Igh cny 191 nov15

in good November • Issue 191

The Martian Could ‘The Martian’ Scientist Survive on Potatoes Alone?

Expert Alert: Are CT Scans Safe?

Mayo Clinic radiation safety expert writes a paper with clear answers to potential patients’ fear of CT scans

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Alzheimer’s Tsunami Coming How bad is the problem? Pretty bad, experts say. Just consider this: The number of people affected will nearly triple in a few decades.

PLUS: 10 Early Signs You May Have Alzheimer’s Inside

‘Tennis Elbow’ Bothering You? Read what the experts say about it

US Surgeon General Launches Call to Action on Walking Why you should eat more

LEEKS

Read the SmartBites column

Where Miracles Do Happen

Crouse Hospital’s Neonatal Intensive Care Unit (NICU) treats the sickest babies from 15 counties in the region. It’s turning 40 this year amid a campaign to raise funds for a large expansion November 2015 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 1

Where Are the Hot Jobs?

Twelve Out of Top 20 Are in Healthcare

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

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he number of healthcare jobs is growing substantially, despite a semi-stagnant economy. Of the Bureau of Labor Statistics’ top 20 jobs slated for growth between 2012 and 2022, 12 are related to healthcare.

The top five are, in order, personal care aides (No. 2), home health aides (No. 3), diagnostic medical sonographers (No. 6), occupational therapy assistants (No. 8) and genetic counselors (No. 9).

Fortunately, the Central New York area boasts institutions offering education for people seeking careers in these areas.

Personal care aides and home health aides usually receive training from their places of employment upon hire. New Beginnings, for example, offers free training to qualified applicants. The company serves Onondaga, Cayuga, Oswego and Seneca counties. As an entry level into a possible long-term healthcare career, personal care aide and home health aide positions present no risk and provide an opportunity to try out the industry. The aging baby boomer population, along with the industry-wide shift toward at-home care, should supply plenty of work for the foreseeable future.

Future diagnostic medical sonographers can receive training at SUNY Upstate Medical University. The school requires applicants to have completed 60 hours of prerequisite

coursework, comprised of specific numbers of general education, electives and major-related classes.

As the role of ultrasound expands with both use, such as for breast ultrasound, and its scope, including 3-D and 4-D technology, it’s easy to see how sonography holds a bright future for students.

Bryant and Stratton College recently announced that its Syracuse campus offers an occupationalt assistant (OTA) associate of applied science degree program, one the few in the Syracuse area. OCM BOCES also offers education in physical therapy assistant.

Le Moyne also offers a variety of programs, ranging from nursing, physician assistants and occupational therapy, among others.

Again, the aging baby boomers likely contribute to the demand for occupational therapy assistants. As more Americans have healthcare coverage than ever before, while reimbursements for many medical disciplines have become squeezed, the need for assistants to pick up the slack also drives demand for occupational therapy assistants.

SUNY Upstate offers degrees in genetics. As the field of study continues to grow in importance for predicting, preventing and treating disease, the number of genetics experts needed should continue to rise.

Labor Department: Fastest Growing Occupations

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he Bureau of Labor Statistics listed the following fastest growing occupations. These 20 occupations should have the highest percent of change of employment between 2012 and 2022, meaning those in school and enrolling in school soon should reap the benefit of employment availability and career stability.

1- psychologists 2- personal care aides 3- home health aides 4- insulation workers, mechanical 5- interpreters and translators 6- diagnostic medical sonographers

7- helpers (brickmasons, block masons, stonemasons and tile and marble setters) 8- occupational therapy assistants 9- genetic counselors 10- physical therapy assistants 11- physical therapy aides 12- skincare specialists 13- physician assistants 14- segmental payers 15- helpers / electricians 16 -information security analysts 17- occupational therapy aides 18- health specialties teachers, postsecondary 19- medical secretaries 20- physical therapists

Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by

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In Good Health is published 12 times a year by Local News, Inc. © 2015 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776.

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Matthew Liptak, Chris Motola, Suzanne M. Ellis • Advertising: Amy Gagliano, Cassandra Lawson Design: Chris Crocker • Office Manager: Alice Davis 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

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Page 3

‘Tennis Elbow’ Usually Heals Without Therapy, Study Finds

Expert Alert: Are CT Scans Safe?

For most people, pain is gone within a year

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ost people with tennis elbow recover without physical therapy and steroid injections, according to a study by researchers in Norway.

“I’m not surprised because that’s really been the classic teaching,” said Joshua Dines, an orthopedic surgeon at the Hospital for Special Surgery in New York City.

“The number that’s often cited is that 90 percent of tennis elbow, golfer’s elbow, will get better by the end of the year no matter what you do.”

Study first author Morten Olaussen, a specialist in family medicine at the University of Oslo, agreed that the finding was expected.

But, he added, “it is interesting to note that after one year, as much as one-third of the patients still reported considerable discomfort.”

What was surprising, said Olaussen, was that physical therapy was not effective. “It has been shown to be effective in earlier research but then on more chronic conditions,” he said.

In their study, published recently in BMC Musculoskeletal Disorders, Olaussen and his colleagues looked at outcomes for 177 Norwegian patients with a recent onset of tennis

elbow pain.

Symptoms of tennis elbow include a weak grip and pain from damage to tendons in the forearm. Often, this happens from repetitive use, such as with tennis, golf or carpentry.

The patients in this study had experienced their symptoms for up to three months. Each was randomly assigned to one of three groups: either no treatment except for drugs such as naproxen (Aleve); physical therapy for 12 sessions along with two corticosteroid injections to reduce inflammation; or 12 sessions of physical therapy and two placebo injections.

Patients underwent the therapies for six weeks, and they were tracked for one year. At the end of that time, 157 people had completed the study.

Overall, improvement with physical therapy plus placebo injection or steroid injection was about the same as with no treatment at all.

For three-fourths of the patients, the elbow pain had disappeared at one year, regardless of which group they were in.

But at least one-quarter still had symptoms at one year.

W

ith questions lingering about the safety of medical imaging and the radiation that is used in some of those tests, Mayo Clinic radiation safety expert Cynthia McCollough wrote a paper that provides clear answers that she hopes will allay patients’ fears.

McCollough wrote “Answers to Common Questions About the Use and Safety of CT Scans,” which was published Oct. 1 in Mayo Clinic Proceedings as a Q&A in an effort to provide credible, balanced information about how much radiation a CT scan delivers and what levels are considered safe.

So, are CT scans safe?

Yes, says McCollough.

Patients can get a prescribed CT scan without worrying, McCollough says. “Radiation has a bad rap. The Incredible Hulk and Spider Man were mutants created from some radiation exposure; that’s science fiction. The truth is we are all ex-

posed to radiation every day of our lives, with no evidence that those low doses cause any longterm harm.”

Areas that have higher background radiation levels (from the sun and radon in the ground, for example) have lower cancer rates. If there is a cause and effect, it’s simply too small to measure. And, because of increased research and updates in technology, less radiation also is used these days in medical imaging.

“Over the past decade, the radiation doses used in CT have been cut by almost a factor of two,” McCollough says. “The current dose levels are not dangerous, but if we can use less, we will. I can take two Tylenol for a headache and not worry about it being dangerous. But, if one Tylenol will get rid of my headache, it is prudent medicine to take a lower dose — and that is what we want with radiation.”

In addition, radiologists are keenly aware that radiation doses will vary based on patient size, so children are given a child-size dose instead of the amount an adult would receive.

“What we have done over the past decade is, as a community, launched national and international campaigns to make sure that CT providers understand that they need to right-size the dose and dial down for the little ones,” McCollough says.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

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US Surgeon General Launches Campaign with National Call to Action on Walking

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he United States surgeon general recently issued a call to action to address major public health challenges such as heart disease and diabetes.

Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities articulates the health benefits of walking while addressing the fact that many communities unacceptably lack safe and convenient places for individuals to walk or wheelchair roll.

“Walking is the simplest way to add more physical activity into our everyday lives,” said Lawrence E. Armstrong, president of the American College of Sports Medicine.

“Research demonstrates numerous health benefits of walking and healthy eating, and ACSM supports this call to action to create healthier, more active communities in the U.S.” Data consistently show there are safety and accessibility issues that make communities less walkable. A 2013 study by the U.S. Department of Transportation, for example, found that three out of every 10 Americans

reported that no sidewalks existed along any streets in their neighborhood. In many communities violence – and the perception of violence – may prove a barrier to walking.

“Everyone deserves to have a safe place to walk or wheelchair roll. But in too many of our communities, that is not the reality,” said Vivek H. Murthy, the 19th U.S. Surgeon General. “We know that an active lifestyle is critical to achieving good overall health. And walking is a simple, effective and affordable way to build physical activity into our lives. That is why we need to step it up as a country ensuring that everyone can choose to walk in their own communities.”

The surgeon general calls on community planners and local leaders to create more areas for walking and wheelchair rolling and to prioritize the development of safe routes for children to get to and from schools. The call to action suggests that these designs should include sidewalks, curb cuts, crosswalks, safe crossings for the visually impaired and more green spaces.

Blueberry Extract Could Help Fight Gum Disease, Reduce Antibiotic Use

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um disease is a common condition among adults that occurs when bacteria form biofilms or plaques on teeth, and consequently the gums become inflamed. Some severe cases, called periodontitis, call for antibiotics.

But now scientists have discovered that wild blueberry extract could help prevent dental plaque formation.

Their report in ACS’ “Journal of Agricultural and Food Chemistry” could lead to a new therapy for periodontitis and a reduced need for antibiotics.

Many people have had some degree of gum inflammation, or gingivitis, caused by dental plaque.

The gums get red and swollen, and they bleed easily. If left unchecked, the condition can progress to periodontitis. The plaque hardens into tartar, and the infection can spread below the gum line and destroy the tissue supporting the teeth. To treat

this condition, dentists scrape off the tartar and sometimes have to resort to conventional antibiotics.

But recently, researchers have started looking at natural antibacterial compounds to treat gum disease.

Daniel Grenier and colleagues wanted to see if blueberry polyphenols, which work against foodborne pathogens, could also help fightFusobacterium nucleatum, one of the main species of bacteria associated with periodontitis.

In the lab, the researchers tested extracts from the wild lowbush blueberry, Vaccinium angustifolium Ait., againstF. nucleatum. The polyphenol-rich extracts successfully inhibited the growth of F. nucleatum, as well as its ability to form biofilms.

It also blocked a molecular pathway involved in inflammation, a key part of gum disease. The researchers say they’re developing an oral device that could slowly release the extract after deep cleaning to help treat periodontitis.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Q: What is ClearPath Diagnostics?

A: We’re a privately owned, physician-owned pathology lab specializing primarily in GYN pathology and women’s health. We also do a wide range anatomic pathology as needed by our physicians that’s related to women’s health. Other tests we do related to STDs in women in addition to HPV: gonorrhea, chlamydia, herpes, syphilis. We also can run a panel on specific infections including yeast and bacterial vaginosis.

that involves visualizing the cervix and sometimes taking biopsies. Now we can do co-testing, doing the HPV test at the same time as the pap, so we can look for HPV strains that are more likely to cause lesions. If the pap test and HPV test both come back negative, there’s a very low chance of that the patient is going to have cervical cancer and then we can go to one of the longer callback periods, depending on the age of the patient.

Q: What diagnostic tools do you most rely on?

A: Probably the most wellknown screening tool is the pap smear. It’s probably the most effective cancer screening test that’s ever been developed. It’s caused a massive reduction in the rate of cervical cancer for women. In concert with that, we also do HPV testing on the same sample. So that really helps us out with identifying women who have precancerous dysplasias. After that, if you have abnormal paps, then standard biopsy material is examined and follow-ups are done with patients to make sure they don’t develop cancer.

Q: Is the callback period typically longer for older patients?

A: It usually is. If the patient is more sexually active, they’re at a higher risk. The screening recommendations for younger women is co-testing (pap test with HPV test) every three years; older patients may do this every five, provided both tests are negative.

Q: Have you seen any noticeable changes in your work post HPV-vaccine?

A: It’s still a little too early to tell.

There are a lot of hospitals around the United States where we’re starting to see decrease in the volume of pap smears. That’s due to changes in the recommendations made for pap test —It’s actually not a smear anymore — and HPV testing. So if you do both and they’re both negative, the recommendation is now to increase the amount of time before the next follow up. So instead of testing those patients every year, we’d test them every three to five years.

That’s not due so much to the immunization as the HPV testing.

The HPV vaccine shouldn’t really add to the decrease in pap testing, since even if you’re vaccinated, you still need regular screening. The volume decrease we see is a direct effect of the change in screening recommendations.

Q: You alluded to the pap test changing. Can you go into more detail?

A: It used to be that the patient would — if they had an abnormal pap, depending on the findings — come back in for colposcopy, which is a more invasive procedure

IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

Q: Do you interact with patients?

A: As far as the work we do on a daily basis, we don’t see patients here. We don’t see a lot placenta pathology or perinatal pathology. We’ll sometimes get specimens to check for products of conception, so for patients going elective abortions or things like that, we make sure there’s evidence of fetal tissue. We also get breast biopsy specimens to check for breast cancer. That’s primarily what we see on the anatomic pathology side of things.

In the News Physician Brian T. Pavlovitz recently joined ClearPath Diagnostics, a regional, tissue and cytopathology group, headquartered in Syracuse. Pavlovitz, a Baldwinsville native, is board certified in anatomic and clinical pathology. He was fellowship trained in cytopathology at Virginia Commonwealth University after serving his pathology residency at SUNY Upstate Medical University. Pavlovitz has expertise in surgical pathology and cytopathology. He was most recently staff pathologist at Rochester General Hospital and laboratory director at Clifton Springs Hospital & Clinic.

Q: What is the pipeline of communication between yourself and the patients?

A: All of the doctors we work with have a direct interface with our computer system, so they get their results that way. We’ll also fax reports to clinicians. We offer access to patients through our patient portal to look up their own results. It’s pretty easy for both the patients and docs to have direct communication with us if they need to.

Q: What’s steered you more toward the research side of things?

A: Earlier in my career I was a lab tech, so I had a lot of lab experience and enjoyed the diagnostic work. I liked the autonomy of it. I liked diagnosing diseases. It’s interesting, because we deal mostly with the patient’s physician. It’s not for everybody, but it’s perfect for me. I love dealing with the clinicians and helping them help their patients.

Q: Is there any promising research on the horizon?

A: I think as far as cervical cancer goes, we’re still waiting to see how these high-risk HPVs can develop into cervical cancers, and waiting on the results of the immunization program. It will be really interesting to see if the vaccine decreases the numbers of other HPV-related cancers, specifically squamous cell carcinomas of the head and neck. We’ll also want to see what the results of these longer intervals between tests will be and revise the standards to best help our patient population.

Q: What should women know about their reproductive health?

A: Never be complacent. HPV doesn’t usually give outward symptoms, so you probably won’t know that you have it, so it’s important to see your gynecologist to make sure that you’re in good reproductive health.

Lifelines Position: Pathologist at ClearPath Diagnostics Hometown: Baldwinsville, NY Education: St. Georges University, Grenada Affiliations: SUNY Upstate Organizations: United States and Canadian Academy of Pathology, American Society of Clinical Pathologists, American Society for Cytopathology Family: Married Hobbies: Cooking, baking, taking care of his two black Labrador Retrievers

The Healing Power of Horses More people in CNY are using animals for therapy purposes

By Deborah Jeanne Sergeant

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any in Central New York enjoy horses as recreational and competitive companions but a growing number of people are using them for therapy purposes.

Experts say that the bond created between client and horse achieves results not possible otherwise.

Therapeutic/adaptive riding refers to using groundwork or riding to help people with social problems, developmental delays, behavioral health or physical impairment improve their lives.

Hippotherapy represents a medical treatment overseen by a professional such as a physical, occupational or speech therapist who possesses further training in using horses for hippotherapy.

The Central New York area offers several facilities that partner with horses to help people.

Paul Caldwell, volunteer and board member with From The Ground Up Therapeutic Horsemanship, Inc. in New Woodstock, said that its six horses serve about 25 clients, including people with autism, Down syndrome, traumatic brain injury, post-traumatic stress and emotional and behavioral issues.

He believes that the horses connect with the clients’ emotional, spiritual, cognitive and social needs.

“Horses help with all of those,” Caldwell said.

The horse’s gait, for example,

mimics a human’s and gives the feeling of ambulation to someone who has never walked. That, combined with improving balance and core and leg strength, has helped some clients improve their ability to walk.

Clients also must learn to follow directions and, in time, will feel pride in controlling a large animal’s movements with ease.

Laura Little manages ARISE at the Farm, a 77-acre, 15-horse farm in Chittenango. About 90 children of all abilities attend the farm’s horsemanship camp and about 60 participate in therapeutic riding.

“The horses are large animals,” Little said. “Some people have no control over anything in their life.

Riding a horse, they can learn to steer, stop and have some control in their lives.

“Our therapy horses are very able to read their rider and make a connection with participants. I’ve seen this many, many times.”

Little sees many riders benefit physically from the program.

“Riding builds core strength,” she said. “Kids are working hard in therapy and don’t even know how hard they’re working. They’re achieving a lot of goals without knowing it.”

Barbara Lea, president of ASTRIDE of CNY, Inc. at Tanglewood Riding Center in Jamesville, also believes that “the outside of a horse

is good for the inside of a person.”

Weekly, the organization serves seven to eight clients with developmental disabilities and physical challenges.

“We work on whatever the rider needs to accomplish,” Lea said.

Caring for horses, for example, involves following directions and learning a sequence of smaller tasks.

Clients who struggle to communicate find that horses understand and follow their commands.

“In a year, when he is speaking better, that horse won’t do what the child wants unless he asks right,” Lea said. “It’s amazing the rapport that develops between a horse and rider.”

The program also serves adults who weigh less than 200 pounds and who can sit independently.

The eight horses at the Root Farm in Vernon help veterans and clients with developmental disabilities with therapeutic riding and hippotherapy.

“Seeing is believing,” said Alice Root, founder and board member of the 100-acre operation. “It’s not until you see one of these children get on a horse and you see what happens with them physically and emotionally that you can believe it.”

Volunteers help with both the care of the horses and in facilitating lessons since most riders need a leader and walkers on either side of the horse to ensure their safety.

Buffalo Therapeutic Riding Center, Buffalo: “More research is showing [hippotherapy] helps people.

We want everyone to know that we are helping people and serving needs here,” said Susie Schoellkopf, the organization’s executive director.

For some clients, physical or occupational therapists also trained in hippotherapy may be part of the session. Root hopes to expand the facility’s offerings in hippotherapy.

“We are now planning things that had only been a dream up to this point,” Root said.

All of these organizations use volunteers. If you enjoy horses and helping people, consider lending your time to benefit others.

Healthcare in a Minute

By George W. Chapman

Career opportunity

Researchers predict a shortfall of 130,000 nurses by 2025. There are about 2.8 million active nurses right now. The good news is, while 40 percent of RNs are over 50, the average age (recently peaked at 44) is declining as older nurses leave and younger nurses enter the workforce.

The bad news is the surge in nursing school enrollment in the 2000s has leveled off. Nursing, then, is still a pathway to a steady and good paying job. Nursing jobs at hospitals remain the most competitive, but hospitals typically hold out for experienced nurses as the acuity level of inpatients continues to rise.

Geriatricians needed

As the U.S. population continues to age, there will be an increasing need for these specialists who handle the complex medical problems of seniors. According to an article in Kaiser Health News, we will need 30,000 geriatricians by 2030. Right now, there are only 7,000 of these board certified specialists. The two keys to successfully turning out more geriatricians are medical students electing the specialty and hospitals converting existing residency slots to geriatrics. In any event, all physicians (except pediatricians, of course) will have to make adjustments in their modus operandi as their patients age.

Your doctor bill

As of Oct. 1, 2015, physicians are required to include much more diagnostic information and detail when submitting their bill to your insurance company for payment. The old diagnostic coding system was called ICD9 or International Classification of Diseases version 9. The latest version is ICD10. The number of diagnostic codes jumps from 14,000 under the old system to 69,000-plus under the new. Understandably, there will be some confusion, delays and honest mistakes made as physicians and insurers get used to the incredible amount of extra data required in claims processing. Consequently, you will need to be patient with both your doctor and insurance company as they become acclimated to ICD10. According to Forbes magazine, it is estimated that 25 percent of physicians are not prepared for the transition.

Health Republic Insurance shut down

New York state’s only co-op type healthcare insurer was ordered to cease operations by the NYS Department of Financial Services. Existing policies will be honored but not renewed. Last year Health Republic lost $77.5 million. It is projected to lose over $100 million this year.

Health Republic had a good start with a $241 million low-interest loan

from the feds and 200,000 members.

However, as discussed here previously, no matter how many members enrolled, the relatively low/unrealistic premiums were unsustainable.

Claims surpassed premiums by tens of millions. Inexplicably, the NYS Department of Financial Services, which reviews premiums on behalf of consumers, approved Health Republic premiums that were 30 percent below what other carriers on the exchange were offering. Many thought Health Republic was doomed from the start.

Uninsured decreasing

The Affordable Care Act provided two avenues for previously uninsured or under-insured Americans to purchase healthcare insurance.

First, it expanded Medicaid eligibility from 100 percent of federal poverty guidelines to 133 percent. Despite the fact that the federal government pays the bulk of the additional cost, some states opted out. (New York is in.)

Second, it set up healthcare exchanges so individuals could purchase insurance from private commercial carriers. As a result, in the last two years, the national percentage of uninsured has decreased from 17.3 percent to 11.7 percent. Massachusetts and Rhode Island have the lowest percentage of uninsured at less than 3 percent. New York is at 8.3 percent.

The states with the most uninsured November 2015 •

tend to be those that opted out of the expanded Medicaid program such as Texas at 20.8 percent and Wyoming at 18.2 percent.

Consumer satisfaction

A study based on 27,000 surveys, published in the American Journal of Medical Quality, found that patient satisfaction was somewhat correlated to the site of service. Physician care and concern had the biggest impact on patient satisfaction in outpatient or office based pediatrics. Nursing care was most important to patient satisfaction in hospital care. Overall personal care, or attention paid to the patient by all staff, had the biggest impact in emergency rooms.

Not surprisingly, patient satisfaction dropped precipitously the longer the patient waited for care. The research found that team-based care is the key to higher patient satisfaction.

George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York.

To reach him, email gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Say ‘No thank you’ this Thanksgiving!

I

n addition to counting your many blessings this Thanksgiving, I encourage all my readers who live alone (as well as those who don’t) to say “No thank you” to those things that get in the way of your personal growth and happiness.

Say “No thank you” to feeling sorry for yourself.

Feeling sorry for yourself only perpetuates a cycle of self-pity that can make you feel sad and needy. Chances are, you’ve survived a lot this year and have gained new self-knowledge and growth. Feel good about that.

Say “No thank you” to self-imposed isolation. We humans aren’t meant to be alone. We’re social creatures and need each other for companionship, stimulation and inspiration. Pick up the phone. Schedule an outing. Invite someone over.

Say “No thank you” to an unmade bed, kitchen clutter and any other depressing signs of discontent at home that make you feel lousy about yourself, conjure up bad or sad memories or zap your energy. Clean up and create a pleasing, harmonious

home.

Say “No thank you” to languishing on the couch. The more you move your body, the healthier it gets and the better you can feel, physically and emotionally.

The good news? Studies show that it doesn’t take an enormous amount of physical exercise to achieve health-enhancing results. About 30 minutes a day of walking, swimming, running or biking can have positive health effects.

Say “No thank you” to over-spending and to credit card debt. Think twice before you make that purchase: Do you really need it? And, can you really afford it? Since most everyone spends more on credit cards, you just might want to leave home without it. Increased financial security, peace of mind and a sense of empowerment are the rewards for those who spend within their means.

Say “No thank you” to jumping into a relationship to avoid feeling lonely. It can be risky. When you are lonely and desperate, it shows, which can make you vulnerable

to the advances of someone with less-than-honorable intentions. Use the gift of time alone for some soul searching, problem solving and future planning. A content and confident person is more likely to attract a quality companion.

Say “No thank you” to having a bowl of cereal for dinner, while standing at the sink. As the saying goes, “You’re worth more than that.”

When it comes to eating alone at home, treat yourself as you would treat a good friend you are having over for dinner. Creating a pleasant “table for one” is a great opportunity to focus on yourself and to nourish your body and spirit at the same time.

Say “No thank you” to negative thinking. Negative self-talk (e.g., “I’ll never meet anyone” or “I hate my body”) unwittingly becomes a self-fulfilling prophecy. Become aware of negativity, stop it in its tracks and replace it with a positive thought.

Say “No thank you” to friends who complain all the time and bring you down. Instead of helping themselves or the world, complainers spread gloom and doom. Who needs it? Hang out with people who make you smile, lift you up, support you in

your efforts to overcome challenges and generally make you feel good to be alive.

Say “No thank you” to “letting yourself go.” How you look says a lot about you and how you value yourself. Leave the house disheveled and you are likely to be ignored. Spend a few minutes on your appearance, put on a pleasant expression, and watch the world open up. When you care about yourself and your appearance, you radiate vitality. It’s intriguing.

And it can draw people and compliments to you.

Say “No thank you” to feelings of helplessness. Babies are helpless, most adults are not. Learning to master things around the house — from making minor repairs to hiring a painting contractor, from changing the furnace filter to winterizing your car — can be a real source of satisfaction and self-pride. It can also make you an even more interesting, secure, and well-rounded person.

Say “No thank you” to that second helping this Thanksgiving. As tempting as that second piece of pumpkin pie might be, you will feel better the day after if you pass it up. You’ll feel proud of your self-discipline, enjoy more energy, and have more room for leftovers.

Happy “No-thanks” giving!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call 585-624-7887 or email her at gvoelckers@rochester.rr.com.

Could ‘The Martian’ Scientist Survive on Potatoes Alone?

I

n the movie “The Martian,” the main character, astronaut Mark Watney (played by Matt Damon), is stranded on Mars and must rely on his own super-science knowledge to survive. Because the crew had packed some potatoes for a Thanksgiving celebration, Watney creates a lab “garden” and is able to survive off the potatoes — after calculating how many calories he would need to survive until a rescue mission could arrive.

According to plant scientists from the Crop Science Society of America (CSSA), growing potatoes in a lab situation was a very good idea, but bringing along just a few ounces of bean seeds — called pulses — on the mission would be a better plan to start any emergency garden. “Pulses” is the broad category of edible beans that are a great source of protein and essential minerals. Pinto beans, chickpeas and peas are all examples of pulses.

“Nutritional diversity is key for survival,” says Roch Gaussoin, a professor at University of Nebraska.

Watney calculates he may need to live for four years before rescue.

“Spuds are great for calories but it’s hard to beat Pulses for nutritional quality,” says Gaussoin. “Both plants would be easy to carry into space and would require minimal space to Page 8

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grow when compared to many other crops. They are also adaptable to controlled environment production, versus being in the field.” Gaussoin is the current president of CSSA. “Pinto beans would be the perfect nutritional partner with the movie’s potatoes,” says Janice Rueda, a scientist with ADM Edible Bean Specialties. “They’re high in both protein and fiber, as well as many important nutrients like potassium,

magnesium and iron.”

In addition, “pinto beans would also have a positive impact on the agricultural production in a challenging environment like Mars. Like all pulse

crops, beans fix nitrogen into the soil and require very little water to grow — especially when compared to other protein sources.”

Injury Toll in U.S. in 2013: $671 Billion

I

njuries from accidents and violence cost the United States $671 billion in 2013, with men accounting for far more of those costs than women, federal health officials reported in Ocotber.

Fatal injuries cost $214 billion and nonfatal injuries cost $457 billion.

The amounts include lifetime health and work loss costs for fatal and nonfatal injuries treated in hospitals and emergency departments, according to the U.S. Centers for Disease Control and Prevention.

“Injuries cost Americans far too much money, suffering and preventable death,” CDC Director Tom Frie-

IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

den said in an agency news release.

“The doubling of deaths by drug poisoning, including prescription drug overdose and heroin, is particularly alarming.”

Men accounted for 78 percent ($166.7 billion) of fatal injuries and 63 percent ($287.5 billion) of nonfatal injury costs in 2013. More than half of the medical and work loss costs of fatal injuries were from accidents ($129.7 billion), followed by suicide ($50.8 billion) and murder ($26.4 billion).

Prescription drug overdoses and other drug poisonings accounted for the most fatal injury costs (27 percent), followed by transportation-re-

lated deaths (23 percent) and gun-related deaths (22 percent).

The cost of injury-related hospitalizations was $289.7 billion, and the cost of injured patients who were treated and released was $167.1 billion. Falls (37 percent) and transportation-related injuries (21 percent) accounted for most of the costs of nonfatal injuries treated in emergency departments, according to the report.

The findings appear in two studies published Oct. 2 in the CDC’s “Morbidity and Mortality Weekly Reports.”

SmartBites

The skinny on healthy eating

Reach for Nutritious Leeks

O

nce dubbed “poor-man’s asparagus,” leeks are anything but poor when it comes to taste, tears and nutrition. They’re flavorful without being overpowering. They don’t produce tears with cutting.

And — most importantly — they’re loaded with health benefits, much like their well-researched cousins: onions and garlic.

A member of the Allium family of vegetables, leeks are a rich source of allicin, a sulfur-containing compound with multiple merits. Not only is it anti-bacterial, anti-viral and anti-fungal, but allicin, upon digestion, produces sulfenic acid, a compound that, according to research, neutralizes cell-damaging free radicals faster than any other known compound. Ponce de Leon?

Can you hear me now?

Leeks love hearts. The above-mentioned allicin may reduce cholesterol formation, as well as promote blood vessel elasticity. In addition, leeks’ high concentration of kaempferol, a flavonoid that has

repeatedly been shown to help protect our blood vessel linings from damage, can only do a heart good.

Leeks also love bones, with one cup providing a whopping 50 percent of our daily needs for vitamin K. Vitamin K, most well known for its important role in blood clotting, also promotes bone health by assisting in the transport of calcium throughout the body. With the threat of osteoporosis looming in my future, I’m always looking for foods that may reduce bone loss and decrease the risk of bone fractures.

Consuming leeks is good for the peepers. They’re a super source of vitamin A, an essential vitamin that helps retinas function under low-light conditions; and, they serve up generous doses of two valuable nutrients — lutein and zeaxanthin — that may reduce the risk of chronic eye diseases, including age-related macular degeneration and cataracts.

More great reasons to reach for

leeks: They’re low in fat, cholesterol, sodium and calories (about 50 per sliced cup). They rock with manganese (important for energy and bone health) and folate (essential for red blood cell production and fetal development). And, they boast a decent amount of immune-boosting vitamin C.

Helpful tips

Look for leeks that have as much white and light green as possible.

Stalks should be firm and crisp; avoid those with wilted or yellowed tops. Select smaller leeks — those with a diameter of 1½ inches or less for better taste. Store unwashed leeks in a plastic bag in the refrigerator for up to two weeks.

Healthy Potato-Leek Soup Adapted from Feastingathome. com Serves 4 3-4 medium leeks (white and light green parts) 2 tablespoons olive oil 1 small onion, diced 3 cloves garlic, minced 2 baking potatoes, diced 4 cups chicken or vegetable stock 1 tablespoon fresh thyme (or 1 teaspoon dried) 1 teaspoon salt ½ teaspoon coarse black pepper ½ cup light sour cream Frank’s hot sauce (optional) Garnish: fresh chives, freshly grated cheese, whole wheat croutons • Remove dark leek stems and cut

leeks in half lengthwise. Rinse to remove any dirt. Slice leeks into ¼-inch half rounds.

• Heat oil in medium-sized soup pot over medium heat. Add leeks and sauté 3-4 minutes. Add onion and continue sautéing for five minutes until tender. Add garlic and sauté for two more minutes. (Note: Add a splash of water at any time if vegetables start to burn.)

• Add potatoes, stock and thyme. Bring to a boil, turn heat to low, cover pot, and simmer for 15-20 minutes, until potatoes are tender. Add salt and pepper. Using a hand held blender, puree soup until smooth. (Use a potato masher versus a blender if more texture is desired.)

• Stir in sour cream and hot sauce (if using). Top soup with garnish of choice.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 9

TELEMEDICINE

Need to See a Doctor? Just Get on the Internet Local hospital execs say doctor appointments from home — through the Internet or video connection — may be around corner

By Matthew Liptak

T

elemedicine has been around for 40 years according to the American Telemedicine Association (ATA), but officials from St. Joseph’s Health and Upstate Medical University said that getting your doctors’ appointment from home may be in the near future.

The ATA defines telemedicine as the use of medical information exchanged from one site to another via communications to improve a patient’s clinical health status.

“I can see in the not-to-distant future the ability for a patient to access either a physician or a nurse practitioner or a physician’s assistant through technology and have that intervention occur rather than have a patient going to a health care center,” said Mark Murphy, the senior vice president for system development and ambulatory care leadership at St. Joseph’s Health. “I think we’re probably talking about the wide application of that within the next year or two.”

Physician Robert Corona, the head of Upstate’s pathology department and vice president of innovation and business development, agreed and noted that some technology is already being used that way.

So why isn’t telemedicine a more common practice?

“It’s politics and economics that largely drive whether telemedicine is successful or not,” Corona said.

“It’s not expensive, but it’s often not reimbursed. The cost of it is not that bad. In fact it’s probably more cost effective than live visits, but there’s a lot of resistance to pay for the technologies.”

He also said doing the actual physical exam was tough to do telemedically. Procedures such as using a digital stethoscope on a patient, feeling the abdomen to detect abnormalities and checking the eyes would need a stand-in to assist with the exam.

But telemedicine consultations

Physician Robert Corono, head of pathology at Upstate University Hospital, is seen here in front of a high tech scanner that digitizes slides for telemedicine.

The technology has made it possible for doctors to diagnose cancer from a remote location while a patient is still on the operating table. In the background is pathologist assistant Nancy Drotar.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

Mark Murphy, an executive at St. Joseph’s Health, believes home doctor consultations may become commonplace in the future via telemedicine. Murphy is seen here supporting the American Cancer Society’s Heart Walk in 2014. may be ideal for follow up doctor calls and also less urgent maladies.

Emergency rooms are often clogged with non-emergent patients who are just under the weather and have no other way to access health care.

Corona said remote consultations through an Internet or other video connection would reduce costs for health systems, but also the patients.

“The people that don’t need to come because you’ve done a telemedical consultation—that’ll save time and cost for them, too,” he said.

Murphy emphasized his hospital’s tele-psychiatry program.

Patients as far away as Lowville in northern New York can access psychiatrists from St. Joseph’s for a psychiatric session or their general practitioner there can consult with the psychiatrist to get guidance.

The tele-psychiatry program at St. Joe has been successful and is expanding. It both cuts costs and is more convenient for patients who might otherwise have to drive hours to get to Syracuse.

“We’ve been doing it for about a year and a half,” Murphy said. “It started relatively slowly. We’re at the point where we have more requests for services than we have supply of psychiatrists. We’re in the process of expanding to five different sites with telepsychiatry. We’re also in the preliminary stages of providing hospital-to-hospital consults as well.”

Upstate has become a test site for digital pathology by General Electric, Corona said. Through this technology doctors can biopsy tumors and diagnose them immediately. The cancer specimens are converted to digital slides. Wax slides of biopsies were conventionally done which took about a day to process.

“Let’s say a hospital was doing it in Utica and they didn’t have a neuropathologist there,” Corona said. “They said ‘I don’t know what this is.’ They can immediately beam it over to me on my computer and I can look at it and tell them what it is while the patient’s still in the operating room.”

Telemonitoring makes up a portion of telemedicine. It is the use of devices that measure a patient’s condition remotely. Murphy said St. Joseph’s has given some thought to the possibility of intensive care services using monitoring at a remote facility.

“I think for higher acuity patients there is increasing need for information generated from devices,” Murphy said. ”There are areas of the country where they have electronic ICU or tele-ICU where you have physicians that are monitoring patients in an ICU at an offsite location. We’re preparing for it and we’re building towards that competency.”

Both officials — Mark Murphy of St. Joseph’s Health and Robert Corona of Upstate — are excited about how the evolution of telemedicine could increase the quality and access to health care for patients. They also think it could bring down costs for health care systems. But it may not reach its potential until it is fully accepted and integrated into all of modern medicine.

And by then the term itself could become a thing of the past.

“It won’t be called telemedicine,” Corona said. “It will be called using the latest technology to bring the best care to a patient.”

Officials at Crouse Hospital declined to offer comments for this story.

My Turn

By Eva Briggs

Reactions to Intravenous Contrast

I

ntravenous contrast is sometimes used with CAT scans or MRI tests.

These are substances that make structures like blood vessels and soft tissues show up more clearly. Sometimes these materials cause reactions – although fortunately, modern agents are safer than the agents used years ago.

There are two main types of contrast agents. Iodinated contrast, in use for over a century, contains iodine and is used to enhance CT scans. Gadolinium agents are used with MRI scans.

Early iodinated contrast agents had high osmolarity — that’s a measure of the concentration of particles in the solution — and were more likely to trigger reactions. Modern agents are either iso-osmolar (similar to the concentration of body fluids) or low-osmolar (less concentrated).

With these agents, the chance of any reaction ranges from 0.7 to 3.1 percent. The risk of a severe reaction is 0.02 -0.04 percent, or two to four per 10,000 contrast injections.

Reactions to contrast materials may be physiologic or allergic-like.

Physiologic reactions are caused by chemical toxicity from the injected substance. Nausea, headache, flushing, elevated blood pressure and altered taste are typical physiologic side effects. They usually resolve on their own and rarely require treatment. They don’t respond to, and can’t be prevented by, prednisone or other steroids.

Most contrast reactions are anaphylactoid — they resemble allergic reactions but aren’t due to antibodies due to the specific agent.

This happens when the agent binds nonspecifically to cells and causes them to release histamines. Patients and increased risk of these types of reactions can be pre-treated with prednisone or other steroids, and the antihistamine Benadryl.

Who is at high risk of reacting to a contrast agent? Patients with asthma, and people with multiple allergies are most likely to react. Although shellfish allergy increases the chance of a reaction to iodinated contrast material by a factor of three, this is similar to the relative risk caused by other food allergies. So be sure to tell your doctor about the type and severity of your allergies before undergoing a contrast procedure.

Mild allergic-like reactions might consist of limited hives, minor skin swelling, slightly itchy or scratchy throat, runny and itchy nose, watery eyes and sneezing. This might not require any treatment other than antihistamine and careful monitoring to be sure symptoms don’t progress.

Moderate allergic-like reactions manifest as widespread hives, widespread skin redness or swelling with normal blood pressure and heart rate, facial swelling without breathing trouble, throat tightness without difficulty breathing or mild difficulty breathing.

Severe allergic-like reactions

include hives and swelling with low blood pressure, spasm of the larynx/ upper airway leading to difficulty breathing, bronchospasm causing wheezing, shortness of breath, and low oxygen levels. Shock can develop.

Moderate to severe reactions are treated with epinephrine, antihistamines, and fluids. Steroids can help, but they don’t work right away.

Anyone with severe symptoms will need to be observed in the emergency room or as a hospital inpatient, even if they respond quickly to initial therapy.

Iodinated contrast agents may increase the risk of lactic acid build up in patients taking the diabetes medicine metformin. That’s rare, but patients on metformin may be advised to stop it for a few days, especially people with poor kidney function or multiple other illnesses.

Nephrotoxicity, or kidney damage, is another potential reaction.

This was especially a problem with older high-osmolar agents. The risk of this side effect is greatest n people over 60 years old, people with a history of kidney disease, and patients with high blood pressure, diabetes or taking metformin. If you risk factors, your doctor will discuss whether the benefit of the test outweighs the risk, and will monitor your renal function.

Extravasation is the leakage of IV fluid into the soft tissue at the IV site. It causes swelling, tightness, and sometimes burning. Most cases re-

solve with warm packs and elevation of the affected area. In rare cases the swelling is severe enough to injure blood vessels or nerves, sometimes requiring surgery to relieve the pressure.

Like iodinated agents, gadolinium agents can cause both physiologic and allergic-like reactions. The risk of any reaction is 0.7-2.4 percent, but allergic-like reactions are rare, 0.004-0.007 percent, and most are minor, with a few hives or a minor rash. Severe reactions occur in about 0.001-0.01 percent of people. There is no cross-reactivity between iodinated and gadolinium agents. This means that an allergy to one type doesn’t mean you will be allergic to the other.

A very rare reaction is nephrogenic systemic fibrosis. It’s associated with certain gadolinium agents in patients with poor renal function. This condition causes collagen fiber deposition in the skin, causing thickening and in the muscles, causing contractures. It can also affect the heart, liver and lungs. It usually becomes symptomatic two to three months after gadolinium exposure. It’s debilitating and there is no effective treatment.

For this reason, the agents associated with this disorder (Omniscan, Magnivist, and Optimark) can’t be given to people with stage 4 or 5 kidney disease, pregnant women, and babies under 1 year of age.

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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Page 11

Guys Should Improve Eating Habits as They Age All the pizza, bags of chips and beer you had in your 20s? Well, that brings more consequences if you’re 40 or older

By Deborah Jeanne Sergeant

M

ost guys in their teens and early 20s can get away with wolfing down copious amounts of pizza, gulping soda and devouring bags of chips without any visible consequences.

Around age 30, that chowhound habit begins to affect their weight.

By 40, the pounds have really begun to pile up, and by 50, many serious health complications surface.

“The metabolism decreases 2 percent or more every decade from 20s,” said Laurel Sterling, registered dietitian and wellness educator at Natur-Tyme in Syracuse. “If Adams they were very active in sports and now not, then [they should] decrease calories. Also, health issues such as diabetes, cholesterol, blood pressure, and prostate issues creep up.

In addition to monitoring portion size, men can improve their diet by avoiding the dietary pitfalls to which men are prone.

Men who don’t cook, for exam-

ple, may rely upon more convenience foods; however, Sterling encourages men to reduce their intake of sugars and white flour products, both of which are prevalent among convenience foods.

Instead, Sterling wants men to eat more plant-based foods. For example, “pumpkin seeds are high in zinc and good for prostate as well as pomegranate, and cruciferous veggies, such as broccoli, kale, Brussels sprouts, and ground flaxseeds.”

Lori Vashaw, owner of Riverview Wellness Center in Oswego, encourages men to incorporate other “super foods” into their diet regularly, including almonds, avocados, nut butter and hummus.

“Remembering that eating protein and protein-based snacks every three hours will help them have a better metabolism,” she said. “We all need to remember that we are what we eat. Healthy aging depends upon a healthy diet. Eating a diet rich in vegetables, protein and good fat is important not only for healthy physical eating but also mental acuity.”

Vashaw is a certified herbalist and completed 600 credit hours in clinical nutrition.

Saturated fat has been linked to heart disease. To decrease intake of saturated fat, Sterling encourages men to eat grass-fed animals instead

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

of grain-finished.

That doesn’t mean guys have to avoid all their favorite foods. Merely exchanging most of the red meat in a burrito or chili for more beans can reduce the saturated fat content. Or choosing meat more wisely and adding a side salad can help, too.

Buffalo, venison, and grass-fed beef are also generally leaner than grain-fed beef. And sticking with 97-percent lean and loin cuts of beef also greatly reduces the saturated fat content. Skinless poultry, pork loin and seafood also offer great protein sources.

Swinging into the drive-through lane provides an easy meal; however, it’s just as easy to plan ahead for more wholesome eating. Grilled fish can offer both convenience and nutrients.

“Increase fish consumption — wild caught Alaskan salmon--or use fish oil,” Sterling said. “Omega-3 [fatty acids, found in fish] has been linked to supporting brain, joint and heart health.”

It’s also important to improve your beverage choices. There’s a reason they call it a “beer” belly: alcohol packs a wallop of calories. So do sweetened drinks, such as soda, sports drinks and energy drinks.

Though juice offers nutrients, it is high in naturally-occurring sugars.

“Your body is 65 percent water,” said Holly Adams, registered dietitian with Kelly’s Choice, LLC in Skaneateles. “You need to drink more of it. If water is boring, you could add a splash of fruit juice to flavor it.”

She said that men should consume no more than 9 tsp. of sugar daily, but a 20-oz. bottle of Mountain Dew contains 19 tsp. of sugar.

“A lot of people don’t realize how much sugar is in many beverages, like soda or Gatorade,” Adams added. “It has electrolytes but it’s loaded with sugar.”

Kelly’s Choice helps clients manage weight loss, diabetes, and heart disease by nutrition education.

For guys who drink a lot of milk, switching to skim or 1 percent to reduces overall fat intake.

Making dietary changes may sound like “going on a diet” but that phrase describes short-term changes.

Adams encourages clients to make lifestyle changes.

“Instead of four cookies, have three, then two, then one,” she said.

“It’s all about lifestyle changes. Fad diets are set up for failure.

“It’s about moderation. I’m not a dietitian that restricts people on anything.”

St. Joe’s Director Tackles Subject of Preeclampsia

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reeclampsia is a dangerous and sometimes deadly disorder that can occur during pregnancy and endanger both the mother and unborn child. Physician James Brown, the medical director of women’s and children’s services at St. Joseph Hospital, talked with In Good Health about the condition.

“Preeclampsia is essentially a multisystem disease that comes from being pregnant that cause the mom to develop high blood pressure and the consequences of having high blood pressure,” Brown said. “That would be having kidney damage, liver damage, having problems with seizures and even going as far as having strokes, blindness or dying from it. It happens every day unfortunately.”

The large majority of cases of preeclampsia take place late in the pregnancy, so the general Brown course of action is to deliver the baby, which normally remedies the disorder.

Occurrence varies due to multiple factors, Brown said, but he indicated preeclampsia occurs in between 5 percent and 20 percent of pregnancies.

“We see it every day,” the doctor said. “The vast majority of people, they’re at term or near term so you just end up inducing their labor and delivering them. That usually takes care of their issue. Most of those people at full term, they do fine.”

The Preeclampsia Foundation states on its website that in rare cases the disorder can occur before 20 weeks gestation. It is in these earlier cases, Brown said, where preeclampsia creates a lot of its problems.

The baby may have to be delivered before they are viable outside the womb, because the mother’s life is in danger.

“If you’re 24 weeks along, it’s a 50-50 chance that the baby’s going to survive,” Brown said. “If you’re 32 weeks pregnant or beyond, the baby’s going to make it. They’re going to be fine. It all depends on how far along you make it.”

Some women are more at risk for preeclampsia than others.

Brown said first time mothers, mothers at extremes of age (young and old), mothers who have high blood pressure, and moms who are

to deliver twins or other multiple pregnancies, are most at risk.

While the threat of preeclampsia is real, the likelihood of dying from it is relatively remote. The mortality rate for mothers in childbirth is about 18 per 100,000, Brown said. That’s according to 2013 statistics.

California comes in as one of the safest states with a rate of 12 deaths per 100,000 women. Those deaths are generally due to hemorrhage, preeclampsia and blood clots.

The only treatment for preeclampsia is bed rest, which may extend the pregnancy by a few weeks, Brown said. The doctor said it was also discovered that taking baby aspirin may delay the onset of the disorder until later in the pregnancy.

The only real cure usually is to deliver the baby and placenta.

The cause of preeclampsia is unknown. There is a theory that a hormone is produced from the placenta which triggers the disorder.

Brown said more research is needed to understand the cause and to find possible treatments.

The signs of preeclampsia are severe headaches and swelling. Headaches that don’t subside with Tylenol and swelling that leads to sudden, significant weight gain can be an indicator which your doctor should be made aware of.

“It’s the headache that won’t go away, that’s what we want to know about,” Brown said. “The swelling, it’s dramatic. It happens overnight.

That’s what we want to know about.”

Expectant moms should be aware that preeclampsia exists and what to look for, but they shouldn’t be worried, Brown said. The vast majority of pregnancies turn out well even when the disorder is present.

“We don’t want to paint a picture of doom and gloom,” Brown said.

“Pregnancy should be a happy time, but people need to be aware that not everything is perfect and us medical people don’t have control over allowing this to happen or not allowing this to happen.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

Excellus BCBS to offer new health plan for $0 or $20 a month

E

xcellus BlueCross BlueShield in 2016 will offer a new health plan with monthly premiums of $0 or $ 20 a month.

This new “Essential Plan” is subsidized by New York state and will only be sold to eligible individuals on the New York State of Health marketplace. Each of the Essential Plans offered by the different health insurers will have the same premiums with similar benefits.

“The new Essential Plan is for individuals who don’t qualify for Medicaid and don’t have access to affordable health coverage,” said Lynne Scalzo, vice president of business strategy and administration, Excellus BCBS. “Our goal is to inform eligible individuals that they might be able to purchase affordable health coverage, possibly for the first time,” she added.

Individuals will qualify for the Essential Plan based on household size and income. Households at or below 150 percent of the federal poverty level ($17,655 for a household of one; $36,375 for a household of four) will not pay a monthly premium for the plan. Households between 151

percent and 200 percent of the federal poverty level ($23,540 for a household of one; $48,500 for a household of four) will pay a monthly premium of $20 for each adult. Individuals will have access to low-cost coverage and valuable benefits, including: • Access to a wide selection of doctors and hospitals • Routine preventive care checkups, screenings and immunizations for a $0 copayment • No deductible • Prescription drug coverage • $400 a year toward a fitness facility or individual fitness class reimbursement The federal penalty for going without health insurance will increase in 2016. The penalty in 2016 will be $695 per person, or 2.5 percent of your household income – whichever is greater.

“For those who qualify for an Essential Plan, you can now purchase health insurance for $0 or $20 a month and avoid the financial penalty,” Scalzo said. “The Essential Plan might be a good option for young adults purchasing health insurance for the first time.”

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Know an Exceptionally Compassionate Doctor?

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o you know an exceptionally compassionate physician? One who communicates openly, honestly and sensitively? Who respects each patient’s decision about healthcare needs? Who remains connected to the patient during difficult times?

Hospice of Central New York is seeking nominations for the annual Anita Award, which recognizes a local physician for excellence in the care of patients with an incurable illness. The Anita Award was established at hospice in 1998 by friends and family in memory of Anita Stockman. Its purpose is to heighten awareness of the importance of physician communication and support to patients and their families facing life-threatening illness and to promote this understanding among physicians in training.

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This award is to be presented to a physician who is attentive to his or her patients, who communicates openly, honestly and sensitively, who respects patient decisions and remains actively involved with the patient in his or her final journey. The award will be presented in January.

A few physicians who have received the award include Joseph Navone, Ajeet Gajra, Benny Wong, Michael Glowacki, Jacqueline Bays and Jesse Williams.

Any patient, family member or friend may make a nomination. Please send your nomination by Nov. 30 to Anita Award, Hospice of CNY, 990 Seventh North St., Liverpool NY 13088 or email your nomination at info@hospicecny.org. Include your name and phone number, and why you think this physician merits this award.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

Parenting

By Melissa Stefanec

melissa@cnyhealth.com

To hug or not to hug?

H

ugging has been in my thoughts a lot lately. Hugging wasn’t always on my radar, but parenting my daughter Stella, 4, and son River, 1, has put me in a cage match with the act. As a self-identified tree hugger, peace seeker and lover of people, I never thought I would be on the offensive in regards to hugging. However, here I am, advocating against it (sometimes).

Hugging is fabulous; except when it’s not. Hugging turns from fabulous to bad under one circumstance — when a hug is forced and unwanted. Too often, that is the case for children. That single concept has put me at odds with some people, but that hasn’t deterred me. I do not force my children to hug or kiss anyone, and I certainly don’t guilt them into thinking they should have to. It doesn’t matter if that person is a beloved family member, my best friend, their best friend of the minute, or myself. Hugs and kisses are not requirements, ever.

There is a lot of pressure in society for children to give and receive affection, and this pressure is especially true for little girls. This pressure isn’t typically mean-spirited. Children are cute and a lot of us just want to eat them up. We aren’t trying to be forceful or inappropriate, we are trying to be kind. However, no matter what the intent, I let my children decide when and how to be affectionate with others.

I think forcing them to do otherwise would teach them some very horrible lessons. Some of these lessons are: Forced hugging and kissing teaches them forced physical contact is acceptable I think I could stop writing right now, and this would neatly sum it up. However, I allowed myself a late-afternoon caffeine jolt in anticipation of writing this column, and I don’t get paid for half of an article, so I will keep preaching.

It teaches them their bodies aren’t their own As adults, most of us call the shots regarding our bodies. We say how and when we want affection.

We recognize each other’s autonomy.

Why should it be different for children? My daughter knows people are in charge of their own bodies. I will teach my son the same. Why would I want to teach them anything else?

It’s not logical.

It teaches them not to trust their gut feelings and judgment There is probably a good reason children don’t want to hug people at certain times. Maybe that person makes them uncomfortable. Maybe that person made them upset recently. Maybe that person has stinky

coffee breath. Maybe they just want some personal space. Maybe they are just trying to assert authority and be objectionable. Whatever the reason, I want my kids to know they can trust their judgment and gut feelings.

They are going to need those things throughout their lives. I will not be the one to habitually silence them.

It teaches them it’s OK to touch someone else if that person doesn’t want to be touched Affection is a two-way street. I don’t let anyone force affection on my kids. I also don’t want them to think they can touch people whenever they want. Humans read each other’s body language all the time.

We should be reading children’s body language and teaching them to do the same to others. As adults, we should have the common sense and courtesy not to touch someone who doesn’t want to be touched, no matter what that person’s age is.

It teachers them not to speak up for themselves Why teach your kid that he or she doesn’t have a say for herself or himself? I won’t always be around to advocate for my children. In fact, I will likely be physically absent for some of the most critical and difficult circumstances of their lives. Although I can’t always be there, I want to give them a foundation. They will know that it is always OK to say no and know how to advocate for themselves. There are consequences for these things, but they are better than the consequences associated with standing down.

It’s starts the guilt ball rolling Not only do I not force affection, I also never make them feel guilty for not wanting to give it. Teaching my children to trust themselves, respect their bodies, trust their instincts, and be autonomous is essential. Letting them do it with confidence and support is even more so.

It starts them down some dangerous paths If I teach them it’s OK for people to force affection on them, I condone that act. Where does it stop? Children see the world as a rather black and white place. They don’t have the mental capacity to navigate gray areas. God forbid the unthinkable happens, I want them to know that if something makes them feel bad, it’s not OK. They don’t have to feel guilty. They can say no, and, most importantly, they will know Mommy is in their corner, as she always has been.

So, next time you want to hug an adorable wee one, think twice before you snuggle in. Make sure he or she is on board. It will make hugging, which is pretty awesome, feel 100 percent right.

Golden Years Hospice Helps Patients Embrace Life Studies show end-of-life patients who use hospice care can live longer

By Deborah Jeanne Sergeant

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any people think that patients who opt for hospice care are “giving up” since they no longer pursue medical treatment for their terminal disease. But the opposite is actually true. In fact, some patients may live longer once they switch to palliative care, according to a study released in August by the New England Journal of Medicine.

The research included patients with non-small-cell lung cancer. On average, patients admitted to hospices survived nearly two months longer than comparable patients who continued receiving traditional treatment for their cancer. They may also transition to hospice care sooner.

“With earlier referral to a hospice program, patients may receive care that results in better management of symptoms, leading to stabilization of their condition and prolonged survival,” wrote the authors of the study.

A 2007 study printed in the Journal of Pain and Symptom found that on average, patients with either congestive heart failure or cancer of the breast, colon, lung, pancreas or prostate lived an average of 29

days longer than those not receiving hospice care.

The studies correlate with a growing body of research indicating that hospice patients not only experience a better quality of life, but may actually live a little longer in some cases than those who continue to follow treatment.

Hospice and palliative care work with patients and families to improve the patient’s comfort and enjoyment of life during a terminal illness.

Vera Dunsmoor supervising public health nurse at Oswego County Hospice, said that the research doesn’t surprise her.

“There’s no way to know if hospice would give them more life but we’ve seen people told they have two to four weeks left, and they live six more months on hospice,” she said.

“I feel it’s true, but there’s no way to know. Everyone’s an individual.”

Dunsmoor attributes the increased longevity to the increased quality of life and comfort patients receive. Most people prefer staying at home instead of in an institutional setting. She said that they’ve enabled hospice patients to attend church, go camping and even get married.

Instead of “giving up on life” the patients who select hospice care embrace life and have the means to choose how they want to spend the time they have.

Bill Pfohl, communications officer with Hospice of CNY in Liverpool, said the public doesn’t realize that many people who are terminal are walking around and doing things. “They may be ahead of you in the line at the grocery store or still working as they’re able,” he said.

Pfohl said his organization provides help for the entire family and offers bereavement programs that go beyond when the person passes.

Hospice of CNY’s grief center serves anyone in the community, not just its patients and clients.

Hospice of CNY also serves primary caregivers of hospice patients and maintains a 24-hour, 365-days-ayear phone line staffed by nurses.

Many people think hospice is only for the last few hours of a patient’s life when actually, they may request hospice care months in advance. Medicare pays for hospice care when a doctor estimates the patient has six or fewer months to live.

If the patient lives longer, Medicare

covers additional time.

“We often get referrals very, very late,” said Angela Ryan, a licensed social worker at Hospice of the Finger Lakes in Auburn. “We no sooner get in there and get things set up and the person’s passing away. We see so many things we could’ve done.

Hospice is helping the person live to their fullest.”

She added that many assume hospice care is only for cancer patients; however, Ryan said that nearly half the clients Hospice of the Finger Lakes served in 2013 had other conditions.

Hospice care doesn’t have to occur in an institutional setting. The care may be provided to patients at an adult child’s home, hospital, nursing home, hospice facility or an assisted living facility.

Planning ahead for hospice care can help the patient and family take full advantage of the services offered, so Ryan encourages patients to plan early.

“Even if you use the services longer than six months, the patient can stay in hospice as long as we can justify the expense, that the patient isn’t improving,” Ryan said.

Many Factors Contribute to Fractures But experts say older adults can help prevent them by keeping bone strength

By Deborah Jeanne Sergeant

A

study published in the journal Nature indicates that genetics may contribute to the development of osteoporosis. The discovery

by Hebrew SeniorLife Institute for Aging Research may someday help physicians treat individuals using custom approaches to better treat osteoporosis. People with the condition bear a greater risk of breaking bones, especially as they age and bone mass decreases.

In the meantime, seniors can do plenty to reduce their risk of a bone fracture.

Although the body lays down much of its bone Brown density when young, older adults can still maintain their bone strength.

Susan E. Brown, executive director of Center for Better Bones and in East Syracuse, encourages older clients to use diet, supplementation and exercise to help maintain bone density rather than relying on bone density tests, which she said aren’t as

reliable as many think.

“The average woman 35 to 85 loses 45 percent of bone and men slightly less,” Brown said. “People who are active and often outside lose less.”

She attributes this to several lifestyle factors, including greater vitamin D levels (since sun exposure generates vitamin D), more exercise and consumption of more whole foods, which tend to be higher in minerals than processed foods. Crash dieting tends to deplete bone mass as many fad diets are unbalanced and skip needed nutrients.

Exercise also plays an important role in preventing fractures by helping the body keep bones strong and improving balance.

“Building muscle strength helps build bone strength,” Brown said.

“They form the bone-muscle unit.

The body responds to the demands you put on it. As you lose muscle, you lose bone. The mechanism of exercise builds bone.”

Brown also blamed stress and certain medications for diminishing bone strength.

In many instances, falling causes broken bones in senior adults. Brown encourages seniors to request a fall

risk evaluation to see what home modifications can help prevent falls.

Many modifications are simple and easy to afford. Keeping the home well-lit with bright light bulbs and using nightlights at night reduces the chances of falling.

Because the bathroom and kitchen usually have slick floors, many people fall in these rooms. Grab bars near the toilet and tub can help improve safety. A non-skid tread in the tub may prevent a fall as well.

In the kitchen, using tippy stepstools can cause a fall. Storing items in lower cupboards eliminates the need to climb.

Christian Reitler, program officer and expert in fall prevention for Health Foundation for Western & Central New York, recommends getting rid of or fastening down throw rugs.

“They tend to be a huge tripping hazard,” he said. Eliminating cords that cross pathways and clutter can reduce tripping hazards.

“If you have a cat or dog, they could get caught up in your feet,” Reitler said. “Perhaps put a bell on the collar.”

Anyone in the market for a new pet could consider an older, more November 2015 •

sedate animal in a lighter coat color that’s easier to see in dim lighting.

Safer stairways have secure handrails and non-skid, lighter-colored treads for both better gripping and visibility.

Anyone who feels dizzy or lightheaded should talk with a doctor about the symptoms, which may be side effects of medication.

“See which ones may be switched, if possible,” Reitler said.

“You may be able to take them at a different time of day.”

In addition, treating vision and inner-ear problems can improve balance. Anyone not exercising ask the doctor about safe activities. Reitler recommended holding a secure structure while alternately lifting and lowering each knee.

“Standing up and sitting down a few times is also good for strengthening,” Reitler said. “There are lots of exercise programs you can do at your own pace, like tai chi or seated yoga.”

Senior center or community centers also offer exercise programs for seniors that increase balance and reduce fall risk and some physical therapy offices provide gym membership-style access to their facilities.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Golden Years Alzheimer’s Tsunami is Coming Number of patients, financial resources to skyrocket, experts say

By Deborah Jeanne Sergeant

F

rom 2015 to 2050 the cost for caring for Alzheimer’s patients will increase from $226 billion to more than $1.1 trillion, according to the Lewin Group, a healthcare policy research and management consulting firm in Falls Church, Va. In addition to the financial resources needed, experts believe there won’t be enough human resources to provide the care patients will need.

In a recent report — “Changing the Trajectory of Alzheimer’s Disease” — the Alzheimer’s Association estimates that by 2050 the number of people 65 and older living with Alzheimer’s will top 13.5 million — from 5.1 million today.

Catherine James, CEO of the Alzheimer’s Association, CNY chapter in Syracuse, said the increase in Alzheimer’s patients is mainly due to the number of baby boomers aging into Alzheimer’s disease and the longer lifespan expectancy of modern times, among other factors. Though not a normal part of aging, older age is a risk factor for Alzheimer’s disease.

The Alzheimer’s Association has awarded more than $340 million to

research through its International Research Grant Program.

With all of this effort, only four drugs are available that can potentially help slow — but not stop — the progression of the disease, that affects memory, balance, and ability to make sound choices. That’s why early screening can help patients get an early diagnosis to buy more time to make plans.

The medical community is partnering with organizations such as the Alzheimer’s Association to raise awareness among medical providers.

“Our colleagues across New York state are already gearing up, using state resources to add more program staff, peer consultation and more training,” James said.

James wants primary care physicians to routinely screen for Alzheimer’s disease as part of an annual wellness visit. It’s not just about forgetting names and dates. A person affected by Alzheimer’s may live alone longer than is safe to do so and make poor judgments that involve safety. Or one with balance issues may fall without the needed grab

bars and other home modifications.

It’s also important for other caregivers, such as paramedics, to recognize signs of memory impairment so that they can better assess patients in health care crisis.

For example, a patient with impaired memory may neglect to take vital medication that would have prevented the current problem.

Sharon Brangman, geriatrician with SUNY Upstate, said that health care professionals “have been sounding this alarm for a long time.

In general as a society, we’re reactionary. We wait for the train to hit.”

She said that part of the reason that the number of Alzheimer’s patients will be increasing in coming years is that advances in health care have enabled more people to live longer. Anyone 85 or older bears a 50-percent chance of having Alzheimer’s disease.

“There have been some small efforts to prepare health care professionals, but it’s locally inadequate,” Brangman said. “We don’t have enough doctors trained in managing dementia diseases. There are not

enough geriatricians. Most health care professionals get very little training on aging and dementia to prepare them in working with older people.”

Without knowing the signs of Alzheimer’s disease and other forms of dementia, most medical doctors won’t probe deeper when an older patient exhibits a few cues during a visit. Since the patient may not recognize his own issues, he likely won’t bring it up.

Brangman said SUNY Upstate has begun implementing programs to help identify these patients so they have a better chance of a positive outcome. The organization developed an acute care for the elderly team to evaluate people who may have dementia so patients can receive proper care.

SUNY Upstate also offers educational sessions for the medical community to help bring them up-to-date on caring for people with dementia.

Brangman advises everyday people to “keep an eye out for older members of your family and neighbors, if they’re clean, well-fed and doing well day-to-day. If not, get them in for an evaluation so you can figure out what to do to help them.

“There’s no cure for dementia diseases, but we can make them comfortable and safe.”

10 Early Signs and Symptoms of Alzheimer’s

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emory loss that disrupts daily life may be a symptom of Alzheimer’s or another dementia. Alzheimer’s is a brain disease that causes a slow decline in memory, thinking and reasoning skills. There are 10 warning signs and symptoms. Every individual may experience one or more of these signs in different degrees. If you notice any of them, see a doctor.

1

Memory loss that disrupts daily life One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; increasingly needing to rely on memory aids (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own.

What’s a typical age-related change?

Sometimes forgetting names or appointments, but remembering them later.

2

Challenges in planning or solving problems Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than Page 16

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they did before.

What’s a typical age-related change?

Making occasional errors when balancing a checkbook.

What’s a typical age-related change?

Vision changes related to cataracts.

3

6

4

7

Difficulty completing familiar tasks at home, at work or at leisure People with Alzheimer’s often find it hard to complete daily tasks.

Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.

What’s a typical age-related change?

Occasionally needing help to use the settings on a microwave or to record a television show.

Confusion with time or place People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

What’s a typical age-related change?

Getting confused about the day of the week but figuring it out later.

5

Trouble understanding visual images and spatial relationships For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast, which may cause problems with driving.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

New problems with words in speaking or writing People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch” a “hand-clock”).

What’s a typical age-related change?

Sometimes having trouble finding the right word.

Misplacing things and losing the ability to retrace steps A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

What’s a typical age-related change?

Misplacing things from time to time and retracing steps to find them.

8

Decreased or poor judgment People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment

when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.

What’s a typical age-related change?

Making a bad decision once in a while.

9

Withdrawal from work or social activities A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.

What’s a typical age-related change?

Sometimes feeling weary of work, family and social obligations.

10

Changes in mood and personality The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.

What’s a typical age-related change?

Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

Source: Alzheimer’s Association (alz.org)

Golden Years Self Care for Care Givers

By Deborah Jeanne Sergeant

P

eople engaged in care giving roles or caring occupations face an additional employment hazard: emotional burnout.

Pouring so much emotional energy into others can cause people in education, health care, emergency services and other sectors to suffer.

“If you don’t develop ways of keeping yourself stable, you’ll burn out, or you’ll become bad at what you’re doing,” said Douglas Goldschmidt, PhD., and liGoldschmidt censed clinical social worker practicing in Liverpool.

“Burnout in the healthcare industry is bad for you and bad for your clients. You’re not helping your clients.

You’re just making yourself more and more miserable to the point where you can’t do the work anymore. It’s a particular for clinicians who work

with any kind of trauma.”

The same can hold true for “givers” in any role of life. Eventually, the stress cumulatively manifests in many ways, including physical exhaustion, changes in sleep, repeated illnesses, headaches and gastro-intestinal problems.

Distracting oneself from emotional burnout by avoiding feelings only provides some short-term relief. Using television viewing to wind down, for example, offers only mental escape and not catharsis.

Some people turn to alcohol, drug use or other harmful means of escape emotional burnout. These efforts do not address the underlying issue.

Truly dealing with burnout requires planning a healthy outlet.

“You can seek therapy,” Goldschmidt said. “If it’s upsetting, you need an outlet. It can be fairly simple, like talking with a colleague.”

Goldschmidt deals with emotional stress by not attaching himself to stressful work in a personal way.

“Mindful meditation is very helpful because you’re aware of

what’s going on in the moment, yet you’re not attaching to the issue,” he said.

Part of it involves simply acknowledging what’s happening or the emotions of the moment “without criticizing yourself for feeling fear, anger, depression or whatever but you don’t act on them or hold onto them.”

Goldschmidt also advises givers to build a support network. Seeking people in a similar situation can help you vent and perhaps access resources to give yourself a break.

Taking planned breaks and occasional time away can help you regain perspective and refresh yourself. If you can’t get away physically, think about a relaxing place, imagining its sights and sounds. Take a few moments to pray or think relaxing thoughts.

Make sure you care for your physical health by getting sufficient, regular exercise and sleep and eating a balanced diet.

In addition to the self care tips above, Jennifer C. Bregande, licensed

marriage and family therapist practicing in East Syracuse, encourages givers to counter emotionally draining experiences “with experiences that are soothing and calming to the caregiver. Taking a yoga class, making one night a week to spend by yourself or make your favorite meal can help you reenter your role as a more balanced and energetic person.”

It’s also important to set healthy boundaries such as how much time and energy you can give away instead of becoming so flexible that you overdraw your emotional bank account.

“If people feel good about doing these things in their work, that’s good for them, but they need to have limits because it can get to the point where it creates imbalances in other areas of their lives,” Bregande said.

“Some people don’t think about how much is enough when they’re giving.

Be clear about your boundaries. Let people know and stick to it. It sounds like simple advice, but the trick to it is making your life more conscious.”

alzheimer’s assoc 1/2 page

New problems with communication is 1 of the 10 warning signs of Alzheimer’s disease. Recognizing the symptoms is the first steps toward doing something about it. For more information, and to learn what you can do now, go to alz.org/10signs or call 800.272.3900.

The 10 Warning Signs of Alzheimer’s Disease 1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

igh ad.indd 1

Memory loss that disrupts daily life Challenges in planning or solving problems Difficulty completing familiar tasks Confusion with time or place Trouble understanding visual images and spatial relationships New problems with words in speaking or writing Misplacing things and losing the ability to retrace steps Decreased or poor judgment Withdrawal from work or social activities Changes in mood and personality

November 2015 •

11:01:14 AM IN GOOD HEALTH – CNY’s Healthcare Newspaper10/28/2015 • Page 17

Expert: Eating disorders is on the rise: Media’s emphasis on ‘Barbie-type’ look, early dieting contribute to problem

By Matthew Liptak

A

sked point blank about whether eating disorders were on the rise Carolyn Hodges-Chaffee, director of Upstate New York Eating Disorders Service (UNYEDS), had an upfront answer.

“Absolutely,” she said. “The reason is that dieting is occurring at a much younger age.”

It was difficult to find recent statistics that supported the observations of Hodges-Chaffee, but, if true, it is a trend that has been going on for years now.

A study by the federal governments’ Agency for Healthcare Research and Quality determined that between 1999 and 2006 eating disorders among children rose by 119 percent.

Hodges-Chaffee believes the increase in eating disorders among young Hodges-Chaffee kids is due to the emphasis placed on getting a good BMI (body mass index) in schools.

“Schools are much more focused on measuring the BMIs and letting kids know if they are in range or if they need to lose five or 10 pounds,” she said. “There’s much more of a focus and push to achieve a lower BMI. I think that the way it’s being handled, it’s certainly problematic.

You really have to present things to younger individuals in a way that they don’t hear that there’s something wrong with them.”

Hodges-Chaffee points to the American culture as part of the reason for the problem. She said images young people experience in the media encourage a “Barbie-type” look which can be almost impossible to achieve without undertaking

unhealthy habits.

Pictures of celebrities kids look up to are often manipulated with comput- er software, Hodges-Chaffee noted.

The possible eating disorder increase doesn’t seem to be limited to American culture though. A more recent study of the number of young people admitted to hospitals for an eating disorder in England between 2003 and 2014, showed an increase of 172 percent. The statistics from the country’s National Health Service, were reported in The Guardian newspaper in June.

A leading English pediatrician told the newspaper images on kids’ cell phones were the source of the increase.

“Adverts for children are a very powerful force,” said physician Colin Michie, the chairman of the nutrition committee at the Royal College of Paediatrics and Child Health. “I think we have released a behemoth we cannot control.”

Back at home experts are also focusing on how biological systems are a component of diseases like anorexia, bulimia and others.

“What happens with eating disorders is truly a change in brain chemistry the longer the body is starved,” Hodges-Chaffee said.

“What will happen is that brain becomes hard wired about what’s OK and not OK to eat, when can I exercise, how much can I exercise.

That sort of dialogue just starts in their thought process and pretty soon it’s all-consuming.”

She said genetics often “loads the gun” when it comes to eating disorders. Some people seem to be naturally more sensitive to seratonin, a hormone found in the body which impacts both the brain and appetite.

Joslyn Smith is a 37-year-old legal assitant from the Ithaca area.

She was once a congressional intern for then Sen. Hillary Clinton. She first confronted her eating disorder

had managed to create my dream job of sorts, but was in an environment where my health was spiraling downward.

“Going into treatment at Sol Stone helped me get back on track with food, helped me really understand what my body needed to function properly and be optimally healthy, and helped me decide that ultimately I needed to make a move to create a life that felt really fulfilling to me.”

Hodges-Chaffee’s organization helps patients get the treamtment they need such as counseling, cognitive behavioral therapy, help from dietitians and medication through a psychiatrist. UNYEDS offers services in Syracuse, Ithaca, Binghamton and Elmira. That includes two levels of outpatient care, the residential program located in Elmira and free

Joslyn Smith, 37, has recovered from eating disorders she had while in college.

in college where she was diagnosed with what is now known as purging-type anorexia. Later she was admitted to Sol Stone the redsidential treatment program of Upstate New York Eating Disorders Service.

“UNYEDS really changed my life,” she said. “I went into treatment there at a time when I was living and working in Washington, DC,

case management for anyone who is struggling with an eating disorder.

While the number of people with eating disorders may be on the rise in Central New York so is the number of people who are succesfully recovering from the disease. Once held back by anorexia, Joslyn Smith is now making plans for a brighter future.

“I am in the process of adopting my foster daughter, and I very much look forward to being her mommy, serving as a healthy role model for her in helping her celebrate the incredible being that she is,” she said.

For more information on Upstate New York Eating Disorders Service go to www.unyed.com.

Jacquie lost 100 lbs. and found a whole new perspective.

Sitting down for storytime with her students was hard. Getting back up was nearly impossible.

But since Jacquie had weight-loss surgery, she’s found the energy to keep up with her class.

Jacquie also found a compassionate team at Crouse. From trusted surgeons and nutritional experts to an ongoing support group that’s with her every step of the way. Hear Jacquie’s

story at crouse.org/weightloss.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

Is Weight Loss Surgery Right for You? Upcoming Free Seminars: Oct. 5 • Oct. 22 To register: crouse.org/weightloss 315/472-2464

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How to Find a Better Medicare Prescription Drug Plan Dear Savvy Senior, I recently received a letter from my Medicare drug plan provider notifying me that they are increasing my co-pays next year. I’d like to look for a better plan but could use some guidance. What’s the easiest way to do this?

Need a Change Dear Need, Cost increases and coverage changes are an annual event for many Medicare Part D prescription drug plans. Fortunately,

during the open enrollment period (which is Oct. 15 through Dec. 7), you have the ability to shop and compare plans and choose one that better fits your needs and budget. Your new plan will go into effect Jan.1, 2016.

Here are some tips that can help with this process.

Shop Online

If you have Internet access and are comfortable using a computer, you can easily shop for and compare all Medicare drug plans in your area, and enroll in a new plan online.

Just go to Medicare’s plan finder tool at medicare.gov/find-a-plan, and type in your ZIP code or your personal information, enter in how you currently receive your Medicare coverage, select the drugs you take and their dosages and choose the pharmacies you use. You’ll get a cost comparison breakdown for every plan available in your area so you can compare it to your current plan.

This tool also provides a five-star rating system that evaluates each plan based on past customer service records, and suggests generics or older brand name drugs that can reduce your costs.

It’s also important to keep in mind that when you’re comparing drug plans don’t judge a plan strictly by its monthly premium cost.

Low-premium plans are often associated with higher prescription co-payments and may end up being more expensive. Look at the “estimated annual drug costs” that shows how much you can expect to pay over

a year in total out-of-pocket costs, including premiums, deductibles and co-pays.

Also, be sure the plan you’re considering covers all of the drugs you take with no restrictions. Most drug plans today place the drugs they cover into price tiers. A drug placed in a higher tier may require you to get prior authorization or try another medication first before you can use it.

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If you need some help choosing a new plan, contact your State Health Insurance Assistance Program (SHIP), which provides free one-onone Medicare counseling in person or over the phone. They also conduct seminars during the open enrollment period at various locations throughout each state. To find the contact information for your local SHIP visit shiptacenter.org or call the eldercare locator at 800-677-1116.

Shrinking Donut Hole

You also need to know that Medicare’s “doughnut-hole” — the coverage gap in which you must pay out-of-pocket for your drugs — continues to shrink. In 2016, you will get a 55 percent discount on brand-name drugs, and the federal subsidy for generic medications will rise to 42 percent.

The 2016 coverage gap begins when your total drug cost exceeds $3,310 (that includes your share and the insurer’s share of the costs) and ends when your total out-of-pocket costs reach $4,850. After that, your Part D plan usually covers around 95 percent of your remaining drug costs for the year.

Low-Income Assistance

Also, be aware that if you’re income is under $17,655 or $23,895 for married couples living together, and your assets are below $13,640 or $27,250 for married couples not counting your home, car or life insurance policy, you may be eligible for the federal Low Income Subsidy known as “Extra Help” that pays Part D premiums, deductibles and copayments.

For more information or to apply, call Social Security at 800-772-1213 or visit socialsecurity.gov/extrahelp.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Helping Veterans and Active Duty Military Members

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n Veterans Day, the nation honors the men and women who risk their lives to protect our freedom. Social Security honors veterans and active duty members of the military every day by giving them the respect they deserve. A vital part of that is administering the Social Security disability program.

For those who return home with injuries, Social Security is a resource they can turn to. If you know any wounded veterans, please let them know about Social Security’s Wounded Warriors website. You can find it at www.socialsecurity.gov/woundedwarriors.

The Wounded Warriors website answers many commonly asked questions, and shares other useful information about disability benefits, including how veterans can receive expedited processing of disability claims. Benefits available through Social Security are different than those from the Department of Veterans Affairs and require a separate application.

Q&A

Q: I own a small business. How can I verify employees’ Social Security numbers?

A: Employers can use our Social Security Number Verification Service to verify the names and Social Security numbers of current and former employees for wage reporting purposes. For more information, go to www.socialsecurity.gov/employer/ssnv.htm.

Q: I can’t seem to find my Social Security card. Do I need to get a replacement?

A: In most cases, knowing your Social Security number is enough.

But, if you do apply for and receive a replacement card, don’t carry that card with you. Keep it with your important papers. For more information about your Social Security card and number, and for information about how to apply for a replacement, visit www.socialsecurity.gov/ssnumber.

If you believe you’re the victim of identity theft, read our publication “Identity Theft and Your Social Security Number,” at www.socialsecurity. gov/pubs.

Q: What is substantial gainful activity?

A: We use the term “substantial gainful activity,” or “SGA,” to describe a level of work activity and earnings. Work is “substantial” if it

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

The expedited process is used for military service members who become disabled while on active military service on or after Oct. 1, 2001, regardless of where the disability occurs.

Even active duty military who continue to receive pay while in a hospital or on medical leave should consider applying for disability benefits if they’re unable to work due to a disabling condition. Active duty status and receipt of military pay doesn’t necessarily prevent payment of Social Security disability benefits.

Although a person can’t receive Social Security disability benefits while engaging in substantial work for pay or profit, receipt of military payments should never stop someone from applying for disability benefits from Social Security.

Learn more by visiting www.socialsecurity.gov/woundedwarriors.

Social Security is proud to support the veterans and active duty members of the military. Let these heroes know they can count on us when they need to take advantage of their earned benefits.

involves doing significant physical or mental activities or a combination of both.

If you earn more than a certain amount and are doing productive work, we generally consider that you are engaging in substantial gainful activity. For example, the monthly SGA amount for 2015 is $1,090.

For statutorily blind individuals, that amount is $1,820. You would not be eligible for disability benefits.

You can read more about substantial gainful activity and if your earnings qualify as substantial gainful activity at www.socialsecurity.gov/oact/ cola/sga.html.

Q: What can Social Security do to help me plan for my retirement?

A: Social Security has some great online financial planning tools you can use to make an informed decision about your retirement. Social Security’s online Retirement Planner and our online Retirement Estimator are both tools you can access at any time. These will let you compute estimates of your future Social Security retirement benefits. They also provide important information on factors affecting retirement benefits, such as military service, household earnings, and federal employment.

You can access our Retirement Planne” at www.socialsecurity.gov/ retire2. And, you can use the Retirement Estimator at www.socialsecurity.gov/estimator.

Where Miracle Happens: 40 Years of Crouse’s NICU As it celebrates 40 years caring for the region’s sickest babies, Crouse’s planning to expand its Neonatal Intensive Care Unit

By Suzanne M. Ellis

I

n 1975, what was then known as Crouse Irving Memorial Hospital opened its Neonatal Intensive Care Unit. Its purpose was to provide specialized care for premature babies and those born with life-threatening health issues.

That facility, known today as the Walter R.G. Baker Neonatal Intensive Care Unit (NICU) in what is now known as Crouse Hospital, is celebrating its 40th anniversary in Syracuse.

Now a top-level regional perinatal center, Crouse’s NICU is still caring for critically ill newborns, some so tiny that their hands fit inside their mother’s wedding ring.

But the highly trained staff also helps at-risk mothers, provides education, consultation and support to families, and oversees medical transport for babies as well as expectant mothers when the need arises.

Crouse’s NICU offers the most up-to-date technology for diagnosis and treatment of patients from 15 New York state counties and 19 birthing affiliates. Its coverage extends north to the Canadian border, south to the Pennsylvania border and east to the Utica/Rome area.

“We get the sickest babies here,” said Cathy O’Connor, a registered nurse who has been in the NICU at Crouse for 37 years. “And it’s not just [premature] babies; we get babies who are born with all sorts of problems like cardiac issues, mothers who are drug addicts or diabetic, babies who are having seizures. There are

babies in the NICU who’ve had difficult deliveries and have problems with oxygen getting to their brains, or they have broken shoulders or arms.”

One of those babies cared for

by O’Connor 32 long years ago in the early days of the NICU, is now a registered nurse, a wife and mother of three boys, and a colleague of O’Connor’s in the NICU. Her name is Honora Marceau; she was born Sept. 26, 1983 at then Community General Hospital and was quickly transferred to Crouse’s NICU. “I was a full-term baby, but I was diagnosed with a congenital cystic malformation on one of my lungs,” said Marceau, of Syracuse. “It’s basically a large mass, and it was so large that there was a lot of pressure and it was moving my vital organs around.

It had to be removed, as did the lower right portion of one lung.”

Marceau spent more than a month in the NICU, and O’Connor still remembers the “pretty” baby girl who was fighting for her life.

“People always laugh at me when I say it, but I really do remember her very well,” O’Connor said.

“She was absolutely beautiful, a really, really pretty baby.

“Nora was like this absolutely perfect baby doll,” O’Connor said.

“I remember taking care of her, and I remember her being very sick. I was able to keep track of her over the years because her father and one of my sisters-in-law are first cous-

Nora Marceau, left, and Cathy O’Connor work today in the Neonatal Intensive Care Unit (NICU) at Crouse Hospital. Thirty-two years ago, O’Connor took care of Marceau when she was gravely ill after birth. Photo courtesy of Crouse Hospital.

This is what the NICU at Crouse Hospital looks like today. Photo courtesy of Crouse Hospital. ins.”

Marceau, of course, remembers nothing of her time in the NICU. But she’s heard all the stories.

“I know it was so hard and so frightening for my parents that my mother wouldn’t talk about it for years,” Marceau said. “Until I had my own babies, I didn’t realize how a mother might feel having a baby that was so sick. Even a regular RN has no comprehension of what this is like. As a NICU nurse, I have come full circle in the realization of how serious my situation was when I was born.”

O’Connor and Marceau are part of a highly specialized team of more than 170 doctors, nurses, physician’s assistants and nurse practitioners who care for gravely ill babies 24 hours a day, seven days a week, 365 days a year.

“We generally have 25 nurses on for every shift,” O’Connor said.

“There’s a lot going on in the NICU all the time.”

Currently, there is room for 57 tiny patients and a staff that cares for babies born as early as 24 weeks (a full-term pregnancy is 36 weeks) and weighing as little as 500 grams — or 1.1 pounds.

“I work with some excellent nurses,” Marceau said, “and we have wonderful camaraderie. There is fantastic teamwork in the NICU.” Both women agree that the changes in technology over the past 40 years, especially in the NICU, are phenomenal.

“The equipment we had to use back then was sort of adult equipment that had been adapted for use November 2015 •

by babies,” O’Connor said. “Neonatology is such an exacting science, and the technology today is just unbelievable.”

“Technology has certainly come such a long way since then,” Marceau said. “They can do such amazing things.”

Because the NICU is caring for more babies all the time, Crouse is in the midst of a fundraising campaign called “Little Fighters.”

“We moved about 16 years ago into a new area,” O’Connor said, “but we are quickly outgrowing that now. We just have so many babies here all the time.”

“Crouse’s NICU cares for more than 1,000 infants annually ... the dedicated staff is made up of more than 170 renowned neonatologists, nurses and pediatric specialists,” said Bob Allen, vice president of communications and government affairs.

“The current NICU was constructed in 1999 and the hospital’s goal is to increase, modernize and transform the physical space to provide more private, one-on-one care ... as well as [to enhance] comfort and convenience for their families,” Allen said.

The Central New York community can support the expansion by making a donation at crouse.org/ littlefighters or at Syracuse-area Tim Horton restaurants. Parents of babies cared for in the NICU can also help the effort by sharing their stories on the online site.

“It’s a really wonderful place to work,” Marceau said. “They make miracles happen here.”

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H ealth News St. Joseph’s Health appoints new VP of HR Erika Duncan has recently been appointed vice president, human resources. She replaces Sally Biittner who retired in December.

“Erika will be responsible for defining and implementing the key initiatives consistent with our organizational goals — particularly as it relates to our need to address a shortage of clinical professionals due Duncan to retirements and increased demand,” said Kathryn Ruscitto, St. Joseph’s president and CEO. “Her primary areas of focus will include recruitment, retention, leadership development, diversity and benefits, in addition to leading HR’s integration with Trinity Health.”

Duncan has more than 20 years of leadership and operational experience. She most recently served as vice president of human resources for Metro Health, an integrated healthcare system based in Grand Rapids, Mich. An advocate for the employee, Duncan is credited with guiding the development of implementation of polices that resulted in improvement of the system’s recruiting, retention and engagement initiatives. Previous to Metro Health, Duncan served as senior director, human resources/ talent management for Spectrum Health, a Grand Rapids multi-hospital health system for eight years.

Weigelt named director of Springside at Seneca Hill Oswego Health has named Sarah Weigelt as director of Springside at Seneca Hill, the health system’s premier retirement community.

Since her arrival at Oswego Health 12 years ago, Weigelt has advanced up the career ladder at the health system.

She joined the health organization as an administrative assistant, working in the clinical Weigelt administration department before being named director of volunteers and auxilians in 2011.

While she progressed in her career, Weigelt also earned her associate’s degree in business administration from Cayuga Community College.

Weigelt said she was most excited to start her new position at Oswego Health. “I have always felt that I had more to give and so much more to do for the health system,” she said. “This is an opportunity offering me new challenges. I am very much looking forward to being a part of Springside and all that it offers, as well as getting to know all the residents and their families.”

St. Joseph’s foundation nets over $209 K St. Joseph’s Hospital Foundation netted more than $209,000 at its annual golf classic, held Sept. 11, at the Turning Stone Resort Casino.

The presenting sponsor of the 2015 tournament was Franciscan Companies, an affiliate of St. Joseph’s.

“We are delighted with this year’s enthusiastic turnout of 360 participants and over 70 volunteers,” said Douglas G. Smith, vice president for development.

St. Joseph’s Foundation accepts donations year round. To donate, contact the Foundation at 702-2137, or visit its website www.sjhsyr.org/ foundation.

St. Joseph’s Successfully Completes First MitraClip Case in CNY

Physicians Ayman Iskander and Ronald P. Caputo along with the St. Joseph’s Hospital Health Center cardiovascular team on Oct. 7 successfully performed the first MitraClip case in Central New York. For some patients, this is an alternative to open heart surgery.

MitraClip is a less-invasive treatment option for high risk patients with mitral regurgitation, which is caused by a leaky heart valve. The MitraClip device is a small clip that is attached to the patient’s mitral valve, allowing the valve to close more completely and helping to restore normal blood flow through the patient’s heart.

“Open-heart surgery is the standard method of treatment for patients with mitral valve regur-

HealtheConnections launches HealtheCNY site HealtheConnections, in collaboration with regional partners, recently launched of a new website to provide access to population health data, evidence based practices, and information about regional health resources and activities.

Technology helps patients regain ability to swallow A new ACP Synchrony biofeedback system used in the rehabilitation departments at both St. Luke Health Services in Oswego and Michaud Residential Health Services in Fulton is aiding individuals regain their ability to swallow after suffering a stroke or because of a degenerative illness like Parkinson’s disease.

Pictured are Paul McIntyre (left) and speech language pathologist Mallory Donigan, as they use the biofeedback system. The system looks and acts like a video game but the patient use sensors attached to their jaw and throat to control the animation and strengthen the muscles used for swallowing. Both patient and therapist can easily see progress and the technology has made the process more engaging.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015

gitation, but not all patients are eligible for it,” said Caputo, from SJH Cardiology Associates. “So the MitraClip is an alternative to heart surgery. It does not involve openheart surgery, but can be just as effective. And it has the potential to help improve the quality of life for thousands of patients.”

This procedure accesses a patient’s inner organs via needle-puncture through the skin, rather than an “open” approach in which the inner organs are exposed. MitraClip is the only FDA approved alternative to mitral valve regurgitation surgery.

According to a press release issued by the hospital, St. Joseph’s is the first to offer the procedure in Central New York.

HealtheCNY (pronounced “Healthy CNY”, at www.HealtheCNY.org) provides health departments, hospitals, and community-based health and human service providers with the resources needed to facilitate regional and community health improvement activities and strengthen collaboration in Cayuga, Cortland, Madison, Oneida, Onondaga and Oswego counties.

Using HealtheCNY, organizations can view more than 140 health and quality of life data indicators; map and visualize data, and generate tailored data reports; examine zipcode level maps of socio-economic need; browse through a database of over 2,000 evidence based practices and programs; access county specific pages with local data, priorities, health improvement activities, and resources; track progress towards county and regional goals for New York State’s Prevention Agenda, and use a tool for creating a community health needs assessment.

“Our vision for HealtheCNY was to provide Central New York with a vital resource to support population health improvement work in the region. This new site will engage diverse stakeholders, help pinpoint at-risk populations and areas of need, promote the implementation of programs proven to affect change,

H ealth News and provide tools to track and report on results at the community, county, and regional levels,” said Rob Hack, Executive Director of HealtheConnections.

Said Tom Dennison, director of Lerner Center for Public Health Promotion and a professor at Syracuse University’s Maxwell School: “This much-needed tool has the potential to align health promotion efforts in Central New York. HealtheCNY will help move the needle on the region’s health priorities,”

Upstate announces recent awards and appointments Upstate Medical University announces the following awards and appointments: • Kathi Durdon, director of operations for the Central New York Biotech Accelerator at Upstate Medical University, has received the Presidents’ Recognition Award by the Society of Clinical Research Associates (SOCRA). The award recognizes Durdon’s service to the organization.

With nearly 16,000 members, SOCRA provides education and certification in addition to other services to individuals across the country who are employed as clinical research associates. Durdon is a certified clinical research professional (CCRP), and a member of the Association for the Advancement of Medical Instrumentation (AAMI) Human Factors Committee.

• Paul Suits has been appointed

to the position of director of infection control. Suits is a licensed medical technologist. He earned a bachelor’s degree in medical technology from Upstate and has been employed by Upstate since 1997.

• PhysiWilliamson cian Zachary Williamson has been named a clinical assistant professor of medicine. He received his medical degree (2012) and completed his residency in internal medicine (2015) from Upstate Medical University. Prior to joining Upstate, Williamson served in Germany and Iraq with the U.S. Army.

(Photo attached.)

• Shelby Spagnola has been named assistant director of utilization management.

An Upstate employee since 2011, Spagnola most recently served as a utilization review senior coordinator nurse in the utilization management Seabury

Oswego Health’s Ferlito Recognized with NYS Legislative Resolution

Among those at the presentation of a state legislative resolution to Oswego Health’s Teresa Ferlito, from left, Oswego Health Vice President for Communication and Government Affairs Jeff Coakley; Oswego Health President and CEO Chuck Gijanto; Oswego Health Board Treasurer Mark Slayton; State Assemblyman Robert Oakes; Ferlito; State Assemblyman Will Barclay; State Senator Patty Ritchie; Oswego Health Executive Vice President for Finance Bob Pompo; Executive Vice President and Chief Operating Officer for Oswego Hospital Allison Duggan; and Vice Chair of the Oswego Health Board of Directors Barbara Bateman.

Oswego Health’s Teresa Ferlito has been recognized by state elected representatives for her years of dedicated service as vice president and chief operating officer of Springside at Seneca Hill.

Ferlito, who recently retired, was formally presented with a state

legislative resolution by Assemblymen Will Barclay and Robert Oaks, along with state Sen. Patty Ritchie.

The presentation took place at Senator Ritchie’s senior health and wellness fair on Sept. 23. The resolution was officially adopted by the state assembly and senate in May.

Alzheimer’s event in Liverpool breaks record, raises more than $200K A recent Alzheimer’s Association Walk to End Alzheimer’s at Long Branch Park in Liverpool raised $208,169 to support Alzheimer’s programs and research.

The amount was a record for the local organization and it was the first time it surpasses the $200,000 mark.

“I cannot explain in words how incredible this walk was,” said Catherine James, chief executive officer for the Alzheimer’s Association, Central New York department. She holds a bachelor’s of science degree in nursing from Upstate and is certified in case management • Robert Seabury has been named assistant vice president of revenue cycle. Seabury has nearly 30 years of revenue cycle experience with positions that include director of patient financial services at Ellis Hospital (Schenectady); executive director of patient access and business services at Stamford Hospital (Stamford, Conn); assistant vice president of patient financial service at Seton Health System (Troy).

• Physician Eduardo Bonilla has been named a clinical assistant professor, specializing in rheumatology. He received a degree in medical science in 1999 from Universidad de Costa Rica, Costa Rica. Bonilla completed his residency in internal medicine (2005), a fellowship in rheumatology (2007) and an advanced fellowship in rheumatology (2008) at Upstate Medical University. Prior to Upstate, Bonilla served as a staff physician for the division of rheumatology at Hospital San Juan de Dios in San Jose, Costa Rica, as well as a clinical professor of medicine for Universidad de Costa Rica in Costa Rica.

• Physician Abirami Sivapiragasam has been named an assistant professor, specializing in hematology and oncology. Sivapiragasam earned her medical degree (2006) from Tver State Medical Academy in Tver, Russia. She completed an internal medicine residency (2012) and a fellowship in hematology/oncology (2015) at Winthrop University Hospital in Mineola, N.Y., where she also served as a clinical instructor of internal medicine for medical students from Stony Brook University.

• These physicians are now affiliated with Upstate University Hospital: Hans Cassagnol, obstetrics and gynecology; Lucian Catania, anesthesiology; Grahame Gould, neurosurgery; Rainer Gruessner, November 2015 •

Chapter. “Everyone outdid themselves this year, from our tireless committee members to the efforts of our team and walkers. I could not be happier and more proud of an event than I am today.”

More than 1,800 people took part in the event, which began with an emotional opening ceremony led by Jim Teske of WSYRTV and emcees at Long Branch Park and included a 3-mile walk along the Onondaga Lake shoreline. transplant; Stephen Hoag, family medicine; Amie Lucia, surgery; Muhammed Naqvi, internal medicine; Lee Segal, orthopedics; Robert Swan, ophthalmology; and William Whetsell, radiology.

• The following nurse practitioners are now affiliated with Upstate University Hospital: Sarah Hunt, family medicine; Melanie Dunham, pediatrics; Sharon Zuis, pediatrics.

Physician Kamal Gautam joins Central Square practice Physician Kamal Gautam has joined Oswego Health’s Primecare Medical Practice in Central Square. . Gautam recently completed his residency in internal medicine at Interfaith Medical Center in Brooklyn.

He earned his Bachelor of Medicine and Bachelor of Surgery degree (MBBS) from Tribhuvan University in Kathmandu, Nepal.

After earning his MBBS, he worked as a medical officer delivering patient care at hospitals in Nepal.

Gautam, who grew up in the small country of Gautam Bhutan, between China and India, migrated to the United States and settled with his family in the Syracuse area.

He said he was looking forward to caring for patients age 18 and older at Primecare Medical Practice.

Dr. Gautam said he chose to become an internist, as he enjoys caring for a variety of patient conditions.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • November 2015