IGH - CNY-240 - December 2019 by In Good Health: CNY's Healthcare Newspaper

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Lucy’s Legacy

CNYHEALTH.COM

Organs of former student at SUNY Upstate Medical University give life to several people, including a 30-year-old health care professional and a 70-year-old grandmother

UROLOGY SUNY Urology has more specialists, more procedures — including gender affirmation — and draws more patients. Physician Gennady Bratslavsky discusses the reasons for this growth

DECEMBER 2019 • ISSUE 239

Surviving the

Holidays

3 Guide for a stress-free holiday season 3 Dodging dietary dangers 3 Healthful holiday gifts Page 16

Does it Run in the Family? How to create a family health portrait. P. 27

CHEERLEADING Of all sports, football sends the most U.S. males to the emergency room, while cheerleading and gymnastics most often do the same for women and girls

Turning the Tide Against HIV/AIDS Page 20

Things You Need to Know About Vaping

Roast beef

It is packed with good-quality protein and it sizzles with impressive amounts of selenium, several B vitamins, zinc and iron. Page 15

A Higher Purpose Goat Yoga in Baldwinsville helps fund mentoring services for youth. Page13

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

ADHD Rates Doubled Among U.S. Adults Over 10 Years

f the latest statistics are any indication, attention-deficit/hyperactivity disorder (ADHD) is no longer an issue for children only. Over a 10-year period, ADHD rates more than doubled among American adults, new research shows. However, the rate among children remains much higher than in adults. “While we can’t pinpoint the source of the increase in ADHD rates in adults, we can surmise that it has to do with growing recognition of ADHD in the adult populations by doctors and service providers, as well as increased public awareness of ADHD overall,” said study co-author, physician Michael Milham. He is vice president of research at the Child Mind Institute, in New York City. For the study, researchers analyzed data from more than 5 million Kaiser Permanente Northern California patients, and found that the percentage of adults with a diagnosis of ADHD rose from 0.43% in 2007 to 0.96% in 2016. White adults showed a larger increase — 0.67% to 1.42% — than those in other racial/ethnic groups. Adults with other mental health conditions — such as depression, and bipolar, anxiety or eating disorders — were more likely to have ADHD. The researchers also found

that adults with ADHD had higher rates of health care use and sexually transmitted infections. Meanwhile, ADHD diagnoses among children aged 5 to 11 rose from 2.96% in 2007 to 3.74% in 2016, a 26% increase. The study was published online Nov. 1 in JAMA Network Open. “More work needs to be done to better understand why rates are higher in white adults, particularly whether there are deficiencies in detection and diagnoses among non-white adults,” Milham said in a journal news release. “And,” he added, “we must develop more effective diagnostic tools and standards for adults, who, in general, remain more challenging to diagnose than children.” Study lead author Winston Chung, a psychiatrist with Kaiser Permanente in San Francisco, noted that people in some cultures are less likely to regard certain behaviors as a disorder or to seek help for them. “It’s always been just understood that different cultures and races might vary in meaningful ways in how they cope with stress or expressing emotions,” Chung said. However, “this is something we don’t actually have definitive answers to,” and more research is needed, he added.

Extending the Hand of A.A. Alcoholics who are deaf can access A.A.’s program of recovery in an updated American Sign Language translation of Alcoholics Anonymous

ith over 35 million printed copies sold, the book Alcoholics Anonymous is now available in an updated abridged translation into American Sign Language (ASL). Commonly referred to as “The Big Book,” this basic text of the worldwide fellowship that bears its name is now available on DVD to the deaf community, the hard-of-hearing community and the hearing community as well. DVD features: • Professional ASL signers and DVD video production; • Updated translation inspired and reviewed by A.A. members who are deaf • Audio track and subtitles for use among ASL and non-ASL users; • The basic principles and practices of the fellowship that have provided a pathway to recovery for alcoholics for over 80 years; • Can be ordered at www. aa.org or may be available through a local A.A. office near you. A.A. has always been committed to making its program of recovery available to anyone, anywhere who reaches out for help with a drinking problem. This translation has been updated with current language and signing most familiar in today’s deaf community. Founded in 1935 on the principle of one alcoholic helping another to achieve sobriety, A.A.

is an effective and enduring program of recovery that has changed countless lives. As explained in the book, A.A.’s recovery program of 12 suggested steps was formulated through the experience of its first 100 members and has reached millions of sufferers around the world. For more information about A.A. resources for alcoholics who are deaf or hard-of-hearing, contact the accessibilities and remote communities coordinator at the general service office at access@aa.org or by phone at 212-870-3344. For additional information about Alcoholics Anonymous, visit www. aa.org.

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December 2019 •

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Closures affect 1 in 8 pharmacies in the US

Urban, independent pharmacies in low-income neighborhoods most at risk

n a report published in JAMA Internal Medicine, researchers from the University of Illinois at Chicago found that despite an overall increase in the number of pharmacies in the U.S. from 2009 to 2015, one in eight pharmacies, or 9,654, had closed during this period. The researchers examined how pharmacy, community and market characteristics influenced the risk of a pharmacy closing. According to their analyses, independent pharmacies in both urban and rural areas were three times more likely to close than chain pharmacies. “Independent pharmacies are often excluded from preferred pharmacy networks and 340B contracts, which are both increasingly important aspects of the pharmacy market, so it is not surprising that independent stores are at greater risk for closure,” said Dima Mazen Qato, senior author of the study and associate

professor of pharmacy systems, outcomes and policy at the UIC College of Pharmacy. “Efforts to improve access to prescription drugs have focused almost exclusively on reducing drug costs, but affordable medications aren’t easily accessible when a local pharmacy closes. We need policies that specifically address pharmacy closures because such closures negatively impact access and adherence to prescription drugs,” Qato said. In prior studies, Qato and her colleagues have shown that pharmacy closures are associated with non-adherence to prescription medications. These declines in adherence also were shown to be worse in patients using independent pharmacies that subsequently closed. “Although efforts to promote pharmacy access have focused on addressing pharmacy closures in rural areas, we found that pharmacies located in low-income, urban areas are

at greater risk for closure,” she said. They report that approximately one in four pharmacies located in urban, low-income neighborhoods closed, compared with one in seven pharmacies located in rural, low-income neighborhoods. In urban areas, pharmacies serving disproportionately more uninsured or publicly insured residents with Medicare or Medicaid were two times more likely to close than other pharmacies. These market factors did not influence the risk of closure in rural areas. “Pharmacies located in rural areas may have financial incentives, including tiered pharmacy reimbursement rates for Medicaid prescriptions and critical access pharmacy payments, that are lacking in urban areas,” Qato said. The researchers say these analyses have important implications for policymakers seeking to address barriers in access to prescription drugs

in the U.S. According to Qato and her colleagues, payment reforms — including increasing reimbursement rates for Medicaid and Medicare prescriptions — and strengthening the regulation of pharmacy access standards, preferred pharmacy networks and the 340B Drug Pricing Program are necessary in order to protect pharmacies most at-risk for closure, specifically in urban areas. “Such policies may also protect pharmacies in predominately black and Latino communities and reduce disparities in access to prescription medications in urban areas,” said Jenny Guadamuz, first author of the study and UIC graduate student. “Our findings also indicate that pharmacy retailers, in partnership with health plans and pharmacy benefit managers, may need to consider more innovative, targeted and efficient strategies in the delivery of pharmacy services,” Qato said.

drug manufacturers a fair profit. Congressman Tom Reed (R-NY) incredibly said, “You are putting too much weight in the hands of the government dictating price.” But isn’t that how negotiations work? Isn’t that the whole point? Why can’t CMS be the 800-pound gorilla at the negotiation table when it comes to drugs? We’re talking 130 million lives. Congressmen like Tom Reed seem to have no problem dictating hospital and physician prices. And to exacerbate this total inequity, commercial insurers were quick to jump on the CMS fee control bandwagon and mimic CMS payments to hospitals and physicians. We’re basically most of the way to a single payer system since CMS and commercial insurers are already paying hospitals and physicians about the same fee per procedure. Instead of a bill with some teeth that would simply and broadly allow CMS to negotiate prices for drugs, bipartisan bickering has watered down the bill to the point where they are actually debating how many drug prices CMS will be allowed to negotiate. Right now, the bill would allow CMS to negotiate a whopping 25 prices. But Congress has magnan-

imously allowed CMS to negotiate (ready?) 35 whole drug prices … by 2033. Thirteen years from now? Despite the almost unanimous consensus that drugs cost too, much you can thank the drug lobby the next time you are at a fundraiser for a friend who can’t afford his cancer drugs. CMS indifference to providers continues. No negotiating here. The 2020 fee schedule at least gives physicians a paltry 1-2% increase, but then alters the hoops they have to jump through to get paid. Physical therapy fees will be cut 8% and psychology fees 7% in 2021.

Healthcare in a Minute

By George W. Chapman

Lower Drug Costs: What’s Been the Holdup in Congress?

efore we overhaul our expensive healthcare system, we have to start with drug prices. So, Congress needs to get this seemingly no brainer bill done first. It’s called the Elijah Cummings Lower Drug Costs Now Act of 2019. It is well documented, almost ad nauseum, that we pay way more for drugs (and use way more drugs per capita) than most countries. We spent $345 billion or over $1,000 per person on drugs last year. In countries with a single payer or universal healthcare model, the government uses its purchasing power to negotiate prices with drug manufacturers.

But not the U.S.

Our government — through the Centers for Medicare and Medicaid Services (CMS) — covers 60 million people on Medicare and 70 million people on Medicaid. That’s a staggering 130 million people or 40% of the U.S. population. Canada negotiates drug prices and pays far less than we do. The purchasing power of our northern neighbor is a less than staggering 30 million people. CMS literally sets the fees for hospitals and physicians. There really isn’t any negotiation per se, unless CMS “listens “to hospital and physician trade associations counts. So why doesn’t CMS use its staggering 130 million people purchasing clout to negotiate drug fees? What’s the holdup? Simply: the drug lobby. It is the No. 1 lobby on the Hill, by far, spending $4 billion over the last 20 years and employing almost 1,300 drug lobbyists. That’s 2.4 lobbyists per congressperson. How are they not tripping over each other as they Page 4

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Why are drug prices so high and still going up? Blame the drug lobby. They are the largest of all lobbies in Washington D.C., spending $4 billion over the last 20 years and employing almost 1,300 drug lobbyists. That’s 2.4 lobbyists per congressperson. enter and exit congressional offices? The ubiquitous drug lobby has succeeded in making this no-brainer issue into a partisan issue by contributing heavily to campaigns. Curiously, by comparison, there is little to no partisan bickering or compunction when it comes to setting prices for hospitals and physicians. By doing so, Congress has unwittingly limited its ability/cash to spend like the drunken sailor drug lobby. The drug manufacturers attribute their high prices and exorbitant profits to research and development, the cost of going through FDA approval, getting the drug to market and potential lawsuits. All debatable, but I’ll concede those points. So, this begs the question: why are they negotiating prices with anyone? Apparently, the U.S. government and U.S. consumers — paying anywhere from four to 120 times the price paid by other countries — are bearing most if not all of the costs of drug development. A lot of congressmen continue to parrot the drug lobby mantra that controlling drug prices will lead to less innovation and new drugs entering the market. No one is begrudging

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

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.

December 2019 •

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Meet

Your Doctor

By Chris Motola

Gennady Bratslavsky, M.D. Thanks to a high number of specialists, robotic platforms and new procedures — such as gender affirmation surgeries — Upstate Urology is attracting growing number of patients, including from overseas Q: You and I have spoken a couple times in the past. Quite a bit seems to have changed since then. At the time, you were one of the few urologists in the area. Now you have a large team and are pulling in patients from well outside Central New York and even Upstate New York. You’ve developed a pretty big reputation. A: I certainly hope so. Big, and a good reputation. Q: What does your department look like now? A: We now have probably one of the largest academic programs in the country. With faculty members and doctors-in-training, we have close to 45 physicians plus several mid-level providers like nurse practitioners and physician assistants who are dedicated to very comprehensive urologic care. We’ve grown the department from a small group of a dedicated few who stayed through several times of department turmoil to a department that has representation of every subspecialty in the urologic field. Urologic oncology, robotics and laparoscopy, female reconstruction and pelvic floor surgery, male trauma and reconstruction, endo-urology, infertility and erectile dysfunctions, pediatric urology.

who are having problems with urine control, a topic that is often taboo and not discussed. Our program is led by women, has women-only members and women-only surgeons. Q: Is the faculty mainly homegrown at this point or is SUNY Upstate attracting physicians from other regions? A: Some of the thought leaders have come from the most prestigious universities and institutions: the National Cancer Institute, University of California San Francisco, Indiana, Roswell Park. We also operate at 12 locations throughout Central New

Q: Are you offering any new techniques? A. We’ve pioneered several new techniques for diagnosis and management of cancers, namely prostate bladder and kidney. The program now offers numerous clinical trials for diagnosis and treatment. We also enjoy the presence of a molecular tumor board, where the genetics of patients with cancer are discussed. We have brought in key leaders in science and data science and now have several scientific laboratories with national funding. We have several key opinion leaders and surgeons in every above-mentioned discipline. We cover the full spectrum of ages. Each of our services is recognized on a national and international level. Our faculty is continuously sharing their expertise throughout the world, be it in the field of female reconstruction, or the field of management of stones. A: Any focus on female-related urologic issues? Q: One of our focuses has been on treating women

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

York. Our offices span from Alexandria Bay in the north to Binghamton in the south to Auburn in the west, and Utica in the east. We’re delighted to be able to provide services locally, to support local communities, local hospitals, local physicians and certainly local patients and families. Q: Urologists are a notoriously hard-to-find specialty. How did you grow your department into being such a force, based out of Syracuse? A: Yes, we are lucky to be in a major academic center. Urologists are hard to find and recruit, but we’ve been able to not only recruit urologists but top talent. Our department shares a strong clinical mission along with one for education and research. Each one in the department is dedicated to bringing up a new generation of physicians, groundbreaking research and patient education. Being affiliated with the only academic center in Central New York is certainly an enormous attraction to many of the faculty. In addition, the department does have a strong history of excellence going back to some of the grandfathers of urology like Dr. Zahi Makhuli, who performed the first renal transplant in the area, who is still with us. Upstate is also home to several new generation of robotic platforms, which offer minimal-

ly invasive procedures. Within the department there’s an embedded mentorship for some of the more junior faculty who join the department. The support and collaboration allow the department and field to move forward. SUNY Upstate’s urology department now has a position of prominence in the field. Q: To the point where I understand you’ve got patients coming from pretty far away for your services. A: There are several programs where we’re not just drawing from Central New York. We’re getting referrals from Sloan Kettering, Harvard, John’s Hopkins. We have referrals all the way from Beverly Hills and Hollywood from some of our expertise in gender affirmation surgery, as well as management of complications. We have people flying from South America and Europe to have surgery here at Upstate. A big compliment: every month we have rotating physicians from as far away as Brazil and Japan to learn the skills of our physicians. Overall, the stature of the department has changed in a way that’s led many international community members to refer patients here. We also have performed surgeries overseas, so our expertise is appreciated both here and overseas, where we do master class in surgeries. Q: What effect has the increased demand for gender affirmation surgery had on departments like yours? A: It’s been a big hit. Few centers offer comprehensive teams. We have a robust team, not just in urology, but in endocrinology, plastic surgery, social work. We have our own techniques using robotic assistance. While we aren’t heavily advertising, patients are flying to Upstate from all over the United States, as far away as Miami, Los Angeles and Texas. It’s added some “stress” to the system, but it’s a positive stress that we welcome as we continue to pick up speed in both bread and butter urology and more specialized procedures. Q: Do you see the model you used to grow the department applicable to other specialties? A: This model is being utilized in other centers. It’s a known Cleveland Clinic model. Several other departments are already using this model of regional presence, including radiation oncology. I can assure you Upstate is very much committed to delivering strong, regional, high quality care.

Lifelines

Name: Gennady Bratslavsky, M.D. Position: Chairman of the Department of Urology at Upstate Medical University, professor Hometown: Kiev, Ukraine Education: Albany Medical College (medical school and residency), National Cancer Institute (fellowship) Affiliations: SUNY Upstate, Community General, Rome General Hospital, MVHS, UHS, VA. Organizations: American Urological Association, Society of Urologic Oncology, Society of Urological Oncology Clinical Trial Consortium Family: Married (Katya), three sons (Michael, Mark, Dean) Hobbies: Soccer, fishing, traveling, art, guitar playing

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December 2019 •

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My Turn

By Eva Briggs

Multiple Sclerosis 101 Syracuse has the highest rates of MS in the country, according to study

recently read a report that Syracuse has the highest rate of multiple sclerosis (MS) in the United States. This was based on an analysis of medical claims by BlueCross BlueShield. The study found a rate of 45 per 10,000 commercially insured people, almost double that of the national average of 24 per 10,000 and about 50% higher than the New York state rate of 31 per 10,000. The reason for this high prevalence remains unknown. MS is a disease of the central nervous system — brain, spinal cord and optic nerves. It involves inflammation of the myelin sheath (fatty substance surrounding insulating nerves) and the nerves themselves. The body’s immune system attacks these areas causing damage that interferes with messages sent by the central nervous system. The cause is unknown but probably involves an interaction between genetic susceptibility and environmental factors. The “multiple” part of the name derives from the fact that the disease typically affects more than one area and at different points in time. “Sclerosis” refers to scarring or damage caused by the disease.

Common symptoms include fatigue, affecting 80% of patients. Numbness or tingling of the face, body, arms or legs is often the first symptom. Weakness occurs because of damage to the nerves that control muscles and deconditioning of unused muscles. Patients with MS may experience dizziness, the feeling of being off-balance or lightheaded, or vertigo, a sensation of spinning. Spasticity (stiff muscles) and muscle spasms can affect any muscles but are most common in the legs. Trouble walking arises from weakness, spasticity, balance problems, loss of sensation and fatigue. Vision changes include blurred vision, decreased color vision and pain with eye movement. Trouble with bladder control is common. Additional symptoms include pain, itching, emotional changes,

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depression and cognitive changes. Less common symptoms are speech problems, tremor, breathing problems, swallowing problems, seizures and decreased hearing. There is no one single test to diagnose MS. The criteria include evidence of damage to two or more separate areas of the central nervous system, and evidence that the damage occurred at different periods of time. Other possible diagnoses need to be excluded. The evaluation begins with a careful history of symptoms. The doctor will also seek information about birthplace, family history, environmental exposures, other illnesses and travel. A thorough neurologic exam can assist with making the diagnosis. Possible tests include MRI and analysis of cerebrospinal fluid (spinal tap). There are four typical forms of the disease. Clinically isolated syndrome (CIS) is a first episode of neurologic symptoms due to inflammation and demyelination in the central nervous system. Such patients are at high risk of going on to other forms of MS, although some people have one episode that does not recur. Relapsing — remitting MS (RRMS) — is the most common course of MS. Episodes of new or increasing neurologic symptoms (relapses) are followed by periods of partial or complete recovery (remissions). About 85% of patients with MS are initially diagnosed with RRMS. Secondary progressive MS (SPMS) follows an initial RRMS course. Over time, neurologic dysfunction and disability accumulates. There may be relapses and partial

remission, but the symptoms worsen over time. Primary progressive MS (PPMS) is characterized by worsening neurologic function from the onset of symptoms. When I started my career in medicine, the only treatment for MS was high doses of steroids to manage relapses. These medicines, however, didn’t alter the course of the disease. Now there are a variety of disease-modifying medications. The National Multiple Sclerosis Society lists eight injectable medicines, six oral medicines and four infused (IV) medicines to treat the disease. So patients definitely need a neurologist experienced with the different medicines to determine which, if any, is the best choice. Because MS is a complex and chronic disease, a team approach is needed to treat exacerbations, manage ongoing symptoms, promote function through rehabilitation and provide emotional support. A good place to start gathering information is the website of the National Multiple Sclerosis Society, nationalmssociety.org.

Eva Briggs is a medical doctor who works at two urgent care centers in the Syracuse region.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Thoughtful Gift Ideas for Those Who Live Alone

his column is for all of you who have friends or family members who live alone. While the holidays can be a joyous time filled with laughter, cheer and gift giving, this time of year may not feel so “merry and bright” for singles. Feelings of loneliness and anxiety are not uncommon and may give way to the holiday blues for those on their own. What can you do to brighten the holidays for those who live alone? You can give the gift of time together — probably the most welcome and cherished gift of all. You can also give a thoughtful gift to lift a spirit, safeguard a loved one and warm a heart. Below, I’ve compiled a list of gift ideas for you. Some are practical, others personal, all are designed to put a smile on the face of someone who lives alone:

For fun

• An invitation to join you on New Year’s Eve. This can be a challenging night for those who are newly divorced or widowed. I popped the cork with my sister and her

husband after my divorce and was deeply grateful for their invitation to spend the evening together. It got my new year off to a great start. • Tickets or gift certificates to movies, concerts, art openings or the theater. Include an invitation: “Be my guest.” And insist on doing the driving. • Dancing, cooking or art/craft classes. Do you have a single friend with two left feet? Dancing lessons might be in order. A widowed father who eats supper directly from the container? Consider a cooking class. Or a divorced sister who’s been looking for a creative outlet? A workshop in jewelry-making might delight her. There are so many possibilities!

For safety

• An AAA membership. I don’t leave home without it. A flat tire, an empty tank, a lost key – I’ve been there! This is a gift worth its weight in gold. • Handy tools for emergencies or life’s unexpected moments. Consider a compact “no-battery” wind-up LED flashlight with a hand crank.

CANCER BEWARE TOGETHERWEFIGHT hoacny.com Page 10

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

This is one of my prized possessions. How about a Swiss Army knife, complete with screwdrivers, scissors, a toothpick, and tweezers? It even comes with a nail file, can opener, and corkscrew. Or, consider a motion-activated doorbell that sounds a chime or alarm when a visitor (or perhaps Santa?) arrives. Those of us who live alone need to be prepared for whatever life offers up. • A gift certificate for car washes. While not necessarily a “safety gift,” I always feel better when my car is clean (and that can’t help but make me safer on the road). Who doesn’t enjoy a clean, sparkling car? Choose a car wash near your recipient’s home or work place.

For pampering

• An opportunity to be “treated like royalty.” How many of your friends who live alone indulge or pamper themselves? My guess is not many, if they’re like me. Who has the time or money? But that’s what makes this the perfect gift! Why not surprise her with a spa certificate for a massage, facial, manicure or pedicure? Or make his day with a certificate for a gentleman’s facial or deep tissue/sports massage. You might also consider an extra toasty and colorful pair of socks. One World Goods in Pittsford Plaza features Maggie’s Organic Merino Wool Snuggle Socks with whimsical winter-themed designs. A fair-trade producer and distributor, Maggie’s is the oldest surviving organic apparel company in the US. • For women in particular who live alone — fresh flowers delivered. Do you know a single woman who lives by herself? When’s the last time she got flowers? It’s probably been years ... don’t I know it. So, delight her with a bouquet of yellow roses or tulips. The color yellow has been closely associated with sunshine, making these flowers excellent for cheering people up. • And speaking of deliveries, check out Gift of the Month clubs. Coming home alone at any time of year may feel a little empty, but it can

really feel lonely during the holidays. Discovering a package on the doorstep can change everything. Go online and check out gourmet gifts and food clubs. You won’t believe the variety of delicious items that can be delivered on a monthly basis: chocolate, hot sauce, cheese, tea, cigars, wine, beer, pastas, olive oil, cookies, popcorn, pancakes, you name it. I love this idea so much I might treat myself.

For inspiration

• A gift of charity. Making a donation in someone’s name is a gift you can both feel good about. Think about your friend or family member who lives alone. What do they care about? Choose an organization that supports his or her values. • An invitation to join you in a volunteer activity. Helping others is a great holiday tradition. • Early on in my solo journey, a dear friend invited me to join her for a holiday gift-wrapping event to support the Humane Society. It felt wonderful to be out of the house and surrounded by other volunteers and staff who embraced the spirit of giving. • A subscription to “In Good Health” and/or “55 Plus” produced by editor and publisher Wagner Dotto. Both periodicals are filled with inspirational articles and trusted health information. Consider gift subscriptions for your friends and family who live alone. Chances are good your holidays and theirs will be healthier and happier for it.

Gwenn Voelckers is the founder and facilitator of “Alone & Content” empowerment boot camps for women held throughout the year in Mendon. She is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” For information about her boot camp, to purchase her book, or invite her to speak call 585-624-7887, email gvoelckers@rochester.rr.com

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Put Some Distance Between You and Invasive Knee Surgery. I refused to let my chronic knee symptoms slow me down. So when an MRI showed a bone defect - also known as a bone marrow lesion - in the subchondral bone near my knee*, my doctor recommended The Subchondroplasty® Procedure. This minimally-invasive technique fills these defects with a biomimetic bone substitute that is replaced with new bone during the healing process.1,2,3 Best of all? I’m back on the court.

Visit subchondroplasty.com to learn more about The Subchondroplasty® Procedure and find a surgeon in your area.

*AccuFill BSM may only be used in areas not intrinsic to the stability of the bony structure. Not an actual patient. Results are not necessarily typical, indicative, or representative of all recipient patients. Results will vary due to health, weight, activity and other variables. Not all patients are candidates for this product and/or procedure. Only a medical professional can determine the treatment appropriate for your specific condition. Appropriate post-operative activities and pain will differ from patient to patient. Talk to your surgeon about whether the Subchondroplasty Procedure is right for you and to discuss the risks of the procedure. For additional information or to find a surgeon near you, visit www.subchondroplasty.com or call 1-800-HIP-KNEE. All content herein is protected by copyright, trademarks and other intellectual property rights, as applicable, owned by or licensed to Zimmer Biomet or its affiliates unless otherwise indicated, and must not be redistributed, duplicated or disclosed, in whole or in part, without the express written consent of Zimmer Biomet. ©2019 Zimmer Biomet or its affiliates. 1. Knaack D, Goad ME, Aiolova M, Rey C, Tofighi A, Chakravarthy P, Lee DD. Resorbable Calcium Phosphate Bone Substitute. J Biomed Mater Res. 1998 Winter;43(4):399-409. 2. Colon DA, Yoon BJ, Russell TA, Cammisa FP, Abjornson C. Assessment of the Injection Behavior of Commercially Available Bone BSMs for Subchondroplasty® Procedures. Knee. 2015 Dec;22(6):597-603. doi: 10.1016/j. knee.2015.06.017. Epub 2015 Jul 23. 3. Hernandez, C.J. Keaveny, T.M. A Biomechanical Perspective on Bone Quality. Bone. 2006 Dec; 39 (6): 1173-1181.

TRUSTED FOR 80 YEARS

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Parenting By Melissa Stefanec

MelissaStefanec@yahoo.com

Leaders Come from Anywhere

s parents, we want to have answers for our kids. We want to be a beacon of truth in a world full of chaos. However, the learning opportunities are a two-way street. If we keep an open mind and actively listen, children can teach us a lot about ourselves and the world around us. I recently completed a leadership course through a local business consultant. The class was untraditional, as far as leadership-development courses go. However, it was quite useful. It forced me to take a hard look at myself and my potentially negative behaviors — at work and at home. As I sat through weeks’ worth of classes, I found myself going back to the same thought: Everything (good or bad) starts in the home. So how does all of this relate to learning being a two-way street? I pinky promise it does. As the end of my leadership course drew near, I had to assemble a presentation for the class. In our

presentations, we all had to answer the same five questions, which I will obscure to preserve the consultant’s secret sauce. When I started to assemble my presentation, I started to hit dead ends. I felt what I was writing was trite. I feared it would be redundant — and I wanted to be insightful. So, I did what so many of us adults do when faced with a crisis: I started overthinking things. The more I overthought it, the more forced and trite my presentation started to sound. I needed input. More importantly, I needed input from a mind that would give me fresh perspectives and clear thoughts. As I sat scorning the page, I listened to a light-saber battle upstairs. It suddenly became clear. I wanted to interview my kids. The more I thought about it, the more sense it made. Young kids have to follow a lot of leaders. Everywhere they go, they are told what to do. Kids probably have pretty good ideas regarding what makes a good leader

or bad leader, and they won’t mince words or overthink it. I called my kids down to where I was working. What they shared with me blew me away. First, I asked my 5-year-old a simple question: What can I do to be a good mommy? He answered, “Be nice and be happy.” I asked if I should still give consequences. With a sideways glance and a little smugness in his voice, he replied, “Yes, sometimes.” He then threw his arms around me and ran back upstairs.

Be happy. Be nice. Others will follow. I then called my 8-year-old daughter downstairs. I asked her plain and simple, “What makes a good leader?” What she said may well be some of the best leadership advice I will receive in the course of my career. She said, “Help. Be kind. Have fun.”

Be helpful. Be kind. Enjoy yourself. I pressed her with a grown-up question and asked what leaders should do when things get tough. She said, “Find a way to fix it and don’t give up.” I pressed her further, wanting to crack her flawless replies. I asked what leaders should do when they get mad. She said, “Take a deep breath and say you’re sorry.” There’s more insight in that than most adults could convey. As I mulled over her responses, she bounded back upstairs. However, a few minutes later, she reappeared.

‘If we keep an open mind and actively listen, children can teach us a lot about ourselves and the world around us.’ “I thought of something else leaders should do, Mommy. They should stick up for people and always be thankful.”

Fight for everyone. Show gratitude. The heavy tasks implied by her simplistic responses weighed on me. My kids had just taught me some valuable lessons about how to be a great leader. They taught me to keep it simple. Furthermore, they taught me most problems in life have very simple solutions. They also taught me leaders listen to other leaders, no matter how tall or old they are (or how many cookie crumbs they have on their faces). Leaders come in many forms, and my home is lucky enough to have four leaders. When you’re a parent, learning is a two-way street. I hope I can take what they taught me and put it into practice in this crazy, beautiful world.

s d i K Corner

These Sports Are Most Likely to Send Young Americans to the ER ERs see about 2.7 million patients with sports-related injuries each year

f all sports, football sends the most U.S. males to the emergency room, while cheerleading and gymnastics most often do the same for women and girls, a new report finds. And, overall, U.S. emergency departments see about 2.7 million patients between the ages of 5 and 24 for sports-related injuries each year, according to a new report from the U.S. Centers for Disease Control and Prevention. In some cases, these injuries might even be a gateway to opioid addiction: Opioid painkillers were given to ER patients suffering from a sports injury in about one in five cases, the study found. That num-

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ber rose to nearly half (46%) among young adults aged 20 to 24. “As we have learned from the opioid crisis, many patients move from appropriately prescribed opioid medications to misuse of opioids,” noted physician Teresa Amato, who directs emergency medicine at Northwell Health’s Long Island Jewish Forest Hills, in Forest Hills, New York. She wasn’t involved in the new research. “I would encourage any parent with a child that has a sports-related injury who is being evaluated in an emergency department to have an open and frank discussion about pain control and if opioids are needed,” Amato said. “Of course, in some

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

cases there will be a need for these medications, but the discussion prior to dispensing or prescribing opioids may prevent misuse later on.” The new analysis of 2010-2016 national data was conducted by the CDC’s National Center for Health Statistics. According to the report, football, basketball, cycling, soccer, ice/roller skating, and skateboarding are the leading causes of emergency department visits for sports injury for young Americans. Among males, just over 20% of these visits were due to a football-linked injury, while gymnastics and cheerleading accounted for the highest percentage among females (nearly 12%).

In terms of where on the body the injuries occurred, kids aged 5 to 9 were more likely to have injuries to the arms and upper body than young adults aged 20 to 24, who were more likely to have lower-extremity injuries. Three-quarters of sports-related emergency visits for young patients needed scans, such as X-rays or CT scans, the report found. Opioid and non-opioid pain medications were given or prescribed at nearly two-thirds (64%) of visits. Non-opioid pain medication was given or prescribed nearly twice as often (41.4%) as opioid painkillers (22.5%), the CDC team found.

About 30 people gather each month — from spring to fall — at Purpose Farm, an 11-acre property nestled alongside the Seneca River in Baldwinsville. They practice yoga while mingling with goats and other animals. Photos by Payne Horning.

A Higher Purpose

Goat Yoga in Baldwinsville helps fund mentoring services for youth By Payne Horning

he goat yoga fad that took the country by storm is now three years old, but even today the classes offered at a farm in Baldwinsville continue to sell out. About 30 people gather each month at Purpose Farm, an 11-acre property nestled alongside the Seneca River. At first glance, it looks more like a zoo than a farm. In addition to horses, pigs and goats, you can find chinchillas, a peacock and a camel. The reason behind this wide assortment of animals is because all of them share a common background: they were rescued. That’s part of the draw for many who arrived one early Saturday morning for goat yoga, including Skylar Ryll, who came for her birthday. “Animals brighten your day, no matter what kind of animal it is,” Ryll said. “Just being with animals is really important so it seemed like the perfect way to start a birthday.” But it’s not just the animals that

benefit from these goat yoga fundraisers. Purpose Farm is a nonprofit that provides free mentoring services for youth in crisis. Children aged 6-18 who are suffering from abuse, neglect, trauma, loss, anxiety, behavioral issues or those living in highrisk environments can find an escape at this farm where they have an opportunity to work one-on-one with mentors and tend to the animals. Sandra Seabrook, president and founder of Purpose Farm, says the children they mentor often struggle to form relationships with friends and family. But they are able to bond with the animals here because both have endured troubling experiences. Some of the animals at Purpose Farm were found abandoned in Syracuse after people who had purchased them as part of fads, like backyard chickens, later let them loose. Others, like horses, were discarded, about to be slaughtered because they had reached the end of their useful life on other farms or as racehorses.

“I actually have some kids that we see that have food-hoarding conditions due to being starved, so they can relate to animals we have that had been starved in their previous home,” Seabrook said. “They’ve been mistreated and they don’t understand — they feel like it’s just them. So when they come here, they

December 2019 •

see that it happens to a lot of different living things. They then can turn around what they’re feeling inside of them and use it for good to help the animals.” Seabrook says there is a high demand for their services, so much so that each year, they have to turn away about 50-75 applications. She attributes that need to the many sources of anxiety children face today, especially with the stress and pressures that come with social media. Purpose Farm also sees a lot of kids who live in foster homes or with relatives, displaced due to issues like drugs. Kristen Diment from Oswego says that’s why she came out for yoga. “I like helping the animals and the kids experiencing hardships,” Diment said. “It’s for a really good cause.” Like many of the people who come to goat yoga at Purpose Farm, Diment had never done yoga before. Now, she plans to return, possibly as a volunteer as well. It was a fun experience, she says, even though the goats tried to eat her sweatshirt. Seabrook says none of her goats respect personal space. They crawl under people, lick their faces, and even rifle through the contents of their bags. But that’s part of the fun and the appeal that keeps people coming back for more. “They’re not aggressive animals, they’re just they’re fun-loving beings,” Seabrook said. “It’s the best day ever. You’re giving back to the community, you’re allowing a kid to be able to continue to come to our farm free of charge, and at the same time you’re getting to enjoy a healthy Saturday morning exercising in this great environment around goats. It’s a win-win.” The goat yoga sessions will return to Purpose Farm in the spring.

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ucy Reff was only 23 when she died in January of this year due to a colloid cyst in her brain. Yet, the donations of her organs gave life to others, including a 30-year-old health care professional and a 70-year-old grandmother. Through a recent phone conversation and subsequent emails, Lucy’s mother, Laura Reff, and her best friend, Jessie Seeger, shared Lucy’s story and the decision to donate her organs. “As a mom, I never want her to be forgotten or all the good she accomplished in her life,” Laura wrote. “Organ donation was a way for her to live on, and helping someone else is what Lucy was all about. It is in giving that we receive, and Lucy gave the biggest gift.” Lucy was a quiet person, they said, but the look in her eyes spoke volumes, and they fondly remembered, with a knowing chuckle, her sass. Lucy had loved the outdoors, riding horses and teaching hip-hop. The Clayton native had worked hard in school and at part-time jobs as a teen. She was a student at SUNY Upstate Medical University in the respiratory therapy department, and was due to graduate in May. She and Seeger had been friends since their days in Girl Scouts. The friends would later become equestrians, showing horses in county fairs and at the New York State Fair for several years. Lucy was engaged to her longtime boyfriend, Skyler Weston, and the couple was planning to wed in mid-August. She had just chosen her wedding dress a few days before she was hospitalized. Some time prior, Seeger and Mark, Lucy’s father, had registered as organ donors, and had mentioned it to Lucy and their son, Joshua. The younger Reffs talked about it later, and thought it was something they would do, Laura said. However, Lucy hadn’t had the opportunity to renew her license after first getting it at the age of 16. A New York state driver’s license is good for eight years, and she hadn’t had the chance to register. Because Lucy hadn’t registered, once doctors had informed Lucy’s family and loved ones that she was brain dead, Laura, Mark, Joshua, Weston and Seeger discussed it and decided to move ahead with having Lucy’s organs donated. In Lucy’s case, Laura explained, the brain damage she had suffered caused her organs to shut down. But with the family’s permission, the medical teams were able to administer medication in the hopes that her organs would respond and become worthy to be donated. Ultimately, her kidneys, liver and heart were usable. Since then, Laura, Seeger and the others have come to learn more about the statistics and need for organ donations. “Now that we know the numbers, the need is so huge,” Laura said. New York state has the third greatest need in the country, but out of the 52 donor registries in each of the states, Puerto Rico, and Washington, D.C., New York ranks 51, according to Nancy Ryan, director of marketing and community relations for the Finger Lakes Donor Recovery Network, a federally designated

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stories and told what it means to them that their loved one was able to give these gifts, that their spirit lives on, and that they were able to give others another opportunity at life through organ donation.

Dispelling myths

Lucy Reff was only 23 when she died in January of this year due to a colloid cyst in her brain. She was engaged to her longtime boyfriend, Skyler Weston, and the couple was planning to wed in mid-August.

Lucy’s Legacy

Donated organs are the gift of life By Mary Beth Roach

organ procurement organization. This agency helps residents in its 20-county coverage area to register for organ donation, as well as assists families at the time of their loved one’s passing to fulfill those “end-oflife wishes,” Ryan added. While the state’s ranking and the corresponding numbers are “pretty alarming,” Ryan was quick to point out that the state has been making progress in the past several years. For example, in the 20-county area that the Finger Lakes organization covers, its enrollment rate is 48% while the state’s is 36%. This compares to a 29% enrollment rate for the Finger Lakes Donor Recovery Network in 2013. There are a variety of reasons for the increase, Ryan pointed out. A new electronic online system has been launched, which allows people to register in less than two minutes, Ryan noted. Furthermore, the question about whether people want to register as an organ-eye-tissue donor is now included in the New York State of Health marketplace. When people enroll to receive their benefits through the state, Ryan explained, that online enrollment system also includes the question of organ-eye-tissue donation. That information is passed along to the New York State Donate

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

Organs of former student at SUNY Upstate Medical University give life to several people, including a 30-year-old health care professional and a 70-year-old grandmother Life Registry. That alone resulted in 206,000 new state residents enrolling, Ryan said. In addition, young adults, those aged 16 and 17 years old, can now register their intent to donate when they sign up to get their learner’s permits or driver’s licenses. In the past, they wouldn’t be allowed because they had to be 18 years of age or older. “If something unfortunate was to happen, the parents would have the final determination,” Ryan said. “But it’s giving the young people the opportunity to share the info with their family and let them know what their wishes were as well.” Ryan also credited donor families like the Reffs, who have shared their

There are several obstacles and myths that hinder a person from registering to become an organ donor. “The most common statements we hear are, ‘I’m too old,’ ‘You wouldn’t want any of my organs,’ or ‘I haven’t led a healthy life,’” Ryan said. When one registers to be an organ-eye-tissue donor, there are no medical restrictions or age restrictions, except you need to be at least 16 years of age, Ryan explained. Medical professionals at the time of death make those determinations if there are organs and tissues that are healthy enough. Some people believe that their religion or their faith does not support organ-eye-tissue donation. However, Ryan said most major religions in the United States are supportive of organ donation. For those who are unsure, Ryan suggested they talk with their faith leaders and primary care physicians. Ryan said there is another significant fear for people in making the decision. Many believe if they register to become an organ donor and then find themselves in an emergency department or a critical care setting, doctors and nurses won’t try that hard to save their lives if they know that they’re registered organ donors. That is a myth, Ryan said. The medical personnel in the ER don’t have access to the registry, Ryan pointed out, so they have no way of knowing if someone is even a registered donor. “Frankly, what’s most important in their mind is to save your life,” she said. Medical teams in hospitals have been trained to deal with patients who have been admitted in critical condition and rely on mechanical ventilation to keep the heart beating and blood flowing. The Finger Lakes Donor Recovery Network has agreements in its service areas with 37 critical care and critical access hospitals. Those hospitals’ staff members are trained to call and notify them that they have a patient who is meeting clinical triggers for organ donation. “We then respond directly to the hospital and begin working with the medical teams and eventually speaking with the family that their loved one could give the gift of life,” Ryan noted. The network has been crucial to Lucy’s loved throughout the past few months, offering them guidance and emotional support. As the Reffs and Weston approached what would have been his wedding day in August, they were planning at Weston’s suggestion to spend the day celebrating Lucy’s life. And also remembering the lives she saved.

How to Become a Donor To learn more about organ donation and how to register, visit the Finger Lakes Donor Recovery Network at http://www.donorrecovery.org/ or Donate Life at https://www.donatelife.net.

SmartBites

Helpful tips

By Anne Palumbo

The skinny on healthy eating

Roast Beef Rounds Up Crucial Nutrients T o beef or not to beef? That is the question that plagues many as red meat has come under fire. Does its consumption cause cancer? Heart disease? Type 2 diabetes? Conversely, what benefits do we reap from eating beef? While the answers to these questions are complex, varied and continuously being investigated, the bottom line, according to leading experts and health organizations is this: It’s still a smart idea to reduce your red meat intake in order to reduce your risk of the diseases mentioned above. Reduce. It’s doable advice. For both health and environmental reasons, I don’t eat a lot of red meat. But I do eat some; and, at this festive time of year, I probably indulge more than I normally do. Roast beef, especially the leaner cuts, offers clear nutritional benefits. Not only is it packed with good-quality protein, but it also sizzles with impressive amounts of selenium, several B vitamins, zinc and iron. An average 3.5-oz serving of roast beef has about 25-28 grams of complete protein, which, for many, tackles over half of our daily needs. Protein helps to keep our muscles and bones strong, which is important

for maintaining balance, mobility and independence as we age. Roast beef is a selenium superstar, with an average serving providing 50% of our daily needs. A powerful antioxidant, selenium fights oxidative stress and helps defend our body from chronic conditions, such as heart disease, cancer and Alzheimer’s. This essential mineral is also important for the proper functioning of our thyroid gland, which regulates metabolism and controls growth and development. Healthy doses of immune-boosting zinc, energy-producing iron and vitamins B:6, B:12 and niacin provide more good reasons to eat beef. Working together, the B vitamins strengthen our immune system, convert food to energy, keep our nerves in tiptop shape, and help make red blood cells. So, why do leading institutions, including the American Institute for Cancer Research, say we should limit our consumption to no more than about three portions per week (total: about 12-18 oz)? Strong evidence suggests a link between the regular consumption of red meat and colon cancer.

Garlic-Rosemary Roast Beef with Horseradish Sauce Adapted from Diabetic Living Magazine

3 pounds beef eye of round roast 1 teaspoon salt, divided ¾ teaspoon ground pepper, divided 1 tablespoon vegetable oil 3 tablespoons unsalted butter, softened 1 shallot, minced (1/4 cup) 2 tablespoons minced fresh rosemary (or 2 teaspoons dried) 4 cloves garlic, minced, divided 1 cup nonfat plain Greek yogurt 1½ tablespoons prepared horseradish 2-3 teaspoons Dijon mustard 3 teaspoons fresh lemon juice, more if prefer • Preheat oven to 400°F. • Season roast with ¾ teaspoon salt and ½ teaspoon pepper. Heat oil in a large ovenproof skillet (see Tip) over medium-high heat. Add the roast and cook, turning every few minutes, until browned on all sides, about 10 minutes. Remove from heat. • Combine butter, shallot, rose-

Choose lean cuts, which run lower in saturated fat, cholesterol and calories. Anything with “round,” “chuck” or “loin” in its name is usually either extra lean or lean. For example, eye round roast has only 4 grams of total fat, l.4 grams of saturated fat, 54 mg of cholesterol, and about 165 calories per average serving versus prime rib that has 17 grams of total fat, 7 grams of saturated fat, 77 mg of cholesterol, and 265 calories. If “char”—a potential carcinogen— develops during the cooking process, scrape it off. mary, and 3 cloves minced garlic; spread on top of the roast. Transfer the pan to the oven. Roast until a thermometer inserted in the center of the meat registers 125-130°F for medium-rare, 35 to 40 minutes. Transfer the roast to a cutting board and let rest for 10 minutes. • Meanwhile, whisk remaining garlic, yogurt, horseradish, mustard, and lemon juice in a small bowl. Season with the remaining salt and pepper. Adjust seasonings, adding more lemon juice if needed. Slice the beef thinly and serve with the sauce. • Tip: If you don’t have a large ovenproof skillet, you can brown the roast in a large skillet and transfer it to a roasting pan for Step 3.

Anne Palumbo is a lifestyle colum-

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.

Can Intermittent Fasting Work For You? Diet has been in the news after actress Jennifer Aniston said she follows it By Deborah Jeanne Sergeant

raditionally, breakfast is the most important meal of the day, but don’t tell actress Jennifer Aniston that. According to numerous media outlets, the svelte star relies upon intermittent fasting to keep her figure trim — despite having turned 50 years old in 2019. The eating plan as Aniston uses it involves eating nothing from 6 p.m. until 10 a.m., although she does drink beverages such as celery juice in the morning. Physician Az Tahir, who practices holistic medicine in Rochester, said that intermittent fasting “has been shown to have health benefits,” he said. He listed weight loss, reversing symptoms of Type 2 diabetes, reducing LDL cholesterol levels, mitigating the effects of Alzheimer’s disease and augmenting chemotherapy to both increase its ability to fight cancer and lessening its negative side effects. As for weight loss, “mainly, it regulates glucose and glycogen,” Ta-

hir said. “When you do intermittent fasting, the amount of the food you eat is less, so the calories are less.” He said the easiest way to fast is eating two meals per day. Eating right — when ones does eat — is important while on this type of plan: eschewing processed foods and simple carbohydrates in favor of a mostly plant-based diet with only a small amount of animal-based food. Heather Carrera, doctor of clinical nutrition who works in the office of Lesley James, MD in Pittsford, also said that research indicates that intermittent fasting offers “a lot of benefits” for people with Alzheimer’s, gastrointestinal problems or excess weight. Like Tahir, she said that eating a better diet is important and added that those with diabetes should be monitored. “I think there’s a lot of merit to intermittent fasting, but it needs to be done in a healthy way,” Carrera said. “If you eat poorly and you start to intermittent fast, it won’t have the health benefits.

Carrera has irritable bowel syndrome and said that intermittent fasting helps her and many others with IBS because it allows the digestive system to rest. “You should do it for health reasons, not necessarily for weight loss, although that can be a side effect,” Carrera said. Shifting the hours is all right, too. Some may find it easier to stop eating earlier in the evening so they can eat again sooner the next day. Others prefer sharing their evening meal for social reasons and then pushing out their next meal until lunchtime the following day. The time span isn’t set in stone, either. Some intermittently fast for fewer or longer hours. Some even eat only every other day. Before making any changes in eating patterns, it’s important to receive a healthcare provider’s approval to ensure it won’t interfere with any medication or health conditions.

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Holiday Greetings

Healthful Holiday Gifts By Deborah Jeanne Sergeant

“Health is wealth” as the saying goes. Why not give healthful gifts this season? While giving something as obvious as a diet book is likely not a great idea, gifts to promote good health come in many forms.

Fruit basket. Most grocers

sell beautiful arrangements of fruits. Or, you can make your own with a large basket or other festive container. I like to cushion the interior with a new kitchen towel or shredded red and green paper and fill it with a variety of fruit to about 1/3 above the container’s capacity. Placing firmer fruit on the bottom, like apples, helps ensure it will last longer, as will cradling softer fruit in a few layers of tissue paper. For the lack of a nicer container, I’ve even wrapped a sturdy cardboard box with Christmas paper. Include more exotic fruits and also favorites like apples and oranges so if feels more special. Party stores and dollar stores cell cellophane shrink wrap bags that will keep the goodies inside. Then top with a bow. Fruit baskets make great thank-you gifts to a family hosting your celebration. Also consider people who may seldom have fresh fruit, like a relative living in a nursing home. An elderly person who has enough “stuff” may also enjoy an edible gift.

omega-3 fatty acids. Avoid the glazed varieties, as they’re high in sugar. Nuts roasted and sprinkled with sea salt offer a better option. Or just plain nuts are good, too. Grocery stores usually provide containers of nuts in the shell this time of year in the produce section. Add a nutcracker and pick and you’re all set. Or peruse the store for shelled nut gift sets.

4. 2.

Chocolate. Select a high-qual-

ity dark chocolate. Despite its decadence, chocolate’s antioxidants can provide a boost to the immune system. Skip milk chocolate, which contains a much lower level of antioxidants, and white chocolate, which isn’t really chocolate at all. Whether it’s a stack of bars wrapped and tied off with a ribbon (children especially love this), a fancy holiday gift package or a seasonal box of candies, chocolate is always welcomed and when eaten in moderation, a treat that provides some health benefits.

Nuts. Providing

allergies aren’t an issue, fancy nuts represent a terrific present, as they’re delicious sources of minerals, protein and healthful

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Maple syrup. Most people love it but consider it a special treat because of its price. With its bevy of minerals (even calcium!) as an all-natural sweetener, maple syrup represents a very healthful food. I’ve found that shopping at a maple farm’s store can offer a wider variety of decorative glass bottles and even seasonal containers instead of the taupe plastic jug or plain glass bottle.

Tea or coffee. Both bever-

ages offer antioxidants. But among teas, white tea has the most, followed by green and then black. Fruit tea is usually made with a black tea base. Some herbal teas purport to support the immune system’s health.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

Many stores sell tea or coffee packaged nicely. Or, as with the fruit, choose a few varieties and package them up yourself. As a nice touch, include a set of nice mugs in a style appealing to the recipient or accessories like a tea cozy or a French press and grinder.

Community supported agriculture membership. Also

known as a CSA, this membership gives your recipient a share of a local farmer’s freshly harvested crops all summer and fall. Some also offer winter shares, which tend to include more root crops. That should expand the recipient’s produce consumption, since most CSAs offer a vast array of fruits and vegetables. Some CSAs include items like eggs, honey and meat. Before you purchase, make sure that the pick-up location — which may or may not be on the farm — is close enough to your recipient.

Healthful gift cards. Support your recipients’ interest in a new activity, whether it’s dance lessons, martial arts school membership, golf club membership or anything else that gets them moving. But as with the aforementioned diet book, don’t make it as obvious as a gym membership unless they have explicitly stated that kind of gift would be welcomed. Along with the membership certificate, package up an accessory such as a vacuum-sealing, stainless steel insulated water bottle.

Holiday Greetings

CANCER CARE

CLOSE TO HOME.

Holidays: Dodging Dietary Dangers By Deborah Jeanne Sergeant

ith family gatherings, work parties, cookie exchanges and food gifts, the season can feel full of dietary hazards if you have food restrictions. Whether it’s an intolerance or allergy, your dietary restrictions may not seem important to others. From a “forgotten” ingredient in a side dish or a relative who thinks it’s “all in your head,” here’s how you can dodge dietary dangers. Tips from Ali Olsen, registered dietitian and bariatric dietitian with Center for Weight Loss and Surgery at Oswego Health: • “Communicate! Contact party hosts as soon as your invitation arrives. Gently and nicely communicate by educating others. Remember, your host is probably hoping to have a safe holiday party as well. Discuss your concerns about food allergens, the possibility of cross-contact, and how you can best create a safe environment. By having a conversation about food allergies in general, you have an opportunity to educate without offending your host. • “Ship ahead. If you’re flying to visit friends or family, and you can’t bring a dish, you may want to make some simple problem-free foods that travel well and ship them to your host ahead of time or research what grocery stores carry in the area that you might be able to use. • “Make a list. Include an ingredient listing card with your dish to the party, perhaps you’ll inspire others to start doing the same. If you are hosting, keep all labels from the food you prepare in case one of your guests has a question about a product. • “Keep an eye on young ones with allergies. Take turns supervising children with food allergies. Make a rule with the children before the party starts to check for permission before eating anything. • “Be prepared. If you’re unsure,

ask about ingredients, check labels when possible, and carry medications with you in case of a reaction. Remember to have dedicated serving dishes, serving utensils, and prep space for those special allergy free foods. If the situation can’t be controlled safely enough, you might need to eat before the party or sneak a small snack in your bag. • “Plan some food-free activities. The holidays are about more than just the food. Skip the cookie swap and enjoy time with your friends and family by making crafts, wrapping presents, watching holiday movies, or playing games instead.” Tips from Laurel Sterling, registered dietitian and nutritionist and educator for Carlson Laboratories: • “Certain people have dietary restrictions like irritable bowel syndrome, celiac disease or allergies. This can be difficult while traveling, at get-togethers and during holiday dinners. I had many clients with these health concerns, and they brought along a dish for themselves to enjoy. • “They can also eat beforehand. • “People can make specific dishes for the person with the dietary restriction. • “Nowadays there are so many stores and restaurants that have foods which cater to many with dietary concerns.” Tips from physician Az Tahir, High Point Wellness, Syracuse: • “It can be a challenge, especially when traveling and at family functions, if you’re allergic to foods commonly used. Usually, you have fruits and vegetables. They’re usually safe and you can buy them anywhere. • “Nuts can be a healthful food if you’re not allergic to them. • “If you’re allergic to something, don’t just eat it because you’re afraid of offending other people.”

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Page 17

Holiday Greetings

Survival Guide For a Stress-Free Holiday Season By Kimberly Blaker

o you dread the hustle and bustle of another holiday season? Between shopping, wrapping, baking, holiday cards, parties, and many other obligations and tasks, surviving the season can be a feat, let alone finding the time to enjoy it with your family. This year, why not make a pact to eliminate stress by following these tips?

Early planning — First, close your eyes and think back to the previous couple years and how hectic and stressful they felt. What percentage of holiday activities and tasks would you need to eliminate to make the season truly enjoyable and relatively stress-free? During this process, don’t think about what you can’t eliminate. Just determine the

Share in the preparation — Enlist your family to help prepare for the holidays, and divvy up the tasks. Don’t expect perfection from yourself or your family. Remember, you probably don’t notice or mind the imperfections in others’ holiday gatherings. They’re just as unlikely to see any in yours. Also, keep in mind the holiday season isn’t the time to be head cook. Plan potluck gatherings. Then, either suggest what each person should bring or, to avoid duplicates, ask guests to let you know what they’ll bring. Holiday time-and-energy savers. Save time — in gift wrapping by setting up a station in a spare room or the basement. Or stock a large box or basket with wrapping paper, ribbon, bows, tags, tape, scissors, and pens, so everything is stored in one place. Have extras of everything on hand. Keep cleaning to a minimum during the holidays. Dismiss unused areas guests won’t see or use, and clean only the obvious in rooms that will be seen. The barely-visible layer of dust on your baseboards is unlikely to be noticed with all the holiday decorations and festivities. Make everyday meals quick and simple throughout the season. Soups, sandwiches, fresh fruit and vegetables, cottage cheese, pre-cut veggies and dip, and other prepared or semi-prepared healthy foods will suffice for one month of the year. Do your holiday shopping early in the day on weekdays while your energy is high and crowds are small. Shop online or by catalog. If an item lacks details, search for a manufacturer’s website to get the information you need. Give gift cards. Hard-to-shop-for

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percentage of reduction you need to make. Next, make a list of everything you need to do during the holiday season, to which parties you’ll be invited, and how much money you’ll spend. Now cross off the least important, least necessary and least desirable events and tasks. Then review the list, and calculate how much time and expense you’ve shaved off. If you haven’t reached your predetermined reduction, go through your list again. Once you’ve decided which parties you’ll attend and the commitments you’ll make, plan how you’ll say ‘no’ to all the others, so you’re not caught off guard.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

recipients will appreciate something practical. Gift cards to restaurants, department stores, sporting good outlets, and specialty shops, or for a massage, pedicure, or round of golf make great gifts. Don’t overdo the baking. Your guests will likely have had their fill of holiday treats long before your gathering arrives. As for the warm gesture of taking a plate of baked goodies to friends or neighbors, instead, show they’re in your thoughts by visiting or calling them to wish them a happy holiday season. Money saver — Does your gift list grow each year? Decide with whom it’s essential or important to exchange gifts. Then talk to extended family, friends, coworkers, and others about forgoing gift exchanges, putting a cap on the price, or doing a drawing instead. You’ll likely learn many feel the same as you do. Care for yourself — Enjoy holiday treats in moderation. High fat and sugary foods and the lack of healthy meals can lead to tiredness and stress. Keep goodies stored in the freezer where they’ll be less of a temptation. Have plenty of convenient, healthy snacks such as raw vegetables and nuts on hand. Prepare low-fat meals that won’t bog you down. Pace yourself, and don’t try to do everything in one day. Finally, give yourself a break. Get plenty of exercise such as a brisk walk in the fresh air, and set aside time for relaxation, like a long bubble bath. Things to do for next year — Start your shopping early. Create a new tradition with a friend or family member and set a monthly shopping date for the upcoming year. By making a scheduled commitment, you’ll be more likely to follow through. Keep the early holiday shopping fun and choose a different town or shopping center for each trip, focusing on unique malls or trendy towns. Also, get a label printing software program or app early in the year and enter all of the addresses on your holiday card list. When the holidays roll around, you can print the labels and eliminate the most time-consuming aspect of sending out holiday greetings. Finally, remember the holiday season should be a joyful time for everyone, including yourself, to join in the good cheer with family and friends. Maximize ways to ease your stress to keep the ‘happy’ in your holidays!

Things You Need to Know About Vaping

By Ernst Lamothe Jr.

aping has been an issue that continues to concern medical professionals, especially after several states reported unexplained teenage hospitalization, lung injuries and deaths. This year, more than 1,500 lung injury cases associated with the use of vaping products have been reported to the Centers for Disease Control and Prevention nationwide. Thirty-three deaths have been confirmed in 24 states. All patients have reported a history of using e-cigarette or vaping, products. Vaping works by heating a liquid to produce an aerosol that users inhale into their lungs. The liquid can contain nicotine, tetrahydrocannabinol (THC) and cannabinoid (CBD) oils, and other substances and additives. THC is the psychoactive mind-altering compound of marijuana that produces the “high.” “Vaping has become something that is socially accessible and socially acceptable,” said Dr. Zafer Soultan, associate professor of pediatrics and chief pediatric pulmonary and sleep medicine at Golisano Children’s Hospital at Upstate Medical University in Syracuse. “It is cheaper than cigarettes and people think there is no big deal about vaping and that is an extremely dangerous thought for the medical community.” Soultan has five thoughts that he believes people should know about vaping.

It is not safe

There are some who say vaping is a safer version than smoking because it may produce fewer toxins and chemical compared to a traditional cigarette. But with the sudden rash of reported deaths, there has been a hyper focus on investigating

these cases. Since the specific cause or causes of lung injury are not yet known, the only way to assure that you are not at risk while the investigation continues is to refrain from the use of all e-cigarette, or vaping, products. “Vaping is not as safe as some people perceive,” said Soultan. “Anything with nicotine can lead to high blood pressure and bad health outcomes.” The Centers for Disease Control and Prevention and the Federal Drug Administration have not identified the cause or causes of the lung injuries in these cases, and the only commonality among all cases is that patients report the use of e-cigarette or vaping, products.

Vaping turns something healthy into something dangerous.

There have been some traces of vitamins and supplements that e-cigarette companies have put into its vaping components. One of them is vitamin E, which is a vitamin that dissolves in fat. It is found in many foods, including vegetable oils, cereals, meat, poultry, eggs, fruits, vegetables and wheat germ oil. It is also available as a supplement. However, vaping turns a healthy supplement into something dangerous. “Vitamin E is meant to be taken by mouth and it has oils that can be very beneficial for the body, for the eyes and skin. But it is not meant to be ingested through the lungs, which is causing severe health problems and can be toxic. It should not be inhaled.”

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People who vape are developing symptoms and findings consistent with a toxic inhalation syndrome, which includes coughing and shortness of breath. Inhaled substances may cause injury in pulmonary epithelium at various levels of the respiratory tract, leading from simple symptoms to severe disease. “People are dying from this. That is simply a fact,” said Soultan. “Plus nicotine is by nature addictive. This is a serious topic that can’t be ignored. These deaths and young people getting severe lung diseases should open our eyes the same way it did when we started nationwide campaigns against smoking.”

Physician Zafer Soultan is tchief ofpediatric pulmonary and sleep medicine at Golisano Children’s Hospital at Upstate Medical University in Syracuse: “Vaping is not as safe as some people perceive.”

It could be a gateway

Medical experts are worried that the opposite effect of vaping will occur. Once touted as smoking cessation option, it may open the door to people smoking more. “There is a perception that people can use vaping as a way to stop smoking,” said Soultan. “But they may not be able to stop if they abuse it too much because companies will start putting more nicotine in it to keep their customers wanting more. They may be looking for more of the same in other drugs too because vaping has THC.”

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ACR Health: Turning the Tide Against HIV/AIDS in CNY By Deborah Jeanne Sergeant

ince the early days of the AIDS epidemic in 1983, ACR Health has been part of the fight against the infection’s spread. Based in Syracuse with locations in Watertown, Utica, Oswego and Canton, ACR represents the largest HIV/AIDS program in Central New York. The organization serves the counties of Cayuga, Herkimer, Jefferson, Lewis, Madison, Oneida, Onondaga, Oswego and St. Lawrence. Wil Murtaugh, executive director, said that ACR has made great headway in recent years. “We’ve come so far with HIV/ AIDS in this area and this state,” Murtaugh said. “The state was the center of the epidemic at the start of this.” He calls the “three pillars” in fighting HIV/AIDS: more testing, ongoing use of medication to those who are positive, and increased use of preventive medicine for at-risk populations who are still HIV negative. Since 2014, New York state has promoted End the HIV Epidemic by 2020 (EtE2020). Though there are a number of other similar initiatives in the U.S., New York state’s was the first EtE2020 initiative. Its goal is to reduce the number of new HIV infections to 750 annually. “That is a controllable infectious disease, like tuberculosis,” Murtaugh said. “That was Murtaugh the No. 1 killer in 1900.” He said that statewide, the number of new HIV infections was 2,481, compared with close to 15,000 in 1993. In 2018, the number of new HIV cases dropped by 11% from 2017. The U.S. and the World Health organizations’ initiatives are very similar to New York’s program, except for a target year to achieve their goals: 2030 instead of 2020. ACR offers HIV positive patients

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a test that can measure the level of viral load within the blood. If it’s below a certain level — thanks to medication suppressing the virus — the patient cannot sexually transmit the virus to anyone else. Among Central New York HIV positive patients, 71% have undetectable viral load, which means they cannot transmit HIV. Statewide, it’s 67%. ACR’s other emphasis is preventive medicine, pre-exposure HIV prophylaxis (PrEP). Taken daily, pill can prevent infection among HIV negative people who may be at risk for HIV. “It’s been a turning point,” Murtaugh said of PrEP. “In populations like sex workers, men who have sex with men, intravenous drug users, people of color and people who aren’t settled in their life and have multiple sex partners, we recommend people go on it. If they’re risky in their behavior, PrEP can help them be safe.” The success of patient compliance with taking PrEP is especially notable since many in the population taking it have one or more risk factors, yet they consistently remember to take a pill every day to make PrEP effective. “It’s a choice people can make that takes away some of the stigma of HIV that people have,” Murtaugh

said. “Condoms are always recommended and can be used while taking PrEP.” Patients receiving medication to suppress their viral load are encouraged to visit the office every three months to discuss how they’re doing and to receive further information about their health. The office staff also helps patients overcome any obstacles to taking their prescriptions. ACR has a team of prevention navigators who work with patients to take down their sexual histories, talk about education, and give them information. “We have a lot of wrap-around services for HIV/AIDS,” Murtaugh said. These include housing programs, transportation to get to medical appointments, care management, a nutrition program to teach clients how to maintain their health and nutrition better and an outreach that tries to locate people that are HIV positive who are not in care. “We hook them up with insurance,” Murtaugh said. “In New York, if you’re HIV positive, you’re pretty much all covered.” Many clients who are HIV positive get on viral suppressing medication the same day so that they’re less likely to spread the infection. ACR operates HIV/AIDS mobile units in multiple cities that go into

the community where people can be tested an get connected to care. The organization also houses more than 100 people per month by paying 65% to 75% of their rent. “Housing is healthcare,” Murtaugh said. “If someone is stable in their housing, they’re more apt to care for their health.” ACR also operates eight Q Centers, which help LBGQT people obtain safe housing and get off the streets. Murtaugh said that a syringe exchange program to help stop HIV is also in place. “We’re trying to get more exchange sites for those who are using,” Murtaugh said. “We definitely want to create a relationship so when they’re ready to get off drugs, we can take them into care.” ACR’s operating budget of more than $10 million comes from grants and patient billing. The organization works to get all its patients on health insurance so ACR can bill for services as needed or allowed. “Keep testing,” Murtaugh said. “We don’t deny anyone to be tested. Know your status. If you’re positive, we’ll link you with care. They really need to get into care immediately. At least there’s medicine that can prolong your life if you take it correctly.”

ACR Health: HIV/AIDS at a Glance n In ACR Health’s ninecounty service area, 2,346 people are living with HIV/ AIDS. n ACR Health has greatly expanded HIV testing, a priority for ending the AIDS Epidemic, up 410% in 2018 compared to 2012. n Since 2012, new HIV infections in Onondaga County have dropped from 10.3 per 100,000 people to 8.3 per 100,000. n The Central New York Regional rate of 5.2 cases/100,000 population is well below the New York state target of less than 16 cases/100,000 population. Source: ACR Health

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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. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Deborah Sergeant, Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Anne Palumbo, Melissa Stefanec, Chris Motola, Eva Briggs (MD), Payne Horning, Ernst Lamothe Jr., Mary Beth Roach, Kimberly Blaker • Advertising: Amy Gagliano, Cassandra Lawson Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Nitz 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.

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Dear Savvy Senior, Can you write a column on ethical wills and how to make one? The attorney that made up my will recently suggested I write one as a tool to explain the intentions of my will, as well as express my thoughts and feelings, but I don’t know where to start.

Interested Senior

Dear Interested, An ethical will — also referred to as a legacy letter — can be a valuable complement to your legal will, as well as a wonderful gift to your family or other loved ones. Here’s what you should know along with some tips to help you make one.

Ethical Wills Unlike a last will and testament, which tells your loved ones (and the legal world) what you want them to have, an ethical will (which is not a legal document) tells them what you want them to know. With an ethical will, you can share with your loved ones your feelings, wishes, regrets, gratitude and advice, as well as explain the elements in your legal will, give information about the money and possessions you’re passing on, and anything else you want to communicate. Usually no more than a few pages, the process of writing an ethical will can actually be quite satisfying. But be careful that you don’t contradict any aspects of your legal will or estate plan. And, if you’re having trouble with the writing, there are resources available to help you, or you can express yourself through an audio or video recording.

Where to Start To craft an ethical will, start by jotting down some notes about

what’s really important to you and what you want your loved ones to know. Take your time and remember that you’re not trying to write for the Pulitzer Prize. This letter is a gift of yourself written for those you love. After you’ve gathered your thoughts you can start drafting your letter. You can also revise or rewrite it anytime you want. And for safekeeping, keep your ethical will with your other legal documents in a secure location but be sure your executor has access to it. A safe-deposit box or fireproof filing cabinet or safe in your home is a good choice.

Get Help If you need some help, there are numerous resources available like Celebrations of Life (CelebrationsofLife.net), which offers how-to information and examples of ethical wills, along with a “Ethical Wills: Putting Your Values on Paper” book, and the Ethical Wills/Legacy Letters workbook that you can purchase for $16 and $10 respectively. Another good resource is Personal Legacy Advisors (PersonalLegacyAdvisors.com), a company that offers ethical will writing classes and workshops, along with personalized services like coaching, editing, writing and/or audio or video recording your ethical will. Prices will vary depending on the services you choose. They also sell a do-it-yourself guidebook “The Wealth of Your Life: A Step-by-Step Guide for Creating Your Ethical Will,” by Susan Turnbull for $24. You also need to know that many people choose to share their ethical will with their family and friends while they’re still living so they can enjoy their reactions, while others think it should be read after their death. It’s up to you. 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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Q&A

Q: I plan to retire in spring. How soon can I file for my Social Security benefits? A: You can file four months before you plan to receive benefits. Go ahead and apply now if you plan to retire when winterâ&#x20AC;&#x2122;s frost finally lets up. To apply, go to www.socialsecurity.gov/applytoretire. Applying online has never been easier â&#x20AC;&#x201D; you can do it from the comfort of your home. All you need is 15 minutes and internet access. Q: Iâ&#x20AC;&#x2122;m retiring early, at age 62, and I receive investment income from a rental property I own. Does investment income count as earnings? A: No. We count only the wages you earn from a job or your net profit if youâ&#x20AC;&#x2122;re self-employed. Non-work income such as annuities, investment income, interest, capital gains and other government benefits are not counted and will not affect your Social Security benefits. Most pensions will not affect your benefits. However, your benefit may be affected by government pensions earned through work on which you did not pay Social Security tax. You can retire online at www.socialsecurity.gov. For more information, call us toll-free at 1-800-772-1213 (TTY 1-800-325-0778). Q: I was wounded while on military service overseas. What are the benefits for wounded warriors, and how can I apply? A: Through the Wounded Warrior program, Social Security expedites processing of disability

IN GOOD HEALTH â&#x20AC;&#x201C; CNYâ&#x20AC;&#x2122;s Healthcare Newspaper â&#x20AC;˘ December 2019

vide the necessities of life for family members and help make it possible for those children to complete high school. When a working parent becomes disabled or dies, Social Security benefits help stabilize the familyâ&#x20AC;&#x2122;s financial future. Children with disabilities are among our most vulnerable citizens. The Social Security Administration is dedicated to helping those with qualifying disabilities and their families through the Supplemental Security Income (SSI) program, which is separate from the Social Security program. To qualify for SSI: â&#x20AC;˘ The child must have a physical or mental condition, or a combination of conditions, resulting in â&#x20AC;&#x153;marked and severe functional limitations.â&#x20AC;? This means that the claims of current military service members or veterans disabled while on active duty on or after October 1, 2001. Service members and veterans who have a Veterans Administration compensation rating of 100 % permanent and total (P&T) may also receive expedited processing of applications for Social Security disability benefits. Keep in mind, this expedited process applies to only the application for benefits. To be eligible for benefits, you must meet Social Securityâ&#x20AC;&#x2122;s strict definition of â&#x20AC;&#x153;disability,â&#x20AC;? which means: â&#x20AC;˘ You must be unable to do substantial work because of your medical condition(s); and â&#x20AC;˘ Your medical condition(s) must have lasted, or be expected to last, at least one year or to result in death. You can apply online at www.socialsecurity.gov/applyfordisability or call us at 1-800-772-1213 (TTY 1-800325-0778). Find more information for veterans at www.socialsecurity.gov/ people/veterans. Q: My brother had an accident at work last year and is now receiving Social Security disability benefits. His wife and son also receive benefits. Before his accident, he helped support another daughter by a woman he never married. Is the second child entitled to benefits? A: The child may qualify for Social Security benefits even though your brother wasnâ&#x20AC;&#x2122;t married to the second childâ&#x20AC;&#x2122;s mother. The childâ&#x20AC;&#x2122;s caretaker should file an application on her behalf. For more information, visit www.socialsecurity.gov. Q: What do I need to report to Social

condition(s) must severely limit your childâ&#x20AC;&#x2122;s activities; and â&#x20AC;˘ The childâ&#x20AC;&#x2122;s condition(s) must be severe, last for at least 12 months, or be expected to result in death. If the parents of the child or children have more income or resources than are allowed, then the child or children will not qualify for SSI. You can read more about childrenâ&#x20AC;&#x2122;s benefits at www.socialsecurity.gov/pubs/ EN-05-10026.pdf. Social Security and SSI also covers many chronic illnesses and conditions. The Compassionate Allowances program is a way to quickly identify people with diseases and other medical conditions that, by definition, meet the standards for disability benefits under the Social Security and SSI programs. Thousands of children receive SSI benefits because they have one of the conditions on the Compassionate Allowances list at www.socialsecurity.gov/compassionateallowances/conditions.htm. Keep in mind, Social Security and SSI are two very distinct and separate programs, and eligibility for each is different. Visit www.socialsecurity.gov/ people/kids to learn more about all we do to care for children. Social Security is with you and your children throughout your lifeâ&#x20AC;&#x2122;s journey, securing today and tomorrow. If you know a family who needs our help, please share these resources with them.

Security if I get Supplemental Security Income (SSI) payments? A: You need to report any changes that may affect your payment amount. This includes changes in your income or resources. You must report changes of address, changes in your living arrangements, and changes in your earned and unearned income. To learn more about SSI, visit www.socialsecurity.gov/ssi. Q: I was incarcerated for two years. Before I was imprisoned, I received SSI benefits. Will my SSI payments start automatically when I am released? A: No. You must contact your local Social Security office and provide them with information regarding your release dates. In some cases, it may be necessary to reapply for SSI benefits. For more information, visit www.socialsecurity.gov/reentry or contact your local Social Security office. Q: I am applying for Extra Help with Medicare prescription drug costs. Can state agencies help with my Medicare costs? A: When you file your application for Extra Help with Medicare prescription drug costs, you can start your application process for the Medicare Savings Programsâ&#x20AC;&#x201D;state programs that provide help with other Medicare costs. When you apply for Extra Help, Social Security will send information to your state unless you tell us not to on the application. Your state will contact you to help you apply for a Medicare Savings Program. Learn more by visiting www.socialsecurity.gov/prescriptionhelp.

H ealth News Janet Ready named new COO at St. Joe’s Janet L. Ready has been named the new chief operating officer at St. Joseph’s Health. In this role, she will oversee the daily operations at the organization and serve as an integral member of the administrative leadership team. “With over a decade Ready of health care leadership experience, Janet’s solid industry expertise and acumen will help us continue to uphold and advance operational excellence across our network,” said St. Joseph’s Health President and CEO Leslie Paul Luke. “Janet will be a valuable member of the St. Joseph’s Health team as we continue to provide the highest quality care to our patients.” Ready served as president of Penn Health Princeton Medical Center in Plainsboro, New Jersey, and as senior vice president at Penn Health since 2014. As president of Princeton Medical Center, Ready oversaw several expansions and initiatives, including the hospital’s magnet nursing recertification process. In her role as senior vice president at Penn Health, Ready focused on the organization’s quality and safety control and strategic growth. Prior to Penn Health, Ready spent nearly 10 years in hospital leadership roles at Healthquest in LaGrange, New York, and at Vassar Brothers Medical Center in Poughkeepsie, where she improved the organization’s financial performance and significantly raised the medical center’s patient experience. Ready holds a Bachelor of Science in nursing, a Master of Science in public health and a Master of Business Administration from Columbia University. She is a fellow of the American College of Healthcare Executives.

Arc Oswego County’s Heather Wilsey gets award Heather Wilsey, behavior support coordinator at Arc of Oswego County, a Fulton-based nonprofit agency that supports adults, children and families with developmental disabilities, has recently received the New York State Association of Day Service Providers (NYSADSP) Wilsey Leadership Award. The award is a significant honor given to someone who provides strong, consistent leadership for direct support professionals.

Wilsey received the award based on her work with the agency’s community habilitation program, a person-centered service that helps people with disabilities become more active in their local community by fostering inclusion and integration. “It’s all about improving the lives of the people we support and advocating for them in every way we can,” said Wilsey. “I’m truly honored to be recognized for that, but it’s secondary to my goal of bringing joy to their lives.” When Wilsey started at the agency three years ago, the community habilitation program included four professionals providing services to four people with disabilities. At present, that number has grown to more than 40 enrolled individuals, ranging in age from 6 years old to senior citizens, supported by 18 professionals. According to a news release, “Wilsey’s creative and flexible leadership style has been instrumental in ensuring success far beyond enrollment numbers. Under her guidance, staff members have embraced their supportive roles while simultaneously promoting individualized goals related to independence and community integration. In turn, this approach assists people with disabilities in developing social skills and realizing their full potential.”

Two primary care physicians join Oswego Oswego Health welcomes primary care physician Meaghan Primm and Andrew Rogall to its Fulton PrimeCare office, located at the Fulton Medical Office Building in Fulton, where both will deliver care to those of all ages. Both physicians recently completed their Primm family medicine residency at Louisiana State University (LSU) in addition to receiving their medical degrees from Saba University, School of Medicine, in the Caribbean Netherlands. Rogall was chief resident for two years while at LSU. “During my family medicine residency, I found I liked everything involved in the specialty, from providing women’s health and prenatal care to ensuring older patients received the care they need,” Primm said. “The specialty also offers the opportunity for Rogall me to get to know my patients as I provide care to them.” “I’m thrilled to be a part of Oswego Health and providing care for the whole family,” stated Dr. Rogall.

Paul Johnson, Ph.D. Behind him is the cover story of the December 2018 issue of Clinical Chemistry that featured his work on the development of an online training model for clinical biochemists.

Upstate Professor Named an Academy Fellow of the American Association for Clinical Chemistry

aul Johnson, Ph.D., associate professor in the department of clinical laboratory sciences in the College of Health Professions at Upstate Medical University, has been named an Academy Fellow of the American Association for Clinical Chemistry (AACC). It is the academy’s highest honor. Johnson is a resident of Fayetteville. The AACC is an international scientific and medical professional organization dedicated to clinical laboratory science and its application to healthcare. Individuals selected as fellows must be doctoral-level clinical scientists, show consistent publication of their work in peer-reviewed journals, presentations at clinical laboratory science meetings and development of curricula for clinical science-related disciplines. Johnson joined the Upstate faculty in 2012, where his primary research focus has been on diagnostic utility of concussion injury biomarkers in human subjects with a goal of improving early diagnosis. Other primary research

“I enjoy being a part of the shared decision making when it comes to family medicine and Oswego County seems like the perfect fit.”

Doctor joins St. Joe’s Cardiovascular Institute Cardiothoracic surgeon Anton L. Cherney recently joined St. Joseph’s Health Cardiovascular Institute. Cherney is an expert in minimally invasive procedures, including transcatheter aortic valve replacement (TAVR). His interests include surgery for coronary heart disease, heart valve and aortic surgery, vascular surgery and surgery for lung cancer. Prior to joining St. Joseph’s December 2019 •

interest includes applied statistics in laboratory medicine with focus on human biological variation of clinical test results. He has presented his findings at numerous clinical science conferences and his work has been published in peer-reviewed journals, including Clinical Chemistry and PLoS One. Johnson developed an online training module for clinical biochemists for which he was honored with co-authors on a featured cover story in the December 2018 issue of Clinical Chemistry journal. He has served as peer-reviewer for several leading journals in laboratory medicine, including Clinical Chemistry, ASCP Lab Medicine, and Clinica Chimica Acta. Johnson is board-certified as a medical laboratory director by the American Board of Clinical Chemistry (ABCC). He earned his doctorate in biochemistry and molecular biology from the School of Medicine at the University of Louisville and an MBA from the University of Illinois.

Health, Cherney was a cardiothoracic and vascular surgeon for Mercy Hospital Northwest Arkansas located in Rogers, Arkansas. He earned his Doctor of Medicine from Cherney Schulich School of Medicine and Dentistry at the University of Western Ontario in London, Ontario, Canada, and completed his residency in general surgery through Queens University in Kingston, Ontario, Canada. Cherney completed post-gradu-

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H ealth News ate fellowships in cardiothoracic surgery at Beth Israel Deaconess Medical Center in Boston, and advanced cardiac surgery at Brigham and Women’s Hospital, also in Boston. “Dr. Cherney brings a wealth of experience in cardiothoracic surgery,” said St. Joseph’s Chief Medical Officer Joe Spinale. “His background and interest in the advancement of the field through use of cutting-edge surgical procedures is an excellent fit for St. Joseph’s Cardiovascular Institute.” Cherney is certified by the American Board of Thoracic Surgery and the American Board of Surgery. He is licensed to practice medicine in New York, Arkansas and Massachusetts. He is a fellow of the American College of Surgeons (FACS) and the Royal College of Physicians and Surgeons of Canada (FRCSC) and is a member of the Society of Thoracic Surgeons. St. Joseph’s Health Cardiovascular Institute is nationally recognized for its multi-specialty teams providing the widest and most-advanced range of diagnostic and treatment options in Central New York.

St. Joe’s gets ‘A’ in Leapfrog hospital safety rating St. Joseph’s Health Hospital was the only hospital in Central New York (within 100 miles) to be awarded an ‘A’ in the fall 2019 Leapfrog Hospital Safety Grade, a national distinction recognizing St. Joseph’s Health Hospital’s achievements protecting patients from harm and providing safer health care. The grades were released in early November. This is the second consecutive ‘A’ rating St. Joseph’s has received. The Leapfrog Group is an independent national watchdog organization driven by employers and other purchasers of health care committed to improving health care quality and safety for consumers and purchasers. The safety grade assigns an ‘A’, ‘B’, ‘C’, ‘D’ or ‘F’ grade to all general hospitals across the country based on their performance in preventing medical errors, injuries, accidents, infections and other harms to patients in their care.

“Transparent third-party expert ratings like these reflect our commitment to keeping patients safe from preventable harm and medical errors,” said Leslie Paul Luke, president and CEO at St. Joseph’s Health. “Leapfrog analyzes everything from our culture and our leadership, to our staff’s communication with each other and with patients, to patient recovery, infection rates, and even hand hygiene. This rating further demonstrates the success of our efforts to continuously improve quality, safety and efficacy of care across our continuum.” “‘A’ hospitals show us their leadership is protecting patients from preventable medical harm and error,” said Leah Binder, president and CEO of The Leapfrog Group. “It takes genuine commitment at every level — from clinicians to administrators to the board of directors – and we congratulate the teams who have worked so hard to earn this A.” Developed under the guidance of a national expert panel, the Leapfrog Hospital Safety Grade uses 28 measures of publicly available hospital safety data to assign grades to more than 2,600 U.S. acute-care hospitals

Health professionals at Crouse Hospital recently graduated from the hospital’s Future Leaders program, now in its second year. The program helps prepare professionals to take leadership roles within the organization.

Crouse Health Future Leaders Program Graduates 19

rouse Health recently announced that 19 health professionals have graduated from the Crouse’s Future Leaders program, now in its second year. The program provides a pathway for leadership to those in the organization who aspire to enter supervisory or management roles. Those who apply and are accepted into the program attend monthly classes, led by members of the Crouse management team, in areas ranging from finance to emotional intelligence. “Our goal is to provide as

much support and opportunities to our employees as possible,” said CEO Kimberly Boynton. “The Future Leaders program helps prepare interested individuals for the responsibilities that come with leading an organization,” she said, noting her own movement from an entry level position in finance to her current position as chief executive officer. Graduating from the program are Doreen Boateng-Kennedy, Pomeroy College of Nursing; Nancy Counterman, patient access; Vickie Dimaggio, PACU; Aris Dysert, chemical dependency; Brenda Harrington, NICU;

Lauren Hartung, corporate compliance; Charles Klinger, chemical dependency treatment services; Matthew Madonia, CT scan; Susan Mccaffrey, physician assistants; Kristin Merritt, care coordination; Taylor Mizro, respiratory therapy; Rebecca Morgan, purchasing; Jennifer Obremski, patient access; Jessica Parry, physical therapy; Jeannette Rainbow-Galvin, HIM; Jessica Redmond, CMP; Emily Tedesco, radiology; Patricia Sorbello, ICU; and Daniel Vona, Finance.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • December 2019

twice per year. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public.

Upstate professor wins $300,000 research grant Samuel A. Herberg, PhD, assistant professor of ophthalmology, cell and developmental biology, and biochemistry and molecular biology, has been awarded a $300,000 Research to Prevent Blindness (RPB) Career Development Award. The grant will support Herberg’s glaucoma research that focuses on the trabecular meshwork, an important tissue located in the anterior chamber angle of the eye between the cornea and the iris. The trabecular meshwork Herberg regulates the outflow facility of the aqueous humor and thus controls intraocular pressure. Dysfunction of the trabecular meshwork is the principal cause of elevated intraocular pressure that is associated with irreversible vision loss in primary open-angle glaucoma. The grant comes during a year in which two of Herberg’s papers from his Ruth L. Kirschstein National Research Service Award-supported postdoctoral work in bone tissue engineering at Case Western Reserve University from 2014-2017 were published in key scientific journals. The RPB grant is a big win for Herberg. The Career Development Award is designed to attract young basic scientists to eye research. Others at Upstate who have received the funding are among the top names in vision research internationally, including Eduardo Solessio, PhD; Michael E. Zuber, PhD; Andrea Viczian, PhD; Peter Calvert, PhD; Reyna I. Martinez-DeLuna, PhD. “I am very grateful to receive this grant and grateful for the support of the department,” said Herberg, who is eager to bring his expertise and research prowess to ocular disease. Herberg’s goal is to build a three-dimensional model of the trabecular meshwork in his lab that would simulate the composition and architecture of the native tissue, allowing him to investigate the cellular behavior and tissue remodeling behavior as well as to test the effect of pharmacological agents or cellular therapies to restore function of the meshwork. In these efforts, Herberg collaborates with researchers at Duke University, Syracuse University, SUNY Downstate Medical Center, and Wake Forest School of Medicine. Herberg was appointed to the Upstate faculty last August. In addition to his post at Case Western Reserve University, he also served as a senior research fellow at Wake Forest School of Medicine. He earned his doctorate from Augusta University (formerly Medical College of Georgia) and his undergraduate degree from the University of Applied Sciences, Darmstadt, Germany.

Does it Run in the Family? How to create a family health portrait By Jim Miller

he holidays are a perfect time to create a family history to help identify your own genetic vulnerabilities. An accurate family health history remains one of the most important tools in keeping yourself healthy as you age, and the holidays when family members come together is a great time to do it. Here’s what you should know, along with some tips and tools to help you create one.

Know Your Genes

Just as you can inherit your father’s height or your mother’s eye color, you can also inherit their genetic risk for diseases like cancer, diabetes, heart disease and more. If one generation of a family has high blood pressure, for example, it is not unusual for the next generation to have it too. Therefore, tracing the illnesses suffered by your relatives can help you and your doctor predict the disorders you may be at risk for, so you can take action to keep yourself healthy. To create a family health history, you’ll need to start by collecting some basic medical information on your first-degree relatives including your parents, siblings and children. Then move on to your grandparents, aunts, uncles and first cousins. You need to get the specific ages of when they developed health problems like heart disease, cancer, diabetes, arthritis, dementia, depression, etc. If family members are deceased, you need to know when and how they died. If possible, include lifestyle information as well, such as diet, exercise, smoking and alcohol use. Some relatives may not want to share their medical histories, or they may not know their family history, but whatever information you discover will be helpful. To get information on diseased relatives, get copies of their death certificates. This will list the cause of death and the age he or she died.

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To get a death certificate, contact the vital records office in the state where your relative died, or go to VitalChek.com. Or, if you were adopted, the National Foster Care & Adoption Directory Search (see ChildWelfare. gov/nfcad) may be able to help you locate your birth parents so you can get their medical history.

Helpful Tools

To get help putting together your family health history, the U.S. Surgeon General created a free webbased tool called “My Family Health Portrait” (see phgkb.cdc.gov/FHH/ html) that can help you collect, organize and understand your genetic risks and even share the information with your family members and doctors. Another good resource that provides similar assistance is the Genetic Alliance’s online tool called “Does It Run In the Family.” At FamilyHealthHistory.org you can create a customized guide on your family health history for free.

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