in good February 2015 • Issue 182
Crouse’s New Chief Medical Officer Physician Seth Kronenberg picking up where his dad — former Crouse CEO Paul Kronenberg — left off
Teen Driving
Study: Half of teen, young adult car crash deaths involve pot or alcohol.
BLOOD TYPE People whose blood type is A, B or AB have an increased risk of heart disease and shorter life spans than people who have type O blood: study.
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HOW HIGH RESOLUTIONS IS YOUR Why we keep making them year after year? Experts explain BLOOD how we to make resolutions that we can achieve PRESSURE? Also: What your doctor
Local experts discuss ways to you to do in 2015 bring it down wants Page 13
More Families in Need of Food Bank Services
Coconut Oil Supports Good Health Consumers using it as moisturizers, mouth wash and acne control Page 12
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Stroke Care
Alternative Treatments for Psoriasis
Leola Rodgers now at helm of Syracuse Community Health Center
Crouse’s new neurosurgeon Eric M. Deshaies talks about a new, innovative way to treat stroke patients
Local experts weigh in Page 11 See Smart Bites on page 9
Move Over, Chicken: It’s Pork Time!
Page 6
Valentine’s Day:
Love the One Who Matters Most: YOU!
Page8
February 2015 •
My transition from nursing mom to pumping mom
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Your Blood Type May Put You at Risk for Heart Disease
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eople whose blood type is A, B or AB have an increased risk of heart disease and shorter life spans than people who have type O blood, according to a new study. But that doesn’t mean people with blood types other than O should be overly concerned, because heart disease risk and life span are influenced by multiple factors, including exercise and overall health, experts said. In the study, researchers followed about 50,000 middle-age and elderly people in northeastern Iran for an average of seven years. They found that people with non-O blood types were 9 percent more likely to die during the study for any health-related reason, and 15 percent more likely to die from cardiovascular disease, compared with people with blood type O. “It was very interesting to me to find out that people with certain blood groups — non-O blood groups — have a higher risk of dying of certain diseases,” said the study’s lead investigator, Arash Etemadi, an epidemiologist at the U.S. National Institutes of Health. The researchers also examined
whether people’s blood type may be linked with their risk of gastric cancer, which has a relatively high incidence rate among the people living in northeastern Iran. They found that people with non-O blood types had a 55 percent increased risk of gastric cancer compared with people with type O blood, according to the study, published online Jan. 14 in the journal BMC Medicine. The association between blood type and people’s disease risk and life span held even when the researchers accounted for other factors, including age, sex, smoking, socioeconomic status and ethnicity.
Just because you don’t have symptoms doesn’t mean you don’t have the hepatitis C virus Were you born between 1945 and 1965?
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
It is a state law that healthcare providers offer testing for the hepatitis C virus to all baby boomers. Hepatitis C is the leading cause of liver disease and liver cancer. Early diagnosis, determined by a laboratory blood test, can lower the risk of damage through monitoring and treatment.
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Untangling the New Daily Aspirin Study: Many Don’t Really Need It
I
f you’re taking aspirin to prevent heart attack and stroke, there’s a chance you may not need to be popping the little white pills after all. Researchers at Baylor College of Medicine and several other health institutions studied records of 69,000 people taking daily aspirin for primary prevention of heart attack and stroke. They concluded that more than one in 10 of them didn’t need to be taking the over-thecounter drug because their risk of developing heart disease was too low to warrant a daily aspirin regimen, according to the study published in January in the Journal of the American College of Cardiology. Aspirin risks can include stroke caused by burst blood vessels and gastrointestinal bleeding, both of which can be fatal, cardiologists say. But the researchers in this study did not look at aspirin-related complications — such as gastrointestinal bleeding or ischemia — in people taking it inappropriately. “People have a tendency to think
that aspirin is a benign drug, which it is not,” said Daniel Simon, chief of cardiovascular medicine at UH Case Medical Center in Cleveland, Ohio. People should take daily aspirin for heart disease prevention only if they have a more than 6 percent risk of developing heart disease over the next 10 years, according to the American Heart Association. This new study deemed anyone taking daily aspirin with a lower risk to be using the drug “inappropriately.” Simon said people can use online tools, such as the Framingham Risk Score, to determine their risk, or ask their doctors. Questions generally include age, gender, smoking status and family history. The Journal of the American College of Cardiology study did not include people who had already had a heart attack, stroke or anything else that would warrant aspirin for prevention of a second cardiovascular problem. They also did have information on specific aspirin doses.
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February 2015 •
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We
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Feb. 4, March 19
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Anyone 18 years or older who voluntarily provides care and assistance to an older or disabled person is a caregiver.
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There Are Many Options for You and Someone You Are Caring For
Legal Issues in Healthcare Planning Is It Just Clutter? Or Is Someone You Care About Hoarding?
JUNE
Learn about the basics of Medicare at a free workshop to be held from 10 a.m to noon, Wednesday, Feb. 4 at the basement training room of the Cayuga County Office Building. This session will be geared toward Cayuga County residents who are approaching Medicare enrollment and for those already enrolled who are overwhelmed or confused by the information and the options available. This is not an event during which sales efforts will be made, and no insurance vendors will be present; this program will contain unbiased information only. Information in this program includes: the basics of original Medicare; Medicare Advantage and Medicare Part D prescription coverage; Medicare Preventive benefits; Medicare supplemental insurance and EPIC; costs, copays and deductibles; and information about available assistance to help those beneficiaries of a low-income status. Registration is required. Another upcoming class will also be held March 19, and is ready for registration now. For more information or to register, please call the Cayuga County Office for the Aging at 315-253-1226, or visit the website at www.cayugacounty.us/ aging under the “News & Activities” section.
Feb. 5
Cardiologist returns as an Ask The Doctor presenter In recognition of the month of February being proclaimed heart month, Oswego Health cardiologist Thomas Grady Jr. will be the guest speaker at an Ask the Doctor presentation at 6 p.m. Thursday, Feb. 5. He is affiliated with St. Joseph’s Hospital Health Center. His presentation will be held in the lower level JPC conference room of the
Balancing Your Work with Your Caregiving Powerful Tools for Caregivers Healthy Eating for Successful Living Intimacy, Sexuality and Aging What Happens in the Hospital? Squeezed in Between? Are You in the Sandwich Generation? To receive a catalog of spring classes and to register, contact Cynthia at 315-435-2362 ext 4993 or e-mail cstevenson@ongov.net Funding for the Institute for Caregivers is provided by the New York State Office for Aging, the US Administration on Aging and Onondaga County Office of Aging. Page 4
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
Oswego Health Services Center, which is adjacent to Oswego Hospital. He will discuss how to be heart healthy and the importance of a cardiac rehab program for those who have had a heart event. Grady’s past programs on heart-related issues have been very informative and educational. The Ask The Doctor forum is a free presentation sponsored by the Oswego Health community development office. For more information on the forum, call 349-5500.
Feb. 7
Cardboard sledding derby at Four Season ACR Health, a nonprofit, community-based organization providing a range of support services to individuals with chronic diseases, including HIV/AIDS, will hold its 5th Annual Sled for RED cardboard sledding derby at Four Seasons Golf & Ski Center in Fayetteville on Feb. 7. Registration and food and drink sampling begin at 4 p.m. with the Syracuse men’s basketball game on the big screen in a heated tent. The cardboard sledding derby begins promptly at 5 p.m., followed by a tubing party. The tubing party following the competition is $12 per person. The fee to attend the hot chocolate, food, beer and wine sampling is $10 per person; $5 for age 10 and younger. Each sledding team can have a maximum of five members and is allowed to use only regular cardboard, tape, and paint to construct the sled. The sledding team must fundraise a minimum $250 to enter Sled for RED. The cheer team for each sled can be an unlimited number. Awards are given for the loudest cheer team, the fastest sled, the slowest sled, the highest fundraiser, the best decorated sled, and the best team costume. All money raised will support ACR Health’s youth prevention programs and emergency client needs. For more information or to register, call 800-475-2430 or go to www. ACRHealth.org.
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More Americans Getting Needed Health Care, Survey Shows
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lthough problems persist, more Americans had significantly less trouble getting and paying for needed medical care in 2014, as the health insurance expansions of the Affordable Care Act kicked in, a new survey suggests. The number of working-age adults who said they didn’t get the care they needed because of the cost dropped to 66 million in 2014 from 80 million in 2012, the first decline since 2003, according to The Commonwealth Fund’s latest Biennial Health Insurance Survey. At the same time, fewer adults — 64 million in 2014 versus 75 million in 2012 — reported medical bill problems,
and that’s the first decrease since 2005. “This new report provides evidence that the Affordable Care Act’s new subsidized options for people who lack insurance from employers are helping to reverse national trends in health care coverage and affordability,” Commonwealth Fund President David Blumenthal said in a news conference with reporters in January. Uninsured rates tumbled to their lowest levels in more than a decade, the survey found. A total of 29 million working-age adults (16 percent of the population) were uninsured in 2014, down from 37 million (20 percent of the population) in 2010.
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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
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February 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Eric M. Deshaies, M.D. Crouse’s new neurosurgeon talks about a new, innovative way to treat stroke patients Q: What are some of the challenges of treating stroke patients with drugs? A: For quite some time, the primary stroke centers have typically been able to give a clot-busting drug called tPA into the veins. You can give it up to three hours after the stroke — and now up to four-and-a-half with consent — but we know that for large blood clots in the brain, it only works about 10 percent of the time when given by the vein. Additionally, there are certain patients who can’t receive the drug, if they’ve recently had surgery or had bleeding in the brain in the past. So those patients, and patients who are beyond the four-and-a-half hour window, can’t be treated with the clot-busting drug alone. Q: But you are utilizing a new therapy now to help those patients, correct? A: So endovascular therapy was developed that allows us to use devices to suction the blood clot out. The newest generation of devices are retrievable stents that you open up inside the clot using X-ray guidance and actually pull the clot out of the blocked vessel. That allows you a window of up to eight hours rather than just four-and-a-half. We can also give medication directly into the arteries up to six hours as the dose is much lower than with clot-buster drugs because you’re giving it directly into the clot rather than the whole circulatory system. Q: How are the outcomes? A: There had been a study done about two years ago that I was one of the primary researchers in that concluded that clot-retrieval procedures weren’t significantly better than doing the clot-busting drug alone. But the devices were early generation. They were more difficult to use and ran the risk of complications. In 2013, they came out with a stent called Solitaire to remove clots up to eight hours later. I was the second in New York state to use that device and we’ve been having great results with that. It hasn’t generally been used in the fourhour window because people have the clot-busting drug, because that’s what had been shown to work. Recently, however, there were a number of trials going on to find out if using the clot-busting drug alone, or with one of these devices, would have better outcomes for those patients. Q: What have the more recent trials found? A: There was a study done called “Mr. Clean” that
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
looked at the Solitaire stent and a similar stent called Trevo that looks a bit like chicken wire fencing. You open them up in the artery, they trap the clot and restore the blood flow. So that trial showed that if you use these devices along with a clot-busting drug, you get better outcomes within the first fourand-a-half hours. Now, it’s not indicated for the very tiny blood vessels that you can’t get the stent into. The Mr. Clean trial had such excellent results that the FDA actually stopped several other similar trials. Q: Just to clarify, the stents are actually going into blood vessels in the brain, correct? A: Correct. We use X-rays to guide catheters up into the arteries in the brain. Then we use a micro-catheter to go through the clot and deploy these devices and remove the clot. One of the techniques I developed and published involves a little vacuum device called the Penumbra that I put the stent through. When I turn the device on, it reverses flow in that area and helps reduce the chance of losing any blood clot that might break off. So it’s a combination of techniques. Q: How many patients can be helped with this technique. A: So there are about 800,000 in the US every year. About 200,000 of them are eligible for having these stent devices used, but only about 10,000 are going to have access to them. There aren’t yet many physicians in the country who use these devices and, in many places, getting patients to a stroke center within the time frame can be challenging. Q: So is this considered an interventionary process? A: So it is an interventional procedure, but we call it “stroke rescue.”
Physician Eric M. Deshaies has been appointed as Crouse Hospital’s medical director for endovascular and cerebrovascular neurosurgery We often think that someone comes to the hospital when they have a stroke. That’s kind of inaccurate nowadays. Before the days of clot-busting drugs, you’d come to the hospital with stroke symptoms and we’d say let’s keep an eye on it for a few days and then we’d send you to a nursing home for rehabilitation. After the clot-busting drugs allowed us to intervene, we were able to say “these are stroke patients, but they’re not patients who have had a stroke.” They’re experiencing stroke symptoms and, if we don’t remove the clot, they may have a stroke. Time is brain. The faster you can get the clot out, the faster you can restore blood flow to the brain, the better the patient will do. Q: Along with rocket science, brain surgery is typically cited in cultural idioms as being one of the hardest professions. How difficult is neurosurgery? A: If I said “very difficult,” you might not want me operating on your brain, but it is brain surgery. It requires a lot of training and is one of the most delicate types of surgery. A lot of what I do is operate on tumors in the brain stem. It’s the part of the nervous system responsible for most of your basic life functions, so a tumor there can cause serious problems. So knowing the pathways to get in there and take it out without causing complications takes a lot of training. A small little vibration can be an earthquake under the microscope. Q: What do recovery times from neurosurgical procedures look like? With other systems, the affect on tissue is a bit more obvious. A: There’s a wide variety. Depends if there’s a hemorrhage or a stroke. It depends how quickly you’re able to get the blood clot out. Everyone’s brain is different. For some of the open surgeries I do to get brain tumors out, I might spend 36 hours operating with multiple teams, so it always takes longer to recover from that kind of procedure than a minimally invasive one. So we could be talking about the difference between going home the next day to a few weeks. It does take the brain longer to heal than any other tissue. You might have cognitive deficits, speech, or concentration problems. If it’s a part that controls motor functions, you may have physical deficits as well. It can take the brain months or years to recover its full ability.
Lifelines Hometown: Bristol, Conn. Education: Trinity College (Hartford), Uconn Medical, Albany Medical Center, University of Miami (fellowship) Affiliations: Crouse Hospital, St. Joseph’s (privileges) Organizations: American Association of Neurological Surgeons, American College of Surgeons, Congress of Neurological Surgeons, Alpha Omega Alpha Medical Society, Phi Beta Kappa Honor Society Family: Wife, two children Hobbies: Running, swimming, cross country skiing, photography, astronomy If you could look at the brain of any person in history, who would you choose: Steve Jobs
NPs Increase Clout New York state loosens restrictions on nurse practitioners By Matthew Liptak
S
ince last month, nurse practitioners in New York state with two years or more of full-time experience will no longer be required to have a collaboration agreement with a physician thanks to a new state law. It is a welcome change for many NPs in the area. “It’s time for this law and I’m very pleased that it passed,” said Mary Oot, a long-time nurse practitioner working in East Syracuse. “We have an estimated 37 million people through the ACA [Affordable Care Act] coming into the health care system and nowhere near enough primary care physicians to provide that care. We all have to think of ways Coppola to improve that access. The law is a good first step.” Jody Coppola, a NP at Jamesville Family Medicine for 11 years, said the Nurse Practitioner Modernization Act is a good step too, but wondered why the original restrictions were in place in
the first place. “While it’s a good thing as a step in the right direction, we never really needed a law to make us consult with someone when we felt that we needed some help,” Coppola said. “Having a law telling us we had to do that was kind of ridiculous. It was certainly somebody else’s idea.” Coppola said she doesn’t think her practice will be strongly impacted by the new law since she has a physician collaborator who is also the co-owner of Jamesville Family Medicine — her husband, Devin Coppola. But Oot’s practice is a different story. “The Nurse Practitioners Modernization Act will immediately remove the constant fear of losing my collaborator. Getting a new collaborator is not as easy as you think,” Oot said. Oot, who has been an NP for 22 years, said she would have had to close her practice under the old law if she had lost her collaborating physician.
Collaboration is king
Collaborating is just a part of practicing good medicine, Coppola said. She doesn’t think it requires legal interference. “I would have collaborated with a
physician if I needed one anyway,” she said. “Physicians also collaborate with other physicians. Everyone needs help once in a while. We all need to step out and ask for assistance because you can’t possibly do everything.” Despite the support for the law by many in the medical community, it had its detractors, doctors among them. Oot thinks the protesting physicians probably have not had much experience with NPs and their practices. She said the negative sentiments will change as the law gets its footing. Of about 50 physicians she has worked with, Coppola said she knows of three who don’t think NPs should be working independently. She thinks some doctors might be territorial. “I think some physicians also fear that nurse practitioners will take away patients,” she said. “Numbers are huge. You have to see a lot of patients in a day in order to pay your overhead and in order to get paid, especially in primary care. It’s a problem that we all face.” More than state laws are restricting nurse practitioners. Starting one’s own practice is prohibitively expensive, Coppola said. It is the reason many NPs have come
together in group practices — to share expenses. Even then it can be challenging, because nurse practitioners get only a percentage from insurance companies that physicians get. Coppola said the reimbursement for an NP is about 80 to 85 percent of what a doctor takes. Both NPs said more barriers need to come down. One reason they might is demand for primary care medicine is exceeding the supply of both NPs and primary care physicians. Med students just aren’t going into primary care in the numbers needed because they may have to pay off a school loan that can be upwards of $150,000. They make more money when they choose a specialty. Oot called primary care a “labor of love.” Having more NPs could fill the growing gap. “I feel primary care is kind of our place,” Coppola said. “Docs don’t go into it because they just don’t get paid. Do you want to go to school for 13, 14 years and have all those bills and not get paid? I mean I don’t blame them. I think we are absolutely there to help fill that gap.”
Healthcare in a Minute By George W. Chapman
family policy is now over $16,000. That’s $1,333 a month, which for most Americans, is a healthy mortgage payment. Out-of-pocket expenses — premium contribution, deductibles, coinsurance — now account for almost 10 percent of median household income. Ten years ago it was just over 5 percent.
The changing ACA landscape Many factors impacting execution of Affordable Care Act
A
ffordable Care Act-ObamaCare. Now that the GOP controls both houses in Congress, it is further emboldened to repeal at least some aspects of the ACA. There have been over 50 attempts to repeal so far. Realizing President Obama will clearly continue to veto any repeal of the entire law, the GOP plans to hack away at parts of the law like the employer mandate and the medical device tax. The GOP is also hoping the U.S. Supreme Court will declare federal subsidies unconstitutional. The states would then have to step up and pay 100 percent for ObamaCare, which many believe would be its undoing. In the meantime, early signs indicate that enrollment will hit more than 9 million. That includes 6.7 million returning enrollees. Small businesses under 50 employees do not have to offer health insurance. Consequently, many are dropping employer-sponsored insurance and are encouraging their employees to shop for care on the exchanges, many of which would qualify for a subsidized/ cheaper premium. While some larger employers like Sears and Walgreens have opted for private health exchanges, most large employers are taking a wait-and-see approach and continue to provide employer-sponsored insurance.
About 3 percent of all large employers opt to send their employees to an exchange for their insurance. The House just passed a bill raising the definition of “full time” from the current 30 hours to 40 hours. Most likely this bill, even if passed by the Senate, would be vetoed. Many predict the tactic will backfire as more people would be dropped by their employer and seek government-provided insurance which would increase the deficit. The Congressional Budget Office estimates if the full-time definition was raised to 40 hours, 1 million people would lose their employer insurance by having their hours cut to just below 40. They would end up on taxpayer-supported healthcare, increasing the deficit by $46 billion over the next 10 years. Medical debt. According to the Consumer Financial Bureau, 43 million of us have unpaid medical debts averaging $1,766. Fifty-two percent of the debt referred to collection agencies is healthcare-related. Healthcare-related debt is one of the major causes of personal bankruptcy. Some nonprofit hospitals are suing patients or garnisheeing their wages via a for-profit subsidiary. Nonprofit hospitals are tax-exempt primarily
because of their charitable mission. Smoking costs. According to the Centers for Disease Control, 480,000 of us die from illnesses caused by smoking every year. About 18 percent of Americans still smoke, which is actually a historic low. The CDC has calculated that 9 percent of all healthcare expenses (about $170 billion annually) are the result of smoking. Many advocate higher premiums for smokers. Medically uninsured rate down. According to Gallup, the percentage of Americans without health insurance is 12.9 percent. It was 17.1 percent a year ago. This is due to a combination of the ACA (Medicaid expansion and commercial coverage through private exchanges) and an improving economy. Massachusetts remains the only state that mandates individual coverage. Only 1.5 percent of that state’s residents are uninsured. The Obama administration is said to be amenable to considering conditions on Medicaid enrollment like job requirements, plan premiums or wellness screenings. Premiums. The Commonwealth Fund reported health insurance premiums have increased 73 percent over the last 10 years. The national average for a February 2015 •
Telemedicine at school. More studies are beginning to show the effectiveness of telemedicine. Consequently, insurers are gradually acknowledging the effectiveness, clinically and financially, by paying for telemedicine services when provided. While consumer demand remains far ahead of what most providers are willing to offer right now, forward-thinking health systems are forging ahead with innovative programs. The world- renowned Mayo Clinic has recently struck a telemedicine deal with the Austin Public Schools of Minnesota. Instead of taking children out of the classroom and working parents out of their offices, the two partners are developing telemedicine protocols for quick and effective consults for common, low-level complaints such as coughs, colds, respiratory infections and minor skin conditions through videoconferencing. GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Valentine’s Day: Love the One Who Matters Most: YOU!
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s I’ve shared with you in the past, my divorce and reluctant return to singlehood was a real blow to my self-esteem and identity. My confidence took a nosedive, and I struggled with self-doubt and feelings of worthlessness for too long. When I finally “came to,” I realized I needed to shift my thinking before I could move on with my life. After all, I concluded, if I didn’t feel I deserved a good life or love, why should the universe feel any differently? I knew I needed to hold myself in higher regard if I were going to create a better life, make new friends, and perhaps fall in love again. A change of heart was definitely in order. But where to begin? How was I going to rebuild my sense of self-worth in the face of all my negative thinking? How was I going to love myself again amidst all this rubble? It happened one small step at a time. Slowly, steadily and with intention, I decided to focus on my positive features instead of my faults. I decided to be kinder and gentler to myself and to be more deliberate in my thoughts and actions. It took some time, but eventually
I began to like, and ultimately love myself again. My confidence and happiness returned and life got better. Much better. If you are struggling to love yourself, as I did after my divorce, you may find the tips below helpful. These are the things I did to reclaim and rekindle my love for myself: I stopped beating myself up. I was taking ownership for any and everything that went wrong in my world: I didn’t do that right, I could have done this better, I should have said that, if only I’d chosen this . . . and on and on. It was never-ending. It was doing me no good. So I put a stop to it. When I started going down that useless thought path, I would deliberately shift my thinking to something more constructive. Constantly finding fault with myself was a hard habit to break, but with practice I was giving myself more pats on the back than punches in the stomach.
KIDS Corner Half of Teen, Young Adult Car Crash Deaths Involve Pot or Alcohol
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alf of the teen and young adult drivers who die in car crashes are under the influence of either pot, alcohol or both, suggests a new study done in states where toxicology screening for accident victims is routine. What’s more, the increasing legalization and availability of marijuana does not seem likely to push alcohol use aside, the researchers said. The crash victims in the study who were over age 21 (and of legal drinking age) were more likely than younger victims to have used both marijuana and alcohol prior to their crash. “Given the rapid changes currently underway in marijuana availability and permissibility in the U.S., understanding the effects of drug control policies on substance use behavior and adverse
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health outcomes, such as fatal motor vehicle crashes, has never been more important,” study researcher Katherine Keyes, of Columbia University’s Mailman School of Public Health, said in a statement.
Under the Influence
Car crashes are the leading cause of death of 18- to 25-year-olds in the U.S., and driving under the influence is a major cause of accidents. Not every state conducts routine toxicology tests on car crash victims right after the accident, but those that do have come up with alarming results. For example, a 2012 study in the journal Addiction found that 57.3 percent of the drivers in this age group who died were on some kind of mind-altering
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
I became grounded spiritually. This means different things to different people. For me, it meant two things: searching for a deeper sense of self and nurturing a stronger connection with something bigger than myself. Greater inner peace and security emerged, and the feelings were both liberating and profound. I found myself becoming less fearful and less self-centered, which unlocked my heart. I became a more compassionate and loving person, not only toward others, but importantly, toward myself. I learned to forgive myself. People say it all the time: “Give yourself a break; we all make mistakes.” So why did I think that applied to everyone but me? Why was I choosing to obsess over my misdeeds, and to live with so much angst and apprehension. Sound familiar? I needed help to make progress here. I talked with a therapist about my past missteps and learned how to trust in my own goodness. When that began to happen, my
substance, usually alcohol. For Keyes and her colleagues pulled data on 16- to 25-year-olds from the Fatality Analysis Reporting System (FARS), a federal database of fatal crashes. They focused on California, Connecticut, Hawaii, Illinois, New Hampshire, New Jersey, Rhode Island, Washington and West Virginia, because each of these states tests at least 85 percent of its fatal car crash victims for
world opened up and I could again see possibilities. I created my own positive feedback. My “self love” project needed all the reinforcement it could get. I started to dress and behave in ways that invited healthy, positive attention — attention that boosted my ego and helped me feel good about myself. I spruced up my wardrobe, put a smile on my face (even when I didn’t feel like it), looked people in the eye, and listened more intently. When I took these deliberate steps, the universe returned the favor and I got what I needed — affirmation, engagement with others and a compliment or two along the way. I learned to love and accept myself. At the end of the day, when I look at my reflection in the mirror, I now see someone I love. Not a perfect person, but someone I’ve grown to admire and accept, flaws and all. Is my work done? Not by a long shot. I am a work in progress and, like my garden, I need constant tending to grow, change and become more bountiful. Nurturing and loving myself has been the key to living a fulfilling life on my own. What do you see when you look in the mirror? If you don’t adore the person staring back at you, ask yourself “What can I do today to demonstrate my love?” Then do it. And do it again tomorrow. And the next day. And the next . . . Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call 585-6247887 or email: gvoelckers@rochester.rr.com.
drugs and alcohol within an hour of the accident. The researchers found that half (50.3 percent) of the young drivers who died were drunk or high at the time of their fatal crashes, the researchers found. In total, 36.8 percent tested positive for alcohol alone, while 5.9 percent tested positive for marijuana alone and 7.6 percent had been using both.
SmartBites
thiamine (helps convert food to energy), niacin (good for nerves, digestion and skin), vitamin B12 (essential for red blood cell production and overall energy) and selenium (a powerful antioxidant).
By Anne Palumbo
The skinny on healthy eating
Helpful tips
Move Over, Chicken: It’s Pork Time!
Select lean cuts of pork — tenderloin, loin chops, and boneless loin roast—if you’re looking for healthy pork options. Bacon, pork cutlets, spareribs and shoulder roast are all higher in saturated fat and calories. Just a few years ago, the USDA lowered its safe cooking temperature of pork to 145 degrees, from the longtime standard of 160 (trichinosis, a type of parasite sometimes found in undercooked meat, can’t survive above 145 degrees). The easiest way to tell when pork is done is to use a meat thermometer.
E
ver since the medical community revealed links between heart attacks and foods high in saturated fat — such as red meat — I have made a concerted effort to consume less of this particular protein, especially the fattier cuts. In its place, I initially substituted beans, fish and the only white meat I could think of: chicken. But then, recalling a brilliant ad campaign that positioned pork as “the other white meat,” I looked into pork, the leaner cuts touted in the ads. I am now a bona fide pork-a-holic. Although technically a red meat, pork (select cuts) has many of the health advantages of lean, white meat: it’s low in fat and calories, it’s super high in protein, and it’s chockfull of B vitamins. On the fat and calorie front, an average 3-ounce serving of pork loin has only 3 grams of total fat, 1 gram of saturated fat, and 122 calories, which is on par with a similar serving of skinless chicken breast. A 3-ounce rib eye steak, on the other hand, has 18 grams of total fat, 9 grams of saturated fat and 230 calories. According to the American Heart Association, the average adult should
not consume more than about 15 grams of saturated fat a day. As many know, foods that are high in saturated fats raise our total blood cholesterol and unhealthy LDL cholesterol levels — levels that, over time, contribute to clogged arteries and an increased risk of heart disease or stroke. On the protein front, pork is a prodigious source, serving up around 22 grams per 3-ounce serving. A nutrient we need to build up, keep up and replace tissues in our body, protein also makes up the enzymes that power many chemical reactions and the hemoglobin that carries oxygen in our blood. Put another way: We’d be limp noodles without this mighty nutrient. In addition to all that good protein, pork is also an excellent source of
Pork Tenderloin Studded with Rosemary and Garlic Adapted from “Cooking Light” Serves 4
the rosemary and garlic. Make several 1/2-inch-deep slits in pork; place about half of rosemary mixture in slits. Rub pork with remaining rosemary mixture; sprinkle with salt and pepper. Place pork on a rimmed baking sheet lightly coated with canola oil. Insert a meat thermometer into thickest portion of pork. Bake at 475° for 20 minutes or until the thermometer registers 145° (slightly pink) or desired degree of doneness. Let stand 5 minutes, and cut into 1/2-inch-thick slices. Note: If using fresh rosemary, strip leaves by running your fingertips along the stem in the opposite direction from which the leaves grow.
2 tablespoons finely chopped fresh rosemary (or, 2 teaspoons dried, crushed) 4 garlic cloves, minced 1 (1-pound) pork tenderloin, trimmed 1/2 teaspoon salt 1/4 teaspoon black pepper Canola oil Preheat oven to 475°. Combine
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.
NOT TAKING YOUR PRESCRIPTIONS AS DIRECTED?
YOU’RE TAKING
A CHANCE.
If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember:
If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/TakeAsDirected. #TakeAsDirected
February 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Menorah Park offers grants for those who want to live in The Inn
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enorah Park of Central New York has established a $110,000 financial assistance program to provide financial aid for eligible older adults to live in its assisted-living facility, The Inn. “We’re so pleased to establish this fund that makes The Inn at Menorah Park uniquely responsive to those in the community wishing to move into our assisted-living residence,” said Mary Ellen Bloodgood, Menorah Park CEO. “These funds are available to adults who need the care the Inn can provide but who require financial help. This financial aid will make assisted living available to more residents in our community and is in keeping with the mission at Menorah Park to assure maximum independence and dignity to those in need of the broad range of services we provide. A fully licensed assisted living facility, The Inn offers a home-like setting with 51 apartments for older adults needing some personalized care. Resident care aids are on site 24/7 and each resident has a personalized care plan to meet medical, comfort and social needs. For information on The Inn at Menorah Park, contact Katie Hughes, 446-9111, extension 180 or khughes@ menorahparkcny.com. Menorah Park of CNY, www.menorahparkcny.com, was established in 1912 as The Jewish Home for the Aged.
My Turn
By Eva Briggs
A New Antibiotic — From a Soil Bacterium
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y husband is a soil scientist. Years ago, one of his colleagues attended a party where a woman asked him, “What is your specialty, doctor?” He replied, “Soil science” “Oh,” she sniffed, “I thought you were a real doctor.” It turns out that soil science, or at least its subdivision of soil microbiology, is in the news due to the discovery of a bacterium — Eleftheria terrae — that produces a potential new antibiotic. This substance is in an entirely new class unrelated to current antibiotics. The other Dr. Briggs says he’s not surprised, since an estimated 90 percent or more of soil bacteria have yet to be identified, much less studied. One problem is that many soil bacteria won’t grow in the lab on standard agar plates. New techniques involve diluting a soil sample with agar, placing the solution in a special chamber and inoculating it with a single bacterium. The chamber contains a semipermeable membrane which, when placed into the soil, allows soil nutrients to diffuse in, but prevents the bacteria from escaping. This permits the culture of many more species of bacteria than can be grown on agar plates. The next experimental step is to expose bacteria, such as streptococci, to
the newly isolated species of bacteria, and to see which specimens inhibit bacterial growth. Then the potentially antimicrobial species are analyzed to isolate the effective substance. Using this method, researchers identified a substance they dubbed teixobactin that kills gram positive bacteria via a novel method. This chemical binds to bacterial cell walls. Many antibiotics bind to bacterial proteins. Proteins easily mutate producing changes that permit rapid development of drug resistance. Teixobactin binds instead to two non-protein elements of the cell wall. Coupled with the fact that teixobactin kills bacteria quickly, resistance is expected to take much longer
to develop. When teixobactin was tested in mice infected with lethal doses of MRSA (methicillin resistant Staphylococcus aureus) or lethal doses of tuberculosis, the mice not only survived, but also showed no signs of toxicity. This is potentially great news, as S. aureus and tuberculosis have evolved highly resistant strains. Of course, it takes years to develop a new antibiotic from a promising candidate chemical. And bacteria will sooner or later develop resistance. Past experience with antibiotic resistant suggests that if successful, teixobactin and related new drugs should be reserved for serious infections because overuse accelerates the pace of antibiotic resistance. So it turns out that soil scientists are real doctors after all. 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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Complementary Medicine Alternative Treatments for Psoriasis By Deborah Jeanne Sergeant
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bout 3 percent of the world’s population has psoriasis. That’s a pretty small percent. But if you’re among them, the itching, pain and redness typifying many psoriasis flare-ups can affect many aspects of life. Though the condition isn’t contagious, friends and family may fear “catching” it if they mistake it for other skin problems. Psoriasis often presents white, flaky skin and it can cause skin to crack open, inviting infection. Medication may provide relief for psoriasis, but it does not completely work for some patients. Some patients seek other options, such as alternative health treatments and lifestyle modification. Lifestyle and dietary changes “can help, but depending upon the severity, it may Farah not be enough,” said Ramsey Farah, dermatologist with Farah Dermatology & Cosmetics in Syracuse. “Some need dietary changes, lifestyle changes and systemic medication.” When alternative methods help, patients and doctors may not know why they worked. For example, many patients experience relief while on vacation. But it’s not clear if their psoriasis clears because of sun exposure, salt water, lower stress, higher or lower humidity, different foods or a combination of some or all of these factors. It’s also not clear as to why some methods help some people, but not all. “Biologic systems are extremely complicated systems,” Farah said. “People are biologic systems and respond differently to treatment.” Some people seek tanning beds for relief; however, tanning increases the
risk for skin cancer. Some dermatologists use a narrow band, UVB light, which is not like a broad-spectrum light found in tanning beds. Many people take omega-3 supplements, eliminate gluten from their diet or apply olive oil, the last of which Farah said may help. But in general, most dermatologists don’t recommend alternative health options because they lack scientific studies and because it’s hard to know what will help a specific individual. “If you have a friend who makes a recommendation, you don’t have to close the door on it, but don’t automatically jump on it,” Farah said. “Take it to a dermatologist to get an answer on the validity and chances on it working. “It’s a very slippery slope to try things from hearsay. People with psoriasis are vulnerable because they’re self-conscious. They want something to work. The danger is because of that vulnerability, they can try things that don’t work or that are inappropriate for the condition,” said Farah. Psoriasis medication has become much more effective than it used to be. Systemic treatments for modLaDuca erate to severe psoriasis can control flare-ups’ severity and duration. “New generations of these medicines clear people quite remarkably,” Farah said. “If you have psoriasis, you’re lucky to live in this age.” Since psoriasis is a systemic disease, not just a skin disease, it’s important to more aggressively treat moderate to severe psoriasis. Jeffrey LaDuca, dermatologist with Reflections Dermatology and Psoriasis Center in Auburn, said: “There’s an
All About Psoriasis There are five types of psoriasis. The most common form, plaque psoriasis, appears as raised, red patches covered with a silvery white buildup of dead skin cells. Psoriasis can occur on any part of the body and is associated with other serious health conditions, such as diabetes, heart disease and depression.
Symptoms and Diagnosis
Psoriasis is an autoimmune disease that causes raised, red, scaly patches to appear on the skin.
Types of Psoriasis
Psoriasis appears in a variety of forms with distinct characteristics. Typically, an individual has only one type of psoriasis at a time.
increased risk of metabolic syndrome, cardio events, and more. Treating this may also help people live longer. People with untreated psoriasis tend to live a few years less.” LaDuca recommends that people unsatisfied with their current treatment to seek a different dermatologist to make sure they receive the newest, latest treatment. “Some aren’t as eager to prescribe newer things that the FDA just approved,” LaDuca said. “In the past decade, there have been a number of new medicines that have changed the way we treat it. I can make people so they nearly know they have it with these medicines.”
Specific Locations
Psoriasis can show up anywhere—on the eyelids, ears, mouth and lips, skin folds, hands and feet, and nails. The skin at each of these sites is different and requires different treatments.
Severity
Psoriasis can be mild, moderate or severe. Your treatment options may depend on the severity of your psoriasis.
Triggers
Researchers believe that for a person to develop psoriasis, the individual must have a combination of the genes that cause psoriasis and be exposed to specific external factors known as “triggers.” From the National Psoriasis Association (www.psoriasis.org):
He said that many of the alternative treatments he’s heard of — such as rubbing banana peels on the affected skin or taking vitamin supplements — probably won’t hurt most people, but they’re not FDA approved for efficacy or safety. “If you take hundreds of times the US dietary allowance of vitamins, it just makes expensive urine, unless fat soluble vitamins. That gets stored in the body and can be harmful.” He advises patients to reduce stress, eat right and exercise, all of which improve overall health and, by extension, help reduce psoriasis flareups.
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
February 2015 •
Is Weight Loss Surgery Right for You? Upcoming Seminars: Feb. 2 • Feb. 19 Marley Education Center Feb. 10 Ramada Hotel and Conference Center, Cortland To register: crouse.org/weightloss 315/472-2464
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Complementary Medicine
Mangosteen: Tropical Fruit Offers Many Benefits By Deborah Jeanne Sergeant
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angosteen represents a tropical super fruit, packed with numerous healthful properties. Sectioned like an orange, sized like a tangerine, and covered with a purple rind, the tangy, sweet fruit tastes like strawberry, kiwi and plum and contains almond-sized seeds. Mangosteen primarily grows in Southeast Asia. In recent years, growers have begun growing mangosteen trees in Columbia, Puerto Rico, and India. Mangosteen trees thrive in climates where the temperature stays above 75 degrees Fahrenheit year round and the relative humidity stays around 80 percent. Prolonged freezing temperatures have been known to kill even mature, well-established trees, making the United States inhospitable to mangosteen cultivation. Despite its healthfulness and exotic flavor, don’t count on finding mangosteen at your local grocery store. It’s a fruit that’s next to impossible to export from where it’s grown because it easily
bruises and spoils while shipping. Its delicate nature doesn’t mean you’ll never enjoy mangosteen’s health benefits. Some specialty markets in larger cities carry it. Check Asian markets when you’re traveling and you could find mangosteens for sale. Locally, health foods stores and the natural health aisles of mainstream stores sell products containing magnosteen, including canned mangosteen, though the fruit’s flavor is compromised through the canning process. “You can get it in a juice form and we carry the juice,” said Becca Lewis, doctor of naturopathic medicine at Green Planet Grocery in Oswego and Fairmount. “It’s really high in phytochemicals that are antioxidants.” Scott Pierson, assistant manager of Syracuse Real Food Coop, also raved on mangosteen’s antioxidants. “It’s a super fruit,” he said. “It helps get rid of free radicals in the blood and clear out toxins you pick up day by day.” Laurel Sterling, certified dietitian
Chicken Soup and Other Wives’ Tales
and integrative dietitian and wellness coordinator at Natur-Tyme in Syracuse, said that mangosteen contains many nutrients. “It’s high in magnesium, phosphorus, vitamin C,” she said. “Vitamin C is a water soluble antioxidant that helps stave off infections and scavenge pro-inflammatory free radicals. Mangosteens have been used in numerous an-
T
here are plenty of wives’ tales for preventing and fighting colds and flu. Which are true and which aren’t?
Chicken Soup
Plenty of moms have made chicken soup to help fight off a cold’s effects and, it turns out, mom knows best. “Chicken soup works!” says physician Roy Buchinsky, director of wellness at University Hospitals (UH) Case Medical Center. “It works as an anti-inflammatory, it boosts the immune system, and can help with nasal congestion.” Chicken soup works: TRUE!
Feed a Cold, Starve a Fever
“You should eat whether you have a fever or a cold,” says Buchinsky. “Eating enhances your immunity to fight off infections.” Buchinsky says
ti-cancer studies with positive results.” While it sounds like mangosteen is a panacea, don’t consider it a cureall. Instead, integrate it into a healthful diet. Eating more of any type of whole fruit or vegetable helps add more nutrients to your diet, whether it’s a “super fruit” or just a “regular” one. Consult with your doctor before making any changes to your diet. Mangosteen has not been approved by the FDA to treat or prevent any health conditions.
before modern medicine, people believed colds thrived when your body temperature was low and therefore your immunity was low so eating was recommended to increase a body’s internal thermostat and raise immunity. That part of the equation has merit. People also believed by not eating, you could lower the body’s temperature to lower a fever. That part of the equation is incorrect. Buchinsky says eating healthy helps regardless of whether you have a cold or a fever. FALSE!
Vitamin C
“Studies have shown there is no benefit of vitamin C in the normal population in preventing colds,” says Buchinsky. It might help, however, with the elderly, the immune-suppressed, and for people with poor diets. MOSTLY FALSE!
Coconut Oil Supports Good Health By Deborah Jeanne Sergeant
C
oconut oil has become a popular health food and topical. As a healthful, saturated fat, it is high in calories like any fat or oil, but it also boasts many healthful properties. Ingested in moderation, it may offer health benefits and support good health in numerous ways. Scott Pierson, assistant manager at Syracuse Real Food, likes coconut oil as an all-around cooking oil. “It has a higher smoking point than olive oil, though not as high as safflower oil,” Pierson said. “Some use it instead of butter. “Others rinse out their mouths with coconut oil, followed by water, because it help eliminate bacteria and plaque in the mouth.”
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Laurel Sterling, registered dietitian and integrative dietitian and wellness educator at Natur-Tyme in Syracuse, said that the key to coconut oil’s healthfulness is that it’s a medium-chain triglyceride fat. “It’s an instant energy source for the body, and it is a good fat used by the brain and all the nerves,” Sterling said. “They are seeing it help somewhat with Alzheimer’s and dementia.” Since coconut oil is rich in lauric acid, it is anti-fungal, anti-viral, and anti-bacterial. “Topically, it is used in many skin care and hair products,” Sterling said. Becca Lewis, doctor of naturopathic medicine at Green Planet Grocery with various locations in Central New
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
York, added that lauric acid repairs the gut, yet another reason people turn to coconut oil. “It has been shown to help in abdominal weight loss,” she said. “It is a saturated fat, but since it has medium chain triglycerides, you tend to use it up before it’s stored.” She advises people interested in coconut oil to seek extra virgin, coldpressed oil. “Sometimes they say ‘raw’ but they have to heat it up a little bit to extract it,” Lewis. “If it’s white and looks solid with crystalline structure, that’s good.” Some parents prefer using coconut oil for diaper cream instead of chemical-laced preparations and as a natural nursing cream. For topical use,
any type of coconut oil works, not just extra-virgin. Though coconut oil may provide many benefits, don’t go overboard. Just use it wherever you would other types of oil or moisturizers. It’s also important to discuss any change of diet or topical application with your doctor prior to use to avoid a contraindication with any medication, treatments or health conditions. Coconut oil has not been FDA approved for use in treating or preventing any health conditions. For more coconut oil uses, visit http://wellnessmama.com/5734/101uses-for-coconut-oil.
Controlling Blood Pressure By Deborah Jeanne Sergeant
A
bout 78 million U.S. adults have high blood pressure, also known as hypertension, according to the American Heart Association. Many of them don’t realize they have hypertension until it’s detected during a medical exam or until they experience a health crisis. Of those with high blood pressure, about half do not follow their doctor’s orders regarding medication and lifestyle changes. In Good Health interviewed several experts who presented suggestions to keep blood pressure in check. • “Stress can raise blood pressure. Stress hormones increase blood pressure. They constrict blood vessels, making the blood pressure go up. Chronic stress that happens again and again cause damage that can be hard to reverse. Get rid of these: anger, worry, fear and stress. They’re like poison. • “Twenty-four hours a day, seven days a week, stay in an environment you love. • “Use breathing techniques. Breathe into the nose as deep as you can and out of your mouth. You relax the whole body. Doing it 15 to 20 times helps. If you’re stressed, have a three- to five-minute walk to melt away stress.” Az Tahir, MD, practicing internal and holistic medicine in Syracuse.
Why Bother Keeping Your Blood Pressure Low? Why is controlling blood pressure important? Physician Az Tahir, who practices internal and holistic medicine in Rochester, said that blood pressure is important to control because if the pressure in blood vessels becomes too high, they can rupture and hemorrhage in the brain, the heart, or kidneys. “Normal blood pressure keeps the normal flow of circulation to every part of your body and, eventually, every cell of the body. If it’s down, it changes circulation and that’s what gets oxygen to the cells which we need for survival.”
• “Decrease salt intake. Salt is hidden in so many foods. Avoid garlic salt, seasoned salt, ketchup, mustard, hot foods, canned soups, salami, bacon, sausage, ham: almost any processed food will have salt in it. There are many, many ways to cut back. A natural diet will help. • “Weight loss is a big thing. It’s hard to achieve but losing 5 to 10 percent of your weight will help tremendously. • “Take your blood pressure medication. Nationally, only 60 percent of prescriptions ever written are ever filled and of those, only half are taken.” William Bayer, MD, family medical physician with Jefferson Family Medicine in Rochester. • “[Avoid] alcohol, refined sugar, and high sodium foods, table salt can
contribute to hypertension. • “Celery, dark green leafy vegetables, garlic, fresh fruits high in potassium, parsley, cucumber, hibiscus tea, and apple cider vinegar all can assist in lowering blood pressure.” Laurel Sterling registered dietitian and integrative dietitian and wellness educator at Natur-Tyme in Syracuse • “Regular aerobic exercise can help manage blood pressure by opening peripheral blood vessels. It works on different levels. Smaller bouts of exercise more often is more effective for lowering blood pressure throughout the day than one session. Break up a 30-minute cardiovascular workout into three, 10-minute sessions a day. Work out at least five days a week. To lose weight, you’ll need more exercise, 300 minutes a week.
• “The long term effect is that exercise helps to strengthen your blood vessels. They become more flexible, pliable. They can respond and react to your blood pressure a lot easier. The lower your elasticity, the more pressure that’s put on your blood vessels. If you have hard blood vessels, it’s more effort for your heart. • “Some foods have been shown to reduce blood pressure, like legumes. Fruits and vegetables that are high in vitamins K and C help, too.” Michael Knapp, certified personal trainer and owner of At Your Home Personal Training in Syracuse and Rochester
What we don’t breathe plays an important role in heart health By Patricia Briest
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ebruary is designated as heart health month. Having a healthy heart and cardiovascular system are important for overall health since many of the habits that help to maintain good heart health actually help the entire body. Most people are aware that what we eat and what we do play an important role in maintaining overall good health. Maintaining a healthy diet and incorporating exercise into daily routines are important. What many people do not realize is that what we breathe can also contribute to a healthy heart, and what we don’t breathe plays an important role in heart health as well. It is common
knowledge that cigarette smoking is considered a “risky” behavior, a contributing factor to heart disease both in smokers and in those who are breathing second and third hand smoke. Roughly one out of five deaths from heart disease is a direct consequence of smoking. People who smoke are two to four times more likely to suffer with heart disease, with an increased risk for women taking birth control pills. Physiologically, smoking raises triglycerides in both smokers and in those exposed to second hand smoke. Good cholesterol (HDL) is lower — often dramatically — in smokers and in those
breathing second hand smoke and blood is often thicker, allowing clots to form more easily. The combination can be deadly, and sadly, often is. Measures to decrease heart disease due to cigarette smoking include quitting smoking and, as a community, promoting smoke-free housing and cars so that those who do not smoke are not exposed to harmful chemicals and carcinogens. Infants and children are particularly susceptible to second and third hand smoke, and medical research has revealed that the development of heart disease has already begun in many of these infants and children.
If you are a smoker, talk to your doctor about quitting. The N.Y.S. Smokers’ Quitline is available to assist as well. Toll free at 1-866-NY-QUITS, quit coaches are waiting for your call! Patricia Briest is a board-certified family nurse practitioner and nurse manager for cardiopulmonary rehabilitation, wellness and outpatient diabetes management at St. Joseph’s Hospital.
Comprehensive Cardiology Care February is National Heart Month EXERCISE. Why does it matter? Your heart is a muscle. When you use a muscle during exercise, it gets stronger and more efficient. A more efficient heart can pump more blood with each heartbeat and deliver more oxygen and nutrients to the rest of your body. Getting regular exercise is important because even a short period of inactivity can weaken your heart.
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Profile Leola Rodgers Now Playing New Role in Health Industry Former Upstate University Hospital administrator now at helm of Syracuse Community Health Center By Aaron Gifford
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eola Rodgers aspired to attend a secretarial training program after high school graduation, but her guidance counselor refused to endorse the application. Instead, the guidance counselor and school faculty members persuaded Rodgers to continue her education. She didn’t envision then that she would graduate from college with honors and continue on to earn a master’s degree in what was an emerging field at the time. It was a giant step forward and one she completed successfully. Decades later, Rodgers took another major step ahead when she was appointed to lead Syracuse Community Health Center, replacing the man [Dr. Ruben Cowart] who founded the organization in 1978. “It is a little intimidating,” said Rodgers. “But at the same time it is so exciting, so energizing. He had the legacy of building something that never had existed. I’ll bring a different perspective, but the focus should still be that what he built, no one can take away.” Rodgers, 58, started the job on Jan. 12. She succeeds Cowart, a dentist by trade who decided to retire after overseeing Syracuse Community Health Center’s operations since establishing the institution 36 years ago. She previously served as an associate administrator at Upstate University Hospital, where she played a key role in building and running the Golisano Children’s Hospital. Over the past year, she had been overseeing the outpatient services department. In many ways, Rodgers is returning to the same type of grind she grew accustomed to when she began working in the field. She’ll represent an organization that operates on a relatively lean budget while providing similar services as its larger counterparts. For example, Syracuse Community Health has three employees who will carve out time outside of their main responsibility to transition to an electronic medical system. Local hospitals, by contrast, might have entire in-house IT teams to perform the same task, or enough money in the operating budget to hire outside contractors. “You have to be resourceful with what you have,” she says.
Preps for career
Resourcefulness was a family Page 14
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value in Rodgers’ household growing up. They lived in a suburb just outside of Detroit, one of only a few African-American families in their neighborhood. Rodgers, whose father was employed as a truck driver, loved school even though she did not have her sights set on a specific career. School guidance counselors helped Rodgers find a way to afford college. She commuted to the University of Detroit and also worked while attending school full time. She started out as an accounting major but later changed to finance and economics. “I loved numbers,” she explained. “But it was more than just the equations. I liked how you could use numbers to tell a story.” After completing her undergraduate degree, Rodgers was selected for a National Association of Health Services Executives program aimed at grooming high-achieving minority graduates for health care administrator jobs. She worked at a hospital in southwest Detroit, where her task was to produce a binder on all of the hospital’s facilities. She was enchanted by the inner-workings of a health care organization. The focus, energy and dedication of medical providers and administrators could be contagious. “I fell in love with it,” she said. At that time, there was an emerging emphasis on public health, so Rodgers decided to obtain a master’s degree in that field and enrolled at the University of Alabama in Birmingham. There, she studied alongside physicians and learned about the clinical side of health care, which she would later put to good use with her experience on the business side of the industry. Rodgers was pregnant during her last year of grad school with a due date expected near the end of the semester. “They approved my thesis,” she said with a laugh, “because if they didn’t, I’d go into labor.” Rodgers and her new son, Brandon, then moved back to Detroit so they could spend more time with family and she could pursue a career. She took on temporary jobs as a secretary while completing informational interviews at various hospitals. She was eventually awarded a fellowship that split her work between three local hospitals as the assistant to the vice president. She gradually took on billing and
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
Rodgers budget work and got a taste for what it was like to be an administrator. It was also during that time when Rodgers embraced the idea that the financial and operations pieces of a health care organization should be more closely connected. From there, Rodgers went to work at hospitals in Boston and Jacksonville, Fla., taking on more leadership roles as she bolstered her resume. That era, the 1980s, was also a unique challenge in that information technology systems were beginning to play a bigger role in the health care industry. “My computer back then,” she said, “the battery itself must have weighed 20 pounds.”
Drawn to pediatrics
Rodgers also developed a special fondness of pediatrics. In her view, the medical approach for treating young people is a glowing example for all specialty areas to follow. “In pediatrics, you look at the whole body,” Rodgers said. “But it’s also a field that really cares for a family. You get everyone involved. Now, you’re starting to see that with geriatric medicine.” Rodgers accepted a position at Upstate University Hospital in 1999 for two main reasons. She enjoyed the environment of academic medical centers, and she relished the chance to be part of a team that built a pediatric hospital. She played a key role in the fund-raising efforts that brought the Golisano Children’s Hospital to fruition. Rodgers has enjoyed watching the children’s hospital here thrive. She says the doctors there are “unbelievably good at what they do, and perform
miracle after miracle.” When the top leadership job opened up at Syracuse Community Health Center, Rodgers was not interested in leaving Upstate. “They used an outside head hunter and my name kept coming up — even from Dr. Cowart,” Rodgers said. “Others approached me as well. I put up a barrier for taking the job, but the barrier would fall away. This was another new opportunity without having to move again. I didn’t have any excuses not to take it.” The organization serves more than 80,000 people at 15 neighborhood-based health centers throughout Onondaga County. Services include primary and urgent medical care, dental and behavioral health. When she’s not working, Rodgers enjoys watching old movies, listening to jazz music and reading. She belongs to a book club and is invigorated by the challenging of reading new authors and different genres on a deadline and talking about the books in front of her peers. “It’s nice because I’m the youngest one in the club,” she says. “You’re forced to try new things and you can’t blow off reading.” Rodgers also volunteers with various organizations, including the United Way, Ronald McDonald House and the Community Health Foundation of Western and Central New York. “There’s a lot of work involved, just like there is with my career, and you want to help make a difference,” she explained. “But the main reason — I really enjoy it.”
Food Bank: More Families Using its Services One of several factors: Existing recipients using services for longer periods of time, official says By Matthew Liptak
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hings aren’t as bad as they were during the height of the recent recession, but the Food Bank of Central New York has seen a definite increase in demand over the past year. “During the height of the recession, when food and fuel prices escalated, the food bank experienced a 12 percent increase in meal requests across our service area [as compared to the previous year],” said Kathleen Stress, executive director of the Food Bank of Central New York. “Currently we are seeing a 4 percent increase requested for meals. That is an additional 477,681 meals through our emergency food partners.” Stress said the increase was due to more families using the emergency food network and existing recipients using services for longer periods of time. She said more working families may be reliant on food pantries because they either are working multiple part-time jobs or may be working new jobs that don’t pay as much as they did before the recession. “We’re seeing more families so you have more children coming in,” she said. “Not that we’re not seeing individuals, but we are certainly seeing more families that have four or more in the household.” Despite the increased demand, the food bank, with ample help from CenStress tral New York communities, has been able to meet the need. Back when the recession hit, the food bank provided 12 million pounds of food a year to hungry residents. In 2014, that number was 16 million pounds of food. In 2015, it is projected to be 17 million pounds. “I’m proud to say that even though we’ve gone from 12 million to 16 million pounds, our expenses to run the operation have maintained fairly consistent,” Stress said. “Our ability to turn that dollar into meals has increased because our expenses haven’t increased.” The food bank runs an efficient operation, Stress said. Ninety-six cents of every $1 donated goes back into programming. Each $1 donated can be turned into 3.5 meals, because the food bank buys by the truckload, she added.
Lots of ground to cover
The organization covers 25 percent of the state, or 11 counties — St. Lawrence, Jefferson, Lewis, Herkimer, Oswego, Oneida, Onondaga, Madison, Cayuga, Cortland and Chenango. “We have 252 emergency food programs,” Stress said. “Those are food pantries, soup kitchens and shelters. Then we have 110 more what we call non-emergency programs. Those are day care centers, senior centers and neighborhood programs.”
A fleet of 16 refrigerated vehicles helps the food bank receive donations and deliver orders. A recent example of the Central New York community’s generosity involved that fleet. The organization had four cargo vans that it had outgrown. Stress reached out to 10 local foundations to see if they would help with the purchase of two new trucks costing $130,000 each to replace the smaller vans. The foundations came together and helped supply the funding. “It’s very exciting,” Stress said. “Vehicles are our means to get the food both into the warehouse as well as out of the warehouse to the programs that need it. I just finished my first year as director and this was the first time I’ve reached out to the foundations and asked, ‘Would you guys consider a collaboration?’” Many area residents have been generous toward the food bank too. Stress said they have about 22,000 consistent donors in the region. There are corporate and agricultural donors also. Some of the companies Stress mentioned included Cisco, Dot Foods, Chobani and Giovanni. “There were almost too many agricultural partners to mention,” she said. The food bank is trying to expand its services to clients in 2015. Stress gives credit to the four dietitians on staff at the food bank for creating a new pilot program called “Diabetes and You.” There is one pantry in Onondaga County and one in Oswego County that will begin the program. The pantries will provide diabetes prescreening for those clients who want it. The program can refer clients to a four-week class on coping with the disease. It will also provide boxes filled with food that are effective with helping manage diabetes. “Then hopefully we can create a model that we can replicate at other pantry sites,” Stress said. As demand has grown, the food bank has been able to meet it with an outpouring of generosity from the Central New York community. In the new year, the organization will continue to rely on that generosity to help more hungry neighbors. The face of hunger has changed in Central New York, but it is still combated the same way. “I think what the community has started to embrace is that it could be your neighbor,” Stress said. “It could be that senior citizen sitting next to you in church. It is probably that child sitting next to your child in school. The face of hunger has shifted. It’s no longer the homeless man who is going to a soup kitchen to seek services. It is families right in our neighborhood and it can happen to any one of us,” she said. “If you can just give up a cup of coffee for the week, that four or five dollars, that’s going to help feed a family. I think that’s an important stance to take — that we can all help and it doesn’t take a lot to help out.” For more information on the Food Bank of Central New York, go to www. foodbankcny.org or call 1-800-444-1562.
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Crouse’s New Chief Medical Officer Physician Seth Kronenberg picking up where his dad — former Crouse CEO Paul Kronenberg — left off By Aaron Gifford
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lthough medicine and hospital administrative work go back generations in the Kronenberg family, Seth Kronenberg says his original intent was not to follow someone else’s career path. As a teenager, Seth did well at Fayetteville-Manlius High School and went on to the University of Pennsylvania before completing a medical degree and residencies at Upstate Medical University. He then would practice internal medicine — just like his dad, Paul Kronenberg, an alumnus of both schools who specialized in the same field and worked at the same Syracuse hospital. Paul’s father was also a physician. “It’s more that we have similar personalities than it is trying to follow in his footsteps,” the younger Kronenberg said. “I saw the gratitude of patients, and maybe that inspired me a little. There was no push to go into the same profession. Internal medicine interested me because of the continuity with patients and being able to follow through with chronic issues. He enjoyed that, too. After that, I guess the similarity is that both of us are good at dealing with conflict, difficult personalities and difficult circumstances.” By “after that,” KroKronenberg nenberg is referring to leadership positions. He was recently named Crouse Hospital’s chief medical officer. The senior Kronenberg also had hospital privileges at Crouse and eventually became its chief of medicine medical officer and then chief executive officer, retiring last year to serve as the executive vice president of its board. The elder, who served as Crouse’s CEO for 10 years, is credited with
perform clinical work while also working as Crouse’s chief physician integration officer. “Trying to do a good job at both,” he says, “was pretty difficult. I was really taking on more and more administrative work.” Kronenberg’s new responsibilities include overseeing medical affairs, physician recruitment, delivery system development and many other tasks. He said his main focus is to “unite” the inpatient and outpatient worlds. “Care of the patient should extend beyond the four walls of the hospital.” That can be accomplished through Crouse’s developing integrated health care delivery system, which encourages collaboration among health professionals representing different aspects of the care delivery system, such as providers, long-term care, homecare and rehabilitation. They work as a team to address patient needs, Kronenberg said, “and it’s all physician-governed.”
Goal: Better Care
making the facility financially stable, helping several departments obtain high levels of accreditation, winning the hospital several awards of national recognition and expanding its services. Current CEO Kimberly Boynton was appointed to the top role in January 2014. Seth Kronenberg practiced internal medicine for 15 years and continued to
Making health care more affordable is also among Kronenberg’s goals. He favors a value-based approach where providers and facilities are rewarded for the quality of care as opposed to the number of patients seen. A system of measurements and metrics already exists to help Crouse prioritize quality over quantity. “You need more primary care doctors seeing 15 patients a day instead of 30,” he said. “It also involves delegating responsibility to care managers. You need the help of the entire health
care team.” Crouse leaders have reviewed examples from hospitals in other parts of New York state and in California. “We’re trying to learn from their successes and their failures,” Kronenberg said. “The lesson is — it’s hard work, and it’s hard to achieve.” He said it’s possible for patients to have shorter and fewer hospital stays and the number of expensive tests can be reduced. “There are plenty of opportunities to reduce costs,” Kronenberg said. “Value is the new buzzword — it’s quality divided by cost. You’re really going to be incentivized to do the right thing.” The new medical chief also wants to expand the use of data analysis functions at the hospital to find areas where physicians can utilize resources more efficiently. As for his recruiting role, Kronenberg said Crouse’s culture as an enjoyable, mission-focused place to work is a strong selling point. Departments are managed in such a way that there is plenty of staff to deal with paperwork and other tasks, which allows doctors to fully concentrate on caring for patients, he said. In the months to come, Kronenberg will largely focus on recruiting primary care physicians, neurologists and psychiatrists. When he’s not working, Kronenberg enjoys camping, fishing, sailing, skiing and spending time with his wife, Meredith, and their four daughters. Kronenberg has known Meredith since they were in the fifth grade. Their decision to remain in Central New York and remain close to family and friends was a no-brainer. “We love it here,” he said. “We love the different seasons. There are so many different lakes and rivers. The cost of living is low; the schools are great. You’re still close to Boston, New York City and Philly.” Kronenberg has adjusted well to his non-clinical role at the hospital, though he says the slower turnaround time on completing tasks is a new challenge. “In practicing [medicine], if there was an issue with blood pressure, you adjust the medications, check back with them and then go from there,” he explained. “But with administrative work, you have to learn a little more patience and depend more on your team. Things happen much slower.” So far, Paul Kronenberg has no complaints on how his son is performing in his role as a hospital leader. “He [father] tried not to give advice,” Seth Kronenberg said. “I ask a lot of questions, and he’s a huge resource to me.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
Parenting By Melissa Stefanec melissa@cnyhealth.com
Breastfeeding and Work My transition from nursing mom to pumping mom
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f you happened to catch my last column, you know how I feel about the United States’ parental leave policies regarding childbirth. This column won’t be a reiteration of our nation’s failings. For now, parents have to play the “go fish” cards they are dealt. For most new moms, that means returning to work fairly soon after childbirth. It’s not easy, and when you are a working mom who wants to breastfeed, leaving your baby behind is even more complicated. The general public knows breast is best. New moms have that credo stuck — or sometimes shoved — into almost every interaction with a healthcare professional and every click on the Internet. However, maintaining full-time breastfeeding is a very challenging endeavor when paired with full-time work. Some employers are more supportive than others, but there are certain New York state rights that all nursing moms are entitled to. You can check them out at: www.health.ny.gov/publications/2028/. Now that I have made the transition from nursing mom to pumping mom on two occasions, I have some helpful tips for moms who will soon be staring down breast shields, tubing and storage containers during every free moment at work. It’s not easy to maintain a household, a career, breastfeeding and your sanity, but I hope these tips I’ve
gleaned from personal experience will make some moms’ post-baby life just a little bit easier. Commit to the task. As with any challenge in life, your mind has to be ready. If you are breastfeeding because you feel pressured by anyone or anything, it’s going to be tough to keep your head in the game. Have the attitude that you can and want to do it. Don’t set yourself up for failure. When it gets hard, remember that it gets easier and isn’t forever. Get acquainted with pump. The lactation consultants I spoke with recommended waiting until my babies were four weeks old to start pumping. I listened and started pumping at this point. I pumped every day and got very well acquainted with my pump. This took the fear and anxiety out of the process and left me with more than a day’s worth of milk. Going back to work with more than a day or two’s supply made me feel more confident. Break out those creams. Your nipples are probably just starting to feel better when it’s time to introduce your pump. The pump is going to undo all of that. Break out all of your creams and salves and use them. Keep one in your pumping bag. Your nipples will get used to the pumping, but be armed with reinforcements until then. Get a good breast pump. Thanks to the Affordable Care Act, insurance companies have to provide some level
of coverage for breast pumps. Call your company while you are still pregnant and get all the details. That way, when you have a screaming infant in your life, all you have to do is drive and get the pump. Get a double-electric pump. It’s going to be difficult to fit pumping into your work schedule. Having a reliable and comfortable pump will make a big difference. Talk to your employer. This may be the most important tip on the list. Make sure you speak with your employer, and make sure you know your rights. Talking about pumping with your employer isn’t a joyride, but avoiding it is even more difficult. Figure out where and when you will pump. Demand a private place. You are entitled to it. Buy a hands-free pumping bra. If I were to just sit idly by and think about pumping while I pumped, I don’t think it would have ever worked out. Hands-free pumping bras are amazing. Use them. You won’t regret it. Make sure you have extra sets of supplies. Dedicate a drawer in your office to pumping. Have back-up supplies to your back-up supplies. No mom wants to be stuck without the needed accessories when pumping time is upon her. If possible, get two pumps. This may not be an option for everyone, but not having to lug your pump back and forth to work every day is a huge help in the time-saving department. Don’t stop that extra pump. Once you establish a pumping time when you are on maternity leave, keep up that extra pumping when you go back. This will give you a little extra milk in your stock and help you have enough milk for a newly bottle-fed baby. Get some microwave steam bags. Places of employment aren’t known for being germ-free. At the end of each day, I sterilize my
supplies in a microwave-steaming bag. I do it right in the office microwave. Move over burritos! Believe in how awesome you are. If you are able to breastfeed and work, you are amazing. Remind yourself you have conquered unbeatable odds. According to the Centers for Disease Control’s 2014 breastfeeding report card, only about 49 percent of American moms are doing any amount of breastfeeding when their babies reach six months of age. Only about 19 percent of those babies are exclusively breastfed. If you are breastfeeding at all at six months — working outside the home or not — you are in the minority. You are strong and bucking the statistics. But also be humble. Kindly remember to never be condescending about your achievements. It’s great to give yourself a pat on the back and recognize yourself for your hard work and dedication, but don’t get preachy or look down on other moms. We all have our own victories to celebrate.
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Song Berg Former music educator creates program for dementia patients and their families By Mary Beth Roach
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he Forget-Me-Nots are starting to blossom under the guidance of Francine Berg, music director at Menorah Park on the east side of Syracuse. This isn’t the garden variety of flowers, but a chorus assembled by Berg featuring seniors with dementia and their caregivers and loved ones. The music acts as a bridge between the two generations with songs familiar to both. While it operates out of Menorah Park, the program is open to anyone from the Syracuse area that would like to be a part of it with his or her loved one with dementia. “When they can sing with a caregiver or a loved one and make it a positive visit, then that’s very special,” Berg said. Berg has been successful in securing grants from the Jewish Federation of CNY and Salt City Dishes, an organization that raises funds for innovative community projects. The funds will help pay for her staff, which includes a director, accompanist and social worker. Inspired by a story she saw on the Internet about a group called The Unforgettables in New York City, Berg decided that, with her musical expertise, she could develop a similar group in the Central New York area. The NYC chorus was started by Mary Mittelman, director of the psychosocial research and support program at the Center for Cognitive Neurology. Mittelman said research may prove that music and social interaction can be of significant benefit to people suffering from dementia and also benefit family members. According to the Alzheimer’s Foundation of America, music can shift mood, manage stress, stimulate positive interactions and coordinate motor functions for individuals with Alzheimer’s and related dementias. Following her retirement as a music educator after more than 35 years, Berg began playing for the general population at Menorah Park. One of the recreational therapists asked her to visit the memory unit at Menorah. “I fell in love with that population,” she said. “That’s really where I wanted to focus my singing and my work.” She doesn’t just entertain them as much as engage them in the music, telling them stories, passing out instruments and encouraging them to join in. Through her work at Menorah Park and other senior communities in the area, she has seen the magic that music can provide to seniors, and especially those with dementia. She recounted the story of a woman who was so moved by the music, she got up, set aside her walker and began waltzing around the room. “The music just took her; that’s what music does,” Berg said. In addition to her work with the Forget-Me-Nots and at the facilities on the Menorah Park campus — the memory unit; the adult day program for special needs adults; The Oaks, and the general population — Berg travels to various other senior facilities through-
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out the area, bringing music to those at Van Duyn, Clare Bridge of Manlius in Fayetteville; East Side Manor in Fayetteville; Winwood in Manlius; James Square, the Kirkpatrick Day Program, and The Hearth on James Street in Syracuse; West Side Manor in Liverpool; Bellevue Manor and St. Camillus in the western suburbs.
Her third career
Her foray into making music for senior centers in the area marks Berg’s third career, so to speak. The Crane School of Music graduate, who majored in voice and minored in dance, had Francine Berg, music director at Menorah Park in Syracuse, plays for patients with dementia, their been a music teacher and retired in 2007. She also was caregiver and loved ones. ““When [patients] can sing with a caregiver or a loved one and make it a a cantor at Temple Concord, positive visit, then that’s very special,” Berg said. retiring last year. “I planned my retirement before I “All the songs we sang were about March, singing and tap dancing to retired,” she said. “I’m very goal-oripeace, love and tolerance in differ“I Got Rhythm.” Howie Mandel and ented. Before I retired from teaching, ent languages. Music is the universal Howard Stern loved her, Berg joked. I planned on coming to Menorah language. You hear that a lot, but that’s Her father was also very involved in Park and playing, not realizing how it what it is.” the community. He now resides at would grow and expand.” At the same, she was also a cantor Clare Bridge. Berg started her first career in the at Temple Concord, starting in 1980. Her mother was instrumental in early 1970s in music education, teachShe started singing at all the Friday honing Berg’s talents, she said, giving ing in Iowa; Canton, N.Y.; and several night services and the high-holiday her the opportunity to take singing Central New York schools, including services with a professional choir. and piano lessons. Berg also helped her Syracuse City School District’s H.W. She tutored most of the bar mitzvah mom with her dance school and did Smith School on the city’s east side, students, and of course, she had a chilcivic theater during high school. where she stayed from 1987 to 2007. dren’s choir at the temple. “I think everybody has a lot of While she was at H.W. Smith, the She was involved in community talent, but you have to dig deep. You school had a large number of refugees programs too, lending her talents and could have a skill and you could exfrom Russia and Bosnia. She recalled energy to InterFaith Works and Women pound upon that. I was given the gift having children from 35 countries from Transcending Boundaries. of music. I feel very fortunate that I can around the world. So, she decided to “I want to make a difference,” she still use the skills that I have and do it make her program multicultural and said. “I think that’s what I’m all about.” in a little different way,” she said. created the Rainbow Kids chorus. Her sense of community and sharLike cultivating Forget-Me-Nots, The group sang all over the coming her talents come, in large measure, for example. munity, in all the languages of the chilfrom her parents — Lynn Mitchell, 92, For those who would like to learn dren and with flags of the countries. and Ira Mitchell, 94. more about the Forget-Me-Nots chorus, “I cried every time we’d play the Lynn still sings and dances, and contact Berg through her email at songOlympic theme and have the kids paBerg told how her mom even audiberg@hotmail.com. rade down with all the flags,” she said. tioned for “America’s Got Talent” last
Francine Berg, music director at Menorah Park on the east side of Syracuse, playing to a crowd at Kirkpatrick Day Care Program in Syracuse. Inspired by a story she saw on the Internet about a group called The Unforgettables in New York City, Berg decided that, with her musical expertise, she could develop a similar group in the Central New York area.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
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What Medicare Doesn’t Cover “The Medicare Lady”
Dear Savvy Senior, I’m about to sign up for Medicare Part A and B and would like to find out what they don’t cover so I can avoid any unexpected costs down the road. Almost 65 Dear Almost, While Medicare covers a wide array of health care services, it certainly doesn’t cover everything. If you need or want certain services that aren’t covered, you’ll have to pay for them yourself unless you have other insurance or you’re in a Medicare Advantage health plan, which may cover some of these services. Here’s a rundown of what original Medicare generally does not cover. Alternative medicine: This includes acupuncture or chiropractic services (except to fix subluxation of the spine), and other types of alternative or complementary care. Cosmetic surgery: Elective cosmetic procedures are not covered, however, certain surgeries may be if necessary to fix a malformation. For example, breast prostheses are covered if you had a mastectomy due to breast cancer. Long-term care: This includes nursing home care, the costs of assisted living facilities and adult day care. Medicare does, however, help pay up to 100 days of skilled nursing or rehabilitation care immediately following a three-day inpatient hospital stay. Personal care: The cost of hiring help for bathing, toileting and dressing are not covered unless you are homebound and are also receiving skilled nursing care. Housekeeping services, such as shopping, meal preparation and cleaning, are not covered either unless you are receiving hospice care. Dental and vision care: Routine dental and vision care: Medicare will not cover routine dental checkups, cleanings, fillings or dentures. Nor do they cover routine vision care like eye exams, eye refractions, contact lenses or eyeglasses — except when following cataract surgery.
Hearing: Routine hearing exams and hearing aids are not covered either, although some hearing implants to treat a severe hearing loss may be covered. Foot care: Medicare does not cover most routine foot care, like the cutting or removing of corns and calluses, nor does it pay for most orthopedic shoes or other foot supports (orthotics). Medicare will, however, cover foot injuries or diseases like hammertoes, bunion deformities and heel spurs, along with foot exams and treatments if you have diabetes-related nerve damage. Non-emergency services: Medicare does not pay for copies of X-rays or most non-emergency transportation including ambulette services. Overseas coverage: In most cases, health care you receive outside of the United States is not covered. The best way to find out if Medicare covers what you need is to talk to your doctor or other health care provider. Or visit medicare.gov/coverage and type in your test, item or service, to get a breakdown of what is and isn’t covered. Also keep in mind that even if Medicare covers a service or item, they don’t usually pay 100 percent of the cost. Unless you have supplemental insurance, you’ll have to pay monthly premiums as well as annual deductibles and copayments. Most preventive services, however, are covered by original Medicare with no copays or deductibles. For more information on what original Medicare does and doesn’t cover, see the “Medicare and You” 2015 booklet that you should receive in the mail a few months before you turn 65, or you can see it online at medicare. gov/pubs/pdf/10050.pdf. You can also get help over the phone by calling Medicare at 800633-4227, or contact your State Health Insurance Assistance Program (SHIP), who provides free one-on-one Medicare counseling in person or over the phone. To find a local SHIP counselor visit shiptalk.org, or call the eldercare locator at 800-677-1116. If you enroll in a Medicare Advantage plan, you’ll need to contact you plan administrator for details.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Caring Beyond the Front Door: St. Joe’s Charity Care is Community Care
A
s the Affordable Health Care Act and health care in general continue to be discussed in the news, around the workplace and at home, we’re taking a closer look at how the healthcare industry is responding to the need for individuals and families to pay for increasing costs. As traditional health insurance costs rise for employers and for individuals, more people are exploring alternative options, such as plans that use tax deductible health savings accounts, other tax credit subsidies and charity care. Charity care is available at many hospitals for those who cannot afford to pay, and is based on information like family income, assets and family size. At St. Joseph’s Hospital Health Center in Syracuse, financial counselors work with each case to determine the best payment option, including financial assistance. For St. Joseph’s, providing services like charity care to address this need isn’t anything new. It’s been an area of focus for the hospital for over 100 years, and continues to be a topic of dedicated discussion. The reason that St. Joseph’s Hospital continues to make all patients a priority — without regard to race, color, creed or the ability to pay — is deeply rooted in mission and its commitment to serve the community. Between 2012 and 2013, St. Joseph’s conducted a detailed assessment of the community’s health needs, in collaboration with the Onondaga County Health Department other local hospitals. It began implementation of a three-year community health improvement strategy to address priority areas of concern — including chronic disease, mental health, access dental services, and injuring resulting from falls. “Part of the answer is trying to find ways to make healthcare more affordable, but another part of the answer is creating community access
to more preventive care,” said Deborah Welch, St. Joseph’s vice president for people. “For example, as part of the Near Westside Initiative, St. Joseph’s provides community health programs for residents of Syracuse’s near westside that include diagnoses, nutritional counseling and other preventive healthy living guidance. Our recently expanded Primary Care West health center offers education groups to help patients manage their conditions and ideally help to prevent unnecessary hospitalization.” A similar program is offered at the Family Medicine Center. St. Joseph’s also provides funding to Assumption Food Pantry to help the soup kitchen purchase fruits and vegetables. Additionally, the Wellness Place actively reaches out to the community to provide free education and health screenings. And in the hospital’s emergency department, St. Joseph’s implemented a patient navigator program, the first of its kind in Central New York, to ensure access to primary care services and improve patient management of chronic health conditions. As a ministry sponsored by the Sisters of St. Francis, St. Joseph’s maintains a strong mission of care to underserved populations through its hospital main campus and regional services. St. Joseph’s Hospital Health Center is a 431-bed hospital and health care system, which has served the Central New York community for nearly 145 years. Today, St. Joseph’s has more than 5,000 employees, treats more than 26,000 annual inpatients, and more than 600,000 outpatients. Its annual operating budget includes approximately $22 million of charity care, unreimbursed services and costs associated with community programs. Submitted by St. Joseph’s Hospital Health Center.
NYSID names Upstate Medical University customer of the year Upstate Medical University has received a 2014 customer of the year award from New York State Industries for the Disabled Inc (NYSID). The award recognizes Upstate for creating jobs for New Yorkers with disabilities through its partnership with NYSID and NYSID vendors that contract through New York’s preferred source program. “We are proud of our partnership with NYSID and NYSID agencies, and particularly proud of the Upstate Medical University personnel who are active supporters of the NYSID programs at the university and hospital,” said Paul Seale, chief operating
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officer of Upstate University Hospital. “We also commend our NYSID preferred source workers who provide Upstate and its many constituents with high quality services. This year alone, Upstate has employed 181 individuals with disabilities through NYSID member agencies.” Under the legislatively mandated New York State preferred source program, NYSID acts as a “virtual storefront” for a statewide network of 165 community rehabilitation agencies and private sector business partners to employ skilled people with disabilities in production facilities and community-based jobs.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
The Social Ask Security Office Provided Deborah Banikowski, Social Security OfficeSocial Security Office
Wear Your Heart On Your Sleeve
F
whose medical condition meets the ebruary is the month when we strict definition of disability under the celebrate love and friendship. The Centers for Disease Control (CDC) Social Security Act. A person is considered disabled under this definition if has also declared February as Amerihe or she cannot work due to a severe can Heart Month to bring awareness medical condition that has lasted or to the leading cause of death for both is expected to last at least one year or women and men in the United States: result in death. The person’s medical heart disease. condition must prevent him or her We encourage you to wear red from doing work that he or she did in all month to promote cardiovascular the past, and it must prevent disease prevention. the person from adjusting to Just as the heart is vital other work based on their age, to our emotional and physieducation and experience. You cal well-being, Social Security can find all the information disability benefits are often a you need about eligibility vital lifeline for people who are and benefits available to you unable to work due to severe by reading our publication, disabilities — whether heart-reDisability Benefits, available at lated or not. www.socialsecurity.gov/pubs. There are numerous ways If you are disabled, and to protect our hearts, including think you are eligible to reeating well, exercising and not Banikowski ceive disability benefits, you smoking. We get checkups and will need to complete an application make sure to keep our cholesterol for Social Security benefits. It’s easy down. to apply online at www.socialsecurity. However, sometimes these meagov/disability. sures aren’t enough. In fact, disability We also invite you to visit our will affect one in four of today’s 20 Faces and Facts of Disability website year-olds before reaching retirement to watch and read stories about people age. The Social Security disability who have truly benefited from Social program excels in providing financial Security’s disability program and to help to people when they need it most get the facts about this very important — help they earned by paying Social program. Helping people is at the heart Security taxes on their earnings or of what we do. You can learn more at as dependents of someone who paid www.socialsecurity.gov/disabilityfacts. Social Security taxes. During American Heart Month, Social Security pays benefits to go ahead and wear your heart on your covered people who can’t work and sleeve. Go red, and go to www.socialsecurity.gov/disabilityfacts.
Q&A
Q: I heard that Social Security benefits increased at the beginning of the year. What is the average Social Security retirement payment that a person receives each month? A: You are right — Social Security benefits increased this year. In 2015, nearly 64 million Americans who receive Social Security or Supplemental Security Income (SSI) began receiving a cost-of-living adjustment (COLA) increase of 1.7 percent to their monthly benefit payments. The average monthly Social Security benefit for a retired worker in 2015 is $1,328 (up from $1,306 in 2014). The average monthly Social Security benefit for a disabled worker in 2015 is $1,165 (up from $1,146 in 2014). As a reminder, eligibility for retirement benefits still requires 40 credits (usually about 10 years of work). The Social Security Act details how the COLA is calculated. You can read more about the COLA at www. socialsecurity.gov/cola. Q: I recently got married. How can I update my insurance under the Affordable Care Act? A: You can do so before the Affordable Care Act open enrollment pe-
riod ends Feb. 15. You and your spouse can shop for a new healthcare plan any time before Feb. 15. Be sure to update your information, including your new name, address or anything that might have changed. Healthcare.gov is your hub for everything involving affordable healthcare. Q: My child lost his Social Security card. How can I get a replacement? A: You can replace your child’s Social Security card at no cost to you if it is lost or stolen. You are limited to three replacement cards in a year and 10 during a lifetime. Legal name changes and other exceptions don’t count toward these limits. Also, you may not be affected by these limits if you can prove you need the card to prevent a significant hardship. The documents you will need to provide will differ depending on whether your child is a citizen of the United States or foreign-born citizen. To get a new card, you will need to provide original documents that prove citizenship. No photocopies or digital replications are accepted. You will have to provide proof of your identity as well using a U.S. driver’s license, a state-issued non-driver identification card, or a U.S. passport.
H ealth News St. Joe’s nurse honored with award for service St. Joseph’s Hospital Health Center honored registered nurse Angela Baldini with its Leadership in the Franciscan Tradition award. “This award was created four years ago as a way for us to recognize and honor the leaders among us who follow St. Francis of Assisi as servant leaders,” said Deborah Welch, vice president for people. “As a Catholic organization in the Franciscan tradition, we call on our leaders to strive to lead and serve the way St. Francis did.” Baldini Employed by St. Joseph’s for 26 years and a graduate of its college of nursing, Baldini has held many positions, including staff educator and clinical coordinator and most recently as clinical manager for the hemodialysis programs. In 2008-2009 Baldini was mobilized with the Army and spent a year in Louisiana working in an Army hospital providing care to soldiers, wounded warriors, veterans and their family members. In 2010 she spent a month in Haiti providing medical care and support after the devastating earthquake. Baldini is a resident of Phoenix.
Urgent Care of Auburn partnering with SOS Syracuse Orthopedic Specialists (SOS) is pleased to announce that it
has recently begun a partnership with Urgent Care of Auburn (formerly Insource Urgent Care) to provide convenient access to orthopedic care for patients in Auburn and surrounding locations. Kevin Lake, PA-C, currently a physician’s assistant with SOS, will see patients Thursday afternoons at Urgent Care of Auburn, 37 West Garden Street, Suite 105, Auburn. Urgent Care of Auburn, which opened approximately one and a half years ago, led by medical director, physician Mark McSwain, offers a high quality health care option to the greater Auburn community, with fast, friendly, reliable and affordable service, and no need to make an appointment. McSwain, board certified in both internal medicine and pediatrics, has been providing primary care in the Auburn area for 12 years, and is glad to welcome SOS as a partner. “This partnership is a logical step for Urgent Care of Auburn, and more importantly offers greater patient convenience,” says McSwain. “Our patients now have easier access to some sub-specialties of orthopedics that aren’t currently available in the Auburn area, and are introduced to SOS through the familiarity of Urgent Care of Auburn.”
Crouse: new way to treat cancer tumors Crouse Hospital is the first in the area to use the NeuWave gas-cooled microwave ablation system to treat cancer tumors without surgery and percutaneously (with a needle), according to the hospital. A microwave antenna at the end of the needle allows the tumor to get ‘cooked’ (ablated). The gas-cooling (the only one of its kind on the market)
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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H ealth News allows the heat to stay in the tumor rather than spread out to healthy tissue or the patient’s skin and ultimately acts to kill the cancer cells without resection or needing to remove healthy tissue. Because this is a minimally invasive procedure, the patient doesn’t need stitches afterwards, just a bandaid, according to the hospital. Microwave tumor ablation can be used to treat liver, lung, kidney and bone tumors, according to Crouse Interventional Radiologist Stuart Singer, who recently performed the first procedure at Crouse. Assisting from the IR control room were (standing) IR Supervisor Jim Guyle, RT(R), and Patrick Hoffstead, RT(R).
AccessCNY: New nonprofit in CNY AccessCNY is the new nonprofit serving Central New York as a result of the merger of Enable and Transitional Living Services (TLS). The agencies began partnering nearly two years ago and have been working towardbecoming one since that time. According to a news release issued by the nonproft, the new name is an encapsulation of the agency’s mission to provide person-centered services to Central New Yorkers with physical and developmental disabilities, traumatic brain injuries and mental health issues. “We are excited to expand our mission under the name AccessCNY,” said Prudence York, executive direc-
tor. “The merger makes us a stronger agency that can provide a wider range of services not only to more individuals, but to people with a wider range of needs. As AccessCNY our programs are broader, our staff more experienced and our resources richer. This collabYork oration was made possible thanks to the hard work and dedication of our staff and board of directors whose focus is always on providing the highest level of care to the individuals we serve.” The agency will celebrate the new name March 26 at an evening event at the Holiday Inn on Electronics Parkway. The community at large is invited to attend. The event will acknowledge community members who have embraced the agency’s mission and will also serve as the unveiling of the new AccessCNY logo. The permanent visual image is currently under development. AccessCNY offers a dynamic array of services that include training, therapy, and communitysupports that help individuals with physical and developmental disabilities, traumatic brain injuries and mental health issues. AccessCNY serves over 3,000 people of all ages and abilities each year, helping them lead more independent lives. More information is available at www. accesscny.org.
Crouse College of Nursing has been renamed
Longtime Oswego Hospital Auxiliary Members Step Down From Leadership Roles
Three volunteers at Oswego Hospital Auxiliary are retiring from their leadership roles but will remain as volunteers. Three longtime Oswego Hospital Auxiliary members who have volunteered countless hours to improve local healthcare services at Oswego Hospital, have recently stepped down from their leadership roles. Pictured from left are outgoing Treasurer Sheila Gurdziel, along Page 22
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Crouse College of Nursing Renamed as the Bill and Sandra Pomeroy College of Nursing at Crouse Hospital. Celebrating the milestone are Paula Miller, executive director of The William G. Pomeroy Foundation, Bill Pomeroy and his wife, Sandra Pomeroy.
with Barbara Handley-Place who is pictured passing the president’s gavel to incoming president Julia Burns. At far right is Marion Duplessis, who is stepping down from the role of secretary. While they are leaving their leadership duties, the trio plans to remain active with the auxiliary.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015
Crouse Hospital’s College of Nursing was officially re-named during a recent ceremony, thanks to the generosity of The William G. Pomeroy Foundation. A significant gift from The Pomeroy Foundation in November 2014 is now being used to enhance the school’s curriculum, make capital improvements to classrooms and ancillary spaces, as well as rename the school the Bill and Sandra Pomeroy College of Nursing at Crouse Hospital. The Pomeroy Foundation gift also established the Bill and Sandra Pomeroy College of Nursing Endowment Fund, a permanent source of monies that will support equipment purchases, student activities and faculty development for perpetuity. “Today we celebrate a new name — and a new era — for the future of nursing education at Crouse,” announced College Director Rhonda Reader. “This naming gift will help support the mission of the college by allowing for additional resources and support for student success and faculty development, as well as to remain current with trends in healthcare, nursing, nursing education and building improvements.” The Pomeroy Foundation’s gift was made with much forethought and appreciation for Crouse that began over a decade ago. In October 2004, Bill Pomeroy was diagnosed with acute myeloid leukemia. Working with the medical teams at both Crouse Hospital and Dana-Farber Cancer Institute in Boston,
he went through treatments and a stem cell transplant seven months later. Pomeroy spent much time on 4 South Irving, Crouse’s oncology unit, and became close with and appreciative of the physicians and staff, particularly the nurses who cared for him. “Each time I needed access to the services at Crouse, I became impressed by the expertise of the providers and the importance of the role nurses play in the delivery of skilled, compassionate care,” Pomeroy said.
The Pomeroys
Bill Pomeroy is an active member of several local and national nonprofit boards, including the National Marrow Donor Program and the Be The Match Foundation. He serves as a caring connection volunteer for the Blood & Marrow Transplant Information Network and a First Connection volunteer for the Leukemia & Lymphoma Society (LLS). Bill received LLS’s annual Courage Award in 2006. Sandra Pomeroy, senior vice president of CXtec and TERACAI, serves as a trustee for The William G. Pomeroy Foundation, in addition to her role on the Crouse Health Foundation’s board of trustees. She is also a caring connection volunteer and First Connection volunteer, as well as a former board member of the Leukemia & Lymphoma Society. Bill and Sandra are recipients of the Crouse Health Foundation’s 2012 Tribute Award.
Meet Your Provider Farah Dermatology and Cosmetics
Family-owned practice serves patients at several locations in Central and Northern New York
Q: What are the most common medical dermatology concerns of patients today? A: There is a definite increase in the incidence of skin cancer and of particular concern the malignant melanoma with an estimated 76,100 new cases of invasive melanoma diagnosed in the US in 2014. One person dies of melanoma every hour. Despite this disquieting statistic, we are detecting melanoma earlier and therefore survival with melanoma increased from 49 percent (1950 – 1954) to 92 percent (1996 – 2003). These statistics are all from the Skin Cancer Foundation. Patients need to play an active role, and see a dermatologist whenever something looks remotely suspicious. And The Farah Team and Family — top left and bottom left, respectively, are Mrs. Mona Farah and Mrs. please, avoid tanning booths at all Michelle Farah, PhD, who both manage the office. Top right and bottom right, respectively, are Dr. costs. Q: How about cosmetics — what are some of the aspects that patients would like to accomplish in the field of skin aesthetics and is there a fountain of youth? A: The sun plays a role in aging, and genetics does as well. Again, regular SPF (even in the winter) is key here. And we have found
Joyce B. Farah and Dr. Ramsay S. Farah, a past president of the Onondaga County Medical Society (OCMS). Pictured at the center is Dr. Fuad S. Farah, who recently received the OCMS Distinguished Service Award, the highest esteem held by members of this society for his lifetime of contributions as a physician, mentor and role model. Photography by Fernando.
that a combination of treatments is key with many of our patients and, to that extent, we regard that as the fountain of (skin) youth. The right products, laser treatments,
filler treatments, the e-matrix eye treatment and regular aesthetician treatments (such as chemical peels and microdermabrasion) are all ways to keep your skin youthful.
The delicate skin surrounding the eyes is especially reflective of youth and fortunately there are several key treatments for that area. One new cutting edge treatment, microneedling, targets anything from acne scarring to fine lines to hyperpigmentation. We are using the Dermapen in combination with other treatments, such as Botox and fillers, to help our patients achieve a more youthful, brighter complexion. Most patients address skin issues when it is spring or summer, but actually the winter is the best time to do it all, so that one is ready for the spring and summer! Q: According to media reports, it may take months to get an appointment with a dermatologist. Is that correct? A: We strive to accommodate patients as much as possible, and can usually make an appointment for someone in one to two weeks. In addition to our main office in Syracuse, we do travel to different locations such as Fulton, Watertown and Camillus and many people know that we are in Fulton almost every Friday.
Farah Dermatology • 1000 E. Genessee St. ste. 601 • Syracuse • 315-422-8331 • farahdermatology.com
Do you BOSU? If you’re looking to refresh your exercise routine, check out BOSU training. Taking a group exercise class or two that incorporates the BOSU Balance Trainer will quickly acquaint you with the benefits of using this domeshaped piece of fitness equipment. Invented by David Weck in 2000, BOSU was originally an acronym for “both sides up.” This means that the equipment can be used with either the
dome or platform side up. Today, the term BOSU has evolved as acronym to also stand for the “both sides utilized” approach to exercise. “BOSU exercises are appropriate to a variety of fitness levels and physical abilities,” says Paula Pacini, exercise coordinator at the JCC of Syracuse’s Sports and Fitness Center. “It represents an approach that is more mindful than traditional training. BOSU training can help improve physical balance using integrated movement challenges that impact the
brain, muscle and nerve connections. As a result, enhanced performance is possible in a wide range of activities such as sports, recreation and daily tasks.” Using the BOSU offers a fun and effective way to work out muscles that you may not always use in traditional workouts. It can be used as an upper body workout, lower body workout, total body workout, core workout and an athletic circuit workout. The BOSU Balance Trainer can even be incorporated into yoga, Pilates and stretching.
Donated artwork now on display at Upstate University Hospital’s Community Campus
Local artist Katya Bratslavsky presents the donated painting “Cosmic Symphony” to Upstate University Hospital’s Community Campus. The painting is on display in the main lobby of the hospital.
A piece of art, titled “Cosmic Symphony” was recently added to the main lobby seating area at Upstate University Hospital’s Community Campus. The large one-of-akind painting was donated by local artist Katya Bratslavsky to the Foundation for Upstate to be displayed at the campus. “Syracuse is my home,” said Bratslavsky. “And it is important to me to support the community and to give back.” Associate administrator for ambulatory services and Women’s Health Network, Deb Stehle was instrumental in connecting the artist to the hospital. “Katya is a tremendously talented artist,” said Stehle. “We are so touched by her generous gift. Her artwork is a treat for visitors and staff alike.” A self-taught artist, Bratslavsky February 2015 •
works mainly with acrylics and creates texture in her pieces through the use of various mediums and techniques. While “Cosmic Symphony” is an abstract-style painting, Bratslavsky also creates pieces focused on nature and sunsets. Her work has been showcased locally, including the Fayetteville YMCA and Manlius Library. The painting was signed by Bratslavsky — wife of Upstate professor and chairman of urology Gennady Bratslavsky — on Dec. 19. The painting is accompanied by a plaque that reads, “The Upstate Foundation would like to recognize Artist, Katya Bratslavsky for sharing her extraordinary talent through this gift of art entitled ‘Cosmic Symphony’ 2014.” More information about the artist and her work is available online at www.katyabratslavsky.com.
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At St. Joseph’s, Connecting Lives is something we take to heart Cardiac Services When you come to St. Joseph’s for cardiac services, you’re connected to some of the best care in the region, with faster times to treatment, advanced technology and award-winning services. But you’ll find an even greater connection with our people – doctors, nurses and staff who are emotionally invested in healing, and making you and your loved ones comfortable along the way. It’s our way of connecting lives – and that’s what it means to provide A Higher Level of Care. To see why more patients in the region choose us for cardiac care, visit www.sjhsyr.org or call 315-703-2138. St. Joseph’s is sponsored by the Sisters of St. Francis. Franciscan Companies is a member of the St. Joseph’s Hospital Health Center system.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2015