in good
free FREE
THE PILL It remains the most common method of birth control followed by IUDs
Activity tracking bracelets
January 2015 • Issue 181
CNY’s Healthcare Newspaper
RESOLUTIONS Why do we keep making them year after year? Experts explain how to make resolutions we can achieve
Should you get one?
Also: What your doctor wants you to do in 2015 Page 14
Kidney Transplant
Medical Society Has New President Page 16
New rules for those awaiting kidney transplants in the United States went into effect in December
Good Bye Paper Scripts
US Birth Rate Hits All-Time Low
Physician Gennady Bratslavsky talks urology and why prostate cancer doesn’t get the same attention as breast cancer
Find out why this is happening now
Page 2
What Makes Romaine So Remarkable
The Power of Red
If your physicians still write paper prescriptions, they won’t much longer. As of March 27, New York state mandates electronic prescriptions. Says Mohammed Chhipa, pharmacist at Warrens Pharmacy, Inc. in Rochester: “It’s excellent. You don’t have to call the doctor to figure out what it says.” Page 5
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See Smart Bites on page 12
Real Hero Page 15 January 2015 •
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Suicide Risk Falls Substantially After Talk Therapy
R
BABIES
T
US Birth Rate Hits All-Time Low
he U.S. birth rate reached an alltime low in 2013, as the number of babies born in the country declined for the sixth straight year since the peak in 2007, a new report finds. The country’s birth rate dipped to 62.5 births per 1,000 women between ages 15 and 44, according to a Dec. 4 report from the Centers for Disease Control and Prevention (CDC). That is 10 percent lower than the birth rate in 2007, which was 69.3 per 1,000 women, and a record low since the government started tracking birth rates in 1909, when birth rate was 126.8.
In 2013, there were 3.93 million babies born in the U.S., down less than 1 percent from 2012, and down 9 percent from 2007, when a record-breaking 4.32 million babies were born in the U.S. But trends in the birth rate varied among age groups. Among women under age 30, childbearing is on the decline, whereas it continues to rise among women older than 30, in line with the general trend over the last three decades. In fact, 2013 birth rates for women aged 35 and over was “at the highest levels seen in approximately 50 years,” the researchers wrote in their report. In 2013, the birth rate for women
Attention Medicare Part D Members
ages 35-39 reached 49.3 births per 1,000, and for women ages 30–34, the rate reached 98 births per 1,000, both small increases from the previous year. The rate for women aged 40 to 44 was unchanged from the previous year, at 10.4 births per 1,000, whereas for women ages 45 to 49 the birth rate increased from 0.7 to 0.8 per 1,000. In contrast, among teenagers the birth rate fell 10 percent from 2012, dropping to 26.5 births per 1,000. Rates also declined by 3 percent for women aged 20 to 24, continuing the general decline of birth rates for women under age 25 over the last two decades, the researchers said.
epeat suicide attempts and deaths by suicide were roughly 25 percent lower among a group of Danish people who underwent voluntary short-term psychosocial counseling after a suicide attempt, new Johns Hopkins Bloomberg School of Public Healthled research suggests. The findings are believed to be the first to show that talk therapy-focused suicide prevention actually works, averting future suicide attempts in this very high-risk population. Although just six-to-10 talk therapy sessions were provided, researchers found long-term benefits: Five years after the counseling ended, there were 26 percent fewer suicides in the group that received treatment as compared to a group that did not. A study on the findings is published online Nov. 24 inLancet Psychiatry. “We know that people who have attempted suicide are a high-risk population and that we need to help them. However, we did not know what would be effective in terms of treatment,” says the study’s leader, Annette Erlangsen, an adjunct associate professor in the Department of Mental Health at the Johns Hopkins Bloomberg School of Public Health. “Now we have evidence that psychosocial treatment — which provides support, not medication – is able to prevent suicide in a group at high risk of dying by suicide.”
You may have been affected by recent changes in your current Medicare Part D plan. If you are self-enrolled in Excellus BlueCross BlueShield, you recently received a notice that Walgreens and Rite Aid are no longer part of its Medicare Part D pharmacy network as of January 1, 2015. If you need to switch pharmacies, or need advice, we hope you'll consider Wegmans Pharmacy as your new partner in wellness. ¥ Wegmans accepts most Medicare Part D plans ¥ Member of the Excellus pharmacy network for over 40 years ¥ Recently rated the #1 Pharmacy in America
It's easy to switch. Just provide us your prescription information and we'll do the rest. Stop in to our pharmacy today, or give us a call at 1-877-934-2479, and speak directly to our pharmacy team. Our friendly, helpful Pharmacy staff takes your health to heart. We're here to help make sense of these changes and set up worry-free wellness care for you.
Rated the #1 Pharmacy in America! Page 2
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2015
Drug Overdose-related Deaths Double from 1999 to 2012
Neuropathy & Pain Expert
The rate of heroin-related deaths nearly tripled between 1999 and 2012
ACU-CARE ACUPUNCTURE CENTER
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he number of yearly deaths from drug overdoses in the United States more than doubled between 1999 and 2012, according to a new report. In 2012, more than 41,000 people died of drug overdoses in the United States, compared with about 17,000 in 1999, according to the report released Dec. 2 by the Centers for Disease Control and Prevention. However, the report also found that the number of yearly deaths due to an overdose of opioid pain relievers, such as oxycodone and hydrocodone, actually decreased 5 percent between 2011 and 2012. Still, about 16,000 of the deaths in 2012 involved opioid pain relievers, according to the report. There are a variety of reasons drug overdoses have increased over the past few years, said Rich Hamburg, deputy director of Trust for America’s Health, a nonprofit
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Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by Local
Health CNY’s Healthcare Newspaper
News, Inc. Distribution: 35,000 copies. To request home delivery ($15 per year), call 315-342-1182.
In Good Health is published 12 times a year by Local News, Inc. © 2015 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, Ernst Lamothe • Advertising: Jasmine Maldonado, Marsha K. Preston • Design: Chris Crocker • Office Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
January 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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CALENDAR of
HEALTH EVENTS
Jan 12
Brain aneurysm group to hold support meeting The CNY Brain Aneurysm Awareness Campaign will hold its firs support group of the year at 6:30 p.m., Jan. 12, at Health Link / OASIS, 6333 Route 298, East Syracuse. Patients, survivors, caregivers, family and friends are invited to participate. An estimated 6 million people in the United States — or one in 50 — have an unruptured brain aneurism. The annual rate of ruptured is about eight per 100,000 people, or about 25,000 people. About 40 percent of all people which have a ruptured brain aneurysm will die as a result. For more information, email braincny@gmail.com or visit www. braincny.org.
Jan. 31
Life coach to address “Love God, Live Healthy” Certified life coach Connie Silva
will present “Love God, Live Healthy” with tips for totally healthy living at St. Cecilia’s Catholic Church on Grove Street in Adams. The event will take place Jan. 31. The free 10 a.m -12 p.m. program is sponsored by Live More Ministries, providing quarterly programs for women in the southern Jefferson County area. The St. Cecilia’s Church Women will offer a complimentary breakfast from 9 – 9:45 a.m. “Living in total health does not mean just being physically healthy. I am excited to share tips for managing heart and soul issues and for loving God with all our strength and minds,” says Silva. She inspires women through her coaching practice Hope for All Seasons, and with inspirational speaking programs that draw on her experience with abuse and raising a mentally-handicapped child. She also offers concerts and has a published record album. To learn more about Live More Ministries, contact Chris at 315-7672058, email sallyj@twcny.rr.com, or visit the website at livemoreministries. blogspot.com.
Diabetes prevention workshops in Madison County One in three Americans has prediabetes. Without weight loss and moderate physical activity, many will develop Type 2 diabetes within three years. If you have prediabetes, the National Diabetes Prevention Program (NDPP) offered at Oneida Healthcare, through Hamilton Family Health Center and in the Cazenovia area can help you make lasting lifestyle changes to prevent Type 2 diabetes. Participants will work in a group with a trained coach to learn how to eat healthier and add physical activity to help lower weight and blood glucose levels. The reduction of chronic diseases such as diabetes is a priority in the Madison County Community Health Improvement Plan (CHIP), according to the event’s organizers. Many people are unaware of their prediabetic status and need to check with their physician and ask if they are at risk for the condition. The National Diabetes Prevention
Program offered is a proven program to prevent or delay Type 2 diabetes. The groups meet once a week for 16 weeks, then once a month for six months to maintain healthy lifestyle changes. The program is based on research that found people with prediabetes can cut their risk of developing Type 2 diabetes in half by losing 5 to 7 percent of their body weight. There will not be a cost to participants this year. This program is supported by Excellus BlueCross BlueShield and the New York State Health Foundation in collaboration with Herkimer County Healthnet. Workshops will start in January in locations in Madison County. To learn more about the National Diabetes Prevention Program and register for a program near you, call the Madison County Rural Health Council at 315726-4869.
Alzheimer’s Association announces support group dates The challenges and emotions that come with caregiving for an individual with Alzheimer’s disease or other form of dementia can be overwhelming. The Alzheimer’s Association, Central New York Chapter invites local caregivers to join a community of their peers by attending a support group. Caregiving for someone with Alzheimer’s disease or another form of dementia can be a stressful endeavor surrounded by anxiety, worry and guilt. Caregivers may feel as if they are alone in their journey. The reality is that a community of their peers exists to support one another. These peer- or professionally-led groups for are individuals, caregivers and others dealing with Alzheimer’s disease or a related form of dementia. Caregiver support groups promote an open forum of sharing and discussion among people facing many of the same issues. The group’s power rests within its members’ ability to show compassion, develop strategies and empower its members to provide the highest quality care possible. Early-stage groups provide peerto-peer conversation and support for individuals specifically diagnosed in the disease’s early stages. Groups are open to the individual with the disease and the caregiver (as noted). Advanced screening is recommended prior to attending by calling the office nearest you. All support groups are free of charge to attend and facilitated by trained individuals. For more information, call 1-800-272-3900 or email cny-programs@alz.org. Upcoming meetings include:
Onondaga County
Early-Stage Support Groups
The Hearth on James, 830 James St. First and third Thursday, 1 p.m. Jan. 15, Feb. 5 and 19 John Ryan: 463-0308
DeWitt (Person With Dementia & Caregiver) Pebble Hill Presbyterian Church 5299 Jamesville Road Third Wednesday, 5:30 p.m. Jan. 21, Feb. 18 Katrina Skeval: 472-4201 x103 Caregiver Support Groups Oneida County Clare Bridge Clinton, 115 Brookside Road Last Wednesday, 3 p.m. Jan. 28, Feb. 25 Dianne Mahanna & Laura Wratten: 859-1947
Baldwinsville Baldwinsville Methodist Church, 17 W. Genesee St. Second Tuesday, 6:30 p.m. Jan. 13, Feb. 10 Eileen Krupka: 638-0814 Liverpool Keepsake Village at Greenpoint, 138 Old Liverpool Road Second Saturday, 10 a.m. Jan. 10, Feb. 14 Florence Felt & Skip Collins: 849-2140 Manlius Manlius Public Library, 1 Arkie Albanese Way Fourth Tuesday, 7 p.m. Jan. 27, Feb. 24 Claire Duffy: 247-1775 North Syracuse Andrews Memorial Church, 106 Church St. Third Tuesday, 1 p.m. Jan. 20, Feb. 17 Chapter Staff: 472-4201 Skaneateles The Athenaeum of Skaneateles, 150 E. Genesee St. Last Thursday, 2 p.m. Jan. 29, Feb. 26 Trudy Scarr: 685-1400 Syracuse The Centers at St. Camillus, 813 Fay Rd. Third Tuesday, 5:30 p.m. Jan. 20, Feb. 17 Ellen Somers: 488-2951 x406
Syracuse V.A. Hospital, 800 Irving Ave. First and third Wednesday, 1 p.m. Jan. 7 and 21, Feb. 4 and 18 Louise Choroser and Eileen Welch: 425-4400 Oswego County Central Square Divine Mercy Parish Center (St. Michael’s), 592 S. Main St. Fourth Monday, 7 p.m. Jan. 26, Feb. 23 Gail Lauricella: 676-7533 Oswego The Manor at Seneca Hill, 20 Manor Dr. Fourth Wednesday, 7 p.m. Jan. 28, Feb. 25 Dianne Morrisette: 349-5341
Corrine lost 80 lbs. and found her sense of adventure. Corrine couldn’t find the courage to step out of her comfort zone. Since having weight-loss surgery, she’s stepping into her harness and finding comfort high above the trees. And at Crouse, she’s discovered a support group, along with trusted surgeons and nutritional experts who encourage her quest for a happier, healthier life. Come to our next weight-loss surgery seminar and discover what you can find.
crouse.org/weightloss
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2015
Is Weight Loss Surgery Right for You? Upcoming Seminars: Jan. 5 • Jan. 15 To register go to crouse.org/weightloss
Good-bye Paper Scripts Starting in March, all prescriptions will be in the electronic form
Inspiring your child’s success
By Deborah Jeanne Sergeant
$100 OFF
I
f your physicians still write paper prescriptions, they won’t much longer. As of March 27, New York state mandates electronic prescriptions, including for controlled substances, which have been previously banned from electronic prescriptions. Area pharmacists sound positive about the change, as most primarily work from electronic prescriptions already. At Hannibal Pharmacy, pharmacist and owner Jonathan “Jack” Hess said that electronic prescription increases legibility. Instead of calling the office whenever a doctor’s handwriting lives up to the stereotypical scrawl, all the prescriptions are completely legible since they’re transmitted in a uniform font. “It’s easier for younger doctors but I think for older ones who aren’t as used to technology, it’ll take getting used to,” Hess said. “There’s a learning curve there.” Electronic prescriptions also make it easier for recordkeeping, since the prescriptions automatically enter the patient’s electronic health records. “E-scribing is safer on the doctor’s side because there’s an exact record on what was prescribed,” Rowland said Mark Cohen, internal medicine physician and pediatrician with Lifetime Health. “If it’s on paper, you have to make sure it’s in the notes. In the past, they’ve had to [photocopy] it and put it in the notes.” Nixing paper scripts also means greatly reducing fraud since the only way to generate a prescription is using the encrypted, password- protected system accessible only through the medical system’s mainframe. Lifetime Health uses its own private network run off servers, so no individual has patient information stored on his own desktop or laptops. Electronic prescribing can help reduce incidences of contraindication. Some health conditions and prescriptions preclude a patient from taking certain medications. While doctors and pharmacists work to eliminate these conflicts, electronic prescribing adds another layer of oversight, especially if patients forget to mention medication or if they use more than one physician and/or pharmacy. A small percentage of prescriptions will still require a call to the doctor’s office for clarification.
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“The problem with any technology is, it boils down to the user,” said Craig Rowland, pharmacist and owner of Pine Hill Hometown Pharmacy in Cato. Overall, he likes the convenience and accuracy of electronic prescriptions, but also experiences a few drawbacks. “The software that is designed for it is a good format, in theory, but the user still has to enter quality information.” Since the electronic forms typically rely upon clicking selections instead of manually writing out a drug’s name, dosage, and instructions, it might be easier to click the wrong box. Despite improved clarity on prescriptions, pharmacists like Rowland still work with providers and patients to spot potential errors and ensure that prescriptions are filled accurately. Hess agreed that user issues could cause problems. “We’ll still have to call on some because there will be inconsistencies,” he said. “It has to qualify for insurance purposes. Doctors will have to re-enter things if there are inconsistencies. Just because we’re using more technology doesn’t mean that there will be no problems.” Since the electronic forms rely upon clicking selections instead of manually writing out a drug’s name, dosage and instructions, it’s easier to click the wrong box. Despite improved clarity on prescriptions, pharmacists like Rowland and Hess still work with physicians and patients to spot mistakes and ensure that prescriptions are correct. The electronic system also helps snag data entry errors, but the doctor, pharmacist and patient should work together to spot human errors and increase prescription accuracy. In case of technical problems, power outages, or a few other exceptions, paper prescriptions will be honored after the March deadline.
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Advertise with In Good Health, Central New York’s Newspaper Monthly readership: 100,000 readers based on a distribution of 35,000 papers. Readers: Health consumers, health professionals, everyone interested in health issues and healthy living. Advertise montly for under $100. Call 315-342-1182. January 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Meet
Your Doctor
By Chris Motola
Gennady Bratslavsky Urology chief at Upstate talks about why prostate cancer doesn’t get the same attention as breast cancer and how campaigns such as ‘Movember Mustache Challenge” tries to change that Q: What’s your role at Upstate? A: Presently, I’m professor and chair[man] of the department of urology at Upstate Medical Center. I’m also co-director of the prostate cancer program here. I’m also director of the robotics program. I wear a few hats. Q: I hear you’ve been doing some outreach with regard to prostate cancer. A: So November was one of the biggest months for awareness campaigns. You’ve probably heard of Movember, where men grow mustaches and facial hair to raise money and awareness for prostate cancer research. So when people ask you what’s going on with your mustache, you can use that opportunity to talk to them about prostate cancer. Q: There has been a lot of work done to raise awareness of women’s health issues over the years that’s been quite effective. Are men’s health issues lagging behind somewhat? A: I think what we’re dealing with is that the actual concept of men’s health has been somewhat underrepresented when compared to women’s health. I’m certainly a big supporter of breast cancer aware-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2015
ness, and our urology department is also the recipient of awards from breast cancer foundations to support research — many of the pathways are very similar between breast cancer and prostate cancer. But I don’t think prostate cancer has gotten nearly the same amount of attention. That’s why Movember is such a great opportunity to raise awareness. We had a mustache competition between our prostate cancer team and the Syracuse Crunch hockey team. Jim Boeheim took on a largely symbolic role as the “coach” of both teams. Part of the joke is that he’s going to declare that he coached whichever team won. So while the fundraiser part of it is mostly symbolic, we have a great opportunity to raise awareness in the community. Q: Prostate cancer is often portrayed as an inevitability for men as they age. Is that accurate? A: There’s no question that the prevalence of prostate goes up as men age, but you can develop it much earlier. But it’s wrong to think that nothing can or should be done
about it. Now, sometimes those who are old and in frail health might not benefit from treatment and screening, but those decisions need to be made on a patient-by-patient basis. Even though it can be curable, it would be a mistake to say every prostate cancer must be treated. So we’re looking at how aggressive the cancer is, the patient’s health, available technology. Prostate cancer is the second leading cause of cancer deaths for men and the most common type of cancer for men. Since we’ve introduced screen processes, we have been able to demonstrate that prostate cancer mortality in this country has decreased by 30 percent. Q: What’s the robotics department consist of? A: We have the most modern daVinci robot currently on the market. Certainly the vast majority of those treated with the robot are treated under the department of urology, but we have other services as well. In addition to urology, this applies to gynecology, neurology, general surgery, surgical oncology; everyone’s joining in and pushing the technology to treat both oncologic and non-oncologic conditions. I oversee numerous aspects of the robotics program, from safety policies to appropriate usage, allocation, and efficiency of the operating system. That includes credentialing of staff to use the robot. Q: It seems like urologists are pretty rare at the moment. What’s the picture like for the next generation of physicians? A: Urology is a very broad field with a lot of sub-specialties. Every aspect of it is well-represented within our own department at Upstate. We’re also very strong in research. We’re in the top 15 departments in NIH-funded researched [NIH stands for National Institutes of Health]. We’ll likely be in the top 10 this year. We’re probably one of the most diverse departments in terms of sub-specializations and in the number of fellowships we have. By fellowships, I mean those urologists who have gone into sub-specialization after residency. Q: Did you grow a mustache? A: Absolutely. Q: Worse winters: Kiev or Syracuse? A: For those who complain about Syracuse winters, you’ll be delighted to know that Kiev is much farther north. People here tell me that they’re sorry I had to move north from Washington, but I actually moved south from Kiev. Syracuse is a wonderful place to enjoy winters. It gets more snow, but the winters are more enjoyable than in Kiev.
Lifeline Name: Gennady Bratslavsky, M.D. Hometown: Kiev, Ukraine Education: Albany Medical College (medical and residency), National Cancer Institute (fellowship) Affiliations: SUNY Upstate, Community General, Rome General Hospital Organizations: American Urological Association, Society of Urologic Oncology Family: Married (Katja), three sons (Michael, Mark, Gene) Hobbies: Soccer, fishing, travel, art, guitar
Charity care declines, but not in CNY By Ernst Lamothe Jr.
N
ationwide hospital financial assistance or charity care programs are becoming a little less charitable. As a result of the Patient Protection and Affordable Care Act, more than 10.3 million people have signed up for health plans through the exchanges, with more than 80 percent of new enrollees eligible for subsidized coverage, according to Becker’s Hospital Review. An additional seven million have been added through Medicaid and Children’s Wright Health Insurance programs. With subsidized health plans available and Medicaid expanding in 26 states, some hospitals are scaling back their charity care programs, which offer health care financial assistance to those in need at no charge or at a reduced charge when they meet financial eligibility requirements. All medically
necessary services are covered by the program, including outpatient services, emergency care and inpatient admissions. At St. Louis-based BJC HealthCare — a 12-hospital system with facilities in Illinois and Missouri — the charity program changed requiring all patients to contribute to the cost of their care, regardless of their income level. The online charity care policy at Southern New Hampshire Medical Center in Nashua, for example, now states that “applicants who refuse to purchase federally mandated health insurance when they are eligible to do so will not be awarded charitable care.” It seems to be the trend with more hospitals, especially when people factor the record number of institutes that are losing money due to higher standards levied by the Affordable Care act. Other hospitals nationwide are slashing financial assistance even for patients who earn more than the poverty level. Several hospital systems in Syracuse are going against the grain. Officials believe just because more people have health insurance doesn’t mean all their medical financial needs
are being met. “Upstate University Hospital is the safety net facility for Central New York. We offer more unique services for indigent populations than any other provider in the area,” said Stuart Wright, chief financial officer of Upstate University Hospital in Syracuse. “It is part of our core mission to provide these services to those in need.” At Upstate University Hospital, patients requesting consideration for financial assistance are provided an application. When they complete the application, they return the form to the hospital’s business office. The staff completes the review within 30 days and mail a determination to the patient notifying them of any reductions and a proposed payment plan for the remaining balances. Reductions are provided on a sliding scale based on household size and income as a percentage of the Federal Poverty Level. The poverty rate for a family of four is $23,850. Upstate have decided not to change their charity care or financial assistance policy because of the Affordable Care Act. “While there are more people with insurance, there are an increasing number of patients with insurance plans that include high co-insurance amounts or deductibles,” added Wright. Once a patient is approved for assistance or a reduction, the same level of reduction is good for one year. However, patients are required to notify the hospital if their financial situation changes for the better or worse. “Without a robust charity care policy and commitment to public missions, the growing number of under-insured
individuals in Central New York would not have access to critical healthcare services without facing financial ruin,” said Wright. At Crouse Hospital, officials understand that patients may be faced with a difficult financial situation when they receive medical bills for their hospital care. To meet the needs of patients, they offer a financial assistance program that includes a process to provide patients with assistance in applying for publicly sponsored New York state health insurance programs. The hospital offers charity care discounts to patients who receive medically necessary care at no charge or reduced charge when they meet eligibility requirements. Patients are encouraged to submit their application prior to receiving services at Crouse Hospital or within 120 days from their hospital service. At Crouse, a family of four can make up to $70,650 as a maximum household income for discounts. Charity care discounts are available to patients who reside in New York state only. For uninsured patients residing outside of New York state and who receive services at Crouse Hospital, a self-pay discount of 30 percent off charges are available, according to the hospital’s website. St. Joseph’s Health Center, a 431bed hospital health center with many outpatient programs, satellite facilities and affiliated organizations, does not have a charity care program, according to media relations officials.
Healthcare in a Minute By George W. Chapman
U.S. Still No. 1 When it Comes to Healthcare Spending
O
ur annual spending on healthcare increased 3.6 percent in 2013, which has been about average since 2009. We spent $2.9 trillion or $9,255 per person in 2013 to once again retain the dubious No. 1 ranking in the cost of care among developed countries. Healthcare spending is 17.4 percent of the nation’s gross domestic product. Many experts attribute the historically modest increases to lingering effects of the recession. The fear is that as the economy picks up, so will the annual increase in healthcare spending. Despite another year of modest medical inflation (3.6 percent) most likely your premium (through the exchange or through your employer) for next year will increase two to three times the medical inflation rate. Almost half of that increase is attributable to taxes on insurers for: Obamacare subsidies, number of participants or insured in their plan and health information technology. Insurers must charge the same for comparable plans offered on the exchange or through employers. Retail clinics gaining acceptance. Walgreens, RiteAid, CVS and Target all offer primary care services. The Advisory Board, a healthcare consultancy group, surveyed users of these retail clinics and found the following to be the main reasons for user satisfaction: centralized online scheduling, extend-
ed hours, price transparency, less than 30 minutes waiting time and a broad range of services. Some see these clinics as a threat to traditional private practices and others see them as the future of primary care and a way to mitigate the shortage of primary caregivers. In any event, these successful and growing companies have seized upon opportunity in the market and are becoming more popular with consumers. 2014 is active year for hospital mergers. Odds are if your favorite hospital hasn’t already merged with another hospital or hospital system, it may do so in the next couple of years. 2014 was a busy year in the industry for healthcare mergers and acquisitions. Worldwide, healthcare related deals reached $438 billion, which is about 14 percent of all mergers and acquisition business. Hospitals also continued to gobble up physician practices to shore up their market share and achieve operating efficiencies. Rural hospitals continue to be most at risk if they continue to stand alone. There are too many hospital beds in the US and mergers/ acquisitions often result in the reduction of beds. Twenty years ago there were about one million licensed beds in the US. Today, there are about 800,000 and on an average day, 35 percent are vacant/unused.
Integrating your medical device with your EHR. There are a lot of personal medical devices on the market ranging from heart, blood pressure and sugar monitors to Fitbits. iHealth is a leading developer in taking these devices a step further by integrating the information from them with your electronic medical record. iHealth is working with Apple, Duke, Stanford and Epic, which is the largest EHR vendor in the country. Critics caution that while the intent is great, already over taxed clinicians could be further overwhelmed with this additional data. Paying upfront. More and more providers are requiring their patients to pay their deductible or coinsurance upfront prior to an elective procedure. In the past, the provider would bill the insurance company after the procedure was performed. The insurance company would pay the provider the negotiated fee less whatever the patient owes in deductible or coinsurance. The provider would then, in turn, bill the patient. However, with 20 percent of us now having a high deductible plan, bad debt for providers has increased significantly. Consequently, they are requiring payment up front. Many hospitals offer payment plans directly or through outside loaners like Banker’s Healthcare Group. January 2015 •
Future of Obamacare. Republicans now control both houses in Congress. They are proposing to repeal the 2.3 percent excise tax on medical device sales, which will cut $30 billion in revenue over the next 10 years from the Affordable Care Act. Experts predict that this cut alone, if not replaced, could increase premiums by 45 percent. The G.O.P. also wants to increase the work week definition (hours an employee works per week to receive health insurance from their employer) from 30 hours to 40 hours. The Congressional Budget Office estimates 1 million people would lose their employer based coverage if hours were increased to 40. Finally, the US Supreme Court will hear a challenge to the federal government offering tax payer subsidized insurance rates through the 34 federally run exchanges. The 16 state-run exchanges could continue to do so.
GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Blood Test That Gauges Heart Attack Risk Approved by FDA The screen is meant for people without history of heart disease, agency says
T
he U.S. Food and Drug Administration in December approved a new blood test that can help determine a person’s future odds for heart attack and other heart troubles. The test is designed for people with no history of heart disease, and it appears to be especially useful for women, and black women in particular, the agency said. “A cardiac test that helps better predict future coronary heart disease risk in women, and especially black women, may help health care professionals identify these patients before they experience a serious [heart disease] event, like a heart attack,” Alberto Gutierrez, director of the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health, said in an agency news release. The test tracks the activity of a specific biological signal of vascular inflammation, called Lp-PLA2. Vascular inflammation is strongly associated with the buildup of artery-clogging plaques in blood vessels, the FDA explained. As plaque accumulates, arteries narrow and the chances of a serious cardiovascular event increase. “Patients with test results that show Lp-PLA2 activity greater than the level of 225 nanomoles per minute per milliliter are at increased risk for a [heart disease] event,” the FDA said. The FDA said its approval of the new blood test comes from data compiled in a study funded by the U.S. National Institutes of Health. Almost 4,600 people aged 45 to 92 with no prior history of heart disease took part in the study, and were followed for an average of just over five years. In subgroup analyses, the test seemed especially sensitive for black women, because they experienced a “higher jump” in the rate of heart attack and other heart disease events when their blood levels of Lp-PLA2 exceeded a certain level. “As a result, the test’s labeling contains separate performance data for black women, black men, white women and white men,” the FDA said. The test is manufactured by San Francisco-based diaDexus, Inc. According to the U.S. Centers for Disease Control and Prevention, heart disease remains the leading killer of Americans, and coronary heart disease is the most common form of the illness, killing over 385,000 people each year. “Almost two-thirds of women and half of men who die suddenly of coronary heart disease have no previous symptoms,” the FDA noted.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
A Dozen Don’ts for 2015
I
’ve shared lots of “do’s” in the past to help people live alone with more success. Here are a few “don’ts” — some lighthearted — that may also help you on your journey toward contentment in the New Year: Don’t isolate. Get up, get dressed, lose the PJs or sweat pants, and get out of the house (or get on the phone). We humans are social animals; we’re meant to be with others. Solitary confinement is for criminals, not for people who live alone. Stay connected! Don’t go on a shopping spree to fill an emotional void. Your savings account will thank you. Don’t make Cocoa Puffs your main course for dinner. Well . . . maybe on occasion. But as a general rule? No. Create a nice place setting, fill your plate with something healthy, light a candle, pour yourself a glass of wine or cranberry juice, and enjoy some well-deserved time to yourself. A favorite magazine or book can make for a nice dining companion. Bon appetite! Don’t label yourself a loser just because you are spending Saturday night alone. It’s not the end of the world. It doesn’t define you. Stream a Netflix movie or clear some clutter and call it a night. If the prospect of a Friday or Saturday night alone is too difficult, reach out to a friend today and make plans for next weekend. Don’t put too much stock in that Dreamcatcher. If you find yourself wide awake in the middle of night fighting demons, you might try meditation, journaling or aromatherapy. I fill my diffuser with lavender oil and do some deep breathing while I repeat the phrase, “Sleep is
healing.” If that doesn’t do the trick, I get up and prepare myself some warm milk or herbal tea. I return to bed with fingers crossed and eyes closed. If all else fails, consider sleep aids. Don’t avoid dancing lessons because you don’t have a partner. Good teachers know how to incorporate singles into their classes by making introductions or by partnering with single members to demonstrate steps. Lucky you! Don’t jump into someone’s arms out of loneliness. Feelings of desperation can make you easy prey for a “suitor” with dubious intentions. It’s a risky place to be. Getting good at living alone will build your self-esteem and improve your chances of meeting someone who appreciates your strengths, not your weaknesses. Don’t get behind the wheel after a night of drowning your sorrows with friends. No explanation needed. Drink and drive responsibly. Don’t be afraid to travel alone. Some of my best trips have been taken with my favorite traveling companion: myself. I create my own itinerary, go at my own pace, and meet all kinds of interesting people along the way. Even a small jaunt can boost your confidence. On your own, you’ll discover your own resourcefulness, ability to solve problems, and capacity to spend some time alone. It can be an enlightening adventure in self-discov-
KIDS Corner Higher Birth Weight Indicates Better Performance in School
I
t’s no secret that low-birth-weight babies face significantly greater risks for certain health problems early on, such as respiratory distress or infection. Now, a new study from researchers at the University of Florida and Northwestern University shows that lower weights at birth also have an adverse effect on children’s performance in school, which is likely due to the early health struggles small babies often face. Using a unique set of data that matched birth and school records from 1.6 million children born in Florida
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2015
between 1992 and 2002, the researchers found that the higher the weight at birth, the better children performed on reading and math tests in school. The findings held true throughout elementary school and into middle school regardless of the quality of the schools children attended. These findings held true when socioeconomic and demographic factors were equal among children’s families, said Jeffrey Roth, Ph.D., a research professor of pediatrics in the UF College of Medicine and a co-author of the study.
ery. I highly recommend it. Don’t decline an invitation because it means walking in (and walking out) alone. You can do it. Make a beeline for the host to say “hello” and ask for an introduction to someone, if you are surrounded by strangers. Or, get in line at the refreshment station. You’ll be engaged in conversation before you know it. Be yourself, be sincere, and be curious about others. Go and have fun! Don’t act your age. You are free, unencumbered, and on your own. What better time to spread your wings, be silly, and otherwise express your glorious, outrageous self. Put yourself with people who make you laugh. For me, that’s my sister. So keep your sense of humor. After all, life can be funny. Don’t take these “don’ts” too seriously. You are in the best position to decide what to do or not to do — no shoulds, musts, or other people’s agendas. That’s one of the best benefits of living alone. Don’t I know it! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops or to invite Gwenn to speak, call 585-624-7887, e-mail gvoelckers@rochester.rr.com
But when socioeconomic factors and demographics are not equal, higher birth weights don’t always translate to better performance in school. For example, lower-birth-weight babies of highly educated parents tend to perform better in school than heavier babies of high school dropouts because the educational level of a child’s mother is a stronger predictor of school success, Roth said. But when researchers compare children with similar family backgrounds, birth weight plays a key role in predicting future school success. “We tend to think that good schools are places where struggling kids get special attention and motivated teachers can correct any problems with learning,” he said. “This research indicates that is not always the case. Good schools are good for everyone, but even the best schools don’t seem to differentially help kids with early health disadvantage.”
Activity Bracelets Becoming More Popular But do they work in keeping people fitter? Experts weigh in By Deborah Jeanne Sergeant
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ctivity tracking bracelets, such those made by Fitbit, Microsoft and Misfit, can help you get and stay fit. Ranging from nondescript, rubbery bracelets to gold-tone and silver-tone fashion jewelry (Fitbit’s higher-end bracelets were inspired by designer Tory Burch), the bracelets include a bevy of features. The bracelets record the body’s statistics and wirelessly transmit
them to the user’s handheld device or other computer. Users can set personal goals and receive real-time feedback. Depending upon the brand and model, they track resting time and movement, monitor heart rate, display calories burned and compare the user’s performance from day to day. The devices’ interface with mobile devices also allow users to seamlessly track caloric and fluid intake and weight, too. Activity tracking bracelets are popular, but do they work in keeping people fitter? Area fitness experts weighed in. At Bayview Wellness Center in Fair Haven, Karen Haas, certified personal trainer, said that calorie and activity tracking “is particularly helpful to anyone 35 and up and essential to those 50 and older. I’m 64 so I know whereof I speak.” She regularly wears an activity tracking bracelet. She encourages clients interested in activity tracking jewelry to find a device that allows inputs including age, weight and gender, since these factors influence weight gain and loss. “Steps alone aren’t always a good measurement,” Haas said. “I’m not a jogger. I don’t generally get 10,000 steps in per day. I do other forms exercise that burn calories.” Greg Payne, certified personal trainer with Work-
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outs B’ville in Baldwinsville, likes that activity tracking bracelets can help people become more conscientious of their health, but said that most of the equipment he has seen doesn’t distinguish between “climbing stairs or walking downhill. The intensity doesn’t matter because to the bracelet, a step is a step.” Understanding the science behind the device can help you find a truly helpful piece of tracking jewelry. Chrissy Mason, certified personal trainer at Stability Fitness in Oswego, wears a monitor daily and knows many others who do, too. “They motivate people to move and if that’s what they need, that’s what they need,” she said. She especially likes monitors that display heart rate so clients can get in the ideal zone of 75 to 85 percent of their target heart rate during workouts. Michael Knapp, personal trainer and owner of At Your Home Personal Training in Syracuse, agrees that it’s helpful for his clients. “Most who have it like it and it’s exciting to set and monitor their goals,” Knapp said. “Some people swear by it. It helps generate improvements in overall health and it helps people stick with a routine longer.” He also cautions clients to not take the data too seriously. “Like any equipment, you have
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to give yourself a 20 percent leeway,” Knapp said. “If it says you burned 100 calories, you probably burned 80.” He said that when he’s using fitness equipment that estimates how many calories he has burned, he increases his activity by 20 percent to make up for errors. For example, instead of feeling satisfied with “200 calories burned” he pushes himself to burn 240 to account for the margin of error. He estimates that about one-third of people he knows using the jewelry continue to use them for an extended period of time. Another third give them up after six months and the final third don’t bother after three months.
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Page 9
My Turn
By Eva Briggs
The Power of Red Why men are more attracted to women in red and other myths
R
ed is one of those seasonal colors that are everywhere now, from candy canes to Santa suits. It turns out that there’s a lot of research into the psychological meaning of red. As well as some myths that deserve debunking. Woman in a red dresses. It turns out that men find woman more attractive and sexually desirable when dressed in red rather than other colors — or shades of gray. Ditto for lipstick. Men at a bar approached women with red lipstick more quickly than women wearing pink, brown, or no lipstick. Is it a cultural phenomenon? Or is it because, as hypothesized by some researchers, the heightened contrast makes faces appear more feminine. It doesn’t seem to work the other way — women weren’t swayed by the color of a man’s shirt. Appetite stimulated by red? Nope. It turns out to be a myth that red makes you eat more. I’ve always heard that restaurants use red tablecloths, menus and chairs because it stimulates your
appetite so that you’ll order and spend more. It turns out that there’s no data to support that. In fact, a 2012 study showed that people are less apt to snack on food from a red plate than from a blue one, and drank less from a red-labeled cup than from a blue-labeled cup. Hear that, red solo cup? Red for power. When people are blocked in traffic, they respond more aggressively if the offending vehicle is red. And it’s not just people. It really is true that bulls find red more annoying. Perhaps it’s because cattle have only two types of color receptors in their eyes, unlike the three possessed by humans. So to a bull, blue and green are indistinguishable, but red stands out. One study found that cows were more active and aroused in red light than in blue or green light. And bulls
charged warm-colored (such as red) objects with more force than they directed toward cooler-colored targets. In a study of summer Olympic contact sports, it turns out that red uniforms confer a slight competitive advantage over blue gear. Athletes randomly assigned to wear red beat out their blue-clad opponents slightly more often than predicted by chance. Go Cards! (That’s short for the Louisville Cardinals, my daughter’s college running team). Red for visibility. This also turns out to be myth. It’s the traditional color for fire extinguishers, stop signs and
danger. But the most visible color for fire trucks is lime yellow. It’s not only easy to see in the daytime, but it’s also the most visible color at night. Red for danger. Animals often use the color red to advertise their toxicity. Examples include king snakes, flamboyant cuttlefish and the granular poison frog. Some nontoxic species take advantage of this fact by mimicking the color of dangerous species, fooling their predators. This tactic is called Batesian mimicry. Red means pain. The color red seems to intensify the experience of pain. Researches did an experiment where they applied heat to subject’s arms, while causing a dot adjacent to the area area to glow with red, green, or blue as they cranked up the heat. People reported first feeling pain at a lower temperature when they saw the red glow. Red cars are the most dangerous to drive and the most costly to insure. That’s another myth. Studies have shown that red cars are no more likely to be involved in an accident than cars of any other hue. So color is not a factor that affects the price of your insurance premium. Feel free to choose whatever color you want for your next vehicle. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2015
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Nathan G. Everding, M.D Upper extremity surgeon with Syracuse Orthopedic Specialists, specializing in hand, wrist, elbow, and shoulder surgery problems). This broad scope of practice is exciting and keeps me on my toes.
Q. What is an upper extremity surgeon and what do they do? As an upper extremity surgeon I am able to treat a wide variety of patients — laborers, athletes, musicians, children, adults, and the elderly — with a wide variety of problems and injuries (broken bones, torn tendons, arthritis, inflammation, nerve dysfunction and congenital
Q. What is your favorite part of the work? Orthopedics is a unique field of medicine. Many medical fields focus on treating acute or chronic illnesses, guiding sick patients back to health. In orthopedics, we focus on improving quality of life. Oftentimes our patients are not “sick” in the true sense of the word; rather, they are experiencing pain and limitations in function that affect their quality of life. Whether the problem is an injury, such as a broken bone, or a degenerative problem, such as arthritis, we treat patients and improve their quality of life, often improving function and pain. Helping a patient get back to their activities whether that be returning to work, sports or just regaining their independence is extremely gratifying.
Q. What is something about your business you would want people to know? Although I enjoy treating patients of all ages with varying aliments, one of my passions is treating patients with arthritis of the upper extremity. Many people have experienced, or know someone who has hip or knee arthritis. These patients are commonly treated with joint replacement surgery. Although less common, arthritis also happens in the fingers, wrists, elbows and shoulders. There are many different treatments for arthritis in the upper extremity, including joint replacement surgery. In particular, shoulder replacement surgery has become increasingly common in the past decade. The increased frequency of, and demand for shoulder replacement surgery likely relates to improvements in surgical techniques and implant designs. Shoulder replacements can be used to treat arthritis as well as a variety of other problems including fractures, dislocations, and irreparable
rotator cuff tears. A significant portion of my training has been dedicated to researching and treating upper extremity arthritis and in particular, performing shoulder replacement surgery. For patients with pain and dysfunction, shoulder replacement surgery can significantly improve quality of life and independence and return patients to their pre-injury level of function. Q. What is your educational background? I completed an orthopedic surgery residency in Boston at Boston Medical Center. Following residency, I completed two extra years of specialized training in hand and upper extremity surgery at the Cleveland Clinic and shoulder and elbow surgery at the Holy Cross Orthopedic Institute in Fort Lauderdale, Fla. As a native of Central New York, I am honored and privileged to return home and care for the people of the community in which I grew up.
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Page 11
SmartBites
By Anne Palumbo
The skinny on healthy eating
What Makes Romaine So Remarkable
A
h, January…month of snug waistbands and shirts that won’t button, no thanks to the endless supply of goodies over the holidays. But the eating season has come to a close and we all know what that means: Time to get back in the saddle and “eat clean” for a while until those favorite jeans fit again. My favorite go-to “clean” food is lettuce; and of all the varieties, romaine finds its way onto my plate more than any others. Crunchy like iceberg, but much more nutritious because of its darker green color, romaine delivers the goods: it’s tasty, it’s super low in calories, and it’s loaded with nutrients. To begin, romaine is a vitamin A heavyweight, providing over 100 percent of our daily needs in an average serving (about two cups). A nutrient we can’t live without, vitamin A benefits the body in several ways: it promotes good vision; it helps keep our immune system healthy; and it’s needed for normal bone growth and proper tooth development. While deficiencies are rare in countries like ours, they do occur and typically present with a decreased ability to see in dim light. Romaine also packs an impressive vitamin K punch, knocking off over 100
serving), this delicious green, with its incredibly high water content, keeps me hydrated, happy and full.
Helpful tips Choose crisp, compact heads of romaine lettuce that are free of holes or discoloration. To help romaine last longer in the fridge: cut off the core, separate the leaves, wash it, pat it dry, then wrap it with paper towels to remove excess moisture. Store away from ethylene-producing fruits, such as apples, bananas and pears, since they will cause the leaves to turn brown. Limp leaves can be revived by immersing them in ice water for a few minutes.
Charred Romaine with Gorgonzola and Toasted Pecans percent of our daily needs with just a few cups. Vitamin K, which helps blood clot properly, is a key ingredient in maintaining strong, healthy bones. As a middle-aged boomer with budding osteoporosis, I’m always looking for foods that will fortify my bones. I also reach for romaine because it’s a decent source of two more vital nutrients: folic acid (a B vitamin that reduces the risk of birth defects and may reduce the risk of heart disease and stroke) and heart-healthy fiber (2 grams per serving). Romaine is not only my go-to “clean” food during January, it’s also my yearlong salad staple. Remarkably low in calories (only 15 per average
Adapted from Bon Appetit Serves 4 3 cups crumbled Gorgonzola cheese ½ cup light mayonnaise ½ cup plain yogurt ¼ cup water 1 to 2 cloves garlic, minced ¼ teaspoon hot pepper sauce (optional) 2 heads of romaine lettuce, outer leaves removed, halved lengthwise 1 to 2 tablespoons olive oil Kosher salt ½ cup pecan halves, toasted, coarsely chopped Blend 1½ cups cheese, mayonnaise, and yogurt in food processor. Add 1/4 cup water, garlic and hot pepper sauce;
blend until smooth. Season with salt and pepper. (Can be made 1 day ahead. Cover; chill. Whisk before using.) Prepare grill for medium-high heat. Drizzle cut sides of romaine with oil; season with salt. Grill, cut side down, until charred, about 3 minutes. Turn and grill just until warmed through, about 30 seconds. Place romaine on plate, charred side up, and drizzle dressing over lettuce. Sprinkle with pecans and remaining cheese. 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 • January 2015
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Eat Well to Feel Well
FREEDOM FROM KNEE AND HIP PAIN...
By Deborah Jeanne Sergeant
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any people take prescription pills to treat health issues; however, the food you put in your mouth is “medicine” as well. The nutrients food contains nourish our bodies’ functions — or not. Several factors play into whether or not your body gets what it needs. Understanding the healthfulness of foods represents the first step. “I believe that striving for a balanced diet along with routine exercise and adequate, restful sleep are critical to our good health,” said Ellen M. Holst, a registered nurse who serves as senior director of health and nutrition for Oswego County. “Many of us have developed habits that fly in the face of these sound practices. “Healthy eating is one of the best things you can do to prevent and control many health problems, such as heart disease, high blood pressure, Type 2 diabetes and some types of cancer.” An overall balanced diet can help support your body’s disease-fighting mechanisms. Don’t eschew any one food group. Despite the advice of fad diets, a balanced diet should include carbohydrates and sufficient protein sources. Skipping carbohydrates, for example, eliminates some good sources of B vitamins found in whole grains. In general, prepackaged foods contain the least nutrients. Check the nutrition Information panel to see what you’re getting for vitamins and minerals. Prepackaged foods usually contain much more fat and sodium than most people should eat, or the portion sizes are so small that many people overeat unknowingly. The quality of the food source also concerns Holst. “My experience tells me that fresh [produce] offers introductions to locally grown foods that do not contain salt and preservatives, known contributors to some of our chronic diseases,” Holst said. She added that though she has read that fresh produce contains the highest quantities of vitamins and min-
erals, canned produce are also good to have on hand for convenience and during the winter months. Just beware of added salt or sugar. Strain canned vegetables and shop for canned fruit packed in natural juice. Frozen produce can help you find an economical middle ground between costly off-season fresh produce and canned goods. Strive for variety in fruits and vegetables, known as “eat the rainbow” to some. “The phrase is an easy way for all of us to remember to eat a variety of fruits, vegetables and foods, fresh when possible, available naturally in many different colors, shapes and sizes,” Holst said. “Red, yellow, orange, green, blue, purple each bring different flavors, textures and health benefits.” Laurel Sterling, registered dietitian and wellness educator at Natur-Tyme in Syracuse, advises clients to occasionally try a cup of fresh juice to add nutrients to the diet. People whose medications should be taken with food should ask their doctors before replacing a meal with juice. “The nutritional benefits of juicing are immense,” Sterling said. “Juicing can pack a tremendous amount in just one delicious cup. Fresh juice, not from a bottle or concentrate, is an excellent source of vitamins, minerals, enzymes, proteins, and so much more.” She likes combinations offered at Natur-Tyme, such as lemon, orange, kiwi, and pineapple, which is “rich in antioxidants, and loaded with vitamin C,” Sterling said. Or spinach, lime, cilantro, pineapple, “a great option for those looking to decrease systemic inflammation.” Another example contains orange, carrot, and ginger, which is rich in vitamin A, “which enhances immunity, and with the addition of warming ginger it has an added benefit of being anti-inflammatory as well.” Juicing can provide a convenient means of packing more nutrients into your diet.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
In Good Health, half page (vertical):In Good Health,
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NEW YEAR’S RESOLUTIONS
What Your Doctor Wants You to Do in 2015 Losing weight and quitting smoking are on top of doctors’ wish lists for their patients By Deborah Jeanne Sergeant
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o many people, New Year’s Day represents a clean slate, an opportunity to start anew. Maybe you’d like this year to be the year you get a raise, get organized or spend more time with your family. Area doctors have a few ideas of New Year’s resolutions they would like their patients to make. Julie Colvin, a physician with St. Joseph’s Hospital Health Center, summed up many doctors’ ongoing advice: “Quit smoking, lose weight, Brodey eat healthy and be happy,” she said. Smoking negatively affects nearly every function and organ of the body. It can contribute to the development of cancers, and lung and heart diseases. Smoking also makes it harder to ward
off illness. Ife Ojugbeli, a physician with Chittenango Medical & Wellness, also wants smokers to kick the habit and to improve in other areas, too. “Have a healthy diet,” he said. “Watch what you eat.” Ojugbeli takes weight loss so seriously that the organization offers a weight loss clinic and the doctor wrote a cookbook emphasizing low-calorie dishes, and recipes with healthful substitutions, such as using low-calorie ingredients instead of full-calorie ones. Physician Mitchell Brodey with Five Towns Associates in Syracuse, echoed the other physician’s thoughts on weight control and smoking. “Smoking and being overweight and not exercising contribute to prediabetes, heart disease and pretty much every way in which you exit from this earth,” he said. It may seem like if you’ve smoked for decades it won’t make any difference if you quit now; however, the American Cancer Society states that 20 minutes after quitting, the heart rate
and blood pressure drop. Just 12 hours after quitting, the carbon monoxide level in the blood drops to normal. In only two weeks to three months after quitting, circulation improves and lung function increases. A year after quitting, the excess risk of coronary heart disease is half that of someone who continues to smoke. If you keep up the resolution, five years from now, your risk of cancer of the mouth, throat, esophagus, and bladder decrease by half. Risk of cervical cancer risk falls to that of a non-smoker. After 10 years of quitting, your risk of dying from lung cancer is about half that if you kept smoking. “These are just a few of the benefits of quitting smoking for good,” the organization’s site states. “Quitting smoking lowers the risk of diabetes, lets blood vessels work better, and helps the heart and lungs. Quitting while you are younger will reduce your health risks more, but quitting at
Resolutions Why Are They so Hard to Keep? By Deborah Jeanne Sergeant
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bout a year ago, we felt sure 2014 would be the year we’d get in shape, keep our regular doctor check-ups and kick our bad habits to the curb. Yet it’s a new year and nothing has changed. Why must we keep making the same resolutions year after year? “I think that the main reason that people don’t keep their New Year’s resolutions is that human being don’t like change,” said Shannon Rice, registered, licensed clinical social worker at Wellness Therapy Center in Syracuse. “We
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are creatures of habit. Once we get into bad habits, poor behavior patterns, it is difficult for a person to change.” She added that short-term behavior modification works, but “people often revert to unhealthy behavior because it is easier to maintain the unhealthy behavior even if you are unhappy with the consequences.” Grace Puchalski, registered licensed clinical social worker with Bright Path Counseling Center in Syracuse, thinks that people shouldn’t reserve their life changes only for Jan. 1, but should regularly “check in” with themselves on meeting goals to find better success. “As a counselor, I see the new year beginning as a time for reflection,” Puchalski said. “A regular reflection time to gauge yourself
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2015
helps you meet goals. As yourself, ‘Am I doing what I want to be doing? Am I valuing what I want to value today?’ “If you carry reflection on throughout the year, it helps.” Perhaps a reminder alarm in your phone or memo in your planner can help you remember to self-evaluate more frequently than Jan. 1 each year. For example, every day, week or month may be often enough for many resolutions. Enlisting the help of someone making a similar goal can also help you stay accountable. Some people like to go even more public with their goals by blogging or posting on social media about their progress. Whatever your goals, self-evaluation, whether public or private, can help you analyze if you’re making positive steps towards your goal. Puchalski advises people who say they “lack willpower” to avoid focusing on past failures. “The power is within to change your direction or track,” she said. “The end is in your hands. When we say it’s too hard, we’re carrying on things from past efforts into the ‘now.’” Many people say they’re too busy
any age can give back years of life that would be lost by continuing to smoke.” Brodey hopes more patients will resolve to eat less and better and exercise more. “Examine yourself and see what you want to make better and decide to do it.”
to make important lifestyle changes such as losing weight, getting organized or quitting smoking; however, Puchalski reminds clients that “every moment is busy. What will you regret later? Immediate needs will be taken care of, but what brings the lasting value?” To find better success in achieving goals, she tells clients to “marry” the logical left side of the brain with the emotional right side of the brain by staying in the moment. The logical, left side of the brain would prepare to quit smoking by planning to buy nicotine gum and throw away ashtrays and lighters. These are all important steps to take, but don’t equal guaranteed success. The emotional, right side of the brain must also “agree” to the plan. That way, in the moment of temptation, the right side of the brain will prompt the quitter to call a friend, go for a walk or take sips of water instead of buying cigarettes and lighting up. Planning to meet both the logical and emotional needs of the mind makes the difference between success and failure. It’s also important to take resolutions seriously. Listing them on a whim almost surely means failure. Physician Mitchell Brodey with Five Towns Associates in Syracuse doesn’t deny resolutions are hard to keep, but encourages patients to “decide what you will do and do it. The day before or week before New Year’s, decide how you will fit it in. Make it a priority.”
Firm Resolve What are some of our neighbors’ New Year’s resolutions? By Matthew Liptak
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n a mid-afternoon in December, I strolled the byways of a certain Syracuse megamall and talked to some of our Central New York neighbors. They were in the middle of a hectic holiday season, but they took the time to give their thoughts on the year ahead and that celebrated New Year’s tradition — the New Year’s resolution. Health is just one of the things on their minds.
these years it’s going to work.” What’s the percentage of sticking to your past resolutions? “Probably about 40. I usually lose weight at the beginning of the year. That’s until about March or April.” Do you recommend making a resolution to other people? “I do because I think if you make one, you’re more apt to stick to it.”
Randy Rome
Syracuse; retired schoolteacher
Syracuse; guitar teacher What’s your New Year’s resolution for 2015? “I’m going to continue not drinking carbonated beverages and try and get to my goal weight. What did you do for your resolution last year? “I stopped drinking carbonated beverages. I lost 75 pounds since Jan. 1. Do you think setting a New Year’s resolution is a good idea? “Sometimes it is. I try to change myself a little bit. I believe New Year’s is a good day to set a goal.”
Brenda Solada
Hannibal; Oswego County employee What’s your New Years Resolution for 2015? “It’s the same as everybody’s — lose weight and save money. That would be my two big ones.” How successful were you with your resolutions last year? “I started out really well until about March and then you fall off. They were the same resolutions. I am not giving up. One of
Carol Venner
What’s your New Year’s resolution for 2015? “I want to be kinder to people. I feel the way the world is going, people need to be befriended by other people whether you know them or not.” Have you made resolutions in the past? “Very few. It’s always been to go on a diet. Last year, I decided it doesn’t always work, so why bother with it? You need to be realistic. Dieting is realistic but there are other needs greater in the world right now.” What’s the percentage of your resolutions in the past working out? “I would say maybe a fourth of them. I don’t make a lot of them because I don’t want to break them all, but I do make a few of them.” Do you recommend making a resolution to other people? “I do. I think then it keeps them more focused. It doesn’t always have to be about food or diet that people always laugh about. I’ve decided that in this time of my life now I want to be more realistic.”
Jonathan Hall
Utica; Center for Instruction, Technology and Innovation student What is your New Year’s resolution for 2015?
Ready, Set: QUIT! By Patricia Briest
I
t’s January and that means “resolution time” for many. Getting a fresh start is rewarding, but keeping the momentum is challenging.. To quote Elbert Einstein, “Quitting smoking is easy. I’ve done it hundreds of times!” If you are determined to quit tobacco use, good for you. Persistence does pay off in this case, since every time a person tries to quit but is not successful in the long run, they learn what does and does not work for them. If you
have never tried to quit, you may be wondering how to start. The most successful way to quit smoking is to plan ahead. Talk to your doctor and decide if a medication or nicotine replacement product might work for you. You may call the N.Y.S. Smoker’s Quitline for free quit coaching or nicotine patches. The toll free number (1-866-697-8487) can provide you with a skilled quit coach who can guide you through the process.
Laura Raymond of Cicero
“I find myself unable to keep up with my heating bill and now I’m living without heat. I tried to see if I could get some assistance with that and everybody just gives me a cold shoulder. I thought maybe I should write about it to the local paper and see how many people like myself are experiencing that. That’s what I think I’m planning on doing. I will also continue to go to school parttime.” Do you advise people to have New Year’s resolutions? Do you think they’re good? “Yeah. It’s a good thing to start because at least you have a goal — a direct purpose that you have. Once you stay on that path, it could open up more avenues for you. I think it’s a very good thing to start because some people are going into the new year blank. They don’t know where they are going or what they will be doing. If you have something you are focusing on, when you get to that point you’ll find there are a lot more avenues open for you.”
Laura Raymond
Cicero; Wegmans employee
Learn your triggers: when do you light up, and why? Is it routine and automatic or do you really crave a cigarette? Is there something that causes you to want to smoke — perhaps gathering with others who smoke or being in a particular place where smoking is permitted? Once you learn your triggers, you can plan to avoid those triggers, or develop a plan to do something other than smoke when the “habit” component kicks in. Many people find that they need a nicotine replacement product or prescription medication to help them quit. Your doctor can help you make that decision. Nicotine replacement products and medications to help you quit are January 2015 •
What’s your New Year’s resolution for 2015? “I’m trying to get into a healthier routine — going to the gym, getting more exercise, eating healthier, drinking less coffee. It’s expensive to buy it and sometimes it can get stressful too when you drink too much coffee. Do you recommend having a resolution to other people? “I do because if you set a goal for the year, even if you don’t accomplish it, if you made an effort to try to accomplish the goal, actually made a legitimate effort, it shows discipline. That’s the way I look at it.” What’s your percentage for succeeding do you think? “I almost made it to my goal weight. I tried to get to 190, but I’m happy that I lost the weight. It encouraged me. I’m not going to give up and I’m going to continue to not drink carbonated beverages. I don’t even drink diet soda because they’ve done studies that drinking diet is like drinking regular. It slows down your metabolism. I was told that.” Is it a good idea to set a New Year’s resolution? “I think it is and I think sometimes even before New Year’s, you should get your ideas settled up in your mind with what you want to do and try to get a plan going. I think it’s a good way to stay inspired. What’s your percentage for success with New Year’s resolutions? “I don’t know, 80 percent maybe.”
approved by the Federal Drug Administration (FDA) and developed to help smokers quit. Seek out others who are in the process of quitting smoking and offer support to one another. This is one resolution that is worth keeping — and may give you many more years to ring in the New Year. Patricia Briest is a family nurse practitioner with a certificate of advanced study in nursing education. She is a manager with St. Joseph’s Hospital Health Center’s cardiopulmonary rehabilitation and outpatient diabetes services.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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PROFILE
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here is power in numbers. Just ask Daniel Nave, who was recently elected and installed as the 187th president of the Onondaga County Medical Society. Founded in 1806, the society’s membership includes 1,228 physicians and 348 medical students. Nave also is president of the Greater Syracuse Labor Council, AFL-CIO, which is over 100 years old. As leader of the council for over seven years, he represents 40,000 working families. While representing thousands of healthcare professionals and consumers throughout Central New York, Nave is well armed to make change happen on the community and legislative levels. Nave, 59, specializes in family medicine at Family Medicine Associates in Cicero. He has been practicing medicine for more than 33 years. Nave is truly a homegrown physician. He is the youngest of three children in a family of Italian descent. He and his wife Ann raised their five children while residing in Syracuse. With the children grown, the couple recently downsized to a smaller house in Jamesville. Nave graduated from Syracuse city schools, Syracuse University and earned his medical degree at SUNY Upstate Medical University. He accomplished his residency in family practice at St. Joseph’s Hospital Health Center, Syracuse. The Jamesville resident was appointed to the medical society’s executive board about 10 years ago. “I am just like any other physician that serves in these positions,” Nave said. “There are concerns about community issues that need to be addressed and we are willing to donate time and energy into this.” Nave said the No. 1 mission of the medical society is to advocate for physicians’ positions in the community in order to best serve patients. Among Nave’s primary job duties is to oversee the agenda that goes before the governing body at every meeting. He appoints people to take on certain roles that help drive the medical society’s mission. He meets with community leaders and anyone who has issues relating to the delivery of healthcare in Onondaga County. Nave said the main focus for the medical society is access to adequate medical care. “Our community and nation as a whole are going through a lot of changes with the Affordable Care Act,” he said. “There is going to be more emphasis on preventive medicine and making sure we have adequately trained physicians.” An issue that has become paramount is dealing with infectious diseases such as Ebola. Nave said there is emphasis on making sure hospitals are prepared and medical staff is trained to deal with infectious diseases. “We need to take the proper precautions in our emergency rooms and urgent care centers to do what is necessary to address the issue so we don’t have any debacles like what happened down in Texas,” he said.
Physician recruitment
Nave said one of the ongoing Page 16
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community members and organizations that see problems in the delivery of healthcare in Central New York. Nave said he understands the ins and outs of the medical society. He is a primary care physician himself and often interacts and works with other various specialties. As president of the medical society, Nave is assessing what community needs are as well as what physicians can do to better serve patients throughout Central New York. “We want to make sure all children receive proper healthcare, and want to look at mortality and morbidity rates among infants. We want to look at minorities to see whether they are getting adequate medical care that they deserve,” he said. “These are just some of the issues that are important and have influenced my life and why I want to be involved in leadership and taking a position to help the medical society,” he said.
Where are the youth?
Homegrown Doc New Onondaga County Medical Society president deeply rooted in Syracuse area By Lou Sorendo problems for many years has been the retention of physicians in Central New York. “This is not an easy area to recruit physicians,” he said. “This is also an area where we have a medical school and several residency programs, but yet most of these doctors who train in Central New York do not stay in Central New York,” he added. He said many of them are being trained at taxpayer expense at SUNY Upstate Medical University, yet taxpayers of the community and state do not reap any benefits. “Retention is a big problem, and the medical society does have student and resident representatives who try
to reach out to students and residents about who we are and what we do,” he said. “We have a commitment to the community and would like to see as many stay here as possible, especially in the area of primary care,” Nave said. He said one of the cornerstones of the ACA is to establish an adequate level of primary care, something that is critically lacking in Central New York. “The main goal is to get out there in the community and let everyone know who we are, what we are and what our mission is,” he said. Nave said the medical society’s purpose is not solely to serve physicians, but also to interact with other
“This is not an easy area to recruit physicians. This is also an area where we have a medical school and several residency programs, but yet most of these doctors who train in Central New York do not stay in Central New York.”
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2015
In terms of challenges, Nave said it is extremely difficult to get young people involved today. “It’s very hard to get them to be passionate about things. We have a new generation that is more connected through the Internet and social media,” he said. “These are different forms of communication than what I grew up with. Baby boomers got their news differently and communicated differently. We were more used to face-to-face interaction,” Nave said. “Young people have different ways of meeting and there doesn’t seem to be quite the interest or passion right now. Maybe there isn’t enough of a fire or enough of an issue to get involved in organized medicine.” Nave said this issue not only applies to medicine, but “anything in general.” He said getting younger people engaged in any type of organization that deals with community problems is the No. 1 challenge. “One of the things that I enjoy is actually listening to other people and finding out what their issues are,” he said. “You find that these are issues not unique to yourself.” He said by listening to other ideas, it gives one a chance to incorporate that into his or her practice. “Just thinking out loud and putting our heads together and asking, ‘What can we do to make our community better? Let’s identify what the problems are,’” he said. Nave succeeds David Halleran as the organization’s president.
Lifelines: Birth date: March 23, 1955 Birthplace: Syracuse Current residence: Jamesville Education: Undergraduate, Syracuse University; medical degree, SUNY Upstate Medical University, Syracuse (1981); residency in family practice, St. Joseph’s Hospital Health Center, Syracuse Affiliations: American Diabetes Association; fellow, American Academy of Family Physicians Personal: Wife Ann, five children Hobbies: Model railroading
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honored for performing selfless acts to help others in need. Upstate’s Chief Nursing Officer Nancy Page recently spoke with Tilbe about the accident. She says that Tilbe felt that she didn’t do anything that any other health care provider wouldn’t have done. “But we don’t all do the same thing, do we,” said Page. “We don’t all stop when we might be able to provide help and we need to recognize that. Shannon Tilbe did stop and clearly made a difference in this young woman’s survival.” Upstate recently honored Tilbe as a hero by presenting her with a certificate of appreciation. Tilbe came to Upstate University Hospital as a traveling nurse before signing on permanently in September 2013 as a 6B staff nurse at Upstate’s downtown campus.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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sands of women with no FMLA coverage and no maternity leave. That should embarrass lawmakers in the United States. The fact that even those who qualify for FMLA get no financial gain from it should further embarrass them. Maternity laws do vary by state. In New York, most mothers (with fulltime jobs) qualify for New York state disability for six or eight weeks postpartum. However, this dismal amount of money doesn’t go very far when caring for a newborn. I will be frank and share that I bought home about $160 a week from New York state for a total of five weeks. That’s better than nothing, but that barely covers groceries and household goods for the week. Some mothers aren’t even eligible for this sum. I am lucky enough to have supplemental short-term disability through my employer. However, I couldn’t collect either insurance for the first week I was out of work, and then received payments for five weeks. I also had
Parenting By Melissa Stefanec melissa@cnyhealth.com
The United States— a Third-world Nation
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am being a little bit dramatic with this headline, but unfortunately, regarding one aspect, it isn’t far from the truth. I am just finishing my maternity leave. In a few short weeks, I will do the unthinkable: I will drop my baby off at daycare. I will leave a baby who depends on me for everything with someone else. Even though that person is already caring for and loving my daughter, and I know I can depend on her and trust her, it will still be very difficult to give my 10-week-old son to a new primary caregiver. As a mommy, I feel like that is my job. It may sound like I am complaining that I am not able to be a stay-athome mom, but that isn’t the case. I’m a type-A personality and a go-getter. My job is a very important part of my identity, and I wouldn’t want to stop working. However, I want (borderline need) more maternity leave. I am lucky enough to work for a progressive and understanding employer, but almost no employer can trump the lack of federal regulations and financial support. As a nation, the United States does a terrible of job of providing for new parents. We are one of only four countries in the entire industrial world that doesn’t mandate paid maternity leave. That puts us in a class with Swaziland, Lesotho and Papua New Guinea. We rank behind 185 other nations and territories. Something that the rest of
I am just finishing my maternity leave. In a few short weeks, I will do the unthinkable: I will drop my baby off at daycare. the world sees as a social necessity is overlooked by most of our lawmakers. The only thing keeping some new moms sane is the Family Medical Leave Act (FMLA). It was enacted in 1993, and it gives mothers the option to take up to 12 weeks of unpaid leave to care for their newborns. Fathers can do the same, but almost none do because of the attached stigma or financial reasons. However, the FMLA doesn’t cover every mother. According to the Department of Labor, a mother has to meet the following criteria to be eligible: have worked for that employer for at least 12 months; have worked at least 1,250 hours during the 12 months prior to the start of the FMLA leave; and work at a location where at least 50 employees are employed at the location or within 75 miles of the location. That leaves thousands and thou-
to spend the summer paying for my health insurance and flexible spending for daycare for the time I would be out, which left with me with about half pay for the bulk of the summer. I am not writing about this topic to smear my employer — far from it. I have a great employer and am luckier than most working mothers. I am writing to smear our federal government and its approach to working mothers and fathers. In an age of supposed equality for women, it’s outdated and ignorant to not have a more progressive maternity and paternity leave policy at the federal level. It’s inexcusable. If the politicians in charge
want to shove any social issue into the spotlight, it should be one that actually affects the livelihood of anyone who chooses to reproduce. It’s time to start talking about maternity and paternity benefits. Addressing this topic would have long-lasting positive benefits for American families. As both Republicans and Democrats reproduce, such reforms should have bipartisan support. Not only do mothers return to work financially drained because of the lack of maternity leave, women also return physically and emotionally depleted. We shouldn’t need a scientific study to prove that women who return to work after a measly six or 12 weeks of maternity leave have higher rates of post-partum depression, but a recent study — published online in the Journal of Health Politics, Policy and Law, used data from the Maternal Postpartum Health Study conducted by the Minnesota School of Public Health — proved this obvious idea. Returning to work also poses hardships on women who want to continue breastfeeding. Breastfeeding is proven to provide multiple physical and mental health benefits to baby and mother. Why wouldn’t our government want to support policies that promote that? It’s time to start a national conversation. I have to believe that if the United States were worse than almost any other nation in the world in regards to any other topic, there would be a huge public outcry. Where is the public outcry on this matter? Write your government representatives at the state and federal level. Make phone calls. Start a barrage of social media posts. Start conversations. Your tax dollars have to go somewhere. Send them to the sweetest little faces in the country and give every one of those faces a better start.
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Hyperemesis Gravidarum: More Than Morning Sickness By Deborah Jeanne Sergeant
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he former Catherine Middleton, Duchess of Cambridge, has brought hyperemesis gravidarum again into the spotlight with her second pregnancy. With each of her pregnancies, the royal mum has experienced what’s commonly known as “severe morning sickness.” Although caused by pregnancy, hyperemesis gravidarum represents far more than the run-of-the-mill morning sickness most women suffer as their hormones elevate for pregnancy. Regular morning sickness causes moderate nausea and sensitivity to odors and flavors for all or part of each day, and not necessarily in the morning. Going on an empty stomach or eating foods MacBlane poorly tolerated can cause vomiting. Patients with hyperemesis gravidarum vomit up to 50 times per day and can become debilitated. Doctors are not certain as to why some women have hyperemesis gravidarum. Only about one-half to 2 percent of pregnant women experience it. “Children of mothers who had hyperemesis are five times more likely to have it when they are pregnant, but [it’s] not thought to be hereditary but more due to shared environment,” said Luis Castro, OB/GYN with St. Joseph’s Hospital Health Center.
Diagnosis includes checking for signs of dehydration and the frequency of vomiting. Physicians can test for ketones in the urine, which indicate the body is breaking down its own stores of fat and its muscle for survival. The earlier women start treating hyperemesis gravidarum, the more likely they are to minimize its effect. Taking a prenatal vitamin before pregnancy can, in general, reduce nausea. Beginning with conservative treatment, Jennifer MacBlane, certified nurse midwife with Syracuse Midwives, first suggests that clients try what helps ordinary morning sickness, such as eating small, frequent meals, eating before rising from bed, and sticking with bland foods. She often tells them to “get calories in liquids, so you won’t have reflux. Avoid acidic foods, but eat whatever doesn’t bother you. Look at your diet in a week’s time, not in a day’s time.” For example, if carbohydrates work on Monday, but don’t on Tuesday, it’s OK since by the end of the week, the diet is likely Castro balanced. “As long as we can get some calories and fluids in, they outgrow it by next trimester and do pretty well,” MacBlane said. Some women find relief in taking doctor-recommended vitamins. Doc-
tors can also prescribe anti-nausea medication. “Vitamin B6 and anti-nausea meds like Metocloperaminde or Zofran may help the symptoms,” Castro said. Intravenous fluids and nutrients can also help hospitalized patients recover. Thankfully, hyperemesis gravidarum doesn’t harm baby. “There is no evidence of harm to mom or baby long-term,” Castro said. “Short term [it causes] dehydration of mom in severe cases.” Many women tolerate sweet or salty things, in addition to bland foods like crackers, plain noodles and oatmeal. A few tolerate sour foods. In general, most women better tolerate bland food than dairy, seasoned, spicy, green or fatty foods. Women who aren’t coping well at home may need to be admitted to the hospital to receive intravenous fluids and nutrition and for observation. Some patients need IV help so frequently throughout their bout with hyperemesis gravidarum that they opt for a peripherally inserted central catheter (“PICC line”), an IV inserted into the arm that travels between the heart and junction in the shoulder. “Every pregnancy is different,” MacBlane said. “They shouldn’t assume the next pregnancy will be like this. Some people with hyperemesis have something else going on, like twins. It’s good to follow up with your provider to figure out why this is happening, if possible.” By 15 to 20 weeks of pregnancy, hyperemesis gravidarum ends for 90 percent of women.
The Pill Remains Most Common Method of Birth Control But long-acting IUDs are gaining in popularity, experts note
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he pill remains one of the most popular methods of birth control for women, along with female sterilization and condoms, a new report shows. Among the two-thirds of women aged 15 to 44 who used birth control between 2011 and 2013, approximately 16 percent used the pill. Female sterilization, where women have their fallopian tubes closed or blocked, was used by 15.5 percent of women, while 9.4 percent used male condoms, according to the report published Dec. 11 by the U.S. National Center for Health Statistics (NCHS). But intrauterine devices (IUDs) and implants, both types of long-acting reversible contraceptives, are close on the heels of these other forms of birth control, with 7.2 percent of women using them. “Use of long-acting reversible contraceptives is becoming more popular,” said report author Kimberly Daniels, of the NCHS. Their use has nearly doubled since the last report on findings from five years earlier, when approxi-
mately 3.8 percent of women were using them, Daniels said. The most popular long-acting reversible contraception is the IUD, used by 3.5 percent of women in 2006 to 2010 and by 6.4 percent of women in 2011 to 2013, according to Daniels. The IUDs available in the United States include two hormonal versions, Mirena and Skyla, and one containing copper, ParaGard. This increase in long-acting reversible contraception has followed changes in guidelines by leading health care organizations that now recom-
mend their use to younger women and those without children, said Laura Lindberg, a senior research associate at the Guttmacher Institute. When IUDs came out years ago, there were concerns they might raise the risk of pelvic infection and jeopardize a woman’s fertility. But IUDs currently on the market don’t carry those risks, according to the American Academy
of Pediatrics. The academy now recommends these contraception devices as the first option for teens. January 2015 •
Fruit Flies with Better Sex Lives Live Longer Can sexual frustration be bad for your health? Male fruit flies that expected sex — and didn’t get it — experienced serious health consequences and aged faster
S
ex may in fact be one of the secrets to good health, youth and a longer life — at least for fruit flies — suggests a new University of Michigan study that appears in the journal Science. Male fruit flies that perceived sexual pheromones of their female counterparts — without the opportunity to mate — experienced rapid decreases in fat stores, resistance to starvation and more stress. The sexually frustrated flies lived shorter lives. Mating, on the other hand, partially reversed the negative effects on health and aging. “Our findings give us a better understanding about how sensory perception and physiological state are integrated in the brain to affect longterm health and lifespan,” says senior author Scott D. Pletcher, Ph.D, professor in the department of molecular and integrative physiology at the U-M Medical School and research professor at the U-M Geriatrics Center. “The cutting-edge genetics and neurobiology used in this research suggests to us that for fruit flies at least, it may not be a myth that sexual frustration is a health issue. Expecting sex without any sexual reward was detrimental to their health and cut their lives short.” U-M scientists used sensory manipulations to give the common male fruit fly, Drosophila melanogaster, the perception that they were in a sexually rich environment by exposing them to genetically engineered males that produced female pheromones. They were also able to manipulate the specific neurons responsible for pheromone perception as well as parts of the brain linked to sexual reward (secreting a group of compounds associated with anxiety and sex drive). “These data may provide the first direct evidence that aging and physiology are influenced by how the brain processes expectations and rewards,” Pletcher says. “In this case, sexual rewards specifically promoted healthy aging.” Fruit flies have been a powerful tool for studying aging because they live on average 60 days yet many of the discoveries in flies have proven effective in longer-lived animals, such as mice.
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Q: I’m creating my budget for 2015. How much will my benefit increase at the beginning of the year? A: The monthly Social Security and Supplemental Security Income benefits for nearly 64 million Americans will increase by 1.7 percent in 2015. This annual cost-of-living adjustment (COLA) is tied to the Consumer Price Index as determined by the Department of Labor’s Bureau of Labor Statistics. This New Year, you can enjoy your COLA starting in January. Q: I’d like to change the healthcare coverage that I signed up for through Healthcare.gov. How can I do that? A: The open enrollment period for Affordable Healthcare coverage takes place from Nov. 15, 2014 to Feb. 15, 2015. During this four-month period, you can enroll in a new plan or change current plans using the Affordable Care Act’s Marketplace. To continue health coverage in 2015, simply renew the current health plan or choose a new plan through the Marketplace between now and Feb. 15, 2015. Once the open enrollment deadline passes, the only way to get coverage for 2015 is to qualify for a “Special Enrollment Period” due to a qualifying life event as specified by HealthCare.gov. You have four months to decide what type of coverage you want, but the sooner you act, the sooner you will enjoy the security of affordable healthcare. Q: I went back to work after retiring, but now the company I work for is downsizing. I’ll be receiving unemployment benefits in a few weeks. Will this affect my retirement benefits?
A: When it comes to retirement benefits, Social Security does not count unemployment as earnings, so your retirement benefits will not be affected. However, any income you receive from Social Security may reduce your unemployment benefits. Contact the state unemployment office for information on how your state applies the reduction to your unemployment compensation. Q: I was wounded while on military service overseas. What are the benefits for wounded warriors, and how can I apply? A: Through the Wounded Warrior program, Social Security expedites processing of disability claims of current military service members or veterans disabled while on active duty on or after Oct. 1, 2001. Also, service members and veterans who have a Veterans Administration compensation rating of 100 percent Permanent and Total (P&T) may receive expedited processing of applications for Social Security disability benefits. Keep in mind, this expedited process applies to only the application for benefits. To be eligible for benefits, you must meet Social Security’s strict definition of “disability,” which means: • You must be unable to do substantial work because of your medical condition(s); and • Your medical condition(s) must have lasted, or be expected to last, at least one year or to result in death. You can apply online at www. socialsecurity.gov/applyfordisability or call our toll-free number, 1-800-7721213 (TTY 1-800-325-0778). You can find more information for veterans at www.socialsecurity.gov/ people/veterans.
H ealth News By Jim Miller
How to Improve Your Balance as You Age Dear Savvy Senior, I’ve always been a walker, but when I fell last month my doctor suggested I start doing some balance exercises. Is this really something I need to practice? What can you tell me? Avid Walker Dear Walker, Most people don’t think much about practicing their balance, but you should, the same way that you walk to strengthen your heart, lungs and overall health, or you stretch to keep your body limber.
As we age, our balance declines — if it isn’t practiced — and can cause falls. Every year more than one in three people age 65 years or older fall, and the risk increases with age. A simple fall can cause a serious fracture of the hip, pelvis, spine, arm, hand or ankle, which can lead to hospital stays, disability, loss of independence and even death.
How Balance Works
Balance is the ability to distribute your weight in a way that enables you to hold a steady position or move at will without falling. It’s determined by a complex combination of muscle strength, visual inputs, the inner ear and the work of specialized receptors in the nerves of your joints, muscles, ligaments and tendons that orient you in relation to other objects. It’s all sorted out in the sensory cortex of your brain, which takes in the information from those sources to give you balance. But aging dulls our balance senses and causes most seniors to gradually become less stable on their feet over time. Poor balance can also lead to a vicious cycle of inactivity. You feel a little unsteady, so you curtail certain activities. If you’re inactive, you’re not challenging your balance systems or using your muscles. As a result, both balance and strength suffer. Simple acts like strolling through a grocery store or getting up from a chair become trickier. That shakes your confidence, so you become even less active.
Balance Exercises
If you have a balance problem that is not tied to illness, medication or
some other specific cause, simple exercises can help preserve and improve your balance. Some basic exercises you can do anytime include: • One-legged stands: Stand on one foot for 30 seconds or longer, then switch to the other foot. You can do this while brushing your teeth or waiting around somewhere. In the beginning, you might want to have a wall or chair to hold on to. • Heel rises: While standing, rise up on your toes as far as you can. Then drop back to the starting position and repeat the process 10 to 20 times. You can make this more difficult by holding light hand weights. • Heel-toe walk: Take 20 steps while looking straight ahead. Think of a field sobriety test. • Sit-to-stand: Without using your hands, get up from a straight-backed chair and sit back down 10 to 20 times. This improves balance and leg strength. For additional balance exercises visit go4life.nia.nih.gov, a resource created by the National Institute on Aging that offers free booklets and a DVD that provides illustrated examples of many appropriate exercises. You can order your free copies online or by calling 800-222-2225. Some other exercises that can help improve your balance and flexibility is through tai chi and yoga. To locate a beginner’s class in your area that teaches either of these disciplines, call your local senior center, health club or wellness center, check your yellow pages or try online directory sites like americantaichi.net and yogafinder.com. If nothing is available near you, there are DVDs and videos that offer tai chi and yoga instructions and routines for seniors that you can do at home. Some good resources for finding them are amazon.com, collagevideo.com and iefit.com, or check with your local public library. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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.
Lymphatic USA opens in Liverpool Lorraine Sanderson, owner of Lymphatic USA, has opened a new location at Family Chiropractic Center, 7550 Oswego Road in Liverpool. Lymphatic USA specializes in manual lymph drainage, which aids the lymphatic system functions. The lymphatic system is a vital circulatory and immune regulating system of the body. It removes large molecules and toxins from the tissue spaces that cannot fit back into the blood capillarSanderson ies, and produces antibodies that protect the body from diseases. Usually the lymphatic system becomes sluggish due to lifestyle, diet, environmental effects and aging. Manual lymph drainage (MLD) is a light manual skin therapy that helps the lymphatic system to promote optimal health and cell rejuvenation. In the process, the therapist uses hands to provide a gentle rhythmic light touch directed on the lymphatic vessels located in the skin and below. When applied correctly, MLD assists to move the lymph fluid forward which cleanses tissue spaces of waste, swelling and pain and stimulates cell rejuvenation as you relax. According to Sanderson, some of the benefits of MLD include relief from pain, reduction of swelling, increased rate of healing and stimulation of cell rejuvenation. Sanderson is a licensed massage therapist and manual lymphatic drainage certified therapist. She has a 16-year background in healthcare, cytology and microscopy with a bachelor’s degree in science from Cornell University and a bachelor’s degree in cytotechnology from SUNY Upstate Medical University. She graduated from the Onondaga School of Therapeutic Massage, Syracuse, in 2013 and has certification in manual lymphatic drainage / MLD from the Academy of Lymphatic Studies.
Crouse Hospital’s Sleep Center reaccredited The Sleep Center at Crouse Hospital has been reaccredited by the American Academy of Sleep Medicine (AASM). The reaccreditation is good for five years. “We are very proud of the Sleep Center for once again fulfilling the high standards required for receiving AASM accreditation,” said Stephen Alkins, medical director. “Our efforts to achieve accreditation have been significant and reflect commitment to our patients that suffer from sleep disorders as well as to the complex field of sleep January 2015 •
medicine.” To receive a five-year accreditation, a sleep center must meet or exceed all standards for professional healthcare as designated by the AASM. The accreditation process involves detailed inspection of a center’s facility and staff, including an evaluation of testing procedures, patient contacts, physician advanced credentialialing in sleep medicine and polysomnographer credentials. The facility’s goals must also be clearly stated and include plans for positively affecting the quality of medical care in the community it serves.
Oswego Health has new director of physician recruitment Oswego Health has named Christopher Mitchell as its new director of physician recruitment. In this position, Mitchell will develop and implement strategies that assist in retaining and attracting new physicians to the health system. In recent years, Oswego Health through its renewed physician recruitment program has welcomed physicians in specialties needed within the community, including otolaryngology, orthopedics, Mitchell general surgery and primary care, to name a few. Mitchell most recently worked in similar positions in both the greater Washington D.C. area and in southeast Virginia. In his most recent position, as director of program management and business development for a multi-specialty medical group, he assisted in the recruitment of more than 30 physicians. Mitchell previously served as the manager of patient care for surgical services at Children’s Hospital of The King’s Daughter, which is the largest children’s hospital in Virginia. At the 206-bed hospital, he oversaw a $26 million budget and was also responsible for his department’s strategic planning, as well as other business-related duties. Mitchell has also worked for the fourth largest health system in Virginia, the Bon Secours Virginia Health System, where he served as the lead analyst for service line strategic planning. Mitchell earned his undergraduate degree from SUNY-Oswego and his masters of business administration (MBA) from Union Graduate College, which offers a unique MBA program that specializes in healthcare. Mitchell, an Oswego native, said the position gives an opportunity to return home and work in an exciting job his chosen field. “I see this as an opportunity to make an impact on my home community, using my vast experience and my personal knowledge of the Oswego service area,” he said. “Oswego Health has invested and developed
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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H ealth News many resources to attract exceptional physicians to the community and I am proud to become a part of this growth.�
says Joseph Battaglia, medical director for cardiac services at Crouse.
Mina appointed to executive Crouse get accreditation for position at St. Joe’s heart failure Crouse Hospital has received full Cycle I Heart Failure Accreditation status from the Society of Chest Pain Centers. Only 75 hospitals in the United States have received this recognition. Crouse also is a nationally accredited chest pain center by the society and was the first hospital in New York state to receive dual heart failure and chest pain accreditation.

 Heart failure is a leading cause of morbidity and mortality in the United States. Approximately five million patients in the United States have heart failure. In addition, heart failure patients are responsible for 12 to 15 million physician office visits per year and 6.5 million hospital days.
 
The goal of the Society of Chest Pain Centers is to help facilities manage the heart failure patient more efficiently and improve patient outcomes. Crouse Hospital has demonstrated its expertise and commitment to quality patient care by meeting or exceeding a wide set of stringent criteria and completing on-site evaluations by a review team from the Society of Chest Pain Centers. Crouse’s protocol driven and systematic approach to patient management allows physicians to reduce time to treatment, and to risk-stratify patients to decrease length of stay.
 “This latest designation, coupled with our chest pain accreditation, underscores Crouse’s continued commitment to providing the very best diagnostic and interventional cardiac care to Central New York patients,�
St. Joseph’s Hospital Health Center has appointed Anthony G. Mina to the position of executive operations officer at the hospital’s Acute Care Enterprise. This position was created to support our growing physician enterprise. Mina brings with him 23 years of successful senior level experience managing multi-specialty/ multi-site physician practices. Most recently, Mina was the executive director of Upstate Health Providers, Mina P.C. at Upstate University Health System where he corporately, organizationally and financially reengineered captive PC by realigning and structuring the hospital based services and freestanding owned or contracted ambulatory medical practices. “We are pleased to have Anthony join our organization,� said physician Sandra Sulik, vice president for medical affairs. “His knowledge of hospital operations and interdisciplinary patient care models will help us implement changes that will not only improve quality but also increase our revenue and reduce costs, thereby strengthening our ability to meet our mission.� Mina will work with Sulik to expand revenue cycle opportunities for employed physicians through new practice models, and improving clinical
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documentation and billing procedures. A resident of Liverpool, Mina earned a Master of Business Administration and healthcare management degree from The University of Phoenix and a bachelor’s degree in professional studies, School of Business Management from Clarkson University.
Allard credits the dedicated and skilled staff with the company’s ability to rank as one of the HomeCare Elite. In order to be considered for the HomeCare Elite designation, an agency must be Medicare-certified and have data for at least one outcome in Home Health Compare. Out of 9,996 agencies considered, 2,501 are elite.
St. Joe’s Home Health Care among top 25%
Crouse receives grants from the March of Dimes
St. Joseph’s Hospital Health Center’s Certified Home Care (CHHA) agency announced that it has been named to the 2014 HomeCare Elite, a compilation of the top-performing home health agencies in the United States. Now in its ninth year, the HomeCare Elite identifies the top 25 percent of Medicare-certified agencies and further highlights the top 100 and top 500 agencies overall. Winners are ranked by an analysis of performance measures in quality outcomes, best practices implementation, patient experience, quality improvement and consistency, and financial performance. In addition to St. Joseph’s Hospital Heath Center CHHA, St. Elizabeth Certified Home Care, Oswego Health Home Care, Inc., and Lewis County General Hospital CHHA made the HomeCare Elite Top 25 list. “The hard work and dedication of the entire team at the home care agency proves to be our biggest asset as we strive to improve quality of care allowing the agency to provide a positive impact and improved quality of life to the patients we serve,� said Melissa Allard, director of patient services at St Joseph’s Hospital Health Center’s CHHA. Allard has been providing consultation and management services to these other agencies to improve quality, financial and regulatory issues.
Premature births and postpartum depression are two serious conditions that present significant health risks to mothers and infants in our community. In an effort to address these important issues, the March of Dimes Central New York Division recently awarded grants to Crouse Hospital totaling $11,500. The largest grant, $10,000, is for Crouse Hospital’s childbirth education team to integrate the March of Dimes’ “Healthy Babies are Worth the Wait� campaign into current programs and in Crouse Spirit of Women education events. Crouse will use funds from the second grant to increase education and awareness of postpartum depression symptoms and warning signs. The program will target Crouse staff and physicians and many of its community partners. In the past two decades, the United States has seen a 30 percent increase in preterm births, reaching an all-time high of 12.8 percent in 2006. For pregnant women, the Healthy Babies are Worth the Wait program offers information on why getting to at least 39 weeks is so important. For professionals, it encourages quality improvement initiatives aimed at preventing premature birth. “The last few weeks of pregnan-
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cy are really important in a baby’s development,” says Barbara Miller, director of Women and Infant Services at Crouse Hospital. “Major organs, like the brain, lungs and liver, are still growing. Eyes and ears are developing,
and the baby is learning to suck and swallow. At least 39 weeks of pregnancy gives a baby all the time he or she needs to grow before birth.”
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Physician John McCabe, chief executive officer of Upstate University Hospital in Syracuse, has been named to the Becker’s Hospital Review’s list of 100 physician leaders of hospitals and health systems in 2014. McCabe’s inclusion on the list reflects his healthcare experience, accolades and his commitment to quality care, according to Becker’s. It is the fifth time McCabe has been recognized by Becker’s in recent years. Most recently, McCab McCabe has overseen the hospital’s Ebola planning as Upstate was designated by New York Gov. Andrew Cuomo as one of only eight hospitals in the state that would be equipped to receive an Ebola patient if treatment was necessary in the Syracuse area. Under McCabe’s leadership, Upstate designed, built and opened the 90,000 square foot Upstate Cancer Center that brings most of Upstate’s outpatient cancer services under one roof. Additionally the center is
equipped with some of the most advanced treatment technology for cancer in the state. Additionally, McCabe oversaw Upstate’s acquisition of Community General Hospital, creating the largest hospital in Syracuse. Since the acquisition in 2011, Upstate has introduced new services at what is now called its Community Campus, including a geriatric emergency room, transitional care unit and pediatric after hours care, among other services. McCabe has provided leadership for the implementation an electronic medical record system that enables Upstate’s patients—both inpatients and outpatients—to access their medical records through smart phones, tablets and home computers. Epic, Upstate’s electronic medical record vendor, recognized Upstate for having one of the most successful implementations. McCabe’s national leadership positions include service on the board of directors of the American Board of Medical Specialties, the organization that oversees the certification of physician specialists in the United States. In addition to his role as hospital CEO, McCabe serves as senior vice president for hospital affairs at Upstate Medical University. McCabe resides in Cazenovia.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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It’s in your breast interest to get your Mammogram today Come to St. Joseph’s Imaging North Medical Center • Genesee Medical Center Northeast Medical Center • Medical Center West Radisson Health Center • River Vista Medical Center • Oswego
To schedule call 315-452-2004 www.stjosephsimaging.com Page 24
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2015