Igh cny 179 nov14

in good New Health Commissioner

Physician Indu Gupta is moving from California to take the reins of Onondaga County Health Department, CNY’s largest

Crunch Time for PTs

Physicial therapists’ double trouble: higher co-pays for patients, lower reimbursement for PTs

November 2014 • Issue 179

CNY’s Healthcare Newspaper

‘How I lost 40 pounds’ Newspaper reporter shares his experience trying to lose weight Page 11

Can Human Growth Hormone Reverse Aging?

Second Act

Seeking a Second Opinion?

A psychologist and a surgical nurse now run their own business — a horse farm in rural Madison County

Sure, but please, not in the urgent care, says physician Eva Briggs New internist in Oswego, Joan Newell, talks about how small lifestyle changes can make a big difference in one’s health

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Teen Driving Vehicle crashes still the leading cause of death among teenagers

Humble rutabaga rocks with nutrition Find out why rutabaga is the star of this month’s SmartBites column Page 13

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OSTOMIES Bill to cover equipment and supplies signed into law.

Page 9 November 2014 •

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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s e i r u j n I Crash More 2.5 million people ended up in the ER in 2012

M

ore than 2.5 million people went to the emergency department (ED) — and nearly 200,000 of them were hospitalized — because of motor vehicle crash injuries in 2012, according to the latest Vital Signs report by the Centers for Disease Control and Prevention.

Lifetime medical costs for these crash injuries totaled $18 billion. This includes approximately $8 billion for those who were treated in the ED and released and $10 billion for those who were hospitalized. Lifetime work lost because of 2012 crash injuries cost an estimated $33 billion.

“In 2012, nearly 7,000 people went to the emergency department every day due to car crash injuries,” said CDC Principal Deputy Director Ileana Arias. “Motor vehicle crash injuries occur all too frequently and have health and economic costs for individuals, the health care system, and society. We need to do more to keep people safe and reduce crash injuries and medical costs.”

Key findings include:

• On average, each crash-related ED visit costs about $3,300 and each hospitalization costs about $57,000 over a person’s lifetime.

• More than 75 percent of costs occur during the first 18 months following the crash injury.

• Teens and young adults (15-29 years old) are at especially high risk for motor vehicle crash injuries, accounting for nearly 1 million crash injuries in 2012 (38 percent of all crash injuries that year).

• One-third of adults older than 80 years old who were injured in car crashes were hospitalized — the highest of any age group.

• There were almost 400,000 fewer ED visits and 5,700 fewer hospitalizations from motor vehicle crash injuries in 2012 compared to 2002. This equals $1.7 billion in avoided lifetime medical costs and $2.3 billion in avoided work loss costs.

See related story in Kids Corner, page 8.

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‘Hog Wild Jam’ fundraiser hosted by Arc of Oswego Arc of Oswego County will host its second annual “Hog Wild Jam” at 5:30 p.m. on Friday, Nov 14 at Hibernians (22 Munn St., Oswego).

Arc of Oswego County and its sister agency, Oswego Industries, Inc., are private, nonprofit organizations.

The mission is to be a partner in the development of comprehensive community services designed to improve the quality of life for all people, with the primary emphasis on those with disabilities by providing the necessary support programs to enable individuals to grow with dignity and achieve their highest level of independence and self-fulfillment.

“At the Hog Wild Jam fundraising event, there will be live music, food, raffles, silent auctions, and much more.

In an effort to ensure the financial future of our organization, our agency relies heavily on community support” said Arc of Oswego County Marketing Manager Heathe Jones. “This event is one of our largest fundraiser events of the year and all money raised will go back into the programs that Arc of Oswego County provides,” said Jones.

Visit www.arcofoswegocounty. org for more information about Arc of Oswego County and to find ways that you can help. For ticket information, please contact Heathe Jones at 591.4419 or by email at HJones@oswegoind.org.

Nov. 15

Oswego literacy group sponsors event The Literacy Coalition of Oswego County (LCOC) will host a free literacy event, “Fizz! Boom! Read!,” noon – 3 p.m., Nov. 15 at Lura Sharp Elementary School, 2 Hinman Road in Pulaski.

“The event promises to be a wonderful celebration of literacy and the joy of reading for all ages — from preschool through adults,” said Meg Hen-

derson, co-chairwoman of the event.

“There will be a multitude of activities for families throughout the day. Among these are balloon animals, craft projects and the ARISE Unique Art Exhibit.

Kids will also get the chance to interact with local authors and character of the books “The Cat in the Hat” and “Dr. Health E. Hound.” Door prizes will also be offered.

Nov. 22

Jingle Bell Run / Walk to help arthritis causes The Jingle Bell 5K Run/Walk, scheduled to take place Saturday, Nov. 22, will once again bring runners and families together to raise funds to fight and cure arthritis, the nation’s leading cause of disability. The annual festive event, which features a holiday costume contest, kids’ zone and fun run, music and a sponsor expo, will be held at Onondaga Community College at 10 a.m. Registration begins at 8 a.m. inside the SRC Arena and Events Center.

More than 1,500 residents including competitive and recreational runners, walkers, corporate teams and families are expected to participate in the Jingle Bell Run/Walk this year. The race is run on a USATF-certified 5K course with finisher awards in each age bracket.

“Arthritis affects 50 million Americans, or roughly one in five adults,” says Michelle Vercruysse, Community Development Manager with the Arthritis Foundation’s Upstate New York Chapter. “Contrary to popular belief, arthritis is not an ‘old person’s’ disease.

Two-thirds of people with arthritis are under the age of 65 and there are more than 300,000 children who live with the disease. In New York more than 3.6 million people have arthritis.”

Voted as one of the nation’s “Most Incredible Themed Races,” the Jingle Bell Run/Walk helps the Arthritis Foundation raise funds to discover better treatments and a cure for arthritis.

To learn more and register for Jingle Bell Run/Walk, visit www.jbrsyracuse.kintera.org or contact the Arthritis Foundation at 585-419-6903.

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

Health CNY’s Healthcare Newspaper

News, Inc. Distribution: 35,000 copies.

To request home delivery ($15 per year), call 315-342-1182.

In Good Health is published 12 times a year by Local News, Inc. © 2014 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776.

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Aaron Gifford, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Matthew Liptak, Chris Motola, Gary Band • 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.

Page 4

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

My Take

“I would definitely recommend VNA Homecare they did a great job with my physical therapy.”

By George W. Chapman

Do Hospital Mergers Drive Up Costs?

They are happening all around us.

But we are faced with a conundrum.

On one hand, in order to survive, many hospitals are merging. Smaller hospitals have little purchasing power, cannot justify providing certain expensive services, and face an increasingly difficult time recruiting, retaining and paying physicians. Larger multi-hospital systems should be able to reduce costs, provide more services and retain physicians. On the other hand, mergers reduce or outright eliminate competition. Since hospitals are still in a predominantly fee for service/ volume environment, several studies show mergers have resulted in price increases, (not to be confused with cost increases), as any merged hospitals take advantage of their new found market dominance and raise prices.

For this reason the FTC must approve and then monitor mergers. It remains to be seen what will happen to hospital prices once providers are paid based on outcome and performance versus volume.

Healthcare Costs to Escalate Again

The non-partisan Office of the Actuary at Center for Medicaid and Medicare Services (CMS) is predicting healthcare spending will once again begin to escalate this year. Healthcare spending will account for 19-20 percent of our economy by 2023. It was 17.2 percent in 2012. The dire prediction comes after a few years of relatively modest increases of 4 percent. The report, published in Health Affairs, predicts an average annual increase of 6 percent a year from 2015 through 2023. Contributing factors are increased coverage under the Affordable Care Act, an aging population and overall economic growth. The “good” news is the experts are not calling for a return to the double-digit increases of the ‘80s and ‘90s. Much of the growth in spending will come from CMS, which now covers 100 million people.

Nurses Needed According to the American Nurses Association, we will need another 1.1 million nurses by 2022 as 20 percent of existing nurses are eligible for or set to retire soon. Several other countries are predicting nurse shortages as well.

US Hospitals Lead In Administrative Costs

This goes right along with our world leading highest per capita spending on healthcare ($8,000-plus).

According to a study published in Health Affairs, 25 percent of hospital costs are for administration, more than twice that in Canada and other countries. However, in defense of US hospitals, many of the other countries in the study, like Canada, have a single payer system, which makes running a hospital far easier when you have to deal with only one set of benefits, one

fee schedule and one set of rules and regulations. US hospitals must deal with myriad payers, which results in dealing with myriad benefits, fee schedules and rules.

US Leads in Obesity

In addition to leading the world in costs, we claim the No. 1 position in obesity. In 1980, no state had an obesity rate over 15 percent. Today, Mississippi and West Virginia lead the way with 35 percent, closely followed by Arkansas, Tennessee, Kentucky, Louisiana and Oklahoma. On average, we are 24 pounds heavier than our counterparts in 1960. The least obese state was Colorado at 21 percent. When considering high costs of healthcare, we all need to take a good look in the mirror.

Reference Pricing

Keith Depauw, Jordan, NY

Post-surgical patients like Keith benefit from the physical therapy services they receive from VNA Homecare – because they are able to recover in their own homes.

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As deductibles and coinsurances increase, consumers want to know “how much?” Reference pricing is an idea to make prices more competitive. Insurers would establish payment for elective services (office visit, knee replacement, colonoscopy, etc.) and require the consumer to pay the difference between the reference price or payment and the provider’s charge. Theoretically, people will seek the cheapest (and hopefully qualified) provider. The FTC argues this won’t work in a market dominated by one hospital (see mergers above). The counter to that is these are elective procedures and most people have access to transportation (the world is getting smaller) and would be willing to drive 50 miles to a qualified provider if they would save hundreds if not thousands of dollars.

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New York Healthcare Forum The healthcare industry is confusing and constantly in flux. You need to advocate for yourself and understand how things work in order to make your experience more satisfying and productive. An informed and engaged patient will always have a much better relationship with their providers and insurers. I am constantly asked for advice when it comes to navigating the healthcare system. Consequently, a group of us with decades of experience in the industry created a website to assist consumers — free. Check it out at www.newyorkhealthcareforum.com.

GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Syracuse. To reach him, email gwc@gwchapmanconsulting. com.

November 2014 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 5

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Joan Newell, M.D. New internist in Oswego talks about profession, chronic diseases and how small lifestyle changes can make a big difference in one’s health Q: Tell me a bit about your specialty.

A: I’m an internist, so I see patients who are 18 and older. It’s primary care medicine, so we try to take care of as much of the whole patient as we can and if we need more specialty care we refer as needed. But we take care of a lot of problems from muscular-skeletal to heart, lungs and liver. It’s a nice specialty because you get to know your patients very well.

Q: Is internal medicine synonymous with primary care?

A: Primary care just refers to around five different subspecialties that are considered basic health care.

So that’s psychiatry, general surgery, OB/GYN, internal medicine and family medicine.

Q: What kinds of conditions do you typically see?

A: It varies. In general I spend a lot of time doing regular physicals and preventive health, talking about colonoscopies, screening labs for diabetes or cholesterol. I do a lot women’s health like pap smears and contraception. We also do pre-op evaluations before they have surgeries, cardio-pulmonary risks of surgery. And we deal with chronic diseases like hypothyroidism, diabetes, kidney disease, heart disease and hypertension.

Q: What’s generally the best way to get patients to face their chronic diseases, especially if they may be in denial about them?

A: I do think many medications can do a lot to improve medical problems, but a lot of the times patients can do it on their own with diet, exercise and lifestyle changes. It depends on the diagnosis. But a lot of times talking with the patient, I like to find out what scares them. Maybe they’ve watched someone suffer with diabetes — they don’t want to prick their finger all the time to test their blood sugar, for example — and they might be afraid to get tested for it. So I like to talk to them, let them know that not everyone who has diabetes has to do it that frequently.

You can’t force people into anything.

Not everyone is going to want to treat their disease in the same way.

Q: Do you generally try to encourage lifestyle improvements over medication when possible?

A: Yes, because that’s always part of treatment. Every time you eat, some of the choices you make can affect an aspect of your health. Even arrhythmias, which we don’t generally think of as being

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

affected by your diet. If you end up eating too much salt, your heart can’t handle that and you end up having your blood pressure go up. It’s amazing how small things can affect your overall health.

Q: One of the bigger criticism of the medical profession is that it’s not full of great communicators. How do you successfully communicate with patients when circumstances dictate that you can’t spend a lot of time on each patient?

A: I really try to let patients know that we do have a time limit, so I try to let patients know to limit the number of complaints per visit to a number that I can handle. Usually when I first meet a patient, I ask them to list all of things they could possibly want to talk about.

So, if there are 10, I’ll say let’s address three and, as long as they’re not life-threatening, make another appointment to address the others, so we could focus on those at that time.

Q: Specialties seem like they’re really driven by new developments, research and technology.

How do these things end up affecting primary care, if they do?

A: There are a lot of things in internal medicine that are

the same for the subspecialists. A lot of them are internists first, who then went on to focus on the heart or the lungs. So a lot of the developments in those specialties also apply to us and that makes internal medicine exciting because you get to read about a lot of different fields and keep up with what’s going on.

Q: Do you end up doing any urgent care?

A: We definitely see patients with acute complaints, but it’s not urgent care in that you can just walk in when you’re not established as a patient here.

So if you call and say “I’d like to be a patient and I have this complaint,” you can make an appointment. But you can’t walk off the street and say, “I have a headache.”

Q: What’s some general health advice you have for patients?

A: A lot of the things that are heavily advertised in our culture now. Eat a balanced diet, get plenty of exercise, don’t smoke, try not to be too stressed out, get a good night’s sleep. What I’d add is that, especially as you get older, to find a physician’s office you can go to for when you have questions and concerns.

Q: What put you on the path to internal medicine.

A: Before I went to med school, I knew I was interested in primary care in general. I liked the idea of taking care of the whole patient and work with them in all aspects of their health. If they have shoulder pain and diabetes, I get to help them with both, which is great because both affect their quality of life. Some of it was a location preference. The family medicine program was an hour south of where I was living at the time. I’m glad that I did.

Lifelines Joan Newell, M.D. Hometown: New Milford, Conn.

Education: Earned her medical degree from the University of Vermont and completed her internal medicine residency at the Dartmouth Hitchcock Medical Center in Lebanon, New Hampshire. During her residency she was presented an Excellence in Teaching Award three different years.

Affiliations: Oswego Health, Port City Family Care.

Previously, she provided primary care services for the past three years at an outpatient clinic at the Cayuga Medical Center in Ithaca.

Organizations: Oswego County Medical Society, American College of Physicians Family: Husband (a SUNY Oswego microbiology professor) and two children Hobbies: Running, hiking, soccer, playing with her children

New Health Commissioner Wants to Be a ‘Physician for the Community’ Indu Gupta takes the reins of Onondaga County Health Department

By Aaron Gifford

A

s a youngster, Indu Gupta would often accompany her veterinarian father as he tended sick animals throughout rural communities in northern India. It was an enjoyable and eye-opening experience, she recalled, because he made such an impact on village life.

“I tagged along with him during summer vacations,” Gupta said during a recent telephone interview from the UCLA Medical Center, where she was previously employed as a hospitalist and a professor at the medical school.

“Animals were the villagers’ livelihood. He used to compare and contrast that there’s not much of a difference between the animals he treated and humans. We are all mammals.”

Those early lessons sparked an interest in biology and other sciences.

Gupta said her mother, Haripriya, was a very strong advocate of education and motivated her four children to do well in school. Gupta excelled in the classroom en route to gaining entrance to medical school. During her hands-on training in poor villages, she discovered that in addition to becoming a physician she had a deep desire to improve the quality of life for entire communities.

“We dealt with rabies and tetanus,” she said. “You don’t see things like that as much here. You never forget that.”

Gupta now brings that desire to serve the community at large — along with decades of clinical experience as a doctor — to the Onondaga County Department of Health. She was to begin her duties as commissioner Nov. 3. She recently left her positions at UCLA in southern California to replace former department head Cynthia Morrow, who resigned earlier this year after disagreements with county officials over program restructuring. Morrow

previously told news sources that she believes Gupta was an excellent choice as her replacement and will serve the county well.

Gupta, who practices internal medicine, is no stranger to Central New York or the department of health: She worked for Morrow part time as the department’s director of preventive services from 2005-2007. She also worked at St. Joseph’s Hospital Health Care Center before opening her own practice. In addition, during her time here she completed a master’s degree in public administration at Syracuse University.

While she enjoyed her work as a physician, Gupta pursued a side career in public health because of the impressions left on her in India, where medical schools require a curriculum on social and preventive health issues.

She later earned a master’s degree in public health at Johns Hopkins University in Maryland.

“That should be part of the curriculum here to open the eyes of the students,” she said. “I thought public policy would be part of the solution. I was so determined to do that, so I took the position [county health department preventive services]. I learned a lot and I strongly believe in this cause.”

Gupta came to the United States because her husband, Salil, a nephrologist, was hired to work at a New Jersey hospital. She did her medical residency there before they relocated to Syracuse.

She later took the position at UCLA while Salil maintained his practice here.

“I was looking for something different, and UCLA gave me the opportunity to do inpatient care and some outpatient care with nursing home patients while also teaching medical students and residents,” she said.

“It’s a great institution in a wonderful place.”

With both of her daughters now grown and graduated from the University of Southern California (one is interested in pursuing a career in global health), Gupta said this was the perfect opportunity to return to Central New York. She looks forward to spending more time with her husband and enjoying some cross-country skiing this winter. She also enjoys gardening and yoga.

Gupta declined to discuss her plans for new or expanded services or programs at the health department because at the time of the interview she hadn’t started the job yet. But she did indicate that, in general, she hopes to work closely with individual health care providers across the county, regardless of whether they work in the public or private sector.

“We are both doing things in our own worlds,” she said. “We just need to connect with each other. I’ll always be a physician in my heart, and now I’ll be a physician for the community.”

Gupta stressed that that individual health and public health are not mutually exclusive but interdependent and complimentary to each other.

The intent of both services is to protect and improve the health of the individual and the community. When illness strikes, she explains, the goal should be to save lives both by direct care and by finding various means to reduce or stop the spread of the illness at the individual as well as at the local or global level.

Consider, for example, the treatment of an obese patient who suffers from diabetes. That person’s health problems may be at least partially related to the lack of healthy foods available in their neighborhood. That same

Gupta neighborhood might lack recreational opportunities for residents to engage in exercise, or maybe the local school is not teaching children about fitness and nutrition. The patient might have children who are making the same unhealthy choices because of the lack of resources and knowledge in their community.

“You can treat the patient,” Gupta said, “but you also want to get to the root of the problem.”

County officials are excited to work with Gupta. Onondaga County Executive Joanie Mahoney said the doctor’s sense of mission set her apart from other candidates.

“When you meet Dr. Gupta you immediately understand how passionate she is about public health,” said Onondaga County Executive Joanie Mahoney. “Then you look at her career and accomplishments during the nearly 20 years she lived, worked and practiced here and you realize that her passion for our community is just as strong. Her work at UCLA Medical Center has been exemplary, and we are fortunate that she will be returning to Onondaga County as our health commissioner. “

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Make the Most of Living Alone by ‘Letting Go’

A

re you convinced you’ll never be good at relationships? Or, do you regret the way you behaved in your marriage? Still angry at your ex? Or yourself?

Holding on to past hurts, slights, negative thinking or lost opportunities can compromise your sense of well-being and ability to live alone with contentment. Whether it’s emotional baggage or tangible reminders that keep you anchored in the past, I encourage you to give them up and start fresh.

“Letting go” is a beautiful thing.

And not just for those who live alone.

Letting go of old ways of thinking, of a negative self-image, of anger, of regret or destructive thoughts or behaviors can free you up to embrace life’s blessings and the possibility of feeling whole and complete on your own.

When I purchased my home in the country 15 years ago, one of the first things I did was to carve out a fire pit in my backyard. I love everything about a bonfire: the warm glow it casts on the faces of those gathered around it, the earthy scent of burning branches, the flames that invite inspection . . . and introspection. Little did I know that when I built my fire pit that it would also become the ceremonial dumping ground for my “old baggage” — those

useless beliefs and feelings that were holding me back and keeping my life small.

I remember one evening in particular. I’d been holding on to old Day-Timers — large, leather-bound calendar/ planners that I used in the ‘90s before everything went pocket-size. In these Day-Timers, I made calendar entries that captured “the good, the bad, and the ugly” over the course of what turned out to be a bumpy, transforming decade.

Why I hung onto these Day-Timers I’ll never know.

Maybe out of misplaced sentimentality. But this I do know: Whenever I looked at the neat stack of volumes stashed away in my closet, I would wince inside.

And so one night, I decided to hold a private Letting Go ceremony. I started the bonfire, grabbed my Day-Timers, and made my way to the fire pit. And there I sat with my memories (and my wine!), and slowly, deliberately leafed through each bound year of my life, before tossing it on the hot embers. It was a moving experience. Sad at times.

KIDS Corner Teen Driving Vehicle crashes still the leading cause of death among teenagers

M

otor vehicle crashes are the leading cause of death among teenagers. In 2011, about 2,650 teens in the United States aged 16 to 19 were killed and almost 292,000 were treated in emergency departments for injuries suffered in motor-vehicle crashes. This means that seven teens aged 16 to 19 died every day from motor vehicle injuries that year. Per mile driven, teen drivers aged 16 to 19 are three times more likely than drivers aged 20 and older to be in a fatal crash.

Who’s at Risk?

Among teen drivers, those at especially high risk for motor vehicle crashes are: • Males: In 2011, the motor vehicle death rate for male drivers and passengers aged 16 to 19 was almost two Page 8

•

times that of their female counterparts.

• Teens driving with teen passengers: The presence of teen passengers increases the crash risk of unsupervised teen drivers. This risk increases with the number of teen passengers.

• Newly licensed teens: Crash risk is particularly high during the first months of licensure.

Other factors that put teens at increased risk:

• Low seat belt use: Compared with other age groups, teens have the lowest rate of seat belt use. In 2013, only 54 percent of high school students reported they always wear seat belts when riding with someone else.

• Drinking and driving: At all levels of blood alcohol concentration,

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

But, mostly, I began to feel lighter, freer.

And I felt something I didn’t expect: a sense of peace and self-satisfaction for having taken control and done something good for myself.

That evening set the stage for many Letting Go ceremonies to come. I look forward to them and the release of the pent-up, negative energy they promise.

Interested in giving it a try? Here are some tips: Step One: Identity what is holding you back or keeping you stuck. Be honest. Ask yourself what negative beliefs or thoughts are getting in the way of your ability to feel hopeful and enthusiastic about yourself and your life.

What do you need to let go of to feel freer and to move forward? Anger toward something or someone?

Regret over a past mistake?

Guilt? A negative self-image? A bad habit? A feeling of inferiority? A deep sadness?

Step Two: Write down this negative belief or thought in a “Letter to Self.” Put it down on paper and get it out of your system. Or, identify

the risk of involvement in a motor vehicle crash is greater for teens than for older drivers.

• In 2012, 23 percent of drivers aged 15 to 20 involved in fatal motor vehicle crashes were drinking.

• In a national survey conducted in 2011, 24 percent of teens reported that, within the previous month, they had ridden with a driver who had been drinking alcohol and 8 percent reported having driven after drinking alcohol within the same one-month period.

• In 2012, 71 percent of drivers aged 15 to 20 who were killed in motor vehicle crashes after drinking were not wearing a seat belt.

How crashes involving teen drivers can be prevented?

There are proven methods to helping teens become safer drivers.

• Seat Belts —Research

something tangible (as I did with my Day-Timers) that conjures up painful or disappointing memories. This negative “something” — a photograph, gift, letter or other reminder — can be powerful. Even if it’s out of sight, perhaps tucked into a closet, you know it’s there and just having it in your possession may keep you tethered to a past disappointment or regret.

Step Three: Hold your own Letting Go ceremony in whatever style or fashion suits you. I like the bonfire approach, but you may prefer another method. Tying your Letter to Self to a stone and throwing it into a lake may be more fitting and symbolic. Or burying your anger in your backyard.

You decide. But, on your own or in the company of friends and family, let go of what’s holding you back and keeping you stuck.

Doing so may help liberate the hope, passion and power residing deep inside you. It can be a very meaningful step toward independence.

Needless to say, Letting Go ceremonies aren’t the cure-all. Believe me, my long-held feelings about my difficult decade didn’t magically dissipate with the burning of my Day-Timers. But letting go can help open the path to personal growth and fulfillment. It’s part of a healthy process, and I encourage you to give it a try. For now, however, I hope you’ll excuse me. I have a bonfire to build and some baggage to burn.

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 fall workshop or to invite Gwenn to speak, call 585-624-7887, or email her at gvoelckers@rochester.rr.com

shows that seat belts reduce serious crash-related injuries and deaths by about half.

• Not Drinking & Driving — Enforcing minimum legal drinking age laws and zero blood-alcohol tolerance laws for drivers under age 21 are recommended.

• Graduated Licensing Systems (GDL) — Driving is a complex skill, one that must be practiced to be learned well. Teenagers’ lack of driving experience, together with risk-taking behavior, puts them at heightened risk for crashes. The need for skill-building and driving supervision for new drivers is the basis for graduated driver licensing systems, which exist in all US states and Washington, DC. Graduated driver licensing puts restrictions on new drivers; these are systematically lifted as the driver gains experience. Research suggests that the most comprehensive graduated drivers licensing (GDL) programs are associated with reductions of 38 percent and 40 percent in fatal and injury crashes, respectively, among 16-year-old drivers. When parents know their state’s GDL laws, they can help enforce the laws and, in effect, help keep their teen drivers safe.

Source: Centers for Disease Control and Prevention (CDC).

Bad News Crunch Time for Physical Therapists Recent changes mean higher co-pays for patients, lower reimbursement for PTs

By Deborah Jeanne Sergeant

N

eed physical therapy? It’s going to cost you more. A lot more.

And in the near future, physical therapy offices may become scarce.

Recent changes in insurance copays have increased patient co-pays as much as three times what they were before and decreased the payment received by physical therapists by up to 15 percent.

For example, a patient paying a $15 co-pay may now pay $45. Already receiving among the lowest reimbursements in the nation, Upstate New York’s independent physical therapy offices struggle to absorb the difference of lower insurance reimbursement.

“For over 18 years, there have been no increases in reimbursement rates,” said Michele Mills, office manager of Mauro-Bertolo Therapy Services Physical Therapy, P.C. in Cicero. “With workers compensation cases, we get $47.28 per visit regardless of what we do to patients and how long it takes.

We stay in business by the hair of our chinny-chin-chin.”

Because insurance companies now classify physical therapists as specialists instead of treating providers, physical therapy is viewed as a privilege and not a necessity, even for insured people.

At Active Physical Therapy Solutions, PC in Auburn, Associate Director Cara Cuthbert said that the practice “is reimbursed only a fraction of what we bill. We’re obligated by contract to not bill the patient for the remainder.

We have to record time, but it doesn’t mean we’ll get reimbursed.”

Mills said that with workers compensation cases, patients with injuries to more than one area of the body receive coverage for treatment for only one area of the body per day. So the injured hip may be treated Monday, the neck Tuesday and back to the hip on Wednesday. The arrangement creates unnecessary travel and hassle for an injured patient.

Mills added that insurers’ universal reimbursement stays the same for independent practices, regardless of the time spent with the patient.

“It can be only $50 and our rate is $100 for an evaluation and $75 for subsequent visits,” Mills said. “A lot of these have a $45 co-pay and the insurance company pays only $5 toward the treatment.”

Competition from hospital-affiliated offices represents another hurdle for independent PT offices. After surgery, patients may receive physical therapy from a PT office affiliated with the hospital or an independent office. Few patients realize they have the right to choose.

“We court the doctors as much as we can because of referrals,” Mills said.

Although patients can directly access physical therapy without a referral, it creates a huge headache if they should need more than 10 visits or three weeks of treatments. At that point, insurance companies require a doctor’s prescription, so the patient must pay the doctor’s co-pay and get a referral anyway, which can create a few weeks’ gap in the treatment. And if the patient can’t get that prescription, providers like Mills’ office don’t receive reimbursement.

“We don’t see people via direct access because we’ve been hurt too many times,” she said.

She added that hospitals “have a vested, financial interest in sending people to a PT within their affiliation.

We want people to know they don’t have to go to the PT where the doctor tells you to. There are PT clinics on every corner.”

Hospitals also aren’t under the same daily caps for coverage, meaning that for the same amount of treatment, a hospital-affiliated PT could be paid for an entire 90-minute session instead of just 45 minutes.

Although an independent practice may receive $45 for a treatment session, a hospital-affiliated PT may receive two or three times that amount.

Mills’ office, Mauro-Bartolo, and other independent physical therapy offices are coming up with creative ways to generate additional revenue streams.

One of these is prevention and wellness programs to help people learn how to properly exercise, prepare patients for

surgery such as total knee replacement, and use of the facility’s fitness center.

At $25 per month, Mauro-Bartolo’s wellness program permits use of the equipment as often as participants would like, though patients in treatment get dibs on its use.

Auburn’s Active Physical Therapy Solutions hopes to soon open a med-

ically-oriented gym with supervised gym exercises for clients.

“It might not be medically necessary for formal physical therapy,” Cuthbert said. “They can pay a flat fee and do their exercises under the supervision of a physical therapist or physical therapist assistant.”

The time spent in the gym would not be billable to insurance companies.

“It’s very unfortunate that a patient needing care has a really high co-pay and can’t afford to come,” Cuthbert said. “We can offer a payment plan if they truly need to be here and need on-site care that they can’t do at home.

They can pay on a monthly basis and we don’t charge an interest rate. We are genuinely trying to help patients get better.”

Good News Bill to cover equipment and supplies for ostomies signed into law

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ov. Cuomo in September signed into law legislation sponsored by Sen. David J. Valesky (D-Oneida) that requires every insurance policy to include equipment and supplies necessary for the treatment of ostomies.

An ostomy is a surgically created opening connecting an internal organ to the abdomen, caused by many different conditions, including cancer, bowel disease, birth defects and injury.

Different kinds of ostomies are named for the organ involved, such as a colostomy, ileostomy or urostomy.

Ostomies can be a lifelong health condition and require necessary and costly equipment and supplies, including pouches, seals, belts, tubes and wafers. Previously, the law did not require full coverage of ostomy supplies — as it does with other conditions like diabetes — causing those living with ostomies a great cost burden.

The new law sponsored by Sen. Valesky changes that. In addition to greatly improving the quality of life for those dealing with an ostomy, full coverage of equipment can ultimately result in savings to the healthcare system caused by repeat and extended hospital visits due to lack of or insufficient equipment.

“This law makes sense, and makes the coverage of necessary ostomy supplies consistent with coverage for other conditions like diabetes,” Sen. Valesky said. “I thank Gov. Cuomo for recognizing the importance of this issue.”

“Not having proper ostomy supplies can be devastating to patients, and this bill will make a huge difference in the lives of ostomy patients throughout New York state. We are very grateful to Sen. Valesky for helping us with this issue,” said ,” Heidi H. Cross, ostomy nurse practitioner at Upstate University Hospital and a member of the United Ostomy Associations of America.

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www.oswegohealth.org November 2014 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

Oswego County Hospice

My Turn

By Eva Briggs

Seeking a Second Opinion Providing family-centered service for over twenty-five years OSW EG

315.349.8259 www.co.oswego.ny.us/health/hospice.html The only certified Hospice located in Oswego County.

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(But, Please, Not in the Urgent Care)

I

t was a request that I hear a few times every year in the urgent care: “I’m here for a second opinion.”

There are many valid reasons for seeking a second opinion, but the best place is seldom the urgent care.

First, when you come to the urgent care, you usually aren’t selecting the doctor or other provider you’ll be seeing. You will see whichever provider is working that day. So you have no way to research whether that doctor’s (or midlevel’s) training, expertise, experience or interests match the medical concern for which you are seeking help.

If your problem requires advanced expertise, whether it be a neurologist, a cardiologist, a podiatrist or some other specialist, you are unlikely to find that at an urgent care. Most urgent care providers have training in emergency medicine, family medicine, pediatrics or internal medicine.

That’s exactly what is needed for an urgent problem, but may not be the best fit for something that has already puzzled a specialist.

Second, when you show up at

the urgent care, it’s impossible for a provider to formulate a rational second opinion without the full knowledge of your medical history. Imagine that you were exceptionally lucky to find a provider working at the urgent care who was board certified and fellowship trained in exactly the specialized niche you required. But he or she still needs to know the following: What tests were performed? What were the results?

What treatments have been tried? What was the response to these treatments?

Some patients don’t want the second doctor to see their prior records, for fear it will bias their opinion. But withholding this information at best prevents formation of a reasoned opinion and, at worst, may cause you to undergo unnecessary costly duplicate tests or to repeat failed therapies.

Third, sometimes people come to the urgent care for a referral to a specialist, but try to insist on referral to the incorrect specialist. The best example I can recall was a man in his early ‘60s who requested referral to an orthopedic surgeon because both

of his ankles were swelling with fluid.

The man had not seen his primary care doctor. I explained that most cases of ankle swelling were not due to orthopedic problems at all, and required evaluation for medical causes such as heart disease, kidney disease, anemia, etc. I offered to initiate the appropriate work-up, and to refer the man to either the hospital or his primary doctor depending on the results of standard tests for this problem (EKG, chest X-ray, labs). But he left instead, upset because his preconceived expectations didn’t jive with my recommendations.

One reason that people come to the urgent care for a second opinion is that they fear their doctor will be angry, insulted or upset if they ask for a second opinion. In reality, that shouldn’t bother your doctor. It’s not an unusual request from a patient with a serious, rare or puzzling condition.

If your doctor is upset by this request, then he or she is probably not someone with whom you have a good therapeutic relationship. A reasonable doctor should respect your request, and be willing to send appropriate records. He or she can advise you as to what type of specialist is most appropriate, and can often suggest specific doctors. But you’re free to choose whomever you want for your second opinion.

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

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

My Journey to Lose Weight

By Gary Band

E

leven years ago at the age of 33 it hit me: I was overweight. And it didn’t take long to figure out how it happened. Over the previous four years, my physical activity decreased while my intake of calories increased.

Until I was 29, with the exception of the occasional run or walk, I’d always been in decent shape and looked good enough without trying too hard.

I played sports as a kid and a teenager, served in the Navy, walked up and down the stairs of my aircraft carrier and all over the countries I visited. In college, other than walking all over campus in Boston and up and down the hills of Brookline to and from the train, I wasn’t doing much of anything else but still I was in great shape.

But when I started a full-time job as a newspaper reporter in 1999, it never occurred to me that I needed to engage in any kind of regular activity to keep looking the same as I always had. Day after day I sat at my desk, at my meals, and celebrated the completion of the paper every two weeks with a couple of beers and some bad bar food, bliss-

fully unaware of what was happening to my body.

It wasn’t until I went to a pool party in Swampscott, Mass., one summer day in 2003 that I saw myself for the first time in an unflattering light.

Resolving then and there to remedy my condition, I left the party and drove to the nearby Gold’s Gym. I met with a trainer and prepared myself to step on the scale for the first time I could remember in recent years. Incredibly, it read 217, compelling me to sign up for a membership and start working out on a regular basis. But the weight wasn’t coming off.

Six years later in 2009, after a variety of regimens, including walking, running and hiking, and trying to eat better, I left Massachusetts for a job in Vermont weighing around 210.

Over the next three years working as a newspaper editor in Woodstock and then Chester, Vt., eating at every community supper and area restaurant, I gained back the small amount of weight I had lost and then some. When at last I stepped into the studio of a

Before

personal trainer in Chester in November 2012, I weighed 243 pounds. Over the next six months I worked out with this trainer three times a week for over an hour each session and lost over 20 pounds. It was a start, but I had many miles and pounds to go.

I moved to Brighton in November 2013 to be with my wife, and worried about how to continue dropping weight in the absence of a strict training regimen and the steep hills of Vermont on which I supplemented my workouts with long walks. On Dec. 1, at a starting weight of 222, I joined After the nearby Jewish Community Center, worked out three to five times a week, and walked a few miles along the Canal Trail whenever the weather allowed.

After a long winter, complete with two bad colds in February and March that set me back a bit, by the time our wedding day came around on April 1, I weighed 217. Following the food-filled honeymoon, and a larger wedding party over Memorial Day Weekend, I was at 213.

By June, with all the relative gluttony of those days behind me, I really began to focus. I cut back on going to the JCC in favor of being out in nicer weather, doing regular seven- to ninemile walks and five- to seven-mile jogs on the Canal Trail, along with a few 30plus mile cycling trips to Spencerport.

Instead of brewing coffee or black tea like I’ve done for years, I started making green tea in the coffee pot every morning. I stopped getting food from

the hot bar at Wegmans and snacking after 9 p.m. And due to my wife’s dietary restrictions, which requires her and our house to be vegetarian and gluten free, I’ve been eating accordingly at home over these past 10 months.

Lo and behold, one day in mid-August the scale showed 203, down 40 pounds from my heaviest weight in November 2012. I still want to lose another 10-20, and believe it can be done by walking, jogging, working out and eating right all year long. Like my former trainer said, it’s not a sprint, but a marathon. Making small changes to your life style makes a big difference.

The sooner you start, the healthier you’ll be and the better you’ll look.

Gary Band has worked as a reporter and editor at newspapers and magazines in Massachusetts, Vermont and New York. He lives with his wife near Rochester.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

Healthcare Workers’ Second Act A psychologist and a surgical nurse now run their own business — a horse farm in rural Madison County

By Aaron Gifford

T

homas D’Aquanni worked as a psychologist and eventually found creative ways to apply his clinical skills to the corporate world.

Marion Secor was a surgical nurse, worked in public health and later established a successful home health aide business.

Growing up, neither imagined that when they reached their 60s they would put their careers aside to bale hay, feed chickens and perform various barn chores in rural Madison County.

Now, they hope they can use the farm as a tool to help others become more successful in their respective professions.

“This would be pretty unique,” said D’Aquanni, who purchased Skanda Farms in Nelson with Secor in August 2012. Their agritourism plans for the property include corporate retreats. “We see this as a destination that people would come to from all over.”

“This is a journey of what’s next,” Secor added.

The business partners talked about the paths their lives took to the point where they weren’t afraid to take risks and embark upon a new venture as they approached an age where others favor retirement.

D’Aquanni, a New Jersey native who is in the process of moving to Nelson, originally worked as a psychologist for children and families.

After years or running family therapy sessions, he realized that the same skills could be put to work as a management consultant.

“It’s all about systems,” he said. “I got the idea to apply it to systems larger than families, like organizations.”

That was 20 years ago. At that time, global corporations were becoming more common and many companies seemed to be more powerful than some small countries. He carved out a niche in transforming the culture of big business. As part of that work, D’Aquanni would obtain honest opinions of executives and employees and create a vision for the company where workers could look forward to the future.

“The key element is to get people excited to work together,” said

D’Aquanni, 65.

Secor, 62, a longtime friend of D’Aquanni’s, also grew up in New Jersey. She graduated from nursing school and worked as a surgical nurse before moving to Central New York in the early 1980s for family reasons. She continued in the health care profession here, working for the Onondaga County Health Department and later establishing her own home health aide business. Her own illness forced her to take a break from caring for others for awhile and sell the business.

“It would become a full-on lifestyle change,” Secor said. “In a sense, the gift of illness is we can live in the direction life is moving us into.”

For Secor, that direction was equine. Five years ago, a friend asked Secor for help in caring for a mare and a foal. The horses, Norna and Ella, were thoroughbreds off a racetrack breeding facility that had been indicted on animal cruelty charges.

“I’ve always been amazed by horses,” she recalled, “but I didn’t have any experience with them. You usually don’t start with a mare and a newborn foal.”

Secor took equine classes and read as much on the subject as she could.

She established a connection with horses and decided that she would prefer to take care of them her own way rather than board them. So when an equine facility went up for sale, Secor jumped at the chance to turn her newfound hobby into a career.

Secor was drawn to the “natural horsemanship philosophy” and a set of techniques that focus on a gentler approach as well as a bilateral communication between horse and human. She claims she has developed a unique method of working with horses that treats horses as sovereign, intelligent beings and equal members of the horse-human partnership. Called “Equidanse”, her training system supports a deepening level of trust, an open flow of communication, and a freeness of movement for both horse and rider.

Skanda Farms is named after Secor’s fondness for Scandinavia. She

Marion Secor was a surgical nurse, worked in public health and later established a successful home health aide business. She is now co-owner of Skanda Farms in Madison County.

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

Thomas D’Aquanni worked as a psychologist and now co-owns Skanda Farms in Nelson in Madison County.

visits Sweden, Norway and Iceland frequently, and friends from those northern European nations have visited the farm and enjoyed their experiences there. She even added Icelandic and Swedish chickens to the grounds.

“We are always looking to learn from Scandinavia,” she said. “It’s very progressive. The people are very honest, and they keep life very balanced.

They work hard but enjoy their time off. They’re environmentally conscious, creative and practical.”

Skanda began as a boarding facility, but has evolved into a farm and agritourism destination. Secor wants to add lodging there and also offer children’s camps where kids can care for the horses, goats and chickens and connect with them. “Chickens,” she said, can purr like a cat if they get used to people.”

And in the Scandinavian tradition, Secor wants to build troll and elf houses in the woods; hunts for those mythical creatures is a popular activity for youngsters in northern Europe.

She also sees potential for a larger bird sanctuary, and fields to grow mushrooms and rice. She is also planning a “Goat Days” event where the public can be educated about quality goat dairy products.

“Our goats just love people.”

In recent months, Skanda took in horses that were removed from a farm in Nedrow. D’Aquanni and Secor are open to the idea of including a horse rescue program in their long-term development plan, which could provide a non-profit designation to the facility for some of its functions.

Secor added that her nursing background — which was centered on caring for others — has been a great fit so far for a career in equine and agriculture.

“You never stop using it [nursing],” she said. “I apply it to the 26 horses, eight goats, 16 ducks, the chickens.”

D’Aquanni, who is in the process

of moving from New Jersey to Nelson full-time, has his sights on adding a corporate retreat center to the property. The way he sees it, horses have the ability to teach people.

“Use the farm as an environment to discover themselves and learn to work as a team with more fluidity,” he said.

Each animal can bring out “a different kind of energy” in individuals, D’Aquanni explained. Baby chickens, for example, provide a warm, rich experience. Horses, meanwhile, allow you to feel like you’re so far away from the workplace and the hustle and bustle of daily responsibilities. Walk with the horses or ride them, and you develop a different rhythm and tempo of life.

Likewise, the concept of permaculture — that nothing is wasted — would be presented to those who participate in the corporate retreats. For farm operations, almost everything – whether manure or stems, leaves, stalks and seeds after crops are harvested – is used. The same should apply to people’s ideas, D’Aquanni said.

“Too many ideas get written down on a pad somewhere but never looked at again or discussed,” he said. “We need to look at systems where everything is used. Every problem is pointing in the direction of a solution.”

D’Aquanni acknowledged that these are ambitious plans that may not materialize until he’s long past the official age of retirement. But the idea of not working anymore actually scares him. He recalls how his grandfather, who loved his job as a city bus driver and was adored by the neighborhoods he served, had a heart attack two years after taking mandatory retirement.

“We think that, as a culture you get to a certain point and then you just relax for the rest of your life. But how much fun is that really?” D’Aquanni said. “I’ve always felt like growth is all there is. If I’m not expanding myself, what am I doing?”

SmartBites

By Anne Palumbo

The skinny on healthy eating

Humble Rutabaga Rocks with Nutrition

G

rown beneath the earth, stored in dark basements for weeks on end, a tad gnarly on the outside: root vegetables can be a scary bunch!

It’s no wonder we give some of these veggies the bum’s rush at the market.

Many look like they’re from another planet. But hold the phone. Roots are loaded with nutrients, versatile in the kitchen, and last longer than most vegetables when properly stored.

Rutabaga, the star of today’s column, shines in the vitamin C department — yes, vitamin C! — with one cup serving up about 50 percent of our daily needs. A powerful antioxidant with immune-boosting capabilities, vitamin C helps the body maintain healthy tissues and is essential for healing wounds. Although no studies confirm that vitamin C prevents colds, it may shorten the length of a cold.

This tasty root also packs a decent fiber punch, with one cup providing about 3 grams of primarily insoluble fiber, a type of fiber that does not break down within the digestive tract.

Consuming insoluble fiber promotes regularity and, according to the American Heart Association, can lessen your chance of cardiovascular disease.

Concerned about blood pressure?

sible for the bitter taste and pungent aroma of these kinds of vegetables.

According to research conducted at the Linus Pauling Institute, glucosinolates may help eliminate carcinogens before they damage DNA, thus thwarting the transformation of normal cells into cancerous ones.

Lastly, this sweet yet savory vegetable has no fat or cholesterol, scant sodium, a bit of calcium, and is only 60 calories per cup.

Helpful Tips Choose firm, medium-sized rutabagas (about two inches across) that feel heavy: extra large ones tend to be tough and not as sweet; lighter ones may be woody. Because they are often waxed, they should be peeled. To peel: trim ends, cut in half, place flat side down on cutting board, and then remove peel with a paring knife. Rutabagas are good keepers and will last up to two weeks (or more) in the refrigerator.

To store in fridge: first rinse rutabagas under cool water, cut off tops and small roots, dry well, and then place in a plastic bag.

Reach for a rutabaga: one cup has as much potassium as your average banana. While research has shown for some time that potassium can lower blood pressure, a new study shows that aging women whose diets are rich in potassium are less likely to suffer strokes and die than women who have less of this mineral in their diet. Eating more potassium is essential not only for heart health, but for the skeletal and muscle systems as well.

Rutabagas, like all cruciferous vegetables, are top sources of cancer-fighting glucosinolates, which are sulfur-containing compounds respon-

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Cover the chopped rutabaga with about two inches of cold water and bring to a boil. Add a generous pinch of salt, cover pan, and boil until tender, about 40 minutes. A fork should easily penetrate the chunks. Drain and return to the pot.

Mash with a potato masher for a few minutes. Then, add butter (if using), milk, sour cream and salt and pepper; mash until fairly smooth. They will be chunkier than your traditional mashed potatoes. Add more milk or sour cream if you desire a creamier consistency. Mix in the chives, and enjoy! (Not a chives fan? Try dill.)

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes.

She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

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

Upstate Medical University Now Part of National Innovative Shoulder Replacement Implant Study

U

pstate Medical University is enrolling adults in a two-year study to test the safety and effectiveness of a new shoulder replacement system for people with degenerative shoulder joint disease. The trial compares the Arthrex Eclipse Shoulder Prosthesis to a more conventional prosthesis among people receiving total shoulder replacement surgery. Upstate is among 15 sites in the U.S. to test the system.

“Shoulder replacement surgery involves the removal of the damaged part of the shoulder, replacing it with artificial components, called a prosthesis,’ said physician Kevin J. Setter, associate professor of orthopedic surgery, who is leading Upstate’s participation in the study.

“People with different types of arthritis and other conditions causing Setterk pain and disability are candidates for the procedure.”

The shoulder is a ball and socket joint with the top of the upper arm shaped like a ball. Traditional shoulder replacement surgery attaches the new ball joint to a large metal stem inserted into the upper arm. The new “stemless” procedure under investigation fixes the ball joint at the top of the upper arm with a special screw, without inserting a stem all the way through the upper arm.

Since the Arthrex Eclipse avoids the insertion of a long stem, it is a much less invasive surgery designed to preserve more healthy bone and tissue

in the shoulder. This may reduce pain and make the new joint function more naturally.

While it remains an investigational device in the United States, the Arthrex Eclipse has been approved for use in Europe and Canada, where thousands of procedures have been completed.

To qualify for the study

Patients enrolled in the study will receive either a new ‘stem-less’ prosthesis or a conventional one. The study will follow patients for two years after surgery to assess functional outcome, radiographic success (appearance on an X-ray) and absence of complications, revisions and adverse events.

To qualify, candidates must be at least 21 years old and have significant pain and functional impairments of the shoulder from a diagnosis of arthritis or avascular necrosis (death of bone tissue due to lack of blood supply). They must have also tried at least six months of non-surgical treatment, such as anti-inflammatory medications, physical therapy or steroid injections.

This trial is investigational, and it may not be appropriate for all patients.

The safety and effectiveness of the Arthrex Eclipse is being investigated by this study and any benefit to patients has not been determined.

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epression can be a debilitating and sometimes deadly disease, but there is help in Central New York. The Depression and Bipolar Support Group is an alliance of people suffering from many types of mood disorders who meet each Tuesday to offer each other their collective knowledge and encouragement.

“Just to be in a room where all the other people have mental illnesses of one sort or another, then they understand and they can share,” said the group’s president Karen Vogtle.

About eight to 25 people come to the meeting each week, Vogtle said.

The group meets from 6:15 – 8 p.m. in a room at Transitional Living Services at 420 E. Genesee St. in Syracuse. New members are welcome.

The support group is the local chapter of the Depression and Bipolar Support Alliance, a national organi-

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zation. The local group was started in 2002 by Gregg Phillips, but when he died in 2013 Vogtle, a depression-sufferer herself, picked up the reins.

Although issues discussed center on depression or bipolar disorder, members often have overlapping mental illnesses that they must cope with. These can include obsessive-compulsive disorder, generalized anxiety disorder, social phobia, post-traumatic stress disorder, schizophrenia and others.

“People that come to the group don’t necessarily have a diagnosis of depression or bipolar,” said the support group’s vice president Vanessa Watts.

“They may have been diagnosed with something else that causes symptoms of depression. The group has been open to all kinds of people.”

Depression and bipolar disorder are devastating in themselves. The group’s national website reports that 21 million Americans are affected by the two illnesses. They account for 90 percent of this country’s suicides each year and cost $23 billion in lost workdays and other work place losses.

Both Vogtle and Watts emphasize that the group is not a replacement for the care of a mental health provider.

It is simply “a little more support,” Vogtle said.

The help the group provides has been greatly appreciated by those who attend though. Vogtle said she has never received any negative feedback in the surveys given out at meetings.

After a recent meeting a half dozen members sent some anonymous thoughts to In Good Health about the group. None of them were negative.

“My mental health is like a job,” one member wrote. “I struggle with depression every day. I feel the DBSA group is helpful. It gets me out of the house. It is good to know I am not the only person suffering with depression.

By speaking thoughts I feel I can better understand which ones should be validated.”

Those words underline the fact that for most a mental health diagnosis is a chronic condition. Those with a mental disorder have to work every day to cope and overcome it. The stigma persists that those with mental health issues should just “pull themselves up by the bootstraps,” Watts noted, but that is unrealistic. She said cures are currently out of reach too.

“I think it’s confusing because we throw around the word recovery in the mental health world these days and a lot understand recovery as being cured,” she said. “It’s more that you are going to have days that are better and maybe months that are better and then symptoms may reappear, but then they’ll go away.”

While the illness may not go away for good, the symptoms can be alleviated and life may get better. The support group offers a push in the right direction. Those who attend have said the it has definitely had a positive impact on their lives. People have come from as far away as Utica and Watertown to get some of that support, Vogtle said.

To learn more about the Depression Bipolar Support Group call 315-2180805 or go to www.dbsacentralnewyork.org.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Danger in the Bathroom

By Deborah Jeanne Sergeant

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Page 16

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ASSISTED LIVING

f your elderly parents struggle with mobility and balance, a bathroom renovation may help maintain their independence.

“Bathtubs can become very hazardous,” said Sharon Brangman, geriatrician with SUNY Upstate.

“Bathrooms are places where falls can result in bad injuries because things are slippery and there are so many hard surfaces. I’ve had patients get trapped in their bathtubs because they can’t muster the strength to get back up. It can be a dangerous situation.”

Without their eyewear and shoes, their risk for falls increases. Add to that issues with balance, mobility or depth perception, and falling is nearly inevitable for seniors.

Hip fractures resulting from falls often start a downward spiral of health as senior loses muscle mass, strength and, after recovery, the confidence to walk and exercise.

Brangman recommended a few low-cost options to start with, such as a hand-held sprayer to help people who sit on a shower chair, along with a long-handled scrubber for hard-toreach places. It may also help to keep bath supplies nearby so the senior doesn’t have to strain to reach them.

Sliding shower chairs “can help you transfer from a wheelchair or other chair and you can get into the bathtub, but you generally need someone to assist you with that,” Brangman said.

“A shower is the best way to go to be independent, one you have where you don’t have a high threshold to step over and have a lot of grab bars. You don’t want one with shiny tile, but a matte finish or a rough surface.”

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what equipment or renovations could help.

Frank Hurd, owner of Frank’s Home Improvement in Weedsport, said that grab bars are the most common bathroom modification he installs.

“They should be professionally installed because it’s important to hit the lumber in back of it,” Hurd said.

“Otherwise it won’t be sturdy.”

He installs grab bars near the shower entry, over the faucets and another in the center of the shower.

He added that a walk-in shower with a low, six-inch threshold is relatively easy to install in most bathrooms in replacement of the tub.

“These are large enough for a person to sit in,” Hurd said.

He recommends removable seats instead of permanent ones because the former provide a larger seating area.

“The mobile ones are wider and more stable,” he said. “I like shower curtains instead of a sliding door. It’s easier to get in and out of and less chance of tripping on the edge of the glass door frame.”

People also tend to grab the door’s handle when falling and a shower door handle cannot support a falling person.

Zero-threshold showers entirely eliminate the threshold by using a gradually slanting floor to direct water to the drain. These showers require a large-sized bathroom to accommodate the sloping floor. Though a major renovation, a zero-threshold shower may be the best option for someone unable to step over a threshold.

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Parenting

By Melissa Stefanec melissa@cnyhealth.com

A rare glimpse into the carnival that is a pregnant woman’s mind

S

tep right up boys and girls. What I am about to show you is a thing of rare and frightening beauty.

Few people dare to even talk about this thing, except in their most private circles. People far and wide wonder at this thing’s thoughts, desires and displeasures. This tired creature, known for its almost insane dedication to nesting and food consumption, is on display for your pleasure and amusement. Behold, in all its hyper glory, the thoughts of a pregnant woman’s mind. It is a mere days from bringing another life into this world and it’s in overdrive.

All right, pageantry aside, I thought I would offer In Good Health readers a glimpse into what transpires in my head during a typical day. Late pregnancy has almost completely hijacked my brain with thoughts of pain, delivery and carbs. I hope you enjoy a few minutes inside my (very) pregnant world.

5 a.m. — I might as well get up. I have a lot to do today. It’s Saturday, I don’t have to work, and I need to hammer some stuff out around the house before my little bundle of joy arrives.

6 a.m. — I could really go for some scones. I should bake while I still can. After this baby gets here, I won’t be making anything from scratch until 2016. Is it too early in the day for waffles?

7 a.m. — How does this house go to the dogs in a mere week? My husband and I try to stay on top of things, I swear. It looks like a laundromat and toy box had mutant children and used a leaf blower to scatter them around my house.

10 a.m. — Owww, owww, owww.

Leg cramp. I can’t wait until pointing my toes and stretching my legs are no longer dangerous activities.

10:15 a.m. — Is it lunch time yet?

Is it pre-lunch time? I think it is. I will have a yogurt, even though all I want are cupcakes, lots of cupcakes.

10:45 a.m. — I should run errands, but what if my water breaks at the store? That only happens in the movies right? Would I have to clean it up myself? The awkward, 16-yearold bagger at the grocery store doesn’t get paid enough to clean amniotic fluid out of the cereal aisle. Maybe I should buy something liquid in a glass container. That way, if the unthinkable happens, I can just drop the container on the floor and cover my tracks.

11:15 a.m. — Is it lunch time yet?

Close enough. Maybe I can eat half of my lunch now and save the other half for later.

Noon — Did I send out all my thank-you cards? I don’t want anyone thinking I am ungrateful. Should I get more cards? I am running low. Do I have enough stamps? Great, two more errands to add to the list.

12:30 p.m. — I should sweep again. I swear I can see crumbs in the corner. When is the last time I cleaned underneath my daughter’s booster seat? Maybe I should make myself a chore matrix.

1 p.m. — Chore matrix? What was I thinking? I should make a nap matrix.

I should be saving up my energy for this whole labor and delivery thing. I should nap while my daughter is napping. I should nap while I can. Speaking of labor, I did nothing to prepare this time. I didn’t read articles, blogs or books. Do I think I am some sort of professional just because I birthed one child three years ago? When did I become so cocky?

2:15 p.m. — I wish I had saved the other half of my lunch. How can I be so hungry? I should eat something high in fiber and protein. I should eat some almonds and a piece of fruit. Or I could eat a cupcake. I’m sure bakers use nothing but whole-grain flour, and frosting has cream and butter. There has to be some protein in there, right?

4 p.m. — Did I file all my paperwork and pay all my bills? I don’t want to be worrying about this stuff while I have a screaming infant around. What did I forget? I know there’s something.

I had better check the mail.

6 p.m. — Dinner time! Time to waddle into the kitchen and eat whatever is easiest to make.

7:30 p.m. — More Braxton-Hicks contractions. This is like the tenth set today. Maybe these are the real ones.

Oh, dear, God. I am so not ready for this. I still haven’t filed last week’s dependent care claim, vacuumed the back porch or made a fabric cover for the baby’s mobile. This can’t happen now.

8:30 p.m. — It doesn’t look as though this is happening now. How can I be dreading something that I want to be over with so badly, and yet be so darn excited? Oh, the magic of motherhood. Should I have a snack before bed? I don’t want to wake up in the middle of the night hungry. I am dreading stepping on that scale Monday at the doctor’s office. Why must carbs taste so good?

10 p.m. — Ahhh, glorious bed time. There is no better feeling than crawling into bed.

11:50 p.m. — Sweet! I slept for two whole hours. That sleep took a lot out of me. I am going to need a bowl of cereal after I take a midnight potty break.

1:40 a.m. —Potty break. Arg. How exactly do I get out of bed without pulling something? Thank goodness we have a pillow-top mattress. That edge gives me something to grab onto and helps me hoist myself out of bed.

3:15 a.m. — Potty break again?

4:50 a.m. — Awake again? Why is there so much pain involved in feeling like I have to pee? Should I even bother to go back to sleep?

So there you have it folks. A titillating glimpse into the mind of a pregnant woman.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 17

GoldenYears Can Human Growth Hormone Reverse Aging?

By Deborah Jeanne Sergeant

Y

ou’ve likely seen ads online about human growth hormone (HGH), popularly touted to reverse the aging process.

While HGH is FDA-approved for certain uses, turning back the clock for middle-aged and older adults isn’t one of them.

Reports of its success in doing so are “largely anecdotal,” said Vincent Sportelli, certified sports physician, sports clinical nutritionist, chiropractor and owner of Sportelli Chiropractic Health & Wellness Center in Syracuse.

The pituitary gland produces HGH naturally to spur children’s and teens’ growth. It also controls functions involving metabolism. No evidence has shown that synthetic HGH can recapture youthful appearance and muscle mass; however, side effects of using HGH for non-prescribed purposes includes increased cholesterol, increased risk of diabetes, carpal tunnel syndrome, swelling joint pain and, in men, gynocomastia.

“It is very risky to take it non-prescribed,” Sportelli said. “It can cause tumors and accelerate cancerous growths in the body.”

People misusing HGH often obtain it from dubious sources such as sketchy Internet “pharmacies” and from foreign suppliers. It could be contaminated or a placebo.

Beth Smythe, registered dietitian and representative of the New York State Dietetic Association, said that eating right is vital for feeling and looking one’s best at any age.

“Foods deliver physiological benefits such as protein for muscle repair, carbohydrates for energy and vitamins and minerals for cell function,” she said.

For optimal benefit, Smythe advises eating less processed foods and more whole foods. Many foods boast fortification; however, these don’t offer equal nutritional value as foods which naturally contain the same nutrients.

“For instance, omega-3 fatty acids: many foods Smythe are fortified with omega-3s, but one of the best sources is cold water fish such as salmon which is naturally high in omega-3s,” Smythe said. “They can lower your risk of heart disease. You would have to eat a lot more of fortified foods with omega-3 fatty acids to get the same physiologic response you would get from eating salmon.”

Filling the diet with whole fruits and vegetables, whole grains, nuts, beans, low-fat dairy and lean sources of proteins helps the body stay healthy.

The “My Plate” diagram illustrates a balanced meal comprised of one-half fruits and vegetables, one-quarter lean protein and one-quarter whole grain carbohydrates.

Lisa Thomas, registered dietitian and owner of LTG Nutrition Counseling in Syracuse, encourages adults to make sure they stay adequately hydrated.

“Half your body weight in pounds equals how many ounces one should drink per day,” Thomas said. “It does not need to be water only. All fluids count, but I recommend that water be about half of total needs.”

As part of a produce-rich, balanced diet, Thomas suggests clients add fermented foods to improve digestion, such as miso, sauerkraut, yogurt, kefir and kimchi.

Sportelli added that strength training helps maintain muscle tone midlife and later.

“People tend to only do aerobic exercise,” he said. “From age 35, you start to have atrophy of the muscles and the older you get, the more you lose. If you keep up with weight training, you can build muscle mass and it helps perpetuate natural HGH secretion.”

Free Legal Assistance to Seniors Available in Syracuse

By Matthew Liptak

T

he law can be complex and confusing to anyone, and it’s expensive to hire a professional. The Syracuse University College of Law’s Elder Law Clinic offers free legal help to those in the Onondaga County area who are 60 years of age or older and have a maximum income of 250 percent of the poverty level. The poverty level for a household of one in 2014 is $11,670; for a household of two is $15,730 according to federal guidelines.

The clinic’s director, professor Mary Helen McNeal, estimates the second and third year law students have helped 500 clients since the program’s inception in 2008. It is one of probably about 10 to 15 elder law clinics being operated at McNeal the 150 or so law schools in the United States, she said.

Two or three students are assigned to each client with close supervision being provided by McNeal, who is a lawyer.

Page 18

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“They have to have a legal problem that we feel we have the capacity to handle and that we have enough resources to handle it well,” McNeal said. “If somebody calls at the end of the semester and the students are all finishing up, typically we won’t be able to take that case. If we can’t help somebody, we try to find another resource for them.”

Issues the clinic covers fall into two general categories, McNeal said. The clinic does “preventive lawyering” — creating documents that help direct the clients’ wishes as they get older. Examples of this are simple wills, living wills, health care proxies and powers of attorney.

“A health care proxy appoints a particular person to make health care decisions for you,” McNeal said. “A living will spells out exactly what your wishes are. We recommend them both.”

The second category of cases the clinic often handles is specific legal problems. These can include almost anything from helping clients who are facing eviction or having trouble making mortgage payments to dealing with Medicare denials.

McNeal keeps a close eye on all of

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

the students’ work. She said she enjoys her job and recalled some cases that were particularly rewarding for her and students.

“One case comes to mind,” she said, “We represented a veteran in doing a will and advanced directives. The student quickly gauged that our client was quite ill, and didn’t know how long he would live. We were able to do the documents for him and he died the next day. That was hard on the student but it’s also very rewarding work. We were able to help him effectuate what he wanted.”

In another case, students, who put in 20 to 25 hours of work in at the clinic each week, were able to help an older man to enjoy independence in his later years. He was under risk of having a guardian appointed. His student legal team and their professor worked with local agencies. The results allowed the man to enjoy a less restrictive situation.

He was given more control over his personal finances.

McNeal feels strongly about that area of the law. The clinic will not represent a family member in getting guardianship over an older adult.

“I think it’s an area where there’s still a lot of need for improvement,”

He also encourages adults to get enough sleep since HGH is released at night.

Tim Webster, fourth-degree black belt and owner of Kuk Sool Won Korean martial arts and Excel Health and Wellness, both in Auburn, offered a few more tips.

To maintain vitality, “the number one thing someone should focus on is their diet,” he said. “Vitamins, minerals, carbs, proteins, essential fats and oils are needed daily. Fast food diets are literally killing us.”

He added that regular exercise is also important.

“When we exercise with an increased heart rate, our bodies create nitric oxide,” Webster said. “That has been dubbed the ‘miracle molecule’ and aids in everything from heart and circulatory health to brain health and overall wellness. Exercise for 45 minutes to one hour daily.”

Webster also likes the fact that practicing martial arts offers not only regular, ongoing exercise but mental and physical challenges and goals to keep motivated.

While martial arts may not be the activity for you, seek something you enjoy doing and engage in regularly to get — and stay — physically fit.

she said. “There’s lots of discussion about alternatives, but I think it’s an aspect of elder law that still has a long way to go to be ideal.”

The class of eight to ten students meets twice a week. The whole class sometimes brainstorms cases and issues, but clients deal directly with the two or three students assigned to them.

They can come to the clinic or the clinic may go to them. It is a great opportunity for law students to get hands on experience, McNeal said.

Emily North, 26, of Baldwinsville, is a former SU law student who took the elder law clinic. She is now staff attorney at the Legal Aid Society of Mid-New York in Syracuse. North said the experience at the clinic was very rewarding.

“I had a fantastic experience with the elder law clinic,” she said. “One aspect that I especially appreciated from the clinic was it gave me the opportunity to evaluate my abilities as an advocate. The clinic allows students to practice skills that are essential to advocacy, but are sometimes overlooked in traditional classes.”

McNeal said the elder law clinic offers a unique opportunity for both students and older area residents.

“It’s sort of a win-win,” she said.

“It’s a win for the clients who get services they might not otherwise be able to get and it’s a win for the students because they learn skills they might not get in other places in law school and they have the opportunity to work with clients which is incredibly rewarding.”

To contact Syracuse University’s Elder Law Clinic call 315-443-4582.

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Vaccination Options Available to Seniors this Flu Season Dear Savvy Senior, I understand that there are several types of flu vaccines being offered to seniors this flu season. What can you tell me about them?

Cautious Senior Dear Cautious, Depending on your health, age and personal preference, there’s a buffet of flu shots available to seniors this flu season, along with two vaccinations for pneumonia that you should consider getting too.

Flu Shots Options

Just as they do every year, the Centers for Disease Control and Prevention (CDC) recommends a seasonal flu shot to almost everyone, but it’s especially important for seniors who are at higher risk of developing serious flu-related complications. The flu puts more than 200,000 people in the hospital each year and kills around 24,000 — 90 percent of whom are seniors.

Here’s the rundown of the different options: Standard (trivalent) flu shot: This tried-and-true shot that’s been around for more than 30 years protects against three strains of influenza. This year’s version protects against the two common A strains (H1N1 and H3N2), and one influenza B virus.

Quadrivalent flu shot: This vaccine, which was introduced last year, protects against four types of influenza — the same three strains as the standard flu shot, plus an additional B-strain virus.

High-dose flu shot: Designed specifically for seniors, age 65 and older, this vaccine, called the Fluzone HighDose, has four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. But be aware that

the high-dose option may also be more likely to cause side effects, including headache, muscle aches and fever.

Intradermal flu shot: If you don’t like needles, the intradermal shot is a nice option because it uses a tiny 1/16inch long micro-needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shots. This trivalent vaccine is recommended only to those ages 18 to 64.

To locate a vaccination site that offers these flu shots, visit vaccines. gov and type in your ZIP code. You’ll also be happy to know that if you’re a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot, as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays. Private health insurers are also required to cover standard flu shots, however, you’ll need to check with your provider to see if they cover the other vaccination options.

Pneumonia Vaccines The other important vaccinations the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. An estimated 900,000 people in the U.S. get pneumococcal pneumonia each year, and it kills around 5,000.

This year, the CDC is recommending that all seniors 65 or older get two separate vaccines, which is a change of decades-old advice. The vaccines are Prevnar 13 and Pneumovax 23. Previously, only Pneumovax 23 was recommended for seniors.

Both vaccines, which are administered just once, work in different ways to provide maximum protection.

If you haven’t yet received any pneumococcal vaccine you should get the Prevnar 13 first, followed by Pneumovax 23 six to 12 months later. But, if you’ve already been vaccinated with Pneumovax 23 you should get Prevnar 13 at least one year later.

Medicare currently covers only one pneumococcal vaccine per older adult.

If you’re paying out of pocket, you can expect to pay around $50 to $85 for Pneumovax 23, and around $120 to $150 for the Prevnar 13.

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

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The Social Ask Security Office Provided Deborah Banikowski, Social Security OfficeSocial Security Office

Holiday Season: Being Aware of Fraud Is Your First Step to Avoiding It

W

ith all of the holiday shopping est-growing crimes in the United going on this time of year, States. If you or anyone you know has both in stores and online, been the victim of an identity thief, there is no better time to remind you contact the Federal Trade Commission to beware of fraud — you never know at www.idtheft.gov, or 1-877-IDTHEFT where it is lurking.

(1-877-438-4338); TTY 1-866-653-4261.

When it comes to doing busiAnother form of fraud that ness with Social Security online, people fall victim to: businessthere is little to worry about — es using misleading adverall of our online services are protisements that make it look as tected by strong Internet security though they are from Social protocols and you should have Security. These businesses confidence that they are safe and often offer Social Security secure. But there are other ways services for a fee, even though identity thieves and criminals the same services are available can obtain your personal infordirectly from Social Security mation and cause you significant free of charge. By law, such an harm. Here are some tips to help advertisement must indicate Banikowski keep that from happening. that the company is not affiliIf someone contacts you claiming ated with Social Security. to be from Social Security and asks for If you receive what you believe is your Social Security number, date of misleading advertising for Social Secubirth or other identifying information, rity services, send the complete mailbeware. Don’t provide your personal ing, including the envelope, to: Office information without first contacting So- of the Inspector General, Fraud Hocial Security to verify if Social Security tline, Social Security Administration, is really trying to contact you. It could P.O. Box 17768, Baltimore, MD 21235. be an identity thief phishing for your Also, advise your state’s attorney personal information. Call Social Secugeneral or consumer affairs office and rity’s toll-free number at 1-800-772-1213 the Better Business Bureau. If you see (TTY 1-800-325-0778). or hear what you believe is misleading If you receive a suspicious call, readvertising related to Social Security, port it by going to http://oig.ssa.gov/ you can report it at the address above, report. Or call by calling 1-800-269-0271 from 10:00 1-800-269-0271 from 10 a.m. – 4 a.m. to 4:00 p.m. Eastern Time, or by p.m. You should provide as much of visiting http://oig.ssa.gov/report. the following information as you know: Protect your investment in Social • The alleged suspect(s) and Security and do your part to report victim(s) names, address(es), phone potential fraud. We rely on you to let number(s), date(s) of birth, and Social us know when you suspect someone Security number(s); is committing fraud against Social • Description of the fraud and the Security. location where the fraud took place; Reporting fraud is a smart thing • When and how the fraud was to do—and the right thing to do. Visit committed; Social Security’s Office of the Inspector • Why the person committed the General at http://oig.ssa.gov. Learn fraud (if known); and more about identity theft and mislead• Who else has knowledge of the ing advertising by reading our publicapotential violation. tions on the subjects at www.socialseIdentity theft is one of the fastcurity.gov/pubs.

Q&A

Q: What is Supplemental Security Income (SSI)?

A: SSI provides monthly income to people with limited income and financial resources. People who never worked at a job that withdrew Social Security tax won’t qualify for Social Security, but may still be eligible for SSI. To be eligible, an individual must be a citizen and resident of the United States or be a noncitizen lawfully admitted for permanent residence. There are, however, some noncitizens granted a special immigration status that are also eligible. To get SSI, an individual’s Page 20

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

financial resources (savings and assets) cannot be more than $2,000 ($3,000, if married). Recipients must be age 65 or older, or blind or disabled. For more information, please read SSI or What You Need To Know When You Receive Supplemental Security Income (SSI).

Both are available at www.socialsecurity.gov/pubs.

Q: Are Supplemental Security Income (SSI) benefits subject to federal income tax?

A: No. SSI payments are not subject to federal taxes. If you get SSI, you will not receive an annual form SSA1099. However, your Social Security benefits may be subject to income tax.

Learn more at www.socialsecurity.gov.

H ealth News Nephrology Associates adds new physician Physician Gordana Obradovic has joined Nephrology Associates of Syracuse, PC as a new nephrologist.

Gordana earned her medical degree from the University of Belgrade School of Medicine and completed her internal medicine residency and nephrology fellowship at the Geisinger Medical Center in Danville, Obradovic Pa. She will provide Nephrology care in Syracuse, as well as one day a month at the office’s satellite location in Auburn.

For more information, call 315-4783311 or visit www.nephrologysyracuse. com.

Physical therapist opens office at JCC’s sports Physicial therapist Alexander S. Talev, owner of Home Stretch Physical Therapy, P.C., recently opened a physical therapy clinic at the Sam Pomeranz Jewish Community Center of Syracuse’s Neulander Family Sports and Fitness Center, 5655 Thompson Road, DeWitt.

Talev, a town of Onondaga resident, specializes in treatment and management of balance disorders/ falls, orthopedic injuries (including post-surgical conditions such as joint replacement), Talev spine care, neurological conditions, arthritis and pain management.

“I am excited to be practicing at the JCC and serving more patients in the eastern suburbs,” said Talev. “The fitness center’s facilities, equipment and staff are top-notch, and having all of this available to patients is extremely beneficial for their physical recovery, conditioning and overall wellness.”

While Talev has focused his practice on treating older adults, he has experience working with individuals of all ages. He takes a highly personalized approach to providing individualized care and identifying the root cause of patients’ conditions, which makes treatment more effective and efficient.

“Having Alex here at the JCC is a nice complement to all that our sports and fitness center has to offer,” said JCC of Syracuse Executive Director Marci Erlebacher. “It’s wonderful that we’re able to open our doors to even more people in the community and take part in helping with their health goals.”

Talev is a doctor of physical therapy with 12 years experience, and a graduate of Upstate Medical Univer-

sity. He accepts Medicare and most Medicare-advantage insurance plans, and also offers private-pay options. For more information and appointments, call 315-569-9308 or email homestretchpt@gmail.com.

Aubry Motherhood Fund established at Upstate Foundation

Inforia, Inc. changes executive management Syracuse-based Inforia, Inc., premier provider of electronic health records software and other paperless solutions for the medical community, recently announced changes to its executive management team. Ryan E. Long has been promoted to president. He succeeds Karen S. Goetz, who will stay on as chairwoman and remains a principal investor in Inforia.

Long joined Inforia in 2012 as director of software development, where he most recently led the comLong pany’s successful 2014 government certification of its CaregiverDesktop suite. Long will build on Inforia’s unique approach to modernizing, securing and improving the flow of health records in doctors’ practices and the offices of other health care providers. He also will continue to Jerome collaborate with staff, management, and customers to advance the company’s IT-related projects and priorities.

“Most electronic health record systems fall short and are cumbersome to use, which is why physicians are often resistant to converting to electronic records,” said Long said. “We customize our system to the workflow already in place at each doctor’s practice. We will continue to enhance this experience for our clients with further innovation and growth of our cloud and mobile platforms, while maintaining our ease of use and flexibility.”

Long, a company investor, returned to the Syracuse area after 11 years with UBS Wealth Management in the Data Warehouse and Business Intelligence Group, where he rose to the director level. He resides in Manlius with his wife and two children.

Inforia also promoted its operations manager, Stephen D. Jerome, to vice president. Jerome has been with the company since its inception in 2000 as Integrated Documents Inc. He will assume new duties in operations, while continuing to work closely with customers to understand and communicate their needs, which inform the company’s strategic planning and software design process. Jerome resides in Liverpool.

Goetz, who served as Inforia’s president and CEO since 2000, leaves day-to-day operations of the company

SUNY Upstate Professor Emeritus Richard H. Aubry, of DeWitt, died in a car accident Oct. 11. Days before the accident Upstate Foundation announced he had established a fund to help disadvantaged and high-risk mothers achieve successful outcomes of pregnancy, childbirth and parenting.

A new fund has been established at the Upstate Foundation to aid those who strive to help disadvantaged and high-risk mothers achieve successful outcomes of pregnancy, childbirth and parenting.

The RMB Aubry Motherhood Fund was created by the late Professor Emeritus Richard H. Aubry, of DeWitt, who retired from Upstate Medical University’s obstetrics and gynecology department after 50 years of aiding public health efforts to improve maternal and infant mortality rates in Central New York.

In addition, to ensure that his life’s work is carried on in perpetuity at Upstate, Aubry left a legacy gift for the department of obstetrics and gynecology to endow a professorship.

“I’m leaving a bequest in my will to support funding for someone who will continue this important public health mission,” Aubry.

“I’m grateful to Upstate for allowing me to conduct this work all these years.”

The physician died in a car accident Oct. 11 days after the announcement.

Eileen Pezzi, vice president for development at Upstate, said it is passion that often motivates faculty members to have long and storied careers at Upstate.

“They devote their lives caring for patients, educating and conducting research or otherwise advancing Upstate’s threefold mission,” said Pezzi.

November 2014 •

“Establishing a fund or endowment is a way faculty members can preserve their years of hard work, leave a lasting legacy and fund the future of Upstate. We are grateful for those who, like Dr. Aubry, understand and appreciate this vision.”

Aubry was one of the nation’s first 17 maternal fetal medicine specialists focusing on high-risk pregnancies.

In 1976, he established the Central New York Regional Perinatal Center, one of the first facilities of its kind in the country. That center, a joint effort of Upstate and Crouse hospital, serves high-risk mothers and babies from a 15-county region. He helped develop what has evolved into the Women & Children’s Services program of excellence at St. Joseph’s Hospital Health Center in Syracuse. In 1997, he worked with Onondaga County to launch a federally funded program called Healthy Start to promote healthy pregnancies through home visits, case management and education.

Upon his retirement, Aubry was medical director of the Center for Maternal & Child Health at Upstate, which he established 20 years ago to serve mothers and children via education, research and patient care to optimize family health.

Anyone interested in contributing to the RMB Aubry Motherhood Fund may do so by contacting the Upstate Foundation at 315-4644416.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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H ealth News to accept the position of executive director of the not-for-profit private Richard S. Shineman Foundation, a catalyst for change in Oswego County.

St. Joe’s: Cancer Gold Standard Accreditation St. Joseph’s Hospital Health Center has received CEO Cancer Gold Standard accreditation, recognizing the organization’s extraordinary commitment to the health of its employees and their families.

Christopher A. Viehbacher, chief executive officer of Sanofi, is chairman of the CEO Roundtable on Cancer, a nonprofit organization of CEOs who created the CEO Cancer Gold Standard in collaboration with the National Cancer Institute, many of its designated cancer centers, and leading health nonprofit organizations and professionals. Today, more than four million employees and family members are benefiting from the vision and leadership of employers who have chosen to become Gold Standard accredited.

“Staying healthy means not only eating right, but also exercising, managing stress and more,” said Kathryn H. Ruscitto, president and chief executive officer for St. Joseph’s. “We have a comprehensive employee wellness program in place that allows our employees to focus their efforts on what will best meet their needs, whether it be creating a walking route around campus or offering tobacco cessation services. Our culture of wellness extends beyond our staff to our patients, their families and our community.”

The CEO Cancer Gold Standard calls for companies to evaluate their health benefits and corporate culture and take extensive, concrete actions in five key areas of health and wellness to address cancer in the workplace. To earn Gold Standard accreditation, a company must establish programs to reduce cancer risk by prohibiting tobacco use at the workplace; encouraging physical activity; promoting healthy nutrition; detecting cancer at its earliest stages when outcomes may be more favorable; and providing access to quality care, including participation in cancer clinical trials.

The CEO Roundtable on Cancer was founded in 2001, when former President George H.W. Bush challenged a group of executives to “do something bold and venturesome about cancer within your own corporate families.”

Kohl’s donates $230,031 to Upstate Foundation Kohl’s Department Stores has donated $230,031 to the Upstate Foundation to support the Upstate Golisano Children’s Hospital and the Kohl’s autism and related disorders program of the Margaret L Williams Developmental Evaluation Center at Upstate Golisano Children’s Hospital.

The donation was presented Sept. 28 during Autism Awareness Day at Critz Farm in Cazenovia.

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Since 2004, Kohl’s Department Stores has donated more than a $1.6 million to the Foundation for Upstate Golisano Children’s Hospital to support the Kohl’s autism and related disorders program. The program has reached thousands with its outreach services supporting autism awareness and education, which includes its highly successful interactive puppet workshop and autism awareness events.

“The Kohl’s autism and related disorders program helps us to create a more inclusive environment for those with disabilities in our community,” said Carroll Grant, director, Margaret L. Williams Developmental Evaluation Center. “The continued support we receive from Kohl’s makes it possible for us to serve more families and help more kids.”

Kohl’s commitment to Upstate Golisano Children’s Hospital is made possible through the Kohl’s Cares cause merchandise program. Through this initiative, Kohl’s sells $5 books and plush toys where 100 percent of net profit benefits children’s health and education programs nationwide, including hospital partnerships like this one. Kohl’s has raised more than $257 million through this merchandise program.

Oswego has new medical imaging chief of service Oswego Health welcomes physician David Wang of CRA Medical Imaging as the new chief of service for medical imaging.

Wang has more than 20 years of experience as a physician radiologist. A native of Michigan, he earned his medical degree from Wayne State University in Detroit. He completed his residency in diagnostic radiology at Sinai Hospital of Detroit and his fellowship at Henry Ford Hospital in nuclear medicine, also located in Detroit.

While he is trained in all medical imaging areas, he specializes in Wang nuclear medicine and mammography.

“I am looking forward to working with Oswego Health’s patients, physicians and staff,” said Wang. “This is a wonderful opportunity.”

CRA Medical Imaging and Oswego Health partnered several years ago to provide community members with exceptional medical imaging services.

CRA Medical Imaging physician radiologists represent a wide range of sub-specialists trained in neuroradiology, breast imaging and musculoskeletal imaging, as well as interventional radiology and nuclear medicine. These radiologists have immediate access to their subspecialty-trained colleagues for consultation on complex cases.

CRA Medical Imaging also uses voice recognition software for the prompt turnaround of patient imaging reports to the referring physician.

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

Upstate has new assistant VP for shared business services Sandra Delaney has been named assistant vice president for shared business services.

As assistant vice president for shared business services, Delaney will direct and supervise the daily activities of the payroll services office as well as oversee shared business services functions to include accounts payable and travel, contracts and campus purchasing.

Delaney will also explore shared service opportunities with other SUNY Delaney campuses and other partners to respond to SUNY’s shared services initiative as well as work with other the university’s other shared services to promote process improvement and efficiency related initiatives.

Delaney joined Upstate in October 2006, as the director of payroll services. Her primary responsibilities included administration of payroll and timekeeping for more than

Neurosurgeon joins Crouse Institute for Neurosciences Crouse Hospital has appointed Central New York neurosurgeon David Padalino as education director for neurosurgery. Padalino will see patients at Crouse starting Jan. 1.

The development of a comprehensive neurosciences service line has been one of Crouse’s key strategic initiatives.

This includes neurology, endovascular neurosurgery and comprehensive stroke care.

“We feel there is an opportunity to enhance the delivery of care for the brain and spine in Central New York and Dr. Padalino will be a great addition to our clinical team,” says Crouse CEO Padalino Kimberly Boynton.

Padalino, who will be affiliated with Crouse Medical Practice, specializes in brain aneurysms; arteriovenous malformations of the brain and spinal cord; stroke rescue therapies; and skull base and brain stem tumor surgery.

A native of Liverpool, Padalino received his medical degree from the Buffalo School of Medicine in 2005. He completed his residency in neurosurgery at Upstate Medical University in 2012 and earned a fellowship in neuroendovascular surgery from Upstate in 2013.

As part of its ongoing development of neurosciences, Crouse began construction in July on two new hybrid operating rooms in the Witting Surgical

8,000 employees, badging for all employees, contractors and students, the maintenance of personnel files, and acting as a member of the CG pension oversight committee.

Delaney earned a bachelor’s degree from Columbia College and an MBA from LeMoyne College. Prior to her appointment at Upstate, she acted as controller for Young & Franklin Inc./ Tactair Fluid Controls Inc., a local manufacturing firm, for nearly 20 years.

In that capacity she was responsible for overseeing all aspects of accounting, reviewed contracts, performed acquisition due diligence/implementation and led several process improvement initiatives.

The Baldwinsville resident was honored with a Presidential Employee Recognition Award as campus employee of the year on 2013.

Center. These existing ORs are being adapted so that certain diagnostic and interventional neurovascular and peripheral vascular procedures can be performed by Padalino and other members of the hospital’s neurosurgical and vascular service teams. The new suites will open in December.

St. Joe’s earns national recognition for respiratory care St. Joseph’s Hospital Health Center has earned Quality Respiratory Care Recognition (QRCR) for 2014 under a national program aimed at helping patients and families make informed decisions about the quality of the respiratory care services available in hospitals.

The QRCR program was initiated by the American Association for Respiratory Care in 2003 to help consumers identify those facilities using qualified respiratory therapists to provide respiratory care. Hospitals earning the QRCR designation ensure patient safety by agreeing to adhere to a strict set of criteria governing their respiratory care services.

The program grew out of increasing concerns among health care leaders and the general public regarding the safety and quality of health care services provided to patients. Hospitals that meet the QRCR requirements provide a level of respiratory care consistent with national standards and guidelines, and should be commended for their commitment to quality care.

About 700 hospitals or approximately 15 percent of hospitals in the U.S. have applied for this award.

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Dwyer Family of Chittenango Awarded In The Fresh Air Fund’s Annual Photo Contest Chittenango residents, the Dwyers, celebrated the pure joys of summer with The Fresh Air Fund and were among the winners of The Fresh Air Fund’s 2014 Photo Contest! All winners were selected from the hundreds of pictures sent in by volunteer host families across 13 states from Virginia to Maine and Canada, reflecting the memorable experiences they shared with their New York City visitors this past summer.

Categories include “Laketime Fun,� “Summer Siblings,� “By the Beach,� and “Fresh Air Foodies.�

Vicky, of the Bronx, The Dwyer family’s photos munching on her new were determined the winners in the favorite food.

“Fresh Air Foodies� and “Playground Fun� categories, and feature Fresh Air visitor Vicky, age 8, enjoying backyard fun in the sun in New York with her host sibling, Brooklyn. “Having Vicky come stay with us was by far the best part of our summer! We loved watching Vicky have so many first experiences. She caught fireflies, camped out in a tent in our backyard, rode in a boat, and picked fresh vegetables from a garden!� said Donielle about her hosting experience.

The Fresh Air Fund, an independent, nonprofit agency, has provided free summer experiences to more than 1.8 million New York City children from low-income communities since 1877.

For more information on hosting a Fresh Air child next summer, please contact Nicholas Kamen at 212-8978908 or visit The Fresh Air Fund online at www.freshair. org.

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Vicky playing on the tire swing with her summer sister, Brooklyn.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 23

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