people. The solution for most of our problems in this country is education. Hopefully, we can educate people to be better healthcare consumers. We often joke that people know more about the oil that they put in their cars than what’s going on with their bodies. Q.: What are some of the foremost challenges involved in practicing medicine today? A.: We have to deal with too many middlemen who don’t have the patient’s best interest in mind. People need to realize that. Even though we have a great healthcare system, in many ways the system is broke financially. Many regulatory bodies — the fourth branch of government — have a lot of people who really have no skin in the game and yet control the action. Many of these middlemen go home at 5 at night and 3 on Fridays. Sometimes my day doesn’t start until 7 or 8 o’clock at night due to a fracture or trauma. You are trying to give good care in a broken system with all these middlemen who have influence but really don’t add any value. When you look at these middlemen, whether it is in government or insurance, there is little added value. There are all kinds of compliance and paperwork that waste my time. Rather than taking care of patients, I am
making sure to sign papers in a timely fashion or adhere to some compliance that I’m not even sure about. It’s this whole regulatory morass with more and more middlemen [that is the most challenging to deal with]. Certainly, our system needed some tuning because it was economically unsustainable. What the government has done is horrible and it created a system that is probably going to implode if people don’t get educated and start standing up. Insurers have their heads up the government’s you know what. I have to deal with insurance every day, and if I didn’t have to talk to an insurer again, I’d be thrilled. They add no value, their CEOs are arrogant, they don’t understand healthcare and they blame you, me, hospitals and everything else. The purpose of insurance at its inception was to prevent you or I as patients from having an economically unsustainable event that can lead to our bankruptcy. That’s all it’s for and not to pay for birth control, Viagra or hospital and ER visits. It’s gone way beyond that and we let them. Q.: What have been some of the more significant medical advances over the past several years which have made the practice of orthopedics more efficient and less invasive? A.: Two big advances over the last 30 years or so have been total joint replacement along with coronary artery bypass surgery. These are procedures that have improved the quality of life. Bypass surgery might extend it while total joint replacement may not extend it, but with the time one has left, will lead to more independence and comfort. Over the last five to 10 years, there have been less-invasive procedures developed to reduce fractures and stabilize them. Computer-assisted surgery is also used in specific joint replacements, such as a partial knee replacement. Preventive treatment is also being used to address obesity, lack of fitness and osteoporosis, which are preludes to morbidity and healthcare costs. Q.: Do you see orthopedics as a popular choice among graduating medical students? Is there a shortage of orthopedic surgeons in Central New York? A.: Relative to other specialties, I don’t think there is a shortage of orthopedics in New York. Everybody seems to get an elective appointment within a couple of weeks, which to me is a good thing. In general there is a shortage of doctors across the board in the country and Central New York, but it’s more in the primary care fields like GPs and internists.
Lifelines: Herbert L. Kunkle Jr. is an orthopedic surgeon who joined Auburn Orthopaedic Specialists a year ago. He is also active as a member of the American Academy of Orthopedic Surgeons in helping to shape healthcare policy. Birth date: Sept. 23, 1952 Birthplace: San Antonio, Texas Current residence: Skaneateles Education: Bachelor of Science degree in biology/biophysics, Penn State University; medical degree, Hahnemann Medical College, Philadelphia, Pa. Affiliations: American Board of Orthopedic Surgery; American Academy of Orthopedic Surgeons Personal: Married, two daughters Hobbies: Golf, biking, reading, spending time at family home in Maine
Dead Last
Official: Culture of health is needed in Oswego County By Lou Sorendo
O
swego County is highly regarded for many things, such as its vast natural resources and rich history. However, it also traditionally features one of the highest unemployment rates in the state. Now, according to recent health rankings, it is last among counties in the state in the area of health behaviors. Health rankings for counties in New York state for 2014 have been unveiled, and once again Oswego County is among the unhealthiest in the state. In fact, it ranks 62nd out of 62 counties in the critical area of health behaviors. Rankings are divided into two main segments: health outcomes and health factors. Health outcomes involve aspects such Huang as length and quality of life. Oswego County is ranked 37th in this category. The second main segment is health factors, which entails health behaviors, clinical care, social and economic factors, and physical environment. The county ranks 58th in this segment. In the health behaviors subset, Oswego County is worse than the state
average in adult smoking, adult obesity, physical activity, access to exercise opportunities, excessive drinking, alcohol-impaired deaths and teen births. The County Health Rankings & Roadmaps is a Robert Wood Johnson Foundation program. Some of the findings for Oswego County include: • 30 percent of the adult population smokes compared to the state average of 17 percent. • 34 percent of adults are obese, compared to the state average of 24 percent. • 26 percent of adults are physically inactive, compared to the state average of 24 percent. • 60 percent of adults have access to exercise opportunities, compared to 89 percent statewide. • 22 percent of adults drink excessively, compared to a statewide average of 17 percent. • 29 percent of driving deaths involve alcohol, compared to 24 percent statewide. • The teen birth rate per 1,000 females aged 15-19 is 29 in Oswego County, compared to 24 across the state.
‘Culture of health’
For Jiancheng Huang, Oswego County public health director, the solution to the county’s ills involves creating a culture of health.
Answering the Challenge OCO takes proactive stance against county’s poor health rankings By Lou Sorendo
O
swego County Opportunities is not taking the county’s poor health ranking lightly. It has at its disposal an arsenal of programs designed to improve the health behaviors of county residents. Danielle Wert, an OCO employee, serves as the program coordinator for the Rural Health Network of Oswego County. Wert also oversees OCO’s Cancer Services Program, the Healthy Cooking Connection program and the Oswego County Falls Prevention Coalition. OCO has numerous health and human service programs that support its anti-poverty mission. The RHNOC is an example of one of those programs. RHNOC, funded through the New York State Office for Rural Health, is a consortium of over 30 health and human service providers. They are committed to collaborating to improve the quality, affordability, and availability of health care services in Oswego County by focusing key resources to address specific health care priorities and strengthen the local health care system.
Taking on tobacco
“It is incredibly significant that lo-
cal pharmacies have decided not to sell tobacco products,” Wert said. “In the tobacco-control world, the reduction of point-of-sale tobacco advertising is critical in reducing the footprint of tobacco in our communities.” The county legislature recognizing the pharmacies that have decided not to sell tobacco is an important step, she noted. New York state legislation and funding supporting tobacco control programs like the Tobacco Free Network in Oswego County is important as well, Wert added. Wert The Tobacco Free Networks have point-of-sale goals and activities in their annual work plans that include outreach and education on the importance of the reduction of tobacco advertising not just in local pharmacies, but in other businesses that sell tobacco as well, she said. “This advertising often targets adolescents,” Wert noted. One of the network’s member
“The endeavor is to build a culture of health. It will take every individual and each public and private institution in the county to work together to achieve it,” Huang said. “We need to let people know how health is determined by many factors and how community health impacts economic development. This will motivate people to build a culture of health.” Oswego County government and several pharmacies have taken a big step toward creating this culture. The Oswego County Legislature recently recognized four pharmacies for discontinuing the sale of tobacco products. They are Fulton Medicine Shoppe, Fulton; Hannibal Pharmacy, Hannibal; Hargraves Pharmacy, Fulton; and Medicine Place, Phoenix. The legislature applauded the pharmacies for considering the health of county residents above the fiscal incentive of selling tobacco products. Huang said it is significant that these pharmacies have decided not to sell tobacco products. “These pharmacies are leading the efforts in reducing adverse health outcomes from tobacco in Oswego County,” he said. “These community-minded pharmacies have already started to build a culture of health in Oswego County.” “We need to let people know these pharmacies’ spirit of putting the health of our county residents before tobacco profits and encourage every person and each business and organization to participate in building a culture of health in the county,” he noted. “Building a culture of health requires all of us to think and work differently,” he said. “At an individual level, it means taking personal responsibilities in making healthy choices that lead to healthy lifestyles.” At the institutional level, building the culture is contingent on each busi-
ness and organization fostering healthy lifestyles in the community when they make public or private decisions, Huang said. “Not every business or organization is as directly related to health as a pharmacy is,” he said. “Every business or organization, however, can help to make healthy choices easy choices for its employees and customers by promoting physical, mental, and social well being.”
organizations, Integrated Community Planning of Oswego County, offers the Tobacco Free Network program. ICP received funding from Excellus BlueCross BlueShield and Fidelis in partnership with the Oswego County Health Department, OCO, St. Joseph’s Health Services, REACH CNY and Oswego County OB-GYN to launch their “Smoke Free for My Baby and Me” program. This program targets pregnant and parenting mothers of infants who smoke with cessation resources and education.
versity’s Chronic Disease Self-Management Program and the Active Living Every Day and Walking With Ease programs. There is also the Nutrition Collaboration of Oswego County in addition to the Healthy Cooking Connection program that promotes local food resources to community members as a way to curb hunger and improve health, she noted.
Battling obesity
Meanwhile, the rate of obesity in Oswego County is among the worst in the state. Wert said improving healthy eating habits and increasing the physical activity level of residents is a goal of OCO through its Wellness Works program. It promotes positive messaging and resource sharing for employees and community members. In addition, OCO’s Women, Infants and Children program, the Head Start programs and nutrition services — Meals on Wheels, congregate meal service, and summer feeding programs — all have goals of promoting healthy weight, she noted. “Physical activity and nutrition objectives have been an on-going focus for Rural Health Network members collectively,” Wert said. The Oswego County Health Department is partnering with network members to promote evidence-based programming such as Stanford UniMay 2014 •
A starting point
“The local independent pharmacies are a small fraction of all pharmacies in the county,” Huang said. “Many great changes are rarely recognized at the beginning stages because these changes are initiated by everyday people and do not look spectacular at the start.” Huang said the pharmacies’ impacts appear seemingly insignificant, but they are part of a national trend. CVS pharmacies will discontinue selling tobacco products in its stores in October. “These pharmacies have kept reminding county residents that smoking is not a healthy choice for many years,” he said. “It is time for every individual to make healthy choices in response to the kindness of these pharmacies.” Huang said major health behavior challenges in Oswego County besides adult smoking include childhood and adult obesity, adult excessive drinking, increased sexually transmitted diseases, and illegal drug use. “These are key factors that make residents in Oswego County sicker and liver shorter lives than those in neighboring counties,” he said. “To make these behavioral changes, we need everyone’s and every institution’s involvement in building a culture of health in the county. Partnership is essential to plan, implement, and conduct projects addressing these issues.”
Controlling the drink
Oswego County is also ranked high in the state for the percentage of adults who drink excessively. OCO partners with various New York State Offices of Alcoholism and Substance Abuse Services-sponsored agencies such as Farnham Family Services and COCOAA to support the treatment of alcoholism, in addition to enhancing preventive services, Wert said. “Network partners are focused on delivering health care services that treat patients in a more patient-centered, comprehensive manner as opposed to traditional services where patients are treated only for issues they present with,” she said. “In addition, many network partners offer care management-related services that seek to improve many aspects in the lives of patients affecting their health status.” Wert said many of the Rural Health Network’s regional partner organizations attest to the outstanding collaborative nature of the health and human services organizations in Oswego County.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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My Turn
By Eva Briggs
Three-parent Babies R
ecently there’s been a lot of debate about a technique that some dub “three-parent babies.” This creates an embryo for in vitro fertilization that contains DNA from three individuals. The father’s DNA combines with DNA from the mother’s nucleus plus DNA from the mitochondria of a third person — a healthy female mitochondrial donor. The idea is to enable a woman with mitochondrial disease, who might pass the disease to her children, to produce children to whom the parents are genetically related, without transmitting the disease risk. That motivated me to wonder, what are mitochondrial diseases? First, what is a mitochondrion? It’s an organelle, a structure inside of a cell. It resides in the cell’s cytoplasm, the stuff inside the cell but outside the nucleus. Mitochondria accomplish several important functions. I learned in high school biology that mitochondria are the cell’s powerhouses. Chemical reactions in the mitochondria generate ATP, the substance that supplies the cell’s chemical energy. Mitochondria also perform important roles in signaling, cellular differentiation, cell growth
and cell death. When cells reproduce, they rely on information stored in DNA inside the cell’s nucleus. But mitochondria have their own separate DNA, and that DNA is used to make new mitochondria. How did this curious arrangement arise? The theory that seems the most likely is that bacteria came to live inside the cells of more advanced life forms. These bacteria eventually morphed into mitochondria, ceasing to live independently and becoming part of the cell. Another theory proposes that mitochondrial DNA split off from the cell’s nuclear DNA. When an embryo is formed, the sperm provides half of the nucleus’s DNA. The egg supplies the other half of the nucleus’s DNA as well as the new embryo’s cytoplasm. And since the cytoplasm contains the mitochondria, all of our mitochondria come from our mother. Thus the idea that for women with diseased mitochondria, their defective mitochondria could be removed and replaced with healthy mitochondria. Wait a minute, you might ask. If
the mother’s mitochondria are defective, shouldn’t the mother be sick, too? It turns out that the inheritance of mitochondrial diseases is not as simple as all that. Many factors seem to affect the severity and expression of mitochondrial disease, such as other inherited genes and environmental triggers. So a woman with mild disease can produce children with severe symptoms. A good example would be Mattie Stepanek, an American poet, peace activist and motivational speaker who died at age 14 in 2004. He had the disease dysautonomic mitochondrial myopathy, a form of muscular dystrophy that caused Mattie to have severe physical disabilities. The disease killed his three siblings before they reached school age. The disease arose from defective mitochondria in Mattie’s mother. She had no symptoms until later in life, after her children were born. You can learn more about Mattie and his legacy at www.mattieonline.com Although most mitochondrial diseases are rare, many different ones have been identified. Most mitochondrial diseases affect the cells with the highest energy demands: brain, nerves,
muscles, heart, kidneys, liver, eyes, ears or pancreas. Symptoms can vary widely and may be vague. Children might grow poorly, lose muscle strength or coordination, have developmental delays, increased risk of infection, seizures, and other symptoms. And some mitochondrial diseases don’t become apparent until adulthood. The diagnosis can be difficult, and often requires a physician with special training in metabolic diseases. In some cases a muscle sample, called a biopsy, is needed. This test is expensive and the sample must be sent to a highly specialized facility. There are no cures for mitochondrial diseases. But sometimes treatments reduce symptoms, delay disease onset, or slow its progression. Depending on the disease, treatment includes a specialized diet, vitamins, supplements, physical therapy, or occupational therapy. Will the technique of mitochondrial transfer work? That remains a scientific and ethical debate.
Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
World No Tobacco Day A day designated to encourage abstinence from all tobacco products for 24 hours By Gail Behm
M
ay 31 is the day we recognize World No Tobacco Day, a day designated to encourage abstinence from all tobacco products for 24 hours. The World Health Organization (WHO) established World No Tobacco Day in 1987 to draw global attention to the widespread use of tobacco products and their negative impact on health. This year’s theme is focused on raising taxes on all tobacco products, global tobacco advertising, promotion and sponsorship.
Raising taxes on tobacco products has been shown to reduce tobacco consumption in youth and lower income groups. Tobacco companies use marketing techniques that appeal to youth along with messages that are very persuasive. Marketing strategies are commonly seen in the movies, the Internet, billboards and magazines. Research has shown that the more youth are exposed to these tobacco marketing techniques, the more likely they are to try tobacco
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products. Current research noted in the “Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General 2014,” suggests that nicotine exposure during the adolescence stage may have long lasting, negative consequences for brain development. Globally, tobacco kills approximately six million people each year. More than 600,000 non-smokers die from exposure to second hand smoke. By the year 2030 this epidemic will eventually take the lives of eight mil-
lion people. Let’s make everyday World No Tobacco Day! Need help kicking the habit? Contact the NYS Quit line; 1-866-NY-QUITS. Gail Behm is a registered nurse. She works in the cardiopulmonary rehabilitation program at St. Joseph’s Hospital Health Center in Syracuse.
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Parenting By Melissa Stefanec melissa@cnyhealth.com
Cupcakes for dinner and other parenting fails
I
f you pick up any parenting magazine or visit any parenting blog on the Internet, you can very quickly discover all the ways you are falling short as a parent. You can discover you are praising your child too much or praising him or her for the wrong things. You can discover your child is playing with useless and under-stimulating toys. You can learn how uncrafty and under-motivated you are when it comes to crafts and gatherings. You can learn you are a helicopter parent or that you are a negligent monster. Considering this can all be accomplished within 10 minutes of reading, it’s no wonder so many parents have the parenting self-esteem equivalent of an awkward, middle school child. I could sit here and tell my fellow parents all the ways we are winning. I could battle back against the tirade of parenting analysis and opinions with a force of empathy and understanding. That’s not what’s going to happen this month though. This month, I am going to publically recognize all the ways I am failing as a parent. I don’t do everything right. I will never do everything right. At the risk of being called a negligent monster, a helicopter parent or anything else people may label me, I offer some of many shortcomings up on a plastic, neon pink, divided plate. This way, my daughter will have documentable evidence of how awful I am during her teenage years, but more importantly we can share in the not-so-perfect moments that make us human. • Sometimes, I let my daughter eat ice cream or cupcakes for dinner. That’s right. No vegetables. No whole grains. Very few vitamins. I did it last night after a particularly grueling doctor’s appointment. She had corn chips for dessert. That’s how we roll sometimes. • Sometimes, my daughter goes days without a bath. • There are only so many hours in a day, and sometimes she strolls back into daycare with a touch of yesterday’s maple syrup still stuck in her hair. I am a firm believer that a baby-wipe wipe down is almost as good as a bath. • One time, in a very weak moment, I told my daughter to shut up. Let’s hope the husband skips this month’s column, but yes this actually happened. I immediately started apologizing profusely. She started apologizing too. It was a rare moment of toddler-parent understanding. • Sometimes, I swear out loud. Stubbed toes and broken dishes solicit mindless swearing. I can’t watch my mouth and practice my spelling all
the time. I try to be good, and usually am, but sometimes the no-no words just slip out. • I praise my daughter a lot. Apparently, consistent praise is bad for a whole host of reasons. I am just so proud; I can’t seem to help myself from verbally recognizing her adorable accomplishments. • I let the TV babysit her when she is home sick from daycare and I have to telecommute to work. At less than 3 years old, she can navigate Netflix like a pro. Sometimes, I just have to let her overindulge in digital distraction, for both of our sanities. • I let her use digital devices while doctors are doing exams. My daughter puts up such a fuss when she is being examined, I will do anything to get her to sit quietly so she can be properly evaluated. It beats going home with a sick kid, a half-baked diagnosis, and frazzled, desperate nerves. • I bribe her with candy to go on the potty. Although potty training hasn’t come to fruition, I still praise and reward almost every properly placed bodily function with a treat. So there you have it, some real parenting moments that are less than ideal. I’ll never be perfect, but the good news is, I don’t have to be. My daughter seems to love me anyway. Maybe next month I will share some ways I am an awesome parent. After all, it would only be fair and balanced reporting on my part.
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Live Alone & Thrive
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
F
or some women, living alone in mid-life is a welcome change, especially if they are coming out of an unhappy marriage. Being alone can offer a respite from the stress and heartache of a relationship gone bad. But even when change is welcome, the prospect of living alone can still appear on the horizon as a daunting challenge. The ending of my own marriage years ago was not a welcome change, but it was a change nonetheless and one I had no choice but to accept and ultimately to embrace. It took some time and some hard-knock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to organize and offer workshops to support other women in the similar circumstances. “Living Alone: How to Survive and Thrive on Your Own” is a threepart workshop I developed to help women discover the know how to create a satisfying and enriching life on their own. I’ve been leading the workshop for almost 10 years now, and often get questions from “In Good Health” readers about what the workshop covers and how it is organized. In this month’s column, I am pleased to answer the most frequently asked questions: Q. What is the purpose of the workshop and what do you cover? A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude, and my workshop will help you think differently about living alone. Specifically, I cover how to overcome loneliness and other emotional pitfalls, banish negative thinking, rediscover your true self, socialize in a couples’ world and otherwise embrace what may be a once-in-a-lifetime opportunity to create a wonderful and rewarding life on your own. Getting good at living alone takes practice. There’s no magic pill and it doesn’t happen overnight. But it can happen — and good things can result. Feeling comfortable with your independence will improve your chances of finding contentment and it will improve your chances of finding a new healthy relationship, if that’s what you desire. When you feel better about yourself — more confident and resourceful — life on your own or with a special someone can be richer and more satisfying Q. Who attends the workshop? A. Most, but not all, of the women who attend the workshop are between the ages of 40 and 70 and have come out of long marriages or relationships. Some are on their own for the first time in their lives. All have one thing
in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist, and/or their congregation. Q. I’m still grieving the loss of my marriage/spouse. Is this workshop right for me? A. Good question. My Living Alone workshop is a “nuts and bolts” practical workshop to help women become more confident and independent on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend grief counseling or the help of a professional counselor. Q. What are your credentials? A. I’m not a licensed professional. My expertise is born out of real-life experience. I’ve “been there.” I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of living alone. After some hit and misses, I found my way and now thoroughly enjoy the freedom and independence that comes with living alone. My time-tested experience, valuable resources, and tried-and-true tips and techniques have inspired and helped many workshop participants. Q. How large are the workshops? A. Ideally, I like to have eight women in each workshop, although on occasion I have led workshops with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly gives way to a comfortable camaraderie and it’s not unusual for nice friendships to develop among participants. Q. Where are the workshops held? A. At House Content Bed & Breakfast in Mendon. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the workshop. What’s my next step? A. I like to speak with potential participants by phone, as a first step. That way, I can answer your questions and you’ll know better whether this workshop is right for you. Just call me at 585-624-7887 or email me at gvoelckers@rochester.rr.com. You’ll find information about my upcoming workshop in the Calendar of Health Events included in this issue. 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 upcoming May workshops, check out the calendar listing in this issue or to invite Gwenn to speak, call 585-624-7887 or email: gvoelckers@ rochester.rr.com.
‘Who’s the Boss?’ Actress Now the Boss at CNY Red Cross Rosie Taravella in charge of Red Cross operations in 16 counties in the region By Matthew Liptak
R
osie Taravella has gone from being an actress on TV’s “Who’s the Boss?” in the early 1990s to being the boss of the American Red Cross in Central New York today. The Skaneateles resident lived 25 years in Los Angeles. She acted for 10 years before moving back to New York state in 2007. Among other shows, she appeared in “Married with Children,” “Full House,” and other popular television shows. “I did a lot of sitcoms and commercials for about 10 years,” she said. “Nothing major but I was able to pay the bills. I wrote plays and I got those produced. I was really dedicated to it, but it began to feel a little empty for me. It sounds corny but I really did want to use my time to help people, to be a little more engaged with humanity.” Taravella is the Red Cross’s regional chief executive officer for 16 counties in the Central New York region. She said she sees parallels between her old life as an artist and her new work as an executive. As an actress she used to do 60 auditions a year and would probably get five or six jobs. She would try to make her best impression to get each part. Today she meets potential donors regularly and has to provide her best pitch in order to persuade them to give
to her organization. There were some steps in between her time on screen and her time behind the desk at the Red Cross. Around the year 2000 she gave up her work as an artist and got into fundraising for arts and education. She landed jobs at Mount St. Mary’s College in L.A. and the Los Angeles Opera, raising money for both. In 2007 she moved back to Upstate New York and worked for the Rochester-High Falls Film Festival. She was happy about the changes. It took her closer to the region she had grown up in. She was born in Dansville, attended elementary school in Marcellus and graduated from high school in Cortland. In 2009 she landed a job at public broadcasting’s WCNY where she was vice president of corporate advancement. It’s four years later and she is now with the Red Cross. Her passion for working for a good cause has made an impression on those around her. “I worked with her at WCNY,” said Matt Michael, chief communication officer for the Red Cross in Syracuse. “I’m here because I believe in what Rosie’s all about. The energy and the vision and everything that she brings here that I saw at WCNY. She’s great... extremely outgoing, personable. You could say that’s sort of the fundraising
Taravella today as the Red Cross’s regional chief executive officer
Snapshot of a YouTube video of the show ‘Who’s the Boss’ portrays Rosie Taravella and the actor Tony Danza. Rosie, but that is Rosie. That’s Rosie all the time and we see it all the time and the public certainly does.” That energy is needed. Central New York’s Red Cross has a big job to do. They do more than plan blood drives. They are at the scene of disasters big and small. They will often get a call when there has been a house or apartment fire to help those left homeless. “In the 16 counties that I oversee, last year there were, I think, 600 families that were displaced,” Taravella said. “It’s more than one a day if you were to add it all up. Typically if an apartment burns down there’s several families that can be displaced. We’re not the ones who put out the fire obviously but we are the ones who assist.” They are also called out of the area to deal with larger disasters. In the wake of Hurricane Sandy, the local office was called upon to offer help. “For Sandy every single one of our emergency relief vehicles was called to the scene so if anything happened in California that day or for those few weeks it would have been tough,” Taravella said. “We were all there. So occasionally we have to spread out and out and out. “Essentially the Red Cross builds a corporation overnight. When you’re responding to something large you need people to run shelters, people to provide food, but you also need people who do staffing and figure out who’s going to stock the warehouse.” The heart of the Red Cross is its volunteers. There are about 20 volunteers for every paid staff member, Taravella said. The Central New York office alone has 2,000 names of local volunteers in its database. At least 200 of them are very active. “They’re the ones who really interact with the client,” Taravella said. “They’re on the ground. I think it’s a very rewarding experience to be able to help somebody. We get letters from people who’ve finally moved back into a home and they’re excited about getting their lives back in order. They’ll take the time to write a letter to thank a volunteer for the compassion that he or she showed at their darkest moment. That’s a cool thing.” Currently Taravella and her organization are undertaking a strategic evaluation of how they can do a better job of accomplishing their mission. The plan may be limited because they are bound by the initiatives of the national organization, but Taravella wants to make sure they are providing Central New Yorkers with the best services. May 2014 •
Her biggest goal is to provide every community under her watch with every possible service, she said. The strategic plan will seek to answer how the services they provide to veterans and soldiers might be updated for 21st century needs. It will explore the organization’s relationship with first responders and also its collaboration efforts with other nonprofits. Taravella said she also wants to know if the Red Cross has the proper real estate footprint in the communities it serves or if they should have more of a virtual presence. The answers that are found will direct the actions of Central New York’s Red Cross into the future. It is a responsibility that this one-time actress does not take lightly. She knows her organization may have a lot on its plate in the years to come. “The truth is, disasters are on the rise,” she said. “New York state has seen three hurricanes in two years. That’s not supposed to happen. We are susceptible. We always think it’s going to happen to somebody else. These things happen to us now. We can’t hide our heads in the sand.” For more information on the programs the American Red Cross provides go to www.redcross.org.
Taravella Chosen as Executive of the Year Rosie Taravella, the chief executive officer of the American Red Cross Central New York Region, was honored as an executive of the year at the 6th annual Nonprofit Awards, which took place March 25 at the Oncenter in Syracuse. Presented by M&T Bank, Business Journal News Network and BizEventz, the Nonprofit Awards celebrate and recognize area nonprofit executives, board leaders and volunteers for their leadership and impact on the community. Taravella was one of four honorees in the Executive of the Year category, along with Janet Agostini (Friends of the Rosamond Gifford Zoo), Kerry Quaglia (Home HeadQuarters, Inc.), and Suzanne Williams (Syracuse Habitat for Humanity). “It’s an honor to be included in a group that includes Janet, Kerry and Suzanne,” Taravella said. “We all share the common goal of making our community a better place to live.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
ince 1999, Sunshine Friends and Upstate University Hospital in Syracuse have been teaming up to help the sick through the use of animal-assisted therapy. The partnership has been an unqualified success with visits expanding to the hospital’s rehab, pediatric inpatient and psychiatric units. Sunshine Friends, which is changing its name to PAWS of Central New York to more accurately represent its mission, actually provides animal visits to many facilities around Central New York. PAWS stands for pet-assisted wellness services. “We have about 180 volunteers and we visit facilities in Onondaga and Oswego counties,” said Jessica Marabella, the nonprofit’s vice president. “We’ve had requests to expand into Watertown and Cortland but it hasn’t quite gotten there yet.” The arrangement with Upstate hasn’t hit a snag yet in over a decade of operation, said Margaret Nellis, director of the program at Upstate. The reviews from patients have all been positive. “It’s working out fantastic,” she said. “They [Sunshine Friends] do all the screening of the dogs for behavior, temperament and make sure they are up to date on all their annual physicals and so forth. They take care of all of that for us. “The animals’ owners volunteer here at Upstate so they get processed through our volunteer department as does the dog. The owner and dog both get ID tags. The dogs have these handkerchiefs that say Sunshine Friends and they actually have Upstate’s ID hanging from their handkerchief. They actually go over to payroll and have their picture taken. The dogs are walking around. They have a hospital ID. It is quite funny.” The work of the dogs is serious, though.
state is 13-year-old Daphne, a golden retriever. “You often hear about how pets are good for your health, but getting the chance to see it in person was amazing one day a few years back when Daphne was visiting in 6H ICU and the patient was in a distressful situation,” O’Connell said. “They wanted Daphne in the bed with the patient and you could see on the monitor how their vital signs got better with the contact of the therapy dog.” Dogs also help in communication. Nellis said dogs often open kids up to conversation who were previously quiet. They want to know about the dog and relate it to their own pets at home. Even nonverbal patients, people unable to communicate due to their medical condition, often sport a smile when they see the animal. Not all dogs make good candidates for therapy dogs. If they have basic obedience skills and are receptive to both people and other dogs, they might be up for the challenge, Marabella said.
Caring canines
The dogs are there for socialization, entertainment and distraction, Nellis said. They sometimes even help in physical therapy, where the patients walk along with the dog or throw a ball. “The presence of a dog just brightens the environment of the hospital,” Nellis said. “Really the program has not only benefited the patients, but it also benefits the employees. When the dog is on the floor and you might be having a hard day for different reasons just like any job, and then this dog comes in and you’re like, ‘‘Oh, what a cute dog.’ The next thing you know you’re petting the dog and your stress level goes down.” Volunteer experience backs up the therapeutic value of the visiting dogs. The dog Tom O’Connell brings to Up-
Giulana was a 14-year-old patient of Upstate. Here she is having a friendly visit with a therapy dog brought in by Sunshine Friends.
Visits usually last 30 minutes to an hour. “We’re growing both with facilities and volunteers,” Marabella said. “We’re constantly holding training programs and running certification classes. We get new volunteers frequently. We also have some facilities that have reached out to us. We actually have a short waiting list of facilities at this time so we are certainly growing.” The success of the partnership between Sunshine Friends and Upstate shows no signs of slowing. The unique ability of man’s best friend to bring a smile to a patient’s face, ease physical therapy, or even improve vitals signs is now treasured by many humans who work with the animals. They offer respite to those who are in most need. “The dog is there for socialization, for distraction, for entertainment and the dog just accepts the child and the patient as is,” Marabella said. “He doesn’t care if you’re burned. He doesn’t care if you’re a stroke victim and you can’t lift your arm. The dog comes in and he’s there just for you.” For more information, go to SunshineFriends.org or call 457-7622.
Daphne is a 13-year-old golden retriever Crouse and St. Joe’s: Response who works as a therapy dog as part from Patients Positive of Upstate’s Animal Assisted Therapy Pet therapy programs are also Program. Daphne’s owner Tom O’Connell thriving at Crouse Hospital and St. said his dog seems to have an extra “spring Joseph’s Hospital, both in Syracuse. in her step” when she knows she is going to A pet therapy program was forwork at the hospital. mally implemented at Crouse Hospital in 2005. Like Upstate, the hospital is partnered with PAWS of Central New Daphne was practically bred for the job. Her parents were both hunting York. The program takes place through the hospital’s healing environment champions, O’Connell said, which initiative. lends itself to her ability to handle “The response from our patients stress. and staff members has been very “Daphne and I just love visiting positive,” said Nancy Williams, the with the children,” he said. “I think hospital’s director of patient and guest I’m motivated to do this because I relations. “Oftentimes it is our front love the feeling of making a difference line team members who are identifying in someone’s life if just for the time and advocating for patients that would Daphne is with them.” benefit from a pet therapy visit. We also Pet project have patients and visitors themselves Marabella said other volunteers inquiring about visits and helping us get similar rewards for their work. to best understand the needs of their “It gives people some satisfaction loved ones. Really, what we see is that to know that they’re making people everyone just lights up when these happy who are either sick or alone,” special volunteers come to our hospital she said. “They also really enjoy volto spend time with our guests.” unteering and having that experience St. Joseph’s Hospital just started with their own pets.” their pet therapy program in the winter Thousands of patients are visited of last year. Services are provided each year at Upstate, Nellis estimates. through Pet Partners of Syracuse (petThere are four visits a month alone in partnersofsyracuse.org). That orgapediatrics and the dogs visit at least nization is affiliated with a national a dozen kids or so with each visit. non-profit human services organization Sunshine Friends provides thousands called Pet Partners. more visits to patients outside the Four teams made up of humans hospital and the business is growing.
and dogs at St. Joseph’s make private visits to patients and families. They also go to various units in the hospital to visit with staff and keep loved ones company in waiting rooms while a patient is undergoing a procedure. “The feedback has been great,” said Rachelle Lando, coordinator of the
hospital’s office of patient experience. “The animals brighten their day and are something to look forward to. Patients have stated they can only watch so much TV as a distraction and that the dogs really bring a much needed respite to why they are in the hospital.”
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Our physicians are faculty of the Upstate Medical University We are the only group with the Academic Difference Most insurances accepted May 2014 •
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If you haven’t done patient care in the home setting, it’s a lot different and a lot more rewarding! Home healthcare allows you to see one patient at a time. So it’s more like the environment you imagined when you started your career. Home Healthcare Career Opportunities currently available in Onondaga, Oswego and Cayuga counties with Gentiva, the nation’s leading home healthcare provider. • RN CLINICAL MANAGERS – Auburn and Syracuse positions • FULL TIME RNs Onondaga, Oswego and Cayuga counties • FULL TIME OCCUPATIONAL THERAPIST – Onondaga county • Competitive Pay, Full Benefits and Paid Time Off • Flexible daytime schedules For more information 315-457-0184 or email Lynda.fox@gentiva.com Apply online at www.gentiva.com/careers
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You’ve bought insurance on the exchange.
Now what? By Lynne Scalzo
E
ntrepreneurs, part-time employees, small businesses, the unemployed and the previously uninsured were among the first to purchase health insurance plans on the new NY State of Health marketplace. Many individuals spent hours comparing options, talking to experts, determining subsidy eligibility and seeing whether their doctors and hospitals were part of the insurer’s network. Now what? Whether you’re newly insured or a health Scalzo coverage veteran, there are eight things you might want to do in 2014 to get the most out of your new health insurance plan: 1 — Pay your monthly bill as soon as possible. If you pay your bill late, you risk having a gap in coverage. Your bill is likely due by the first of each month. 2 — Don’t forget your health insurance identification card. Bring the card with you to save time at the pharmacy or doctor’s office. 3 — Understand your coverage before you need it. Do you have to meet a deductible before your health insurance kicks in? Are you familiar with your various co-pays for services? Visit youtube.com/excellusbcbs to watch educational videos on the basics of health insurance. 4 — Get paid for joining a fitness facility. All health plans on the NY State
Move Up to Retirement Living.
of Health marketplace offer up to $600 a year in reimbursement for membership to a fitness facility. Excellus BCBS members can go to excellusbcbs.com/ exerciserewards for details. 5 — Contact NY State of Health if you experience a major life event. You might have to recalculate your subsidy or choose a new plan. Major life events could include a move, a new baby or a change in your financial situation because of a divorce or job loss. You could be eligible for more financial help. 6 — Before you visit a new health care provider, make sure he or she is part of your health insurer’s network. You can confirm this information by asking your doctor or health insurer. You’ll typically pay less for services when seeing an in-network health care provider. 7 — Don’t skip your annual flu shot or routine preventive care. Much of that is now covered by your marketplace health plan at no charge to the consumer. 8 — Don’t hesitate to call your health plan with questions. Excellus BCBS members can call the customer service number on the back of their identification card. The NY State of Health website, nystateofhelth.ny.gov, lists contact information for insurers. Lynne Scalzo is vice president, business strategy and administration, Excellus BlueCross BlueShield.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
SmartBites
By Anne Palumbo
The skinny on healthy eating Why Shrimp Are a Nutritious Catch
W
hen it comes to seafood, we love our shrimp. From shrimp cocktail to scampi to kabobs, these curled crustaceans are America’s most widely consumed seafood. But, wait. Aren’t shrimp high in cholesterol? Yes, they are: an average serving can amount to a full day’s allotment for some people. However, much like nutrient-dense eggs, the benefits of eating shrimp typically outweigh the drawbacks. Let’s look at why those in the know — including the Academy of Nutrition and Dietetics—say yes to shrimp, even for those with elevated cholesterol. To begin, shrimp are an excellent source of low-calorie protein. A typical serving (around six shrimp) supplies about 25 grams of protein for a mere 135 calories. For the average adult, that amounts to nearly half of your daily needs. Protein, as many know, is a workhorse nutrient that’s essential for tissue repair and muscle building. Shrimp also serve up a healthy dose of selenium, an antioxidant mineral that plays an important role
in preventing cell damage from free radicals. Growing evidence suggests a possible link between selenium intake and reduced risk of certain cancers, including lung, bladder, colorectal and prostate. To top things off: Brains love shrimp! Not only are shrimp rich in omega-3s, which can keep the mind agile and protect against Alzheimer’s disease, but they also brim with vitamin B12—a vitamin that may ward off depression. Our bodies need this important B vitamin to make blood cells and maintain a healthy nervous system OK, back to cholesterol and why shrimp are no longer considered taboo for lots of us watching our intake. While eating shrimp does indeed raise cholesterol levels, studies have shown that shrimp boost the good (HDL) cholesterol slightly more than the bad (LDL). Go HDL! What’s more, shrimp
— in contrast to most other foods high in cholesterol — are super low in fat, with almost no saturated fat at all. Because saturated fats raise bad cholesterol levels more than dietary cholesterol itself, they’re the ones to watch out for. The bottom line? Shrimp, enjoyed in moderation and prepared in a healthy manner, can be part of heart-healthy diet.
Helpful tips:
Farmed or wild-caught? Domestic or imported? If you want to minimize your risk of exposure to unwanted contaminants in shrimp, check out the latest guidelines issued by the Monterey Bay Aquarium Seafood Watch (seafoodwatch.org) and follow those. Fresh shrimp should look translucent and moist with no black edges or spots; frozen shrimp should not have ice crystals (a sign that the shrimp were thawed and re-frozen at some point). Since shrimp naturally have a somewhat high sodium content, rinsing with plain water helps to remove some of the sodium. Choose spices other than salt to boost flavor of shrimp.
Roman-Style Shrimp with Mint
eined 1 cup chopped fresh mint or 2 tablespoons or more dried mint Goat cheese, crumbled, for garnish (optional) Heat olive oil in large, deep skillet over medium heat. Add garlic and cook until just brown, about 3 minutes. Add the tomatoes. Turn the heat to medium-high and bring to a boil, then reduce heat to medium and simmer for 10 to 15 minutes, stirring occasionally. Add red pepper flakes and black pepper, to taste. Add the shrimp and cook, stirring occasionally, until they are all pink, about 5 to 10 minutes. Stir in the mint. Serve with crusty bread or over wholewheat pasta. Garnish with goat cheese, a relatively low-salt cheese. Correction: Oops! We forgot the star ingredient of last-month’s Pea Guacamole: 1 16-ounce bag frozen peas.
Adapted from Mark Bittman Serves 4
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.
2 tablespoons extra virgin olive oil 3 - 4 garlic cloves, coarsely chopped 4 cups chopped fresh tomatoes (or 1 28-ounce can plum tomatoes, chopped, with their juice) 2 - 3 teaspoons red pepper flakes (optional) Coarse black pepper, to taste 1 pound shrimp, peeled and dev-
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Professional, convenient, locally owned and employing more than 445 Central New Yorkers. May 2014 •
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Neurofeedback Gains Popularity Technique used to treat ADHD, depression, anxiety, traumatic brain injury, alcoholism and drug addiction, among other conditions By Deborah Jeanne Sergeant
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eurofeedback sounds like a technique pulled from a sci-fi flick: three electrodes applied to the scalp can change a victim’s--or, in this case, patient’s--thinking and behavior patterns. But the practice has gained in popularity worldwide. Cynthia Kerson serves as executive director of the International Society for Neurofeedback and Research, an advocacy group for neurofeedback practitioners. Kerson estimates that 7,500 US practitioners offer neurofeedback and more than 100,000 have tried it in the past 10 years. Few research projects of any size can vouch for neurofeedback’s efficacy. Practitioners learn how to perform it through hands-on learning instead of formal, curriculum-driven education. The FDA regulates biofeedback equipment upon which neurofeedback techniques are based and classifies it as for relaxation, not treating learning and behavioral issues. But local practitioner Barry Bates said business is booming, though driven by anecdotal success passed on by word of mouth. Practitioners say that neurofeedback works by using electrode sensors to track brainwaves and compare a client’s real-time brain activity with a brain map to show the practitioner what areas of the brain are working at that moment. As the brain’s electrical impulses fire, the sensors pick up on their frequencies. In real-time, neurofeedback equipment “rewards” the client with pleasant stimuli such as pleasing sounds or
visuals the client likes. For example, if a client with ADHD experiences erratic thought patterns sensed by the electrodes, the equipment dims video he is watching. When his thought patterns focus, the video automatically adjusts and brightens to normal viewing mode, mostly without the client’s conscious awareness. Clients select their own videos or sounds. “Nothing goes into you from the sensors,” said Bates who owns Syracuse Neurofeedback. “They are plugged into an amplifier that sends it to a computer that processes the information.” Two of the sensors are active leads and one is a ground. Bates’ background is in nuclear engineering. His wife, Anne, worked as a pediatric psychiatric nurse practitioner. She became concerned about the effects of medication on her small patients. She heard about neurofeedback and wanted to train in its use. “I went along with her to her classes to try to prove it was snake oil,” Bates said. “I was skeptical of it and I became convinced otherwise.” Bates has spent the past 15 years practicing. His new clients spend an hour with him to become accustomed to the equipment and receive a “symptom inventory.” “They are categorized based upon the theoretical failure modes of the brain,” he said. “I have a symptom inventory and go through it with the person and grade it from one to 10. One is no big deal; 10 is something they want
KIDS Corner Is It Just A Cold Or Is It Allergies? Experts give parents tips on how to tell the difference
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ne of the problems that parents may have during the springtime is deciphering whether their children’s sneezing is due to a cold or allergies. “Runny, stuffy or itchy noses, sneezing, coughing, fatigue, and headaches can all be symptoms of both allergies and colds but when parents pay close attention to minor details they will be able to tell the difference,” says Michelle Lierl, a pediatric allergist at Cincinnati Children’s Hospital Medical Center.
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“Children who have springtime or fall allergies have much more itching of their noses; they often have fits of sneezing and usually rub their noses in an upward motion. They also complain about an itchy, scratchy throat or itchy eyes, whereas with a cold, they don’t,” she said. Lierl also said that nasal discharge for allergy patients is usually clear and has the consistency of watery mucus, while patients who have colds usually have yellowish mucus discharge. Lierl said that there is a blood
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
to get rid of.” He said that his scale and categorization helps him recognize which parts of the brain are underor overaroused. “The subconscious brain likes the reward, as the inherent structure of the brain,” Bates said. “It will change function to get that reward and the computer will make it more and more difficult as the brain gets better at it.” Bates said that the technique may be used to treat anxiety, depression, migraine headaches, sleep disturbances, autism spectrum disorders and traumatic brain injuries. “The client’s willingness helps, but they don’t have to consciously want to get better or sit there,” Bates said. “As long as they’re not actively fighting it, it will work. If they fight it, it will still work but it will be slower. Most people love it. Kids are transfixed by it.” The treatment may seem bizarre to the uninitiated, but Bates’ clients willingly pay the $3,400 for semi-weekly treatments of one hour for 20 weeks. Clients hope for successes like that of a
young man under Bates’ care who had been disabled by a traumatic brain injury. Bates said that he progressed from a state of non-verbal helplessness and continual care to walking, speaking full sentences, walking independently and caring for his own personal needs. Some patients may require as many as 30 sessions, depending upon the individual and what issue needs attention. Most health insurance plans don’t cover the treatment.
test called the Immunocap, or RAST, that can screen for allergy to specific foods or airborne allergens. RAST can be ordered by any doctor, but it is important that patients or their parents talk with their doctors first. Children experiencing seasonal allergy symptoms should be tested for environmental allergens present during that season and not for food allergies or allergens present during seasons when they had no symptoms. The results of the RAST test are back after seven to 10 days, whereas allergists can do allergy skin testing in one day in the doctor’s office. If parents discover that their children have allergies, Lierl suggests the following tips to combat symptoms: • Windows should be kept closed during periods of very high pollen and fungal spore levels. • Change air conditioner filters every month. • Change children’s clothing when they come inside from the outdoors. Clothes should also be washed thoroughly to rid them of all of the outdoor pollutants. • Children should wash their face, hands and hair after being outside. • Wash the child’s eyes and nose with a non-prescription saline solution when the child has been outside to
remove the pollen and fungal spores from the eyes. • Minimize early morning outdoor activity since pollen counts are higher in the morning. • Keep vehicle windows closed while traveling with an allergic child in the car to keep allergens and pollen out. • Most important, make sure children take their allergy medicine daily during the pollen season. For more information about springtime allergies, please search the American Academy of Allergy, Asthma and Immunology’s website at www. aaaai.org.
GoldenYears Study: Alzheimer’s Underreported Disease more widespread in US than reported, according to study in Neurology By Deborah Jeanne Sergeant
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yons resident Neil Washburn, 59, enjoys an active retirement. A year ago, he completed his 25-year career as director of administrative services at Wayne County Social Services, what he calls “the most enjoyable and challenging work.” Now he divides his time among volunteering, participating at Palmyra First United Methodist Church and serving on the board of the Wayne County Nursing Home. He also lives with a diagnosis of early-onset Alzheimer’s disease. Receiving the news in 2011 shocked him and his family. He wondered how long—or if—he could keep working. Washburn isn’t alone. A study published in the March 5, 2014 issue of Neurology, a journal by the American Academy of Neurology, states Fuschillo that Alzheimer’s disease is more widespread in the US than reported in the past. In fact, Alzheimer’s may contribute to more or as many deaths as heart disease or cancer, diseases listed as first and second on the Centers for Disease Control and Prevention’s list of causes of death. That would move Alzheimer’s disease up from its present sixth-place listing and would mean that about six times as many people die from Alzheimer’s disease as previously thought. “It’s overlooked by the government,” said Charles Fuschillo, CEO of the Alzheimer’s Foundation of America based in New York City.” Alzheimer’s is a stepchild as far as recognition compared with the Washburn funding for other diseases. I hope the government will increase funding for providing care and for research. “Hopefully one day there will be a cure for it. There are a lot of trials out there.” Fuschillo said that one of the reasons Alzheimer’s has been overlooked as a cause of death is that it diminishes the person’s ability to communicate his symptoms to health care providers until the point where an illness such as pneumonia takes his life. “It’s critically important that a caregiver communicates properly with a primary caregiver,” Fuschillo added. Sharon Brangman, geriatrician with SUNY Upstate Medical University, is not surprised that Alzheimer’s disease is under-diagnosed. “Death certificates aren’t always accurate about the cause of death,” she said. “Many doctors aren’t aware
you can die of Alzheimer’s. Often, an infection like a urinary tract infection or pneumonia is the immediate cause of death, but the actual cause of death is Alzheimer’s.” She explained that since the disease causes the brain to break down, other bodily functions also deteriorate. Incontinence makes people who are in the last stages of Alzheimer’s more prone to infection, for example. “When people have trouble with swallowing, they are more prone to aspirating,” Brangman said. “They have an impaired immune response, so they’re more prone to illness. They maybe don’t eat a lot and don’t move a lot which makes them prone to illness.” Part of the reason for the seeming increase in Alzheimer’s cases is better, earlier diagnosis. Previously, someone like Washburn would have been Brangman overlooked since he has remained relatively stable since onset and does not fit the typical earmarks of an older, frail Alzheimer’s patient. A single father of two adult sons, Wasbhurn lives alone. His concern about his own memory loss grew since about 2008 as he began realizing that “it seemed like time seemed to rush by, or, by logical deduction, I was acting and reacting slower. I was taking more time to achieve less. That was an awareness trigger.” After a referral from his primary physician and subsequent testing by a neurologist, Washburn received an Alzheimer’s diagnosis. In the past, autopsies provided the best way to absolutely confirm Alzheimer’s. But imaging, blood tests and diagnostic tools can pretty much confirm a diagnosis now. “There are lots of aspects as to how this disease approaches people,” Washburn said. “A portion have it attacks them one way and probably have a completely different exposure. Long distance memory is usually not affected, but the current stuff.” Keeping meticulous notes, setting reminder alarms and taping reminders in conspicuous places helps Washburn keep on top of his appointments and obligations. “I’m still capturing and producing the quality [of work] I always have had but it’s a much bigger struggle to maintain a focus,” he said. “Before this issue, your brain kicks in and just does it for you.” Two prescription medications help slow the disease’s devastation, buying time for Washburn. Brangman said that early diagnosis has become an important part of helping people and their families cope and, hopefully, stabilize the disease. “We don’t have a cure right now
but we do have some ways of delaying the time when they’ll have more obvious symptoms,” Brangman said. “It also gives families a chance to get things organized and that person can decide how they want to see their care proceed. “It’s a scary diagnosis but there’s lots of support and we can help a person have the highest quality of life. If you exercise and watch sugar intake, you may be able to help your memory stabilize, some studies say.” As for Washburn, he takes a philosophical approach to knowing what may cause his death. Though he will likely miss out milestones many others typically experience, his diagnosis has helped him develop “a greater appreciation for healthiness and life activities. I’m living on borrowed time.” He has made his final wishes known and wrapped up his legal affairs to make things easier on his family. He has thought of creating a “bucket list” of things he wants to do while he can still do them. “I think what I want to do with the
May 2014 •
time I’ve got and mental faculties is to squeeze every minute of the day into time well lived and enjoyed and make an achievement of having done things with and for other people that not only makes things better for them, but in the same process but makes me feel better about myself and the whole process of how people, together, should do the best for others,” he said. He enjoys volunteering with fellow church members to repair homes for needy people in the community. “How can you be sad when things are being done for good reasons to people who need it?” he asked. “It takes my mind off my own problems. ‘Do as much good as you can for as many people as you can for as long as you can,’ one of our ministers said. Then you have no regrets.” He also realizes that no one knows when he will die, and that death will surely come to every person. “Whatever life we have left, it’s fitting to give it to help others who are in need or are otherwise would not be able to do things,” Washburn said.
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GoldenYears
Golden Opportunities Local organizations offer help with planning twilight years By Matthew Liptak
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s we age, life can get more challenging. It may be you need to plan for long-term residential needs or to simply find a reliable contractor to work on the house. Either way, there are many in the area who specialize in helping seniors find quality care. CNY Elderplanning in Camillus has geriatric care managers who offer older people and their families help in coordinating home care, residential care, alternative care and ideas on how to finance those options. “We look at the whole picture of a client,” said CNY Elderplanning geriatric care manager Lisa Mitchell. “We’re looking at their overall health care. We’re looking at their legal and financial situations, residential options and overall ongoing care management. The whole idea is creating an action plan before a crisis occurs and trying to plan for their future whatever that looks like, whether they want to remain in their home or go somewhere else.” Unfortunately, Mitchell many older people wait until there’s a crisis before they get help instead of planning ahead. “We have a lot of people as they age fall and break bones and end up in the hospital,” Mitchell said. “I see a lot of hospitalizations over and over and over again.” Embracing Age is an eldercare services membership program that is part of the St. Joseph’s Hospital Health Center System in Syracuse. Susan Clancy-Magley, the program’s director, has also noticed clients often wait until they are in a crisis situation before
getting help. “The beauty of Embracing Age, and that’s the word we try to get out, is we can become involved with families with seniors before they have a crisis,” she said. “Number one, we can help avoid the crisis [such as a fall]. Number two, we can have the pieces in place. When an elder life specialist meets with a person, it’s not just, ‘What do you need right now?’ it’s ‘OK, what if something happens? What hospital would you like to go to? What rehab facility do you think you’d like to go to?’ We would have all that information so if something happened we would say ‘Yup, this is what our members want.’”
Embracing the golden years
Rather than geriatric managers, Embracing Age calls its caseworkers elder life specialists. As part of its first-tier membership program, which costs $500, members get an initial assessment of their situation by a specialist and then 10 hours of specialist consultation over the course of a year. There is also a $50 membership that offers access to the preferred providers and elder life specialists on an hourly basis. For the first-tier membership, the elder life specialists Clancy-Magley assess a member for home management and also do a safety assessment. If they see things that can help, like putting in an additional bar in a bathroom tub or increasing a home’s safety in other ways, they will alert a member to the issue. A member’s needs can vary though and Clancy-Magley emphasized the program is versatile.
What They Want You to Know: Gastroenterologist By Deborah Jeanne Sergeant The American College of Gastroenterology states on its website (www. Page 18
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gi.org) that the specialty focuses on “the normal function and diseases of
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
“For some people, it is socialization,” she said. “So it’s going through and getting to know the person and to find out what their interests are and what their desires are. People have comprehensive dreams, desires, and ideas of how they want their life to go. We want to be able to be there for everything.” Mitchell had a number of suggestions on how individuals can better navigate their later years. Most of them seem simple enough: • Get enough sun so you can get the vitamin D your bones need to stay healthy and drink enough water so you don’t get dehydrated and become dizzy and fall. • Keep a journal of all your medications, surgeries and procedures, she said. Doctors are often very busy and don’t always communicate with each other the way they should on behalf of a patient. You need to know what your own medical situation is. • Consider long-term care insurance if you can afford it. It may make the difference between you being able to stay in the home you love and being sent to a nursing home.
Determine your quality of life
“It could make or break the opportunity for somebody to remain in their home and have a good quality of life in their later years,” Mitchell said. “That would be a huge piece of advice, to make sure they have long-term care insurance.” She also said to get your docu-
the esophagus, stomach, small intestine, colon and rectum, pancreas, gallbladder, bile ducts and liver. It involves a detailed understanding of the normal action (physiology) of the gastrointestinal organs including the movement of material through the stomach and intestine (motility), the digestion and absorption of nutrients into the body, removal of waste from the system, and the function of the liver as a digestive organ.” • “The specialty of gastroenterology and hepatology involves a myriad of conditions. • “Of course we deal with colon cancer screening which has dramatically decreased the incidence of colon cancer and have save lives and torment. But as opposed to the popular opinion, our specialty is not all about the rectum. • “We like patients who come to our office to be educated and interest-
mentation in order for your entire life because if you need to go on Medicaid, you’ll be prepared. Many of her clients have needed to because the average cost of a nursing home is now around $11,000 a month, she said. Both Mitchell and Clancy-Magley said they consider it a privilege to be able to work with their older clients and their families. They are part of the evolving service industry that seeks to serve Central New Yorkers in their later years. They are jobs they feel lucky to have. “Today, how lucky am I?” Clancy-Magley said. “One of our members is at the Nottingham and I stopped to see him and hand him over a Valentine’s Day card and a box of candy. I went up to the Cunningham, did the same thing. I just sat with one of our members who was having lunch, got filled in on everyone in his family and I’ll be going to St. Joe’s Hospital later today for one of our members who fell and ended up in the hospital. How lucky am I to get to know these older people who have lived fabulous lives and have so many wonderful stories to tell?”
ed about their conditions so we can empower them to actively participate in becoming healthier. • “Despite all the administrative changes in health care, I can think of no other career I would enjoy better than taking care of patients.” Thomas J. Romano, gastroenterologist with Gastroenterology & Hepatology of CNY, Liverpool 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.
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How to Get Help with Medicare Decisions Dear Savvy Senior, Where can I get help with my Medicare decisions? I’m approaching 65, and could use some help sorting through the different Medicare plan options that are available to me. Almost Eligible Dear Almost, The options and choices available to Medicare beneficiaries today can be overwhelming. In addition to original Medicare (Part A and B) that has been around for 49 years, you also have the option of enrolling in a Part D prescription drug plan, and a supplemental (Medigap) policy — both of which are sold by private insurance companies. Or, a Medicare Advantage plan which covers health care, prescription drugs and extra services all in one. These plans, which are also sold by private insurers, are generally available through HMOs and PPOs. To help you figure out the Medicare plans for you, there are a variety of services and tools available today depending on how much help you need. Here are several to get you started.
Free Resources A good starting point to get familiar with Medicare is the “Medicare & You” 2014 handbook that overviews the program and your options. You can read it online at medicare.gov/pubs/ pdf/10050.pdf, or you should receive a free copy in the mail one month before your 65th birthday. The Medicare website also offers a free “Plan Finder” tool at medicare. gov/find-a-plan that can help you find and compare health plans, supplemental policies and prescription drug plans in your area. Or, if you don’t have Internet access, or don’t feel confident in working through the information on your own, you can also call Medicare at 800-633-4227 and a customer service representative will do the work for you over the phone. Other free resources that can help include planprescriber.com or ehealthmedicare.com, two websites developed by eHealth Insurance that will compare Part D, Advantage and supplemental plans in your area and connect you to a licensed insurance agent.
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In addition, the Medicare Rights Center (medicarerights.org) staffs a hotline at 800-333-4114 to help answer your Medicare questions. And your State Health Insurance Assistance Program (SHIP) provides free Medicare counseling in person or over the phone. To find a local SHIP counselor see shiptalk.org, or call the Eldercare Locator at 800-677-1116. And, for tips on choosing a top Medicare Advantage plan, see the HealthMetrix Research Cost Share Report at medicarenewswatch.com. This resource lists the best Advantage plans by area based on your health status.
Fee-Based Services If the free services don’t cut the mustard and you need some additional help in making your Medicare decisions, there are a handful of fee-based companies that are very helpful. One of the best is Allsup Inc. (ama. allsup.com, 866-521-7655) which offers a Medicare adviser service that takes your personal information online or over the phone, such as the prescription drugs you take and the doctors you use, and provides you customized advice on the best Medicare plans that match your needs and budget. They’ll even help you enroll in the plan(s) you select. Fees for their services range between $200 and $495 depending on how much help you need. Another option is Healthcare Navigation (healthcarenavigation.com, 877-811-8211), which charges $750 for a 90-minute comprehensive Medicare consultation.
Commission-Based Another way to get help with your Medicare enrollment is to consult an independent insurance agent. Agents typically get paid a commission to sell you a policy, although they offer plans from a number of providers. The Independent Insurance Agents and Brokers of America have a directory on their website (see independentagent.com/contactus) that lets you search for agents in your area. But keep in mind that agents typically specialize in the Medicare plans they represent, rather than all the plans in your market. 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 • May 2014
Provided Deborah Banikowski, Social Security OfficeSocial Security Office
E
Older Americans Benefit From ‘My Social Security’
ach May, groups and organizaSecurity statement, be sure to visit tions around the nation join in cel- our Retirement Estimator. Like a “my ebrating Older Americans Month. Social Security” account, you can use Established in 1963, Older Americans it as many times as you’d like. The Month provides an opportunity for our estimator lets you change variables, nation to recognize seniors for their such as retirement date options and many contributions and share imfuture earnings. You may discover portant information to help them stay that you’d rather wait another year or healthy and active. two before you retire to earn a This year’s theme is “Safe higher benefit. To get instant, Today, Healthy Tomorrow.” personalized estimates of your Social Security has something to future benefits just go to www. help keep you safe and healthy: socialsecurity.gov/estimator. a suite of online services. Rather Deciding when to retire is than driving or taking public a personal choice and depends transportation to a local office, on a number of factors. To you can use our secure, free help, we suggest you read online services to handle much our online fact sheet, “When of your Social Security business. To Start Receiving Retirement With the amount of time you Benefits,” available at www. save, you’ll have more time to Banikowski socialsecurity.gov/pubs. spend with the grandkids or If you’re ready to retire, the online have time for a brisk walk around the service you’ve been waiting for is our neighborhood or local park. online application for retirement beneBefore going for that walk, though, fits, which allows you to complete and visit www.socialsecurity.gov. Whether submit your application in as little as you already receive benefits or you’re 15 minutes at www.socialsecurity.gov/ just starting to think about retirement, retireonline. Once you complete and it’s a great time to open a “my Social submit the electronic application, in Security” account. most cases, that’s it—no papers to sign “My Social Security” is a secure on- or documents to provide. line account that allows you immediate Are you already receiving benefits? access to your personal Social Security You can use “my Social Security” to information. During your working immediately get your proof of benefits years, you can use “my Social Security” letter, change your address or phone to view your Social Security statement number on our records, start or change to check your earnings record and see your direct deposit information and estimates of the future retirement, discheck your benefit and payment inforability and survivor benefits you and mation. your family may receive. Check it out We encourage you to take advanat www.socialsecurity.gov/myaccount. tage of our online services and resourcAfter you check your online Social es, freeing up more time for activities you really enjoy. Learn more at www. socialsecurity.gov.
Q&A
Q: I lost my Social Security card, but I remember my number. Do I really need a new card? A: No, probably not—but it is important to know your number. The only time you may need the Social Security card is if your employer asks for it when you get a new job. If you do decide to get a new card or your lost one turns up, don’t carry it with you. Keep it with your other important documents. Generally, you are limited to three replacement cards a year and 10 cards during your lifetime. Legal name changes and other exceptions do not count toward these limits. Keep in mind this is a free service. Learn more at www.socialsecurity.gov/ssnumber. Q: What type of information will I need to provide if I’d like to apply online for Social Security retirement benefits? A: Whether you apply for retirement benefits online, by phone or in an office, we suggest that you have the following information at hand when
you do it — it will make completing the application easier for you. • Your birthdate, place of birth and Social Security number; • Your bank account number and your bank’s routing number, for direct deposit; • The amount of money you earned last year and this year. If you are applying for benefits in the months of September through December, you may also need to provide an estimate of what you expect to earn next year if you plan to continue working; • The name and address of your employer(s) for this year and last year; • The beginning and ending dates of any active military service you had prior to 1968; and • The name, Social Security number and date of birth of your current and any former spouses. Depending on your situation, you may need to provide additional documentation with your application. We’ll give you instructions on how to mail or bring it to us. To get started, visit our Retirement Planner at www.socialsecurity.gov/retire2.
H ealth News NP joins University Otolaryngology Associates Nurse practitioner Kirsten L. Manganiello has recently joined the practice of University Otolaryngology Associates of CNY, LLP, based in Liverpool. Before joining the practice, Manganiello provided patient care as a registered nurse for seven years in the field of otolaryngology. Manganiello received her nursing degree from The Decker School of Nursing at Binghamton University and her master’s degree in nursing from Manganiello SUNY Upstate Medical University in Syracuse. She is certified as a family nurse practitioner by the American Academy of Nurse Practitioners. Other medical doctors in the practice include Robert Kellman, Tucker Harris, Jack Hsu, Richard Kelley, Anthony Mortelliti, Brian Nicholas, Amar Suryadevara, Sherard Tatum, and Charles Woods.
Method 360 holds grand opening in E. Syracuse Method 360, a fitness studio, has re-opened in the former Strength in Motion location off Bridge Street, next to Rico’s restaurant in East Syracuse. According to owner Trish Gallen’s is a unique type of studio. It offers workouts designed to prevent injury and enhance clients’ outside activities, including races and athletics. It’s located at 314 E. First Street. Gallen’s philosophy on exercising is like no other in the Syracuse market, she said. “I believe that people would embrace exercise if it was treated less like torture and more like a lifestyle.” She said she refuses to tell clients what to do, instead she tries to empower them to learn why what they’re doing works or doesn’t. “Knowing what works and what doesn’t is half the battle. I wish someone told me how this stuff actually worked a long time ago. I had it all wrong for 20 years.” M360 classes offer a full body workout and includes a large TRX apparatus that Method 360’s clients have named “The Rack.” Method 360 has no start-up or cancellation fees. Clients can choose from several purchasing options, including discounted class passes, monthly auto-renews, and yearly memberships.
Oswego Hospital welcomes new hospitalist Oswego Hospital welcomes hospitalist Clarissa Del Rosario to its active medical staff. Del Rosario will care for inpatients at Oswego Hospital whose primary
care physicians have opted to take advantage of the healthcare facility’s hospitalist program. Del Rosario is board-certified as both an internist and as a nephrologist. A member of the hospitalist team is always in the hospital, able to provide immediate Del Rosario care, including the ordering of tests and procedures. Since a hospitalist is always available, they can conveniently discuss the plan of care with their patients and their family members. Oswego Hospital implemented its hospitalist program in 2009. Del Rosario earned her medical degree, graduating cum laude from Far Eastern University Medical Center in the Philippines, where she also completed a post-graduate internship. Del Rosario completed an externship in internal medicine at Providence Hospital, located in Washington, DC, and an internship and residency, also in internal medicine, at Winthrop University Hospital in Mineola. She fulfilled her nephrology fellowship at the University of Medicine and Dentistry of New Jersey and Robert Wood Johnson University Hospital. Del Rosario said it has been her goal since she was 5 years old to become a physician. In her native Philippines, her grandfather had a successful general physician practice.
Breast Health Center. “Crouse is dedicated to providing the best possible screening and treatment services to all women,” said physician Stephen Montgomery, medical director of the Crouse Breast Health Center. “Unfortunately, a lack of education about the services we provide or a lack of access to healthcare prevents many women from getting an annual mammogram, even though it can save lives.”
Run For Dennis raises over $10,000 More than $10,000 has been raised by more than 450 participants in the third annual Run For Dennis 5K Run/ Walk, held March 15 to honor the memory of Oswego resident Dennis Pacheco, a victim of bladder cancer. “The event was a tremendous success and a wonderful day to remember
my Dad,” said Jessica Newson, race director and Pacheco’s daughter. “We have raised a total of $36,000 over the past three years and have donated it to the Bladder Cancer Advocacy Network, the oncology unit at Oswego Hospital, and Strong Memorial Hospital in Rochester. It’s another way we’re continuing my Dad’s fight to find a cure for bladder cancer and give comfort to families who are
Oswego Hospital receives Excellus incentive Oswego Hospital has been awarded $56,361 by Excellus BlueCross BlueShield as part of the health insurer’s Hospital Performance Incentive Program. “The physicians and staff are constantly working to improve the quality of care at Oswego Hospital,” said Chief Medical Officer Renato Mandanas. “We
Oswego Health Recognizes Its Volunteers and Auxilians
Crouse Receives $48,000 Grant from Komen Crouse Hospital has been awarded a $48,000 grant from Susan G. Komen Central New York to continue efforts to raise awareness regarding free and reduced-cost breast health services for women in the area. The Komen grant enables Crouse to build upon ongoing outreach efforts dedicated to providing underserved women the opportunity to take advantage of free screenings and other breasthealth services through three areas of focus: • Targeted outreach projects to specific minority groups in the Syracuse area, including refugee populations and chemically dependent populations. • Establishing connections with OB-GYN physicians and practitioners who have patients under the age of 40 with a family history of breast cancer or abnormal results from exams. • Outreach and educational programs aimed to support those who are uninsured. The grant also helps Crouse provide mammograms and other tests for women who otherwise could not receive them because they carry insufficient insurance or do not qualify for Onondaga County’s Cancer Services Program. Crouse continues to work on educating the community about the importance of early detection of breast cancer and access to testing services available to women through the Crouse
Oswego Health recognized its many dedicated volunteers and its auxilians at a luncheon held during National Volunteer Week. The health system has nearly 100 volunteers and auxilians who devote their time helping to ensure exceptional healthcare is available locally. At the luncheon, the volunteers were given a small gift in appreciation for their service and Oswego Health President and CEO Ann C. Gilpin showed a video that illustrated how completing a small task can lead to big things. At the luncheon, several members were May 2014 •
also recognized for their many years of service. Seated in the photo from left are Maurice “Mo” Laws, who volunteered 3,522 hours this year at Oswego Hospital, which was nearly double what he volunteered last year, and Emma Corradino, who has volunteered for an unprecedented 28 years, the longest of any volunteer. Standing are Amy Oralls, who has volunteered 1,074 hours, which was more than double the hours she volunteered last year in Oswego Hospital’s emergency department; and Debbie Hough, who has been a hospital volunteer for ten years.
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have put several programs in place which have been very successful and we will continue to build on these programs. Our expectation is that all our patients will experience a high level of quality care and at the same time enjoy a pleasant customer service experience, as we want to become the healthcare provider of choice.” To improve its patient quality, Oswego Hospital implemented an Excellus endorsed program, Bordering on Zero, which assisted the healthcare facility in nearly eliminating the number of patients who experience pressure ulcers during their stay. Excellus first made the incentives available in 2010 and since then, Oswego Hospital has received more than $140,000 for making quality improvements. Oswego Hospital was among 47 area hospitals to be presented an award by Excellus for making quality improvements in 2013.
COMING PETS SPECIAL ISSUE Don’t miss the next issue of In Good Health—CNY’S Healthcare Newspaper Call 315-342-1182 for advertising information
Radio Show ‘Take Care’ Turns 1 Health and wellness show marks one year anniversary with big names and bigger topics “Take Care,” an award-winning program, debuted a year ago on WRVO Public Media as a new halfhour locally-produced health and wellness program. Hosts Lorraine Rapp and Linda Lowen have hosted 50 distinct shows since then with regional and national experts on a variety of topics. From developments in disease research to advances in nutrition to dissecting popular health myths, “Take Care” has supplied its listeners with a wide variety of health information. Over the past year, listeners have heard from doctors and experts at the Mayo Clinic, the Centers for Disease Control (CDC), the Cleveland Clinic, the Memorial Sloan Kettering Cancer Center and more. Many guests have written best-selling novels or have written extensively on their topics — like Gretchen Reynolds, health blogger for the New York Times. Some “Take Care” guests are considered world experts in their field. These include: Charles Hennekens, the first to discover that aspirin prevents a first heart attack, reduces mortality when given during a heart attack, and benefits a wide range of heart attack survivors; physician Norman Kaplan, who wrote the text book on hypertension; and physician Lynn Schuchter, who is at the forefront of research into melanoma. These are just some of the people behind the vast knowledge base “Take Care” has established thus far.
Linda Lowen and Lorraine Rapp are celebrating one year as the anchors of “Take Care,” a healthcare show that airs at 6:30 p.m. on WRVO-FM. Whether it’s basic information to help you understand a diagnosis or an in-depth look at the science behind food packaging, “Take Care” provides interesting and engaging information to a broad listener-base. Hosts Lorraine Rapp and Linda Lowen ask the right questions to help you pursue a healthy lifestyle. “Take Care” airs each Sunday at 6:30 p.m. and is also available for play-
back or download on the WRVO website. Podcasts of “Take Care” are also available on iTunes. “Take Care” marks the fourth collaboration of co-hosts/ co-producers Rapp and Lowen, who previously co-hosted and produced the award-winning women’s issues program “Women’s Voices” from 19982006, first on WAER-FM, then on Time Warner Channel 13 and WCNY-TV.
ExcellENT Care New Center of Excellence in ENT Surgery
Lakeshore ENT offers the highest standard of otolaryngology and facial plastic surgery care. The Board Certified team of Melanie Pence, D.O. and Nicholas Groch, D.O., provide exceptional ear, nose and throat care for patients ranging from young children to the elderly. Using the latest technology, Lakeshore ENT is the region’s new Center of Excellence for ENT care.
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Call For Appointment: 349-5828 Oswego Health Services Center: 140 West Sixth, St., Suite 210, Oswego, NY 13126
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014
Silver Fox Senior Social Club Helps Members and Their Families
E
llie Jerome is 99 years old, but she still dances, sings, creates crafts and, most importantly, makes friends — all at the Silver Fox Senior Social Club in Baldwinsville. “I love to come here,” said Jerome recently. “People are nice to you. I have fun, learn new things and talk to other people.” Her attendance at Silver Fox helps her avoid the isolation and loneliness that often occur among the elderly. “It does her a world of good to be there, and it provides me respite from caregiving a few days a week,” added her daughter, Carol Westfall, who enrolled her mother in the program almost five years ago. Opened in 2007 to meet a growing need for seniors and their families, Silver Fox Senior Social Club provides an enriching, interactive schedule of activities Monday through Friday from 7:30 a.m. to 6 p.m. Other services include assistance with personal care (including showers and toileting), medication reminders as well as physical therapy provided by Onondaga Physical Therapy. Aides are certified and trained in Alzheimer’s and dementia care, diabetic care and other conditions common in the elderly. An on-site chef prepares a homemade lunch each day as well as morning and afternoon snacks. Meals may be customized according to members’ needs. Silver Fox Senior Social Club is located on the Seneca River at 22 E. Genesee St. in the heart of Baldwinsville. Transportation for those living in Onondaga County may be arranged through Call-a-Bus. Flexible private pay membership plans are available as well as special assistance through the Veterans Administration and the Onon-
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Genesee Medical Center: 1200 E. Genesee Street, Syracuse, NY 13210 Tel: (315) 475-1669 * Fax: (315) 475-9518
River Vista Medical Center: 810 South 1st Street, Fulton, NY 13069 Tel: (315) 593-1529 * Fax: (315) 593-1542
North Medical Center: 5100 West Taft Road, 2A, Liverpool, NY 13088 Tel: (315) 452-2555 * Fax: (315) 452-2559
St. Joseph's Medical Office Center: 104 Union Ave., Suite 905, Syracuse, NY 13203 Tel: (315) 703-5116 * Fax: (315) 703-5109
Northeast Medical Center: 4109 Medical Center Dr., Fayetteville, NY 13066 Tel: (315) 329-7555 * Fax: (315) 329-7559
Oswego Location: 300 State Route 104 East, Oswego, NY 13126 Tel: (315) 216-6060 * Fax: (315) 216-6249
Radisson Health Center: 8280 Willett Parkway, Baldwinsville, NY 13027 Tel: (315) 635-6814 * Fax: (315) 635-6816
West Medical Center: 5700 West Genesee Street, Camillus, NY 13031 Tel: (315) 631-6555 * Fax: (315) 631-6559
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2014