PRICELESS
Caring for S.U. Football Team
CNYHEALTH.COM
April 2019 • ISSUE 232
Understanding the Dramatic Fall in Number of Births
Todd Battaglia is the lead orthopedist for the Syracuse University football team. He shares his experience caring for the athletes
Hot Flashes 101
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Birthrate in the U.S. is at the lowest level in 30 years.
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Things You Need to Know About Autism
Planning for a Good Death
Organ Donation
Former SUNY Upstate president pens book about end of life
New York state still lags nation when it comes to number of people registered to donate
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The good, the bad, and the better choices. Story on p. 15
Cyberbullying How to keep your kids safe See Kids Corner on p. 10
Pelvic Health... Woman to Woman Pelvic health is nothing to whisper about. But that’s what many women do when it comes to talking openly and honestly about an important part of the female anatomy. Leading the discussion locally is Hadley Narins, MD, a fellowship-trained urologist dedicated to making women feel comfortable about bringing up problems — and treating them. Specializing in urinary incontinence and managing pelvic organ prolapse, she has the skill and sensitivity to make women’s lives healthier and happier. Welcoming new patients! Call 315-478-4185. Learn more at
crouse.org/pelvichealth
Hadley Narins, MD
B R E A S T H E A LT H | C A R D I A C C A R E | W E I G H T- L O S S S U R G E R Y | U R O L O G Y | P E LV I C P H Y S I C A L R E H A B | G Y N | G Y N O N C O L O G Y
Women’s services at Crouse. As individual as you are. No two women are alike. At Crouse, we believe you want — and need — healthcare that puts a continual focus on what matters most — you. Our hospital was founded by women — and more than a century later, services for infants and women of allages remain at the heart of Crouse Health. Partner with women’s wellness providers who discover your individual needs by listening more closely and caring more deeply — and treating you with the respect and dignity you deserve. That’s Carepassion.TM Page 2
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
JCC CAMP JOE & LYNNE ROMANO
July 1 – August 23 | 315-445-2360 • For ages 6 weeks • Full- and part-time • Daily swim through 5 years sessions available lessons
• Cheerleading • Coding • Dance
• Day Tripper • Fishing • Rocketry
• Spy Academy • Theatre • ...and more!
• SyraCruisin’ Travel Camp for grades 7–10
JCC of Syracuse 5655 Thompson Rd., DeWitt • 315.445.2360 • www.jccsyr.org
Organ Donation: NYS Still Lags Nation Rate of registered organ donors grows, but NYS still behind
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ore New Yorkers than ever before are signing up to be organ donors, but the state still lags the nation when it comes to the percentage of adults in the donor registry, according to an analysis by Excellus BlueCross BlueShield. At the same time, the need for organ and tissue donors in New York remains among the highest in the country. “New York state’s 35 percent participation rate is the second-lowest donor registration rate among the 50 states,” said physician Richard Lockwood, vice president and chief medical officer at Excellus BlueCross BlueShield. “Yet, the need for organs in New York state is third-highest among the 50 states, with 9,500 individuals currently on the transplant waiting list.” Only California (21,387) and Texas (9,750) have more people waiting for organ transplants. Nationwide, 58 percent of adults are registered organ donors, and 113,000 Americans are on the waiting list for an organ transplant. About 17,000 of them have been waiting five or more years. Every day last year, about 14 Americans died while waiting for a transplant. “When we looked at the data five years ago, 22 percent of New York adults were in the organ donor registry, so today’s 35 percent participation rate shows that more people understand the need for giving others a lifesaving gift,” said Lockwood. “We need to do a better job of communicating the ease of registering as an organ and tissue donor.” New York state has simplified the process to register as an organ and tissue donor. In 2017, 16- and 17-year-olds became eligible to join the registry when they apply for a driver’s license or permit. That same year, New Yorkers became eligible to sign up for the Donate Life Registry when applying for or renewing a health insurance plan on the NY State of Health marketplace. The simplified process appears to be working. According to New York State Department of Health data
from October 2018, nearly 38,000 of new organ registrations in the previous 12 months were 16- or 17-yearolds, and approximately 91,000 new registrations came from the health insurance marketplace. The Upstate New York region, with 47 percent of adults registered as organ and tissue donors, performs better than the state as a whole. In the Central New York region, 48 percent of adults are registered organ and tissue donors. “Last year, 386 New Yorkers became too sick to remain on the waiting list, and 387 died awaiting a transplant,” said Lockwood. “These people could be your parent or child, friend or neighbor, co-worker or classmate. The need for organ and tissue donors touches all of our lives.”
Learning does not have an age limit. Lifelong Learning at SUNY Oswego July 21 - July 25 & July 28 - August 1 Multiple four-day programs for adult ages 50+ to pursue exciting educational and social experiences on campus For more information, visit our website:
oswego.edu/lifelong-learning
Need for Donors at a Glance • New York has the third highest need for organs but has the second lowest donor rate registration rate. • 35 percent of NYS adults are registered organ donors compared with 58 percent of US adults who are registered organ donors. • 9,500 New Yorkers are waiting for an organ • 17,000 Americans have been on the waiting list for more than fiver years Source: Excellus BlueCross BlueShield
How to Become an Organ Donor Sign up through the New York State Department of Motor Vehicles in-person or online at DMV. NY.gov; Sign up when you register to vote; Enroll through New York State of Health when applying for health insurance at NYStateofHealth. NY.gov; Complete a paper or online registration form at DonateLife. NY.gov.
Office of Business & Community Relations 315.312.3492 • lifelonglearning@oswego.edu April 2019 •
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CALENDAR of
HEALTH EVENTS
April 13
Good Samaritan Race event benefits CHSOS
Christian Health Service of Syracuse (CHSOS), a local medical mission, will host its Sixth Annual Good Samaritan Run/Walk — 5K and 10K event Saturday, April 13 at Long Branch Park in Liverpool. CHSOS is a nonprofit organization that strives to make primary healthcare both available and affordable to all patients, regardless of their financial needs or level of insurance coverage. The organization’s mission is to reach the medically under-served of Central New York with high quality healthcare coupled with the love of Jesus Christ and prayer. Presently, about 70 percent of its patients are financially disadvantaged or are medically under-served as they are on Medicaid, Medicare, or are self-paying. The Good Samaritan Run/Walk, the group’s main fundraiser, has raised more than $50,000 over a four-year period to support an additional 500 patient visits per year to individuals and their families who cannot afford primary healthcare otherwise. The event begins at 10 a.m. Cost is $25 for the 5K (children 12 and under are free for the 5K) and $30 for the 10K per participant. Certified course will be an out and back on the
West Shore Trail of Onondaga Lake. Regular 5K will be on the East Shore trail of the lake. Event includes a Kids’ Sprint ($10 per child) for ages 5-12 beginning at 9:30 a.m. Awards ceremony, concession stands, family-oriented activities, live music, and vendors are included with the event. Registration information can be obtained at www.goodsamaritanrun. org or by emailing goodsamaritanrun@gmail.com.
April 13
Fashion show to benefit Friends of St. Camillus
The Friends of St. Camillus invite the public to attend, “Spring in Bloom,” the group’s annual benefit fashion show and luncheon with onsite shopping boutiques. It will take place from 11 a.m. to 3 p.m., Saturday, April 13, at the DoubleTree by Hilton on Route 298, just off Carrier Circle in East Syracuse. Presenting sponsors are the China Towne Furniture and Mattress, Geddes Federal Savings and Loan Association and the Kinney Drugs Foundation. New this year, the live fashion show will feature fashions generously provided by Chico’s of Fayette-
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SAFE Fair Mixes Fun and Substance Abuse Awareness By Maria Pericozzi
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2019 Kathryn Fish Lecture Series Sunday April 28th - 1-2pm Dr. Jim Yonai Next Lecture: May 19th
Reverend Mick Keville - Believing the Best Come Visit The Farm! See “Chocolate Cream” and the goats. Walk the track and enjoy the farm. We have 3 professional therapist that see patients. Please call for more information.
PUBLIC IS WELCOME!
Jim Marshall Farms Foundation, Inc.
1978 New Boston Road, Chittenango, NY 13037 www.jmffinc.org Please call 315.687-5064
Like us on Facebook
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
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Issues Affecting Aging and Mental Health
he sixth annual Oswego County Substance Awareness Family Education (SAFE), fair will focus on holistic and alternative ideas for treatment and recovery for those with an addiction or mental health illness. This family-friendly free event will be held from noon to 4 p.m. on Sunday, April 28, at the Lake Ontario Event and Conference Center in Oswego. The event is hosted by the VOW foundation, a nonprofit organization formed following the death of Victor Orlando Woolson from synthetic drugs in Oswego. His mother, Teresa Woolson, said the goal of the event is to bring together all of the service providers in the area to provide education for the community in a family-fun way. “Nobody wants to just go to an event to learn, so there are a lot of fun things to bring people out to learn all about different things having to do with substance abuse, mental illness [and] suicide prevention,” Woolson said. At this year’s event, the students in the New Vision High School Health Program at SUNY Oswego will have stations set up about mindfulness. Each service provider will have an activity set up at their table. Narcan training will be available, as well as speakers, presentations, games, a driving simulator and prizes. Each person who attends the event and visits 10 of the stations or tables, will be entered into a free drawing. Woolson said it will en-
courage people to walk around and participate in the events. Putting on the event is a large collaboration, Woolson said. There are a large number of sponsors who are contributing to the event to help put it on. She said she is hoping this event will educate the community. “There are a lot of new programs because addiction and the opioid epidemic in our area is still very high,” Woolson said. “We have a lot of synthetic drugs in the area that are causing harm. Unfortunately, synthetic drugs are being mixed into all the different drugs.” In 2012, Woolson’s 19-year-old son went into a store, bought a product containing synthetic drugs, which killed him. She said she keeps Victor’s story alive which keeps Victor alive in everyone’s hearts. “[Everyone] really understands this does happen and it happens here in this community,” Woolson said. “It’s very dangerous and we all need to be prepared.” Woolson started the VOW Foundation in his honor and his name, and vows to save lives. She said community members need to be aware of what’s out there, what’s going around, how to look for it, prevent it, treat it, and how to cope with things like stress and anxiety instead of going to things like drugs and alcohol. “This event is important to bring all the new programs and all the new ideas and everything to the public and community to have more tools in their toolbox to help with life,” Woolson said.
TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.
Partner with Your Provider
Be Heart Smart
To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.
A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure
New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com
Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.
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WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015
April 2019 •
©WellCare 2015 NA_03_15_WC IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 5
Meet
Your Doctor
By Chris Motola
Todd C. Battaglia, M.D. Lead orthopedist for the Syracuse University football team shares his experience caring for the athletes
Working More, But Getting Less Done? Study: Productivity starts to fall considerably after the 50th work hour of the week
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t’s no surprise that many Americans are working overtime. Conservative estimates say that 19 percent of adults put in 48 hours or more a week and 7 percent log in 60 or more. But what you might not realize is that, after a certain point, extra hours could be hurting both your health and your productivity. In addition to a variety of medical issues and unhealthy lifestyle choices associated with long hours, a British study used cognitive tests to show that working 55 hours a week was associated with lower scores in vocabulary and reasoning, and can lead to cognitive problems as you get older. Adding insult to injury, research done at Stanford University found that, besides the personal toll that overtime takes, you probably aren’t working effectively. Productivity starts to fall considerably after the 50th work hour of the week and gets worse with every additional hour. So, if you put in 70 hours a week, you’re not likely to accomplish anything worthwhile during those last 15. One reason for this is that you might be too stressed or tired to function at peak level since working overtime usually results in your getting less sleep — and that in turn leads to making mistakes that can set you back at work. Take action to improve the balance between your personal life and your work life. Prioritize responsibilities and focus on the most important ones. Assert more control over time-draining tasks like answering emails. If you check your email every few minutes, cut down to every half hour or just scan the subject lines and open the most essential ones. And when you must stay late, make getting sleep a priority so that you’ll be well rested when you’re back at work in the morning.
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Q: Tell us about your experience taking care of the Syracuse University football team. A: It’s the most enjoyable portion of my job. I travel with them, cover their games, spend a lot of time in practice. It’s just a very rewarding way to stay involved in sports when you’re a little too old to participate yourself. Q: What’s the most interesting story you have from doing college sports medicine? A: It’s hard to get into specifics due to confidentiality, but we’ve seen some pretty unique injuries that you don’t see with your high school or recreational athletes. Open fractures, major ligament injuries and dislocations, tears of muscles off the pelvis — some unusual injuries that come from the speed and weight at which those guys play. The amount of trauma they put themselves through in each game, it’s kind of amazing more of them make it through uninjured. Q: Do you make recommendations for protective equipment, or is that out of your hands? A: In terms of basic equipment, helmets and pads [recommendations] are dictated by the sport and staff at the university. But there are things we can influence, like recommending special helmets that provide extra protection from concussions. For players with knee and shoulder injuries, there are pads and braces we can recommend. So, for uninjured players, we don’t really have much influence, but we can make recommendations for equipment for injured or recovering players. Q: What does sports medicine in the context of your practice mean? A: Sports medicine is really a pretty broad descriptor that tends to focus on specialty arthroscopic joint surgery. For me, about 95 percent of my practice is knee and shoulder surgery. That includes ligament reconstruction, cartilage and meniscus surgery, rotator cuff surgery and should dislocations. So that includes patients from age 10 up through 90. Q: What are the common causes of injury to those joints? A: In my practice, it’s two different causes. The younger patients tend to have more acute injuries, usually caused by an athletic event, whether it’s impact, jumping or from cutting. For the older patients, while they may still have trauma, a lot of their problems are
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
more of the wear and tear variety. Q: What makes joints vulnerable to injury? A: Joints have moving parts that tend to wear out just like they would with a machine. So, the ligaments and cartilage, even the bones themselves can only withstand so much force, so much stress, before they reach the breaking point. Q: Why are they so hard to heal naturally? A: It depends on what structure we’re talking about. Some tissues around the knee actually have a very good healing potential, but some have very little ability to heal. Cartilage has very little blood supply and little ability to heal itself. Some ligaments may as well, due to the environment they’re in like the ACL [anterior cruciate ligament]. Q: What kinds of interventions are we usually talking about? A: It depends on the injury. In a practice like mine, the great majority of patients I see don’t need any surgery at all. They’re treated with medication, injections, physical therapy, bracing, casts, that kind of thing. For those who do require surgery, it depends on what type of injury they have. When it comes to surgery, I run the whole gamut from arthroscopic surgery to total joint replacement for both shoulders and knees. Q: How effective are non-surgical interventions at promoting healing? A: Depending on the specific treatment, most of those treatments are quite effective. Less than 10 percent of patients who see me ultimately need surgery. We have a very well-trained physical therapy staff with a few offices across the city. I would say the majority of our patients end up doing physical therapy at one of our facilities or at one of their choosing.
Q: What’s the recovery time like for surgery? How much of your movement and strength can you expect to get back? A: Recovery is highly variable depending on the surgery. Some of the more minor surgeries may take only a few weeks to recover from. Bigger surgeries up to joint replacement could be nine to 12 months to get back to full activity. Q: What sports send you the most patients? A: We take care of everything. In the course of the week, I’ll see softball players, cheerleaders, soccer players, football players, lacrosse players. For the older patients, golf and tennis players. Q: Do you play any sports yourself? Does your job make you anxious about the risks? A: I still do play a little bit. I’ve been a lacrosse player for the better part of 35 years and still play a little bit. You see a lot of knee injuries in lacrosse from all the cutting and pivoting. We see some shoulder injuries, but they tend to be from getting hit. Also, ankles, elbows and wrists, so it’s a pretty wide variety. But most of my involvement is covering teams and standing on the sidelines, so it’s more watching than playing. Q: For the wear and tear injuries, what factors determine how long a joint lasts? A: There are a lot of factors. We haven’t really discerned precisely what weight the factors play, but overall we know it’s things like: body weight, previous injury, genetics, athletic level, medical issues like diabetes, smoking, and so on. Probably the most important things you can do is keep a healthy body weight and not smoke. There are some other strategies that may or may not health. Like taking cartilage or fish oil supplements. There’s some limited evidence that they may help the joint, but most of the research is mixed at best at this time. Q: How does smoking affect joints? A: That’s a good question. I don’t know that we’ve explained it down to the molecular level, but basically the quality of all of our tissues suffer from smoking.
Lifelines
Name: Todd C. Battaglia, M.D. Position: Orthopedic surgeon at
Syracuse Orthopedic Specialists, where he directs its Cartilage Center. He is also the lead orthopedist for the Syracuse University football team, head team physician for the Syracuse Silver Knights professional soccer team, Onondaga Community College athletic teams, Bryant & Stratton soccer teams, and numerous area high schools. Hometown: Marcellus Education: Amherst College (bachelor’s in psychology), SUNY at Buffalo (medical school), University of Virginia (orthopedic residency) Affiliations: SUNY Upstate; Crouse; St. Joseph’s Medical Center Organizations: Arthroscopy Association of North America; American Orthopaedic Society for Sports Medicine; International Cartilage Research Society Family: Married, one daughter Hobbies: Sports, music
Get fitter Get et healthier bG etter sooner
For high-tech, contemporary, personalized rehab from injury, illness or surgery, call us today.
Onondaga Center 217 East Ave, Minoa, NY 13116 315 656 7277 Oneida Center 1445 Kemble Street, Utica, NY 13501 315 732 0100 Carthage Center 1045 West Street, Carthage, NY 13619 315 493 6523
April 2019 • In Good Health Central NY Region - April 2019 - 9.75”x13.75”
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Physician Well-being Improving, But Burnout Risk Remains
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he good news is that physician burnout appears to be improving, along with indicators for physician well-being. However, physicians remain at high risk for burnout, depression and depersonalization, compared to other professionals. Those are the updated findings from Mayo Clinic researchers and their collaborators that are published in Mayo Clinic Proceedings. “This is good news. It shows that burnout is being addressed nationally and programs are having some impact,” said physician Lotte Dyrbye, Mayo Clinic researcher and senior author of the paper. “Clearly more organizational change and more research is needed to sustain this trajectory.” Researchers from Mayo Clinic, the American Medical
Association and Stanford University collaborated in the national survey of physicians across more than 20 specialties to assess any changes between the previous study in 2014 and the original survey in 2011. While burnout varies by specialist, overall reported levels of burnout and satisfaction with work-life integration improved between 2014 and 2017 — but only to 2011 levels. The researchers say individual and organizational efforts have improved the situation, but more work needs to be done. Burnout encompasses many aspects but includes the areas of emotional exhaustion, depersonalization, distress and depression. Extreme cases of burnout can lead to medical errors affecting patients, job loss and suicide. Survey responders say the demands of updating electronic health records are a major
factor in burnout. These demands limit the time physicians can spend with patients, and that affects career satisfaction. More than 30,000 physicians were invited to participate in the electronic survey. Roughly 17 percent (5,197) responded, and a second attempt to reach nonrespondents gained 248 more participants. Questions mirrored those on the previous surveys. Researchers say the reason for the change may be due to physicians adapting to the new work environments over the three-year period. Also, much progress may be attributed to interventional programs to stem burnout in hospitals and other facilities. Conversely, they say the indicators may have improved because many distressed physicians have left the profession.
Healthcare in a Minute By George W. Chapman
‘Vaccine Hesitancy’ Among Top 10 Threats to Global Health “Vaccine hesitancy” is the term coined by the World Health Organization to describe the resistance to vaccination due to unfounded safety fears, complacency about infectious diseases or difficulty accessing vaccinations due to supply or price. Vaccine hesitancy is now listed in this year’s top 10 threats to global health. Lately, close to 200 people in New York, mostly children, contracted measles, according to the Centers for Disease Control. An ongoing measles outbreak in Portland, Ore., has sickened 23 people, mostly children. Twenty of them were never vaccinated. Incredibly, despite the overwhelming evidence that vaccines work, the rate of unvaccinated kids has quadrupled in the past 17 years. Thanks to vaccines, smallpox has been completely eradicated and polio soon will be. Some children remain unvaccinated because of choices made by their parents. The American Medical Association is clamping down on providers who flippantly provide feeble excuses for children not to be vaccinated so they can enter school. The CDC is debunking the myths about vaccines.
No. 1: Numerous studies have found no connection between vaccines and autism. People might think the two are linked because the MMR vaccine is administered at the same phase in a child’s development when they may begin to show signs of autism spectrum disorder (not responding to their name, oversensitive to noise). No.2: It is not “safer” to space out the vaccines. The CDC recommended schedule is based on disease risks, vaccine effectiveness at certain ages and vaccine interactions with each other. No. 3. Vaccines do not contain harmful chemicals. Some substances contained in some vaccines do sound harmful, notably formaldehyde and mercury. The former is naturally produced in our bodies and the trace in vaccines is far less. The ethylmercury used in flu vaccines is safe and much different than the toxic methylmercury which most of us should be worried about. No. 4. You cannot rely on everyone else’s immunity/ vaccination to protect your unvaccinated children. If an outbreak occurs, unvaccinated children are far more likely to get sick.
Socialized Medicine
in 2027. When you add in those insured/covered by federal employee insurance, Tri-Care (military), the VA and the Bureau of Indian Affairs, the government pays for over half of us. The “Medicare for All” movement would slowly transition the other 50 percent, typically by age, into a single payer system, eventually eliminating commercial insurance. Most physicians now very cautiously back a single payer system because most commercial insurers are paying Medicare based rates, so a single payer would just be easier for them to manage. The American Medical Association’s legitimate concern is
If your definition of socialized medicine means government controlled or paid for medical care, then we are almost halfway there. Within the next few years, the government’s share of healthcare spending will approach 50 percent, according to The Centers for Medicare and Medicaid. Aging baby boomers entering Medicare will drive this. By 2027, CMS estimates about 74 million people will have Medicare and about 83 million will be covered by Medicaid for a combined total of 157 million which will be about 45 percent of the projected population of 350 million Page 8
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
once there is a single payer, they are at the mercy of the single payer. Seventy percent of Americans favor universal healthcare, but few are sure how it would work or be paid for. Of course, taxes would go up if the entire cost of universal care is paid for through taxes. But what hasn’t been considered in proposals is, what happens to the amount of care paid for by employers? Will they keep it and then pass the savings along to their employees in higher wages, which would then ameliorate the increased payroll taxes? Or will they continue to pay a percentage of the premium to the single payer? On average, employers cover about 67 percent of the employee’s health insurance.
Rural Hospital Jeopardy
One in five rural hospitals in the U.S. is at risk of closing unless there is direct fiscal relief or they affiliate with a larger, healthier system. Sixty-five percent of the rural hospitals at risk are considered essential because of their trauma status, services to vulnerable populations, isolation and economic impact on the surrounding communities. The states with the most at-risk rural hospitals are: Mississippi, 31 hospitals; Kansas, 29: Montana, 12; and Texas, 12. Ninety rural hospitals have closed since 2010. Left alone, most rural hospitals will close because of poor finances or their ability to attract and retain physicians. Ironically, telemedicine could hasten closures as rural populations get increased access to physicians in urban areas.
More MDs Employed
As of a year ago, 44 percent of practicing physicians were employed by hospitals or health systems. Just seven years ago, only 25 percent of physicians were employed. Over the last two years, hospitals acquired 8,000 more practices and another 14,000 physicians left private practice to become employed, according to the Physicians Advocacy Institute. In the last seven years, hospital-owned
practices more than doubled from 36,700 to more than 80,000. The vast majority of physicians completing their residencies will bypass private practice and seek employment. The hassle/risk of running a private practice has become overwhelming and unfulfilling for many physicians. Physician employment is actually encouraged/driven by payment policies that favor integrated health systems where physicians and hospitals work in coordinated and managed unison to improve population health.
Your medical record
Many hospitals and physician offices are still providing only paper copies of records to their patients. Because paper copies are labor intensive, you can be charged per page. It can get expensive, especially if a hospital record. HIPAA regulations state you are entitled to a digital copy of your record if the provider has the capability to do so. In response to complaints from consumers about providers blocking/impeding electronic access to their data, the Department of Health and Human services recently made public several rules that would allow consumers easier access to their record via the app of their choice, like a smartphone, at no additional cost. The healthcare industry has been slow to adapt to available technology. In fairness, providers cannot simply raise prices to pay for their investment in information technology because their reimbursement from their party payers is fixed. George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
Stroke: Death of TV Actor Confirms Trend More young people are dying as a result of strokes, according to data By Ernst Lamothe Jr.
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he news of TV star Luke Perry’s death hit people hard for many reasons. Some were his long-time fans. Others were just shocked about the speed in which he went from being hospitalized to being dead. Finally, many people just couldn’t believe that someone could die of stroke, especially someone in their 50s (he was 52 when he died). Stroke is the second most common cause of death worldwide, according to the American Stroke Association and there are an estimated 17 million strokes worldwide each year. “Stroke cases are extremely important and it is not an issue that can be ignored,” said Fahed Saada, a neurologist at St. Joseph’s Health in Syracuse. “While stroke does happen more in the elderly, it can happen to anyone.” Stroke is the fifth leading cause of death in the U.S. killing 140,000 people a year. It is also the leading cause of disability among Americans, as it can leave survivors paralyzed or unable to communicate. A stroke happens when a blood vessel that brings oxygen and nutrients to the brain is either blocked by a clot, which is called an ischemic stroke, or it ruptures, a hemorrhagic stroke. That cuts off the vital blood and oxygen flow to that part of the brain. This kills brain cells, which can kill a person or severely debilitate them.
“Even though we have billions of neurons, you are losing millions for every minute you are suffering a stroke,” said Saada. “There are long term effects such as memory loss and losing cognitive skills. That is why time matters some much.” Perry was slightly young for a stroke victim, as 66 percent of those who suffer from such an attack are 65 or older, according to the Center for Disease Control and Prevention. But strokes, which are behind about 5 percent of U.S. deaths annually, are on the rise among those between 25 and 44. Perry’s father died in his mid-30s from a heart attack. Saada stresses that people need to keep their bodies healthy or they could be prime candidates for strokes. “If you have any risk factors like high blood pressure, high cholesterol or smoking, you have to beware. Patients with these issues have a higher likelihood of stroke,” added Saada. “That is why you have to watch for as many warning signs as possible.” The American Stroke Association suggests learning the F.A.S.T warning signs that someone is having a stroke, including: • Face drooping: Does one side of the face droop, or does it feel numb? Ask the person to smile; is the smile uneven or lopsided? • Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one drive
downward? • Speech: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence. • Time to call 911: If the person shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital ASAP. The faster a person is treated, the more likely they are to recover. Additional symptoms can include sudden numbness or weakness in the face, arm or leg, especially on one side of the body, severe headache, sudden confusion or trouble seeing in one or both eyes. “The medical community needs to do a better job at educating our society on the dangers of stroke,” said physician Elad Levy, professor and chairman of neurosurgery at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo. “The brain is such a complex organ. And we need to do a better job at educating people that while you can’t modify your genes or family history, you can exercise more which keeps the blood flow pumping through your body. People who have high blood pressure, cholesterol and other weight issues are more susceptible. Even though we live in western New York where it can be cold, we have to keep moving.” Saada added that the medical community must also reach out to more primary care physicians and re-
Actor Luke Perry died recently at age 52. mind them to tell patients how their risk factors can lead to bad outcomes. Levy also added that it is important to keep this topic on the forefront of people’s minds. “People need to know that strokes do not discriminate between gender, culture or age,” said Levy. “I have seen strokes in young children to seniors.”
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
On Her Own: Up Close and Personal with Ginger Howell
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t was love at first sight. At the ripe old age of 14, Ginger Howell met and was smitten by her future husband-to-be Dick Howell in Saginaw, Mich. They happened to be neighbors — and Ginger was robbing the cradle. Dick was 13. “Even at that young age, he was so good-looking, smart, and athletic — especially at swimming!” Ginger beamed. These childhood chums turned into highschool sweethearts, and then years later got engaged when they were students at the University of Michigan. Ginger got “pinned,” an old-time expression, which signaled the beginning of an exclusive courtship akin to engagement. Dick and Ginger tied the knot following graduation. When Dick was drafted, the couple lived and traveled abroad in post-war Germany for a year, then moved to Rochester where Dick was hired by Eastman Kodak and they started a family. Three kids later, they had nestled into a rustic ranch in Pittsford, where Ginger launched Seasonal Kitchen, a cooking school in their home, while Dick made a name for himself at Kodak. When Dick retired, he joined Ginger in the kitchen and together they taught cooking classes that mixed good-hearted ribbing with lots of laughs, helpful cooking tips and demonstrations. The classes, which included dinner, were (and continue to be) a hit! Sadly, Dick lost his battle with cancer five years ago. As a widow,
Ginger was determined to carry on their cooking legacy and love of life, both the sweet and the savory.
Q: After you lost Dick, what were some of the biggest challenges you faced?
classes.
A: Facing life without someone to lean on was a huge change for me. Dick and I did everything together after he retired. We were inseparable. And he did so much around the house. I wasn’t sure how I was going to stay on top of things. I was also very worried about finances and whether I would be able to hold onto the house and continue the cooking
Q: How did you overcome these challenges?
A: Well, I thank my lucky stars for my daughter Holly. She stepped right in to help me lead the cooking school, which was no small feat. Each class requires lots of preparation, shopping and rehearsal ahead of time, followed by hours of clean-up afterwards. While Holly and I couldn’t sustain the 11 classes per week Dick and I led, she and I kept it going. This was important for financial reasons. I needed to pay the bills. But I also needed and wanted to maintain my social network. Many of my class members became friends and, as such, became my support system after Dick died. I’ll be forever grateful for that. My financial consultant was also invaluable. Thanks to his help,
s d i K Corner
How to Keep Your Kids Safe From Cyberbullying
N
o type of bullying is acceptable, but cyberbullying can be harder for parents to spot because it takes place via cellphone, computer or tablet, often through social media. Cyberbullying can be a hateful text message or post of embarrassing pictures, videos and even fake profiles of the victim. Victims are often bullied in person, too, and have a harder time escaping it. But unlike facing a bully at Page 10
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school, cyberbullying can happen 24/7, even when your child is home with you. Messages and images can be posted anonymously and spread in no time. And it can be difficult or even impossible to find the culprit. The consequences of being cyberbullied are far-reaching. Young victims are more likely to use alcohol and drugs, skip school, lose self-esteem and develop health problems. What can parents do? The website Stopbullying.gov recommends
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
Dick and I had a retirement nestegg I could live on as long as I was careful about my spending. That’s not always easy when you love to entertain, cook and enjoy delicious food! But I made it work. Q: There is a commonly held belief that single women in midlife are inevitably unhappy without a partner. How do you respond to that?
A: I’m bemused by that belief. Perhaps these are women — or men, too, I suppose — who haven’t given themselves a chance to see what they can do and experience for themselves. Living alone can be so empowering. I know this may sound cliched, but I find every day to be an adventure.
Q: Has living alone provided you with any unexpected revelations or opportunities?
A: Oh, so many! For one thing, I can still shovel snow at my age — I’m 90! I know this sounds simplistic, but it’s very symbolic. I’ve learned I can do things for myself. My attitude is that shoveling snow is great exercise! Good for the legs. It gives me a great deal of satisfaction knowing that I am capable on my own; that I can depend on myself. I’ve also learned that if things are beyond me, I can ask for help and rely on the kindness of others. Last month, the UPS guy showed up with a delivery on a very snowy day. I asked if he could help shovel the front porch before he left, which he did so gladly. I don’t see asking for help as a weakness; I see it as a sign of strength and self-confidence.
Q: What does an ideal day look like for you now?
A: On an ideal day, I wake up to a clean kitchen, having washed the dishes the night before. I put away the clean dishes, make my list of chores for the day (which typically includes a trip to the grocery store), and then I get busy trying new rec-
ipes or prepping for a cooking class that evening. After the class and everyone has left, Holly and I clean up and collapse exhausted, but happy, in my living room. We are full of gratitude for the beautiful people and purpose in our lives. Q: What advice do you have for women and men who find themselves living alone in midlife?
A: Keep working at something you love to do — something that matters. Working keeps us young and alive! For me, it’s Seasonal Kitchen. For others it could be hiking, writing, playing an instrument, travel, you name it. I encourage people to stay active and engaged in life. And to be with friends and definitely own a pet, if possible. Oh, and take a cooking class!
Q: And one last question: How do you plan to spend this evening?
A: Mercifully alone (smiles). I adore a quiet evening to myself. As you can imagine, I’m very busy food shopping, prepping and leading classes, going out to dinner with friends, participating in wine tasting events, attending fundraisers, etc. I look forward to an evening alone watching “World News Tonight,” followed by “Jeopardy,” and then snuggling up with a good book. I love reading and re-reading anything by Irwin Shaw and Rona Jaffe. Tomorrow I will wake up rested and eager to take on a new day, on my own and looking forward to what’s to come.
Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon. She is also the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” To purchase her book, learn about workshops, or invite her to speak, call 585-624-7887, email gvoelckers@rochester.rr.com or visit www.aloneandcontent.com.
being proactive — talk with your kids about cyberbullying, including why they should never bully others, and encourage them to tell you about any incident right away. Friending or following your kids on social media may help you know if they become the victims of unwanted postings.
More tips for parents • Teach kids not to share anything that could hurt or embarrass them or others to avoid retaliation. • Regularly check your kids’ social network pages to look for signs of bullying behavior, such as mean images of another child. • Tell your kids to talk to you if an online message or image makes them feel threatened or hurt. • Encourage your kids to speak up if they see cyberbullying happening to someone else, and not to engage in the bullying by forwarding posts. • If your child is cyberbullied, print and save screenshots, emails and texts for evidence. He/she should not react to the bully, but should block and/or delete him/ her from their friends lists. Block the user name, email address and phone
number. If your child finds a profile that was created or altered without his/her permission, contact the site to have it taken down. • Report cyberbullying to your online service provider, and go to its safety center to block users and limit who can contact your child. • Report cyberbullying that involves a crime to police. • Contact law enforcement if cyberbullying involves: Threats of violence, child pornography or sexually explicit messages or photos, any photo or video of someone in a place where he or she would expect privacy, stalking and a hate crime. Also report incidents to your child’s school. The school can use the information to help with prevention and response strategies.
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April 2019 •
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Page 11
My Turn
By Eva Briggs
Rabies: What to Do if an Animal Bites You
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hen my youngest daughter was about 6 or 7, she and her friend had a game they called “rabie [sic] chicken.” It was a version of tag where one child was a rabid chicken pretending to froth at the mouth, trying to tag the others. She and her friend didn’t really know what rabies was other than what they had learned from watching cartoons. Their first mistake was selecting a chicken as the infected critter. Rabies is a virus that infects mammals (although, in the laboratory, the rabies virus can infect bird cells). Rabies affects the nerve tissue of infected animals. It’s chiefly spread by contact with the saliva of an infected animal. Once an animal is bitten, the virus travels via the peripheral nerves to the brain. After reproducing in the brain, the virus now spreads to the salivary glands. Symptoms of rabies develop days to weeks after a bite. The initial symptoms resemble the flu, with weakness, muscle aches, fever and headache. As the disease progresses, delirium, abnormal behavior, hallucinations, excessive salivation and insomnia develop. Once a human
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develops symptoms, he or she invariably dies. There have been just a handful of patients who reportedly survived rabies infection after intensive treatment and a prolonged hospital course. The most important reservoirs for rabies in the United States are raccoons, skunks, foxes, coyotes and bats. Domestic animals such as dogs, cats and ferrets — especially those that haven’t been vaccinated — can potentially become infected by contact with a rabid wild animal. If an animal bites you, the very first step is to clean the wound. The most effective method is to use plenty of soap and running water to clean and irrigate the bite. Your next step
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
should be evaluation by a medical professional. The wound can be assessed for damage to underlying structures such as tendons. If needed, antibiotics can be started. For example, the little sharp needlelike teeth of cats act like hypodermic needles to inject bacteria into bite wounds. This leads to an infection rate as high as 50 percent, so cat bites almost always require antibiotics to prevent bacterial infection. In New York state, the health department decides whether rabies post exposure prophylaxis (PEP) is needed. Medical providers are mandated to report animal bites to the health department. The county health department then investigates. Living animals that can be observed will be placed in quarantine for 10 days. If no symptoms develop within that 10-day period, rabies PEP isn’t needed. If the animal is dead but the head is available for investigation, the state lab examines the brain for signs of rabies. If the animal is not available, as when the biter runs off and disappears, or an overzealous human bashes its brain beyond recognition, the health department will determine whether rabies PEP is needed based on species of animal and circumstances of bite. Rabies PEP consists of both immunoglobulin and rabies vaccine. Human rabies immunoglobulin (HRIG) is given once along with the first dose of rabies vaccine in previously unvaccinated patients. HRIG provides antibodies to bind rabies virus. This jumpstarts the treatment while waiting for the patient to start producing his or her own antibodies in response to the rabies vaccine.
The rabies vaccine is given as a four-part series. It’s injected in the shoulder on day 0, and on days 3, 7, and 14. Immunocompromised patients may need a fifth dose. People who have previously received the full rabies vaccine series don’t need immunoglobulin. They need just two booster doses of vaccine on day 0 and day 3. The greatest reason that I see people hesitate to come and seek medical care for an animal bite is fear that the health department will take their pet away. Given how serious rabies is, it’s important to determine whether a human who has suffered a bite needs rabies PEP. It’s very expensive and should be given only when required. The health department’s goal isn’t to take someone’s pet away. It’s to determine whether there is a public health threat. So please don’t let that deter you from seeking medical care for an animal bite. We’re lucky that New York state is one of the few states where the health department actually picks up some or all of the cost of the vaccine itself. Here’s a link to a story about the high cost of rabies vaccine https://www.webmd.com/a-to-zguides/news/20180220/the-highcost-of-surviving-rabies Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
Yoga at the Library Yoga program at White Branch Library in Syracuse features Bhutanese influence By David L. Podos
A
re you interested in fitness and improving your general overall health? Consider a visit to Syracuse’s White Branch Library. Public libraries have become more than a repository of books. Nowadays, they’re community centers offering a variety of activities. Although it seems an incongruous place at first glance, several libraries now host free exercise classes and events. White Branch Library, on Syracuse’s north side, has hosted informal yoga sessions for over six years on most Saturdays. Betts Branch Library, on the south side, has hosted yoga classes for many years at 6 p.m. on most Mondays. Yoga at White Branch Library is unique compared to elsewhere. New Americans forced to leave their homes in Bhutan have led the effort. They lived in refugee camps in Nepal before arriving in the United States, some for more than 20 years. For many decades, Syracuse’s north side has been known as the local hub of new Americans. Several resettlement and other organizations help refugees make the most of their new lives in Syracuse, but this program is the opposite because the new Americans have freely helped everyone interested at the library. The program began back in 2012 after Lisa Warnecke, a resident of Syracuse, returned from a trip to Nepal, where she hiked the Himalayan mountains. Her journey was more than just hiking — she became immersed in the culture and people of Nepal, particularly while there solo. Warnecke volunteered with various refugee assistance organizations, and discovered an affinity with the Bhutanese after her trip. The Bhutanese started arriving in the U.S. in 2008, beginning with human rights activist Hari Adhikari, who chose to locate in Syracuse. Other Bhutanese leaders also chose Syracuse. As friendships deepened, Warnecke mentioned a hip pain to one Bhutanese friend, Dil Dahal. They both were volunteers with Women Transcending Boundaries’ program to teach new Americans how to sew clothes. Dahal provided many helpful exercise suggestions. Warnecke later learned that many Bhutanese refugees practiced yoga in the camps, while others wanted to learn more. Dahal lived close to White Branch Library at the time, so Warnecke invited her to go benefit from many library resources. They reviewed library books about yoga. Soon after, dialogue began with library leaders to host yoga sessions in the community room. Dahal became the first leader in coordination with the Bhutanese community of Syracuse.
Over time, several Bhutanese refugees and others have led yoga at White Branch Library. “I have learned something helpful from each and every leader. Even if no one is in attendance from Bhutan, we follow techniques learned from them in many cases,” Warnecke said.
Standard part of life
Mamta Sharma came to Syracuse from Nepal while in high school, and served as one of the volunteer yoga leaders at White. “When we lived in the camps, local volunteers would come in and teach us yoga,” she recalled. “It brought people together, and improved our health mentally, physically and spiritually, which was so important as it was very stressful for us living in the camps,” she said. While Sharma moved out of town, and recently graduated from college, she is still very involved in her yoga practice. “I mediate and practice Pranayama yoga or yoga of breath,” she said. “It has helped me immensely in reducing anxiety.” Theresa Shephard of Syracuse is also a yoga enthusiast. “I started going to White Library when I saw that yoga was being offered,” she said. “I particularly like the space that they have available, with windows on three sides of the room. I try to attend regularly on Saturdays.” Shephard feels very strongly about the health benefits of yoga. “Since we have become such a sedentary and sitting society, yoga can help with using and stretching muscles that can make our bodies more flexible and prevent long-term health problems,” she said. “There are also specific poses and breathing exercises that may help with relaxation.” “What I find unique and particularly helpful about the yoga taught by Bhutanese refugees compared to others, is the sequenced focus beginning with the feet and then working up the rest of the body with often differing exercises before focusing on the head and the mind,” Warnecke said. Every session at the library is different, and people may do different moves than others depending on varying skills and needs. Bridging Eastern and Western thought has been fun and rewarding for Sharma. “It has been a great feeling for me to know that people are interested in learning yoga. You find out we are all part of the human race. We just want to be healthy and peaceful,” she said. White Branch Library is located at 763 Butternut St., Syracuse. Contact the library at 315-4353519 to learn when the group will be there on Saturdays because other programming can impact the schedule.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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U.S. Deaths From Suicide, Substance Abuse Reach Record High Hardest hit are 18- to 54-year-olds, men, blacks, whites and city dwellers
D
eaths from drugs, alcohol and suicide in the United States hit an all-time high in 2017 — more than 150,000 in all. That number was more than double 1999 levels, according to a chilling new analysis of U.S. Centers for Disease Control and Prevention data by the Trust for America’s Health and Well Being Trust, two health policy organizations. Nationwide, the death rate due to alcohol, drugs and suicide rose 6 percent between 2016 and 2017, from nearly 44 to 46.6 deaths per 100,000, the study found. Though that increase was smaller than in the two preceding years, it was higher than the 4 percent average annual increase since 1999. “It is important to see hope in the slowing of rates — but it’s not nearly enough,” Benjamin Miller, chief strategy officer of Well Being Trust, said in a news release from the two groups. “We should not be satisfied at all. Too many of us are dying from preventable causes.” Synthetic opioids are driving the sharp rise in drug deaths — up 10-fold in the last five years and 45 percent between 2016 and 2017. The number of deaths attributed to synthetic opioids alone now exceeds those from all drugs in 1999. In 1999, fentanyl and synthetic opioids caused fewer than 1,000 deaths a year nationwide. In 2017 alone, more than 1,000 people died every two weeks from a synthetic opioid overdose. Hardest hit were 18- to 54-yearolds, men, blacks, whites and city dwellers. Synthetic opioid deaths were largely concentrated in Northeastern and Midwestern states, the analysis found. The researchers also reported a 4 percent rise in suicide deaths between 2016 and 2017, up from 13.9 per 100,000 to 14.5. That was the largest increase since data collection began in 1999. Between 2008 and 2017, suicide rates rose an average of 2 percent per
year, or 22 percent overall, the study found. Whites, males and people in rural areas had the highest suicide rates. In 2017, the death rate from alcohol, drugs and suicide was 72.4 per 100,000 for 35- to 54-year-olds. For all men, it was 68.2 per 100,000, and for all women, 25.7 per 100,000. “As a nation, we need to better understand and to systematically address the factors that drive these devastating deaths of despair,” John Auerbach said in the joint news release. He’s president and CEO of Trust for America’s Health. Overall, 43 states and the District of Columbia saw their death rates from alcohol, drugs and suicide rise between 2016 and 2017. Five states -— Massachusetts, Oklahoma, Rhode Island, Utah and Wyoming — saw declines. West Virginia had the highest rate per 100,000 at 91, followed by New Mexico (77); Ohio (69.4); Alaska (67.6), and New Hampshire (66). Miller said tackling such a complex problem is not about adding up small changes but about a bigger transformation. “Each time we make progress — like with prescription opioids — new problems, like synthetic opioids, appear,” he said.
“As a nation, we need to better understand and to systematically address the factors that drive these devastating deaths of despair.”
Onondaga, Oswego, Cayuga and Madison Counties
CNY’s Healthcare Newspaper
A monthly newspaper published by Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.
In Good Health is published 12 times a year by Local News, Inc. © 2019 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776.
ASK FOR THE EXPERTS. ASK FOR UPSTATE. 315.464.1803 | WWW.UPSTATE.EDU / HERNIA
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Chris Motola, Ernst Lamoth Jr., Eva Briggs (MD), David L. Podos, Payne Horning • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Manager: Beth Canale No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
SmartBites
The skinny on healthy eating
Ham: The Good, the Bad, and the Better Choices
I
s eating ham healthy? It’s certainly something to ponder, whether ham only makes a holiday appearance at your table or is a regular indulgence. Truth is, compared to other meats, ham — the cut of meat from a hog’s hind leg that’s preserved by curing — gives many nutritionists pause. But with Easter right around the corner and ham being a crowd favorite, let’s say we start with the good! Ham, like all meat, is an excellent source of complete protein, with a 4-ounce portion serving up around 20 grams. An important component of every cell of the body, protein is needed to build and repair tissues, as well as make enzymes, hormones and other body chemicals. And while we often associate greater protein needs with growing bodies, research is increasingly showing that pumping up your protein — no matter
your age — can boost your health and help prevent a decline in muscle mass with aging. Along with thwarting weakness as we head into our twilight years, maintaining muscle mass has another powerful benefit: it decreases the risk of fracture from falls. Ham, especially lean ham with its fat trimmed away, is relatively low in fat and calories, which is good for those watching their weight and fat intake. An average 4-ounce serving, for example, has only 120 calories and about 4 grams of total fat, of which only 1 gram is saturated fat. Three more good reasons to eat ham, notwithstanding its delicious flavor? Ham delivers healthy doses of selenium, niacin and phosphorous. While selenium plays an important role in the health of our immune system, both niacin, which helps
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raise good cholesterol and lower bad cholesterol, and phosphorous, which helps regulate heartbeat and muscle contractions, contribute to heart health. And now for the bad. Ham — versions that are not reduced-sodium, that is — can be loaded with sodium. Loaded! We’re talking around 1,200 milligrams in a 4-ounce serving, which is almost all of the 1,500-milligram recommended daily limit for people with high blood pressure and over half of the 2,300-milligram limit recommended for healthy people. Consuming too much sodium, as many know, increases your risk for high blood pressure and heart disease. Also bad: Processed meats, like ham, can increase your risk for numerous health problems. Studies show that consumption of these cured meats has been linked to a higher risk of heart disease, Type 2 diabetes, and certain cancers. The nitrates used to preserve processed meats and improve the flavor are known carcinogens.
Honey-Balsamic Glazed Ham with Garlic
Adapted from Eatwell 101 (serves 12-15)
1 (5-6 pound) cooked bone-in ham (uncured, if available) 40 garlic cloves (about 4 heads) 2 tablespoons olive oil 3/4 cup water 1 tablespoon balsamic vinegar 1 tablespoon honey 2 tablespoons Dijon mustard 1 tablespoon chopped fresh rosemary or 1 teaspoon dried rosemary, crushed 1 tablespoon chopped fresh thyme or 1 teaspoon dried thyme Coarse black pepper, to taste Preheat oven to 350°F. Score ham in a diamond pattern by making shallow diagonal cuts at 1-inch intervals. Place ham, cut side down, on a rimmed baking sheet lined with foil. Set aside. Meanwhile, soak garlic cloves in
Healthy tips
Eat ham in moderation. Choose lean, uncured (nitrate-free), low-sodium ham whenever possible. Uncured cooked ham is preserved with a celery juice-sea salt mixture that has naturally occurring nitrites, making it less harmful. Many groceries now carry healthier ham versions. When preparing ham, consider using less salt, less sugar, and ingredients that are lower in both. boiling water and simmer for 3 or 4 minutes. Drain from boiling water and rinse under cold water. Remove skin from cloves; it should come off easily. Pat dry, if moist. Heat olive oil over medium heat in small skillet; brown garlic gently for a couple of minutes until golden, stirring frequently to avoid burning. Remove garlic and set aside. In the same skillet, combine water, balsamic vinegar, honey, mustard, rosemary, thyme, and pepper and bring to a simmer. Cook for 5 minutes until the sauce thickens. Add garlic back to the glaze and cook for 2 minutes more. Remove from heat. Brush ham with about 1/3 of the honey-balsamic glaze, tent with foil, and bake for 50 minutes. Remove foil tent, brush with another 1/3 of the glaze, add garlic to the pan around the ham and bake for an additional 50 minutes. Remove from oven and let rest 10 minutes. Serve sliced ham with remaining glaze and garlic on the side.
Anne Palumbo is a lifestyle colum-
Holistic Healing:
nist, 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.
Caring for the Mind, Body and Spirit S A V E T H E D A T E : T H U R S D AY, A P R I L 1 8 , 2 0 1 9 April 2019 •
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Planning for a Good Death Former SUNY Upstate president pens book about end of life By Deborah Jeanne Sergeant
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eath is a natural, inevitable part of the human experience. Physician Gregory L. Eastwood, who served as president of SUNY Upstate, has seen a lot of death and has recently published a book on the topics that’s part guidebook, memoir and philosophy book. Eastwood is no stranger to writing. Across a medical career that touches six decades, he has penned and edited more than 140 medical papers and book chapters and completed four books. But his most recent book, unlike much of his previous work, isn’t aimed at the professional medical community. “Finishing Our Story: Preparing for the End of Life” (Oxford University Press: 2019) is for the general population. In it, he compiles his experiences caring for end of life patients and ethics consulting, along with advice on wrapping things up. “I’m often called on to mediate conflicts and issues that arise,” Eastwood said. “I’m also getting older and starting to think about these issues myself.” Many Americans don’t feel comfortable talking about death, even though it happens to everyone. Eastwood implicates fear as the reason. “Death is not something well understood,” he said. “Is it final or not final? Other phases of life, like con-
ception, gestation, birth, childhood and on and on, we’ve dissected those pretty well. There’s more to learn, of course, but we understand the facts and can interpret and experience them in different ways.” Though death remains the same, he believes the process of dying has changed dramatically over the past 30 to 40 years. Memorializing loved ones changed a lot since Eastwood was a boy. Such an occasion formed his first memory, when he was 3. “I was standing in the parlor of my grandparents’ home in Yeagertown, Pa., holding my father’s hand,” Eastwood said. “My grandmother was in her mid-70s and had died suddenly of a stroke. We were all standing around there for the wake in the home.” He added that he remembered nothing of his family’s trip from Michigan to Pennsylvania, but the gathering in the parlor stood out to him. “That really relates to one of the points I make in the book,” Eastwood said. “She died at home. Her family was around. Her minister lived three blocks down the street and I’m guessing he was there. The funeral costs were very low. That’s almost impossible to experience now and many wouldn’t want to because we want to take advantage of modern medicine. Sometimes, it puts us in a
Physician Gregory L. Eastwood
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situation where maybe we wouldn’t want to be.” He wrote about quality of life and what it means to him and what it should mean to anyone: a combination of physical and mental wellbeing. When contemplating a medical emergency that causes lasting disability or diminished capacity, “people say, ‘If “that” happens to me, I don’t want to live,’ but many have ‘that’ happen and recover and adapt and live happy lives,” he said. “But at what time do we say, ‘Enough is enough.’? That’s what is hard for many people.” He said that creating a do not resuscitate order (DNR) can be difficult. Part of end-of-life planning, the DNR is a legal document that pre-plans medical care decisions
for when a person is incapable of making them. When making declarations like “Don’t intubate” or “Don’t resuscitate,” it’s impossible to know the context of the future situation. “We usually think of it in the context of terminal care,” Eastwood said. “That’s why it’s important to be very careful. Have a health care proxy agent who knows how you think and behave. My view is to leave it at that and let the health care proxy agent make those decisions.” A health care proxy agent is a trusted person who can make tough decisions based upon the patient’s wishes and the context of a specific situation. Tapping into his experience in medical ethics, Eastwood discusses physician-assisted death, which is self-administered, and euthanasia, which is physician-administered, along with voluntary stopping eating and drinking (VSED). “Not a lot of people know about VSED,” Eastwood said. “It’s a way of allowing one’s self to die where there are no laws against it. Not eating accompanies the normal process of dying. For someone who’s dying already, not eating and drinking is more natural than people think.”
Practical guide for end-of-life decisions The book is infused with practical advice, woven into Eastwood’s recounting of his experiences in the medical world. In the last chapter, he encourages readers to contemplate what’s important for them to do as they approach the last chapter of their lives. “What is important to you?” he said. “Is it important to you that some friction is resolved or loose ends tied? This is the time for you to think of these things. A leopard can’t change its spots, but we can change a little bit and adjust some of the relationships we’ve had.” For people who are nostalgic, it may be time to revisit places and people important to them. While death isn’t easy for the patient’s family nor the patient, Eastwood views his book as a practical guide about making end-of-life decisions. “It is about ‘finishing our story’ in that we all construct narratives of our lives,” Eastwood said. “Think about what end of life means to us. Plan accordingly. If the most important thing is the spark of life itself, or quality of life, that has to be taken into account. “The first thing is to think about what our life means to us in the context of its ending, closely coupled with assuming it’s highly likely we won’t be able to make every decision. Who do we want to make those decisions for us? It implies that person will know how we think. It’s so important to have someone designated to do that.” Eastwood served as president of SUNY Upstate Medical University from 1993 to 2006. Later, from 2013 to 2016, he returned to the position as interim president. Eastwood continues to teach several courses at SUNY Upstate. He also serves on the Upstate Foundation board of directors. He also is a member of the board of trustees of Case Western Reserve University, where he received his medical degree. He is active in several professional medical organizations.
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Pain Management Program at Upstate Program gives people the ability to manage health, pain and maintain an active lifestyle By Deborah Jeanne Sergeant
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he opioid crisis has drawn much attention to pain management. Improving pain management represents one means of curbing the epidemic of prescription pain medication abuse. Upstate is launching Chronic Pain Self-Management, a six-week program for 20 participants aged 18plus that will meet at Upstate OASIS. The evidence-based, peer-led workshop will meet for 2.5 hours each week with the goals of improving energy and mental health; decreasing pain levels and dependence on others; increasing involvement in everyday activities; and improving overall life satisfaction. Upstate has seen much success with similar programs, including Living Healthy with a Chronic Condition for chronic disease self-management; Peer Support for Adults with Type 2 Diabetes, which focuses on diabetes self-care. Like those programs, Chronic Pain Self-Management “gives people the ability to manage their health, manage pain, and how to maintain an active and fulfilling life,” said coordinator Lisa Vigliotti-Bane, outreach and women’s health manager for Upstate’s HealthLink/Oasis. “Chronic” or “long-term” means pain that lasts longer than three to six months or beyond the normal time of
Lisa Vigliotti-Bane healing for an injury. Some examples include fibromyalgia, repetitive strain injury, post-surgical pain and neuropathic pain. “It may benefit people who have persistent headache, irritable bowel syndrome, diabetic neuropathy and pain due to conditions like multiple sclerosis,” Vigliotti-Bane said. “A lot
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of chronic conditions also have pain as a secondary diagnosis.” She said that the program will cover a lot, but “it does fly by.” Participants learn about the differences between acute and chronic pain, tips for managing pain, how to communicate with their healthcare team effectively, and how to create an action plan related to their condition and how it affects their lives in general. “We set them up so they can achieve it,” Vigliotti-Bane said, “and if they don’t, we ask why they weren’t partially able to achieve it. We teach them how to problem solve and make decisions. They learn how to manage when they can’t set out to achieve it.” The program also emphasizes exercise: maintaining strength, flexibility and endurance. “We have to be aware of our level and limits so we grow from there,” Vigliotti-Bane said. Though the program isn’t clinical, it covers the appropriate uses of medication and patient responsibility if they are on medication so they understand it and how it’s supposed to work and how to use it appropriately. Grants help fund the programs, though voluntary contributions are welcomed. By teaching patients to
self-manage conditions, they use fewer healthcare resources. “At the end of the program, we have exercises in place so the participant can recognize how far they have come,” Vigliotti-Bane said. “What they tell us in their closing comments are that they are aware of what their responsibility is now. Many of them see a change in their health. “They are excited that they have been able to make small changes to their diet and exercise program and, most importantly, they come to the realization that their doctor only is aware of what they tell them.” Patients need to take responsibility to keep their care providers informed so they can more effectively manage their care. Anyone in Onondaga County with a primary or secondary diagnosis of chronic pain who wants to improve its management is welcome to apply to the free program, “but we never turn anyone away,” Vigliotti-Bane added. All class participants receive a free book and CD. To register, call 315-464-8668 or register online at www.Upstate.edu/LivingHealthy. The program meets Thursdays: April 25, May 2, 9, 16, 23, 30 from 5:30 to 8 p.m. at Upstate OASIS, 6333 Route 298, East Syracuse.
5
Things You Need to Know About Autism By Ernst Lamothe Jr.
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here has been a tenfold increase of autism prevalence in the last 40 years, according to the Centers for Disease Control and Prevention. There are three million individuals in the United States and tens of millions worldwide who have autism. As a parent who may have a child with autism, you may be scared and wonder what you can do to help your child when you find out that diagnosis. While having a child with autism can present some challenges, this diagnosis does not mean that all hope is lost. Half the battle with any diagnosis is understanding what the condition means, how to be proactive in treatment, and managing the illness so that your child can still have a high quality of life. “In order to help individuals with autism reach their full potential we have to find ways of teaching them that are meaningful to them as an individual,” said psychologist Nicole DeRosa, assistant professor of pediatrics at Upstate Golisano Children’s Hospital in Syracuse. “We all learn differently, and we all behave differently.” DeRosa offers five key facts about autism.
Early detection helps 1. When it comes to treatment options, early intervention can im-
prove learning, communication and social skills. In 2018, the CDC determined that approximately one in 59 children are diagnosed with an autism spectrum disorder. The American Academy of Pediatrics recommends that all children be screened for autism at their
18- and 24-month well-child checkup. Much was not previously known about what causes the disorder, but research is showing that some combination of environmental influences and rare gene changes can contribute to the development of autism, which impacts early brain development. “I talk a lot with families about the importance of early diagnosis,” said DeRosa, who is also a clinical psychologist at SUNY Upstate’s family behavior analysis program. “The earlier we can diagnose autism the quicker we can start giving people the resources and services they need.”
2.
Autism is a spectrum Autism spectrum disorder is a neurodevelopmental condition characterized by differences in social skills and social communication, along with the presence of restricted and repetitive behaviors. There are various signs of autism that include avoiding eye contact, delayed speech and communication skills, reliance on rules and routines. With every child being different that doesn’t mean that every child will display these signs but they are simply markers to be made aware of. There can also be unexpected reactions to sounds, tastes, sights, touch and smells, difficulty understanding other people’s emotions, focusing on or becoming obsessed by a narrow range of interests or objects, engaging in repetitive behavior such as flapping hands or rocking and children not responding to their name by 12 months. “If you’ve met one person with autism, you’ve met one person with
Sleep Difficult for Children on Autism Spectrum By Deborah Jeanne Sergeant
R
ecent research published in the journal Pediatrics indicates that children with autism spectrum disorders (ASDs) are at double the risk for experiencing difficulties with sleep than children not on the spectrum. Researcher Ann Reynolds, a physician and associate professor of developmental pediatrics at University of Colorado School of Medicine, found that children between the ages of 2 and 5 are more likely to delay bedtime, struggle getting to sleep, feel anxious about sleep, awaken during the night and have night terrors, all of which can mean fragmented sleep. Children need sleep for their own mental health benefits. “Just like with anyone, having impaired sleep can exacerbate behavior problems,” said Henry S. Roane, Ph.D. “If you’re cranky in the morn-
ing no matter what, not sleeping makes that worse.” Roane is SUNY Upstate professor of pediatrics and division chief of Center for Behavior, Development, and Genetics. He said that among children with special needs and typically developing children, a lack of sleep causes three negative outcomes. The first is heightened psychological stress. “They’re more reactive to environmental stresses,” Roane said. “They may be less consolable.” The second is temporary impairment of the ability to take in and process information. “The person might be impaired anyway, but lack of sleep makes it that much worse,” Roane said. “They might have difficulty in understanding what they’re supposed to do or a change in routine. That can trickle down to behavior.”
autism,” said DeRosa. “The overarching message is that all humans are different and behave differently, and thus different individuals with an autism diagnosis may display various and different symptoms.” with autism are just like 3.Individuals you and me. The reason why it is essential
to reiterate this point is because many times those who have autism spectrum disorder can be treated or looked at differently. “Individuals with autism have the same needs, wants, emotions and ability to learn as everybody else,” she said. “At times some individuals with autism may express their wants and needs differently, due to communication or socialization difficulties. Thus, it’s important that we teach them in ways that are meaningful to them to help them reach their greatest potential.”
4.
There is a lot of misinformation on autism spectrum disorder It can be difficult for families to know what is right and what is wrong when it comes to knowing about autism. DeRosa encourages families to thoroughly look into the sources of information and discuss any concerns or treatment considerations with their child’s pediatrician or other health professionals with expertise in working with individuals with autism. “Misinformation can result in not only a waste of time, money and other resources, but in some instances may be harmful,” said DeRosa. “It can be frustrating because there is a lot that we still don’t know. However, In turn, that altered behavior can cause difficulty with others. Roane said that teachers and caregivers may lessen their expectations for the child or they could look at other causal factors. The problem may continue for a long time if the child is unable to express how he or she slept or why good sleep isn’t happening. “You have two effects because the parent can’t sleep well, either,” Roane added.
Uncertain causes
So why do kids on the spectrum experience sleep disturbances? It’s not entirely clear. Angela Saturno, director of the Kelberman Center in Syracuse, said that medical issues, such as gastrointestinal problems, psychological issues or medication could worsen sleep. “The first thing you do is look at the medical, medication and psychiatric,” she said. “Try to rule those things out before you go on a behavioral track.” Examining and exploring those variables could help mitigate and manage their effects. Saturno advises parents to keep a sleep diary for their April 2019 •
Psychologist Nicole DeRosa, clinical psychologist at SUNY Upstate’s family behavior analysis program. families should know that they are not alone. There is a community of peers and professionals out there that want them to have access to the best resources and the most successful outcomes for their child to have a happy and healthy life.” may not be a cure, but there are 5.There effective treatments Experts still do not know all of the causes of autism spectrum disorder, according to the CDC. There may be many different factors that make a child more likely to develop symptoms of autism, including environmental, biologic and genetic factors. “Although we still have more to learn about the causes and risk factors associated with autism, there are effective treatments for autism symptoms and treatments with the strongest evidence base include those that are based on the principles of learning and behavior, such as applied behavior analysis,” said DeRosa.
child to see what may affect their sleep positively and negatively. Sensitivity issues prevalent with people on the autism spectrum may affect sleep quality and quantity. Just before bedtime isn’t a good time for vigorous activity; however, sufficient activity earlier in the day may improve sleep. Quieting the household before bedtime can assist in easing into the transition to sleep. Saturno recommends a regular nighttime routine, illustrated by a picture board or other display with times listed for older children. For example, a picture of a toothbrush, toilet, sink, storybook and bed in a row could symbolize the order of use of these objects. The display should be located where children can reach it so they can check off each item as they complete it. Saturno also advises limiting vigorous activities 30 to 60 minutes before bedtime starts and doing some relaxing activities just before bedtime or as part of the routine. Breaking down bedtime to a set of rules may seem harsh or controlling, but it’s actually what
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Kids with Autism: ‘Rules Are Comforting to Them’ continued form last page children need–and want. “Rules are comforting to them so they feel safe,” said Sarah Marsh, a pediatrician at St. Joseph’s Primary Care Center. “It gives them some control. They can decide to follow them or not and know the consequences. “If they don’t have rules, they
have to find the boundary all the time. Routine is key.” Roane said that environmental factors conducive to good sleep are highly individual for those on the autism spectrum. For example, for some children, the same pajamas, teddy bear, blanket or other objects associated with sleeping help them
Avoiding Nocturia Episodes There are ways to prevent waking up during the night to urinate By Elizabeth Ferry, MD
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aking up at night to urinate, or nocturia, is a common condition that may significantly lower quality of life and daytime functioning. While the culprit of this condition may vary between individuals, there are steps that may be taken to decrease the frequency of these disruptive bathroom trips. Evening routine, especially diet, medications and behaviors, may significantly impact the amount of time your head is on the pillow. Drinking caffeinated, carbonated or alcoholic beverages may irritate the bladder or cause more urine to be produced. Avoiding any fluid consumption two hours prior to bed —
and these irritants especially — may decrease the frequency of nocturia
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settle because they’ve added them to the routine. Those who are noise sensitive may find white noise or a fan unbearable, as well as ambient sounds from outside the room. Thick carpeting, soft wall hangings and sound-absorbing ceiling material can help absorb sounds from the rest of the household with a later bedtime. Consider the room’s temperature, as well as the bedclothes and pajamas. It’s difficult to sleep in an overly warm bedroom. “Create a behavior chain that will work for the family, not one the child
has made that involves night terrors or sleeping with mom,” Roane said. For children who get up in the night Roane recommends issuing one “Get Out of Bed Free” pass that’s good for only one night. Once they use their pass for a drink or extra cuddle, it’s gone. If they still have the pass by morning, they may turn it in for a reward, such as access to a preferred activity or favorite fruit. If children get out of bed after using the pass, Roane recommends prompting them to go to bed with as little fanfare as possible.
episodes. If diuretics, or water pills, are prescribed, check with your doctor if these may be taken earlier in the day instead of prior to bed. Finally, fluid in your legs may be reclaimed overnight, creating more urine. This process can be jump-started by elevating your legs to the level of your heart for one to two hours prior to bed. If these general changes to your nighttime routine do not improve the number of times your bladder is waking you up, it may be time to check with your doctor. You may have other medical conditions that worsen nocturia. Poorly controlled diabetes, sleep apnea and congestive heart failure may all encourage your kidneys to make too much urine at night. There are also several urological reasons for waking up at night to urinate. If you find yourself urinating frequently during the day as well, the blame may lie with your bladder or prostate. Overactive bladder causes urinary urgency that typically cannot be controlled and may strike during the day or night. Men may suffer from an enlarged prostate. When
the prostate enlarges and starts to block the urine channel it may cause overactive bladder or make the bladder unable to empty well, causing frequent urination. You may be referred to a urologist to help determine the cause and recommend treatment to finally start sleeping through the night again. Physician Elizabeth Ferry is a Water town native. She completed medical school at SUNY Upstate in Syracuse and urology residency at Case Western Reserve University in Cleveland. She is currently an assistant professor of urology in the department of urology at SUNY Upstate Medical University, specializing in female and general urology.
MEET THE UPSTATE UROLOGY TEAM Chairman Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
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ZAHI N. MAKHULI, MD
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JOSEPH JACOB, MD
OLEG SHAPIRO, MD
RYAN SIDEBOTTOM, DO
DMITRIY NIKOLAVSKY, MD
NICK LIU, MD
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JONATHAN RIDDELL, MD
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IMAD NSOULI, MD
Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
General urology, male health, urologic oncology, enlarged prostate, kidney stones , and robotic surgery
MAHMOUD CHEHAB, MD
Incontinence, urethral stricture disease, vesicovaginal fistula, reconstructive surgery, transgender care
General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn.
Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities
MATTHEW D. MASON, MD
JC TRUSSELL, MD
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NATASHA GINZBURG, MD
General Urology, Endourology and Laporoscopic Surgery
General Urology, Endourology
SERGEY KRAVCHICK, MD
EDWARD IOFFE, MD
Urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
RAKESH KHANNA, MD
General urology, female and reconstructive urology
ELIZABETH FERRY, MD
General Urology; Female Urinary Incontinence
MICHAEL CASTELLO, DO
MRI fusion, male health, prostate cancer and kidney stones
TIMOTHY K. BYLER, MD
Reconstructive urology; incontinence, prosthetics, urinary fistula, neurogenic bladder, urinary diversion. Robotic surgery.
STEPHEN BLAKELY, MD
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RUBEN PINKHASOV, MD, MPH
UROLOGY FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500 Page 20
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Women’s Health
Dramatic Fall in Number of Births in the U.S. Local experts: Many factors are believed to cause shrinking birthrate, which is at the lowest level in 30 years By Deborah Jeanne Sergeant
I
f it seems that people are having smaller families, you’re right. The Centers for Disease Control and Prevention recently reported that the rate of childbirth dropped for nearly every age group of reproductive-age U.S. women in 2017, reaching the lowest levels in 30 years. According to the Census, the U.S. birthrate in 2017 decreased to 60.2 births per 1,000 between the ages of 15 and 44, which represents a 3 percent drop from the birthrate in 2016. In 2017, the nation experienced 3.853 million births, approximately 92,000 less than the year before. What’s most concerning is that birth declines tend to happen during times of war or economic hardship, not when unemployment is down and the economy is improving such as in recent years. Since 1971, the nation isn’t producing enough children to replace those who have died, a trend also noted by the census. Numerous factors contribute, both physical and societal. Easier access to contraceptives and abortion has made delaying and avoiding childbearing more widespread among every age group of women. “In a state like New York, abortion is available, and electively or certainly if necessary,” said Howard M. Weinstein, a physician and professor of obstetrics and gynecology at Upstate University Hospital. “That will tend to limit the population. If there are facilities where they can legally obtain an abortion, that’s another population limiter.” Weinstein said that fewer women are choosing to have babies at younger age, which means smaller families, since they have a shorter span of years when they’re trying to have children. For example, fewer teen pregnancies play a role in reducing births.
“We used to have kids getting pregnant at 14,” Weinstein said. “Some had three kids by the time they were 21. That’s not healthy.” While it’s positive that teen pregnancy is declining, it does have an effect on the birthrate statistics. But other reasons factor into the waning birthrate. Since the women’s rights movement, marrying and having children hasn’t been the expected and main option for women of childbearing years. Pursuing education and career are also options, but they tend to delay childbearing for those who do become mothers. That means fewer young adults are having children. “People are thinking more clearly about long-term reasons for not getting pregnant and early on,” Weinstein said. “They’re trying to get enough financial wellbeing to achieve a pregnancy.” Waiting for greater financial stability can make family life more comfortable; however, it also makes for fewer children on average. Older couples aren’t having as many children, either. As they look forward to retirement in the next 20 years, financial considerations may cause them to doubt parenthood’s affordability. Skipping parenting isn’t always by choice for older parents. Weinstein said that around age 38, getting pregnant is trickier. Women are born with only a finite number of eggs. Once they hit their upper 30s, their supply is low and the health of the eggs isn’t what it used to be. Once older couples have one or two children, they typically either don’t want more or can’t have more. As people age, their chances of having children with disabilities increase, which presents a drawback to some couples. They may also consider how old they’ll be when their child
will graduate from high school. How would they feel if they are seniors at the same time their children are “seniors” in school? For those who want to have children, maintaining overall health is vital to maximizing their chances of fertility, including a healthy weight, healthful diet, regular exercise and eschewing tobacco use and excessive alcohol, according to physician Rosalind Hayes, affiliated with Rochester Fertility Care. Taking those steps “goes a long way,” Hayes said. “A lot of things happening later in life are associated with lifestyle issues. Diabetes, high
blood pressure, high cholesterol, obesity: all of those issues creep up as people get older if they’re not maintaining a healthy lifestyle. They all affect fertility.” She recommends seeking professional fertility help if conception isn’t achieved in six months for a couple if the woman over 35 or a year if for a couple if the woman 35 and younger, or anytime if she does not experience regular menstrual cycles. But “it’s never wrong to come in and talk about pre-conception planning,” Hayes said. “There’s a lot of testing to see if you carry any genetic risks.”
The recently issued report by the Centers for Disease Control and Prevention report also found: • The rate of births to women ages 15 to 44, known as the general fertility rate, sank to a record low of about 60 per 1,000. • Women in their early 40s were the only group with higher birth rates in 2017, up 2 percent from the year. The rate has been rising since the early 1980s. • The cesarean section rate rose by a tiny amount after having decreased four years. Studies have shown C-sections are more common in first-time births involving older moms. • Rates of preterm and low birth weight babies rose for the third straight year. • Birth rates for teens continued to nosedive, as they have since the early 1990s. In 2017, they dropped 7 percent from the year before. • Rates for women giving birth in their 20s continued to fall and hit record lows. They fell 4 percent. • Birth rates for women in their 30s fell slightly, dipping 2 percent for women aged 30 to 34 and 1 percent for women 35 to 39. Birth rates for women in their 30s had been rising steadily to the highest levels in at least half a century, and women in their early 30s recently became the age group that has the most babies. The U.S. once was among a handful of developed countries with a fertility rate that ensured each generation had enough children to replace it. The rate in the U.S. now stands less than the standard benchmark for replacement. It’s still above countries such as Spain, Greece, Japan and Italy, but the gap appears to be closing. A decade ago, the estimated rate was 2.1 kids per U.S. woman. In 2017, it fell below 1.8, hitting its lowest level since 1978. Information based on reports published in USA Today.
Specialists in Integrative Oncology & Gastroenterology Amy Lazzarini, MD, MSHS
Integrative Gastroenterology Integrative Lyme Disease Treatment Mold Related Illness (CIRS)
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Women’s Health
Good Night, Sleep Tight: Helping Baby Sleep Better By Deborah Jeanne Sergeant
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ew parents realize that their new baby’s needs will likely curtail their own sleep at night for the weeks and months ahead. Babies’ small stomachs cannot hold enough to last all night. Along with those nighttime feedings, they will require changes as well — they may also simply wake up and need soothing to get back to sleep. Parents can do quite a bit to lengthen the time that a baby sleeps, starting at about 3 months. Winter Berry, assistant professor of pediatrics at Upstate Medical University and pediatrician with Upstate Pediatric and Adolescent Center, said that babies’ sleep cycle hasn’t adjusted to the common circadian rhythm of sleeping at night and remaining awake during the day. “Babies will have overnight awakenings and parents are doing nothing wrong,” Berry said. “There’s no specific patterns to when children sleep.” During this time, most babies just eat and sleep with little recognition of when it’s bedtime. Berry said at about 4 months, babies begin to consolidate sleep, meaning they sleep for longer time periods and start to nap more regularly during the day. Berry said that the signs of a
tired baby are harder to recognize in young babies than in older ones, but look out for eye rubbing, whiny crying, a long-distance stare and turning away when you try to engage the baby. “If the baby can’t sleep at that time, they can cry and get hyper,” Berry said. “When you miss that window, it can be hard for them to get to sleep and stay asleep.” Establishing bedtime routines encourage better sleep, such as a bath, feeding, burping and time to cuddle in a rocking chair. Putting babies down immediately after feeding can cause discomfort. They need a little time to digest. How babies are soothed before bed makes a difference, as they have preferences, such as rocking, shushing sounds, white noise machines, pacifiers and swaddling; however, teaching self-soothing at around four months can help you get more sleep. Tiffany Rickert, licensed massage therapist, certified infant massage instructor, owns of Metta Therapeutic Massage and Wellness in Syracuse. She teaches infant massage and she’s also a new mom. “Infant massage is one way that he sleeps the best,” Rickert said. “I do it often, if he wakes in the middle of the night, to help him get back to
sleep.” She said the modality helps calm a baby’s autonomic nervous system and relieve tension from the stimulation encountered during the day. While baby massage may seem strange, many parents already pat, rub and touch their infants to calm them. Rickert added that circular, clockwise strokes on the belly may help relieve gas that makes babies uncomfortable. “Infant massage can be stress-relieving for infants and for the mother, father or caregiver,” Rickert said. “Babies feel safe and comforted. It’s a great bonding tool.” Sometimes, she uses a little jojoba oil for her son’s massage, which also helps him relax before bedtime. St. Joseph’s Health was recently recognized by the National Safe Sleep Hospital Certification Program as a “Silver Safe Sleep Leader” for their commitment to best practices and education on infant safe sleep. A conducive sleep environment can also help establish good sleep habits. Keep the room dark, at the optimal temperature and quiet. Physician Sarah Marsh, affiliated with St. Joseph’s Primary Care Center West in Syracuse, said to put the baby down to sleep on the back while yet drowsy helps them learn
Tiffany Rickert, licensed massage therapist, certified infant massage instructor, with her son, John Higgins III they don’t have to have you help them transition into sleep. Since babies may awaken for a feeding or soothing, learn to tell the difference. Babies who are rooting — making sucking movements, turning their head to the side, sucking on their fist — need to feed. It’s also OK to let babies cry if they’re well, fed, burped and dry. “I tell mothers, it’s a terrible, awful sound for you,” Marsh said, “but no baby ever died of crying. You know they’re breathing.” Sometimes, a brief check-in is all baby needs. If so, a gentle pat or touch is reassuring, but picking baby up doesn’t allow the chance to self soothe back to sleep. Once parents get into a good rhythm, it seems like babies’ sleep pattern changes. For instance, a young baby will need more naps and as naps phase out, the timing of the naps will change, too–and that’s developmentally expected. While your best friends’ baby may sleep six hours at a time by three months (lucky them!), yours isn’t abnormal for waking. Neither baby is “right” but simply different. Above all, ensure babies sleep safely. The American Academy of Pediatrics states that babies should sleep on their backs, alone, and in a crib with immobile sides containing nothing but a firm mattress and a fitted crib sheet. Babies do not need pillows, crib bumpers, blankets, stuffed animals, bottles or anything else in their cribs. Placing cribs near parents can keep babies safe, yet close by for feedings and comfort.
Are Some Birth Control Methods Doomed to Fail?
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omen who get pregnant when using certain contraceptives might have their genes to blame, a new study suggests. A gene variant that breaks down hormones in birth control could be the culprit, researchers reported. “When a woman says she got pregnant while on birth control, the assumption was always that it was somehow her fault,” said lead study author, physician Aaron Lazorwitz. “But these findings show that we should listen to our patients and consider if there is something in their genes that caused this.” According to Lazorwitz, an assistant professor of obstetrics and Page 22
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gynecology at the University of Colorado School of Medicine, “The findings mark the first time a genetic variant has been associated with birth control.” Contraceptives are not 100 percent effective, but the reasons they fail are not fully understood. The new study included 350 healthy women, half older than 22. All had a contraceptive implant in place for between 12 and 36 months. Five percent of the women had a gene called CYP3A7 1C, which is usually active in fetuses and then switched off before birth. But some women with this gene continue to make the CYP3A7 enzyme into adulthood, the study authors noted.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
“That enzyme breaks down the hormones in birth control and may put women at a higher risk of preg-
nancy while using contraceptives, especially lower-dose methods,” Lazorwitz said in a university news release. The gene variant can be found through genetic screening, he added. Pharmacogenomics is a relatively new field that focuses on how genes affect a person’s response to drugs. The study shows how this field could dramatically change women’s health, “especially in light of the social, financial and emotional consequences of contraceptive failure,” the researchers noted. The report was published March 12 in the journal Obstetrics & Gynecology.
Hot Flashes 101
What are hot flashes?
The most common menopause-related discomfort is the hot flash . Although the exact cause still isn’t fully understood, hot flashes are thought to be the result of changes in the hypothalamus, the part of the brain that regulates the body’s temperature. If the hypothalamus mistakenly senses that a woman is too warm, it starts a chain of events to cool her down. Blood vessels near the surface of the skin begin to enlarge, increasing blood flow to the surface in an attempt to dissipate body heat. This produces a red, flushed look to the face and neck in light-skinned women. It may also make a woman perspire to cool the body down. The heart may beat faster, and women may sense that rapid heartbeat. A cold chill often follows a hot flash. A few women experience only the chill.
How long will I have hot flashes?
Most women experience hot flashes for six months to two years, although some reports suggest that they last considerably longer — as long as 10 years, depending on when they began. For a small proportion of women, they may never go away. It is not uncommon for women to experience a recurrence of hot flashes more than 10 years after menopause, even into their 70s or beyond. There is no reliable way of predicting when they will start — or stop.
I’m having a hot flash. Should I be concerned about what lies ahead?
Menopause is a fact of life for every woman around the world. However, the physical and mental impact of this physiologic inevitability varies both within and across all cultures. While there is no universal menopause experience, it can mark the beginning of an exciting new time of life for all women.
As I mature past menopause, how can I achieve the best possible health?
Get the checkups you need and maintain a healthy lifestyle. The risks of osteoporosis, heart disease, diabetes and cancer all rise after menopause. Most women visit their primary care doctor or gynecologist once a year for a “well-woman visit,” which insurance now covers with no copay. Even height, weight, and blood pressure checks at your visit reveal a
Women’s Health
lot about your health risks, and you and your healthcare team can discuss other tests you might need, such as cholesterol measurements, PAP tests, and mammograms. Physical inactivity, obesity, and unhealthy eating, smoking, and excessive alcohol consumption increase the risk of heart disease, stroke, diabetes, and cancer. The evidence continues to grow that getting active, losing excess weight, and healthy habits can reduce these risks.
What are the treatments for hot flashes?
Although the available treatments for hot flashes do not cure hot flashes, they do offer relief. Hot flashes usually fade away eventually without treatment, and no treatment is necessary unless hot flashes are bothersome. A few women have an occasional hot flash forever. There are a number of low-risk coping strategies and lifestyle changes that may be helpful for managing hot flashes, but if hot flashes remain very disruptive, prescription therapy may be considered. Prescription hormone therapy approved by the US Food and Drug Administration include systemic estrogen therapy and estrogen-progestogen therapy (EPT; for women with a uterus) — are the standard treatment. Another FDA-approved hormone product, for women with a uterus, combines estrogen with bazedoxifene instead of a progestogen. Bazedoxifene is an estrogen agonist/ antagonist, which means that it works like estrogen in some tissues while inhibiting estrogen activity in others. In this case, it helps to protect the uterus from cancer. For women who prefer not to take hormones or cannot hormones, nonhormone drugs approved to treat depression, called selective serotonin-reuptake inhibitors (SSRIs), have been found to be effective in treating hot flashes in women who don’t have depression. The only SSRI FDA has approved thus far for treating hot flashes is paroxetine 7.5 mg.
Source: The North American Menopause Society.
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Questions to John Radford, MD, owner and founder of Buffalobased WellNow Urgent Care With recent acquisition and new sites, WellNow today has more than 30 facilities in NYS. Owner, who launched the business in 2012, plans to open 14 new locations this year alone, including some around Chicago By Payne Horning Tell us a little about your back1. ground in health care. I am an emergency room doctor
turned healthcare entrepreneur. In my almost 20 years as an entrepreneur, I have been driven to find ways to keep patients healthy and safe in a rapidly changing health care industry. Appropriately, the companies I’ve founded share a common commitment to offering quality care that is accessible, affordable and quick. I’ve always believed that patients come first. How did your experience in 2. the industry contribute to your decision to create a chain of urgent-care
facilities? In my time working in the emergency room, I worked closely with health systems, doctors and patients. This gave me a firsthand appreciation for the challenges faced by healthcare practitioners and patients. It’s an up-close experience, and you truly empathize with the emotional and financial complexities that patients face. I saw an opportunity to provide greater and convenient access to non-emergent care that put patients first. This inspired me to create Five Star Urgent Care, which today is WellNow Urgent Care. Since 2012, your company has 3. quickly expanded its presence in New York state – and continues to grow today. Was that expansion and large footprint always part of the plan? From our earliest beginnings, we have always been committed to serving communities where there is a need for greater access to quality
urgent care. Our growth is a reflection of the rapidly growing urgent care industry across New York state. It connects directly to how we provide our communities’ residents with greater access to quick and convenient medical care for non-life-threatening injuries and illnesses. Today, we have more than 30 locations and are one of New York’s fastest growing urgent care providers. We are very proud of that. WellNow Urgent Care is not currently located outside New York state but we do have plans to expand to the Illinois area with locations in Crestwood and Evergreen — both suburbs of Chicago — in 2019. In October, Five Star rebrand4. ed itself as WellNow. Why the change and what does it represent?
The name “WellNow” ties back to our company’s strong history of putting the needs of our patients first. We believe the new brand best aligns with our mission of providing high quality, quick and convenient urgent care. It also reinforces our focus on empowering every patient when it comes to managing their healthcare decisions about where, when and how they receive treatment. For us, the name is a true representation of our service and our standards of getting patients and their families back to being well. Now. How is WellNow addressing the 5. medical needs of Upstate New York?
The urgent care industry continues to grow, both in Upstate New York and across the country. As a
Physician John Radford during the opening of a WellNow Urgent Care in Vestal. Radford is the founder and owner of WellNow, which has more than 30 locations in New York, mostly Upstate. He’s planning 14 new facilities this year, including in the suburbs of Chicago. He started the business in 2012. Western New York native and longtime healthcare practitioner, I’ve seen it firsthand and saw the need for an urgent care network that can match this region’s growing demands for quality care. This is especially true for smaller communities where it’s common for care to be less accessible. We address this in a few ways. WellNow employs highly talented and experienced urgent care providers. We have more than 600 employees, which include 95 percent full-time staff. This allows us to truly get to know our business, so that we can deliver quality, convenient care with consistency. Our recent growth, which includes Western New York’s MASH Urgent Care joining our network, also means that we are able to serve an even greater number of communities — both in Upstate New York and across the state. What role does urgent care play 6. in the larger health care industry, and has it changed at all in recent years?
As the urgent care industry continues to grow, we are always looking for ways to stay ahead of our field by continually making ourselves available to patients. For example, demand for urgent care clinics is growing rapidly. Patients seeking medical care often don’t want to wait. By offering longer
hours, walk-in service and the opportunity to check in online, urgent care centers can fulfill patients’ needs in a way that traditional doctors’ offices often cannot. Financial burden is another consideration. Urgent care centers can sometimes provide an alternative to emergency departments and facility fees. It’s a way to provide middle ground to care for non-emergent needs. We’re cognizant of all of these things — capacity, hours, convenience and more. We don’t take our status for granted and are always looking for new ways to stay connected with patients. Trust is earned, not to be expected. What is next for WellNow? 7. We are continuing to grow. Looking ahead, we have
plans to open approximately 14 new locations in 2019 which will allow us to further deepen our connections across New York state, while also starting to expand into Illinois. Through it all, our commitment to putting patients first will never change. We deeply value the strong relationships with communities and individuals we serve. This passion is what brings us to work, every day.
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New Nurses Work Overtime, Long Shifts, and Sometimes a Second Job Nearly half of newly licensed nurses work overtime, while more than one in 10 have a side job
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ew nurses are predominantly working 12-hour shifts and nearly half work overtime, trends that have remained relatively stable over the past decade, finds a new study by researchers at NYU Rory Meyers College of Nursing. In addition, 13 percent hold a second job, according to the study published in the Journal of Advanced Nursing. Changes in health policy in recent years — from the passage of the Affordable Care Act and increased access to healthcare to the recession, which delayed some nurses’ retirements — have had implications for nurses and the hours they work. “Research shows that nurses’ hours, scheduling patterns, and overtime have been associated with patient safety and nurse well-being,” said Amy Witkoski Stimpfel, Ph.D., assistant professor at NYU Meyers and the study’s lead author. “However, we wanted to understand what these changes in the global economy have meant for the newest generation of nurses. Stimpfel and her colleagues analyzed surveys from more than 4,500 newly licensed nurses in 13 states and Washington, D.C., collecting information on nurse demographics, education, work attributes, and attitudes. Specifically, nurses were asked about their work schedule, daily shift length, weekly work hours, overtime, and whether they worked a second job. Four different cohorts of nurses — those first licensed in 2004-2005, 2007-2008, 2010-2011, and 20142015—completed the survey soon after being licensed; these cohorts were compared to observe changes over time. The researchers found that newly licensed nurses work an average of 39.4 hours a week, predominantly in 12-hour shifts. More than 13 percent report having a second paid job. New nurses prefer working the day shift, and the preferred shift length is 12 hours. Twelve percent of nurses report working mandatory overtime (an average of less than an hour in a typical week), and nearly half (45.6 percent) work voluntary overtime (an average of three hours in a typical week). The researchers observed nuanced changes in overtime hours during the decade studied: there was a decline in both mandatory and voluntary overtime during the economic recession by about an hour per week, but overtime hours rose in the most recent cohort.
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Parenting By Melissa Stefanec MelissaStefanec@yahoo.com
Health and Home: A Painful Parallel
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n an age where Marie Kondo is a household name, the state of our homes has become a very public topic. So, I was not surprised when I recently heard a colleague and fellow mom say the following: “It’s like my self-worth is tied to how high the clothes piles are in our laundry baskets.” Kondo’s series is a reality television show where she works with families to clear their homes and lives of unnecessary clutter. Although the show has been met with differing sentiments, the concept of decluttering to improve mental health is documented in psychological studies. The Science — Professionals have conducted a number of studies about this correlation, but here is one. According to a 2016 study conducted by the University of New Mexico’s Catherine Roster and colleagues, clutter and mess can compromise an individual’s perception of home and ultimately feelings of satisfaction with life. If you think a clean home isn’t important, the study found the
following outcomes of living in an overly cluttered home: low subjective well-being; unhealthier eating; poorer mental health; less efficient mental processing; and less efficient thinking. The Sentiment — So, back to my colleague. There are a lot of people out there who might think her statement was sad, crazy, relatable or a little bit of all of these things. However, when you start digging into the science behind it, you realize it was about as honest and rational of statement as one hears nowadays. The self-worth part may seem like an overstatement, but it’s actually spot-on. I think most of us would agree our state of well-being, diet, body image, strategic thinking and problem-solving capacity are all very important to our mental health. If mess is having a negative impact on all of those things, how can you have a positive image of yourself? All of a sudden, tying your selfworth to the cleanliness and order of
your home doesn’t sound so silly; it sounds down-right grounded. Those overflowing baskets of laundry are more than just physical clutter. They are mental clutter that affects many aspects of our lives. The Kid Factor — Most children are born slobs. A combination of short attention spans, a lack of fine motor skills and allegiance to all things fun and chaotic makes kids fully optimized mess-creators. The irony in this amazing ability is kids crave order and structure. In my experiences, my kids are happier and more content when their bedrooms, surroundings and lives are kept in order. Sure, they need to make messes and immerse themselves in play, but at the end of the day they need to see order restored to their world. The Catch-22 — Even if we, as parents, recognize the benefits of maintaining a clean and organized home, we might not have the means to get there. We want to clear our homes to clear our minds, but by the time we do all of things that need doing each day, we often find ourselves depleted. Thus, that basket of laundry takes on an entirely new form. It becomes a very real reminder of our failures. It starts closing in on our happiness. It’s not pretty, but for many of us, it’s reality. Baby Steps — Most of us don’t have enough free time to maintain sparkling homes. It’s not realistic, and we shouldn’t aspire to it. However, that doesn’t mean we can’t do better by ourselves and our children. Here’s a quick and un-dirty list of ways to stay ahead of the mess: • Require your children to pick
up after themselves by giving them specific direction and possible consequences • Dedicate two hours once a week to decluttering your home • Take 15 minutes at the end of each day to pick up your house • Give yourself one small project each week to declutter it (think linen closet or vanity drawer) • Donate or sell books and toys as soon as your children outgrow them • If you didn’t wear it this season, donate it • If you have a significant other, clearly outline each of your responsibilities for the week (i.e., divide and conquer) • Clean up as you go; don’t let mess accumulate until it becomes intimidating • Bring less stuff into your home • Demand your extended family bring less stuff into your home • Make a small and reasonable chore list for your kids and reward their efforts • Put a box or bin out of sight and try to put an item into it each day (e.g., clothing, toys, trinkets, books). If you don’t miss those items within a couple of months, donate the items in the bin • Remember, even those who seem to be immune to mess can reap the benefits of a tidier home The clutter in our lives is a monster to our mental health. It’s time to take the teeth and horns off that laundry basket lurking in a dark corner. It can only have power if it’s there. Our self-worth and sanity might just be on the line.
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By Jim Miller
Does Medicare Cover Vision Services?
Dear Savvy Senior,
I will be enrolling in Medicare in a few months, and would like to know how Medicare covers vision services? I currently have vision insurance through my employer but will lose it when I retire.
Looking Ahead Dear Looking, Many people approaching 65 are unclear on what Medicare does and doesn’t cover when it comes to vision services. The good news is that original Medicare covers most medical issues like cataract surgery, treatment of eye diseases and medical emergencies. But unfortunately, routine care like eye exams and eyeglasses are the beneficiary’s responsibility. Here’s a breakdown of what is and isn’t covered. • Eye exams and treatments: Medicare does not cover routine eye exams that test for eyeglasses or contact lenses. But they do cover yearly medical eye exams if you have diabetes or are at high risk for glaucoma. They will also pay for exams to test and treat medical eye diseases if you’re having vision problems that indicate a serious eye problem like macular degeneration, dry eye syndrome, glaucoma, eye infections or if you get something in your eye. • Eye surgeries: Medicare will cover most eye surgeries that help repair the eye function, including cataract surgery to remove cataracts and insert standard intraocular lenses to replace your own. Medicare will not, however, pick up the extra cost if you choose a specialized lens that restores full range of vision, thereby reducing your need for glasses after cataract surgery. The extra cost for a specialized lens can run up to $2,500 per eye. Eye surgeries that are usually not covered by Medicare include refractive (LASIK) surgery and cosmetic eye surgery that are not considered medically necessary. • Eyeglasses and contact lenses: Medicare does not pay for eyeglasses or contact lenses, with one exception: If you have had a conventional intraocular lens inserted during cataract surgery, Medicare will pay for eyeglasses or contact lenses following the operation. Ways to Save Although original Medicare’s vision coverage is limited to medical issues, there are ways you can save on routine care. Here are several to
check into. • Consider a Medicare Advantage plan: One way you can get extra vision coverage when you join Medicare is to choose a Medicare Advantage plan instead of original Medicare. Many of these plans, which are sold through private insurance companies, will cover routine eye care and eyeglasses along with all of your hospital and medical insurance, and prescription drugs. See Medicare.gov/find-a-plan to shop for plans. • Purchase vision insurance: If you get routine eye exams and purchase new eyeglasses annually, a vision insurance plan may be worth the costs. These policies typically run between $12 and $20 per month. See Ehealthinsurance.com to look for plans. • Check veterans benefits: If you’re a veteran and qualify for VA health care benefits, you may be able to get some or all of your routine vision care through VA. Go to Vets. gov, and search for “vision care” to learn more. • Shop around: Many retailers provide discounts — between 10 and 30 percent — on eye exams and eyeglasses if you belong to a membership group like AARP or AAA. You can also save by shopping at discount retailers like Costco Optical, which is recommended by Consumer Reports as the best discount store for good eyewear and low prices — it requires a $60 membership fee. Walmart Vision Centers also offer low prices with no membership. Or consider buying your glasses online. Online retailers like WarbyParker.com, ZenniOptical. com, and EyeBuyDirect.com all get top marks from the Better Business Bureau and offer huge savings. To purchase glasses online you’ll need a prescription. • Look for assistance: There are also health centers and local clinics that provide free or discounted vision exams and eyeglasses to those in need. To find them put a call into your local Lions Club (see Directory. LionsClubs.org) for referrals. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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Legacy Nursing & Homecare, PLLC Generations Caring For Generations
By Deborah Banikowski District Manager, Syracuse
Elizabeth O’Connor
How Social Security Decides If You Still Have a Qualifying Disability
Owner ElizabethAO’Connor9@gmail.com 315-256-3210 1848 Kiley Rd. Cazenovia, NY 13035
SENIOR CITIZEN HOUSING SIMEON DEWITT
150 E. 1st St. Oswego, NY 13126 315-343-0440
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SPRINGBROOK APARTMENTS
ns Applicatio g now bein accepted. The following services are included in your rent • Trash Collection • New Appliances • Bus for shopping/groceries • Heat, Electricity & Hot Water • Snow Removal & Lawn Care • Planned Activities • All repairs & maintenance
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The Social Ask Security Office
• Assistance • Education • Health/Wellness
• Employment • Skill-Building • Recreation/Art
635 James Street, Syracuse, NY 13203 Phone: (315) 472-3171 • TTY: (315) 479-6363 • ARISEinc.org
S
ocial Security is required by law to review, from time to time, the current medical condition of all people receiving disability benefits to make sure they continue to have a qualifying disability. Generally, if a person’s health hasn’t improved, or if their disability still keeps them from working, they will continue to receive their benefits. These continuing disability reviews help us ensure that only eligible people receive disability benefits. It supports the integrity of the Social Security system while delivering fair services to wounded warriors, chronically ill children and adults and other people with disabilities. To help us make our decision, Social Security first gathers new information about an individual’s medical condition. We’ll ask their doctors, hospitals and other medical sources for their medical records. We’ll ask them how their medical condition
Q&A Q: I own a small business. How can I verify employees’ Social Security numbers? A: Employers can use our Social Security Number Verification Service to verify the names and Social Security numbers of current and former employees for wage reporting purposes. For more information, go to www.socialsecurity.gov/employer/ssnv.htm.
limits their activities, what their medical tests show and what medical treatments they’ve been given. If we need more information, we’ll ask them to get a special examination or test, for which we’ll pay. If we decide their disability benefits will stop, and they disagree, they can appeal our decision. That means they can ask us to look at their case again. When they get a letter telling them about our decision, the letter will tell them how to appeal the decision. You can read more about how we decide if you still have a qualifying disability at www.socialsecurity.gov/ pubs/EN-05-10053.pdf. People can check the status of their disability application with a personal my Social Security account at www.socialsecurity.gov/myaccount. This secure account gives people access to many tools that can save them time. Find out how Social Security is securing today and tomorrow at www.socialsecurity.gov.
Q: What is the earliest age I can begin receiving Social Security retirement benefits? A: The earliest age you can begin receiving Social Security retirement benefits is age 62. If you decide to receive benefits before your full retirement age, which for most people is age 66 or 67, you will receive a reduced benefit. Keep in mind you will not be able to receive Medicare coverage until age 65, even if you decide to retire at an earlier age. For more information, go to www. socialsecurity.gov/retire.
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BRIGHTON PHYSICAL THERAPY PLLC
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(315) 498-5510 Page 28
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
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Protect Seniors from Scams
W
hile the world is filled with plenty of good people, it’s a sad truth that there are also many individuals who don’t hesitate to take advantage of the elderly. Anyone can be a victim of a scam, but senior citizens are especially susceptible. Seniors tend to be more trusting than younger generations, making them more vulnerable. Educate yourselves — Do some research and watch the news for the latest scams, and inform your elderly loved ones. Have a conversation about all the places scams can occur, including over the phone and the internet. Know the signs — Talk to your loved one about the different types of scams that exist. The most common types include computer virus scams, sweepstakes scams, tax scams and repair scams. If something seems too good to be true, or an offer comes out of nowhere, it’s a sure sign of a scam. For example, if your loved one suddenly wins a sweepstakes contest they didn’t sign up for, or a repair
man shows up out of the blue claiming they can fix a roof or water pipe, this shouldn’t be trusted. Protect Information — Stress the importance of never giving out personal information unless it’s to a secure and trusted source. If a random caller asks for a social security number or bank account information, that’s a big red flag. Offer to help — Help older adults un-list their phone number so it’s harder for scammers to find. Place their address on opt-out lists with the Direct Marketing Association to reduce junk mail from legitimate businesses and marketers, so the junk mail that does come through can be more easily identified as a scam. Help them check their credit reports and show them how they can keep track of their bank accounts online. If you’re concerned that your loved one may need additional care, Loretto offers caregiver support as well as long-term care. Submitted by Loretto.
ELDER LAW FAIR PLANNING FOR LIFE AFTER 50 WHEN
Walk-Ins Welcome to older adults & caregivers
SESSIONS INCLUDE: Paying for Long Term Care, Aging Safely at Home, Senior Scams & Exploitation, End of Life Care, Wills & Planning, Estate Administration, Protecting Your Assets and more…
EVENT DETAILS:
Thursday, May 23 8:00 a.m. - 1:15 p.m.
Doors open at 8:00 a.m. Breakfast offered before sessions begin at 9:00 a.m.
WHERE
Onondaga Community College Academic Building 2 4585 W. Seneca Turnpike Please use Rt 175 entrance; Park at SRC ARENA & use shuttle bus.
*Syracuse’s Centro bus route 26 goes directly to campus. You may connect to this route in downtown Syracuse at the Centro Transit Hub.
REGISTRATION
Free EVENT!
Register Online: http://aarp.cvent.com/ElderLaw2019 OR By Telephone: 1-877-926-8300
Breakfast provided Parking & shuttle transportation available Free consultations with a lawyer onsite
PRESENTED BY:
Avalon Document Services, Estate Planning Council of CNY, M&T Bank Mortgage Division, Onondaga County Department of Adult & Long Term Care Services, Volunteer Lawyers Project of Onondaga County, AARP & AARP Onondaga Chapter #243, Vera House
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We offer comfort to our patients. We console family and friends. We care about the quality of life.
Fallon & Fallon Family Dentistry 5109 West Genesee St Camillus, NY 13031 315-487-9377
315-634-1100 www.hospicecny.org Serving Onondaga, Cayuga, Oswego & Madison Counties
Dr. Michael Fallon, Dr. Anne Marie Fallon, Dr. Mike Fallon
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Fingerlakes Wildlife Service Your Answer to Nuisance Wildlife Issues Bat Proof Your House! Rodent Proof Your House! Ask About Our Guarantee!
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• Outpatient Behavioral Health Forensics Care Management Treatment
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HEALTH EVENTS
from page 4 ville. On-site shopping boutiques and artisans include Whimsical Wire Designs featuring handcrafted jewelry and soy candles by Linda Boronczyk, hand-made scarves and jewelry by Nancy Mango, and purses, embroidered towels and soaps by Nancy Smith. A portion of sales from all on-site shopping will also benefit the Friends of St. Camillus. Returning this year as a special guest model is Christie Casciano, author and anchor, WSYR News Channel 9. Also returning are the event’s popular gift card, certificate and basket raffles, along with a valuable 50/50 cash raffle. Tickets to the event are $35 each and can be purchased by calling 315-703-0660.
April 16, 23
• Care Management for Adults and Children
• Home and Community Based • Outpatient Behavioral Health Services for HARP Plans Treatment
CALENDAR of
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019
Madison County: ‘Ticks: Avoiding the Bite’
Are you worried about ticks? Would you like to know more about these pests, how to prevent bites and about proper removal if a bite occurs? Join Cornell Cooperative Extension of Madison County with information from NYS Integrated Pest Management and Cornell University as experts talk about “Ticks: Avoiding the Bite!” This discussion will be held on 5:30 p.m., Tuesday, April 16, at the Cazenovia Public Library and at 5:45 p.m., Tuesday, April 23, at the Oneida Public Library. During the talk, local experts will discuss different types of ticks, where you can pick them up and common misinformation. There is no cost to this discussion and the group will be meeting in the public meeting space at both libraries. Sign up for this event by registering at https://reg.cce.cornell. edu/Ticks_225 for Cazenovia and at https://reg.cce.cornell.edu/ Ticks-2_225 for Oneida or by contacting Cornell Cooperative Extension of Madison County. Any other questions may be directed to Tess Southern at 315-684-3001 ext. 101.
April 24, May 2
Senior fairs take place in Manlius, Cicero
Nancy Aureli of Community Living Advocates has teamed up with local area libraries and senior centers to host Senior Information Fairs this spring. These fairs are geared toward seniors and caregivers. Various representatives from local senior centers, Onondaga County Office for Aging, Retired Senior Volunteer Program and many more will be available during this time. No registration is required — these fairs are free and open to the public. It is simply an opportunity for people to gather information from local organizations. They will be held at the following places: • From noon to 2 p.m. April 24 at Cicero Northern Onondaga Public Library (NOPL), 8686 Knowledge Lane, Cicero. • From 12:45 to 3 p.m. May 2 at the Manlius Senior Activities Center’s gym, 1 Arkie Albanese Ave., Manlius.
May 22
Internationally-known expert on dementia to speak in Syracuse
Dementia expert Teepa Snow, whose innovative approach to Alzheimer’s disease and dementia care has been recognized internationally, will be the featured speaker at the Alzheimer’s Association Dementia Care 2019 caregiver conference May 22 at the Holiday Inn-Syracuse/ Liverpool/Exit 37, 441 Electronics Pkwy., Liverpool. The eighth annual conference, presented by McHarrie Pointe Assisted Living, is intended for family and professional caregivers of individuals living with Alzheimer’s disease or another dementia. Register for the event at alz.org/cny or by calling 315-472-4201. Admission is $65 through April 30 and increases to $80 on May 1. Snow, an occupational therapist and educator with more than four decades in geriatric care, developed The GEMS brain change model focusing on the person living with Alzheimer’s disease or another dementia’s abilities within a moment to create a supportive care environment. According to Snow, “Just as gemstones need different settings and care to show their best characteristics, so do people. Rather than focusing on a person’s loss when there is brain change, seeing individuals as precious, unique, and capable encourages a care partnership and is the core of this model.”
June 12, 13, 14
Senior Roadshows take places in Oswego County
Caring Community Advocates of Oswego County, a group of local professionals and service providers dedicated to the health and wellbeing of the local aging population, announced a series of events especially for older adults, featuring games, guest speakers and information on a wide variety of topics, taking place at locations across Oswego County in the month of June. The events will feature area providers who will be sharing resources focusing on nutritional education, health/wellness needs, financial information, and medical resources available locally. Attendees will enjoy lunch, courtesy of The Oswego County Office for the Aging, funded by federal and state grants through the New York State Office for the Aging and by Oswego County government. Each event runs from 10 a.m. to 2 p.m., is free of charge and open to the public. The dates and locations of the events are as follows: • June 12 — Fulton Municipal Building, 141 S. 1st St. Fulton; • June 13 — Central Square Community Church, 833 U.S Route 11, Central Square; • June 14, The Lighthouse Church of God, 11 S. Jefferson St., Mexico For more information about “The Senior Roadshows,” contact Virginia Bough, Rural Health Network/ DSRIP program specialist at 315-5984740 ext. 1090.
I invite you to join me in creating a legacy gift through your will or financial plans. Together we can do great things for Central New York. – Jack Gorham
UPSTATE LEGACIES: Lifesaving and life-changing “She and I were one. What they did for her, they did for me.” The appreciation is evident in Jack Gorham’s voice when he talks about the “angelic” way Upstate University Hospital physicians, nurses, physician assistants and staff treated his wife Colleen throughout her 17-year journey with cancer.
For Jack it’s personal!
Jack and Colleen were overwhelmed by the compassion of the Upstate team, particularly in the radiation oncology department. Over the years, Colleen was treated for three different cancers beginning with breast cancer, followed by skin cancer and eventually throat cancer. As she came out of her 60th (and final) treatment, the physicians and staff gave her a standing ovation for her courage and bravery. Jack wants to help maintain this level of care and compassion for future cancer patients. That is why he has remembered The Upstate Foundation in his will. It’s also personal for you. Every dollar donated to the Upstate Foundation has an impact on our community’s health and well-being as every dollar stays right here in Central New York to help assure happy, healthy and longer lives for your loved ones, friends and neighbors.
For free and confidential information on how to make a low cost, high impact legacy gift contact, or have your professional advisor contact, John Gleason at 315-464-4416 or email us today at FDN@Upstate.edu Our legal name is THE UPSTATE FOUNDATION INC.
www.UpstateFoundation.org April 2019 •
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7th Generation Medical Acupuncture Anti-inflammatory Therapy for Neuropathy, Pain, Numbness, Tingling Diabetes Care and Cancer Supportive Care www.AcupunctureCenterUSA.com Anti-Inflammatory Acupuncture Therapy: More than Pain Management Inflammation Builds Roots of Most Diseases, 7th Generation Medical Acupuncture Builds Host Immunity and Power Integrative, Personalized, Therapeutic and Preventive Healthcare Philosophy of Care: Treat the Roots of Diseases Rui Wang, MD of China, L.AC. Experienced in both Western Medicine & Traditional Chinese Medicine Experienced in both Academic & Private Practice Experienced in both Basic Science & Clinical Science Experienced in Cancer Research at Major Medical Centers in USA
CLINICALLY PROVEN TO BE SAFE AND EFFECTIVE Acupuncture is a general practice alternative medicine, it can help a wide range of health problems at different extents. Ask for professional, confidential, personalized evaluation / consultation appointment before starting any treatment
ACU-CARE ACUPUNCTURE CENTER 7th Generation Rui Wang, LLC Northeast Medical Center, Suite 209 4000 Medical Center Dr., Fayetteville, NY 13066 Tel1:315-329-7666; Tel2: 315-378-5556; Tel3: 607-798-7680; Tel4: 607-372-2082
Ancient Wisdom Integrated with Modern Medicine
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LIFE CHANGING MEDICINE, MOVING MEDICINE FORWARD
IN GOOD HEALTH – CNY’s Healthcare Newspaper • April 2019