in good IT’S ALL ABOUT YOUR HEART Cardiologist Riya Susan Chacko talks about male-dominated field, why she left St. Joe’s to join Crouse and what difference she wants to make as a female cardiologist
Kidney Disease Ken Rogers, a local resident, shares his experience as a dialysis patient. Number of people with chronic kidney disease has tripled recently
March 2016 • Issue 195
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Work-Life Balancing Act Onondaga County Health Commissioner Indu Gupta says she can work long hours but she doesn’t let that get in the way of healthy living. A practicing Hindu who believes in pursuing personal health for mind, body and soul, she talks about balancing work and personal life. A gifted cook, she also shares some recipes
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11 Food Trends
MEN’S SPECIAL ISSUE
• More options to fight prostate cancer • Fat Dads = Fat Children Page 9 Page 10 Twenty-eight percent of consumers in the U.S. are preparing ethnic foods more frequently than five years ago. Bowl of Thai is just an example. See story inside
Fat Dads = Fat Children 5 Reasons to Do Aquatic Therapy
A recent study indicates that maternal health isn’t the only influence on childhood obesity. Having a father who is obese may increase the child’s chances of becoming obese as well Page 15
Oh Boy, Is Bok Choy Nutritious! And it is loaded with an impressive array of nutrients, so loaded that the wellregarded World Health Organization considers bok choy to be one of their highest nutritionally ranked vegetables.
High Season for Maple Syrup Nutrients inherent to maple syrup helps the body resist many kinds of health problems. We spoke with local dietitians about the good qualities of 100-percent pure maple syrup.
Heroin Use in Onondaga Has Reached Epidemic Proportions Page 16 March 2016 •
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High Deductibles = Fewer Imaging Tests Insurance costs keep patients from seeking X-ray, CT or MRI scans, researchers report
U
.S. patients whose health insurance plans have high deductibles undergo fewer diagnostic imaging tests, a nationwide study finds. Researchers analyzed 2010 insurance data from more than 21 million adults nationwide and considered plans with high deductibles to be those with an annual deductible of at least $1,200 for one person and $2,400 for a family. They found that patients in plans with high deductibles underwent 7.5 percent fewer diagnostic imaging tests, such as X-rays and CT or MRI
Where Independent Living meets Personalized Care. 81 South St., Auburn, NY 13021
315-252-0507
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scans, than those with other plans. This resulted in 10.2 percent less in imaging payments, according to the study in the journal Medical Care. "I think what we found most surprising is the large reductions in imaging use among people with high deductibles. We had hoped to find that patients were reducing use of low-value imaging, but we found they reduced all use similarly," study senior author Kimberley Geissler, from the University of Massachusetts at Amherst, said in a university news release. Geissler, an assistant professor of health policy and management, noted that a growing number of people are enrolling in high-deductible plans because of the lower premiums. But, she added, "It seems patients are not informed enough to discern which tests are more optional and which are medically necessary." Low-value imaging tests are those that are less critical, such as MRIs for low back pain. The study findings raise concerns that high-deductible health plans "may be a blunt instrument reducing all diagnostic imaging, rather than helping physicians and patients choose high-value imaging," the researchers wrote. Efforts to reduce diagnostic imaging tests should be combined with improved patient awareness and education about the appropriate use of such tests, the researchers said.
ONONDAGA, OSWEGO, CAYUGA AND MADISON COUNTIES in good A monthly newspaper published by
Health CNY’s Healthcare Newspaper
Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.
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, Joseph Barry, M.D. • Advertising: Amy Gagliano, Cassandra Lawson Design: Eric J. Stevens • Office Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
New Non-Surgical Protocol for Neuropathy What is Neuropathy?
Neuropathy is a collection of disorders that occur when nerves of the peripheral nervous system are damaged. The condition is generally referred to as peripheral neuropathy. In the United States, over 20 million people suffer from peripheral neuropathy. Neuropathy can be brought on by a number of different causes including Diabetes, back problems and certain drugs. Damaged nerves send incorrect signals back to the brain causing scattered signals resulting in numbness, burning, tingling and sharp pain sensations that are usually felt in the feet, legs, hands and arms. Symptoms associated with the motor portion of the nerve may include muscle weakness, cramping and spasms as well as a lack of coordination and poor balance.
Are you Experiencing Pins & Needles? Numbness and Tingling? Pain or Burning in your Feet or Hands?
Traditional Treatments:
Over the years neuropathy treatments in general have had poor results at best. Many medications are used that have significant side effects and poor treatment outcomes. Only recently have we had a promising breakthrough to help reduce symptoms of neuropathy with lasting results.
New Non-Surgical For Neuropathy:
Protocol
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) March 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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CALENDAR of March 6
HEALTH EVENTS
Red Cross offers babysitter training class The American Red Cross of Central New York will host a babysitter’s training class for youth aged 11 to 15 from 9 a.m. to 4 p.m., Sunday, March 6 at the Red Cross office at 344 W. Genesee St., Syracuse. Babysitter’s training from the American Red Cross builds confidence to hold, feed and care for infants and toddlers, work with children safely, and deal with emergencies. It also teaches lifelong entrepreneurial and career development skills. The fun, fast-paced class includes hands-on activities, videos, roleplays, take-home training materials, and discussion that will teach teenagers a variety of issues. The cost of the class is $85, which includes a babysitter’s training certificate from the American Red Cross, handbook and CD ROM. Participants are asked to bring a bag lunch. Space is limited and advanced registration is required. To register, call 1-800-733-2767, or visit www. redcross.org/take-a-class.
March 11
Thrift shop to reopen, recruiting volunteers
The courage and determination of cancer survivors is an inspiration to all. On National Cancer Survivors Day®
Sunday, June 5, 2016
Hematology Oncology Associates of CNY will honor those in our community who are living with and beyond cancer and those who have supported them along the way. Come celebrate life at
Willow Bay @ Onondaga Lake Park on June 5, 2016. Our celebration will include:
Speakers • Fun Activities • Entertainment Door Prizes • BBQ Lunch. This event will be held from 10:30am until 1:30pm and is free for survivors and guests.
We encourage RSVP to pcase@hoacny.com or (315) 472-7504 ext 1133.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
The Second Chance Thrift Shoppe of CNY Inc., located on Route 20, a quarter mile west of Morrisville, will reopen on March 11 for its fifth year of operation and will remain open until mid December. Hours of operation are 10 a.m. to 4 p.m. every Friday and Saturday. The store is operated 100 percent by volunteers and raises funds for local animal rescue programs. It is incorporated in New York as a nonprofit charity corporation and is in the process of applying for federal status as a 501c3 tax exempt corporation. The thrift shop is in the process of recruiting volunteers to work three-hour shifts or for 1 1/2 hours on Wednesday evenings from 6:30 until 8 p.m. for general cleaning and restocking merchandise. For more information, contact Gail Smith by email at rsmith39@ twcny.rr.com or by phone 315-4800336.
March 12
‘Run For Dennis’ run/walk to take place in Oswego The fifth Run For Dennis 5k Run/Walk is scheduled for 10 a.m., March 12, at Gibby’s Pub on Lake Street, Oswego. The events honors the memory of Oswego resident Dennis Pacheco, a victim of bladder cancer. This run/walk will be chip timed and USA Track & Field (USATF) certified. Proceeds from the race will benefit The Charles and Mary Haney Fund (which assists cancer patients with medical expenses); Strong Me-
morial Hospital Urologic Oncology, Rochester; and the Bladder Cancer Advocacy Network (BCAN). Prizes will be awarded to winners in all age groups—including last place. Registration for the race is between $25 and $35 per person depending on when it’s made. For registration and other information, visit www.EZRaceReg.com. The website for the race is www.runfordennis.com and the event is also on Facebook at www.facebook.com/ runfordennis.
March 15, 16
AARP driver safety course to be held at JCC The Sam Pomeranz Jewish Community Center of Syracuse will host an AARP driver safety course for seniors from 9 a.m. to noon Tuesday, March 15, and Wednesday, March 16, both at the JCC on 5655 Thompson Road in DeWitt. The class is $25 per person ($20 for AARP members) and open to licensed drivers aged 50 and older. Attendees must come both days and bring their drivers license. The AARP driver safety course teaches current rules of the road, defensive driving techniques and how to operate your vehicle more safely in today's increasingly challenging driving environment. Attendees will also learn how to manage and accommodate common age-related changes in vision, hearing and reaction time. Upon completing the course participants may be eligible to receive an insurance discount. AARP membership is not required to take the course and there are no tests to pass. To register for the class, call the JCC of Syracuse at 315-445-2360 or stop by the JCC front desk.
March 19
Nutrition & Health Expo for Seniors in Syracuse The Onondaga County Office for Aging will hold a free, fun-filled Nutrition & Health Expo for Seniors from 10 a.m. to noon, March 19, at the CNY Regional Market “F” Shed (indoors and heated), 2100 Park St., Syracuse. This event will include exhibits, health screenings and massages, presentation on how to eat right, continental breakfast, cooking and t’ai chi demonstrations. This event is sponsored by Onondaga Elders, Inc., in conjunction with the Onondaga County Department of Adult & Long Term Care Services, Office for Aging, Nutrition Services. Registration is required. For more information, or to register, call 315435-2362 ext.4987 by March 4. Local businesses are encouraged to join as exhibitors/advertisers. Over 200 Onondaga County seniors are expected to attend; to participate, call 315-435-2362 ext. 4942 by March 4. The event flyer and sponsor form are at www.ongov.net/aging/nutrition.html.
Healthcare in a Minute By George W. Chapman
Best jobs
Healthcare jobs fared well in the US News & World Report’s 100 Best Jobs ranking. Five healthcare jobs were in the top 10. Rankings are based on salary, work-life balance, stress levels and opportunities for advancement. The rankings are: No. 4: nurse anesthetist; No. 5: physician assistant; No. 6: nurse practitioner; No. 8: pediatrician and No. 9: anesthesiologist.
Hospital cost cutting
The American Hospital Association is recommending that members cut down on paperwork by reducing and converting as many administrative processes to electronic as they can. In its report, the AHA estimates that overall, the healthcare delivery system in the United States spends 15 percent to 32 percent on administrative costs.
‘Narrow’ provider networks
Organized healthcare systems are moving toward narrower provider networks in order to control costs and improve outcomes. The upside for consumers is the providers in the system are much more familiar with each other and work more as a cohesive unit. The downside for consumers is less choice. The Affordable Care Act is encouraging the development of these more defined delivery systems, or accountable-care organizations. How the physicians in a network
interact and communicate with each other is far more important than the pure number of physicians in a network. To protect consumers, both federal and state regulators have issued proposals to better regulate narrow insurance and provider networks. Number of physicians, how well care is coordinated, communications and the average turnover rate are all useful information for consumers.
Satisfied consumers
The results of a poll taken by the Kaiser Family Foundation show many insured Americans are satisfied with their health plan. Seventy-four percent of those under 65 (nonMedicare) said their coverage was worth what it costs. Sixty-one percent rated their plan as a good or excellent value. Eighty-seven percent said they were satisfied with the choice of physicians. Only 12 percent said they had to change physicians because of their plan.
Hospital star ratings
Medicare bases its hospital rating system on 113 measures of inpatient and outpatient quality. A survey, called the Hospital Consumer Assessment of Healthcare Providers and Systems, is sent to patients recently discharged from a hospital. Quality measures are lumped into seven weighted categories: mortality, safety, readmissions, patient experience, effectiveness of care,
aging such as hypertension, peripheral vascular disorders, dementia, mobility, medication management, depression, nutrition, hydration and social support. Current compensation issues prevent many medical students from specializing in geriatrics.
timeliness of care and efficient use of medical imaging. Only 7 percent of 3,500 ranked hospitals achieved five stars. Forty percent received three stars. The survey intentionally avoids asking patients about amenities that don’t impact quality and outcome like food, telephone and television services, parking, visiting hours, etc.
Malpractice alternative
ACA enrollment
The Congressional Budget Office has lowered considerably its estimates for the number of people insured under the ACA in any month this year from 21 million to 13 million. For the first time, spending on federal healthcare programs — ACA, Medicare and Medicaid — exceeded spending on Social Security. The $936 billion spent in 2015 was 13 percent more than what was spent on healthcare in 2014. The CBO did predict spending would increase due to the increased life expectancy of baby boomers. The CBO report will surely add fuel to the debate in Congress over federal healthcare spending.
Hospitals and physicians spend almost $10 billion a year on payouts and associated administrative costs linked to malpractice. That is literally a drop in the bucket compared to total spending on health care that is more than $3 trillion. The problem isn’t the expense of malpractice; it’s the perpetuation of the blame shifting and adversarial relationship between patient and provider. Denmark and New Zealand compensate patients for harm due to medical errors, but then share the data with physicians, hospitals and researchers. It keeps all parties on the same side so to speak with the main interest being how to prevent the errors from reoccurring rather than simply pointing a finger at someone.
Geriatrician shortage
Related to increased life expectancy is the predicted shortage of geriatricians. The current supply of 7,000 geriatricians needs to grow to 30,000 by 2030, a recent New York Times’ article pointed out. Geriatricians focus on the chronic conditions brought about by normal
George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
Vourgsnti, Paonessa and Byler.
UPSTATE UROLOGY IS PROUD TO INTRODUCE THE NEWEST MEMBERS OF THE TEAM: N NATASHA A GINZBURG, MD G I
Assistant A ss Professor FFemale em and reconstructtive ive urology, urinary inc incontinence in women, p el floor treatment pelvic aand nd neurourology.
GENNADY BRATSLAVSKY, MD
ZAHI N. MAKHULI, MD
SPECIALTIES: urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
SPECIALTIES: general urology, andrology
Professor & Chairman Department of Urology
JC TRUSSELL, MD
Associate Professor Department of Urology SPECIALTIES: male infertility, erectile dysfunction, andrology, general urology
OLEG SHAPIRO, MD
Associate Professor Departments of Urology and Radiation Oncology SPECIALTIES: urologic oncology & endourology, robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal; renal stone disease
JESSICA E PAONESSA, MD
Assistant Professor Department of Urology SPECIALITIES: nephrolithiasis (kidney stones); enlarged prostate, urination problems; voiding dysfunction; bladder surgery; kidney surgery
GENNADY BRATSLAVSKY, M.D.
ZAHI N. MAKHULI, M.D.
SPECIALTIES: Urologic Oncology Robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
SPECIALTY: General urology, andrology
Professor & Chairman Department of Urology
Professor Department of Urology
DMITRIY NIKOLAVSKY, MD
M MATTHEW A D. MASON, MD M A
Assistant A ss Professor Pediatric P ed urology, ttreatment re nd of hernias and h yd hydroceles in children, rrobotic ob surgery in cchildren, hi urinary tract infections, in nfe and penile aabnormalities. bn
Professor Department of Urology
RAKESH KHANNA, MD
Assistant Professor Department of Urology SPECIALTIES: urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
JONATHAN RIDDELL, MD
FRCS Assistant Professor Department of Urologyy SPECIALTY: pediatric urology
RYAN SIDEBOTTOM, MD RY
Assistant A s Professor All A ll urologic needs, general urology, m a health, urologic oncology, male e n enlarged prostate, kidney stones. Dr. D r Sidebottom sees patients at Upstate Urology of Auburn office U p iin nA Auburn, NY
penile a
DMITRIY NIKOLAVSKY, MD
Assistant Professor Department of Urology SPECIALTIES: female/male incontinence urethral stricture disease pelvic organ prolapse vessico vaginal fistula, reconstructive surgery
IMAD NSOULI, MD
Associate Professor Department of Urology Associate Professor SPECIALTY: general urology
SRINIVAS VOURGANTI, MD
Assistant Professor Department of Urology SPECIALITIES: urologic oncology; prostate cancer, bladder cancer; kidney cancer; penile cancer
TIMOTHY T TI M K BYLER,, MD
Assistant A ssis Professor D epa Department of Urology S PEC SPECIALITY: general ffemale ema urologic health
FOR QUE QUESTIONS OR TO MAKE A REFERRAL, CALL 315-464-1500 Q
Assistant Professor Department of Urology SPECIALTY: Female/male incontinence Urethral Stricture Disease Pelvic Organ Prolapse Vessico Vaginal Fistula, Reconstructive Surgery
March 2016 •
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 5
Vinegar may be effective in treating colitis
V
inegar is the perfect ingredient for making tangy sauces and dressings. Now, researchers report in ACS' Journal of Agricultural and Food Chemistry that the popular liquid could also help fight ulcerative colitis, an inflammatory bowel disease that research suggests is related to the gut microbiome. They found that vinegar suppressed inflammation-inducing proteins while improving the gut's bacterial makeup in mice. Ulcerative colitis is a chronic condition that affects millions of people around the world. Although its cause isn't completely understood, research suggests that bacteria in the gastrointestinal tract play an important part. People with the condition experience repeated inflammation of the large intestine's lining, which can cause ulcers, abdominal pain, diarrhea and other symptoms. At least one recent study suggested that vinegar, which has been used in traditional medicine for centuries, might be effective against ulcerative colitis.
Hiccups: seek medical advice if they last
M
ost of us can remember the “Grey's Anatomy” episode where Meredith's stepmom checks into the hospital for a case of hiccups that won't go away. The diagnosis wasn't pretty and it may have caused viewers to panic about their health every time they hiccupped. Everyone gets hiccups in their life. The majority of the time they are completely harmless and are more of an irritant than a symptom of an underlying condition. However, if you experience hiccups that last more than 48 hours this could potentially signal serious health complications. "You should seek advice from your health care provider if your hiccups progress from happening every once in a while to becoming persistent or intractable," said physician Timothy Pfanner at the Texas A&M Health Science Center College of Medicine. Hiccups happen when the diaphragm and respiratory organs experience a sudden, involuntary spasm. This spasm is usually followed by the closure of the glottis (the slit-like opening between the vocal cords and larynx) and a characteristic sound like that of a cough. Persistent hiccups are hiccups that last more than 48 hours but less than 30 days while intractable hiccups are classified as hiccups that last more than 30 days.
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Meet
Your Doctor
By Chris Motola
Riya Susan Chacko, M.D. Cardiologist talks about male-dominated field, why she left St. Joe’s to join Crouse and what difference she wants to make as a female cardiologist Q: What is your specialty? A: I specialize in cardiology, which includes non-invasive cardiac imagining, as well as women's heart health. My interest in it came about because my mother was born with congenital heart disease. I saw her symptoms and accompanied her to most of her cardiologist appointments. She ended up having surgery for her defect the summer before I went into medical school. Subsequently her cardiologist and her cardiac thoracic surgeon became mentors for me. Eventually, I found myself in the same field, helping patients similar to my mom. Q: What types of patients do you most frequently have referred to you? A: So I see men and women with all kinds of heart disease, ranging from issues around pregnancy, to heart failure, to electrical abnormalities, to valvular disease. Q: Heart health seems like it's one of the great victories of the medical field right now. What role has the diagnostic end of things played in improving outcomes? A: There are two factors. We've become better at encouraging lifestyle modification and how to impact your mortality rate when it comes to heart disease. So that includes exercise, diet, smoking, living a healthier lifestyle. The second part is treatment. There have been many advancements that have allowed us to better treat patients, from medicated stents to better medications. In terms of diagnostics, we have a lot of new or improved methods, including cardiac MRI and nuclear imaging, which help us identify problems. Q: You've previously worked at St. Joe's, which has a reputation as being a particularly strong hospital when it comes to treating heart disease in CNY. What led you to the transition to Crouse and what do you think you can bring with you from your previous position? A: The cardiology group at Crouse is very well-reputed. They are known to be a very cohesive group that works well both together and with the hospitalist group and referring physicians. They have a wide variety of expertise. What I
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
hope to bring is my interest in women's heart health and my perspective as a female cardiologist. Q: Is cardiology male-dominated? A: Yes. It's predominantly male. Q: How do you integrate yourself into that paradigm? A: Although there are few women nationally in the specialty, it's exacerbated in the local area. The truth is, to be viewed as an equal, you can't view yourself as different. If you act like an equal, you're more likely to be treated as one. I don't consider myself different in terms of skills, qualifications. The only difference is I might approach things from a slightly different angle. Q: What does your perspective, as a woman, bring to the table? A: In terms of women's heart health, it's just a passion of mine. I understand and have experienced some of the issues women have gone through. There are unique issues, including oral contraception, pregnancy, menopause and certain medications that women are more likely to be on. Women sometimes also have atypical symptoms. Q: The conventional wisdom has been that women are a lot less likely to have heart attacks than men until they hit menopause. Is that accurate? A: That's actually not true. There was a very large study of about 27,000 women. We used to think estrogen was heart protective, so many post-menopausal women were on post-menopausal hormone therapy. The study found there was actually an increase in the risk of cardiovascular disease and stroke. So we found the opposite to be true. We are fighting the perception a lot of women have that it's a man's disease, because in the past it's led to a lot of symptoms being overlooked by both the patient's and the physicians. A woman dies every minute from cardiovascular disease. Women over the age of 65 are actually more likely to have a stroke than men. So there's a lot of room for improvement. I want to help lift up Crouse's heart health program. Q: What are some of the specific things women should keep an eye out for?
Free presentation
Cardiologist Riya Susan Chacko will be the guest speaker during the Spirit of Women event from 6:30 to 8 p.m., Wednesday, March 9, at Drumlins Country Club, 800 Nottingham Road in Syracuse. The event is sponsored by Crouse Hospital. The cardiologist will discuss ways of keeping a woman’s heart healthy and happy. While there is no cost to attend, space is limited and advance registration is requested at crouse.org/accessory or 315-472-2464. A: Women should take note of exertional symptoms. Symptoms can be typical angina, chest pressure that radiates to the jaw. The left arm is most commonly affected, though sometimes it can be in the center of the back. All patients should be aware of exertional symptoms, even if they just have one. Unfortunately, some people have silent coronary heart disease, which will only be picked up by a physician. Sometimes you may only experience weakness or profuse sweating. A sign of myocardial infarction is those symptoms appearing while the patient is at rest. If patients ever think they're having those symptoms, they should call 911. Q: You received an interesting award in medical school, the William F. Kellow award, which is awarded to a student who “most closely exemplifies the attributes of an ideal physician.” That's pretty high praise. A: To explain the award: the deans [of Jefferson] select a student each year. It was very humbling. Really, I think what people want in a physician is someone who is caring, intelligent, knowledgeable, and willing to listen to a patient. Those are the things I strive to be.
Lifelines Name: Riya Susan Chacko Hometown: San Antonio, Texas Position: Cardiologist at Crouse Medical Practice Education: Penn State; Jefferson Medical School Affiliations: Crouse Hospital Personal: has co-authored articles published in the American Journal of Cardiology and the Journal of the American College of Cardiology Cardiovascular Intervention Career: Prior to joining Crouse, was a staff cardiologist at St. Joseph’s Health in Syracuse and a non-invasive general cardiologist for the Cardiovascular Group of Syracuse. In the Boston area, she served as a cardiologist at Beth Israel Deaconess, South Shore Hospital and at Harvard Vanguard Medical Associates. Organizations: American College of Cardiology, American Society of Nuclear Cardiology, Onondaga Medical Society Honors & Awards: received numerous honors and awards, among them the Annie Simpson General Medicine Prize for best general average and the William F. Kellow Prize for the student who “most closely exemplifies the attributes of the ideal physician,” both from the Thomas Jefferson Medical College. Family: Married, two children. Husband,Thomas Chacko, MD, is a radiologist with Crouse Radiology Associates. Hobbies: Cooking, cross-country skiing, volunteering
5
Reasons to Do Aquatic Therapy
Buoyancy can relieve pain as you exercise By Deborah Jeanne Sergeant
I
f you're recovering from a longterm illness, injury or surgery, consider pursuing aquatic therapy from a physical therapy office. It offers benefits you may not have previously considered. 1. You don't need a referral from your doctor. "New York state is a direct access state," said Elizabeth Cohen, physical therapist and owner of CNY Physical Therapy & Aquatic Centers in Camillus and North Syracuse. "But people doing aquatic therapy, they usually need more time than the allowed 10 visits or 30 days." After that time period, you would need a prescription to receive insurance coverage (providing your insurance covers aquatic therapy; check first). 2. Aquatic therapy can help you if you have certain painful conditions. If you have a condition such as arthritis or fibromyalgia and need physical therapy to recover from an injury, aquatic therapy may likely help you heal more comfortably. "Aquatic therapy is helpful for people with significant arthritis," Cohen said. "It works particularly well for people with arthritis in the spine. With conventional physical therapy, you have to get into a variety of positions, which isn't always tolerated. This takes some of the pressure off your back you can do things you can't do on land. It works well for people with balance issues, too. You can't fall over. You just float." 3. Water temperature can help hasten the healing progress. "It's 93 degrees," Cohen said. "We use warm water to soothe the joints. You could exercise in a community pool, but the water won't be warm like this."
Patients can accomplish more in each session if they experience less pain, and thus can achieve their goals more quickly. In addition to keeping patients more comfortable, warm water can help improve blood flow to injured areas. 4. Buoyancy can relieve pain as you exercise. "It decreases the weight bearing on the joints," said Lauris Rigdon, physical therapist and CEO of Onondaga Physical Therapy with locations in Syracuse, Baldwinsville, Cicero, Liverpool and Fayetteville. "The property of buoyancy in the water makes people feel like they weigh less. It has compressive qualities to reduce swelling." 5. Aquatic therapy can help those who are weak or de-conditioned to slowly regain strength or challenge those who want to improve their performance. "It's good for higher-level athletes looking to get back to their sport or who want to increase their endurance," Rigdon said. "Water provides resistance. You have to push the water to move. If you put on a flipper, you can move more water and it's harder to kick. You can vary the resistance easily." Those fearful of water-based exercise can relax. The water is usually kept chest-deep at its deepest and the pools' grab bars help patients remain stable. Like a gym membership, some physical therapy offices offer memberships for former clients or openly to use their equipment for a monthly rate. If you find an office you like, you may be able to continue self-guided exercise after your 10 treatments or 30 days have expired, so ask if the office provides a membership.
BRIGHTON PHYSICAL THERAPY, PLLC Kevin L. Gretsky, PT
■ Orthopedic Rehabilitation ■ Pre and Post Surgical Care ■ Injury Assessment ■ Total Joint Replacement Care ■ Neck & Back Pain ■ Sports Injuries ■ Worker Compensation/No Fault ■ 20+ Years of Experience ■ Most Insurances Accepted & Filed Including Medicare www.TheBrightonPhysicalTherapy.com
181 Intrepid Lane Syracuse, NY 13205 • (315) 498-5510 HOURS BY APPOINTMENT • FREE PARKING
A physical therapist working with aquatic therapy patients. "It's 93 degrees. We use warm water to soothe the joints. You could exercise in a community pool, but the water won't be warm like this," says Elizabeth Cohen, physical therapist and owner of CNY Physical Therapy & Aquatic Centers.
March 2016 •
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Page 7
Live Alone & Thrive
first things I did after my divorce. I picked up the phone and made an appointment with a financial adviser. I now enjoy peace of mind."
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Making the Best of Living Alone: Are You a Pessimist or an Optimist? Is your glass half empty or half full? Take a look at the list below, which contains actual quotes from divorced or widowed women and men I've encountered along my journey and in my Living Alone workshops. Do you find yourself identifying with one perspective over another?
"Optimism is essential to achievement and it is also the foundation of courage and true progress." – Nicholas Murray Butler
N
NOT BEING MARRIED
icholas Murray Butler knows a thing or two about the power of optimism. He is an American philosopher, educator and diplomat. He was president of Columbia University and a recipient of the Nobel Peace Prize. Seeing the glass as half full rather than half empty is all about focusing on what's positive in our lives, regardless of what life offers up. It's about being thankful, appreciative and even grateful for the challenges we face. I’m convinced that our thoughts and attitudes determine the life we have. And experience has taught me that seeing the glass half full can make all the difference for those who live alone. We have a choice. We can choose to see the positive or we can choose to wallow in the negative — to close our eyes to possibilities and to begrudge the cards we have been dealt. So, how do you view your life?
• HALF EMPTY "Something must be wrong with me. All my friends are married, and here I am alone and miserable." • HALF FULL "Not in a million years did I expect to be divorced at my age, but I am resourceful and persistent. I've always wanted to travel and try new things, and now I have that opportunity — to create a life that's full of new people and experiences."
DECISION MAKING
• HALF EMPTY "Are you kidding? I don't know enough to buy a house or a car. Those are the big decisions my husband used to make. I wouldn't know where to begin." • HALF FULL "Finally, I get to make all my own decisions! No one's around to second-guess my choices. I just purchased my first car all on my own: a new Nissan Sentra. I did the research and was completely prepared when I went to the dealership. My color choice? Fresh Powder!"
IN A CRISIS
• HALF EMPTY "I'm no good in a crisis. I go to pieces. When I hear bad news, I long to be taken care of and protected, as if I'm a child. But, on my own, there's no one to turn to." • HALF FULL "Being alone in a crisis isn't the end of the earth. In fact, some of my most significant growth has been during tough times. When I got the call that my father had had a heart attack, I took charge, made calls, and brought the family together. I learned I could take care of myself and others, too."
DATING
• HALF EMPTY "I can't imagine dating at my age. What could anyone possibly see in a middle-aged, gray-haired retiree with grandchildren?" • HALF FULL "Warm friendships, even romance, can happen at any age. I met my second husband when I was 72. We met in a grief support group and the rest is history. Next year, we are celebrating our fourth anniversary."
FINANCES
• HALF EMPTY "He took care of all the finances, the bills, the taxes, everything. I feel helpless and, honestly, I fear dying alone and penniless." • HALF FULL "I knew it wouldn't be easy, but I figured I could do it. Getting help with my finances was one of the
COOKING FOR ONE
• HALF EMPTY "Why would I invest any time in creating a special meal for just myself? It hardly seems worth it. I often indulge in Ben and Jerry's and call it a night." • HALF FULL "Creating a pleasant 'table for one' makes me feel good about myself. It means I'm nourishing my body as well as my spirit. When I prepare a nice table setting and sit down to a healthy, home-cooked meal, a sense of serenity comes over me. I feel at home with my own good company."
TIME ALONE
• HALF EMPTY "Living alone is for the birds! I just want to stay in bed and pull the covers up over my head." • HALF FULL "Living alone need not be a time of diminished opportunities. It can be a time of expanding possibilities. Used wisely, time alone can be an adventure in self-discovery and reveal opportunities for personal growth and fulfillment." That last quote is one of mine. I discuss this at length in my workshops. If you don’t like the results you are getting in your life, consider changing the attitudes that are producing those results. Who knows what great adventures and joy await those who adopt an optimistic outlook and embrace the wisdom of seeing the glass half full. 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.
Gains in Kids' Health Coverage Continue, But Many Still Uninsured
KIDS Corner
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NYS still has one of the highest percentages of kids with no insurance
D
espite a significant increase in the number of American children with health insurance, many still lack coverage, a new study reveals. From 2013 to 2014, the number of uninsured children fell from 5.9 million to 4.9 million. In 2013, 7.5 percent of youngsters were uninsured, compared to 6.3 percent in 2014 — a 16 percent decrease. While the findings show progress, nearly 5 million Americans under age 19 still lack health insurance, according to the Robert Wood Johnson Foundation report
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
prepared by University of Minnesota researchers. "Despite the politicking around health policy lately, I think we can all agree that coverage for kids is essential for their healthy development," Kathy Hempstead, the foundation's director of coverage issues, said in a news release from the organization. "The last year has shown continued progress in expanding coverage to children and the reduction of differences by race, ethnicity and income, but there is more work to be done," she added. The percentage of uninsured children fell sharply in 23 states and no states had significant increases, the investigators found. The states with the largest declines in uninsured children were Ar-
izona, Colorado, Minnesota, Nevada and Rhode Island. Nearly half of the 4.9 million uninsured children are in six states: Texas (880,000), California (550,000), Florida (410,000), Georgia (210,000), Arizona (180,000), and New York (160,000). Of these six states, four had the largest decrease in the number of children without coverage from 2013 to 2014: California (down 210,000), Texas (down 95,000), Florida (down 87,000), and Georgia (down 53,000). Two states — Massachusetts and Vermont — had fewer than 2 percent of children who were uninsured. In three states, more than 10 percent of children lacked coverage: Alaska (12.3 percent), Texas (11.8 percent), and Arizona (10.5 percent).
although maple syrup contains some valuable nutrients and may have some health benefits, it’s not a magic bullet," Szklany said. "It does contain sucrose, it is caloricallydense, and it should be used in moderation." But maple syrup contains many more nutrients than nearly every other sweetener, so if you want a sweet topping for a dessert, sweet potato casserole, meat glaze or other dish, reach for your jug of maple syrup. Use it to replace other sweeteners in equal amounts. Consider using maple sugar, a granulated form of maple syrup, suitable in many recipes calling for white granulated sugar. It's made by cooking the maple sap until it crystallizes. Most recipes require only half as much maple sugar because of its intense sweetness.
Maple Syrup:
Get the 100-percent Pure Maple Syrup
Nature's Nutrient-rich Sweetener High season for maple production By Deborah Jeanne Sergeant
A
s frigid winter days give way to warmer daytime temperatures, maple syrup producers will soon begin their annual season of transforming sap into syrup. To transform maple sap into syrup, producers heat it to evaporate excess water until the syrup reaches the correct temperature and consistency. It takes about 40 gallons of sap to make one gallon of syrup. Nothing is added. Maple syrup Szklany offers nutrients not found in other sweeteners. Kathryn Szklany, registered dietitian at St. Joseph’s Hospital Health Center, said maple syrup is "an excellent source of manganese, which is important in energy production and antioxidant defenses, and is neces-
sary for brain and nerve function. Just one-quarter cup of maple syrup provides 100 percent of the recommended daily value of manganese." The same amount of syrup also provides 37 percent of the daily value of riboflavin "which aids in the metabolic processes," Szklany said. "Other minerals found in maple syrup include calcium, magnesium and potassium." The nutrients inherent to maple syrup helps the body resist many kinds of health problems, according to J. Elizabeth Smythe, registered dietitian in private practice and director of community engagement for the American Diabetes Association Upstate region. "The darker the color, the more antioxidants — disease fighting properties — it contains," she said. "It has anti-aging, immune system- boosting properties. It prevents the inflammatory response and goes hand in hand for lowering risk of Alzheimer's, osteoporosis, and coronary heart disease."
She said that the key is that syrup contains polyphenols, which are plant-based compounds. Of course nearly all sweeteners contain carbohydrates. That's why Smythe advises clients to consume any sweetener in moderation. Compared with other sources, the amount of antioxidants that maple syrup contains is low. "It is important to remember that
Make sure you purchase 100-percent pure maple syrup to receive the health benefits of genuine maple syrup. Some manufacturers package syrup in jugs similar to the classic maple syrup container to associate their product with genuine maple syrup. Most stores stock genuine maple syrup right next to artificial products, so look for "100-percent pure maple syrup" on the label to find the real deal. Watch out for terms such as: pancake syrup, maple flavoring, pancake topping, genuine maple flavor, contains natural flavoringnaturally flavored These terms can indicate that the product contains corn syrup or other sweeteners and is not 100-percent pure maple syrup.
Where to Find It Want to find a maple producer in your area? Visit www.nysmaple. com, the website of the New York State Maple Producers Association. Most producers sell syrup yearround. The site lists 160 maple weekend events throughout the state. Most are the third and fourth weekends of March. Call in advance to confirm information.
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ore than ever consumers are identifying themselves as foodies with an on-the-go lifestyle that translates to food choices that are more experiential, convenient and impulse-driven. In the January issue of Food Technology magazine published by the Institute of Food Technologists (IFT), contributing editor A. Elizabeth Sloan writes about consumers’ mealtime choices and behaviors in 2015.
1.
Forty-seven million adults define themselves as foodies, and 29 million are categorized as being part of a highly involved, serious culinary core group. Millenials account for 36 percent and baby boomers for 32 percent. In addition, those consumers who enjoy food as an “art form” climbed by 20 percent.
2.
Yogurt tops the list of foods/ beverages that are consumed more today than 10 years
Facts About 6. America’s Eating Habits 7.
Desserts account for half of in-store bakery sales and specialty desserts and brownies/dessert bars show the highest sales growth.
When it comes to fast casual restaurants the Asian/noodle sectors is projected to lead growth followed by Mexican, coffee/ café, chicken and bakery café. The pizza, sandwich and burger segments are expected to underperform.
ago, followed by bottled water, pizza, poultry sandwiches, Mexican foods, fresh fruit, bars, frozen sandwiches, chips and pancakes.
3.
An increase in the number of meals prepared and eaten at home and a corresponding decline in restaurant usage is one the single biggest changes in eating patterns in the United States in the past five years.
Twenty-eight percent of consumers are preparing ethnic foods more frequently than five years ago.
8.
More than half of grocery shoppers buy fresh readyto-eat items like rotisserie chicken, sandwiches and sushi often or sometimes.
9. 10.
For the first time in more than five years, indulgent snack sales outpaced healthy in the $38 billion snack product category. Vegetarian tops the list of hot appetizer trends, followed by charcuterie/ house-cured meats; ethnic street food inspired appetizers; seafood charcuterie; and high-end chef-inspired appetizers and ethnic dips.
11.
Nine out of 10 adults say that information about fruit and vegetable content is important to them in determining if a food is healthy. That is followed by preservative-free, added nutrients or no artificial sweeteners, no antibiotics, unprocessed, natural or hormone free, organic or non-genetically modified, clean and “real.”
4.
One-quarter of consumers ate soup at home at least once a week in 2014. While broth, stew, chowders and chili are Americans’ favorite forms of soup, one-third of consumers would eat more soup if it contained a serving of vegetables, was heart healthy, or high in protein.
5.
Best sellers in the fresh bakery category are breads, cakes, cookies and rolls.
Bowl of Thai food. Twenty-eight percent of consumers are preparing ethnic foods more frequently than five years ago, according to an article in Food Technology magazine.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
SmartBites
The skinny on healthy eating
Oh, Boy, Is Bok Choy Nutritious!
L
ooks can be deceiving, even with food. Consider bok choy. On the outside, bok choy — also known as Chinese cabbage — doesn’t look like a nutritional powerhouse. Its soft green leaves appear wan next to kale’s; and its rather pale stalks seem devoid of all value. Ho hum? Hardly. Bok choy is loaded with an impressive array of nutrients, so loaded that the well-regarded World Health Organization considers bok choy to be one of their highest nutritionally ranked vegetables. A member of the cruciferous vegetable family, bok choy has unique sulfur-containing compounds that help the body fight cancer. These magic bullets launch their attack in one of three ways: by helping the body eliminate carcinogens, by preventing cells from turning into cancer or by altering metabolism to stop the development of hormone-sensitive cancers. Several population studies, in fact, have shown that people who eat more cruciferous vegetables (cauliflower, cabbage, garden cress, broccoli, brussels sprouts) have a lower
risk of developing lung, prostrate, colorectal and breast cancer. Bok choy’s remarkable arsenal of antioxidants — from vitamins to minerals to phytonutrients — further boost its cancer-fighting properties. Antioxidants gobble up damaging free radicals, which have been implicated in many cancers, along with a host of chronic, age-related diseases. Bursting with vitamins A, C, and K, bok choy plays an important role in maintaining good eyesight and a healthy immune system, keeping our bones strong and our skin elastic, and helping our blood clot properly. Hearts benefit from bok choy, too, as this tasty vegetable teems with nutrients that keep our tickers tocking longer: potassium, folate, calcium and vitamin B6. Lastly — and more good reasons to reach for China’s most popular vegetable — bok choy is super low in calories (only 10 per shredded, raw cup), has no fat or cholesterol, and offers up some fiber and a bit of protein.
Helpful tips
Look for firm stalks and crisp,
green leaves. Avoid those that appear wilted, discolored, or distressed. With proper storage, bok choy can last up to a week in your refrigerator. To store, place bok choy in a plastic bag, removing as much air from the bag as possible, and put in the crisper section.
Healthy Bok Choy Salad with Sesame Dressing Dressing ingredients: ¼ cup red wine vinegar 2-3 tablespoons olive oil 2 garlic cloves, minced ¼ cup sesame seeds, toasted 2 tablespoons soy sauce ¼ teaspoon red pepper flakes (optional) salt and pepper, to taste Salad ingredients 1 head bok choy, rinsed and sliced (trim off tough base) 1 red pepper, chopped 4 scallions, sliced 2 carrots, shredded
¼ cup sliced almonds, toasted In small bowl, whisk together dressing ingredients. Prepare salad ingredients and place in large bowl. Toss dressing with salad and top with sliced almonds. (Toast sesame seeds in a dry skillet over medium heat for three to five minutes or until lightly browned, stirring occasionally. Toast sliced almonds—spread out on a cookie sheet—in a 350-degree oven for five to eight minutes; they easily burn, so closely monitor.)
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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Healthy Work/ Life Balance
Onondaga County Health Commissioner Indu Gupta talks about balancing health, work, family.
By Matthew Liptak
O
nondaga County Health Commissioner Indu Gupta not only talks the talk, she walks the walk. Gupta, a physician who has been commissioner since late 2014, can work long hours at her government position, but she learned long ago not to let that get in the way of living healthy. “Health is your business because it affects everything else,” she said. The Jamesville resident and native of India is a practicing Hindu who believes in pursuing personal health for mind, body and soul. She said it is important to take some time each day to just take care of yourself. Gupta tries to do 20 to 40 minutes of exercise a day. Often she does yoga, but she has incorporated the elliptical machine and weights, too. “I have shifted toward yoga,” she said. “It's something I will combine sometimes. If you do monotonous things, sometimes you get bored. You have to push active exercises. Yoga can be very active also depending on what kind of intense poses you do.” Things were not always so balanced for Gupta earlier in her career.
She was a married doctor with two young children and a job that took away a lot of time from family life. A few words from her concerned dad changed all that. He reminded her of the reason she was working so hard in the first place. He reminded her that parents work so they can make sure their children have food, shelter, clothing and schooling. But he noted although she had everything, she had no time to eat. “I just felt like, ‘Oh, he is so right.’ What is the point when I can't even enjoy something for which I work hard?” she asked. She changed her schedule, making sure she had more time for her family. That included time to sit down and eat dinner each day. She believes the decision changed all their lives. “Since then I never turned back,” she said. “It was wonderful not only for physical health, but also emotion-
Commissioner Gupta’s Vegetarian Farfalle
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
al and mental health because you are not stressed out.” Time in the kitchen together became important bonding time for the family. Gupta is an avid vegetarian who loves to cook. Cooking up new dishes with her kids or while they did their homework at the kitchen table became a vital daily ritual. Today her two children live out west, but they come home for the holidays. They came home last
November. Hinduism may have influenced Gupta's decision to be vegetarian, but the faith does not prohibit eating meat. Gupta jokingly called some of her cousins “hard carnivores.”
Staying engaged
She did not try to force her kids to eat vegetarian because she believes it's an individual decision, but they chose it anyway.
Makes 5 servings; 360-400 calories per serving
Ingredients
Directions
• Finely cut vegetables: 1 cup each of your choice ~ I used eggplant, green beans, broccoli, yellow peppers, and mushrooms (5-6 cups) • 1/4 cup of olive oil • 1 cup tomato sauce • 1 cup finely chopped fresh tomatoes of your choice ~ I used a combination of roma and grape tomatoes • 2 cups dry farfalle (4 cups cooked) • 4 ounces cubed fresh mozzarella cheese • 1 cup of finely cut fresh basil • Splash of aged balsamic vinegar • Optional: dried oregano and/ or basil leaves if you don’t have fresh basil (approximately 1 tsp each)
1. Sauté the vegetables in a skillet with olive oil. Cook the vegetables in the order of their hardness ~ hard vegetables first 2. Add the tomato sauce and chopped tomatoes. 3. Add dry oregano and basil leaves (optional) 4. In a separate pot, cook the pasta. Once cooked, add the pasta to the skillet after the hard vegetables are tender. 5. After 3 to 4 minutes, add the softer vegetables. Cook covered for approximately 2 more minutes. 6. Add the mozzarella and basil. Add salt and pepper and splash with the balsamic vinegar to taste. Continue
a
My Turn
Commissioner Gupta tries to do 20 to 40 minutes of exercise a day. Often she does yoga.
“They've tried some non-veg things, but they kind of came back,” she said. “They said, 'Mama, we like your food.'” They like it so much they suggested she start her own restaurant. Gupta said she is a good cook, but didn't want to take on that much work. It’s not that she doesn't work a lot now. She can work 12-hour days and sometimes even does weekends. “My work requires me to stay engaged,” she said. “There is no 40 hours, 60 hours or 80 hours — it's how much is needed. I will do it essentially to make things happen.” Keeping her body fueled for such long work days is critical. She pays special attention to packing her lunch because it's important to keeping her going for the rest of the day. “I need to make sure I have protein because I'm vegetarian,” she said. “I have to make sure I have yogurt or milk and have some greens. Usually a lot of times salads are my favorite because it's easy and it's fresher. It just has to be nice and tasty because time is very important. I have to make my brain happy.” Gupta admits that some days are better than others. Occasionally her days aren't as balanced as she might want because of the demands of her
job. Even then though she'll try to escape for at least a few minutes to exercise. “I'm a human being,” she said “No one is perfect.”
On the job
Being the health commissioner means addressing a number of different health issues for the community on a daily basis, including obesity (28 percent of adults are obese in Onondaga County); smoking (20 percent of county residents smoke); sexually transmitted diseases (some rates are on the rise); suicide rates (also on the rise); heroin addiction; and racial disparity (blacks and Hispanics have more negative health issues). It is important for Gupta to keep healthy so she can get her county on a healthier footing. The example she sets personally may be as important as her administrative efforts. It's all about being in the driver's seat for your life and not being a passenger, she said. “Life is truly a balance everywhere,” Gupta said. “You have to find that balance whether it's individually, or organizationally or as a community.”
Make it your own! You can substitute tofu for the mozzarella, choose a different herb such as parsley, or try using whole wheat or brown rice pasta! You can also add garlic for extra flavor. To try a different pasta shape, just use the following measurements: 2 cups of dry pasta if using small to medium shaped pasta like elbow macaroni, penne, or ziti; 8 ounces of dry pasta if using long pasta like angel hair, spaghetti, or linguine. Cooking is like music; play with it and have fun!
By Eva Briggs
Famous Medical Outbreak in Oswego Episode in 1940 considered a classic in the field of epidemiology — and has helped scientists ferret out the particulars of epidemics from H.I.V. to Zika
R
ecently I read an article in the journal “Pharos,” published by the Alpha Omega Alpha national medical honor society. I was surprised to see the mention of a famous medical outbreak that I was unfamiliar with — from Oswego. After all, I am affiliated with Oswego Hospital and work in Oswego County. Well, the outbreak did occur in the village of Lycoming (north of Route 104 where the nuclear power plants are located) in 1940, a few decades before I was born. After a church supper on April 18, there was an outbreak of a gastrointestinal illness, where 46 people became sick with vomiting and diarrhea within 24 hours. It turns out that this case is considered a classic in the field of epidemiology, demonstrating how to investigate a disease outbreak. A. M. Rubin, an epidemiologist from the district health office in Syracuse, performed the investigation. He learned that all the sick people had attended the church supper. So he focused on interviewing everyone who had attended the church supper, and succeeded in collecting data from 75 of the 80 attendees, of which 46 had become sick. The first step for an epidemiologist is to determine whether there was an epidemic or outbreak. Using the definition of an epidemic as the occurrence of an illness clearly in excess of its normal expectancy, the 1940 illness was indeed an epidemic. It was also an outbreak, defined as a localized disease epidemic. Once an outbreak has been detected, the next steps for a foodborne epidemic include: • Defining and finding cases. Rubin did this with his detailed interviews. He learned that the supper began at 6 p.m. and ended at 11 p.m. Food was spread out on a table and consumed over several hours. Rubin asked what food or drink each individual had consumed, at what time, and when the symptoms began. He learned that the food with the highest attack rate was vanilla ice cream. So he suspected it was the most likely cause. • Generation of hypotheses about likely sources. Rubin used March 2016 •
that data to prepare a table for the 14 food items identified. He calculated what percent of people who ate the food became sick, and also what percent of people who did not eat the food became ill. And remember, this must have been done by hand, as there were no home computers in 1940! • Testing the hypotheses. Rubin gave a detailed report of how the ice cream was prepared, describing the ingredients, who prepared the food, and how. He examined the cooks for signs of illness (none found) and cultured their noses and throats, as well as culturing a specimen of the ice cream. Large numbers of the bacteria Staphylococcus aureus and Staphylococcus alba were found in the ice cream. There were also three people who got sick who did not eat the vanilla ice cream. But all three had eaten chocolate ice cream served with the same scoop. • Finding the point of contamination and source of the food. Although the nose cultures of the ice cream preparers did show the same species of Staphylococci found in the ice cream, Rubin concluded that he didn’t know how it got into thee ice cream. But lab techniques that would allow more detailed analysis of the bacteria today, didn’t exist back in 1940. • Controlling an outbreak. In this case, any leftover ice cream could be tossed. • Deciding if the outbreak is over. This was also straightforward, as Dr. Rubin’s data showed no new cases occurring after 10 p.m. on April 19. It was fascinating to read this piece of local history that is now considered a classic, helping scientists ferret out the particulars of epidemics from HIV to Zika! Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.
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Men’sHealth Options for Prostate Cancer Continue to Grow By Deborah Jeanne Sergeant
M
en have more options than ever for treating prostate cancer. As with other kinds of cancer, treatment continues to become more and more specialized, both to the cancer type and the individual. "There are several new avenues that are being pursued in prostate cancer therapy," said physician Grennady Bratslavsky, professor and chairman of urology at Upstate Medical University. As recently as 2007, the only options were chemotherapy or surgery. In the past several years, more drugs have been approved, such as Enzalutamide (xtandi) and Zytiga (abiraterone acetate), which have proven effective for men with metastatic prostate cancer. Many other new drugs awaiting approval by the FDA show improvement in men's survival rates. Immunotherapy, another type of treatment for metastatic prostate cancer, uses the patient's own blood to expose the immune Bratslavsky system to a protein in the prostate cancer and make a vaccine. For certain mutations, physicians
can use lab tests to determine the most effective therapy, including clinical trials available nationwide. When a biopsy may be warranted, the Telsa magnet MRI and the UroNav platform, both available at SUNY Upstate, "essentially give a GPS technology designed specifically for Mitteldorf the prostate," Bratslavsky said. Together, they can guide placement of the biopsy needle into areas deemed suspicious, instead of blindly taking a biopsy sample, which could result in a false negative result. "It can help identify what needs further treatment," Bratslavsky said. "Such technology allows us to diagnose men in whom previously biopsies have failed to identify prostate cancers. It also allows many men to be reassured that there are no worrisome lesions or tumors within the prostate, thus avoiding multitudes of unnecessary unneeded further biopsies or procedures." Darryl Mitteldorf is a licensed clinical oncology social worker and founder and executive director of Malecare (www.malecare.org), a nationwide 501(c)(3) men’s cancer
survivor support and advocacy organization. He encourages men to take charge of their own health when it comes to prostate screening and, if needed, treatment. Although he's pleased that research is showing some promising treatments, he encourages men to feel confident in their decisions regarding prostate health. Prostatectomy, for example, bears the risk of urinary incontinence and impotency, he said. "All men 35 and older should talk with their doctors about screening for prostate cancer," Mitteldorf said. "It has to be tailored to individual men and his desires. Some men will do anything to see the sunrise. Others are willing to trade some years in their 70s for quality of life in their 50s and 60s." Unlike many types of cancer, when it comes to prostate cancer, early detection and treatment only saves the lives of very few patients, Mitteldorf said. This is because not all cancers are fast-growing and require treatment. Elevated prostate specific antigen (PSA) levels can indicate prostate cancer or health conditions unrelated to prostate cancer. That's why some men opt for scheduled surveillance. For some men, prostate cancer doesn't grow rapidly. "You have to treat 24 men to extend the life of one man," Mitteldorf said. "Another study says you have to treat 47 men to extend the life of one man.
Health
"Prostate cancer isn't just about cancer but overtreatment, surveillance, and what a man wants out of life. Most people just look at it as how to stop the progression of disease. From our support groups, it's not just about cell division but about life." Unlike other cancer-related surgeries, prostatectomy can significantly and negatively affect the patient's life even though he doesn't have "a visibly appreciated body part removed or have [his] hair fall out," Mitteldorf said. "But if you have to sit around your house because you have urinary incontinence or you're a single man, it's hard to seek out intimate partners if you're incapable of engaging in intimate acts. Prostate cancer treatment can do that to men." Because of the swelling number of support group members, Mitteldorf believes men undergoing prostate surgery do not have all the information they need to make a decision with which they will be happy. "It's a difficult thing to be told you might have cancer and that's followed up with, 'We don't know what to do about it.' It's not as easy a thing as people make it out to be to the point where if you have doctors you feel confident in, go for it. All the support groups say talk with someone who's already gone through it." He recommends his group as a source of information. Upstate Men to Men (http://www.upstate.edu/ cancer/cancer-care/programs/prostate/men-to-men.php) represents a support group closer to home.
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Paternal health affects child's obesity, say experts By Deborah Jeanne Sergeant
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recently released Danish study indicates that maternal health isn't the only influence on childhood obesity. Paternal obesity may affect the father's sperm so that his offspring's satiety cues mimic those of obese people. In essence, having a father who is obese may increase the child's chances of becoming obese. Obesity elevates the risk of disease later in life, such as diabetes, Scinta cardiovascular disease, and certain types of cancer. These diseases are now more frequently seen among children because of the rise of childhood obesity. "Certainly one thing we know is that at the moment of conception, the genetics are predetermined whether the baby will be obese," said physician Wendy Scinta, who operates Medical Weight Loss of Central New York, PLLC in Fayetteville and DeWitt and is certified as an obesity medicine specialist. Scinta said that parental genetics raises a child's risk of obesity by 50 percent if one parent is obese and to 85 percent if both are. Though obstetrics places a heavy emphasis on maternal health, "there really is an equally contribution from mom and dad." She said purchasing more fruits, vegetables, whole grains, lean protein sources and low-fat dairy and fewer processed and shelf-stable foods helps families eat better. "The most important thing they can do is model good behavior and not bring bad food in the house for themselves or the kids," Scinta said. "Eat at home and prepare meals as a family. "Try not to eat in the car or in front of the TV. Eating should be eating, not combined with other things." Though lab tests can't determine if someone has a higher genetic risk of obesity, a blood test can indicate insulin resistance. Along with a family health history, physicians can
help their patients determine if they should change their lifestyle. Laurel Sterling, registered dietitian and wellness educator at Natur-Tyme in Syracuse, noted that the study "did not prove that their children will inherit" the tendency toward obesity-causing behaviors. "They are looking into seeing if their results may change the behavior of both parents-to-be." J. Elizabeth "Beth" Smythe, registered dietitian in private practice and director of the American Diabetes Association for Upstate New York, isn't as convinced by the Danish study, but said that the home environment and eating habits of the family can "directly affect a child's weight and that fathers can positively be role models in establishing a healthy relationship with food and good eating habits." Paying attention to a baby's satiety cues, such as turning away from the offered spoon, can start children on the path of a healthy perception of food. Smythe "Parents buy into the concept of cleaning the plate," Smythe said. "Children mirror parents. If you eat sugar-sweetened beverages and no vegetables, that's what they'll eat." Most children don't initially like many foods. It may take as many as a dozen times for them to eat a new item. Modeling healthy activity behaviors also help. Encourage physical hobbies and helping out with chores. "Especially if there's a propensity for being overweight, don't mention dieting, but model and encourage healthy behaviors," Smythe said. "Many school systems don't have the same PE that we had 20 to 30 years ago. It depends on the parents to encourage that, like going for a walk after dinner or having a dance party in the living room." Consulting the child's pediatrician can provide more detailed and specific information.
Community Information Seminar:
Bariatric Surgery March 8, 2016 • 6:00 pm Presented by
Gregory Dalencourt, MD Medical Office Center St. Joseph’s Hospital Campus 104 Union Ave. • Suite 809 • Syracuse, NY
To register call 315-477-4740 or toll free 877-269-0355 Parking will be validated
March 2016 •
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Heroin Use in Onondaga Has Reached Epidemic Proportion Commissioner of health says problem affects Cayuga Nursing all age groups, races, income levels and Graduates neighborhoods Achieve 100 Percent Licensure By Deborah Jeanne Sergeant Pass Rate eroin use is increasing in higher rate of babies born to moms
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ayuga Community College has announced the National Council Licensure Exam (NCLEX) score of its 2015 nursing class. The most recent graduates of the school’s two-year associate in applied science degree achieved a 100 percent pass rate. As Cayuga’s nursing graduates have consistently done, the 2015 class surpassed the state and national average pass rates by 20 and 15 points respectively. The program’s five-year pass rate is a notable 99 percent. The Cayuga class also had a perfect rate of graduates seeking employment in nursing. Ninety percent of the graduates are employed by a hospital in the Central New York region with 10 percent working in long-term care and residential settings. “We are very proud of these outcomes,” said Linda Alfieri, professor and nursing program director. “Cayuga’s 40th graduating class continues our rich tradition of excellence.” Cayuga’s program, which currently enrolls 110 students, attracts a diverse group of individuals including recent high school graduates, “empty-nester” parents looking to re-enter the marketplace and those looking for a second career.
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Onondaga County and more people are dying locally as a result of its consumption. Onondaga County listed only one heroin-related death in 2010 and 24 deaths related to opioids, the broader drug classification to which heroin belongs. The 2015 data list 34 heroin-related deaths and 57 for opioids. And that data is incomplete. Those numbers may increase as Long the remaining data are added. "It is affecting all age groups, races, income levels and neighborhoods," said physician Indu Gupta, commissioner of health for the Onondaga County Health Department. "It has reached an epidemic proportion." Onondaga County Health Department's website now features a "Combat Heroin" button, designating heroin addiction as a pressing issue in the county. Jodi Martin, supervising public health nurse for Oswego County Public Health, has also observed a
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
addicted to heroin. "Two main reasons for this troubling trend are the increased use of prescription opiate painkillers and the widespread availability of cheap street heroin." Andrew Long, program director at Harbor Lights Chemical Dependency in Mexico, said that part of the reason some people become addicted in the first place is that they were prescribed opioid painkillers after surgery. "There's been a crack down on doctors prescribing narcotics," Long said. "It can be more difficult to get a hold of prescription opioids. Heroin is cheap, easy to obtain and potent." By the time their prescription ends, some have become dependent upon the opioid because of a genetic tendency toward addiction and a desire to escape struggles they face. This class of painkiller works by affecting the area of the brain that controls emotions and pain sensitivity. The patient may no longer need pain control, but crave the effect the drug has on blunting their emotions. Purchasing prescription opioids on the street is expensive; heroin is much less expensive. By turning to street drugs, addicts don't know the potency of the drugs they're taking, or even if it is the drug they think. Heroin is often laced with fentanyl, a opioid up to 100 times stronger than morphine.
Or, a bag that should contain heroin mixed with fentanyl could be straight fentanyl. Taking illicit drugs just one time can kill. Exploring additional means of pain management can help prevent addiction since the patient would not experience the euphoric effects of opioids. Naloxone, sold under the brand name Narcan, is a heroin overdose antidote. Long said that more people knowing the signs of overdose and how to administer naloxone should help reduce the number of overdose cases. Naloxone may now be purchased without a prescription. For people who seek treatment for addiction, Harbor Lights Chemical Dependency offers numerous programs, from weekly individual meetings to five-day-a-week group programs. The center offers help to people with multiple mental health needs. "If we look solely at the substance use, it's not necessarily going to fix the problem," Long said. "Unless the underlying issues are addressed, it's not going to [resolve the issue]." Using medication to reduce cravings can help addicts recover, along with cognitive behavioral therapy and peer support groups. "It's a complicated issue," Long said. "I'd rather see them on a prescription than heroin. If it's prescribed and taken correctly, it's better than heroin on the street." Anti-craving drugs may also help some addicts break their heroin addiction as they work with their physician to reduce their dose. People taking opioid medication — or any medication — have to make sure it's taken as directed by the instructions on the bottle and to monitor the prescription. In addition to making opioids less available, "it is equally important to have these conversations at your dinner table with family and friends to understand the enormity of this crisis," Commissioner Gupta said. "We must all work together to implement public health prevention strategies and to find local solutions." Signs of drug dependence could include abrupt changes in behavior, socializing, eating and sleeping. Properly dispose of any unused medication, not by using the trash, sink or toilet to get rid of them. Check with your local pharmacy or police department for drop-off events and locations.
Parenting By Melissa Stefanec
The Myth of Being Caught Up W
hen I talk to other parents, it’s apparent we have a lot of common goals. We want our children to be happy, healthy, well-adjusted, well-fed and all the other wellnesses that we are lucky enough to give them. However, some of our common goals revolve around less-ambitious and more mundane things. When I ask another mom what she did over any given weekend, her answer probably sounds something like this, “Eight loads of laundry, tumbling class, bills, some cooking prep for the week, a playground trip and some other stuff around the house. I feel mostly caught up, except I have to sort through all the clothes in the sizes my kid doesn’t wear anymore and go through his/her 15 toy bins to gather a donation pile and squeak in four more loads of laundry. I can’t wait to be caught up on all of this stuff.” I sympathize with any mother that relays this to me, because, I too am that mom. My expansive to-do list runs right off the page it’s written on. Errands, tasks and stuff I plan to do multiply like gray hairs. For every task I pluck from my list, seven more come roaring in with more gusto and demands than their predecessors. It’s like I am playing a grown up version of whack-a-mole, except I’m too tired to swing the mallet. I keep telling myself that if I keep on keeping on, sooner or later the list will become manageable. One day, I will be caught up. On that glorious day, I will ship my children off to their grandparents for the weekend, walk around barefoot on crumbless floors, run my hands across the orderly garments in my closet, admire the space on the counter where the pile of papers used to be and toast my husband to a job well done. I will breathe a sigh of relief so loud the neighbors will hear it. It will be amazing. Except that, in my most rational moments, I know this day will never come. My dream of a crumb-free Prosecco toast, orderly home and taskless bliss is just that, a dream. And, it’s a dangerous one. I spend so much of my life looking ahead to how and when I can get things done, and I know I am not alone in this practice. Parents everywhere suffer from trying to obtain being caught up. There is some nagging voice in the back of my head that says, I need to get there. However, unlike a lot of gut feelings, this one is wrong. It ain’t happening. Its allure is a lie, and the sooner more parents realize that, the sooner we can all move on to some more important priorities, like playing with our kids, sleeping more,
exercising more and seeing more of our friends and family. Being caught up plays into the modern-day fairy tale of having it all. As parents, we feel internal and external pressure to be on top of everything. We expect ourselves to give our children the very best of everything, and we will (almost) literally kill ourselves trying to make good on that illusion. I think a lot of parents feel that if everything isn’t perfectly in place, the whole façade is going to come crashing down. We treat the undone things in our lives as though they are the keystones. We think getting them done is going to bring us peace and happiness. Rationally, we know how absolutely silly this is. We know that unfolded baskets of laundry and lingering DIY projects aren’t going to destroy our family bonds or lives, yet somehow, we let them impact our sanity. I think the only actual way to glean some peace and happiness from the crazy child-rearing years is to make peace with the undone. To reclaim our collective sanities, we need to convince ourselves the only monsters under the bed are some dust bunnies and a pile of unsorted paperwork. Then we need to scream from the tippy tops of our dirty laundry piles that these monsters don’t scare us anymore. In the spirit of annihilating the myth of being caught up, here is a list of monsters I am no longer afraid of: • The times the floors in my house are a little too sticky or crumby to walk on in bare feet • The boxes of kids’ clothes to sort through in the basement • My closet, which looks like a department store clearance rack that has been picked over by ruthless shoppers • My kids’ toys, which are everywhere but in their bins • My yard and garage, which sometimes look like toddlers threw a secret party in them • The pile of mail and paperwork on my counter next to the fruit bowl (when my children grow up, they will recount how they were always afraid to take an apple for a snack because of the leaning tower of paperwork that was supported by the fruit) • The weeds in my flower beds and garden; at least something is thriving there So, next time I start playing the “I need to be caught up” game, I promise to take a step back. No amount of work is every going to get me there, and my family will be just fine if many of the things I worry about go undone. After all, a Saturday is a terrible thing to waste. March 2016 •
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Chronic Kidney Disease Cases tripled since ‘90s; to continue to rise By Aaron Gifford
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he organ is small, but treating it has had massive implications on the national health care system. According to a recent report from the Centers for Disease Control and Prevention (CDC), the number of kidney failure cases in the United States has more than tripled since 1990, and that number is expected to grow with the nation’s aging population. Total Medicare spending for patients with kidney failure, excluding prescription drugs, reached almost $29 billion in 2012 (the latest year available), or about 6 percent of the program budget. In addition, overall Medicare costs for people over 65 with chronic kidney disease (kidney failure and subsequent medical problems) totaled about $45 billion, or $20,000 per person per year. What’s more, the CDC estimates that 20 million American adults have chronic kidney disease right now but haven’t been diagnosed yet. African-Americans are three and a half times more likely than whites to develop kidney disease, according to the CDC. On a more positive note, the number of new kidney disease cases in people with diabetes or high blood pressure decreased by 2 percent from 2010 to 2011, suggesting that the treatment available to people with those diseases is improving. Chronic kidney disease is a condition where damaged kidneys have difficulties filtering toxins out of the blood. The waste in that blood that remains in the body can cause other health problems. Chronic drug users and adults with high blood pressure or diabetes have a higher risk of developing chronic kidney disease. The only way to diagnose the disease is through specific blood and urine tests. If the kidneys fail, also known as end stage renal disease, survival depends on receiving a kidney transplant or getting dialysis treatments regularly, usually several times per week. During a dialysis treatment, a patient is connected to a machine that performs the tasks as a real kidney, filtering waste and excess fluids from the body and restoring healthy blood. So many things in the body can go wrong if kidneys aren’t functioning properly. If the organ is unable to stop fluids from building up in the body, swelling can occur in the arms, legs or other organs, according to the CDC. The disease can also cause potassium levels in the blood to spike, which results in heart problems. It also causes bones to become brittle and weak. Anemia, a condition where a low number of red blood cells causes weakness, is not uncommon in kidney disease patients. A weakened immune system, malnourishment and even depression are also the brought on by kidney problems. According to the National Institute of Health, 118 Onondaga County residents who suffered from end stage renal disease died in 2012, up
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from 107 in 2002 and 47 in 1992. Locally, there are more than a dozen dialysis facilities to treat those with kidney failure. Fresenius Medical Care operates seven of them, two of which are in partnership with St. Joseph’s Health Care System. Those seven facilities currently treat 565 patients, an increase of roughly 50 patients from five years ago, said Natalina Crouse, Fresenius’ director of operations for the Syracuse and Watertown area. Statewide, the average dialysis patient is about 65 years old with a primary condition of either diabetes or hypertension. Sixty-three percent of the patients are Caucasian and 29 percent are African-American. Sixty percent are men and 40 percent are women. Locally, the root cause of most dialysis patient can be traced to obesity, Crouse said. The CDC recently announced an initiative for promoting kidney health, which will include screening process demonstrations in high-risk areas (for diabetes and subsequently kidney disease) in several states. It will also work with the U.S. Veterans Administration to study health outcomes of the population of aging military veterans. Fresenius recently surveyed thousands of patients who are chronically ill from end stage renal disease, diabetes, heart problems or a combination of conditions. The study determined that, typically, there is a lack of coordination among all the different physicians who treat a patient for a specific problem. The endocrinologist who monitors a person’s diabetes, for example, does not communicate with the nephrologist who deals with the kidney disease. In the Syracuse and Watertown area, Fresenius and St. Joseph’s Health Care System have already incorporated a team approach where numerous health care professionals, including doctors, nurses, social workers and other specialists work together to treat individual patients. “Caring for them is not just dialysis,” Crouse said, “but also their on other needs — bone and mineral issues, their fluids. We’re looking at everything, and we’re looking at quality. Patients are on dialysis lon-
The CDC estimates that 20 million American adults have chronic kidney disease right now but haven’t been diagnosed yet.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
Ken Rogers, a dialysis patient who goes to St. Joseph’s Regional Dialysis Center in Syracuse three times a week, said the improvement in nephrology care has exploded during his lifetime. His first experience in a dialysis facility was in California in the 1970s. “The machines weren’t very efficient,” he says. “The patients were cramping a lot — seems like they were suffering. They couldn’t drive themselves home.” ger, they are living longer and [some] are able to work.” Betsy Bedigian, communications manager for St. Joseph’s Health Care System, said the use of electronic medical records shared among the providers assigned to a patient’s care has improved the quality of care. “With one patient record for their care, it’s easier to communicate in other settings across the system,” she said. “Everything we are doing now is working toward that coordinated care.” Crouse added that home dialysis care is another option for many patients in this area, depending on their needs. “We’re trying to make it an option for anyone who wants to do it. We get creative.” Ken Rogers, a dialysis patient who goes to St. Joseph’s Regional Dialysis Center in Syracuse three times a week, said the improvement in nephrology care has exploded during his lifetime. Rogers, of Syracuse, suffers from a hereditary kidney disease that is not related to diabetes or hypertension. His first experience in a dialysis facility was in California in the 1970s, when he visited his older sister during treatment. “The machines weren’t very efficient,” he said. “The patients were cramping a lot — seems like they were suffering. They couldn’t drive themselves home.” Rogers, 56, of Syracuse, experienced kidney failure in 1996. He received a transplant in 1998 but the organ only lasted two years. He’s been in dialysis three times a week since then. Over the years, the process has become much more comfortable, he explained, due to better
equipment and improved efforts from medical staff who are more attentive to patients and share more information about what is going on in their bodies. Rogers was able to work full time up until three years ago, first in a metals foundry and then as a warehouse laborer. “The biggest [improvements over the past 20 years] is I’ve got more energy after the treatment,” he said. “I consider myself very fortunate. The positive attitude helps.” Angie Baldini, clinical manager of the facility where Rogers is treated, said today’s machines have sensors that automatically adjust the fluid levels administered to a patient. By contrast, the dialysis machines 20 years ago had pressure gauges that staff would review every half hour or so and make adjustments as needed. Rogers has taken on the role of kidney care advocate, boosting the morale of other patients and organizing social activities such as fishing trips. “Years ago, you wouldn’t see this kind of thing here,” he said. “Patients should not be stressed. If you have high blood pressure, you won’t have a good treatment. Support and information is key to everything.” The National Kidney Foundation, which proclaims March as “National Kidney Month” is leading an initiative to educate Americans about the importance of the small organ and to give their kidneys, which filter about 200 liters of blood a day, a well-deserved checkup. As part of “World Kidney Day,” March 10, providers across the globe will provide free kidney disease screenings.
Home Care by Seniors for Seniors There’s a huge difference in the kind of home care you can receive from someone who really understands what your life is like as a senior. The concerns you have. The need for independence. Someone who, like you, has a little living under his or her belt. Our loving, caring, compassionate seniors are there to help. We offer all the services you need to stay in your own home, living independently. By Jim Miller
2016 Tax Filing Requirements for Retirees Dear Savvy Senior, What are the IRS income tax filing requirements going to be for this tax season? Due to health problems I stopped working early last year, so I’m wondering if I need to file. Unintended Retiree Dear Unintended,
There are a number of factors that affect whether or not you need to file a federal income tax return this year including how much you earned last year (in 2015), and the source of that income, as well as your age and filing status. Here’s a rundown of this tax season’s IRS filing requirements. For most people, this is pretty straightforward. If your 2015 gross income — which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately — was below the threshold for your age and filing status, you probably won’t have to file. But if it’s over, you will. • Single: $10,300 ($11,850 if you’re 65 or older by Jan. 1, 2016). • Married filing jointly: $20,600 ($21,850 if you or your spouse is 65 or older; or $23,100 if you’re both over 65). • Married filing separately: $4,000 at any age. • Head of household: $13,250 ($14,800 if age 65 or older). • Qualifying widow(er) with dependent child: $16,600 ($17,850 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see irs. gov/pub/irs-pdf/p554.pdf.
Special Requirements
There are, however, some other financial situations that will require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment
in 2015 of $400 or more, or if you owe any special taxes to the IRS such as alternative minimum tax or IRA tax penalties, you’ll probably need to file. To figure this out, the IRS offers an interactive tax assistant tool on its website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. You can access this tool at irs. gov/filing — click on “Do you need to file a return?” Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See irs.gov/localcontacts or call 800-829-1040 to locate a center near you.
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Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. Check with your state tax agency — https://www. tax.ny.gov/ — before concluding that you’re entirely in the clear.
Tax Prep Assistance
If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit irs.treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at more than 5,000 sites nationwide. To locate an AARP Tax-Aide site call 888-2277669 or visit aarp.org/findtaxhelp. You don’t have to be an AARP member to use this service.
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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. March 2016 •
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Excellus Awards Hospitals $22.4 Million for Quality Improvements
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orty-one Upstate New York hospitals and health centers last year earned $22.4 million in quality improvement payments from Excellus BlueCross BlueShield as part of its performance incentive program. Since 2005, Excellus BlueCross BlueShield’s program has paid out more than $210 million. “To provide the best value for our customers, collaboration with our provider partners is more important than ever as we identify new best practices to improve health outcomes and use health care resources more effectively,” said Tony Vitagliano, Excellus BCBS vice president, health system performance. Eight hospitals in the Central New York region participated in this program in 2015, including Auburn Community Hospital, Cortland Regional Medical Center, Crouse Hospital, Oswego Hospital, Samaritan Medical Center, St. Joseph’s Hospital Health Center and Upstate University Health System (two sites). In 2015, Excellus BlueCross BlueShield’s hospital performance incentive program evaluated participating hospitals on more than 241 performance measures. Hospitals that received quality improvement
incentive payments achieved 90 percent of all quality improvement targets. In addition to achieving required clinical and patient safety measures in 2015, other nationally-endorsed measures and target outcomes were jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, The Joint Commission, the Institute for Healthcare Improvement, and others. Areas targeted for 2015 improvement included: • Clinical Processes of Care focused on improvements in heart attack care, heart failure, pneumonia, and surgical care, and other measures that may be unique to each participating hospital • Patient Safety Centered on reductions in hospital-acquired infections, falls, pressure ulcers, readmissions, and other adverse events or errors that affect patient care • Patient Satisfaction Used the Hospital Consumer Assessment of Healthcare Providers and Systems survey, which is the first national, standardized, publicly-reported survey of patients’ perspectives of hospital care
A Wake-Up Call: You’re Probably Not Sleeping Enough By Kelly Quinn
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ne in three Americans does not get enough sleep on a regular basis, raising their risk of obesity, diabetes, high blood pressure, heart disease and stroke, according to the U.S. Centers for Disease Control and Prevention. Sleep experts at St. Joseph’s Sleep Laboratories agree; Central New Yorkers are not getting enough shuteye. Healthy sleep is defined as at least seven hours per day for adults aged 18-60. Locally, many adults are averaging far less — about five to six hours of sleep per night. “Meeting the recommended amount of sleep is crucial to a person’s health and well being. When the required hours of sleep are not achieved, there are many health and lifestyle risks that will result,” said Neil Widrick, RRT, RPSGT, RPFT, manager, St. Joseph’s Sleep Laboratories. The sleep many people get is not what’s considered ‘good’ sleep. It is estimated that 22 million Americans have sleep apnea. Eighty to 90 percent of people with moderate to severe sleep apnea are undiagnosed. “People tend to think that poor sleep and being tired during the day are normal, especially when you factor in stresses at home and at work,” said Widrick. “However, it is not normal to feel this way.” A sleep study is the first step toward restful nights and energetic days. St. Joseph’s Health has two sleep labs; they are located in Liverpool and Fayetteville. They offer Page 20
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comfortable hotel-like rooms and are fully accredited by the American Academy of Sleep Medicine for in-lab and home sleep testing. Home sleep testing is a fairly new option for people who prefer to do the study at home. Once a sleep study is complete and sleep apnea is diagnosed, St. Joseph’s affiliate, Franciscan Health Support provides patients with the latest CPAP equipment and supplies. Franciscan’s team of registered respiratory therapists works with each patient to customize their sleep therapy plan. CPAP equipment is more comfortable now than it’s ever been. “Patients are raving about the new DreamStation. It’s quieter than other CPAP machines and the screen and knob that are easier to use when you’re in bed,” said Tim Curtis, Respiratory Care Manager at Franciscan. “The DreamWear mask has soft tubes which bring air to your nose. The hose connects on the top of the head and patients say it’s much more comfortable; they can move around more and not get tangled up in hoses.” If you’re waking up tired, snoring or your bed partner says you stop breathing during the night, ask your healthcare provider to refer you to one of St. Joe’s Sleep Labs. It’s the first step to a better night’s sleep. Kelly Quinn, Director of Marketing and Public Relations, Franciscan Companies
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
The Social Ask Security Office By Deborah Banikowski District Manager, Syracuse
Filing Taxes Just Got (a Little Bit) Easier
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ow that it’s March, your annual tax filing deadline is fast approaching. If you receive Social Security benefits, one of the documents you need to file your federal income tax return is your Social Security Benefit Statement (Form SSA-1099/1042S). Your Social Security benefits may be taxable. This includes monthly retirement, survivor and disability benefits. About one third of people receiving Social Security benefits must pay taxes on some of these benefits, depending on the amount of their taxable income. This usually happens if you have other substantial income — such as wages, self-employment, interest, dividends and other taxable income that must be reported on your tax return — in addition to your Social Security benefits. You will never have to pay taxes on more than 85 percent of your Social Security benefits, based on Internal Revenue Service (IRS) rules. To find out if you must pay taxes on your benefits, you will need your Social Security Benefit Statement (Form SSA-1099/1042S). You should automatically receive it in the mail each January. It shows the total amount of benefits you received from Social Security in the previous year so you know how much Social Security income to report to the IRS on your tax return. The benefit statement is not available for people who receive Supplemental Security Income (SSI), as SSI payments are
not taxable. Whether you file your taxes early or wait until the deadline, Social Security makes it easy to obtain a replacement benefit statement if you didn’t receive one or misplaced it. You can get an instant replacement easily by using your secure online My Social Security account. If you don’t already have an account, you can create one in minutes. Follow the link below to the my Social Security page, and select “Sign In or Create an Account.” Once you are logged in, select the “Replacement Documents” tab to obtain your replacement 1099 or 1042S benefit statement. You can also use your personal My Social Security account to keep track of your earnings each year, manage your benefits, and more. You can also obtain a replacement benefit statement by calling us at 1-800-772-1213 (TTY 1-800-3250778), Monday through Friday from 7 a.m. to 7 p.m., or by contacting your local Social Security Office. If you live outside of the United States, please contact your nearest U.S. embassy or consulate. But by going online you can print your replacement benefit statement immediately and not have to wait to receive it in the mail. With a My Social Security account, gathering your Social Security information for tax season has never been easier. Open your own personal My Social Security account today at www.socialsecurity.gov/myaccount.
Q&A Q: Do I need a Social Security card? I want to get a summer job and my dad can’t find my card. A: If you know your number, you probably don’t need to get another card. If you find out that you do need a replacement card, the best place to go to find out how to get a replacement is www.socialsecurity. gov/ssnumber. In some states and the District of Columbia, you might even be able to request a replacement Social Security card online. In other areas, you can download the application to print out, complete and submit by mail or in person. If you do get a replacement card or find the original, you shouldn’t carry it with you. Keep it in a safe place with your other important papers. Learn more at www.socialsecurity.gov/ssnumber.
Q: Can I get a new Social Security number if someone has stolen my identity? A: We don’t routinely assign a new number to someone whose identity has been stolen. Only as a last resort should you consider requesting a new Social Security number. Changing your number may adversely affect your ability to interact with federal and state agencies, employers, and others. This is because your financial, medical, employment and other records will be under your former Social Security number. We cannot guarantee that a new number will solve your problem. To learn more about your Social Security card and number, read our online publication “Your Social Security Number and Card_ at www.socialsecurity. gov/pubs/.
H ealth News Rome Memorial Hospital Has New CEO Rome Memorial Hospital’s board of trustees has unanimously selected David W. Lundquist has been named Rome Memorial Hospital’s new president and chief executive officer effective March 1. He succeeds interim President/CEO Darlene Burns For nearly 25 years, Lundquist has served as CEO of hospitals in Oklahoma, New Jersey, and most recently at the Health Lundquist Alliance of the Hudson Valley in Kingston, NY, where he navigated three hospitals and two residential centers
Excellus has new chief medical officer Excellus BlueCross BlueShield has named physician Richard Lockwood, vice president and chief medical officer of the company’s Central New York region. He replaces Marybeth McCall, who is now serving as vice president and chief medical officer of Excellus BlueCross BlueShield’s Utica region. Lockwood has been vice president and chief medical officer of utilization management for Excellus BlueCross BlueShield since July 2015. He joined the company as a part-time associate medical director in 1999 and was named medLockwood ical director for the company’s Central New York region in 2011. In his professional career, Lockwood has been in private practice with Onondaga Hill Internists, Family Care Medical Group, Van Duyn Home and Hospital, Loretto, and Hill Haven Nursing Home, all in Syracuse. He has held the position of medical director at Iroquois Nursing Home, Jamesville, since 2005. After graduating cum laude from Syracuse University and SUNY Downstate College of Medicine, Brooklyn, Lockwood completed his internship and residency in internal
through a successful affiliation and system integration. In his early career, he developed his healthcare experience as a management engineer and a director of employee relations before transitioning into administration. Lundquist earned his bachelor of science degree in industrial engineering at the University of Oklahoma and a master of business administration degree from Oklahoma City University. Lundquist defines his leadership approach as “focused, collaborative and positive; focused because that’s how we get the important things done; collaborative because we can’t accomplish anything without teamwork; and positive because anything worth the effort can be attainable through teamwork, planning and a positive attitude.” Lundquist is relocating to Rome with his wife, Jane. Married for 44 years, the couple raised three children and has six grandsons. medicine at the Medical College of Pennsylvania in Philadelphia. He is a clinical instructor at SUNY Upstate Medical Center and has hospital privileges at Upstate Medical University and Upstate University Hospital Community Campus, where he served as president of the medical staff prior to the hospital’s merger with Upstate Medical University. A member of the Onondaga County Medical Society, Medical Society of the State of New York and American College of Physicians, Lockwood is a fellow of the American Board of Internal Medicine. Lockwood and his wife Mary live in Manlius.
Follett will be developing and implementing an overall marketing strategy, directly supporting the management team in advancing LRI’s mission. In addition, she will conceptualize and advance the social media messaging for Liberty Resources and its affiliate programs. “Antoinette has previously worked with Liberty Resources on the creation of marketing brochures and other creative services,” said Carl Coyle, CEO, Liberty Resources. “Her vision for communications will help build Liberty Resources’ identity through a combination of branding, community outreach, and social media. Our staff are truly excited to have a resource that can promote and showcase the excellent work they do with the thousands of clients we serve throughout New York, Texas, and elsewhere.”
Lab at Nephrology Associates recognized Nephrology Associates of Syracuse PC has been selected as a recipient of the COLA Laboratory Excellence Award and has met all criteria for laboratory accreditation by COLA, a national healthcare accreditation organization. Accreditation is given only to laboratories that apply rigid standards of quality in day-to-day operations, demonstrate continued accuracy in the performance of proficiency
testing, and pass a rigorous on-site laboratory survey. According to a new release, Nephrology Associates of Syracuse PC has earned the COLA accreditation as a result of a long-term commitment to provide quality service to its patients. COLA is a nonprofit, physician-directed organization promoting quality and excellence in medicine and patient care through programs of voluntary education, achievement, and accreditation.
New information security director at St. Joe’s Neil Andersen has been named director and information security officer for St. Joseph's Hospital Health Center. This position will oversee the information security program at St. Joseph's Hospital Health Center, St. Joseph's Physician PC, the Franciscan Companies, and any future partners. Andersen is an experienced Information technology professional with more than 30 years in information technology in multiple technical and managerial roles in access control, telecommunications and network security and other related issues. He comes to St. Joe’s from Trinity Health where he most recently served as the regional information security officer for Sisters of Providence Health System, now a part of Trinity
Metro Fitness Health Club Opens Location in Fayetteville
Liberty Resources has new marketing director Human services leader Liberty Resources recently announced the addition of Antoinette Follett as director of marketing and communications. Follett is a communications professional with more than 20 years of experience in marketing, publishing and public relations. Previously, she was president of Bentley-Hall, Inc., a local publishing Follett company, and editor-in-chief of International Musician and Making Music magazine.
A ribbon-cutting ceremony to dedicate the Fayetteville location of Metro Fitness Health Club. Pictured is Sen. John DeFrancisco with Metro Fitness Owner Randy Sabourin. The event took place January29.
M
etro Fitness Health Club has added a second location in the former Koinonia Fayetteville Athletic Club (formerly known as Track & Racket/Fitness Forum Club) at 6800 E. Genesee Str. in Fayetteville, right across from Wegman's in DeWitt. Currently Metro Fitness owns and operates a club at 205 S. Salina March 2016 •
St. in the heart of downtown Syracuse. “With more than 20 years of experience and great expertise in the health and fitness industry, Metro Fitness is looking forward to bringing their passion for health, fitness, personal training and excellence in customer services to Fayetteville,” said owner Randy Sabourin.
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H ealth News Health — New England. Andersen has been part of the Trinity Health system since 2013. Andersen has extensive experience in computer information systems and cybersecurity and has served in an adjunct faculty role with Boston University’s and University of Findlay’s Graduate School in areas of computer information systems, cyber security, and healthcare informatics. Andersen earned a Master of Science degree in computer information systems with Andersen a concentration on cyber security at Boston University in addition to his Bachelor of Science in information technology. He is a certified information systems security professional (CISSP), certified ethical hacker (C|EH). Andersen has also held certifications from Cisco, Nortel Network, 3Com, and Microsoft.
RMS Healthcare welcomes new specialist Research & Marketing Strategies, Inc. (RMS) is pleased to announce that Jeff Emmi has recently joined the Research & Marketing Strategies, Inc. (RMS) healthcare team as practice transformation specialist. Emmi previously worked with POMCO in its customer service department, where he was responsible for researching and responding to benefit, eligibility, authorization and claim inquiries from members, providers and employer groups. In his new role, Emmi will be responsible for assisting RMS Healthcare clients with individEmmi ual project needs in preparation for NCQA approval. He will also assist clients in achieving patient-centered medical home (PCMH) recognition, as well as being involved in quality improvement initiatives relating to the PCMH model and patient-centered care. Jeff's commitment to provide excellent customer service will be instrumental in coaching practices through their PCMH transformation journey. Emmi has received accolades for his dedicated commitment in providing outstanding assistance to customers. Emmi graduated from St. John Fisher College in Rochester. He resides in Syracuse.
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Infectious disease doctor joins St. Joseph’s Physician Joel E. Moses has joined St. Joseph’s Hospital Health Center as a specialist in infectious disease. Moses received his medical degree from Albany Medical College in Albany in 1989. Following his residency at North Shore University Hospital of Cornell University Medical College in Manhasset, Moses completed a fellowship in the division of infectious diseases in 1994. Most recently Moses was in private practice as an adult infectious disease consultant and provided services to both Samaritan Hospital and Seton Hospital in Troy. Additionally, he supervised hyperbaric oxygen therapy dives and provided wound care treatment at Albany Memorial Hospital Wound Care Center in Albany Prior to 2005 he was employed as an infectious disease consultant at Albany Medical Center, Albany; St. Peter’s Hospital, Albany; Robert Packer Hospital, Sayre, Pa.; Cayuga Medical Center, Ithaca; St. Joseph’s Hospital, Elmira; and Arnot Ogden Med Center, Elmira. He was medical director at the HIV “Ivy” Moses Clinic at Arnot Ogden Med Center from 1996-2002. “Dr. Moses has been active on medical committees at all of the hospitals in which he practiced including as a member of the bio terrorism task force,” says Sandra Sulik, chief medical officer and vice president for medical affairs for St. Joseph’s Health. “His experience in infectious diseases and his commitment to lifelong learning and excellent patient care is commendable.” Moses is board certified by the American Board of Infectious Disease and certified in hyperbaric oxygen therapy and supervision. He is an active member of the Infectious Disease Society of America and the Health Information Exchange of NY.
St. Joseph’s recognized for heart services St. Joseph’s Hospital Health Center has received the 2016 Women’s Choice Award as one of America’s Best Hospitals for Heart Care. This evidence-based designation is the only heart care award that identifies the country’s best healthcare institutions based on robust criteria that considers female patient satisfaction, clinical excellence, and what women say they want from a hospital. The list of 352 award winners, including St. Joseph’s Hospital, represents hospitals that not only performed well clinically with regard to heart care measures, but also had a high recommendation rate, a mea-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2016
sure that is very important to women when choosing a hospital; signifying St. Joseph’s commitment to meeting the highest standards in heart care. “As the top provider of cardiac care in the region, St. Joseph’s Hospital Health Center holds nearly a dozen different accreditations, certifications and recognitions for cardiovascular care. But this award looks beyond our medical staff and treatments,” said Kathryn Ruscitto, president and CEO of St. Joseph’s Health. “This award speaks highly to our commitment to deliver a higher quality of care to the hundreds of thousands of patients we serve throughout Central New York, and the positive experiences that our patients are having at St. Joseph’s Hospital.”
HealtheConnections receives $2 million award Gov. Andrew M. Cuomo last month announced that HealtheConnections of Syracuse will receive $2.05 million to implement improvements in six Central New York counties, identified by the New York State Department of Health as having high rates of chronic disease. The counties are Cayuga, Cortland, Herkimer, Oneida, Onondaga, and Oswego. The award is part of $7 million package given to HealtheConnections and three other organizations in the state designed to prevent and control obesity, diabetes, heart disease and stroke. The grant, originating with the federal Centers for Disease Control and Prevention (CDC), will be dispersed to the four awardees over the next three years. “We are thrilled with the opportunity to leverage our experience in population health improvement, provider engagement, and health data analytics for Local IMPACT,” said Rob Hack, president and CEO of HealtheConnections. “The work associated with this award is a natural extension of our role as neutral convener and health improvement organization for the region, along with our valued partner organizations, to improve the health of both the general population, as well as populations experiencing health disparities.” To carry out this initiative, HealtheConnections will partner with organizations from each of the six identified counties. Partners include Cayuga County Community Health Network, Seven Valleys Health Coalition of Cortland County, Herkimer County HealthNet, Central New York Health Home Inc. of Oneida County, Onondaga County Health Department, and Oswego County Rural Health Network. HealtheConnections will also collaborate with other organizations, including pharmacies, health care providers, and higher education, across the region who will lend their support and expertise to the program.
ARISE expands long-term care program ARISE has overseen an advocacy
program, known as the long-term care ombudsman, in Cayuga County for the past few years and has been selected to coordinate the program in three additional counties. ARISE is now operating the program in Onondaga, Cortland and Oswego counties. The organization is seeking volunteers who want to be part of this enriching effort. The purpose of the long-term care ombudsman program is to protect the health, safety, welfare and civil rights of people living in nursing homes and adult care facilities. Certified ombudsmen in the program advocate for residents’ rights and ensure that their complaints are resolved to support a higher quality of life. Long-term care ombudsmen are trained and certified volunteer advocates who are passionate about the well-being of people living in nursing homes or adult care facilities. They can help resolve complaints, provide information about resident rights, and advocate on behalf of residents for high standards of quality care. If you want to volunteer or want more information, contact Jeffrey Parker at 315-671-5108 or jparker@ ariseinc.org.
‘CNY Tobacco Treatment Champions’ The Central New York (CNY) Regional Center for Tobacco Health Systems at St. Joseph’s Hospital Health Center (SJHHC) recognized local medical and mental healthcare organizations who championed comprehensive tobacco treatment policies throughout the region. “These tobacco treatment champions were honored for their leadership, vision and dedication in ensuring that their patients and clients are not only asked about tobacco use but are continuously provided with support and resources for when they are ready to quit,” said Christopher Owens, director of the CNY Regional Center for Tobacco Health Systems at SJHHC. The following organizations were recognized for implementing a gold-standard, comprehensive tobacco health system policy to their standard of care protocols to guarantee that tobacco users are provided with continuous assistance with quitting: Cayuga Center for Healthy Living, Cayuga Medical Center, Community Memorial Hospital of Hamilton, Cortland Regional Medical Center, Credo Community Center, Endwell Family Physicians, LLP, Family Counseling Services of Cortland County, Inc., Greater Binghamton Health Center, Hutchings Psychiatric Center, Ithaca Health Alliance, Mary Rose Clinic, North Country Family Health Center, The Rescue Mission: Syracuse, Binghamton, Ithaca and Auburn sites, and Transitional Living Services of NNY For more information about the CNY Regional Center for Tobacco Health Systems at SJHHC, visitwww. tobaccofreeny.org.
Stephen V. Faraone: ‘World’s Most Influential Minds’ in Psychiatry/Psychology
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or the second consecutive year, Stephen V. Faraone, SUNY distinguished professor of psychiatry and behavioral sciences at Upstate Medical University, has been included in the Thomson Reuter’s list of world’s most influential minds and its list of highly cited researchers in the field of psychiatry/psychology. Thomson Reuters is a major multinational mass media and information firm. The 2015 report is an updated listing of the elite scientists officially designated as highly cited researchers, based on their respective output of top-cited papers in their fields. “Covering an 11-year period, it features the scientists who have Faraone won acclaim and approval within a key population: their peers,” says Emmanuel Thiveaud, vice-president/head of government solutions and research analytics with Thomson Reuters IP & Science Business. The report listed some 3,000
highly cited researchers in 21 main specialty areas. “Professor Faraone has had a profound influence on the field of psychiatry and has elevated the standards of scholarship of colleagues in both psychology and psychiatry,” said physician Robert Gregory, professor and chairman of Upstate’s department of psychiatry and behavioral sciences. “He has made important contributions to the clinical literature regarding the diagnosis and treatment of ADHD. In fact, his studies of the age at onset of ADHD were an important influence in current plans to modify the American Psychiatric Association’s diagnostic criteria for the disorder and his work on adult ADHD was instrumental in teaching clinicians and researchers about the persistence of ADHD into adulthood.” An author on more than 800 journal articles, editorials, chapters and books, Faraone was the eighth highest producer of high impact papers in psychiatry from 1990 to 1999 as determined by the Institute for Scientific Information. In 2005, ISI determined him to be the second highest cited author in the area of attention deficit hyperactivity disorder and in 2013 he was the third most highly cited researcher in psychiatry and psychology in the world, according to Microsoft Academic Search.
Upstate Doc Named to National Task Force that Makes Health Screening Recommendations
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hysician John Epling, professor and chairman of the department of family medicine at Upstate Medical University, has been named to the U.S. Preventive Services Task Force (USPSTF). The task force issues evidence-based recommendations about a variety of screenings, and medications aimed a preventing illness and disease. With his appointment, Epling becomes one of 16 members on the task force. Members are appointed to serve four-year terms by the director of the Agency for Healthcare Research and Quality, a part of the U.S. Department of Health and Human Services. “Upstate is please to congratulate Dr. Epling on this important appointment,” said physician David Duggan, dean of Epling the college of medicine. “His appointment to this noteworthy panel reflects his outstanding work in preventive and evidence-based medicine and
family medicine. Clinicians, patients, policy makers will be well served by Dr. Epling as he shares his expertise creating new recommendations for a healthy future across the United States.” The task force was created in 1984 as an independent panel of national experts in prevention and evidence-based medicine. The task force works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. A recent recommendation that garnered significant attention was the group’s recommendation for screening for depression in the adult population, including pregnant and postpartum women. The group also recommended that screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. Other recent noteworthy screenings include the recommendation that adults 18 and older be screened for high blood pressure. In 2013, the USPSTF recommended annual screenings for lung cancer with lowdose computed tomography in adults 55 to 80 years who have a 30 pack-ayear smoking history and currently smoke or have quit within the past 15 years.
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Spiritual Care:
Training Chaplains to Work in Hospitals, Nursing Homes One of the missions of Upstate’s Rev. Terry Culbertson is to train new chaplains
By Aaron Gifford
I
n hospitals and nursing homes, spiritual care often goes beyond religion. The chaplains, whether Christian, Jewish, Muslim or Hindu, commonly visit with patients of other faiths. They are there mainly to listen, sometimes to comfort, but never to preach. “Go into a room with empty hands and an open heart, making space for the other person,” says the Rev. Terry Culbertson. “Don’t come in with a preset agenda. Visiting the sick is more about listening than talking. In a hospital setting, you’re not in charge.” Culbertson established Upstate Medical University Hospital’s clinical pastoral education training program 13 years ago and has been involved with spiritual care since the late 1970s. She trains chaplains to work in hospitals and nursing homes. While she’s taught many experienced priests, ministers, rabbis and imams, her certified graduates also includes nurses, lawyers, dairy farmers, a retired police detective, and a Buddhist nun who was raised Catholic. The program is open to ordained professionals as well as laypersons and seminarians. Two training sessions are offered each year. Each is 400 hours — 300 of direct ministry, and 100 hours of instruction. Training groups are limited to six students. During the course work the trainees learn about a variety of medical specialties, from oncology, to neurology, to pediatrics. The retired police detective, Jose “Joe” Colon, works at St. Joseph’s Hospital Health Center in Syracuse. After working for the New York City Police Department (NYPD) for 20 years, six in the homicide division, Colon attended seminary college in Rochester and later relocated to
Central New York. Following the events of Sept. 11, 2001, Colon was committed to the idea of a career where he could continue to help people, initially pursuing training as a social worker and then deciding on the clergy. “It’s a weird combination [police work, social work and seminary school] from any parish or pulpit,” said the Rev. Colon, who was ordained with the United Church of Christ around the time he completed his training with Culbertson. “What do you do with that? A hospital chaplain felt right. It fit in with everything I had Rev. Terry Culbertson has been a chaplain at Upstate Medical University been involved with.” Colon mainly sees patients in Hospital for 13 years. She also helps train new chaplains. “Don’t come the intensive care unit. Many pain with a preset agenda. Visiting the sick is more about listening than tients have asked him for a miracle, and he’s had to explain that his role talking. In a hospital setting, you’re not in charge,” she says. is not to speak for God, but to take the journey of hospitalization with them. Over time, he has gotten to “And the answer never changYork has a spiritual care program know many of the patients’ families es. I always tell them, ‘that’s up to that places certified chaplains in and loved ones. He calls the work the doctors,’ ” said Beigel. The rabbi hospitals, nursing homes and correcchallenging and exhausting, but also himself was recently hospitalized, an tional facilities throughout Onondaga important and rewarding. experience that he calls a boost to his County. It serves up to 2,000 people “I’ve seen humanity at its career development. “I really learned per month. worst,” recalled Colon, who spent 18 to appreciate just how important the One of its contractors, Rabbi months at the Ground Zero site after Irvin Beigel, who was also trained by visits are. Being a patient is a very 9/11. “In that light I’ve always tried lonely experience.” Culbertson, considers the transition to find the best in humanity. A key In the spirit of interfaith works, from pulpit to bedside a full-fledged thing we learned in [pastoral care] Beigel organized a trip to Israel last career change. The Queens native training is how we have to take care year. Several chaplains attended repwas ordained in 1970 and had more of ourselves. Part of it is knowing resenting multiple faiths. A handful than 30 years of experience leading our limits, knowing when to take of local hospital employees joined synagogues, including a long-term a break or ask for help. Sometimes, them. The group visited several position in Toronto, before his chapyou’ve got to tap out.” Jewish, Christian and Muslim sites, lain training in Central New York. Culbertson, Colon’s teacher, emlearning from each other and enjoyAs Beigel explains it, “the esphasized that the need for more hosing each other’s company. sence of what we do is to support pital chaplains in Central New York While the sight-seeing experiencthem — give them strength and give and across the nation is immense. es allowed the chaplains and health them meaning. In that sense, spiritual “The hardest part, for me, is gocare providers a chance to relax and ing home at night knowing that there care goes beyond any religion.” reinvigorate themselves, they also The rabbi has visited many is a need for more and more trained visited Israeli hospitals that employ hospitalized Christians. While Interpeople,” she said. chaplains of various faiths. Faith’s clients can request chaplains InterFaith Works of Central New “Israeli hospitals treat everyof specific religions and often do, one,” Beigel said. “You can have the many hospital patients just ask for victim of terrorism in one bed, and whoever is available. The spiritual the perpetrator of terrorism in the care providers are trained to respect next room. I think it’s a great thing all faiths, even those who are agnosthat Israel society places such a high tic or atheist, and do not attempt to value on human life. You have Arab change anyone’s beliefs. doctors working alongside Jewish Regardless of faith or lack of doctors. You may think that they are faith, a patient’s conversation with two separate worlds, but it really the chaplain can be about almost isn’t true.” anything, Beigel said, recalling an “Part of the success of the trip instance where a terminally ill retired was the fact that the group fit togethscientist talked about Roman philoser very well,” he added. “We were ophers. Terminally ill patients often pres- able to ask each other questions and we truly learned from each other.” ent the “Why me?” question, and it’s Beigel is organizing another never easy to understand or explain, trip to Israel for February 2017. The Beigel said. Multiple faiths share storabbi said several clergy leaders and ries of righteous men who suffered. members from area churches have “It seems unjust, in the end,” expressed an interest, along with area he said. “We just don’t know. It’s Rabbi Irvin Beigel organized a trip to Israel last year and brought several CNY hospital employees. The trip will be beyond human understanding.” chaplains representing multiple faiths with him. Behind the group is Jerusalem. Rabbi open to anyone who wants to go, not Beigel said another common just people involved in clergies or question is, “What can you do to get Beigel is organizing a new trip to Israel in 2017. The trip will be open to anyone who health care. me out of here?” wants to go, not just people involved in clergies or health care. Page 24
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