in good Flu? What Flu?
cnyhealth.com
January 2016 • Issue 193
Danielle Laraque-Arena, the new president at SUNY Upstate Medical University, is all wired to excel. In an interview she explains her vision for SUNY Upstate — and the community. She starts Jan. 14.
Teens, Sex, STDs Onondaga County has higher than expected rates for gonorrhea, a trend that experts say is ‘alarming’
Why Premiums Keep Going Up
Soup Can Aid in Weight Loss
And why you’ll have to pay a higher penalty If you don’t have health insurance in 2016
Soup contains no ‘magical’ properties that cause weight loss but it can replace higher calorie choices
Living Alone: Making the Best of 2016
Why you should add this Indian spice to your diet
CNY’s Healthcare Newspaper
First Lady of Health Care
So far, number of cases has been very low, according to experts. When will the flu season start? Hard to predict, they say
Turmeric
free FREE
Plus: Choosing a plan not as easy as in the past
Stress Levels Doctor Burnout Rates on the Rise January 2016 •
U.S. Abortion Rate Hits Record Low: CDC IN GOOD HEALTH – CNY’s Healthcare Newspaper
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When Will Flu Season Start? The start of flu season is hard to predict. So far, number of cases has been very low
T
here's not much flu going around in the United States so far this season, according to a new report released in mid December by the Centers for Disease Control and Prevention. Between Oct. 4 and Nov. 28, the percentage of people visiting the doctor who were there because of a flulike illness was just 1.9 percent, which is actually slightly lower than the percentage typically seen in the "off season," or the summer months, the report said. And during the last week of November, 44 states reported minimal flu activity (the level of activity that's normal for the off season), while just two states (Oklahoma and South Carolina) reported increased, or moderate flu activity. No states reported high flu activity. "[Flu] activity is still really low," said Lynnette Brammer, an epidemiologist in the
CDC's influenza division. "There are multiple ways that we measure flu activity ... [and] any of that data that you look at, there's just not a lot going on flu-wise," Brammer said. And the start of flu season is hard to predict, Brammer said. Last year, flu activity started to rise in late November and peaked in December. Sometimes, flu outbreaks can start as early as October, while in other years, flu activity has not increased until February. "You will start to see it begin to increase, but it's really hard to predict when it's just going to really kick in and take off," Brammer said.
Doctor Burnout Rates on the Rise
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urnout is a growing problem among American doctors, a new study indicates. Analyzing the results of 2011 and 2014 surveys of more than 6,000 doctors across the U.S., researchers found that the number who met the criteria for burnout rose from 45 percent to 54 percent over that time. Burnout rates rose in nearly all specialties, but the highest rates of burnout were among those in general internal medicine, family medicine and emergency medicine. There was no increase in work hours or in rates of depression among doctors. Doctors' satisfaction with worklife balance fell between the two surveys, according to the study, which was published Dec. 1 in the journal Mayo Clinic Proceedings and conducted by Mayo Clinic researchers in partnership with the American Medical Association. "Burnout manifests as emotional exhaustion, loss of meaning in work, and feelings of ineffectiveness," study author, physician Tait Shanafelt, said in a Mayo news release. "What we found is that more physicians in almost every specialty are feeling this way, and that's not good for them, their families, the medical profession or patients."
Curious about your cardiovascular and cognitive health? We deliver healthy babies. I have had all three of my babies at Oswego Hospital and the care has been just wonderful. This last time, I was able to use the new C-section recovery room, which
The Exercise Science Department at Syracuse University is recruiting participants for a RESEARCH STUDY examining the effect of whey protein (milk protein) on artery and brain health! You are eligible if you are 60 - 85 years old and do not smoke or have diabetes or kidney disease.
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You will visit the laboratory 4 times over the course of 12 weeks (2 hours each visit). You will be given either whey protein or carbohydrate to consume twice each day for 12 weeks. You may receive up to $100 compensation for completing the full study
Oswego Health oswegohealth.org/healthybabies
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ocobgyn.net
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
Please contact us at hplcuse@gmail.com or 315-443-4540
U.S. Abortion Rate Hits Record Low Greater use of more effective birth control may help explain trend, expert says
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he U.S. abortion rate has declined by more than one-third over the past two decades to a record low, federal officials reported Friday. Abortions fell 35 percent between 1990 and 2010, reaching 17.7 procedures per 1,000 women aged 15 to 44, said report lead author Sally Curtin, a statistician for the Centers for Disease Control and Prevention's National Center for Health Statistics. That's the lowest abortion rate since the CDC began tracking the procedure in 1976, Curtin said. "Abortion has been on a nearly steady decline since the rate peaked in 1980," she said. The pregnancy rate also hit an all-time low in 2010, according to the report. Many factors likely contribute to the reduction in abortions, but increased use of highly effective birth control is one of the most important trends, said report co-author Kath-
ryn Kost, principal research scientist at the Guttmacher Institute, a sexual and reproductive health think-tank. Pregnancy rates have been declining across the board for women under age 30, according to the CDC report. That includes a 67 percent reduction for teens 14 or younger and a 50 percent reduction for teens 15 to 19. At the same time, pregnancy rates increased for women 30 and older between 1990 and 2010, suggesting that men and women are using effective contraception and choosing to start families later in life, Kost said. "Across the states, the rate of unintended pregnancy is going down," Kost said. "That suggests that fewer women are getting pregnant when they don't want to. It's happening across the board, and affects the birth rate and the abortion rate."
UPSTATE MEN TO MEN helps men cope with prostate cancer by offering education and support for anyone touched by prostate cancer. Free monthly meetings include guest speakers and camaraderie among members through their journey of diagnosis, treatment and survivorship. Meetings are held on the last Thursday of every month at 5:00.
OUR NEXT MEETING IS THURSDAY, JANUARY 28 OASIS/HEALTHLINK | One Telergy Parkway 6333 State Route 298 | East Syracuse, NY 13057 For more information, please call Upstate Connect at
(315) 464-8668.
Located in Liverpool
Call 315-254-0580 today for a FREE confidential phone consultation
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P.O. Box 1116 • 5821 Route 80 • Tully, NY 13159 (315) 696-6114 or (800) 456-6114 www.tullyhill.com
January 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Alzheimer’s Association Announces Support Group Dates The Alzheimer’s Association, Central New York Chapter invites Central New Yorkers to start 2016 on the right foot by joining a community of their peers and attending a support group. All support groups are free of charge to attend and facilitated by trained individuals. For more information, call 1-800-272-3900 or email cny-programs@alz.org.
Upcoming meetings include:
Early-Stage Support Groups North Syracuse
DeWitt (Person With Dementia & Caregiver) Pebble Hill Presbyterian Church, 5299 Jamesville Road Third Wednesday, 5:30 p.m. — Jan. 20 and Feb. 17 Audrey Lawrence: 315-472-4201 x118
Caregiver Support Groups Madison County Cazenovia Community Resources for Independent Seniors Cherry Valley Professional Plaza, 2662 Route 20 E. Second Wednesday, 6 p.m. — Jan. 13 and Feb. 10 Karen Clark: 315-289-4345
Onondaga County Baldwinsville Baldwinsville Methodist Church 17 W. Genesee St. Second Tuesday, 6:30 p.m. — Jan. 12 and Feb. 9 Eileen and Mike Krupka: 315638-0814 Don Broska: 315-638-1519
Liverpool St. Joseph The Worker Church 1001 Tulip St., second floor library Second Saturday, 11 a.m. — Jan. 9 and Feb. 13 Florence Felt & Skip Collins: 315849-2140
Manlius
Manlius Public Library
1 Arkie Albanese Way Fourth Tuesday, 7 p.m. —Jan. 26 and Feb. 23 Claire Duffy: 315-247-1775
Andrews Memorial Church 106 Church St. Third Tuesday, 1 p.m. — Jan. 19 and Feb. 16 Ann Page: 315-427-8478
CALENDAR of
HEALTH EVENTS
Jan. 13
Classes to help people to choose Medicare plans Are you turning 65 and overwhelmed by all the mail, calls and Medicare options? The Cayuga County Office for the Aging offers complimentary monthly classes to help people make sense of Medicare. Participants will learn how to determine whether the plan they are considering will give them peace of mind or potential headaches, learn about how Part D drug plans work and whether EPIC co-pay assistance is an option. The two classes will be held from 10 a.m. – noon. in the basement training room of the Cayuga County Office Building, Wednesday, Jan. 13, and Thursday, Feb. 11. 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.
Skaneateles Grace Chapel 1674 U.S. Route 20 Last Thursday, 2 p.m. — Jan. 28 and Feb. 25 Trudy Scarr: 315-436-1575
Jan. 15 – 17
Syracuse
Rebeccah Silence of Inspired Results LLC has announced that the next Inspired Results Women’s Weekend will be held starting at 5 p.m on Friday, Jan. 15, until 3 p.m., Sunday, Jan. 17 at an eight-bedroom house on Lake Ontario in Fair Haven. The goals of event are to empower women with the skills they need to create the life they imagine, and help participants overcome issues that prevent them from realizing their potential. Twelve participants are expected to spend the entire weekend together in this safe space, engaging in intensive group experiences and individual coaching to help them eliminate emotional blocks, heal past patterns,
The Centers at St. Camillus 813 Fay Rd. Third Tuesday, 5:30 p.m. — Jan. 19 and Feb. 16 Mary Ellen Steele: 315-703-0695 The Hearth on James 830 James St. First & Third Thursday, 1 p.m. — Jan. 7, 21; Feb. 4,18 John Ryan: 315-463-0308 Syracuse V.A. Hospital 800 Irving Ave., Room B905 First Wednesday, 1 p.m. Jan. 6 and Feb. 3 Louise Choroser and Eileen Welch: 315-425-4400
Oswego County Central Square Divine Mercy Parish Center (St. Michael’s), 592 S. Main St. Fourth Monday, 7 p.m. — Jan. 25 and Feb. 22 Gail Lauricella: 315-676-7533
Oswego The Manor at Seneca Hill 20 Manor Drive Fourth Wednesday, 7 p.m. — Jan. 27 and Feb. 24 Kathy Cocciole: 315-349-5344 Heather Williams: 315-767-3679
Women’s Weekend to focus on empowerment
and change firmly held beliefs that are causing them to suffer. The cost of the weekend is $1,200, which includes accommodations, food, materials, and the program. The host, Rebeccah Silence, has helped countless individuals to make positive life changes and more than 150 women have experienced Silence’s one-day radiance seminars. As a personal life coach and on her KISS FM radio show, “Confession Tuesday,� Silence works with clients daily, helping them live more intentionally and authentically. For more information, visit www. inspiredresultscoach.com/events/ or call 303-521-1413 or rebeccah@ inspiredresultscoach.com.
Jan. 27
Free healthy living classes in Fulton To help residents improve their health status, Oswego Health is offering free workshops developed by Stanford University. The healthy living classes will be held from 9 – 11:30 a.m., Wednesdays, starting Jan. 27 and ending March 2, at the Fulton Medical Center, located at 510 S. Fourth Street. This evidenced-based program is designed to help those with any chronic disease, such as arthritis, heart disease, osteoporosis or diabetes to improve their health status through its living healthy workshops. The workshops will cover nutrition and exercise, as well as how to get support, deal with pain and fatigue and talk with your physician and family members about your condition. Participants will learn goal setting techniques and establish a step-by-step plan to improve their health. Those taking part in the program will be provided a free workbook and healthy snacks at each class session. To register, or if you have questions, please call 349-5513.
Cancer Survivors
Exercise Class
Starts Wednesday, January 6 Offered three times per week:
• Wednesdays 11 am – noon • Fridays 4:30-5:30 pm • Saturdays 9–10 am Free for JCC Fitness members. $10 per class for non-members—first class is free! Class instructor: Laurie Kushner, personal trainer and certified cancer exercise specialist
Call 315-234-4522 today!
5655 Thompson Rd. • DeWitt • www.jccsyr.org
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
The New Drink Fad? Try Bubble Tea Despite claims of being healthy, bubble tea has huge caloric content, according to experts By Deborah Jeanne Sergeant
I
t's creamy, bubbly and the latest drink fad: bubble tea. Roji Tea Lounge, and Unique Tea House, both in Syracuse, offer two examples of shops in the area that sell the beverage. Originating in Taiwan, bubble tea, also known as pearl tea, seems like a health drink at first. "Brewed tea is a good source of phenols and polyphenols — antioxidants that fight against inflammation, cancer and cardiovascular disease," said Holly Adams, registered dietitian at Kelly's Choice, LLC in Skaneateles. Adding wholesome, protein- and calcium-rich milk and tapioca pearls seems harmless enough; however, the other ingredients in bubble tea dramatically detracts from its healthfulness.
Bubble tea's 200 to 400 calories for a standard, 16-oz. serving make it a dessert. "Traditional bubble teas, depending on their specific ingredients, can be higher in sugar or fat and should be considered an every-once-inawhile-treat," said Susan Branning, registered dietitian and clinical nutrition manager at St. Joseph's Hospital Health Center. One-quarter cup of boba tapioca pearls, the kind used in bubble tea, contain about 110 calories, so skip extra pearls to keep the calories lower. "Tapioca provides additional calories but no real nutrient benefit than a typical diet already provides," Branning said. "Consider adding blueberries or other fresh fruits instead of tapioca pearls." Bubble tea offers lots of sugar,
around 35 grams per 16-oz. serving, a "small" at most shops. That equals 11 tsp., more than the American Heart Association's recommended maximum of added sugar, six teaspoons for women and nine for men." Ask the server to reduce the amount of sweetener or request stevia as a substitute to reduce calories. "Use honey, agave, or stevia," said Laurel Sterling registered dietitian and wellness educator at Natur-Tyme in Syracuse. "They would be better." To reduce cholesterol, fat and calories, choose the milk wisely. "If ordered with milk, ask if it is a non-dairy creamer or fresh milk," Branning said. "Opt for low-fat or fatfree milk or milk alternative." Soy milk or non-dairy creamer can offer a good option for people
intolerant of lactose; however, "nondairy creamer does not contain the same benefits [as milk]," said Ali Pregent, registered dietitian with Auburn Hospital. She recommends making homemade, brewed tea (not powdered tea) without added sugar. "Or, try an iced green tea latte made with skim milk and no added sugar," she suggested.
Healthcare in a Minute By George W. Chapman
Healthy competition
Competition among insurance companies is good — up to a point. According to studies published in the recent edition of Health Affairs, the addition of just one more insurance company doing business in a market tended to lower rates for the one existing plan that was considered the benchmark or dominant plan in its market by an average of 3.5 percent. However, the impact on the benchmark plan’s premium with the addition of two or more plans was nominal. Going “too low” in the market can result in disaster. So, a choice of two or three plans is good. Health Republic, a New York-based insurance coop, was one of 17 plans offered on the NY Exchange. It came in with premiums way below market. It had no impact on the premiums of market-dominant plans. In November, Health Republic, citing claims expenses far exceeded premium revenues, went out of business. “Healthy’ competition means that the plan you select would still be around for the foreseeable future. Like anything else we buy, if the price seems too good to be true …
Exchange deadline
To enroll for healthcare coverage via the exchange, you must do by Jan. 31. In previous years, there was a special enrollment around April 15. If you elect not to buy insurance, you will be fined the greater of $695 or 2.5 percent of your household income.
Affordable Care Act 2017
It’s hard to predict what will happen to the ACA once President
Obama is out of office at the end of 2016. He won’t be around to veto any more attempts to repeal it. However, it is safe to say that the entire law will not be repealed because too many Americans count on the ACA for insurance. Certain basic features like insurance portability from job to job, the elimination of lifetime limits and an insurer’s right not to cover preexisting conditions are all firmly incorporated into all commercial and government plans. Also to be considered, but still fairly transparent to most consumers, is the impact of the ACA on hospitals, physicians and even insurance companies. The entire delivery system and how providers will be paid is being revamped. It will be close to impossible to turn back this tide. Billions have been invested on electronic records, information technology and the formation of large, integrated comprehensive healthcare systems — accountable care organizations — that encourage and reward cooperation and coordination between physicians and hospitals. Most likely, any efforts to reform the ACA post 2016 would include eliminating the individual and employer mandates, the medical device tax and the Cadillac tax on super-rich benefit plans.
Cost is top concern
Not surprisingly, a recent Gallup poll revealed that the biggest concern among us is cost. Twenty-two percent of respondents indicated this as their No. 1 concern. A family premium averages about $20,000 a year. The No. 2 concern was access
to care. Regarding the No. 1 concern, cost-containment measures are slowly being introduced to the delivery system under the ACA. Most will take effect by 2018. Despite how much it costs, only 53 percent of those polled rated U.S. healthcare as good or excellent, which is the lowest rating in 10 years. It is hoped that the development of more consumer-focused delivery models will improve satisfaction scores.
Concierge practices
Also referred to as direct primary care, “concierge” medicine is still a very small component of the healthcare system. Almost all of these practices have four or fewer physicians. The average monthly cost to a patient is around $100. According to one survey, 84 percent of these practices relied only on the monthly fee. It should be noted that most of their patients also carried traditional insurance to cover all other care not provided by the concierge practice. Concierge or DPC medicine is still an emerging model, so there still isn’t a lot of reliable data proving it provides better care than traditional practices.
In 1915
Or 100 hundred years ago: Average life expectancy: 47 years. Homes with a phone: 8 percent. Average hourly wage: about 25 cents. Physicians with college education: 10 percent (They attended so-called medical schools right out of high school.) Leading causes of death: flu, tuberculosis, diarrhea, heart disease, January 2016 •
stroke. Number of states: 45. High school graduates: 6 percent of population. Available over the counter: Marijuana, heroin, morphine.
Who we still trust
Despite all the problems consumers have with costs, accessibility, quality and the overall “medical establishment” per se, according to a study published in the New England Journal of Medicine, most of us trust and value our own physician. So, physicians can play a huge role in mitigating the confusion and fear among consumers trying to fend their way through the maze of our increasingly faceless healthcare system. A lot of confusion and fear is created by the drug industry through direct to consumer advertising. In a largely symbolic gesture, the American Medical Association has recently voted to support a ban on drug advertising that drives up both the cost and unnecessary utilization of drugs. While the U.S. is only 4-5 percent of the world’s population, we consume 50 percent of all the drugs. The powerful drug industry counters that it is merely creating an informed consumer.
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
Ayman Iskander, M.D. Cardiologist who once played professional soccer introduces innovative procedure, the MitraClip, which is an alternative to open heart surgery for some patients Q: What is the MitraClip procedure, and how did you come to use it? A: So to understand the MitraClip procedure, we have to understand why it's needed. We have a lot of patients with severe mitral valve regurgitation, which means that the mitral valve leaks. When it gets into the moderate to severe range, they're at enormous risk for congestive heart failure, about 50 percent or more if left alone. About 50 percent of those patients will be turned down for surgery because they are considered high-risk surgical candidates. The MitraClip was introduced as a way to treat high-risk surgical candidates with leaking heart valves. It became FDA approved recently, and the rollout from the company has been very slow since the devices are very sophisticated and requires a lot of training. We were lucky to be one of the first centers to be selected and had our first two cases in October. Q: How does the device work? A: It's essentially a tiny implant that we put in the mitral leaflet that captures the leaflets and holds them together. We can insert multiple clips as needed. It's made of a metal alloy called cobalt chromium that has a polyester fabric covering, which promotes tissue growth so that it will eventually become part of the lining of the heart and no longer foreign to it. The mitral valve is one of two independent leaflets. With the device, we can attach the tip of the two leaflets together and essentially take a one-orifice valve and turn it into a two-orifice valve. So it lessens the degree of the leakage. The procedure is usually done in the catheterization lab under general anesthesia. We get access through the femoral vein in the groin. We go up through the vena cava that leads up the right atrium. In the right atrium we perform a puncture through the wall separating the right and left atrium.
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In the News In October St. Joseph’s Hospital physicians Ayman Iskander and Ronald P. Caputo led a team that performed the first MitraClip cases in Central New York. MitraClip is a less invasive treatment option for high risk patients with mitral regurgitation, which is caused by a leaky heart valve. The MitraClip device is a small clip that is attached to the patient’s mitral valve, allowing the valve to close more completely and helping to restore normal blood flow through the patient’s heart.
We're able to introduce a catheter through that hole. From there we start steering up the catheter for the MitraClip device until we get close to the orifice of the mitral valve. From there we cross the mitral valves, we deploy the two wings of the device, then we pull back until the leaflets fall into those two wings. Then we capture the wings with a gripper. If we're happy with this, we can bring the leaflets together. If everything checks out and the leakage is mitigated, we eventually release the MitraClip from the catheter was holding it into place.
without high risks.
Q: So this is a minimally invasive procedure? A: This is catheterization procedure, so it's extremely minimally invasive. Most patients left the hospital the next day. So it's a very simple procedure for the patient. They're left with a small puncture wound near their groin. For us, it's a very sophisticated procedure. Having said that, the MitralClip is not at this stage a replacement for surgery. I strongly believe that surgery is the standard of care and that the patient should get surgery if they're able to. The MitralClip is a good alternative for patients who are unable to undergo surgery
Q: What are the risk factors? A: For the pathological version, one of the most common pathologies here in the U.S. is mitral valve prolapse. Aging. Bacterial infection of the valves. Some autoimmune diseases. For the second type, the functional type, is usually a result of debilitation of the heart due to heart failure.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
Q: Do valve leaks tend to be genetic in origin? A: There are two types of leaky mitral valves. The first type has to do with the abnormality or pathology of the valve. The second type has less to do with the valve than the enlargement of the valve's orifice. As of now, the MitralClip is only indicated for the first type. There are studies being done now on using it to treat the second type. Neither of them are congenital. They are acquired during life.
Q: Do you see further possible applications of this technology down the road? A: As I said, we're waiting on the results of the clinical trials for functional valve leaks. That would be a huge improvement, because those patients usually have a very weak heart muscle and tend not to be good candidates for surgery anyway. Another possible use being looked at is for other types of valve regurgitation. Q: What do you think medical students can do to prepare them-
The MitraClip next to a penny. It's made of a metal alloy called cobalt chromium that has a polyester fabric covering, which promotes tissue growth so that it will eventually become part of the lining of the heart.
selves to deal with a surgical landscape that includes a lot of rapidly evolving technologies? A: The MitralClip falls under a category that is exploding these days. It's called structural heart disease, which we are promoting a lot at St. Joe's as part of an effort to become a center for treating it. Anybody who is going to be interested in cardiology has to be familiar with all of these procedures because they're evolving very rapidly. In 2012, we introduced the TAVR valve replacement and three years later we're on the third generation of the device, which is totally unheard of. So a resident or even a physician needs to be familiar with the technology or at least know when to refer a patient for a procedure using the technology. There are meetings and seminars that help. Q: What can smaller cities like Syracuse do to stay on the cutting edge? A: It depends on the mindset of the institution. We're lucky because St. Joe's is very proactive about cardiology. St. Joe's is actually the place where the first angioplasty took place. We also serve a large region that draws patients from Canada down to Binghamton, which helps us function as a center of excellence. We've maintained good outcomes and metrics, which has allowed us to earn the trust of patients. Q: I understand you were a professional soccer player at one time. A: I was. I was a member of the Egyptian national under-17 team. I left when I went to medical school. Maybe I should have made another decision? (laughs)
Lifelines
Name: Ayman Iskander, M.D. Position: Attending physician, St. Joseph’s Medical Center; assistant professor of medicine, SUNY Upstate Medical University; interventional cardiologist, endovascular specialist and structural heart disease specialist with SJH Cardiology Associates. Hometown: Cairo, Egypt Education: Ain-Shams University, School of Medicine (Cairo), Lahey Clinic Medical Center, Burlington, Vt. Affiliations: St. Joseph’s Medical Center Organizations: American College of Cardiology, Family: Married, three children Hobbies: Former professional soccer player (Egypt), scuba diving, wood working
My Turn
By Eva Briggs
All About the Difference Between Fraternal Twins and Identical Twins
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ecently a patient mentioned that she had twin sons. I asked whether they were identical twins, and she answered that she wasn’t sure. Her doctor had told her that they were not identical, but she thought they looked identical. And they’d had a condition called twinto-twin transfusion syndrome (TTTS) before birth, something she’d heard happened only with identical twins. I looked it up and, sure enough, TTTS affects only identical twins. Identical or monozygotic twins occur when a single egg and sperm fuse to form a zygote (very early stage of pregnancy) and that zygote splits in half. Fraternal, or dizygotic, twins form when two different eggs are fertilized by two different sperm, forming two zygotes from the start. As an embryo develops during early pregnancy, a two-layered sac forms to enclose the developing fetus — the inner amnion and the outer chorion. Fraternal twins each have their own amnion, their own chorion, and their own placenta. But it’s not that simple with identical twins, because the configuration of the two membranes varies depending upon
when the zygote splits into two. If the split happens during the first three days, each twin forms its own individual amnion and chorion. A split during days 4 – 8 leads to twins with one outer chorionic membrane, but separate amniotic membranes. A split during days 8 – 13 leads to twins enclosed together in a single chorion and a single amnion. And if the split occurs in days 8 – 13, conjoined twins form. TTTS occurs only in twins whose single chorion allows them to share a placenta. TTTS happens when the twins don’t share the placenta equally. It’s a random event, not caused by genetics or environment. The shared blood vessels allow one twin (the donor) to send blood the other twin (recipient). It’s not a good thing for either twin. The donor twin develops a low blood volume, grows poorly, and produces too little amniotic fluid (olighydramnios). The recipient twin’s increased blood volume can stress the recipient’s heart, causing it to fail. The recipient twin may make too much amniotic fluid (polyhydramnios). Chronic TTTS occurs early in pregnancy, weeks 12 – 23. Acute
TTTS occurs suddenly, usually in the last third of pregnancy. Untreated, there is a high risk of one or both twins dying. And if one twin dies in utero, the surviving tween may bleed through the connecting vessels in the placenta and die as well. A treatment that has been used for a while is amniocentesis, drawing off excess amniotic fluid. If the twins have separate amniotic sacs, an opening may be made between the two amniotic sacs to allow some of the excess fluid produced by the donor twin to enter into the recipient twin’s amniotic sac, equalizing the fluid. A newer treatment uses fetoscopic laser surgery to obliterate the connecting placental vessels. This results in the highest survival when TTTS occurs early in pregnancy, before the babies can survive outside the womb. This requires general anesthesia for the mother. Jumping back to the original scenario, how common is it for doctors to be wrong when deciding whether twins are identical or fraternal? According to the Minnesota
Center for Twin and Family Research, the error rate is as much as 20 percent! Some doctors aren’t aware that identical twins can have two separate placentas, but this happens in 30 percent of monozygotic twins, those who split during the first three days of gestation. And sometimes the placentas of fraternal twins grow so close together as to appear fused, leading to the misidentification of dizygotic twins as identical. When there is doubt, DNA testing can determine whether twins are identical or fraternal.
Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
NOT TAKING YOUR PRESCRIPTIONS AS DIRECTED?
YOU’RE TAKING
A CHANCE.
If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember:
If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/TakeAsDirected. #TakeAsDirected
January 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
Making the Best of 2016 A little gratitude can make a big difference
W
hen loss is gripping my heart, when change feels threatening or when disappointment overcomes me, I find it helpful to revisit and add to my “gratitude list.” Lately, it’s been a daily ritual. I’ve kept my list close at hand and have used it to lift my mood and renew my hope. I have found the process of writing down and reflecting on those things for which I’m grateful to be a fulfilling, even healing, exercise. More and more, I am relying on my gratitude list to bolster my spirits. By focusing on gratitude, we become more aware of the positive aspects in our lives, which in turn can help shift our thinking and attitudes. One of the easiest ways to make it a part of your life is to start a gratitude journal. The following five steps may help you get started: First step: Purchase a blank notebook or journal in which to write
every day. Any kind will do, but I suggest choosing one that reflects your own individuality. Mine is a beautiful little spiral-bound journal covered in handmade paper, with a decorative satin ribbon. It’s pretty just to look at, and very inviting. I keep it within easy reach on my bedside stand. Second step: Find a time to write in your gratitude journal each day. It might be the last thing you do before you go to sleep or the first thing you do in the morning. What’s important is that you find a quiet time when you can be alone with your thoughts and feelings. I’ve found I do a better job of keeping my journal when I make a commitment to write at a regular time each and every day. Third step: Think back over your day. Identify those things or people or places that made an impression on you or that touched your heart. Great or small, it could be the sound of a breeze through the trees, a new
assignment at work, your daughter’s decision to go back to school or a stranger’s warm hello in passing. Make your list personal, and try to come up with at least two blessings. If nothing comes to mind, just take your time and keep thinking. You may be surprised at what surfaces, and discover the transformative power of gratitude. Fourth step: Start every day with an open heart and with a view to see the positive and the possibilities in life. If you bump into an obstacle, try to appreciate the opportunity it presents to overcome it. When you focus on the wonderful things in life, wonderful things begin to happen. It reminds me of the law of attraction. Your positive thoughts and energy can become a magnet and draw even more positive thoughts and energy in your direction. Document these miraculous moments in your journal. Fifth step: Make your gratitude journal your own. Make your writing come to life by adding doodles, photos, quotes, scripture, or magazine clippings. I love embellishing my journal with my favorite sayings and simple sketches. So, what will I include in my gratitude journal before I turn in for the night? I have so much to be thankful for, but today, I am especially grateful for my family and friends: — I’m grateful for my parents’ influence, which I feel in the deepest part of me, even in their absence. I’ll forever be grateful for my mother’s strength, sensitivity and caring touch. Her big smile and warm hug when I came to visit was always so reassur-
ing and welcome. I am also reminded of and thankful for my father’s creative, entrepreneurial ways whenever I pick up a tool, dare to take a risk, or find the courage to be direct in my dealings with others. — I’m grateful for my sister Anne’s gigantic heart, sense of humor and passion for her family and friends. She knows me like no other, and still enjoys my company! When I’m with her, I’m inspired to be a better person (and a sillier one, too). Our relationship is precious and brings me so much joy! — I’m grateful for my dear friend Terry’s generous and determined spirit. When confronted with life’s uncertainties, he perseveres with resourcefulness and conviction. We share a wonderful friendship, and I just smile when I think of his patience, warmth and engaging personality. Even after years of gratitude journaling, I am struck by how the simple act of writing down what I value and love every day can change my world for the better. It’s simple. It’s free. And it can work wonders. So give it a try, and count your blessings!
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.
VISIT WWW.UPSTATE.EDU/BARIATRICS TO REGISTER FOR A FREE UPCOMING INFO SESSION.
KIDS Corner Cholesterol Levels Are a Problem for Many US Kids Page 8
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
About 20 percent of U.S. children have problems with their cholesterol levels, such as high levels of "bad" cholesterol or low levels of "good" cholesterol, according to a new report. The report found that, overall, 7.4 percent of children ages 6 to 19 have high levels of total cholesterol, meaning their cholesterol levels are at or above 200 milligrams per deciliter. High cholesterol levels are more common in children who are obese, the report found. Among obese children in the study, 11.6 percent had high total cholesterol levels, compared with 6.3 percent of children whose body weight fell into the normal range. In addition, the researchers found that girls were more likely to have high cholesterol levels than boys: nearly 9 percent of girls had high total cholesterol levels, com-
pared to about 6 percent of boys. The most common cholesterol problem in kids was having levels of "good" cholesterol that were too low, meaning having levels of HDL cholesterol below 40 mg/dL, the report found. Overall, 13.4 percent of children had low HDL cholesterol, but the rate was much higher among obese children. About 33 percent of children with obesity had low HDL cholesterol, compared with only 6.8 percent of children with a normal weight. Studies suggest that risk factors for heart disease, including abnormal cholesterol levels, "track from childhood into adulthood," the researchers said. "Continued monitoring of abnormal cholesterol levels among children and adolescents may inform public health interventions to promote long-term cardiovascular health and prevent [cardiovascular disease] in adulthood," they said.
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among them has been infected. "They also aren't quite clear on how STDs are spread," Lloyd said. ago. "You can pick them up through The Centers for Disease Control's anal or oral sex as well. I make it a "Youth Risk Behavior Surveillance" point to emphasize these facts when states that of all high school students, I make presentations. Even many 46 percent have engaged in interschool administrators don't realize course at least once. By senior year, this." 62 have had sex. Overall, around Skin to skin contact without 9 million teens have experienced actual intercourse can spread some intercourse. STDs, irrespective of condom use National data also shows that because condoms do not cover all of 79 percent of female teens and 84 the affected tissues. percent of males used a method of The Centers for Disease Control contraception the first time they had states on its website, "Consistent and sexual intercourse — and those using correct use of male latex condoms condoms greatly reduce their risk of can reduce (though not eliminate) the contracting STDs. risk of STD transmission." Despite these trends, people One reason is that people don't aged 15 to 24 represent about half of always use condoms correctly. Also, the estimated 20 million new cases of sometimes condoms break. STDs annually in the nation. "The most reliable ways to avoid Local community health edutransmission of sexually transmitted cators still see far too many STDs diseases (STDs), including human among the area's teens, the opposite immunodeficiency virus (HIV), are trend of the nationwide statistics. to abstain from sexual activity or to "Right now we're seeing gonbe in a long-term, mutually monogaorrhea and Chlamydia in large mous relationship with an uninfected numbers among all persons, not just partner," The Centers further states. teens," said Tiffany Lloyd, house "However, many infected persons education coordinator at Family may be unaware of their infections Planning Service of the Onondaga because STDs are often asymptomatCounty Health Department. ic or unrecognized." Local data also indicates a rise in Lloyd encourages parents of STDs. teens to try to help the young people "The Onondaga County Vourgsnti, Com- Paonessafeel comfortable about discussing sex and Byler. munity Health Assessment and so that they receive accurate informaImprovement Plan, 2014-2017" states, tion. "The increase in gonorrhea incidence Initiating the conversation disproportionately impacts females themselves also empowers parents to aged 15 to 24. Onondaga County has help instill the values they want their higher than expected rates for gonor- teens to share. But many parents find rhea and recent trends are alarming." the subject awkward, especially if From 2010, the rate jumped from they fear the conversation may cause 80.3 per 100,000 to 188.4 per 100,000 greater interest in sex. by 2012. The data didn't distinguish A television show, movie or age of the patients. news story that touches on STDs In 2013, the Oswego County may help parents raise the subject Health Department reported 285 without sounding too personal, cases of Chlamydia, up from 126 in which can backfire and cause teens to 2009. Over the same time period, clam up. By explaining the possible cases of gonorrhea jumped from six consequences of intercourse, parents to 40. The county's data accounts for can arm teens with the information all ages. they need to choose wisely and keep Lloyd said that concern over themselves safe. unwanted pregnancy prevention has More teens who choose absticontributed to the increase in nence have become outspoken about STD cases for some teens. their choice. They are starting to use "I think there was a time where long-acting contracepwe were worried they'd be teased tives such as intraby peers, but now I'm seeing teens uterine devices and exercising their right to set boundimplanted contraceparies," Lloyd said. "If you choose tives instead of connot to have sex, it's your choice doms. The former two and no one bothers you about it. do nothing to prevent It's part of a movement going STDs. across the nation. I see a Teens perceive lot of it. Teens choose pregnancy as a what they will or won't more imminent do and they're resolute threat since they with their decision." likely attend school with other Tiffany Lloyd, house teens who were education coordinator parents. But few at Family Planning likely discuss Service of the STDs with their ZAHI N. DMITRIY GENNADY Onondaga County peers or even MAKHULI, M.D. NIKOLAVSKY, MD BRATSLAVSKY, M.D. know who Health Department. Professor Assistant Professor Professor & Chairman Department of Urology
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January 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 9
No Health Insurance? It's Going to Cost You Those who don’t have insurance will have to pay up to $900 penalty this year; amount to go up to $2,085 next year By Deborah Jeanne Sergeant
I
f you don't have a health insurance policy, you likely paid a penalty when you filed your income taxes in 2015. Expect that penalty to sharply increase this year — and go even higher for the next year. The penalty for the 2015 ranges from $162.50 per child under 18 to $325 per adult with a $900 maximum. Next tax season, expect more than double that amount, $347.50 per child, $695 per adult with a $2,085 family maximum. In 2015 about 7.5 million paid the penalty out of 138 million taxpayers, according to the IRS. Shirley Kessler, tax accountant and owner of Kessler Accounting & Tax Service in Pulaski, said the majority of her clients had a full year's coverage when they filed in April 2015. Those who didn't included self-employed people and retirees who aren't yet 65. "Those who retired around age 55 may find it hard to pay for COBRA," Kessler said. "It's very, very expensive for retirees. Paying $5,000 to $6,000 a year in premiums is a lot." Opting for Consolidated Omnibus Budget Reconciliation Act (COBRA) health benefits costs former employees more since the employer does not contribute to premiums. The only advantage is the lower group rate the ex-employee receives. But the coverage lasts only up to 36 months. Others forgoing health insurance include part-time employees, those who make too much money to qualify for Medicaid but can't afford health insurance premiums and those working for exempted companies of fewer than 50 employees. Some opt out of their company's bare-bones plan if the portion of the premiums they pay stretches their budget too far. "Paying an extra $300 or more a month per person is just so much money for them," Kessler said. The mandated premium contribution cap — it must be less than 8.5 percent of the gross household income — pushes premiums out of reach for some people such as those with large households. Those with no chronic health problems seldom require health care. Some would rather pay the penalty than pay more for services they don't use. As another factor, the difficulty in signing up may turn off some people. The online Health Plan Marketplace has received criticism for its difficulty of navigation and, during open enrollment periods, crashes and glitches. Page 10
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"With the way the website worked last year, they didn't all achieve getting insurance by January, but there was an extension so you could get more time," Kessler said. The wait time for the call center can drag on for nearly an hour, plus the time it takes to wade through all the questions. St. Joseph's Hospital Health Center is partnering with community-based enrollment counselors to work with patients one-on-one for free to find the right plan for their needs. "St. Joseph’s recognizes that exploring health insurance options can be confusing for patients and caregivers," said Betsy Bedigian, communications manager with St. Joseph’s Hospital Health Center. "We are working hard to help make sure that anyone who wants coverage can find a way, or a product that helps them or their family." Despite accessibility problems, it's likely more will sign up for health insurance as the penalty rate rises.
Another catalyst for new enrollees includes the Essentials Plan offered by Excellus BlueCross BlueShield. The plan offers income-based premiums as low as $0 to $20 for people whose employers don't offer insurance and whose income is below $23,540 for individuals and $48,500 for households of four. "St. Joseph’s believes it is important for all individuals to have access to low-cost coverage and valuable benefits," Bedigian said. "Excellus BlueCross BlueShield's new insurance product is one of several options for those who need insurance." The Essential Plan provides free preventive care and basic health benefits such as doctor's visits, doctor-ordered tests, prescription drugs and inpatient and outpatient hospital care. Compared with other inexpensive plans, the Essential Plan offers good coverage and requires no deductible, which usually hampers inexpensive plans from effectively helping low-income participants.
Deadline to Enroll is Jan. 31 If you don't have health insurance, you have until Jan. 31 to enroll for 2016 unless you qualify for a special enrollment period. These include changes in your family status or employment that affect insurance. To avoid paying any penalty, you must carry insurance for the entire year. Want to figure out the penalty you may owe if you don't have health insurance coverage? Visit www.healthinsurance.org/ obamacare/obamacare-penalty-calculator. For more information on health insurance in New York, visit www.healthinsurance. org/new-york. The official site for signing up for insurance is https://nystateofhealth.ny.gov. If you have no insurance, you may not pay the penalty if: • Your income is low enough that your share of premiums (after federal subsidies and employer contributions) would total more than 8.5 percent of your income • You don't make enough money to file income taxes. • You had a short gap in coverage during the year, that lasted no more than three months (if you’re uninsured for more than three months, the penalty is prorated) • You qualify for a religious exclusion. • You are a member of a Native American tribe. • You are an illegal immigrant or are incarcerated. • You qualify for a hardship exemption.
Why Premiums Keep Going Up Consumers need to carefully examine coverage options when it comes to heath insurance By Ermst Lamothe Jr.
The healthcare landscape has drastically shifted causing numerous initiatives, mergers, joint programs, unintended consequences and unanswered questions. Unfortunately, increasing health care premiums is the only constant during the past decade and especially during the last few years. Single and family premiums for employer-sponsored health insurance rose an average of 4 percent this year, continuing a decade-long period of moderate growth, according to the Kaiser Family Foundation / Health Research & Educational Trust, a national organization which surveys results each year. Since 2005, premiums have grown an average of 5 percent each year, compared to 11 percent annually between 1999 and 2005. The average annual premium for single coverage is $6,251. And in many
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
states, more than half the plans offered for sale through HealthCaregov, the federal online marketplace, have a deductible of $3,000 or more, according to the New York Times. Michael Szymoniak, employee benefit consultant for Lawley in Buffalo, believes one of the biggest trends today is the buffet of choices consumers have. “It used to be that the human resources or finance team gave employees two or three plans and they were stuck to chose between them. Today, the number of plans are rapidly growing, and it is not uncommon to see as many as six or eight different plans, and some companies even going as far as 10 to 12 plans,” added Szymoniak. “Employees at least get to be in the driver's seat of picking the plan that works best for them.” Because variety is the theme of
the moment, Lawley wanted to educate employees about their different options. During enrollment season, employees can log onto a computerized tool, which asks them questions about their projected health care needs and gives them a algorithm options about what plans might work best for them. “It allows people to feel more educated about their insurance, which is key to making a good decision,” said Szymoniak. “We have received great feedback and it does make people spend more time as they should looking at health care insurance.” Just like every other company, Szymoniak said Lawley has heard complaints about premiums on the rise. “Nobody likes spending more money than they have to,” he
continued on the next page
Premiums Keep Going Up Experts: Picking up a health plan: not as easy as before from previous page said. “But we are a little luckier in New York state where the medical increases are not going up as rapidly as what I am hearing in other states. That can be thousands and sometimes tens of thousands of dollars in savings in New York than other areas.” And things are not going to get any better anytime soon. “Unfortunately, we are seeing premiums increase where they are going up 10 to 15 percent each year in most markets,” said Brooks Wright, sales and marketing director at KBM Management in Syracuse. “It’s a trend that doesn’t seem to be changing anytime soon.” Wright’s organization provides employers with cost containment strategies and implementation to better manage their health and Workers’ Compensation insurance business. They do a thorough market analysis, fiscal management, budget guidance and personalized customer service. Through analysis performed by the company, he is seeing higher deductibles for any business with 100 or less employers. He said it is not uncommon to see an individual having a $4,000 to $6,000 deductible. “Health insurance is getting more complicated and costly,” said Katy Votava, president and founder of Goodcare, a nationwide, independent healthcare consulting firm in the Rochester area. “Because of this issue, people have to look ahead of time on all the health plans that are available and be their best advo-
cates.” Since 2010, both the share of workers with deductibles and the size of those deductibles have increased sharply, according to Kaiser. These two trends together result in a 67 percent increase in deductibles since 2010, much faster than the rise in single premiums (24 percent) and about seven times the rise in workers’ wages (10 percent) and general inflation (9 percent). Businesses are looking at either high deductible health plans or health saving reimbursement plans to offer to employees. “They are setting up a situation where employees will pay more if they want better benefits, but also offering other plans where if you are healthy then you might be fine paying a higher deductible,” Votava added. Sometimes employers mitigate cost simply by passing it on to those doing unhealthy risk behaviors. “The first step we are going to see is groups making smokers pay a higher percentage of the premiums,” Wright added. Votava believes too often people put themselves in tough situations
by not doing their own due diligence. Whether it is because of the time consumption to look through plans, difficult to understand healthcare language or a general laissez-faire attitude, she sees a knowledge gap in people understanding their coverage. “I think that if people did a little more of their homework and looked at all their options, they would be better off,” he added. “I advise people to look at various health care plans and really see what fits them best. Find out what medications you have to take and what doctors you want to see and find something that make sense for you.” Votava has also written an ebook called “Making the most of Medicare: The Guide for Baby Boomers.” The book talks about how people should be educating themselves about Medicare a minimum of six months to a year. This guide highlights the most important factors to help you plan for your Medicare transition right now. Votava also reveals how some savvy financial planning before you enroll in Medicare can have a big impact on how much you will pay. She hopes that her advice and books help people become less afraid of health care insurance and simply better informed. “Some people are still eligible to look for health care options until the end of January and that is something that not everyone knows,” said Votava. “You need to find out what window of opportunities you have because when the window is closed you can’t make changes.” But the conversation often turns back to the inescapable premiums. Another trend she sees is families putting their children under a different plan than their employer such as New York State Child Health Plus. To be eligible for either Children's Medicaid or Child Health Plus, children must be under the age of 19 and be residents of New York State. Whether a child qualifies for Children's Medicaid or Child Health Plus depends on gross family income.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 11
Smoking and pregnancy: kicking the habit helps moms and babies By Deborah Jeanne Sergeant
A
study from the University of Edinburgh reviewed more than 10 million births and indicates that rates of premature deaths, still births, and newborn deaths decreased by nearly 8 percent since a ban to prohibit smoking in public places. They estimate that 1,500 lives were saved because of the measure between 1995 and 2011. Though lawmakers generally enact these laws to protect non-smokers from secondhand smoke, "studies have shown that the implementation of smoke-free laws and policies can increase cessation...and also Seaman help pregnant women," said Julie Seaman, coordinator of the CNY Regional Center for Tobacco Health Systems at St. Joseph's Hospital Health Center. "Researchers found a 10 percent reduction in premature births and severe childhood asthma attacks within a year of smoke-free laws being introduced. This could be the result of more pregnant women being able to quit or being exposed to less secondhand smoke," Seaman said. Joe Wicks, lead coordinator for
community engagement for Tobacco Free Central New York, believes that restricting where people can smoke, along with educating moms, can help reduce the number of smoking mothers. Smoking while pregnant can dramatically affect babies' health. "It contributes to the trend that you see around the community we live in and the realization in the past 10 to 20 years that smoking is bad and second-hand smoking is almost as bad, with all the chemicals in second-hand smoke," Wicks said. "Smoking isn't a protected class or a right because it affects others. "For someone who's pregnant and trying to quit, having fewer places to smoke can help them." On average, it takes seven attempts to quit successfully. The March of Dimes states that half of all pregnancies are unplanned, which means that many smoking women unwitting expose their babies during the earliest phases of development. "A recent study suggests that women who smoke anytime during the first trimester put their fetus at a higher risk for birth defects, particularly congenital heart defects, than women who have never smoked," Seaman said. "That risk only continues to increase the longer into the pregnancy a woman
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
How to Quit The experts' best tips for quitting include: • Setting a target quit date. Write it on a calendar. • Making plans to quit, such as disposing of ashtrays and lighters. • Preparing for withdrawal symptoms. • Asking for support from friends and family. • Replacing smoking with a healthful habit, such as taking a walk instead of smoking after meals. smokes, and is also impacted by the number of cigarettes smoked." Although quitting before pregnancy is ideal, Seaman added that quitting at any point in the pregnancy is better than continuing to smoke, which can contribute to problems such as ectopic pregnancy, placenta previa, spontaneous abortion, pre-eclampsia, preterm births, and still births, among others. After baby is born, it's important for new moms to continue to stay tobacco-free. In addition to second-hand smoke, which negatively affects babies' development, so-called "third hand smoke," the toxins clinging to the smoker's skin, hair, and clothing, can also affect infants. Cessation can also help parents stay healthier so they can remain active parts of their children's lives in the decades to come. Smoking has been identified as a factor in cardiovascular disease, numerous types of cancer, stroke, and many other life-threatening health problems. Even for children born seemingly healthy to smoking mothers, the exposure can cause long-term problems for the youngsters such as learning disabilities, asthma, and greater likelihood of infections.
• Keeping the hands busy doing something else, such as knitting. • Avoiding e-cigarettes. They are filled with chemicals that aren't FDA-regulated and do not help smokers really kick the habit. The following free resources can help pregnant women quit smoking: • 1-800-QUIT-NOW, 1-866-NY-QUITS • www.becomeanex. org/pregnant-smokers.php • www.smokefree.gov, www.nysmokefree.com •www.cdc.gov/reproductivehealth/TobaccoUsePregnancy/Resources.htm • www.marchofdimes. org/pregnancy/alcohol-and-drugs.aspx
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Parenting By Melissa Stefanec
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Mommy’s 12 Resolutions for 2016
t’s time for my annual column dedicated to New Year’s resolutions. Last year, I wrote this column through the eyes of sleep-deprived new mom to baby No. 2. My little guy was only about 3 months old, and I had already gone back to work full-time. I’m sure the column contained multiple incoherencies and spelling errors that my editor kindly left in for their comic value. This year’s resolutions will hopefully offer multiple coherent sentences, contain proper English and even offer a little “awwww” factor. So, without further adieu, here are this mommy’s resolutions for 2016. • Resolution 1 — I will not look back at my resolutions for 2015. New Year’s resolutions are all about looking ahead. Why rehash my failures? If, by some strange chance, I managed to nail every single one of my resolutions (which would only have happened if they contained line items like “Keep your children alive” and “No matter how tired you are, remember to wear pants”), I still don’t want to look back. That would just make me cocky and lead me into 2016 with a false sense of security. I can look back at 2015’s resolutions when I’ve had the proper amount of time to reflect on, forget or paint over the past. • Resolution 2 — I will stop eating the leftovers off my kids’ plates. This is gross. It’s cold and flu season. I do not need to be eating someone else’s used and picked-over food. When people talk about reducing food waste, they can’t be suggesting I save two teaspoons of macaroni with unidentified bits in it from the compost bin. I feel like I owe myself more. • Resolution 3 — I will remember to wash my kids’ hands before every single meal and randomly throughout the day. When we break routine, I forget this. I am a not a germaphobe, but kid’s hands have to be one of the grossest things out there. I need to commit to overzealous hand washing, the kind that lasts for two rounds of the birthday song and keeps an illness or two at bay. • Resolution 4 — I will give everyone in the family a little more downtime. I think I am good about this for my kids, but I’m not so good for my husband and me. We need to relax more. That’s one thing I, and a lot of people I know, aren’t very good at. So much of what I rank as important really isn’t. Relaxing is important. I resolve to recognize that. • Resolution 5 — I will get to the gym more, even if when I have to literally pry two screaming children off my legs. I love exercising. I feel better after I exercise. I am more positive when I exercise. My body and mind are just as important as everyone
else’s. My disposition is important to my children. I will not feel guilty for this resolution or demote its importance. • Resolution 6 — I will play with my kids more. I will get down on the floor and play. I will run, jump and pop out of random places. Unless there is a very good reason I can’t, I plan to say yes to all “Will you play with me?” requests. I will do arts and crafts. I will break out the sleds. I will build towers of blocks. I will go down the slide. All job commitments and laundry folding make mommy a dull gal. I need a little happy time in the craziness, and so do my kids. • Resolution 7 — I will not fault myself for wanting to throttle my children. Sometimes, my kids are going to get under my skin. Sometimes, I will want to get in the car and just drive away. Sometimes, I will want to lock myself away somewhere and just scream. That is OK, I am a mother and a human being. It’s all right to have throttling urges, as long as I don’t follow them. These urges don’t make me a bad mother. • Resolution 8 — I will forgive myself when I have a less-than-stellar parenting moment. If I say the word “stupid” to my kids, I won’t beat myself up for days. If I raise my voice, I won’t chalk myself up as a failure. If I stop listening and go on autopilot after my daughter asks me 25 questions in three minutes, I won’t feel like an unsupportive jerk. I will apologize, tune in and move on. Perfection is a horrible ideal to live up to and model. • Resolution 9 — I will be present. I will play. I will talk. I will engage. I will make sure that the most important thing I am for my children is there. We will keep having living room dance parties after a long day. We will always make time for books. We will get outside and play. I will be here now. • Resolution 10 — I will keep loving every little inch of my children’s squirming, messy and beautiful selves. Everyone needs a “gimme” on her or his resolution list. By the time the clock strikes 12:01 on Jan. 1, this one will be checked off. • Resolution 11 — I will keep raising two feminists, no matter how uncomfortable it makes people. My husband insisted I add this one. I will do things like say “hers and his” instead of “his and hers.” I will change the pronouns in children’s books so the dog hero is a heroine. I will pick up dead bugs and mice without screeching for my husband to do it. I will encourage my son to hug and my daughter to build. In my eyes, my kids are equal people. I will continue to treat them as such. Here’s to success and happiness in 2016.
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Soup Can Aid in Weight Loss Experts: Soup contains no ‘magical’ properties that cause weight loss; however, it can replace higher calorie choices By Deborah Jeanne Sergeant
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o reputable dietitians advocate trying fad diets like the cabbage soup diet to lose weight; however, eating more soup this winter as part of a healthful, balanced diet, paired with adequate exercise, may help you lose a few of those holiday pounds. Perception helps soup make a good meal choice for weight loss. Since it's mostly water, you can enjoy a large serving with few calories. "Merely eating soup will not necessarily promote weight loss, but soup can certainly be a part of a healthy weight loss effort," said Morgan Susan Branning, registered dietitian and manager of clinical nutrition at St. Joseph's Hospital Health Center. "Eating a serving of lower calorie soup as part of your meal can help to fill you up so you may eat less calories overall at that meal." The "Volumetrics" concept researched by Barbara Rolls from Pennsylvania State University shows that consuming high water content food that contains few calories can help people lose weight. "Some soups are a great example of foods with a higher water content and lower caloric density," Branning said.
The type of soup makes a difference, however. Molly Morgan registered dietitian, past-president of the New York Dietetic Association and owner of Creative Nutrition Solutions in Vestal, near Binghamton, specified that broth-based soup tends to contain the least calories. "Anytime you're reducing your calorie intake, the result can be weight loss," Morgan said.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
She recommended adding ingredients such as vegetables to increase portion size and nutrition while keeping control of calories. Soup contains no magical properties that cause weight loss; however, it can replace higher calorie choices well and leave you feeling satisfied longer. Depending upon the type of soup you eat, soup can increase your intake of low-calorie, nutrient dense foods, which can also help you feel full. Many people find that eating more soup helps them increase the variety of vegetables they eat. Chopped kale or spinach taste great in Italian-based soups, for example, and provide a tasty means of eating these nutritious greens for people who typically don't like them. Diced carrots taste good in many varieties. "Adding vegetables to soup is a great way to add flavor and fiber without adding a lot of calories,"
Branning said. Although veggies dish up plenty of vitamins, soups that skimp on protein can lead to overeating later. Adding a lean protein source such as chicken breast, lean beef, fish or beans can help soup keep you satisfied longer. If your soup du jour contains little protein, pair it with sides like low-fat Greek yogurt, low-fat cheese on crackers, or nut butter spread on apple slices or whole-grain crackers.
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SmartBites
The skinny on healthy eating
The Amazing Health Benefits of Turmeric Why does India have one of the lowest rates of colorectal, prostate and lung cancer in the world? Why do elderly villagers in India have one of the world’s lowest rates of Alzheimer’s? Interest in turmeric — and especially curcumin, the active ingredient in the spice credited with its numerous health benefits — began years ago when researchers went looking for answers to these important questions and arrived at this possibility: The reason may be the turmeric that they consume in their daily curries. Turmeric, a brightly colored relative of ginger, is a major ingredient in Indian curries, makes American mustard yellow, and adds a distinctive zing to most dishes. It is also believed to have anti-inflammatory, antioxidant and perhaps even anticancer properties, which explains why turmeric is one of the most researched medicinal plants in history. What has the research revealed? Let’s begin with turmeric’s anti-inflammatory properties, since chronic inflammation and its link to a plethora of diseases seems to top many of our health-worry lists. In some studies, turmeric’s anti-inflammatory effects have been shown to be comparable to potent drugs, from hydrocortisone to Motrin. That’s good news. Also good: Unlike the drugs, which may produce side effects, turmeric is relatively side-effect free. Recent research suggests that turmeric may help quell inflammatory bowel disease, may offer relief for arthritis,
and may even play a role in protecting us from life-threatening diseases linked to inflammation, such as heart disease and Alzheimer’s. Turmeric is a powerful antioxidant, the Michael Jordan of the spice world. Antioxidants minimize cell damage that may lead to heart disease, cancer, Alzheimer’s and other diseases by neutralizing toxic free radicals that attack healthy cells and tissues. According to a study published in the journal Basic and Clinical Pharmacology and Toxicology, mice receiving turmeric showed significant decrease in oxidative stress and notable increase in a liver-produced enzyme that acts as an antioxidant. Another study showed that turmeric may improve liver function by increasing its detoxification abilities. This bright yellow spice may also turn out to be a bright light in our fight against cancer. While there is no definitive research on humans that shows that turmeric can prevent or treat cancer, early trials have shown some promising results. In a recent American study that combined curcumin with chemotherapy to treat bowel cancer, cells in a laboratory showed that the combined treatment killed more cancer cells than the chemotherapy alone. In another American study, mice appeared to show that curcumin helped to stop the spread of breast cancer to other parts of the body. While our culture is not one of “daily curries” — a dietary behavior that may explain the low rates of certain cancers in India — there are
easy ways we can bolster our diet with turmeric. We can add it to scrambles, frittatas and rice; toss it on roasted vegetables; eat more curried dishes; consume extracts in tablet and capsule form; and drink turmeric tea (I add ¼ teaspoon directly to my mint tea).
Helpful tips
How much turmeric should we consume to reap benefits? Amounts vary because turmeric can be consumed in many forms, from the fresh root to the dried root powder. The University of Maryland Medical Center recommends ½ to 1 ½ teaspoons per day of powdered turmeric, while other sources say the ideal turmeric dosage is about 1 teaspoon per day. Almost all sources recommend eating turmeric with black pepper and some fat, as the combo boosts absorption of curcumin. Best bet on amount? Check with your doctor or nutritionist.
Cauliflower Steaks with Ginger, Turmeric, and Cumin Adapted from The Kitchn (Serves 3-4)
1 large head cauliflower Salt and pepper 2 tablespoons olive oil, divided 1 teaspoon freshly grated ginger (or ¼ tsp. dried) 1 teaspoon ground cumin ½-1 teaspoon ground turmeric Small handful of cilantro, chopped
Preheat the oven to 400°F. Remove the leaves and trim the stem end of the cauliflower, leaving the core intact. Using a large knife, cut the cauliflower from top to base into three 3/4-inch-thick "steaks." Season each steak with salt and pepper on both sides. (Reserve any loose florets for another use.) Heat 1 tablespoon of olive oil in a large skillet over medium-high heat. Sear the cauliflower steaks until golden brown, about 2 minutes per side. Gently transfer the steaks to a baking sheet. Whisk together the remaining 1 tablespoon of olive oil, ginger, cumin, and turmeric. Brush or spoon the mixture onto the cauliflower steaks. Roast in the oven until tender, about 15 minutes. Garnish with cilantro. Suggestion: Serve atop a bed of quinoa; add chickpeas for more protein 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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Transplanted Face May Age Prematurely Transplanted faces seem to age faster than normal, a new study suggests. More than 30 face transplants have been performed worldwide, but there is little information about recipients’ long-term outcomes, the researchers said. In this study, three fullface transplant patients were followed for three years. They had a significant decrease in facial volume that resembled premature aging, said physician Bohdan Pomahac, of Brigham and Women’s Hospital and Harvard Medical School, both in Boston. This change in appearance was the result of bone and muscle loss rather than the reduced facial fat or skin thickness that occurs in normal aging of the face, said Pomahac, who in 2011 led the first full-face transplant in the United States. The study was published online Dec. 3 in the American Journal of Transplantation. The findings show the need to find ways to prevent, delay or reverse muscle and bone loss in face transplant patients, Pomahac said.
Cornell: Private Hospital Rooms Cut Infection In the war against infections, constructing single-patient rooms — rather than sick-bay style, multi-patient rooms — reduces hospital-acquired infections among patients. A new Cornell-led study finds that the purported high building costs of private hospital rooms are more than offset by the financial benefits of keeping patients safer from infection. “We showed that although single-patient rooms are more costly to build and operate, they can result in substantial savings compared with open-bay rooms — all of this by avoiding costs associated with hospital-acquired infections,” said Hessam Sadatsafavi, Cornell postdoctoral researcher and lead author of a recent paper in the Journal of Critical Care.
Parkinson Drug May Prevent and Delay AMD RPB-supported researchers have made a significant discovery that might lead to the delay or prevention of the most common cause of blindness in the elderly: age-related macular degeneration (AMD). Patients who take the drug L-DOPA (for Parkinson disease, restless legs or other movement disorders) are significantly less likely to develop AMD and, if they do, it is at a significantly later age. Page 16
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SU Institute Gives a Voice to the Voiceless Institute helps individuals with severe autism or other disabilities who have problems communicating By Matthew Liptak
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n the past, individuals with severe autism and other disabilities were often considered incapable of expressing themselves constructively or, worse, of not having anything worth saying. For two decades now Syracuse University’s Institute on Communication and Inclusion has been blowing holes in that view. “Everyone has a voice,” said the institute’s director Christine Ashby. “We really believe in the notion of presuming competence, which is this idea that, even in the absence of concrete evidence, we believe people are capable of more that they can currently show us. That belief in people’s competence forces us to make sure we give people all the resources and possibilities for them to demonstrate their understanding.” That presumption of competence has helped change the lives of many both here in Central New York and around the country. The institute is open to serve people nationally. Sammy Noon being supported by his mother Jennifer Russo. They are both from Syracuse. Individuals, usually family or friends of the disabled, can get in touch with the Burke is on the autism spectrum growth over time.” institute and, if they are good canand started working with the inAshby acknowledged that there didates, an evaluation is set up. The stitute when he was 4 year old. He institute’s offers facilitated communi- has been some controversy attached did supportive typing all the way to the communication process. She cation or supportive typing to those through school and graduated from said the controversy has come over in need. Syracuse University with a dual dewho is actually doing the commuSupportive typing is when a gree in Native American studies and nicating. Is it the facilitator or the trained facilitator helps the disabled religion after a full course load over person do keystrokes, offering physi- disabled individual? five years. Best practices and clear success cal resistance to the disabled person. “I think for a lot of people it’s stories support the position that The person with disabilities this great example of what’s possifacilitated communication provides doesn’t have full control over their ble if you believe it’s possible, you a very real way for the severely body. By offerprovide the right kinds of support,” disabled to give voice to their feeling resistance Ashby said. “Now he does trainings ings, thoughts and ideas. But Ashby to the disabled for us and he travels around the emphasized that each individual’s persons’ moveworld teaching other people. He can ments the facil- circumstances had to be analyzed type with no touch or a very minimal carefully to see if the process was litator allows touch and now reads aloud when he viable for them. Facilitated commuthem better types.” nication should be considered more control so they Sheree Burke, Jamie’s mother, on a case-by-case basis to see if it was can type on a works as a communication trainer at effective rather than looked at as an keyboard and the institute after having been a voloverall concept. communicate. unteer there for over a decade. She “We really look at the emphasis The indisaid she is humbled by her particion best practices making sure that vidual is able pation in helping give others a voice. the person providing that support is to type and She sees the impact first-hand with always using backwards resistance, communicate her son. making sure the person’s eyes are with help, “It changed his life in an imon their device, that they can type otherwise it Ashby mense and powerful way,” she said. with multiple people, that we are would not be “It gave him a way to express himself constantly stating our support with possible. and to be able to tell us his thoughts the goal of independence or as close “It’s not magic,” Ashby said. and opinions and to have rich and to independence as we can get,” she “You don’t sit down and suddenly full life.” said. are able to communicate. You want With practice and training most to build patterns of movement. You To learn more about the university’s loved ones of the disabled can be want to start with tasks that have Institute on Communication and Inclutaught to be effective facilitators. a lot of predictability and the idea sion, send an email to icistaff@syr.edu or Jamie Burke is one example of that we really want to systematize call 315-443-9379. the potential of facilitated communiand pay attention to best practices so cation or supportive typing. that we can document somebody’s
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
Timothy Endy, MD, MPH, left, and Mark Polhemus, MD, will lead the Dengue Human Infection Model study and clinical trials
Upstate, U.S. Army Medical Research Announce $12 Million Initiative to Address Dengue
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pstate Medical University has partnered with the U . S. Army Medical Research and Materiel Command (USAMRMC) in the development of a dengue human infection model (DHIM). USAMRMC will invest up to $12 million over the next 3.5 years to fund five FDA-regulated clinical trials in which healthy adults between the ages of 18 and 45 can volunteer to participate. Establishme of a safe and well tolerated DHIM will be instrumental in understanding the immune response to dengue disease and advancing the development of safe and effective vaccines and drugs to protect humans from all four dengue viral strains; criteria that are necessary for complete protection from dengue. “This is a partnership that reflects the power of SUNY: Upstate Medical University and the U.S. Army working together to address a global health concern,” said SUNY Chancellor Nancy Zimpher. “Every day, researchers and scientists at SUNY’s academic medical centers bring us closer to
medical breakthroughs and new treatments for disease. This partnership is a sterling example of the ground-breaking work they do.” Dengue is mosquito-borne viral disease that affects about half of the world’s population, according to the World Health Organization. There are no licensed dengue vaccines or antiviral therapies currently available. The severity of dengue can range anywhere from mild flu-like symptoms to the life-threatening dengue hemorrhagic fever that most often occurs in children under the age of 10. Upstate was selec ed as a partner in this development effort, in part, because of Upstate’s established clinical trial center with investigators who are experts in dengue disease and experienced with human infection trials. Leading the studies are p h y s i c i a n s Timothy Endy, and Mark Polhemus of Upstate’s Center for Global Health& Translational Science (CGHATS) and Division of Infectious Diseases. Both have collaborated previously with WRAIR and USAMMDA on dengue vaccine studies.
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seling facility. “I wanted to find the greatest way to use my skill set to create a positive impact on the community and help people,” he said. Bresee is comfortable working individually with people in a therapist role, but also enjoys working at a higher level in terms of building systems, programs and processes to create a positive impact on the community.
Rewarding career
“It’s rewarding to help people. I love our community and Oswego County. I want this to be a place where my child wants to grow up and stay so that we can remain a family unit,” Bresee said. He resides in Scriba along with his wife Amy, their 8-year-old son Brayden and a dog named “Booey.” “I’ve been running programs in the community for a long time and I have a lot of experience with administering programs,” Bresee said. He said the component of OCO he was in charge of is three times the size of Farnham, and much more broader in scope. He has experience on the prevention side, and knows how to navigate through contracts and grant funding for nonprofit organizations. He also understands the clinical side thanks to his direct experience of being a clinician. Eric Bresee, former administrator at Oswego County Opportunities, is the new executive director of Farnham Family Services “I think what I found helpful in Oswego. He succeeds Jeanne Unger, right, who directed the agency for 22 years. is that I’m a good listener,” he said. “There are some things in being a therapist that tend to align well in being a leader, and listening is where I always start from.” “I always come from that perspective. I seek to understand first and am always looking to listen. I tend to do a pretty good job of understanding points of view, which helps me when I am trying to bring people along and lead and take initiatives into the future,” he added. The Leadership Oswego County graduate also participated in the Merchant Leadership Program, which is a New York state communiBy Lou Sorendo ty action agency program. He is a certified community action program professional. “A lot of that learning applies t’s a fresh frontier for new Farntrying to develop leadership skills gree in human services counseling at because it’s focused around poverty, ham Family Services’ Executive over my career and I think that is SUNY Oswego. and a lot of what we are dealing with Director Eric Bresee. something the [Farnham] board He started working for OCO at Farnham is rooted around poverBresee, 37, formerly director of found attractive,” he said. during his senior year of undergrad- ty,” he said. crisis and development services for He has also been a member of uate work. He began as a substitute “Our community is highly imOswego County Opportunities, is the the Farnham board of directors for resident counselor with developmen- poverished, and my background and new leader at the nonprofit agency nearly two years. tally disabled people. skills hopefully prepared me to come that specializes in the prevention and “I know a lot about what’s going Bresee worked himself up the here and do a good job and continue treatment of substance abuse. on here internally and what some ranks at OCO during his 15-year the success that Jeanne and her staff He succeeds Jeanne Unger, who of the upcoming opportunities and career there. have had for over 20 years,” he said. recently retired after being director challenges are,” he said. In his position as director of crisis The agency will celebrate its 45th for the past 22 years. Bresee said he has been closely and development services at OCO, year in 2016. Bresee is entering the Farntied to changes in managed care he oversaw programs that included Bresee said he has the necessary ham scene in the midst of a heroin as well, including various healthhealth education services, interenergy to make his career a success at epidemic. Farnham is a drug and care initiatives such as the Delivery vention services such as Services to Farnham. alcohol rehabilitation center based in System Reform Incentive Payment Aid Families, and care management “I have a real passion to get Oswego. program. services such as Medicaid service involved here and in making a huge At Farnham, people who were “I think there is a great alignment coordination and The Path, a transidifference. That brings with it a ton seeking treatment for heroin abuse between essentially my skill sets tional living program for homeless of energy,” he said. jumped from 4 percent in 2012 to and experience, where Farnham is youth. “I’m just so jazzed about this 19 percent in 2014. There was a 33 currently positioned and community Bresee said he always had an opportunity and its potential and the percent jump in people seeking treatneed. Those things are all going to interest in working with people, huge difference I can make alongside ment for overall opiate abuse in that come together to create high commuand did his undergraduate work in this team and community. It’s really same time frame. nity impact. That is what my hope is psychology. motivating,” he said. It is the worst drug epidemic anyway,” he said. After earning his bachelor’s Bresee was a 2006-2007 recipient that Unger saw during her tenure at The licensed mental health coundegree, he was faced with the task of Oswego County Business MagaFarnham. selor sits on the board of the stateof finding out how he was going to zine’s “Forty Under 40” recognition Bresee concedes that substance wide Coalition for Homeless Youth, apply his degree. award. abuse is a relatively new area of exand will retain that position despite Through his experience at OCO, Bresee is also a volunteer for the pertise for him. leaving OCO. Bresee “just really developed a love 30+ Crowns Skate League, a group However, he did work with clifor helping people,” he said. that supports the YMCA in-line skate Up through ranks ents who suffered with addiction. He also worked as a clinician at park in Oswego. “It’s a field of expertise that I am Integrative Counseling Services, an The Hannibal native came to developing. I am really focused on Oswego-based mental health counOswego and earned a master’s de-
Fighting Fire New Farnham director starts tenure in the midst of a heroin epidemic
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
First Lady of Health Care New president at SUNY Upstate Medical University wired to excel. She starts on the job Jan. 14 By Lou Sorendo
D
anielle Laraque-Arena is all too familiar with the plight of the impoverished. She is from Haiti, regarded as the poorest country in the world with a poverty rate of 77 percent. On Jan. 14, Laraque-Arena will begin a new phase in her career as the first female president of SUNY Upstate Medical University in Syracuse. “We are the leading teaching university in Central New York and also embedded in an area that has some of the most severe poverty,” she said. “How do we begin to connect to each other and address work that needs to be done? That conversation and those collaborations around research, education and health care delivery is what needs to happen in the early stages of my presidency,” she said. Laraque-Arena said a “contradiction” exists between the plentiful resources society has and the deep poverty that exists. “It’s a major health challenge. It’s not an issue that a campus can solve on its own. Poverty is a health issue because those who live in poverty are unhealthy,” she said. “It is imperative to partner with others to solve this issue. It cannot be done in isolation.” An expert in child abuse and injury prevention, Laraque-Arena was born in Port-au-Prince, Haiti and immigrated to the United States in 1962. Her parents left their native country under difficult circumstances, and it was the poverty there that helped inspire their daughter to pursue a career in medicine. Laraque-Arena said maltreatment is one of the leading causes of morbidity and mortality among children. She said it wasn’t until the 20th century that the pattern of injuries in children led to the recognition that these injuries were inflicted by caretakers and these children were in fact abused. Laraque-Arena noted this was “revolutionary recognition” that children were not property, and that caretakers — parents in particular — were responsible for the physical, sexual and emotional abuse of children. In the 1970s, recognition of battered child syndrome and child abuse as an entity occurred. The societal response led to mandated reporting by those caring for children, tied to legal repercussions throughout the country for the abuse or neglect of children, Laraque-Arena noted. “Children are not property and they do have rights,” she said. In 2009, the American Board of Pediatrics administered the first certification exam for those with the necessary knowledge to become a child abuse pediatrician. Laraque-Arena was among the first
Danielle Laraque-Arena deemed a child abuse pediatrician after going through the formalized process in 2009.
Passing the torch
Laraque-Arena said education is at the heart of Upstate. “We don’t live forever, so we hope what we leave is a legacy of work we’ve done, and that we have both inspired and provided skills and tools for the next generation” of health care professionals. Laraque-Arena will continue to cultivate an environment where medical students, residents, fellows and faculty members learn and grow. “Medicine is lifelong learning,” said Laraque-Arena, noting it is essential to integrate evidence-based medicine into clinical care. “We have to keep standards very high to be able to continue to do good work” and prepare the next generation of health care professionals, she noted. “That’s really the fun part. Education also provides the stimulus to stay sharp. There is nothing like a student asking you a question that you haven’t thought about in that particular perspective,” she said. While Laraque-Arena enjoys sharing her knowledge and experience, her intent is to also stimulate the need to think more effectively. “One of the things we need to continue to emphasize is critical thinking,” said Laraque-Arena, noting it is even more imperative during an information technology age that features “massive” data. “What we want to teach is how to think, not just regurgitate information, but to think. That process is interactive and it is what education is about,” she added.
Laraque-Arena said she enjoys all aspects of medicine, including clinical practice, teaching, research and administrative work. “I love clinical medicine, and it’s always grounded what I’ve done,” she said. “But, I think the reason I’m an academic is because I integrate education and research into my clinical work. “I love clinical work on its own, but it’s stronger when you continue to challenge the field by integrating education and research into it. I believe this can be done at every level.” Her first faculty position was in Central Harlem, a challenging clinical venue that featured high demand for health care and delivery for a needy population. Integration of education and research into clinical practice was commonly thought to be non-existent in a setting such as that, Laraque-Arena pointed out. However, she specifically chose that setting to do just that. “The integration of those things has driven me in my career choices,” she said. “Your best work hopefully can be done where it’s most needed.” Becoming president of Upstate is certainly welcomed by a professional intent on not only overseeing four colleges, but a clinical enterprise as well during a time that features the most challenging health care reforms in history.
Role of leader
Laraque-Arena said she is at Upstate to carry out the mission of the organization, which is to improve the health of the communities it serves through education, biomedical research and health care. “One of the things a president and leader does is inspire individuals to do their best work,” said Laraque-Arena. “My role as president is to inspire, support and bring innovation to bear in all those three areas.” She said the short-term challenge is the ability for individuals to work together while amplifying what they can do. “My role as leader is to create that opportunity,” she said. Laraque-Arena is succeeding interim president Dr. Gregory Eastwood. Laraque-Arena noted the chancellor’s office, the board of trustees, its search committee and Eastwood showed her “extreme support” with the goal of “really bringing the potential of this institution to bear.” She said many significant developments have recently occurred at Upstate, including the new UpJanuary 2016 •
state Golisano Children’s Hospital, the Upstate Cancer Center, and the designation of Upstate University Hospital as a Level 1 trauma center in the region. The academic medical center is the region’s largest employer with nearly 9,000 employees. It educates 1,500 students enrolled in the colleges of health professions, graduate studies, medicine and nursing, features a $30 million-plus research enterprise and includes the area’s largest hospital, Upstate University Hospital. “I think the challenge is to bring it all together and pick it up a notch,” Laraque-Arena said. “It’s not sufficient to be good. It’s good to be good, but even better to excel.” She said her initial focus is to take a “good environmental scan” of what is working well at Upstate. “People need to start from a position of strength and what works well,” she said. The task then is to determine what can be done better in efforts to go from “good to great,” she said. “Part of my job as president will be to search for some of the best minds and recruit them to the Syracuse area. That’s what I hope to do,” she said.
Breaking down barriers
Being the first female president at Upstate, Laraque-Arena said it hopefully serves to open up dialogue in terms of recruiting and faculty development. “It’s important to talk about how we as a society can better support diversity in leadership,” she said. “There are some real barriers that have occurred for some individuals that have led to unequal representation at high levels.” She looks favorably upon her position as a way to “shine some light” on the fact that women have the opportunity to work at high levels. “I hope to bring some diversity and perspective to the position. I think it is important to target diversity in leadership as a major issue,” she noted. Laraque-Arena said she is a perpetual optimist. “The challenge is never too big,” she said. “I love the work that I do. I’m not only an optimist, but I truly enjoy the journey.” She is the former chair of the department of pediatrics and vice president of the Maimonides Infants and Children’s Hospital of Brooklyn and professor of pediatrics at the Albert Einstein School of Medicine and Yeshiva University. She earned her medical degree at the University of California at Los Angeles School of Medicine. She is married to Dr. Luigi Arena and the mother of two: Marc Anthony Arena and Julia Marie Arena.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Ending arbitrary withdrawals of insurance coverage: Insurers can no longer cancel your coverage just because you made an honest mistake.
You now have the right to ask that your plan reconsider its denial of payment. Open enrollment began in November and ends Jan. 31. Compare healthcare plans so that you can find the best one for you, and sign up before the enrollment period ends. You can learn more about the insurance marketplace and how to apply for benefits at www.healthcare.gov. If you are 65 or older, you are entitled to Medicare. Certain people younger than age 65 can qualify for Medicare, including those who have disabilities and those who have permanent kidney failure. The program helps with the cost of healthcare, but it does not cover all medical expenses or the cost of most long-term care. You can access everything you need for Medicare, including online applications and publications, at www.socialsecurity.gov/medicare. Social Security and affordable healthcare go hand-in-hand. The Affordable Care Act and Medicare help ensure that you and your family are covered.
Q: My neighbor, who is retired, told me that the income he receives from his part-time job at the local nursery gives him an increase in his Social Security benefits. Is that right? A: Retirees who return to work after they start receiving benefits
may be able to receive a higher benefit based on those earnings. This is because Social Security automatically re-computes the retirement benefit after crediting the additional earnings to the individual’s earnings record. Learn more by reading the publication, How Work Affects Your Benefits, at www.socialsecurity.gov/ pubs.
Ending pre-existing condition exclusions for children: Health plans can no longer limit or deny benefits to children under 19 due to a pre-existing condition. Keeping young adults covered: If you are under 26, you may be eligible to be covered under your parent’s health plan.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
Onondaga, Oswego, Cayuga and Madison Counties in good A monthly newspaper published by
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In Good Health is published 12 times a year by Local News, Inc. © 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. 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 • 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.
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How To Write Your Own Obituary Dear Savvy Senior, Can you provide any tips on how to write your own obituary? At age 80, I am in the process of preplanning my funeral and would also like to take a crack at writing my own newspaper obit, too. Still Alive Dear Alive, For many people, writing their own obituary can be a nice way to sum up their life, not to mention avoid any possible mistakes that sometimes occur when obituaries are hurriedly written at the time of death. Here’s what you should know, along with some tips and tools to help you write one.
Other relevant information you may also want to include is: cause of death; place of birth and parents names; your other survivors including your children, other relatives, friends and pets and where they live; family members who preceded your death; high school and colleges you attended and degrees earned; your work history and military service; your hobbies, accomplishments and any awards you received; your church or religious affiliations; any clubs, civic and fraternal organizations you were members of; and any charities you feel strongly about that you would like people to donate to either in addition to or in lieu of flowers or other gifts. You’ll also need to include a photo, and be sure to leave copies with your funeral director and/or immediate family members.
Need Help?
Obit Tips
If you need some help writing your obituary there are free online resources you can turn to like legacy. com, obituaryguide.com or caring. com/obituary, which offer tips, templates and sample obits. Or, if you want your obit to be more memorable, purchase the ObitKit (obitkit.com). This is a $20 workbook that helps you gather the details of your life so you can write an obituary that will reflect your personality and story.
What to Include
If you’re interested in writing your own obituary, you may also be interested in writing a legacy letter or ethical will. A legacy letter is a heartfelt letter that you write to your loved ones sharing with them your feelings, wishes, regrets, gratitude and advice. And an ethical will (which is not a legal document), is like an extension of a legacy letter that many people use to express their feelings as well as explain the elements in their legal will, give information about the money and possessions they’re passing on, and anything else they want to communicate. For help in creating these, there are lots of resources available like celebrationsoflife.net and personallegacyadvisors.com, which offers practical information, examples and materials you can purchase to help you put it together.
Before you start writing your obit, your first step is to check with the newspaper you want it to run in. Some newspapers have specific style guidelines or restrictions on length, some only accept obituaries directly from funeral homes and some only publish obituaries written by newspaper staff members. If your newspaper accepts self-written obits, find out if they have a template to guide you, or check with your funeral provider. Most funeral homes provide forms for basic information, and will write the full obituary for you as part of the services they provide. You also need to be aware that most newspapers charge by the word, line or column inch to publish an obituary, so your cost will vary depending on your newspaper’s rate and length of your obit — most range between 200 and 500 words.
Depending on how detailed you want to be, the most basic information in an obituary usually includes your full name (and nickname if relevant), age, date of birth, date of death, where you were living when you died, significant other (alive or dead), and details of the funeral service (public or private). If public, include the date, time, and location of service.
Ethical Will
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
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H ealth News New COO at Bassett Healthcare Network Andrew R. Manzer has been appointed executive vice president and network chief operating officer Bassett Healthcare Network in Coopertown, effective March 1. Manzer comes to Bassett from Schuyler Hospital in Montour Falls, near Ithaca, Manzer where he has been president and CEO since 2011. He also recently led Schuyler Hospital’s successful
affiliation and merger with Cayuga Health System in Ithaca, serving as system vice president since 2014 in addition to retaining his role as CEO at Schuyler. Prior to his roles as CEO at Schuyler Hospital and system VP for Cayuga Health System, Manzer was vice president of operations at Riverside Methodist Hospital in Columbus, Ohio, between 2007 and 2011. He also previously served as vice president of support services at Carle Foundation Hospital in Urbana, Ill., between 2004 and 2007, and he was administrative director of operations at Guthrie, 1997-2004. Manzer obtained his master’s in health services administration from George Washington University and his bachelor’s in health services administration from Ithaca College. He is a member of the American College of Healthcare Executives and currently resides in Montour Falls, with
his wife Michele and their daughters Mia and Emily
Hospital recognized for total joint replacement Community Memorial Hospital announced that it has been recognized by Healthgrades as being the only hospital in New York to be one of America’s best hospitals for joint replacement. CMH is also being recognized as one of the 100 best hospitals for overall orthopedics. Healthgrades is the leading online resource helping consumers make informed decisions in order to find the right doctor, the right hospital, and the right care. This achievement was released as part of the Healthgrades 2016 Report to the Nation, which evaluates hospital performance at nearly 4,500 hospitals nationwide for 33 of the most common inpatient procedures and conditions. The new report highlights the disparity in hospital performance for specific conditions and procedures both nationally and regionally. A five-star rating indicates that Community Memorial Hospital’s clinical outcomes are statistically significantly better than expected when treating the condition or performing the procedure being evaluated. CMH
has been five-star rated for total knee replacement for 10 consecutive years — meaning CMH has lower rates of complications than most of the hospitals in the country, according to a hospital’s news release. “This achievement is recognition of the quality of the Medical staff and employees of Community Memorial Hospital and Hamilton Orthopaedics. The continuous focus on quality outcomes and patient satisfaction is reflected in being recognized by Healthgrades” states Community Memorial Hospital’s President and CEO, Sean Fadale. “I am extremely proud of the whole team at Community Memorial Hospital — as one of America’s 100 best hospitals for total joint replacement and for orthopedic excellence it puts Community Memorial in the top 5 percent of hospitals across the nation for these services”
Rehab programs at St. Joe’ get recertification St. Joseph’s Health announced its cardiac and pulmonary rehabilitation programs have been recertified by the Academy of Cardiovascular and Pulmonary Rehabilitation hospital’s news release, the accreditation process is stringent and difficult to obtain; not all programs achieve this
Crouse CEO Kimberly Boynton, award-winning recipient Christopher Connelly, and Brad Hellwig, Crouse’s director of medical imaging.
Christopher Connelly Receives 2015 Umeshchandra Patil Family Educational Award Christopher Connelly is the winner of the 2015 Umeshchandra Patil Family Educational Award, organized by Crouse Hospital. Connelly is a team leader in medical imaging and in the hospital’s Witting Surgical Center. Crouse CEO Kimberly Boynton presented the award to Connelly at a recent meeting of the hospital’s management team. He will use the proceeds to attend the 2015 Scientific Assembly and Annual Meeting of the Radiological Society of North America in Chicago and then after the conference will share what he learned through a presentation to his Page 22
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colleagues and with the Patil family through a written summary of the program. In 2005, physicians Umesh and Vijay Patil established the Patil Family Foundation Fund within the Crouse Health Foundation’s Endowment Fund. Each year, an award committee convenes to select the winner from among the nominations received. A cash award of up to $3,500 is presented to a technician, LPN or RN working in the area of surgical services for the purpose of continuing education, professional development or training.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016
Director of Volunteers Michelle Viau (from left), volunteers Karen Todeschini and Sondra Purcell, and payroll and human resources assistant Nancy Bellefeuille sort through presents donated to residents and patients at The Centers at St. Camillus.
St. Camillus Receives Holiday Gifts For Residents, Patients Staff members and volunteers at The Centers at St. Camillus organize hundreds of new men's and ladies' socks, as well as dozens upon dozens of hand-knit slippers, hats and blankets to distribute to residents and patients this holiday season. The gifts were donated by several donors from throughout Central New York, including St. Camillus staff members and members of the Friends of St. Camillus.
The Centers at St. Camillus is a non-denominational, nonprofit organization that offers services and programs designed to help individuals reach their maximum potential and achieve their highest level of independence. The Friends of St. Camillus is a volunteer organization whose mission is to enhance the daily quality of life of St. Camillus residents and patients.
H ealth News level of excellence. “This honor is a reflection of the incredible work of St. Joseph’s clinical team,” said Stephen Swierczek, director of respiratory care and cardiac-pulmonary rehabilitation at St. Joseph’s Health. “Being part of the national registry allows us to compare our outcomes with other cardiac-pulmonary rehabilitation programs across the country. Our outcomes have been shown to be favorable as compared to those in the registry, and every year, we set goals to surpass our outcomes as part of our commitment to provide a higher level of care.” Founded in 1985, the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) is a multidisciplinary professional association comprised of health professionals who serve in the field of cardiac and pulmonary rehabilitation.
Katie Shepard to lead compliance at Crouse Crouse Hospital has named Katie Shepard as director of risk management and corporate compliance. Shepard will be responsible for coordinating and managing insur-
Health
ance coverage and risk financing mechanisms; managing claims against the hospital and interacting with legal counsel and insurers; and managing and analyzing risk manageShepard ment data. Serving as compliance officer for the hospital and the Crouse Health Network, Shepard will also provide coordination of all corporate compliance matters for the organization, ensuring that compliance standards are maintained. A graduate of SUNY Polytechnic Institute, Shepard has been with Crouse for 16 years. She holds certifications in registered health information administration (RHIA) and healthcare compliance (CHC). She is an active member of the Central New York Health Information Management Association; the Health Care Compliance Association; and the American Society for Healthcare Risk Management.
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Pomeroy College of Nursing at Crouse Hospital and Le Moyne College Announce New ‘Early Assurance’ Option for Nursing Students Pomeroy College of Nursing at Crouse Hospital (CON) and Le Moyne College have announced a new partnership between the institutions that will greatly benefit nursing students. The new Early Assurance option provides Pomeroy College of Nursing students with the opportunity, once they have earned their earned associate degree in applied science with a major in nursing, to seamlessly transfer from Pomeroy into the Le Moyne College bachelor of science in nursing (BSN) degree program. Early Assurance provides a student with the ability to take advantage of the educational and health care resources on University Hill in Syracuse the first two years of college and then the student services and
campus facilities at Le Moyne College, including the opportunity to live in a Le Moyne student residence during the third and fourth years of study. “Our Early Assurance option provides an exceptional educational opportunity for the nursing student seeking an immediate entry into the clinical realm, knowing that they will experience the Le Moyne campus setting once they’ve completed studies at Pomeroy CON,” said Dean Rhonda Reader. “An additional benefit to a student is that he or she can pass the nursing licensure exam before continuing on at Le Moyne, allowing them to pursue professional employment while completing the requirements for the BSN program.”
Medical Laboratory Technicians Medical Laboratory Technologists Cytotechnologists Histotechnicians
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RN Nurse manager $2500 Sign-On Bonus LPNs $1500 Sign-On Bonus We are currently hiring for Part-time and Full-time LPNs and CNAs. We offer an opportunity to work with experienced LTC staff, great wknd shift diff, flexible schedules and no mandatory overtime. Located in a safe & convenient residential setting minutes from downtown Syracuse and Destiny USA, St. Camillus has been serving the community for over 40 years!
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New Non-Surgical Protocol for Neuropathy What is Neuropathy?
Are you Experiencing Pins & Needles?
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.
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.
3452 Route 31 • 622-0102 • Baldwinsville, NY 13027 (located across from Hickory Hill Golf Course) Page 24
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2016