in good BIG LEAGUE
February 2016 • Issue 194
cnyhealth.com
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CNY’s Healthcare Newspaper
New Hope for Cancer Patients
Physician Mitchell Brodey talks about managing one of CNY’s largest private medical practices, and why some doctors opt to work in private practice and not in a hospital
At 91, former President Jimmy Carter is the most famous cancer patient to benefit from a groundbreaking new treatment — immunotherapy See story inside
Maple Syrup Season Coming
First-Time Moms Are Getting Older in US
One in five regrets getting a tattoo
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Telehealth Expected to Grow Exponentially
JOB OPPORTUNITIES. SEE HELP WANTED ADS
“Healthcare in a Minute” on p. 5
EMPLOYMENT SECTION OF IN GOOD HEALTH. PAGES 22 & 23
Oysters
Is there any truth to their libidoboosting power? Read “SmartBites” column inside
Half of Those with Glaucoma Don’t Know They Have it — Are You at Risk? February 2016 •
Concierge Medicine Physician Joseph T. Barry, who practices in Syracuse and Camillus, explain why concierge medicine is here to stay.
New Guidelines New U.S. Dietary Guidelines: Boost Fruit and Veggie Intake, Limit Sugar and Salt
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Sugary Drinks Tied to Increase in Deep Belly Fat
26
Average age of American women who have a child for the first time.
And that type of fat associated with risk of Type 2 diabetes, heart disease, researchers report
First-Time Moms Are Getting Older in US The age at which U.S. women have their first baby is going up, according to a new report from the Centers for Disease Control and Prevention. From 2000 to 2014, the average age of a mother's first birth rose from 24.9 to 26.3, data from the CDC report found. In the report, published Jan. 14, the researchers attributed the shift to two main factors: a decrease in the percentage of women having their first birth before age 20, and an increase in the percentage having their first birth over age 30. The percentage of women having their first child under age 20 fell to
13.4 percent in 2014, down from 23.1 percent in 2000, according to the report. The percentage of women having their first child between ages 30 and 34 rose to 21 percent in 2014, up from 16.5 percent in 2000, according to the report. And 9.1 percent of women having their first child in 2014 were 35 or older, up from 7.4 percent in 2000. This is a trend that will likely continue as more women pursue professional goals, said Brooke Hodes-Wertz, an assistant professor of obstetrics and gynecology at New York University Langone Medical Center.
People who drink sugary beverages every day tend to accumulate more deep belly fat over time, new research suggests. The study, of over 1,000 adults, found that those who downed at least one sugar-sweetened drink a day had a bigger increase in deep abdominal fat over the next six years. Researchers said the results are concerning because that type of fat -— known as visceral fat — surrounds a number of vital organs and is particularly unhealthy. "Visceral fat is the kind that's closely associated with the risks of Type 2 diabetes and heart disease," said Alice Lichtenstein, a
spokeswomen for the American Heart Association (AHA), who was not involved in the study. The findings, published Jan. 11 in the journal Circulation, are far from the first to connect sugary drinks to health consequences. Past research has already found that people who consume a lot of sugary drinks tend to have higher rates of diabetes and heart disease.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016
New Non-Surgical Protocol for Neuropathy What is Neuropathy?
Neuropathy is a collection of disorders that occur when nerves of the peripheral nervous system are damaged. The condition is generally referred to as peripheral neuropathy. In the United States, over 20 million people suffer from peripheral neuropathy. Neuropathy can be brought on by a number of different causes including Diabetes, back problems and certain drugs. Damaged nerves send incorrect signals back to the brain causing scattered signals resulting in numbness, burning, tingling and sharp pain sensations that are usually felt in the feet, legs, hands and arms. Symptoms associated with the motor portion of the nerve may include muscle weakness, cramping and spasms as well as a lack of coordination and poor balance.
Are you Experiencing Pins & Needles? Numbness and Tingling? Pain or Burning in your Feet or Hands?
Traditional Treatments:
Over the years neuropathy treatments in general have had poor results at best. Many medications are used that have significant side effects and poor treatment outcomes. Only recently have we had a promising breakthrough to help reduce symptoms of neuropathy with lasting results.
New Non- Surgical Protocol For Neuropathy:
A new development in Class IV laser technology called Deep tissue Laser Therapy has been shown to improve the function of the blood vessels and tissues that surround the injured nerves. This improves the elasticity and function of the blood vessels. As the blood vessels become healthier, the nerves begin to thrive. Another choice of treatment, MICROVASCULAR THERAPY, is used to expedite healing and reduce pain through the process called
“Vascular Profusion”. This is the process of delivering blood to the capillary beds in the tissues and organs of the body. Microvascular Therapy is PAIN FREE and stimulates the pumping action of the smallest blood vessels which increases the oxygenation, nutrient transport to the cells and waste removal causing tissues to heal more rapidly. Additionally, a landmark study demonstrates the benefits of an arginine based nutritional protocol for patients. This pharmaceutical grade supplement containing L-Arginine boosts the production of Nitric Oxide in your body and has been labeled The Ultimate Cardio Health Solution. The Nobel Prize in Medicine was awarded in 1998 validating the effects of nitric oxide on the cardiovascular system and how L-Arginine is critical to the production of nitric oxide in the body. Ironically the use of L-arginine was also found to deliver dramatic results to patients with diabetes and peripheral neuropathy by improving circulation.
If you would like to learn more about this successful drug-free and pain-free protocol for neuropathy and other nerve and pain conditions call 622-0102 Mention This Article to Qualify For A Free Consultation.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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ARISE to train long-term care volunteers ARISE has overseen an advocacy program, known as the long-term care ombudsman program, in Cayuga County for the past few years and has been selected to coordinate the program in three additional counties, Onondaga, Cortland and Oswego. ARISE is now seeking volunteers who want to be part of this enriching effort. The purpose of the long-term care ombudsman program is to protect the health, safety, welfare, and civil rights of people living in nursing homes and adult care facilities. Certified ombudsmen in the program advocate for residents’ rights and ensure that their complaints are resolved to support a higher quality
Health
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Gay Alliance promotes open workshop The LGBTQ Academy at the Gay Alliance of Rochester is sponsoring a workshop to train community members on issues related to lesbian, gay, bisexual, transgender, queer/ questioning (LGBTQ). The workshop is particularly helpful for counselors, teachers, student leaders, dignity act coordinators and social workers, according to a Gay Alliance news release. The event will take place from 6 to 9 p.m. on Friday, April 22, and from 8:30 a.m. to 5 p.m. on Saturday, April 23, at the Gay Alliance LGBTQ Resource Center, 100 College Ave. in Rochester. Members of the alliance say participants will become more confident and articulate while talking with others about LGBTQ issues. “We will focus on your personal story as a tool for education, responding to questions mindfully and tips for respectful communication,” reads a news release, which state that the workshop is “a great experience for someone new to LGBTQ issues, or someone who has lived or worked with the issues for years.” For more information, send an email to jeanneg@gayalliance.org or register at www.gayalliance.org. Click on the programs/education link.
Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by
Bruce Stewart, DDS • Advanced Laser Periodontal therapy available. • Implants placed and restored • CEREC Crowns - beautiful, strong, done in one visit • Digital low radiation x-rays • Root Canal therapy • Natural tooth colored fillings • Complete Smile makeovers • Complete recare services including periodontal and oral cancer screenings
Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? The Cayuga County Office for the Aging offers a complimentary monthly class to help people make sense of Medicare. In those classes participants will learn how to determine whether the plan they are considering will give them peace of mind or potential headaches. People will learn about how Part D drug plans work and whether EPIC co-pay assistance is an option. The class also addresses information about programs to help pay for insurance coverage, as well as a listing of the free and low cost preventive care under Medicare. The next class will take place from 10 a.m. to noon in the basement training room of the Cayuga County Office Building. Seating is limited, so registration is required. For more information or to register, call the Cayuga County Office for the Aging at 315-253-1226, or visit www.cayugacounty.us/aging under the News & Activities section.
of life. Long-term care ombudsmen are trained and certified volunteer advocates who can help resolve complaints, provide information about resident rights, and advocate on behalf of residents for high standards of quality care. ARISE will offer a new ombudsman training for interested volunteers Feb 16, 17, 19, 23, 25, 26, hosted by Regional Long-Term Care Ombudsman Coordinator Jeffrey Parker. People interested in learning more about this program or the training should contact Parker at 315-6715108 or jparker@ariseinc.org.
CNY’s Healthcare Newspaper
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In Good Health is published 12 times a year by Local News, Inc. © 2016 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Eva Briggs, M.D., Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Matthew Liptak, Chris Motola, Joseph Barry, M.D. • Advertising: Amy Gagliano, Cassandra Lawson Design: Eric J. Stevens • Office Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
Fight Erectile Dysfunction With Berries Flavonoid-rich diet helpful, study finds
B
lueberries and other foods rich in flavonoids are linked to a reduced risk of erectile dysfunction, researchers at the University of East Anglia (UEA) in England and Harvard University have recently found. Eating more fruit was associated with a 14 percent reduction in risk. If fruit consumption is combined with exercise, that reduced risk of erectile dysfunction by 21 percent, according to the study, published in The American Journal of Clinical Nutrition on Jan. 13. Eating a flavonoid-rich diet is as effective in preserving erectile function as walking briskly for as many as five hours a week, the researchers concluded. Foods rich with any of three flavonoids — anthocyanins, flavanones and flavones — were the most beneficial, especially for men younger than 70, researchers say.
Sound-based therapy works on supporting change in learning, development, and wellness. The Davis Model of Sound Intervention ® repatterms the subtle energy system between the voice, ear and brain, supporting a pathway of self-healing. Appropriate programs are determined by a proprietary test battery. People of all ages with all issues/diagnoses have obtained a more balanced self with this approach. Now at the RoseHeart Center 5900 N. Burdick Street, East Syracuse, NY 13057 ddavis@thedaviscenter,com • 862-251-4637 Dorinne Davis Schedule online at www.thedaviscenter.com World’s Leading Sound-based Therapist
SEX AFTER PROSTATE CANCER?
Free Seminar in Rochester Thursday, Feb. 11, at 7 p.m. “Treating Sexual Dysfunction After Prostate Cancer”, by Louis Eichel MD.
They include: blueberries, cherries, blackberries, radishes and blackcurrant.
How much to eat?
This doesn’t mean that men should go all-out in consuming such foods, citrus and red wine. “In terms of quantities, we’re talking just a few portions a week,” says Aedin Cassidy, the study’s lead researcher and UEA professor, in a statement.
Sengupta Conference Room, Rochester General Hospital, Polisseni Pavilion, Ground floor. Spouses and significant others welcome. Registration not required. Arrive early for best seating. Use Portland Ave. garage. Parking passes to first 30. Email:ustoorochesterny@gmail.com
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In 2016, choose to advertise with In Good Health, Central New York’s Healthcare Newspaper. cnyhealth.com • editor@cnyhealth.com
Healthcare in a Minute By George W. Chapman
T
Telehealth Growing Exponentially
here were just 250,000 telehealth “visits” in 2013. That number is expected to hit 7 million by 2018. Most plans are now paying for telehealth, which means more and more physicians will participate, if only to remain competitive. Telehealth allows physicians to remotely monitor diseases like diabetes and develop care coordination plans. This is a tremendous boon to homebound elderly or those living in predominantly rural areas. A major impediment to telehealth has been state borders. Getting licensed to practice in different states has been a hassle for physicians. The new Interstate Physician Licensure Compact is an agreement that makes it far easier for physicians to get credentialed in other states. Currently 12 states participate with most being clustered in Western/Central states with large rural populations like Nevada, Idaho, Wyoming, Utah, South Dakota, Iowa, Wisconsin and Illinois. So far, New York has not enacted. Contiguous states Vermont and Pennsylvania have introduced legislation. Some carriers are getting way ahead of the competition in order to attract and retain business. New York state- based Oscar Health offers telehealth through Teledoc to its 100,000 members for free. Members can call or use the Oscar Health website (www.hioscar.com) to relay their symptoms. A physician responds in less than 10 minutes.
Medical Bills
The No. 1 cause for bankrupt-
cy is still medical debt. 1.7 million Americans will file for bankruptcy this year because they can’t pay their medical bills. A study conducted by NerdWallet (yes, NerdWallet) considered data from the CDC, federal courts and the Commonwealth Fund. Most people max out credit cards, which carry high interest rates. The study also reveals 10 million people with insurance claim they can’t pay all their outstanding medical bills. While ObamaCare has reduced the number of uninsured Americans by 15 million, it isn’t a panacea. The average US household income is about $50,000. The cost of a basic family plan is about $20,000.
Doula Care
Doula is from the Greek word for “a woman who serves.” As women choose alternatives to delivering their baby in a hospital, many are hiring doulas who are trained to provide non-clinical emotional, practical and informational support throughout pregnancy. Doula care is not covered by insurance. Advocates claim the use of doulas can reduce costs by lowering C-sections, the use of epidurals and preventable complications. The problem is there hasn’t been enough experience with doulas to confirm the claims. While research has shown that the cost of inpatient deliveries far exceeds the benefits, the mortality rates for “outside”-born babies was twice that for hospital-born babies.
Cost Containment
Most industry experts estimate 30 percent of healthcare is unnecessary.
But how much is attributable to overly demanding patients? According to a study in the American Journal of Managed Care, a lot. Fifty-two percent of primary care physicians admit to making unnecessary referrals to specialists to placate patients. Thirty-nine percent acquiesced to prescribing expensive drugs when equally effective generic drugs were available. It is totally understandable why physicians would want to avoid conflict with their patient customers. Many believe fee for service/volume is a major cause of unnecessary care since there is not a financial incentive for either party to keep costs down. Cost containment incentives are gradually being imposed on physicians and hospitals. Patients can do their part in cost containment by cooperating and becoming informed consumers.
Nurse Placement Reflects Change
In what should come as no surprise, a 10-year study that tracks nurse employment found nurses are increasingly employed outside of hospitals. In 2012, 76 percent of new nurses took jobs in hospitals compared to 87 percent in 2005. This reflects the shift about where care is being delivered. Hospital occupancy has been declining 5 percent a year while services provided to the community by home care agencies, case management companies, ambulatory care centers, urgent care centers and physician offices have seen marked increases.
Free Doctor Visit
In order to improve overall February 2016 •
health, some health plans in large markets like Atlanta, Chicago, Dallas and Miami are offering a free primary care visit to their members. The physician still gets paid, but the patient does not have to pay down their deductible or the 20 percent co-pay. The hope is that the “free” visit will give the primary physician an opportunity to identify any health issues before they become serious and to reduce unnecessary trips to the emergency department. It also gives the physician chance to meet brand new patients and establish a baseline on them. Many consumers are deterred from getting necessary care because of high out-of-pocket expenses.
ACA Headed for Veto
While there have been over 50 attempts to repeal the ACA/ ObamaCare, the various bills never got past the Democratic-controlled senate. But now that the Republicans control the senate, a bill will finally reach the President’s desk. While it will definitely be vetoed by Obama, it is an indication of what might happen if a Republican wins the White House next year.
George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Meet
Your Doctor
By Chris Motola
Mitchell Brodey, M.D. Physician talks about managing one of CNY’s largest private practice, and why some doctors opt to work in a large practice and not in a hospital Q: Tell me about FamilyCare Medical Group. A: FamilyCare Medical Group is a multi-specialty group of about 65 doctors, 40 or so physician assistants and nurse practitioners. It started about 20 years ago with 13 family practitioners who joined together. I joined about three years after that. The group has grown over the years. Dave Page was the president for about 15 years. I wound up becoming the president about three years ago. Q: What kinds of advantages do groups like yours offer physicians as opposed to being in private practice or working for a hospital? A: So we are private practice, that's the advantage of this arrangement. We have about 35 different offices. The physicians who started FamilyCare wanted to stay in private practice and run their offices the way they want to run them, be self-employed and have control over their environment. If they want to make a lot of money, they can see a lot of patients. If money's not as big a deal and they want to have more free time, they can see fewer patients. Either way, being in this group allows them to do that without having to worry about the day-to-day business aspects. We have business staff that takes care of the billing, the politics, IT departments. We
were an early adopter of electronic medical records and have had them since 2000. Most docs don't get into medicine because they want to do all that stuff, and it's become more complex over time. I joined the group because I didn't have any intention of getting involved in the business aspects.
Q: What led you to want to take on an administrative role in light of all that? Was it an evolution? A: For me it was more revolution than evolution. I spent the first 33 years of my medical career trying to avoid any kind of business or administrative work. I'm an internist and infectious disease doctor. I went into practice to see patients; that's the part I like the most. My first job was at Upstate. I was full-time faculty. After a couple years I decided it wasn't for me and went into a practice with four other doctors. One of them handled all the business aspects. After about eight years those doctors retired and a couple years later my new partner and I joined the group. I got interested in this after being on the board of our practice management company. Then I started to take on more responsibility at the hospital. For me, I did it because I want the group to
be able to continue so that there's an alternative to working for a hospital or becoming businessmen themselves. So there was a need to do it and I was the one on hand to do it.
Q: Is there an opportunity to still address your specialty, but from a higher-level strategic perspective rather than an individual one? A: Within the group I do still have my areas of expertise and interests, so that may play out in terms of how people are screened for infections like HIV. Our group takes care of a couple hundred thousand patients, so I'm able to influence the care of a lot of patients outside of my practice. That's one reason, as a doctor, to do it. I'm also chief of medicine at the Community Campus of Upstate. My ultimate goal is to get doctors to work together as colleagues rather than competitors. Q: Do you think most doctors enter the field with a more competitive perspective? A: So when a young doc comes out, they've got loans to pay off. They're probably not interested in taking out more loans to start a private practice. So the days of docs starting solo practices are pretty much over. So in our region they can either work for a doctor-owned group or work for a hospital. And within that doctor-run group there are different arrangements. You might be an employee of that group with a salary or you might become a prospective partner of that group. Ideally, we prefer doctors not making money off of other doctors. We like to have them run their own practices and have some incentive to do that. We like to let doctors be doctors. The advantage of working for a hospital is that you don't have to worry about too much of the logistics. That comes at the cost of having very little control over your environment. Some people prefer that, but we want to make sure there's an alternative. Q: Within the organization, how much freedom do physicians have? What do you regulate? A: So people can set up their own practice. The money they take in, minus the overhead and ancillary fees that we share, belongs to them. But they hire who they want, fire who they want. They can
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016
run their office the way they want as long as they practice good, quality medicine. Now what do I mean by that? Well, in the era of value-based medicine, reimbursement is going to depend a lot on perceptions of quality and those are measured with a number of metrics. You have to make sure that preventive care is being taken care of, chronic diseases being controlled, immunizations being given. So we track all of that and we give our members report cards. We give them their own report cards but also show where they are in relation to the other members as a form of peer pressure. You want the respect of your peers and not to be thought of as a slacker. Everyone wants to deliver high quality care, but it's another thing to back that up.
Q: In terms of reimbursements are you judged as individuals or a collective entity? A: For a lot of these things, it's a team sport. So some things are individual, but most insurance is looking at teams. So how do you function as a team? Unfortunately, and hopefully this will change, none of the criteria for being admitted to medical school has to do with evaluating the student's ability to work on a team. Sitting in a lab and getting good grades doesn't teach you the humanist aspect of medicine. Q: What goals do you have, personally, as an administrator? A: I want the group to survive and thrive. A lot of the issues we have now are related to the aging population and the shortage of primary care physicians. We're primarily a primary care organization. So I want to make sure we have a new generation of primary care physicians to take care of our aging population. Above that, I'd like to see the community work together. I'm not against competition. I'm a competitive person myself, but when I say competition I'm talking about trying to “win” by being better than everyone else. You don't win by undercutting somebody else or by putting up ads saying you're better than someone else. I think everyone around here believes in that, but sometimes we get off track.
Lifelines Name: Mitchell Brodey, M.D. Position: President and CEO of FamilyCare Medical Group Hometown: Lawrence, NY Education: Wayne State University (medical), Columbia University (undergrad), Fellowship in infectious diseases, University of Wisconsin Affilations: SUNY Upstate University; Crouse Hospital; serves as president of the medical staff at Upstate University Hospital; chief of medicine, Community Campus University Hospital; clinical professor of medicine at Upstate University Medical School; medical director, Crouse Health Network Career Highlights: Practices both general internal medicine and infectious disease and is board-certified in both. His primary areas of interest are antimicrobial stewardship, infection prevention and HIV Organizations: Infectious Disease Society of America, American College of Physicians, Onondaga Medical Society Family: Married, four children Hobbies: Rowing, snowboarding, windsurfing, reading
Tattoo Removal Growing in Popularity More than one in five people regret getting tattoos
or seek or have completed their removal By Deborah Jeanne Sergeant
A
bout 45 million Americans have at least one tattoo, according to the Pew Research Center. Of them, about 17 percent regret a tattoo and 11 percent are seeking or have completed tattoo removal. Some find that what they thought was clever years ago isn't funny anymore. Or that their tats don't look right for working in a professional environment. Others who got inked with a significant other's name want that moniker removed once the relationship ends. Keith Williams, tattoo artist and owner of Inkings in Oswego, said that tattoo regret for name tattoos is so common that when quoting a price, "we tell them how much for the name and how much for the cover-ups." Instead of blotting out the name, others opt for removal of the name and rewriting of a new name, but that's not always possible. "I've seen examples where it isn't hard to do if it's faded or bad workmanship," Williams said. "Ninety-nine percent of the time, covering it is easier." He's been in the tattoo business for 20 years. For small tattoos, some successfully use cosmetics to camouflage
their ink. Surgical removal can replace a tattoo with a scar. A series of chemical peels may lighten some tattoos. Over-the-counter and Internet-sourced tattoo "removal" products are "hocus pocus," said Ramsay Farah, dermatologist with Farah Dermatology and Cosmetics in Syracuse. "I've seen a lot of unorthodox methods of tattoo removal. The science and technology is not behind those." Farah has seen clients bearing painful and serious side effects such as skin infections from home tattoo removal, including pouring acid on the skin. Instead, he advises people to seek laser tattoo removal, a service his office has provided for 15 years. The latest addition to the office is the PicoWay laser. It works differently from previous lasers because it delivers the energy at higher levels and at shorter pulses. It shatters the ink more quickly and into smaller pieces without affecting as much tissue near the tattoo. As a result, the patient requires fewer treatments — two to four, instead of eight to 12 — because the body absorbs the ink for expulsion easier. Patients experience less pain, too. The PicoWay also works for people with dark skin tones, as previous
laser technology could not differentiate between the tattoo color and the natural, dark skin tone. Farah said clients wait a month between treatments to give the body a chance to expel the ink. Side effects include minor irritation, redness, minor scabbing and tenderness. Patients should avoid direct sun exposure while healing. "A lot of the side effects of previous lasers was because of energy seeping out into other skin," Farah said. Though there's always a risk of scarring or skin tone fading with any laser treatment, Farah said that the PicoWay reduces those risks. The precision also reduces the cost. Farah's office charges about $300 to $400 per session, which covers an area the size of a business card. For larger tattoos, it's an additional $100 to $200 for each business card sized area. For people who want to modify a tattoo, such as to change a name or alter an
unwanted statement or image, laser removal can provide a blank area for the tattoo repair after the skin heals. Williams said that it takes about one to three months after the final laser treatment for skin to heal well enough for another tattoo in the same place.
Vourgsnti, Paonessa and Byler.
UPSTATE UROLOGY IS PROUD TO INTRODUCE THE NEWEST MEMBERS OF THE TEAM: N NATASHA A GINZBURG, MD G I
Assistant A ss Professor Female F em and reconstructtive ive urology, urinary inc incontinence in women, p el floor treatment pelvic aand nd neurourology.
GENNADY BRATSLAVSKY, MD
ZAHI N. MAKHULI, MD
SPECIALTIES: urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
SPECIALTIES: general urology, andrology
Professor & Chairman Department of Urology
JC TRUSSELL, MD
Associate Professor Department of Urology SPECIALTIES: male infertility, erectile dysfunction, andrology, general urology
OLEG SHAPIRO, MD
Associate Professor Departments of Urology and Radiation Oncology SPECIALTIES: urologic oncology & endourology, robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal; renal stone disease
JESSICA E PAONESSA, MD
Assistant Professor Department of Urology SPECIALITIES: nephrolithiasis (kidney stones); enlarged prostate, urination problems; voiding dysfunction; bladder surgery; kidney surgery
GENNADY BRATSLAVSKY, M.D.
ZAHI N. MAKHULI, M.D.
SPECIALTIES: Urologic Oncology Robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
SPECIALTY: General urology, andrology
Professor & Chairman Department of Urology
Professor Department of Urology
DMITRIY NIKOLAVSKY, MD
M MATTHEW A D. MASON, MD M A
Assistant A ss Professor Pediatric P ed urology, ttreatment re nd of hernias and h yd hydroceles in children, rrobotic ob surgery in cchildren, hi urinary tract in nfe infections, and penile aabnormalities. bn
Professor Department of Urology
RAKESH KHANNA, MD
Assistant Professor Department of Urology SPECIALTIES: urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
JONATHAN RIDDELL, MD
FRCS Assistant Professor y Department of Urology SPECIALTY: pediatric urology
RYAN SIDEBOTTOM, MD RY
Assistant A s Professor All A ll urologic needs, general urology, m a health, urologic oncology, male enlarged e n prostate, kidney stones. Dr. D r Sidebottom sees patients at Upstate Urology of Auburn office U p Auburn, NY iin nA
penile a
DMITRIY NIKOLAVSKY, MD
Assistant Professor Department of Urology SPECIALTIES: female/male incontinence urethral stricture disease pelvic organ prolapse vessico vaginal fistula, reconstructive surgery
IMAD NSOULI, MD
Associate Professor Department of Urology Associate Professor SPECIALTY: general urology
SRINIVAS VOURGANTI, MD
Assistant Professor Department of Urology SPECIALITIES: urologic oncology; prostate cancer, bladder cancer; kidney cancer; penile cancer
TIMOTHY T TI M K BYLER,, MD
Assistant A ssis Professor D epa Department of Urology S PEC SPECIALITY: general ffemale ema urologic health
FOR QUE QUESTIONS OR TO MAKE A REFERRAL, CALL 315-464-1500 Q
Assistant Professor Department of Urology SPECIALTY: Female/male incontinence Urethral Stricture Disease Pelvic Organ Prolapse Vessico Vaginal Fistula, Reconstructive Surgery
February 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 7
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Message For Those Who Live Alone
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’m often asked by readers and those who attend my “Live Alone and Thrive” workshops whether I ever date or would consider getting married again. My answer is unequivocally “yes!” More often than not, people are surprised by my answer. I like the question, because it gives me a chance to remind everyone that being successful at living alone doesn’t mean abandoning the idea of building and sharing a life with someone special. I’ve said it before and it bears repeating: Living alone doesn’t mean being alone. Many people satisfy their need and desire to be with people by developing a great group of friends, including family members. Others want more, and long for romance and the exclusive domain of a loving relationship. It is to this latter group that I dedicate this column. If the idea of dating in mid-life seems daunting, know that you are not alone. I’ve talked with many older women and men who have resigned themselves to “terminal single-hood,” after having tried unsuccessfully to enter the dating scene. It only takes a few disappointments
and rejections to send people running for cover. But like any challenge, if you approach dating with thoughtfulness and care, a satisfying and lasting relationship is possible at any age. Below are a few tips I’ve assembled from my own experience and the experiences of others that may help you jump-start your search for a loving companion: Define what dating means to you. If you haven’t dated in years (perhaps in decades), the term “dating” may suggest the first step in a predictable path to marriage. These days, dating is, well, dating. And you can define it any way you like. Maybe you just want a date for a work event. Perhaps you’d be happy with a number of companions with whom you could enjoy movies, dinner, intimacy, etc. Or, you may be on a serious quest to find a new life partner. Your definition — your dating goal — will shape the style and pace of your search. Know what you’re looking for. I remember reading an article recently in which the author details her experience of writing down the qualities she wanted in a man, and then — lo and behold — having the man of her
dreams stroll right into her life. Was it coincidence? Magic? Who knows, but the exercise has merit. Thinking about what you want as well as what’s unacceptable will help you refine your search and improve your chances of finding a compatible partner. Be yourself. This is no time to try and become the person you wish you were or you think others will find attractive. One of the advantages of being a little older is increased self-awareness and the confidence to be who you truly are. Accept and embrace yourself “as is.” Pretending to be otherwise will only compromise your chances of meeting someone who loves you just the way you are. Spread the word. If you want to meet someone, make your search a priority and let friends and family know you’re looking. Don’t be apologetic about expressing your desire to find a companion. It might sound like this: “You know, it’s been a while, and I’m feeling ready to meet someone. May I ask a favor? Would you keep me in mind if you run into someone you think might be a good fit for me?” Other ways to initiate your search include joining a matchmaking website or by subscribing to a dating service. Having had no experience with these avenues, I can only offer this bit of cautionary advice: It’s potentially risky, so take precautions.
There's a lot written on this subject, so look for books and articles, or conduct a Web search to learn how to best protect yourself. Put yourself with like-minded people. Do you like to dance? Are you an athlete? Is reading your passion? We all like being with people who share our interests; and one way to kick-start your dating adventure is to attend social functions that attract the kind of partner you are looking for. Now’s the time to join clubs and groups whose members include potential partners. It could be a book club, a hiking group just for singles, dance lessons that don’t require partners, or organizations that cater to divorced or widowed men and women. To be successful, you need to get out of the house. Have fun and keep your expectations in check. We’ve all suffered the occasional bad date or rejection. Try not to let that stop you from meeting new people and pursuing that special someone. Dating, just like networking for a new job, can put you in the company of interesting, stimulating people. Even if your heart doesn’t go pitter-patter, you’ll be out in the world and expanding your experiences and circle of friends. So give it a whirl. Muster your courage, pick up the phone, and enjoy the search for that special someone! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call her at 585624-7887, email her at gvoelckers@ rochester.rr.com.
Stressed Teens May Face Higher Diabetes Risk as Adults: Study
KIDS Corner
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eens who have trouble coping with stress may be at increased risk for Type 2 diabetes as adults, new research suggests. For the study, researchers examined data from more than 1.5 million 18-year-old men who were conscripted into the Swedish military between 1969 and 1997. The participants all underwent standard testing for stress resilience, and none of them had
diabetes at the age of 18. But during the follow-up period, from 1987 to 2012, more than 34,000 of the men were diagnosed with Type 2 diabetes, according to physician Casey Crump, from the department of medicine at Stanford University in California, and colleagues. Compared to men with the highest resistance to stress when they were 18, those with the lowest stress
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resistance were 51 percent more likely to have been diagnosed with Type 2 diabetes later, the investigators found. However, the study only found an association, and was not designed to prove a cause-and-effect relationship between stress resilience and diabetes risk. The study was published online Jan. 13 in the journal Diabetologia.
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New U.S. Dietary Guidelines: Boost Fruit and Veggie Intake, Limit Sugar and Salt Recommendations revised every five years
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mericans need to cut back on added sugars, saturated fats and salt if they want to eat a diet that can improve their health, according to the federal government's latest version of its dietary guidelines. The guidelines, released early in January, break new ground by specifically recommending that people limit added sugars to fewer than 10 percent of their daily calories. The last version of the guidelines, which came out in 2010, only said that people should reduce their intake of added sugars without setting a specific goal. The guidelines are updated every five years, so they keep up with current science. The new recommendations — called the 2015-2020 Dietary Guidelines for Americans — also ask that people limit saturated fats to fewer than 10 percent of their daily calo-
ries, and consume fewer than 2,300 milligrams per day of salt. That's a bit less than one teaspoon of salt. Overall, the guidelines emphasize the adoption of a healthy eating pattern that fits into a person's lifestyle, rather than recommending specific amounts of different foods, such as vegetables or meats. "These patterns can be tailored to an individual's personal preferences, enabling Americans to choose the diet that is right for them," the report states. The guidelines even provide three examples of a healthy eating plan that people can adopt: a healthy American diet; a Mediterranean-style diet; and a vegetarian diet. The emphasis on a healthy eating plan is meant to be more consumer-friendly, making it easier for people to use the guidelines, experts said. According to the new guidelines, a healthy eating pattern includes: n Any type of vegetables, especially if they're eaten in a wide variety. n Fruits, especially whole fruits. n Grains, at least half of which are whole grains. n Fat-free or low-fat dairy, including milk, yogurt, cheese, and/or fortified soy beverages. n A variety of protein sources, including seafood, lean meats and poultry, eggs, beans and peas, nuts and seeds, and soy products. n Oils. n If alcohol is consumed, it should be done so in moderation — up to one drink a day for women and up to two drinks a day for men, the guidelines say.
E-cigs Not the Answer for Those Trying to Quit
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mokers who have resolved to quit are cautioned to avoid using e-cigarettes to wean themselves off of tobacco products, according to research issued by Excellus BlueCross BlueShield. Electronic cigarettes are battery-operated products that turn their contents into a vapor that is inhaled. They are not regulated by the Food and Drug Administration and can contain liquid nicotine, flavoring and potentially harmful chemicals. “The risks associated with inhaling these vapors are largely unknown,” said physician Matthew Bartels, medical director of health care imBartels provement at Excellus BCBS. “Because e-cigarettes aren’t held to the FDA's rigorous review standards, there’s no way to verify the safety of these devices." If you’re planning to quit smoking, Bartels recommends only FDA-approved smoking cessation methods: • Patches, gum and lozenges • Prescription medications, including nicotine inhalers prescribed
February 2016 •
by a health care provider • Nasal sprays Smokers can receive free resources and assistance to help quit by calling the New York State Smokers’ Quitline at 1-866-NY-QUITS (1-866697-8487). In New York state, high school students and young adults aged 18 to 24 are almost twice as likely to use e-cigarettes than adults aged 25 and older, according to an Excellus BCBS infographic, “Smoldering Facts on E-Cigarettes.” According to the infographic, 8.7 percent of eighth graders, 16.2 percent of 10th graders and 17.1 percent of 12th graders nationally admitted using e-cigarettes in the past month. “Such flavors as bubble gum, cotton candy, and tutti-frutti could appeal to youths," said Bartels. "The pleasing flavors, coupled with the stimulating effect of liquid nicotine, make for a dangerous combination that could potentially lead to nicotine addiction.” “This should be enough to make us question the impact e-cigarettes can have on the health of our children and others who may believe that e-cigarettes are a safe alternative to using tobacco products,” he added. • To view the infographic: http://tinyurl.com/juy9kvn • Mobile-friendly infographic: http://brand.excellusbcbs.com/infographics/
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My Turn
By Eva Briggs
Chagas Disease
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hen I was a kid, my best friend and I used to enjoy being scared by a science fiction TV show called “Night Gallery.” I remember a particularly creepy episode about a fictional earwig, an insect wreaking havoc by crawling through a man’s brain. Some recent social media posts about Chagas disease capitalize on that horror and creepy fear factor of disease-causing insects that sneak up on you at night. So what is Chagas disease, and should you be losing any sleep over it? It’s a parasitic infection caused by the protozoa Trypanosoma cruzi. Insect vectors, triatomine bugs, spread it. They’re often called kissing bugs because they prefer to feed on exposed skin, such as the face, at night. They suck up their blood meal (they don’t have biting or chewing mouthparts), poop and leave. Unlike mosquitoes or ticks that spread disease via their bite, with kissing bugs it’s the backside that’s a problem. because the T. cruzi protozoa are in the feces. An unwitting victim accidently smears the feces, wiping the parasites into the bite, or their mouth or eyes, allowing it to enter their body. The disease can also be acquired when an infected insect falls into food as it’s cooked, leaving behind the parasites to be eaten. It’s also
spread via the blood borne route, such as transfusions. (Donated blood is screened for Chagas disease and discarded if positive.) Chagas disease begins with the initial acute phase, lasting a few weeks or months. During this phase, people have a high number of T. cruzi in their blood. Many people have no symptoms, or nonspecific symptoms: fever, fatigue, muscle aches, rash, headache, vomiting or diarrhea. There might be swollen lymph nodes or an enlarged liver or spleen. If the infection entered the body through the eye, the eyelid may swell — Romaña's sign. Even if untreated, the initial signs usually fade away. The chronic phase lasts years, decades or a lifetime. Most people simply harbor the parasite without symptoms. But a significant portion, 30 percent, develops symptoms caused by infection of the heart or digestive tract. Cardiac infection can damage the heart muscle (cardiomyopathy) leading to heart failure, abnormal heart rhythms, or sudden death. In the digestive tract, the esophagus can become enlarged, causing eating difficulties; or the colon can become dilated, interfering with bowel function. Treatment involves antiparasitic medicines. These are most effective
in the acute phase. Some people can’t tolerate the antiparasitic medicines, due to age or other factor. But treatments related to their symptoms help. The good news for us is that most cases of Chagas disease in the U.S. are in people who acquired it in Central or South America and immigrated. The causative parasite has been found in many nonhuman animals in Texas: dogs, armadillos, wood rats, and rattlesnakes. It’s found in kissing bug species in Texas, and people in Texas have been found to have positive blood tests. On the other hand, experts in Ohio (a lot closer to us here in Central New York) state that the species of kissing bugs found in that state aren’t likely to transmit Chagas disease. It seems that these northern insects wait until they have left the host to defecate, sparing the human host from infection. Another interesting twist in the Chagas story is that the drugs to treat it aren’t approved by the FDA. But they are available from the CDC. Martin Shkreli — that same creep
who purchased an antimalarial drug and overnight raised its price by 5,500 percent from $13.50 to $750 per pill — is trying to do the same thing with the Chagas drug benznidizole. In Latin America, the current cost of treatment with this drug is $50-$100. But Shkreli would like to raise that to — hold on to your hats folks — $80,000! As I write this, he has just been arrested on securities fraud charges. One can only hope that stops him. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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Vice President Immunotherapy Breaking Biden Pushing for Cancer Cure Ground in Cancer Battle U
President Carter at 91 is the most famous cancer patient to benefit from therapy By Deborah Jeanne Sergeant
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he news of former President Jimmy Carter's successful cancer treatment with pembrolizumab, used as an immunotherapy drug, drew attention to the cutting-edge, still-developing therapy. Immunotherapy cannot prevent cancer, but it otherwise works in a similar fashion to influenza vaccine by stimulating an immune response to fight the disease. In essence, immunotherapy uses medication to stimulate the body's immune system to fight the multiplying cancer cells without damaging healthy cells. It works differently from chemotherapy drugs, which affect any healthy and diseased tissue that multiplies quickly. "So far, it's approved for people with advanced disease," said physician Jeffrey J. Kirshner, director of research at Hematology Oncology Associates of CNY. "It's approved only for lung cancer patients who have failed chemotherapy. We're studying to see if it's effective as initial therapy." "Immunotherapy" may be used to refer to several types of therapies. One is antibody therapy, which has been used for the past Kirshner 15 years to treat cancers like lymphoma and breast cancer. Cellular therapy, including bone marrow transplantation, represents another kind of immunotherapy. Newer drugs that help to stimulate the immune system, such as the kind of treatment Carter received, represents another kind of immunotherapy. Kirshner said it works by "revving up" the immune system. "The treatment President Carter receives is given every two weeks,"
he said. "I have a couple patients on it now and we just don't stop it. One melanoma has responded over half a year, and a lung cancer patient is in remission." The newest immunotherapy drugs may seem like a miracle cancer cure, but it's too soon to know its long-term effectiveness and for what types of cancer it is most useful. Carter's cancer, melanoma, "is one that we know is very involved with the immune system," said physician Leslie Kohman, medical director of SUNY Upstate’s Cancer Center. "Kidney cancer is another. They have a very intimate relationship with the immune system, and many others do." Kohman serves as the medical spokesperson for the American Cancer Society, Inc. in New York and New Jersey. She said that only a very small percentage of all cancer patients make good candidates for this kind of immunotherapy, but she hopes that in the next few years, additional clinical trials will help researchers understand what types of cancer the therapy can most benefit. "In the cancer community, people are really talking about immunotherapy," Kohman said. "We're going to be learning as we develop more drugs. There are only a few of these drugs and they're only applicable to a few patients." Kohman said that since Carter's cancer had spread to his brain, immunotherapy made sense as a treatment since it passes through the blood/brain barrier, something that most chemotherapy drugs cannot do. The immunotherapy drugs followed Carter's radiation therapy that provided precise treatment in high doses to very small areas. "Every normal cell gets a very, very small dose but the tumor gets a very large dose," Kohman said. "It can be administered over a few treatments." Carter, 91, had four small lesions on his brain. Their size made the cancer easier to treat.
Cancer Death Rates Down 23 Percent Since 1991: Study
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eaths from cancer continue to decline in the United States, according to a new report from the American Cancer Society. Since peaking in 1991, cancer death rates have dropped by 23 percent, the ACS said in the report released in January. "Cancer death rates are continuing to decline by about 1.5 percent per year," said study author Rebecca Siegel, strategic director for surveillance information services for the American Cancer Society. The 23 percent drop in death rates occurred from 1991 through 2012, she said, and that translates to more than 1.7
million cancer deaths averted. "We are doing very well, I would say, is the bottom line," she said. The findings are included in Cancer Statistics, 2016, the American Cancer Society's latest annual report on cancer incidence, mortality and survival. The report was published online Jan. 7 in CA: A Cancer Journal for Clinicians. The data was collected from the U.S. National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program and other sources. Over the past decade, the rate of cancer deaths has dropped by 1.8 percent a year in men and 1.4
"Immunotherapy is another tool which may turn out to have definite advantages over some of our more traditional chemotherapy regimens," Kohman said, "but it's not a magic bullet--that we can tell right now. "Cancer develops resistance to everything eventually. These newer drugs are much less toxic. But there hasn't been five-year follow-ups on these drugs." Kohman said that only about 5 percent of adult cancer patients are offered or participate in clinical trials, mostly because they're not aware of them, they don't qualify or their physicians do not mention them. Most insurance includes immunotherapy drugs when used for cancers for which it has been FDA-approved. "There might be a big co-pay but the pharmaceutical companies will work with the patient," Kirschner said. He foresees the cost lowering as generic drugs become available and Kohman researchers learn what types of cancers respond to them. "The way we get answers faster is we have more people participating in the trials," Kohman said. Wilmot Cancer Institute currently seeks clinical trial subjects, as does Kirshner's facility, Hematology Oncology Associates of CNY. "We have a trial now where we're testing the drug in earlier stage melanoma with positive lymph nodes, people who have had surgery," Kirshner said. "They have a high risk of reoccurrence." "These are very exciting times, but we have a long way to go," Kirshner said.
percent in women, according to the report. The decline in the past 20 years has been driven by the continuous drop in deaths for four major cancer types: breast, colon, lung and prostate, the report noted. For 2016, the ACS estimates that there will be about 1.6 million new cancer cases and nearly 600,000 deaths in the United States. Despite the progress, death rates for certain cancers are increasing, Siegel and her colleagues found. These include cancers of the liver, pancreas and uterus. Thyroid cancers are the most rapidly rising, increasing more than 5 percent yearly in both men and women, the research revealed. However, some of that increase stems from overdiagnosis due to advanced imaging techniques, the experts said. February 2016 •
.S. Vice President Joe Biden said recently that the United States would speed up the approval of promising new drug combinations in his government’s newly announced drive to cure cancer “once and for all.” So-called combination therapy is increasingly seen as central to fighting tumors, as scientists unlock the different genetic factors driving cancer cell growth, but bringing such cocktails to market can be a slow and costly. Biden said he had hosted a meeting at his home with three unnamed large drug companies and the head of the U.S. Food and Drug Administration (FDA) at which both sides had pledged to do more to get novel cancer drug cocktails to patients. “The head of the FDA made a commitment that everybody would move much more rapidly in approving combinations,” Biden said. At the same, the pharmaceutical industry executives had all said they were “open to different way of doing business” in order to ensure that promising drugs from different companies were tested together as early as possible, he added. Cancer experts are particularly excited by the promise of new immunotherapy medicines that help the body’s immune system fight tumors and which have been shown to work well when used alongside other drugs.
For Cancer Survivors, Expenses Keep Mounting
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cancer diagnosis is costly, and new research suggests that it remains costly even after the disease has been treated. "Cancer survivors are facing high costs even after years. The economic burden is substantial," said study author Zhiyuan Zheng, senior health services researcher at the American Cancer Society's Surveillance and Health Services Research program. For example, the study found that non-elderly survivors of colon cancer had extra expenses of about $20,000 annually. Those extra expenses included direct medical costs, as well as lost productivity. For survivors of breast cancer under 65, the economic burden totaled about $14,000, and for prostate cancer it was approximately $9,000, the research revealed. For elderly people, colon cancer survivors had extra costs of about $19,000 a year. Senior prostate cancer survivors faced about $17,000 in extra expenses, and older survivors of breast cancer had about $14,000 in extra medical costs and lost productivity, the study found. The findings are scheduled for publication in the May issue of the Journal of the National Cancer Institute
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SmartBites
The skinny on healthy eating
Irresistible News About Oysters Is there any truth to its libido-boosting powers? Oh, oysters. Nothing says “aphrodisiac” more than this pearl of the sea. With its luxurious texture and arousing reputation, no wonder consumption soars during Cupid’s favorite month. But is there any truth to its libido-boosting powers? According to the U.S. Food and Drug Administration: no; there is no such thing as an aphrodisiac. But current research tells a different story. According to a team of American and Italian scientists, oysters contain rare amino acids that may temporarily increase the production of hormones (testosterone in men; progesterone in women) that increase libido. While more research is clearly needed — the studies were done on rats, after all — the findings do show rousing promise. Provocative properties aside, there are oceans of other reasons why we should be consuming this luscious mollusk. To begin, oysters are an excellent source of lean protein that’s low in both calories and fat. Six medium oysters, for example, shell out between 6 to 8 grams of this essential nutrient at only 60 calories and
2 grams of fat. (Slurp a dozen and you’ve knocked off about a fourth of your daily protein needs.) We need protein because it has its hands in every critical function of the body, from tissue repair to energy production to immune function. Are you sitting down? Six little oysters deliver over 400 percent of our recommended daily allowance for zinc. Zinc, best known for its immune-boosting properties, also helps expedite wound healing and quell out-of-control inflammation. But it doesn’t end there. This little mineral may also play a role in testosterone production, further fanning the oyster’s amorous flame. Oysters are surprisingly rich in other nutrients, too — from bone-building vitamin D to energy-boosting iron and vitamin B12 to cell-protecting selenium. What’s more, oysters boast a decent amount of heart-healthy omega-3 fatty acids. Although Casanova, the Italian womanizer, was purported to eat 50 oysters a day, he clearly was not under the care of a good nutritionist! That many oysters could pose a potential health risk — if not for the
abundant zinc than for the excess cholesterol.
Helpful Tips
When buying fresh, look for oysters no more than five or six days out of the water (seafood markets must display the date when oysters are harvested). Shells should be closed (oysters with open shells are often dead) and the oysters should not smell fishy or rotten. Buy them either the day or the day before you plan to eat. To store oysters in the fridge, put them on a tray or plate with the round cup side of the oyster down and then cover them with a damp towel or cloth. Do not store oysters in a plastic bag, sealable container or tucked in ice.
Healthy Oyster Stew
Adapted from Cooking Light
1 bacon slice, finely chopped 3/4 cup chopped onion 1/2 cup finely diced celery 1/2 cup finely chopped green onions 3 tablespoons all-purpose flour 1/3 cup dry white wine 2 cups 1% low-fat milk 1/2 teaspoon dried thyme 3/4 teaspoon salt 1/2 teaspoon freshly ground black pepper 1/8 teaspoon Tabasco sauce (optional) 1 (16-ounce) container standard oysters, undrained 1 teaspoon dried parsley 2 teaspoons (or more) fresh lemon juice Cook bacon in a medium saucepan over medium-high heat until crisp. Remove bacon from pan, reserving one teaspoon drippings in
pan; set bacon aside. Add onion, celery, and green onions to drippings in pan; cook over medium heat seven minutes or until celery is tender, stirring frequently. Stir in flour; cook one minute, stirring constantly. Stir in wine, scraping pan to loosen browned bits. Stir in bacon, milk, thyme, salt, pepper and Tabasco sauce (if using); bring to a simmer. Cook two minutes or until slightly thick, stirring constantly with a whisk. Stir in oysters; cook four minutes or until edges of oysters curl (do not boil). Stir in parsley and lemon juice. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.
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Glaucoma. Many Don’t Know They Have it — Are You at Risk?
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pproximately 2.7 million Americans have the potentially blinding eye disease glaucoma, but only half are aware of it. Meanwhile, glaucoma incidence is
on the rise. Researchers predict that glaucoma will affect as many as 6.3 million Americas by 2050. The American Academy of Ophthalmology is sharing a list of risk factors that can lead to the disease. Family History: Individuals with a parent or sibling with glaucoma have a nine times higher risk of developing the disease, according to one study. Older Age: As people age, their risk for glaucoma increases. Because this is the case for several
eye diseases, the American Academy of Ophthalmology recommends that adults start getting regular comprehensive eye exams at age 40. This is the age when early signs of eye disease and changes in vision may first occur, even if you have seemingly perfect vision. It is important to get comprehensive eye exams from an ophthalmologist, a physician specializing in medical and surgical eye care. African, Hispanic or Asian Heritage: People of African and Hispanic heritage are three times more likely to have the most common form of glaucoma than Caucasians. Glaucoma-related blindness is at least six times more prevalent in African Americans than in Caucasian Americans. Additionally, people of Asian heritage are at an increased risk of a sudden and acute form of glaucoma February 2016 •
known as angle-closure glaucoma. Nearsightedness: People who are nearsighted are more likely to have glaucoma. One study even found that the more severe the nearsightedness, the higher the risk of glaucoma. Type 2 Diabetes: Having Type 2 diabetes increases risk of glaucoma. The longer a person has lived with diabetes, the greater their risk for glaucoma becomes. Additionally, when the cornea — the clear, round dome on the front of the eye that covers the iris and pupil — is abnormally thin, IOP readings may be falsely low. This puts patients at increased risk for undiagnosed glaucoma. This is common among those who have had refractive surgery, such as LASIK or photorefractive keratectomy. Another risk factor associated with glaucoma is a history of eye trauma.
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Parenting By Melissa Stefanec
The Name Game Can we, as mature adults, just leave people alone in regards to what they name their children?
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hat’s in a name? Apparently, a whole lot. There are lots of topics that stir up a debate in a parent’s life, but lately, I’ve been hearing a lot about names. Names are an important thing. There are a lot of people out there who think names play a critical role in development, serve as a guide for one’s identity and offer a means for other people to make snap judgments. And that’s just first names. Last names are tied to lineage, heritage, pride and family identity. When you name a child, you often face some level of adversity. Unless you named your child after a Christian saint, you’ve probably taken a few jabs when it came to picking out names for your child. Why is this? Why do we care what other people name their children? To me, that’s like caring about where another family goes on vacation or shops for groceries. Unless someone is naming their kid a bad word or after something awful, why does anyone care what’s in a name? As a parent, I’ve fought my own name battles. Some of them have been from strangers, some with acquaintances and some with family members. Here are some of the obstacles I’ve encountered regarding the naming of my children: Page 14
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I kept my own last name when I married. My children do not have my last name. Instead, they have my last name as their middle name and my husband’s last name as their last name. I think it’s cute they share middle names. I think it provides an unusual path to family unity. Unfortunately, many members of the general populace don’t feel that way. Before my children were even a twinkle in my eye, I was fielding questions and insults about keeping my last name. People were worried about my unborn (and unconceived) children being labeled as being born out of wedlock or children of a divorce. People actually wondered aloud how people would know they were mine if they didn’t share my last name. People wanted to know how I could be selfish enough to do this to my children. My children have (mildly) unconventional names. My daughter’s name is Stella, and my son’s name is River. When I tell some people this, you would think I told them my children’s names were Glovebox and Banana Peel. One of my children has a gender-neutral name. River is about a 60/40 split when it comes to male/female ratios. Some people aren’t down with gender-neutral names, especially if those
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016
names are uncommon. So, what’s my point in all of this? The real intent of this column is to drive home an important point. Can we, as mature adults, just leave people alone in regards to what they name their children? I hear too many sarcastic comments about other people’s names. Here is a list of things we should stop caring about when it comes to other’s people’s names: • Poking fun at “ethnic” sounding names — My guess is Melissa sounds pretty silly to people in remote regions of the Amazon. We need to stop making fun of names from other cultures or calling their validity into question. Doing so is just plain ignorant. • Worrying about kids’ last names and their parents’ last names — There are all sorts of family dynamics out there. Some people have unmarried parents. Some are adopted or have parents who are divorced. Some people are cared for by people other than their biological parents. Some kids have feminists for mommies and daddies. We need to stop classifying people based on something as trivial as a last name. • Telling people you don’t like their kid’s name — What can possible be gained from this? If you don’t have something nice to say, then keep your yap shut and respond with something trite. The same rule goes for facial contortions in reaction to hearing a name. We are all adults here; let’s conduct ourselves as such. • Telling someone his or her child’s name reminds you of someone/something derogatory — Why do people divulge this information? If you really hate the name Ashley because your mortal enemy in high school was named Ashley, why is this relevant to a different Ashley’s mom or dad? If the name Chuck makes
you think of up-chuck, can’t you keep that savory tidbit to yourself? • How people spell their kid’s name — Some people want to be a little different. Also, depending on what language a name is derived from, a name could be spelled unconventionally. Who cares if that kid has to spell his or her name out to everyone in the future? Who cares if that kid’s name is constantly mispronounced? People mispronounce my last name about 80 percent of the time, and I always have to spell it. This didn’t draw me to a life of crime. • Judging people on what they name their children — Of all the things you can judge a person on, should what that person names her or his child be one of them? If you are into the whole judging business, there are lots of other things to get condescending about. The takeaway. I think most parents want some pretty elementary things for their children. They want things like comfort, health, happiness and success. Another thing most of them probably want is a kinder and gentler world for their children. Next time you want to say something critical about a child’s name, think about the impact that has in his or her world. Is one snarky remark worth making that dent?
Why Concierge Medicine is Here to Stay Joseph T. Barry, MD
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oncierge medicine is here to stay! Concierge or personalized care medicine, as it’s more commonly referred to, is a growing style of medical practice where the patient pays extra or a separate direct fee to the physician. This extra fee ensures 24/7 access to the doctor via phone or email, same day or next day office calls and shorter waiting times, often in an upscale environment. There are multiple different payment models. Some physicians add a charge to their regular insurance dealings, while others completely forsake the insurance route and bill the patient directly for services. The unifying theme is better access equals better relationship with your healthcare provider equals hopefully better health care or at least better patient satisfaction with the experience. The early data suggests that personalized care medicine can cut down on hospitalizations and should be welcomed by patients and insurance companies alike. In the traditional medical model, a patient picks a health insurance plan based on costs and what’s provided for that premium, and then picks a provider. The choices have stopped there. Now you can choose to pay more and get a more satisfying experience. It’s analogous to air travel. You could travel in coach or you could elect to travel first class. Concierge medicine is that first class experience. Why would anyone choose to
pay more? To get more attention and more time with the doctor. n Patients typically complain that it takes too long to get in to see their provider and that they see a different provider each time. n Patients often complain about the long wait in the waiting or exam room. n Patients are dissatisfied with a provider encounter where the doctor or nurse practitioner spends more time looking at the computer screen than examining the patient. n Patients are dissatisfied with the shortness of the visit. All these problems go away with personalized care medicine because the physician has limited his practice so that he is available and you have the time needed to not only work on your current illness but to focus on the long run and your wellness issues as well. Good health is about getting past the particular illness that brought you to the doctor’s office and moving toward a more holistic approach to your health that focuses on the lifestyle issues that directly impact your health. Why would physicians choose to adopt this model of care? Charging more per patient but seeing fewer patients and spending more time with them and on them makes it often a wash financially — so why do it? In a word, satisfaction. The opportunity to feel like you can make a difference in patients’ lives again
by giving the patient more attention. Today's physicians find themselves in a world of increasing government regulation, increasing patient loads, decreasing reimbursement, increasing hassles of prior authorization and coverage, increasing expenses overall, higher taxes etc. More and more physicians are either leaving the practice of medicine or joining a big group or hospital in hopes of being able to focus on care and not on the business of medicine. Concierge medicine allows physicians to have the time to spend with patients to really understand their problems and concerns and focus again on wellness, not just illness. Because the doctor is not trying to see a patient every 10-15 minutes,
they have the opportunity to better focus on the issues of the patient. There is still a tremendous amount of paperwork and charting to do, but with a smaller patient load these hassles are more tolerable. There is going to be an increasing shortage of primary care doctors in the coming years, and given the ever-worsening work environment for physicians, you are likely to see more and more doctors considering this option. Currently, only 1 percent to 4 percent of physicians are adopting this model but the number will grow larger over time. Many pundits think the future of medicine in the U.S. is a two-tiered system with most people getting their care in hospital-owned clinics where you see a different “provider” each time, usually not a physician, and some people, those who can afford more or those who put a priority on their health care, going to a concierge practice. So concierge medicine is here to stay and is coming to a neighborhood near you. Physician Joseph T. Barry earned his medical degree at SUNY Downstate Medical Center College of Medicine in 1984 and did his internal medicine residency at St. Elizabeth's Hospital in Boston. In 1987 he joined his father’s practice in Syracuse. He admits to Community General Hospital and sees patients also in Van Duyn Home and Hospital as well as the Iroquois Nursing Home where he is medical director. He also works at Preventive Medicine Associates, PLLC. in Camillus. He can be reached at torbarry@aol.com.
No Home Phone is Needed to Get Help at a Moment Like This
Protect the ones you love February 2016 •
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Stress Possibly Linked with Alzheimer's Disease By Deborah Jeanne Sergeant
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eed another reason to destress? Experts identify increased stress levels as a risk factor that could lead to Alzheimer's disease. Cathy James, CEO of the CNY chapter of the Alzheimer's Association and co-chairwoman of the New York State Alzheimer's Association Coalition, said that research has not yet established a direct causal relationship between chronic stress and the condition. James "We've known that prolonged, chronic stress has impact on our bodies," James said. "It elevates heart rate, blood
pressure, and is linked to depression. Because there's a strong heart and brain connection, scientists are focusing on the possible causal relationship on stress and Alzheimer's disease." When a person undergoes stress, the body releases "stress hormones" that kick in the "fight or flight" response. While this may prove useful in a physical confrontation, it's not helpful for the type of stress most people experience. Instead, it can elevate blood pressure, damage blood vessels, and affect the ability to accurately remember data. The latter effect represents one reason why researchers believe uncontrolled stress could influence the development Alzheimer's disease. The subject has proven difficult to research because of the subjective nature of stress. Not everyone experiences stress the same way. "The perception of how much stress I may be under is of interest to scientists as well," James said. Indirect factors may play a role.
Q&A
With Former Upstate CEO Dr. Gregory Eastwood
He had the distinction to lead Upstate Medical University twice, first as president — from 1993 to 2006 — then as interim president from 2013 to January 2016. He recently sat down with writer Matthew Liptak. Q. What are your future plans? A. I’m going back to being a professor. I will move back to my old office in the Center for Bioethics and Humanities where I was before. At least over the next six months I’ll be on an official sabbatical, what they call ‘post-presidential leave,’ but I will be doing some things in the Center for Bioethics and Humanities. I’ll be trying to write a book and I will be doing some other things for the university. The title of the book is “Dying Isn’t What It Used To Be.” Of course death is always the same, but the process of dying has changed over the last several generations, at least in this country. I’d like to examine that a little bit more. I have some other ideas I think I’ll include in the book, too, about the ethical and practical implications of if we don’t die—if we can somehow unlock the mystery of why cells and organisms die. I think we probably will — “we” meaning medical science. We’ll probably figure that out and we’ll probably increase the potential lifespan of humans beyond what it is now.” Q. What was the biggest challenge of your second tenure? A. When I first got back to this Page 16
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For example, people experiencing stress may not sleep well, suffer from depression or engage in unhealthful methods of attempting to cope with the stress that could in part or all together raise their risk for Alzheimer's disease. James said that people in the early stages of Alzheimer's disease experience disrupted sleep, but it's not certain whether the sleep disturbance causes the disease or the disease causes the sleep disturbance. "Stress, anxiety and depression go along with each other, and they seem to increase the risk of Alzheimer's disease," said geriatrician Sharon Brangman at SUNY Upstate. "With some medication used to treat stress and anxiety, long-term use may also increase risk of getting a dementia. It's an evolving science as we start to look at what makes our brains healthy. I call the brain the final frontier. We know a lot about other organs, but the brain's not fully explored yet." Many methods can help you deal
office two years ago there seemed to be a lot of morale issues throughout the institution. It was after a time when our medical school had been put on probation. In some ways that may have been a blessing in disguise because (our) control of the curriculum was the focus of the probation. That’s been corrected. The curriculum itself which was not the focus of the probation, but...it’s been an opportunity for the medical school to improve things. “But anyway, people were feeling a little discouraged I think about Upstate. I think what I intended to do and people have told me that I did was to provide some stability in the leadership. To the extent that I was able to do that I’m proud of doing that.”
Q. What do you see when you look back at your tenures as president? A. This time I’ve been in it for a little more than two years. The first time I was in it for approaching 14 years. It was 1993 to 2006. I see a number of things. Certainly on this campus we’ve built new buildings. We’ve started
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016
new programs. We’ve expanded. Our operating budget when I got here in 1993 was something like $300 million a year. Now it’s more than four times that. It’s about $1.3 billion or $1.4 billion to operate everything that is under the roof of Upstate Medical University. I look at several things. I look at the Children’s Hospital that others certainly raised money for. I helped with that. I helped actually with the interaction with Mr. Golisano. I’m very proud of that, but that really was very much a team effort. “Team,” including thousands of people in this community. Q. $1.3 billion — How do you handle that much money? A. Well, it’s daunting. I have to say I have some very good people who give some very good advice. It’s a con-
with stress, such as avoiding situations that generate stress. For example, instead of procrastinating, plan and complete tasks ahead of time. Or instead of accepting invitations from difficult people, politely decline. If you take on too many responsibilities, delegate Brangman to others. It's impossible to eliminate all stress. But part of coping is knowing what you can and can't avoid, and gracefully managing the stress you must carry. "For those stressors you can't eliminate, develop healthy coping mechanisms," Brangman said. "Talk therapy or support group can help." As routine stress management, plan to decompress in ways that you enjoy, such as hobbies, reading or spending time with family. "Identify what your stress relievers are," Brangman said. "Everyone is different. Do activities that help counteract stress, like exercise. That's one of the best things to do every day to keep stress under control."
stant energy-requiring process to conserve resources and to get new resources. We are a state-associated entity, but somewhere about 7 or 8 percent of that $1.3 billion...about $90-plus million, comes from the state. The rest comes from some other source. It’s from research, tuition — most of it comes from patient-generated revenues.
Q. What are your hopes for Upstate? A. There are several things. One is that it can continue to grow. You know our mission statement says that our purpose, our mission, is to serve the community. That means the local community. It means the regional community. It means the state and to the extent that we can do research and educate people that are relevant to the community of the world then we do that. My hope is that we can expand that and be more effective in those areas. I also hope, and I express this to new employees when I greet them every several weeks, that we can become a place where people can come to work and nurture their own careers and feel that they are contributing in some important way to the welfare of people. What I tell people who are new employees is something like this: ‘It’s great to have a job that pays you money that allows you to live the life that you want to live and pays your bills, but it also is wonderful to be in an organization, a place like Upstate Medical University that is committed to the improvement of the welfare of others.’ That purpose is really laudable. To be part of that commitment I think is special. I hope that we can continue and we will continue to have that opportunity for people in their careers.
Golden Years Beyond Genes
Americans are living longer and in generally better health, but with more medically managed conditions, says SU professor By Deborah Jeanne Sergeant
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veryone wants to live to old age, so long as they're healthy. But the Administration on Aging, part of the US Department of Health, states on its website that most older people have at least one chronic health condition and many have multiple conditions." According to the organization, from 2011 to 2013, the most common conditions among older people were: • arthritis (49 percent) • all types of heart disease (31 percent) • any cancer (25 percent) • diabetes (21 percent in 20092012) • hypertension (71 percent in 2009-2012). Marty Pond, registered nurse in gerontology at St. Joseph’s Hospital Health Center, said that more older people are paying better attention to their health, including exercising, watching their nutrition, and becoming more active in monitoring their own health. "More seniors are also seeking out new information to assist them to live longer," Ponds said. "This is evident by the huge crowd of seniors that attend Senator. DeFranciso’s senior fair every year." While these efforts certainly help, their awareness and interest would have better served them earlier in life since so many deal with chronic health conditions in their senior years. Janet Wilmoth, Ph.D and head of the sociology department, part of the Maxwell School of Citizenship and Public Affairs at Syracuse University, believes that Americans are living longer, and in generally better health, but with more medically managed conditions. "As a society, the potential impact obesity has on the aging population, particularly among boomers and younger populations, is associated with a number of negative health outcomes," Wilmoth said. "The prospects for us to live better lives is diminished by that population trend." Although genes play a role in aging, lifestyle choices — begun when young — represent the larger reason behind why people aren't as healthy as they could be. "The American College of Sports Medicine recommends cardiovascular fitness, strength training, flexibility and balance training to prevent risk of falls," Wilmoth said. "Leading an active lifestyle in your 20s and 30s can keep Alzheimer's, heart disease, and diabetes at bay. Being active younger can help prevent these later on." Kevin S. Heffernan, exercise
scientist with Syracuse University, studies the aging process. He encourages younger people to find an active leisure activity they enjoy. "You'll still derive a lot of health benefits, instead of a structured aerobics class three times a week in a gym," he said. "I think we're still way off on meeting the American Heart Association's recommendation of 150 minutes a week of physical activity." Especially if you work a sedentary job, try to work more movement into your day such as walking or biking to work, taking the stairs, walking in place or lifting light weights while on hold, walking during your lunch break, and getting active after work. It's also important to retain flexibility, balance and strength. Activities such as yoga, Pilates, strength training and martial arts can help. You can also incorporate socializing into your fitness activity. Numerous studies indicate that staying connected to others helps people age better. Eating right influences aging in incalculable ways. J. Elizabeth Smythe, registered dietitian, nutritionist in private practice and director of community engagement for the American Diabetes Association Upstate region, agrees that "you are what you eat." Many chronic conditions and diseases involve inflammation response, which begins at the cellular level. To combat this effect, Smythe advises clients to "eat a more colorful plate, and more plant-based foods." "Obesity causes more inflammation and more rapid aging," she said. "Calorie deficits may slow down the aging process." Laurel Sterling, integrative dietitian and wellness educator at Natur-Tyme in Syracuse, said that certain foods "contribute to unhealthy aging." She listed fast foods, those containing transfats, sugar, acidic foods, and genetically modified crops like wheat, corn, and soy. "Reduce intake of meat, especially red meat; dairy, alcohol, refined foods, like white pasta and breads crackers, cookies; artificial sweeteners, and sugary foods," Sterling said.
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Community Information Seminar:
Bariatric Surgery February 9, 2016 • 6:00 pm Presented by
Gregory Dalencourt, MD Medical Office Center St. Joseph’s Hospital Campus 104 Union Ave. • Suite 809 • Syracuse, NY
To register call 315-477-4740 or toll free 877-269-0355 Parking will be validated
February 2016 •
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The Social Ask Security Office By Deborah Banikowski
Preventing Debilitating Diseases Among Women
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ust about every minute, a woman dies of heart disease. But the majority of these deaths are avoidable. That’s why Social Security encourages you to participate in National Wear Red Day on Feb. 5, which aims to raise awareness about preventing heart disease and stroke among women. Social Security plays an important role in many women’s lives — nearly 60 percent of people receiving Social Security benefits are women. Social Security provides important financial assistance to women in times of need, including a sudden illness or an injury leading to disability. While many illnesses and injuries are difficult or impossible to prevent, there are steps that women can take to help prevent some health issues, so that they can live longer and healthier lives. According to the American Heart Association, “heart dis-
ease is the No. 1 killer of women, causing one in three deaths each year.” But the American Heart Association reports that this is 80 percent preventable with education and lifestyle changes. Changes in diet and exercise can help prevent these events, along with obtaining preventive healthcare such as cholesterol checks. You can take part in raising awareness about this women’s health issue by wearing red on Feb. 5 to show your support. You can also learn more about heart disease and stroke prevention by visiting www.goredforwomen.org. Raising awareness about women’s health issues is important to improving quality of life for all women. Social Security is also committed to addressing the unique concerns that women may face in obtaining Social Security benefits, whether they’re seeking benefits for health or other reasons. Women may face different
situations than men throughout their lives that can affect their need for benefits. For instance, women are more likely than men to outlive their spouse. Working women earn less on average than men do. Women are more likely to be stay-at-home parents or spouses. All of these circumstances can cause women to have different Social Security needs than men have. In order to address these concerns in one place, we have a website designed for women that provides pertinent information to women regarding Social Security’s services. This website includes information that may be particularly useful to working women, women who receive
Social Security benefits, brides, new mothers, wives, divorced women, caregivers and widows. Our website for women provides information on retirement, survivors, disability, and Supplemental Security Income benefits. Our website also contains links to Social Security publications relevant to women’s issues, such as our publications “What Every Woman Should Know and Understanding the Benefits.” You can visit our website for women at www.socialsecurity.gov/people/women. We hope that raising awareness on women’s health issues and providing women easy access to information about Social Security benefits can enrich your life and the lives of those you love.
Q: I was told I shouldn’t be carrying my Social Security card around. Is that true? A: We encourage you to keep your Social Security card at home in a safe place. Don’t carry it with you Even if you’re going to new job or to meet someone who needs it, all they really need is your number —not your card. Identity theft is one of the fastest growing crimes in America, and the best way to avoid becoming a victim is to safeguard your card and number. To learn more, visit our Social Security number and card page at www.socialsecurity.gov/ ssnumber.
benefits. Will our combined benefits be reduced because we are married? A: No. When each member of a married couple works in employment covered under Social Security and both meet all other eligibility requirements to receive retirement benefits, lifetime earnings are calculated independently to determine the benefit amounts. Therefore, each spouse receives a monthly benefit amount based on his or her own earnings. If one member of the couple earned substantially less than the other or did not earn enough Social Security credits (40) to be insured for retirement benefits, he or she may be eligible to receive benefits as a spouse. To learn more, visit www. socialsecurity.gov/retirement.
Q&A
Q: My husband and I are both entitled to our own Social Security
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016
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By Jim Miller
How to Find Discounts for People with Disabilities Dear Savvy Senior,
Are there any worthwhile discounts available to people with disabilities, and if so, how can I find them? My wife — who’s 48 — has multiple Sclerosis that now requires her to use a wheelchair. Need to Save Dear Need, There are actually a wide variety of discounts and services available to people with disabilities and those living with a chronic illness that can literally save you hundreds and even thousands of dollars each year. Here are some tips to help you find them. Always Ask
The first thing to know is that most businesses that offer discounts to people with disabilities or their escorts don’t publicize them, so it’s important to always ask. Also note that most nonprofit organizations and government agencies that provide disabled services or benefits will require proof of disability through a letter from your doctor or some other form of verification before they will accommodate you.
Search Locally
The disabled discounts available to your wife will vary depending on where you live, so a good place to start is to contact the local chapter of the nonprofit organization that specializes in your particular disease or disability — in your wife’s case that would be the National Multiple Sclerosis Society (nationalmssociety. org, 800-344-4867). Local chapters often know where to find discounts on the medical supplies, mobility equipment and support services. Some organizations have even negotiated special discounted rates with suppliers, and a few even provide subsidized equipment directly. To search for other disability or disease specific organizations, use any Internet search engine, any type in your disease or disability followed by organizations — for example “Arthritis Organizations” or “Hearing Loss Organizations.”
Search Online
DisabledDiscounts.com is one of the best resources for finding disabled discounts online. This is a free website that lists thousands of discounts in all 50 states. You search by state and county in 30 different categories ranging from assistive technology to federal and state tax discounts, entertainment to educa-
tion and so much more. Also visit Benefits.gov and BenefitsCheckUp.org, two great sites that will help you look for financial assistance programs your wife and you may be eligible for, and will tell you how to apply. And see Disability. gov, a site that connects people with disabilities to helpful programs and services in your area.
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Types of Discounts
Here are a few examples of the different types of disabled discounts and services that are out there. • Recreation: Most movie theaters, museums, zoos, theme parks and aquariums provide reduced admission to people with disabilities or their escort. And, the National Park Service offers the “America The Beautiful Access Pass” (see nps.gov/ findapark/passes.htm) to disabled residents, which provides a lifetime of free access into all national parks and federal recreational lands. • Taxes: There are numerous federal tax deductions and credits available to people with disabilities, and a number of states and counties also offer property tax deductions to disabled homeowners. • Utilities: Many utility companies, including electric, gas, phone, water and trash services offer discounts to customers who are disabled, elderly or low income. • Communication devices: Forty seven states have equipment distribution programs (see tedpa.org) that offer free amplified telephones to residents with hearing impairment. • Home modifications: There are a number of federal, state, local and nonprofit organizations that help pay for home accessibility improvements like wheelchair ramps, handrails and grab bars for elderly and disabled people in need. • Travel: Amtrak offers a 15 percent rail fare discount to adult passengers with a disability and up to one traveling companion. • Reading services: For those with vision or physical impairments that make it difficult for them to read, the Library of Congress (see loc.gov/ nls) offers a “Talking Books” program that provides free audiobooks, magazines and audio equipment. And the National Federation of the Blind offers a free newspaper and magazine reading service at nfbnewslineonline.org. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. February 2016 •
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H ealth News Crouse appoints Betty O’Connor as chief nursing officer Crouse Hospital has named Betty O’Connor its chief nursing officer. In her new role, O’Connor will provide strategic direction and operational leadership for the hospital’s nursing division, which includes more than 900 registered nurses. O’Conner “Betty O’Connor is an engaged and mission-focused leader who is highly regarded for her leadership and passion for the role of nursing in today’s healthcare environment,” says Crouse CEO Kimberly Boynton. O’Connor is a member of the Crouse Hospital Auxiliary Board and co-chairwoman of the Crouse Hospital United Way Campaign. With Crouse since 1979, O'Connor most recently served as vice president of nursing operations. She is a graduate of Crouse Irving Memorial Hospital School of Nursing and received her bachelor's degree in nursing from SUNY Utica Rome. She earned the healthcare leadership certificate from the Madden School of Business at Le Moyne College, where she is also pursuing her master’s degree in nursing. O’Connor is a member of the American College of Healthcare Executives and the American Organization of Nurse Executives.
Nanavati to receive ANITA Award from hospice Hospice of Central New York has named physician Digant Nanavati as the 2015 ANITA Award recipient. Nanavati specializes in family medicine and works at FamilyCare Medical Group in Syracuse. The award will be presented Nanavati at hospice’s community awards breakfast at 8:30 a.m., Feb. 5, at Hospice of Central New York in Liverpool. According to the hospice, local physicians have a high regard for the ANITA Award as it comes directly from their patients and patient’s families. “Dr. Nanavati gives his end-oflife patients access to him 24 hours a day,” said Rita Wood of Syracuse who nominated Nanavati. “He Page 20
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makes their final journey as comfortable as he can for them, making sure all their needs are met." Some of the previous awardees include physicians Joseph Navone, Michael Glowacki, Jacqueline Bays, Anthony Scalzo, Jesse Williams and Joel Potash.
Hospitalist Udekwu joins Oswego Health Oswego Hospital has recently welcomed physician Adaora Udekwu to its active medical staff and to the hospitalist team. As a hospitalist, Udekwu will care for inpatients at Oswego Hospital, whose primary care physicians have opted to take advantage of the healthcare facility’s hospitalist program. Udekwu recently completed Udekwu her family medicine residency at the University of Arkansas Medical Sciences, in Fayetteville, Ark. She earned her medical degree from Sint Eustatius School of Medicine, located in Antilles. Udekwu originally began her healthcare career as a registered nurse. Before earning her medical degree, she obtained her Bachelor of Science in Nursing from Salisbury University in Maryland. She worked as a nurse after earning her BSN degree and while she completed her medical training. Udekwu and her husband, a neurosurgeon, have three children. In her spare time, she enjoys writing poetry, listening to music and dancing, along with reading and traveling.
RMS Healthcare welcomes new research associate Research & Marketing Strategies, Inc. (RMS), a healthcare consulting firm based in Baldwinsville, announced that Samadhi Moreno has joined the RMS Healthcare team as healthcare research associate. Moreno previously worked with SUNY Upstate Medical University as a health administration intern, responsible for Moreno developing strategic hospital and hospice plans in Central New York. Moreno also has prior experience as a research associate at Boston Medical Center as well as interning at the National Institute of Health grant-supported. Syracuse Lead Study. In her new role,
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016
The Crouse medical imaging team, pictured here front (left to right): Patrick Hoffstead, CT technologist; physician Stuart Groskin; Kathryn Lumpkin, medical imaging supervisor; Lois Wille, CT technologist; Hollie Zimmerman, radiation safety and compliance coordinator, and Michael Ryan, CT technologist and back (left to right): Richard Schneider, CT technologist; Matthew Madonia, CT technologist; Stan Bogwicz, CT technologist; Brad Hellwig, director of medical imaging; Gregory Caplan, quality improvement analyst and Steve Dlugolecki, CT technologist.
American College Of Radiology Designates Crouse Hospital As a Lung Cancer Screening Center
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he American College of Radiology (ACR), recognized as the gold standard in medical imaging, has designated Crouse Hospital as a lung cancer screening center. “This designation affirms our commitment to providing most advanced diagnostic and therapeutic services available in the region,” says Brad Hellwig, director of medical imaging at Crouse. In early 2015, Crouse launched its lung cancer screening program to provide low-dose lung CT screening for current and former smokers at high risk for developing the disease. Finding lung cancer early, when it
is most treatable, is the goal of this screening. Those wishing to receive a lung screening should consult first with a primary care physician, who will make the referral if appropriate. More information is available at crouse.org/ lungscreen. Lung cancer is the second leading type of cancer and represents 13 percent of all new cancer cases in the United States, according to the American Cancer Society. Approximately 400,000 patients in the United States have lung cancer. The goal of the ACR is to help facilities manage the lung cancer patient more efficiently.
Moreno is responsible for auditing, analyzing and entering information for all aspects involved within the CAHPS (Consumer Assessment of Healthcare Providers Survey) reporting process. Moreno graduated from Syracuse University with a bachelor’s degree in public health, and received her master's degree in healthcare policy and management at Boston University. She resides in Syracuse.
services and academic student development. Pudney brings more than 13 years of higher education experience to this position, including student services. Most recently he served as the vice president of enrollment management at SUNY Onondaga Community College. Pudney’s experience also includes director of student services at Bryant & Stratton College, as well as dean of student services Pudney
New associate dean at St. Joe’s nursing school Terry Pudney has been appointed associate dean of students at St. Joseph’s College of Nursing. In his new role, Pudney is responsible for managing all student services at the college, including admissions, financial aid, disability
H ealth News Oswego Hospital Laboratory Earns Joint Commission Accreditation
The Oswego Hospital laboratory was recently accredited by the Joint Commission following a thorough survey earlier this fall. Pictured are members of the lab staff. Oswego Hospital has earned the Joint Commission’s Gold Seal of Approval for laboratory services accreditation by demonstrating continuous compliance with its performance standards. The Gold Seal of Approval is a symbol of quality that reflects an organization’s commitment to providing safe and effective patient care. The hospital’s laboratory underwent a rigorous, unannounced onsite three-day survey this fall. During the review, a Joint Commission expert surveyor evaluated compliance with laboratory standards related to several areas, including document and process control, healthcare-associated conditions, risk reduction, and staff qualifications and competency. The surveyor also conducted on-site
observations and interviews. During 2014, hospital lab staff members conducted more than 640,000 lab tests, with another 148,000 tests done at the Central Square and Fulton Medical Centers. More than 80 individuals work at the hospital laboratory, which consists of numerous sub-departments, including the hematology department where tests on a patient’s blood or blood forming-organs are conducted; a microbiology department where staff study organs and tissues; a chemistry department which examines blood, urine and other fluids and a pathology department where staff examine organizes and tissues to learn of potential diseases.
at Bryant & Stratton’s Syracuse North Campus. Pudney earned a Bachelor of Arts degree in psychology and a minor in industrial relations and human resource management from Le Moyne College, a Master of Science in education degree in adult education from Elmira College, as well as advanced certificates in human resources development and training of trainers.
laude in 2012. This past May, she earned her degree as a family nurse practitioner, also from Upstate Medical University. While studying for her latest degree, she also worked as a registered nurse at St. Joseph’s Hospital. Primecare’s other Hansberger providers include physicians Heather Finger, Vandana Patil, Timothy Tramontana, and Kamal Gautam, and physician assistant Claudia Krider.
Nurse practitioner joins practice in Central Square Family Nurse Practitioner Cassandra Hunsberger has joined the staff of Primecare Medical Practice, located in the lower level of the Central Square Medical Center. Hunsberger will provide comprehensive primary care services to patients of all ages. She will treat upper respiratory issues, sick visits, injuries, infections, rashes and sprains or strains, as well as routine screenings and the related follow-up care and women’s health services. Hunsberger has steadily advanced her nursing education, first with earning an Associate of Science nursing degree from Broome Community College and then obtaining a Bachelor of Science in nursing from SUNY Upstate Medical University, where she graduated magna cum
Upstate announces promotions, new staff, honors The following appointments and honors were announced by Upstate Medical University: • Susan Furtney has been named associate administrator for ambulatory services. Furtney most recently served as the executive director of
community engagement and primary care administration for St. Joseph’s Hospital Health Center and has held leadership positions at Syracuse University, Care Ring, Goodwill Industries of the Southern Piedmont, Lash Group, Carolinas Healthcare System and Humana. She has a master’s degree in public health, health policy and management from Emory University. • Palma Cassano has been named business manager for perioperative services and Family Birth Center at Upstate’s Community Campus. Cassano holds a bachelor’s degree in accounting and an MBA from Le Moyne College. Prior to joining Upstate, she held positions at Syracuse University. • Sara Fisher has been named pediatric trauma program coordinator. An Upstate employee since 2003, Fisher has extensive experience in pediatrics and high degree of organization and project management skills. She received her bachelor’s degree in nursing from Syracuse University in 2003 and her master’s degree in nursing from Upstate in 2009. • Simone Seward has been named director of the Center for Civic Engagement in the department of public health and preventive medicine. The CCE is involved in coordinating both local and global volunteer, service learning, and interprofessional community based opportunities for students in all colleges. It is also involved in strategic planning for increasing university inter-professional education. • Stacey Todd has joined the campus environmental service department as operations manager. Todd previously worked for 10 years with The Hertz Corporation. She received a bachelor’s degree in economics from the University at Buffalo. • Physician Robert Swan has been named assistant professor of ophthalmology, with clinical specialty in pediatric and adult uveitis/ ocular inflammatory disease. He also serves as the quality officer for the department of ophthalmology. Prior to joining Upstate, Swan was an attending ophthalmologist at Mary Imogene Bassett Hospital in Cooperstown. His research interests include ocular inflammatory disease and other causes of preventable blindness, and access to care issues in ocular inflammatory disease. He is the author of several articles and book chapters related to his medical specialty. He is a Swan member of the American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Uveitis Society and Foster Ocular Immunology Society. He received his medical degree from Upstate Medical UniverFebruary 2016 •
sity in 2008. • Phsycian Muhammad Osman Arif has been named assistant professor of medicine, with clinical specialty in general gastroenterology and hepatology and biliary and pancreatic diseases. His research interests include the study of post polypectomy bleeding in patients on clopidogrel, an oral medication used to inhibit blood clots in heart disease and stroke patients; and the psychological characteristics of patients with persistent symptoms of non-erosive esophageal reflux disease. He is the author of articles and published abstracts related to his medical specialty. He received his bachelor of medicine, bachelor of surgery (MBBS) degree from Aga Khan University, Karachi, Pakistan (2008). His post-graduate education includes a clinical research assistantship with the Cardiac Imaging Research Group at Massachusetts General Hospital, Boston (2009). He completed a residency in internal medicine (2012) and a fellowship in gastroenterology (2015) at Upstate Medical University.
Honors and Awards • Physician Leonard B. Weiner was honored with the Section on Infectious Diseases Award for Lifetime Contribution In Infectious Diseases Education by the American Academy of Pediatrics. The award is given annually to an Academy member who has made outstanding contributions to education in infectious diseases. The candidate’s contribution is indicative of a substantial long-term dedication to the highest ideals of education. Weiner is professor of pediatrics and pathology, vice chairman for academic Weiner affairs in the department of pediatrics and pediatric infectious disease & immunology division director at Upstate Golisano Children’s Hospital. • Roger P. Greenberg, PhD, distinguished professor in Upstate’s department of psychiatry and behavioral sciences has been selected to receive the 2016 American Psychological Association Career Award for distinguished contributions to education and training in psychology. The award will be formally presented at the association’s national convention in Denver in the summer. The award recognizes Greenberg’s impressive and multifaceted impact on the training and practice of psychologists. The APA, which was founded in 1892, has about 123,000 members and is the leading scientific and professional organization representing psychology in the United States. • Joyce Mackessy, associate administrator for Upstate University
continued on the next page
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Health in good
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Part time and Per Diem supervisor positions available for NYS licensed RN in a 200 bed skilled nursing facility. RN with prior long term care experience preferred. Good assessment, problem solving skills and ability to effectively communicate with residents and staff required. Enhanced Pay Rates and Competitive Benefits Packages.
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Please apply in writing to: Director of Nursing St. Luke Health Services 299 E. River Road Oswego, NY 13126
Or apply on-line at: www.michaudhs.com Equal Opportunity Employer
Or apply on-line at: www.stlukehs.com Equal Opportunity Employer
Also available for PCA’s and CNA’s to transfer for Home Health Aide. Students who have successfully completed the training program will fill a variety of positions with St Luke Home Health Services. Sign-On Bonus Available.
Please apply on-line at: w w w.stlukehs.com Or via mail at: Director Health Ser vices c/o St Francis Commons 12 Burkle Street Oswego, NY 13126
No Phone Calls Please Equal Opportunity Employer
Health News Hospital, received the first annual Spirit of Nancy Calhoun Award from Upstate’s Clinical Pastoral Education (CPE) Professional Advisory Council of the department of spiritual care. The award is given to individuals who support Upstate’s CPE program and share the enthusiasm exhibited by the council’s first chairwoman, Nancy Calhoun. • Carl A. Thomas Jr., of facility design services, received the inaugural Mover & Shaker Award from Catholic Charities in recognition of his volunteer service and community involvement. He received his award Oct. 7 at the Catholic Charities’ fourth annual Salt City Shaker fundraiser.
Crouse Medical Practice Announces New Hirings Crouse Medical Practice, PLLC, a multispecialty physician practice affiliates with Crouse Hospital, has announced the following hirings: • Physician Diana Christensen, board certified in internal medicine and infectious diseases. Christensen earned her medical degree from the Buenos Aires University (UBA) School of Medicine in Argentina. She completed her internship and residency in internal medicine from the Spanish Hospital, a part of Buenos Aires University in Page 22
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Argentina and at the James J. Peters Veterans Affairs Medical Center, Mount Sinai School of Medicine in the Bronx. Christensen also completed a fellowship in infectious diseases at the Hospital de Clinicas “Jose de San Martin,” Buenos Christensen Aires University, in Argentina and at Montefiore Medical Center/University Hospital for Albert Einstein College of Medicine in the Bronx. Prior to joining Crouse, Christensen was an infectious diseases and internal medicine attending physician at Massena Memorial Hospital in Massena in St. Lawrence County. She has co-authored articles published in the American Journal of Infection Control, Clinical Infectious Diseases, European Respiratory Journal, Infectious Diseases in Clinical Practice and Kentucky Medical Association Journal. •Physician Fafa Komla Xexemeku, board-certified in internal medi-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016
cine and specializing in cardiovascular disease. Xexemeku earned his medical degree from the University of Ghana Medical School in Ghana. He completed his residency in internal medicine and was a physician specialist at Korle-BU Teaching Xexemeku Hospital in
Ghana. Xexemeku also completed a fellowship in cardiology and a residency in internal medicine at Bridgeport Hospital/Yale University in Bridgeport, Conn. Prior to joining Crouse, he was a staff physician at Middlesex Hospital in Middletown, Conn. Xexemeku is a member of the American College of Cardiology (FIT), American Registry of Diagnostic Medical Sonography and Society of Cardiovascular Magnetic Resonance. He has co-authored articles published in Clinical Infectious Diseases, the Journal of Clinical Pharmacology and the World Journal of Cardiovascular Diseases.
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Michaud Residential Health Services, an 89 bed skilled nursing facility, is accepting applications for a full time Social Worker. This is a rewarding position for a person with a background in human services or experience working with the elderly. Must possess minimum of bachelor’s degree in human services. BSW and experience in a long-term care preferred. Please send resume to: Administrator Michaud Residential Health Services 453 Park Street Fulton, NY 13069 Equal Opportunity Employer
OR via USPS to: Director of Nursing Michaud Residential Health Services 453 Park Street Fulton, NY 13069 for immediate consideration. Equal Opportunity Employer
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Full Time evening RN supervisor position available for NYS licensed RN in a 200 bed skilled nursing facility. Monday through Friday. RN with prior long term care experience preferred. Good assessment, problem solving skills and ability to effectively communicate with residents and staff required. $3,000 Sign on Bonus, Enhanced Pay Rates and Competitive Benefits Packages. Please apply in writing to: Director of Nursing St. Luke Health Services 299 E. River Road Oswego, NY 13126
We are currently seeking a skilled REGISTERED NURSE for our weekend position at our Varick Campus in Romulus, NY. Two 12hour shifts, Friday and Saturday, 8 am-9 pm. Based on scheduled hours, this position includes: • Great benefits package (Medical, Dental, Life, Retirement 403b with match, Paid Time Off, and Holidays). • Competitive salary with $1,500.00 SIGN-ON BONUS ($500 paid in first month and balance paid after successful completion of 4 months). Per Diem positions also available (note – Sign-On Bonus does not apply to Per Diem positions). Associate’s Degree from an accredited registered Nursing program and current NYS RN license required. Bachelor’s degree and adolescent psych and/or pediatric experience preferred.
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Or apply on-line at: www.stlukehs.com Equal Opportunity Employer February 2016 •
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • February 2016