IGH CNY September 17

in good On the Road Srinevas Reddy, a cancer doctor from Roswell Park Cancer Institute, is now commuting to provide services to patients at Oneida Healthcare, a hospital that’s building a new comprehensive cancer program

Men’s Belly

cnyhealth.com

September 2017 • Issue 213

Binge Drinking A new study shows rates dropping on college campuses, rising for young adults not in school

More breastfeeding rooms available for women in Syracuse, Oswego

Scientists are still testing using eye drops to dissolve cataracts in humans; in the meantime, new techniques to remove them are available

Inside

Protecting Chronically Ill Young People

it’s time to say “open sesame” to all that makes this small seed so big on nutritional benefits.

CNY’s Healthcare Newspaper

Call it beer belly, love handles, spare tire: doctors say men with large bellies have increased risk of death by various associated diseases. Find out what they can do to address the problem. See Men’s Health Special inside

Eye Drops to Cure Cataracts?

4 Reasons to Eat Sesame Seeds

priceless

­

800,000 That’s the number of Americans who receive medical care for dog bites annually

What Diabetics Need to Know About Over-the-Counter Meds Many cold, cough and headache remedies contain carbs, and as much alcohol as glass of beer or wine, pharmacist says

I

t can be tough for people with diabetes to choose appropriate over-the-counter medicines for a cold, cough or headache, a pharmacist explains.

Many of these so-called OTC drugs contain carbohydrates (including sugar) that can affect blood sugar levels, or ingredients that can interact with diabetes medications, according to Miranda Wilhelm. She is a clinical associate professor at Southern Illinois University School of Pharmacy.

But labels on OTC medicines don’t list carbohydrates, she said.

Wilhelm presented a report on the topic at the annual meeting of the American Association of Diabetes Educators, held recently in Indianapolis.

“It’s a dilemma because in some cases the carbs are so high it’s equivalent to a snack,” Wilhelm said in an association news release.

“On the other hand, if you actually read the ingredients, you might be afraid to take something that’s safe and could help with symptoms.

In other words, you may not be limited to OTC medicines that are formulated for people with diabetes, and that’s surprising for most people with the condition,” she said.

Wilhelm offered the following

35%

advice: • Good diabetes management is important. “If your A1C levels are well-managed and your blood pressure is at or near your goal, you should be fine taking most OTC medicines whether or not they contain carbohydrates if you just need them for a few days,” she said.

• Read the label. “If you’re concerned about your blood sugar levels, look for medicines labeled ‘sugar-free’ or ‘for people with diabetes,’” Wilhem suggested.

• Take pills instead of liquids. Liquid forms of medicines typically contain more carbohydrates, and sometimes as much alcohol as a glass of beer or wine, she said.

• If possible, choose a “topical” medicine. The reason: They don’t get into your bloodstream. For example, a nasal spray is better for treating a stuffy nose than a medicine you take by mouth. If you have muscle pain, ice the area and use a skin cream that treats pain instead of taking Motrin, Advil (ibuprofen) or Tylenol (acetaminophen).

• Get OTC recommendations from health professionals. Your doctor or pharmacist can help you avoid ingredients that would interact with your other medicines. Check labels

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for ingredients that can pose problems, such as caffeine and acetaminophen.

“Something that says it’s safe for people with diabetes is fine, but if it

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doesn’t address your symptoms, it’s not going to help you, meaning it’s medicine you don’t need,” Wilhelm said.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

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Sept. 12

Addiction support group to meet in Auburn The Heroin Epidemic Action League (HEAL) has started a new bereavement group meeting for the family members of those who have lost loved ones to addiction. The group will meet Sept. 12 and every second Tuesday of the month at 5:30 p.m. at HEAL ‘s offices in the East Hill Medical Building, 144 Genesee St., suite 203, in Auburn. All are welcome to attend. Participation is free to all who would like to participate.

Further information will be posted on its website, healheroin.org. For more information call 315-374-8192.

Sept. 12

Creative card workshop held in Central Square Serving Seniors Inc., a locally owned company that offers services to the senior community in Syracuse and the surrounding area, is organizing a Creative Card Workshop & Bingo Party. The event will take place from 1 to 3 p.m., Sept. 12 at McDonalds-Central Square, which is located near I-81. Participants will learn how to make homemade cards and bookmarks. Suggested donation is $15, which will help cover the cost of supplies. RSVP to info@cnyservingseniors.com For questions call 315-382-4300.

Sept. 13, Oct. 2

Medicare questions?

Auburn classes may help Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? The Cayuga County Office for the Aging is offering complimentary monthly classes to help you make sense of Medicare. Here you will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches. You’ll also learn, among other things, about how Part D drug plans work and whether EPIC co-pay assistance is an option for you. All classes will be held in the basement training room of the Cayuga County Office Building. Classes are scheduled from 11 a.m. to 1 p.m., Wednesday, Sept. 13, and from 2 to 4 p.m., Monday, Oct. 2.

Registration is required. For more information or to register, call 315-253-1226, or visit at www.cayugacounty.us/aging under the “News & Activities” section.

Sept. 15

Hospice to hold its largest fundraising event Hospice of Central New York will hold its largest fundraiser of the year, September Song, Sept. 15 at Traditions at The Links in E. Syracuse.

During the event, the group will honor Maryann Roefaro, the chief

IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

executive officer at Hematology-Oncology Associates of CNY. Roefaro is a longtime volunteer at the hospice, having served in various capacities, including president of the organization. According to a news release issued by the group, it costs over $190 per day on average to provide a day of care. Insurance reimbursement falls short of that by approximately $20 per day per patient. With over 40,000 patient care days, fundraising is critical for the organization.

If you are interested in supporting terminally ill patients and honoring Roefaro, call 315-634-1100 or go to the hospice website at www. hospicecny.org.

Sept. 15

‘Senior Moments’ fair to be held in Auburn Are you a senior? A caregiver?

The Cayuga County Office for the Aging will sponsor its Senior Moments Resource Fair from 9 a.m. to 1:15 p.m., Friday, Sept. 15, at the Fingerlakes Mall, Clark Street in Auburn. Some of the highlights: • At 9:30, the Office for the Aging will hold its annual public hearing where it invites suggestions from the public to help set its agenda for next year.

• At 10:30, Leita King from Lifespan will speak on scams and help participants to become empowered against them.

• At 11:30, podiatrist Daniel T. Smith will speak about how to maintain healthy feet • At 12:30, pharmacist Richard Pinckney from Rx City will speak about Medicare and what it means for your prescriptions.

In addition to speakers, many vendors will be present to help you find out what services are available to you in Cayuga County. Goody bags will be handed out, snacks will be available and Medicare insurance reviews and benefits screening can be done.

The SCAT Van is available to transport some of those who are interested in attending. Call 315-2530996 to find out the details. Call the Office for the Aging at 315-253-1226 with any questions.

Sept. 16

Multi-organ blood test held in Central Square Oswego Health will hold a multi-organ blood analysis from 6:30 to 9:30 a.m., Saturday, Sept. 16, at the Central Square Medical Center. This full battery of tests can help prevent potential health problems. The cost of the analysis is $40. Typically these tests can cost more than $340. In addition, there are two optional tests that each cost an additional $20. They include a vitamin D screening and the prostate specific antigen (PSA) test, which is recommended to men older than age 50. Appointments can be made online at oswegohealth.org/ bloodanalysis. They can also be made by calling 315-349-5914 weekdays

from 8 a.m. to 4 p.m. A 12-hour fast is required. Checks to cover the cost of the screenings should be made out to Oswego Health. The analysis screens individuals for various conditions such as anemia, diabetes and others, as well as for coronary, kidney and liver diseases. The most popular screening at the event is the portion of the analysis that assesses LDL and HDL cholesterol along with triglycerides. The results of the multi-organ blood analysis will be sent directly from the Oswego Hospital lab to the participant’s home and their physician in an easy-to-read format.

Sept 30

Walk to End Alzheimer’s to take place at OCC The Alzheimer’s Association invites local residents to join the fight to end Alzheimer’s by participating in the Alzheimer’s Association Walk to End Alzheimer’s. The event will take place Saturday, Sept. 30, at SRC Arena on the campus of Onondaga Community College in Syracuse.

Participant will complete a three mile walk on campus and will learn about Alzheimer’s disease, advocacy opportunities, clinical studies enrollment and support programs and services from the Alzheimer’s Association. Walk participants will also join in a meaningful tribute ceremony to honor those affected by Alzheimer’s disease. This year marks the first time the event will take place at OCC. The event had taken place at Long Branch Park since 2011.

In addition to the walk participants will enjoy entertainment, refreshments, raffles, the opportunity to interact with event sponsors, and can learn more about how the Alzheimer’s Association enhances care and support for the thousands in Central New York living with Alzheimer’s disease or other dementia. Registration begins at 8 a.m. inside the arena.

The opening ceremony starts at 10 a.m., followed by the walk at 10:15 a.m.

Sign up as a team captain, join a team or register to walk as an individual at alz.org/walk.

Oct. 12

Parkinson’s disease conference in Syracuse “Living an Active Life with Parkinson’s Disease” is the name of a conference that will take place Oct. 7 at Drumlin’s County Club, 800 Nottingham Road, Syracuse. This will be a free all day long conference that is offered by the Onondaga County Office for Aging and Upstate University Hospital’s HealthLink. Check-in is from 8:10 to 8:45 a.m. and the program runs from 9 a.m. to 2:15 p.m.

The conference will be hosted

by Susan Kennedy (host, WCNY’s “Cycle of Health”) who will introduce presentations on “Nutrition and Parkinson’s Disease,” “Resources for Care in the Home,” “Tools and Techniques for Making Tough Medical Conditions” and “Sleep Issues and Chronic Fatigue with Parkinson’s Disease.” Participants will also enjoy a light lunch at no cost.

There is no cost for the conference but pre-registration is required as space is limited. To register, call Upstate Connect at 315-464-8668. The deadline for registration is Friday, October 6, 2017.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 5

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STAY IN YOUR OWN HOME, LONGER!

Your Doctor

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Srinevas Reddy, M.D. Cancer doctor from Roswell Park Cancer Institute now providing services to patients at Oneida Healthcare, a hospital that’s building a comprehensive cancer program

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Q: Since I caught you while you’re driving to Oneida, tell us about the partnership between Roswell Park Cancer Institute and Oneida Healthcare.

A: The partnership is a joint initiative between Roswell Park and Oneida Healthcare to start a cancer center. The idea is to provide better access to patients living in rural New York. The state granted Oneida funds to build a comprehensive program in partnership with Roswell Park.

Q: How did you become involved personally?

A: I’ve been at Roswell for about a year and a half and one of the things that I’ve done in the time I’ve been there is outreach, where I meet physicians to talk about the care that I provide for patients with complex liver, bile duct and gallbladder problems. One of the things I’ve long recognized as a barrier for patients with these problems that prevents them from getting appropriate care is access. Once I learned of this partnership, I jumped at the opportunity to help set up a clinic in Oneida so that we could provide more convenient and direct patient care.

Q: Given that you’re commuting from Buffalo, are you going to be involved long term, or just for the setup?

A: This is something that I envision doing long term. Right now I go every other week, but starting this month I’ll be going every week.

Our teams are working to open the chemo-infusion center and launch collaborative medical-oncology services onsite. So this is definitely a long-term thing for me.

CHERYL BLANKENBURG CHRISTINE HENNING

Page 6

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Q: Do you see this as a model that will work for rural communities in general, leveraging the expertise and resources of bigger

IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

institutions from bigger cities in the state?

A: Absolutely. One of the things I’m committed to is the idea that, when possible, care should be delivered locally. It’s more convenient for the patient, provides a better quality of life. I’m very committed to developing relationships with physicians all over the state — in Syracuse, in Watertown, Utica, Binghamton.

By doing this, we can really try to integrate highly specialized care into these local communities. I do think this is replicable in other service lines. I don’t think it’s unique for our kind of surgery.

Q: What are the facilities going to be like in Oneida?

A: So, it will obviously be smaller than the one in Buffalo; however, all of the key cancer center facilities will be available. There will be fulltime oncologists on site, full-time care coordination, full-time nurse practitioner. There will be chemo-infusion services and all of the pharmacy components. We’re looking at ways to add additional cancer services onsite, too.

Q: Do you see the bigger Upstate cities being able to collaborate in a similar way?

A: Absolutely. I’ve been doing this clinic for a month and a half and I’ve seen patients from Syracuse and Albany. So, we see this clinic as not just providing highly specialized services to patients in Oneida and Rome, but to expand it for the entire region. It’s just not always practical to come to Buffalo, especially in the wintertime. So it’s kind of our outpost for the central, eastern and southern tier parts of the state.

Q: Who is most at risk for developing liver cancer?

A: I deal with two classes of diseases.

The first is complex

benign diseases and the second is cancer. It turns out that the liver is a very complex organ. Not only can cancer start in the liver, but it can spread to it. Cancers that start in the liver often develop in patients with cirrhosis, but not always. The most common types of cancer that spread to the liver are colon and rectal cancer, but there are other types that can spread there as well. The complex benign diseases includes things like liver cysts. Those problems can affect almost anyone.

Q: How effective do medical interventions tend to be on the diseases you treat?

A: Good question. When possible, surgery tends to be the best option for most of the cancers I treat.

But in addition to surgery, there are other treatments we offer, like chemotherapy and radiation therapy. We can target chemotherapy directly to the liver, so there’s not as much risk to the rest of the body. That’s really part of the unique challenge. It’s my responsibility to get these patients to the appropriate treatments and get them in the right order.

Q: To what degree do you think rural hospitals can meet the new fee-foroutcome reimbursement standards?

A: I have done a great deal of work meeting physicians in rural hospitals and have been pleasantly surprised by their capabilities. But for complex cancers and patients who can benefit from multidisciplinary case review and coordination of care by a specialist, that’s where I think we can really make a difference. That’s really my role and that’s why I’m so excited by this opportunity. Patients should only have to come to Buffalo for those complex services.

Q: Do you see yourself moving somewhere between Buffalo and Oneida for an easier commute?

A: Right now I plan on staying in Buffalo since I’m still seeing patients in Western New York, but more of my partners are going to be involved.

We’ve integrated all of our electronic health records, so I can see anything that gets done in Oneida from Buffalo and vice versa.

Lifelines Name: Srinevas Reddy, M.D. Position: Surgical oncologist at Oneida Healthcare; co-director of Liver and Pancreas Tumor Center at Roswell Park Cancer Institute Education & Training: Medical degree from University of Wisconsin Medical School, Madison; residency in general surgery, Duke University Medical Center; fellowship in the hepatobiliary field at the department of surgical oncology, University of Pittsburgh Medical Center Hometown: Appleton, Wisconsin.

Affiliations: Oneida Healthcare; Roswell Park Cancer Institute Organization: American Society of Clinical Oncology, American College of Surgeons, American Hepato- Pancreato-Biliary Association; Society of Surgical Oncology Family: Married, two brothers Hobbies: Sports fan, religious activities

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 7

cancer and other illnesses.

A person with a mutation of the BRCA-1 or BRCA-2 genes has a much higher risk of developing ovarian cancer and breast cancer compared to the general population, so the “Positively BRCA” support group is specifically geared toward women with a mutation.

Hope for Heather also supports Heather’s Angel Fund at Upstate Cancer Center, which covers non-medical expenses for ovarian cancer patients. Patients and their families may be traveling from far away to seek treatment in Syracuse, so Heather’s Angel Fund provides them with gift cards for gas, hotels and food, including the hospital cafeteria.

“If we can do one little thing to ease someone’s burden, that’s important to us,” Frieda said.

Men of Teal

Frieda and Gary Weeks, of Liverpool, founded Hope for Heather to raise awareness and funds for ovarian cancer research. Their late daughter, Heather, worked for the Ovarian Cancer Research Fund. Photo courtesy of Rick Policastro.

Hope Runs Eternal Frieda and Gary Weeks carry on daughter’s mission to fight ovarian cancer

By Ashley M. Casey

E

ach October, the color pink lights up the National Grid building in downtown Syracuse for Breast Cancer Awareness Month. Pink ribbons, wristbands, pens, ties and other merchandise are emblazoned with promises to donate proceeds to nonprofits that support breast cancer awareness and research.

But the month before “Pinktober,” Frieda and Gary Weeks douse the community in teal to highlight another, less publicized gynecological cancer — ovarian cancer.

The Weeks family founded Hope for Heather in May 2009 to educate people about ovarian cancer and raise money for research.

“Breast cancer is much more common, but ovarian cancer is much more lethal,” said Gary.

Hope for Heather’s flagship fundraiser is the annual Teal Ribbon Run, which takes place Sept. 23 at Lewis Park in Minoa.

In addition to the walk/run, the event features a tent for survivors to gather and share their stories, vendors and health information, raffles and awards for the top race finishers and fundraisers. To date, Hope for Heather has raised $800,000 for ovarian cancer research, patient support programs and more.

This year’s race is dedicated to Mary Gosek, the president of the Oswego chapter of Hope for Heather and a longtime SUNY Oswego computer program analyst. She died from ovarian cancer June 3.

“I don’t want to put any more names on my ‘angel board,’” said Frieda, nodding toward the wall of Page 8

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photos, letters and other mementos dedicated to people who have died of cancer.

Heather’s mission

The Weeks family’s mission to spread awareness about cancer is personal. Gary is battling recurrent bladder cancer, and the couple’s daughter, Heather, died of colon cancer at age 24.

The vivacious young dancer had worked for what is now the Ovarian Cancer Research Fund Alliance before falling ill with colon cancer, so her parents decided to continue her mission of raising the profile of ovarian cancer.

“She saw a real need that wasn’t being taken care of,” Gary said of his daughter’s work.

After her diagnosis in June 2008, Heather asked her parents if they could have a booth at the Great New York State Fair to spread the word about the symptoms of ovarian

cancer. While she didn’t live to see that booth at the 2009 fair — she died Nov. 14, 2008 — her parents kept their promise.

“We didn’t have any money, but we managed to download some information,” Gary recalled. “I built a lemonade-style booth out of a banner and some PVC pipe.”

Hope for Heather’s first run at the fair didn’t attract too many visitors, but the organization gained a few solid volunteers. One of them suggested making ribbons. That first year, Gary said, Hope for Heather gave out between 20,000 and 30,000 ribbons. These days, the organization distributes 50,000 ribbons annually.

In addition to raising money for the Ovarian Cancer Research Fund Alliance, which is the world’s largest organization dedicated to researching the disease, Hope for Heather provides support groups for women who are currently undergoing treatment or who have survived ovarian

Signs and symptoms of ovarian cancer Many women who are diagnosed with ovarian cancer report the following symptoms: • Bloating • Pelvic or abdominal pain • Difficulty eating or feeling full quickly • Urinary symptoms (urgency or frequency) • Fatigue • Indigestion • Back pain • Pain with intercourse • Constipation • Menstrual irregularities

IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

“These symptoms are very vague,” said Gary Weeks. “Most women have some of them every month with a normal [menstrual] cycle.”

These nonspecific symptoms become a problem if a woman experiences them daily for two or three weeks. Frieda and Gary Weeks encourage women to track their symptoms and to visit a gynecologist if the symptoms don’t go away after a few weeks. Early detection of ovarian cancer is key to improving a patient’s outcome.

In addition to the Teal Ribbon Run, Hope for Heather kicked off another initiative for Ovarian Cancer Awareness Month, which began in mid-August. For the fourth year in a row, 30 men from across Central New York are featured on the organization’s Facebook page as “Men of Teal.” Each Man of Teal receives a teal polo shirt and a kit of symptom cards and ribbons to distribute to the women in his life and to every woman he meets.

“We wanted to come up with a way for men to get involved,” Frieda said.

Notable Men of Teal from 2016 include Rick Roberts, on-air personality, music director and assistant program director at 93Q; Michael Speach, owner of the Speach Family Candy Shoppe; and State Assemblyman Al Stirpe.

“Once a Man of Teal, always a Man of Teal,” said Frieda, adding that past Men of Teal often return for more awareness supplies even though they’re no longer being officially featured.

“We hope their commitment stays with them every September and throughout the year, because cancer is 365 days a year,” Frieda said.

Gary said his battle with bladder cancer has given him a new perspective on the mission of Hope for Heather and the survivors it serves.

“After going through my treatment, I’m very empathetic,” he said.

“I’m much more likely to understand what other people are going through.”

“There’s been a change in Gary,” Frieda said. “He’s always used his voice, but his voice is much larger now.”

Register to run The 2017 Teal Ribbon Run takes place at 8 a.m. Saturday, Sept. 23, at Lewis Park on South Main Street in Minoa.

The event includes a 5K run, a 3K family walk and a Teal Dash for kids. Registration through Sept. 15 costs $30 and includes a race T-shirt; from Sept. 16 to 20, register for $35.

On-site registration on the day of the event costs $40.

To register, visit hopeforheather.org/ TealRibbonRun.htm.

Binge Drinking Rates Dropping on College Campuses But study also shows those rates are rising for young adults who are not in school

A

fter years of increases in binge drinking among the college crowd, new research shows those rates have now dropped.

Unfortunately, the reverse held true for young adults who did not go to college.

Between 1999 and 2005, binge drinking among college students jumped from 37 percent to 45 percent. But that trend reversed itself after 2005, landing back at 37 percent by 2014, according to the analysis from the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Meanwhile, binge drinking rates among those who were not enrolled in college increased from 36 percent to 40 percent between 1999 and 2014.

"For many years, there was an increase in the percentage of college

students in national surveys who binged," said study first author Ralph Hingson, director of the division of epidemiology and prevention research at NIAAA. "We saw that up until 2005.

"But since then, the percentages have gone down," he noted. "Same thing for driving under the influence of alcohol and our estimates of alcohol-related unintentional injuries.

"But there is still a lot of work to do," Hingson cautioned, with binge drinking on the rise among 18- to 24-year-olds who are not enrolled in college. "And this group now has a higher percentage of binge drinkers

than same-age college students," he added.

Binge drinking is defined as a pattern of excessive consumption that usually involves imbibing four drinks (among women) or five drinks (among men) within a two-hour period.

To get a handle on binge drinking trends among young Americans, the investigators culled data collected by a wide swath of government agencies.

The team found that alcohol-impaired driving among college students declined from 29 percent in 2005 to 17 percent in 2014.

Similarly, alcohol-related unintentional injury deaths and traffic deaths fell nearly 30 percent and 43 percent, respec-

tively, among the same age group between 1998 and 2014.

The findings were published in the July issue of the Journal of Studies on Alcohol and Drugs.

Hingson suggested that the strides made against binge drinking on college campuses reflect "increased efforts at federal, state and community level to reduce underage drinking."

For example, he noted that as of 2005 all 50 states had adopted an 0.08 percent blood alcohol level limit for drivers, up from just 17 states back in 2000. As well, 38 states now have underage drinking strategic plans.

"The last thing is the downturn in the economy," he added. "People have less discretionary income, and so less money to spend on alcohol."

Healthcare in a Minute

By George W. Chapman

ACA Update

It’s hard to report on the fate of this bill on a monthly basis because things are so fluid in Washington lately. But as of mid-August, the ACA, with all its pros and cons, is still the law of the land. The critical feature of the ACA right now are the two subsidies available to people with incomes between 100 percent and 400 percent of federal poverty guidelines. The first subsidy is a tax credit toward the premium of a bronze, silver or platinum plan. The second subsidy, CSR or “cost- sharing reduction,” is for out-of-pocket expenses like deductible and copays.

The CSR subsidy applies only to silver plans. Of the 7 million people who buy on the exchanges, 58 percent receive the CSR. The CSRs will cost an estimated $7 billion this year. Congress filed a lawsuit against Obama, House v Price, claiming there is no authority for the expenditure of this money as all funds must be approved and appropriated by Congress. The court ruled in favor of Congress but the ruling was stayed by the Court of Appeals, so the whole thing is in limbo. If the CSR is ultimately revoked, it is estimated insurers would be forced to raise their rates on the exchanges by 19 percent.

President Trump has threatened to end the CSRs which would virtually kill the exchanges.

Price Transparency

You can get the price, or at least an idea of what something will cost, on just about anything in this world.

Not so much in healthcare. Patient advocates believe price transparency makes sense as consumers are faced with rising out-of-pocket costs (deductibles and copays) and healthcare reformers believe price transparency will create competition and lower

costs. But it is not that simple. Shopping around for prices can be a fool’s errand because healthcare prices or charges have little to no relationship to either the cost of the procedure or what your insurance eventually pays the provider. Hospitals are reluctant to quote a price because they don’t really tell the consumer anything. One hospital may quote you a price/charge of $20,000 and another hospital $15,000. But the odds are both will be reimbursed virtually the same by your insurance company. The explanation of benefits (EOB) you receive after a hospitalization from your insurer tells the story. The charges total $20,000, but your insurer paid only $5,000. Your deductible and copays are based then on the $5,000 reimbursement, not the $20,000 price/charge. Also consider that the vast majority of consumers will be hospitalized where their physician works or refers them. While hospital charges are meaningless and indefensible, it makes little sense for consumers to shop around for care based on “prices.” Hospitals are reluctant to lower their prices/charges out of fear consumers will think the care isn’t as good as a hospital with higher charges.

Single Payer System

California, New York, Colorado and Vermont have all introduced legislation for a single payer or “Medicare for all” plan. Concerns over costs have killed the bills. Ironically, the per capita cost of care in every country with a single payer system is much lower than in the U.S and quality is not compromised. An argument for a single payer system by Cornell professor Robert Frank appeared in New York Times in July. He argues that costs are lower under single payer systems. Administrative costs for single payer systems, (Medicare is around 2 percent), are far less than

for private payers which are around 10-15 percent. Single payer systems don’t need to advertise which accounts for a lot of the administrative costs. As a matter of fact, in order to attract private insurers into the Medicare Advantage market, the federal government had to subsidize their high administrative costs.

Single payer systems have far greater negotiating power with providers and suppliers. Medicare has already set physician and hospital payments so further efforts to save money there would be getting blood from a stone. The biggest savings would be from drug and device manufacturers which heretofore have been left unscathed thanks to intense lobbying.

Single payer systems cover everyone, under one huge risk pool, young and old, healthy and unhealthy. No exceptions. Our several government risk pools — for example: Medicare, Medicaid, VA — cover disproportionate amounts of people who need medical attention. Our population is further divided into literally tens of thousands of smaller risk pools as most businesses with over 200 employees are self-insured. In a single payer system, all must participate and, yes, all will pay taxes. But our entire system would collapse if tax payments were purely voluntary.

US Surgeon General

Physician Jerome Adams has been confirmed as our 20th surgeon general. Adams was an assistant professor of anesthesiology at Indiana University School of Medicine before becoming Indiana’s commissioner of health. One of his first priorities will be tackling the opioid epidemic. The position of surgeon general began in 1871 to head the Marine hospital service.

September 2017 •

Opioid Epidemic

These highly effective and addictive pain killers include OxyContin, Percocet, Vicodin and fentanyl.

62,000 people died last year of an opioid overdose. Nearly half of the opioid deaths involved prescriptions. The epidemic is worsening every year. In 2010, 16,000 people overdosed. The national average is 10 overdoses per 100,000. It’s 30 per 100,000 in New Hampshire and 40 per 100,000 in West Virginia. Opioids are the most prescribed drug in the US with about 289 million scripts a year. As the epidemic grew, heroin became more prevalent as it was cheaper, easier to get and didn’t require a script. In the 1980s, many medical experts thought opioids were not addictive due in part to a letter published in a popular medical journal in 1980. “Addiction Rare in Patients Treated with Narcotics” may have unwittingly been the genesis of the epidemic. It is estimated that over 1 million people have been eliminated from the job market because of their addictions. Big pharma has done well. Purdue pharma has made over $3 billion on their OxyContin.

They have paid over $635 million in fines for misleading physicians and the public. Substance abuse treatment costs us about $600 billion a year.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 9

My Turn

By Eva Briggs

Allergy to Red Meat Caused by the Lone Star Tick

T

icks in Central New York recently launched an all-out assault. While nursing a particularly nasty bite, I couldn’t help but muse about tick-borne illnesses. One of the weirdest isn’t an infectious disease at all. It’s an allergy to red meat that develops after the bite of the lone star tick.

Sufferers develop gastrointestinal symptoms like nausea, vomiting and diarrhea; itching and hives; and sometimes anaphylaxis with symptoms like airway swelling, wheezing, and collapse.

It happens hours after eating a meal containing red meat. Affected individuals have IgE antibodies that react to a substance in red meat with the tongue-twisting name of galactose-alpha-1,3-galactose — alpha-gal for short.

Because the reaction occurs hours after eating non-primate mammalian meat, it’s not easy to make the connection for an individual patient. It’s caused by the bite of the lone star tick. The name stems not from the state of Texas (although it does occur in the eastern part of that state), but from the single silvery-white star found in the center of the adult female’s body. The lone star tick inhabits the eastern, southeastern, and midwestern U.S.

The allergy to red meat caused by this tick affects the consumption of non-primate mammalian meat — chiefly beef and pork. Affected people frequently have eaten meat for years before the symptoms start.

They don’t need to have any special susceptibility to allergies, and need not have a prior history of allergies or asthma.

To make the diagnosis for sure requires allergy testing in the form of skin or blood tests. There isn’t a cure.

The treatment is avoiding red meat and carrying an epinephrine auto injector (one brand is Epipen) for emergency treatment.

The exact mechanism by which the lone star tick causes he allergy isn’t known. It might be that the tick makes a substance in its saliva that cross reacts with alpha-gal, inducing the allergy. A second theory is that while feeding, the tick contaminates its human host with alpha-gal that it picked up when feasting on a previous meal. Or even from a meal eaten by its mother and handed down via the egg from which the tick grew.

A third theory is that some as-yet undiscovered microorganism living within the tick is the actual culprit.

One fascinating aspect is the tale of how scientists made the connection between alpha-gal and meat

allergy from tick bites.

In the early 2000s, scientists were testing a drug to treat colon cancer. A few people developed severe allergic reactions to the drug the very first time they received a infusion.

That seemed odd. Usually prior exposure to a drug has to occur before an allergy develops. When they studied the blood of allergic patients, they found the antibody to alpha-gal. It was already known that alpha-gal is found in mammal meat.

But why were these people allergic to the cancer drug? At about the same time, patients turned up in increasing numbers with new red meat allergies. The people who reacted to the cancer drug and the people with meat allergies lived in the same geographic area. This location coincided with distribution of the lone star tick.

On careful questioning, both groups of patients recalled tick bites. Eventually scientists connected the dots and confirmed that lone star tick bites were to blame.

In Central New York we’re on the northern edge of the lone star tick distribution. It doesn’t spread Lyme disease but still is capable of transmitting many other nasty infections:

human monocytotropic ehrlichiosis, canine and human granulocytic ehrlichiosis , tularemia, and southern tick-associated rash illness (STARI).

So, be sure to tuck in your pants, consider treating your outdoor clothes with permethrin, and use insect repellant.

Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated

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Syracuse Refugee Children Find Care at Upstate Clinic

By Matthew Liptak

T

he many refugee children who are welcomed to Syracuse each year have come a long way to find safety, but many of them have brought health issues with them. The Upstate pediatric refugee clinic exists to see that they have the healthiest start possible in their new country.

It’s called UPAC — the Upstate Pediatric and Adolescent Clinic and its health providers take in 24 new patients every month or close to 300 a year, according to physician Andrea Shaw, the clinic’s director.

“Even though we call it a clinic, it’s nested within Upstate’s outpatient pediatric practice which is really nice because myself and another nurse practitioner handle all the new patients that come in,” said Shaw.

Refugee children are referred to the clinic by their relocation organizations. They are seen over the space of two years. It’s a long-term commitment by Upstate Medical University, not just one quick examination. Providers want to make sure the children are adjusting well and healthy in their new home.

“We get to see them frequently over the first couple of years that we are here, iron out any medical problems that they had come with or problems that arise in their initial period of resettlement,” Shaw said.

Initially the children’s medical care is covered by New York state — the first two visits. Then Medicaid usually kicks in for the families. After the two-year initial clinic period, the children are transitioned to Upstate’s regular pediatric services.

The clinic watches for any tropical diseases that the children might have or any chronic ailments they already have. They are screened before coming into the country for dangerous contagions, but there are more common illnesses they may encounter.

“It’s everything from primary care issues that anyone might deal with — chronic health needs that they may have carried their whole life, but then also tropical diseases depending on where they come from, and different exposures they may have had based on where they had to travel before they came to the United States,” Shaw said. “The two biggest questions we always want to know is where they’re from and where

they’ve been.”

The kids often have to deal with the trauma of whatever they’ve had to escape in their homeland, the stress of constantly moving, and the challenge of coping with a new culture.

“All of those have different layers of stress that the kids feel,” Shaw said. “We’re able to see them through a lot of that transition.” Shaw keeps a lookout for signs of psychiatric trauma. Coming from a war-torn nation can leave kids with scars that are not just physical, not to mention the stress of constantly relocating to new areas of the world. The children get the help they need, though at this point Upstate itself doesn’t have psychiatric counselors on staff. Shaw is hoping to change that.

“That is one area that I’m looking to enhance further,” she said.

The presence of a refugee clinic at Upstate is beneficial to the providers too. Many of them have an interest in the healthcare of people from around the world, not just here.

“This is a niche where many of us with an interest in global health find that this is a global health practice in our own back yard, because we’re taking care of patients from all over the world with the same conditions that they would have in their home countries,” Shaw said.

There are peculiar challenges to this care. These children are coming in from around the world. They don’t often know English and the providers don’t know their language.

“I think communication is the biggest crux,” Shaw said. “We spend a lot of our time communicating, a lot less of our time focused on some of the nitty-gritty medical words. You learn how to work with translators to really connect with patients and find the way to get the message across.”

There is a great demand for the clinic in Syracuse and Upstate is working to meet it. Shaw said 1,400 refugees relocated to Syracuse in 2016, and over 50 percent were children. These young outcasts of the world can finally find a place to call home in Syracuse, and Shaw and her clinic are happy to help them do it.

“On the whole, these families are incredible,” she said. “These kids are clearly survivors and they’re adaptable or they wouldn’t have made it as far as they did.”

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Living Alone Takes Courage

I

was inspired to write this column on courage after receiving the email below from a reader last month: Dear Gwenn, You would appreciate this. I just have to share these two recent experiences I had as a single woman.

Last week, I went to a concert on the spur of the moment called “Old Hippies Reunion.” As a Baby Boomer (and former hippie), I thought it might be interesting and fun. I dined out alone at a restaurant, then left alone to enjoy the concert in a nearby music venue. I tried my best to adopt the posture of a confident single woman at a bar — you know, that casual look. I faked it for a while, then retreated to the safety of my car, and ultimately to my couch at home. Still, I felt good that I made the effort!

Then this week, I went to meet a “match.com date” — only I went to the right place on the wrong day. I waited

an hour, established rapport with the single-mom hostess and then gave up.

I went into the dining room, ordered a glass of wine and an appetizer. Clearly the waitress thought it most odd I was alone. (I did not have the courage to eat outdoors where all of the other couples had seen me waiting for an hour). Last night, I met the gentlemen at the right place on the right day. It was a pleasant first, but last encounter.

Being single requires courage!

Kathy (not her real name) How right this reader is. Living alone does require courage. In fact, Kathy’s email got me thinking about all the many and varied ways that living alone asks (demands!) that we demonstrate courage, almost on a daily basis.

On my own, I’ve discovered it takes courage to:

Sleep alone. That “bump in the night” can test even the strongest among us.

Get up alone. Where did all this anxiety come from? I just want to stay in bed!

Show up alone. Walking in alone can still feel so uncomfortable.

Especially if my ex is at the event.

Throw a party. What was I thinking? Will anyone show up? The bathrooms still need cleaning!

Ask for help. When am I going to stop letting my pride get in the way?

Set a mousetrap. Or worse, dispose of one that’s “occupied.”

What to do?

Be nice to my ex. After all, we did share some good times together.

Once and for all, start exercising. I know it’s good for me. And

could add quality and years to my life. What’s stopping me?

Survive a Saturday night alone.

Why is this so daunting? I need to get a grip. Or, a good book.

Express true feelings. If not now, when?

Say “no” to an unwelcome advance. Despite how lonely I feel, the ring on his finger is a showstopper.

Say “yes” to a welcome invitation. He’s kind and kinda cute. But

then what? At my age?

Travel alone. You mean I have to carry my own luggage? Make my own flight arrangements? Enjoy blissful time alone, with my own good company? Yes! I guess this one doesn’t take much courage.

Tackle a home repair. Hey, if a guy can replace the flapper in the toilet tank, I can, too.

Make a major purchase. I know I should be practical, but what I really want is that sporty red convertible.

On that last item, writing this column takes courage. Within these columns, I share some of my deepest feelings, thoughts and fears. I make myself vulnerable. And that takes courage.

But, guess what? When we demonstrate courage and take risks, we grow. We become stronger, more resilient, more independent, and more able to live the life of our dreams. We become better at living alone. And that’s a good and courageous thing to do!

Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive,” empowerment workshops for women held throughout the year in Mendon, N.Y. For information or to contact Voelckers, call 585-6247887 or email: gvoelckers@rochester. rr.com.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

SmartBites

The skinny on healthy eating

4 Reasons to Eat Sesame Seeds

A

lthough beloved on bagels, breadsticks and hamburger buns, many folks can’t say why sesame seeds are good for health. Too tiny to make a difference?

Too much of a “topping” to warrant investigation? Too common to think twice about? Whatever the reason (and I’ve been guilty of all three), it’s time to say “open sesame” to all that makes this small seed so big on nutritional benefits.

1

Bone-building minerals. It’s

remarkable how sesame seeds’ most abundant minerals — copper, manganese, magnesium and calcium — all contribute to bone health in some important way. With osteopenia bearing down on my rickety bones, I’m always on the lookout for calcium sources. Individually, copper helps make red blood cells and promotes healthy connective tissues; manganese is needed for digestion and nerve function; magnesium contributes to energy production; and calcium keeps our blood clotting and our hearts thumping.

2

Heart-healthy fiber. Men-

tion fiber and “regularity” often comes to mind first, which is indeed a good thing! But there’s so much more to this valuable nutrient.

Current research shows that adding more fiber to your diet may lower

blood pressure, improve blood cholesterol levels and reduce the inflammation closely linked to all stages of atherosclerosis. Also, dietary fiber may help control diabetes. Just two tablespoons of sesame seeds provide about 4 grams of fiber (as much as one apple).

3

Cholesterol-lowering phytosterols. Sesame seeds

are loaded with phytosterols, those beneficial plant compounds that have been scientifically proven to lower cholesterol. Their benefits are so significant that foods are often fortified with phytosterols. Of course, having lower cholesterol levels leads to other benefits, such as a reduced risk of heart attacks and stroke. Antioxidant-rich phytosterols have also been found to help protect against the development of certain cancers.

4

Good-for-you fats. Sesame seeds are no slouch in the fat department, with just a few tablespoons serving up about 13 grams of fat. Thankfully, most are good fats — the mono and polyunsaturated fats. These fats help the body absorb nutrients and vitamins A, D, E and K that are vital to vision, strong bones and nerve development. They also help regulate hormones and body temperature and keep our skin, nails and hair in tiptop shape.

Eye Drops to Cure Cataracts?

Scientists are still testing using eye drops to dissolve cataracts in humans; in the meantime, new laser techniques are making surgery a lot more precise

By Deborah Jeanne Sergeant

M

ore than half of people will have cataracts by age 75, according to the American Academy of Ophthalmology. Cataract surgery is a simple out-patient procedure and most insurers cover it.

Scientists are working on drops that seem to dissolve cataracts in animal testing; however, human trials and subsequent FDA approval are needed before it’s available to treat patients.

In the meantime, cataract advances in surgical technique and materials have helped improve patients’ vision.

Robert Fechtner, ophthalmologist, professor and chairman of ophthalmology at SUNY Upstate Medical University, said that the standard technique is to make a small incision through the cornea with a blade and

then open up the front of the capsule surrounding the lens. “Now, a laser can do those two steps. It’s brilliant technology,” he said.

He added that the laser method costs more and doesn’t yet show strong evidence for a significantly different outcome, but using the laser does make the procedure more predictable.

“The incision is so neat and clean that it may reduce the chance of leakage and makes a nearly perfectly round opening in the lens, which can help with the procedure and stability,” Fechtner said.

The newer lenses also help improve distance and near vision and astigmatism. According to the American Academy of Ophthalmology, 23.9 percent of the American population

Sesame Bars with Walnuts, Coconut and Dried Cranberries Adapted from Bon Appetit

1¼ cups white sesame seeds ¾ cup unsweetened shredded coconut ¼ cup chopped walnuts (or nut of choice) ½ teaspoon kosher salt ¼ cup honey 2 tablespoons tahini (sesame paste) or creamy peanut butter ½ teaspoon vanilla extract ½ cup dried cranberries or raisins Preheat oven to 350°. Lightly oil an 8x8” baking pan; line with parchment paper or nonstick foil, leaving a generous overhang on all sides. Mix sesame seeds, coconut, nuts, and salt in a large bowl. Mix honey, tahini or peanut butter, and vanilla in a small bowl. Add to sesame seed mixture and mix well. Stir in cranberries.

Scrape mixture into prepared baking pan; press firmly into an even layer. Bake until golden brown around the edges, about 20 minutes.

Transfer to a wire rack and let cool until firm, 30–40 minutes. Lift out of baking pan (if it starts to crumble, let cool longer) and cut into bars or squares. Let cool completely. Store at room temperature or in fridge. age 40-plus — more than 34 million — are myopic (nearsighted). Almost 14.2 million of the same age group are hyperopia (farsighted). Nearly one in three Americans has astigmatism and 150 million wear corrective eyewear.

“The good news is modern cataract surgery is so vastly successful for most people that it’s reasonable to expect rapid restoration of your vision,” Fechtner said.

Surgeons can put a patient’s glasses prescription right into the lens implant to eliminate the need for glasses at distance or near.

The lens implants can also correct astigmatism, an irregular shape of the eye.

“When you’re preparing for cataract surgery, your surgeon will measure your eye and select the correct lens,” Fechtner said. “The technology is still advancing. The early lenses weren’t so great but the new ones are pretty good.”

Ophthalmologist Scott MacRae, who practices at University of Rochester Medicine’s Flaum Eye Institute, said that the new lenses have improved the intermediate vision that previous lenses didn’t correct as well.

“This lens allows patients to see that intermediate area, which is becoming more and more important as people become more dependent on computers,” MacRae said. “Patients really like that.”

September 2017 •

Helpful tips: If buying sesame seeds from bulk bins, take a whiff and a gander: they should smell fresh and be free of any moisture. Store hulled seeds, which are more prone to rancidity, in the fridge or freezer; unhulled seeds can be stored in an airtight container in a cool, dark place. Boost your consumption of this nutritious seed by adding it to baked goods, meatloaf and stews, and by sprinkling it on vegetables, meats, noodles and more.

Anne Palumbo is a lifestyle colum-

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

He added that some patients subsequently undergo Lasik to clear out any residual refracting.

The surgery is done in less than 15 minutes, and post-surgical eye drops are pretty easy for most patients to administer. Though patients may not lift heavy objects for a week after surgery, but after that, patients can return to normal activity without restriction. Fechtner said that the surgery is pain-free.

Most surgeons perform the surgery on each eye about two weeks apart.

“The technology is so good that any skilled surgeon can get outstanding results for most people,” Fechtner said.

He estimated the chance of complication is about one in 10,000 surgeries.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 13

Parenting

By Melissa Stefanec melissastefanec@yahoo.com

Bringing Up a Little Man

T

his month, my son, River, is turning 3. My first child was a daughter, and I have learned so much about kids, society and myself from raising her. However, raising a boy has taught me a whole, separate set of lessons about people, raising children and myself. As a feminist and humanist, I spend a lot of time contemplating how to best raise a boy in today’s society. Navigating gender stereotypes and norms is complicated, but I am trying to help my son make his way. Nothing in parenting is a guarantee, but here are some of the ways I am trying to raise a well-rounded, well-respected, strong, resilient and open-minded man.

wants to push these ideas on any child, regardless of his or her sex. If my son does something bad, it’s not because he’s a boy. It’s because he is a child and he is learning. He will get a consequence for his bad behavior and not have it excused by adults or himself.

“Boys will be boys”

Default pronouns

This saying doesn’t fly in my house or around my kids. This attitude does two things I don’t like; it gives boys a pass at bad behavior and associates bad actions with being male. I still can’t understand who

With both of my children, I have been very careful to not use “he” as the default pronoun when the sex of something is unknown. When we see a toad hopping around our front yard, I often say something

The golden rule My husband and I teach our son to treat others as he would like to be treated. We don’t treat boys like boys and girls like girls. We don’t make exceptions or accommodations for others based on sex. We promote respect, strength and kindness to all people.

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like, “look at her, isn’t she amazing?”

There is no reason to assign things as male until we know otherwise.

I don’t want my children thinking either sex is the default. I figure if I do my best to default to “she,” that will counteract the rest of the world defaulting to “he”.

Use of adjectives There’s no “_____ like a girl” in our house. There’s no “_____ like a man” in our house. I won’t tolerate either gender being embodied as good, bad, strong, superior, inferior or otherwise. I think for real progress to be made in gender equality, one thing we need to stop doing is using similes and metaphors regarding gender and sex, especially around children.

Books about girly stuff I’m not spending all day reading my son books about princesses, mainly because I don’t want either of my children to be immersed in that culture, but we spend lots of time reading books about sharing, caring, adorable baby animals, super heroes, trucks, bugs, kittens, people unlike us, people like us and funny stuff. My son and daughter share a lot of the same books. I like to expose them to a lot different topics. Then, I can find out what they actually like to read about, instead of feeding them topics they are supposed to like based on their sexes.

Body autonomy I teach my son that his body is his own. He is in control of his body and what it does. He gets to tell others when he wants to be hugged or kissed. I am also treating him to view other’s bodies in the same manner.

It’s that simple.

Clothing and toys My son loves dinosaurs, just like I did at his age. As such, he has all sorts of clothing and toys featuring his favorite critters. However, I stay

away from violent and angry dinosaur clothing and toys. That way, he gets to enjoy dinosaurs without having violence and physical power being marketed to him. He is simultaneously interested in kittens and baby animals. He totes around his favorite toy, a big-eyed, neon green and blue leopard kitten named Leona, with pride and love. Boys like cats too.

Crying is cool If my son is hurt, I let him be hurt. He is a tough little person and usually shakes things off, but if he is hurt physically or emotionally, I give him whatever support he needs.

I don’t ask him to hide his emotions or pain. I let him have an outlet and seek the love he needs to fix his problems. I want him to know men have feelings and nerves too; he can be strong and male while simultaneously acknowledging his own pain, fears, frustrations and challenges.

Cuddles are cooler My son gives hugs and kisses to people he loves, and I don’t plan on making him rein that in at any point in his life. Boys need cuddles just as much as girls, and I’m not going to tell him he is ever too grown up for love. When he decides to pull back on such things, I will respect that, but it won’t be curtailed because I or my husband encouraged it.

New perspectives I am thankful every day that I have a son. It makes me want to view things from a male’s perspective. It makes me think about special challenges that little boys (and men) face in our society. Raising a boy is giving me a chance to become a more thoughtful and empathetic person. I will always be grateful for that. I am glad I have the opportunity to raise a daughter and a son; it will help to keep my perspectives and biases in check. It’s also a lot of fun and making for a lot of love.

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Men’sHealth

Men and Their Belly Fat Call it beer belly, love handles, spare tire: doctors say men with large bellies have increased risk of death by various associated diseases

L

ove handles, spare tire, beer belly: whatever it’s called, it’s not pretty and it can actually harm a man’s health.

The issue is that weight around the belly is visceral fat that surrounds the organs.

David Cruz, certified personal trainer at Gold’s Gym in Dewitt, said that this deep fat increases risk of some chronic disease like cardiovascular disease, insulin resistance, Type 2 diabetes and high blood pressure, colorectal cancer and sleep apnea.

University of Rochester Medicine Primary Care physician Louis Papa said that the location of these fat deposits — not the overall weight — is what’s so vital.

“People with a normal body mass index (BMI) but with more belly fat are at a greater risk of disease than people with a high BMI but normal amount of belly fat,” Papa said.

He added that people with an abnormal amount of belly fat have a 51 percent increased risk of death by various associated diseases than those with a normal amount of belly fat.

“Since belly fat is related to insulin resistance and inflammatory changes, that puts you at higher risk for these diseases,” Papa said. “These fat cells have a lot of hormonal activity. The belly/hip fat produces a lot of endocrine and hormonal activity that puts you at risk for diabetes and heart disease.”

So how can you specifically get rid of belly fat?

“We don’t know a good way to get rid of just belly fat,” Papa said.

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How to Get Rid of It Although lots of marketing hype promises to blast belly fat with a product or technique, it’s not that easy since weight loss can’t target one area. Instead, try these expert tips: Tips from Shauna Burke, certified personal trainer at Pacific Health Club in Liverpool: • Find what works for you. “Everyone is slightly different. If there was one answer to the question, my profession would be over. It does come down to calories in versus calories out.”

• Go with technology. “Health apps on your phone are awesome. Many people have smart phones. You can track steps, calories, fitness activities and more. Synching a Fit Bit to the phone helps.”

• Count calories accurately. “Studies show 50 percent of people really underestimate their calories. Plus, many overestimate how many they’re burning.”

• Don’t let mobility stop you. “If you’re in a wheelchair, I can design an exercise routine. There are still many things we can do.”

David Cruz, certified personal trainer, certified group fitness instructor and certified spin instructor at Gold’s Gym in Dewitt • Look at your lifestyle. “See what in your life style can be inhibiting your goals for weight loss. Look at those factors that might restrict you from doing it, like drinking alcohol. That does not help in losing weight or any metabolic function.”

• Get moving. “If you are someone who lives sedentary lifestyle, going to the gym at least three times per week is what I suggest. Focus on large muscle groups and that will help you lose more fat. If people do a lot of cardio, it will help with fat loss, but make sure it’s going to be beneficial.

You don’t want to do too much where it will eat up your muscle building.

It depends upon the person. Do about 30 minutes of cardio each session three times a week. It’s really not that much. On non-cardio days, do resistance training.”

• Lift weights. “If you can make it past 20 reps, increase the weight, given that your form is perfect. If your form is compensating somewhere, fix your form first and see what your repetitions look like. Do two sets per muscle group.”

• De-stress. “Cortisol may contribute to belly fat and has a lot to do with stress factors. Look into meditation to relax you after a stressful day. Exercise de-stresses your mind and body. Plus, you’ll build muscle which burns more calories and more fat.”

• Don’t try spot reduction. “Many guys think, ‘If I do a lot of ab workouts, I’ll lose a lot of belly fat.’ We can’t choose where we lose fat. Having a good workout plan targets core activation but using larger muscle groups, as long as it’s safe and effective. Make sure it won’t cause injury.”

Tips from Chris Purcell, certified personal trainer and wellness coach at SC 481 Fitness in Syracuse • Eat “clean” foods. “Skip processed foods. Get in your B vitamins and sunlight, which makes vitamin D in your body, helps balance out the hormones.”

• Keep it simple. “Focus on the basics. In today’s society, we’re looking for instant gratification.”

• Rest enough. “If you’re getting adequate sleep, seven to eight hours a night, you balance out your hormones and lower cortisol so you can handle more stress load in the body. If you continue to get five hours or less, you’re not handling stress increased cortisol.”

• Be patient. “I’ve seen people fail because they set unrealistic goals.

SMART goals are specific, measurable, attainable, realistic, and timely. If they want to lose 20 pounds in a couple months, that’s doable.”

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Men’sHealth

Only About OneThird of Americans Use Condoms: CDC They aren’t the best method of birth control, but they do help prevent STDs, health experts say.

Condoms can help prevent pregnancy and the spread of sexually transmitted diseases (STDs), but only about a third of Americans use them, a new federal report shows.

“The use of condoms is a public health issue,” said report author Casey Copen, a statistician at the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

“STDs can lead to long-term consequences, such as infertility,” she said. “Condoms, when used consistently and correctly, reduce the risk of HIV and STDs.” About 20 million new cases of STDs are diagnosed each year in the United States, the CDC said.

These infections include human papillomavirus (HPV), gonorrhea, chlamydia, syphilis, hepatitis and HIV. The choice of whether to use a condom or not is influenced by a number of factors. These include: a woman’s desire to get pregnant, one’s experience using other methods of contraception, and the relationship of the partners, Copen said.

“People who say they are dating casually use more condoms than people who say they are co-habitating or engaged,” she said.

Most people who use condoms say they use them to prevent pregnancy and avoid getting an STD, Copen said.

One expert said there are other, better choices of birth control.

“We have much better methods of birth control than a condom. If people don’t want to have a baby, they should be using a more effective method,” said physician Jill Rabin.

“Sex can be wonderful, but I don’t know any climax that’s worth the heartache of an unwanted pregnancy,” said Rabin. She is cochief of the division of ambulatory care in the Women’s Health Programs-PCAP Services at Northwell Health in New Hyde Park, in the New York City region.

But condoms do have a role in preventing STDs, Rabin said. Often people don’t know they have an STD until it’s too late and they are infertile or sick, she said.

“We know that condoms can protect against many STDs,” Rabin said. “So why would you deliberately place yourself in a position to get hepatitis B or C or HIV? “I understand human nature, but take responsibility and think ahead,” Rabin said.

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$100 Sweetens the Pot for a Colonoscopy Study found those who were offered cash to get cancer screening were twice as likely to do so

I

t appears that $100 might go a long way toward convincing someone to get a colonoscopy.

New research found that such a cash incentive doubled the chances that older adults were screened for colon cancer.

“Colonoscopy is challenging for patients, requiring a day off from work, a bowel-cleansing preparation, and transportation, in addition to non-financial costs of anxiety and discomfort,” said study author, physician Shivan Mehta, an assistant professor of medicine at the University of Pennsylvania in Philadelphia.

“The improvement we saw in the rate of screening colonoscopies was statistically significant, and shows for the first time that a financial incentive can at least modestly boost that rate,” Mehta added in a university news release.

Colon cancer kills more than 50,000 people in the United States every year, second only to lung cancer. But most potential tumors can be detected by colonoscopy and removed, usually before they become cancerous, researchers said.

The study included more than 2,000 people between the ages of 50 and 64. All were eligible for colonoscopy screening.

Some received an email asking them to opt in or opt out of a screening colonoscopy (the simple active choice group). Others received an email with the same message plus an offer of $100 if they had a colonoscopy within three months. A third group (the control group) received an email with just a phone number for scheduling a colonoscopy.

After three months, almost 4 percent of those in the $100 offer group

had undergone a colonoscopy, compared with 1.6 percent in the control group and 1.5 percent in the simple active choice group.

The rate of colonoscopy appointment scheduling was 5 percent in the $100 offer group, 2.1 percent in the control group and 2 percent in the active choice group.

The effectiveness of the financial reward may be due to the large amount of money and the fact that it was offered along with easy access for booking an appointment, Mehta suggested.

“Although a $100 incentive seems relatively large, this amount is comparable to what employers already offer for completion of health risk assessments or biometric screening activities,” he said.

The study was published recently in the journal Gastroenterology.

Do Muscle Supplements Work?

Shakes and body building supplements promise to pack on pounds of muscle — but do they work?

By Deborah Jeanne Sergeant

H

ealth foods and fitness stores stock many kinds of shakes and body building supplements that promise to pack on pounds of muscle.

But can these really help you get the body of your dreams?

First, consider the source of the product’s claims. Supplements aren’t regulated by the Food & Drug Administration like medication. Manufacturers’ claims are not approved by the FDA and do not have to present double-blind, peer-reviewed studies before they make claims. They must be safe and contain the ingredients they claim — that is all.

“A lot of them are fancy packaging,” said Chris Purcell, certified personal trainer and wellness coach based in Syracuse.

While he doesn’t discourage clients from trying a well-made protein supplement that works for them, he said, “Many times, we can get these things from the environment around us.”

Purcell suggests eating whole foods such as eggs, poultry and meat.

Vegan or vegetarians can choose nuts, seeds and legumes — including peanut butter and beans — along with vegan or vegetarian protein

IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

powder.

David Cruz, certified personal trainer at Gold’s Gym in Dewitt, recommends .8 to 1 gram of protein per pound of body weight for most people who are strength training if they want to “go by the book,” he said.

“I like to coach my clients to not worry about the day’s protein, but the meal should have 28 to 35 grams [of protein per meal], regardless of how much you weigh,” he added.

“As you gain more muscle mass, then that has to increase.”

He believes that supplements should not replace meals, but enable busy people to get the protein they need if they can’t eat a balanced meal occasionally.

He advises that the diet overall should be balanced with sufficient whole fruits, vegetables, and grains, along with protein sources and traces of plant-sourced fat.

“Supplements help if you have good diet, but they don’t replace a good diet,” said Shauna Burke, personal trainer at Pacific Health Club in Liverpool. “If you have a broken diet, fix that first.”

She said that a protein shake after a workout may be a good idea for a post-workout snack, but drinking them should not replace a healthful diet.

Chris Purcell advises clients to manage what he calls the “four pillars” of health: sleep, nutrition, exercise and stress/time management.

“If you manage these four pillars, you have a head start above many individuals,” he said.

Making time for workouts challenges many people. But Purcell said performing just 10 squats, 10 push-ups and 10 planks twice a day, three to five days a week “will get you a lot closer to your goal and you will be a lot happier. When you are able to add more time, your body won’t react with an immediate stress response.”

For a more intense workout, using kettle bells, tubing, free weights and weight machines represent a few ways to perform resistance training.

Instead of just stressing one movement, such as raising the weight, men should lower the weight with just as much care to work both muscles-push and pull movements.

Use the maximum amount of weight that can be lifted in good form for about 10 to 15 repetitions.

Perform another 10 to 15 repetitions and then move on to another muscle group. Exercise each muscle group twice weekly, but not two days in a row. On “off” days, engage in aerobic exercise.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

•

Page 17

Men’sHealth

Vasectomy Procedure remains popular contraceptive for men

By Deborah Jeanne Sergeant

W

experience bruising and infection. ith all the varieties of conRyan Sidebottom, urologist with traceptives available, are Upstate Urology of Auburn, said vasectomies still popular?

Area experts say yes — and for good that the new “no-scalpel” technique provides “a minimally invasive way reasons.

“There are very few birth control of doing it, as it uses one poke in the center of the scrotum. We can bring methods for men,” said urologist J.C. Trussell, associate professor with out the vas deferens and separate the connection.

Upstate Urology. “The interest in “Some guys wonder why they vasectomy has increased compared were so worried, once it was done. with the 1980s.”

It’s a very tolerable procedure,” SideVasectomy costs about one-third bottom said. that of female sterilization via tubal Despite local popularity of valigation. sectomy, the US overall lags behind Trussell explained that although Canada and the UK, according to vasectomy is a surgical procedure, United Nations figures. American it’s performed under local anesthewomen experience double the tubal sia as an out patient surgery. Only ligations as men experience vasec5 to 10 percent of men experience tomy; however, the large number of chronic scrotum pain, and only a small percentage of those find it to be cesarian sections performed in the US may account for some of that figure, life-changing. since for couples done having babies, The chances of injury to the it’s easier to go ahead with sterilizablood supply can cause loss of testicle, but less than 1 percent of men ex- tion for the partner who’s already surgery. perience this side effect, according to1:12undergoing urologyIGH.10.25x6.75.qxp_Layout 1 8/19/16 PM Page 1 Trussell. Less than 5 percent of men

Misconception about Vasectomy • Few other men seek vasectomy. “It’s actually quite popular. There are very few birth control methods for men.”

• Tubal ligation of women is better. “Vasectomy is cheaper and safer and less risk of failure compared with tubal ligation for women. It’s easily covered by nearly all insurance.”

• Recovery is difficult and sex is off-limits for a long time. “After the surgery and three days’ rest, they can have sex but with protection.

Eighty percent of guys clear at two months. Other may require a few more ejaculations to get sperm count to zero. I use very specialized instruments that allow for a very delicate dissection of the vas tubes.

There’s very little downtime. I do a lot on Thursday or Friday so by Monday, they’re back to work.”

• It likely won’t work. “The chance of failure is less than 1 percent, compared with 3 percent for tubal ligation.”

J.C. Trussell, associate professor and urologist with Upstate University Hospital’s Urology Department.

• Tubal ligation has the same recovery time. “Vasectomy has a much shorter recovery time.”

• Vasectomy is very painful. “There’s a fear guys have, which is understandable, but it has a fast recovery time.”

• Vasectomy is easily reversible. “Vasectomy should be considered only by men who are sure they are done having children.”

Ryan Sidebottom, urologist with Upstate Urology of Auburn and privileges at Auburn Community Hospital.

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•

IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

of typically developing individuals differ from those on the Autism Spectrum!

Be a Researchers part of an important study to help want understand how thehow brains of typically at Syracuse University to understand developing individuals differ from those on the Autism Spectrum! children with Autism Spectrum Disorder and Typically Developing children process andwant puttotogether information.

Researchers at Syracuse University understand sensory how children with Autism Spectrum Disorder and Typically Developing children process and put together sensory information.

Participation would involve comingcoming to our lab to for our approximately 5, 2-3 hour visits and Participation would involve lab for approximately 5,completing paperwork and experiments while wearing an EEG cap (pictured left). Ages 6-30 invited to participate!

2-3 hour visits and completing paperwork and experiments while You willan earnEEG $10 an hour for each time youAges visit the lab. You will also contributing to science! wearing cap (pictured left).

6-30 invited tobeparticipate!

To learn more or to get involved in this study please contact: You will earn $10 an hour for each time you visit the lab. You Dr. Natalie Russo, 426 Ostrom Ave, Syracuse University will also be contributing to science! n

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To learn more or to get involved in this study please contact: Dr. Natalie Russo, 426 Ostrom Ave, Syracuse University, Lab Phone: 315-443-2428 Email: carelab.syracuse@gmail.com

Not All Fidos Are Friendly

800,000 Americans receive medical care for dog bites annually

K

ids love dogs — dressing them up, tugging on them, kissing them, and even riding them like a horse. But sometimes, things can end badly, a pediatricians’ group says.

That’s probably why children account for more than half of the 800,000 Americans who receive medical care for dog bites annually.

Children are much more likely than adults to suffer serious injuries when bitten by a dog, and children are most likely to suffer bites from familiar dogs, according to the American Academy of Pediatrics.

The group offered the following dog-bite prevention tips.

• Never leave a small child and a

dog alone together. And that advice holds true even if it’s the family dog, a dog that you know, or a dog that you have been assured is well-behaved. Any dog can bite.

• Don’t let your child play aggressive games with a dog, such as tug-of-war or wrestling. Teach children to ask a dog owner for permission before petting any dog. Let a dog sniff you or your child before petting, and stay away from the face or tail.

• Pet the dog gently, and avoid eye contact, particularly at first.

• Instruct children to move calmly and slowly around dogs, and to never bother a dog that is sleeping, eating or caring for puppies.

• Tell children that if a dog behaves in a threatening manner —such as growling and barking — to remain calm, avoid eye contact with the dog, and back away slowly until the dog loses interest and leaves.

• Teach children that if they’re knocked over by a dog, they should curl up in a ball and protect their eyes and face with arms and fists.

If your child is bitten by a dog, ask for proof of rabies vaccination from the owner, get the owner’s name and contact information, and ask for the name and telephone num-

ber of a veterinarian who is familiar with the dog’s vaccination records and history.

Immediately wash out the wound with soap and water. Call your pediatrician because the bite could require antibiotics, a tetanus shot and possibly rabies shots. The doctor can also help you report the incident to the police, the pediatricians said.

If your child has severe injuries, call 911 or take the child to an emergency room.

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Page 19

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Protecting Chronically Ill Young People

By Deborah Jeanne Sergeant

C

hronic illnesses in children can cost hundreds of thousands of dollars. As teens become young adults, a rite of passage necessary for chronically ill young people is transitioning to adult health coverage. Parents shouldn’t delay making their plans, experts say.

Physician Tiffany Pulcino serves as medical director of Complex Care Center in Rochester, a part of the University of Rochester Medicine.

Her organization helps teens starting at age 14 to develop processes for moving into the adult health system.

While that may seem inordinately young, the system is so complex that the “extra” time is warranted.

“They fit into a lot of gaps in the system,” Pulcino said.

The Complex Care Center offers numerous specialties — from dental to behavioral to medical health — all in one place. While that one-stopshop approach can help, providing a “safety net” for complex medical care aids young adults in monitoring their care so they don’t miss appointments or filling prescriptions.

“That’s not easy for a 19-year-old with normal cognitive ability,” Pulcino said, “say nothing of one who does have delays.”

Once disabled teens on Medicaid reach 19, they must re-certify as adults. The process isn’t straightforward.

“People need a navigator to get through that,” Pulcino said. “Our care manager will help them with the process. There’s support no matter where you’re touching the health care system.”

She said that starting the process in advance can help improve continuity of care.

“Work with your doctor to make a roadmap as to where you and your team want to go by the time your child is 18 years old,” Pulcino said. “Have a conversation with the care provider about critical steps to take along this path to help them be healthy when they want to reach this goal. It’s a graduation in health care to prepare for.”

Carrie Scholz, a patient advocate with over 30 years of professional

social work experience in medical social work, owns Health Navigation of Central New York.

As for a chronically ill young person who is also cognitively disabled, she Carrie Scholz advises parents to obtain a court ruling that their 18-year-old is an incapacitated adult so they can continue to help make decisions about health care, residence and education.

For young people without a cognitive disability, they can sign a power of attorney and health care proxy to continue receiving parental help in making decisions. Without those legal instruments, the parents are left out, even if their now-adult child entirely depends upon their input for making medical choices about their care.

“You may need to think of guardianship, housing, and the ability to be employed, Scholz said. “There’s a lot of preparation families need to do.”

Regardless of ability, young adults who are dependent upon their parents may remain on their parents’ insurance through age 26.

For chronically ill young people who are able to work full time, staying on their parents’ insurance, if possible, may promote better continuity of care because they may not need to change providers. Prescription drug coverage can vary among insurance plans as well.

That’s why it’s important to discuss the family’s needs with a caseworker to fully know their options and make an informed decision, said Scholz. The teen’s medical provider can offer recommendations on caseworkers that can help them navigate the often complex processes and make plans that work well for their family.

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Page 20

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

Purpose Farm Needs Funds to Help Abused, Neglected Kids

By Matthew Liptak

I

Don’t want to hide your legs this summer because of unsightly veins?

Ever wonder if you could treat them?

The Specialists at St. Joseph’s Imaging could help.

Our in-office procedures can rid you of those painful bulging veins without surgery.

n Good Health last visited Purpose Farm three years ago. The Baldwinsville farm, run by the No Surgery. No Downtime. Why wait?

Seabrook family, was created to help abused and neglected area children recover through the use of animal to schedule a free screening* therapy.

Back then the farm was just getting on its feet. Today it is a nonprofit that has seen 500 people come through it for services each year — the number of people helped so far this year has reached 600.

But it is a lot of weight on one family, to run and fund an organization all by themselves.

Sandy Seabrook runs the Purpose Farm “It’s the funding,” Sandy in Baldwinsville, which animals to Seabrook said. “I need paid staff. help children who have been abused or That’s the main thing. It’s very overwhelming. That’s the main challenge. neglected.

If I had paid staff things would run with her anger issues, that her psyso much smoother and we would acchologist is planning to come to the tually be able to open more regularly. farm to see how it has helped with It’s still by appointment only. I would the change. Other kids have gone MP Order Propo honestly be able to take in more kids This will appear from ad being afraid of caring at for the the classification of: for sessions. We would have a tour horses, to now riding on the backs of leader so we would have set tour Rome NY said. them, Seabrook times. That’s the ultimate vision.”

Purpose Farm is a place of refuge Seabrook is practically a with in Home Date 05/2014 and recovery for kids who need it one-woman show. Her son, Noah, most, Seabrook explained.

Date: March 17, 2014 Acct# A1ZGFE Sales Rep: GRIMALDI, JENNIFER L Size: HCN6 Ad Id: AM who has helped her, is going off to They have had some luck with graduate school, and a daughter, funding since their start, but not as Raven, will attend college soon. Her much as they really need. Two thirds husband, Howard Seabrook, runs of the farm’s funding come from Mohawk Plumbing, which is where the family income, while one third most of the funding comes from. comes from a variety of local charity *a full consultation will be scheduled following the screening if treatment is an option Things have changed since the competitions the nonprofit has won. family was inspired by a mission the patient will be responsible for all costs not covered by insurance But those only last one year, and the trip to an orphanage in Romania, $72,000 yearly budget just about covand was heartbroken by the murder ers expenses for the animals.

Diabetes? of young Erin Maxwell in Oswego Diabetes?

What the farm really needs, County in 2008. At the time, 11-yearSeabrook believes, is paid staff.

Flat Feet? old Erin was murdered by her step “Most people have said that I brother Allan Jones. Seabrook heard Plantar Fasciitis? need a development director,” she the news over the radio and, like said. “That’s the next step, but a deYou may be at little little or or no no cost! cost!

You may be eligible eligible for for shoes shoes at much of the rest of the Central New velopment director gets like $52,000 a York community, was shocked by it. year. That I guess is the key next step.

“I think God always instilled a She or he is the person that would go place for kids that have been abused out and meet with potential sponsors in my heart,” she said. “It was Erin and corporations within the commuMaxwell that was the straw that nity. That person is the one that’s in broke the camel’s back. It just made charge of building up the financial me ask what I could do. When I did, support.” there was a clear answer.”

Sandra Seabrook has tried writPurpose Farm has been helping ing for some grants, but she said she people every week ever since. is not talented in that area. She could “A lot of people get it confused really use some help. Right now and they think that we do special some help comes from her family needs,” she said. “We don’t do speand a mother-daughter team that cial needs. Our specialty is the every does some volunteering at the farm. day kid that has emotional trauma.

Purpose Farm continues to A lot of them do go to alternative accept volunteers, but most people schools because they do have the aren’t available on the weekdays anger built up. They don’t fit into they are needed, or able to meet the school. They get kicked out a lot.” physical challenges of farm work.

Letting the kids work with over Despite the toll it can take, the 40 animals at the farm has really family is continuing its mission to shown positive results, Seabrook reach out to children who need it the said. There are 12 horses, two donmost. Sandra Seabrook is resolute keys, peafowl, chickens, pigs and about the farm and she hopes things alpacas at the farm — all rescued will stabilize eventually. animals.

“Keep moving forward and AMZHMDNLM 14-Mar-2014 07:57 “What they get when they come eventually I do believe we will get here first of all is unconditional love there,” she said. “I believe eventually not only from our family, but from my vision will come to full force and the animals,” she said. “The other that is where we will have paid sesmain thing is they get a purpose sion leaders. You will have sessions because when they come here they’re running Tuesday through Friday. not thinking about themselves.

We’ll have set tours where you have Information: Corresponding Listing They’re not thinking about what a tour guide. That’s the overall vitheir situation is at that time. They’re sion—to have a real system in place in shock and awe of the animals.” and have set days for things.”

One child has graduated from To reach out to Purpose Farm his group home program while at email info@purposefarm.org If you require or a call change, please contact your sales representative the farm and come back to volunteer. 315-303-595. or call Yellow Book Customer Service at 1-800-891-1899.

Another, has made such progress

Call 315-362-VEIN

Check us out on Facebook

Central New York’s Healthcare Newspaper

AAMZHM

SIGNATURE: __________________________ September 2017 • IN GOOD HEALTH – CNY’s Healthcare Newspaper

• Page 21 PR DUPLICATE

Please Note: Print quality may vary from final product.

Free Breastfeeding Cafés Launch in Oswego County I n an effort to offer mothers an ongoing source of peer support, assistance and breastfeeding information, REACH CNY is launching Breastfeeding Cafés of Oswego County.

Breastfeeding Cafés, which are completely free and open to breastfeeding and expecting mothers and their family members, will provide monthly informal breastfeeding support in a comfortable setting. Breastfeeding Cafés of Oswego County are led by certified lactation counselors and peer leaders committed to breastfeeding promotion and education to support the health of Oswego County families and communities.

Breastfeeding Cafés of Oswego County will meet monthly in three locations: Mexico, Fulton and Oswego.

Gatherings are for one and a half hours with light refreshments provided. Weekday, evening, and Saturday sessions are offered to fit busy schedules. A baby weigh station will also be available for moms to track their baby’s growth and keep their own records. Certified lactation counselors will be available to provide support as needed, such as assessing latch, answering questions and providing useful information and referrals for breastfeeding moms

and expectant mothers.

Monthly drop-in meetings will take place the following locations: • From 1 to 2:30 p.m. on the second Monday of each month at Backstreet Books, 201 Oneida St. in Fulton.

• From 10 to 11:30 a.m. on the third Saturday of each month at the Elim Grace Christian Church, 340 W. First St., Oswego.

• From 6 to 7:30 p.m. on the fourth Tuesday of each month at the Mexico Public Library, 3269 Main St, Mexico.

The first 150 participants will receive a unique handcrafted breastfeeding tote bag created by an Oswego County artisan, an infant T-shirt, and educational materials.

Breastfeeding Cafés of Oswego County are brought by REACH CNY, Inc. in collaboration with Oswego County Health Department, OCO WIC, OCO OPTIONS, Oswego Health, Cornell Cooperative Extension of Oswego County, Pregnancy Care Center, Mother Earth Baby, Integrated Community Planning and the Oswego County Breastfeeding Coalition. This project is funded through a community grant from Excellus BlueCross BlueShield.

For more information, call 315424-0009 ext.111.

More Breastfeeding Rooms Throughout Syracuse

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Trinity Health announced their Transforming Communities Initiative in 2016. At that time, St. Joseph’s Health (a member of Trinity Health) convened a local group of key organizations to tackle the significant health challenges and social determinants that cannot be addressed by healthcare providers alone.

The TCI Syracuse partnership includes St. Joseph’s Health, CenterState CEO/Northside Urban Partnership, HealtheConnections, Lerner Center for Public Health Promotion, Onondaga County Health Department, Near Westside Initiative, and the Tobacco Action Coalition of Onondaga County.

For more information, visit www. tcisyracuse.org.

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yracuse now has 11 new breastto create new dedicated breastfeed• PEACE, Inc. Head Start at feeding rooms available to the ing-friendly room within our space,” Sumner public, located throughout the said Liz Crockett, executive director • PEACE, Inc. Head Start at Northside, Westside, Southside, and at REACH CNY. “We support and UUMC other areas of the city. appreciate the aims of this Initiative • Southwest Community Center The rooms were recently renoto help women in our community • St. Joseph’s Health Hospital vated and outfitted with new furniachieve their breastfeeding goals • Syracuse Community Health ture and equipment through a grant through education, environmental Center award to TCI Syracuse from Trinity changes, and practice changes.”

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• Family Planning Service Clinic health education materials and “This project encourages and (Slocum Ave) support, disseminating culturally supports breastfeeding in prenatal • Interfaith Works on James tailored breastfeeding education and Nominate Us at www.bestoffingerlakes.com and postpartum women in SyrStreet marketing materials in several key acuse, with a particular focus on • Onondaga County WIC (W. languages, and working cooperathose living in the Near Westside Onondaga St.) By Sharon M. Grasta tively with community partners who and Northside• neighborhoods,” said • PEACE, Inc. Head at serve the target population.

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By Jim Miller

Finding Help for Seniors Addicted to Opioids Dear Savvy Senior, I’m worried about my 72-year-old mother who has been taking the opioid medication Vicodin for her hip and back pain for more than a year. I fear she’s becoming addicted to the drug but I don’t know what to do.

Medicare Made Simple, LLC Your Medicare Specialist and Independent Agent Serving New York State’s Medicare eligible population since 2008!

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Concerned Daughter Dear Concerned,

The opioid epidemic is a national problem that is hitting people of all ages, including millions of older Americans. Here’s what you should know and do to help your mother.

The Cause

The main reason opioid addiction has become such a problem for people over age 50 is because over the past two decades, opioids have become a commonly prescribed (and often overprescribed) medication by doctors for all different types of pain like arthritis, cancer, neurological diseases and other illnesses that become more common in later life.

Nearly one-third of all Medicare patients — almost 12 million people — were prescribed opioid painkillers by their physicians in 2015. That same year, 2.7 million Americans over age 50 abused painkillers.

Taken as directed, opioids can manage pain effectively when used for a short amount of time. But with long-term use, people need to be screened and monitored because around 5 percent of those treated will develop an addiction disorder and abuse the drugs.

Signs of Addiction Your mother may be addicted to opioids if she can’t stop herself from taking the drug, and her tolerance continues to go up. She may also be addicted if she keeps using opioids without her doctor’s consent, even if it’s causing her problems with her health, money, family or friends.

If you think your mom’s addicted, ask her to see a doctor for an evaluation. Go to the family or prescribing physician, or find a specialist through the American Society of Addiction Medicine (see ASAM.org) or the American Academy of Addiction Psychiatry (AAAP.org). It’s also important to be positive and encouraging. Addiction is a medical matter, not a character flaw. Repeated use of

“The Medicare Lady”

opioids actually changes the brain.

315-676-4933 • tcangemi@twcny.rr.com www.MyMedicareMadeSimple.com “Commissions Paid by the Carriers, Not Fee Based”

Medicare Advantage • Medicare Supplement • Prescription Drug Plans Long Term Care (CLTC) • Life Insurance • Final Expense (Burial) • Dental Plans Travel Insurance Coverage

Treatments Treatment for opioid addiction is different for each person, but the main goal is to help your mom stop using the drug and avoid using it again in the future.

To help her stop using the drug, her doctor can prescribe certain medicines to help relieve her withdrawal symptoms and control her cravings.

These medicines include methadone (often used to treat heroin addiction), buprenorphine and naltrexone.

After detox, behavioral treatments such as individual counseling, group or family counseling, and cognitive therapy can help her learn how to manage depression, avoid the drug, deal with cravings, and heal damaged relationships.

For assistance, call the Substance Abuse and Mental Health Services Administration confidential help line at 800-662-4357, or see SAMHSA.gov.

They can connect you with treatment services in your state that can help your mom.

Also, if you find that your mom has a doctor who prescribes opioids in excess or without legitimate reason, you should report him or her to your state medical board, which licenses physicians. For contact information visit FSMB.org.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

September 2017 •

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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.

The Social Ask Security Office

By Deborah Banikowski District Manager, Syracuse

• Transportation • Shopping • Doctor Appointments • Companion Care • Housekeeping services • Meal preparation/cooking • 24-Hour Care • and more

Get to Know Your Social Security

Call us today. Like getting a little help from your friends.

Onondaga, Madison, and Cortland counties

Call 315-280-0739

Oneida, Oswego, Cayuga, and Seneca counties

Call 315-720-4441 ©2009. Each office is independently owned and operated. All trademarks are registered trademarks of Corporate Mutual Resources Incorporated.

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S

ocial Security touches the lives of nearly every American. We’ve been with you from day one, when your parents applied for your Social Security number, and we are with you from your first job through your retirement party and beyond.

For more than 80 years, Social Security has stayed true to its mission of providing financial protection for the American people and has served as one of the most successful anti-poverty programs in our nation’s history. We encourage everyone to take steps toward their financial security. Regardless of your age or place in life, now is the right time to start planning for a financially secure future for you and your family.

Everyone can benefit from our first step: Get to know your Social Security. You can start your journey through all things Social Security by visiting www.socialsecurity.gov and navigating through our menu.

Along the way, you’ll see how your Social Security number opens many important doors throughout life, from making it easier to apply for student aid and open your first bank account to starting your first job and buying your first house. You’ll also discover how your contributions

Q&A

Daybreak Adult Medical Day Program A medically-based day program that provides comprehensive health service to eligible adults 21 years or older. Services Include: • • • •

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3 St. Anthony Street Auburn, NY 13021 (315) 282-6815

IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

Q: Can I get a new Social Security number if someone has stolen my identity?

A: We do not 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 on the subject at www.socialsecurity.gov/pubs/10002. html.

Q: I’m trying to decide when to retire. Can Social Security help?

A: Deciding when to retire is a personal choice, and you should consider a number of factors, but we can certainly help. First, take a few minutes and open a “my Social Security” account at www.socialsecurity.gov/myaccount. With a “my Social Security” account, you can

to the Social Security system through FICA payroll taxes can make you eligible for important future benefits when you reach retirement age or if you become severely injured or ill.

You’ll find how Social Security helps your family in the form of survivor benefits and how our Supplemental Security Income program assists disabled children and our most vulnerable adults.

We also encourage you to visit our website and set up your own “my Social Security” account today so you can begin taking steps toward financial security.

Through our website and your online account with us, you can: • Verify your lifetime earnings record to ensure you’re getting credit for all your contributions toward Social Security and Medicare; • Estimate future benefits for you and your family; • Manage your Social Security benefits and personal information; and • Learn more about how we’re securing your today and tomorrow.

Now that you’ve started to get to know your Social Security, stay in touch by visiting our Social Security Matters blog at blog.ssa.gov/.

We encourage you to visit us at www.socialsecurity.gov.

access your Social Security statement and estimate your retirement benefits at age 62, your full retirement age, and age 70. Also, we have several online calculators that can help you decide when to retire. Our retirement estimator gives estimates based on your actual Social Security earnings record. You can use the retirement estimator if: • You currently have enough Social Security credits to qualify for benefits; and • You are not: – Currently receiving monthly benefits on your own Social Security record; – Age 62 or older and receiving monthly benefits on another Social Security record; or – Eligible for a pension based on work not covered by Social Security.

You can find our retirement estimator at www.socialsecurity. gov/estimator. Also available at www.socialsecurity.gov/planners/ benefitcalculators.htm are several other calculators that will show your retirement benefits as well as estimates of your disability and survivor benefit if you become disabled or die.

You may want to read or listen to our publication, “When To Start Receiving Retirement Benefits,” available at www.socialsecurity.gov/pubs.

H ealth News Cathy L. Palm reelected to NAATP board Cathy L. Palm, executive director of Tully Hill Chemical Dependency Treatment Center, has been reelected to the board of directors of the National Association of Addiction Treatment Providers for a three-year term at an annual meeting held in Palm Austin, Texas, in May Palm is the immediate past chairwoman of the conference committee and serves on the finance committee. She was appointed to the recently launched NAATP Enhanced Ethics Compliance and Consumer Protection Initiative. She is also a trustee of the NAATP PAC committee. NAATP is an association of over 400 addiction treatment organizations in the USA as well as outside the United States.

Syracuse Community Health gets $12.8M grant The Syracuse Community Health Center (SCHC) has been awarded a $12.8 million grant through the Department of Health’s Statewide Healthcare Facility Transformation Program to expand and integrate urgent care, primary care and behavioral health and substance use disorder services.

This award represents the largest amount granted to any federally-qualified health center (FQHC) across the state by the transformation program.

SCHC opened in 1978 and is the only federally qualified health center that services Onondaga County.

With over 34,000 patients, SCHC is a major provider of primary medical care, including pediatrics and OB-GYN; dental; behavioral health; and substance use disorder services, as well as specialty services such as podiatry and ophthalmology/ optometry. SCHC operates several

community sites and school-based health centers.

The Department of Health’s Statewide Healthcare Facility Transformation Program grant will enhance the long-term sustainability of SCHC through the renovation of its outdated facilities.

The reconstructed layouts, particularly in the laboratory, urgent care, behavioral health and substance use disorders treatment areas, will increase capacity and patient flow. It will also provide a more functional integration of primary care and behavioral health services. Equipment will be updated to ensure efficient use of resources, and improve work flow, patient and staff satisfaction, and the recruitment and retention of physicians and mid-level providers, according to a news release.

serving as coordinator of our Rural Health Network, Brian was diligent in keeping abreast of the many changes in the health care arena. His ability to stay on the cutting edge of service delivery, and willingness to explore new initiatives, will serve him well in his new position.”

Coleman said, “I grew up in Oswego County and I look forward to ensuring that OCO continues to offer its array of health and nutrition services to those who live here and implementing new strategies to address any future needs that may arise.”

He holds a bachelor’s degree in criminal justice from Keuka College.

Coleman to lead OCO Health & Nutrition Serv.

Jeff Knauss and Greg Lancette have joined the Loretto Foundation board of trustees.

Knauss is a co-founder of Digital Hyve, a full service digital marketing agency with offices in Syracuse and Rochester, which received CenterState CEO’s 2017 Business of the Year, Best Places to work in CNY, and the 2017 Small Business Association’s Small Business Excellence Award.

Knauss is also an active board member for the Food Bank of Central New York and for Byrne Dairy.

Lancette is president of The Central-Northern New York Building & Construction Trades Council (CNNYBTC) which represents approximately 5,000 construction workers and 17 member unions that are highly skilled in a wide array of crafts. Occupying positions with the NYS Fair advisory board and the Onondaga County Resources Trust, Lancette also holds the responsibilities of vice-president of the CNY Area Labor Federation and of the NYS Pipetrades Association.

The Loretto Foundation is a nonprofit organization established to advocate for elders, and to raise funds to help sustain Loretto’s role as an innovator in long-term care.

Overseen by a board of trustees, the foundation strives to heighten community awareness of Loretto, its programs and services and the needs of older adults, and ensures that the generous contributions made by benefactors address both current and

Brian Coleman has been named director of Oswego County Opportunities (OCO) Health and Nutrition Services.

A native of Phoenix, Coleman joined OCO in 2012 as the agency’s homeless services program manager.

Since 2014 Coleman has served as coordinator for the Rural Health Network (RHN), a collaboration consisting of 35 human services, Coleman government and behavioral health organizations.

In his new position, Coleman will be responsible for overseeing programs that touch the lives of thousands of individuals of all ages: from summer youth feeding programs, Meals on Wheels and dining and activity centers to reproductive health services, health insurance enrollment and cancer screenings.

“In Brian’s five-plus year tenure with OCO, he has excelled in several different manager and leadership positions,” said OCO Deputy Executive Director Patrick Waite. “While

Community leaders join Loretto board of trustees

future needs of an organization that operates in a very dynamic environment.

Through fundraising initiatives and a variety of giving opportunities, the Loretto Foundation continues to invest over $250,000 a year back into the organization.

ACR Health opens new office in Syracuse ACR Health recently opened a new office space at 990 James St., second floor, in Syracuse. The new offices will accommodate 13 agency programs, including all HIV services and health insurance programs. The 13th and newest program to be located at this new location is OASAS HIV Early Intervention. Part of New York’s plan to End the AIDS Epidemic by 2020, the program provides HIV testing services for individuals staying at OASAS facilities.

ACR Health’s move to James Street was made necessary by catastrophic flood and sewer damage to the satellite office space at 835 W. Genesee St. late last year, forcing permanent closure of that office. The emergency move was possible thanks to the assistance of the Allyn Family Foundation, Gifford Foundation and Karis Wiggins Designs, according to a press release issued by the nonprofit.

ACR Health headquarters remain at 627 W. Genesee St. in Syracuse with offices for case management, prevention services, development and administration.

Oswego foundation has new officers The Oswego Health Foundation, the philanthropic arm of the health system, has announced its officers and a new board member following its Aug. 2 annual meeting. Elected chairwoman was Barbara Bateman, who serves as the vice president, branch manager of NBT Bank in Oswego. She has been in the banking industry for the past 27 years and is an active member of the community serving on several boards, including Oswego Health’s board of directors.

Mark Slayton was elected vice chairwoman and will also continue

Meet Our Doctor

We are pleased to welcome orthopedic surgeon Kevin Kopko, MD, to the Crouse family.

Dr. Kopko, now a member of Syracuse Orthopedic Specialists, is a fellowship-trained orthopedic surgeon. He earned his medical degree from Penn State College of Medicine and completed an orthopedic residency at Stony Brook University Hospital. He also completed a fellowship in joint replacement surgery at Massachusetts General Hospital.

A Syracuse University graduate and former member of the Orange football team, Dr. Kopko is skilled in primary and revision joint replacements of the hip and knee, fracture care, orthopedic trauma surgery and non-operative management of osteoarthritis.

Welcoming new patients! Call 315-251-3163 Learn more at crouse.org/kevinkopko September 2017 •

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H ealth News serving as the foundation’s treasurer.

He is a certified public accountant and is employed at SUNY Oswego as the director of finance for both the Oswego College Foundation, Inc. and the Oswego Alumni Association, Inc. Currently, Slayton is responsible for the financial operations of both organizations, working with the foundation’s investment committee and overseeing the college’s endowment fund.

Local businessman William Reilly was elected secretary. For the past 17 years, Reilly and his wife, Mindy, have been the owners of the river’s end bookstore in Oswego. He is also an active member of the community.

Joining the board is Katherine Toomey, who serves as executive director of the Greater Oswego Fulton Chamber of Commerce/CenterState CEO. A native Oswegonian, Toomey has held leadership positions in public relations for most of her career and recently returned to her hometown to lead the chamber.

Other members of the Oswego Health Foundation Board include Ed Alberts of Rehab Resources/Little Lukes; Julia Burns, who is president of the Oswego Health Auxiliary and the Oswego Kiwanis Club; Tom Ciappa, who, along with lending his voice to major companies for advertising purposes, is an owner of the American Foundry, in Oswego; Peter Cullinan, an employee of Exelon has worked in the nuclear power industry for more than 25 years; Rachael A. Dator, an assistant district attorney for Oswego County, who is a graduate of the University of Illinois Champaign-Urbana and earned her

Juris Doctorate from New England Law Boston; Allison A.N. Duggan, MD, who is executive vice president and chief operating officer for Oswego Hospital; and Michael Harlovic, who recently joined Oswego Health as president and CEO. The foundation’s staff includes director Karen Ferguson; development manager Myia Hill and administrative assistant Tiffany Woodward.

Orthopedic surgeon to provide care at Oswego

Oswego Health welcomes orthopedic surgeon Glenn Axelrod, of Syracuse Orthopedic Specialists, who will begin providing surgery and office visits at the health system’s Oswego Health Services Center.

Axelrod is a board-certified orthopedic surgeon specializing in sports medicine, joint replacements, arthroscopic and open shoulder surgery and general orthopedics. “I am looking forward to joining the axelrod orthopedic team at Oswego Health and providing convenient care to area residents,” Axelrod said. “SOS has been so pleased with the success of this collaboration as we work alongside the knowledgeable and skilled Oswego Health team to ensure exceptional orthopedic care is

Brownell Center Rebranded as Liberty Resources Integrated Health Care With the expansion of primary care services at Liberty Resources, the Brownell Center will now be part of Liberty Resources Integrated Health Care. Liberty Resources Integrated Health Care provides behavioral health counseling and medication management for children, adolescents, and adults along with primary care for adults.

“The newly rebranded Liberty Resources Integrated Health Care clearly reflects the affiliation with our parent agency and the wide array of human services Liberty Resources provides the Central New York community,” said Kim Langbart, vice president of Liberty Resources Integrated Clinic Services, who has overseen the integration project.

According to a news release issued by the agency, Liberty Resources is a leader in providing affordable and convenient access to exceptional behavioral health care services to patients in Syracuse and surrounding communities. It administers behavioral health and primary care in collaboration with therapists, psychiatrists, doctors, family nurse practitioners, nutritionists, and support services.

Over the past 10 years, Liberty Resources’ Brownell Center (named for retired Onondaga County Mental Health Commissioner David Page 26

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Brownell) has grown into a state-ofthe-art facility and expanded capacity from serving approximately 300 clients to more than 1,500 annually.

The largest provider of outpatient mental health services in the region, Liberty Resources now offers telepsychiatry services and operates satellite clinics in Fulton, Oneida, Rochester and in 12 Syracuse city schools.

As Liberty Resources incorporates primary care services into the behavioral health setting, ultimately resulting in improved overall health status of the clients served, the practice will increase patient capacity. Nearly 6,000 square feet will be renovated to accommodate the growth with eight new primary care exam rooms and expanded behavioral health and substance use disorder services.

In 2017, Liberty Resources Integrated Health Care is projected to serve more than 1,700 adults, children, and families in the Syracuse community with mental health diagnoses and substance use disorder.

The rebranding/name change will not affect patients or patient care. Behavioral health patients will, however, be the first to be welcomed into the primary care practice and notice the name change on signage and correspondence from the group.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017

provided to the residents of Oswego County.”

Axelrod is providing care in suite 280 with Oswego Health orthopedic surgeon John Ayres and physician assistants Sarah Ames, Rahul Shinde and Brandon Weaver. He is also scheduling surgical procedures in Oswego Hospital’s Surgery Center.

Axelrod completed his undergraduate, medical school training, orthopedic residency and orthopedic fellowship training all at the University of Rochester.

New Surgeon joins Oswego Health Board-certified surgeon Yuriy Zhurov recently joined General Surgery Associates practice in Oswego.

Zhurov will provide care to patients in need of general surgeries and minimally invasive procedures in Oswego Hospital’s advanced surgery center.

He is a third-generation physician.

Zhurov’s mother was an endocrinologist, while his grandmother was a general practitioner who during her medical career treated wounded

World War II soldiers.

He received his medical degree from Kharkiv National Medical University and a Ph.D. from the Institute of General and Emergency Surgery in Ukraine. He completed his residency at Nassau University Medical Yuriy Center, located in East Meadow, N.Y. He also completed fellowship at the Institute of General and Emergency Surgery in Ukraine. This fellowship included training in thoracic surgery, as well as hepatobiliary and minimally invasive surgery. A second fellowship was completed in minimally invasive and bariatric surgery at New York Medical College in Valhalla, N.Y. Zhurov has been practicing in Michigan where he also serves as a clinical assistant professor at Michigan State University’s College of Osteopathic Medicine.

Upstate Names New Division Chief of Cardiac Surgery St. Joe’s cardiologist hired by Upstate Medical University in an effort to build a stonger cardiology program

P

hysician G. Randall Green has been named division chief of cardiac surgery at Upstate Medical University. He will also serve as co-director of the Upstate Heart Institute and associate professor of surgery.

The Upstate Heart Institute is a presidential priority in Upstate’s recently launched strategic plan, which calls for strengthening Upstate’s cardiovascular service by expanding existing cardiology and cardiovascular services, Green including the extracorporeal membrane oxygenation (ECMO) program, adopting new state-ofthe-art cardiac intervention and surgical modalities.

Green, who was selected from a national search, comes to Upstate from St. Joseph’s Hospital Health Center in Syracuse, where he is a cardiothoracic surgeon and has served as program director for the division of cardiac surgery since 2011. He is also a partner with the medical practice Cardiac Surgery Associates of CNY, PC. Prior to joining the medical practice, he was affiliated with Cleveland Clinic New York, PC. In the most recent state Health Department report on cardiac surgery outcomes (2012 to 2014), Green was one of six surgeons in

the state and the only one in Central New York with a risk-adjusted mortality rate significantly lower than the state average.

“Dr. Green is an outstanding cardiac surgeon with high quality clinical outcomes and success in building quality programs,” said physician Robert Cooney, professor and chairman of Upstate’s department of surgery. “He brings to Upstate the expertise and experience necessary to help create the Upstate Heart Institute.”

Green holds an MBA from The Johnson School at Cornell University, a juris doctorate from Syracuse University College of Law and a medical degree from Northwestern University Medical School. He also studied at Oxford University, St. Peter’s College. He earned his undergraduate degree at Le Moyne College (1989).

He did his residency (general surgery), fellowship (cardiothoracic surgery), and internship in (general surgery) at Stanford University, as well as an additional fellowship (thoracic and cardiovascular surgery) at the University of Virginia.

He is board-certified in general surgery and cardiothoracic surgery.

In addition to service on several local boards, Green is a member of the Strategy Group at the Center for Healthcare Innovation, a Chicago-based nonprofit think tank for health care innovations.

His professional society affiliations include the Society for Thoracic Surgeons, American College of Legal Medicine and the American and New York State bar associations.

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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Matthew Liptak, Anne Palumbo, Melissa Stefanec, Chris Motola, Eva Briggs (MD) • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler 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.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • September 2017