IGH - CNY 254 February 2021 by In Good Health: CNY's Healthcare Newspaper

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Golden Years

CNYHEALTH.COM

FEBRUARY 2021 • ISSUE 254

Special Issue

n Aging in Place: More accidents happen in the bathroom than any other room in the house. How seniors can make their bathrooms safer. n What Caregivers Should Know About Medicare: Having a working knowledge of Medicare can help them take full advantage of the coverage and services it provides n Acupuncture: Does it work and is it covered by Medicare? n Food Insecurity: Many seniors across the country (and in our region) are not certain they will have food tomorrow. n Hearing Loss: What are the signs? n Heart Month: Post-heart attack. What is typical for patients after they’ve survived a heart attack?

Drug Makers Raise Prices on 500 Prescription Drugs

Flu Cases in NYS Dramatically Down

Life in a Van Liverpool couple traded their 9 to 5 jobs for a year of van-fueled travel and adventure, dramatically boosting their health in the process.

Surprising Benefits of Rye Bread P. 11

Medical Minute: Debunking Vaccine Myths

Also: ‘I’ve Already Had COVID-19, Do I Need the Vaccine?’

U.S. Cancer Death Rates I Keep Falling: Report Decline boosted by fewer lung cancer deaths, says study

mproved lung cancer treatment is a major reason for the 31% decline in cancer death rates in the United States between 1991 and 2018, including a record 2.4% decrease from 2017 to 2018, the American Cancer Society says. How the COVID-19 pandemic will affect this downward trend is unknown, the society noted. “The impact of COVID-19 on cancer diagnoses and outcomes at the population level will be unknown for several years because of the time necessary for data collection, compilation, quality control and dissemination,” according to the report’s lead author, Rebecca Siegel. “We anticipate that disruptions in access to cancer care in 2020 will lead to downstream increases in advanced-stage diagnoses that may impede progress in reducing cancer mortality rates in the years to come,” she said in a cancer society news release. The American Cancer Society said about 3.2 million cancer deaths were prevented from 1991 through 2018 due to declines in smoking, earlier detection, and improvements in treatment that led to long-term decreases in deaths from the four leading cancers: lung, breast, colon and prostate. Lung cancer is the most common cause of cancer death, causing more deaths than breast, prostate and colon cancers combined. While there’s been slow progress against breast, prostate and colon cancers in recent years, declines in lung cancer death rates grew from

2.4% a year during 2009 to 2013 to 5% a year during 2014 to 2018. Lung cancer accounted for nearly half (46%) of the overall decline in cancer deaths in the past five years, driving the record single-year drop of 2.4% from 2017 to 2018 for the second year in a row, according to the cancer society’s new report on cancer statistics, which was published Jan. 12 in CA: A Cancer Journal for Clinicians. The report also appears in Cancer Facts & Figures 2021. Recent large reductions in lung cancer deaths reflect better treatment for the most common subtype of the disease — non-small cell lung cancer (NSCLC). Two-year survival for NSCLC increased from 34% among patients diagnosed in 2009 to 2010 to 42% among those diagnosed in 2015 to 2016, including gains of 5% to 6% for every stage of diagnosis. Two-year survival for small cell lung cancer remained at 14% to 15% over that time period. In 2021, nearly 1.9 million new cancer cases will be diagnosed in the United States and there will be over 608,000 cancer deaths, the cancer society estimated. However, that prediction is based on 2017-2018 data and doesn’t account for the potential effects of the COVID-19 pandemic. The report also said that cancer is the leading cause of death in Hispanics, Asian Americans and Alaska Natives. In addition, the five-year survival rate for all cancers combined that were diagnosed from 2010 through 2016 was 68% in white patients and 63% in Black patients.

Thank You To our physicians, providers and employees Thank you for your resilience, dedication and teamwork as we have worked together to keep patients, visitors, staff and our community safe and healthy during this challenging time. You are true superheroes.

To our community We extend sincere appreciation to the individuals, businesses and organizations across Central New York that have generously donated financial contributions, personal protective equipment/ supplies, food, electronic devices and other items in support of Crouse Health and our fight against COVID-19.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

crouse.org/covidthanks

WE WANT TO

SEE YOU HEALTHY Safety is part of our culture at St. Joseph’s Health. As the only hospital in Syracuse to receive a Leapfrog Hospital Safety Grade ‘A’, we are driven to keep our community healthy and thriving. Every St. Joseph’s Health location has put measures in place to ensure the safety and comfort of our patients: from COVID-Free Zones to mandatory screenings at the door to a myriad of other protocols. Our top priority is and has always been the health, trust and safety of Central New York. No matter the challenge, we are ready and able to care for our community as we work alongside our fellow health care professionals to treat and advise all who come through our doors.

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11/23/20 6:21 PM

Meet

Your Doctor

By Chris Motola

On Waitlist for Liver Transplants, Women Die More Often Than Men

railty may explain why women awaiting a liver transplant are more likely than men to become too sick for a transplant or die before transplantation, a new study suggests. Exercise and a healthier diet may help narrow that gender gap, researchers say.For the study, researchers followed more than 1,400 patients with cirrhosis awaiting a liver transplant from nine U.S. transplant centers. About 40% were women. The men, aged 49 to 63, were more likely to have chronic hepatitis C and alcoholic liver disease. The women, aged 50 to 63, were more likely to have non-alcoholic fatty liver disease and autoimmune cholestatic liver disease. Both groups had similar levels of disease severity. However, the women were significantly frailer than the men, the researchers noted. “This is the first time that frailty has been identified and quantified as a risk factor among women with cirrhosis who are waiting for liver transplants,” said lead study author Jennifer Lai, a general and transplant hepatologist at the University of California, San Francisco. “The importance of this finding is that this gender gap can potentially be mitigated through early interventions as basic as providing adequate caloric and protein intake and engaging in regular exercise. Clinicians can advise women on diet and exercise interventions that build strength,” she said in a university news release. Why women were frailer was not explored, but it is generally attributed to physical inactivity, chronic liver failure and poor diet, Lai said. The women had a 36% greater risk of being too sick for a transplant or dying before one was available. In all, frailty accounted for 13% of the gender gap, the researchers said. “The waitlist mortality gender gap has persisted for 15 years across the entire U.S. liver transplant system and will continue to persist if it is not recognized,” Lai said. “Now that it has been recognized, it can be addressed.” The study was published Dec. 30 in JAMA Surgery.

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Philip Falcone, M.D.

Physician becomes St. Joe’s new chief medical officer during the pandemic. He talks about his new position and how his idea helped the hospital secure enough N95 medical masks at a time of profound shortage Q: You were promoted to chief medical officer last year. Seems like a crazy time to step into that role. How has that been? A: It really was. I was the medical director of quality for the first part of the COVID storm. Since October, I’ve been chief medical officer and we’re right back in it after a lull. Now we’ve got the vaccine, but we’re still trying to navigate some very choppy waters. It’s definitely a very challenging time to take over as CMO. I have done my best to try to help my medical staff understand what we’re up against and what we’re asking of them to help us get through this — from rearranging surgery schedules to asking some people to accept some compensation reductions, a lot of things that have helped us manage our way through this in a way that preserves our quality of care. Q: How is the rollout of the vaccine going? A: I think it’s been going relatively well. I think there are always going to be issues when you’re talking about such a large scale project as is being attempted. New York state has provided us with vaccine to be used. We are using it very efficiently here. We used our first 3,000 doses and are now into our next allotment. We’ve vaccinated over 3,300 members of the our staff and affiliated members of healthcare community [as of mid-January]. So I think we’re making great headway. We’re getting ready for the next phase, which we’re coordinating with the county, which will be vaccinating people 75 years old and older, but a lot of the details are still being worked out. Q: Which of the two vaccines are

IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

you using? A: We have access to both the Pfizer and the Moderna vaccines, and we’ve used them both on staff. They’re very similar. They are mRNA vaccines. They’re both very effective, better than 94% effective at preventing COVID. Pfizer’s is three weeks between the two doses, Moderna is four weeks. Once you have the second dose, after a few weeks you’re very well protected against the virus. We haven’t had any major problems related to these vaccines, just some typical minor things like arm pains and headaches. Most people having been doing quite well, and it’s been very well-received by our staff. Q: You introduced a method of sterilizing N-95 masks. How does that work, and what affect has it had on the hospital? A: Back in the early days of the pandemic, we were having the same problems as most other hospitals, which was that we weren’t able to get the amount of PPE [personal protection equipment] that we needed for day-to-day patient care and needs. I had been doing some research on it and found that Duke [University] was using a vaporized hydrogen peroxide system to do decontaminate the masks. So I looked into that, realized we could potentially do that and was able to locate a machine — one of the last ones in New York state. I was able to work with finance to get the machine here. We converted one of our older cardiac catheterization labs on the second floor to a hydrogen peroxide chamber. That allowed us to decontaminate masks and reuse them. That gave us the ability to really extend our supplies. We were able to do that. We had over 5,000 masks we were able to reprocess that way. This gave us the comfort of knowing we had back-up masks we could use to protect our staff, especially the nurses in our COVID-positive unit, who desperately need them every day. So I think that was very helpful. Q: Are you still decontaminating masks on site? A: We needed our personnel and that space back when we resumed surgery, so we out-

sourced the hydrogen peroxide decontamination to another company. Q: How long can you extend the lifespan of these masks with this method? What’s the limit? A: I think the testing that was done found that it could be done up to 20 times. We did it up to 10 times without any issues. We were preserving the ones we had without having to throw them out. Q: How much money did the hospital save this way? Or is that besides the point? A: It’s kind of besides the point although, as you can imagine, the masks were becoming a lot more expensive. The supply was going down and the demand was very high. Cost wasn’t really the issue for us though, we just needed a ready supply. We were still able to source the masks, but unfortunately some of them were only available in larger sizes, so having the ability to reprocess the masks that our staff were most comfortable in was important. And just knowing they were available was comforting to the staff. It helped at a time when we really weren’t sure what was coming down the road at all. Q: Has this process become more widely adopted? A: I think it is being used more commonly now. As I said, we’re no longer doing this onsite, but we are still using it. A lot of hospitals around the country have started to do it because we are in crisis capacity so far as PPE goes. It’s more available than it was, but it can still be a little bit difficult to source the amount of masks you need in the sizes you need. So it’s still something that’s being done. There’s still a short supply of masks throughout the country and even throughout the world. Q: You received a 2020 Excellence in Healthcare award for being a “healthcare innovator,” for this, correct? A: Yes, it was an award given out by the Central New York Business Journal recognizing my contributions toward this endeavor at a time when no one else in our city was doing it. So it was just my contribution toward getting us past a crisis point.

Lifelines

Name: Philip Falcone, M.D. Position: Chief medical officer at St. Joseph’s Health Hometown: Syracuse Education: SUNY Upstate Medical University Affiliations: St. Joseph’s Health; Crouse Hospital Highlights: Started at St. Joseph’s In 1991 as an attending physician in the department of plastic surgery. Member of the Governing Board of the St. Joseph’s College of Nursing and a past co-chairman for the Ambulatory Surgery Center Governance Committee. Also a member of the Onondaga Community College’s Surgical Technology Advisory Board Organizations: American College of Surgeons; Onondaga County Medical Society; New York State Medical Society Family: Wife, son Hobbies: Crossword puzzles, reading (British mysteries, especially), golf

Flu Cases in NYS Dramatically Down Excellus BlueCross BlueShield reports 2,046 labconfirmed cases of influenza in NYS as of January compared to 32,848 cases in the same period last year. Reasons: More vaccine and COVID-19 safety protocols

he prevalence of flu in New York state is way down compared to this time last year, according to an analysis of health tracking data by Excellus BlueCross BlueShield. Contributing factors include a closer match between the genetic make-up of this year’s influenza virus and the vaccine, a majority of the adult population supporting vaccination, and the intense safety protocols being practiced in order to limit the spread of COVID-19. As of Jan. 2, there were 2,046 laboratory-confirmed cases of influenza, 357 patients hospitalized, and no pediatric influenza deaths. At this time last year, the state reported 32,848 laboratory-confirmed cases of influenza, 5,694 patients hospitalized, and one pediatric influenza death. “We have a proven threepronged approach to challenging the flu virus: We have a flu vaccine that’s safe and effective and widely available, we have buy-in from much of the public to get the flu vaccine, and we have everyone practicing common-sense behaviors that can reduce the spread of a virus,” said Excellus BCBS Senior Medical Director for Clinical Services Nicholas Massa. “The success of this approach in reducing the impact of this year’s flu virus is the template for reducing the impact of COVID-19,” said the

physician. The exact timing and duration of flu seasons can vary, but influenza activity often begins to increase in October, peaks between December and February, and can last as late as May. The U.S. Centers for Disease Control and Prevention (CDC) reports 192.5 million doses of this year’s flu vaccine have been distributed nationally to date (as of Jan. 1), compared to 174.2 million doses in total for the 2019-2020 flu season. “Each year brings a new formulation for the flu vaccine to reflect the different strains that are expected, so it’s important for everyone to get the flu vaccine each year,” said Massa. New York state reports influenza A and B are circulating this season. “And as we’ve learned this year, there’s more to practicing personal responsibility than simply coughing into your elbow. We need to wear masks, practice social distancing, and wash our hands effectively and often to protect ourselves and others.” Last year, 22,000 Americans died from the flu and flu-related complications and 405,000 were hospitalized, according to the CDC. A 2020 survey of 2,000 Upstate New York adults commissioned by Excellus BCBS and conducted by One Research found 60% of adults believe it is important to get a flu vaccine.

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Drug Makers Raise Prices on 500 Prescription Drugs

ith the new year comes another round of prescription drug price hikes. The data comes from 46brooklyn Research, a nonprofit company that aims to improve access to drug pricing information. AbbVie, Bristol Myers Squibb, GlaxoSmithKline, Pfizer and other major pharmaceutical companies are raising their prices by a median of 4.6%, the nonprofit said. In all, more than 500 drugs will cost more this year, the data shows. Drug prices are higher in the United States than in other developed countries, where governments typically negotiate with manufacturers to control costs. GlaxoSmithKline raised the price on 34 of its drug brands on Jan. 1, company spokesperson Lyndsay Meyer said in an interview. “Compared to last year, we’ve taken fewer list price increases and we didn’t raise the list price of 18 products across our portfolio,” Meyer noted. Pfizer officials said that its prices rose about 1%. “This modest increase is necessary to support investments that allow us to continue to discover new medicines and deliver those break-

throughs to the patients who need them,” a company spokeswoman said. Bristol Myers Squibb “responsibly balances pricing its medicines so high-risk innovation is rewarded while providing access and affordability support for its patients,” the company said in a statement.the company sells the lung cancer treatment Opdivo, which is expected to rise 2% in price, and the arthritis drug Orencia, which is looking at a 5% jump, CBS News said. Other drugs expected to see price hikes include: • The pain medication Zipsor, by 10% • The anti-epileptic treatment Sabril, by 10% • The Crohn’s disease drug Humira, by 7% • The heart attack treatment Kengreal, by 6% • The diabetic nerve damage treatment Lyrica, by 5% • The smoking cessationdrug Chantix, by 3% February 2021 •

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Solo Travel:

‘You Had Me at Hello’

ho doesn’t remember one of the most romantic lines ever spoken in a movie: “You had me at hello” from the 1996 film “Jerry Maguire.” In one of the film’s most memorable scenes, Tom Cruise’s title character pours out his heart to his on-screen wife, played by Renee Zellweger, and asks her for a second chance. Zellweger stops Cruise mid-sentence and tearfully says “You had me at hello,” after which they fall into each other’s arms, destined for a long and happy reunion. I watched the movie clip on YouTube this morning and it brought a tear to my eye. I’m a softy at heart. But, what in the world does this have to do with solo travel? For me, travel — like a captivating romance — holds intrigue, excitement and the promise of profound, life-changing moments. When I took my first stroll by myself in the Luxembourg Gardens in Paris, I could easily have exclaimed, “You had me at bonjour!” But those were the good ol’ days, when we could move easily throughout our lives and the world. Sadly, the pandemic brought travel to a near standstill in 2020, keeping most

of us hunkered down at home for most of the year. Because it may still be months before we can safely travel again (even with the roll-out of the vaccines), people are busy doing the next best thing: They are joyfully plotting, planning and preparing their future vacations and visits with loved ones. Goodbye Netflix; hello TripAdvisor! Now’s the perfect time to compile your bucket list of destinations near and far. And while you’re at it, consider including a solo dream trip in your planning. Why do I have such a love affair with solo travel? Let me count the ways: n You call the shots — When you travel alone, you are free to see and do whatever you like. Your decisions and itinerary are your own. And when it’s just you, you are reminded of who you are, what you enjoy doing the most, and what you like least. When you travel with other people, their interests may be at odds with yours. And precious time can be consumed with the inevitable negotiations that come with trying to satisfy everyone’s needs and desires. Traveling alone allows you to follow your heart and own path.

s d i K Corner

Youth Vaping Triples Odds for Adult Smoking

aping may not be a way for kids to avoid the smoking habit, after all. A new study finds that teens who start vaping are three times more likely to smoke cigarettes in adulthood than those who never started with electronic cigarettes. Although the number of teens who start smoking cigarettes in high school has declined, vaping has soared. From 2016 to 2019, the number of cigarette smokers among U.S. high school seniors dropped from 28% to 22%, but e-cigarette use increased from 39% to 46%, the researchers found.

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“The rapid rise in e-cigarette experimentation among the youth of our country appears to mean that we will have a whole new generation of cigarette smokers along with all the health consequences that follow,” said lead researcher John Pierce. He’s a professor emeritus in the department of family medicine and public health at the University of California, San Diego. “There is an urgent need to reconsider the policies on e-cigarettes and at least hold them to the same standards as the cigarette companies, such as restricting their right

IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

n You make new friends more easily — I’ve discovered this time and time again. When I’m on my own, other travelers and “locals” are more likely to strike up a conversation with me or extend an invitation to join them. I’ve met some of the nicest, most interesting people this way. When traveling with friends and family, we tend to stay focused on each other and lose the chance to meet people we might otherwise have met. That could be a missed opportunity, especially if you are single and hoping to meet someone new. n You can release your adventurous spirit — By yourself (with no one watching), you may be willing to take more risks — maybe zip-lining, bungee jumping, or swimming with dolphins. I’ve never been that adventurous, but I have sampled some pretty exotic food, wrestled Old Paint into submission on a horse trail, and held on for dear life while rafting down the Colorado River. n Likewise, you can find some heavenly time to yourself — On your own and with fewer distractions, the opportunity for a tranquil, soul-soothing retreat is within your grasp. Whenever I travel, I like to build in time to myself to relax and recharge my batteries. Solo travel makes guilt-free “me” time possible. Want to sleep in till noon, find splendid solitude in a secret garden or enjoy your own company and a nightcap at the end of the day? Go for it, because you can. n You learn a new language faster — Je peux en témoigner! (I can vouch for that!). When traveling alone in France, I was forced to make sense of the language. It was either that or go hungry. Without a traveling companion to talk with or to aid in translation, I had to fend for myself. While I am far from fluent in French, I can at least order a croque-monsieur — a hot ham and cheese sandwich. Want to learn a

language more quickly? Travel solo. n You build your confidence and sense of independence — Even a small jaunt can boost your self-confidence. All the decisions are yours, including your budget. You decide how to get where you’re going, where to stay, and how much to spend on transportation, food, accommodations and things to do. In no time, you’ll discover your own resourcefulness, ability to solve problems, and capacity to spend some time alone. Those are invaluable, lifelong lessons. Solo travel is ripe with opportunities for self-discovery, growth and joy. Start dreaming today. When the travel advisories are lifted, you’ll be ready. Pack your bags, and with no reservations (pun intended), set out on your journey with a spring in your step and unbridled anticipation for all the hidden treasures that await. I’m already contemplating a vacation with just “me, myself and I” when the time is right. It might be a weekend away for a change of pace or a great big adventure for a jolt to the senses. Lately, I’ve been pouring over travel guides for Austin, Texas. I have a sneaking suspicion that the “Live Music Capital of the World” will — you guessed it — have me at howdy!

to advertise to our teens,” Pierce said. For the study, the investigators collected data on nearly 16,000 people in the United States, aged 12 to 24. Nearly two-thirds had tried at least one tobacco product, and almost one-third tried five or more tobacco products, of which e-cigarettes and cigarettes were the most popular, the findings showed. Each additional product tried increased the users’ odds of becoming a daily cigarette smoker, as did trying tobacco before age 18, according to the report published online Jan. 11 in the journal Pediatrics. Physician Pamela Ling is interim director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. She said, “This is a problem because the tobacco companies are continuing to produce more new tobacco products every year.”

E-cigarettes and other new tobacco products gained popularity because people think of them as safer alternatives to cigarettes, explained Ling, who was not involved in the study. But this study shows that in the hands of young people, e-cigarettes lead to harm. “Some young people may think they are decreasing their risk because they smoke a little, vape a little, chew a little, but may not use any single product very much. But this poly-tobacco use behavior increases risk to end up a daily smoker,” Ling said. Pierce noted that there are a number of people who advocate e-cigarettes as a way of reducing the harm caused by cigarettes. These people have assumed that young people who start using e-cigarettes will become dependent on them to get their nicotine.

NOTE: As of this writing, the CDC and other health experts and institutions advise staying at home as the pandemic surges. Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite Gwenn to speak, visit www. aloneandcontent.com

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My Turn

By Eva Briggs, MD

Artificial Breast Milk I begin this article intending to write about a futuristic idea to improve infant bottle feeding, to produce a substance more closely resembling mother’s milk. I’ll get there, but my reading led me down the internet rabbit hole to some fascinating facts about the history of infant feeding. Breast feeding is the ideal, but sometimes it doesn’t work out. A mother may not produce enough milk. The baby may have difficulty latching on and suckling. Breast feeding could be too painful. The mother’s work schedule might preclude breast feeding. So, back into prehistory, mothers sought alternative ways to feed infants. Before the introduction of artificial formula and safe baby bottles, wet nursing was common. That’s the practice of a woman breast-feeding another’s child. Records indicate it dates back at least 2000 years. In biblical times Pharaoh’s daughter hired a wet nurse to feed baby Moses. Ancient medical remedies to treat lactation failure probably weren’t very effective, judging by this example from the Papyrus Ebers out of Egypt 1550 B.C.: “Warm the bones of a swordfish in oil and rub her [the mother’s] back with it. Or let the woman sit crosslegged and eat fragrant bread of soused durra while rubbing the parts with the poppy

plant.” Durra is a type of grain, so I’m guessing that soused durra was soaked in alcohol. The earliest use of wet nurses arose from necessity. As early as 950 B.C. in Greece, women of higher social status demanded wet nurses, apparently for status or convenience. Between 300 B.C. and 400 A.D. in the Roman Empire, written contracts were formed for wet nurses to feed abandoned infants. These were usually females thrown onto rubbish piles, and subsequently purchased by the wealthy as an inexpensive slave for future use. Eventually doctors recommended that women nurse their own infants when possible, but wet nursing remained a popular, well-paid, highly organized profession during the Renaissance. Bottle feeding, initially not as common as wet nursing, goes back to prehistoric times. 7000-year-old clay feeding vessels, often shaped like cute animals, contain remnants of animal milk from cows, sheep and goats. Other devices were made from wood, ceramics and cow horns. One of the most common feeding bottles of the Middle Ages was a perforated cows horn. The “bubbly pot” invented in 1770 was similar to a small coffee pot with the neck arising from the bottom of the pot. The end of the spout formed a knob

in the shape of a small heart with several small holes punched into it. A small rag, piece of linen, or sponge was tied over the holes for the infant to play with and suck milk through. In 16th through 18th century Europe, the pap boat was a device to feed infants pap (bread soaked in milk or water) or cereal cooked in broth. This included a spoon with a hollow stem so that the food could be blown down the infant’s throat. This permitted caretakers to cram more food more quickly into an infant than breast feeding. Glass bottles came into use in the early 1800s, evolving from elaborate affairs with cork nipples and ivory pins at air inlets, to the modern bottles used today. The first rubber nipples had a repulsive odor and taste. Early feeding bottles and devices could not be easily cleaned or sterilized, allowing bacterial buildup infecting and killing some infants. Synthetic baby formulas began to be developed in the late 1800s. These formulas gradually improved in composition and ability to be sterilized and stored safely. But synthetic formula does not include all the bioactive cells, enzymes, and proteins found in mother’s milk. Scientist Leila Strickland, a cell biologist, had difficulty breast feeding her children. She felt as if she spent all day every day either nursing or pumping to stimulate her milk flow and yet her children cried and seemed hungry. While watching the unveiling the first laboratory grown hamburger, Strickland had an inspiration. Perhaps breast cells could be cultured to make human milk that could be fed to infants whose mothers couldn’t breast-feed.

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After a number of years of research, starting with a cow udder she bought for $20 from a local slaughterhouse, she’s making progress toward that goal. One of the difficulties is that breast milk changes in composition over time. The first few days mothers produce colostrum. This thick yellow concentrated milk is packed with compounds like antibody IGA and lactoferrin. That colostrum is soon replaced by transitional milk which is thinner with more fat and lactose (a milk sugar). And after about two weeks mother’s milk has what is considered a “mature” composition. Other scientists are also trying new approaches to make better infant formula. A Singapore lab is working to synthetically produce proteins and carbohydrates to fortify current formulas. Another company plans to use microbes to synthesize milk proteins, carbohydrates, and fats to be recombined into an improved infant formula.

Michael Diaz, DO

Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.

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Pandemic Causes a Spike in Medical School Applications Enrollment up 26.2% at Upstate, 40% at UB. Experts attribute that to ‘Fauci Effect’ By Payne Horning

assidy McGinn, a 22-year-old from Tully, has always considered pursuing a career in medicine, but it was never a guarantee. Even though her major at SUNY Geneseo was chemistry, McGinn was also interested in other professions. She even considered going to law school. It wasn’t until her senior year at SUNY Geneseo, in the fall of 2019, that McGinn finally settled on medical school. She applied for admission to SUNY Upstate Medical University and was accepted. It was at this moment, after McGinn had finally found her footing in the world, when the world itself shifted underneath her. COVID-19 struck. “This pandemic came quickly to the United States and it was evident that we didn’t have the proper PPE, we were understaffed in a lot of hospitals, they didn’t have the resources,” McGinn recounted. “So, it definitely takes a certain type of person to pursue this career.” As it so happens, McGinn is that exact type of person. The pandemic didn’t make her regret the decision

to go into the medical field at all. If anything, she says, it had the opposite effect. “If you know anything about med students, it’s that they’re persistent, it’s that they are courageous, and they need to be resilient,” McGinn said. “I think in a time when the medical community has been so challenged, I think it reaffirmed my decision to apply to medical school and the same thing goes for a lot of other premedical students.” McGinn is right. Rather than serving as a deterrent, the coronavirus served as a rallying cry. Applications for medical schools have surged across the country in the past year — up 18% according to the Association of American Medical Colleges. Some schools in New York are seeing even bigger numbers. M.D. program applications rose by 40% at University at Buffalo and 26.2% at SUNY Upstate Medical University compared to 2019. Although encouraged by the spike, physician Lawrence Chin, dean of Upstate Medical University’s College of Medicine, said he is not surprised.

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As the shadow of the pandemic spread across the world in spring 2020, Chin said the students enrolled at SUNY Upstate stepped up to the plate. They volunteered in large numbers by manning the phone lines for contact tracing and helping test people. “So, I knew that this was going to kind of be a challenge to young people and also an opportunity for them to make a difference,” Chin said. Equally motivating for this class of future medical professionals, Chin says, was watching the healthcare system actually make that difference in the world. They witnessed the rapid mobilization of every end of the medical field from frontline workers saving people with COVID-19 who were on the threshold of death to developing multiple vaccines in record time. Upstate itself played a major role in this fight. The U.S. Food and Drug Administration recently named a test Upstate developed as the No. 1 COVID-19 saliva test in the world. While all frontline workers are inspiring in their own right, this spike in applications to medical schools is being named for one person in particular: Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. With his dogged persistence in educating the public about the coronavirus and how to combat it in the face of nonsensical backlash from a small but loud group who question science, Fauci has developed a large fan base. Among them is McGinn, who called Fauci one of the best public figures of our time. And now it can be said that Fauci also has what could be referred to as

a following. Many healthcare professionals attribute the rising interest in pursuing a career in medicine at this moment to the so-called “Fauci Effect.” “There are so many people involved at the federal level, at the state level, and at the local level, but he is a symbol, emblematic of the kind of example of what we’re trying to do at academic institutions like Upstate –following the science, using science,” Chin said. “Dr. Fauci is an excellent example of how we communicate it to the public so that they trust what they’re hearing and that they trust the treatment, and the messages we are sending like wearing a mask.” God willing, the pandemic will end before this incoming class of medical students graduate and have a chance to be the next Fauci. But even if that does happen, Chin said the work is far from over. COVID-19 exposed many of the health inequities and disparities that exist in the United States. For example, the mortality rate from this disease is higher among Black Americans than white Americans even though that community represents a smaller share of the nation’s population. The next generation of medical leaders will be called on to carry the baton in those fights and others. “The combination of this pandemic and the need to right the health inequities that exist really capture the imagination and I think that also is driving interest in medical schools,” Chin said. “There’s certainly a long way to go and you have a group of students that see an opportunity for them to participate in making a difference.”

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Does Van Life Equal Fit Life? Couple traded their 9 to 5 jobs for a year of van-fueled travel and adventure, dramatically boosting their health in the process.

Living quarters inside a van: the place had all the basics the couple needed for a year. They stopped at grocery stores every three to five days.

hen the time came for New Year’s resolutions, you vowed to eat healthier, get more exercise and improve your overall health. And then, a few weeks into the new year, you gave up. If you’re looking for help with health and fitness goals, consider the van life. Justin and Savaria Crego traded their 9 to 5 jobs for a year of van-fueled travel and adventure, dramatically boosting their health in the process. The couple had been married about a year and was happy together, but their day jobs and being tethered to a cramped apartment ground them down. They wanted to hike the national parks, visit Canada and experience the rugged beauty of the Pacific Northwest. Instead, they found themselves living for the weekend. They took hikes, explored parks and went to concerts. There were wine tastings with friends and semiannual camping trips. Savaria devoted her time to crafts and becoming a certified yoga instructor. Justin belonged to a CrossFit gym. But they realized they needed a change. Before embarking on their adventure, they had an apartment in Liverpool.

New trend

The van life movement has soared in popularity with millennials. On Instagram, “van lifers” share a steady stream of breathtaking landscapes and selfies; nearly 10 million posts are tagged with the hashtags #vanlife and #vanlifediaries. Living in a customized van appealed to Justin and Savaria. They crunched the numbers and realized they could afford to buy a used van, fix it up and spend at least a year traveling the country. “I realized we could actually do it,” Savaria says. “That kind of made it real for us.” In August 2019, after months of work, they quit their jobs, got rid of their apartment and donated or stored their belongings before hitting the road. The couple had been health-conscious while living in Central New York. They followed a paleo diet and learned to eat for nutrition rather than just eating for the sake of eating. But they soon found their nomadic Page 10

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Savaria and Justin Crego, after traveling more than a year in their van, settled down into an apartment in Baker, a small town in remote eastern Oregon. Savaria grew up in Chittenango. Justin grew up in Scriba. They had an apartment together in Liverpool up until they hit the road. lifestyle took things a step further. Their secondhand 12-volt cooler, which they eventually replaced, didn’t work particularly well, which limited the amount of perishable foods they could have. That meant they all but stopped eating meat and cut back on dairy. They got their protein from hemp seeds, quinoa and beans. They traded snacking on chips for munching on cashews, raisins and pickles. Chia seeds also worked their way into their repertoire of meals.

No normal day

There’s no normal day for a van lifer, but Savaria and Justin tried to develop a routine, especially with food. If they stayed at a campsite, they usually took their time getting ready for the day. Morning coffee in folding camp chairs under the van’s awning offered a front row seat to a panoramic landscape. Then they’d usually turn to a trusted breakfast staple, like oatmeal or cereal before hitting the road; occasionally they’d indulge with Pop-Tarts. With only a Coleman propane stove to cook on, they tried to keep things easy and simple, typically making salads, veggie wraps or cooking one-pan meals. The idea was to include as much fresh produce and fruit as possible. “We were eating for nutrition, not just to get full,” Justin says. “We wanted to get our vitamins and minerals.” They frequently used potatoes, peppers, onions and carrots. Sometimes they added an extra ingredient,

IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

Justin and Savaria Crego of Liverpool quit their jobs, bought a used van, fixed it up and spent at least a year traveling the country. They visited 15 states and three Canadian provinces — and hiked at almost every destination. like eggs or salsa. Hot sauce was plentiful. With a few changes, they were able to make many variations of the same handful of meals. Despite a healthier diet, the couple’s rickety cooler limited how long they could be off the grid. “We figured out that we could only last three days without going to a store,” Justin says. The couple did have a few Meal Ready to Eat (MREs) tucked away for emergencies (they never used them) and there was enough canned soup, pasta and other dry food in their tiny mobile pantry to limp along a few extra days if necessary. But their diets dictated a lot of fresh food. Once they replaced their cooler, they could go five days without a grocery store. They prepared the majority of their meals, only occasionally stopping to splurge on Mexican or Chinese. They avoided fast food altogether.

Weight loss

Justin and Savaria noticed differences soon after they hit the road. They were consuming fewer calories than they ate back home and were more active. “I think our diets have improved a lot,” Savaria says. Justin, who is 6 feet 5 inches tall and once weighed 320 pounds, had slimmed down to roughly 260 pounds in 2014 when he joined a CrossFit gym. He managed to lose another 10 to 20 pounds, but says he wasn’t satisfied. “I got to a point where I plateaued,” he says. “Working out I

wouldn’t really lose weight.” On the road, however, with the challenges of apartment living and a typical American diet behind them, Justin noticed he was running a caloric deficit. “The first three months I was constantly hungry, but there was always something to distract me from the hunger,” he says. Justin hadn’t set out to lose weight during their adventure and at first he didn’t see a significant change. He did notice that he lost some muscle mass without a gym for regular strength training, although he did try to keep up by doing exercises using his body weight or jugs of water. Over the course of a year, however, Justin says he lost roughly 30 pounds and two pants sizes. While their diet improved on the road, their activity level also skyrocketed. If they were driving somewhere new, they would leave as soon as possible. Depending on the day, they might go for a hike or if they day at a new campsite, take a few hours to pick up the trash and litter that was usually left behind by previous campers. Throughout the day, they were continuously munching on healthy snacks like nuts and raisins. Justin continued to squeeze in strength training and Savaria practiced yoga often. “I think our main thing was we’d go to destinations to hike,” Savaria says. “Hiking was definitely our primary source of exercise.” The couple had done a fair amount of hiking on flat terrain

On the Road Meals

Instead of taking their time and enjoying themselves, Savaria says it was hard to break the mentality that they had to keep moving to see and do as much as possible. They rarely stayed in one spot for more than a day. “We were just constantly moving,” she says. “We’d climb a mountain and then say ‘What’s next?’” It may have contributed to their physical fitness, but they wanted to slow down a bit. They got their chance in spring 2020 when the pandemic made travel increasingly difficult. They spent three months with relatives. When they left, they took their time and enjoyed themselves more. In addition to being more aware of their physical health, the couple also took steps to improve their mental health.

Settling down

around Syracuse, such as Onondaga Lake, but became bored repeating many of the same trails.

No alarm clock

Throughout their journey, which lasted a little over a year, the couple visited 15 states and three Canadian provinces. They hiked at almost every destination. There were obvious highlights, such as the Grand Canyon. At Sequoia National Park Justin marveled at the largest trees on earth. In White Sands National Park, they climbed the glistening white dunes

that create the world’s largest gypsum dune field. Hiking multiple times a week quickly built up their endurance. Their hikes often led them to a new landscape so beautiful it could have been clipped out of a National Geographic magazine. Throughout their adventure the Cregos had no alarm clock, no jobs, no set schedule. Yet they still found themselves racing against time. The couple had saved enough money to spend about a year on the road and wanted to see as much as possible.

As they prepared to begin their adventure, Justin says it was apparent from social media that one of the selling points of van life was becoming mentally centered and living a sort of Zen lifestyle. He was excited for their journey, but skeptical about much of the hype. “I still had some expectation of being more mindful and being more present,” Justin says. “It just didn’t happen.” To be sure, the couple enjoyed the freedom and exploring new places. But stresses and issues in life don’t disappear when you trade a 9 to 5 job for life on the road, Justin says. “You can have great parents and grow up in a great environment and still have issues,” he says.

So, in spring 2020 he began seeing a therapist via regular video chats. He says the results have been positive and a learning experience. Justin says he has gotten better at coping with stressors and has become less critical of himself for not meeting physical fitness expectations. The results were so positive that Savaria began seeing a therapist also. They have since given up their nomadic lifestyle and in late 2020 moved into an apartment in Baker, a small town in remote eastern Oregon. Justin has a job as a technology consultant with the local school district and Savaria is pursuing a home crafting business. They’re in the process of buying a house there. The couple says they enjoy the fact that bathrooms and hot showers are no longer luxuries, and that heat is only a flick of the thermostat away. They also have a backyard for their dog Zuko. “I don’t mind the structure and getting back into a routine where we don’t have to worry about where we lay our head every night,” Justin says. Transitioning to apartment life has presented some hurdles too. Savaria is baking a lot more and the couple is much more likely now to cook something prepackaged than making it from scratch like they did on the road. The holidays were a challenge too. And even with access to a gym, it can be tough to be as active as they once were. “We still binge on TV shows and get into routines of eating dinner, watching TV and then desserts,” Justin says. Find Justin and Savaria on Instagram: @cloudthevan

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Medical Minute: Debunking Vaccine Myths V accine. The word conjures up a host of emotions, from relief and hope to skepticism and even fear. In truth, says physician Patrick Gavigan, a pediatric infectious disease physician at Penn State Children’s Hospital, vaccines are among the most heavily studied of all medical interventions, and the evidence shows they are safe and extremely effective. Many once-daunting diseases, such as measles, meningitis and pneumonia, have been combatted successfully with childhood vaccinations. Most parents readily accept the vaccine schedule and bring their children for well-child visits expecting the vaccines will be given, Gavigan said. Those who hesitate often want clarification on things they have heard about vaccine safety or additives. Doctors understand there is misinformation and are happy to set the record straight. “Most people with reservations about vaccines come to us with pretty good questions and are just looking for advice,” Gavigan said. Here are a few of the most common myths about vaccines and reassuring truths. n Vaccines can make you sick and cause the illness they’re supposed to prevent. The truth: Vaccines contain inactive viruses or components of the virus or bacteria and cannot cause infection in people with normally functioning immune systems. “Common side effects, such as fever or pain at the injection site, that people often mistake for illness are the immune system’s response to the components and actually show the body is building immunity to the virus or bacteria,” Gavigan said. (People with compromised immune systems should consult their physician before

taking any live virus vaccines.) n Vaccines contain toxic ingredients. The truth: Mercury and thimerosal, a mercury-containing organic compound, are no longer used in childhood vaccines or in many other vaccines. Safety data shows, however, that there was no increased risk of harm even when these compounds were present, Gavigan said. n The choice not to vaccinate affects only my child, or only me. The truth: Vaccines protect the person who gets vaccinated and build herd immunity by decreasing the prevalence of the virus to such low levels that people who are unable to get vaccinated or who don’t fully respond to the vaccine also are protected. A certain percentage of the population must be vaccinated to

attain herd immunity, so a decision against vaccination affects the whole group, Gavigan said. n Natural immunity is better than vaccine-acquired immunity. The truth: While it may be true that someone who naturally catches a virus has longer-term immunity, the risks and consequences from actually getting sick with the infection far outweigh any value that may come from having the virus itself. “And with COVID-19, we don’t know that

immunity from getting the infection is any better than the vaccine,” Gavigan said. n It’s best to space out vaccines and even delay the COVID-19 vaccine until the pandemic is over. The Truth: All of the data on a standard schedule for vaccines has shown them to be very safe. “Any time you space out vaccines, there’s a big risk that you’re providing additional time when you can contract the disease,” Gavigan said. In addition, getting multiple vaccines at the same time doesn’t diminish your immune system’s response to them, and there’s no need to worry that your body can’t withstand multiple vaccinations in short order. “The amount of antigen, or virus protein, in the vaccine is much lower than what you would encounter if you got the infection,” Gavigan said. The COVID-19 vaccine has been developed and approved in short order, which makes people understandably concerned about its safety, Gavigan said. “However, the data has been thoroughly looked at in tens of thousands of people involved in the studies, and the rates of adverse effects were exceedingly low,” he said. “This vaccine looks to be as safe and effective as we could hope for.” The Medical Minute is a health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff. It’s distributed by Newswise.com

Facebook Posts Big Drivers in Vaccine Resistance, Study Finds

s Americans await their COVID-19 shot, a new study of a different vaccine shows the power of Facebook posts in fueling “anti-vax” resistance to immunization. The study included more than 10 years of public Facebook posts on the human papillomavirus (HPV) vaccine. It found that nearly 40% of 6,500 HPV vaccine-related posts from 2006 to 2016 amplified a perceived risk. The data suggest the posts had momentum over time. “We should not assume that only the disease is perceived as a risk, but when research supports it, that medical treatments and interventions might unfortunately also be perceived as risks,” said Monique Luisi, an assistant professor at the University of Missouri School of Journalism, in Columbia. “It’s more likely that people are going to see things on social media,

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particularly on Facebook, that are not only negative about the HPV vaccine, but will also suggest the HPV vaccine could be harmful. It amplifies the fear that people may have about the vaccine, and we see that posts that amplify fear are more likely to trend than those that don’t,” she said in a school news release Luisi said the findings could shed light on the COVID-19 vaccine rollout and distribution. During the rollout, people will likely see a lot of negative information and that negative information will be what trends on social media, she said. “If the public can anticipate this negative information, it will be interesting to see if that will make them less sensitive to the perceived risk of the vaccine,” she noted. Research must continue to address.

IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

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New external beam radiation therapy at Hematology/Oncology Associates of CNY uses high amounts of radiation to destroy cancer cells and shrink tumors. Without any incisions, TrueBeam uses cutting-edge imaging technology to target only the tumor and minimize potential damage to healthy cells. TrueBeam’s sophisticated motion management quickly and quietly rotates it around the patient to deliver a prescribed radiation dose from different angles.

‘I’ve Already Had COVID-19, Do I Need the Vaccine?’

F New Radiation Therapy Technology at HOACNY Benefits Cancer Patients It uses pinpoint accuracy to deliver higher doses of radiation in less time

ematology/Oncology Associates of CNY (HOACNY) recently added a TrueBeam radiation therapy system to its cancer-fighting arsenal in its Brittonfield office in East Syracuse, completing its planned radiation technology upgrades. Providing the most advanced linear accelerator and radiosurgery treatment system available, TrueBeam uses pinpoint accuracy to deliver higher doses of radiation in less time. It allows for treatment of many different types of tumors, including those in sensitive areas such as the abdomen, liver, lung, breast and head and neck. The practice began using this system last year in its Onondaga Hill office. “With this second TrueBeam all our radiation therapy patients now have access to the most advanced technology available for targeting tumors with greater comfort,” said medical doctor and HOACNY’s Radiation Oncology Medical Director Tracy E. Alpert. “Offering our patients greater accuracy and shorter treatment times close to home is at the core of our mission to provide the highest level of quality care in a healing environment.”

How It Works

External beam radiation therapy uses high amounts of radiation to destroy cancer cells and shrink tumors. Without any incisions at all, TrueBeam uses cutting-edge imaging technology to target only the tumor and minimize potential damage to healthy cells. TrueBeam’s sophisticated motion management quickly and quietly rotates it around the patient to deliver a prescribed radiation dose from different angles. TrueBeam also offers new respiratory gating technology providing

Radiation team at Hematology/Oncology Associates of CNY. physicians the ability to synchronize radiation beams to accommodate a tumor moving during a patient’s natural breathing patterns. For example, the diaphragm will shift the liver minutely with a breath, and lungs move as they work. TrueBeam adapts to these tiny changes in position. HOACNY has begun using DIBH (deep inspiration breath hold) for select breast cancer cases, whereby patients are asked to take a deep breath in and hold it during delivery of a radiation beam. With TrueBeam, this now typically takes 20 seconds and is verified based on its respiratory gating software. “We studied this process with 15 breast cancer patients between November 2019 and October 2020, and our data shows sparing of heart and lung can be improved with DIBH compared to historical numbers for left breast cancer,” says Alpert. “This improved avoidance should translate into low risk of late heart and lung side effects from radiation, which is a major advantage for patients.”

Additional Benefits

With speed and precision as the hallmarks of the TrueBeam system, the following advantages also are worth noting, according to Alpert. • Its automated technology can result in up to a five-fold reduction in the steps needed for imaging, positioning and treating patients. • The system performs accuracy checks every 10 milliseconds throughout an entire treatment. • More than 100,000 data points are monitored continually during treatment to ensure safety. • It has communication technology enabling interaction between patients and clinicians operating the equipment. • TrueBeam also has two closed-circuit television systems so your treating clinicians can always see and hear you. Submitted by HOACNY February 2021 •

olks who’ve gotten through a COVID-19 infection might naturally question whether they need to get a coronavirus vaccination when their turn comes. Experts say they really need the shot anyway, because even after having COVID-19 they might be vulnerable to reinfection. “We’re encouraging people if they meet the other criteria to get immunized because we don’t know how long either natural immunity or vaccine immunity lasts,” said physician Chris Beyrer, a professor of public health and human rights at Johns Hopkins Bloomberg School of Public Health in Baltimore. All previously known coronaviruses are notorious for promoting short-lived immunity in humans, he said. “Unfortunately, with other coronaviruses typically the immunity you have — like if you get a common cold coronavirus — usually only lasts about a year and a half to two years and then you’re vulnerable again,” Beyrer said. This is because the body uses a relatively simple strategy to fight off common cold coronaviruses, and this strategy does not appear to make a lasting impression on immune system memory, said physician Greg Poland, director of the Vaccine Research Group at the Mayo Clinic in Rochester, Minn. As such, he said there’s a chance people who had asymptomatic or mild cases of COVID-19 did not build up any lasting immunity. “Particularly for people who have milder cases, it may be that they don’t have immunity for very long,” Beyrer said. “So we still think it’s a good idea to get immunized.”

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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physician assistant and regional lead provider at WellNow Urgent Care, which operates in several locations in Central New York and other locations. “Many patients are comfortable calling their PCP as a first step if they feel well enough to wait for an appointment. However, if someone is experiencing a non-life-threatening illness or injury and doesn’t have a PCP, or their PCP is not available and they need to be seen right away, urgent care is a good option.” Urgent care facilities typically use the same equipment as PCPs, plus have access to X-ray and other tools related to acute issues. But for issues like chest pain, suspected stroke or heart attack or a complicated fracture or burn, the ER is the right place to go. When it gets tough is when a patient cannot wait for a PCP visit but cannot decide if their issue is serious enough to go to the ER. If the illness or injury is not life, limb or function threatening enough for the emergency room, yet the availability of the primary care physician cannot accommodate them, the urgent care is a good option to avoid waiting several days. “Then a visit to urgent care would make sense,” Foster said. Urgent care is not meant to replace regular care from a PCP for chronic conditions. Ongoing treatment by a primary care physician would suit these patients better as they would see the same provider instead of whoever happens to be at the urgent care. “When you need non-emergency care and your primary care physician is not available, urgent care physicians, physician assistants, nurse

PCP, Urgent Care or ER? Where to go when you need quick medical help By Deborah Jeanne Sergeant

rgent care centers have helped decrease the load on emergency rooms. According to a 2018 study published by JAMA International Medicine, ER visits dropped by 36% between 2008 and 2015 and during the same time period, visits to urgent care facilities and telemedicine increased by 140%. Shifting to urgent care and telemedicine can help reserve ER person-

nel and resources for the direst cases. Knowing the difference between what is treatable at the primary care physician (PCP), urgent care or ER can continue to improve those numbers. “More and more people are realizing that urgent care centers fill an important care gap between primary care providers and the emergency room,” said Jenilee Foster,

LET’S MOVE FORWARD

SAFELY.

Right now, it’s easy to focus on all the things we can’t do. But what if we all focused on the things we can do? We can learn more about testing and vaccines. We can protect ourselves and others by continuing to wear a mask. We can show support for essential workers and local businesses. We can stay home and safely connect with the people who matter to us. Explore what you can do at

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IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

practitioners, nurses and others can care for you,” said Jamie Leszczynski, senior director of communications for Oswego Health. “An urgent care does not take the place of your primary care physician, but it can work in cooperation with your physician. Urgent care can be more costly than your physician’s office but less expensive than a visit to the emergency department.” She suggested symptoms that can help make the decision of where to seek care:

When to visit an urgent care center:

• Cuts or wounds that may require stitches • Sprains, strains or deep bruises • Mild to moderate asthma attacks • Ear infections • Upper respiratory infections • Coughs and congestion • Sore throats • Insect bites • Rashes

When to visit an emergency room:

• Severe bleeding • Chest pain or pressure • Trauma or injury to the head • Severe abdominal pain • Difficulty breathing • Broken bones • Sudden dizziness • Pregnancy-related complications Any condition perceived as life threatening should be evaluated at the emergency department.

SmartBites

The skinny on healthy eating

Surprising Benefits of Rye Bread

asteless, white Wonder bread was not the only bread I consumed during my growing years. Our family also ate a lot of rye bread: dark pumpernickel, marbled rye and traditional light rye. My German father insisted on it; and, over time, I grew to love the taste and texture. Since then, and with each pass-

ing year — years marked by disturbingly high cholesterol counts or worrisome digestive issues or tightening waistbands — my fondness for rye has only intensified. Why rye? Earthy, dense, chewy rye? Like other whole grains with the germ, endosperm and bran intact, unprocessed rye rocks with a variety of nutrients and health benefits.

Rye is a terrific source of fiber, ranging from about 2 grams to 6 grams per slice, depending on the kind of rye bread consumed. Many of our health problems — from heart disease to certain cancers, Type 2 diabetes to obesity — stem from too little dietary fiber, which is why leading institutions, like the American Heart Association, recommend we consume at least 25 to 30 grams of fiber a day. Whole-grain rye bread can help meet that goal. Blood sugar control is important for everyone, especially people with diabetes or at risk for developing Type 2 diabetes; and rye bread — thanks to its unique concentration of fiber, manganese, and phenolics (powerful antioxidants) — aids how we process sugar. Working together, these important nutrients help stabilize blood sugar levels by slowing both the release and absorption of sugar and insulin into the bloodstream. Adding whole grains like rye bread to your diet may reduce the risk of heart disease, according to studies at the Harvard School of Public Health. Multiple factors — from its cholesterol-lowering fiber to its aid in weight control (since whole grains make you feel full longer) to its inflammation-busting plant compounds — all contribute to healthier hearts.

Avocado Rye Toast with Egg, Tomato, and Sriracha Mayo

Sriracha Mayo 2 tablespoons light mayo ¼ cup plain low-fat Greek yogurt 1-2 teaspoons Sriracha sauce (or hot sauce of choice) 1 tablespoon lime or lemon juice salt and pepper to taste Lightly mash avocado with lime juice, salt, and pepper. Set aside. Whisk Sriracha mayo ingredients together in small bowl. Cook eggs any way you like. Toast rye bread. Spread Sriracha mayo (if using) over the toast, then top with avocado mash, tomato slices, and cooked egg. Lightly sprinkle with salt and pepper, if needed.

Helpful tips If possible, seek authentic rye bread from local bakers. If buying from store, read labels carefully: the first ingredient should say rye flour or rye meal, whether you buy light, dark or marbled rye. True pumpernickel, one of the healthier ryes, is made entirely from coarsely ground whole rye grains. For those who prefer a more lightly flavored rye, Pepperidge Farm makes a “Whole Grain Seeded Rye Bread” with a blend of whole wheat and whole grain rye flours.

Anne Palumbo is a lifestyle colum-

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

Serves 2

2 slices rye bread 1 avocado 1-2 teaspoons lime or lemon juice salt and pepper to taste 2 eggs 8 thin slices Roma tomato

AHA News: The Best Foods for Brain Health

t’s easy to see the connection between an unhealthy diet and an expanding waistline. The connection between food and brain health can be harder to get your mind around. But experts agree. Eating right is essential for brain health. “Of all the organs in our body, the brain is the one most easily damaged by a poor diet,” said physician Lisa Mosconi, director of the Women’s Brain Initiative and an associate professor of neuroscience in neurology and radiology at Weill Cornell Medicine and NewYork-Presbyterian Hospital. “From its very architecture to its ability to perform, every aspect of the brain calls for proper food.” Mosconi, who has written books about the science of food and the brain, said many people have misconceptions about what “proper food” might be. One of the biggest fallacies she’s been hearing lately is the idea that a very high-fat diet is somehow helpful to the brain. “This is not what most research shows,” she said. Dietary supplements are another area where people get misled, said physaician Kristine Yaffe, professor of psychiatry, neurology and epidemiology at the University of California-San Francisco. Except when someone is deficient in a specific

nutrient, vitamin supplements don’t seem to improve brain health, she said. Similarly, supplements that contain omega-3 fatty acids and fish oil have gotten a lot of attention. But while they might help certain heart patients when prescribed by a physician, research has not confirmed benefits for brain health. “There have been a number of trials, and they haven’t borne out,” said Yaffe, who was a co-author on a 2017 American Heart Association advisory on brain health. So, what does work? “We still have a lot to learn about that,” Yaffe said. But certain foods do seem to help when they’re part of an entire dietary pattern. And that diet looks similar to the ones physicians recommend for heart health. A Mediterranean-style diet — heavy in fruits, vegetables, fish and nuts — lowers stroke risk in women and may lead to better cognitive ability in old age, studies have found. A 2018 study Mosconi led estimated it provided 1.5 to 3.5 years of protection against the development of biomarkers for Alzheimer’s disease. Another science-backed eating plan that limits red meat, sodium and added sugars and sweets, called DASH (dietary approaches to stop hyperten-

sion), may reduce stroke risk. Mosconi highlighted some nutrients — antioxidants, such as vitamin C, vitamin E and beta-carotene, and anti-inflammatory B vitamins and omega-3 fatty acids — that she said are important for the health of neurons. But neither Yaffe nor Mosconi is a fan of singling out something as the perfect brain food. “I don’t believe in ‘superfoods,’ or that any one food or food group is key to brain health,” Mosconi said. And not that there’s anything wrong with blueberries, Yaffe said, but “you wouldn’t want to be thinking, ‘If I only eat blueberries, that’s going to do it.’” It’s also important to think of foods that are potentially harmful to brain health, Mosconi said. Saturated fat, especially from animal sources, is associated with a higher risk of cardiovascular disease, she said. And some research also shows it increases the risk of cognitive problems. “When we eat a fatty, sugary meal and experience symptoms like sluggishness, brain fog and drowsiness — these symptoms originate not in the stomach but in the brain,” Mosconi said. And the effects aren’t necessarily temporary. Research indicates a poor diet February 2021 •

may cause the loss of key structural and functional elements in the brain, she said, along with “a higher vulnerability to brain aging and dementia.” A 2018 report from the Global Council on Brain Health, an independent group convened by the AARP, noted that foods and diets that are good for heart health are also good for brain health. Yaffe, a member of that brain health council, said the mechanisms of the brain are complex, but it stands to reason that “if you’re eating a dietary pattern that is heart-healthy, it’s probably also healthy (for) the vessels in the brain.” She acknowledged that some people have a hard time seeing the connections between brain health and their diet – or with other activities such as smoking, sleep and exercise. Mosconi, also a member of the AARP brain health council, put it this way: “Day after day, the foods we eat are broken down into nutrients, taken up into the bloodstream, and carried up into the brain. Once there, they replenish depleted storage, activate cellular reactions and, finally, become the very fabric of our brains. “Consider that the next time you reach for a brownie. Its ingredients will actually become part of your brain.”

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Parenting By Melissa Stefanec

MelissaStefanec@yahoo.com

Go Outside Before You Go Out of Your Mind

don’t choose to live in Central New York because of its Februarys. The lack of daylight, unrelenting ice and snow and frigid temperatures often make me want to stay inside. I’m not alone. After eight minutes of playing in the snow, my kids feel the same. However, our brains and bodies need to be outside. In the face of social distancing and quarantining, getting outside is, perhaps, more important than ever. The pandemic has us engaging with screens at an alarmingly high rate, and too much screen time makes monsters (whether those monsters are 38 or 8 years old). In past winters, my family has found ways to stay active indoors. We’ve sought most of our physical activity through the gym, indoor swim lessons, trampoline parks and play parks. Sure, we got outside for some sledding, hiking and the occasional family snowshoe, but it wasn’t a weekend priority in the dead of winter. If I wanted to get outside, I often went solo. I tackled shoveling the driveway, went snowshoeing or

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strapped on my cross-country skis. Getting the whole family out on all of our days off felt like an unnecessary and time-consuming endeavor. The events of 2020 changed all of that. Our indoor go-tos aren’t an option. If we want to get out of the house, we can’t go to another building or home for fun. That has been a blessing in disguise. I recently read an article by physician Claire McCarthy, a senior faculty editor at Harvard Health Publishing. Her article, titled, “6 Reasons Children Need To Play Outside,” cited the following benefits of getting kids outdoors: • Getting sunshine (making vitamin D) • Getting exercise • Increasing executive function (skills that help us plan, prioritize, troubleshoot, negotiate and multitask) • Encouraging safe risk taking (e.g., tree climbing and independent negotiation while interacting with the environment) • Socializing (having unstructured play time with other people, especially children) • Increasing appreciation for

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nature McCarthy’s article reinforces what I’ve already experienced. My kids are happier when they get outside (and so am I). So, despite the biting temperatures, ice and snow, my family is spending a lot of time outdoors. This change in lifestyle is just one more way the events of the past year have inadvertently made our lives better. This year, we’ve been sledding, cross-country skiing, snowshoeing and hiking. We’ve had fires at our firepit. We’ve gone to playgrounds and visited waterfalls. I’ve watched my kids happily throw rocks into icy waters, climb trees, throw sticks into creeks and build cairns on snowy trails. I’ve watched them play in their backyard fort and run laps around the yard. The snow hasn’t held them back. However, winter outdoor play involves a lot more preparation than summer play. So, I wanted to share my tips for getting outdoors in the winter and not regretting (or resenting) it. A little proper planning has made our adventures surprisingly enjoyable. (I want to express that a lot of the items on this list may be difficult for families who are struggling financially. I recognize I’m writing this list from a place of privilege.) — Make sure they have the proper clothing When it comes to dressing for outdoor adventures in the winter, staying warm and dry is paramount. I make sure my kids wear warm everything. Sure, they fight me while we are getting dressed. But, once we get outside, they don’t immediately ask to come inside because they are cold or wet. — Pack backup clothing Kids will be kids. If there is mud or water, they will find it and find a

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IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

way to get it into it. Assume your adventure will include some mishaps, and plan on needing a change of everything. Having dry clothes when you get back to the car will feel like the ultimate luxury. — Get extra winter boots If you can, get them two pairs of boots. That way, when they fill one pair with snow, water or mud, they have a backup. Between water and mud, I’ve seen boots need a two-day recovery time. — Invest in waterproof pants Waterproof or highly-water-resistant pants are a gamechanger. When my kids wear them, they can truly choose their own adventures and not worry about being wet and cold the whole time. — Pack snacks and water Before you go outside, make sure your kids aren’t hungry or thirsty. Those two feelings can ruin the fun. Pack snacks for when you get back to the car. My kids usually have an appetite after their adventures. — Prepare yourself We parents often see to our kids and neglect ourselves. Make sure to pack yourself backup clothing, water and snacks. Grumpy adults are just as bad as grumpy kids. — Redirect whining Inevitably, your kids will whine about being outside during the winter. Encourage them to be tough and strong. Redirect their energy to something you know they will enjoy. (My kids usually take me up on an offer to throw rocks or whap things with sticks.) These tips can help to ensure a successful outdoor winter adventure for you and your family. Next time you feel like the walls are closing in, escape the walls, even if the world outside your window looks like a snow globe.

CNY’s Healthcare Newspaper

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In Good Health is published 12 times a year by Local News, Inc. © 2021 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Deborah Sergeant, Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Anne Palumbo, Melissa Stefanec, Chris Motola, Eva Briggs (MD), Mary Beth Roach, Payne Horning, Catherine Miller, Kyra Mancine, Brenda McCutcheon Advertising: Amy Gagliano, Cassandra Lawson Layout & Design: Dylon Clew-Thomas • Office Manager: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

Q A &

With Lisa Smith

New American Red Cross director talks about the mission, challenges and how COVID-19 has impacted the group

isa Smith of Syracuse became executive director of the Central and Northern New York Chapter of the American Red Cross this past July. She is overseeing a restructured new chapter; a budget of $20 million; 23 staff members and over 700 volunteers. She brings to the position an extensive background in nonprofit work, having served as the executive director of the Syracuse Opera Company and as regional vice president for the eastern division of the American Cancer Society for 16 years. She continues on the Syracuse Opera board of directors. She has also served on Crouse Hospital’s board of directors, as a trustee of hospital’s

foundation and Auxiliary president. She is also a member of Hospice of CNY’s board of directors and its executive committee as well as its professional advisory board. Q: Can you briefly describe the work of the American Red Cross in this area? A: The American Red Cross started during the Civil War in the battlefield, so we’ve had a very long and robust history. Our job is to relieve pain and suffering during catastrophes. Q: What is the accurate name of the chapter for this area? A: The appropriate name is Central and Northern New York Chapter. In April, there was a merger done across many states, and they

collapsed some of the old chapters in regions, creating three regions within the state, and made the chapters larger. This chapter is actually new, and it is eight counties — Herkimer, Oneida, Madison, Onondaga, Oswego, Jefferson, Lewis and St. Lawrence. Q: What is some of the work that you do in the area? A: Every time you hear of a fire, whether it’s a home fire or an office fire, the Red Cross is normally right there. If it’s a home fire, we would be called in to work with the families. Often, they’re displaced. They need key resources. We put them in hotels; we give them money for food. We’ll give them clothing and blankets and toothbrushes to get through their first days, and we will stay with them until they are back on their feet. It’s one of the biggest things we do in the community. If there’s any civil unrest, we would be called in for that as well. Whenever there’s any kind of destruction of homes or businesses, we would be called in. When you look across the country, this year in particular, has been extremely difficult with natural disasters. We’ve had over 7,000 people deployed from all over the country to go and help out and house these people and get them back on their feet again. Right from our area, we’ve had 250 volunteers that have been deployed to different sites across the country. Q: The American Red Cross is so well-known for its blood banks. Can you talk about the need? A: For the longest time, we were really almost like two separate organizations. One of the things that we’re doing is really creating one Red Cross to bring Bio-Med, which is the blood side of the business, in with Disaster Services and Instruction. Across the country we manage probably about 50% of the people’s blood. Here, locally, we manage between 80 and 90%, which means that all the blood that is used in the hospitals. Whether be it for transfusions or in the time of an accident, cancer treatments, the blood is going to come from the American Red Cross. The issue that we’ve had with the pandemic is, although since everyone was staying in, the need dropped a little. But, we lost all of our sites, and the volunteers that come in to give blood. We were very fortunate that the NYS Fair allowed us to use whatever open site was available throughout the summer just to keep the blood going in the community. Blood only lasts so long, same with plasma. We’re actually testing for an-

February 2021 •

tibodies for the virus. If you give blood, you find out if you had the antibodies. Once we find people with the antibodies, we ask them to give convalescent plasma, which is used in treatment for people with coronavirus. It’s so very important to keep blood drives going. One of the big things we’re pushing going forward is diversify and be more inclusive, not only in the people that volunteers, but also the people that are donating blood. Q: What are some of the other programs that your chapter does? A: We do a variety of different things. It’s all about resiliency and prevention and education. We do CPR and that type of training. We work with military. We have a staff member up at Fort Drum that works with veterans and military families. We do workshops for children to train them on preparedness. When you think of emergency preparedness, it’s the idea you know how to put a bag together for emergencies. Q: How has the chapter been navigating the pandemic? A: When people come together and work together, it’s amazing what you can accomplish. For us, for the most part, everyone is working from home, except for the people in BioMed and then some of our disaster service people. As much as it’s been difficult — because you’re sitting in your home and you are isolated — I think the depth of relationships has grown because people understand the need for each other. Not having interaction personally is hard. That’s very hard on our volunteers. They can’t do that anymore because of COVID. That’s a big piece of why they volunteer and the support that they give. Q: What new initiatives would you like to see the chapter embark on? A: It’s hard when you’re a national organization. It’s not necessarily the idea of coming up with new initiatives and different things; it’s really trying to identify what is your mission, what do you have to accomplish and, how best to accomplish that. When I came to the Red Cross, the one thing I noticed, we are very good at building relationships. What I want everyone to do is to be more inclusive and holistic when we deal with companies or community groups and community leaders. It’s to really focus on building a relationship with that organization, so if would be natural for people to select one of the many of the things we do and get involved.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 17

Golden Years

Things You Need to Know About Alzheimer’s Disease

By Ernst Lamothe Jr.

lzheimer’s disease occurs when changes in the brain methodically stunt and slow down memory and cognitive thinking. It’s associated with those in their senior years and it often worsens with time. Alzheimer’s disease is the most common cause of dementia, a continuous decline in thinking, behavioral and social skills that disrupts a person’s ability to function independently. With any disease it is essential to know as much information as possible. “We have come a long way since I started working in the Alzheimer’s and dementia field where it was viewed as a scarlet letter and a hidden secret. However, now more people know and understand the diagnosis and that way we can get the family all the information they need to begin helping their loved ones,” said Mary Koenig, administrator at the Heritage in Syracuse, one of the largest providers of Alzheimer’s and dementia care, offering the first residential program in Central New York created especially for affected individuals. Heritage is part of Loretto, CNY’s largest nonprofit providing services for seniors. Koenig discusses five key things people should know about the disese. Symptoms 1. One of the key indicators of Alz-

heimer’s is memory loss. While we all have moments of forgetfulness, what makes this different is the recurring aspect along with the sudden decrease of short-term memory. “It is drastically different from regular memory loss where you can’t find your keys or you temporarily

blank out on a person’s last name,” said Koenig. “You are now forgetting major events and important dates where it is now disrupting your life. You are starting to exercise poor judgement, putting milk in the cupboard or truly having difficulty finding the right words in conversation. My father had Alzheimer’s and that last symptom was one of the first noticeable signs.” is no cure but there 2.There are solutions Alzheimer’s disease is the sixth leading cause of death in the United States, according to the National Institute of Aging. More than five million Americans live with the disease. By 2050, the number is projected to rise to nearly 14 million. In the early stage of Alzheimer’s, a person may function independently, according to the Alzheimer Association. He or she may still drive, work and be part of social activities. Middle-stage Alzheimer’s is typically the longest stage and can last for many years. As the disease progresses, the person with Alzheimer’s will require a greater level of care. In the final stage of the disease, dementia symptoms are severe. Individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. While there is no cure, the situation is not hopeless. “There have been research and studies that show everything you do for your heart such as physical activity and giving up smoking can have a positive impact on the brain,” said Koenig. Support is essential 3. Because Alzheimer’s targets the

mental health of an individual, it can cause layers of difficulties for those battling through it. That is why it is

important to have a close support system. “Without family support, there are fewer options on how to handle care,” Koenig said. “When someone gets diagnosed with Alzheimer’s, caring for them can be a 24-hour job which is mentally and physically exhausting. You have to get everyone on the same page so they can have all the resources they need and put together a plan of caring. Sometimes you need multiple family and friends to take over different aspects from the financial side to the emotional side of the situation.” Heritage has a 79-bed facility that can help those suffering from Alzheimer’s as another option for families. are numerous myths 4.There about the disease Medical officials believe one of the reasons that Alzheimer’s gets diagnosed later than it should is because people just see memory loss as part of getting older. They equate it in the same manner as arthritis, back pain or diminished eyesight. Koenig believes that is why too often the correct diagnosis comes late because either the individual or physician doesn’t connect the dots earlier. “I read an interesting article that says if someone goes to the doctor and says they are having trouble remembering things, oftentimes the diagnosis ends up being depression,” she added. “It’s sometimes harder for the person who is experiencing the symptoms to see it and have an honest discussion with themselves.” Another myth is that it only affects older citizens. “200,000 people under the age of 65 have been diagnosed with Alzheimer’s and we are seeing more people in their 30s, 40s and 50s,” said Koenig.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

Mary Koenig, administrator at the Heritage in Syracuse, one of the largest providers of Alzheimer’s and dementia care, offering the first residential program in Central New York created especially for affected individuals. detection tests are 5.Early available For years, medical experts have been hoping to find new ways to predict someone’s ability to get Alzheimer’s. Recently, researchers found that a combination of brain PET scans and spinal fluid tests can help discover the disease as many as two decades before it occurs. While that doesn’t mean anything is reversible, when early detection occurs it can help any medical treatment. Experts say the new discovery could lead to testing of new drugs and creative treatment options. While it is optimistic, it remains early. “There are some people who might say why would you want to know ahead of time but there are various reasons why that would be a good decision. After you get past the initial shock, there are decisions you want to make about your life,” said Koenig.” It also gives you the possibility of being part of a clinical trial or experimental drugs because your symptoms are not severe and advanced.

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Golden Years

U.S. Life Expectancy Rose in 2019, But 2020 Reversed That Trend

efore the COVID-19 pandemic hit, life expectancy in the United States rose in 2019 for the second year in a row, according to

two new federal government reports. But don’t expect that good news to be repeated in 2020. The impact of COVID-19 and

other ills are projected to boost the death rate by 15% to exceed 3 million deaths for the first time in U.S. history, according to the Associated Press. COVID-19 has already killed more than 400,000 Americans. According to the AP, preliminary data suggest a year-end total for 2020 of more than 3.2 million U.S. deaths. That would be a new record and represent 400,000 more deaths than were recorded for 2019. The news agency noted that the rise from 2019 to 2020 marks the biggest such jump since 1918-1919, when deaths soared due a combination of fatalities from World War I and the Spanish Flu pandemic. That remains the record period for any one-year uptick in American deaths, with fatalities rising by 46%, the AP reported. This year’s big rise in death comes after a welcome rise in Americans’ life expectancy during 2019, according to new data for last year, issued in December by the U.S. Centers for Disease Control and Prevention. The agency reported a record number of deaths nationwide in 2019

— 2,854,838, up 15,633 from 2018, which is expected as population rises. But life expectancy actually rose by 0.1 year, so that the average American had a life expectancy in 2019 of 78.8 years. Put another way, the age-adjusted death rate fell from 723.6 deaths per 100,000 population in 2018 to 715.2 in 2019. For 2019, the reports from the CDC’s National Center for Health Statistics showed that • Heart disease remained the No. 1 killer, claiming 659,041 lives • Cancer came in second with 599,601 deaths, and • Accidents/unintentional injuries totaled 173,040 deaths. In some good news, suicides fell from 48,344 in 2018 to 47,511 in 2019, and the suicide rate also declined, from 14.2 per 100,000 in 2018 to 13.9 in 2019. According to the American Federation for Suicide Prevention (AFSP), that’s the first decline in the suicide rate in two decades. For more information on life expectancy, visit www.cdc.gov/nchs/ fastats/life-expectancy.htm

COVID Still Causes Food Access Challenges for Seniors A report by the Food Bank of Central New York shows 167,630 people in a 11-county area in CNY affected by food insecurity By Deborah Jeanne Sergeant

hile many people have figured out ways to get what they need and do what they need to do during the pandemic, some older adults still feel the effects of food access challenges because of COVID-19. According to Food Bank of Central New York’s 2017 hunger assessment, 167,630 people in the organization’s 11county service area are food insecure. The pandemic has only worsened the problem. Although stimulus checks have helped, many businesses and organizations have opened since last year’s quarantine period and the supply chains have become re-established, many older adults are still understandably hesitant to go near crowds — including at the grocery store. The frailty of older age, along with the age-related conditions many older adults experience, makes them more vulnerable to infectious illnesses such as COVID-19. Staying away from crowds represents one strategy to limit exposure; however, it also makes obtaining food difficult. “I see older adults in stores shopping, but I also hear of many that won’t go out for fear of exposure,” said Laurel Sterling, registered dietitian, nutritionist and educator with Carlson Laboratories. “This applies to people of all ages, I feel.” Sterling recommends looking into stocking healthier microwavable meal options, soups and stews, as “these are nutritionally packed and easy to reheat.” Older adults who feel uncomfortable using technology may not be

as likely to order food online for delivery or curbside pickup like those who use technology well. “Most of my patients have wall phones,” said geriatrician Sharon Brangman, chairwoman of the department of geriatrics and director of the Geriatric Medicine Fellowship Program at Upstate Center of Excellence for Alzheimer’s Disease and Nappi Longevity Institute. “They need help in ordering things off the internet. I can think of one couple at the beginning of the pandemic who were used to going to the grocery

store. They actually had smartphones but couldn’’ get the app on their phone. If you can’t afford internet, then you’re really lost. This is where families need to help.” Brangman knows of adult children taking over the grocery shopping so their parents can stay home, away from germs, even though they ordinarily would drive. Some adult children set up grocery and prescription delivery so their parents do not have to worry about shopping at all. “If you don’t have any idea how to use the internet, this isn’t the time

February 2021 •

to learn,” Brangman said. “It’s stress inducing.” The pandemic has also exacerbated food insecurity for older adults who had previously relied upon senior centers for meals, since most of those remain closed; however, some have begun offering grab-andgo meals and are delivering meals to clients’ homes. COVID-19 has also affected food affordability for some older adults. Although older adults on fixed incomes saw no change to their income because of the pandemic, some who are still working to supplement their income may have lost work hours or experienced a furlough or permanent layoff. Or they may live with relatives who are out of work or struggling to get by with fewer hours. That means less money for the household to spend on food. Food Bank of Central New York (www.foodbankcny.org) distributes emergency food to 443 programs like food pantries and soup kitchens among 11 counties in Central and Northern New York. The Food Bank distributes more than 20.4 million pounds of food — about 17 million meals — annually. These programs help people spend less on food so they can eat better and afford housing and medication. Oswego County’s mobile food pantries are listed at https://health. oswegocounty.com/information/ mobile_food_pantry.php. Other organizations such as churches and senior centers have organized grab-and-go meals, too. This helps connect seniors who are concerned about COVID-19 with the food they need until congregant meals open. Most of these programs have still not fully opened. Anyone struggling to obtain food because of COVID-19 concerns or finances should call 211 to ask about the options available to help.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 19

Golden Years

Transportation, Income Affects Senior Food Insecurity By Deborah Jeanne Sergeant

ood nutrition supports good health; however, for some older adults, obtaining sufficient healthful food is challenging. According to USDA data gathered in 2018, more than 37 million Americans were food insecure. Of those, 5.3 million are seniors. But resources are available to help them. Laurel Sterling, registered dietitian, nutritionist and educator with Carlson Laboratories, recommends that older adults and their loved ones look into programs offered by their county’s office for the aging. “They can assist with transportation and other needs,” Sterling said. While in the past, many older adults relied on their adult children for assistance, “some do not have any family around to help,” Sterling said. “Some have certain health issues that keep them confined to their home, some are unable to stand and cook for themselves, and some can no longer drive.” Seeking outside help may make a big difference because an older adult facing food insecurity may have several needs. “It has many different layers of complexity,” said geriatrician Sharon Brangman, chairwoman of the department of geriatrics and director of the Geriatric Medicine Fellowship Program, Upstate Center of Excellence for Alzheimer’s Disease and Nappi Longevity Institute. “We have to break it down to which area it is. Then we have to try to connect them to appropriate resources.” Some older adults do not drive anymore or limit their vehicle use. Driving to a full-service grocery store may require driving on busier streets,

which can challenge some older adults who try to drive only in local, less congested areas. “They may live in a neighborhood that would require them to take two busses from the suburbs to get groceries,” Brangman said. “Rural elders and urban elders have a lack of ready access to a grocery store.” Going to a convenience store for most of the groceries can mean subsisting on an unbalanced diet of mostly pre-packaged foods. That sort of diet only worsens existing health problems and can cause new ones. For some older adults, navigating a large store is hard because of issues like balance, stamina, COPD, recent surgery or illness or arthritis. While ordering delivered groceries online seems an easy solution, it is not as readily embraced by some older adults. The tiny icons on a smartphone may be difficult to see and use. Some may feel uncomfortable buying things online or lack the technology to do so; however, a family member could assist in these tasks. Some websites accept Supplemental Nutrition Assistance Program (SNAP) benefits but charge a fee for delivery that SNAP does not cover. Ordering shelf-stable food through Amazon Prime or Walmart. com, for example, may help people unable to lug around heavy groceries. Paring down the shopping list to just the few fresh foods they need may make their weekly grocery shopping easier. Prime offers free delivery for members ordering $35 or more. Delivery is free through Walmart.com for orders of $35 or more. Not all food items in Wal-Mart

Aging in Place

More accidents and injuries happen in the bathroom than any other room in the house. How seniors can make their bathrooms safer and easier to use By Jim Miller

ecause more accidents and injuries happen in the bathroom than any other room in the house, this is a very important room to modify, especially for seniors with mobility or balance problems. Depending on your parents’ needs and budget, here are some simple tips and product recommendations that can make their bathroom safer and easier to use. • Floor: To avoid slipping, a simple fix is to get non-skid bath rugs for the floors. Or if you want to put in a new floor get slip-resistant tiles, rubber or vinyl flooring, or install wall-to-wall carpeting. • Lights: Good lighting is also very important, so install the highest wattage bulbs allowed for the bathroom fixtures and get a plug-in

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nightlight that automatically turns on when the room gets dark. • Bathtub/shower: To make bathing safer, purchase a rubber suction-grip mat, or put down adhesive nonskid tape on the tub/shower floor. And have a carpenter install grab bars in and around the tub/ shower for support. If your parents use a shower curtain, install a screw or bolt-mounted curtain rod, versus a tension-mounted rod, so that if she loses her balance and grabs the shower curtain the rod won’t spring loose. For easier access and safer bathing, consider getting a shower or bathtub chair so your parents can bathe from a seated position. In addition, you should also have a handheld, adjustable-height showerhead

IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

are available through the site. Amazon allows customers to set up regular shipments (choose “subscribe”), so a customer can automatically receive orders of frequently used goods without having to go online to order them. Ordering shipments may require a higher number of items, such as four-pack of soup instead of a single can. Some pharmacies that provide delivery do not mind adding to the order a few other items the store sells. That could help an older adult stay stocked up. A growing number of grocery stores provide curbside pick-up for those who have transportation but struggle with store navigation. This service may incur a fee. Centro (www.centro.org/ fares-passes/reduced-fares) offers reduced rates for seniors aged 65plus in Syracuse, Auburn, Oswego and Rome and 60-plus in Utica who show a valid reduced fare photo id or a medicare card and photo ID upon boarding. They may also purchase a permanent Centro reduced fare photo ID. Some communities offer scheduled senior rides or routes to help older adults access places to shop or keep appointments, such as those listed at Onondaga Aging Services (www.lake.ongov.net/aging/documents/OnondagaCountyTransportationServices.pdf), 211 CNY (https://211cny.com/taxsearch. php?tax=BT-4500.6500-800) and through Oswego County Opportunities (www.oco.org/transportation). Asking a younger friend or relative, a civic or religious organization or a neighbor for assistance can make a big difference in eating well and eating poorly. It could be as simple as, “Could you give me a ride to the store the next time you’re going? I don’t drive into the city anymore.” Or asking, “Since you said you were going to the store, would you mind picking up a few things?” Perhaps offering to set up an Amazon subscription or a meal delivery plan would help an older adult. For any senior struggling to afford nutritious food, resources are available to help.

“We have social workers in our office who might call the Office of Aging or, before COVID, connect them with a senior program, which has lunch programs,” Brangman said. “They can connect seniors with financial support and resources and programs to help with medical bills and utilities and other sources of financial stress.” Programs such as SNAP can help make food more affordable. For people who do not cook, staying well fed is challenging. “I’ve had husbands who don’t know how to cook trying to take care of a wife with dementia and they’re both losing weight,” Brangman said. “One of my nurses was helping a husband come up with a menu for the week. His wife did all the cooking prior. I can prescribe a healthy diet but it won’t do any good if they can’t do these things.” Many restaurants deliver; however, until recent times, the selection was limited. Apps such as Grubhub and DoorDash deliver food from restaurants that normally do not deliver; however, the food is more expensive and less healthful than home-cooked food and the services charge a fee. Home meal delivery, food pantries, mobile food pantries and senior lunch grab-and-go sites are sources of inexpensive or free food for older adults. Some older adults living alone struggle to eat well for social and emotional reasons. Brangman said that can affect nutrition, as can cognitive issues. “People with memory issues usually do what people around them are doing,” she said. “Weight is a sensitive indicator of wellbeing. If they’re starting to lose weight, we have concerns. If they gain or maintain, we know they’re doing okay.” Home health assistance can also make mealtime easier for older adults who are no longer safe cooking at home or who experience depression. For further resources, call SNAP, 1-800-692-7462 or NY Connects or 211.

installed that makes chair bathing easier. If your mom or dad has the budget for it, another good option is to install a curb-less shower or a walk-in-bathtub. Curb-less showers have no threshold to step over, and come with a built-in seat, grab bars, slip resistant floors and an adjustable handheld showerhead. While walkin tubs have a door in front that provides a much lower threshold to step over than a standard tub. They also have a built-in seat, handrails and a slip resistant bottom, and some have therapeutic features like whirlpool water jets or bubble massage air jets. Curb-less showers and walk-intubs run anywhere between $2,500 and $10,000 installed. • Toilet: Most standard toilets are around 15 inches high and can be an issue for taller seniors with arthritis, back, hip or knee problems. If your mom has trouble getting on or off the toilet, a simple solution is to purchase a raised toilet seat that clamps to the toilet bowl, and/or purchase toilet safety rails that sit on each side of the seat for support. Or you can install a new ADA compliant “comfort height” toilet that is 16 to 19 inches high.

• Faucets: If your mom or dad has twist handles on the sink, bathtub or shower faucets, consider replacing them with lever handle faucets or with a touch, motion or digital smart faucet. They’re easier to operate, especially if she has hand arthritis or gripping problems. Also note that it only takes 130-degree water to scald someone, so turn the hot water heater down to 120 degrees. • Doorway: If your mom or dad needs a wider bathroom entrance to accommodate a walker or wheelchair, an inexpensive solution is to install some swing clear offset hinges on the door which will expand the doorway an additional two inches. • Emergency assistance: As a safety precaution, you should also consider purchasing a voice-enabled medical alert system like Get Safe (GetSafe.com) for her bathroom. This device would let her call for help by simple voice command, or by pushing a button or pulling a cord. You can find all of these suggested products at either medical supply stores, pharmacies, big-box stores, home improvement stores, hardware and plumbing supply stores, as well as online.

Golden Years

Why Visit a Hearing Specialist? Expert says some people with hearing loss won’t admit the problem and wait years to look for treatment By Deborah Jeanne Sergeant

pecialists in the ears and hearing care for not only the actual function of hearing but may also deal with other issues and concerns such balance. Numerous conditions can affect hearing. Audiologists may also deal with other issues and concerns such balance and tinnitus, commonly called ringing in the ears. “We are trained to evaluate these problems,” said Doug Brown, audiologist and owner of dB Audiology in Syracuse. “Generally, balance issues are referred because most people see their primary care physician to see if there’s a treatable disorder and primary care refers to us to do a more in-depth diagnostic.” For diminished hearing, it may not mean a hearing aid is the answer. Sometimes, the cause is temporary or

treatable. In some cases, a hearing aid may present the best way to address the problem. “There’s an entire set of skills necessary to test the hearing,” Brown said. “We then can develop a plan with the patient to deal with the problem. If it’s medically or surgically treatable, we refer you to your physician. “We can also discuss various options for improving communication which can include hearing aids. You should consult an audiologist if you have a sudden onset of hearing loss in one or both of your ears. That’s considered an audiological emergency because treatment has to occur within in a short time frame or permanent hearing loss can occur.” Unfortunately, most gradual hearing losses are not diagnosed

for seven to 10 years after they have become problematic. And there are those whose hearing gradually diminishes and don’t notice or don’t want to admit the problem for a long time. Patients often put up with the inconvenience for a long time. What draws many people to seek treatment for hearing loss is the discomfort of those around them who do not want the television so loud or become weary of repeating themselves. While in ideal listening situations they may hear fine, they have trouble at other times. “They have trouble hearing sounds in noisier situations than others,” Brown said, “like not hearing a waitress when the others at the table know what the specials are. Wearing masks because of COVID-19 has made it even more challenging for people who struggle to hear conversation because the mask both conceals visual cues and muffles sound. While primary care physicians can provide basic screening, an audiologist possesses a wider array of testing capabilities for hearing issues. Audiologists also help patients preserve their hearing with custom ear plugs, including designs especially suited for hunters and musicians who need to clearly hear for their pursuits but can also experience exposure to loud sounds. “We can help you find which form of hearing protection is going to be best for the activities you’ll use them in,” Brown said. David DeFrancis, director of outreach and education for hearing and vision services at Aurora of Central New York in Syracuse, said that signs of hearing loss could include noticing that “everyone mumbles” or the television is turned up very loud. “Medicaid does pay for one hearing aid every five years,” DeFrancis said. “Medicare does not cover hearing aids.” For those best treated with hearing aids, the performance and

What Causes Your Hearing Loss O By Deborah Jeanne Sergeant

Snow blowers with an average sound level of about 80 to 85 decibels can potentially harm your hearing after two consecutive hours of exposure, according to the Centers for Disease Control and Prevention. Other noises that can cause hearing loss include firecrackers, sirens and other loud sounds.

ne out of eight people in the U.S aged 12 or older has hearing loss in both ears, according to the National Institutes of Health. Up to 2% of adults 45 to 54 have disabling hearing loss. The percentage rises to 8.5% for the age group of 55 to 64. Almost 25% of those 65 to 74 have disabling hearing loss and half of those 75 and older have disabling hearing loss. While some hearing loss is genetic, many cases are because of preventable causes. Doug Brown, audiologist and owner of dB Audiology in Syracuse, said that exposure to loud sound, either one very loud, acute sound or prolonged exposure to moderately loud sound can cause hearing damage. The latter is the type most people do not think about. “The recommendation from national organizations is 80 dB for eight hours,” Brown said. “As you increase the sound level by 5 dB, you halve February 2021 •

capabilities of current instruments over instruments of even a decade ago have dramatically improved. Like eyeglasses, some aids come in fashion colors and designs, while others appear more discreet. Modern hearing aids use Bluetooth to stream phone calls and movies to the user and can come with features like fall detection for frail patients.

Some Kids Also Need the Help of an Audiologist Specialists in the ears and hearing care for people of all ages, not only for older adults. Robin Ngumbi, audiologist with Hear 2 Learn in East Syracuse, said the specialists at her organization treat children from newborn through 3 years of age. “Even a mild hearing loss can cause speech and development delays,” Ngumbi said. Most of her patients are referrals from pediatricians when an infant fails a newborn hearing test; however, some newborns do not receive these if they are born at home. Parents may notice their baby does not startle at loud sounds or look for the source of a sound. “It may be developmental where they haven’t reached that stage where they look,” Ngumbi said. “Some babies are used to noisy homes and get good at ignoring it and it may be from hearing loss. Not responding to sounds is a main reason parents come to us.” Some parents notice an issue when their baby does not reach milestones for babbling or saying first words. Ngumbi said that checking hearing is a good first step to figuring out what is going on.

the exposure time. The lawn mowers and equipment will run in the 90 to 95 dB range.” Hobbies that could cause hearing damage include those involving musical instruments, woodworking equipment and firearms. While headsets can be perfectly safe to use, their prolonged use at high volume can cause hearing damage. Brown said that as a rule, people using a headset can test its volume safety by removing it and allowing the device to play. If it can be heard while off the ears, it is too loud. Or users should pay attention to any volume warnings the device offers. Occupational sounds can also cause damage. Many small farm owners and other home-based business owners may remain unaware of safety guidelines or choose to ignore them because unlike a larger, more public business, there is no OSHA oversight. In addition to noise-induced injuries, medical conditions and some prescription medication may contribute to hearing loss. Medical conditions, including high blood pressure, high cholesterol, Type 2 diabetes and kidney disease, can contribute to

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Golden Years

Acupuncture: Does It Work and Is It Covered by Medicare?

any studies over the years — funded by the National Institutes of Health — have found acupuncture to be very effective in easing pain and can help with a variety of other ailments too. Here’s what you should know.

Acupuncture Treatment

David DeFrancis, director of outreach and education for hearing and vision services at Aurora of Central New York in Syracuse. “Without proper hearing protection, permanent hearing loss can be an outcome,” he says. hearing loss. Very high doses of aspirin taken daily, some anti-malarial drugs, Viagra, and chemotherapy can also cause hearing damage. Brown encourages patients with medical and prescription concerns to discuss it with their primary care providers. “They may be able to change protocols so less damage can result,” Brown said. “If no changes can be initiated, we can at least know there’s a change in hearing and we can suggest hearing aids or ways to augment communication.” Head trauma can also cause hearing loss. That is another reason for wearing helmets when riding bicycles, all-terrain vehicles, horses and participating in any other activity where it is warranted. Brown added that heredity can play a role in hearing loss; however, a person cannot tell if that is a factor. He recommends a baseline hearing exam so that patients can monitor any future changes in hearing, especially before taking necessary medication associated with hearing damage. Wearing approved foam earplugs or muffs while in an environment where loud sounds are expected can protect hearing. David DeFrancis, director of outreach and education for hearing and vision services at Aurora of Central New York in Syracuse, recommends these devices for any time someone is exposed to loud noises. “Without proper hearing protection, permanent hearing loss can be an outcome,” DeFrancis said. “It’s like going to a concert and afterwards, your ears are ringing. If you do it repeatedly, it can cause permanent harm. Once hearing is gone, it’s gone permanently. There is no cure for hearing loss. It’s imperative that we protect the hearing we have.” He said that small, expandable foam earplugs can protect hearing in many situations. For people who may need to remove them periodically, muffs may be more convenient and if they are approved by the American Hearing Association, they should provide adequate protection. Page 22

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First used in China more than 2,000 years ago, acupuncture has become increasingly popular in the United States over the past decade. While acupuncture isn’t a cureall treatment, it is a safe, drug-free option for relieving many different types of pain, including low back pain, neck pain, osteoarthritis, migraine headaches, fibromyalgia, postoperative pain, tennis elbow, carpel tunnel syndrome, dental pain and more. Studies have also shown that it can be helpful in treating asthma, depression, digestive disorders, menopause symptoms like hot flashes, and nausea caused by chemotherapy or anesthesia. Exactly how or why acupuncture works isn’t fully understood, but it’s based on the traditional Eastern theory that vital energy flows through pathways in the body, and when any of these pathways get blocked, pain and illness result. Acupuncture unblocks the pathways to restore health. However, today most Western practitioners believe that acupuncture works because it stimulates the nerves causing the release of endorphins, which are the body’s

natural painkiller hormones. It’s also shown to increase blood circulation, decrease inflammation and stimulate the immune system.

What to Expect

During acupuncture, practitioners stimulate specific points on the body by inserting thin needles through the skin. The needles are solid, sterile and disposable (used only once), and as thin as a cat’s whisker. The number of needles used for each treatment can vary anywhere from a few, up to a dozen or more. And where the needles are actually stuck depends on the condition being treated, but they are typically inserted about a quarter-inch to one-inch deep and are left in place for about 20 minutes. After placement, the needles are sometimes twirled or manipulated, or stimulated with electricity or heat. You may feel a brief, sharp sensation when the needle is inserted, but generally it’s not painful. Once the needle is in place, however, you may feel a tingling sensation, numbness, mild pressure or warmth. How many treatments you’ll need will depend on the severity of your condition — 12 treatments done weekly or biweekly is very common. It’s also important to know that acupuncture can be used in conjunction with other conventional medical treatments, or by itself.

Cost and Coverage

The cost per treatment typically runs anywhere from $40 to $150, depending on where you are in the country and what style of treatment you are receiving. Today, an increasing number of private insurance plans, including some Medicare Advantage plans, and policies provided by employers offer some type of acupuncture coverage. You’ll also be happy to know that in January 2020, the Centers for Medicare and Medicaid Services announced that original Medicare will now cover up to 12 acupuncture sessions in 90 days for patients with chronic lower back pain. Eight additional sessions can be added if patients show improvement. But in order to receive Medicare coverage, you must use a licensed acupuncturist who is supervised by a medical doctor, physician assistant or nurse practitioner trained in acupuncture, who will need to process the acupuncture claim. Currently, licensed acupuncturists can’t directly bill Medicare. To find an acupuncturist in your area ask your doctor for a referral, or you can do a search online. Two good resources are the National Certification Commission for Acupuncture and Oriental Medicine (nccaom.org), and the American Academy of Medical Acupuncturists (medicalacupuncture.org), which offers a directory of MDs and DOs who are certified to practice acupuncture.

Telehealth Now Mainstream as Insurers and State Expand Access to Care Excellus BCBS reports 2.2 million telehealth claims in 2020 vs. 28,529 in 2019

omprehensive telehealth legislation was an area of focus in New York state Gov. Andrew Cuomo’s 11th State of the State Address. “The COVID-19 pandemic laid bare the inequities in our healthcare system and showed that telehealth is a critical tool to expand access and lower costs for low-income communities, especially for behavioral health support,” said Cuomo, as he took executive action to expand access to remote care. Telehealth is when a patient and a provider communicate by audio, video or text messaging. “The number of telehealth visits soared in 2020 as a result of the COVID-19 pandemic,” said physician Stephen H. Cohen, senior vice president and chief medical officer at Excellus BlueCross BlueShield. The insurer processed 2.2 million telehealth claims in 2020, compared to 28,529 in 2019. Behavioral health

IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

services, including care for mental health and substance use issues, accounted for 43% of telehealth claims in 2020, compared to 25% in 2019. Most adults in Upstate New York (77%) have heard of telehealth though less than a third have used it, according to a survey commissioned in late 2020 by Excellus BCBS. Of those adults who reported using telehealth, 90% did so since the outbreak of COVID-19. Additional survey findings: The primary reason telehealth is currently used: • Required to use because of COVID-19 – 59% • Convenience – 40% • Preferred to use because of COVID-19 – 34% • Cost of visit – 8% The most important features of telehealth: • Ability to obtain prescriptions (79%)

• Avoid in-person visits (69%) • Cost of visit (58%) Excellus BCBS spent $102 million in 2020 to expand telehealth coverage to all members and waive any member cost-share responsibility for telehealth services, regardless of the medical issue. The insurer increased provider reimbursement rates to help replace some of the revenue lost due to the decline in in-office patient visits. The health plan’s provider relations team trained more than 500 health care providers in the use of telehealth technology and proper claims submission for telehealth visits. “When seeing a health care provider in person isn’t possible, or preferable, telehealth offers an effective alternative,” said Cohen. “Telehealth is here to stay, and our health plan will continue develop and support ways to increase access to this innovative way to get care.”

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What Caregivers Should Know About Medicare Dear Savvy Senior, I am the caregiver for my 81-year-old mother, who recently fell and broke her hip, and have a lot of questions about how original Medicare works and what it covers. Where can I get some help understanding this program?

Overwhelmed Caregiver

Dear Caregiver,

Excellent question! Having a working knowledge of Medicare can help you take full advantage of the coverage and services it provides to ensure your mom receives the best care possible. Here’s what you should know.

Medicare Assistance

A good starting point to get familiar with Medicare is the official “Medicare & You” handbook that overviews the program. It’s mailed to all beneficiaries every fall and provides an up-to-date description of all services and benefits. You can also see it online at Medicare.gov/medicare-and-you. If you have a particular question, you can call and visit with a Medicare customer service representative at 800-633-4227. Medicare also works closely with State Health Insurance Assistance Programs (SHIP) to provide free health insurance counseling. To find a SHIP counselor in your area visit ShiptaCenter.org or call 877-839-2675. Caregivers also find Medicare’s secure website — MyMedicare.gov — especially useful. After setting up a personal account for your mom, you can view the details of her coverage, track recent health care claims and keep up to date on the preventive services she qualifies for.

Compare Tools

Medicare can also help you locate the right health care providers for your mother. At Medicare. gov/care-compare you can find and compare doctors, hospitals, home health agencies, dialysis facilities, inpatient rehab facilities, long-term care hospitals and nursing homes in your mom’s area.

What Medicare Covers

Medicare can reduce many outof-pocket medical expenses your mom incurs, but it doesn’t cover everything. Understanding what Medicare does and doesn’t cover can save you time and spare you frustration when navigating the caregiving maze. Here are some key points for caregivers: Besides basic hospital and physician services (which includes telehealth services) and optional

prescription drug benefits, Medicare covers home health care too. To qualify, your mom must be homebound, under a physician’s care and in need of part-time skilled nursing care or rehabilitative services like physical therapy. Medicare also helps pay for oxygen, catheters and other medical supplies that a doctor prescribes for home use. The same is true for medically necessary equipment like oxygen machines, wheelchairs and walkers. In addition, Medicare covers skilled care in a nursing home for limited periods — up to 100 days — following hospital stays. But it doesn’t cover long-term stays. Patients who need custodial care (room and board) must pay out of pocket unless they’re eligible for Medicaid or have private long-term care insurance. Medicare pays for hospice care too, for someone with a terminal illness whose doctor expects to live six months or less. The hospice benefit also includes brief periods of respite care at a hospice facility, hospital or nursing home to give the patient’s caregivers an occasional rest. Besides long-term nursing home stays, original Medicare typically doesn’t cover regular dental care or dentures, regular eye exams or eyeglasses, and hearing exams and hearing aids. Likewise, it won’t pay for nonemergency ambulance trips unless a doctor certifies they’re medically necessary. To find out what Medicare covers, visit Medicare.gov/coverage and type in the test, item or service you have questions about, or download the Medicare “What’s covered” app in either the App Store or Google Play.

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Financial Assistance

If your mom lives on a limited income, you should check whether she qualifies for help with prescription drug costs or with other Medicare-related premiums, deductibles and copayments. For help with drug costs, visit SSA.gov/prescriptionhelp or contact Social Security at 800-772-1213 and ask about the “Extra Help Program.” For help with other Medicare costs, go to Medicare.gov or call 800-6334227 and ask about the “Medicare Savings Programs.”

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Get Fit in Middle Age to Boost Your Aging Brain

oderate-to-vigorous physical activity in middle age and beyond might help keep your brain healthy, a new study suggests. “Our study suggests that getting at least an hour and 15 minutes of moderate-to-vigorous-intensity physical activity a week or more during midlife may be important throughout your lifetime for promoting brain health and preserving the actual structure of your brain,” said study author Priya Palta, an epidemiologist at Columbia University Irving Medical Center in New York City. “In particular, engaging in more than 2.5 hours of physical activity per week in middle age was associated with fewer signs of brain disease,” she said. For the study, published online Jan. 6 in the journal Neurology, Palta’s team collected data on more than 1,600 people (average age: 53) who had five physical exams over 25 years and rated their weekly activity levels. Participants also had brain scans

at the end of the study to measure their gray and white brain matter and areas of injury or disease in the brain. While the researchers only found a correlation, those participants who didn’t do moderate-to-vigorous intensity physical activity in midlife had 47% greater odds, on average, of developing small areas of brain damage compared to people who engaged in high levels of moderate-to-vigorous intensity physical activity. Higher activity levels were also associated with more intact white matter. White matter is tissue composed of nerve fibers that link different areas of the brain. “Our research suggests that physical activity may impact cognition in part through its effects on small vessels in the brain,” Palta said in a journal news release. “This study adds to the body of evidence showing that exercise with moderate-to-vigorous intensity is important for maintaining thinking skills throughout your lifetime.”

Staying Connected with Loved Ones Submitted by Loretto

taying connected to family and friends has become more important than ever, and Loretto is sharing the new and unique ways they are helping families to safely stay connected with their loved ones. • Video Calls — Schedule video calls with individual family members or a group. Use this as a time to catch up on each other’s lives and focus on sharing good news. (See the Lorettocny.org blog post about “Tips for Using Tech with Seniors” for more tips on video calls.) • Planned Activities Over Video Chats — Add activities to your video chats. Send or drop off gifts or activities in advance, and open the gifts or play games together over video chat. Games like trivia, charades, and board games will provide laughs for everyone and more excitement than your typical call. You can also coordinate eating a meal together by sending food to a loved one and enjoying over a video call, or cooking together while on a video call. • Photo Sharing Apps and Frames — There are many photo sharing apps available. Upload your

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household’s photos and videos to share in your family’s preferred application so that other family members can view them at their leisure. There are also digital photo frames available that allow you to simply email photos directly to the frame, so they appear instantly for loved ones. These frames are especially great for senior loved ones to be able to enjoy. • Valentine’s Day Cards — Have some extra time this year? Make your own Valentine’s Day cards! Either with photos that you can have printed, or handmade cards to be mailed. These are so special, and friends and family will enjoy receiving them. Many local senior living facilities are also collecting Valentine’s Day cards for residents to be able to enjoy. So, if you are feeling crafty consider taking time to donate some beautiful cards. Celebrations and gatherings may be different this year, but they can still be special. Use these creative ideas to stay safe while staying connected to your loved ones.

IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

Hearings With the Social Security Administration During COVID-19

n March 2020, we temporarily closed all of our Social Security Hearing Offices due to the coronavirus pandemic and are not offering in-person hearings. During the office closures, we are providing two flexible, safe and secure hearing options: either a telephone hearing or our new option of an online video hearing. Additional information on both of these hearing options is available here: www.ssa.gov/appeals/hearing_options.html What are “online video hearings”? Online video hearings are a secure way to conduct hearings over the internet, using a free platform called Microsoft Teams. You and your representative, if you have one, can attend the online video hearing safely and securely from any private place with a secure internet connection using a camera-enabled smartphone, tablet or computer. Like our telephone hearings option, the online video hearings option is not mandatory. We will conduct online video hearings the same way we conduct telephone and in-person

Q&A Q: I worked for the last 10 years and I now have my 40 credits. Does this mean that I get the maximum Social Security retirement benefit? A: Probably not. The 40 credits are the minimum number you need to qualify for retirement benefits. However, we do not base your benefit amount on those credits; it’s based on your earnings over a lifetime of work. To learn more about how you earn Social Security credits and how they work, read or listen to our publication How You Earn Credits, available at www.socialsecurity.gov/ pubs. Q: I’m expecting a baby this June. What do I need to do to get a Social Security number for my baby? A: Apply for a number at the hospital when you apply for your baby’s birth certificate. The state agency that issues birth certificates will share your child’s information with us and we will mail the Social Security card to you. You can learn more about the Social Security number and card by reading our online publication “Social Security Numbers for Children”, available at www.socialsecurity.gov/ pubs. Q: Someone stole my Social Security number, and it’s being used repeat-

hearings. During the hearing, the administrative law judge (ALJ) will swear in all hearing participants and listen to your testimony. You will see the ALJ and representative, if one has been appointed. Other participants, such as vocational or medical experts and interpreters, will join by phone. What are the technology requirements to participate in an online video hearing? You and an appointed representative, if applicable, must have access to email and a personal computer, laptop, Android or Apple tablet or mobile device with a secure and private, high-speed Wi-Fi or cellular data connection. The device must have a camera, microphone, and speakers. If using a mobile device, you must download the free Microsoft Teams application. We will send you a link to a user guide that explains how to access and use Microsoft Teams before the date of an online video hearing. Please read our publication Online Video Hearings at the Social Security Administration at www. ssa.gov/pubs/EN-70-10284.pdf for additional information. A short video about online video hearings is available at www.ssa.gov/appeals/ hearing_video.html.

edly. Does Social Security issue new Social Security numbers to victims of repeated identity theft? A: Identity theft is one of the fastest growing crimes in America, so you aren’t alone. If you’ve done all you can to identify and fix the problem, including contacting the Federal Trade Commission (FTC), but someone is still using your number, Social Security may assign you a new number. If you decide to apply for a new number, you’ll need to prove your identity, age, and U.S. citizenship or immigration status. You’ll also need to provide evidence you’re having ongoing problems because of the misuse of your current Social Security number. You can read more about identity theft at www.socialsecurity.gov/pubs. Q: What is the earliest age I can begin receiving Social Security retirement benefits? A: The earliest age you can begin receiving Social Security retirement benefits is age 62. If you decide to receive benefits before your full retirement age, which for most people is age 66 or 67, you will receive a reduced benefit. Keep in mind you will not be able to receive Medicare coverage until age 65, even if you decide to retire at an earlier age. For more information, go to www. socialsecurity.gov/retire.

Oswego Health Opens State-of-the-Art Mental Health Facility in Oswego

swego Health has recently opened its Lakeview Center for Mental Health and Wellness, located at 29 E. Cayuga Street, Oswego, thanks to a $13 million transformational grant from the New York State Department of Health and support from community members and local organizations. All inpatient and outpatient services are already fully operational As the only behavioral health services inpatient and outpatient provider in Oswego County, Oswego Health has constructed this new center specifically to provide this specialized care. The health system has renovated 42,000 square feet of a former grocery store, to feature 32 inpatient beds.

“Patients will find the new location offers a welcoming, soothing, and healing environment that includes secure outdoor spaces and comfortable interior areas,” said Behavioral Health Services Associate Administrator Jody Pittsley. “Also, to assist those that utilize these services become healthier overall, primary care services will be available onsite.” This new center, which is a short drive from the Oswego Hospital emergency room, is located near Lake Ontario and will provide an environment of healing like no other behavioral health facility in the area, according to a hospital news release. For more information about Oswego Health, visit www.oswegohealth.org.

Post-Heart Attack Rehab Saves Lives By Deborah Jeanne Sergeant

ardiac rehabilitation can help patients who have experienced a heart attack reduce their risk of experiencing another heart attack and other cardiac events. While a mainstream practice now, promoting these programs began in the 1970s. They were not widespread until the mid-2000s. Before this point, post-heart attack patients were told to rest and avoid performing hard work. Return to anything close to their pre-heart attack life? Forget about it. “Fortunately, due to significant advancements in medical therapeutics, we are now able to help patients who have survived a heart attack live substantially longer lives and have a better quality of life, too,” said David Bass, doctor of osteopathic medicine. Bass is board-certified in cardiovascular disease and internal medicine and practices at Oswego Health. “For patients that have survived a heart attack, it’s extremely important for them to know that they are not completely out of the woods,” Bass added. “The chances of them having another heart attack, developing congestive heart failure, or having a potentially lethal cardiac arrhythmia are substantially higher.” After a heart attack, patients learn what happened to them and why — along with what they can do to lower the chances of it happening again. As an active participant in their own healthcare, patients learn

about the changes they can make to get better. All that information can be a little overwhelming, so patients should bring along a helper to provide a second set of ears and take notes. Most patients will receive up to five medications, some long-term and others short-term, to perform tasks like lowering cholesterol, controlling blood pressure, prevent blood from coagulating, and more. These medications allow the heart to recover and help the patient get vital

numbers under control. Patients also will plan follow ups with a cardiologist and primary care physician to monitor their health. Other risk factors to work on can include smoking cessation and weight loss. The plan for rehabilitation also includes teaching patients how to safely become fitter, improve their diet, and enhance their emotional health. It is not a matter of a shortterm fix but lifestyle modification to gain and maintain wellness. “Establishing ongoing care with a cardiovascular specialist that you come to feel comfortable with is extremely important,” Bass said. As a result of their new lifestyle, patients may experience reduced need for medication, prevent future hospital admissions, become stronger, lose weight and better manage stress. “We want you to not only survive but thrive and get back to the level you were before,” said physician Seth Jacobson, director of the Cardiac Rehabilitation Program at University of Rochester Medical Center. “We rehab people back to their condition before — and better. We can improve their endurance and confidence. “We also screen for depression. That happens in one-quarter of those who have a heart attack. We think that people who have symptoms of depression are more likely to have February 2021 •

a heart attack. It’s really something that should not be ignored. Depression factors into cardiac disease and leads to worse outcomes afterward.” Patients also meet with a dietitian to plan how to eat better and with an exercise physiologist for help in learning how to exercise. Cardiac rehabilitation lasts 36 sessions. Patients go twice weekly. Those who follow through with cardiac rehab reduce their risk of another significant cardiac event by 25 to 50%. Insurance covers the rehabilitation with co-pays and those with Medicaid or Medicare pay very few fees. Jacobson said that since the rehabilitation is so important, his organization works with people who struggle to cover the co-pays. Social workers can help arrange transportation for those who lack it. Despite its importance, most patients do not follow through with cardiac rehab. Jacobson estimated only 20 to 25% of those eligible participate. “Some patients don’t feel like going,” Jacobson said. “Some of it is because their doctors don’t recommend it strongly enough.” Insurance usually covers cardiac rehab for chronic heart disease such as coronary artery disease or chronic systolic heart failure and patients who have had a heart procedure or surgery.

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H ealth News Oswego Health Foundation has new board members The Oswego Health Foundation, the philanthropic arm of the health system, has announced four new board members. They will serve for a three-year term, concluding June 2023. They are: • Tara FitzGibbons is the business manager and group health administrator at FitzGibbons Agency, LLC, a local and independent full-service insurance agency. FitzGibbons attended SUNY Oswego and earned her Bachelor of Arts degree in 1994, then continued her education earning a Master of Arts in organizational communication from SUNY Albany in 1996. FitzGibbons served as a board member/treasurer of the Friends of Oswego County Hospice board and served as an Oswego Hospital board member from 2009-2011. She is a 2004 graduate of Leadership Oswego County and a 2004-2005 Oswego County Forty Under Forty honoree. • Craig Fitzpatrick is a financial adviser at Pathfinder Bank, who enjoys helping clients of all ages prepare for financial success. Fitzpatrick attended St. John Fisher College and earned his Bachelor of Science degree in 2006. He is active in the community and serves on the board of directors of the Child Advocacy Center of Oswego County, Fulton Kiwanis Club, and has served on the Oswego Health golf tournament committee for the past five years. • John Sharkey IV is the president of Universal Metal Works, a leading metal fabrication facility in Fulton. Sharkey attended St. Lawrence University where he majored in both math and economics and graduated magna cum laude in 2005. He then continued his education earning an MBA in finance and entrepreneurship from Rochester Institute of Technology in 2007. • Heather Sunser is a financial services practice group leader at BarclayDamon, LLP. She primarily concentrates her practice on real estate law, institutional lending, land use and municipal compliance. Sunser Page 26

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attended SUNY University at Albany and earned her Bachelor of Arts in 1996, then continued her education earning a Master of Arts from SUNY Oswego then later her Juris Doctorate from Syracuse University College of Law where she graduated magna cum laude in 2001. Sunser volunteers at Vera House Legal Clinic, Habitat for Humanity, Volunteer Lawyer Project of Onondaga County, and serves on the board of trustees for Onondaga County Bar Foundation. The 2020-21 Oswego Health Foundation board of directors consists of: Ed Alberts, chairman; Peter Cullinan, vice chairman; Mark Slayton, treasurer; Katie Toomey, secretary; Julia Burns; Rachael A. Dator; Mary Ann Drumm; and Michael Harlovic, president & CEO Oswego Health.

St. Joe’s palliative care has new leader Physician Paul Sansone has recently joined St. Joseph’s Health’s palliative care department. He will lead a team of clinicians whose focus is improving the quality of life for patients coping with serious and Sansone

complex illnesses. Sansone is an experienced physician, leader and educator. Leading up to his fellowship in hospice and palliative medicine, he spent six years as the director of pain medicine at Alice Peck Day Memorial Hospital in Lebanon, New Hamphire. Prior to that he was an assistant professor of anesthesiology at Dartmouth-Hitchcock Medical Center. Sansone earned his bachelor’s degree in physics and medical degree from SUNY Buffalo. He went on to complete an internal medicine residency, anesthesiology residency and pain medicine fellowship at Dartmouth-Hitchcock Medical Center in Lebanon, New Hamphire. During his anesthesiology residency he served as chief resident. After practicing pain medicine for several years and prior to joining St. Joseph’s Health, Sansone returned to Dartmouth-Hitchcock Medical center to complete his fellowship in hospice and palliative medicine. Sansone is board-certified in pain medicine, anesthesiology and internal medicine. Sansone assumed his role in summer of 2020 caring for patients admitted to St. Joseph’s Hospital, providing skilled and compassionate care throughout their stay.

St. Joseph’s gets an ‘A’ in Leapfrog safety St. Joseph’s Health Hospital has been awarded an ‘A’ in the fall 2020 Leapfrog Hospital Safety Grade, a national distinction recognizing the hospital’s achievements protecting patients from harm and providing safer health care. This is the fourth consecutive grading period in which St. Joseph’s received the watchdog group’s highest marks

Oswego Health RN Promoted Twice During Pandemic Oswego Health makes it a priority to recognize staff for their hard work and commitment to the organization and its patients. One key staff member who has stepped up throughout the pandemic is registered nurse Ryan French, according to the hospital. French started her career at Oswego Health as a newly licensed RN in the medical surgical unit in 2010. Her career quickly escalated within the organization and within one year transitioned to the intensive care unit. By 2017 she was promoted to senior registered nurse in the ambulatory surgical unit. ast spring, French was promoted to oversee the entire intensive care unit as director of the ICU. Now, Oswego Health is once again recognizing French and her hard work. She will now serve in two roles for Oswego Health as the

IN GOOD HEALTH – CNY’s Healthcare Newspaper February 2021

director of the ICU and director of respiratory therapy. Respiratory therapists treat diseases, infections, and viruses of the cardiopulmonary system, such as lung cancer, asthma, emphysema, bronchitis, and pneumonia. They are vital to the care of COVID-19 patients and Oswego Health has an entire team dedicated to respiratory illnesses, which French will lead. “We are fortunate to have such talented and dedicated nursing staff at Oswego Health,” said director of nursing, Melissa Purtell. “Throughout this pandemic, Ryan has proven to be not only a remarkable RN but a leader here at the hospital. I’m proud of her accomplishments and look forward to continuing to see her grow here at Oswego Health.”

for safety. The Leapfrog Group is an independent national watchdog organization committed to health care quality and safety. The safety grade assigns an ‘A’, ‘B’, ‘C’, ‘D’ or ‘F’ grade to all general hospitals across the country and is updated every six months. It is based on a hospital’s performance in preventing medical errors, injuries, accidents, infections and other harms to patients in their care. “St. Joseph’s Health has always been at the forefront of safety throughout our 150-year history — and this past year has been a perfect demonstration of that commitment with our innovations in air quality, decontamination, prevention measures and more,” said Leslie Paul Luke, president and CEO at St. Joseph’s Health. “As the only hospital in the region to consistently receive an ‘A’ safety grade, especially during the unimaginable challenges of a global pandemic, I am humbled by the hard work of all our colleagues every day to ensure this level of quality.” “We are extremely grateful to hospital leadership and health care workers who have remained steadfast in prioritizing patient safety as our nation battles COVID-19,” said Leah Binder, president and CEO of The Leapfrog Group. “This ‘A’ is a testament to the care and commitment of those who work for St. Joseph’s Health Hospital. With the current pandemic exposing existing flaws within the U.S. health care system, we appreciate you putting patient safety first. Lives depend on it.”

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