PRICELESS
Helping Set the Agenda SUNY Upstate orthopedic surgeon Stephen Albanese discusses his role as the new president of Pediatric Orthopedic Society of North America
Fair Food
CNYHEALTH.COM
AUGUST 2019 • ISSUE 236
GENERICS Recent news stories raise questions about effectiveness and safety of generic drugs sold in the U.S. One problem: Most of these drugs are manufactured in China and India, where oversight is not as stringent as in the U.S. or other countries. See story on page 16
Fried dough, funnel cakes, corn dogs, deep fried cookies — should you resist all these temptations? We’ve asked the experts about eating those delicious treats
Upstate Trauma Aging Eyes Center in the Middle of Peak Season Droopy eyelids, dry eyes, floaters, cataracts, ocular migraines are just some of the eye problems we may have to deal with as we age.
Find out the reasons for the spike. P. 11
Baby Red Potatoes What’s the go-to type of potato the author of column SmartBites reaches for? Yes, baby red potatoes. Find out why. Page 15
Matthew 25 Farm Volunteers at this Onondaga County farm do the planting and harvesting; then food is donated to food pantries, soup kitchens and families in need. Page 18
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
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FRIDAY AUGUST 16TH 9:30 A.M. – YOUTH & OPEN HOLSTEIN DAIRY SHOW, In the Seward Valley Farm Livestock Arena 11:00 A.M. – 2:00 P.M. – AGRICULTURE SCAVENGER HUNT, Sponsored by WHITE’S FARM SUPPLY 3:00 P.M. – PEDAL TRACTOR PULL In the M&T BANK Youth Arena Sponsored by M&T BANK 5:30 P.M. – CHILDREN’S PEDAL TRACTOR PULL In the M&T BANK Youth Arena Sponsored by LAWRENCE CONSTRUCTION 7:00 P.M. – DEMOLITION DERBY In the Show Ring, Sponsored by VINCE’S U-Pull-It 7:30 P.M. & 9:30 P.M. “CHRIS WOODWARD”, Country Rock In the AMERICAN HOMES Entertainment Pavilion
SATURDAY AUGUST 17TH 9:00 A.M. – YOUTH/OPEN HORSE SHOW In Horse Corral 10:00 A.M. – YOUTH & OPEN GOAT SHOW In the Seward Valley Farm Livestock Arena 11:00 A.M. – SOCCER KICK In the M&T BANK Youth Arena, Sponsored by STEWART’S SHOPS 1:00 P.M. – TALENT SHOW In the AMERICAN HOMES Entertainment Pavilion, Sponsored by ILION TRUE VALUE HARDWARE 4:00 P.M. – CHILDREN’S RODEO, In the M&T BANK Youth Arena, Sponsored by M&T BANK 6:00 P.M. – 4-WHEEL DRIVE TRUCK PULL In the Show Ring, Sponsored by LITTLE FALLS LUMBER & MID VALLEY AUTO 7:30 P.M. & 9:30 P.M. – “GRIT-N-WHISKEY”, Country Variety - In the AMERICAN HOMES Entertainment Pavilion
SUNDAY AUGUST 18TH 1:00 P.M. – 7:00 P.M. – *RIDE SPECIAL* 9:00 A.M. – OPEN & YOUTH GYMKHANA HORSE SHOW 11:00 A.M. – TRACTOR PULL In the Show Ring, Sponsored by CLINTON TRACTOR & BUELL FUELS 11:00 A.M. – HOOP SHOOT In the M&T BANK Youth Arena, Sponsored by STEWART’S SHOPS 1:00 P.M. – “BUG COUNTRY SHOWDOWN” In the AMERICAN HOMES Entertainment Pavilion 1:00 P.M. – MILKING CONTEST, In Milky Way’s Farm Adventure, Sponsored by WHITE’S FARM SUPPLY 3:00 P.M. – FARM YARD OLYMPICS In the Seward Valley Farm Livestock Arena 4:00 P.M. – CHILDREN’S RODEO, In the M&T Youth Arena, Sponsored by M&T BANK 6:00 P.M. – *CHILDREN’S POWER WHEEL DERBY* In the Show Ring, Sponsored by THE PETKOVSEK FAMILY Following Country Showdown – Times to be determined “JD & THE ROLLIN SOUTH BAND”, In the AMERICAN HOMES Entertainment Pavilion
August 2019 •
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8:30 P.M. – PRINCE, PRINCESS & QUEEN PAGEANTS, In the AMERICAN HOMES Entertainment Pavilion Sponsored by GILLETTE SHOWS
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TUESDAY AUGUST 13TH 3:00 P.M. – Opening Ceremonies – Memorial Park 4:00 P.M. – Gates Open 5:30 P.M. – SMALL ANIMAL JUDGING – Small Animal Bldg Sponsored by TRACTOR SUPPLY 6:30 P.M. – JR. MISS, LITTLE MISS, LITTLE MISTER PAGEANTS – In the AMERICAN HOMES Entertainment Pavilion Sponsored by GILLETTE SHOWS
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11th Annual Teal Ribbon Run
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Ovarian Cancer Awareness
In a U.S. First, Baby Is Delivered From Womb Transplanted From Deceased Donor
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octors at the Cleveland Clinic announced that they’ve achieved a first in North America: delivering a baby from a uterus that had been transplanted from a deceased donor. The healthy baby girl was delivered by C-section in June. This is only the second time such a delivery has happened worldwide, the first having occurred in Brazil in December. “We couldn’t have asked for a better outcome. Everything went wonderfully with the delivery, the mother and baby girl are doing great,” physician Uma Perni, a Cleveland Clinic maternal-fetal medicine specialist, said in a hospital news release. Perni stressed that “it’s important to remember this is still research. The field of uterus transplantation is rapidly evolving, and it’s exciting to see what the options may be for women in the future.” According to the Cleveland Clinic, the baby’s mother required a uterus transplant due to a condition called uterine factor infertility, which affects about one in every 500 women of childbearing age. The unnamed woman was in her mid-30s when she joined an ongoing clinical trial at Cleveland Clinic, exploring the possibility of uterus transplant to help her bear a child. In late 2017, the patient underwent transplant surgery and received a uterus from a deceased donor. In
late 2018, she conceived through in vitro fertilization, her medical team said. “It was amazing how perfectly normal this delivery was, considering how extraordinary the occasion,” said Cleveland Clinic transplant surgeon Andreas Tzakis. “Through this research, we aim to make these extraordinary events ordinary for the women who choose this option. We are grateful to the donor and her family,” Tzakis added. “Their generosity allowed our patient’s dream to come true and a new baby to be born.” Specialists from many departments collaborated on the effort: transplant surgery, obstetrics and gynecology, fertility, neonatology, bioethics, psychiatry, nursing, anesthesiology, infectious disease, interventional radiology, patient advocacy and social work. The baby’s delivery is expected to be just the first of many, the Cleveland Clinic team said. So far, five uterus transplants have already been completed. “Three transplants were successful and two resulted in hysterectomies,” the clinic said. “Currently, two women are awaiting embryo transfers, while several more candidates are listed for transplant.” The clinic said its program seeks to eliminate risks to living donors by only sourcing the transplanted uterus from a deceased donor.
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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, Eileen Jevis, J C Trussell (MD), Margaret McCormick, Brenda McCutcheon • 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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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
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Meet
Your Doctor
By Chris Motola
Stephen Albanese, M.D. SUNY Upstate orthopedic surgeon discusses his role as the new president of Pediatric Orthopedic Society of North America Q: You’ve been elected president of the Pediatric Orthopedic Society of North America (POSNA). A: Yes, it’s a one-year term. Q: What does POSNA do? A: Most full-time practicing pediatric orthopedists in the United States and Canada are members of POSNA. Our mission is to improve the care of children with musculoskeletal disorders through education, research, and advocacy. We support research grants. We provide educational services to our members. We run two major scientific meetings each year where a lot of original research is presenting and members can get hands-on experience. We have alliances with other pediatric orthopedic societies throughout the world. Q: I think people are generally aware that organizations like yours exist, but there’s not a great sense of, say, how they are organized or how often they meet. What kind of commitment are they for members? A: For a general member, they have the opportunity to attend our annual meeting and other major education programs. They also have the opportunity to participate in our online education. If you’re a member of the board of directors, you meet four times a year in person, plus some conference calls in addition to that.
Q: What kinds of educational programs do you offer and how do they work around physicians’ schedules? A: If you go to our website, there are a lot of educational offerings right on there. There’s a section for patients, with a description of common conditions written more in layperson terms. There are also resources for practicing physicians like online videos about surgical techniques. Curriculum for educating pediatric orthopedists. We also host webinars, which provide an opportunity for live interaction. There are tutorials where physicians can go to remote sites to get some hands-on experience as well. Q: When we’re talking about pediatric orthopedics, what kinds of conditions are we talking about? A: Pediatric orthopedics is unique. When you look at adult orthopedics, it’s usually broken down into very specific areas like spine, hands; pediatric orthopedics cover the whole range. Now it’s true you’re starting to see sub-specializations arise within pediatric orthopedics, but they’re less common. There are a lot of muscoskeletal systems that affect children starting with alignment issues, hip development issues, scoliosis. We do a lot of trauma management. The big difference compared to adult orthopedics is that you’re also dealing with developmental issues.
In the News Physician Stephen Albanese, professor and chairman of the department of orthopedic surgery at Upstate Medical University, has recently been elected president of the Pediatric Orthopaedic Society of North America. POSNA is a professional society of more than 1,400 surgeons, physicians and allied health professionals dedicated to improving the care of children with musculoskeletal disorders. Albanese has been a member at large on the on the American Academy Orthopaedic Surgeons (AAOS) board of directors (2002-2004). He served seven years (2005-2012) on the Accreditation Council for Graduate Medical Education (ACGME) Orthopaedic Surgery Residency Review Committee (RRC) and was chairman for the final three years. He served a six-year term (20122018) on the ACGME board of diQ: What are some examples? A: Children born with congenital disorders. Things like club feet. Hip dislocations. Leg length inequalities. Those are some basic types of things. Q: How does running the society change the way you approach your practice? A: Certainly it takes some time away from practice, but it’s a relatively short-term position. It helps advance the well-being of the profession, so I think it’s worth it to give back. I try to make adjustments to my practice so that it’s manageable. Q: What kind of impact do you feel like organizations like POSNA have on the industry? A: The greatest impact has to do with sharing information and advancing the science of the specialty, as well as teaching providers who may not have the resources that we have. Q: Since it’s a continental organization, how do you navigate the differences between systems? A: We don’t get as involved in
rectors and chaired the Program Requirements Committee (2016-2018). During his 10-year term (2007-2017) on the American Board of Orthopaedic Surgery board of directors, he chaired the Oral Examination Committee (2010-2012) and served as president (2013-2014). ABOS is the national certifying body for orthopedic surgeons. Albanese has been department chairman and residency program director at Upstate since 2000. He received his undergraduate degree in electrical engineering from Bucknell University and his medical degree from SUNY Buffalo College of Medicine. He completed an orthopedic surgery residency at SUNY Upstate Medical University and pediatric orthopedic surgery fellowship at the Hospital for Sick Children in Toronto, Ontario. the politics of medical care. We do have some role in advocacy on behalf of children in both the Canadian and United States systems. Q: Since your patients are children, does that make advocacy more difficult? A: I think it’s different and does require different approaches, no doubt about that. The impact of growth on the musculoskeletal system over time is something we have to take into consideration. Q: How do you reach out to younger orthopedic surgeons? A: After you finish medical school, you enter a five-year orthopedic surgery residency. Then most people then enter a one-year fellowship. Pediatric orthopedics is one of those subspecialty areas. Then, over the course of that fellowship, they usually become aware of our society and, in general, want to be part of it. Now, to be a member of our society, at least 75% of your practice needs to be dedicated to pediatric orthopedics. Q: Is membership pretty consistent year-to-year? A: Our society has been growing. We’ve seen kind of a steady growth. Some of our members are retired, and many of them are less involved, but a number remain involved with the educational aspect.
Lifelines Name: Stephen Albanese, M.D. Position: Chairman of the department
of orthopedic surgery at SUNY Upstate; president of the Pediatric Orthopedic Society of North America Hometown: Canastota Education: SUNY Buffalo Medical School; residency at SUNY Upstate; Fellowship at The Hospital for Sick Children, Toronto Canada Affiliations: SUNY Upstate University Hospital; Crouse Hospital Organizations: Pediatric Orthopedic Society of North America; American Academy of Orthopedic Surgeons; Scoliosis Research Society; American Orthopedic Association Family: Wife Eileen, and two sons, Matthew and Kevin Hobbies: Golf, skiing, cycling Page 6
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
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Coming to Hospital Near You: Artificial Intelligence in the OR
I
t’s coming to your local hospital sooner than you think. According to industry experts, up to 45% of operating rooms will have AI in just three years. Robotic assisted surgery devices (RASDs) are already used by surgeons to provide faster and more precise treatments which reduce recovery times and improve outcomes. Experts predict the RASDs market will increase to $7 billion by 2022. Currently, operating rooms account
Wearable devices
Wearable devices are a form of AI. According to several surveys, about two thirds of consumers responded they would be willing to use a wearable device, like an Apple Watch or a Fitbit, if it means fewer trips to their provider’s office. Fifty-five percent of respondents said they would wear a device at home if it meant their health could be monitored by someone remotely. Many insurers are offering discounts to members with wearable devices. According to a study by Evidation Health, diabetic and hypertensive patients with wearable devices are far more compliant with adhering to their meds. The biggest challenge is engaging patients to adopt and integrate virtual care into their daily lives. Despite all the advances in medicine, it still takes two to tangle. Poor patient compliance still frustrates physicians.
Retiree Concerns
Insurance companies fare better when claims decrease. No longer remaining passive, insurers are more actively involved with their members to improve their health (and of course lower claims). To learn Page 8
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for 60% of hospital revenues. By integrating with advanced home care devices, sophisticated urban hospitals can expand the range of their surgical expertise into rural areas. The goal of AI is to interpret, synchronize and coordinate date to achieve optimal OR results and patient outcomes. The proliferation of artificial intelligence in healthcare will help mitigate the projected shortage of physicians by increasing the efficiency. more about their membership and to develop strategies that help members stay healthy, insurance giant United Healthcare surveyed their Advantage members. Not surprisingly, 70% of respondents said health was their No. 1 concern. Eighty-six percent said they were worried about falling ill or becoming hospitalized in the near future. When asked what would you do to live healthier, 70% said they would start a new routine like a better diet, more exercise or volunteering. Forty percent of United’s Medicare Advantage members have multiple chronic conditions and 40% of their members live alone. 10 thousand people a day turn 65.
FDA Revolving Door
Dwight Eisenhower warned us against the “acquisition of unwarranted influence, whether sought or unsought, by the military-industrial complex.” Arms manufacturers were hiring retired generals to act as lobbyists to their former employer. Now the same can be said of the FDA-pharmaceutical complex. Former FDA commissioner Scott Gottleib resigned in early April “to spend more time with his family.” Less than three months later, he is work-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
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ing for drug giant Pfizer. This has become standard fare in Washington and is just another example of why President Trump wants to require or mandate a two-year waiting period between working in government and becoming a lobbyist for the very industry you were regulating. The US has the highest cost of healthcare per capita in the industrialized world and the pharmaceutical industry plays a huge part in our costs. Drugs invented, tested and manufactured in the US are sold abroad far cheaper. President Trump wants to establish what’s called a “favored nation” policy whereby the US takes advantage of the lowest world-wide price charged for a drug sold outside the US by a US manufacturer. So far, there has been a lot of talk but no action.
ED claims
It’s a tough place to work and it’s where the worst cases present themselves. Emergency departments are a classic metaphor for high reward coupled with high risk. Boston based Coverys, a professional liability insurance company, analyzed over 1,300 claims against EDs from 2014 thru 2018. Cardiac and cardiovascular conditions, (like heart attacks, aortic aneurisms and ruptures), triggered the most liability claims. More than half the cases filed against EDs were due to: the failure or delay to make a diagnosis; lack of an appropriate family history and physical; and inappropriate ordering of diagnostic tests. (Similarly, diagnostic errors are the leading cause for claims against primary care providers.) A boon to emergency departments is the increased availability of and access to crucial patient information via the electronic medical record, especially when the patient presents to the ED unconscious and/or alone.
Cost of Cancer
According to a study published in JAMA Oncology, in addition to the
cost of treatment, premature deaths caused by cancer account for over $94 billion in lost earnings annually. Lung cancer caused the most lost wages at $21 billion. It caused 23% of all premature cancer related deaths. Utah had the lowest amount of lost wages at approximately $20 million, while Kentucky had the most lost wages of any state at $35 million. Researchers suggest states use the data to guide future policy decisions that address risk factors like smoking, obesity and lack of exercise. For example, did states that adopted Medicaid expansion fare better than states that did not when it comes to cancer prevention and premature deaths?.
Climate change
More than 70 medical and public health organizations have deemed climate change to be one of the single greatest threats to our health and a medical emergency. Groups supporting the climate change call to action are: AMA; American Academy of Family Physicians; American Academy of Pediatricians; and American College of Physicians. The “Climate, Health and Equity Policy Action and Agenda” calls for solutions to be incorporated into all healthcare and public health policies. All 70 groups have denounced our withdrawal from the Paris Climate Agreement and favor a rapid transition from fossil-based fuels.
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.
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Create a team or join a team k: 11 a.m. http://web.alsa.org/syracuse
e a team or join a team SUPPORT LOCAL SERVICES /web.alsa.org/syracuse The ALS Association, Upstate New York Chapter Tel: 315.413.0121 • Email: info@alsaupstateny.org
SUPPORT LOCAL SERVICES The ALS Association, Upstate New York Chapter Tel: 315.413.0121 • Email: info@alsaupstateny.org
August 2019 •
5,600 people per year people are newly diagnosed As15many as 30,000 Americans with ALS each day—more than may currently be affected 5,600 people per year by ALS As many as 30,000 Americans 353 people living with were may currently beALS affected served through the Upstate New by ALS York Chapter in the past year 353 people living with ALS were $168,000 ALS assistance and servedinthrough the Upstate New caregiver respite was York Chapter in awarded the past year to patients and families in need in ALS assistance and 2018 in$168,000 caregiver respite was awarded to patients and families in need in 2018 IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 9
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Alone at Home: Spending Quality Time with Yourself
I
t’s a warm August Friday night, and the weekend is stretching out in front of you — a big, empty void to fill. But with what? You can feel your anxiety rising. You can feel yourself spiraling down, questioning the past. And that’s when you grab for the TV remote, a pint of Ben & Jerry’s, and head for the couch, or maybe, for bed. Sound familiar? It’s not uncommon for those who live alone to find time alone at home a real challenge. It’s especially true for those coming out of long marriages or relationships where familiar routines, chore schedules and social obligations filled evenings and weekends. I can remember many nights after my divorce, coming home after work to an empty house with hours on my hands and a hole in my heart. The prospect of a long, lonely evening ahead was almost unbearable. I was fine during the day, but when the sun started to set or the weekend rolled around, I would start to panic. After way too many bowls of ice cream and episodes of Dateline, I had finally had enough and started making better use of my “me time.”
I am now thoroughly comfortable spending time by myself and have come to enjoy my own company. In fact, it’s not unusual for me to pass on an invitation out, in favor of spending a nice quiet evening at home relaxing or fully engaged in something I love to do. If you are challenged by time alone, as I was, consider the suggestions below. You might even clip this column and put it on your fridge as a handy reminder. n Read. In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely evening. Don’t know where to start? Ask a friend for a suggestion or select a book from The New York Times’ best-seller list. Snuggle up in a comfy, well-lit place, and let a good book introduce you to new people, new places and new ideas. We are never alone when reading. n Write. Marcel Proust wrote, “We are healed of a suffering only by expressing it to the full.” Even if you never look back at what you write,
the act of committing your thoughts and feelings to paper can be therapeutic. Consider starting a journal if you haven’t already done so. A few minutes in the evening before bed can be a perfect time to capture what’s on your mind and in your heart. As you work through and write about some of the challenges you face living alone, you will find that reading and rereading your journal entries will be a great way to reflect on and track the progress you are making. n Clear Out the Clutter. I know this might sound mundane, but clearing out the clutter can be very satisfying and a great way to spend a few hours alone. I spent one recent Tuesday night sorting out my closet and filling two Hefty bags for Volunteers of America. It felt good. I not only lightened my load; I did something for a good cause. As a result, I felt part of something bigger than myself and less alone. n Pursue a passion. This can sound daunting, especially if you’ve yet to identify your passion, but hang in there. Many men and women in long-term relationships often sacrifice their own interests in favor of attending to the needs of others. The pursuit of what delights you can be lost in the process. Now’s a good time to rediscover your “loves” and to dedicate your time alone to these pursuits. Do some “internal” digging and identify the things you loved as a child or young adult and make a conscious decision to revisit them now. Evenings or weekends spent doing what you love can shift your perspective and change your world. Whether it’s cooking, exercising, gardening, writing, or practicing music,
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when you’re absorbed doing the things you love, loneliness dissipates and you feel alive. n Reach Out. With time on your hands, you are in a great position to reach out and make connections with others, especially with long, lost friends. This can be a very meaningful way to spend your time. Just yesterday, I received a hand-written note from a friend I hadn’t seen in a while. I was very touched and inspired to do likewise with my own old friends. Pick up the phone, send an email, or send a “snail mail” note to someone with whom you’ve lost touch. n “Veg out.” That’s right, “veg out.” Grab the TV remote, a pint of ice cream, and head for the couch — or better — for bed. But this time, do it without guilt; do it without beating yourself up. Everyone is entitled to an occasional night when they just hang out, do nothing and eat yummy comfort food. Indulge yourself and tell yourself you deserve it. Wake up the next morning — free of remorse — and ready to take on the day: alone at home and “at home” with yourself!
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, or visit www.aloneandcontent.com
Excellus Now Offers Medicaid Managed Care Products in Onondaga County Excellus BlueCross BlueShield recently announced that it has received approval from the New York State Department of Health to offer its HMOBlue Option and Blue Option Plus Medicaid managed care products to residents of Onondaga County. HMOBlue Option provides no-cost health coverage to eligible individuals who are younger than age 65 and meet certain income, resource, or disability requirements. Blue Option Plus includes the same benefits as HMOBlue Option but offers an additional set of benefits and care coordination for those who have qualifying mental health and substance use disorders. “We’re excited to offer our Medicaid managed care products to residents of Onondaga County,” said Aaron Bertram, vice president of safety net products, Excellus BlueCross BlueShield. “Our mission as a nonprofit health plan is to ensure that as many people as possible have access to high-quality health care that meets all of their needs.” Excellus BlueCross BlueShield is now accepting enrollment in HMOBlue Option and Blue Option Plus. For more information and to enroll, visit ChooseExcellus.com, or call us at 1-800-939-7700. You can also find us on nystateofhealth.ny.gov.
Upstate Trauma Center sees a spike in the number of people it treats this time of the year By Payne Horning
F
or most, summer is about vacations, recreation and leisure. But at Upstate University Hospital’s Level I Trauma Center, it’s the opposite. The summer season is its busiest time of the year. Three out of every 10 trauma admissions annually at the hospital occur during the months of June, July and August. Jolene Kittle, trauma coordinator, attributes the spike to the pleasant weather. “There’s a lot more people taking time off work, the kids are not in school, there’s a lot more people on the road in cars or motorcycles, they’re boating, climbing mountains and all sorts of different things — climbing up on the roofs,” Kittle said. “There are just a lot of people outside.” It’s not just the additional activity that’s to blame. It’s also how people are behaving. An increase in alcohol consumption over the summer is a huge factor for many of the injuries the trauma center team sees. Kittle says nationwide, alcohol is responsible for 50 percent of injuries and deaths related to trauma. “It’s not just about driving — you can fall off a roof or you know people go out and cut trees down under the influence of alcohol and end up with a tree falling on them,” Kittle said. Impaired driving accounts for part of the uptick in vehicle-related injuries over the summer months, but so too does the increase in traffic, people driving at faster speeds, and the addition of motorcycles on the road. And unfortunately, the situation is getting worse. Motor vehicle accidents are on the rise in the U.S. — a reversal from a long trend downward. Legislation requiring seatbelts and other protective measures and safer engineering had been reducing these rates. But that’s changed recently, Kittle says, which she accounts to distracted driving. The use of cellphones while driving and walking makes for the perfect storm in summer when more people are outside. Because of these many factors,
• Put your cellphone down when you’re driving or put it somewhere you can’t even access it • Do not drink and drive
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Impaired driving, distracted driving account for part of the uptick in vehicle-related injuries over the summer months.
We Recognize the Symptoms
We Recognize the Symptoms You Live With… You Live With…
the trauma center at Upstate treated an average of 223 patients during June, July, and August in 2018. The average monthly admission the rest of the year was 176. As of mid-June this year, there were 137 trauma admissions. Despite these additional challenges, Kittle says the amount of staff they have on duty does not change. Maintaining the requisite level of readiness all year round is part of the standard Upstate must meet as Central New York’s only Level I trauma center. And they are ready for anything, she says. The trauma center is operational every day of the year, with specialty trained trauma surgeons, an operating room, CT scans, MRI, X-ray scans and a specialty ICU available at all hours. Its staff treats the most severely injured patients in the region, most of whom need treatment within the first 15 minutes of arrival. It’s organized chaos, Kittle says, and those who work there thoroughly enjoy it. “We really love making that difference for people that other places just don’t have those resources to do,” Kittle said. “Coming together and working as a team to save someone’s life — as much as you can see tragedies, which is not the best thing — and working together as a team is what we all really wanted to do.” As much as the Upstate Trauma Center staff enjoys taking care of those who need their services, Kittle would prefer not to see them. Based on her experiences, here are Kittle’s recommendations for the very basic safety protocols people can follow to avoid the trauma center this summer.
How to Stay Out of the ER This Summer Here’s a list of things people should follow to avoid winding up on a hospital’s emergency room, according to Jolene Kittle, trauma coordinator at Upstate University Hospital.
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• Do not drink and boat • Drive at safe speeds • Avoid risky activities like climbing on the roof or handling dangerous machinery while drinking • Wear a helmet if you’re on driving ATV or jet ski • Wear a life jacket while boating
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Page 11
My Turn A Novel Approach to Treating Incurable Cancers By Eva Briggs
Used enough chemotherapy to shrink tumors by only 50%
I
mutation alters the genetics of a parrecently read an article describticular cell. I remember being taught ing a novel approach to treating that cancer cell mutations cause cells incurable cancers. It’s based on principles of evolution. Here’s a brief to grow unchecked. Eventually the rampant growth produces both localreview of how evolution works. ized tumors and metastatic spread. In any population of organisms, But that’s only partly true. The there is genetic variability and mutaenvironment also affects cancer cells. tions. So there are differences, often subtle, between individuals. Any par- They must outcompete healthy cells for available nutrients and oxygen in ticular variation or mutation is not order to run amok. That’s one reason inherently good or bad. It depends cancer is more common as people on the environment surrounding the grow older. Age-associated changes organism. The classic example is the finches reduce the normal cells’ ability to outcompete cancer cells. studied by Darwin. No single beak Even within a tumor, individual shape is necessarily superior to cells have genetic differences. When another beak shape. It depends on cancer is treated with chemotherapy, the seeds found on the island where resistant cells survive. Those survia finch lives. A bird whose beak vors grow, producing a tumor comshape is best for opening the availposed of mostly resistant cells. It’s able seeds will tend to produce more offspring. The baby birds’ beak shape similar to what happens with overuse of pesticides. Sensitive insects are will resemble the parents. Over time, killed. Resistant insects thrive and the finches with the beak shape best reproduce. Eventually the population adapted to that particular island’s of insects is resistant to the pesticide. food source will outcompete other Farmers have learned that pracindividuals. Gradually the species tices that alter the environment to evolves a particular beak shape best make the plants stronger enable them for that island. to better resist pests. Lower levels of The same concept works with 18.XXX_Urology_MeetTheTeam_Horiz.qxp_Layout 1 11/14/18 AM Page 1 pesticide are9:28 needed, preventing or cancer cells. Cancer arises when a
delaying the emergence of pesticide resistance. The goal becomes control and not eradication. Practices to promote a healthier environment to enable our cells to outcompete cancer include a healthy diet, exercise and not smoking. That’s not foolproof. Some scientists thinking about cancer treatment realized there’s a similarity between the evolution of organisms and the evolution of cancer cells treated with chemotherapy. The goal of cancer treatment is typically to eradicate every last cancer cell and eliminate the cancer. However, when this fails, and a patient’s cancer becomes incurable, a change in strategy might be needed. Once the cancer can’t be cured, such as prostate cancer that has metastasized to bone, high-dose chemotherapy not only has lots of side effects, but also can cause chemotherapy-resistant tumors. So they tried an alternative approach. The goal was not to kill every cancer cell, because the patients were known to have cancer not curable by current treatments. Instead, like the farmers using less pesticide, they (doctors) used only enough chemotherapy to shrink tumors by 50%. The new goal was to keep the cancer
in check, and delay spread or metastasis, while using the lowest amount of chemotherapy. The protocol was successful. In their study population, men with metastatic prostate cancer treated by conventional chemotherapy had an average survival time of 13 months. Men treated with the lower dose protocol had an average survival time of 34 months and fewer adverse effects. This approach is still experimental. Even though it appears to work in prostate cancer, it does not mean it will necessarily work in other types of cancer. And it might be difficult to convince patients, even those with incurable disease, that the best approach might be to kill as few cancer cells as necessary rather than as many as possible. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
5
Things You Need to Know About Vaccination
By Ernst Lamothe Jr
T
his was a banner year for measles and mumps. Not good news for health officials and various communities that were rocked by these two viruses. The number of patients diagnosed with measles in the United States grew substantially with more than 900 confirmed cases in 23 states. Measles is an infectious viral disease causing fever and a red rash on the skin, typically occurring in childhood. The United States is presently seeing the highest number of measles cases since the disease was considered eliminated in this country in the year 2000. Measles was reported in several states, including New York. In addition, during the first six months of this year, 44 states and the District of Columbia in the U.S. reported mumps infections in 1,471 people, according to the Centers for Disease Control and Prevention. “Obviously with the local outbreaks of measles and mumps this year, there has been an emphasis to make sure people are getting their shots up to date,” said physician Luis Castro, medical director of St. Joseph Primary Care Center West in Syracuse. “We have to make sure we are keeping our children vaccinated because there are many essential shots that are needed and cannot be ignored.” Castro talks about five vaccines that are important for infants, school-age kids and adults.
1.
DTaP
DTaP vaccine can help protect children from diphtheria, tetanus, and pertussis. Diphtheria can cause breathing problems, paralysis, and heart failure. Before vaccines, diphtheria killed tens of thousands of children every year in the United States. Tetanus causes painful tightening of the muscles. It can cause locking of the jaw so patients cannot open their mouth or swallow. About one person out of five who get tetanus dies, according to the CDC. Pertussis, also known as whooping cough, causes coughing spells so bad that it is hard for infants and children to eat, drink or breathe. It can cause pneumonia, seizures, brain damage or death. “Children receive several doses starting at 2 months and can receive up to five doses up to the age of 6 or 7,” said Castro.
2.
Meningitis
The CDC recommends vaccination with a meningococcal conjugate vaccine for all preteens and teens at 11 to 12 years old. A booster dose is recommended at age 16 years. Castro mentioned there are several groups that should focus on making sure they have the vaccination shot. “Meningitis is an illness that is very common in populations that are living together or in close environments like the military or college dorms,” said Castro. “It can spread very quickly and that is why vaccination is recommended.”
Legacy Nursing & Homecare, PLLC Physician Luis Castro is medical director of St. Joseph Primary Care Center West in Syracuse.
3.
Hepatitis B
Hepatitis B is a liver disease caused by a virus. People who have acute hepatitis B may not have symptoms, but those who do may have fevers, upset stomach, feeling tired, pain in the muscles or jaundice. Others who suffer from chronic hepatitis B may have cirrhosis, which is scarring of the liver, liver cancer or even liver failure. This disease can spread by sharing drug needles, sex with someone who has it already, sharing razors or tooth brushes, and touching open sores. Hepatitis B vaccine is made from parts of the hepatitis B virus. It cannot cause hepatitis B infection. The vaccine is usually given as two, three or four shots during one to six month increments. “This is a vaccine that we give in early stages of development for infants,” said Castro. “This is a common viral illness that can be transferred from mom to baby so we always want to make sure we are on the lookout for that.”
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4.
HPV
Human papillomavirus is a group of more than 150 viruses. Many people who get HPV have no symptoms. Some people who get HPV develop warts in their genital area. Some HPV infections do not go away and can cause cancer such as cervical cancer, cancer in or outside of the vagina, cancer of the penis, cancer of the anus or rectum and cancer of the throat. HPV spreads by intimate skin-to-skin contact. “What a lot of people don’t know is that this is the only vaccine that can prevent cervical cancer and it is given as early as 11 years old,” said Castro. “We try to get our pre-teens to be vaccinated so they only need two doses.”
5.
Shingles
Shingles is a viral infection that causes a painful rash. Although shingles can occur anywhere on the body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso. “We recommend getting one shot before the age of 65 and one after unless you have a chronic condition like asthma or COPD. Then you would get it every three years,” said Castro. August 2019 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 13
Navigating Fair and Festival Food
Fried dough, funnel cakes, corn dogs, deep fried cookies — we’ve asked the experts about eating those delicious treats By Deborah Jeanne Sergeant
F
rom sugary drinks to deep fried everything, fairs and festivals offer a bevy of nutritionally poor food choices. To stick with your healthful eating plan, try these tips from area health experts: • “Fair food is a summertime thing. If there is really something that it’s a one-time treat, you can make some room for it. Funnel cakes are something I cannot pass up. I’m not going to eat it by myself. Food should be something pleasurable. • “Look for kebabs, turkey legs or grilled options. Corn on the cob is usually offered. Ask if you can get them to not douse it in butter. Or salt potatoes with the skin on them if you don’t get it in doused in butter. • “Italian ices can be a nice sweet treat that won’t add up as fast as ice cream as far as calories. • “Go for popcorn you may see at these events. Maybe don’t add the extra butter.
• “Or get roasted nuts. • “Cotton candy, for what you get, with the air, you can eat a lot of it for minimal calories.” Evelyn Mariani, registered dietitian, William A. Graber, MD, PC Utica and Syracuse • “My favorite thing to get at the New York State Fair is the gyro with grilled chicken loaded with lettuce and tomato and cucumbers. It’s delicious and I’m also getting in my vegetables. • “I’m not saying I don’t get a fried dough as well as that’s one of my favorites. Sometimes if you’re at a festival or fair, it’s your time to enjoy that food. Enjoy being at that fair. There are lots of times we see foods we don’t get a lot. • “Watch what drinks you’re having. They can be loaded with sugar and calories. I’d rather get my calories from food. Maybe that day, bring a water bottle. It’s one way to
cut those calories a little bit. Bottled water usually isn’t as expensive as lemonades and other beverages. Many are unaware of the calories they’re getting from. Watch the slushies and drinks at the wine garden. A lot of calories come from those areas. It’s OK to indulge but be aware of what you’re ingesting. Look for the lemonade stand that uses Stevia so you don’t drink all that sugar. • “Try roasted corn on the cob. There are more healthier options than there ever has been. • “Portion size is a big factor. Share items, because some are huge. If you split them with someone, you get to taste these wacky, fun foods but not eating the whole thing. • “If you’re there for a long time, that’s when bringing healthful snacks is important. You can’t live on State Fair food for a week. I do encourage people who will be there multiple times or who are working there to bring healthier options, like a peanut
butter sandwich and carrot sticks. • “The nutrients in milk will satisfy you more, as you get all the nine essential amino acids. It’s a nutrition powerhouse versus a drink that’s pure sugar. You get protein, vitamin D, vitamin A and potassium. It’s a fun tradition. and it supports the local farmers.” Kelly Springer, registered dietitian and owner of Kelly’s Choice, LLC, Skaneateles • “You can bring some fruit and vegetables from home. • “Eating dried fruits in small amounts is healthful. • “More and more, as people get educated, more options will be available. • “You’ll be walking for the day-walking is the very best exercise--so that will help.” Physician Az Tahir, High Point Wellness, Syracuse
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SmartBites
The skinny on healthy eating
Compelling Reasons to Dig into Red Potatoes
B
aby red potatoes are my go-to variety of potato and here’s why: They offer a smidge more nutritional benefit than white; their nutritious skin is easily edible; they affect our blood sugar levels slightly less than white; and they hold their shape when roasted or boiled. First, let’s unearth a potato’s nutrition. From red to white to purple, this popular vegetable delivers the same nutritional goods across the board. All potatoes are an excellent source of vitamin C (nearly half of our daily needs in one serving) and a good source of potassium (more than a banana). Antioxidant-rich vitamin C is vital to our overall health, helping to repair tissues and boost immunity. Potassium, on the other hand, helps to maintain normal blood pressure and keeps the hardest working muscle in our body beating strong. Naturally low in fat, sodium and cholesterol, potatoes also serve up healthy amounts of disease-preventing fiber, mood-boosting vitamin B 6, and bone-strengthening manganese. Un-doctored and simply boiled or roasted, potatoes are not that calor-
By Anne Palumbo utation for causing weight gain and having a high glycemic index (GI), a measurement of how quickly a food raises blood sugar. But, according to experts at Tufts University, the type of potato, the preparation method, and the foods eaten in tandem can
Helpful tips:
Go easy on the add-ins and caloric toppings (one meager pat of butter adds 100 calories); avoid processed potatoes, like chips and fries. Select firm potatoes, minus sprouts and green coloration. Store potatoes in a cool, dark place — away from onions, as they cause potatoes to spoil faster ic: around 110 per average serving. Deep-fry them in oil or smother them with the works, however, and this healthy spud quickly becomes a nutritional dud. Red potatoes are moderately more nutritious than white because of their thin, rosy-hued skin, which comes packed with nutrients, fiber and health-promoting phytochemicals. Their red color also means they contain anthocyanins, a specific antioxidant that may fend off major health problems, including heart disease, cancer and obesity. Studies have found that red- and purple-skinned potatoes have nearly two to three times more antioxidant power than white. Potatoes have gotten a bad rep-
Cream Potato Salad with Lemon and Fresh Herbs Adapted from Bon Appetit; serves 8 3 pounds baby red potatoes, washed and dried 2 tablespoons olive oil, divided 1 teaspoon kosher salt ½ teaspoon coarse black pepper ¾ cup plain Greek yogurt 2 ½ tablespoons lemon juice 1 teaspoon grated lemon zest 1 garlic clove, minced ½ cup chopped fresh dill ½ cup chopped fresh basil 2 celery stalks, diced 3 green onions, thinly sliced salt and pepper to taste
lower the GI. Recent studies suggest the following to lower this tasty tuber’s GI: choose fingerling or red potatoes, elect to boil or roast, and pair potatoes with protein-rich foods to slow digestion and slow the release of glucose into the blood.
Preheat oven to 375 degrees F. Cut the potatoes in half (or quarters, if large) and place in a bowl with 1 tablespoon olive oil, salt and pepper; toss until the potatoes are well coated. Dump the potatoes on two baking sheets, spread out into 1 layer, and roast for 35-40 minutes, flipping once with a spatula during cooking to ensure even browning. While the potatoes are cooking, combine the yogurt, remaining olive oil, lemon juice, zest, and garlic in a large bowl. Add the herbs, celery and green onions on top (don’t stir yet). When the potatoes are cool, add them to the large bowl, stirring gently to combine (hands work great!). Taste and adjust seasonings.
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.
When you need labwork, Camillus is convenient
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Medical Center West 5700 West Genesee St., Suite 209 Hours and directions at laboratoryalliance.com First come, first served • No appointment needed Prompt and courteous
August 2019 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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GENERICS
Are they really safe and effective? Recent news stories raise questions about these drugs
By Deborah Jeanne Sergeant
A
re generic prescription medications as safe and effective as their name brand counter-
parts? News reports such as NBC’s “Tainted Drugs” story by Didi Martinez, Brenda Breslauer and Stephanie Gosk aired in May indicate that imported generics may be subpar compared with name brands. One example was a nationwide recall of generic drug valsartan, a popular blood pressure medication which was found to contain carcinogens. The NBC story stated that about 85% of facilities manufacturing the ingredients used in American drugs come from factories in countries like China and India, where cost is lower, but oversight is not as stringent as in the U.S. or other countries. Since summer 2018, manufacturers have sent out about 45 recalls of generic blood pressure drugs, including losartan and irbesartan. Their ingredients have been sourced from imported ingredients, according to the NBC story. In India and China, local laws make it more difficult to inspect. In some cases, manufacturers demand advanced warning before inspections, which in effect negates the point of “surprise” inspections. Area pharmacists want to
reassure patients on the safety and efficacy of their prescriptions. David Nebbin, pharmacist at Pine Hill Hometown Pharmacy in Cato, said that as a rule, generics are supposed to contain the same active ingredients as the name brand medication. “The majority of the drugs out there are safe and effective compared with brand name,” Nebbin said. “There’s guidelines they have to follow that they have to fall within a certain level range to be found effective. The brand names have their own issues.” Nebbin believes that the recent discoveries and recalls of medication indicate that the FDA is doing their job, but he has one caveat. “They’re finding things after the fact,” Nebbin said. “Sourcing of the ingredients is a big concern, including for the FDA and the policymakers that put these policies in place. They’ve let things go and they’re starting to do more inspections.” James Della Rocco, director of pharmacy systems for Unity Health in Rochester, isn’t worried about U.S.-sourced medications’ safety. He said that the binders and other inactive ingredients may affect how the drug acts for certain patients, such as not dissolving in the same way. But
the low cost of generic drugs makes medication obtainable for many people who would not otherwise be capable of affording their prescriptions, he said. “If you have concerns about where a drug comes from, ask a pharmacist,” he said. “They can say if it comes from the U.S.” The Food and Drug Administration inspects medication production plants every two years, but with foreign plants, “they’re not monitored the same as the plants in the U.S.,” Della Rocco said. “Maybe 50 to 100 are inspected and they need to inspect maybe 700. Oftentimes, you have to notify plants in places like China if you’re going to inspect them. These are points of trade agreements we have to look at.” In the case of carcinogens in the generic drug, valsartan, Della Rocco said that patients would have to consume vast quantities of the medication to “get to the point where you’d get cancer.” Yet he is concerned about medicinal safety because imported medication isn’t as highly regulated as domestically produced medication. “We have got to make sure everything that comes into this country is inspected and is safe,” he said. “If you hear about less oversight and
that it’s going to be de-regulated, I’d be concerned. You’ve got to be vigilant about what you take and where it comes from.” At The Medicine Place in Fulton and Phoenix, Zach Merry, head pharmacist, said some customers are asking about their prescriptions. “Hopefully they sort it all out,” Merry said. “It’s been a frustrating six months since this came to light. All the time, people ask about it. We haven’t had any that are affected. We have definitely been getting questions.” As for the differences between generics and brand names, “no, there’s no differences,” he said. “It’s regulated by the FDA to be within a certain percentile to be within the same levels of safety and efficacy.” But he added that the larger percentage of many drugs’ ingredients come from other countries. Despite this, they still have to meet the FDA’s standards. “We get updates from our wholesalers about recalls,” Merry said. “Any pharmacy keeps a documented list of what they send you to keep an eye out for recalls and any problems.” Patients can also ask about their medication if they have any concerns about recalls, safety or efficacy.
Gingivitis Associated with Alzheimer’s Risk Maintaining oral health may contribute to maintaining cognitive health By Deborah Jeanne Sergeant
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esearchers believe that gingivitis may raise the risk of developing Alzheimer’s disease. A study from Broegelmanns Research Laboratory at University of Bergen included 53 persons with Alzheimer’s disease. Researchers had previously discovered that the bacteria causing gingivitis can move from the mouth to the brain where the harmful enzymes they excrete can destroy the nerve cells in the brain. Now, for the first time, researchers discovered DNA evidence for this process from human brains. Lead researcher Piotr Mydel and his team examined brain tissue, salivary samples and spinal fluid samples and found the enzyme in 96% of the cases, along with an increase in production of the amyloid beta, a compound of the plaque that contributes to Alzheimer’s. Page 16
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That doesn’t mean gingivitis has a causal relationship with Alzheimer’s disease. “There’s increasing evidence that some may have higher risk for Alzheimer’s based on the inflammation in their body,” said physician Sharon Brangman, professor of medicine and head of the geriatric department at SUNY Upstate Medical University. “It can be caused by a lot of causes, but the most controllable is the inflammation in the bones in the mouth.” The study’s size is also too small to prove a causal effect; researchers learned that bacteria can travel from the mouth to the brain, which could indicate a biological role oral health play in development of Alzheimer’s disease. “Overall, especially with peritonitis, if you have any other inflammatory conditions, that contribute to worsening their other conditions,” said dentist Ann Marie Adornato,
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
One of the signs of gingivitis is bleeding in the gum tissue. “It’s a painless disease,” said Liverpool dentist Ann Marie Adornato. “If you see any bleeding when brushing or flossing, that’s an indication that gingivitis could be occurring.” who operates Ann Marie Adornato, DMD, MSD, PC Periodontics & Dental Implants in Liverpool. Whether it’s related to Alzheimer’s disease or not, maintaining good oral health is important. Adornato explained that gingivitis is an inflammatory response in the gum tissue. Many people don’t realize they have gingivitis since it’s not painful, but they may notice bleeding in their gums that doesn’t go away. Dental plaques, also called biofilm, are bacteria deposits on the teeth. They require manual removal or else they will cause inflammation and swelling. Adornato said that left untreated, gingivitis can cause periodontal disease. “The biggest thing is preventive care,” Adornato said. “Go for dental cleanings and do home care.” To keep the mouth healthy, she said that people need to brush after meals, floss daily, and use an antibac-
terial dental rinse such as Listerine. Using a waterpik brush can also help break up bio-film. “It’s a painless disease,” she added. “If you see any bleeding when brushing or flossing, that’s an indication that gingivitis could be occurring, or if gums are puffy, looking red and swollen. “If you’re concerned about using a product, the best way to prove its validity is to look for the American Dental Association seal of acceptance,” Adornato said. “That means that material has been researched and proven to do exactly what it says.” She also advises visiting the dentist for a cleaning and exam every six months, or more often if advised to do so. Some people have underlying conditions or take medication that necessitates more frequent professional oral healthcare. But the most important aspect is home care.
Finding Hope When There is None
Wife joins the fight to find cure for ALS after the untimely death of her husband By Eileen Jevis
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y family thought he had had a stroke. His co-workers thought he was coming to work intoxicated. The first sign that something was wrong was slurred speech. My husband Randy Jevis of Camillus was 60 years old when he received the devastating diagnosis: bulbar onset ALS — the most acute form of amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s Disease. Bulbar ALS robs patients of speech, swallowing and eating. Loss of speech occurs in 93% of people with bulbar ALS and difficulty swallowing occurs in 86% of people with bulbar ALS. Jevis’ inability to speak and to swallow resulted in his dependence on a feeding tube for two years. The loss of his ability to use his arms and hands came next — a cruel fate for someone who was a master craftsman; a man who loved to build things, landscape and garden. He died in January at the age of 62. ALS is a progressive neurodegenerative disease that affects the function of nerves and muscles. The progressive degeneration of the motor neurons in ALS eventually leads to death. Based on U.S. population studies, more than 6,000 people in the U.S. are diagnosed with ALS each year — that’s 15 new cases a day. ALS usually strikes people between the ages of 40 and 70, and at least 16,000 Americans can have the disease at any given time. For unknown reasons, military veterans are approximately twice as likely to be diagnosed with the disease as the general public. Randy was someone who was used to being in charge and taking care of others. He was so frustrated and angry that he had to count on others for his care. We watched as he slowly lost his identity. With the help of his siblings and nurses, our daughters and I were able to take care of his needs and transport him to his 10-day rotations of Radicava infusions. Those times with his family gave us all the opportunity to express our love and appreciation for one another . . . and to say goodbye. There is no hope when you are diagnosed with ALS. There is no cure. There are only trials for new medications, and the questionable effectiveness of the medications that are currently available. The diagnosis is like a punch in the stomach; a feeling of fear and plans unfulfilled. Randy died just four months before the birth of our first grandchild. He was so proud that he was going
Randy and Eileen Jevis at their daughter’s wedding in 2016. Photo provided. to be a grandpa and so devastated that he wouldn’t be here to meet him. It is now my mission to raise awareness of this horrible, cruel disease; to raise money for research, and to support the Upstate New York ALS Association. I recently joined more than 500 ALS advocates from across the country at the ALS Advocacy Conference
in Washington, D.C. Patients, family members and caregivers converged on the Capitol to ask legislators to reverse the decision to add noninvasive ventilators (NIV) to the Competitive Bidding Program and to plead with lawmakers to shorten the five-month waiting period to receive Medicare services. It was an honor to walk beside those afflicted with ALS
Annual Lowell Smith Circle of Courage Walk The event organized by the local ALS chapter is designed to raise awareness and funds to defeat amyotrophic lateral sclerosis (ALS). Checkin will begin at 9:30 a.m. on Saturday, Sept. 14, at Long Branch Park, 3813 Long Branch Road, in Liverpool. The walk will start at 11 a.m. Anyone can make a positive impact by organizing a team, joining a team or making a donation. The funds raised at the local level go toward research, advocacy, a loan closet for medical equipment, financial assistance, resources and practical and emotional guidance. For more information, contact Liz Krisanda at EKrisanda@alsaupstateny.org or call 315-413-0121. August 2019 •
— men and women who are doctors, nurses, veterans, postal workers and other brave individuals who found the strength to campaign for a cause that affects their lives and the lives of those around them. Locally, I volunteer at the local ALS chapter with the hope that my involvement will help others as the chapter helped me and my husband over the past two-and-a-half years. I encourage community members to attend the annual Lowell Smith Circle of Courage Walk to defeat ALS. Check-in begins at 9:30 a.m. on Saturday, Sept. 14, at Long Branch Park, 3813 Long Branch Road, in Liverpool. The walk will start at 11 a.m. Anyone can make a positive impact by organizing a team, joining a team, or making a donation. The funds raised at the local level go toward research, advocacy, a loan closet for medical equipment, financial assistance, resources, and practical and emotional guidance. Liz Krisanda, executive director of the Upstate New York Chapter, said she hopes that the day becomes a day of awareness for the entire community. “When former SU football and NFL player Tim Green announced in November that he was diagnosed with ALS, it brought increased awareness to the disease both locally and nationally,” says Krisanda. “It is just by chance that Syracuse walk is scheduled on the same day as the Syracuse University-Clemson Football game that is scheduled for 7:30 p.m. “Green’s SU football jersey will be retired during the Clemson game. We would love to see the community come together to walk to defeat ALS in the morning and attend the SU football game in the evening in support of Tim and his family,” Krisanda says. A pair of tickets to the SU football game will be given away during the morning event. It is my hope that when my grandchildren are adults, they will look back at the advancements made in ALS research with relief and pride. They will know that their grandfather (and the more than 5,000 people diagnosed each year) did not orwill not die in vain. I hope that their suffering and deaths prompt a concentrated and committed movement toward the cause and a cure. There is strength in numbers. It will take all of us — scientists, researchers, doctors, government officials, advocates, those with a voice, and those behind the scenes, to help eradicate this disease. Because, really, what greater accomplishment is there than making a difference in the world?” n For more information on amyotrophic lateral sclerosis (ALS), request support services, or how you can help, contact Liz Krisanda at EKrisanda@alsaupstateny.org or call 315-413-0121.
Eileen T. Jevis is a native of Syracuse, having grown up on the city’s south side. She is currently the communications manager at University College (UC) of Syracuse University. In addition to writing speeches, scripts, articles, and press releases, she manages and coordinates several campus events, including UC’s commencement ceremony and honors programs. She resides in Camillus.
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Youth from the St. Charles-St. Ann’s Youth Ministry Group volunteering at Matthew 25 Farm. Volunteers come from all over the area, including Scout troops, colleges, and church and civic organizations. Photo provided.
Matthew 25 Farm Harvests Food for Goodwill Volunteers do the planting and harvesting; food is donated to food pantries, soup kitchens and families in need By Mary Beth Roach
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he Matthew 25 Farm, with two locations on the southern edge of Onondaga County, has been harvesting food and goodwill for people in need for more than a decade. Its sites in Vesper-Tully and Cardiff-LaFayette produce 50,000 pounds of fruits and vegetables annually, all of which are planted and then picked by volunteers and a small staff and donated to food pantries, soup kitchens and families in need throughout the Central New York, according to Rick Rarick, manager of the nonprofit farm. Crops range from A-to-Z literally: apples to zucchini. There are also potatoes, onions, pole beans, tomatoes, cabbages, pepper, eggplants, cucumbers, watermelon, cantaloupe, winter and summer squash and raspberries. With the addition of two “hoop houses” at the Vesper/Tully location, they can extend their growing season, having vegetables into late fall. Currently, they are growing tomatoes and cucumbers in these houses, which are arched structures covered with greenhouse plastic and closed at either end, and are often less expensive to construct than greenhouses. Volunteers come from all over the area, including Scout troops, colleges, and church and civic organizations. Members offer their time to work on the farm as a service project. Individual families in need can also come and pick at the farm. However, Rarick said there is a 50% rule. For example, if a family picks 10 pounds of potatoes for themselves, they will be asked to pick an additional 10 pounds to leave at the farm for a food pantry to pick up. Often, he said, those who harvest for themselves and their neighbors will end up picking far more than the 50 percent that they keep. One of the largest corps of volunteers is from the parish of St. CharlesSt. Ann’s Youth Ministry in Syracuse. Terri Condon, program director, Page 18
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Rick Rarick is the manager of the nonprofit Matthew 25 Farm. “Here we are in year 11 and going strong, and we’re looking forward to and making plans for year 12 already,” he says. learned about The Matthew 25 Farm from a newspaper article years ago, and she’s been involved ever since. When she first became acquainted with the farm, she was working at St. Cecilia’s Church in Solvay, and she got parishioners there to join her. She spearheaded fundraising efforts at the church to purchase 100 apple trees, which had been one of the farm’s “wish list” items. Not only did they purchase the trees, they helped to plant them too. Since then, the farm has named the area the St. Cecilia’s Orchard. And along with the apples, that particular area boasts some raspberry plants as well. “When you pick a service project for your teenagers, it has to be something, as far as I’m concerned, that’s life-changing,” Condon said. “They are amazed that if they stick a seed in the ground and come back in several weeks, it’s full of zucchini. And the kids love to get into the dirt,” she said, chuckling. The best part of the service project, Condon said, is that after they pick the produce, they deliver
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
it directly to the food pantries at St. Lucy’s and Assumption churches on Syracuse’s near westside and northside, respectively, as well as their own pantry at St. Charles-St. Ann’s. “The kids get to see the full circle of doing the work and then where it needs to go,” she said. Those groups that don’t have specific pantries to pick for will leave their produce at the farm, and Rick Rarick arranges for other food pantries to pick them up.
Network of help
Some of the other facilities benefitting from the farm’s fruits and vegetables include Isaiah’s Table and the Samaritan Center in Syracuse, PEACE, Grace Episcopal in Cortland, Groton Assembly of God, and the Locke Food Pantry. The farm was established in 2009 with no land and little or no money, but a big dream. While Rick Rarick is manager now, the idea to develop the farm had actually come from his brother, Jeffrey Rarick. He felt it is a calling from the
Lord to do it, according to Rick. Within a few months, money had been donated, tractors were coming in, land was purchased, and “we were off and running,” Rick said. The farm’s name comes from Chapter 25 in Mark’s Gospel in scripture, which includes the passage, “for I was hungry and you gave me food.” During the farm’s second year, Jeff got married and continued pursuing an engineering degree. So, Rick stepped in and took over as manager. Their mother, Elizabeth Esmark, is the farm administrator. She writes the grants that help fund the farm and runs an antique shop called Vere Vintage at the farm’s LaFayette location, which further supports their efforts. As a nonprofit, a board of trustees runs the farm. Assisting them during the growing season, in addition to volunteers, are Brad Clarry and Katie Markstein. Funding for the farm comes for a variety of sources, including donations from individuals and some churches, bottle and can drives and the annual harvest golf tournament, which is being held on Aug. 17 at the Sunset Ridge Golf Course, on West Seneca Turnpike in Marcellus. The farm has also received grants from such organizations as the Syracuse Rotary Foundation, the Central New York Community Foundation, the Wallbridge Fund and the Welch-Allyn Foundation. Rick Rarick attributes much of the farm’s longevity to the faith of its board members and their willingness to help people. There were some people at the beginning who didn’t think they would last longer than two or three years, Rarick said. “Here we are in year 11 and going strong, and we’re looking forward to and making plans for year 12 already,” he said. Those interested in learning more about the farm and how to volunteer can visit www.matthew25farm.com or call 315-558-2212.
Parenting By Melissa Stefanec
MelissaStefanec@yahoo.com
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10 Do’s for Vacation (with Kids)
ccording to every advice column ever written for parents, I should be decompressing with my kids right now. I should be immersed in an energetic game of Chutes and Ladders or, better yet, a spirited game of kickball. I shouldn’t be alternating between bath time, packing for camping and freelance-writing while my children listen to David Attenborough narrate about freshly hatched sea turtles and suckling sperm whales. However, here I am, living my best vacation life. As a parent, vacationing has its own set of rules. Gone are the days of sleeping late and loafing. These are the days of sibling bickering, early rising, home maintenance and catching up — all in the name of keeping up with life while I’m on vacation. Still, in the quieter moments, vacation has a lot to offer. Here are 10 do’s for parents hoping to keep pace and sanity while enjoying their limited time off.
While on vacation, do:
1.
Get out of the house You want to know what never goes away? Home projects. You could spend each day from now until Christmas addressing your to-do list, and it would magically keep getting longer. As a parent, your only hope of mental and physical salvation is to get away from your house. Visit family. Get a hotel. Find a home rental. Don’t let yourself get sucked into the home improvement vortex.
2.
Cut yourself some slack, by cutting your kids some slack Potato chips for dinner? Why not? Up past bedtime three nights in a row? Sure. Vacation is the perfect time to convince yourself that chocolate pudding is just as much of a breakfast as a standard kid’s cereal. Keep expectations low on your vacation.
everyone’s happiness.
5.
Plan a little, but not too much Don’t plan every single day of your vacation. That makes your vacation resemble work. It turns it into something with deadlines that you’re beholden to. Don’t be afraid to say, “I don’t know what we are doing today.” Let yourself fall into the loafing-around trap for a day or two. Some of the best things happen when nothing is planned.
6.
Make lists Before you leave for a vacation outing, start a list of things to pack. Start this a day or two before a larger trip. As things pop into your mind, write them down. Then you won’t spend precious vacation time reminding yourself not to forget something.
7.
Dedicate some time to projects Don’t be afraid to break rule No. 1 (above) here and there. If you’re anything like me, you find it a lot easier to enjoy yourself after a couple of “must-dos” are behind you. Don’t fault yourself for wanting to get a couple of things done in order to make your mental load lighter. Bonus points if you see to these tasks before your vacation starts.
8.
Step away from the screen A lot of us view screen time as a way to escape the day-to-day. However, screens can just as easily turn us into slaves. Why would you want to escape your vacation? Tune into the world around you and turn off the screen.
9.
3.
Get outside In just a few months, this land will be littered with relentless snow and wind, and the only thing keeping you warm will be summer memories. As tempting as the “getting caught up” monster’s song can be, don’t waste precious moments and beautiful weather. Get outside and start making some memories.
Do save your funds for the good stuff Even small vacations can be expensive, and sweating every dollar you spend isn’t relaxing. Be selectively mindful about what you’re spending. Pack the kids’ water bottles and refill them instead of buying bottled water. If bottled water is your thing, pack a small cooler with water in it. If you are going somewhere that is known for its gross yet surprisingly expensive food, pack yourself a picnic. Buy a box of popsicles and eat them in the parking lot before you go into a park and spend $3 per pop. Save your money for the stuff you will enjoy instead of begrudgingly turning it over for sub-par goods.
4.
10.
Play a little You know all those times your kids ask you to play with them or watch a show with them? Usually, I respond to such requests with, “Maybe later; I’m making dinner,” or “I would love to, but I have to get everything ready for the school day tomorrow.” Now is the time to say yes, if even for 15 minutes. Those minutes will go a long way toward
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Do take life less seriously Long days at the office coupled with the responsibilities of raising children often lead to exhaustion and a sense of seriousness surrounding our day-to-day tasks. Vacation is a great time to take a step back and enjoy all the good life has to offer. It’s a time for us to reset our brains and focus on the aspects of parenting that bring us the most joy.
ASK FOR THE EXPERTS. ASK FOR UPSTATE. 315-464-HOPE (4673) upstate.edu/cancer
August 2019 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Weed and Feed: Marijuana’s Effect on Male Fertility By J C Trussell, M.D.
M
arijuana (cannabis) is the most commonly used drug in the world, with an estimated annual prevalence of 3.8% of the adult population. Overall, there has been a trend toward laxity in cannabis regulations as is evident by the recent passage of laws allowing recreational use in selected states in the U.S. Since cannabis use tends to be more prevalent among those of reproductive age, the effect of cannabis on male reproduction must be evaluated. Research looking at the effect of cannabis on becoming a Dad, is at best, confusing.
First the bad news
Most research indicates that marijuana has a negative effect on sperm and therefore on male fertility. A 2015
Kinney Drugs Ends Sales of E-Cigarettes, Vaping Products
K
inney Drugs is no longer selling electronic cigarettes or vaping products in its New York retail stores effective August 1. This decision is in response to statistics
study of 1,215 young Danish men (aged 18 to 28 years) who regularly used marijuana — more than once per week — was associated with a 28% lower sperm count. This was in contrast to other men who did not use marijuana or, used it less than weekly. Making matters worse, the combined use of marijuana (more than once per week) and other recreational drugs reduced the sperm count by 52%. Secondly, a 2011 study reported that chronic exposure to THC — the main psychoactive constituent of marijuana — impaired both sperm count and motility.
Lastly, a 2014 study reported that the use of cannabis among young men, within three months of a semen analysis, was a risk factor for poor sperm quality. Even older studies have demonstrated similar findings. For instance, a 1985 study reported that chronic marijuana users (“chronic” was not defined) had a decline in sperm volume, count and motility.
demonstrating that these products are increasingly being used by teens and children. The drugstore already banned the sales of these product in its stores in Vermont as of July 1. According to the Centers for Disease Control and Prevention (CDC), tobacco use among children grew nearly 38% between 2017 and 2018, driven largely by a surge in e-cigarette use, which increased 78%
among high school students and 48% among middle school-aged children. “We would like to thank Kinney Drugs for taking this important step,” said Franklin Fry, executive director of the American Heart Association in Syracuse. “Actions like this can help prevent our children from starting a deadly habit.” To provide people with the help they need to quit smoking, Kinney Drugs carries a broad line of
Now the good news
A survey of U.S. couples attempting to conceive demonstrated no association between never smokers and the marijuana users and time to conception.
The takeaway
Clinicians should not advise that marijuana is safe while trying to conceive. It appears to have a negative effect on male fertility: worsening sperm count, motility and shape. On the other hand, the good news is that the effects do not seem to be permanent and, may not affect most couples’ time to pregnancy. Physician JC Trussell completed his urology training at Upstate University Hospital in 2002. He then completed additional training in both male infertility and erectile dysfunction prior to spending seven years at the Milton S Hershey Medical Center. In 2009, he returned to Syracuse to join Upstate’s department of urology, where he is the director of the Division of Male Fertility and Sexual Function. smoking cessation products, and its pharmacists will continue to assist patients looking to quit tobacco with its personalized “Ready. Set. Quit.” smoking cessation program. In addition, Kinney Drugs will continue to partner with the American Heart Association to educate patients on the connections between tobacco use and the increased incidence of high blood pressure, stroke, and heart disease.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
Golden Years
Oh, the Aging Eyes Droopy eyelids, dry eyes, floaters, cataracts, ocular migraines are just some of the eye problems we may have to deal with as we age By Deborah Jeanne Sergeant
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s you begin to “play trombone” with your reading materials to get them in focus, it becomes apparent you may need reading glasses. Most people require correction for presbyopia — short distance vision — around their mid-40s to early 50s. While an unwelcomed sign of aging, it’s easily corrected with drugstore “cheater” glasses. Less common are other changes in vision related to aging. Some are
more serious than others. To tell the difference between what’s normal and what’s not, Astrid Ranaldi, optometrist at Eyecare of CNY in Syracuse, recommends annual eye exams and to seek care with any loss of vision. “Occasionally check to see if each eye sees the same. A lot of times, people miss this and they have macular degeneration. If caught right away, it can make a big difference in the outcome,” Ranaldi said
PEP Now Available at Upstate’s Outpatient Pharmacy Only local pharmacy offering immediate prescriptions of an emergency medication for people who may have been exposed to HIV
P
EP, or post-exposure prophylaxis, is a combination of antiretroviral medications that can be given to someone who thinks they have come in contact with the HIV virus. When a patient starts PEP within 72 hours of exposure, the drugs can be effective in preventing infection. (PEP is different from PrEP, which is pre-exposure prophylaxis and is taken regularly by people who are at a high risk of contracting HIV.) PEP is a once or twice daily pill for 28 days. Upstate’s outpatient pharmacy is located near the main lobby of the downtown campus and is open to the public seven days a week. Any-
one who thinks they may have been exposed to HIV can visit the pharmacy and speak with a pharmacist about his or her possible exposure. The pharmacist will discuss those risk factors — instances often include unprotected sex or sharing needles — and obtain insurance information from the patient. Many insurance carriers cover PEP and Upstate has a variety of programs that can help pay for the medication, according to Eric Balotin, associate director pharmacy enterprise. The patient is then given a seven-day dose of PEP, a New York state PEP information leaflet and is scheduled for a follow-up appointment at
People with macular degeneration lose their central vision as part of the retina starts to break down. They see only things on the periphery. With a physician’s guidance, its progress can be slowed, but not cured. Family history plays a role in glaucoma, which is damage to the optic nerve. Usually, loss of the peripheral vision indicates onset. The lost vision cannot be restored. The risk of vision loss is higher for people with certain health issues. Diabetics Upstate’s immune health clinic. Immune Health Clinic staff will conduct HIV testing, offer information about reducing risk factors and prescribe the remaining 21 doses of PEP, which is a combination of name brand drugs Truvada and Tivicay. Often patients who are initially prescribed PEP will later be prescribed PrEP, which when taken consistently can reduce the risk of infection by up to 92%, according to the Centers for Disease Control and Prevention. “We have the ability to get these types of medications to the patients quickly to reduce their risk of HIV,” Balotin said of the outpatient pharmacy offering PEP. At Immune Health, providers will review patients’ histories and determine whether they have ongoing risk for HIV and may be a candidate for PrEP, said physician Elizabeth Asiago Reddy, medical director of the clinic. Making PEP available through Upstate’s outpatient pharmacy — which is open 8 a.m. to 6 p.m. Monday through Friday and 9 a.m. to 2 p.m. Saturdays and Sundays — should cut down on people spending August 2019 •
and those with hypertension should be especially vigilant about their vision. Also report any pain, irritation, flashes or black spots. “These can be normal or not normal,” said David Girardi, optometrist with See Sharp Eyewear in East Syracuse. “When you have flashes and floaters, it’s usually an indication you need an evaluation. If it’s not normal, it can lead to a big problem like a detached retina.” Slowly, over time, cataracts can develop in older age, although for diabetics and those with hypertension, they can develop in younger people. The vision becomes dim and more yellow in tone and night driving becomes very difficult. The lens, which sits behind the iris, becomes cloudy. Physician Sharon Brangman, professor of medicine and head of the geriatric department at SUNY Upstate Medical University, said that cataracts are caused by exposure to sunlight. Wearing sunglasses that protect against UV rays can help protect the eyes. “Smoking and certain medications also increase risk,” Brangman said. “Get a yearly eye exam. If the lens of the eye gets cloudy and thick, that is a cataract and it can distort vision and blur vision and it can be replaced.” Exposure to UV light, diabetes and certain medication can hasten the otherwise age-related condition. With a 10-minute, outpatient surgery, doctors can replace the lens with an artificial lens. It has become perfected to the point that few experience complications and most patients respond very well. “In general, it’s always better to intervene earlier than later,” Brangman said. “I have people with poor vision and if they also have poor hearing, they look like they have dementia because they don’t have sensory input. Invariably, I have patients after cataract surgery who say they shouldn’t have waited so long. It can be sociality isolating and can increase risk of dementia.” long hours in the emergency department seeking the emergency prescription, Balotin said. Currently between 12 and 15 patients per month visit Upstate’s ED to obtain PEP. The new outpatient pharmacy policy will make access to the drugs quicker and easier.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Golden Years
Comfort Care Making a Difference in the Finger Lakes Pathway Home in Seneca County has seen about 60 men and women come through its doors since its inception in 2017 By Margaret McCormick
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plaque in the office at Pathway Home of the Finger Lakes reads, “Difficult roads often lead to beautiful destinations.’’ It’s an apt message for the home’s leadership team and for anyone who spends any time there. Pathway Home, on Route 414 in the town of Tyre, is the only comfort care home in Seneca County. Its mission is to provide compassionate care to people in their end days, usually with three months or less to live. Staff and volunteers are on hand 24/7 to meet the physical, emotional, social and spiritual needs of the men and women in their care, in a supportive home environment. With its peaceful setting and perfectly manicured lawns and flowerbeds, Pathway Home looks like many other ranch homes in the Finger Lakes countryside. But it’s a special place. The home has two beds for residents, which are two of just 88 comfort care beds in all of New York state, according to Pathway Home Executive Director Martha “Martie” Shields. “We’re a home in the community that just happens to have two residents in hospice,’’ she says. “We’re extended family and extra hands. The family is still considered the primary caregiver. They’re just doing it in our home instead of theirs.’’ Studies show that most people would prefer to die at home, in their own familiar surroundings, if possible. No one wants to spend the last leg of their life journey in a hospital or nursing home, attached to tubes and high-tech equipment, tended to by an army of medical professionals. But despite their best wishes and planning, that’s how many people die.
Average stay: 10 to 14 days Pathway Home traces its roots to 2009, when a group of community members began making plans and raising funds for it. Hospice care workers in the area were keenly aware of the need: the nearest comfort care homes in the rural Finger Lakes are an hour away, or more. The home welcomed its first residents in 2017 and has since seen about 60 men and women come through its doors. For some, the stay is very short — one patient was there for just a few hours before passing. For others it’s longer than expected: One woman was there for nearly nine months. The average stay is 10 to 14 days, according to Shields and Beth Boehnke, Pathway Home assistant director. Shields came to Pathway Home after an extensive career in nursing. She previously was a registered nurse for Lifetime Care and Finger Lakes Medical Associates. Boehnke volunteered her time on fundraising events and served on the home’s board of directors before assuming her staff position. “I got sucked in,’’ she says with a smile. Despite its mission and role, the atmosphere at Pathway Home is far from grim. At times, it can be lighthearted and joyous. Several residents have wanted to cook and bake in the large kitchen and residents who are able are welcome to use the back deck. The home has hosted at least one wedding, when a young couple exchanged vows in the room of the bride’s grandmother, with other family members in attendance. “Taking care of someone at home is exhausting not just physically but emotionally,’’ Boehnke says. “One of the really nice things we get to see is
Moving Past Guilt Moving a parent or loved one into an assisted living can bring new opportunities By Brenda McCutcheon
M
any people experience guilt when moving a loved one to a long-term care residence. More and more people want to stay in their homes, stay close to their family and maintain the current structure of their lives. But when you need to care for an older parent or other loved one, it can be stressful and challenging, Page 22
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particularly when we have busy lives full of responsibility. Sometimes a loved one needs more care than we can give them. Caregiving challenges us as roles become reversed, though they are our parents, the caregiving shifts to the children. This role reversal can deepen a parent’s feeling of hopelessness and confusion, making things
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
Running the Pathway Home of the Finger Lakes is Assistant Director Beth Boehnke (left) and Executive Director Martha “Martie” Shields.
Admission to Pathway Home is based solely on need without regard to age, gender, race or spiritual beliefs. The home runs on donations, grants and fundraisers. In order to sustain the quality of its services, the home’s directors will discuss the cost of care with spouses and family members of residents and suggest sliding-scale donations based on income and length of stay. No one is turned away due to lack of financial resources. The one-floor house has several common areas, including a living room with television, dining room and a large, open kitchen, where family members can relax, socialize and enjoy coffee, tea and snacks or a
meal. The patient rooms are airy and bright, outfitted with hospital beds, dressers, chairs, TV and sleeper sofas, where family members are invited to rest and spend the night if they wish. Visiting hours are open and the home is staffed 24/7. Lifetime Care and Hospice of Wayne and Seneca Counties provide additional support for residents A dedicated corps of volunteers does everything from dress, bathe and toilet the patients to prepare meals, clean the house and cut the grass. Volunteer roles can be tailored to suit individuals and groups. At present, the home seeks the assistance of someone in the community to help with grant writing on a volunteer basis. There is also an extensive “wish list’’ for people who would like to donate in other ways. The home is always in need of toiletries for residents (shampoo, shaving cream, sanitary wipes, etc.); kitchen, cleaning and office supplies; gift cards to retailers like Target, Walmart and Wegmans and miscellaneous goods, like sheets, towels and reusable bed pads. “There are a lot of people out there who don’t know about us and don’t know what we do,’’ Shields says.
even more difficult. Moving a loved one into assisted living can alleviate some of the strain for both of you and help rekindle the relationship that was once there. We can begin to enjoy and appreciate spending quality time with our loved one again. It’s just as important to take care of ourselves as it is to care for our loved ones, as it’s not healthy to carry feelings of guilt for doing what’s best for both parties. If caregiving starts to affect you by feeling weighed down, then it may be time to think about the benefits of resources like an assisted living program. It’s normal to feel some angst with all the changes that come with caregiving, but it’s important to also focus on the greater value that this time in one’s life can bring to both you and your loved one.
Brenda McCutcheon is the vice president of mission at Loretto Health & Rehabilitation.
More Info? Pathway Home of the Finger Lakes is at 1529 state Route 414, Seneca Falls. For more information, call 315-257-0307 and visit http://pathwayhome.org families interacting and supporting each other.’’
Running on Donations
For Seniors, Walking the Dog Can Sometime Be a Dangerous Thing Fall-related bone breaks involving senior dog walkers has risen substantially. But there are ways for seniors to mitigate the problem By Deborah Jeanne Sergeant
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wning a dog can provide lots of motivation to get out and walk. While that’s great for your health, dog walking can raise the risk of falling, especially if you’re an older adult. A study recently published in JAMA Surgery looked at 100 hospital emergency rooms nationwide. The number of fall-related bone breaks involving senior dog walkers has risen substantially for more than a decade, from 1,671 in 2004 to 4,396 in 2017. Of those involved with the study, 79% were women, who because of their smaller bone structure are more at risk for bone breaks. The most commonly broken bone was the hip (17%) but more than 50% broke an upper body bone, including the shoulders, arms, hands, wrists and fingers. Nearly one-third required hospital admission. The researchers blame both dog manners and owner conditioning. Many elderly people who experi-
ence a hip fracture never quite regain the level of health they experienced previously. Some also become so de conditioned that they can no longer live independently. Deterioration in physical fitness may contribute to dog walking related falls, since muscle mass and balance tend to decline with age. Elizabeth Cullen, a doctor in physical therapy and owner of CNY Physical Therapy and Aquatics in Camillus and North Syracuse, said that physical therapy for older adults who have noticed balance issues — such as having to take a quick step to stay upright — can make a big difference. Physical therapy can help improve balance, she said. “Then, if there is a slight jolt in your balance, you’re able to maintain balance,” she said. John Mossotti, bachelor’s in human performance and health promotion, certified physical preparation specialist at Elite Personal Fitness in Camillus, advises total body
Crouse ER Recognized for High Care Standards for Older Adults
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he American College of Emergency Physicians (ACEP) has awarded Crouse Health’s Pomeroy Emergency Services its Bronze Standard — Level 3 designation, which recognizes emergency departments in the U.S. that provide excellent care for older adults. The award is provided in partnership with the national Geriatric Emergency Department Accreditation (GEDA) program. Crouse’s emergency department accreditation signals to the public that the hospital is focused on the highest standards of care for the communities’ older adults. The GEDA program is the culmination of years of progress in emergency care of older adults. In 2014, ACEP, along with Society for Academic Emergency Medicine, Emergency Nurses Association, and American Geriatrics Society, developed and released geriatric ED guidelines, recommending measures ranging from adding geriatric-friend-
ly equipment to specialized staff to more routine screening for delirium, dementia and fall risk, among other vulnerabilities. The voluntary GEDA program provides specific criteria and goals for emergency clinicians and administrators to target. The accreditation process provides more than two dozen best practices for geriatric care. The level of GEDA accreditation achieved depends upon how many of these best practices an emergency department is able to meet. A Level 3 emergency department must incorporate many of these best practices, along with providing inter-disciplinary geriatric education, and having geriatric appropriate equipment and supplies available. Led by Medical Director David Mason, MD, Crouse’s Pomeroy Emergency Services is the newest ER facility in Central New York, providing care for some 70,000 patients annually.
Golden Years strengthening program. “It can help them if they need to make a quick movement and still hold themselves up,” he said. “If they lean forward and can’t hold themselves up, they’ll fall. They need to be able to move in different directions, like stepping out to the side as far as they can go so it’s not foreign.” How you walk the dog also matters. Mossotti advises dog walkers to avoid wrapping the leash around their hands in case the dog bolts. “Then you can’t let go,” Mossotti said, “and the dog pulls them down.” Avoid becoming distracted while walking with your dog. Susan Brown, Ph.D., certified nutrition specialist, directs the Center for Better Bones in East Syracuse. “Be mindful of how you’re walking and where you are,” Brown said. “Sometimes people get tangled in the leash, but usually the dog is too rambunctious.” While she appreciates the health benefits of dog walking, she acknowledged that they can contribute to falls if walkers aren’t careful. Using the right equipment will make a big difference while walking the dog. Wearing stable footwear as well as selecting the right leash can greatly improve safety. Andrea Giordano, professional dog trainer and owner of Dogs Among Us in Oswego, suggests harnesses that fit at the front of the chest instead of the back, or a head harness. While it may seem a great idea to simply drive your pooch to a dog park to let it run freely in a safe, fenced area, Giordano said that can be the most dangerous places for
older dog owners. “Once they let the dog run off the leash, the possibility of getting run over by someone else’s dog is high,” she said. If you’re in the market for a new dog, consider your choice carefully. Large, powerful dogs may be much harder to control than a smaller dog. But the dog’s personality and age also make a difference. Smaller dogs also may pose some problems. “If the dog is little, the dog may be a trip hazard,” said physician Sharon Brangman, professor of medicine and head of the geriatric department at SUNY Upstate Medical University. “Bigger dogs are easier to keep in your visual field but smaller dogs are easier to pick up. Adopting an older dog may be a good idea, as they’re out of the puppy stage.”
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Golden Years
Foods for Healthy Aging By Deborah Jeanne Sergeant
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hile the phrase “super foods” may create buzz around fad foods, it’s true that eating a healthful diet can help support healthy aging. Area experts share their advice for eating right. Here’s what they say: • “Fiber is definitely an issue. A lot of my younger and older clients aren’t getting fiber-rich foods, including whole grains, fruits, vegetables, nuts and seeds. It’s a contributing factor to a lot of health conditions we’re having. Increasing fiber can resolve a lot of those issues. • “As we age, we tend to forget about hydration. Especially if you add in more fiber, you have to increase hydration. They go in combination. You can add cucumber slices, watermelon or strawberries to water. That can help you to consume more. Drink non-caffeinated teas. Watch for sugar. That can lead to other health conditions. Hydration is beneficial to support brain function, regulate body temperature, relieve constipation issues, reduce risk of headaches, and rid the body of toxins. it also helps reduce dry mouth. • “Eat seafood containing omega-3 twice a week. Some of the highest are salmon, tuna and sardines. These foods are anti-inflammatory. In recent studies, they’ve been shown to reduce onset of dementia and help with joint lubrication. In the American diet, we have way more omega-6 source, like vegetable oil and grain products. It’s essential but we get too many and they’re pro-inflammatory. You need omega-3 to offset it. Canned tuna and salmon in water can be a big cost saver, as can frozen fish. Flax seed is also a source of omega-3, but the fish sources are
most potent. Flax seed should be ground. Chia seeds are also a good source. Kelly Springer, registered dietitian and owner Kelly’s Choice, LLC, Skaneateles • “Avoid foods that are fried or have a lot of oil, as that adds unhealthy fat and oils. • “Eat healthy carbs that are plant-based and avoid things that are sugar based or made of flour. • “Keep an eye on the size of the portion. A lot of fruits in the super market are really big and may be more than one serving. In general, eat the fruit instead of drinking the juice, which can be a big sugar load. • “Eat food as close as to its natural form as possible. • “Avoid beverages high in sugar.” Sharon Brangman, professor of medicine and head of the Geriatric Department at SUNY Upstate Medical University “If you can convince places like McDonald’s and Burger King to make healthful snacks available, then we will see there will be movement toward healthy eating. “People need more fruits and vegetables.” “We need to eat more of the foods that are natural and not processed. These will keep us healthier as we age.” Physician Az Tahir, High Point Wellness, Syracuse
lem can worsen. B-12 is in anything that comes from an animal, like eggs, chicken, beef. Definitely look at signs of deficiency, like tingling in the hands and feet. As we get older, that can be related to nerve and arthritis issues. Primary care may not pick up on this but it’s really a B-12 deficiency. It can also cause cognitive issues, like the brain isn’t speaking to the arm to move it the right way. The doctor doesn’t usually include B-12 in a panel. • “Increase calcium and vitamin D. Good sources include fortified milk. As we age or in general, lactose can be an issue. Getting calcium from cow’s milk can cause digestive problems. Plant-based milk can be fortified, and juice like orange juice. Broccoli is also a source. • “Folic acid is another one that’s
Making the best of the time that’s left
• “As we age, absorption is different as is the sense of smell and taste. Over the age of 50, our ability to absorb B-12 decreases with decreased stomach acid. As we take these antacid medications, the prob-
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usually fortified in a lot of foods. • “We have a decreased sense of thirst and smell; it’s blunted as we age. You might not feel thirsty but that doesn’t meet you shouldn’t keep fluids in front of you all day. • “You might have a decreased sense of taste where you’re not as interested in food. Herbs and spices can help you keep interested in foods. ª “If you have dental issues as you age, foods hurt sometimes. Hard, raw vegetables and foods with skin can be hard to eat. Try soups and stews made with a lot of healthful vegetables. The nutrients are all there for you.” Evelyn Mariani, registered dietitian, the office of William A. Graber, MD, PC, Utica and Syracuse.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
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Looking for Care: How to Hire an In-Home Caregiver
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Finding a good in-home caregiver for an elderly parent can be challenging. How can you find one that’s reliable and trustworthy, as well as someone your parent likes and is comfortable with? Here are some tips that can help. Know Your Needs Before you start the task of looking for an in-home caregiver, your first step is to determine the level of care your mom needs. This can pinpoint the type of help she’ll need. For example, if she only needs help with daily living tasks like shopping, cooking, doing laundry, bathing or dressing, a “homemaker” or “personal care aide” will do. But if she needs health care services, there are “home health aides” that may do all the things a homemaker does, plus they also have training in administering medications, changing wound dressings and other medically related duties. Home health aides often work under a nurse’s supervision. Once you settle on a level of care, you then need to decide how many hours of assistance she’ll need. For example, does your mom need someone to come in just a few mornings a week to help her cook, clean, run errands or perhaps bathe? Or does she need more continuous care that requires daily visits or a full-time aide? After you determine her needs, there are two ways in which you can go about hiring someone. Either through an agency, or you can hire someone directly on your own. Hiring Through an Agency Hiring a personal care or home health aide through an agency is the safest and easiest option, but it’s more expensive. Costs typically run anywhere between $14 and $25 an hour depending on where you live and the qualification of the aide. How it works is you pay the agency, and they handle everything including an assessment of your mom’s needs, assigning appropriately trained and prescreened staff to care for her, and finding a fill-in on days her aide cannot come. Some of the drawbacks, however, are that you may not have much input into the selection of the caregiver, and the caregivers may
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change or alternate, which can cause a disruption. To find a home-care agency in your mom’s area ask for referrals through friends, family or doctor’s offices, or use the home-care locator service tool at PayingForSeniorCare. com — click on “Find Quality, Affordable Care.” In addition, Medicare offers a home health compare tool at Medicare.gov/ HomeHealthCompare to help you find and compare home health care agencies. You also need to be aware that original Medicare does not cover inhome caregiving services unless your mom is receiving doctor’s ordered skilled nursing or therapy services at home too. But if your mom is in a certain Medicare Advantage plan, or is low-income and qualifies for Medicaid, she may be eligible for some coverage. Hiring Directly Hiring an independent caregiver on your own is the other option, and it’s less expensive. Costs typically range between $12 and $20 per hour. Hiring directly also gives you more control over who you hire so you can choose someone who you feel is right for your mom. But be aware that if you do hire someone on your own, you become the employer so there’s no agency support to fall back on if a problem occurs or if the aide doesn’t show up. You’re also responsible for paying payroll taxes and any workerrelated injuries that may happen. If you choose this option make sure you check the aide’s references thoroughly, and do a criminal background check, which you can do through sites like eNannySource. com. To find someone, ask for referrals or try eldercare-matching services like Care.com or CareLinx.com. Or, for a fee, an aging life care expert (see AgingLifeCare.org) can help you find someone.
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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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
Community can simply mean your family unit. The more you know about what your loved ones are exposed to, the better you can protect them. We also receive reports where someone pretending to be a Social Security employee has contacted members of the public. The intent of this type of call may be to steal your identity and money from your bank accounts. They may state that your Social Security number will be suspended or they may demand immediate payment. The caller generally asks you for personal information such as your Social Security number, date of birth, your mother’s maiden name, or your bank or financial account information. You should not provide any of this information to these individuals. It’s possible that a Social Security employee may contact you to followup on a previous application for Social Security benefits or to followup on other business you initiated with Social Security. Remember, Social Security employees will never threaten you or demand any kind of payment in exchange for services. It’s important that you report any and all fraud. This can only strengthen our communities and your family. You can report Social Security fraud at oig.ssa.gov/report.
A: Social Security Disability Insurance (SSDI) is based on prior earnings. SSDI is financed through the taxes you pay into the Social Security program. To be eligible for a SSDI benefit, the worker must earn sufficient credits based on taxable work to be “insured” for Social Security purposes. SSDI benefits are payable to eligible blind or disabled workers, the widow(er)s of a disabled worker, or adults disabled since childhood. SSI disability payments are made based on financial need to adults or children who are disabled or blind, have limited income and resources, meet the living arrangement requirements, and are otherwise eligible. SSI is a program financed through general revenues. For more information, visit www. socialsecurity.gov. Q: Can a noncitizen get Supplemental Security Income (SSI)? A: The laws and regulations concerning noncitizens differ for Social Security and SSI programs. Social Security administers both, even though they have different eligibility requirements. Some noncitizens do qualify for SSI. See Supplemental Security Income (SSI) For Noncitizens at www. socialsecurity.gov/pubs for more information.
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Making that Connection InterFaith Works’ One to One program offers friendship for nursing home residents By Mary Beth Roach
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or Melonie Unger, her weekly chats with Shirley Beckeman at The Nottingham senior citizen facility are almost like visiting her grandmother. For Beckeman, knowing that Unger is coming is comforting and always cheers her up. The two talk about the good old days in the Cazenovia-Delphi Falls area, mutual friends and acquaintances, and flowers. A master gardener in her day, Beckeman has already made recommendations to Unger for her garden once spring arrives, based on some catalogs the pair pored through during one recent visit. “It just changes my whole day when she visits me,” Beckeman said. “We spend the time laughing, talking about birds, gardening and wonderful memories.” But just several short months ago, the two didn’t even know each other. They met and became fast friends through the One to One program, offered by InterFaith Works of Central New York, which pairs volunteers to senior citizens living in area nursing homes. The organization recently received a $30,000 grant from the Central New York Community Foundation to enable it to continue
to run the program for three years. The program should be sustainable within that time frame. The initiative is “our effort at InterFaith Works to combat loneliness and isolation that we know many nursing home residents experience,” said Toma Tracy, senior services coordinator for the agency. Based on James Street in Syracuse, InterFaith Works has worked in senior services for more than 30 years. But in the past, it has mostly focused on connecting volunteers with people living independently. One to One started last July, following a pilot program the previous year. Through research and a great understanding of the community, Tracy said, the staff at InterFaith Works has seen an increase in population at nursing homes but a decline in those who visit them. Changes in society and family life contribute to this situation, Tracy said. Children often move away from their hometown; divorces can leave people alone as they age; and families no longer live in multi-generational homes, so there’s less family connection and support, she explained. “We wanted to make a difference,” she said. “We decided we
would take a very direct approach to loneliness by connecting a volunteer with a nursing home resident.” Instant match Over the past few months, Unger has come to realize that she and Beckeman have more in common than she could have imagined. For example, she would learn that Beckeman had been an instructor at the same ski resort where Unger had learned the sport, and that Beckeman attended the same church as Unger’s mother’s best friend. Sometimes the two even talk about farming, since Beckeman grew up in Cazenovia and Unger was raised in neighboring Delphi Falls. “It’s a blessing to you, just as much as it is a blessing to the person you’re visiting,” Unger said. The experience, too, can make volunteers appreciate what they have at this point in their lives, she pointed out. Seeing the potential benefits of the program, the Community Foundation was interested in becoming involved, according to Danielle Gill, director of its community grant-making. “As the elderly population grows, more and more studies are coming out talking about the isoAugust 2019 •
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lation and the loneliness, and the effects that that has on individuals both mentally and physically,” she said. “And so, when we saw what InterFaith was looking to do, we were really impressed with the need that they were addressing, but also the way in which they were addressing it. It’s a program that’s making a big difference.” Unger is one of about 10 volunteers in the program, but InterFaith Works is planning to expand to approximately 70 volunteers, according to Tracy. Prospective volunteers are invited to meet with Tracy for about 30 minutes, during which time she learns more about them and assesses their interests in order to make a better match with a senior companion. A background check is also done. It is important that volunteers can make a long-term commitment to the program and be able to schedule their visits at the same time and day each week, so as to provide continuity for their senior friend and establish a good rapport. If those potential volunteers are a fit, they are invited to attend a two-hour training session, where they learn more specifics about the program. In-service training is also scheduled quarterly, Tracy said, in order to continue to support volunteers. InterFaith Works will accommodate, to the best of its ability, requests from family members who aren’t able to visit loved ones in a nursing home. For those wishing to volunteer or seeking to perhaps arrange for a weekly visit for a friend or family member, contact Tracy at 315-4493552, ext. 203 or email ttracy@infaithworkscny.org.
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H ealth News Garden named assistant dean for disability at Upstate Rebecca Garden, Ph.D., associate professor of public health and pre ventive medicine, has been named assistant dean for disability and inclusion at Upstate Medical University As assistant dean for disability and inclusion, Garden will expand her Garden role as co-chairwoman of the disability and inclusion task force to align Upstate Medical University with best practices for disability awareness and accessibility. These efforts will include faculty development, inclusive pedagogy and integrating disability as subject matter into the curriculum. This initiative will help create greater access for all in the university, particularly diverse populations. Garden’s research and teaching are in a field called the health humanities, and she uses literature — particularly autobiographical narratives — as well as literary and disability studies to address social, cultural and ethical issues in healthcare and public health. Her most recent research looks at popular and literary narratives of aging and dementia, exploring the social and ethical issues and how disability studies perspectives might help to address bias and disparities. Garden joined Upstate in 2004 and has served as a professor of bioethics and humanities. She holds a Ph.D. in English and comparative literature from Columbia University.
Crouse Health Receives ‘Get With The Guidelines Heart Failure’ Crouse Health has received the American Heart Association’s Get With The Guidelines — Heart Failure Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring heart failure patients receive the most appropriate treatment according to nationally recognized, research-based guidelines. The goal is speeding recovery and reducing hospital readmissions for heart failure patients. Crouse Health earned the award by meeting specific quality achievement measures for the diagnosis and treatment of heart failure patients at a set level for a designated period. These measures include evaluation of the proper use of medications and aggressive risk-reduction therapies. Before discharge, patients should also receive education about managing their heart failure and overall health; have a follow-up visit scheduled, along with other care transition interventions. “Crouse Health is dedicated to improving the quality of care for our Page 28
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patients with heart failure by implementing the American Heart Association’s Get With The Guidelines-HF initiative,” said Lynne Shopiro, cardiac services administrator “The tools and resources provided help us track and measure our success in meeting evidence-based clinical guidelines developed to improve patient outcomes.” Crouse Health is also recognized on the association’s Target: Heart Failure Honor Roll. Hospitals are required to meet specific criteria that improves medication adherence, provides early follow-up care and coordination and enhances patient education. The goal is to reduce hospital readmissions and help patients improve their quality of life in managing this chronic condition.
Crouse receives ‘Get With The Guidelines Target: Stroke’ Crouse Health has received the American Heart Association/American Stroke Association’s Get With The Guidelines Target: Stroke Honor Roll Elite Plus Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Crouse Health earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines. The program is designed to speed recovery and reduce death and disability for stroke patients. Before discharge, patients should also receive education about managing their health and have a follow-up visit scheduled, along with other care transition interventions. “Crouse Health is dedicated to improving the quality of care for our stroke patients by implementing the American Heart Association’s Get With The Guidelines Stroke initiative,” said Chief Operating Officer/ Chief Medical Officer Seth Kronenberg, MD. “The tools and resources provided help us track and measure our success in meeting evidenced-based clinical guidelines that improve patient outcomes.” Crouse Health additionally received the association’s Target: Stroke Elite Plus award. To qualify for this recognition, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-busting tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke. “We are pleased to recognize Crouse Health for its commitment to stroke care,” said Lee Schwamm, M.D., national chairman of the quality oversight committee, executive vice chairman of neurology and director
IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
Crouse Health Offers Cord Blood Donation Process to Families Delivering Babies
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arents delivering at Crouse Health will now have the opportunity to voluntarily donate their baby’s umbilical cord blood to the Upstate Cord Blood Bank at Upstate Medical University. This new partnership will potentially increase cord blood donations that will be available for public use. “We are pleased to welcome Crouse Health parents to participate in donating their child’s umbilical cord blood to the Upstate Cord Blood Center at Upstate Medical University,” said physician Matthew Elkins, medical director of the Upstate Cord Blood Bank. Thousands of critically ill patients with blood diseases such as leukemia and lymphoma are in urgent need of life-saving transplants. Umbilical cord blood, which is typically discarded as medical waste, is rich with the blood-forming cells that can give blood cancer patients hope for a cure. “Crouse is proud to partner with Upstate’s Cord Blood Bank on this public health initiative,” said Director of Women and Infants Services Betty O’Connor. “If a life can be enhanced or saved through this collection, the Crouse maternity team is pleased to assist in the effort.” Cord blood donation is completely safe for mother and baby; labor and delivery is not affected. No blood is taken from a newborn; it is only removed from the umbilical cord after birth. The designation of Upstate Cord Blood Bank as a public blood bank is important in that there is no cost to donate and donated cord blood is available to anyone who needs it.
of acute stroke services at Massachusetts General Hospital. “Research has shown that hospitals adhering to clinical measures through the Get With The Guidelines quality improvement initiative can often see fewer readmissions and lower mortality rates.”
Clark Burn Center has new medical director Jessica Summers has been appointed assistant professor of surgery and medical director of the Clark Burn Center. The Clark Burn Center is a regional referral center providing stateof-the-art burn care, serving more than 41 counties from Summers as far north as the St. Lawrence River to northern Pennsylvania, and from Rochester to Albany, including the northern areas
Once donated, the cord blood will be stored in the bank and made available to transplant centers in the United States and throughout the world for patients in need. The cord blood units will be listed on national and international registries in order to be matched to the patients who need them. Any units collected that are not suitable for transplantation will be made available to researchers, both at Upstate Medical University and around the country. Deciding whether to donate cord blood is best done during the early months of pregnancy. Various forms are completed by the expectant parents and submitted directly to the cord blood bank no more than 30 days prior to delivery. Once reviewed and approved, the bank notifies Crouse’s labor and delivery unit, which reviews the potential donation with the mother before actual delivery. Once the blood is removed from the umbilical cord, the donation is then packaged and transported to Upstate’s 20,000 square-foot facility that features a state-of-the-art processing laboratory and cryogenic storage containers. “The decision one makes to donate a child’s umbilical cord blood has the potential to save lives, through transplantation or biomedical research,” says Elkins. The Upstate Cord Blood Bank operates under strict guidelines and protocols, established by state and federal health organizations, including the state Health Department; Food and Drug Administration; AABB Center for Cellular Therapies; and the Foundation for the Accreditation of Cellular Therapy. For more information about the Crouse Cord Blood Collection initiative, visit crouse.org/cordblood. of Pennsylvania and parts of Canada. The center cares for both adult and pediatric patients in the inpatient and outpatient settings. Prior to joining Upstate last fall, Summers was on the faculty of the University of Nebraska Medical Center from May 2015 to August 2018, where also she served as medical director of the burn unit. She previously held a faculty post at the UPMC Mercy Hospital and UPMC Presbyterian Hospital, University of Pittsburgh School of Medicine. Summers is board-certified in general surgery and surgical critical care and is a fellow of the American College of Surgeons. Summers has authored numerous abstracts and delivered presentations on a variety of topics including the influence of poverty level on urban versus rural trauma patients, and fall prevention. Summers earned her medical degree from Drexel University College of Medicine and a bachelor’s degree from University of California Davis.
H ealth News Oswego County Integrated Delivery Network Awarded $776,537
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based on several key considerations (innovativeness, compelling need, collaboration with other organizations etc.). In total, the 15 projects were selected to receive funding to develop programs that address critical areas of need. ConnextCare, based in Pulaski, was the lead applicant for the funds on behalf of OCIDN. The funds will support a “collaborative system of care to improve cardiovascular disease outcomes in Oswego County.” The goal of the project is to improve the health outcomes and reduce costs for Oswego County residents with or at-risk for cardiovascular disease (CVD). To achieve this goal, ConnextCare, with its OCIDN partners, will implement an integrated population health management system of care for residents with or at-risk for CVD. The project will integrate services among key Oswego County care and service providers and implement a clinical care management and care coordination system across primary
care, substance use disorder, specialty, hospital, and social service providers. The project will also integrate healthcare services with community-based services, including self-management education programs, nutritional counseling, and services addressing social determinants of health. This will enable to managing populations from a whole-person care perspective. “This integrated approach will also serve to expand the reach of population health management beyond the walls of the delivery system and into the community,” said Daniel Dey, president and CEO of ConnextCare. “When it is in place, the OCIDN system of care will provide services to an estimated 6,200 adults with or at-risk for CVD annually, including an estimated 1,800 Medicaid patients.” OCIDN is comprised of ConnextCare, Catholic Charities of Oswego County, Farnham Family Services, Oswego County Department of Social Services, Oswego County Health Department, Oswego Health, Os-
wego County Opportunities, and St. Luke Health Services. OCIDN was established with a Rural Health Network of Oswego County’s planning grant that was awarded in 2016. The purpose of the planning grant was to develop a roadmap to establish an integrated care management system across providers in Oswego County. The successful grant administration led to the formation of the Oswego County Integrated Delivery Network. According to Eric Bresee, OCIDN’s chairman, “OCIDN’s membership represents stakeholders across health care and community-based service providers. OCIDN’s clinical-community partnership includes community-based entities that that address medical, behavioral health, substance use, and social needs, thus enabling us to create a holistic approach to care for residents of Oswego County.”
Roswell Park, Oneida Health Make Quality Radiation Care Available in Oneida
ity of all treatment options and adherence to guidelines that carefully control radiation doses to improve patient outcomes and quality of life. Every patient’s radiation treatment plan will be reviewed by a team of radiation oncologists at Roswell Park. In addition, all staff based in Oneida will be trained on Roswell Park standards. “This translates to exceptional National Cancer Institute-level cancer care for residents of Central New York,” according to the news release. The center joins an established medical oncology center operated jointly by Roswell Park and Oneida Health on Oneida’s campus under the medical direction of physician Mohamed el-Naghy. Oneida Health is also currently in the process of expanding its outpatient Alice M. Gorman Imaging Center to further meet the needs of its cancer patients. “Today marks another important step in Oneida Health and Roswell Park’s collaborative effort to pro-
vide a high quality of cancer care services to the residents of Central New York,” said Gene Morreale, president and CEO of Oneida Health. “With the addition of radiation oncology we will now be able to provide patients with more comprehensive treatment options, close to home. Patients will benefit from state-of-the-art diagnosis, local access to NCI cancer care guidelines, and the latest treatment options from a comprehensive cancer center ranked among the top 3% in the nation. In 2016, Oneida Healthcare was awarded a grant from the NYS Department of Health for $6.75 million to expand oncology services to CNY in partnership with Roswell Park. That state investment has been further supported by regional donors who have contributed over $2.3 million to the project, including a $1 million gift from the Dorothy G. Griffin Charitable Foundation.
he Oswego County Integrated Delivery Network (OCIDN) was awarded $776,537 from the Central New York Care Collaborative, Inc. (CNYCC). The award was included in an announcement by CCNY of $8.4 million in awards for 15 healthcare and community-based related projects across Central New York through its innovation fund. The innovation fund was established by Central New York Care Collaborative in 2017 to help coordinate services and improve care for Medicaid and uninsured patients by funding creative approaches that address physical, social and mental health needs while also fostering cross-sector partnerships throughout six counties in the region (Cayuga, Lewis, Madison, Oneida, Onondaga, and Oswego). The 2019 innovation fund awardees were selected from nearly 40 applications submitted from local organizations. Applicants submitted proposals that were scored and ranked by an independent evaluator
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he leadership from Roswell Park Comprehensive Cancer Center in Buffalo and Oneida Health recently held the grand opening of the Dorothy G. Griffin Radiation Oncology Center on Oneida’s campus. This is the next step in expanding the reach of the Roswell Park Care Network, which launched in May. “Our shared vision with Oneida Health offers patients state-ofthe-art equipment and clinical and technical expertise that only a National Cancer Institute (NCI)-designated comprehensive cancer center such as Roswell Park can provide,” stated a news release issue by Roswell Park. “Under the Roswell Park Care Network, it means access to chemotherapy infusion, clinical
trials, genetic counseling, supportive care and educational services. Adding radiation oncology to this slate of services expands convenient access to comprehensive cancer care for residents of Central New York.” The completed radiation oncology center features four exam rooms, a consultation room, a CT scanner, a Truebeam linear accelerator for radiation therapy and required support facilities, with clinical and quality management provided by Roswell Park radiation oncologist Shilpa Vyas, as well as a Roswell Park medical dosimetrist and medical physicists. Vyas and her team will follow the same quality standards patients can expect at Roswell Park, including evidence-based and peer-reviewed radiation treatment plans, availabil-
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H ealth News Crouse Health Earns Dual Certification as a Comprehensive Stroke Center Crouse Health has earned the distinction of being the first and only hospital in the region to receive dual certification as a comprehensive stroke center, reflecting the highest level of regional expertise for the treatment of serious stroke events. Comprehensive stroke centers are typically the largest and bestequipped hospitals in a geographical area for treating any type of stroke or stroke complication. In May 2018, Crouse received certification from DNV-GL Healthcare, one of the leading accrediting agencies in the U.S., making it one of just four DNV-certified advanced stroke centers in New York state. Additionally, Crouse received its second designation as a comprehensive stroke center from the New York State Department of Health, which designated the hospital as a primary stroke center in 2007. Crouse is currently the only NYS DOH-designated comprehensive stroke center in the region. Certification by these two organizations is based on quality standards and affirms that the recipient hospital addresses the full spectrum of stroke care — diagnosis, treatment, rehabilitation and education, while establishing clear metrics to evaluate out-
Crouse Health President and CEO Kimberly Boynton. comes. Comprehensive stroke centers deliver the highest quality of care to the most complex cases, delivering evidence-based treatment with the latest research protocols. “Both DNV and the New York State Department of Health have affirmed that Crouse meets the most stringent quality and process standards in treating stroke,” said Crouse Health President and CEO Kimberly Boynton. “Our community can be grateful for the expertise and commitment of our physicians, nurses, interventional technicians and the entire clinical team,” adds Boynton. Crouse is the only hospital in the region equipped with two hybrid
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operating room suites, allowing the stroke team to provide the most advanced endovascular stroke rescue capabilities. The Crouse stroke team consistently meets — and exceeds — aggressive door-to-treatment times that surpass the U.S. average. Tissue plasminogen activator (tPA) is an FDA-approved drug that dissolves clots and improves blood flow to the part of the brain being deprived of blood and, therefore, oxygen. If tPA is given within three hours of symptoms, the effects of stroke decrease significantly. Crouse has earned the American Heart/Stroke Association’s Target: Stroke Honor Roll Elite Plus recognition for meeting — and exceeding — AHA guidelines for giving tPA within 45 minutes. “The time-critical nature of stroke events makes it essential to have rigorous and efficient protocols in place to provide life-saving care,” said physician Tarakad Ramachandran, medical director of Crouse’s stroke program. “Certification from both DNV and the New York State Department of Health validates the experience and dedication of our clinicians and the commitment of Crouse toward the highest quality of stroke care for our region.”
New Breast Biopsy Technology Enhances Care The Dr. Hadley J. Falk Breast Health Center at Crouse Health is the first in Syracuse to offer the new Hologic 3-D Breast Biopsy Prone System. The advanced technology is designed to provide more accurate diagnoses with patients’ physical and emotional comfort at the forefront. During the needle biopsy, the patient is prone, or laying face down, instead of sitting or standing. “The 3-D system is superior in its ability to detect potential cancers and allows us to locate the same abnormality seen on the patient’s screening exam to accurately place the needle for a subsequent biopsy,” said physician Stephen Montgomery, director of the Falk Breast Health Center. The prone system also eliminates a direct view of the biopsy needle, helping to greatly reduce patient stress. To make an appointment with the Falk Breast Health Center, call 315-470-5880 or visit crouse.org/ mammoappt.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • August 2019
TOGETHERWEFIGHT hoacny.com
Impacting patient care, education, research, and community health and well-being through charitable giving.
That is why Dr. Frederick “Fritz” Parker and his wife Ginny have included the Upstate Foundation in their estate plans. Fritz retired from Upstate Medical University in 2001 as chair of the Department of Surgery. In his 30-year career, Fritz pioneered the cardiac surgery department, earning a reputation as the region’s preeminent cardiac surgeon.
“ We’ve been blessed. There’s no question.”
Ginny impacted the lives of countless young people through a long career in education, as co-founder and former co-director of the Kynda Montessori School.
“We want to leave a legacy that reflects our love for our community,” Ginny explained. “Our hope is that our gift will continue to strengthen Upstate and serve as an inspiration to others who are considering their own legacies.” Creating a legacy is easier than you think! Contact our planned giving professionals at 315-464-6490 or Hamiltol@upstate.edu. To learn more about the Parkers, visit www.UpstateFoundation.org/legacy.
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