in good Hospital-Land Program at Crouse has helped nearly 200,000 CNY kids get familiar with hospital settings
Hip Replacement
Report: number of hip replacement procedures has skyrocketed
March 2015 • Issue 183
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VACCINES • Understand the ‘Herd Immunity’ Effect • Mother: Why I Don’t Vaccinate My Kid • Vaccination Myths: What’s True, What’s Not
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Do You Need To File a Tax Return in 2015? Many don’t need to. See the Savvy Senior column inside
Managing Diabetes? Beating Cancer Three Times
There’s an App for That
Come March — when snow and ice still have a death grip on our climate — I pine for pineapples more than at any other time of year. See why at this month’s SmartBites column
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REAL HERO Jerry Ball of Syracuse celebrates 250th time donating blood, enough to fill 31 gallons, save more than 700 people. Page 9
Meet Your Doctor Cardiologist Thomas Grady Jr. talks about how stress, emotional and spiritual health can affect your heart Page 5 March 2015 •
Page 8
Energy drinks tied to inattention, hyper behavior in middle schoolers says study
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Number of Hip Replacements Has Skyrocketed, Report Shows Procedure becoming more common in younger adults, but hospital stays now a day shorter
T
he number of hip replacements performed in the United States has increased substantially, and the procedure has become more common in younger people, new government statistics show. The numbers reveal the rapid evolution of the procedure, which “remains one of the most dramatic and cost-effective ways to improve the quality of life for patients,” said physician Mark Pagnano, chairman of the department of orthopedic surgery at the Mayo Clinic in Rochester, Minn. “Recovery is dramatically easier for patients, the durability of hip replacements has improved, and the baby boomer generation is less willing to accept the limitations that accompany arthritis,” added Pagnano, who was not involved in the study. For the report, researchers looked at hospital statistics on total hip replacement — replacement of the head of the femur (thigh bone) and its socket — from 2000-2010. The researchers focused on patients 45 and older, who accounted for 95 percent of the procedures.
What’s going on?
Report lead author Monica Wolford, a statistician with the U.S. National Center for Health Statistics (NCHS),
said: “The main hypothesis is that osteoarthritis is becoming more common,” but the statistics in the study don’t reveal why the procedures are taking place. Pagnano said the growing number of cases of arthritis is a major factor in the trend. Most hip replacements in middle-aged patients are due to degenerative arthritis caused by wear and tear, he said. So higher numbers of active people translate Year...........Number of procedures into more 2000..........138,700 arthritis. “Thus, the 2010..........310,800 number of patients who are appropriate candidates for hip replacement at a younger age grows,” he noted. The report also found the average What’s next? hospital stay for total hip replacement Report co-author Anita Bercovitz, a patients has shrunk from nearly five health scientist with the NCHS, said the days in 2000 to just under four days in numbers suggest a challenge down the 2010. line: Many of these hip replacements “The early recovery from hip will have to be replaced when they replacement has become dramaticalwear out. “This will have implications ly easier from a patient standpoint,” for planning for the future,” she said. Pagano said, because of improved Physicians first developed modern rehabilitation procedures, better pain “total hip replacement” surgery in the management and better control of early 1960s. But it remained a fairly rare blood loss during surgery. procedure until the late 1980s, when the
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number of cases grew from an estimated 9,000 in 1984 to 119,000 in 1990, according to the report authors. The report was published Feb. 12 by the NCHS as a data brief.
DERMATOLOGY DERMATOLOGY &COSMETICS & COSMETICS
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Patients....................Increase (in %) 75 and older.............92 Aged 45 – 54...........205
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
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What Stresses People the Most? Money leads the list of major stress generators, followed by work, family responsibilities and health concerns
M
oney continues to be the leading cause of stress for Americans, a new survey finds. Overall, stress in the United States is at a seven-year low, and average stress levels are declining, the American Psychological Association poll found. But money worries continue to nag at the American psyche, despite the ongoing economic recovery, the association says in its report released Feb. 4, titled “Stress in America: Paying With Our Health.” Financial worries served as a significant source of stress for 64 percent of adults in 2014, ranking higher than three other major sources of stress: work (60 percent), family responsibilities (47 percent), and health concerns (46 percent). Nearly three out of four adults reported feeling stressed about money at least some of the time, and about one in four adults said they experienced extreme stress over money during the past month, according to the report. “Money is a very important component of establishing a secure life,”
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said Norman Anderson, CEO and executive vice president of the American Psychological Association. “When people are financially challenged, it makes sense that their stress level would go up.” The good news is that, on average, Americans’ stress levels are trending downward. The average reported stress level is 4.9 on a 10-point scale, down from 6.2 in 2007, the report found. Despite this, the association found that Americans are living with stress levels higher than what psychologists believe to be healthy, and 22 percent say that they are not doing enough to manage their stress. Financial stress particularly affects women, parents and younger adults, the survey found. For instance, three out of four parents and adults younger than 50 said money is a somewhat or very significant source of stress. Women are more likely than men to report money as a significant source of stress, 68 percent versus 61 percent.
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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: Amy Gagliano, Marsha K. Preston • Design: Chris Crocker • Office Manager: Alice Davis
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Colon Cancer Screening Thomas J. Romano, MD Robert S. Epstein, MD Borys Buniak, MD Sara H. Mitchell, MD Young Lee, MD Aran W. Laing, MD Carol A. Curreri, RN, FNP Sara L. Gleasman-Desimone, ANP, PhD Judy DiLiberto, PA-C Melanie F. Kukulski, PA-C
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March 4, April 14, May 6, Sept. 22
Healthy living classes for those with chronic diseases Oswego Health and the Oswego County Department of Health are once again offering a free, six-week program that is being taught by experienced health educators based on a program developed by Stanford University. The classes will be held four times during the year at convenient locations throughout the county. This is the second year that the two health organizations have teamed up to offer the classes that have been found to be successful by participants. The first class will be offered from 9 – 11:30 a.m. Wednesdays, at Bishop Commons, beginning March 4 and ending April 8. Participants do not need to be residents of the facility. The three other upcoming class sessions will be held April 14 through May 19 (at the Hannibal Medical Center); May 26 through June 30 (at the Central Square Medical Center), and Sept. 22 through Oct. 27 (in Pulaski, with the specific location to be deter-
mined). Oswego Health and the county health department offered similar programs last year, which assisted more than 40 residents in learning how to live better with their chronic condition. “This program provides participants with the knowledge and skills that truly empower them to make lifestyle changes to improve their chronic disease management,” said Susan Callaway, who is one of the peer leaders. This program is designed to help those with any chronic disease, such as arthritis, heart disease, osteoporosis or diabetes to improve their health status through its living healthy workshops. The workshops will cover nutrition and exercise, as well as how to get support, deal with pain and fatigue and talk with your physician and family members about your condition. Participants will learn goal-setting techniques and establish a step-by-step plan to improve their health. Those taking part in the program will be provided a free workbook and healthy snacks at each class session. To register, call 349-5513 or 3493587. Community members can also sign up online at http://ceacw.org/ by
continued on page 18
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
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Crouse gets grant to help women with substance abuse
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rouse Hospital’s Chemical Dependency Treatment Services, partnering with Syracuse Community Treatment Court, has been awarded a $733,000 grant by the Bureau of Justice Assistance (BJA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) to provide services to women. Crouse Chemical Dependency Treatment Services created the Women of Worth (WOW) program recognizing the many challenges women face that may interfere with their recovery. Some of these challenges include domestic violence, lack of stable housing, absence of healthy social networks, lack of job skills and medical and mental health needs. Through the grant, Crouse’s Chemical Dependency Treatment Services will enhance existing substance abuse programming for women identified as high need/high risk. The grant will allow Crouse to add additional counselors, train clinicians in trauma informed care and cultural competence specific to the target population and provide substance abuse treatment and education not covered by insurance. In addition to traditional substance
use disorder treatment, the target population will be able to participate in vocational counseling and a variety of evidence-based interventions based on individual treatment needs. The program fosters development of safe, healthy and addiction-free individuals and families by increasing resiliency factors, decreasing risk factors and incorporating addiction recovery concepts with healthy family living skills. “The primary goal of this program is to engage women who enter the Syracuse Community Treatment Court system through substance abuse treatment and evidence-based practices specific to their needs in a safe and caring environment,� states Monika Taylor, director of behavioral health at Crouse. “Working with Crouse, our goal for this program is to increase treatment completion rates and enhance employment opportunities for women who complete the program,� says Kim Kozlowski, project director for Syracuse Community Treatment Court. Crouse operates the region’s only hospital-based substance abuse treatment service, which serves over 20 counties and had more than 3,000 admissions in 2014.
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Upstate Medical University Using Novel Device to Perform the Most Challenging, Complex Shoulder Replacements
A
novel, implantable device that is less invasive and allows surgeons to perform the most challenging and complex shoulder replacements is now available at Upstate Medical University through the Upstate Bone and Joint Center. Upstate is one of two health care facilities in New York state and among only six facilities nationwide to use the FDA-approved implantable SMR TT metal back glenoid implant for shoulder replacements. The cup-shaped device replaces the glenoid, the cavity in the shoulder blade that connects to the head of the upper arm bone. The device allows patients who need a shoulder replaceSetter ment a greater range of motion following surgery. Due to its innovative design, the device also creates a more secure and longer lasting bond by allowing for bone ingrowth. Physician Kevin Setter, of Upstate, is the only surgeon in New York state, outside of Buffalo, using the device. He finds the device to be significantly better than the more traditional shoulder prostheses used in shoulder replacement surgery. Setter, associate professor of orthopedic surgery at Upstate Medical University, performed America’s first SMR
TT metal back glenoid implant in 2014. He says that the device shows promise in creating a life-long bond between the component and the patient’s bone because of its composition. It is made up of a special metal, tantilum titanium (TT), a porous material that allows bone to grow in and around the device. “Traditional artificial glenoids use bone cement to secure the prosthesis,� said Setter. “In time, the cement bone interface loosens. This may lead to pain, decreased function and possible need for revision surgery. The fixation of cemented components is greatest when first implanted. Over time this fixation will loosen. The SMR TT metal back glenoid gains its fixation from a tantalum coated peg, available in various sizes to fit anatomical needs. The hope is that with this new design, the fixation of the component will increase over time as the patient’s bone grows into the implant forming a more solid bond. This in turn will hopefully lead to an improvement in already good long-term results with shoulder replacement surgery.� Setter says that the new design is especially attractive for younger patients. “We are looking for long-term stability of these implants,� Setter said. “Certainly with younger patients loosening over time is a concern. We believe with our new glenoid device, this concern will be less.� For more information about the SMR TT metal back glenoid, contact the Upstate Bone and Joint Center at 315-464-8634.
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March 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Compound Found In Grapes, Red Wine May Help Prevent Memory Loss
A
compound found in common foods such as red grapes and peanuts may help prevent age-related decline in memory, according to new research published by a faculty member in the Texas A&M Health Science Center College of Medicine. Ashok K. Shetty, a professor in the department of molecular and cellular medicine and director of neurosciences at the Institute for Regenerative Medicine, has been studying the potential benefit of resveratrol, an antioxidant that is found in the skin of red grapes, as well as in red wine, peanuts and some berries. Resveratrol has been widely touted for its potential to prevent heart disease, but Shetty and a team that includes other researchers from the health science center believe it also has positive effects on the hippocampus, an area of the brain that is critical to functions such as memory, learning and mood. Because both humans and animals show a decline in cognitive capacity after middle age, the findings may have implications for treating memory loss in the elderly. Resveratrol may even be able to help people afflicted with severe neurodegenerative conditions such as Alzheimer’s disease. In a study published online Jan. 28 in Scientific Reports, Shetty and his research team members reported that treatment with resveratrol had apparent benefits in terms of learning, memory and mood function in aged rats. “The results of the study were striking,” Shetty said. “They indicated that for the control rats who did not receive resveratrol, spatial learning ability was largely maintained but ability to make new spatial memories significantly declined between 22 and 25 months. By contrast, both spatial learning and memory improved in the resveratrol-treated rats.” Shetty said neurogenesis (the growth and development of neurons) approximately doubled in the rats given resveratrol compared to the control rats. The resveratrol-treated rats also had significantly improved microvasculature, indicating improved blood flow, and had a lower level of chronic inflammation in the hippocampus. “The study provides novel evidence that resveratrol treatment in late middle age can help improve memory and mood function in old age,” Shetty said.
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Meet
Your Doctor
By Chris Motola
Thomas Grady, Jr., M.D Cardiologist talks about how stress, emotional/ spiritual health can affect heart Q: Do you perform interventional cardiology or preventive? A: My job is to try to prevent people from having to go to the catheterization lab. I’m more of a preventive cardiologist. I deal largely with lifestyle intervention: high blood pressure, diabetes, hyperlipidemia, exercise, nutrition. I try to prevent atherosclerosis from occurring. Q: Most people have a pretty good idea of what they should do to stay healthy — not to smoke, eat healthy, exercise. Are there any less well-known lifestyle habits people should be aware of? A: Just trying to maintain an ideal body weight, avoid being overweight or obese. Knowing which exercises are more beneficial than others. Those are all really important things. It’s a matter of motivating people to take better care of themselves. There’s always room for improvement, even for people who are athletic. We also look at stress and stress reduction, finding ways to spend time with their significant others and family. Oftentimes we forget about the other side of health, the spiritual/emotional side of health. When people come to the office, they’re often nervous, so it helps to establish the trust necessary for people to tell you how things are going not only physically, but emotionally. Your emotional health can affect your lipids, your blood sugar. It’s hard to do in a brief period of time, but just asking them how things are doing back home can be very important. Q: What’s going on biologically with stress? A: In stressful situations your stress hormones are elevated: epinephrine [adrenaline], norepinephrine, dopamine. They cause the heart to beat faster and more powerfully. It also causes the blood vessels to constrict. When you’re chronically stressed, the heart adapts in an adverse way, the blood vessels get stiffer. This can lead to high blood pressure as the blood vessels get damaged. So by decreasing the levels of these hormones, you can prevent that from happening. Exercise, dieting, biofeedback and relaxation techniques can all help. So it’s more than prescribing medication — they’re important — but you want to empower people to be able to do things without relying on medications. Q: One of the newer dietary fads is intermittent fasting. Do you have an opinion on it? A: I think it’s bad. You want
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
to choose a nutritional plan that’s going to last you a lifetime. You want to be able to have the building blocks you need available. So I think it goes back to eating three healthy meals a day. Avoiding eating between meals. Choosing healthy food groups. Eating slowly, so you realize when you’re full. So I don’t think fasting is all that great an idea. I think it needs to start early. We need to teach children how to choose healthy foods. Behaviors are instilled early on. When you get to 7 or 8, it’s already getting harder to change those behaviors. Q: Do you think schools provide healthy lunch options to choose? A: No. There’s a lot of pizza and chicken nuggets in school lunches. A lot of that would have to change at the federal government level. It would be a bit more expensive up front, but down the road they would be saving a ton of money in medical costs. We also shouldn’t be cutting physical education. I do think school lunches have come a long way from when I was growing up even if they’re not as healthy as they could be. A better option is bringing
Cardiologist Tom Grady works for St. Joseph’s Hospital (SJH) Cardiology Associates and provides services at three locations: Dewitt, Liverpool and at Oswego Hospital in Oswego. He recently held a seminar in Oswego to discuss how to prevent heart problems. healthy lunches from home if possible. The things you do early in life add up. Around Oswego County, it’s not uncommon to see young people smoking. There should be no tolerance for it. Seeing someone smoking through a tracheotomy can leave a strong impression. If you make these interventions early on, that’s $5,000 — that’s just for the procedure — you don’t have to spend in the cath lab. Two thirds of the health care the average person receives is in the last six months of their life. We need to make more of an investment up front. Q: Have advances in interventional cardiology had the side effect of making people less afraid of heart attacks? A: No, I think people are still just about as afraid of them, but outcomes are definitely better. They’re still scary and make you feel vulnerable. There’s still the recovery period. People want to know when they can be intimate with their significant other again, when they can go back to work, when they can exercise again. Cardiac disease is on the decline, but there are still a lot of improvements we can make. Q: What got you interested in cardiology? A: I was actually going to go into orthopedics because I’d broken my femur twice. In medical school I realized that being a surgeon is being more of a technician. They’re good with their patients, but once they perform their procedure, they’re done. I get to follow people through a lifetime. It’s a continuity of care that you get see. That’s what attracted me to cardiology.
Lifelines Position: Cardiologist at Oswego Health via SJH Cardiology Associates Hometown: Topsfield, Mass. Education: Tufts University School of Medicine; College of Holy Cross Affiliations: Oswego Health; SJH Cardiology Associates Organizations: American Medical Association; American Heart Association, American College of Cardiology Family: Three children Hobbies: Running, gardening, coaching soccer, hiking, kayaking
Post workout recovery Should you go for a snack? By Deborah Jeanne Sergeant
D
o you need a post-workout snack or drink? That depends on how strenuously you work out. If you stroll the mall for an hour, you’re probably fine with just drinking water during and afterward. You’ve probably not depleted your resources enough to warrant a post-workout snack or shake. Aside from other health conditions, snacking at this point would undo the calorie burning benefit of the walk. Unless you’re training for a marathon or other serious training, a post-workout snack just add excess calories you don’t need. “A lot of people think, ‘I burned 350 calories and want my post-workout recovery at Dairy Queen,’” joked Chrissy Mason, Payne certified personal trainer with Stability Fitness in Oswego. A small Oreo Cookie Blizzard from the popular chain weighs in at 570 calories, which obliterates the calorie burning benefit of many types of workouts.
However, if you work out several days per week with strenuous cardio training and resistance exercise, Mason recommends a small serving of protein, a healthful fat and carbohydrates. For those who vigorously strength-train, the protein intake could be a little higher and the carbohydrates and fat lower. “Eat 30 to 40 grams of protein per sitting,” Mason said. “That’s about all you can absorb in one sitting.” Snacks could include apple slices spread with one tablespoon of peanut butter; a small handful of almonds and a banana; one scrambled egg with one slice of toast and jelly; or one-half cup trail mix with nuts and dried fruit. Michael Knapp, certified personal trainer and owner of At Your Home Personal Training in Syracuse, agrees that a light snack or caloric beverage may be warranted after a hard workout. “Studies show chocolate milk is one of the best recovery drinks,” he said. “It offers cheap, quality protein. Protein drinks are $3 a serving. I think people overlook everyday things that have quality protein.” He encourages clients to drink water for primary hydration and make sure they eat sufficient protein. “You don’t have to overdo it, like
Chrissy Mason, a personal trainer with Stability Fitness in Oswego, leads one of her classes. 100 grams of protein,” Knapp said. “If you’re working out, you need 1.5 grams protein per kilogram of body weight daily. Even if you take in too much protein, it can be stored in the body. You should also have some active rest to increase blood flow and tissue repair.” “Active rest” means that you aren’t lifting weights and engaging in strenuous aerobic exercise the day after a hard workout, but you may go for a leisurely walk to increase blood flow and promote recovery. Greg Payne, certified personal trainer with Workouts B’ville in
Baldwinsville, advises clients who’ve really worked up a sweat to make sure they hydrate with a sports drink that includes “some sugar, sodium and electrolytes,” he said. “Those are good for hydration.” Like Knapp, he advocates drinking low-fat chocolate milk after resistance exercise to rebuild muscle tissue. “It is one of the best post-workout drinks you can have,” Payne said. “You want something that has low fiber, low fat, and protein. You want to feed your muscles for repair and milk has all that.” One cup of low-fat chocolate milk contains about 158 calories.
Healthcare in a Minute By George W. Chapman
V.A. Reins in Hospital-Acquired Infections
K
udos to Veteran Administration. After well-deserved and highly publicized criticism for lengthy appointment delays, which in some cases contributed to vets dying, credit should be given when due. In 2007, the Veterans Administration began to focus on hospital-acquired infections (MRSA) that kill 75,000 people per year. One-in-25 patients will acquire an infection while hospitalized. By 2012, five years after the V.A. began its rigorous program, hospital acquired infections had dropped an astounding 68 percent. This is even more impressive when you consider that V.A. patients are older and sicker than patients in private hospitals. V.A. is the healthcare model for the future. Ironically, the nation’s oldest healthcare system, in business since the Civil War, is basically the exact “system of care” currently being touted. There are basically six characteristics of near-future healthcare systems: 1. Multi-hospital. The V.A. operates 150 medical centers, 140 nursing homes and 1,400 community-based clinics across the country. 2. Employed providers. The V.A. employs 53,000 physicians and other licensed providers. 3. Pay for performance/value. The V.A. operates on a fixed budget. It has never been fee for service. 4. Population management. The V.A. is responsible for the overall
health status of a specific population: 8.7 million vets. 5. Incentives to control costs while improving care. As mentioned above, for example, the V.A. drastically reduced its infection rate that drastically reduced the cost of hospitalization and improved the health of vets. 6. Electronic medical records. The V.A. has had EMR system-wide for years and is credited for being a pioneer in EMR that is critical for population management.
CBO lowers cost estimate
The non-partisan Congressional Budget Office has lowered its estimate of providing health insurance to previously underserved Americans under the Affordable Care Act. The CBO originally estimated the cost would be $710 billion from 2015 through 2019. That has been lowered 20 percent to $570 billion over the next five years. The CBO estimates this year 12 million people will purchase insurance through an exchange with 75 percent being eligible for subsidy. The number of people on expanded Medicaid will be about 70 million this year. Minimum essential coverage. Beginning in 2014, you must have had minimum essential healthcare insurance. That can be either employer sponsored, purchased through an exchange, Medicaid or Medicare purchased directly through an insurance company.
Unless exempt, the uninsured will pay a penalty (when they file their tax return) which is the greater of 1 percent of family income over $10,150 or $95 per person up to a maximum of $285 per family. The penalty increases to 2 percent and $395 per person in 2015. The penalty increases again in 2016.
Medicare to pay physicians on quality vs. volume
Medicare just announced its intention to take the lead by basing 85 percent of payments to physicians on quality or value by the end of 2016. Commercial carriers typically mimic Medicare. This doesn’t mean the end of fee-for-service reimbursement quite yet. It means the end of “blind” fee for service based purely on the act of providing a service. But by 2018, Medicare intends to base 50 percent of its payments to physicians for population management or episodes of care that are not fee for service. The bottom line here is that payment for simply providing a service, regardless of quality or value, is being phased out.
Employer-sponsored insurance declining
Many advocate separating health insurance from employment. Market forces may make that happen. In the past, employees often felt “trapped” March 2015 •
by an employer fearing if they left they could be denied coverage by their new employer. That all changed with the passing of HIPAA (Health Insurance Portability and Accountability Act) which allows individuals to carry their insurance to their new job. Every year, fewer private-sector businesses offer insurance to their employees, most likely accelerated by online exchanges. In 2014, less than half of all private-sector employees were covered by employer-sponsored plans.
NYS passes telemedicine law
Commercial insurers now have to offer the same reimbursement to physicians for “seeing” patients via telemedicine versus seeing them in person. Deductibles and coinsurance must also be the same for a telemedicine “visit” as they are for an office visit. To date, very few physicians have offered telemedicine services to their patients because most carriers would not reimburse. Expect this to be commonplace within the next two years. 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
Forging a new life on your own. Need some help?
U
nmarried in midlife . . . could there be anything worse? Or maybe, just maybe, that’s an outdated myth that warrants examination. My experience leading empowerment workshops tells me that, with a little help and support, women and men are discovering that living alone can be far more complete and satisfying than most could ever have imagined. The ending of my own marriage years ago was not a welcome change for me. I never intended to be on my own in midlife. But it was a change nonetheless and one I had no choice but to accept and to ultimately embrace. It took some time and some hardknock lessons, but I eventually discovered a resourcefulness within myself that enabled me to forge a joyful and meaningful life on my own. It is that same resourcefulness that gave me the confidence to organize and offer workshops to support other women in similar circumstances. “Living Alone: How to Survive and Thrive on Your Own” is a threepart workshop I developed to help women discover the know how to create a satisfying and enriching life on their own. I’ve been leading the workshop for over 10 years now, and often get questions from In Good Health readers about what the workshop covers and how it is organized. In this month’s col-
umn, I am pleased to answer the most frequently asked questions: Q. What is the purpose of the workshop and what do you cover? A. Because I’ve walked in a similar pair of shoes, I can empathize with the challenges you may be facing. And I can support your efforts and desire to feel more content on your own. In many cases, it starts with a change in attitude, and my workshop will help you think differently about living alone. Specifically, I cover how to overcome loneliness and other emotional pitfalls, banish negative thinking, rediscover your true self, socialize in a couples’ world, and otherwise embrace what may be a oncein-a-lifetime opportunity to create a wonderful and rewarding life on your own. Getting good at living alone takes practice. There’s no magic pill and it doesn’t happen overnight. But it can happen, and good things can result. Feeling comfortable with your independence will improve your chances of finding happiness, and it will improve your chances of finding a new healthy relationship, if that’s what you desire. When you feel better about yourself — more confident and resourceful — life on your own or with a special someone can be richer and
KIDS Corner Energy Drinks Tied to Inattention, Hyper Behavior in Middle Schoolers: Study Kids shouldn’t drink sugary, caffeinated beverages, researchers conclude
E
nergy drinks are linked to hyperactivity and inattention in middle-school students, a new study reveals. Yale University researchers looked at more than 1,600 students at middle schools in one urban school district in Connecticut. Their average age was around 12 years. Boys were more likely to consume energy drinks than girls. The research-
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ers also found that among boys, black and Hispanic students were more likely to drink the beverages than white students. Children who consumed energy drinks were 66 percent more likely to be at risk for hyperactivity and inattention symptoms, according
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
more satisfying. Q. Who attends the workshop? A. Most, but not all, of the women who attend the workshop are between the ages of 40 and 70, and have come out of long marriages or relationships. Some are on their own for the first time in their lives. All have one thing in common: They want to get a better handle on living alone and to feel more content with themselves and their independence. Many see this workshop as an extension of the support they are receiving from friends, family, a therapist or their congregation. Q. I’m still grieving the loss of my marriage/spouse. Is this workshop right for me? A. Good question. My Living Alone workshop is a “nuts and bolts” practical workshop to help women become more confident and independent on their own. It is not a grief or mental health support group. If you are still in the grieving process and seek support, I recommend grief counseling or the help of a professional counselor. Q. What are your credentials? A. I’m not a licensed professional. My expertise is born out of real-life experience. I’ve “been there.” I emerged from my divorce feeling very deflated and very alone, faced with both the practical and emotional challenges of
to the study in the current issue of the journal Academic Pediatrics. Energy drinks have high levels of sugar and also often contain caffeine, the researchers noted. For the study, the investigators took into account the number and type of other sugar-sweetened drinks consumed by the students. “As the total number of sugar-sweetened beverages increased, so too did risk for hyperactivity and inattention symptoms among our middle-school students. Importantly, it appears that energy drinks are driving this association,” study leader Jeannette Ickovics, a professor in the School of Public Health, said in a Yale news release. “Our results support the American Academy of Pediatrics recommendation that parents should limit consumption of sweetened beverages and that children should not consume any energy drinks,” she added.
living alone. After some “hits and misses,” I found my way and now thoroughly enjoy the freedom and independence that comes with living alone. My time-tested experience, valuable resources, and tried-and-true tips and techniques have inspired and helped many workshop participants. My workshop has been the jump-start they needed to reclaim their lives. Q. How large are the workshops? A. Ideally, I like to have eight women in each workshop, although, on occasion, I have led workshops with a few more and a few less. A group of about eight gives everyone a chance to actively participate and benefit from the experience. The sharing quickly gives way to a comfortable camaraderie and it’s not unusual for nice friendships to develop among participants. Q. Where are the workshops held? A. At House Content Bed & Breakfast in Mendon, south of Rochester. House Content is a little historic gem, situated on a picturesque six-acre site, surrounded by horse farms and parkland. Reminiscent of a quaint English cottage, this setting serves as a peaceful and inspirational setting for the workshops. Q. I’d like to sign up for the workshop. What’s my next step? A. I like to speak with potential participants by phone, as a first step. That way, I can answer your questions and you’ll know better whether this workshop is right for you. Just call me at 585-624-7887 or email me at gvoelckers@rochester.rr.com. You’ll find information about my upcoming workshop in the Calendar of Health Events included in this issue. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call 585-6247887 or email: gvoelckers@rochester.rr.com.
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Blood Lines Jerry Ball of Syracuse celebrates 250th time donating blood, enough to fill 31 gallons, save more than 700 people By Matthew Liptak
“I
t’s just like giving the first time. It’s a very easy thing to do.” Jerry Ball of Syracuse gave that simple reflection as he sat down to give blood for the 250th time recently. The 57-year-old insurance investigator has donated over 31 gallons of blood in 40 years. That’s enough blood to save at least 747 people. When Ball looked around the room at the OnCenter full of over 700 people there to honor him recently, he realized the faces in that crowd could represent all the people he’d helped to save over the last four decades. He was honored along with 12 others at the 16th annual American Red Cross Real Heroes Breakfast for being community heroes. “This is extremely rare for someone to maintain that level of dedication for that long,” said Rosie Taravella,
regional chief executive officer for the Central New York chapter of the Red Cross. “He’s been giving blood for 40 years. [He] pretty much has come to make that donation every single time he was eligible to do so — every 56 days.” Ball, an Allstate Insurance investigator for 30 years, has made giving back to the community part of his life. He is also parish council president at Blessed Sacrament Roman Catholic Church in Eastwood. At Bishop Grimes High School in East Syracuse, Ball volunteers for the boosters and is on several committees. The investigator doesn’t attribute any super powers to giving so much of himself to his CNY neighbors. He said it’s just a matter of writing the next donation appointment on the calendar as soon as you’re done giving blood.
Jerry Ball, an Allstate Insurance investigator for 30 years from Syracuse, has made giving back to the community part of his life. The parish council president at Blessed Sacrament Roman Catholic Church in Eastwood recently celebrated donation No. 250.
Jerry Ball, center, was honored by the American Red Cross at the Real Heroes breakfast in Syracuse to recognize over 40 years of consistently donating his blood.
Making it routine
The start of his journey with the Red Cross started simply enough too. “I was 17 when I started donating,” Ball said. “My parents were in favor actually. We were walking out of church and there was a blood donation center set up in the school gym. I went over and donated there.” That was at St. Margaret’s in Pearl River. Ball came to Syracuse 30 years ago, but his routine donations didn’t falter. “It’s very easy to do and I just know that my blood goes to people that desperately need it, people that have been in accidents and people with diseases,” he said. “It’s just knowing that with no effort on my part, I might help several people get through a very critical time in their lives.” Only about a third of all people are eligible to give blood, Ball said, and he recommends giving for those who are able. The main criteria are that you be at least 17 years old, weigh at least 110 pounds and are not sick. “Every second somebody in America needs blood,” Taravella said. “That’s for a number of reasons. People need transfusions after car accidents, if they’re being treated for leukemia or if they’ve had a surgery that hasn’t gone well. It’s a surprising number when you think about it. With the limited shelf life, it’s very important to have as much as we can get on a daily basis. We only have as much blood as what is on the shelves right now. That’s why
it’s important to get the message out every day.” Ball has personal experience with loved ones needing blood. He lost his wife, Kimberly, to a fight with cancer and also his parents too. His father had a heart attack when he was younger and then needed a heart transplant. “I know a lot of blood was used during his surgeries,” he said. “A lot of other people donated blood and helped keep my dad around for many extra years.” Whole blood has a shelf life of up to 35 days, according to the Red Cross website. Most all of the blood donated locally stays in CNY. Donors can get an email a few weeks after they give informing them of where their blood went. This time of year, there is a particular need for donors because many people are down with the flu or another bug and can’t donate, or they can’t get to a blood drive because of weather conditions. Despite losing some of those near and dear to him, Ball hasn’t become discouraged about donating. He wants to keep doing it as long as he is able. He knows each pint he donates might mean more lives saved. “It’s just one way of giving back and I’m glad that I can do it because I know there is such a tremendous need for it,” he said. For information on a blood drive near you, go to www.redcrossblood. org. You can also call 1-800-733-2767 and make an appointment to give a donation.
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.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
retrievable stent and catheter device to restore blood flow and retrieve clots from blocked blood vessels in patients experiencing acute ischemic stroke. The procedure uses a micro-sized stent delivered through a micro-catheter, which is put into a groin blood vessel and guided with X-rays upward through the body, through the neck area and into the larger blood vessels of the brain, where the clot has been detected. The stent is opened up — similar to how a heart catheterization procedure works — capturing the clot and removing pieces of it through the catheter, immediately restoring blood flow to that area of the brain. Deshaies was the second endovascular neurosurgeon in New York State to perform a blood clot retrieval procedure on a stroke patient when the device first became available in 2013. “Immediately, I knew that this device would be a game-changer in the way we manage stroke patients. Now we have the data that proves this to be true,” says Dr. Deshaies, one of only a few dual fellowship-trained neurosurgeons in the country and the only one in Central New York. Ischemic stroke is caused by a sudden blockage of an artery to the brain that deprives the brain of critical nutrients, such as glucose and oxygen. Currently, the international standard of care based on Canadian, U.S. and European guidelines is to administer a “clot buster” drug, called tPA, to attempt to dissolve the blood clot. Overall, positive outcomes for patients increased from 19 percent to 32 percent. In many cases, instead of suffering major neurological disability, patients went home to resume their lives.
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new procedure that captures blood clots blocking large arteries in the brain dramatically improves outcomes for stroke patients and may now set a new standard in treatment, according to an article published recently in the New England Journal of Medicine. Researchers have completed an international, randomized, controlled trial showing that the clot-retrieval procedure, known as endovascular stroke rescue therapy (ESRT), can dramatically improve patient outcomes after an acute ischemic stroke, according to the study. Three other similar trials will be reporting Deshaies their findings soon. Crouse Hospital endovascular neurosurgeon Eric M. Deshaies, was a primary investigator in an international stroke rescue trial looking at the use of stent retrieval devices for ESRT. The announcement affirms that this method is safe and effective in removing clots in the brain’s largest blood vessels — the carotid, anterior and middle cerebral arteries — that are linked to the most serious disabilities after a stroke. Evidence released at the International Stroke Conference held recently in Nashville supports its use in more stroke cases, with researchers saying that the technique has dramatically improved patients’ ability to function. Designed to reduce the severity of a stroke and limit potential disability post-stroke, the procedure uses a
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SmartBites
By Anne Palumbo
The skinny on healthy eating
The Perks of Eating Pineapples
C
ome March — when snow and ice still have a death grip on our climate—I pine for pineapples more than at any other time of year. All it takes is a bite and I’m transported someplace exotic and warm. So long, winter blues: hello, spring joy! The rest of the year, I reach for pineapples because they deliver the nutritional goods in a big way. Surprised? You’re not alone. Pineapples are so yummy that we often forget about what’s behind all that sweetness. Pineapples are bursting with vitamin C — just one cup gives you more than you need for a day. A powerful antioxidant, vitamin C can help combat the formation of free radicals known to cause cancer. And though studies show that consuming vitamin C can’t actually prevent colds, loading up on this immune-boosting nutrient may help shorten the time you’re sick and reduce the severity of your symptoms. What’s more, vitamin C plays an important role in maintaining healthy, resilient skin. Concerned about your bone strength? Level of energy? Pineapples may be your ticket to standing tall
For all its sweetness, one cup of pineapple chunks contains only 82 calories and has no fat or cholesterol and scant sodium. Like all fruits, they contain sugar: 16 grams per cup. As a comparison, one cup of grapes has 23 grams; a medium apple, 19, and a medium banana, 14.
Helpful tips
and feeling peppy. This tropical fruit contains nearly 75 percent of our daily needs for the mineral manganese, which is essential for strong bones and energy production. One study suggested that manganese, along with other trace minerals, may be helpful in preventing osteoporosis in post-menopausal women. Also great: Pineapples contain significant amounts of bromelain, a digestive enzyme that has a whole slew of health benefits. Unique to pineapples, this well-researched compound aids digestion quells inflammation and may help reduce certain kinds of pain.
Eat fresh whenever possible. Choose firm, plump pineapples with a sweet smell at the stem end. Exterior colors — from green to golden brown — indicate country of origin, not ripeness. Since the pineapple you buy is as ripe as it will ever be, consume within a few days. Sections not eaten right away may be wrapped in plastic and stored in the refrigerator for one to two days. If consuming canned pineapple, select varieties canned only in pineapple juice, not heavy syrup.
Pineapple-Avocado Salsa
al) 1/4 cup chopped fresh cilantro 1 1/2 teaspoons minced jalapeño chile (include seeds for extra heat) juice from fresh lime 1 tablespoon extra-virgin olive oil salt and pepper Stir all ingredients together and season with salt and pepper. Terrific with chips or alongside any grilled meat or fish.
Adapted from Gourmet
1 cup 1/4-inch-dice fresh pineapple 2 plum tomatoes, seeded and cut into 1/4-inch dice 1 ripe avocado, cut into 1/4-inch dice 2 cloves garlic, minced 1/2 cup chopped sweet onion (option-
Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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Page 11
My Turn
By Eva Briggs
Sharing Doug’s Story 40 Years After his Death from Measles
W
hen I met my husband, we were both attending the same high school. It wasn’t long before we were going back and forth between one another’s homes, meeting each other’s family and friends. When I met my husband’s best childhood friend, Doug, there was already something “wrong” with him. Doug seemed out of it, saying little and losing the thread of conversations. Formerly an average student, he was failing everything. One day he complained that he couldn’t read a clock to tell time any more. At first the doctors and school psychologists told Doug’ parents that he must have smoked too much marijuana or maybe he’d gotten into other drugs that he hadn’t told anyone about. But as Doug’s functioning worsened, the doctors began some serious testing. Finally they arrived at the correct diagnosis — subacute sclerosing panencephalitis (SSPE). SSPE is a disease that, fortunately, is as rare as hen’s teeth. I’ll bet many of my colleagues heard it mentioned in medical school and then promptly forgot it.
This disease attacks the brain and causes a slow deterioration in thinking and other brain functioning, eventually killing those who contract it. It’s a sort of dementia, but it affects kids and teenagers. Imagine watching your best friend die as a teenager of something akin to Alzheimer’s disease. Doug lost his ability to speak, to feed himself, to walk. The stress of taking care of her only son probably killed his mother, who was only a teenager when Doug was born. She died of a heart attack before the age of 40, shortly after Doug lost his three-year battle with SSPE. Given the recent resurgence of measles, this is a timely story. Because SSPE is caused by the measles virus. The anti-vaccination folks didn’t tell you that, did they? A few people who contract measles in early childhood and seem to recover fully actually harbor the measles virus persistently in their brains. A mutation in the typical measles virus allows an abnormal strain to escape eradication by the body’s immune mechanisms. After a number of years, the virus’s
slow attack on the patient’s brain becomes symptomatic. There is no cure, although if the disease is diagnosed early, certain antiviral medicines may halt or slow its progression. But these medicines don’t reverse or cure SSPE. In the early ‘70s, when Doug came down with SSPE, these medicines didn’t exist. People my age almost all contracted measles as children, because the disease is very contagious. Because my father kept meticulous records, I know that I had measles as a preschooler, brought home from kindergarten by my older brother. As scary as SSPE is, it truly is rare. Somewhere between four and 11 out of every 100,000 people who seem to recover from measles develop SSPE. On the other hand, that risk is a lot higher than the risk of contracting paralytic polio from oral polio vaccine (1 in 2.4 million doses). And we don’t give oral polio vaccine in the U.S. any more because of that risk. So why should people refuse the measles vaccine and expose their kids the risk of SSPE? Or — wait — what about the risks of pneumonia (1 in 20)
or regular old measles encephalitis (1 in 1000)? Pneumonia is the most common cause of death in young children with measles. Encephalitis can cause seizures, deafness, permanent brain damage, and death. One or two out of every 1,000 children with measles will die from the disease. One common reason people cite for refusing the measles-mumps-rubella (MMR) vaccine is fear that it will cause autism. That fear stems from a falsified study whose author has long since admitted that his study was fraudulent. There is no evidence, and never was, that MMR causes autism. There is also no evidence to support the anti-vaccination theory that current vaccines expose children to too many antigens too soon. I won’t belabor those points here. But I wanted to tell Doug’s story 40 years after his death from measles, hoping it will persuade at least one doubting person to vaccinate their child. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
Herd Immunity Protects the Community By Deborah Jeanne Sergeant
H
erd immunity — the effect of reducing the spread of communicable disease through majority vaccination — only works with a minimum of 92 to 94 percent of the total population vaccinated. “The best way to reduce the rates of infection is to make sure as many people are vaccinated as possible,” said physician Joseph Domachowske, professor of pediatrics and infectious disease specialist at Upstate Golisano Children’s Hospital. In addition to Domachowske the people vaccinated, herd immunity helps protect those who cannot receive vaccination or who are at higher risk for contracting diseases, according to several sources interviewed for this story.
High-risk populations include chemotherapy patients, organ recipients or patients treated with immune-suppressing drugs for conditions such as lupus, fibromyalgia or rheumatoid arthritis. Many people born before vaccination became widely available in the 1960s face a greater risk of infection because of their lack of vaccination, advanced age and greater likelihood of certain age-related illnesses. Although it’s extremely rare, vacCastro cines don’t provide optimal protection for certain individuals and they won’t know if they’re the unlucky ones until they become infected.
Babies rely upon Mom’s antibodies for the first few months after birth, plus breastfeeding. But for many diseases, vaccinations don’t start until 2 months old and most aren’t complete until age 4. “Local pediatricians and daycares are starting to get phone calls from parents inquiring whether there are any unvaccinated children in their practice or programs and, if so, the parents are considering moving their children to a different doctor’s office or daycare program,” said Luis Castro, physician with St. Joseph’s Hospital Health Center. “This is a new development in the concern over unvaccinated children.” The effect of herd immunity is so important that recent outbreaks have prompted consideration of mandatory vaccination in infancy. Most public schools and private schools require upto-date vaccination for nine communicable diseases before children may
enroll. RocDocs, provided by The Rochester Democrat & Chronicle newspaper, reports that “at least 25,000 elementary and secondary students in Upstate schools are not fully vaccinated against communicable diseases.” Nearly 2 million children attend school in Upstate. Religious and medical exemptions allow some students to skip some or all their vaccinations. Parents can also avoid vaccinating their children if they home school or enroll them in a privately funded school that doesn’t require vaccination. The ideology that causes some parents to opt out can also place their children at higher risk. “There are lots of parents who would rather risk their children getting sick than risk their children getting antibodies,” Castro said.
Vaccination Rates in CNY Schools
Understanding Herd Immunity
R
ocDocs, provided by The Rochester Democrat & Chronicle newspaper, reports that “at least 25,000 elementary and secondary students in Upstate schools are not fully vaccinated against communicable diseases.” • In Oswego County, vaccination among schoolchildren in the 2013-2014 school year ranged from as low as 72.7 percent to the high 90s to 100 percent. • In Onondaga County, one school ranked only 44 percent fully vaccinated, another 79.8 percent, and four schools ranked in the low to mid-90s. The remaining schools ranked in the upper 90s to 100 percent vaccinated. • In Cayuga County while most of the schools show a 100 percent rate in student vaccination, some schools such as Conquest Parochial School rates are in the high 70 percent to 80 percent. • In Madison County the picture is similar to Cayuga County. Most schools have a 100 percent rate of vaccination but some schools, such as New Life Christian School, are in the 80 percent vaccination rate To look up your children’s school, visit http://rocdocs.democratandchronicle.com/database/vaccinationrates-new-york-schools.
H
ave You “Herd” of Herd Immunity (also known as community immunity)? “Vaccines can prevent outbreaks of disease and save lives. When a critical portion of a community is immunized against a contagious disease, most members of the community are protected against that disease because there is little opportunity for an outbreak. Even those who are not eligible for certain vaccines—such as infants, pregnant women, or immunocompromised individuals—get some protection because the spread of contagious disease is contained. This is known as ‘community immunity.’ “In the illustration below, the top box depicts a community in which no one is immunized and an outbreak occurs. In the middle box, some of the population is immunized but not enough to confer community immunity. In the bottom box, a critical portion of the population is immunized, protecting most community members. “The principle of community immunity applies to control of a variety of contagious diseases, including influenza, measles, mumps, rotavirus, and pneumococcal disease.” From Vacines.gov, a site operated by the U.S. Department of Health and Human Services, using information provided by the National Institute of Allergy and Infectious Diseases. March 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 13
Mythsvs.Reality Mother: Why I Don’t Vaccinate My Youngest Daughter By Catherine Miller
K
athryn Schulz of Buffalo is the mother of four daughters ranging in ages from 6 to 18. While Schulz has chosen a traditional course of vaccinations for her oldest three children, with slight variations, she has chosen to forego vaccinating her youngest daughter, Maria, who struggles with the challenges of Down’s syndrome. “Maria was diagnosed with Down’s syndrome a few days after she was born. At the age of 6 months, she received the pertussis vaccine for whooping cough and then developed a seizure disorder,” said Schulz. “I don’t mean to say that the immunization caused the seizure condition. She would likely have had the disorder, regardless, but I think it may have accelerated it.” Schulz is quick to state that she is not a doctor, and that her beliefs are backed by her personal experiences, discussions with doctors and research she has done into her daughter’s condition, and immunizations in general. “At the age of 3, Maria was vaccinated for measles and immediately contracted the disease,” Schulz said. “That is when we realized that Maria’s immune system could not handle live vaccines.”
Takes her own approach
From that point on, Schulz discontinued conventional course of immunizations and viewed each vaccination
on its merits, weighing the risks of contracting the condition with the risk of a reaction occurring after the inoculation. While live and inactive vaccines vary with regard to adverse reactions that may occur, each still carries some risk, especially in the case of a person with a compromised immune system, according to experts. For the most part, Schulz has discontinued all but the pneumonia vaccine for Maria, as people with Down’s syndrome have a high risk of contracting pneumonia and it can prove to be a serious condition in Down’s syndrome individuals. As for her older daughters, while they were past the immunization stage at the time Schulz began to question vaccinations, she carefully considered future immunizations and the timing of them, delaying some when she felt the need to do so. “I believe that not every child should follow the conventional immunization schedule,” Schulz said. “I believe the schedule is built around the time periods that the child is most likely to be seen for a doctor’s visit, and not necessarily at times when it is most likely that the child would need that particular vaccine.” She said her older daughters have received all necessary immunizations for their own health and to assist in not contracting a medical condition that could be transferred to Maria.
Myth: All the terrible diseases have been eradicated. “Most of us haven’t seen measles, polio, tetanus, or other diseases thanks to vaccinations.” Myth: Vaccines do little to save children from diseases. “Despite decades free of many crippling and deadly diseases thanks to the benefits of vaccinations, many people fear side effects, which are often based on faulty or even discredited studies.” Physician Luis Castro, affiliated with St. Joseph’s Hospital Health Center Myth: Since vaccines are so risky, I’ll take my chances with nature. “The Centers for Disease Control (CDC) estimated that 732,000 American children were saved from death and 322 million cases of childhood illnesses were prevented between 1994 and 2014 due to vaccination.” http://vaccines.procon.org Myth: The Internet says that immunizations are dangerous. “It’s reassuring to me when they ask the authoritative sources like health care providers rather than trusting everything they read on the Internet. Anyone could post on the Internet without any background or authority on the subject at all.” Myth: Vaccines cause bad, life-long side effects. “Serious adverse reactions are so rare, it’s hard to determine cause and effect from vaccine. The common reactions are mild, such as injection site irritation and redness. Some can cause a low-grade fever. All of those are self-limiting. They go away. They are, in part, because of the vaccine’s ability to stimulate the child’s immune system.” Myth: Vaccines are a big money racket for pharmaceutical companies.
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“Vaccines don’t make companies much of a profit at all.” Myth: No one dies from childhood diseases; they’re just inconvenient. “Even young, healthy children when they get measles, more than 5 percent have a serious complication.” Myth: I’ll help build up my child’s immune system by exposing him to a child infected with the measles. “That’s irrational, especially with measles which can be a devastating infection. The vaccine exposes them to a very weak form of the virus so when they’re exposed to the virulent form, their bodies resist it.” Myth: Vaccines cause autism. “The original published paper in 1998 by Wakefield...was retracted by the Lancet. Wakefield was fired for fraudulent activity. He was paid by lawyers to prove vaccines cause serious problems. He had a cause and motive to publish something he probably knew was wrong all along. Now, 15-plus years later, we have an enormous body of evidence that fails to reproduce what he found. “Groups have later replicated the experiment with appropriate scientific controls couldn’t come to the same results. Wakefield used a group of only 12 children. “[A Denmark study] followed almost half a million babies... [and found] the relative risk for autism-related disorder was very slightly higher in the non-vaccinated group.” Myth: Vaccines aren’t really all that effective, considering recent outbreaks. “One to two people vaccinated out of 100 will remain susceptible, but most people in the Disney outbreak weren’t vaccinated.” Physician Joseph Domachowske, professor of pediatrics and infectious disease specialist at Upstate Golisano Children’s Hospital
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
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By Deborah Jeanne Sergeant
S
ince 2000, March has been recognized as National Colon Cancer Awareness Month. Campaigns such as this have helped more people understand the importance of screening; however, colon cancer remains the second most common cancer killer and the third most common type of cancer. “The thing with colon cancer is if people would get screened, two-thirds of colon cancer could be prevented,” said Martha Ryan, senior director of community engagement with the American Cancer Society Western and Central New York Region. Since most colon cancer starts with a polyp, most screenings can identify a polyp and allow doctors to immediately remove it. But only about 69 percent of the eligible population — generally those 50 and older — receive colon screening. Colonoscopy isn’t the only screening for colon cancer. “Talk to your provider about which test is best,” Ryan said. Though many doctors feel it’s the gold standard for screening, fecal occult blood test (FOBT) and fecal immunochemical test (FIT) may fit a patient’s profile better instead or in addition to colonoscopy. FOBT, an annual test, uses three samples of stool from three different bowel movements. FIT also uses three different samples, but these are taken from the water in the toilet bowl with the bowel movement in it, and not the stool itself, to detect enzymes in the water released by the fecal matter. If either test is positive, a colonoscopy follows. Generally, colonoscopy is recommended every 10 years. If a polyp is removed, that changes to every five years. If there’s family history and a polyp, that can change to every three years. Anyone experiencing rectal bleeding likely needs a colonoscopy. CT colonography requires the same preparation — completely emptying the bowel first — but doesn’t require a long scope. “If they see something, you still need a colonoscopy,” Ryan said. “But some believe the colonoscopy is too invasive.” CT colonography isn’t always covered by insurance but some people cannot receive standard colonoscopy. Some providers feel CT colonography does not provide the same level of screening as colonoscopy. With colo-
noscopy, a lighted flexible scope views the entire colon. Most people start receiving colon screening at age 50, unless they are African American, which represents a risk factor and lowers the starting age to 45. But anyone with a near family member diagnosed with colon cancer should begin screening 10 years prior to the age of the relative at diagnosis. For example, if a relative received a colon cancer diagnosis at 45, his relatives should begin screening at 35. Unfortunately, many people dislike and fear colonoscopy or don’t understand when they should start receiving colon screening. “It’s not as popular as other screenings, like breast screening,” said Jenny Dickinson, coordinator of cancer services program for Onondaga County Health Department. “People may call for a mammogram, but we offer a colonoscopy and they take it. “There’s a lot of misconceptions about how uncomfortable it will be and how long it will take. These misconceptions need to be cleared up. It’s a full sedation so you don’t even know it’s happening, or you can have conscious sedation.” Unfortunately, 28 percent of adults aged 50-70 of average risk have never received screening. “If everyone who was screened at the ages recommended, 60 percent of colon cancer deaths could be prevented,” Dickinson said. Since most polyps may be removed during colonoscopy, many cases resolve the same day. It’s important to know whether a polyp is malignant or benign; however, doctors remove most polyps regardless. “Colon cancer can be totally cured if found in its early stages and removed before it becomes invasive,” said Thomas J. Romano, MD, of Gastroenterology & Hepatology of CNY, which operates offices in East Syracuse, Liverpool and Camillus. “A majority of colon cancers start with a polyp — especially adenomatous polyps — and removing them during a colonoscopy can prevent colon cancer.” To support good colon health, Romano said, “living healthy” is key. Avoid tobacco products and limit red meat and alcohol consumption. Engage in regular exercise. Eat a moderate calorie, balanced diet with sufficient fiber and water intake. Maintain a healthy weight.
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A.M.P. has 25 Urologists, 2 Radiation Oncologists, 1 Pathologist, 1 Research Director and 13 Physician Extenders March 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 15
Men’sHealth
Breast Cancer vs. Prostate Cancer Why is awareness of breast cancer so much higher than that of prostate cancer? By Deborah Jeanne Sergeant
T
he pink ribbon symbolizing breast cancer appears on innumerable pieces of merchandise to raise awareness. But it seems like prostate cancer receives little press, despite its status as the most common cancer in men and the second leading cause of cancer death in men. Martha Ryan, senior director of community engagement for the American Cancer Society Central and Western New York Region, said that compared with other types of cancer, such as breast cancer and colon cancer, the guideRyan lines for prostate screening aren’t as clear-cut. “We recommend if you’re 50-plus, you need to talk to your healthcare practitioner about getting screened,” she said. “African American men have a higher rate of prostate cancer than other races. They should talking with their practitioner at age 40.” In addition to an exam, the doctor may also order a PSA blood test, she said. Some prostate cancers grow so slowly that doctors recommend a waitand-see approach. “When a woman has any kind of growth in her breast, they usually want to get it out of there because it grows and spreads,” Ryan said. Since some prostate cancers grow so slowly that treatment is never needed, it may seem less serious than other types of cancer and warrant less awareness. However, since prostate cancer death rates remain so high, men need to know about screening. Ray Straub is one of the facilitators of SUNY Upstate’s Men to Men Prostate Cancer Support Group, a local organization that raises awareness about prostate cancer and helps support and educate men who have been diagnosed with prostate cancer. About six attend.
“I’m a believer in PSA testing,” Straub said. “I think it is an important diagnostic tool.” The blood test reveals if a man has an elevated prostate-specific antigen (PSA), which is often high in men who have prostate cancer, but doesn’t necessarily mean a man has prostate cancer. Straub had received annual PSA testing since age 40 during annual physicals. A PSA test at age 57 revealed Straub had an elevated PSA, which later led to a diagnosis of prostate cancer in his case. “What you don’t know is that if you have a slow-growing or fast growing [prostate cancer],” Straub said. Straub, now 65, opted for surgery after he monitored his PSA level for six months and a biopsy revealed cancer. For some men, a wait-and-see approach offers a better option if the PSA level decreases. “Knowing my PSA was very important to me,” Straub said. “It gave me an early warning that something might be wrong. It is very important for men to discuss both diagnostic tools and treatment options with their doctor.” Although routine PSA screening raises the risk for false positives, men can avoid unnecessary surgery or other treatments if they know all their options, such as active surveillance. Surgery bears the risk of urinary incontinence and erectile dysfunction. Since some forms of prostate cancer grow slowly, PSA testing becomes very important as a monitoring tool. Jenny Dickinson, coordinator of cancer services program for the Onondaga County Health Department, said that the department offers payment assistance for uninsured men who have been diagnosed and need further PSA testing. New, advanced tests have become available to help physicians detect if a man carries a gene indicating an aggressive type of cancer. More advanced, 3-D MRI of the prostate can also help physicians help their patients make more educated decisions. Image guided radiation can also more closely target cancer cells.
Beating Cancer Three Times Fayetteville cancer survivor gives of himself to others facing same plight By Aaron Gifford
D
an Mackessy beat cancer three times but refuses to take credit for any victories. He’s also helped hundreds of other men who battled the dreaded disease, presumably many of whom survived it, but still prefers to avoid the spotlight. Mackessy got involved with this cause after cancer took his wife’s life. He helped to grow a men’s cancer support group that later fought for its own survival. Coincidentally, he was also diagnosed with cancer on three occasions well into his golden years, and beat it every time. “I thought if I was fortunate to live long enough,” the Fayetteville resident said, “that I might as well keep volunteering. I say I volunteer because I’m selfish. When someone says you really helped me, it makes you feel so good.” At the age of 90, Mackessy still serves as a facilitator and on-call phone counselor with the Upstate Men to Men prostate cancer support group, which he’s been involved with since the 1990s. He’s happy to listen as long as the patients want to talk, and if anyone is interested in hearing about it he can share the experiences that dozens of others have shared with him — as if his own story isn’t inspiring enough. After graduating from high school, the Chicago native signed on for a college credit work-study program at General Motors. All of Mackessy’s friends joined the military to serve in World War II, so he changed his plans and enlisted as well. He was initially sent to Camp Pendleton Marine Base
Mackess in California, where he was placed on an amphibious force to repair diesel engines. From there, he was shipped to the island of New Caledonia in the South Pacific.
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The night before Mackessy’s unit arrived, hundreds of U.S. troops were killed after the Japanese attacked their ship. “We got in and we didn’t get hit,” he said. Mackessy had been at sea in the South Pacific for over two years when U.S. forces dropped atomic bombs on Japanese cities, ending the war. He worked with a Japanese harbor pilot to remove mines from harbors around the time the peace treaty was signed. “He turned to me and said, ‘how are things in Frisco?’ He said he graduated from UCLA!” Upon returning to the U.S., Mackessy took on a career in manufacturing that allowed him to travel throughout the country. After setting up a factory in Syracuse, he decided to stay. “There was no traffic, life was peaceful. I could fly a plane here, there was great skiing. I didn’t know a place like this existed,” he said. Mackessy also owned businesses, worked in real estate and served as a consultant for General Electric. Mackessy’s first wife died shortly after his retirement. Then, his own health problems began. He remembers skiing in Utah one winter day in 1993. The temperature was below zero and it was snowing. As he reached a lower altitude, Mackessy took his goggles off and a little piece of skin on his face was torn off. The spot continued to sting weeks later and there were problems with ingrown hairs, so Mackessy saw a plastic surgeon. “He said it’s nothing big, but I can pluck it out,” Mackessy said. “Three months later in the same spot, I noticed a big pimple, and it grew the same day. He looked at it again and told me I immediately needed surgery.” The diagnosis was melanoma. He left the hospital with 55 stitches stretching from the corner of one eye to the cheekbone. The cancer was cured, and Mackessy had no trouble with skin cancer ever since.
Diagnosis: prostate cancer
Four years later, during a time at which Mackessy was heavily involved with the Upstate Man to Man prostate cancer support group, the results of his own PSA (prostate specific antigen) test warranted additional tests and biopsies. The same folks at the support group who motivated him to get screened regularly also advised him to weigh his options. He decided against surgery, and instead went to an Atlanta hospital to have radioactive seeds planted in his prostate. Since then, his PSA numbers have remained low. “In this case, I like to point out that there have been clinical trials that have shown that cancer patients who join support groups do a lot better,” Mackessy said. “You get knowledge from other patients who have had or who are considering the same procedures or treatment.” The prostate produces fluid that transports sperm. Family history is a major risk factor for the disease, along with age and obesity. According to the National Cancer Institute, more than 200,000 men in the U.S. are diagnosed with prostate cancer annually, and more than 30,000 of them will die from the disease. According to the National Cancer Institute, symptoms of prostate cancer include not being able to pass urine, having a hard time starting or stopping urine flow, weak urine flow, pain or burning during urination, and needing to urinate often, especially at night. Additional warning signs include difficulty having an erection, blood in the
urine or semen, and frequent pain in the lower back, hips or upper thighs. However, researchers with the National Cancer Institute stress that most often, those symptoms are not due to cancer, and that it’s common for prostate cancer patients not to experience any symptoms before the disease is discovered. Mackessy’s last bout with cancer took place seven years ago. Over the years, starting one day in 1999 when he was skiing in Colorado, Mackessy noticed a significant loss of strength in his legs. He said he had every kind of test imaginable. Time passed and more tests took place. Scans didn’t find anything wrong and doctors simply told him it was his age. He wouldn’t accept that, and in 2007 went with his gut feeling and sought out the most updated MRI test available. “This time,” he recalled, “it lit up like a Christmas tree.” There was a tumor, about 1½-inches in diameter, in his right kidney that hadn’t been detected in earlier tests. Doctors at Strong Memorial Hospital in Rochester used a robotic device to remove the tumor from the 84-year-old patient and, in the process, discovered a cyst on his pancreas. While one team was removing the tumor, the other performed a biopsy on the pancreas. Luckily, it was negative.
Battling back
Since then, after dealing with increased muscle loss, an intestinal infection, a stroke and two knee replacements, Mackessy remains upbeat. He enjoys traveling and spending time with his wife, two sons, seven grandchildren and two great-grandchildren. Even though Mackessy has traveled outside the area for some of his medical procedures, he continually compliments Upstate University Hospital for the care it has provided so many members of his support group. After the American Cancer Society cut off support for the Upstate Man to Man group due to a national restructuring plan, Upstate provided free meeting space for the group, which was renamed Upstate Men to Men. Jason Warchal, hospital systems account representative with the American Cancer Society’s Syracuse area chapter, said Mackessy’s leadership, charisma and dedication should be credited for keeping the organization going for so long. “I worked with him for 12 years,” Warchal said. “He has an awesome knowledge of research and treatment procedures, but at the same time he’s very open and isn’t there to give medical advice. In working with newly diagnosed men, the way he interacts is something very special. He genuinely wants to listen, and he poses the right questions that help them to decide their course of treatment. It’s a pleasure to work with him. He’s a great guy.” Mackessy maintains that joining a cancer support group isn’t enough. He challenges cancer patients to do their own research and to visit the Upstate Medical University library, which is open to the public. He’s also quick to point out that, while support group volunteers enjoy a reputation for compassion, he doesn’t shy away from “dishing out some tough love.” “If there’s someone who just isn’t taking good care of themselves, I’m going to let them know. If they have a waist over 40 inches, I’ll tell them, ‘I hope you’re tough, because you’re going to suffer a lot.’ The thing to keep in mind is, as you age, forget the things you can’t do and concentrate on the things you can do.”
Pharmacy offers specialty care for GEM Care patients
U
pstate University Hospital’s Community Campus pharmacy department was recently featured in the American Journal of Health-System Pharmacy. The article detailed how the department spearheaded an effort to integrate its services with GEM Care, the GEM Care Pharmacist Nikolas Onufrak, left, and Director of senior emergency Pharmacy Elizabeth Szymaniak. department located at the Community Campus. inform providers — even if their chief Guidelines published in 2013 by complaint is not related to their medithe American College of Emergency cation,” Onufrak said. Physicians, The American Geriatrics From the time a patient enters Society, Emergency Nurses Association, GEM Care, a pharmacist follows and the Society for Academic Emereverything from initial lab work to the gency Medicine state that pharmacist selection and dosing medication. The services should be an ancillary service pharmacist also reviews and analyzes of all geriatric emergency departments. the patients’ medication regimens. DoAt GEM Care, pharmacy support ing so typically demands communicasurpasses the guidelines and offers a tion with the individual’s pharmacies, unique service that is readily available family members and physician offices. to all senior emergency department pa- This investigation process results in tients. This ancillary pharmacy service a listing of current medications being is staffed by two on-site pharmacists, taken prior to the emergency departNikolas Onufrak and Kelly Braham. ment visit and why. “As the emergency department is By undergoing this time-intenhighly accessible to patients, and most sive process, the pharmacists are able primary care and specialist offices to assess the appropriateness of each do not have pharmacists on staff, we medication and determine whether represent a touch point to review med- they relate to the reason for the visit to ication regimens, counsel patients, and the emergency department.
Study: Smokers Don’t Have Same Quality of Sleep as Non-Smokers By Patricia Briest
M
arch is designated as National Sleep Awareness Month. A good night’s sleep can make a huge difference in both quality of our day, and quality of our life. Experts tell us that a minimum of six to seven hours of solid sleep is required for adults to maintain good health. Despite this, many of us get far less sleep on a regular basis for a variety of reasons. Everyday stresses such as family, job issues and financial responsibilities are some reasons for poor sleep. Health issues can also interfere with sleep, as well as our daily habits. Over eating, neglecting exercise, drinking excessive caffeine — these habits can all interfere with our sleep. One habit people do not associate with sleep is smoking. Research shows that, on the average, smokers get poorer “good quality sleep” than non-smokers do. Studies also show that compared to non-smokers, those who smoke spend more time in light sleep and less time in deep sleep. Quality of sleep for this research was measured in sleep laboratories (such as the Sleep Lab at St. Joseph’s Hospital) and was part of the sleep heart health study, a multicenter study on sleep disordered breathing and heart disease that was implemented by the National Heart, Lung and Blood Institute. Lack of good quality sleep can cause daytime sleepiness, lack of concentration and irritability. Smokers also report frequent insomnia complaints and complain that they have a hard time falling asleep and staying March 2015 •
asleep. It is speculated that nicotine withdrawal may be a factor, since electroencephalogram testing (EEG) shows most sleep disturbance was noted in the early hours of sleep in smokers. The half-life of nicotine in the system is about two hours, which further supports withdrawal as a potential factor. Researchers concluded that cigarette smoking can alter sleep independent of other factors, such as age, gender, race, mental health status, or caffeine or alcohol intake. If you are a smoker and experiencing sleep issues, you may consider quitting. The NYS Smokers’ Quitline at toll free 1-866-697-8487 can help. Your health care provider can also help and is the best person to talk to if you are considering quitting. Remember, a good night’s sleep can help us cope more effectively with everyday stresses, help us to think more clearly, and be one important step on the path to good health. 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.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Parenting By Melissa Stefanec melissa@cnyhealth.com
Mombie and Dadbie Antidotes T here are probably thousands of clichés and stereotypes regarding parenting. With a 4-month-old baby and 3-year-old daughter, I am no longer a real person, but a walking cliché. You name the new mommy cliché and I can proliferate it. I say I am a walking cliché, but I am more like a shuffling cliché. You see, my husband and I have a bad case of the zombies. We are the under-slept, over-utilized and strung-out parents that are touted in memes, blogs and sitcoms. If a TV writer were to follow us around for a week, we would provide him or her with enough fodder for four seasons of a sitcom or reality show. Just like the sensationalized zombies of lore, mombies and dadbies operate with almost no brains. The deprivation of sleep, real food, hobbies and human interaction takes its toll. Something has to be done to stop the invasion. So, as I brush the crumbs of a makeshift dinner off my keyboard and prop my feet up on a pile of dirty laundry, I am going to offer my readers some mombie and dadbie antidotes.
Ask for help This is the easiest and most obvious way to lighten your load, but it’s so hard to do. Family and friends aren’t always quick to offer help when it’s needed. These same people may not even know help is needed or be quite
busy themselves. So, it’s best to ask (and offer to return the favor someday). If you can’t count on your family and friends to help you through difficult times, who can you count on? (That gives me an idea, maybe that stranger who held the door open for me at the store the other day would watch my children for a few hours. She seemed nice. [I kid.])
Don’t overbook yourself Remember all those hobbies and commitments you had before children? Let yourself neglect them a little. I’m not advocating that your disbar all semblance of your previous self, but you need to be realistic. It’s perfectly fine and healthy to opt out of invitations and scale back your obligations for a while. The people that matter will understand.
Accept that you won’t be able to get much done for a while Spotless house? Hah! Crumbless car? Laugh! Perfectly manicured floors? Snicker! Paperwork filed? Organic garden planted? Do-it-yourself shelving project you saw on Pinterest completed? Laugh, choke, sputter! Parents need to accept the reality that children are black holes for cleanliness and pro-
ductivity. Clutter isn’t good for your brain, but sometimes you just have to ignore it. If you expect your house to be constantly tidy and to remain on top of all of your projects, you are going to be consistently and irrationally disappointed. Consider a roach-free home a major accomplishment.
Practice saying “no,” and then actually say “no” One of things so many mobies and dadbies are bad at is saying “no.” So, I recommend this little strategy. Ignore the dark circles under your eyes and stare into the mirror for at least five minutes every day and practice saying the word “no.” Practice saying it with the same gusto as your 3-year-old would. Say it until it becomes a natural response to almost any question. With all the practice, you may actually be capable of saying “no” when you need to. Allow yourself to take some shortcuts, especially in the kitchen Did you make organic, homemade meals every night of the week before having kids? Those days are gone. Allow yourself to take some shortcuts in the meal department. Find out what you can deal with and what you can’t. Try to strike a balance between feeding your child a homemade, organic, slow-cooked kale and prosciutto soup and peanut butter smeared on a playing card. Your survival may depend on this balance. Identify other shortcuts you can take and take them. You are likely to be the only person who is going to notice.
Take time for yourself It seems counter-intuitive. How can a parent produce time when there is none? As seemingly impossible as it is, you need to carve out time for your own child-free hobbies and enjoyment. There won’t be many opportunities,
but it’s your job to seize them when they come along. If they don’t seem to come along, make some for yourself. Take breaks, or you will never find your brain.
Forgive yourself Couldn’t this world use a little more forgiveness? Let that forgiveness start with yourself. A mombie and a dadbie are bound to do silly things once in a while. If you forget to do something at work, apologize and move past it. If you put the milk in the cupboard (again), buy more milk and move on. If you forget an appointment, an important date, daycare supplies or just about anything, accept that you can’t go back and fix it. You are a human being, and a very tired human being at that. We tend to be harder on ourselves than other people are on us. We are our own worst critics, so stop beating yourself up.
Remember that time heals all things If there is a mantra for this mombie, it’s that this aloof stage isn’t forever. That mantra keeps me balanced. On the one hand, it reminds me that I will get better night’s rest in the coming months. Things will get easier. I will adjust. On the other hand, it reminds me that these moments are fleeting and precious. They may be hectic and tiring, but their inherent beauty will never be again. Those are just some of the ways I fend off the mombies. If you have family or friends suffering from this affliction, take it easy on them as well. You will get your brain back someday, but until then, take it easy on yourself. Someday, we will all look back and chuckle about this stage in our lives. After all, the antidote of time is on the way.
CALENDAR of HEALTH EVENTS contimued from page 4 clicking “the enroll in a class near me” tab.
March 5, 12, 19
Living with Alzheimer’s workshop at CNY Hospice If you are a caregiver for a loved one facing the early stages of Alzheimer’s or dementia, Hospice of Central New York in cooperation with the Alzheimer’s Association of Central New York will be offering a three-session workshop in March. The sessions are free and open to the public. In the early stages of Alzheimer’s disease, families face new questions as they adjust. This series is designed to provide care partners with the knowledge, tools and strategies needed to cope with a diagnosis of Alzheimer’s or Page 18
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related dementia. The series will cover: symptoms associated with early stage, Alzheimer’s, planning for the future, strategies for coping with changes, developing a medical team, disclosing the diagnosis and work issues, legal and financial issues and safety issues. Workshop producers recommend that participants attend all three sessions, March 5, 12 and 19 at Hospice of Central New York, 990 Seventh North St., Liverpool. The three Thursday evening sessions begin at 5:30 p.m. Registration is required at 315-472-4201 ext. 100.
March 16
Workshop in Syracuse: preparing for labor Women are invited to spend an evening learning ways to work with their body during labor naturally. Titled “Preparing for labor: Comfort
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
Measures and Labor Positions,” the event is hosted by CNY Doula Connection and will take place from 6 – 7:30, March 16 at Women’s Info Center, 601 Allen St. Syracuse, in the Westcott area. Labor experts will demonstrate and practice different positions for labor, how the birth ball can be beneficial, and more. Bring a yoga mat and wear comfortable clothing. Light snacks and tea will be provided. For more information, call 315-395-3643
March 27
HIV and hepatitis C is topic of conference in Syracuse The Designated AIDS Center (DAC) at Upstate Medical University and the CNY Association of Nurses In AIDS Care (CNY ANAC) will host the HIV and Hepatitis C In Primary Care conference for health care professionals from 7:30 a.m. – 4 p.m. Friday,
March 27 at the Sheraton Syracuse University Hotel and Conference Center, 801 University Ave., Syracuse. This conference will address issues that affect the patient, provider and the community. Lyn Stevens, deputy director of the AIDS Institute, New York State Department of Health, will provide the keynote address, a reflection on the current state of the AIDS epidemic. In addition to Stevens, several other experts will make presentations. SUNY Upstate Medical University has designated the conference for a maximum of (6.5) American Medical Association Physician’s Recognition Award category one credit. There is a $50 registration free. A reduced $30 fee is offered for students. The deadline to register is Friday, March 20. For more information or to register, contact: Theresa Feola, NP at 315-4645545 or feolat@upstate.edu.
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Do You Need To File A Tax Return in 2015? Dear Savvy Senior, What are the IRS income tax filing requirements for retirees this tax season? I didn’t have to file last year, but I picked up a little income from a part-time job in 2014, and I’m wondering if I need to file this year. Part-Time Retiree Dear Retiree,
Whether or not you are required to file a federal income tax return this year will depend on how much you earned (gross income) — and the source of that income — as well as your filing status and your age. Your gross income includes all the income you receive that is not exempt from tax, not counting your Social Security benefits, unless you are married and filing separately. Here’s a rundown of the IRS filing requirements for this tax season. If your 2014 gross income was below the threshold for your age and filing status, you probably won’t have to file. But if it’s over, you will. Single: $10,150 ($11,700 if you’re 65 or older by Jan. 1, 2015). Married filing jointly: $20,300 ($21,500 if you or your spouse is 65 or older; or $22,700 if you’re both over 65). age.
Married filing separately: $3,950 at any
Head of household: $13,050 ($14,600 if age 65 or older). Qualifying widow(er) with dependent child: $16,350 ($17,550 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see irs.gov/pub/irs-pdf/ p554.pdf.
Special Requirements There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment in 2014
Have you been told nothing will help you see better?
of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file. To figure this out, the IRS offers a tool on their website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. You can access this page at irs.gov/ filing — click on “Do you need to file a return?” Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get faceto-face help at a Taxpayer Assistance Center. See irs.gov/localcontacts or call 800-829-1040 to locate a center near you.
Check Your State Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency before concluding that you’re entirely in the clear. For links to state and local tax agencies see taxadmin.org — click on “State Agencies/Links” on the menu bar.
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Tax Prep Assistance If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, aged 60 and older. Call 800-906-9887 or visit irs. treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 5,000 sites nationwide. To locate an AARP tax aide site call 888-227-7669 or visit aarp.org/findtaxhelp. You don’t have to be an AARP member to use this service. Editor’s Note: Read the column under Ask Your Social Security for more information on taxes. 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.
Home Care by Seniors for Seniors There’s a huge difference in the kind of home care you can receive from someone who really understands what your life is like as a senior. The concerns you have. The need for independence. Someone who, like you, has a little living under his or her belt. Our loving, caring, compassionate seniors are there to help. We offer all the services you need to stay in your own home, living independently. • Transportation • Shopping • Doctor Appointments • Companion Care • Housekeeping services • Meal preparation/cooking • 24-Hour Care • and more Call us today. Like getting a little help from your friends.
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Provided Deborah Banikowski, Social Security OfficeSocial Security Office
In March Americans Recognize Middle Name Pride Day
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
A
t the Social Security Adminwarriors and the chronically ill, all of istration, our middle name is whom tend to be the most vulnerable “Security,” and every day, we of our population. Protecting our critdo everything we can to live up to ically important programs from fraud that name. As part of protecting our can be challenging. Yet, our standard is vital services, we safeguard against all absolute — any fraud is unacceptable. forms of Social Security fraud. And, our focus on preventing fraud Social Security has zero-tolerance works. for fraud and those who try to cheat Our Office of the Inspector Generthe system. While we can’t prevent all al works in concert with our frontline fraud schemes any more than employees to identify fraud the best police force can stop and bring offenders to justice. all crime, we work aggressively Together, we use a number of with our Office of the Inspector tools to help us accurately preGeneral to investigate and prosdict where fraud may occur. ecute people who commit fraud. By monitoring cases closely, Acting Commissioner Carwe identify fraud sooner ratholyn Colvin’s message to those er than later — and often we who would defraud Social Secuprevent it before it happens. rity is clear: “We will find you; We also have stiff penalties we will prosecute you; we will that discourage people from seek the maximum punishment Banikowski committing fraud, including allowable under the law; and we hefty fines, suspension of will fight to restore to the American benefits, and even jail time for the most public the money you’ve stolen.” severe offenses. We provide benefits to one-fifth of We take our middle name seriousthe American population, including ly and so should you. If you suspect elderly retirees, people with severe someone is committing Social Security illnesses, and widows and children fraud, we ask that you report it online after the death of a wage earner. Our at http://oig.ssa.gov/report or call the beneficiaries also include wounded Social Security Fraud Hotline at 1-800269-0271 immediately.
Q&A
Q: I’m gathering everything I’ll need to file my taxes this month. Do I have to pay taxes on Social Security benefits? Also, where can I get a replacement 1099? A: Some people who get Social Security must pay federal income taxes on their benefits. Still, no one pays taxes on more than 85 percent of their Social Security benefits. You must pay taxes on some portion of your benefits if you file an individual federal tax return and your combined income exceeds $25,000. If you file a joint return, you must pay taxes if you and your spouse have combined income of more than $32,000. If you are married and file a separate return, you probably will have to pay taxes on your benefits. You can read more about tax preparation in relation to Social Security at www.socialsecurity.gov/planners/taxes.htm. Social Security benefits include monthly retirement, survivor, and disability benefits. They don’t include Supplemental Security Income (SSI) payments, which are not taxable. You can also get a replacement 1099 or 1042S when you open your own personal my Social Security account at www.socialsecurity.gov/myaccount. (Editor’s Note: Read the column under Ask Your Social Security for more information on taxes). Q: I’ve been planning my retirement throughout my career, and I’m
finally nearing the age when I can stop working. What is the earliest age I can start receiving Social Security retirement benefits? A: You can receive Social Security retirement benefits as early as age 62. Keep in mind that if you retire at age 62, we’ll reduce your benefits by as much as 30 percent of what you’d get if you wait until your full retirement age. If you wait until your full retirement age (66 for people born between 1943 and 1954), you’ll get your full benefit. You can also wait until age 70 to start your benefits. Then, we’ll increase your benefit because you earned delayed retirement credits. When you’re ready to apply for retirement benefits, use our online retirement application, the quickest, easiest, and most convenient way to apply. Visit www.socialsecurity.gov/ retireonline. Q: I recently retired and am approaching the age when I can start receiving Medicare. What is the monthly premium for Medicare Part B? A: The standard Medicare Part B premium for medical insurance is currently $104.90 per month. Since 2007, some people with higher incomes must pay a higher monthly premium for their Medicare coverage. You can get details at www.medicare.gov or by calling 1-800-MEDICARE (1-800-6334227) (TTY 1-877-486-2048).
H ealth News Farneti is Loretto’s new chief nursing officer Diana Farneti has been named chief nursing officer for skilled nursing at Loretto. She will oversee nursing services and nursing education for Cunningham/Fahey in Syracuse, The Nottingham Residential Health Care Facility in Jamesville, The Cottages at Garden Grove in Cicero, The Commons on County House Road and The Commons on St. Anthony in Auburn. Most recently, Farneti served as Farneti director of critical care and cardiac services at St. Joseph’s Hospital Health System, where she held that position for six years. Prior to that, she served as director of patient care services at Carolinas Medical Center Mercy in Charlotte, and worked for many years at the former Community General Hospital in Syracuse. She received her master’s degree in nursing from SUNY Health Science Center. Farneti and her husband live in Camillus.
Team captions for Upstate University Hospital’s Heart Walk team get set to kick off two months of activities aimed at raising money for the American Heart Association/American Stroke Association. Upstate has been one of the top fundraisers for the Heart Walk, raising more than $100,000 in the last three years. The Heart Walk is set for March 28 at Onondaga Community College.
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March 2015 •
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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onsidering the intense personal effort required for effective diabetes management, phone apps offer portable, easy ways to lighten the load. “Any tool that tracks exercise and nutrition would be of benefit to a diabetic,” said Randy Sabourin, president of Metro Fitness Club in Syracuse. “We have trained many diabetics over the years and seen firsthand the benefits exercise and diet have on insulin requirements, so any app or fitness gadget that motivates a diabetic to exercise regularly or track their diet is a good tool to utilize.” Said physician Marisa Desimone, assistant professor of medicine in endocrinology, diabetes and metabolism from Upstate Joslin Diabetes Center: “Apps can be a wonderful tool to help pts to recognize patterns. The more information they can bring to us, the more beneficial our interactions with them are. It makes it easier to address problem.” Apps specific to diabetes include Glucose Buddy (iPhone, free), which allows people to store data like input glucose, how many carbohydrates consumed, and track blood pressure and weight. Glooko (iPhone, free) is similar to Glucose Buddy. Tracking blood sugar on a phone “is very convenient,” Desimone said. Camaraderie and practical tips from other diabetics can help you feel less isolated. Diabetic Connect (iPhone, free) fosters interaction with other diabetics, which can help busy people whose schedules make it hard to attend support group meetings. Diabetes App (iPhone, $6.99) tracks things that affect blood sugar and offers information on how many grams of sugar foods contain. The app also allows you to share on Twitter. Positive peer pressure can help you stay on
track to better health. The American Association of Diabetes Educators (AADE) developed Goal Tracker (Android, iPhone, free) to provides diabetes education and goal-setting tips. Numerous apps can also assist, such as My Fitness Pal (Android, iPhone, free), Lose It (Android, iPhone, free) and others. “Smart phones are amazing little machines,” Desimone said. “There’s so much information you can access on the app. You can type in food from a chain restaurant and know all about the food.” My Fitness Pal allows users to scan food package barcodes for easy food logging and tracking. By analyzing your diet, you can determine what food to cut to stay within a healthful calorie count and how many carbohydrates you eat. Calorie King Food Search (iPhone, free) stores thousands of Nutrition Facts labels. The format found on all store labels provides a familiar glance at nutrition information, even if it’s for a food that typically doesn’t bear a label, such as a piece of whole fruit. Visit the websites of your local grocery stores to see what apps they offer. Wegmans.com, for example, offers an app that helps you find food in that particular location and even if it’s in stock, along with recipes and healthful eating ideas. Many free pedometer apps built right into the phone can help you track your steps or miles. Some also mon-
Comprehensive Cardiology Care 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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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
itor calories eaten and burned, sleep, weight and pulse. Desimone said that apps also help her since doctors don’t have as many hours with their patients as they would like. One doctor visit can only include a small amount of education and interaction needed to effectively manage diabetes. “Most patients are seen every three months and then for only a 20-minute visit,” she said. “There’s a lot of self management.” Joslin provides diabetes management in one-on-one and in group sessions, but apps can help keep patients on target. “I encourage patients to try them if they have a smart phone and try the free ones first,” Desimone said. Feeling more in control of the condition helps patients feel more empowered to make necessary lifestyle changes. Apps also bolster accountability. As to which app is better than
another, Desimone leaves it up to her patients. “I encourage patients to play around with them and find one they like the best,” she said. “A lot of the apps out there for diabetes have free versions, so patients can try them out. The most important thing is that the patient finds it helpful.” Diabetes and general health apps do bear a few caveats. They’re only as effective as users are honest. If you underestimate portion sizes or round up a workout’s time or intensity, your results will appear better than what they actually are. “It’s important that people recognize the app is a tool but not a substitute for comprehensive diabetes education,” Desimone said. “It shouldn’t substitute for common sense. It’s a wonderful management tool but the guidelines we recommend should be in place.”
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About 1 in every 25 U.S. patients develops an infection while in the hospital, agency says
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ates of many types of hospital-acquired infections are on the decline, but more work is needed to protect patients, according to a U.S. Centers for Disease Control and Prevention report. “Hospitals have made real progress to reduce some types of health care-associated infections — it can be done,” CDC Director Tom Frieden said. The study used national data to track outcomes at more than 14,500 health care centers across the United States. The researchers found a 46 percent drop in “central line-associated” bloodstream infections between 2008 and 2013. This type of infection occurs when a tube placed in a large vein is either not put in correctly or not kept clean, the CDC explained. During that same time, there was a 19 percent decrease in surgical site infections among patients who underwent the 10 types of surgery tracked in the report. These infections occur when germs get into the surgical wound site. Between 2011 and 2013, there was an 8 percent drop in multidrug-resis-
tant Staphylococcus aureus (MRSA) infections, and a 10 percent fall in C. difficile infections. Both of these infections have prompted concern because some strains have grown resistant to many antibiotics. Catheter-associated urinary tract infections rose 6 percent since 2009, but initial data from 2014 suggests that these infections have also started to decrease, according to the annual CDC report. The CDC also noted that on any given day, about one in 25 hospital patients in the United States has at least one infection acquired while in the hospital, which highlights the need for continued efforts to improve infection control in U.S. hospitals. According to Frieden, “the key is for every hospital to have rigorous infection-control programs to protect patients and health care workers, and for health care facilities and others to work together to reduce the many types of infections that haven’t decreased enough.”
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March 2015 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Dispelling Fear Crouse’s Hospital-Land makes healthcare journey ‘not too scary now’ for little ones By Matthew Lipta
T
he prospect of going to the hospital can be intimidating or even frightening for children. Crouse Hospital in Syracuse recognized this as a serious issue and has been running a program to combat that fear by familiarizing first-graders with the hospital environment. Hospital-Land started at Crouse 39 years ago in 1976. Since then, over 186,000 children have gone through the Hospital-Land program, said Kathleen Miller, the program’s director and Crouse’s manager of community education and development. It is made possible by the Crouse Hospital Auxiliary. This year the auxiliary provided $43,000 for the program. The program has been effective in allaying fears of kids who need to go to the hospital for the first time either because of an appointment or because of an emergency situation. A recent quote found in a thank you note from one first-grader said because of Hospital-Land, the hospital was “not too scary now.” “Anytime you can provide information and education that will make something less stressful and make it a better experience for that child is very rewarding for us,” Miller said. “We don’t want people to be afraid of the hospital, the doctors, the health care or the nurse.” During the 2013-14 school year, there were 176 classes from 75 schools that came to the Hospital-Land room at Crouse. That’s 3,138 kids learning not to fear the hospital in one year. Hospital-Land is actually a 90-minute interactive course taught to children by one of three experienced nurses. Faith Terry, Jo Sykes Smith and Lois Sexton make up the trio. “It really takes a unique person to do it,” Miller said. “They love to teach. They love kids. They’re community educators, so they love that part of it.” The program starts by the class entering the Hospital-Land room at Crouse where on display is a smorgasbord of hospital equipment and technology: stethoscopes, casts and blood pressure cuffs. The kids take their seats and the nurse who is assigned that class introduces herself. She talks to the class a bit, asks some questions and gets some volunteer actors. Then the fun begins. “We do a mock admission of what it would be like so that they can see,”
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Miller said. “Then different kids in the class will be the doctor, some will be the nurse, somebody will be the patient and somebody will be the parent. We role-play. They love it because they can use the crutches, they can use the wheel chair, the stretcher — they love that.”
Interactive experience
Miller said it’s important to let the children get involved because first-graders can only sit still for so long. After role-playing is over, the kids get to explore the equipment. Each child gets a ride in the stretcher and talks with the nurse while playing the part of a patient in bed. Hospital-Land has been going on so long that there are actually children of the program’s original participants going through the program today. In fact, Crouse’s chief medical officer, 43-year-old Seth Kronenberg, went through Hospital-Land as a first-grader and in more recent years so did his four daughters. “I thought it was fun and a great experience,” Kronenberg recalled. “Riding in the wheelchair was the best.” He acknowledged the program’s more serious aspects too. “I think it is great education for children,” he said. “It takes away the mystique of the hospital and also exposes them to medical careers early on.” Terry said she jumped at the chance to teach the program when it was offered. She had been a chaperone when her own kids had gone though it in first grade. “I love this place,” she said. “I love my job.” Terry teaches morning and afternoon Hospital-Land classes twice a week. Her kids are grown and she has four grandchildren. But even an experienced educator like her gets questions from the young audience sometimes that she just can’t answer. They usually have to do with pregnancy and how babies get out of their mother’s belly. With that question, she refers children back to their parents for answers. “They haven’t asked me how they get in yet,” Terry joked. “But everything is referred back to the parents.”
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2015
The program is growing. More children have come through Hospital-Land in recent years, even though some local schools have consolidated. The program plans to extend a modified Hospital-Land out to different scouting and brownie troops too. They even have thoughts of taking the show on the road. Hospital-Land equipment might be brought to Central New York schools that can’t afford the expense of a field trip. The nurses would set up in an auditorium and the students would experience it there.
Crouse’s Hospital-Land shows no sign of slowing. It’s quite likely future CNY doctors and nurses are getting their first experience of the workings of a hospital at Crouse today. At the minimum, the program is dispelling some of the fear of hospitals for children. The first-graders may be traveling up the hill on Irving Avenue into the unknown, but they’re going back to school with new knowledge and a sense that medicine can be fun. For more information on Hospital-Land, go to www.crouse.org/ about/community/programs.
Nurse educator Faith Terry is one three RNs who teach Crouse’s Hospital-Land program to area first-graders. She is seen here with her assistant “Dr. Teddy.” The educational program has had over 186,00 school children go through it since 1976.