Igh cny 180 dec14

in good ‘The Chocolate Debacle’ New mystery book by Skaneateles author Karen Winters Schwartz centers around mental health message

Winter = Cracked Heels Experts share tips to avoid the problem

December 2014 • Issue 180

free FREE

CNY’s Healthcare Newspaper

The Great Tonsil Massacre Year: 1920-1921• Place: Rochester • Goal: To remove tonsils of children to make them “healthier,” “stronger” and prevent them from having “mental issues” • Recommended by: Doctors, hospitals, community leaders • Result: 9,821 children had their tonsils removed.

Page 18

Phlebotomy

PSTD Not Just a Soldier’s Problem

Entry-level positions pay as much as $30,470

Although many people picture post traumatic stress disorder as a mental problem afflicting soldiers who experienced battle, anyone can suffer from it

Yep, it’s not just your impression.

Prices of generic drugs are going up

Orthopedic surgeon Tim Izant talks about a new program at Crouse: ‘Hip Today, Home Tomorrow’

Child life specialists add a special touch to Children’s Hospital

CNY’s King of Cataract Surgeries Robert Druger, a Camillus-based ophthalmologist, says he performs more than 30 in a single day

The amazing benefits of pomegranates

Does the fruit warrant all the recent hype? Is it still in the limelight?

Page 14

The 10 child life specialists at Upstate Golisano Children’s Hospital work on the psychosocial, emotional and developmental needs of kids who are admitted to the hospital Page Page 16 XX

Eat Eggs, Feel Full Eggs are one of seven foods that can make you feel full without overeating

Sure, the schools have healthier food, but are kids eating it?

Page 8

Page 15

December 2014 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 1

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Page 2

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

U.S. Prices Soaring for Some Generic Drugs

M

arket forces are dramatically driving up the cost of some generic drugs, prompting U.S. investigations into the pricing of what should be cheap alternatives to brandname medications.

Generics that should cost pennies per dose have undergone radical increases in price in recent years, said physician Aaron Kesselheim, author of a new commentary in the “New England Journal of Medicine,” and director of the program on regulation, therapeutics and law at Brigham and Women’s Hospital in Boston.

Example: • The widely used broad-spectrum antibiotic doxycycline has increased from 6.3 cents to $3.36 per pill.

• The long-established antidepressant drug clomipramine has increased from 22 cents to $8.32 per pill.

Supply chain and manufacturing problems have caused some of these price hikes, but Kesselheim believes that other increases have resulted from too few companies making the generic versions of these drugs.

“We take for granted that generic drugs are low-cost, but they’re only low-cost because there’s competition.

When that competition goes away, the prices rise,” said Kesselheim. “Because we leave this up to the free market, this is a risk we take on.”

In response to these increases, both the U.S. Senate and the U.S. Department of Justice have undertaken investigations into generic drug pricing.

Federal prosecutors have issued subpoenas to two generic drug makers, seeking information about possible collusion between competitors, according to a published report. At the same time, the Senate Subcommittee on Primary Health and Aging has sent letters to executives of 14 pharmaceutical companies asking for answers.

Generic drugs are a “critical part

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

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 • 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.

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December 2014 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 3

CALENDAR of

HEALTH EVENTS

Dec. 1

ACR to mark World AIDS Day In recognition of World AIDS Day, ACR Health will hold a service of hope and remembrance at Panasci Chapel at LeMoyne College on Monday, Dec. 1.

The World AIDS Day service begins at 7:30 a.m. and lasts about 30 minutes. Refreshments, pastries and Starbucks coffee will follow. Music will be provided by the Syracuse Gay and Lesbian Chorus. The public is invited to attend.

Dec. 6

‘Breakfast with Santa’ slated for Driver’s Village

St. Joseph’s College of Nursing is hosting its annual “Breakfast with Santa” at 9 a.m. on Saturday, Dec. 6, at the Carnegie Conference Center, located at Driver’s Village, 5885 East Circle Drive in Cicero. The fundraiser benefits the College of Nursing.

Women’s Health — Special Issue Coming...

The January issue of In Good Health will bring several feature stories on women’s health.

For more information, email editor@cnyhealth.com

Children will have a fun-filled morning of breakfast, including raffle prizes, fun activities and a visit from Santa Claus. Photos with Santa are available for purchase.

Tickets are $9.50 per child (3 to 12 years) and $13.50 per adult. Children 2 and under are free. Space is limited. To register or for more information, call 448-5303, or emailconnie.semel@sjhsyr. org.

Dec. 9

Caregivers to be recognized during luncheon The Onondaga County Department of Adult and Long Term Care Services will hold a holiday luncheon celebrating family caregivers. Sponsored by the Villas at Summerfield at 100 Summerfiled Lane on Onondaga Hill,

the event will take place at noon Dec. 9.

Organizers say this is a unique opportunity to relax and be recognized for all caregivers do.

Reservations are required. Contact Cynthia Stevenson at 315-435-2362 ext 4993 or email to cstevenson@ongov.net.

Dec. 13

was created by a coalition of talented, accomplished theater professionals who live and work in Central New York. It’s locally written, directed, performed, and costumed — truly an original, collaborative effort.”

For tickets and more information gotocnyarts.org.

Dec. 13

‘Dasher’s Magical Gift’ presented by CNY Arts

Create custom cookie trays, help church raise funds

CNY Arts invites the public to be part of a new holiday tradition by joining the gorup for the premiere of “Dasher’s Magical Gift,” a new holiday show that will take place at 11 a.m., Dec. 13, at the Crouse Hinds Theater at the Civic Center, 411 Montgomery St. With Dasher’s Magical Gift, CNY Arts continues its 35-year long tradition of providing an educational and affordable production with a new story, new choreography, new sets, new costumes, and a new lighting design to inspire the current generation of today’s young children.

“The Adventures of Rudolph has been a holiday tradition for at least two generations of children, and our staff and board members are excited to announce a brand new holiday show that we hope will become a new tradition,” said CNY Arts Executive Director Stephen Butler. “Dasher’s Magical Gift

The Columbian Presbyterian Church is presenting a “Christmas Cookie Cafe” from 9:30 a.m. – noon Dec. 13, at the church located at the corner of routes 11 and 20 in LaFayette.

Customers will be able to create custom cookie trays from the dozens of varieties available. There will be trays and boxes that you can buy to carry your goodies home or you can bring something of your own, and make it look like you worked for days in the kitchen to bake these delicious treats. The tray will be weighed, and you will pay for the cookies by the pound. The church will also have refreshments available so that participants can treat themselves right away to a sweet snack. For more information, call Tom Redmore at 315469-7446 or send an email to red3467@ schfcu.net.

Time to make health insurance decisions for 2015 Open enrollment for the New York State of Health marketplace started in November: Here are the deadlines to keep in mind

I

t’s time for individuals with a health insurance plan on the New York State of Health Marketplace to make their health plan decision for 2015.

Open enrollment for the New York State of Health marketplace started Nov. 15.

“If you’re happy with your current health plan, renewing your plan is easy,” said Lynne Scalzo, vice president, business strategy and administration, Excellus BlueCross BlueShield.

“You don’t have to do anything. Your plan will renew automatically. Just remember to continue to pay your bills on time.”

If you have questions, or if your situation has changed, Scalzo encouraged individuals to call their health insurer.

At Excellus BCBS, members can call 888-316-4549.

“If you already have a plan from the marketplace, you will receive a letter from them detailing your plan’s new rates and your new financial assistance amounts for 2015,” she added.

But if you’re enrolling in a new plan on the marketplace, here are some questions to keep in mind: • Do your doctors participate in the plan’s network? You typically pay less for services from in-network doctors. If you break your leg, for example, you might pay $4,000 more out of your pocket if you see doctors not in your plan’s network, according to an Excellus BCBS. • Can you get financial help? Indi-

viduals earning up to $46,680 a year or a family of four earning up to $95,400 a year may be eligible for financial assistance when purchasing a health insurance plan on the marketplace.

Here are key dates for those looking to buy a new health plan on the marketplace for 2015: • Dec. 15: Deadline to buy a health plan for coverage starting Jan. 1.

• Jan. 15: Deadline to buy a health plan for coverage starting Feb. 1, 2015 • Feb. 15: Deadline to buy a health plan for 2015. Coverage will start March 1. But if you experience a major life event, such as a marriage or a birth, you may be able to purchase coverage for 2015 after the Feb. 15 date.

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Page 4

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

Proudly affiliated with CNY Surgical Physicians, Crouse Radiology Associates, Hematology/Oncology Associates of CNY

Forget Ebola. Focus on the Flu: Experts

By Deborah Jeanne Sergeant

W

ith Ebola’s surge in the news, communicable diseases have gained center stage in public attention. But according to the Centers for Disease Control (CDC) and just about every medical source, the risk of getting Ebola in the United States is very low, even when working with West African communities in the United States.

Although the common cold or influenza generally do not grab the number of headlines that Ebola has, they can cause deadly complications and will most likely kill more than Ebola in the US this year. The CDC reports that 153 children under age 18 died of influenza in the 2013-2014 flu season, for example. Children, the elderly, and people with compromised immune systems represent three groups especially prone to lethal flu and cold complications.

Several steps can help prevent the spread of colds and flu. Help your immune system stay strong. Eating a balanced diet rich in fruits and vegetables can help your body fight off illness.

Physician Joseph Domachowske, professor of pediatrics and infectious disease specialist at Upstate Golisano Children’s Hospital, said that Hoey vaccine is the most effective way to control influenza, but it’s not foolproof.

“People who get vaccinated may still get influenza, but when they do, it’s a milder infection,” Domachowske said. “Most have a protective response from the vaccine. Influenza vaccines’ effectiveness depends upon how often the person is immunized.”

If the available vaccine matches the strains of virus to which a person is exposed, effectiveness may be as high as 85 percent; otherwise, it can range from 30 to 40 percent.

Domachowske said that since flu vaccines are less effective for older people, it’s important for every person 65 years old and older to receive vaccine for “community immunity.”

“You’re not just getting vaccinated to protect yourself,” he said. “You’re included in that community.”

Vaccination is available in the form of a nasal spray, injection, and intra-dermal that just goes under the skin.

Deanna Hoey, public health educator Cayuga County Department of Health, has a master’s in degree in public health. She agrees that it’s important to get a flu shot. “Get it now,” she said, “before flu season peaks in January and March. If you get your flu shot now, it takes about two weeks to build immunity from that flu shot.”

Although not regulated by the Food & Drug Administration nor proven to reduce illness, supplements may offer help in maintaining a healthy immune system for people whose diet lacks nutrients. Take a daily multi-vitamin per package directions. Mega doses of vitamins do not offer any additional benefit and may be harmful to your health.

Get enough rest and manage stress, too. Your body needs rest and relaxation so it can fight off germs that cause illness.

“Any level of stress can raise our susceptibility to common infections like respiratory infections,” Domachowske said. “As much as possible, get a good night’s sleep, exercise, and maintain good nutrition. Keep in general better health overall.”

Exposure to environmental toxins such as cigarette smoke and second-hand smoke can make the body more susceptible to viral illnesses, among other reasons to avoid them.

“The cilia attached to the respiratory lining help move particles of pollution and bacterial up and out,” Domachowske said. “If that movement is paralyzed, those individuals will have more respiratory infections.”

Working to rid the body of toxins such as cigarette smoke taxes the cilia unnecessarily and makes the body more susceptible to viruses.

Judy Lester, director of patient services at Oswego County Health Department, advises people to wash their hands whenever returning home, before touching their faces or handling food, and after using the restroom.

“That’s the best protection against viruses,” she said. “Make sure that you’re frequently washing your hands throughout the day.”

Viruses can live on many surfaces for days. After touching a contaminated surface, you can transmit viruses to your body if you eat or touch your mouth, eyes, or nose. Before doing any of these, wash up. Use warm water and soap, scrubbing vigorously for about 20 seconds. It takes about that long to sing “Happy Birthday” twice. Use hand sanitizer only when washing the hands isn’t possible.

Resist exposing others to viruses if you become ill.

“Stay home if you’re sick,” Lester said. “If you’re running a fever, stay home and rest. With the flu, typical symptoms include more severe symptoms than colds. You would have a fever, body aches, dry cough, and extreme fatigue. A cold [manifests with] a little tiredness, stuffy nose. It’s best if you stay home, particularly until the fever breaks without using fever-reducing medication for 24 hours. The flu can last three to seven days.”

Use your own hand towel at home and don’t share utensils. Frequently clean commonly touched surfaces such as countertops, doorknobs and faucet handles. Dispose of used facial tissues immediately. Sneeze into the crook of your elbow or a facial tissue.

Don’t demand an antibiotic from your doctor. It won’t help fight your cold or flu. Antibiotics fight bacteria; viruses cause colds and flu. If you take antibiotics needlessly, your body may not be as adept at fighting off bacteria in the future.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

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Meet

Your Doctor

By Chris Motola

Tim Izant, M.D.

Orthopedic surgeon talks about new program at Crouse: ‘Hip Today, Home Tomorrow’ where patients go home a day after hip replacement Q: Do you have a sub-specialty in your orthopedic practice?

A: I’m a sub-specialist in hip- and knee-replacement surgery.

Q: Are most of your patients older adults?

A: Actually, they vary in age. My patients range from 30 to 100. I’ve seen occasional urgent problems from people younger than that, down to kids.

Q: Have hip and knee replacement outcomes been improving?

A: Two of the operations that provide the most improvement of the quality of life for patients with medical problems are cardiac bypass surgery and hip and knee replacement. Most of the time the results are tremendous in restoring people’s quality of life, improving their pain and getting them back on their feet. There’s a small risk of complications, which there are for every specialty, but we enjoy some great improvements. In terms of technology, there are some advances every five years or so, but it’s hard to make sudden changes without really knowing the long-term effects. So we’re conservative about making advances without knowing how they’ll function years from now.

Q: How about recovery time?

A: The new surgical approach to hip replacement allows for a much more rapid recovery from the surgery.

The approach is called the “directly interior approach.” That’s been around for about 10 years. It was initially developed to try to do the surgery through a small incision. Early on they were using experimental implants and instruments that weren’t very well developed. What’s happened in the last five years is that instruments have been developed that allow us to better do the surgery through a small incision with standard implants.

Q: How much time are we talking about?

A: There’s minimal muscle trauma, so the patient’s initial recovery is incredibly fast. Even though I’m an experienced surgeon, it took several years of training to develop the skills. I’ve been doing it for a couple years now, and a whole bunch of my patients have been just flying out after surgery, leaving really fast. About a year ago, I noticed that a lot of my younger, healthier patients were going home the very next day. We were happy with that, so we rolled out a formal program where it was well-organized ahead of time to get the patients up, get them moving.

Most of the patients that I anticipate going home the next day go home the next day.

I’ve partnered with Crouse to develop a formal program that we

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

call Hip Today, Home Tomorrow. There are some places around the country that are even more aggressive and will try to do it as outpatient surgery, sending patients home the same day. We aren’t interested in doing that. We think one night at the hospital allows us to have enough interactions with therapists and pain medications to allow us to safely send the patients home. After we send them home, we have a well-organized group of physical therapists and nurses who go to the patient’s house and follow up on them.

Q: What are the factors that determine recovery time from surgery?

A: The size of the wound, the amount of muscle traumatized from the surgery. We aren’t able to do [the low impact approach] for all patients.

Patients that have difficult anatomy where we can’t visualize everything through a small incision or have super tight ligaments or muscles I have to sometimes do the traditional approach for. It doesn’t really matter what approach you use in terms of outcomes after three months. The advantage of the small incision is that it’s a much quicker initial recovery.

Q: Are there similar procedures available for knee surgery?

A: There are less invasive procedures for knee replacement, but the exposure issue is more of a problem since you need to get a bigger device in there. There’ve been some issues where the small incision makes it harder to properly align the device, and there’s not as significant an advantage in terms of recovery. There have been some advances with pain medication; knee replacement is a lot more painful and requires a lot more therapy. There are some places around the country trying outpatient knee surgery, but that’s not really something on our radar.

Q: What are the typical causes of joint failure?

A: Arthritis, which is a breakdown of the cartilage, which is what we’ll typically see in our over-60 patients.

Some of my younger patients either have an abnormal hip from birth or childhood, or they’ve had injuries to

the hip that have caused premature arthritis.

Q: In terms of upkeep, what do patients typically have to do post-surgery to keep the replacement in good shape?

A: I take only about 10 percent credit for my patients’ results. The rest is due to my patients following through with physical therapy, particularly in the first three months. If they do that, they can expect good results.

It takes a good year until you’re 100 percent, mostly because it takes time to build the muscle back up.

Q: How did you become interested in surgery?

A: Being exposed to the operating room and general surgery in medical school. One of my rotations at the end of my third year was orthopedics, and I had the opportunity to assist the chairman of the department in taking care of a fractured forearm. I was just amazed by the beauty of the anatomy and the technology that allowed us to fix it by implanting plates and screws. You can take someone almost totally disabled and help them get back on their feet. And the surgery is actually a lot of fun to do. They call us “carpenters.”

Q: Do you get an opportunity to get to know your patients prior to operating?

A: We get to know them briefly and intensely. If they haven’t already received the conservative treatments from their primary, I’ll initiate those. Once we’ve exhausted those, we’ll discuss operative therapy. Some patients I get to know really well — I just saw a patient whose knee I replaced 25 years ago — some I’ll be meeting for the first time to discuss the upcoming surgery. With the pressures of health care, we don’t have that much time to spend with them, so I make use of some very talented physician’s assistants. I couldn’t keep up my quality of care without them.

Q: How long do the replacements last?

A: When we first started, we were telling patients they’d last 10 to 15 years. Now, with modern implants, I can safely say 20 to 25 years, if not longer.

Q: If they need a second replacement after a couple decades, is it easier to redo it?

A: No. From a surgical perspective it’s actually a lot more difficult. From the patient’s perspective, it’s actually about the same or easier.

Lifelines Hometown: Cleveland Education: Case Western Reserve University, Hospital University of Pennsylvania Affiliations: Crouse Hospital (chief of orthopedics), Syracuse Orthopedics Specialists Organizations: American Academy of Orthopedic Surgeons, American Association of Hip and Knee Surgeons, American Medical Association Family: Married (Lisa), four sons Hobbies: Tennis, golf, photography, travel, family time Favorite Regional Attraction: Green Lake

Murder in Skaneateles “The Chocolate Debacle” Is a New Mystery Book with a Mental Health Message

By Matthew Liptak

S

kaneateles is known as an attractive and affluent village located along one of the most picturesque lakes in the Finger Lakes region. It’s also the stage for a novel recently published by local author Karen Winters Schwartz, “The Chocolate Debacle.”

The Marcellus resident has published two novels prior to this new book — “Where Are the Cocoa Puffs: A Family’s Journey Through Bipolar Disorder,” published in 2010, and “Reis’s Pieces: Love, Loss and Schizophrenia,” about the main character’s struggle with schizophrenia as a college professor. It was published in 2012.

“The Chocolate Debacle” is set in Skaneateles and, like the other two books, explores mental health issues as well.

“My main protagonist is this dog walker. He walks dogs for a living.

He’s 26. He lives with his parents. He’s had a history of mental illness, but he does really well living in the village walking his dogs. One of his clients is murdered and he’s arrested for her murder.”

This character-driven novel follows a standard murder-mystery outline, but Schwartz does find time to poke fun at Skaneateles. Even so, the author said her new novel got kudos from members of her local book club.

“I do make a little fun of it and obviously they’re going to get mad,” she said. “But they thought it was hilarious and they thought I hit it right on the head about some of the attitudes in Skaneateles. Like I say they’re kind

of embarrassed by their wealth. They don’t want to be pretentious. They try really hard to hide their wealth and yet they run around with all their fancy clothes.”

Schwartz does take the subject of mental illness seriously in all her books. She said her stories have evolved from exploring how a family copes with mental illness in “Where Are the Cocoa Puffs?” to how the individual deals with a diagnosis in “Reis’s Pieces.” In her latest novel the theme is how a whole village deals with mental health issues.

Characters with mental health issues are often portrayed as lunatics or serial killers in popular media, Schwartz said. Through her novels she has done her part to combat that stigma.

“My view with my book is to have these engaging stories,” she said.

“They’re fast reads. They are entertaining, but I sneak a lot of education in about mental illness. I get my little points in about my advocacy points without being preachy. It humanizes them. It shows them as real people, the people who live next door to us.

One out of four people have a mental illness. We just don’t know about it because nobody talks about it.”

Schwartz is doing more than just talking about the problem. Years ago she got involved with the local chapter of the National Alliance on Mental Illness after her daughters had struggles with mental health. Today she is the local NAMI president.

She cites three initiatives her organization is focusing on now. One program, called ‘Breaking the Silence’ seeks to get a mental health curriculum explored in local schools. NAMI is also seeking to get more consideration for mental health conditions in the judicial system, perhaps introducing a mental health court for suspects whose offenses stem from their diagnoses.

“There is a fine line and there are Schwartz certainly people with mental illness that are also criminals,” she said. “That’s just where you need someone who is educated who can go in there and assess every situation because if a person doesn’t have a history of violence and criminal activity and they’re sick that person should not be in the justice system.”

Diverting sick people from jail is just one of NAMI’s goals. The group also wants to get beds for children with psychological disorders into Upstate Golisano Children’s Hospital.

Currently there are none, according to Schwartz.

Kids with psychiatric problems often have to be shipped out of the area, which makes it hard on families, Schwartz said.

Between her work as an author, NAMI president and practice as an optometrist, Schwartz is busy. But she finds the work rewarding. Where once she was simply an advocate for the members of her family with mental health issues, today she is an advocate for the wider world. She wants people to know there is hope.

She points to her own daughters as an example of how a household rocked by mental illness can take a happy turn.

“They are both doing incredibly well,” she said. “My one daughter is married and going to school. She’s pre-med. The other one just moved to Vermont and had a promotion. They are perfect examples of what can happen—recovery and knowing how to treat your symptoms.”

Healthcare in a Minute

By George W. Chapman Healthcare job growth. The healthcare industry has done its share of hiring, contributing to the steady decline in the U.S. unemployment rate.

The sector has added an average of 26,000 jobs per month for the last six months (April thru September). This exceeds the average monthly gain from the prior 12 months (thru March of this year) by 50 percent.

Obamacare good (so far) for insurers. Commercial carriers and their industry spokespeople have been noticeably quiet when it comes to Obamacare, most likely because it’s too early to make bold statements or predictions. There is still a lot of uncertainty out there. But so far so good for the three of the nation’s largest commercial insurers. Aetna, UnitedHealth and WellPoint have seen memberships grow by hundreds of thousands through both federal and state exchanges and Medicaid expansion. Insurers expect 20 percent growth in new Affordable Care Act members in 2015. Most insurers are reporting that the feared huge surge in utilization by newly insured members has not happened.

Massachusetts leads the way in transparent pricing. The birthplace of “Romneycare” has been years ahead

of the rest of the country. What happens in Massachusetts should not be overlooked or marginalized, as it is the harbinger of the Affordable Care Act or “Obamacare.” Massachusetts mandated insurers must post their prices (how much they pay various providers) for certain office visits and procedures on their websites. Not all procedures are listed, but the state feels it is a start.

Consumers can now determine where to go for healthcare based on price as this impacts what they will pay out-ofpocket, be it their deductible or co-insurance. So, a consumer may decide to receive care at the hospital with the lowest reimbursement rate for a particular procedure as this means less out of pocket if their deductible has not been met. One of the biggest misconceptions among consumers is higher prices mean higher quality.

Patient Compensation System (PCS). Some states are considering this new “no fault” concept. It would replace the current adversarial malpractice system. Cases would be heard in front of a panel of healthcare experts instead of a jury. The panel would award compensation should an injury be deemed preventable. In states where tort reform has been introduced, there has been little corresponding reduction in the number of “defen-

sive” tests and procedures ordered by physicians, which drive up the cost of care for everyone. Advocates hope the non-adversarial PCS will improve and protect the relationship between doctor and patient and, by removing the possibility of being “sued,” physicians will reduce the number of “defensive” (unnecessary) tests and procedures.

2015 Health Savings Accounts. For those who have an HSA, the maximum contribution for a single person has been raised $50 from $3,300 to $3,350. The maximum for a family has been raised $100 from $6,550 to $6,650. Those 55 and older are allowed to contribute an additional $1,000, called a “catchup contribution.” You must be enrolled in an eligible high deductible health plan to have an HSA.

America’s youngest billionaire wants your blood. More than seven billion lab tests are performed in the US annually. It is a $76 billion industry. Too often, however, the cost of lab tests or the fear of having a needle stuck in you prevents many Americans from getting necessary tests. So, Elizabeth Holmes, smelling opportunity, dropped out of Stanford University to form her own company called Theranos. Instead of vials, tourniquets and needles, there December 2014 •

is just a relatively painless pinprick of blood that goes into a container the size of a dime. Seventy lab tests can be run on just a drop of blood. Her prices for 1,000 tests are readily available on the website and they are significantly lower than what hospital or commercial labs charge. Her goal is to have a Theranos Wellness Center within five miles of any American.

Medicare Part B $ unchanged.

For the second year in a row, the cost for physician services will not increase in 2015. The basic premium for almost 50 million seniors will remain at $104.90 a month with a $147 deductible. Medicare spending growth has slowed to an average 0.8 percent over the last four years.

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

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Take the chill out of spending the holidays alone

T

he prospect of spending the holidays alone can send a cold chill through even the most independent among us. And it’s no wonder.

All the hype for traditions that tout togetherness can leave divorced, widowed and single people feeling alone and disconnected this time of year. The “holiday blues” can take hold with a vengeance.

What to do? Decide to beat those blues with a change in attitude. Decide to make this holiday season a good one. Take advantage of this special time of year to spend some quality time with yourself, to create memorable moments with friends and family, and to help those less fortunate. Here are a few inspirational and practical tips to get you in the spirit: Slow down. Better yet, stop what you’re doing altogether. Ask yourself what the holidays really mean to you.

Rebirth? Hope? Family time? Gratitude and goodwill? Revisit your most deeply held beliefs about the season and make a conscious decision to participate in the holiday rituals that align with your values and spiritual underpinnings.

Be realistic and give yourself a break. For those who live alone, some degree of loneliness can be considered normal during the holidays. It’s a good time to remember that feelings of loneliness aren’t terminal, nor are they a “state of being” reserved for single people.

Loneliness has very little to do with being alone. It has everything to do with your state of mind. So, take

time to remind yourself that your happiness is in your hands, and that there are positive, healthy steps you can take to avoid the chill of loneliness.

Create new holiday traditions.

This is especially important if you are bemoaning the loss of irretrievable traditions of a “former life.” Consider instituting your very own “signature” traditions — whether it be a new cookie recipe or gathering of single friends at your place.

Volunteer and express gratitude. When you give of yourself, you reap two big rewards: first, you’ll develop connections with people who share your spirit of giving; and second, you’ll help those in need. Volunteering, especially at this time of year, can nurture your soul and make a meaningful difference.

If volunteering doesn’t fit into your schedule this year, there are plenty of other ways to express your gratitude and giving spirit. Consider baking some holiday goodies for your colleagues at work. Or leave a little something on a neighbor’s doorstep.

When you are doing for others and counting your blessings, you can transcend yourself and your current circumstances. The result? You might feel less lonely — more a part of the world and of this season of giving.

Be the instigator. Identify a holiday concert or event you’d like to

KIDS Corner Healthy Food? Well, Maybe Not

Y

ou can offer young children healthier food choices in the elementary school cafeteria, but will they actually put it on their trays and eat it?

Probably not, suggests a new Johns Hopkins Bloomberg School of Public Health study.

Researchers observed 274 children in kindergarten through second grade in 10 New York City public schools as they selected from the offerings during one lunch period when a chicken-and-vegetable entrée was on the menu.

They watched to see whether each of the 6-through-8-year-olds chose a fruit, vegetable, whole grain, low-fat milk or a lean protein, taking before

Page 8

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and after photos of the trays.

They found that while 75 percent of the kids chose the lean protein (the entrée), only 58 percent chose a fruit and 59 percent chose a vegetable. And among those who put the various types of food on their trays, only 75 percent took even a single bite of the protein, while only 24 percent ate a bite of their vegetables.

“We have been thinking that if young children choose healthy food, they will eat it,” says Susan M. Gross, PhD, MPH, a research associate in the Department of Population, Family and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. “But our research shows that is not necessarily so.”

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

attend and invite family or friends to join you. Take on the role of “social secretary” and you’ll gradually feel your holidays and social life becoming more active and interesting.

Just yesterday, I purchased two tickets to the “Christmas From Vienna” concert performed by the Vienna Boys Choir at the Eastman Theatre. I’ve yet to decide whom to invite, but that’s part of the fun! This concert is now on my calendar and I will look forward to surprising a friend with an invitation.

Seeding your future with anticipated events will give you something to look forward to during this wonderful time of year.

Decorate your home or apartment. Do it for you. It will help put you in the spirit of the season.

Hang a wreath on your door. Accent your mantel. Bring the holidays inside your home and feel its essence inside your heart.

Invite people over. It will give you an incentive to decorate, if you just don’t feel motivated to do it for yourself. No need to do anything elaborate or large. Even inviting just a few friends over for brunch or to watch a holiday special on TV can fill your day with warmth and cheer.

Send out holiday cards. Take this occasion to say “hello” and make connections. I love getting an unexpected card from a long-lost friend, and I

delight in tracking down and sending out season’s greetings to those who might be surprised to hear from me.

Sure enough, good things come from reaching out to others.

Include yourself on your gift list.

This is a good time of year to spoil yourself with a little comfort. Take time out for yourself. Snuggle up with a best-seller by the fire. Schedule a massage or pedicure. Treat yourself to that luxurious terrycloth robe you’ve had your eye on.

What’s on my gift list for Gwenn?

Experiences are what I’m after these days; I have all the “stuff” I need. I think I’ll treat myself to a solo weekend away at the Roycroft Inn in East Aurora, N. Y. It’s a charming, beautifully restored inn, steeped in the history of the arts and crafts movement.

Solo travel gives me a chance to just “be” with myself, reflect, and rejoice in life’s blessings. Why not consider a similar gift for yourself?

Let go. This is key. Let go of the notion that you need to be married or in a romantic relationship to enjoy the holidays. Life is all about personal connections, and there are plenty to be found in friends, family, neighbors, colleagues, even people you meet in passing. Reach out. Make those connections.

My warmest wishes to you this season. Have yourself a merry little Christmas, a happy Hanukkah, or a joyous Kwanzaa. Enjoy the season to the fullest. You have a choice. Choose to be with people rather than isolate.

Choose to appreciate what you have rather than focus on what you’re missing. I promise you this: Embrace even half of the tips above and, chances are, you’ll find more meaning and merriment this season. Enjoy!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call 585- 624-7887 or e-mail: gvoelckers@ rochester.rr.com.

When to Call the Doctor About a Cold or Flu Signs they need medical attention Flu and the common cold share some common symptoms. Though both often can be treated at home, more serious cases require a doctor’s care.

The American Academy of Family Physicians mentions these warning signs that you should see a doctor: • A persistent fever of higher than 102 degrees Fahrenheit that causes body aches and fatigue.

• Symptoms that persist for longer than 10 days, or symptoms that worsen instead of improve.

• Shortness of breath, difficulty breathing, or pressure or pain in the chest.

• Confusion, disorientation or fainting.

• Vomiting persistently.

• Significant sinus pain affecting the forehead or face.

• Swelling of glands in the neck or jaw.

Post-traumatic Stress Not Just a Soldier’s Problem

By Deborah Jeanne Sergeant

A

lthough many people picture post traumatic stress disorder (PTSD) as a mental problem afflicting soldiers who experienced battle, anyone can suffer from PTSD. Experiences such as victimization, including domestic violence, assault, and robbery, can cause PTSD. Non-acute trauma, such as a lengthy illness, or prolonged neglect, bullying or abuse, cause it as well.

For some people, witnessing a frightening event, such as a loved one dying in a house fire, watching a horrific car accident or viewing a catastrophe on television, can cause PTSD. The Mayo Clinic defines PTSD as “a mental health condition that’s triggered by a terrifying event, either experiencing it or witnessing it.

Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.”

Pickett They may also experience irritable behavior, angry outbursts, acting in a reckless or self-destructive fashion, hyper-vigilance, flashbacks, sweating, nausea, an exaggerated startle response and problems with concentration and with sleep.

Paul F. Pickett, a licensed mental health counselor in Syracuse, said that people may experience PTSD from events that happened during toddlerhood.

“If [the person experienced trauma] pre-verbally, a lot of things get caught in their bodies,” he said. “They may not have recollections, and they may not be able to tell you, but their bodies may have symptoms of it.”

For example, if the client had been raped as a toddler by a man with facial hair, they may react viscerally to men with facial hair but not understand why. Sometimes, family members’ input can help clients understand their PTSD since the clients have no memory of what happened.

Some people experience horrible trauma, but don’t develop PTSD. Experts believe that it’s partially genetic and partially environmental. People surrounded by a good support system can likely work through a trauma without succumbing to PTSD than someone who has no support.

“When they don’t have people around, and it stays inside, these symptoms of PTSD are the outcome,” Pickett said.

Most people feel stressed by traumatic events, but that stress and associated symptoms subside within a few days, weeks or months. People with PTSD don’t find that kind of relief as time passes.

“PTSD is distinct from other psychiatric conditions as the trauma leads to a change in the way a particular part of the brain functions,” said Douglas Goldschmidt, a licensed clinical social worker with Psychological Health Care, PLLC in Syracuse, Liverpool, New Hartford and Baldwinsville “The

organs that deal with ‘fight or flight’, particularly the amygdala, are over-stimulated by the trauma.”

As a result, reminders of the trauma stimulate the amygdala and associated organs, leading to the ongoing release of stress hormones.

Instead of the fear and stress fading as time passes, the continual release of stress hormones keep the person’s response as intense or more intense as it was originally.

Goldschmidt begins helping PTSD clients by listening to their history to learn about the trauma.

“Sometimes they won’t remember or mention it,” he said. “The diagnostic interview can become very difficult.

Someone will spill their guts and it so scares them, they never come back.

Others leave this part out and you find out later. Then you have to go through that with them.”

Clients who don’t share their trauma often reveal it by describing their symptoms.

That helps therapists ask questions to see if there’s something they missed.

Antoinette Marinelli, licensed Goldschmidt mental social worker at Bright Paths Counseling Center in Liverpool, uses a lot of talk therapy with clients who exhibit PTSD. “It helps them understand,” she said. “If they were in a fire and the person with them didn’t get out, I have to help them understand this was a terrible thing, but what could you have done differently?”

Many clients fear reliving the trauma and talking about it can trigger PTSD symptoms. Some resist discussing the trauma out of guilt or shame.

“Stuffing” their feelings results in harmful methods of coping such as isolation, self-medicating with drugs and alcohol, and avoiding scenarios that remind them of the trauma.

Marinelli helps them frame the trauma accurately so they better understand what actually happened.

“You have to understand the trauma in order to work through it,” Martinelli said. “The goal is for the person to finally say, ‘There was nothing else I could do’ in the traumatic situation.”

Recovery depends upon many factors. Some recovery fully; others achieve better functionality, but still experience triggers. The coping skills the latter group develops helps them lead happier lives.

“There are lots of therapies that can help people with PTSD,” Goldschmidt said. “We have a whole series of therapies that have been tested that we know work. People can go on and have good lives after PTSD. It is a treatable problem.”

Learn more about the treatment of bone defects with

Subchondroplasty® (SCP®):

A Joint Preserving Option for Knee Patients Do you suffer from chronic knee pain?

It may be caused by bone defects called chronic bone marrow lesions (BMLs). The Subchondroplasty® (SCP®) procedure is a new, minimally invasive procedure that helps the body heal defects in the bone.

For More Information Visit:

www.healmyknee.com

The good ol’ days may have left their mark Baby boomers — those born from 1946 to 1965 — have the highest rate of the hepatitis C virus. Most people don’t feel sick or know they have it, yet liver damage may be taking place, silently.

Many baby boomers became infected before the dangers of the hepatitis C virus were well known.

Undetected, hepatitis C can lead to liver disease and liver cancer.

Early diagnosis, determined by a laboratory blood test, can lower the risk of damage.

Ask your doctor for the simple blood test today.

Visit us in Baldwinsville • Camillus • Cazenovia • Cicero • East Syracuse Fayetteville • Liverpool • Pulaski and 3 locations in Syracuse

December 2014 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

My Turn

By Eva Briggs

Your Vision During the Night

M

y drive home is long, and much of it is on dark, winding, hilly, poorly lit roads.

Last week, while driving the most remote segment, I came upon a car lying on its side in the ditch. I was glad to have a powerful flashlight in the car. Not only to see what was going on with the vehicle’s occupants, but also to make me visible to other drivers. Fortunately the driver wasn’t injured.

Now that the days are shorter, it’s time to be prepared for darkness. I recommend keeping not one, but two flashlights in your car, so that you have a backup. Lights come in various styles, enabling you to pick whatever you prefer. I have an LED headlamp that uses AAA batteries. It leaves my hands free

and the LED lights last a long time. Of course, that means I try to keep spare AAA batteries handy. My second light is powerful pistol-grip beam, which I bought at Walmart a few years ago for about $25. It has a built-in rechargeable battery. I have to remember to recharge it on a regular schedule, but it holds a charge for a month in warm weather.

It’s important also to make yourself visible, especially in the snow. Pick up an orange (good for hunting season) or safety-yellow (visible in traffic) reflective vest. It won’t take up much room and will reduce the chance that you’ll be hit if you are along a road at night, in the rain or when it’s snowing.

Now wouldn’t it be great if you could see in the dark?

HEALTHCARE CAREERS

Our eyes, unlike those of nocturnal animals, simply aren’t equipped with enough low-light sensors in our retinas.

But engineers have designed various gizmos to help us overcome out biological limitations.

New technology allows some cars to be equipped with night vision. It’s already available on some luxury cars, though it is beyond the price range of most of us.

Because one out of eight traffic fatalities involves a pedestrian, and 70 percent of those occur at night, it will be nice in the future when the technology drops in price and increases in availability.

Night vision relies on sensors that detect infrared radiation just above the range of visible light to detect warm objects in the road, and to send an image to a screen in the car.

Passive night vision can detect living creatures without additional illumination. It works best in rain and fog, when there is more of a contrast between the temperature of a human (or animal) and the surroundings.

Its range may be as much as 1,000 feet, which translates to more than 10 seconds of stopping time at 60 mph.

They’re mounted low on the grille or

under the bumper.

Active night vision systems light up the road with an infrared illuminator mounted higher in the car, often near the rear view mirror. The images appear more lifelike, but the range is shorter, about 500 – 600 feet. And its effectiveness is reduced in rain, snow, and fog.

In addition to sending images to a display, some systems can colorize the images, such as yellow for a pedestrian and orange for animals. And it can send an audible warning to the driver or a warning icon on the display or the dashboard. Since the chances of striking a deer can be as high as one per 100 drivers over the course of the year, there’s the potential to prevent a lot of injuries and damage.

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

By Deborah Jeanne Sergeant

Phlebotomy: A Vital Career in Healthcare Entry-level positions pay as much as $30,470

I

f you’re interested in working in a medical environment, consider a career in phlebotomy. After only a few weeks of classes, the average phlebotomist earns $25,177 to $30,470 annually, according to Explore Health Careers.

Phlebotomists work in a variety of medical settings, for home health companies and at blood banks performing blood draws and to different degrees, handling and processing samples, depending upon the situation.

“At St. Joseph’s, we do not require national certification but it is preferred,” said Olivia Fedele, phlebotomist with St. Joseph’s Hospital Health Center.”

Fedele attended a 10-week program through a local school to obtain her certification and was hired at St. Joseph’s after passing the national phlebotomy examination.

“Others have been hired with no experience and were given on-the-job training until they were proficient with venipunctures,” Fedele said. “The average training period ranges from six weeks to 12 weeks, depending on previous experience.”

New York does not require certification for phlebotomists to work; however, it does give applicants a distinct advantage over those without certification. Historically, phlebotomists learned only through on-the-job training; however, applicants can obtain a phlebotomy certificate through a vocational program such as at Onondaga Community College.

BOCES’ program ($995 tuition and books) includes 148 hours of classroom training and hands-on clinical work.

Onondaga Community College’s program ($899) involves 120 hours classroom and clinical hours.

The job also offers the prestige of a professional career without the burden of an expensive and lengthy education.

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“Phlebotomy is considered a specialization in healthcare, and therefore is not necessarily offered in smaller hospitals,” Fedele said. “At St. Joseph’s Hospital, we are fortunate enough to have a team that specializes in venipunctures. This team is made up of men and woman of all ages and skills.”

In addition to drawing blood, phlebotomists may also perform other job functions. Fedele listed proper identification of patients, venipuncture procedures with the occasional finger or heel stick, patient education regarding tests ordered, specimen collection in the correct tubes, labeling of tubes, and delivery of the specimens to the lab in a timely manner.

Within some facilities, phlebotomists can advance from the entry-level position to more advanced levels.

Learning these tasks may help them transfer into another, more advanced health-related position.

“Phlebotomy can be a great career for the right person, but it is often used as a stepping stone to a different career path in healthcare,” Fedele said. “At St. Joseph’s, more than 50 percent of our department is currently enrolled in coursework that will advance their career in the field of healthcare.

“Phlebotomy is a perfect job for students interested in pursuing a career in healthcare because it provides a unique perspective to several disciplines within the hospital.”

Some phlebotomists stick with it because they enjoy the work and helping their patients.

“For quality of life, you can have different hours so for some people it’s convenient,” said Paul Gugel, director of Adult and Migrant Education with Oswego County BOCES. “There are lots of different sites where you could work, such as blood banks, doctor’s offices, hospitals and more. You can

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

An Oswego County BOCES student practices a blood draw at school. interact with a lot of people. You can put people at ease while they’re getting their blood drawn. It’s a skill to be that gentle.”

Phlebotomists also enjoy excellent job security once employed, since drawing and testing blood will continue as a vital part of medical care.

In addition to certification, good “soft skills” help people succeed in phlebotomy.

Gugel said that people who have a good attention to detail make good phlebotomists. Being consistent is also a big factor, he said.

“Being patient with people is important because some people are very nervous when they come in. Like

every health profession, you have to be confidential with information.”

Shelly Spencer, nationally certified phlebotomy technician and health and occupations instructor at Oswego BOCES thinks the program draws people because the short training process and it involves working with people.

“On the job, you are dealing with the public and helping them out, but you’re on your own,” she said. “You’re part of a team but operate independently.

“Especially with babies and the elderly, when you can help them with minimal pain, it’s a good feeling that you’re helping them out,” Spencer said.

“It’s a very satisfying job.”

Cracked Heels Worsen with Cold Experts say there are easy ways to alleviate problem

By Deborah Jeanne Sergeant

M

any people find that when winter returns, their heels grow dry and split open. Heel cracks snag on socks and hosiery and detract from the appearance of the feet. But more than just unsightly, heel cracks can become painful and even badly infected, especially in people with neuropathy.

“It’s a difficult problem because feet get abused,” said Joyce Farah, board-certified dermatologist with Farah Dermatology Center in Syracuse.

“The skin of the heel doesn’t have a lot of oil glands, too.”

The combination of dry skin and pressure causes heel cracks. Although heels can crack at any time of the year, the dry winter air from November through March makes heel cracks more easily.

Fortunately, you can prevent and treat heel cracks.

Going barefoot places more pressure on the heels, so it’s better to wear socks and shoes to absorb the impact of walking. Shoes with gel inserts can relieve the pressure. Closed shoes, not open-back clogs, sandals or slippers, provide more protection to heels. Exposure also promotes drying.

For dressy events, women should opt for pumps instead of sling-back heels, for example. Though clogs offer comfort and some styles absorb shock

well, they leave heels exposed to cold air more than sneakers. Moccasin-style slippers represent a better choice than mule styles at home.

Keeping heels moisturized helps prevent cracks; however, you should moisturize properly. Dermatologist Farah recommends using hydrating cream, since water forms the base of most lotions. Even better than cream, petroleum jelly, covered by socks, can help heels heal. Don’t leave moisturized feet bare, since that makes feet prone to slipping.

If cream or petroleum jelly doesn’t help, ammonium lactate cream may help.

“It may not be practical every day, but moisturize after showering a few times a week,” Farah said.

It may seem logical to soak your feet to keep them soft and hydrated; however, it actually has the opposite effect.

People think they’re soaking their feet to add moisture but they’re drying them out,” said Joseph Perillo, podiatrist with Finger Lakes Podiatry in Geneva. “It’s like dishpan hands.”

Since cracks form in dried-out, callused skin, it’s also helpful to remove the dry skin. Use a rough towel, pumice stone or loofah to buff heels after bathing, when dead skin sloughs off readily.

Farah said that a metal foot file, available at drug stores over-the-counter, can help safely file down dead skin if the user is careful.

“I hesitate about razor blades because you can cut too deeply into the skin if you’re not careful,” Farah said.

Cutting callused skin off is quicker, but using a blade makes it too easy to scrape the skin too deeply and harm the sensitive skin underneath, especially if you can’t see your heels.

If you experience a crack that is deep, sore, inflamed or red, have a doctor check it. The crack could be infected to a point that requires an antibiotic.

Diabetics should take special care with their feet since neuropathy makes it hard to recognize foot problems.

People with heel cracks should monitor them daily, using a mirror or enlisting help if they cannot see their heels readily.

“If the heel starts to fissure and is painful, it’s a sign that it’s deep,” Farah said. “There’s a greater risk of infection. It may be uncomfortable to walk, too.”

Worsening cracks need medical attention.

Meet Your Provider

KidSpeak Puppet Team Q. What is KidSpeak?

A: KidSpeak is an interactive puppet workshop about autism spectrum disorders (ASD). It is designed to teach children and adults about autism and ways to support those affected. The Workshop is presented in schools, libraries, camps and recreational facilities for groups of children aged 6 to 9 years old. KidSpeak is a program of the Kohl’s Autism and Related Disorders Program at the Margaret L. Williams Developmental Evaluation Center of Upstate Golisano Children’s Hospital.

Q.: How did KidSpeak get started?

A: Several years ago, Dr. Carroll Grant, director of the Margaret L Williams Developmental Evaluation Center (MLW/DEC) wanted to increase autism awareness and understanding with the hope that our community would become a more welcoming place for children affected.

She believed that if one understands how children with ASD learn and think . . . and why they might act differently, they might be open to becoming a friend with someone

with Autism. She had experienced the educational power of puppetry through her daughter’s participation at Open Hand Theater. With that knowledge, she wrote a script that includes two puppet characters with autism. Geoff Navias, artistic director of Open Hand provided the creative direction, making the workshop appealing to all ages.

Q.: How successful is Kidspseak?

A: Teachers have reported that after a KidSpeak presentation their students are more sensitive to their peers who have some learning or behavioral challenges. In addition, both the adults and the children have some common language to talk about how everyone learns differently and how they can be supportive of one another. The requests for KidSpeak workshops continue to grow.

and occupational and speech therapists on the puppet team as well as a professional puppeteer. These professionals all have many years of experience and specific skills in working with children with autism. Because of this hands on expertise, they are able to answer specific questions that the children and the adults might have at each Workshop .

Q.: What is the cost?

A: KidSpeak is absolutely free!

There is no charge for any of the performances or for the materials that we leave for the children and staff.

Kohl’s Cares provides the funding allowing the Workshop to be offered free of charge.

Q.: Who are the KidSpeak Puppet Team?

A: The KidSpeak Puppet Team members are professionals from the MLW/DEC. There are special education teachers, psychologists,

Q.: How can I get Kidspeak to come to MY school or group?

A: That’s easy. You can call the MLW DEC at 472-4404 extension 318 and speak with Mary Ellen Annesi who can book a KidSpeak

KOHL’S AUTISM AND RELATED DISORDERS PROGRAM

Margaret L. Williams Developmental Evaluation Center • 215 Bassett Street • Syracuse, NY13210 (315) 472-4404 www.kohlsautism.com December 2014 •

performance for you. She can also answer most questions you might have about KidSpeak. Our two KidSpeak teams are able to visit your site in Onondaga, Cayuga, Oswego, Cortland, and Madison counties on Thursdays mornings. You can also visit our website, wwwkohlsautism. com for more information or to see a clip of a KidSpeak performance.

Q.: Anything else I should know?

A: We are happy to announce that the Kohl’s Autism and Related Disorders Program is now piloting a KidSpeak curriculum to accompany the workshop. The curriculum extends the educational content of the puppet workshop using the same friendly characters. The curriculum is designed to be compatible with the second grade common core focusing on how we are all unique but everyone wants friends. Strategies for supporting children with autism and how to be friends are included.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

King of Cataract Surgeries in CNY Camillus-based ophthalmologist sometimes performs more than 30 in a single day

By Aaron Gifford

O

n any given week, Robert Druger will perform upwards of 60 cataract surgeries. It’s not unusual for him to perform 30 in one day alone. He has operated on tens of thousands of eyes in his career so far and could even surpass the 100,000 mark by the time he retires.

The Camillus-based ophthalmologist has become incredibly efficient with the procedure in recent years, but he also credits his staff and continuous improvements in the technology available to eye doctors today. With an aging population in Central New York and across the nation, he doesn’t expect business to slow down any time soon.

“I never get tired of it,” he said.

Eyes are like snowflakes. Everyone is different.”

Cataract surgery is the removal and replacement of the natural lens that helps eyes to focus and let in light.

With age, the lenses deteriorate, become less flexible and cloudy. They can deteriorate to the point of blindness.

Druger says it’s a safe assumption that most American senior citizens have already had the surgery or will have the surgery in their lifetime, though he also sees a fair share of patients who are middle-aged.

“If you live long enough,” he said, “it can get to the point where light can’t get through at all.”

Cataracts are the leading cause of blindness and visual impairment and currently affect about 100 million people in the world, according to the World Health Organization.

Druger believes that cataract surgery is inevitable, though it can certainly be delayed by routine eye care and maintenance. People who had 20/20 vision or better when they were younger often see their reading vision deteriorate when they reach their 40s, and in their 50s they struggle with glare, haze

and driving at night. Frequent change of eye glasses is another warning sign of cataracts.

Druger says it takes him about 10 minutes to perform the surgery on a pair of eyes. He uses an ultrasound device to make very small incisions. The technology has a small vacuum that removes the unwanted tissue from the eyes before artificial acrylic lenses are placed in the eye.

“They last forever,” he said. “Long after you’re dead, they’ll still be there.”

Despite Druger’s volume of the same procedure, he doesn’t find it tedious. He said it’s always a challenge because he needs to be sure that the patient is awake and be aware of their movements. He uses both feet and both hands to control and operate the equipment.

“You learn to focus and not dilly-dally. Your whole body has to do something at the same time. It’s almost like you’re in a state of zen,” he said.

The surgery costs between $1,800 and $2,500 per eye. Most insurance plans cover it.

Druger says he sees most of his patients about once a year. He maintains that he doesn’t try to sell the surgery on a patient if they are still within their comfort zone for reading, driving and other tasks, even if he notices their eyes have deteriorated somewhat. “If it ain’t broke,” he said, “don’t try to fix it.”

Patient Jane Milholland moved from Syracuse to Rochester in 2009 but returns to Central New York for eye appointments with Druger rather than seeing someone closer to her residence.

She has had cataract surgeries on both eyes as well as laser surgery to correct deteriorated membranes around her pupils. She said the appointments go quick and she’s aware that Druger has a huge volume of patients, but she never feels rushed. In fact, she added,

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Page 12

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

Robert Druger of Druger Eye Care in Camillus.

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the eye doctor carries himself with a laid-back demeanor as if he has all the time in the world.

“I respect him professionally and personally,” she said. “He has compassion for his patients. He’s willing to listen and answer questions. He makes eye contact and he’ll joke around. He’s also very devoted and dedicated. He’s the most humble, unpretentious doctor and surgeon I’ve known.”

A Syracuse native, Druger graduated from Nottingham High School in 1981 before continuing his education at Syracuse University. He completed undergraduate degrees in biology, psychology and chemical engineering. He did his graduate work at SUNY Stony Brook school of medicine, earning a PhD in molecular biology as well as his medical degree. He did his residency in ophthalmology at Washington University in St. Louis before returning to Syracuse in 1998.

“My blood is orange,” Druger said of his decision to set up shop in Central New York while continuing to passionately support Syracuse University sports.

Prior to going into private practice, Druger worked on a research project where optic nerves in goldfish were regenerated.

“Fish could regain their sight,” he explained, “and we were trying to figure out why it can’t be done in humans. That was a long time ago, and we’ve come a long way since then. I do believe we’ll be able to restore sight to blind people some day.”

But while there have been great advances in medical researching involving the eyes, there is still a shortage of ophthalmologists. Druger says he and other Central New York eye doctors enjoy staying so busy, but they are

concerned if there are enough specialists in their field to replace them when they retire and as the local population continues to gray. He believes the main problem is the lack of ophthalmology training programs and residencies across the country.

“We’re getting older, and there are not a lot of new ones being trained,” he said. “The number of [eye] doctors simply isn’t going up as fast as the need for them is going up.”

The Association of American Medical College projects that an additional 6,000 ophthalmologists will be needed by the year 2020 to keep up with the expected demand for eye surgeries.

Druger, meanwhile, says a balance of family time, exercise and leisure time has given him the energy, sanity and focus to continue such a busy schedule at work. He and his wife, Suzanne, and their three children live on a horse farm in Manlius. Two of the children are in high school and one is at Onondaga Community College. Suzanne is also involved with dog agility training.

Druger continues to train in martial arts. He’s a second-degree black belt in aikido, an art that he first took up 35 years ago, and currently teaches classes at the YMCA. He explained that aikido, unlike other forms of Japanese karate, is centered on a self-defense system of redirecting force to the point where you also try to protect the attacker from injury.

And it helps him to stay mentally focused as he performs operations that will help others stay focused visually.

“I think it has helped my state of mind to work at this pace,” he said. “To be a good surgeon, it’s not so much a steady hand as it is a steady mind. It helps me stay calm.”

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Page 13

SmartBites

By Anne Palumbo

The skinny on healthy eating

The Amazing Benefits of Pomegranates

A

few years ago, pomegranates and their juice became the darlings of the health-minded. Declared a superfood by some, an anti-aging food by others, this exotic fruit had us by the tongue buds. Did it warrant all the hype? I think so. Is it still in the limelight?

More than ever.

Long used for medicinal purposes in other countries, pomegranates are finally taking center stage here because they’re loaded with compounds we covet: antioxidants. Antioxidants protect our body from disease and accelerated aging by gobbling up harmful free radicals — byproducts of the oxidation process that can turn good cells bad.

Pomegranates stand out as antioxidant superstars because they boast a powerful combination of antioxidants — not just one or two. In fact, according to the U.S. Department of Agriculture, a pomegranate juice’s antioxidant activity is right up there with prunes, dark chocolate and red wine.

Like other antioxidant-rich foods, pomegranates are also the darlings of the research world. Although more studies are needed, preliminary re-

U.K. have found an anti-inflammatory compound in pomegranates that they believe may help slow the progression of Alzheimer’s and Parkinson’s diseases.

On the nutrient front, pomegranates measure up to other fruit superstars. Low in fat, cholesterol and calories (about 70 per ½ cup of seeds), this sweet and tangy fruit contains notable amounts of vitamins C and K (good for the immune system and blood clotting, respectively) and potassium (essential for muscle control and blood pressure regulation). And although one ½-cup serving of seeds contains 12 grams of sugar, the high sugar content is kept in check by the fruit’s substantial 3.5 grams of fiber.

Helpful tips

search suggests that drinking a daily (8 oz glass) of pomegranate juice may significantly slow the progress of prostate cancer in men with reoccurring prostate cancer, cut cholesterol build-up in arteries and improve blood flow to the heart. Wow! Worried about chronic inflammation? Pomegranates may be your ticket to quieting the painful and often destructive fire within. A small study at the University of Maryland Medical Center showed that pomegranate extract decreased joint tenderness in rheumatoid arthritis patients by 62 percent. What’s more, researchers in the

Select pomegranates that feel heavy for their size and have a deep color. To easily extract the seeds, cut the pomegranate in half, put each half under water, and then use your fingers to coax the seeds from the inside. The pith is light and will float to the top while the heavier seeds sink to the bottom. At room temperature, whole pomegranates last about a week (two with refrigeration). Extracted seeds last about five days in the refrigerator and three months in the freezer.

1 clove garlic, minced 2 tablespoons lemon juice Kosher salt and freshly ground black pepper 1 rotisserie chicken, shredded 1 cup pomegranate seeds 2 tablespoons chopped fresh chives 2 stalks celery, sliced Baby arugula or other lettuce (optional) Combine the mayonnaise, yogurt, Dijon mustard, lemon juice, garlic and some salt and pepper. Taste and adjust seasonings as needed.

Add the shredded chicken, pomegranate seeds, chives and celery to a bowl.

Pour some of the dressing around the sides of the bowl and toss to combine.

Add more dressing as desired. Taste and adjust seasonings as needed.

Serve on top of arugula or lettuce, if using.

Pomegranate-Chicken Salad Adapted from the Food Network Kitchen Serves 6-8 1/2 cup mayonnaise 1/2 cup fat-free plain yogurt 1/4 cup Dijon mustard

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 • December 2014

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7 Ways to Feel Full Without Overeating

N

ot feeling full after or between meals can result in overeating.

In the October issue of “Food Technology” magazine published by the Institute of Food Technologists (IFT), contributing editor Linda Milo Ohr writes about studies that show eating certain nutrients and foods may help curb appetite and keep one feeling fuller longer.

These include:

1. Protein Adding one protein to breakfast everyday could contribute to improved satiety and diet quality. Another study showed that daily consumption of a high-protein afternoon snack containing soy lead to improved appetite control, satiety and reduced unhealthy evening snacking in adolescents. Whey, soy, pea and egg protein all contribute to a

feeling of fullness.

2. Whole Grains and Fiber Substituting whole grain bread with refined wheat bread is linked to lower hunger, higher levels of fullness, and less desire to eat. Oats increased appetitecontrol hormones up to four hours after a meal, whereas rice-based foods did not.

3. Eggs Eggs are one of the densest proteins in the non-meat category. It has been shown that eating one egg with breakfast will help to reduce hunger between meal times.

4. Almonds The healthy fats in almonds decrease hunger and improve dietary vitamin E intake. People who ate 1.5 oz. of dry-roasted, lightly salted almonds every day helped satiate their hunger without increasing body weight.

5. Pulses Part of the legume family, pulses include dried peas, edible beans, lentils, and chickpeas. They are very

high in protein and low in fat, and are proven to contribute to a feeling of fullness after consuming.

6. Saffron Extract This type of extract is shown to have a beneficial

effect on appetite, mood, and behaviors relating to snacking, which helps reduce overeating linked to habit or stress.

7. Korean Pine Nut Oil This kind of nut has high levels of healthy, all-natural fats, which are shown to release the satiety hormone, cholecystokinin.

A Third of All Food Is Wasted – and Such Loss Is on the Rise Recent reports conclude that one-third of all food grown or produced is lost each year in its journey from the farm to a consumer’s table. Robert Gravani, an expert in food technology and professor of food science at Cornell University, says developed countries are not immune to such waste, and that food waste is steadily increasing in the U.S. Gravani says: “Food waste has increased dramatically in the last several decades and it is estimated that about 20 pounds of food is wasted per person per month in the U.S.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Child Life Specialists Add a Special Touch to Children’s Hospital

By Matthew Liptak

T

he 10 child life specialists at Upstate Golisano Children’s Hospital are not medical personnel but they play a vital role in ensuring the comfort of their patients and limiting the stress of the hospital environment.

They focus on the psychosocial, emotional and developmental needs of the child.

“Being in the hospital can be stressful and scary for everyone that’s here especially for the kids,” said child life specialist Sue Karl. “What we are trying to do is trying to normalize what is a very abnormal environment, that being the hospital. We work with kids and families to support them through a lot of the difficult things that happen while they’re in the hospital in terms of tests and procedures, learning about their new diagnosis. We talk to kids about everything from ‘We’re going to take off that Band Aid,’ to ‘Yes, in fact, you do have to have this operation.’

We help families in end-of-life situations trying to cope with ‘How do I tell the other children? How do I tell this child’s brother or sister?’”

The position of child life specialist is not well known outside the hospital, Karl said. She describes it as being in its “toddlerhood” in regards to its level of exposure to the public. But it is a profession with a long history in the United States. It began in the 1920s when hospitals realized that children needed someone to help them in mitigating the difficult environment of the hospital.

A study was undertaken in the first half of the 20th century revealing infants were actually dying in hospitals due to sensory deprivation and a lack of human contact. Health officials realized that concern for a child’s welfare in the hospital extended to older children too.

“Hospitals way back when used volunteers to read and play with the children,” said Margaret Nellis, the child life manager of Golisano. “The pioneers back then were referred to as ‘play ladies.’ Way back when the philosophy was that the children in the hospital were sick so they should stay in bed and parents could only visit at a certain time.”

Today hospitals are more child-friendly. Child life specialists will play directly with the kids and help explain the environment to both the

Sue Karl, a child life specialist at Upstate Golisano Children’s Hospital, playing a game with patient Cody, 8, of Ogdensburg. “We work with kids and families to support them through a lot of the difficult things that happen while they’re in the hospital in terms of tests and procedures,” say says. kids and their families. They encourage the young patients to come together in groups at times to socialize. They also serve children in an outpatient setting.

“We try to do things that are as normal as possible so we have groups come in and have entertainment,” Karl said. “We might have someone come in and read stories to them. We do activities where we might have a lunch so kids can get out of their room. It’s kind of unusual for kids to always sit and eat in their bed so we’ll have a group

event. One of the things that kids so often say is that they don’t think about that there is somebody else in the hospital having to go through some of the same things that they’re going through.

It’s nice for them to see other kids who have an IV, other kids maybe riding in a wheelchair.”

The child life specialist role has evolved to the point where in 1982 the Child Life Council was formed.

It helped standardize the child life specialist position by establishing a

IOSWEGO AM HEALTH

certification exam in 1998.

Child life specialists are not medical staff but they have a background in psychology, anatomy and growth and development. They are required to have the minimum of a bachelor’s degree and also complete a 14-week, 40-hour-a-week internship under the mentorship of a certified child life specialist. They are then eligible to take the certification exam themselves.

“You need to know about medical terminology and the body so that if kids and families have questions about what’s going on we can make sure we are discussing it in a developmentally-appropriate manner and knowing exactly what the doctors are talking about,” Karl said.

Talking to younger children can be challenging. To educate them on their situation you have to keep your wording concrete, Karl said. They don’t go into nitty-gritty detail that the boy or girl won’t understand. Older children might ask more questions and be able to understand more.

“We talk a lot about soft language, language that’s going to help them understand but not, hopefully, create more anxiety related to that test or procedure,” Karl said.

Karl said that educating the children, even in a simple way, can make a big difference in their comfort level at the hospital. Oftentimes, she said, parents might think that keeping the child in the dark is the best choice.

These families are often happily surprised when they see how explaining the situation to the child changes the child’s outlook.

The role of caring for children at the hospital has come a long way in almost 100 years. Today the profession of child life specialist plays a vital role on the pediatric health care team. It is a job full of challenges but those are overshadowed by the rewards of the position.

Karl has been doing it for decades now. She has been part of a team that helps thousands of children every year and continues to feel lucky to be a part of its mission.

“I think a lot of what I like is the opportunity to get to help kids and families to make the hospital not be the most scary place that they have to be [in] and help them understand why we’re doing things, reducing the stress and fear that’s associated with the unknown of being in the hospital,” she said. “I think it’s just a great opportunity to help kids and families to cope with all the things that happen in the hospital experience and not be the person who has to do the procedure but be there to help them through it.”

To find out more about the child life specialist position go to www.childlife.org.

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

Parenting

By Melissa Stefanec

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The Newborn Blur “Savor these moments.

They are the best times of your life, and they will be gone before you know it.”

A

dvice in this thread of sentiment comes from a lot directions when you have a newborn.

Your family, your friends, co-workers and strangers on the street all share their variations on this theme. They do it for good reason, they are right. The beginning of a child’s life is precious and fleeting, and there is something about children that has a way of proving the theory that times really move faster the older one gets. The moments are gone before you know it.

So how do you savor the moment?

It’s to easy to say, but so difficult to do.

I want to savor and treasure the moments with my newborn son, but it’s tough to do that when you are suffering from the newborn blur.

It’s a blur that sets in almost as soon as labor begins.

Emotions and adrenaline are high, and I feel as though I am muddling through the moments. Being a mother to young ones is very, very demanding.

I look back at the past few weeks, and they are a blur. It’s hard to focus when you get only a few hours of broken sleep, one of your children is almost always crying or in need, dirty diapers and wet clothes pile beside the changing table and meals are irregular and allowed during 30-second pauses.

When you are constantly engaged and all of your resources are over applied, enjoying much of anything is a challenge. However, you can’t let the demands of motherhood strip you of the many beautiful things it also encompasses.

Here are a couple of ways I am trying to savor the moments, so when I get to be an older woman giving advice, I have something to recall besides the blur.

Put the computer away — I want to multitask all the time, but there can be too much of a good thing. I am trying to turn off the computer and the tablet and give 100 percent of my attention to my son when he needs it.

Walk away — Babies cry, and lengthy periods of crying are unnerving. When I feel like my son is giving me too much to handle, I put him in a safe place and walk away for a bit. That way, I can calm down, and we can both get back to enjoying each other sooner.

Put the camera away — I want to catch every cute moment, but looking for the camera, turning it on, and

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trying to get the perfect picture kills the moment. To enjoy the moments, I have to live in them. It’s hard to do that when you are trying to document the moment.

Ask for help — Being strung out and feeling overwhelmed isn’t a recipe for enjoyment. If anyone offers help, be it with meals, cleaning, shopping or childcare, take it. If no one is offering help, ask for it. Maintaining my sanity is perhaps the most crucial component of enjoying early life with my baby.

Write it in the baby journal — I have a journal I am writing for each of my children. It’s all about them and what their early lives were like. I like to write important things down before I forget them. That way, I have something to look back on and share with them later in life.

Include the family — Moments aren’t just about me and my son, they are about my whole family. We need to get out and enjoy time together. We need to read books together. When my whole family is together and enjoying each other’s company, that’s my new favorite feeling.

Savor the sleep — Not mine, but my son’s. Watching his restful baby face has a way of putting everything in the right place. I can’t help but stare and get lost in it.

Take some me time — I find that when I get a little time to myself, I am a more relaxed parent. Squeezing in a workout, running a solo errand or (gasp) making time for a date night recharges me like little else can. When I am recharged, I can enjoy all the moments—good and bad.

Actually think about the wonder of it all — When I am busy and exhausted, it’s hard to tune into what is actually happening. I created and am maintaining a life. That life is growing and developing at an awesome pace. I love that little guy with all of my being.

When I stop and actually think about the whole process, I am amazed.

Be thankful — Despite all the challenges of caring for a newborn, I am thankful for every tired, beautiful, fleeting moment. I swear it. The more I stop to be mindful of all I have to be thankful for, the more precious the moments get.

Now I have to take my own advice, shutdown the computer, and go stare in awe at the most perfect little face in the entire world.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 17

Book explores odd piece of healthcare history in Upstate New York ‘The Great Tonsil Massacre’ explores an effort by the Rochester medical community in the 1920s to prevent mental illness by removing children’s tonsils

By Deborah Blackwell

W

hen Teresa (Terry) Lehr, a former archivist at Rochester General Hospital, uncovered a little piece of local history begging to be told, her fascination with historical healthcare kept her searching for more.

In her upcoming book, “The Great Tonsil Massacre,” Lehr examines a curious and rather risky public health project that occurred in Rochester between 1920-21.

The informative and somewhat humorous story describes an undertaking by community leaders to have children’s tonsils removed in an attempt to allegedly make every child in Rochester “healthier and happier.”

This endeavor was under the assumption that to not remove the tonsils could possibly give rise to a child’s mental deficiency.

Nearly 10,000 children (9,821 to be exact) had their tonsils removed between 1919 and 1921.

The 100-page novella uses fact and fiction to explore both cultural and ethical motives around removing children’s tonsils, while illustrating economic and social challenges that individual families may have faced during this peculiar effort by leaders of the city.

The story is told through the eyes of a family who must answer the many questions that parents face when considering the health and well being of their children. The decision becomes especially difficult for them, because they are bombarded by community-wide propaganda and pressure in support of the clinics.

“There were many things at RGH [Rochester General Hospital] I found fascinating, although I had never heard of them,” says Lehr. “I went to the George Eastman House and looked at the scrapbooks, because I did not understand the thinking on how a physical thing like having tonsils could make someone mentally deficient.”

The project became one of curiosity and love for Lehr, whose extensive travels backward in time began to reveal interesting facts layer by layer. She uses fictionalized characters in the book to uncover the various layers of this unusual story, but the settings and the historical events are based on extensive research in local archives and newspapers.

She believes that finding the answers to the many questions revealed during a public health initiative can reveal the heart of a family, an institution, and a community.

“When I am doing a research

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project it becomes like a compulsion.

It’s a path of discovery,” says Lehr, “I am fascinated with the questions these events raised, and some of the motives for the leadership were actually putting Rochester on the map.”

The epilogue covers the historical piece of the tonsil health project, and the use of both fictional and non-fictional elements throughout the book allowed Lehr to reconstruct the historical account, and may help the reader understand its significance.

Adding fiction to a historical book is new for Lehr, who wanted to try her hand at it, as well as entice fiction readers into reading nonfiction and vice versa.

“It’s a historic story, but to get into the unreported, undocumented effects of the events on the individuals that are part of this story, I had to use fiction,” says Lehr. “Fiction was essential to it. I have tried to be as objective as possible so people can make some decisions about whether the community leaders were right or wrong.”

Some of the information she presents prompts readers to ask, why did local medical authorities, industrialists and businessmen want to establish and endorse affordable tonsil and adenoid clinics? Why did no citizens seem to question the wisdom of holding a tonsil and adenoid removal clinic in the middle of winter and during a raging epidemic of diphtheria? And what might have happened

within the families of children whose parents resisted this risky project?

“It’s compelling reading, with excellent descriptions, realistic dialogue, and an intriguing storyline that makes me want to read more,” says Almeta Whitis, a storyteller, writer and educator from Rochester.

“The book is impeccably researched and reads like a detective mystery.”

Lehr is no stranger to writing, documenting historical fact, and sharing that with others. She spent most of her career as an educator, first teaching junior high school, then at SUNY Brockport, teaching non-fiction writing and research, English, and literature courses. She has a master’s degree in English and one in history. She also spent years writing articles, designing exhibits, and giving presentations about Rochester General Hospital’s history and how the larger community has responded

Teresa Lehr of Penfield, designed the cover of her book “The Great Tonsil Massacre,” using a scan of an illustration from a 1902 edition of Otto Zukerkandi’s “Atlas and Epitome of Operative Surgery.”

to epidemics and other crises. “The Great Tonsil Massacre” is her first novella.

“The topic of inoculations, healthcare, and sickness is so current right now,” says Lehr. “And this relevant story is 100 years old.”

How to Get the Book “The Great Tonsil Massacre” will be available this November on Amazon, and CreateSpace in both digital and paperback formats. For more information about Teresa Lehr’s other publications and presentations, please contact her via email: tklehr@ frontier.com.

Removing Tonsils Was Routine Practice, Says Dr. Welch

S

o what does a modern physician think about the routine and unnecessary tonsillectomies and adenoidectomies of the past?

Physician Thomas Welch, medical director of Upstate Golisano Children’s Hospital, weighs in.

“For about a century, tonsillectomy and adenoidectomy (“T and A”) has been the most common procedure performed in children under general anesthesia.

“Tonsillectomy got a big boost in the early 1900s, in Great Britain. The School Medical Service began paying for the procedure, and it grew in popularity for conditions as diverse as asthma and mental retardation. There was never any real ‘evidence’ from controlled trials that the procedure worked for most of these indications; it was more of anecdotal belief from

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

physicians and perhaps parents that it was effective.

“Concerns about the procedure becoming too prevalent date back at least to the 1920s and 1930s, when researchers in both the UK and the US found a great regional variation in the frequency with which the procedure was being performed. These concerns peaked in the US in the 1970s, when data began to demonstrate very significant geographic variations in T and A rates which could not be explained by anything objective, except, apparently, physician preference. This was followed by a number of studies which compared outcomes of groups of children receiving T and A to those not receiving the procedure. Most did not show a dramatic benefit from operation. The procedure dropped somewhat in frequency following this,

but lately has been increasing again.

“Today, many T and As in children are Welch being performed for a new indication: obstructive sleep apnea. Although a few children with this problem may have dramatic improvement after the operation, there are as yet no generally accepted guidelines for choosing children best suited to this procedure.

“The best advice I can provide parents today is seek more than one opinion before having this operation performed on their children.”

Interviewed by Deborah Jeanne Sergeant

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A Guide to Finding Affordable Dental Care Dear Savvy Senior, I had dental insurance through my work for many years but lost it when I retired.

Where can retirees find affordable dental care?

Need a Dentist Dear Need, Finding affordable dental care can be challenging for seniors living on a tight budget.

Most retirees lose their dental insurance after leaving the workplace, and original Medicare does not cover cleaning, fillings or dentures. While there’s no one solution to affordable dental care there are a number of options that can help cut your costs. Here’s where to look.

Medicare Advantage

While original Medicare (Part A and B) and Medicare supplemental policies do not cover routine dental care, there are some Medicare Advantage (Part C) plans that do. Many of these plans, which are sold through private insurance companies, cover dental care along with eye care, hearing and prescription drugs, in addition to all of your hospital and medical insurance. If you’re eligible for Medicare, see medicare.gov/find-a-plan to look for Advantage plans in your area that covers dental care.

Dental Discounts

Another way you can reduce your dental care expenses is to join a dental discount network. How this works is you pay an annual membership fee — around $80 to $200 a year — in exchange for 10 to 60 percent discounts on service and treatments from participating dentists. To find a network, go to DentalPlans.com (or 888-632-5353) where you can search for plans and participating dentists by zip code, as well as get a breakdown of the discounts offered.

Another option that’s currently available only in the southern California area is Brighter.com. They provide users free access to a network of dentists offering up to 50 percent discounts on all services.

Dental Schools

Dental school clinics offer savings opportunities, too. All 65 accredited dental schools in the U.S. offer afford-

able care provided by dental students who are overseen by their professors.

You can expect to pay about half of what a traditional dentist would charge and still receive excellent, well-supervised care.

Another option is to check with local colleges that offer dental hygiene programs. For training purposes, many programs provide teeth cleanings by their students for a fraction of what you’d pay at a dentist’s office.

To search for nearby dental schools or dental hygiene programs visit ada. org/dentalschools.

Veterans Benefits

If you’re a veteran enrolled in the VA health care program, or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA is now offering a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost.

The VA also provides free dental care to vets who have dental problems resulting from service. To learn more about these options, visit va.gov/dental or call 877-222-8387.

Low Income Options

If you’re low income, there are various programs and clinics that provide dental care at a reduced rate or for free.

To look for options in your area contact your state dental director (see astdd. org), or your state or local dental society (ebusiness.ada.org/mystate.aspx).

You may also be able to get discounted or free dental care at one of the federally funded HRSA health centers (findahealthcenter.hrsa.gov, 877-4644772), or at a privately funded free clinic (nafcclinics.org).

Also check with the Dental Lifeline Network (dentallifeline.org, 888-4716334) which provides free dental care for low-income elderly and disabled; Remote Area Medical (ramusa.org) which offers free health, eye and dental care to people in select locations; and Indian Health Service (ihs.gov), which provides free dental care to American Indians and Alaska Natives who are members of a federally recognized Indian tribe.

Also see toothwisdom.org, a website created by Oral Health America that will help you locate low-cost dental care.

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

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

benefits mailed to a third party or, if ec. 21 is National Homeless necessary, a representative payee can Persons’ Memorial Day. Since receive their funds.

1990, on or near the first day Social Security also collaborates of winter and the longest night of the with other agencies to help the homeyear, the National Coalition for the Homeless brings attention to and seeks less. At www.socialsecurity.gov/ homelessness/collaborations.htm, you compassion for the homeless who can read more about the health care for have died because they didn’t have a the homeless program that provides warm, safe place to sleep. Even as the grants to a network of local recovery works its way through public and nonprofit private the entire economy, no one is organizations. Social Security immune to potentially being also participates in the Federal homeless. People in our comInteragency Reentry Counmunity — colleagues and family cil, as well as the Projects for members, military veterans, Assistance in Transition from and our friends — might be too Homelessness (PATH) proproud to ask for help. Too often, gram. PATH helps people with homelessness ends in tragedy. serious mental health issues or Social Security provides people who are homeless or at services to the homeless and you risk of homelessness. can find these services at www. Banikowski Every day, and especialsocialsecurity.gov/homelessness. ly on Dec. 21, remember those living Those who are homeless can apply for without a place to call home. Homebenefits and, if they are eligible, their lessness is a complicated and emotional benefits can be deposited directly into issue, but we can help our brothers and a personal banking account, a direct sisters — friends and family — access express debit bank card or another the safety net that Social Security proelectronic account. They can also have vides. Visit www.socialsecurity.gov/ homelessness to learn more.

Q&A

Q: I suspect that someone I know is collecting Social Security disability benefits when they shouldn’t be. What is the best way for me to report fraud?

A: Social Security has zero tolerance for fraud and uses many proven tactics to prevent fraud, waste and abuse. Our office of the inspector general is relentless in its pursuit of people who conceal work activity while receiving disability benefits. We investigate and seek prosecution for people who receive benefits for a child or children who aren’t under their care or who fail to notify Social Security of the death of a beneficiary and continue to receive and cash checks of the deceased. We also depend on you to help stop fraud.

Please report fraud online at http:// oig.ssa.gov/report or call the Social Security Fraud Hotline at 1-800-269-0271.

Q: I haven’t received my Social Security Statement in the mail the last few years. Will I ever get one again?

A: In September 2014, Social Security resumed mailing Social Security Statements to workers aged 25, 30, 35, 40, 45, 50, 55, and 60 who aren’t receiving Social Security benefits, and who don’t have a my Social Security account. Rather than once every five years, those over age 60 will receive a statement every year. Instead of waiting to receive a mailed statement once every five years, we encourage people to open a my Social Security account at www.socialsecurity.gov/myaccount so they can access their statement online, anytime.

Q: Why is it so important that my baby have a Social Security number?

A: Your child may need a Social Security number if you are planning to open a bank account, buy savings bonds, obtain medical coverage or apply for government services for the child. Your child will also need a Social Security number if you are going to declare him or her on your taxes. Getting a Social Security number for your newborn is voluntary, but it is a good idea to apply when your child is born. You can apply for a Social Security number for your baby when you apply for your baby’s birth certificate. The state agency that issues birth certificates will give us your child’s information and we will mail you a Social Security card with the child’s Social Security number.

Q: I am about to retire, but I still have a young child in my care. Will I receive additional benefits for the child I care for?

A: When you qualify for Social Security retirement benefits, your children may also qualify to receive benefits. Your eligible child can be your biological child, an adopted child or a stepchild. In limited circumstances, you may also get benefits for a dependent grandchild. To receive benefits, your child must be: unmarried; under the age of 18; between 18 and 19 years old and a full-time student (no higher than grade 12); or 18 or older and disabled from a condition that started before age 22. You can read more about planning for a disabled child’s care here: www. socialsecurity.gov/retire2/yourchildren.htm.

H ealth News Suzanne Burdick earns the WCC credential The National Alliance of Wound Care and Ostomy (NAWCO) announced that registered nurse Suzanne Burdick of St. Luke Health Services in Oswego has successfully passed the national certification exam to become wound care certified. The WCC credential is a nationally recognized certification, which is highly regarded and held by the most professional wound care clinicians in the United States.

The WCC credential is a multiBurdick disciplinary certification available to licensed wound care professionals across the healthcare continuum. This certification affirms that Burdick possesses the qualifications to deliver the highest standard of wound care to her patients.

Burdick received her nursing degree at Cayuga Community College of Auburn. She has been employed at St. Luke Health Services for 30 years, currently serving as the assistant director of nursing and leads the healthcare provider’s wound care team.

St. Joseph’s Physicians adds new providers

St. Joseph’s Physicians Family Medicine recently announced the hiring of several professionals.

They are: Jackie Barkley, a physician’s assistant, joins St. Joseph’s Physicians Family Medicine from Massena Memorial Hospital’s Louisville Family Health Center. Previously, she held roles in emergency medicine at Crouse Hospital and in a surgical setting at St. Joseph’s Hospital Health Center.

She received her master’s in physician assistant studies from Le Moyne College. She is currently seeing patients at the Liverpool facility.

Donna Devine, an oncology certified nurse, brings clinical experience in both inpatient and outpatient Barkley settings. Devine recently received her Master of Science as a family nurse practitioner and was previously a nurse and nurse manager at the Cardiovascular Group of Syracuse.

She completed her clinical nurse practitioner service with Ithaca Family Medical Associates.

Devine She is an oncology certified nurse with experience in oncology chemotherapy.

She sees patients at the Liverpool facility.

Lisa Isabell, a family nurse practitioner with more than 20 years of experience in patient care, recently completed the Master of Science as a family Isabell nurse practitioner at SUNY Upstate Medical University. She also brings extensive nursing experience obtained while working at Upstate Medical University Hospital and at St. Joseph’s Home Care Agency. She is currently seeing patients at the Liverpool facility.

Mackenzie Neal completed her physician assistant program at Rochester Institute of Technology with a concentration in psychology. Her clinical rotations included patient care

in all aspects of family medicine as well as dermatology, general surgery, geriatrics, pediatrics and psychiatry.

While at RIT, she was a member of the women’s varsity track and field team. She is based at the Fayetteville facility.

Vijaya SeepNeal ana, a physician, is a graduate of SUNY Upstate Medical University and completed her residency in family medicine at St. Joseph’s Hospital Health Center.

Her special medical interests include family medicine, outpatient medicine and women’s health. She comSeepana pleted her medical education at Rangaraya Medical College in Kakinada, India and her residency in family medicine at Glen Cove Hospital in Glen Cove, NY. In addition to English, she is fluent in Telugu and Hindi.

Travis Webb, a physician, provides general surgery services to St. Joseph’s Webb Physicians Surgical Services patients. He has a special interest in hernia surgery and abdominal wall reconstruction. He earned a medical degree from the State University of New York at Buffalo School of Medicine and biomedical sciences and an undergraduate degree from the SUNY Albany. He completed his residency at Geisinger Medical Center in Danville, Pa. Nicole Mattes, a physician’s as-

sistant, completed the family family nurse practitioner program at SUNY Upstate Medical University and is a graduate the Physician Assistant program at Le Moyne College.

Prior to joining St. Joseph’s Physicians, she worked as a general surgery Mattes physician assistant at St. Joseph’s Hospital Health Center.

Clark appointed at Crouse Neuroscience Institute Rochele Clark has been appointed service line administrator for Crouse Hospital’s Neuroscience Institute. She previously served as coordinator for Crouse’s stroke program from 2011 to 2013. Most recently she served as coordinator for the stroke program at Upstate Medical University.

Clark, who has more than 30 years of diverse clinical, management and administrative experience, will oversee the strategic direction and growth of the hospital’s expanding neuroscience Clark service line, working closely with physician leaders and the hospital’s clinical team.

“Shelly’s knowledge of our culture as well as her extensive experience, leadership and customer-service focus will serve us well as we continue to develop a comprehensive neuroscience institute that will encompass high-level stroke care, neurology and neurosurgery,” says physician Seth Kronenberg, chief physician integration officer for Crouse.

Crouse Hospital Introduces Lung Partners Program to Help COPD Patient Crouse Hospital has launched its lung partners primary respiratory care program, a chronic obstructive pulmonary disease (COPD) management initiative created and led by physician Russ Acevedo.

The program combines the education and clinical care expertise of the hospital’s respiratory therapists to manage the unique needs of patients with COPD. According to the hospital, the goal of the program is to improve the quality of life for COPD patients by ensuring that they and their caretakers have a thorough understanding of the disease process and homecare plans, as well as the ability to carry out prescribed therapy, obtain resources and reach out for help once they leave the hospital.

Under the program, the patient will receive an in-depth initial assessment and daily assessment by teams of licensed respiratory therapists who will screen for health literacy, physical functionality, depression, sleep disorders, medication and nutrition management.

As needed, clinical protocols will assist in timely referral of patients to specialists for further assessment and follow-up.

Research done by Acevedo and his team shows that this type of disease management approach can decrease ER visits, lower hospital readmissions, reduce fragmentation of COPD care and facilitate transfer of critical patient information between providers.

According to the hospital, lung

partners is unique in that it establishes a lifelong relationship between the patient and members of the respiratory therapy team as the program will December 2014 •

continue to follow patients — both inpatient and outpatient — utilizing community-based relationships and resources.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 21

H ealth News Crouse awarded for stroke care Crouse Hospital has again received the “Get With The Guidelines-Stroke Gold-Plus Quality Achievement Award” for implementing specific quality improvement measures outlined by the American Heart Association/American Stroke Association for the treatment of stroke patients.

Using Get With The Guidelines’ most up-to-date, research-based directives helps to speed recovery and reduce death and disability for stroke patients.

Crouse, a New York state-designated stroke center, earned the 2014 Gold Plus award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients over a designated period of time. These

measures include aggressive use of medications and risk-reduction therapies intended to reduce death and disability of stroke patients and improve their quality of life.

Crouse Hospital also received the association’s “2014 Target: Stroke Honor Roll” for meeting stroke quality measures that reduce the time between hospital arrival and treatment with the clot-buster tPA, the only drug approved by the U.S. Food and Drug Ad-

Neuropathy & Pain Expert

ministration to treat ischemic stroke.

People who suffer a stroke who receive the drug within three hours of the onset of symptoms may recover quicker and are less likely to suffer severe disability.

“This award demonstrates Crouse Hospital’s commitment to our stroke patients,” said physician Adham Kamel,

medical director for Crouse Hospital’s stroke program. “Studies have shown that hospitals consistently following ‘Get With The Guidelines’ quality improvement measures can reduce patients’ lengths of stay and readmission rates, and reduce disparity gaps in care.”

The program also helps Crouse staff promote stroke prevention and awareness in the community, including education about managing risk factors and knowing to call 911 at the earliest warning signs of a stroke.

Using the acronym FAST is a helpful way to remember stroke warning signs which include, Facial drooping; Arm weakness, numbness or tingling; Slurred or garbled speech; and Time is of the essence.

Team of orthopedic surgeons Irving Raphael and Bradley Raphael joins SOS

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

Joining Syracuse Orthopedic Specialists (SOS) are physician assistant Brandon Weaver, orthopedic surgeons Irving Raphael and Bradley Raphael and nurse practitioner Deborah Pflugh.

Physicians Irving Raphael and Bradley Raphael announced they are joining Syracuse Orthopedic Specialists (SOS) in December. Both doctors have a long history of providing orthopedic care to patients in Central New York and are experts in sports medicine.

“We are excited to welcome both Drs. Raphael to the SOS team,” said physician John F. Fatti, president of SOS. “They are a great addition to the excellent surgeons that we already have on our sports medicine team.”

Irving Raphael has a long and respected career in orthopedics and sports medicine. He had been the director of sports medicine and head team physician at Syracuse University for many years. He is also an orthopedic consultant to the NCAA, NBA, NFL and PGA. Raphael is a graduate of Yale University School of Medicine and completed his orthopedic residency at Upstate Medical School, where he is now a clinical assistant professor of orthopedics. He is a member of the American Academy of Orthopaedic Surgeons, the American Orthopaedic Society for Sports Medicine, the International Arthroscopy Association, and is board certified in orthopedic surgery.

Bradley Raphael also received his medical degree from the Yale University School of Medicine. He completed

his orthopedic residency at the Hospital for Special Surgery at Cornell-Weill Medical School in New York City, and also completed a sports medicine fellowship at the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. While in California, Raphael gained extensive experience working with athletes alongside the team doctors for the Los Angeles Lakers, Anaheim Ducks, Los Angeles Dodgers, and the University of Southern California.

Also joining SOS are Deborah Pflugh and Brandon Weaver, mid-level professionals who have worked with Raphael.

Pflugh is a graduate of St. Joseph’s Hospital Health Center School of Nursing and she received her certification as a nurse practitioner at SUNY Health Science Center. She is certified member of the American Nurses’ Association and an active member in the Syracuse chapter of the Nurse Practitioner Association. Brandon Weaver is a graduate of Rochester Institute of Technology (RIT) with a Bachelor’s of Science degree from its physician assistant program. He is a clinical preceptor for RIT, providing instruction in patient care, treatment and mentoring to Physician Assistant students. Brandon is a member of the American Academy of Physician Assistants.

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Epic honors Upstate for having one of best EMR implementations Bruno IGH Ad 3-14-14.indd 1

As part of the National Patient Accounting Week celebrations, Epic — Upstate’s electronic medical record management application vendor — presented Upstate University Hospital’s finance team Oct. 22 with its Revenue Cycle MVP award for hospital billing.

The Epic MVP award is presented to organizations that launch its electronic medical record program and achieve both exceptional revenue cycle launches and secure quick stabilization.

“Epic’s high-level revenue cycle management team reviews each organization post-launch and reviews metrics to distinguish which organizations are worthy of the award,” said Douglas Wolf of Epic Implementation Services.

“Upstate had a really great install and it is the first of two organizations to receive the honor in 2014.”

On average, two to three organizations are honored with the Revenue Cycle MVP per year. For Upstate, Epic presented the award to applaud its achievement of account receivable days, which returned to baseline within five months; charges that exceeded the baseline metric every week since Epic was launched; and cash, which reached 106 percent of cumulative baseline just 29 weeks after the launch.

Upstate University Hospital Chief Financial Officer Stuart Wright accepted the Epic award at the presentation ceremony and noted that the award

3/17/2014 10:19:00 AM

reflects subsctantial team work.

“The launch of Epic was a success thanks to a talented team involving front-line clinical staff, IT staff, financial and billing staff and everyone in between,” he said. “The award is a testament to the staff’s dedication, hard work and commitment to the organization. My thanks go out to everyone who helped make this a success.”

More than 50 percent of the U.S. population has an electronic medical record in Epic. Based out of Verona, Wis., the company uses a “one patient, one record” approach to gathering and housing a patient’s medical information. The secure, paperless, digital and computerized software system integrates and maintains a patient’s medical profile, or medical history, including medications, illnesses, records of doctor’s office or emergency room visits, and insurance information. Administrative functions such as scheduling, admitting and patient billing are also handled on Epic.

Patients, as well as their health care providers, can access their medical records online from any location to receive a comprehensive medical profile of the patient.

Upstate initially launched Epic in January of 2012 at a clinic, and completed its full installation in May 2014 when Upstate University Hospital’s Community Campus implemented the system across all phases of its care.

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Upstate was honored with the Epic Revenue Cycle MVP award for hospital billing on Oct. 22, 2014. Epic presented the honor to applaud Upstate’s achievements in revenue cycle and quick stabilization after the implementation of the electronic medical record system was completed in May 2014. From left, Upstate University Hospital Chief Financial Officer Stuart Wright, IMT Clinical Systems Manager Dan Malay, Manager of Patient Access and Revenue Cycle Carol Maier, and Director of Hospital Information Systems Laurie Roberts.

To learn more visit www.upstate.edu/mako

December 2014 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

In Good Health, half page (vertical):In Good Health,

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Page 23

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