in good June 2016 • Issue 198
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CNY’s Healthcare Newspaper
Sunbathing
Weight Lifting Mistakes Guys Make
( ( ( (
Men’s Health Inside
) Good for you ) Really good for you ) Bad for you ) Really bad for you Local experts comment on Page 12 the latest about sunbathing
Drone for Dad or Grad?
As number of recreational drones goes up, so are accidents
The Healing Court Syracuse Community Treatment Court focuses on rehabbing addicts
Need a Doctor Now? Head to Price Chopper in Fulton
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Price Chopper in Fulton was selected as one of four locations across NYS to pilot Doctor on Demand, a new video telemedicine program that allows customers to remotely meet with a board-certified physician. Visit is $40 or less, depending on the insurance.
The Nutritious Perks of WholeGrain Pasta
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Ways to Protect Yourself Against Mosquito-born Viruses Central New Yorkers need to be vigilant to mosquito bites, say experts
Q&A with Krislyn L. Flint, M.D. An early skeptic, now chief of OB/GYN at Oneida Healthcare favors use of daVinci robot in cases involving hysterectomies
SmartBite columnist has ditched regular pasta in favor of wholegrain pasta. Find out why
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Need a Doctor? Head to Price Chopper in Fulton
Grocery store testing telemedicine program By Nicole Shue Price Chopper in Fulton was selected as one of four locations across New York state to pilot Doctor on Demand, a new video telemedicine program that will allow customers to remotely meet with a board-certified physician right in the store. The traffic and the engaging pharmacy team were attributed to the choosing of the Fulton site. The partnership between Computerized Screening Inc., a provider of in-store health stations, and Doctor on Demand is giving customers access to live, private, one-on-one video consultations that can help diagnosis and treat minor illnesses. The health station at the Fulton Price Chopper, located next to the pharmacy, is open for use 24/7. The all-day hours offer convenience, and can benefit customers who become unwell over the weekend, saving them a potentially costly trip to urgent care. Price Chopper publicizes the Doctor on Demand service through its store with handouts and signage. During the stores pharmacy hours, a Price Chopper pharmacist can refer a
customer to the Doctors on Demand service. Customers often approach the pharmacy counter to ask the team for advice, and this service allows an alternative to a traditional doctors visit. Pharmacists are available for assistance, but do not engage in the Doctors on Demand session. A customer wishing to use the service enters the in-store health station, answers a series of questions about his medical history and any medications and picks up the phone in the kiosk to begin the call with a doctor. The cost to use the Doctor on Demand service is $40, or less with qualifying insurance. The Fulton Price Chopper offers a coupon that waives the cost of your first visit. Customers must enter a debit or credit card number for the visit, even if the balance is zero. The $40 visit includes a 15-minute consultation with a physician who is able to diagnose, advise, treat symptoms and prescribe medications for a range of non-emergency medical issues like the common cold, flu, respiratory symptoms, sinus infec-
tions, skin and rash issues and pink-eye. Tony Yan is an emergency medicine physician with 17 years of experience in the ER who has worked for Doctors on Demand since 2013. During a recent teleconference call at the Fulton store, he spoke of how Doctors on Demand serves as a good bridge for the gap in medicine. “The service we Customers at Fulton Price Chopper can have a medical provide is the way of teleconference visit with a doctor, get a diagnosis and the future for patients receive a prescription right on the spot. with less serious complaints,” said Yan. According to a study by HIS, Inc., their prescription to be filled. the American Medical Association, Also, following the consultation, and the Wellness Council of America, the patient is provided with a written nearly 75 percent of all doctor, urgent summary of their visit. This docucare and emergency room visits are mentation can be sent to a patient’s either unnecessary or could be hanprimary physician, although, a padled safely and effectively over the tient of Doctor on Demand does not phone or video. need a PCP to use the service. Yan works in California, and is Kathy Bryant, vice president of able to assess patients who visit the pharmacy for The Golub CorporaFulton store through video confertion, the Schenectady-based parent encing. Through these visual exams company of Price Chopper, said that and information gathered on screen the goal of the recent partnership is from the patient prior to the call, Yan to provide health and wellness for its and other Doctor on Demand physicustomers. cians are able to get a good sense of a “We believe that our customers patient’s problem. are ready to test out this new technolYan starts each consultation by ogy, which improves the efficiency asking a patient what symptoms and availability of health care. As a they are experiencing, and for how retailer committed to helping people long these symptoms have persisted. feed and care for themselves and Once a diagnosis is made, the doctor their families, we’re please to be able can send a script to a pharmacy of to make it available in our stores,” the patients choosing, including the said Bryant. Fulton Price Chopper. Customers can shop in-store while they wait for
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 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, Chemotherapy and certain prescription drugs such as Gabapentin, Lyrica, Neurontin and Cholesterol Lowering Drugs (statin 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, Peripheral Neuropathy Vibration Therapy, is used to
expedite healing by increasing blood circulation to the muscles by repeated contraction and relaxation of your muscles. This brings freshly oxygenated and nutrient rich blood to all tissues causing accelerated healing. This treatment also increases the transmission of nerve signals to the affected area to reduce neuropathy pain. 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.
Home Treatment Program Now Available! 3452 Route 31 • 622-0102 • Baldwinsville, NY 13027 (located across from Hickory Hill Golf Course) May 2016 •
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CALENDAR of June 4
HEALTH EVENTS June 5
Fulton Bike Rodeo to ffer free bike helmet Local youngsters can learn more about bike safety and be properly fitted with a free bike helmet during the Fulton Bike Rodeo to be held from 11 a.m. to 2 p.m., Saturday, June 4, from in the parking lot of the Fulton Community Center. This free event will also offer an opportunity to take home a refurbished bike, as well as drawings for three free new bikes, air hop rides, bike registrations, food and more. The Fulton Police Department will provide the free helmets that will be fitted by certified staff from Oswego Health. An initiative of the hospital’s emergency department is to reduce the number of head injuries. Youngsters can also have a helmet that is in use checked for a safe fit. New York state law stipulates that those under the age of 14 must wear a helmet when riding a bike or scooter. In the event of rain, the rodeo will be held inside the Fulton Community Center.
June 5
Cancer events held in Liverpool, Auburn Hematology Oncology Associates is organizing two Cancer Survivor's Day events Sunday, June 5. One starting at 10:30 a.m. at Willow Bay, Onondaga Lake Park, Liverpool, and the other starting at 12:30 p.m. at Throop Fire House, 7159 Beech Tree Road, Auburn. Both events celebrate National Cancer Survivor's Day and will offer food and festivities for people of all ages free of charge. See story about the events in this issue of In Good Health.
AIDS Walk/Run takes place at Beaver Lake Join ACR Health Sunday, June 5, for the 24th Annual AIDS Walk/ Run, sponsored by Empower Federal Credit Union, at Beaver Lake Nature Center in Baldwinsville. The AIDS Walk/Run benefits ACR Health and features a 5K fundraising walk and a 10K timed run, with free food, drinks and fundraising incentives. Participants are encouraged to fundraise a minimum of $25. Those raising more receive great incentives. Registration begins at 8:30 a.m. on event day. The AIDS Walk/Run starts at 10 a.m. – rain or shine. All the the money raised stays in Central New York to benefit ACR Health’s youth HIV/STD prevention programs and emergency client needs. Now in its 24th year, the AIDS Walk/Run is ACR Health’s largest outreach and fundraising event in Central New York. Join the fight to end AIDS by 2020! You can register online to participate in the AIDS Walk/Run at ACRHealth.org/events or call AIDS Walk/Run headquarters at 1-800-4752430.
CNY’s ZERO Prostate Cancer Run/ Walk to take place Saturday, June 25, at Clay Central Park in Liverpool Page 4
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June 11
Rocker Carl Palmer Show to benefit Crouse Carl Palmer, voted by Rolling Stone as one of the 10 greatest drummers of all time, is credited with being one of the most respected rock drummers to emerge out of the 1960s. Palmer, a founding member of the legendary British prog-rock supergroup Emerson, Lake and Palmer, will be in Central New York on Saturday, June 11, as part of his national 2016 ELP Legacy Tour. Syracuse is the only Upstate New
Expert to discuss Duopa treatment for Parkinson’s Chris Sheridan, a registered nurse affiliated with AbbVie Pharmaceuticals, will make a presentation about Duopa, a new medication that treats Parkinson’s disease. In January last year AbbVie announced it had obtained approval for Duopa, its gel formulation of carbidopa/levodopa enteral suspension infused directly rostate cancer is one of the most common cancers in American men. The incidence of prostate cancer is approximately 230,000 new cases annually in the United States. It is a disease of aging, rarely occurring in men under the age of 40. Screening for prostate cancer begins with a primary care physician, especially if a patient is experiencing urinary symptoms. African American men or men with a family history of prostate cancer should be screened at age 40. Caucasian men, with no risk factors or family history of the disease, should be screened at age 55 and every year until they are 70 years old. See a urology specialist or your doctor if you have any of the following symptoms: • Weak flow or frequent urination • Sudden urge to urinate • Frequent urination at night • Difficulty starting flow of urine • Incomplete emptying of the bladder • Pain or burning while urinating • Presence of blood in the urine or semen
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
York stop on Palmer’s tour, and will benefit the Crouse Health Foundation, specifically the spine program of the Crouse Neuroscience Institute at Crouse Hospital. The event begins at 8 p.m. at the Palace Theater, 2384 James St., in Syracuse. Advanced tickets are on sale via EventBrite.com for $40 and tickets can be purchased at the door for $50. Street parking will be available on James Street; behind the Palace Theater and in the lot behind POMCO at 2425 James St.
June 13
Community Memorial holds golf tournament The Community Memorial Hospital Foundation will hold its first “Chip In for Access to Care” golf tournament June 13 at Seven Oaks Golf Club on the Colgate University campus in Hamilton. The captain and crew format will begin with registration at 10:30 a.m. followed by lunch and a noon shotgun start. Seven Oaks Golf Club is also one of the most famous collegiate courses in the United States. The day will also include a generous gift from Callaway Golf, with a representative on-site for the day to consult with participants. There will also be on-course refreshments and other surprises. Sponsors for the event to date include The Kinney Drugs Foundation, SODEXO, The Colgate Inn, Tybo and Marcelle, and MLMIC. For more information or to register, call Dave Buran at 315824-7036.
Miss New York 1981 Turns 55
June 6
Join the P Challenge to End Prostate Cancer By Howard J. Williams, MD
into the small intestine of patients suffering from Parkinson’s disease. This treatment has been approved in Europe under the name Duodopa since 2004. Duopa represents a promising new option especially for those in later stages of the disease, according to experts. Sheridan will explain what Duopa is, how it is used, side effects and other information related to the drug. The discussion will include an introduction to a “Patient Partner” who is a person with Parkinson’s who is on Duopa therapy. The event will take place from 12:30 to 2 p.m., Monday, June 6, at The Hearth at Greenpoint, 150 Old Liverpool Road, Liverpool. It is sponsored by The Hearth at Greenpoint, AbbVie Pharmaceutical and Onondaga County Office for Aging. It’s free and open to the public. For reservation, call Cynthia at 315- 435-2362 x4993 or cstevenson@ongov.net.
Special Issue of 55 PLUS Just published Pick up your free copy at any Wegmans location or in more than 1,000 high traffic locations in the region. Subscribe for $15 a year. Call 315-342-1182
• Persistent pain in the back, hips, pelvis • Shortness of breath, dizziness, or anemia Associated Medical Professionals (A.M.P.) is committed to combating prostate cancer through exceptional care and state-of-the-art resources and equipment. Equal to that is our pledge to education, to research and, above all, advocacy. A.M.P. has taken this commitment to a new level by hosting ZERO — The End of Prostate Cancer’s run/ walk series. ZERO Prostate Cancer Run/Walk is considered to be the premier men’s health event in the country and A.M.P. has brought it to Central New York. Fighting this cause is important to us. A.M.P. is holding its third annual ZERO Prostate Cancer Run/ Walk at Clay Central Park (4821 Wetzel Road) in Liverpool on Saturday June 25. Register today @ Zeroprostatecancerrun.org/Syracuse. See our ad on page 13 for more information on A.M.P. and how you can get screened.
Howard J. Williams is a board-certified urologist, who serves as the chief executive officer at Associated Medical Professionals (A.M.P.), with offices throughout Central New York.
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Women’s Health
Special Issue of In Good Health For more information or to place an ad, please call 315-34211-82 or email editor@cnyhealth.com Page 6
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Meet
Your Doctor
By Chris Motola
Krislyn L. Flint, M.D. An early skeptic, now chief of OB-GYN at Oneida Healthcare favors use of daVinci robot in cases involving hysterectomies Q.: What kinds of patients do you treat? A.: I treat a lot of women with chronic or irregular heavy bleeding or pelvic pain, and women with endometriosis who haven’t been able to treat their symptoms with more conservative treatment. When those things fail, that’s when we discuss a hysterectomy. Q.: You perform most of your hysterectomies with the daVinci robot now, correct? A.: In my training at SUNY Upstate Medical University in Syracuse, on my first day, I was working with a gynecologist-oncologist doing an open hysterectomy with an extensive incision. I think I’ve had one open surgery recently that had to be converted from a laparoscopic procedure due to the patient’s anatomy, but for the most part we can do their surgeries with a tiny incision and send them home the next day. When they come back in two weeks to see me, they usually don’t even feel like they had surgery. It’s a big difference. The robot lets us see their internal anatomy in three dimensions and perform very delicate, intricate dissection to avoid injuries. I was a little reluctant at first, because these are major surgeries, but I love it. Q.: How big a difference are we talking about in terms of outcomes? A.: With the incision, it would be about 10 centimeters. We call it the bikini cut, because the scar hopefully won’t be visible with a bikini. With a large incision, there’s a high risk of infection, more blood loss and more days in the hospital. Q.: Hysterectomies are a fairly extreme procedure. What has to have happened for it to be considered the best course? A.: I go through the same process pretty much with everyone. I try to control bleeding and pain with hormones, intra-uterine devices and endometrial ablation. So we try the more conservative measures first. When those options don’t work, or we can’t use them effectively without harming the patient’s quality of life, we’ll look at a hysterectomy. Q.: What percentage of women ultimately needs hysterectomies? A.: That’s a good question. It’s one of the most common gynecological procedures, so the numbers are high. I would say about 30 percent. It’s less than it used to be. The push for being conservative has worked, whether or not that turns out to be
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
a good thing. A good goal is going through menopause without having a major surgery. Q.: What other procedures can you use the robot for? A.: I’ve used it on younger women who suffer from chronic pelvic pain or endometriosis. That will be considered a minimally invasive procedure, even though no structures are necessarily removed. Q.: Do you also do obstetrics? A.: I deliver babies, too. Q.: What percentage of your practice would you say obstetrics is? A.: I’d say about 30 percent. It’s about 70 percent GYN. We’re trying to grow our OB practice. We’ve
opened up an office in Rome. We’ve hired more mid-level personnel. It’s a work in progress. Q.: Oneida is one of the region’s smaller hospitals. What are some of the challenges and responsibilities of serving a smaller, more remote populace? A.: We’re a small community hospital and a level 1 nursery. We do have high-risk patients. We try not to deliver under 35 weeks. I trained in Syracuse, but I’m from here. It took me a good two to three years to really adjust to moving here. I
was always surrounded by multiple sub-specialties in Syracuse. There isn’t necessarily someone right down the hall here to call during an emergency. It took awhile to build up my confidence. Q.: Do you have to have more of primary care philosophy than you might in a larger hospital? A.: We do have a lot of primary care, as well as specialties like orthopedics and otolaryngologists. We don’t have the GYN-oncologists or 24/7 anesthesia in house. It’s a different way of doing things. We have good outcomes. I’m glad that I did move here. It’s been a great experience. Q.: To what degree does technology like daVinci help close the gap between larger and smaller hospitals? A.: It helps. We don’t have residents or a lot of mid-level support. If I need an assistant on an open case, I’m taking one of three doctors out of our office to be an assistant. That in and of itself is a huge impact. It also lets us do more complicated cases we would otherwise refer out. Despite what you might expect, you can actually see more with the robot than you can with an open cut. Except in extreme cases, I don’t need to refer out anymore. So we’re doing more with less manpower. It was a big step for the hospital to take, but it was worth it. I was apprehensive about the training at first, but I called one of my colleagues for advice and he told me this technology is not going away. So I got the bug.
Lifelines Name: Krislyn L. Flint, M.D. Position: Chief of OB-GYN at Oneida Healthcare Hometown: Oneida Education: Ross University; SUNY Oswego (undergrad) Affiliations: Oneida Healthcare Organizations: American Medical Association, American College of Obstetrics and Gynecology Family: Married, one daughter, one son Hobbies: Gardening, running
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Ways to Protect Yourself Against Mosquito-borne Viruses
Experts: Be vigilant about mosquito bites this season By Matthew Liptak
W
hile the Zika-carrying Aedes aegypti mosquito is not native to Central New York (it requires a tropical or subtropical climate to live and breed), local experts say similar mosquitoes live near New York City. It is possibly that they could move into Central New York in part due to climate change. “What the health department would like to remind everyone is that native mosquitoes to Central New York can carry West Nile [virus] and Eastern Equine Encephalitis,” said Onondaga Health Commissioner Indu Gupta at a recent press joint press conference with Upstate Medical University. “The most effective strategy to reduce these infections is preventing
the mosquito bite. Zika virus does not pose a risk locally at this point, but certainly the population needs to be vigilant, according to
Gupta. “What all these diseases have in common is there’s no treatment. Prevention is the only strategy.” Most mosquitoes are not infected with these illnesses — Zika and other diseases like EEE and West Nile virusus. Gupta and physician Mark Polhemus, director of the Center for Global Health and Translational Science at SUNY Upstate, who led the May 23 press conference, suggest five way to stay safe:
Windows and doors should 1 be screened. Be sure that the screens are in good repair. Use air conditioning when possible.
long sleeves, long pants 2Wear and socks when outdoors. Always use insect repellent 3 according to the label instructions when outdoors. Repellents containing DEET, picaridin, IR3535 and some oil of lemon eucalyptus and para-menthane- diol products provide longer-lasting protection. Mosquitoes tend to breed in 4 containers that collect and hold water, such as pools, wading
pools, buckets, flowerpots, birdbaths and toys that are left outside. Be sure to empty water from these containers when not in use and free your environment of unnecessary items that collect water, such as old tires.
When it is not possible to elim5 inate standing water, use Mosquito Dunk tablets. These tablets kill
mosquito larvae, are found locally in stores, and are safe for humans. Symptoms of mosquito-born illnesses are often flu-like and occur within two weeks of being bitten. These include common symptoms like fever and chills, but there may also be more unusual effects of being infected like disorientation, neck stiffness and seizures. Scientists around the world and locally at Upstate are coming up with new ways to fight mosquito-borne illnesses. The medical university was recently awarded $200,000 to conduct research that includes potential for an early-warning system that would make people aware when dangerous mosquitoes are in the area. The Onondaga County Health Department began annual mosquito surveillance and control program in May. This program collects and tests mosquitoes for viruses, including West Nile and EEE viruses. The program also uses larvicides to control mosquito breeding in standing bodies of water. Just to be safe though, you may want to fight the bite yourself and make use of the above tips this season.
Healthcare in a Minute By George W. Chapman
Drug spending continues to soar
Total spending on drugs was $425 billion last year up a staggering 12 percent from 2014. According to the AARP’s Public Policy Institute report, the average retail cost of a year’s supply of typically used prescription drugs by seniors is over $11,000. The average annual cost for specialty drugs, like those treating cancer and hepatitis, was $53,384 three years ago. Overall Medicare spending was up only 1 percent last year to put the 12 percent drug increase into perspective. Drugs now account for 25 percent of overall spending. (Thirty years ago, drugs accounted for less than 5 percent of all healthcare costs.) Currently, hospitals account for about 32 percent and physicians account for about 20 percent of overall spending. The balance of expenses goes toward skilled nursing facilities, substance abuse and addiction, mental health, durable medical equipment and implants, chiropractic, podiatry, nutrition, etc. Congress establishes Medicare payments to physicians and hospitals but cannot set drug prices.
Reduce your exposure
Seven typical household items rank as most hazardous to your health if not used or maintained properly. They are: step ladders (falls), dryers (fires), lawn mowers (injuries), bed rails (injuries due to poor installation), humidifiers (mold), blenders (lacerations, scalding), toasters (fires).
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Insurance mergers
The pending mergers of insurance giants Aetna-Humana and Aetna-Cigna are undergoing increased scrutiny by the Department of Justice and are facing uphill battles. The DOJ is wary of all “super mergers” that may hurt consumers through less competition on service and price. Hospital mergers are in the same boat. This increased scrutiny by the DOJ has been happening despite the Obama administration being relatively passive when it comes to blocking mergers.
ObamaCare premium subsidies The House Ways and Means committee is questioning the Administration’s method of funding premium subsidies for the indigent who are purchasing insurance through ACA exchanges. Anyone with income between 133 percent and 400 percent of federal poverty guidelines qualifies for the subsidy. (Those under 133 percent qualify for Medicaid.) Subsidies are expected to total $170 billion over the next 10 years. Without taxpayer support, insurers on the exchange could face the prospect of having to cover the subsidies themselves.
Calculating premiums
Determining competitive/fairly priced premiums for new enrollees with uncertain health statuses has been a challenge for commercial carriers. United Health has already announced it is pulling out of most state exchanges next year. As more data becomes available each year, insurers will have more experience that allows them to better assess risk and determine premiums. The
IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
fear, however, is that if premiums are too high, it might drive away the relatively healthy. The only way to combat that potential exodus of the “healthy” is to make penalties for not participating much higher than they are now.
Medical errors
According to researchers at Johns Hopkins University School of Medicine, medical errors in hospitals and other healthcare facilities are the third leading cause of death in the U.S., claiming over 250,000 lives annually — or 700 a day. Head researcher Martin Makary, a physician, summarized: “It boils down to people dying from the care they receive rather than the disease or injury for which they are seeking care.” Only hospital-acquired infections have shown improvement over the years. Many experts believe healthcare has too much tolerance for variability in practice versus other industries. Lack of standardization makes it harder to identify and fix problems.
Oneonta physician creates center for transgender patients
Family physician Carolyn Wolf-Gould offers hormone therapy, counseling, and coordination with other physicians for patients seeking surgery. Wolf-Gould said transgender patients come from as far away as six hours due to short supply of providers offering services.
Opioid addiction
The unfortunate death of pop superstar Prince Nelson
has brought more attention to the opioid painkillers addiction epidemic in the US. Someone dies from an opioid overdose every 20 minutes. Many addiction experts question the rationale of turning to the pharmaceutical industry for more drugs to combat addiction to drugs. Treatment for the underlying psychological symptoms that can lead to substance abuse should also be part of a provider’s arsenal. The FDA is considering making it mandatory (currently voluntary) for physicians who prescribe opioids to undergo safety training courses paid for by opioid manufacturers.
Short-term policy
It is a cheaper alternative to policies offered on the exchanges. It is meant to fill gaps in coverage, but for only a few months. However, short-term policies do not meet minimum ACA requirements for coverage and benefits, so buyers will face significant tax penalties.
Thought for the month
“Discussion is an exchange of knowledge. An argument is an exchange of ignorance.” Attributed to American journalist and humorist Robert Quillen. George W. Chapman is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
The Healing Court Syracuse Community Treatment Court focuses on rehabbing addicts By Matthew Liptak
B
oth the judge at the Syracuse Community Treatment Court and its project director believe their court can be a place for the start of healing. But they recognize the uphill battle they often face when administering to participants who have drug addictions. “In this court, we're looking to treat the person entirely, trying to help them get back on track with their lives,” said Judge James Cecile. “We're more focused on their treatment than we are on making sure the charge is resolved in some quick fashion or some fashion in terms of how the prosecutor wants to handle it.” People who have been arrested, have a serious addiction and aren't involved in felony violent offenses may be eligible to the alternative to jail time. The court has been in place since 1997 and was designed to deal with nonviolent criminals who commit crimes to fuel their drug addiction. It is located at the public safety building on South State Street in Syracuse. Once arrested, a person with a drug problem may come before Ceci-
le and consult with one of the court's four case managers. They will screen the individual to see if he or she is eligible to go through the court. If they are, the person goes through an orientation explaining what's expected. Their first court date is scheduled and they will sign a contract. Then they enter one of several treatment programs the court works with based on the case manager’s recommendation. The participant engages in the program for a minimum of one year depending on his or her charge. Successful completion means their charges will be dropped. “We assume that a lot of the criminality was driven by their drug abuse, perhaps things that they never would have done if not for seeking drugs or [being] under the influence,” said Kim Kozlowski, the project director. The court keeps a close eye on how participants are doing and the level of their compliance. Substance abusers may come to court once every two weeks in the beginning to give updates. As participants progress successfully in their program, they may see the court less frequent-
ly, Cecile said, but the case managers continue to keep in close touch with participants. Successful graduation from the court can lead to a sense of joy among those involved, but it is often a bumpy road to get there and not everyone does.
Reaching out to help
At a recent session, Cecile gave differing counsel to participants at different points on that road. He admonished one participant who had run into trouble before and was being supported by his mother who was in the court audience, letting them know that a lot of those struggling didn't have that kind of support. He gently told another young woman, who was nine months sober with a child on the way, to take one day at a time. She responded quietly that she loved it at her rehab program. “We try to build responsibility within our clients,” Kozlowski said. “A lot of them haven't been responsible for anything in a very long time. A lot of them haven't had anybody in their lives who cared about them for a very long time.” Kozlowski said the path to recov-
ery is chaotic as those struggling with substance abuse often have other drama going on in their lives. That stress often gets transferred to those who work at the court. “We lose participants,” she said. “We've had plenty of overdose deaths here. It's not easy for a case manager who has perhaps been working with somebody for six or seven or eight months. It's very difficult.” The opioid epidemic of heroin and painkillers is no stranger to Syracuse. Most of the court's participants have been hooked on the drugs. “The percentage of participants in our treatment court that are opiate addicted is much higher than it was maybe two years ago,” Cecile said. Cecile said distributing the weight of that burden among more case managers would be helpful. Current caseworkers can have well over 50 cases each. For now, the court is doing its best, he said. Kozlowski said about six out of 10 participants go on to graduate their programs. They also measure success in the little victories. “Success to us is (participants) getting their kids back, or getting a job, or finally having their first apartment,” she said.
Running the Syracuse Community Court in Syracuse are Kim Kozlowski, the project director, and Judge James Cecile. People who have been arrested, have a serious addiction and aren't involved in felony violent offenses may avoid jail time by following certain programs the court puts in place. “We're more focused on their treatment than we are on making sure the charge is resolved in some quick fashion,” says judge Cecile.
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Celebration of Survival Hundreds expected at cancer event in Liverpool, Auburn By Matthew Liptak
T
here are 14.5 million cancer survivors in the United States and several hundred of them and their loved ones are expected to gather at the Willow Bay portion of Onondaga Lake Park in Liverpool on June 5 to celebrate life. The event, put on by Hematology Oncology Associates of Central New York, will offer food and festivities for folks of all ages free of charge. National Cancer Survivor’s Day is in its 29th year, but this is the first year for the park event. As of mid-May, 375 people had RSVPed for the celebration with another 100 people expected for a separate event at the Throop Firehouse near Auburn. “It is our celebration,” said HOA’s director of nursing Jennifer Pichoske. “We have four speakers who are survivors themselves. We have activities for kids, such as face painting and kids’ tattoos. We have a drawing table, an ice cream cart. We do have some complementary therapies which include foot reflexology, chair massages, reiki, a tai chi demonstration, an essential oil demonstration and we have other local vendors coming.” The rain or shine event will also have raffles, giveaways and a free lunch catered by Bella Domani. A jazz duo from the Syracuse Symphoria will be providing music.
“[I’m] very excited,” Pichoske said. “It’s a nice time to get everyone all together just to say life does go on. We have survivors that are coming to speak who are a few years out versus 10 years out. It’s just a nice sense of community support for those who have a cancer diagnosis.”
Survival rates improving
Paula Case is an executive assistant with HOA who helped organize the event. “This is a great opportunity for us to celebrate survivors —their strength and courage and all their supporters,” she said. Both women said the fight against cancer is being won, but they didn’t know if they would see cures to major cancers during their careers. They did give some impressive survival statistics. The 10-year survival rate for non-Hodgkin’s lymphoma, breast cancer and colon cancer are all 50 percent or higher. The increased survival rate is due to early screening which is “huge,” Case said. HOA treats its patients holistically while offering many diverse programs. They attend to the mind, body and spirit. The organization believes both quality of life and outcomes are improved with this approach. The theme for the June 5 event is “Hope
grows here.” Both women are looking forward to the celebrations in Liverpool and Throop. They invite all cancer survivors and their loved ones to RSVP for the event or just come down that Sunday and register for free. “Provided it’s a nice day, it will be perfect,” Case said. To RSVP or to find out more about the celebration, contact Paula Case at pcase@hoacny.com or call 315-472-7504 ext. 1133.
Events at a glance Cancer Survivor’s Day When: Sunday, June 5, 10:30 a.m. to 1:30 p.m. Where: Willow Bay, Onondaga Lake Park, Liverpool What: “Hope grows here” Cancer Survivor’s Day Celebration sponsored by Hematology Oncology Associates of Central New York — Free event including lunch, ice cream, activities, raffles, demonstrations Also at: When: Sunday, June 5, 12:30-3:30 p.m. Where: Throop Fire House, 7159 Beech Tree Road, Auburn — Free music provided by a local DJ and other offerings
Hundreds are planning to come out for the First Annual Cancer Suvivor's Day Celebration put on June 5 by Hematology Oncology Associates of Central New York. Organizers Paula Case, left, and Jennifer Pichoske are hoping for good weather for the event at Willow Bay in Onondaga Lake Park and at the Throop Firehouse in Auburn.
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
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
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.
Sunbathing For Longer Life? Experts Say No
New research says sunbathing increases life expectancy; local experts disputes findings and talks about skin cancer epidemic By Deborah Jeanne Sergeant
A
recently released study of nearly 30,000 women claims sunbathing increases life expectancy. The observational study followed Swedish women for 20 years and researchers speculated that subjects’ exposure to sunlight helped raise their vitamin D levels. Sun exposure causes the body to generate vitamin D, a pre-hormone that supports many functions of the body and has been linked to lowering risks of numerous diseases and health conditions. The study contradicts many dermatologists’ admonitions to limit sun exposure. “You have to be careful about sensational headlines about studies that may not be scientifically strong,” said Ramsey Farah, dermatologist with Farah Dermatology in Syracuse. “Don’t look to that as a justification for lying around in the sun all day. We know about what can promote vitamin D production so we should look to that to keep levels up where we need them,” Farah said. The Swedish study participants’ longevity could be explained by factors including their genetic profile, environment, diet, activity level, tobacco and alcohol use, and stress levels, all of which can influence longevity. Since the study wasn’t controlled for other factors, its conclusion is highly speculative, according to experts. They say too much sun exposure raises the risk for skin cancer. The Centers for Disease Control and Prevention (CDC) reports that in 2012, the rate of incidences of melanoma of the skin ranged from 17.9 to 21.1 per 100 thousand in New York. The CDC also reports that melanoma rates doubled between 1982 and 2011. “Skin cancer is the most common form of cancer in the U.S., and melanoma is the most deadly type of skin cancer,” the CDC states on its website. “More than 90 percent of melanoma skin cancers are due to skin cell damage from ultraviolet (UV) radiation exposure. Melanoma rates increased from 11.2 per 100,000 in 1982 to 22.7 per 100,000 in 2011 [nationwide].” “Everything has a risk and benefit,” Farah said. “There are misconceptions that dermatologists advocate absolutely no sun. People in northern areas should take their vitamin D levels seriously and have them tested. From there you can dictate if it’s low, high or just right. “Not any one element on their own may be the solution, like fortified milk,
mackerel or codfish, which contain vitamin D. Generally, it’s not enough to meet the vitamin D supplement needs.” Farah said that sunlightgenerated vitamin D is more efficient than supplemented vitamin D, but it’s all about “sensible sun exposure,” which means avoiding burning, not eliminating all sun exposure. Exposure before 10 a.m. and after 2 p.m. reduces risk of sunburn, along with limited unprotected exposure to 15 minutes only a few times weekly. “That should lead to a significant amount of D production,” Farah said. During the darker months of the year, supplementation, along with proper diet helps. Supplementing 600 to 800 international units (IU) daily offers what most people need; however, a blood test can determine one’s vitamin D level. Testing in February and July offers the lowest and highest readings for most people. Protecting skin from sun exposure includes applying sunscreen every two to three hours and after swimming. Use plenty; most people don’t use nearly enough. Choose a high SPF; Farah recommends 30 SPF. Shaded areas provide about 70 percent protection, unless it’s near a reflective area such as a poolside umbrella. The water can actually magnify the sun’s effects. “If you take D, make sure it’s with a meal with fat in it for better absorption,” said Laurel Sterling, registered and integrative dietitian in Syracuse. To limit sun exposure and avoid burning, Sterling recommends mineral-based sunscreen with titanium dioxide and zinc oxide, which block out all UVA and UV rays. Sunscreen with nano-particles last longer and don’t appear as chalky on the skin.
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Ramsey Farah, dermatologist with Farah Dermatology in Syracuse.
www.ampofny.com May 2016 •
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Upstate seeks participants for pediatric mental health study
Sunday, June 26th from 1 - 2 p.m.
Families to be financially compensated to be part of study
Sunday, June 26th - Dr. William Cesare - Epic Genetics What to do when your loved one or friend has a mental illness?
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
esearchers in the department of psychiatry and behavioral sciences at Upstate Medical University are seeking participants in a study funded by the National Institute of Mental Health (NIMH). If you are the biological parent of a child between the ages of 6 to 12 years, you may be eligible to participate. Each participant will be financially compensated. The researchers — Stephen Faraone and Stephen Glatt — are studying new ways of classifying mental health disorders in children in order to change the way that psychiatric disorders are understood and diagnosed. To do this, genetic variation and basic cognitive abilities within families will be analyzed. The goal is to provide a better basis for a new diagnostic system that is less subjective than what is currently used. “We’re taking a fresh approach to the concept of gene hunting,” explains Glatt, director of psychiatric genetic epidemiology and neurobiology laboratory at Upstate and one
of the directors of the grant. “Instead of assuming that current diagnoses have unique genetic underpinnings, we’re looking to redefine the disorders based on genetic variations and more basic cognitive abilities that might generalize across diagnostic boundaries.” Combining genetic data with cognitive performance may provide a better basis for a new diagnostic system that is less subjective than the one currently used. Upstate is recruiting about 700 families (2,800 individuals), examining a broad spectrum of childhood behaviors, from those children who are developing typically with no mental health concerns to those who may have mental health concerns or behavioral problems. Parents and their children will complete a series of questionnaires and computer-based tasks, and provide a blood sample for genetic analysis. The study procedure takes up to three hours for the family. For enrollment information, contact Pat Forken at 315- 464-5619.
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SmartBites
The skinny on healthy eating
The Nutritious Perks of Whole-Grain Pasta
L
ast month, my husband and I took the plunge and went cold turkey on refined pasta. For about a year, we’d been making half-and-half portions of refined and unrefined pasta to “ease” into the taste and texture of whole-grain pasta. But, finally, we both agreed: no more. Pasta made from unrefined whole grains is simply too nutritious to water down with regular pasta. What makes whole-grain pasta better for you? In a word, whole-grain pasta is made from grains that have the bran, germ and endosperm all intact, whereas regular pasta is made from refined grains that have been stripped of their bran and germ. While processors do add back some vitamins and minerals to enrich refined grains — so, indeed, these grains still contribute valuable nutrients — whole grains remain the healthier choice, providing more fiber, more disease-busting phytonutrients, and many important vitamins and minerals. The bran portion of the grain provides good doses of fiber and phytonutrients, neither of which processors add back to refined pasta. Fiber keeps us regular, helps with weight control by promoting a full feeling, stabilizes blood sugars and ferries cholesterol-containing
bile out of bodies. All good things that may contribute to a longer life! Antioxidant-rich phytonutrients, whose consumption, according to the USDA, seems to be an “effective strategy” for reducing cancer and heart disease, promote good health by slowing or preventing free-radical cell damage and by quelling inflammation. Many B vitamins, some protein, minerals and healthy fats are found in the grain’s germ portion. Wholegrain pasta is particularly high in both manganese and selenium. Sometimes called the “brain mineral,” manganese is important for mental function, energy production, bone growth and collagen formation. A powerhouse antioxidant, selenium helps make special proteins that play a role in preventing cell damage. Lastly, the two of us have said “pasta la vista” to refined white pasta because of the nature of its carbs: they’re simple (just like those in processed breads, cookies, cakes, etc.), which means they get digested lickety-split — an assault that can send blood sugar soaring and increase risk for developing Type 2 diabetes. The complex carbs that make up wholegrain pasta, on the other hand, take longer to digest, which keeps blood sugars and energy levels on a more even keel. According to the Harvard
T.H. Chan School of Public Health, there is convincing evidence that diets rich in whole grains protect against diabetes. Go, whole grains!
Helpful tips
Most supermarkets stock wholegrain pasta options — just be sure to take a close look at the nutrition labels. True whole-grain pasta will list the whole grain as the first ingredient, whether it’s whole-grain durum wheat flour, whole-grain oat flour or another whole grain. Also check the front of the package for “100 percent whole grain” or the orange “Whole Grain” stamp.
Whole-Wheat Pasta Salad with Spinach and Artichokes
Adapted from Rachel Ray
¾-1 box whole-wheat pasta of choice ½ pound fresh baby spinach 1 (15-ounce) can artichoke hearts in water, drained and chopped 1 red bell pepper, chopped or cut into thin strips ½ small red onion, chopped 1-2 cloves garlic, minced 1 lemon, zested 2 tablespoons lemon juice 2 tablespoons red wine vinegar
¼ cup extra-virgin olive oil ¼ teaspoon red pepper flakes 1 teaspoon dried thyme or basil salt and coarse black pepper to taste 1 cup cherry tomatoes, halved ½ cup crumbled feta cheese ¼ cup kalamata olives, sliced (optional) Prepare pasta according to box directions; drain and let cool. Coarsely chop baby spinach. In large bowl, combine spinach with artichoke pieces, red pepper and red onion. In small bowl, whisk together dressing ingredients: garlic, lemon zest, lemon juice, vinegar, olive oil and spices. Add pasta, cherry tomatoes, feta cheese and olives (if using) to the salad in large bowl. Add dressing and gently toss. Serve or refrigerate. 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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Men’sHealth Garret Wikoff is treasurer for the Central New York Indoor Flying Society in Cicero. He advises people new to drones to join the Academy of Model Aeronautics (AMA). "There are a number of clubs associated with AMA that would have people who can help you with a drone and help you learn how to fly it."
Drone for Dad or Grad? Fly it Safely By Deborah Jeanne Sergeant
I
n recent years, hobbyists have embraced unmanned aerial vehicles (UAVs), commonly called drones. If you receive a UAV as a gift (or purchase one for yourself), realize that the fun comes paired with responsibility. UAVs may look like toys, but they’re not. Consider the injuries you could sustain from a few pounds’ worth of UAV crashing on your head. Those props may not feel sharp when stationary, but in motion can cause severe lacerations. Just ask Elson Shields, professor of entomology with Cornell University, who has flown UAVs as part of his research since 1996. Despite his countless hours piloting UAVs and offering talks statewide on the topic, he suffered cuts to his hand five years ago from a moving UAV propeller. The lacerations required a hand surgeon to repair. “Sometimes accidents happen because people are distracted,” Shields said. “Whirling props are a
risk. I stuck my hand in a prop five years ago, and I had a number of stitches on the backside of my right hand. They had to bring in a hand surgeon.” Before your UAV takes flight, the law requires registration with the Federal Aviation Administration (FAA), which costs $5. Every UAV you own may bear the same number. The law exempts small aircraft flown only inside. Shields encourages UAV pilots to join the Academy of Model Aeronautics (AMA). The $75 annual membership provides $2,500,000 personal liability insurance coverage, $25,000 medical coverage and more. “It’s a great deal,” he said. Once you’ve taken care of these basics, you need to learn the rules. Shields likes the Academy of Model Aeronautics site (www.modelaircraft.org), and also the FAA website (www.faa.gov) for its listing of where you may fly and the safety guidelines.
The AMA lists clubs on its site, which Shields advocates for helping newbies learn the hobby. Garret Wikoff, treasurer for the Central New York Indoor Flying Society that flies in Cicero, also advises people new to drones to join the AMA. “There are a number of clubs associated with AMA that would have people who can help you with a drone and help you learn how to fly it,” Wikoff said. “It appears very simple but it’s not. It’s not something people will learn on their own. Many get it for Father’s Day or a birthday and it ends up in the trash because they break it. They’re reasonably delicate.” Beyond learning the controls, learning about the equipment can help new hobbyists fly successfully. For example, flying a UAV in the rain or through sprinklers can cause it to short out and fall, so only fly in dry conditions. The craft’s propellers and propensity for crashing aren’t the only hazards. Lithium batteries power UAVs. “If you charge it improperly, they can explode,” said Herbert Ziegler, president of the Aero Radio Club of Syracuse. “Spend a little more to get a good charger. Don’t set the charger for the wrong kind of battery. If they get damaged in a crash, they can spontaneously catch fire. They’re not packaged in a rugged housing because in aircraft, you try to keep the weight down.” Only fly in a wide-open space that’s permitted by the FAA. Area clubs listed on the AMA site host regular flying events, for example. As you learn how to fly a UAV, keep the craft close to the ground and at a distance so the inevitable crashes stay safe for both you and your UAV. Because of their lightweight components, their parts snap fairly easily. “You don’t have to be afraid of them, but they have to be treated with respect,” said Larry Brinker, executive director and general counsel at NUAIR Alliance in Syracuse. “They can inflict serious injury. Understand the airspace where you’re flying them. We tell everyone that comes to the test site, treat it like a crawl, walk, run project. Stand a reasonable distance from it when
you first take it out of the box. Fly it up and down. Get experience in an incremental manner. “ Keep pets away, as animals may view the UAV as prey or may inadvertently collide with it. UAVs attract children because they look very much like toys. Keep yours away from children. A small child can become maimed or blinded by attempting to fly a UAV. By taking a few precautions, you can prevent a serious injury to yourself and loved ones. For more information, visit www. knowbeforeyoufly.org, www.suas. modelaircraft.org, http://amaflightschool.org/get-started.
Elson Shields, professor of entomology with Cornell University, has flown droness as part of his research since 1996. He warns people about possible accidents involving drones.
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, Chris Motola, Aaron Gifford, Nicole Shue, Harold J. William (MD) • 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 • May 2016
Men’sHealth
10
Weight Lifting Mistakes Guys Make
By Deborah Jeanne Sergeant
M
any men lift weights to get toned and strong, not get hurt. Yet many become injured by making some of these top mistakes that can cause injury or prove ineffective.
will put yourself at risk of overtraining and injury.”
5
1
. No goals “When it comes down to lifting and working out, it’s better to know what you’re trying to accomplish. Any time I work with anyone, I base it on biomechanics. Do you want to completely change your identity and be an athlete? Or I may have someone who wants general fitness and wants to lose some body weight.
2
. Feeling overwhelmed “Don’t feel intimidated. That’s what you’re here for. You can learn how to do this appropriately and properly. You can have confidence in knowing what you’ve learned. Once you find out what is driving you and giving you that single-mindedness, you can direct yourself.”
. Lifting too much “Choose a weight that you can control on both the concentric (shortening of the muscle) and the eccentric (lengthening of the muscle) movement of the exercise. Heavy lifting done improperly can put more tension on the joints than the muscles being worked and lead to injury. . Improper form “Focus on your breathing first and foremost. Exhale on the exertion. This means breathing out as you move the weight and focus on inhaling as you bring the weight back to start the movement again. Slow the movement down and practice a tempo that doesn’t allow your body to swing as you move the weight (for example, bicep curls) but instead allows you to focus on the muscle you’re working and isolate it.
3
. Overtraining “Overtraining can drain you of your energy and leave you in a weakened state, which in turn, makes your body more susceptible to injury. In order to prevent this keep the duration of your workout to no longer than an hour. You may want to also consider cutting back to three or four days a week of resistance training.
4
. Nutrition “A balanced diet and proper calorie consumption also play a major role in overtraining. If your nutrition is not being properly addressed you
6
of what they’re doing. Ultimately, that’s why I have return clients.
9
. Not learning from the trainer “The things I see them doing over and over again, like jerking weights, is from lack of knowledge. I see guys pop their hips off the bench or go in a bouncing motion. Take one to three things you learn every week to the gym and reiterate it.
10
. Trying to go alone. “Get a buddy who’s on the same page who will encourage and motivate you. If you can get three, that’s even better. Two or more people, it will be easier. That’s a cord that’s not easily broken.”
Sources: • Billy Price, head trainer at Metro Fitness, Syracuse (1 through 4) • Scott Morrell, certified personal trainer with Aspen Athletic Club, Syracuse (5 through 10)
7
. Losing motivation “Most of the time when someone comes in to see me, it’s not so much about how they’re lifting as to what’s motivating them. A lot of times they want to lose weight and feel comfortable again. They can’t move properly. A lot of the overweight has to do with nutrition. If they’re not eating properly, I try to do things to stay connected with them throughout the day. If they’re willing to be coached that way.
8
. Lack of focus They don’t understand what the muscles are doing and how it works. A lot of times, they don’t think about what they’re doing. Put your mind to the muscle. That’s the biggest benefit of a personal trainer to a client. It’s the best way a prospective client can understand and get the most out
May 2016 •
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Upstate Urology
Group is now using one of the most exacting technologies to diagnose and pinpoint prostate cancer cells, according to a new report. It also offers new treatment for enlarged prostate, erectile dysfunction and urethral stricture disease
I
n its 2016 report, Upstate Urology highlights recent clinical, educational and research breakthroughs that reflect the group’s unique role as the region’s only academic urology program. Upstate Urology is part of SUNY Upstate Medical University and affiliated with the Upstate Cancer Center, both located in Syracuse. Upstate Urology specializes in treatment of the entire family with specialty services for men, women and children. “The difference from other practices is that Upstate Urology has unparalleled breadth in experience and knowledge of urology diseases,” said physician Gennady Bratslavsky, professor and chairman of the department Bratslavsky
of urology at SUNY Upstate Medical University. “Upstate Urology combines the acumen of top-flight physicians with the latest technology and a research team that makes discoveries about new treatments that can affect, influence and enhance the care we offer patients.” When it comes to patient care, Upstate Urology continues to introduce the latest in technology and treatment, some of which previously has not been available to patients in the region. Prostate cancer remains one of the most common health concerns for men and is diagnosed in 80 percent of the men who reach the age of 80, but imprecise methods continue to confound doctors and patients looking to make a definite diagnosis. Upstate Urology is now using one of the most exacting technologies to diagnose and pinpoint prostate cancer cells. Using techniques developed at the National Cancer Institute, Upstate uses state-of-theart 3 Tesla multiparametric MRI to identify areas within the prostate gland that are likely to harbor cancer. Next, using special biopsy
technology, the UroNav, physicians can guide the biopsy needle into precise areas of suspicion. “The strategy allows us to not only avoid missed cancers, it also gives us the best Paonessa understanding of how much and how aggressive the cancer truly is within the prostate,” said Bratslavsky. He also pointed out that unless 3 Tesla MRI is used, the images to identify the prostate cancer are suboptimal and he also pointed out that Upstate is the only institution in Central New York that has 3T MRI. One other new procedure recently introduced by Upstate Urology is for the treatment of an enlarged benign (not cancerous) prostate. An enlarged prostate is common as men age, but it can lead to troubling side effects, such as increasing the frequency and urgency to urinate, often interfering sleep and affecting one’s quality of life. The procedure, called holmium laser enucleation of the prostate (HoLEP), uses a high-power laser to remove the obstructive portion of an enlarged prostate in its entirety. The HoLEP procedure is the only minimally invasive option that completely removes the obstructing tissue within the prostate via anatomic dissection. As such, there is a very low reoperation rate and an even lower rate of blocking tissue regrowth. “The results of the surgery are long-lasting and patients experience life-changing results,” said physician Jessica Paonessa. “They can travel, sleep through the night and return to their normal daily activities.” The procedure is only available at Upstate’s Community Campus. Another health concern for men as they age is erectile dysfunction. Upstate urologist J.C. Trussell takes patients from the first office
visit that includes a physical exam and maybe some diagnostic tests to find out a possible cause before reviewing treatment options that range from oral medications to penile implant surgery. Another common condition for men that Upstate Urology cures is urethral stricture disease that causes urinary obstruction. The condition is painful and often leads to an incomplete emptying of the bladder. Under the guidance of physician Dmitriy Nikolavsky, patients can be cured of the disease through outpatient or shortstay surgery. In addition to caring for Nikolavsky patients, many clinicians at Upstate Urology have robust research portfolios aimed at discovering breakthrough treatments or basic science discoveries. Research announced in early May, which included findings from an Upstate Urology study, suggests that the risk of fatal prostate cancer may be linked to the same gene mutations found in breast and ovarian cancer. The finding may spark more aggressive screening of men who have a family history of breast cancer to see if these BRCA gene mutations are present. The 31-page Upstate Urology Update includes information on all clinicians and researchers, as well as program highlights from the past year. For a copy of the report, call 315-464-1500. Upstate Urology has four locations, at 550 Harrison St., Syracuse; 4900 Broad Road, Syracuse; 267 Hill Road, suite 300, Rome; and 17 E. Genesee St., suite 303, Auburn. To make an appointment at any location or to speak to a physician, call 464-1500 or visit www.upstate. edu/urology.
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Parenting By Melissa Stefanec
When Mommy Medicare Made Simple, LLC Loses It
N
one of us are perfect. Not a parent among us is a good parent all of the time. We all have those moments where we lose it. Maybe it’s after fielding the 45th question in a two-minute span. Maybe it’s an eye roll and a door slam or a glass jar smashing on the grocery store floor. Maybe it’s the sassing back or the 27th temper tantrum of the day. Maybe it’s having to repeat yourself a half a dozen times before something gets done. Maybe it’s something worse than all those things combined. Maybe it’s something even smaller. Whatever causes parents to lose it, that moment is never a proud one. I had one of those moments on a recent Friday evening. I was flying solo with the kids. It was the end of a very long week. We were all tired. We had finished dinner, and the kids wanted to listen to song and dance. I said we could do that after the laundry was sorted (Man, am I a killjoy) I asked my daughter Stella, who is just about 5 years old, to help me sort the laundry into two piles — one for her and one for her brother. Stella wasn’t in the mood to listen. She just kept ignoring what I was asking her to do. My son, River, who is about 1 ½ years old, had his own version of helping. It involved throwing any sorted laundry around the living room. After Stella purposefully did the exact opposite of what asked or completely ignored me several times, I totally lost it. “Are you deaf?” I yelled. “Do your ears work? I know you are able to sort these clothes into two simple piles. Do you think it’s fun to not listen to me? Do you think it’s fun to get mommy upset? Do you think you don’t have to pitch in around here? Do you think I am your servant?” I watched as the stress and panic ran over my daughter’s face. I watched the tears build up. I listened as she sobbed and said she didn’t know how to fold clothes. She went to pieces. It probably wasn’t the words I said, as much as how I said them. I yelled them. My crappy and angry attitude brought the evening down. It took only a few moments for me to feel completely awful. So, I took a step back and shut my mouth. I thought about what was actually making me mad. I then apologized. I explained that mommies make mistakes, and sometimes they need a time out, too. I explained
that everyone has some trouble controlling her or himself when angry. I shouldn’t yell, even if someone isn’t listening to me. That’s disrespectful. Recently, I read a great piece of parenting advice. It was about parents losing control of their emotions when their kids push them to their breaking points. This piece asked readers to think about how hard it is to control your anger or sadness. Think about how much restraint and maturity it takes to manage your negative emotions when you are an adult. Now, imagine trying to do that same thing with the brain of a toddler, child or teenager. It’s even harder, and if you can’t do it all of the time, understand when they can’t do it either. After I calmed down and apologized, we finished the laundry and started getting ready for bed. When I was tucking her in, I apologized again and asked her if she could forgive me for yelling so much. She gave me a big hug and said, “It’s OK mommy. I love you one hundred.” That’s when something really important hit me. As parents, we are always thinking about the unconditional love we have for our children. We think about how they couldn’t possibly understand that love until they have children of their own. However, I started thinking about how the opposite is also true. Children have unconditional love for their parents. This special bond and affection is a two-way street. I think about how my kids could never do something to make me stop loving them. The same is also true for children. As parents, barring extraordinary circumstances, there isn’t anything we can do to make them stop loving us. That is one of the most powerful revelations I’ve had as a parent, and I was immediately sorry I didn’t have this revelation sooner. Because, quite frankly, it was one of the best feelings I’ve had in a long time. I held my daughter extra close and told her I appreciated her forgiveness and kindness. As a mother, I’m going to lose a lot of things over the course of her life. She is going to lose a lot of things over the course of hers, but one thing we shouldn’t ever lose sight of, is our love for each other. I am going to spend each day of my mommy life being mindful of that, because it’s going to help me find what’s important.
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The Social Ask Security Office
From the Social Security District Office
Social Security Supports National Cancer Survivors Day
I
n 2016, more than a million people will be diagnosed with cancer around the world. This alarming statistic affects people and families everywhere. On June 5 we observe National Cancer Survivors Day in the United States. In support of this day, Social Security encourages getting checkups to provide early detection, raise awareness through education and recognize the survivors who have gone through this battle or are still living with the disease. Social Security stands strong in our support of the fight against cancer. We offer services to patients dealing with this disease through our disability program and our compassionate allowances program. compassionate allowances are cases with medical conditions so severe they obviously meet Social Security’s disability standards, allowing us to process the cases quickly with minimal medical information. Many cancers are on our compassionate allowance list.
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There’s no special application or form you need to submit for compassionate allowances. Simply apply for disability benefits using the standard Social Security or Supplemental Security Income (SSI) application. Once we identify you as having a compassionate allowances condition, we’ll expedite your disability application. Social Security establishes new compassionate allowances conditions using information received at public outreach hearings, from the Social Security and disability determination services communities, from medical and scientific experts, and from data based on our research. For more information about compassionate allowances, including the list of eligible conditions, visit www.socialsecurity.gov/ compassionateallowances. If you think you qualify for disability benefits based on a compassionate allowances condition, please visit www.socialsecurity.gov to apply for benefits.
Health News By Jim Miller
Protect Yourself from Melanoma Skin Cancer Dear Savvy Senior,
Does skin cancer run in families? My 63-year-old brother died of melanoma last year, and I’m wondering about my risks of getting this. What can you tell me?
Younger Sibling
Dear Sibling, While long-term sun exposure and sunburns are the biggest risk factors for melanoma — the deadliest form of skin cancer — having a sibling or parent with melanoma does indeed increase your risk of getting it two to three times. Each year, about 75,000 Americans are diagnosed with melanoma, and around 10,000 people will die from it. While anyone can get it, those most often diagnosed are Caucasians, age 50 and older. And those with the highest risk are people with red or blond hair, blue or green eyes, fair skin, freckles, moles, a family history of skin cancer and those who had blistering sunburns in their youth.
Skin Exams
The best way you can guard against melanoma and other skin cancers (basal and squamous cell carcinomas) is to protect yourself from the sun, and if you’re over age 50, get a full-body skin exam done by a dermatologist every year, especially if you’re high risk. Self-examinations done every month or so is also a smart way to detect early problems. Using mirrors, check the front and backside of your entire body, including the tops and undersides of your arms and hands, between your toes and the soles of your feet, your neck, scalp and buttocks. Be on the lookout for new growths, moles that have changed, or sores that don’t heal. Follow the ABCDE rule when examining suspicious moles. • Asymmetry: One half of a mole doesn’t match the other. • Border: The border is blurred or ragged. • Color: The mole has uneven colors, often shades of brown, tan or black, with patches of pink, red, white or blue. • Diameter: The lesion is new or at least a quarter-inch in diameter. • Evolving: The mole is changing in size, shape or color. For more self-examination tips and actual pictures of what to look
for, see SkinCancer.org or Melanoma. org. In the spring and summer, there are a variety of places that offer free skin cancer screenings. Check with the American Academy of Dermatology (888-462-3376, aad.org/ public/spot-skin-cancer), which offers screenings done by hundreds of volunteer dermatologists across the U.S., and the American Society for Dermatologic Surgery (asds.net/ skincancerscreening.aspx).
Sun Protection
Even though you can’t change your skin or family history, there are some proven strategies that can help you protect yourself. For starters, avoid tanning beds, and when you go outside, slather on broad-spectrum SPF 30, water-resistant sunscreen on both sunny and cloudy days. If you don’t like the rub-on lotions, try the continuous spray-on sunscreens which are easier to apply and re-apply and less messy. Also, seek the shade when rays are most intense — between 10 a.m. and 2 p.m. You can also protect your skin by wearing a wide-brimmed hat, and long sleeves and pants when possible. The best clothing options are tightly-woven fabric that help prevent the sun’s rays from reaching your skin, or you can wash-in an invisible shield sun protection into your cloths with SunGuard laundry additive (see sunguardsunprotection. com). You can even buy a variety of lightweight clothing and hats that offer maximum UV protection in their fabric. Coolibar.com and SunPrecautions.com are two sites that offer these products.
Treatments
If melanoma is caught and treated early, it’s nearly 100 percent curable. But if it’s not, the cancer can advance and spread to other parts of the body, where it becomes hard to treat and can be fatal. Standard treatment for melanoma is surgical removal. In advanced cases however, chemotherapy or radiation may also be used, along with a variety of new drug treatments.
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.
Onocologist to present research’s finding in Chicago Physician Jeffrey Kirshner, partner and director of research at Hematology-Oncology Associates of CNY, will present the results of his latest study at the American Society of Clinical Oncology (ASCO) annual meeting June 6 in Chicago. Kirshner This nationwide study of 600 patients demonstrated that several over-thecounter medications (loratadine or naproxen) could help reduce the severe pain that may be associated with the administration of Neulasta, a drug administered to decrease the incidence of prolonged lowering of the white blood cell count after chemotherapy is given. This will be Kirshner’s third presentation at ASCO within the past 10 years. To date, he has published the results of five of his studies, which have led to practice changes that have improved the quality of life of cancer patients throughout the country. Hematology-Oncology Associates was established in 1982. It’s the only practice in Central New York certified by the American Society for Clinical Oncology for quality (QOPI Certification) and one of only nine practices in the country and the only practice in New York state to have obtained designation as a certified oncology medical home (OMH) by the Commission on Cancer. For more information, visit www. hoacny.com.
St. Joseph’s adds 20 more beds to hospital The NYS Department of Health has approved St. Joseph's certificate of need to add 20 critical care beds to the hospital. “This takes us from 38 to 58 intensive care beds, and all are in private rooms,” said Kathryn Ruscitto, president and chief executive officer at St. Joseph’s Health. The space for the additional 20 beds was made available by moving existing beds to St. Joseph’s new Christina M. Nappi Surgical Tower. “We are constantly working to identify new ways and best practices to keep up with the growing demand, while preserving our commitment to a higher level of care,” Ruscitto added. “With the trends toward more consolidation in healthcare, we’re seeing an increased number of patients being transferred from smaller hospitals in the region, and we want to ensure we’re providing the safest environment to care for more members of the community.” St. Joseph’s also continues to see an May 2016 •
increase in patients from outside of Onondaga County. The NYS Department of Health granted St. Joseph’s approval to add 20 temporary beds back in March of 2015 to address the increasing number of patients. Now, this permanent approval brings St. Joseph’s from a 431-bed hospital to a 451-bed hospital.
New leadership at ACR Health ACR Health has promoted two veteran managers to top leadership posts. Carrie Portzline-Large has been appointed deputy executive director of operations and Jeanette O’Connor-Shanley has been named deputy executive director of programs to help lead ACR Health’s growing and Portzline-Large diversifying list of services. As deputy executive director of operations, Portzline-Large will supervise daily operations of ACR Health, providing direction and support to directors of development, public relations, volunteer services, information technology, data, facilities, and ancillary services. Portzline-Large came to ACR Health as a care manager in 2003, and then transitioned to the development department. In 2009 she became the director of development and created innovative and successful revenue generating initiatives in addition to sustaining the highly successful AIDS Walk/Runs. As deputy executive director of programs, O’Connor-Shanley will provide direction and support to directors of support services, HIV services, health homes, prevention, youth, insurance services, and QA/QI. O’Connor-Shanley has more than 20 years experience in O’Connor-Shanley the nonprofit sector and before coming to ACR Health, served as program director for REACH CNY Inc., where she was lead trainer on more than 30 curricula from various New York State Department of Health training contracts.
HardCORE Fit opens studio in Fulton HardCORE Fit recently opened a new 1,300-sq.-ft. facility at 1332 state
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H ealth News Route 176 in Fulton. The new HardCORE Fit fitness studio is home to small group training sessions, nutritional counseling and several group exercise classes including dance fitness, kickboxing, high intensity interval training and tabata training. “Having a place to call home is a great thing, for HardCORE Fit and for our clients,” said Jessica Baldwin, certified personal trainer and owner, HardCORE Fit. “We’re able to offer classes multiple times a day and utilize equipment and techniques that were not always accessible before we had this awesome space. There’s always something new going on here, and that’s really motivating for the clients.” After a soft opening at the end of 2015, the studio has seen the addition of some new equipment including a leg press machine, TRX training setup, expanded free weights and cross training implements. HardCORE Fit is now accepting new monthly training memberships, but many classes are also open to the public for $7 each. “The culture here is all about support and empowerment,” Baldwin says. “No one should be afraid to be a beginner because we all start somewhere. Everyone here believes
in that philosophy, and I’m very proud of that.” For more information or class schedules, visit HardCORE Fit on Facebook or call Jessica Baldwin at 315-289-7176.
Crouse: Highest hepatitis B vaccination The Onondaga County Department of Health has presented Crouse Hospital’s Kienzle Family Maternity Center with a certificate of excellence for its higher-than-average birth dosing rates to newborns to prevent hepatitis B, a serious infection that affects the liver and can result in chronic infection or death. In 2015, 99.1 percent of all babies born at Crouse were vaccinated against hepatitis B. Crouse has the highest hepatitis B vaccination rate among hospitals in Syracuse. Wendy Czajak, from the Onondaga County Department of Health, presented the certificate to Nadine Streleski-Flanders, director of women and infants services at Crouse. Babies normally receive three doses of hepatitis B vaccine: the first dose within 12 hours after birth; a second dose at 1 to 2 months of age;
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and a third dose at 6 to 18 months of age. Routine hepatitis B vaccination was recommended for some U.S. adults and children beginning in 1982, and for all children in 1991. Since 1990, new hepatitis B infections among children and adolescents have dropped by more than 95 percent — and by 75 percent in other age groups, according to the Centers for Disease Control and Prevention. Crouse is the region’s leading provider of maternity and neonatal intensive care services, delivering and caring for more than 4,000 infants annually in the Kienzle Family Maternity Center and Baker Neonatal Intensive Care Unit.
Spay and Neuter Syracuse receives grant Nonprofit Spay and Neuter Syracuse (SANS) was recently awarded a $24,400 grant from The Central New York Community Foundation for the SANS clinic relocation project. With this grant, SANS plans to improve the spay and neuter clinic facility and expand the clinic operations to better serve the community. The SANS relocation project
includes renovating a new clinic location, expanding current IT capabilities and adding new clinic equipment. While providing a better facility for the clinic, SANS would also, for the first time, be able to offer spay and neuter services for large dogs, which will provide the community with a much-needed service and increase the clinic's client base. The new clinic location will allow for increased space for clinic operations, more parking, a convenient location for clients, and enhanced marketing opportunities. This grant will benefit SANS mission to provide low cost spay and neuter services for the pets of low income households, students, veterans and animal rescuers in the Syracuse area. “In addition to expanding our clinic operations, we are working within the community to provide more effective outreach to our constituents” said Michael Moynihan, president of SANS. “This will enable us to increase our clinic’s capacity and provide more spay and neuter services to pets from low income households, veterans, seniors and rescue organizations.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • May 2016
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Crouse Recognized for Knee, Hip Replacement Crouse Hospital has earned designation as a Blue Distinction Center+ for Knee and Hip Replacement from BlueCross BlueShield. The national Blue Distinction Center program helps patients identify hospitals that have demonstrated a commitment to providing high-quality care and better outcomes for specialized care. Blue Distinction Centers+ also have met cost measures that address consumers’ need for affordable healthcare. According to Crouse Hospital’s Chief of Orthopedics Tim Izant, this designation reflects the high level of expertise required for an outstanding orthopedic program, plus the hospital’s ability to provide services cost-effectively. “Our surgeons and Izant clinical staff collaborate continuously to provide high-quality, patient-focused care,” said Izant. “Not only do we offer a wide range of orthopedic procedures, but we’re also privileged to have some of the region’s most qualified and experienced surgeons, nurses, anesthesiologists, technologists and physical rehabilitation therapists, all of whom collaborate on achieving excellent care coordination and patient
outcomes.” Izant notes that the hospital’s designation as a Blue Distinction Center+ for Knee and Hip Replacement is an honor that is well earned. “Research shows that patients who get specialty treatment at Blue Distinction Centers have shown better results, including fewer medical complications, fewer readmissions and better patient outcomes. Crouse’s ‘plus’ designation also demonstrates that this is achievable while meeting strict cost-of-care criteria.” Crouse Hospital’s joint replacement outcomes exceed national averages, with patients going home after 2.75 days, compared to the national average of 3.34 days. The program offers full and partial knee replacement; traditional and direct anterior surgical approaches; computer-assisted knee replacement and robotically assisted techniques; shoulder replacement; orthopedic spine surgery; trauma-related orthopedic surgery and minimally invasive procedures. Crouse also offers Hip Today, Home Tomorrow, an innovative program developed by Izant that provides an alternative to traditional inpatient joint replacement surgery, with just one overnight stay that includes the entire spectrum of surgical, nursing, physical therapy and outpatient.
Health in good
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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.
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
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
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
LPN
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
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
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