IGH CNY #219 March 2018 by In Good Health: CNY's Healthcare Newspaper

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March 2018 •  Issue 219

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CNY’s Healthcare Newspaper

MEN’S HEALTH

Surgeon Benjamin Sadowitz had an option to stay with a practice in Florida, but chose to come back to Syracuse

SPECIAL ISSUE

• “I Survived Prostate Cancer” • Reasons to See a Urologist • Men Less Likely to Seek Treatment for Depression • Pain Meds May Affect Sperm Count • Risks and Signs of Testicular Cancer

ALSO INSIDE:

Sleepy Drivers May Be Causing More Crashes Than Thought

Number of Men in Nursing Schools Steadily Growing p.19

Accidents involving sleepy drivers about eight times higher than current federal estimates

How Old Should Kids Be to Get Their First Cell Phones?

Myths You Should Know About Heartburn

Twenty years ago, cell phones were rarely sighted and could be found nearly exclusively in the hands of high-powered business people. Fast-forward to 2018 and it’s not uncommon to see an elementary school student happily tapping away at a game on the screen of a smart phone. But how old should a kid be to get a cell phone?

ACUPUNCTURE Find out why some cancer patients are seeking treatment through this ancient Chinese medical practice

p.9

Dog Bites

Yogurt: Greek vs. Regular Which one is better for you? The answer may surprise you. SmartBites.

p.17

Men are nearly twice as likely to have been bitten as women, according to the study.

p.2

Dog Bites More Common for Anxious People Also: Men are nearly twice as likely to have been bitten as women, according to the study

aybe there’s some truth in the long-standing belief that dogs can sense fear in a

human. According to a new British study, anxious people may be at increased risk for dog bites. The finding came from a survey of nearly 700 people in northern England, done by researchers from the University of Liverpool. As part of the study, participants were asked if they were ever bitten by a dog, whether they knew the dog that bit them, and the severity of the bites. They also took a 10-item personality test. The more emotionally stable and less neurotic the participants were, the less likely they were to have been bitten by a dog, the study found. As a person’s emotional stability score increased by a single point, between one and seven, their likelihood of having been bitten fell by 23 percent. “Dog bite prevention schemes may also need to target particular behaviors around dogs by different

victim personality types,” wrote the authors led by Carri Westgarth, from university’s Institute of Infection and Global Health. Overall, one in four participants had been bitten by a dog. Men were nearly twice as likely to have been bitten as women. More than half of the participants — 55 percent — had been bitten by a

0.3%

dog they didn’t know. Also, people who owned several dogs were three times more likely to have been bitten than those who didn’t own dogs. Dogs’ characteristics — sex, age and breed — were not taken into account. The study only found an association between human personality traits and frequency of dog bites. The study results were published

online in the Journal of Epidemiology and Community Health. “It is essential that previously assumed risk factors are reassessed as this study has revealed that prior beliefs — such as bites typically being from familiar dogs — are contested,” the study authors said in a journal news release.

OUR LOW AVERAGE MARGINS MEAN YOU CAN SAVE FOR OTHER IMPORTANT THINGS.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

Quality health plans & benefits Healthier living Financial well-being Intelligent solutions

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Aetna Medicare is a PDP, HMO, PPO plan with a Medicare contract. Our SNPs also have contracts with State Medicaid programs. Enrollment in our plans depends on contract renewal. See Evidence of Coverage for a complete description of plan benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by service area. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Members who get “Extra Help” are not required to fill prescriptions at preferred network pharmacies in order to get Low Income Subsidy (LIS) copays. You must continue to pay your Medicare Part B premium. The Part B premium is covered for fulldual members. Our dual-eligible Special Needs Plan is available to anyone who has both Medical Assistance from the state and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Other pharmacies, physicians and/or providers are available in our network. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. Aetna complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, free language assistance services are available. Visit our website at www.aetnamedicare.com or call the phone number listed in this material. ESPAÑOL (SPANISH): ATENCIÓN: Si usted habla español, se encuentran disponibles servicios gratuitos de asistencia de idiomas. Visite nuestro sitio web en www.aetnamedicare.com o llame al número de teléfono que se indica en este material. 繁體中文 (CHINESE): 請注意：如果您說中文，您可以獲得免費的語言協助服務。請造訪我們的網站 www.aetnamedicare.com 或致電本材料中所列的電話號碼。 Y0001_4002_9196_FINAL_1 Accepted 01/2017

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS March 18

March 1

Vegan group to hear from D.C. physician, educator

Unbiased expert to address Medicare questions Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? Your local office for the aging offers complimentary monthly classes to help you make sense of Medicare. There you will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches. You’ll learn about how Part D drug plans work and whether EPIC co-pay assistance is an option for you. If your income is limited, they we’ll provide information about programs to help pay for your insurance coverage, as well as a listing of the free-and low-cost preventive care under Medicare. In Cayuga County, classes will be held from 10 a.m. to noon, March 1, in the basement training room of the county office building. For more information or to register, call the Cayuga County Office for the Aging at 315-253-1226, or visit www.cayugacounty.us/aging under the News & Activities section.

The public is invited to attend the March meeting of the Rochester Area Vegan Society, which will feature physician Milton Mills and health educator Roberta Schiff. Their topic is titled “What the Bible/ Torah Teaches About a Plant-Based Diet and Animal Rights.” Mills is an intensivist (critical care/ICU) physician in the Washington, D.C. area, and is associate director of preventive medicine at Physicians Committee for Responsible Medicine, a nonprofit research and advocacy organization based in Washington, D.C., which promotes a vegan diet, preventive medicine, and alternatives to animal research. Schiff is a health educator and nutrition counselor who coordinates educational outreach activities for the Hudson Valley Vegans. The event will take place starting with a vegan potluck dinner at 5:30 p.m., March 18 at Brighton Town Park Lodge, 777 Westfall Road. The program will start at 7 p.m. Dinner is a vegan potluck. Vegan means no animal products (no meat, poultry, fish, eggs, dairy products or

honey). Bring a dish with enough to serve a crowd, and a serving utensil; also bring a place setting for your own dinner. Cost: Free to members of Rochester Area Vegan Society; $3 for guests. Participants are required to bring a vegan dish. For more information, all 585234-8750 or visit rochesterveg.org.

April 7

Nursing school at Crouse holds open house The Pomeroy College of Nursing at Crouse Hospital will welcome prospective students who want to learn more about pursuing a degree and eventual career in nursing during an open house from 10 a.m. to noon, Saturday, April 7, in the Marley Education Center, 765 Irving Ave, Syracuse. Faculty will be on hand to provide information and answer questions, and attendees will be able to tour the college, labs and dorms, as well as speak with current and former students. Free parking will be available in the Marley Education Center garage or the Crouse Hospital garage.Registration is required by visiting crouse.org/openhouse or calling 315-470-7481. Crouse Hospital College of Nursing ranks among the top RN programs in New York state and nationwide. Accredited by the ACEN (Accreditation Commission for Education in Nursing), a high-quality, independent regulatory agency with rigorous educational standards, the college offer a two-year associate’s degree program featuring classroom, clinical, laboratory and computer-assisted study within a state-of-the-art teaching environment. Innovative program design, low student-to-instructor ratios and affordable tuition are among the school’s strengths.

April7 • For ages 6 weeks • Full- and part-time • Daily Red Cross through 5 years sessions available swim lessons

• Cheerleading • Circus • Coding

• Day Tripper • Fishing • Gymnastics

• Rocketry • Theatre • ...and more!

• SyraCruisin’ Travel Camp for grades 7–10

JCC of Syracuse 5655 Thompson Rd., DeWitt • 315.445.2360 • www.jccsyr.org

2018 KATYHRYN FISH LECTURE SERIES Sunday, April 15th from 1-2 p.m. Dr. Jim Yonai

-Retired Director of Madison County Mental Health

*Taking Care of the Caregiver Come Visit The Farm!

Meet: “Big Bad Ben” the Blond Belgian Problems???? We have Therapists Jim Marshall Farms Foundation, Inc. 1978 New Boston Road, Chittenango, NY 13037 www.jmffinc.org Please Call 315.447.6182 for directions and questions Page 4

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

Crouse Spirit of Women to feature ‘Day of Dance’ Listen to your heart and show your moves at Crouse Health’s fifth annual “Day of Dance” presented by Crouse Spirit of Women from 11

Online @

cnyhealth.com

a.m. to 2 p.m., Saturday, April 7, in the Canyon area of Destiny USA. The free event is open to the public, but pre-registration is requested by visiting crouse.org/dayofdance or calling 315-472-2464. Amy Robbins, the popular morning drive-time radio personality from 93Q, returns as emcee of the three-hour event. Free refreshments, prizes and educational items will be offered. The first 300 children at Crouse KIDS care will receive a free surgical cap and stuffed animal. They will also have the opportunity to create their own art with staff from the Everson Museum of Art. The Day of Dance, themed “Listen to Your Heart,” will also feature free mini dance classes, with a special visit by Otto and the Syracuse University Dance Team. Crouse Health experts will provide derma scans and screenings for blood pressure, sleep apnea, TMJ, foot issues and more. Integrative Medicine practitioners will provide complimentary chair massage and Reiki treatments. “Crouse is pleased to present this fun and educational event for all ages again this year,” says Kathleen Miller Murphy, manager of community engagement. “We thank the Central New York community for the ongoing interest in and support of our Spirit of Women program.”

April 18

Senior fair at the Cicero NOPL Nancy Aureli of Community Living Advocates and Joan Sardino of Serving Seniors have teamed up with Cicero Northern Onondaga Public Library to host a Senior Information Fair from noon to 2 p.m., Wednesday, April 18. This fair is for seniors, caregivers and for all caring advocates for the CNY senior community. Various representatives from Alzheimer’s Association, PACE CNY, Cicero Senior Center and more will be available. There is no fee for this event. It is simply an opportunity for seniors to gather information from local organizations. The organizers are Community Living Advocates, a local online directory for caregivers, seniors and people with disabilities (www. CommunityLivingAdvocates.com) and Serving Seniors, a locally-owned and independently-operated agency that provides services to local seniors (www.cnyservingseniors.com). For more information about the fair, call 315-382-4300.

MEN’S UNION CLUB Are you an alcoholic? Do you want help overcoming heavy drinking?

Help is available!

UNION CLUB was founded by a group of alcoholics in Seattle, Washington, to offer men the opportunity to support one another as they share their personal stories at weekly dinner meetings.

Now for the first time a Union Club is being established in the Syracuse area, and you are invited to be part of this venture

Meetings will be held at VALLEY

INN

South of Marcellus at intersection of Rt. 174 & Rt. 20 Meetings begin with dinner at 5:30 pm every Thursday and close at 7:00 pm

First Meeting March 8th

To make reservations or ask questions: Call Jim LeGro, 315-636-7781

Sleepy Drivers May Be Causing More Crashes Than Thought Accidents involving sleepy drivers about eight times higher than current federal estimates

river fatigue causes many more car accidents in the United States than previously estimated, a new report suggests. The finding comes from an analysis of several months’ worth of video recordings taken of nearly 3,600 Americans while they were driving. During that time, participating drivers were involved in 700 accidents. All participants’ vehicles had been outfitted with a dash-cam video recorder. That allowed researchers to analyze each driver’s face in the minutes right before crashing. The researchers also had video of the road scene in front of the drivers. Together, the footage suggested that the percentage of accidents involving sleepy drivers was about eight times higher than current federal estimates. The finding was highlighted in a report released recently by the AAA Foundation for Traffic Safety. The foundation describes the investigation into drowsy driving as the most in-depth of its kind to date. “Driver drowsiness is a notoriously difficult problem to quantify because it typically doesn’t leave behind evidence that a police officer can observe after the fact when investigating a crash — in contrast to alcohol, for example,” said Brian Tefft, a senior research associate with the foundation in Washington, D.C. “Thus, we expected that our study would find that the problem was substantially bigger than the official statistics from the U.S. DOT [Department of Transportation] suggest,” he said. “But we were still surprised by just how many crashes

we found to involve driver drowsiness in our study.” The study found that “approximately 10 percent of all motor vehicle crashes involve driver drowsiness,” Tefft said. The U.S. Centers for Disease Control and Prevention estimates that about one-third of American drivers aren’t getting the minimum seven hours of daily sleep that experts recommend. A recent AAA survey found that nearly three in 10 drivers said that in the past month they’d been so exhausted while driving that they weren’t able to keep their eyes open at some point. To identify driver fatigue during car crashes, the researchers examined video taken during the one-to-three minute period preceding each accident. They then tallied the amount of time each driver’s eyes were closed in that timeframe. Drivers were deemed to have been “drowsy” if their eyes stayed closed for more than 12 percent of the time. The study team concluded that current federal estimates — which link 1 to 2 percent of all car crashes to driver fatigue woefully underestimate the dimension of the drivingwhile-tired problem. “Our previous research has shown that a driver’s risk of crashing increases significantly when they don’t get at least seven hours of sleep, and climbs to levels similar to the crash risk of a drunk driver after missing more than two to three hours of sleep over a 24-hour period,” Tefft said.

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my story

“I call it the big little hospital,” said Joe Caruana, of Hannibal. “It’s big in service, but still small enough to make you feel at home. And, it’s just seven miles from my house.” Joe and his family have used several services at Oswego Hospital, including the Emergency Department and Surgical Services. “It’s been excellent from the first person to the last,” he said. “Everyone is friendly, helpful, efficient and courteous. They stick to their schedules too, just as they promise, including the physicians.” Joe, a former Hannibal Superintendent of School adds, ” The physicians are key and the nurses are first class. I’m happy they are in our county.”

— Joe Caruana Oswego Health

No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

www.oswegohealth.org March 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Bishop

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315-474-1561 ext 531 Ask for Bill Rowe

You don’t have to face hearing loss alone. The Rochester Chapter of the Hearing Loss Association of America (HLAA) unites people with all degrees of hearing loss. Come to one of our monthly chapter meetings to meet others with hearing loss and learn from the professionals who treat it. Visit our website for details: HearingLossRochester.org

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Meet

Your Doctor

By Chris Motola

Benjamin Sadowitz, M.D. Surgeon had an option to practice in Florida, but chose to come back to Syracuse Q: What brought you back to Syracuse to practice? A: I’m actually from Syracuse. I was in Florida doing a fellowship, so I’ve been back for about two-andhalf years. My wife’s from here, too. We thought about staying in Florida — I’d gotten a good job offer there, but my wife said, “We’re going back eventually, so we can either stay here for awhile and go back or just go now.” So I figured it was easier to just head back. Q: As a general surgeon, what kinds of patients do you typically see? A: We do gall bladders, appendixes, bowel obstructions, hernias, things like that. The fellowship I did down in Florida specialized in pancreatic surgery and pancreatic cancer, along with acid reflux surgery. We used some robotics and high-end laparoscopic surgery, so it was a nice fellowship to get some training in. Q: My impression is that pancreatic cancer is one of the hardest cancer diagnoses to survive. How do surgical interventions help? A: There are couple problems with pancreatic cancer. Detection is a major problem. It’s very hard to detect. Something like colon cancer we know a lot more about, can detect early and treat before it develops into cancer. You’ve probably known people who have had colonoscopies and had polyps detected. Those polyps can be precursors to cancer. For the pancreas there’s no early detection test or good way to screen for it. So many people find out they pancreatic cancer when it’s already progressed to the point where they can’t have an operation. So, four out of five people who present to us with pancreatic cancer are past the point where they can’t have an operation. Some of those people will get chemotherapy on a tumor that is biologically responsive and the tumor shrinks enough that it’s not dangerous to operate on. So we’re still not in a good place with that. The five-year survival rate for people with pancreatic cancer still sits around 17 percent. So it’s something

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

that still requires a lot of work. The chemotherapy is usually non-curative and the patients we can operate on surgically are far and few between. We still have a lot more work to do on pancreatic cancer. Q: How effective is surgery when you can operate? A: For the one in five who get to have surgery right off the bat, unfortunately, I would say 80 to 85 percent will have metastatic disease. So over five years, most of them have disease elsewhere. There’s probably going to be a push for anyone who has a diagnosis of pancreatic cancer to be treated with chemotherapy to see if they have a biologically responsive tumor. There are exceptions. I believe the Supreme Court Justice Ruth Bader Ginsburg has had a long, disease-free survival from pancreatic cancer. But if you look at other famous people who had the disease like Michael Landon and Patrick Swayze, they mostly died fairly quickly. That’s unfortunately what happens a lot of the time. But there are a small percentage who get the surgery and chemotherapy whose cancer never returns. Q: What are some of the advantages to having a broader approach to surgery? A: It’s nice because you see a lot of different cases. We have a pretty broad range of things we can do. The variety can be as broad as you want to make it, though the reality is that if you want to be good at something, you narrow it down to five or 10 things that you really do. In the case of general surgeons, we’re called on to either help out with other cases or evaluate things that other services aren’t comfortable with. Q: Do you end up with more of a systemic perspective? A: I think you’re correct in that sense. I think a lot of time people get our opinion because we look at things in that way. Specialty services tend to get really focused in what they do, but as general surgeons, we tend to look more at the whole picture, especially with patients who are critically ill, whereas

specialists tend to be focused on their one thing. Q: What type of surgery do you perform that you find the most interesting? A: I really did enjoy fellowship and pancreatic surgery. Those were interesting, challenging cases. I enjoy acid reflux surgery. The robotics side of surgery. The robot offers several significant advantages over laparoscopy. The cases that we use robotics in is growing exponentially. You’ll see a lot more of that. Q: How does acid reflux surgery work? I think laypeople think of it as a kind of chemical problem more than a mechanical one. A: You actually nailed it there. There is a mechanical problem there. The gastroesophageal flap valve between the stomach and esophagus become dysfunctional. So you can reflux things like stomach acid. And that’s why the antacids help with the symptoms but don’t help with the mechanical problem. So, you can still reflux things that can damage the esophagus and even be carcinogenic. Over the past 20 years, since the invention of all these drugs, the rate of esophageal carcinonoma is increasing. The drugs probably aren’t causing the cancer, but they’re aren’t solving the mechanical problem. There are some people who, due to age or medical comorbidity, are better off just taking the drugs. But younger people with severe reflux should really consider surgery. The drugs were never intended to be used in perpetuity. When I was in Florida, we were pretty aggressive about telling patients that it was a mechanical problem. There are actually several ways to fix it, even ways that don’t require traditional surgery, but the goal is to get people off those medications. Q: As a Syracuse native who returned to practice here, how would you pitch the city to physicians who weren’t born here? A: The cost of living is cheap. Unfortunately, there’s a lot of debt that comes with going to medical school these days, and if you want to live in a high-end city, the cost of living is higher and you may actually get paid less. Secondly, the school system is good if you want to raise a family. Another thing I say for New York state, compared to Florida, is that our healthcare is good even if it costs a bit more. And if people are outdoorsy, there’s a lot of stuff to do here. Now, a lot of my classmates were from New York City and couldn’t wait to get back to that. If you’re looking for big city living, you’re not going to find that here, so I think it’s a matter of finding people who like the kind of lifestyle we can provide.

Lifelines Name: Benjamin Sadowitz, M.D. Position: General surgeon at Crouse Hospital Hometown: Camillus, NY Education: Upstate Medical University Affiliations: Crouse; SUNY Upstate Organizations: American College of Surgeons; Society for Laparoendoscopic Surgeons; Medical Society of the State of New York Family: Married, two children Hobbies: Downhill skiing, tennis, time with family

ACA Enrollment, Marketplaces ‘Remarkably Stable’ About 11.8 million Americans enrolled in 2018 coverage, down 3.7 percent from last year’s total

fter much drama leading to this year’s open enrollment for Affordable Care Act coverage — a shorter time frame, a sharply reduced federal budget for marketing and assistance, and confusion resulting from months of repeal-and-replace debate — the final tally paints a mixed picture. With all states now reporting, ACA plan enrollment ticked down-

ward this year, a report out recently shows, but states running their own marketplaces saw slight gains and did better than those relying on the federal exchange. About 11.8 million Americans enrolled in 2018 coverage, down 3.7 percent from last year’s total, according to the National Academy for State Health Policy. Open enrollment began short-

ly after the Trump administration sharply cut federal enrollment outreach efforts and ended a type of cost-sharing subsidy paid directly to insurers, which generally responded by raising premiums to make up for the loss. “Despite all that, enrollment in the marketplaces across the nation was remarkably stable,” said Trish Riley, executive director of the academy, a nonprofit, non-partisan group. Enrollment in marketplaces fully or partially run by states, for example, showed a small overall increase of 0.2 percent over the previous year, while the 34 states that rely entirely on the federal hub saw sign-ups drop by 5.3 percent, the report said. Officials from states operating their own exchanges said their ability to make changes led to their gains. “We could extend our open-enrollment period, control our marketing budget and nimbly mitigate the impact of the loss of cost-sharing subsidies [to insurers], which led to a very successful open enrollment,”

said Zachary Sherman, director of Rhode Island’s state-run market. Enrollment there is up 12 percent this year, he said, with sharp increases in the number of newly enrolled and policyholders aged 18 to 34. California, which has the nation’s largest state market with about 1.5 million enrollees, saw a 2.3 percent drop in overall sign-ups. Covered California Director Peter Lee attributed some of that to efforts by the state to encourage off-market purchases by consumers who don’t qualify for subsidies. Despite their upbeat tone about this year’s enrollment, directors of several state marketplaces warned that 2019 looks grim. “Just the removal of the [individual mandate penalty in Congress› recently enacted tax overhaul] will mean premiums go up 15 percent to 30 percent or more depending on the state,” said Lee.

Healthcare in a Minute By George W. Chapman

Buffet, Bezos to Get Into the Health Insurance Business

arren Buffett, CEO and chairman of Berkshire Hathaway, has long purported that U.S. healthcare costs are the underlying reason why U.S.-based firms find it difficult to compete globally. Businesses in other countries spend less than half on healthcare as their U.S. competitors. Buffett is teaming up with Jeff Bezos, CEO of Amazon, and Jamie Dimon, CEO of JP Morgan Chase, to develop a system of care for their combined 1 million employees that is “free from profit-making incentives.” The headquarters and management team are to be announced. The mere threat of this alliance caused healthcare stocks (United Healthcare, Anthem, Aetna, Humana, etc.) to drop. Industry observers have noted, however, that there already is a nonprofit system in place. It’s called Medicare.

Federal Budget Passed On Feb. 9, Congress finally passed, and the president signed into law, a two-year $400 billion budget. Among the healthcare related items are: $6 billion to fight the opioid epidemic and treat mental illness; $2 billion for National Institute of Health research; $90 billion for disaster relief; accelerates the closing of the infamous “doughnut hole” in Medicare Part D (drug) coverage; delays funding cuts to disproportionate share (more Medicaid and indigent care than average) hospitals; continues funding of the National Health Service Corps; expands the VA Choice program which allows vets to seek care from the private sector; repeals the Independent Payment Advisory Board which used to make seemingly arbitrary budget cuts to Medicare; continued community health center funding. Uninsured Rate Up It should come as no surprise that the number of uninsured Americans increased, by an estimated 3.2 million people, to 12.2 percent of the US population in 2017. That’s up from the record low of 10.9 percent in 2016. However, 12.1 percent is far better than the 18 percent uninsured rate before the ACA went into effect. The individual mandate repeal takes effect in 2019. The CBO estimates that

repeal will cause 13 million people to drop health insurance over the next decade. Cost of US Healthcare It’s well established that we spend almost twice as much on healthcare, $10,000 per capita, as any other industrialized nation. In 2016, we spent $3.3 trillion, which was 18 percent of our GDP. Interestingly, several studies have shown we actually use about the same amount of healthcare as other countries. The major cost culprit is price. We simply pay a lot more for care than most countries. Neither population growth nor aging can account for the fact that we pay far more. A study by the Institute for Health Metrics and Evaluation in Seattle, published in the Journal of the American Medical Association (JAMA), found that 63 percent of the increase in spending from 1996 to 2013 was due to the combination of more being done for patients during office visits/hospital stays and inflated prices. U.S. hospital prices are 60 percent higher than those in Europe. Another report, from the Healthcare Cost Institute, found that spending per person reached an all-time high in 2016 in employer-sponsored plans despite lower utilization. According to the report, increasing prices were the major factor in rising costs. Between 2012

and 2016 drug prices increased 25 percent and hospital prices increased 24 percent. Opioid Crisis A large bipartisan group from the House of Representatives has made fighting the crisis a top priority. They are focused on getting a package of eight new bills passed and signed by Trump. Among the eight bills are: directing funds for substance abuse centers to rural areas; requiring states with federal health grants to track written scripts and what pharmacists dispense; forcing all Medicare Part D scripts to be electronically transmitted to curb pharmacy shopping; and stopping illegal trafficking of opioids. In his state of the union address, Trump noted that 174 people a day die from an opioid overdose and that he is committed to fighting the epidemic. To date, there has been little funding to fight the battle. Killer Air Pollution was responsible for over six million global deaths in 2016. That is 12 percent of all global deaths that year. While not officially listed as the “cause of death,” pollution is strongly linked to lung cancer and emphysema, according to the Institute for Health Metrics and Evaluation. Two thirds of the six million deaths are due to outdoor or ambient pollution, which is caused by vehicles, coal fired plants and steel mills. Deaths per 100,000 due to ambient pollution are highest in central Africa, India, China and Pakistan. Team Approach to Care A physician can no longer do it alone. Several factors, including the pending physician shortage, uncertainly in Washington, increased regulations and moving target reimbursement methodologies, have made it all but impossible for physicians to effectively keep up. According to research by the AMA itself, consumers prefer coordinated healthcare that is delivered by a physician-led team. The key is the physician is responsible for providing a safe and effective March 2018 •

way of delivering and managing your care. Well-trained staff should be able to handle several of the chores traditionally handled by the physician including: data gathering and recording taking vitals and history information, and patient education. The team approach allows each member to perform at the maximum level of their training, be they medical assistant, LPN, RN, care coordinator, PA or NP. Many visits may not even require a physician. Aetna/CVS The much ballyhooed, potentially game changing merger of the insurance and pharmacy giants, is facing another hurdle. Aetna shareholders filed a class action complaint alleging that a document filed with the SEC contains incomplete and misleading information to win over Aetna shareholders. The Aetna shareholders believe the price offered by CVS is unfair and inadequate. Medicare Advantage Plans Currently, about 60 million seniors are covered by Medicare. Twenty million of them chose to enroll in a Medicare Advantage plan offered by commercial carriers. Among the larger players: United’s enrollment grew 7.3 percent, Humana’s grew 5.8 percent and Anthem’s grew 3 percent. Ironically, these large for-profit insurers have become increasingly dependent on Medicare and Medicaid for their bottom lines. M&M accounts for almost 60 percent of the revenues of the five largest publically traded insurers in the US. 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

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change in protocol for treating out-of-hospital cardiac arrest patients in Western New York has yielded striking results: twice as many patients now survive. The change was implemented by physicians from the department of emergency medicine in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo who serve as medical directors at American Medical Response (AMR), which provides ambulance service to the city of Buffalo and surrounding communities. “When a patient collapses from cardiac arrest in the community, the chance they will survive is low to begin with,” said physician Brian Clemency, associate professor of emergency medicine in the Jacobs School, medical director at AMR and a physician with UBMD Emergency Medicine. “But their chances get even worse if emergency medical services (EMS) providers automatically try to take the patient to the hospital, rather than maximizing their care on scene.” Instead of immediately transporting the patient to the hospital, often at high speeds in an ambulance, a procedure known as “scoop and run,” the physicians found that patients are more likely to survive when first responders stay on the

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scene to focus on high-quality cardiac pulmonary resuscitation (CPR) and defibrillation. With this change, first implemented in April, the UB physicians have seen the number of patients who eventually were discharged from the hospital with favorable neurologic function increase from 1.3 per month to 3 per month. AMR has tracked this progress through a national database that links ambulance care with outcomes from local hospitals. Eric Dievendorf, clinical manager at AMR, said, “We are thrilled with the results of our new program. Measurable gains like these inspire caregiver buy-in, which will continue to drive favorable patient outcomes.” He and his colleagues are now working with local EMS providers to promote treating cardiac arrest in the field instead of rushing patients to the hospital, where they are often pronounced dead. He also intends to launch a public information campaign that promotes CPR training among bystanders. “Taking the patient to the hospital right away robs precious time when that patient could have been getting CPR,” Clemency said. “The message we’ve learned for EMTs is: ‘Stay on the scene. Wherever we find you is where we’ll work on you.’”

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How Young Is Too Young for Their First Phones? Parents need to determine when their children are ready for cell phones By Julie Halm

wenty years ago, cell phones were rarely sighted and could be found nearly exclusively in the hands of high-powered business people. Fast-forward to 2018 and it’s not uncommon to see an elementary school student happily tapping away at a game on the screen of a smart phone. Technology has progressed at lightning speed, leaving behind the bricks with buttons that were once such a status symbol and making way for mass consumption of all types of media on a device that fits easily into one’s pocket. While cell phones are incredibly handy, countless parents have been left to tackle the question, “How young is too young for children to get their first phones?” Elizabeth Beaty, a claims adjuster from Western New York, has had the somewhat unique experience of parenting children throughout the entire dawning of the cellular age. Her oldest son, Brendan Lindahl, is 29 years old. “When Brendan came through, kids didn’t have cell phones, only parents did,” she said. The eldest of her children didn’t get a cell phone from his parents at all; instead, he bought one for himself when he was a young adult. A small age gap made a big difference when her daughter, Kaitlin Jackson, 27, went off to college. She received a cell phone but was not allowed to text for the first year as the cost was too high. It wasn’t until her sophomore year of college that cost-savings plans became more common and the family joined one of its own. Her middle son, Gavin, 23, was younger when cell phones began to become commonplace. “When Gavin came about, the biggest thing for us was that data cost so much. We gave him a handme-down phone and he was on that a long time. He didn’t get a smart phone until college because it cost so much,” she said. Now, she is debating when the right moment will be to get a phone for her youngest son, Logan. He is 14 and on the autism spectrum, adding another layer to the already complicated decision.

Danger ahead? Cell phones can now put children within a click or two of all of the benefits and the multitude of dangers that can come with the Internet and social media. “We worry about him meeting inappropriate people, being able to get onto the amount of sites that he could. However, he already uses a laptop. I think with the phone it just scares you that they might be able to trace it or track it or hack it,” she said. For now, she’s holding off for that reason, as well as to preserve some of the innocence of childhood. “I’m glad we’re not giving it to him because I think they’re getting way too much too soon. They’re going to be burned out. Everything comes with an age,” she said. Amy Ferrari, a mother of two, said she now regrets her children Children and Cellphones

• On average, children are 12.1 when they receive their first mobile device. • 56 percent of children, aged 8 to 12, have a cellphone. • 60 percent of families who have provided a cellphone to their child did so between the ages of 10 and 11. 20 percent provided their 8-to-9 yearolds with a cellphone. • Among children 8 years of age and younger, 21 percent use smartphones. • 69 percent of families with young children under 8 years old have a smartphone. • 38 percent of children under 2 used a mobile device for media. • Dads are more likely to give kids smartphones in elementary school while moms are more likely to give kids smartphones in middle school. Source: www.growingwireless. com/

having gotten smart phones at such a young age. Her children, now 20 and 17, received their first phones at 14. Ferrari said she felt pressured by the notion that they were becoming independent and might need a cell phone in order to call home. In the end, she thinks the devices did far more harm than good. “The kids did not learn any communication skills. That is the optimal age where you’re teaching them to communicate with other human beings and we missed those opportunities,” the Wheatfield resident said. If she could do it all over again, she would have waited until they were 16 and driving and then given her children phones without all of the bells and whistles. That is the route that Teri Cross has opted for with her two children, aged 14 and 16. Each of them has a Tracfone to be used in case of an emergency. “For teens, I like them to have one for emergencies and last-minute school changes I need to know about,” she said. South Buffalo resident Andrea Brown’s only daughter is 6, but she says that she has already given thought to the inevitable decision, and the deciding factor is simple. “She will have to have her own job and pay for her own phone,” she said.

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Bishop’s New Boss: Former Nun, Scholar, Used to Volunteer in India

argaret Mary Wagner, the 70-year-old Kenmore native, brings 40 years of experience to her new position of administrator of Bishop Rehabilitation and Nursing Center. However, before entering the field of nursing home care, Wagner earned degrees in fine arts, and became a nun, teaching college. She eventually left the convent and, unsure of what to do next, applied to be a Fulbright scholar. To her surprise, she was chosen and traveled to India. While abroad, she volunteered in a hospital for people with leprosy. “It was the first time I had ever worked with dying people,” she said. “I couldn’t believe I could go from college kids to elderly people, but I loved it so much.” Upon her return to the United States, she decided to go into the health care field, went back to school in health education, and has been a licensed nursing home administrator for four decades. She was affiliated with Buffalo General, and when Kaleida Health took it over, Wagner became vice president of its long term care, responsible for managing four facilities and a low income housing project. She had retired from Kaleida, but stayed active in the field, remaining involved with the American College of the Health Care Administrators. She has been a national speaker on health care and nursing homes and headed up of a consulting business, Margaret Mary Wagner, Health Care Navigator LLC. Farbenblum had heard of Wagner, arranged a meeting and asked her to come out of retirement and work for him after he bought this Chatuaqua facility. From there, Farbenblum has brought her to the Bishop Center and she’s excited for the challenge. “It’s a huge commitment for anyone to take over a nursing home in distress. But what’s more important is that if you have experience doing it and being successful, it’s certainly to us an exciting process to see change,” she said.

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Rescuing the Former James Square Health New administrator excited about injecting new life into Syracuse nursing home, now renamed Bishop Rehabilitation and Nursing Center By Mary Beth Roach

ew owner, new leadership, new vision.” With this motto, Margaret Mary Wagner is prepared to take on the challenge of turning around the former James Square Health and Rehabilitation Centre that has been dogged by financial and patient care problems. In December, the facility at 918 James St. in Syracuse, was sold by River Meadows LLC to a company headed by Edward Farbenblum for $45 million. Farbenblum has brought Wagner in as the administrator to oversee the center, which currently has 300 residents, but is licensed to accommodate 450, and a staff of 500. The two worked together after Farbenblum took over the Chautauqua Rehabilitation and Nursing Center in Dunkirk. Farbenblum is also a partner in nursing homes in Hamburg, Cheektowaga, Williamsville, North Tonawanda, West Seneca, Dunkirk, Johnson City, Kingston, Long Island and Warren, Mich. One of the first orders of business for the local nursing home, Wagner noted, was to change the name of the nursing home in order to give the facility a fresh start. “That is the beginning of change — your new name,” Wagner said. The administrative staff voted to name Bishop Rehabilitation and Nursing Center, in honor of physician Jeanne Bishop, who has been medical director at the facility for the past 25 years. Wagner credits Bishop, in large measure, for keeping the facility running and staff together during its more turbulent times. But the name change is only the

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

beginning. Saying that the situation is not a quick fix and that she has a list “10 miles long,” she also sees the importance of prioritizing those improvements. “I think it’s the combination of knowing what’s right to do and the timing of when to do it,” she explained. Her immediate areas of focus are staffing, education and training, and improvements to the food service. She’s already attended two family meetings and met with all the residents. She is excited about the current staff. “In many respects what I see here are great staff members who bonded together,” she said. “And Dr. Bishop helped them, giving hope that things are going to get better. There’s this phenomenal wealth of commitment to do it right. And they’re excited about it because they’re getting to see the changes. I think that’s pretty spectacular.” Pay raises for LPNs and certified nursing aides have already occurred. Noting that the LPNs were the lowest paid in the county, they received a $1 million pay hike, and CNAs saw a $500,000 pay increase. They have also added sign-on and recruiting bonuses for the staff, Wagner said. “That’s how you’re going to turn the key on this,” she said. More professional and medical staff will be hired as well, and from mid-December to mid-January she said she has received more than 250 applications. Residents’ meals are already being improved, with ice cream and cookies already making a return to the menu. “If you get what you like

to eat, you’re going to do better,” she noted. Wagner indicated that renovations to the facility, which opened in 1970, are also in store, including a new lobby area, and an increase in the number of security cameras in the facility’s common areas and nurse stations, exterior doors and the parking areas. And certain decorating trends from the ‘70s will be updated, such as the wallpaper in some of the rooms, and the carpeting on the walls and ceilings. Wagner joked that when Farbenblum asked her to be the administrator for the center, she said she would take the position on the condition that the carpets on the walls and ceilings be removed. She anticipates renovations to begin later this spring, once the appropriate approvals from New York state and permits from the City of Syracuse are obtained. As her efforts to turn the facility continue, there will be benchmarks to measure her effectiveness. There are state and federal quality indicators, and her goal is to be at the leading edge in those indicators. But she’ll measure herself, too, against what the residents and their families say. “If a family member sees the improvement; sees the staff on the floor; sees consistency in their answering, their loved one likes the meal, they see that they like the meal. That’s a good indication. The families and the residents are going to be my first one in telling me things are better,” she explained.

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erpes infection rates are dropping among young Americans, and safer sex practices may be one reason why. Roughly 12 percent of adults were infected with genital herpes (HSV-2) in 2015-2016, down from 18 percent in 1999-2000, a new government report found. The same promising trend was seen with HSV-1, a form of herpes that causes sores around the mouth and lips, sometimes called fever blisters or cold sores. Forty-eight percent of Americans had the condition in 2015-2016, a drop from 59 percent in 19992000. “The report tells us that two of our most prevalent viruses in the U.S population, HSV-1 and HSV-2, are steadily declining,” said report author Geraldine McQuillan. She is a researcher with the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). McQuillan added that other countries have seen a similar decline in the past two decades, and “improvements in living conditions, better hygiene and less crowding” may explain that drop. Health experts suggested the findings aren’t entirely unexpected. “Though many factors may be at play, probably the largest impact is that young people are choosing to begin to be sexually active at later timeframes,” said physician Matthew Hoffman. As evidence, he pointed to a 2015 report that indicated that 44 percent of teen girls and 47 percent of teen boys had had sexual intercourse between 20112013. Those figures represent a 14 and 22 percent drop, respectively, over the last 25 years. Hoffman was not part of the CDC study team, but serves as chairman of the department of obstetrics & gynecology with the Christiana Care Health System, in Delaware. Blacks faced the highest risk for genital herpes, while Asians faced the lowest risk, the findings showed. “Though this report is a positive trend, it continues to reflect that there is a very significant burden of disease with lots of affected people,” Hoffman said. “Moreover, we need to continue to work to develop strategies that are effective in preventing the further dissemination of the disease.” The findings were reported in the February issue of the CDC’s NCHS Data Brief.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

• Page 11 2/22/18 4:07 PM

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Making New Friends: It’s Never Too Late

uestion from a reader: I’ve been divorced for about a year now, and struggle with loneliness. I miss the friends we shared as a couple, but I’m just not comfortable socializing with couples anymore. I’m 56, and it feels awkward to try to make friends at my age. Any advice for me?

Answer from Gwenn: It’s unfortunate, but what you are experiencing often happens in the aftermath of a separation or divorce, especially if it was acrimonious. Friends’ loyalties can be split and, just as you feel uncomfortable relating to your former “couple” friends, some couples feel uncomfortable relating to a now-single friend. So how do you meet new people and cultivate friendships as an adult? Here are a few tips: First, be your own best friend. Taking care of yourself matters. Loving yourself shows. The better you feel about yourself, the better friends you’ll attract. Positive people appreciate and gravitate to other healthy,

positive people. Do what you enjoy doing. You won’t make friends sitting alone at home. Get out of the house and do those things you enjoy, whether it’s going to the gym, walking your dog, taking a cooking class, joining a book club, or any number of activities that are fun and interesting. You’ll meet people who enjoy similar pursuits. Friendships can follow. Consider a support group. It’s not uncommon for new friendships to be born out of compassion and empathy. A divorce or grief support group will put you in touch with others facing similar challenges. A friend of mine met her second husband in a divorce support group. She shared, “We got to know each other as friends first, and have remained ‘best friends’ throughout our marriage. It’s the best thing that ever happened to me.” Say “yes” to invitations and opportunities to be with people. Circulating at parties, neighborhood meetings,

s d i K Corner

Hey Kids, Just Say No to Energy Drinks H ighly caffeinated energy drinks aren›t safe for children and teens, and should not be marketed to them, a leading sports medicine organization warns. The American College of Sports Medicine (ACSM) recently released an official statement about the beverages. “Energy drinks are extremely popular, and concerns about their consumption are coming from every sector of society, which is why we’ve published these recommendations,” said physician John Higgins. He’s an associate professor of medicine at the University of Texas McGovern Medical School in Houston. Children and teens appear to be at particularly high risk of complications from energy drinks because of their smaller body size and potentially heavy and frequent use, according to the statement. Page 12

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The warning applies to beverages like Red Bull, Monster and Full Throttle. The fact that they are not meant for children needs to be emphasized and widely publicized, the group stated. “Our review of the available science showed that excessive levels of caffeine found in energy drinks can have adverse effects on cardiovascular, neurological, gastrointestinal, renal and endocrine systems, as well as psychiatric symptoms,” Higgins said in an ACSM news release. “More needs to be done to protect children and adolescents, as well as adults with cardiovascular or other medical conditions,” he added. Among the group’s recommendations: • Stop marketing to at-risk groups, especially children. This includes marketing energy drinks at sporting events involving children

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

people working toward a common goal. Community gardens, political parties, hospitals, museums, animal shelters and many other organizations often need volunteers. Strong connections can be made when you work alongside others who want to make the world a better place. Join an online community of people who share your interests. Social networking sites can be a safe and satisfying way to meet people. One popular site is www.meetup.com, which helps people meet others nearby who share their interests. Meetup allows members to find and join groups unified by a common interest, such as nature, photography, hiking, books, movies, health, pets, careers, hobbies, you name it! Good friendships can make life better. The company of someone who makes you laugh, who provides a shoulder to lean on, and who is just plain fun to hang out with can provide a welcome boost to your health and happiness. So, if you feel your social network is too small, remember you can always meet interesting people, make new friends, and nurture existing ones. It’s never too late.

work events, etc. is one of the easiest ways to make new friends. You’ll be out and about with people with whom you share something in common. Show up and don’t be shy about extending an invitation to someone you meet. It could be a cup of coffee, quick bite to eat or a short walk. Don’t overlook your family. My sister is my best friend, and she helped me re-establish a network of friends after my divorce. I had gone into the proverbial “cave” and lost contact with practically everyone. Her friends became my friends, and now, years later, I enjoy the company of her friends, as well as my own. Rekindle relationships with old friends. Sometimes the friendships you made when you were single drift away after you get married. That’s not unusual. New priorities take over and focusing on married life requires time and attention. But now, when you’re looking to find new friendships, consider reconnecting with old friends. They were an important part of your life at one point, and may still have lots to offer. Pick up the phone. Give a “singles” event a try. Many divorced or widowed men and women find fun and friendship in community activities organized just for singles. It could be a hike, bike ride, dinner club or dance. These opportunities can be found online in community calendars or in your local newspaper. Volunteer or join a cause. Supporting an organization or cause you believe in will put you in contact with

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 about her workshops, book, or to invite Gwenn to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.

and teens. • Do not consume energy drinks before, during or after intense exercise. Some deaths linked with energy drinks occurred when a person consumed energy drinks before and/or after vigorous activity. • Educate consumers about the differences between soda, coffee, sports drinks and energy drinks. Energy drink education should be

included in school nutrition, health and wellness classes. The statement, which also called for more research into the safety of energy drinks, was published Feb. 9 in the journal Current Sports Medicine Reports. The American College of Sports Medicine is said to be the largest sports medicine and exercise science organization in the world.

Myths You Should Know About Heartburn By Ernst Lamothe Jr.

eartburn is more than simply inconvenient. Many people consider the condition as only an irritant or something that taking two Tums can solve. Because of this, the symptoms can later worsen. Heartburn is a burning pain in your chest, just behind your breastbone. It’s a condition that is more prevalent than people think. “Heartburn affects one in five adults, and can make life miserable,” said Atul Maini, medical director and surgeon at The Heartburn Center in Syracuse. “It’s not just what types of food we tend to eat, but also how much food we eat and when we eat it. All of these behaviors have a negative impact on our digestive system, and often cause uncomfortable flare ups of heartburn.” Maini discusses five myths about heartburns.

Heartburn isn’t a serious condition Maini often hears that and it is a concerning thought because he knows that heartburn is absolutely serious. Heartburn can be connected with other issues in the body such as a hiatal hernia, which is diagnosed when the stomach moves up into the chest through the opening in the diaphragm. “If that is ignored, there are cases where it can easily morph into esophagus problems and cause cancer,” said Maini. “It is very dangerous to just ignore the feeling or say it will just pass, especially it happens repeatedly.”

Acid reflux is nothing to worry about either People often complain

about the burning in their chest from the condition, where acidic gastric fluid is regurgitated into the esophagus, causing heartburn. Maini said there are patients who talk about the fact they can feel acid coming back into their mouths when they lay down. “Reflux is one of the fastest growing disease in the United States,” said Maini, who added that the Heartburn Center is the first dedicated and comprehensive heartburn treatment center in the greater Syracuse region. “Until now, patients who suffer from heartburn may have gone to their primary care physicians or a gastroenterologist for treatment, or they may have tried to self-medicate with over-the-counter remedies that may not solve the underlying problem or may cause some serious side effects.”

Medication is the only way to treat it There’s no harm in popping a Prilosec or whatever over-thecounter drug you can find for your heartburn, right? Wrong. Too often people self-medicate in an attempt to quickly find comfort for their heartburn. Medication should only be taken in short intervals. You can help your heartburn. Treatment can include prescription medication, over-the-counter remedies, lifestyle and diet changes. “There are too many people who are using short-term medication as their long-term medical care,” said Maini. “You could be doing more damage than you think to essential gastrointestinal parts of your body.”

Heartburn is only the result of poor eating habits Random eating habits, the most common reason behind heartburn, is not the sole reason. Heartburn actually happens when you have a problem with your lower esophageal sphincter. As a result, the stomach acids move upward. “While we always recommend eating right in general for overall health, eating the wrong foods are not always directly causing your heartburn,” he added. “This is one of the reasons why we recommend seeing a gastroenterologist because there could be necessary tests you need to take to determine what is causing your particular problem.”

Atul Maini a board-certified general surgeon and a fellow of American College of Surgeons, is the medical director of the new Heartburn Center at St. Joseph’s Health.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

My Turn

By Eva Briggs

Plantar Fasciitis and Other Heel Pains

everal years ago, while on an extended backpacking trip of the Appalachian Trail, I noticed pain in my right heel. It started slowly, and worked up to significant pain. Then I stumbled, slammed down hard on my foot, and the resulting serious jolt of pain told me this wasn’t merely a minor inconvenience that would resolve with over-the-counter pain relievers, taping and muscle rubs. So I limped slowly 4.4 miles to the trailhead, where AT hostel operator and shuttle driver “Mechanical Man” gave me a ride back to civilization. I drove home, saw an orthopedic doctor and learned that I had a stress fracture of my calcaneus (heel bone). So I thought that for this month’s article I’d write about common causes and treatments for heel pain. Calcaneal stress fractures arise from repetitive overuse of the heel. It could be an increase in weight bearing activities like running or hauling around a 25-pound backpack for hours, day after day. Or the overuse could entail walking on harder surfaces. In any case, pain starts at first only with activity, and later happens at rest. Swelling and bruising are not always present. The fracture area is tender. Squeezing the heel often reproduces the pain.

Stress fractures don’t always show up on X-rays — mine didn’t. Sometimes a bone scan, CT or MRI reveals the fracture. The treatment is little to no weight bearing for up to six weeks, heel pads, and perhaps a walking boot. (My own personal favorite is the Tuli brand heel cup, which seems to last a long time and costs only about $10 per pair. They’re good for plantar fasciitis, too.) Plantar fasciitis is the most common cause of heel pain. About one in 10 people battle this painful malady during their lifetime. The plantar fascia is a tough fibrous band that connects the heel to the toes. When inflamed, it causes a sharp stabbing pain near the heel. The pain is most severe first thing in the morning — or after resuming activity following a period of rest. People often blame plantar fasciitis on heel spurs, bony-like calcium deposits extending from the heel to the arch. Only 50 percent of people with heel spurs have pain, and patients with plantar fasciitis often have a normal X-ray with no heel spurs. The diagnosis is based on history and exam, not on X-ray. Treatment is rest, activity modification, ice, anti-inflammatory medication and stretches. Other therapies include physical therapy, arch taping, orthotics and night splints. Instructions for heel taping with kinesiology tape

(KT tape) is available online https:// heelthatpain.com/plantar-fascia/ plantar-fascia-taping/ When these measures aren’t sufficient, injections of steroids or plasma-rich platelets can jump-start the recovery process. Heel pain can also come from inflamed or injured nerves. Nerves in the foot and ankle can be trapped and pinched by overuse, trauma or previous surgery. Neuropathic pain often is burning and can be accompanied by tingling and numbness. A compressed nerve in the spine can also cause nerve pain, called radiculopathy, even without back pain. Tests that aid in the diagnosis include MRI and ultrasound to visualize the compressed nerve. Neuropathic heel pain is usually unilateral. Neuropathic pain in both heels might be due to an underlying systemic illness. The Achilles tendon, which runs up the back of the heel (the heel cord), can become inflamed. That’s called Achilles tendinitis or tendinopathy. Usually it stems from mechanical overload such as excessive

running. Sometimes the tendon is not only tender but has a swollen area. Treatments that help include activity change, exercises, pain relievers, heel lifts, and deep tendon massage. But steroid shots don’t help. They can even make the tendon rupture, which is bad thing with a prolonged recovery. These are only a few of the most common causes of heel pain. So if your heel hurts, and doesn’t improve with the usual home treatments for aches and pains, get it checked out. Don’t do what I did and wait until you can scarcely walk.

— in some patients.” Anyone who has received a cancer diagnosis would likely agree that anxiety and fear caused some sleepless nights. Like other modalities of Chinese medicine, acupuncture offers a holistic perspective that supports clients’ wellness rather than the typical Western perspective that focuses more on patient diseases. “There are specific acupuncture points which help the nervous system relax, so acupuncture can also aid in stress management, and help patients sleep better,” Doucet said. “Acupuncture stimulates the natural healing process of the body and works in tandem with traditional Western medicine to restore health.” Acupuncture has no medical contraindications for cancer patients and may help lessen their need of

pain medication and the medication they take to mitigate treatment side effects. Medication may bring many benefits to treating the disease, but it’s not always harmless to natural functions of the body. By lowering the medication load through acupuncture, the patient’s body has fewer substances to filter out and contend with. Acupuncturists generally work by using hair-thin, sterile, one-use needles to stimulate the nervous system and circulatory system, and trigger the release of endorphins. By knowing the correct areas to stimulate, the acupuncturist can achieve the desired results. Many patients find the experience deeply relaxing. Patients usually receive benefits from acupuncture within 24 to 48 hours.

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

Cancer Patients Can Get Help from a Surprising Source: Acupuncture By Deborah Jeanne Sergeant

ancer and its treatment can cause patients numerous unpleasant side effects, including pain, fatigue and nausea. These can also contribute to insomnia, as can stress and anxiety, right at a time when patients need sufficient rest to battle cancer. Acupuncture may help. “Acupuncture: Patient Version,” published by the National Cancer Institute (www.cancer.gov) states that acupuncture has been shown in clinical trials to “control pain and to relieve nausea and vomiting, fatigue, hot flashes, xerostomia [dry mouth], neuropathy, anxiety, depression and sleeping problems.” L. Lolane Glundal, licensed acupuncturist at Harmonious Holistic Acupuncture in Manlius, said that acupuncture is all about balance. “We can bring the body back into balance, between organ systems and yin and yang,” she said. “Traditional Chinese medicine is very helpful.” She explained that acupuncture stimulates blood circulation to support healing, release of endorphins to Page 14

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mitigate pain, and reduces nausea. Some patients struggle to complete all the grueling rounds of chemotherapy or radiation and must take a break. Glundal said that acupuncture may also help improve clients’ energy. Emily Doucet, program coordinator at CancerConnects in East Syracuse, said that patients who have experienced radiation may experience swelling and discomfort in their mouths and throats. These symptoms can further lower their appetite at a time where eating right is important for promoting better health. “Acupuncture can aid in decreasing these symptoms,” she said, citing information from the National Cancer Institute. “Acupuncture can help ease the pain of surgery, scars and neuropathy in cancer patients,” she added. “Some patients may find that they need to take less pain medication as a result. Acupuncture can also help to improve circulation, which can help repair scar tissue, and help regenerate damaged nerves — neuropathy

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

Hypnosis Helps Break Addiction

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ddiction isn’t easy to break. “Over 20 million Americans over the age of 12 have an addiction, excluding tobacco,” according to AddictionCenter (www. addictioncenter.com). The site further states that “100 people die every day from drug overdoses. This rate has tripled in the past 20 years.” Among the many types of assistance available, hypnosis has been shown to help people change their ways. “Hypnosis helps take the struggle out of making change,” said Linda Gilmore, certified hypnotist, certified instructor in hypnosis and certified hypno-coach at Balanced Life Hypnosis in Liverpool. “It’s more effortless.” Gilmore said that the cause of addiction is a person’s unhealthy means of dealing with overwhelming depression and anxiety. She explained that it often helps to discuss why they want to quit smoking, for example, triggers for their unwanted behavior, and also what gets in the way of them becoming their “future self” that’s free from the habit. She also works on some inter-related topics such as stress management, dealing with anxious feelings and confidence. Addictive substances like nicoJim Feinberg tine can trigger the pleasure area of the brain, which induces the person to repeat using the substance to bring more pleasure and relief from emohistory on the client. He learns about tional pain. the addiction, the client’s resources By tapping into the reason clients and support, and how hypnotherapy had initially chosen their now unworks. wanted behavior over healthy coping “Typically, someone is lymechanisms, Gilmore said she can ing down on my couch,” he said. help them achieve better success as “They’re in a very relaxed state, just they follow their health care providas when they’re about to fall asleep. er’s direction. They’re cognizant of my voice. I take For some people, simply working them on a guided imagery tailored to on the level of the conscious mind their experience.” isn’t as effective. Using hypnosis, in The session can last 45 minutes addition to other therapy techniques, to an hour. Then he and the client achieves the best results, according to talk about it afterwards. The clients Gilmore. may write down things they thought Hypnosis is not a matter of placabout and how they feel. At a later ing people in a trance and they wake date, Feinberg may have a typical up transformed. Clients are aware of talk therapy session. the interaction, but in a relaxed state “We then talk about how they of internal focus in which they can were feeling and if they were able to explore what prevents them from cut down use,” he said. doing what they need to do. Results usually don’t happen “Someone has to be 100 percent overnight. Feinberg said clients typimotivated to make any change,” cally reduce use until they break the said Jim Feinberg, licensed clinical habit. He feels that helps them lessen social worker and certified clinical the effects and make quitting easier hypnotherapist in private practice than going cold turkey. in Syracuse. “Hypnosis lends to that Occasionally, clients can succeed framework. Hypnosis is a relaxation after one session; however, for most, technique used to induce suggestions one to two sessions weekly for a few in the unconscious mind to change months augments the other help they deeply rooted behavior as the heart receive, such as drug counseling or of the addiction.” nicotine patches. Feinberg added that it aids in Clients should follow their mitigating symptoms of withdrawal doctor’s advice while undergoing and therefore reinforcesTherapy the person’s hypnotherapy. Sleep Might Be the Answer! commitment to sobriety. Clients can Hypnotherapy rates range from rebuild their emotional strength and around $105 to $150 per session, degain control over their behavior. pending upon the therapist. It’s usuIn his first session, he gathers ally not covered by health insurance.

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March 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Celebrating the news that East Hill Family Medical is expanding its mental health and substance abuse service are, from left, physician Adam Duckett, who is also the Cayuga County coroner, and Keith Cuttler, president and CEO of East Hill.

Auburn’s East Hill Family Medical to Expand Mental Health, Substance Abuse Services

Rates for both mental health and addiction are much higher in Cayuga County compared to surrounding CNY counties, according to East Hill By Mary Beth Roach

ast Hill Family Medical in Cayuga County is expanding its mental health and substance abuse services thanks in part to a $171,000 grant it has received from the Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services. The facility is integrating its addiction medicine with its overall primary care as a means to combat

the addiction crisis that the county, like so many others throughout the country, are battling. The grants were made available to federally qualified health care facilities, like East Hill, in order to expand access to such services, according to Keith Cuttler, president and CEO. The Auburn site serves the under- and uninsured residents of the community, he noted. “We saw an opportunity to get some extra funding to grow the pro-

grams that we were already intending on growing,” Cuttler said. East Hill staff treats addiction and alcoholism as any other medical problem that a patient would come to them for, Cuttler said. “We believe it’s important for patients to work with primary care physicians on the addiction problem,” Cuttler noted, “so the primary care physician can coordinate referrals to other services in the community and make sure that when you’re treating addiction, you’re understanding what else is going on in the patient’s world, be it social, emotional, psychological or physical problems that may impact his ability or her ability to be successful in addiction treatment.” With the grant money, Cuttler explained, East Hill is hiring a licensed mental health counselor, it has retained the services of a family practice physician who is seeing patients specifically for addiction. In addition, he noted, laptop computers will be rolled out to engage the entire staff in further training to recognize mental health and substance abuse issues among their primary care population, and the licensed mental health counselor will be able to consult with other primary care providers as a means to better understand and recognize complex mental health issues. “It’s taking what we have already in primary care and giving a little extra behind it — extra resources, extra training,” Cuttler added. The more comprehensive approach to a patient’s care will also allow the facility to better determine the effectiveness of its programs, Cuttler said. To receive addiction services from East Hill, patients must also have it as their primary care provider. “One of the measures is to see how many people move their care to East Hill to utilize the primary care physician who has a specialization in treating addiction,” he said. East Hill’s physician Adam Duckett has a personal interest in addiction medicine, Cuttler said. He is also the Cayuga County coroner, and he has seen first hand the problem in the community. While opioid addiction and

alcoholism are issues that every community faces, Cuttler said that East Hill’s grant application noted the rates for both mental health and addiction were much higher in Cayuga County statistically than they were even in surrounding counties within Central New York. “We’ve spoken with the sheriff’s office, with the district attorney, with local agencies and not-for-profits that have developed in order to address in particular the opioid problem – one of them the Heroin Epidemic Action League, and no one’s really been able to say exactly the catalyst for the higher rate of mental health and substance abuse problems in Cayuga County,” he said. Some statistics for Cayuga County show a decrease in certain instances, according to the New York State Health Department. For example, there were 17 opioid overdoses in 2015 compared to 10 in 2016; and hospitalizations for all opioid overdoses in 2015 numbered 17 compared to 14 in 2016. However, outpatient emergency department visits for all opioid overdoes in 2015 were 42 and jumped to 77 in 2016. But numbers perhaps don’t show the whole picture. “The rates were actually higher in 2014 to 2015 and then we saw a drop,” Cuttler said. “In talking with the sheriffs and the TLC Ambulance, what they uncovered was the increased access to Narcan was actually preventing deaths. What they were concerned with is that people would construe a drop in the overdose death rate as the community is solving the drug problem, and it’s not anywhere close to that. Probably the issue is that people are getting saved by Narcan, but it doesn’t indicate that the utilization of opioids or the addiction to them has actually declined.” Narcan is a brand of naloxone that is used to block the effects of opioids. East Hill has also expanded its office hours, with some of its facilities open until 8 p.m. on various weekday evenings, making it easier for patients to access medical services.

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s Greek yogurt better for you than regular yogurt? Based on all the press it’s received lately, along with its takeover of the dairy aisle, you might automatically think “yes.” I know I did. While indeed Greek yogurt has certain benefits that surpass those of regular yogurt, its nutritional profile is not necessarily better. It all depends on your dietary needs. Since one of my dietary needs is protein, Greek yogurt is better for me. On average, Greek yogurt contains nearly twice as much protein as regular yogurt. One cup of FAGE nonfat Greek yogurt, in fact, provides a whopping 22 grams. Why is the 60-plus me (who is no longer in a growth spurt or running three miles a day) concerned about getting enough protein? According to research, boosting your protein intake or at least getting an adequate supply helps combat the natural loss of muscle mass and strength that occurs with aging. Greek yogurt, however, is not necessarily better than regular yogurt for my friend who suffers from osteoporosis and seeks calcium. The

cially helpful for those who have lactose intolerance. And fewer carbs and sugar hold huge appeal for those looking to lose or maintain weight. Both Greek and regular yogurts boast the Holy Grail of stomach health: probiotics, aka the “good” bacteria that promote a healthy gut and boost immune health. Eating yogurt with probiotics helps improve digestion and potentially ease conditions like constipation, inflammatory bowel disease and diarrhea. Doctors often suggest eating yogurt while taking antibiotics (which can

Avocado Hummus with Yogurt Adapted from FAGE recipes

straining process that creates Greek yogurt — and gives it its thicker, richer texture — unfortunately removes some calcium. On average, regular yogurt provides 30 percent to 40 percent of the daily recommendation, compared to Greek’s 20 percent to 25 percent. Concerned about carbs and sugar? Lactose? If so, Greek yogurt might be the better choice for you, since the straining process to remove whey reduces all three. Less lactose, the sugar in dairy products that can sometimes upset stomachs, is espe-

2 garlic cloves ½ jalapeno (optional), seeded 2-3 tablespoons fresh cilantro (or 2 teaspoons dried) 15.5 oz. can chickpeas, drained and rinsed 2 avocados, peeled and cubed ½ cup plain, low-fat yogurt: Greek or regular 2 limes, juiced Salt and coarse ground pepper, to taste ½ teaspoon cumin 3 tablespoons extra virgin olive oil

cause “bad” bacteria to flourish) to help reduce the side affects of this treatment. Both yogurts are rich in vitamin B-12, an essential nutrient for nerve and brain function and for forming red bloods cells and DNA. This all-important vitamin also helps prevent a type of anemia that makes people tired and weak. One cup of plain, nonfat yogurt provides about half of our daily needs. What’s more, the B-12 in dairy products, such as yogurt, tends to be more readily absorbed by the body.

Helpful Tips Read yogurt nutrition labels carefully (some have more sugar than you may expect) and look for the words “contains active cultures” to assure the brand you choose has probiotics in it. Use caution when cooking with yogurt, since prolonged high temperatures can kill the beneficial bacteria. Fruit-flavored yogurts tend to be higher in sugar, so opt for plain yogurt and add your own fruit

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Place garlic, jalapeno and cilantro in food processor; pulse to mince. Add chickpeas and pulse for about 2 minutes. Add remaining ingredients and blend until smooth. Serve with toast, tortilla or pita chips, or cut-up veggies.

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Page 17

New Technology to Help A Stroke Patients Study, using brain imaging technology now in use at Upstate, shows doctors have more time for clot removal procedure than first thought

nationwide clinical study, using a brain imaging technology in use at Upstate University Hospital, has shown that doctors now have more time than first thought to perform a life-saving clot removal procedure on stroke victims. Previously, the window for performing a thrombectomy was about six hours, but results of the DEFUSE-3 study further supports evidence showing a positive effect

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for late presenting patients, with the procedure performed up to 16 hours after stroke onset. This is the second study showing benefit of treatment in late presenting patients. Earlier this year, the DAWN trial reported similar positive results in the six-to 24-hour treatment window after stroke onset. The American Stroke Association has recently updated guidelines to extend the time window based on the overwhelming evidence for treatment in this group of patients. Both studies used a special imaging technology — which Upstate acquired last year in anticipation of joining the DEFUSE-3 study — that allows doctors to examine the brain and identify patients with viable brain tissue that still might be saved despite delayed presentation. The imaging technology, called RAPID was developed at Stanford University by the principal investigator of DEFUSE-3, and takes only minutes to process brain scans compared to older systems. “We’ve gone from one end of the spectrum to the other, in terms of stroke care,” said Upstate Vascular and Interventional Neurologist Hesham Masoud. “We now have this opportunity to identify more patients who can benefit from a thrombectomy. Previously it was thought that these late presenting patients did not have options. One in three patients now have the chance to go home with little or no disability; that’s a pretty incredible effect.” Masoud said the study results should be especially encouraging for remote hospitals. “I think the broader implication for this trial is for those centers or hospitals that will not transfer patients to our hospitals for thrombectomy, because they think, ‘Oh well, this happened six or seven, eight hours ago, so that’s beyond the window, so I won’t do this life-saving transfer,” he said. Masoud said this study and Upstate’s use of this technology underscores the urgency for outlying hospitals to transfer patients to Upstate because the window for clot-removal treatment has now widened.

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Number of Men in Nursing Schools Steadily Growing A profession once dominated by females is gradually getting more diverse, despite a lingering gender bias among patients and health care administrators By Deborah Jeanne Sergeant

icture a nurse. Did an image of a kindly-faced woman in white or scrubs come to mind? Decades-long female dominance in nursing has contributed to the gender stereotype of women nurses. While women still outnumber men in nursing, more men have joined the ranks at schools such as LeMoyne College. From 2006 to 2009, the percent of men in the nursing program at Le Moyne hovered around 4.5 percent. Between 2010 and 2013, it surged to 13.25 percent and it’s currently at 9 percent. That reflects the nationwide percent of men employed in nursing, 10.1 percent, according to the Bureau of Labor Statistics. David Goede, regional director for the Nurse Practitioner Association of New York State, remembered that back in 1985 when he earned his associate degree in nursing, men represented only 2 percent of nurses. “I had often encountered the question as why I chose nursing as a career,” he said. “As I contemplated

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this question, the next question that was usually asked is, ‘Are you working on becoming a doctor?’ I have always had difficulty trying to understand the basis of these questions. Do we ever ask female physicians why they chose to be a physician and not a nurse? To me, these comments exemplify bias of career choices based on gender.” Goede also serves as acute care nurse practitioner, cardiac surgical service, at Strong Memorial Hospital in Rochester and assistant professor of clinical nursing at University of Rochester School of Nursing. He said that men in nursing is not new. Males cared for individuals’ health care needs throughout history. During the 1300s, most care provided by non-family members were provided by male monks through monasteries. And during the Crimean War, men worked within the hospital setting alongside women providing direct care until they were called into battle. Goede believes that the origins of female dominance in nursing stems

from how nurses initially received their education. Once formal education became standard for nurses, they were trained at schools with dormitories. Since men weren’t allowed to stay in the dormitories, they faced difficulties in entering nursing school. “It wasn’t until the education of nurses moved from strictly controlled dormitory style education into an academic setting that allowed male students to attend,” Goede said. Kathy Gray-Siracusa heads the nursing department at LeMoyne. She views the growth of men in nursing as a positive trend. “We want to encourage more men to get into nursing,” she said. “It’s becoming more and more accepted as a profession for men. It was harder in previous years. As we become a more accepting society, the gender role is changing.” Some patients prefer a male nurse, but Gray-Siracusa said “some have the old stereotype that male nurses are homosexual,” she said. Like women, men also have

opportunities to seek further education to obtain supervisory roles, work in education or, in the case of nurse practitioners with more than 3,600 hours of clinical experience, practice without a collaborative agreement with a physician. Gray-Siracusa said that career-oriented men tend to look for opportunities to advance in their nursing careers more quickly. Specializing in a medical discipline and acquiring roles in management and education offer higher salary and more responsibility. “Getting more diversity in nursing is a good thing because the patients are diverse,” Gray-Siracusa said. “How can we understand them if we’re not diverse as a workforce?” Officials from several nursing schools in Central New York — Cayuga Community College, Crouse Hospital School of Nursing and St. Joseph’s College of Nursing, among other, did not respond to requests to comment for this story.

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Page 19

Men’sHealth

I’ve survived

Testicular Cancer

Survivor urges men to heed warning signs

ndrew Gibson of Buffalo was 26 years old when he was diagnosed with stage 4 testicular cancer. By the time he received his diagnosis, the cancer had metastasized to his lungs, liver and stomach. His treatment was difficult and lengthy, starting with surgery and followed by four cycles of chemo-

therapy. It concluded with another surgery lasting seven hours — but it didn’t have to be that way. Gibson said he ignored signs that something was amiss in the year leading up to his diagnosis and now he has a message for other young men. “Do not be afraid to say some-

thing, no matter what,” said Gibson. “Don’t be afraid to come forward about something even though it may be a little personal. Go get checked immediately and don’t be embarrassed.” Nearly a year prior to his diagnosis, Gibson noticed a small irregular bump on his testicle. He did what so many do and searched his symptom on the internet. While the possibility of cancer did come up in that search, Gibson said he immediately wrote off the notion. Five months later, that small bump had grown and resulted in major swelling. He began to experience stomachaches. Despite a gut feeling that something was terribly wrong, Gibson remained silent on the topic. “Typical guy, I was like, ‘It’ll go away,’” he said. Then one evening, while hanging out with his friends, Gibson got a stomachache and the pain exceeded what he had felt when he had previously required an appendectomy. He called his father and went to seek emergency care. After testing, including an ultrasound and a CAT scan, Gibson was sent to Roswell Park Cancer Institute in Buffalo. There, he was told that test results showed signs consistent with cancer.

Uphill battle Despite the inconclusive wording, Gibson knew that a difficult path lay ahead of him. He experienced what any person might — the feeling that he had been sucker punched — and questioned why this was happening to him. “When you hear the words, ‘You

have cancer,’ death is the first thing you think of,” he said. After meeting with the staff at Roswell Park Cancer Institute, Gibson says his attitude changed. Once a plan was in place, he said he was confident and began to feel all right, even thankful that it was his battle and not one he had to witness a family member or friend undertake. His first surgery was to remove a testicle in order to better understand what Gibson and his doctors were up against. His first three cycles of chemotherapy were not easy. Gibson lost his hair and the treatment put a halt to the classes he had planned to start on the day he was diagnosed. Three semesters passed before he was able to get back into the classroom. Nausea was not an issue in the first cycle and gradually increased in the second and third. A change in treatment to prevent damage to his lungs during the fourth cycle came around Christmas time and brought with it major side effects. “It was just hell,” he said. Non-stop vomiting sent Gibson to the emergency room but he was told there was nothing to be done but ride it out. When those treatments had concluded, surgery was performed to get one lingering tumor that was causing Gibson’s stomachache, and while the operation was taking place, doctors found a second tumor that they had been unaware of. The procedure lasted seven hours and took a month and a half to fully recover. Today, Gibson is cancer-free with a less than 1 percent chance of recurrence. (By J. H.)

Risks and Signs of Testicular Cancer By Deborah Jeanne Sergeant

stimates for testicular cancer are approximately 9,310 new cases diagnosed in 2018 and 400 deaths, according to the American Cancer Society. About one out of every 250 men will develop testicular cancer at some point during their lifetime. Unlike many cancers, it strikes mostly young and middle-aged men at an average of age 33. Only 6 percent of cases are in children and teenagers and men over age 55 comprise only 8 percent. Also uncommon is its high likelihood of successful treatment. As with most cancers, early detection and treatment improves the chances of good outcome. “The way people present is they feel Albala a lump on a testicle,” said David Albala, urologist with AMP Urology. “Guys essentially notice a mass that came up suddenly. Page 20

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Most guys feel a lump and typically come in to get it examined.” Pain in the scrotum could indicate testicular cancer, according to the urologist. About one-third of cancers are caught once metastatic, meaning they’re spreading elsewhere. A blood test and CT scan of the abdomen can indicate if the cancer has spread to other areas. Albala said those lymph nodes are “landing sites” for cancer. But despite its spreading, Albala said it’s about 90 percent curable. The reason is that testicular cancer is very sensitive to chemotherapy, even in the advanced stage; however, the severity and cost of treatment increases if the disease has advanced. Most doctors recommend removal of the diseased testicle, as European doctors have attempted testicle-sparing approaches with little success. Sparing the testicle increases the chances of the cancer spreading to the lymph nodes. “It’s usually removed through the groin,” said Joseph Jacob, urologist and assistant professor of Urology at Upstate Medical University. “The testicle and the blood supply to

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

it is removed.” Afterwards, a CT scan can help determine the stage of the cancer, which helps patients and physicians decide the next step. If further treatment is warranted, it’s usually chemotherapy and seldom radiation, since the latter can cause secondary cancers. Jacob said that testicular cancer has good “tumor markers” that can indicate through a blood test if the cancer has spread to other areas of the body. After surgery and any follow-up treatment, men visit their doctor periodically for blood tests to Jacob ensure that the cancer has not returned. Although men with one testicle can still father children, the chemotherapy may cause infertility, and it can affect the nerves that cause semen to ejaculate (although erections

still occur). Risk factors include a non-descended testicle at birth, a factor for one out of 1,000 boys. Caucasian ancestry is also a risk factor. A man with a previous testicular cancer has a higher risk in developing cancer in the remaining testicle, which is why banking sperm is a good idea for men who still hope to father children after treatment for testicular cancer. “I always talk with them about that for sure,” Jacob said. Both Albala and Jacob recommend monthly self-exams in the shower. Men should feel for any abnormalities such as hardness, increased size, bumps and lumps. Both testicles should be soft and the same size. “It’s usually in young men, but most of the time we can cure it,” Jacob said. “You have to treat it in a timely fashion and with people who know how. You should see a urologist with a cancer center that has seen this disease and take a multi-disciplinary approach.”

Men’sHealth Men & Depression Do women get more depressed than men or do men just hide their emotions better?

By Deborah Jeanne Sergeant

he lifetime prevalence of major depression is 20 to 26 percent for women and 8 to 12 for men. But those numbers may be skewed by a few factors, according to the Journal of the American Medical Association. Alice Sterling Honig, Ph.D., licensed psychologist and retired professor Syracuse University, believes that few men seek help for depression. “Usually, men do not like to disclose they have weaknesses,” Honig said. “Men are supposed to be strong emotionally. There’s a lack of communication.” Culture also plays a role, as men are conditioned to remain quiet about feelings and not express feelings in healthy ways. Instead, turning to “self medication” such as alcohol and drugs, or relieving stress through angry outbursts or irresponsible behavior, represents unhealthy ways men cope. “Underneath a lot of depression, there are feelings that ‘I have failed in my role as a masculine person,’” Honig said. “Many women aren’t brought up to feel that way. The depression gets worrisome for men. Under the depression is anxiety. They turn to drinking too much, smoking

or taking risks, just to tamp down the feelings.” When men do contact mental health providers, it’s usually because of a crisis, such as a DUI conviction, infidelity or divorce, not for mental health help early enough to perhaps head off problems. Honig said that many primary care physicians don’t screen for depression or, if they do, their male patients who are depressed either don’t recognize signs of depression or decline to discuss their experience. Logistics may hamper men from seeking mental health help. Many entry level insurance plans don’t cover long-term mental health treatment. Providers included in these plants and mental health clinics that accept a sliding scale fee typically have a two-to three-month waiting list and provide care only from 9 a.m. to 5 p.m., a time most men are working. Many men feel reluctant to take time off from work for therapy, both because they need the money and because they fear the stigma of needing mental health help. “You want to project an image of being strong and having it all together, not saying that you have problems,” said Paul Batkin, marriage and family therapist in private

practice in Syracuse. “Also, men don’t feel like they can prioritize their own mental health because they don’t even prioritize their physical health. That’s a mistake; you should seek Batkin help so you can work better and be happier in general.” Judith F. Rozsa, licensed clinical social worker and director at Clinical Counseling Associates in Syracuse, said men in certain careers, such as first responders, “have a real hard time coming in. They’re macho. They won’t have any of their buddies knowing that. The stress they’re under is considerable.” She added that often, it’s a wife or girlfriend who comes in seeking help, not their man. “Sometimes, I work with whoever comes in, whether the significant other or spouse,” Rozsa said. “We try to make a situation that’s feeling safe to the spouse.” Once the man feels safe and not

Sometimes speaking up about your problem may lead to uncovering one of these more concerning issues early. Once your doctor has made sure there is nothing more concerning, most men are treated with oral pills. Most of us have heard about these or know other men who have or routinely use them. These medications cannot be taken if you take nitrates (certain medications) for blood pressure or chest pain as they can react with each other. For best results, these medications should be taken on an empty stomach, one hour before foreplay and alcohol should be limited. Common side effects include headache, vision changes, flushing or muscle cramps. This class of medication has revolutionized the field and given many men the confidence they lost previously. There are several different oral pills with different dosing and your doctor will help you figure out which one is best for you.

For a group of men, medications won’t work or side effects will be problematic. The advanced options for erection loss include penile pumps or injection therapy. Each of these has its pros and cons that your doctor will discuss with you. Often, these options are reserved for urologists who are experts. Don’t get discouraged, many options work better for one man than another. If all others fail or a man wishes for a more permanent solution, there are surgeries to help erection loss. Penile implants come in two main types: one that is rigid all the time and one that has a pump that controls if it is soft or hard. The choice between these is very patient specific and your doctor will discuss both to help you chose which is right for you. Most studies show that over 90 percent of men who have

like he will be judged, he often feels more comfortable to begin and stay in treatment. “There’s so much relief in learning it doesn’t make you weak,” Rozsa said. “It feels a lot better when you deal with it.” She wants more men to realize they have nothing to lose by making an appointment with their primary care physician or a therapist. Websites such as that of Psychology Today (www.psychologytoday.com) or Good Therapy (www. goodthearpy.org) can help people find a therapist with whom they feel comfortable. Any person with thoughts of harming themselves or others should seek emergency care by calling 911 or going to the nearest emergency room.

Depression at a Glance • Major depressive disorder affects approximately 14.8 million American adults, or about 6.7 percent of the U.S. population age 18 and older, in a given year. (Archives of General Psychiatry, June 2005. • While major depressive disorder can develop at any age, the median age at onset is 32. (U.S. Census Bureau Population Estimates by Demographic Characteristics, 2005) • People with depression are four times as likely to develop a heart attack than those without a history of the illness. After a heart attack, they are at a significantly increased risk of death or second heart attack. (National Institute of Mental Health, 1998) From the website of Depression and Bipolar Support Alliance (www. dbsalliance.org):

How to Manage Erectile Dysfunction By Timothy Byler, MD

n the United States, many men are commonly affected by erectile dysfunction (ED). These concerns are often suppressed as men are embarrassed to talk about it or feel like it is just part of aging. In fact, a large study showed that roughly 40 percent of 40-yearold men experienced problems with erections and this number soared up to almost 70 percent at age 70. In each decade after 40, the rate of ED rose 5 to 15 percent consistently. Therefore, if you have a concern, you are certainly not alone. In most cases, there isn’t much extra testing or lab work that needs to be done if you bring up an erection concern. Your doctor will do a thorough history of your medical problems and physical examination to make sure nothing else is contributing. Patients with diabetes, spinal or back problems, high blood pressure, heart attacks, multiple sclerosis, anxiety, depression or who take certain medications often have problems with erections.

March 2018 •

a penile implant are happy with their choice. Not all men are candidates for surgery or implants and these options require careful consideration. Physician Timothy Byler is an assistant professor of urology and member of Upstate Urology at Upstate University Hospital. He received his medical degree from Rutgers University – New Jersey Medical School and completed his residency at SUNY Upstate Medical University. Contact him at 315-464-1500.

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Men’sHealth

Reasons to See a Urologist When should you see a urologist? Area urologists weigh in By Deborah Jeanne Sergeant From J.C. Trussell, urologist, associate professor of urology at Upstate University Hospital: • “Weak erections. • “Curved erection (Peyronie’s disease). • “Slow urine stream or post-void dribbling. • “Blood in the urine or ejaculate. • “Leakage of urine with coughing or standing. • “Birth control (vasectomy is safer and fails less than a tubal ligation). • “If a dad or brother has a history of prostate cancer.” From Joseph Jacob, urologist and assistant professor of urology, Upstate Medical University: • “I’m a cancer guy. Any blood in the urine should be pretty quickly referred to urology. • “Elevated PSA. • “Any kind of testicular mass.

• “Issues with urination. • “Erectile dysfunction. • “Vasectomy. • “Infertility.” From Kent Chevli, urologist, president of Western NY Urology Associates, Buffalo • “Urology is a very broad and diverse field. We take care of men, women and children and the elderly. It covers the entire gamut. • “There is a specialty of pediatric urology. For adolescent or older, generally, urology manages them. • The conditions involve the bladder, kidney, prostate, including many forms of cancer. Urologists diagnose 25 percent of all cancers, more than any other field. Prostate, bladder and kidney cancers are all diagnosed by urologists and they’re in the top 10 of all cancers for prevalence. No other field covers three of the top ten. Urologists are almost always cancer doctors as part of our

Pain Meds May Affect Sperm Count Study says Tylenol, Motrin, Advil and other pain relievers may cause a reduction in sperm count By Deborah Jeanne Sergeant

ant to be a dad? Consider cutting back on certain drugs. A recently released study in the journal Proceedings of the National Academy of Sciences indicates that over-the-counter pain relievers aspirin, acetaminophen (branded as Tylenol) and ibuprofen, (branded as Motrin and Advil), may hamper fertility. French and Danish researchers found that the ubiquitous painkillers disrupted participants’ testosterone levels, affecting their ability to produce normal levels of sperm. Low sperm count, also known as oligospermia, represents a common reason for male infertility. Male fertility matters. Male issues account for about one-third of infertility cases, women’s issues cause another third and the remaining third have unknown or a combination of causes. J.C. Trussell, urologist and specialist in male infertility and erectile dysfunction at Upstate Urology, Page 22

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found the study interesting, but “not easily explainable.” “On one hand, using Motrin, in the literature, has been shown to improve sperm motility,” Trussell said. “But this paper shows it reduces testosterone production. It’s amazing stuff. It might be important, as a lot of people use anti-inflammatory drugs. If I were to talk with someone, I’d have them take Motrin only if necessary, but for the shortest time interval.” Since painkillers disrupt hormone levels, it’s worth abstaining from them to increase the chances of fertility. It may not be as simple as blaming over-the-counter pain medication. The reason for taking the medication — inflammation caused by a painful injury — may also hold some blame. “Inflammation will damage the testes, along with every organ of the body,” said physician Rob Kiltz, who is a diplomate of the American Board of Obstetrics and Gynecology and is

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

training. • “We also take care of kidney stones, troubles urinating for men and women, including bladder control problems or inability to urinate.

• “We take care of fertility problems in men. • “We want to see men about their kidney pain or flank pain.”

Urology: Not Just for Men

of internal medicine, pediatrics, gynecology and other parts of health care. This is because a urologist encounters a wide range of clinical problems. The scope of urology is big and the American Urological Association has named seven subspecialty parts: • Pediatric urology (children’s urology) • Urologic oncology (urologic cancers) • Renal (kidney) transplant • Male infertility • Calculi (urinary tract stones) • Female urology • Neurourology (nervous system control of genitourinary organs)”

According to Urology Care Foundation: “Urology is a part of health care that deals with diseases of the male and female urinary tract (kidneys, ureters, bladder and urethra). It also deals with the male organs that are able to make babies (penis, testes, scrotum, prostate, etc.). Since health problems in these body parts can happen to everyone, urologic health is important. “Urology is known as a surgical specialty. Besides surgery, a urologist is a doctor with wisdom

board-certified in reproductive endocrinology and infertility. He founded and operates CNY Fertility based in Syracuse. He said that diet can contribute to inflammation, starting in the gut. He recommends the ketogenic diet, which eliminates sources of carbohydrates and processed foods. “The standard American diet is high in carbohydrates,” he said. “A lack of natural fats contributes to inflammation and high carbohydrates contribute to inflammation, too.” Trussell Men can improve their sperm count through many other means, too. Kiltz advises men to stop smoking cigarettes, drinking excessive alcohol and using marijuana or other illicit drugs. Some prescription medication may interfere with sperm count, so men should consult with their care providers. Kiltz added that chemical exposure, such as herbicides used in agriculture, may affect sperm count as well. Men should also seek treatment for any sexually transmitted diseases, manage stress, lose weight, and control blood pressure and any other illnesses such as diabetes. “I recommend slowing down and reducing the excess exercise,” Kiltz said. “Yoga, massage, meditation, hypnosis and prayer are necessary to heal our bodies. But the fight or flight exercise activity causes increase in cortisol, friction and heat and stress in our bodies that hurt every cell of our body.”

Trussell said that couples seek help after trying to conceive for a year or longer. Few men appear motivated to check into their fertility. “When success is difficult to come by, the female is usually more motivated to see if she has reproductive problems,” Trussell said. “The male usually gets a semen analysis and that’s generally what prompts the referral to me. Less than 5 percent of the time, a guy shows up on his own to say, ‘Hey I’m having trouble with fertility.’” While no intervention directly increases sperm, avoiding things that decrease sperm can certainly help, along with effectively treating low testosterone. Lacking testosterone can cause a lack of sperm during ejaculation. Simply replacing testosterone may not be helpful. Trussell said that many men on testosterone replacement experience low sperm count and about 30 percent don’t recover adequate sperm production. “Twenty-five percent of urologists would actually treat guys with testosterone if they’re infertile,” Trussell said. “It makes their sperm count even worse.” Instead, Trussell treats with Clomid (clomiphene), which he said stimulates the brain into giving more hormone to the testes. Varicose veins in the groin between the scrotum can bring excess heat near the testicles. Surgically correcting the veins often reduces heat. Trussell said that 70 percent of men having the procedure see sperm count improve.

Men’sHealth

‘I Survived Prostate Cancer’ A survivor’s story By Deborah Jeanne Sergeant

ark Richardson of Pittsford is a veteran, RIT grad and Kodak retiree. He’s also a prostate cancer survivor. The month he retired, August 2015, he received the diagnosis of prostate cancer after a biopsy. The pathology of the prostate indicated that he had stage three cancer, with stage four being the worst. He and his wife Peggy talked over their options. “I have a very supportive wife that stood by my side and helped me make important decisions about my treatment,” Richardson said. His wife had already been researching prostate cancer, as she had suspected something was wrong. Within an hour of diagnosis, while still at the office, the couple decided to go with prostatectomy — surgical removal of the prostate. With slower growing prostate cancer, some men can take a waitand-see approach with periodic testing of the prostate specific antigen (PSA) in the blood to keep tabs on whether or not the cancer was growing and spreading. “Most urologists just give risks and benefits of treatments and they said, ‘Here’s a book, take it home and read it, and come back in two weeks,’” Richardson recalled. “We looked at each other and we didn’t have to think about treatments. We made the decision for surgery for removal.” During the laparoscopy surgery

six weeks later, Richardson experienced less bleeding than typical prostatectomy, but he did run into a small snag. He had volunteered to join a study looking at the outcomes of prostatectomy patients who don’t receive antibiotics. Richardson ended up with a urinary tract infection (UTI) and fever that he said caused him to spend a night in the hospital. “Except for the UTI, surgery went very, very well,” Richardson said. During the surgery, the doctor looked for cancer cells in the margin of the prostate. If it’s a negative margin, the cancer is contained within the prostate. If it’s not, the doctors assumes that cancer cells lurk nearby. Richardson had a positive margin in the fatty tissue outside the prostate. As a follow-up to surgery, he received external beam radiation therapy to further eradicate any existing prostate cancer cells. He could have chosen to wait and see if the PSA rose; however, he felt that radiation would eliminate the chances that the cells would grow. He had to wait a little while, however. As a side effect of surgery, Richardson experienced urinary incontinence which he had to resolve before radiation could start. He hadn’t fully realized urinary incontinence was one of the post-surgical side effects. If he didn’t wait, the radiation could damage his bladder and urethra and likely cause that level of incontinence to persist for the

rest of his life. “Having incontinence was a major shock,” he said. “The book said some men have two to three days and then there’s no dripping. I went three months. But I’m glad it was only three months. Some might need a pad for a few weeks; some go a few years.” He confessed that during the six weeks between diagnosis and surgery, he didn’t perform the recommended Kegel exercises to strengthen the pelvic floor, which can help reduce incontinence. “I was exercising every day and felt my pelvic floor muscles were fairly exercised,” Richardson said. “That was a shock, even though the doctor said, ‘You’ll probably have some urinary incontinence. I shut down after hearing ‘cancer.’” At first, he used six pads daily, which gradually decreased over the next three months until he needed none at all. He underwent radiation for seven straight weeks, five days a week, which he said is standard. Each session lasted about 15 minutes. “After that, I went home,” Richardson said. “The side effects of radiation include fatigue, which affected me, and others include rashes, red spots on the skin, urinary incontinence, bowel issues and stomach issues. Luckily for me, it was only fatigue. I took a one- to three- hour nap each day. It took about a year for the fatigue to go away.”

Mark Richardson of Pittsford Every six months, he visits a specialist: an oncologist alternating with a urologist, to monitor for any recurrence. So far, he remains in remission. “The past two-and-a-half years have been a real challenge for me, but I have a very positive attitude,” Richardson said. He advises other men with a prostate cancer diagnosis — and their spouses and caregivers — to join a support group for prostate cancer, such as Us TOO or Gilda’s Club. At the meetings, patients and families can learn about their treatment options and what to expect. “I’m very, very satisfied with my treatment,” Richardson said. “I wish I’d never had it, but one out of six men my age are diagnosed and I happened to be one of those men. I had surgery and I’m glad I did. “Between diet, exercise and support from my wife, Peggy, those things helped me maintain a positive attitude.” Richardson leads a local chapter of Us TOO. For more information on the local chapter, email ustoorochesterny@ gmail.com or visit www.facebook. com/ustoorochester or www.sites. google.com/site/ustoorochesterny. The national site is at www.ustoo. org.

Walking the Dog, All the Way to Better Health

our dog may be more than your furry companion — new research suggests it may also be an effective personal trainer. The study found that dog walking gives a significant boost to older adults’ exercise levels year-round. Researchers looked at more than 3,000 older adults in England. Dog owners who walked their pooch got an average of 30 minutes more physical activity a day than other participants. The dog walking-linked boost in activity was especially noticeable in the winter when days are shorter, colder and wetter, the study authors said. “We found that dog walkers were much more physically active and spent less time sitting overall.

We expected this, but when we looked at how the amount of physical activity participants undertook each day varied by weather conditions, we were really surprised at the size of the differences between those who walked dogs and the rest of the study participants,” said study lead author Yu-Tzu Wu, of the University of Cambridge. And, project leader Andy Jones said, “We were amazed to find that dog walkers were on average more physically active and spent less time sitting on the coldest, wettest and darkest days than non-dog owners were on long, sunny and warm summer days.” He is a professor at Norwich School of Medicine, at the University of East Anglia. “The size of the difference we

observed between these groups was much larger than we typically find for interventions, such as group physical activity sessions that are often used to help people remain active,” Jones added in a university news release. The researchers noted that owning a dog is not a good idea for all older adults due to the demands of looking after a pet, but said their findings suggest new ideas to increase physical activity. “Physical activity interventions March 2018 •

typically try and support people to be active by focusing on the benefits to themselves, but dog walking is also driven by the needs of the animal. Being driven by something other than our own needs might be a really potent motivator and we need to find ways of tapping into it when designing exercise interventions in the future,” Jones said. The findings were recently published in the Journal of Epidemiology and Community Health.

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Crouse Recognized for Higher About 60 Summer Paid Internship Quality in Bariatric Surgery Positions Available at

xcellus BlueCross BlueShield has recognized Crouse Health with its Blue Distinction Center+ for Bariatric Surgery designation as part of the Blue Distinction Specialty Care program. Blue Distinction Centers are nationally designated healthcare facilities that show expertise in delivering improved patient safety and better health outcomes, based on objective measures that were developed with input from the medical community. Crouse’s bariatric (weight loss) surgery program is the only one in Syracuse to earn the Blue Distinction Center+ designation. To receive the Blue Distinction Center+ for Bariatric Surgery designation, a healthcare facility must demonstrate success in meeting patient safety measures as well as bariatric-specific quality measures, including complication and readmission rate for laparoscopic procedures in sleeve gastrectomy, gastric bypass and adjustable gastric band. A healthcare facility must also be nationally accredited with MBSAQIP (Metabolic and Bariatric Accredidation and Quality Improvement Program) at both the facility and bariatric program-specific levels, as well as demonstrate cost efficiency compared to its peers. Quality is key: only those health

care facilities that first meet Blue Distinction’s nationally established, objective quality measures will be considered for designation as a Blue Distinction Center+. In 2017, the Blue Distinction Centers for Bariatric Surgery program expanded to include not only the type of service provided, but also the site of care. Healthcare facilities were evaluated as either a comprehensive center or as an ambulatory surgery center. “We’re pleased to be recognized by Excellus BlueCross BlueShield for meeting the rigorous selection criteria for bariatric surgery set by the Blue Distinction Centers for Specialty Care program,” said physician Seth Kronenberg, Crouse chief operating officer/chief medical officer. “We are especially proud of our patient-centered team approach, led by surgeons Jeff DeSimone and Ken Cooper, which not only includes pre-operative support and education, but long-lasting support after the procedure to ensure successful outcomes over time. That’s what makes the Crouse weight loss surgery program unique,” adds Kronenberg. For more information about Crouse’s weight loss surgery program visit: crouse.org/weightloss

pathways to independence pathways to pathways to independence independence

Excellus BCBS

Excellus BlueCross BlueShield has about 60 summer internship positions available for college students at its locations in Upstate New York. Summer internship positions include jobs in information technology, marketing, customer operations, finance, human resources, corporate communications and more. Internships are available at health plan locations in Syracuse, Buffalo, Rochester and Utica. “Our goal is to attract students from a wide range of cultures, backgrounds and life experiences to represent all forms of diversity within our community,” said Joseph Searles, corporate director, diversity and workforce inclusion. “It’s important to us, because it is a way to usher in the innovation needed to best serve our customers.” The 10-week paid internships will run from June 2018 through August 2018. To qualify for an internship, students must be actively enrolled in an undergraduate or graduate degree program at the time of the internship. Goals of the Excellus BlueCross BlueShield diversity and inclusion summer college internship program

include: • Providing professional career development opportunities for students, helping them gain hands-on work experience and jump-starting their careers. • Helping the company attract and retain the best talent. Students will be offered development workshops, networking opportunities and meaningful work experiences to help them become qualified applicants for future job openings at Excellus BlueCross BlueShield and other top employers. “Our summer interns are exposed to an array of career fields and development opportunities that we believe enhance their overall employability once they enter the job market. We are proud to say that nearly all of our interns from last year said that they would recommend our program to their peers,” said Searles. Students are encouraged to apply for these competitive internships as soon as possible. Positions will close as candidates are selected for the internships. To apply for the internships, go to excellusbcbs. com/careers.

Mental Health

Treating Co-Occurring Disorders Together By Kimberly Langbart

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t is not uncommon for individuals struggling with a substance use disorder to also have a mental health disorder. Many people turn to drugs or alcohol as a way of coping with mental illnesses such as depression or anxiety. According to the National Alliance on Mental Illness, “About a third of all people experiencing mental illness … also experience substance abuse.” And, “about a third of all alcohol abusers and more than half of all drug abusers report experiencing a mental illness.” A dual diagnosis, or co-occurring disorders, is the co-existence of a mental illness and a substance use disorder. Drugs and alcohol addiction is not just about physical dependence on a substance, but also the changes that occur in the brain. At Liberty Resources Integrated Health Care, clients in dual diagnosis treatment program receive individualized care and evidence-based strategies geared specifically to their needs, as well as their strengths and those of their families. Drug treatment centers and mental health clinics have been historically separated, making co-occurring disorders difficult to treat on a practical level. When one condition is treated

but not the other, it can increase risk of relapse. Mental health plays an important role in relapse prevention and living a higher quality life. Through dual diagnosis treatment, clients build an understanding of how substance use, mental health disorders, and physical health are intertwined.

Liberty Resources Integrated

Health Care is dedicated to the health and well-being of the “whole person”: providing behavioral health, substance use treatment, and primary care. Treating these co-occurring conditions in adolescents and adults simultaneously is essential for effective recovery. Kimberly Langbart, a licensed clinical social worker who holds a Master of Public Administration degree, is the vice president at Liberty Resources Integrated Health Care in Syracuse.

Medicare Made Simple, LLC

Adolescent Vaccination Rates in Syracuse Among Highest in the Nation

dolescent vaccination rates in Syracuse are among the highest in the state and nation, according to a new study of medical claims by the BlueCross BlueShield Association. The study examined U.S. claims for 1.3 million children, born in 2000-2003 and commercially insured by Blue Cross Blue Shield plans. The focus of the study was on three vaccines that the Centers for Disease Control and Prevention recommend for adolescents by their 13th birthday: Tetanus, diphtheria and pertussis (Tdap) vaccination rates In Syracuse, 93.1 percent of all adolescents receive the Tdap vaccine, compared to 87.8 percent statewide and 81.7 percent nationwide. Meningococcal vaccination rates In Syracuse, 83.9 percent of all adolescents receive the meningococcal vaccine, compared to 73.9 percent statewide and 72.1 percent nationwide. Human papilloma virus (HPV) vaccination rates In Syracuse, 43.4 percent of all adolescents receive the first of three doses of the HPV vaccine, compared to 27 percent statewide and 28.7 percent nationwide. The recommended three doses are administered to 14.8 percent of adolescents in Syracuse, compared to 5.7 percent statewide and 7.3 percent nationwide. “Physicians in Central New York are doing a great job when it comes to administering vaccines to adolescents,” said physician Nicholas Massa, medical director of Excellus BlueCross BlueShield’s Central New York region. Syracuse also has a childhood

vaccination rate (84.4 percent) that is in the top 20 among all metropolitan statistical areas examined by the BlueCross BlueShield Association. Despite having an HPV vaccination rate that is significantly higher than the state and national rates, Massa says there is a need for continued education regarding the HPV vaccine. “The medical literature clearly shows that the HPV vaccine can reduce the risk of infections that cause several types of cancer in women and men,” said Massa. “Most side effects of the vaccine are mild, and are far outweighed by the benefit of preventing cancer.” According to the CDC, HPV infections are so common that nearly all men and women will get at least one type of HPV at some point in their lives. Sometimes, HPV infections can cause certain cancers and other diseases. Every year in the United States, HPV causes 30,700 cancers in men and women. Central New York has among the lowest uninsured rates in modern times, which may also explain why Syracuse has among the best records on vaccinations in the state and nation. According to the U.S. Census Bureau’s American Community Survey, the 2016 uninsured rate in Central New York was 3.96 percent, which is half the national rate of 8.6 percent. For more information on this study from the Blue Cross Blue Shield Association’s “The Health of America Report” series, visit “Adolescent Vaccination Trends in America.”

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Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

Dialing Back the Decibels Finding some alternatives to yelling

M M

y children are two the y children areoftwo most precious and beautiful of the most things in my life. precious They fill me with a love, andthings hope andcomfort beautiful that I didn’t know was possible in myhaving life. kids. The smell of their before fillme mefeel with a love, comfort hairThey makes warm inside. and hope that I didn’t know was posTheir smiles and laughter can turn sible before having kids. The smell my worst of days around. They areof their feel warm inside. truly,hair to bemakes cliché,me a priceless gift. Their smiles and laughter can turn They are also the source of some my worst ofembarrassing days around. frustration, They are of my most truly, to be cliched, a priceless gift. anger, temper flares ups and, occaThey are also the source of some sionally, unbridled rage. of my most embarassing frustration, Kids know how to push their anger, temper flare-ups parents’ buttons. Beforeand, theyoccacan sionally, unbridled rage. walk, they are honing their craft. By Kids they know how to push theirsenthe time can form coherent parents’ buttons. Before they can it. I tences, they have often perfected walk, they are honing their craft. By am amazed by how frustrated I can the time they can form coherent senget with my children when they betences, they have often perfected it. I have like little monsters. Sometimes, am amazed how frustrated I can when I can’tby handle that frustration get with my children when beanymore, I choose to yell at they them. haveYelling like little monsters. Sometimes, has some amazing shortwhen I can’t handle frustration term benefits. If theythat ignored my anymore, I choose to yell at them. previous 16 requests to pick up their hasand some dirtyYelling laundry putamazing it in the shortham-

per, yelling makes them seemmy to hear term benefits. If they ignored it for the first time. It to also hasupthe previous 16 requests pick their addedlaundry benefit and of them picking dirty put itoften in the hamup said laundry and putting its per, yelling makes them seemittoinhear place, a feat ultra-patient it for the firstthe time. It also has and the kind version was unable added benefitofofmyself them often pickingto accomplish. up said laundry and putting it in its However, has some place, a feat theyelling ultra-patient andnasty side effects. results themto kind versionItofoften myself was in unable yelling something back at me like, accomplish. “fine” or “no, Iyelling don’t want to.” It also However, has some nasty teaches themIt yelling at someone is side effects. often results in them a way to get something you yelling something back at mewant. like, It teaches them that when “fine” or “no, I don’t want you to.” get It also desperate, you should youris teaches them yelling atsolve someone with anger and bywant. instilling aproblems way to get something you fear. It teaches a deluge life It teaches themthem that when youofget lessons thatyou I find absolutely gross. desperate, should solve your So, yellingwith inevitably makes me feel problems anger and by instilling like aItshoddy makesofme fear. teachesparent. them a It deluge life half thethat mom I want to be at twice lessons I find absolutely gross. the yelling volumeinevitably I want to be at. me feel So, makes since becoming a mom,me I like So, a shoddy parent. It makes havethe consulted my good the half mom I want to befriend, at twice internet, to find some alternatives the volume. to yelling. I’ve accumulated some So, since becoming a mom, I non-yelling ammunition during the my have consulted my good friend, six and ato half years ofalternatives parenting. internet, find some

Next time I’ve you accumulated want to roar at your to yelling. some children with the force ofduring a thousand non-yelling ammunition my “stop with of your brothers,” six andarguing a half years parenting. try these tactics instead. Next timehandy you want to roar at your • Calm yourself down, todchildren with the force of a thousand dler-style “stop arguing with your brothers,” I have purchased number of try these handy tacticsainstead. books for my kidsdown, that instruct them • Calm yourself toddler-style to slow down, count and breathe I have purchased a number of deep when they angry. Many books for my kidsare that instruct them of slow themdown, have catchy refrains. to count little and breathe When Iwhen feel like I want to yell, I often deeply they are angry. Many stop, take several deep breaths and of them have catchy little refrains. re-center. It like really works When I feel I want toastoundingyell, I often ly well, especially for usbreaths grownups stop, take several deep and who needIthelp handling emotions. re-center. really works astounding• Practice some ly well, especially forempathy us grownups someone yellsemotions. at me, I whoWhen need help handling become angry, hurt or despondent. • Practice some empathy Chances my kids feelatthe same Whenare, someone yells me, I way. If Iangry, want them to despondent. listen, I need become hurt or to speak are, softly firmly. Chances myand kids feel the same sure they in way.•IfMake I want them to heard listen, you I need thespeak first place to softly and firmly. Kids are upfirst in • Make surevery theymuch heard caught you in the their own, beautiful little worlds. I place haveKids to remind myself my up chilare very muchthat caught in dren own, may not be actively screening their beautiful little worlds. I me out. If I havemyself something to say have to remind that my chil-to them,may I shouldn’t say it from the othdren not be actively screening er room wonder why they aren’t me out. Ifand I have something to say to payingI shouldn’t attention to me. I should say them, say it from the oththeir names, make eye contact er room and wonder why they and aren’t communicate clearly with them.say paying attention to me. I should Remind yourself how hard their•names, make eye contact andnot yelling is communicate clearly with them. Managing emotions is incredibly • Remind yourself how hard not hard atisany age. However, when I yelling feel Managing myself getting worked up, I try emotions is incredibly to imagine morewhen worked hard at any how age. much However, I up Imyself wouldgetting be if I had a brain feel worked up,ofI try theimagine 3-year-old. I can’t tackle the to howIfmuch more worked problem at be hand, howthe canbrain I expect up I would if I had of a 3-year-old to If conquer it? I need the 3-year-old. I can’t tackle the to have reasonable of my problem at hand,expectations how can I expect That makeit?me wanttoto achildren. 3-year-old to will conquer I need yell less. have reasonable expectations of my • Don’t play their children. That willinto make mechildish want to

games yell less. kids dochildish bad things •Sometimes, Don’t play into their games to get attention,kids evendo if that attention Sometimes, bad things is get yelling. I voweven to not best to attention, if let thatthem attention me mentally. I will staylet strong is yelling. I vow to not them and best withhold theIattention crave me mentally. will stay they strong and until theirthe bad behavior stops. withhold attention they crave Tap bad out of the ringstops. until•their behavior •My Taphusband out of the and ring I have a great agreement that ifand we see theaother My husband I have great losing his or herif cool thatthe weother can agreement that we see tap them andcool send in we the can other losing his out or her that person settle dispute. tap themtoout andthe send in theThis other requirestothe willthe power to disengage, person settle dispute. This but it works wonders requires the will powerfor to everyone disengage, involved. but it works wonders for everyone • Remind yourself of your involved. child’s motives • Remind yourself of your child’s When my kids are doing somemotives thing to make me angry, I trysometo When my kids are doing remind they aren’t attacking thing to myself make me angry, I try to me. Their refusal to aren’t brush attacking their teeth remind myself they isn’tTheir spiteful, theytojust don’t want to me. refusal brush their teeth brush their teeth. isn’t spiteful, they Depersonalizing just don’t want to their behavior canDepersonalizing really put things brush their teeth. in perspective. their behavior can really put things • Raise your arms instead of in perspective. your• Raise voiceyour arms instead of your voiceWhen I really want to tear into my When kids, I Isometimes give really wanttry toto tear into them a hug instead. Then, redirect my kids, I sometimes try toIgive myself to my discipline comes from them a hug instead. Then, I redirect love instead frustration. Starting myself to myof discipline comes from off my lectures with a hug Starting makes my love instead of frustration. lectures a lot more off my lectures witheffective. a hug makes my • Accept that you will yell lectures a lot more effective. (sometimes) • Accept that you will yell (sometimes)I don’t think anyone makes it through a week parenting without I don’t think of anyone makes it raising their voice. When I inevitably through a week of parenting without slip up their and yell, I stop, regroup and raising voice. When I inevitably talkup about withI stop, my kids. When slip andityell, regroup and I lose my cool, I apologize and let talk about it with my kids. When know why I was frustrated. Ithem lose my cool, I apologize and let It’s good to why remind everyone in the them know I was frustrated. family that yelling doesn’t solve It’s good to remind everyone in the problems. family that yelling doesn’t solve problems.

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March 2018 2018 IN GOOD HEALTH – CNY’s Healthcare Newspaper • March

hoacny.com hoacny.com

By Jim Miller

Three Ways to Cut Hearing Aid Costs Dear Savvy Senior, I’ve heard that hearing aids will soon be available over-the-counter and will be much cheaper than they currently are. What can you tell me about this? My husband desperately needs hearing aids but we simply can’t afford them.

Searching Spouse Dear Searching, Unfortunately, for many years the high cost of hearing aids has kept millions of Americans with hearing loss from getting hearing aids because they can’t afford them. Hearing aids — typically sold through audiologists’ offices — are expensive, usually ranging between $1,000 and $4,000 per ear, and are not typically covered by private insurance or traditional Medicare. But there’s good news on the horizon. Last summer President Trump signed the Over-the-Counter Hearing Aid Act of 2017 into law. This will allow people with mild to moderate hearing loss to buy hearing aids without consulting an audiologist, and the devices could sell for between $250 and $300 at drugstores and other retailers. The only problem is that it will be a couple more years before these OTC hearing aids are available to consumers. So in the meantime, here are some tips that can help you find some affordable options.

Check Your Insurance

While most private health insurance companies do not cover hearing aids, there are some that do. For example, Aetna members can purchase aids at a discount through certain suppliers, and United Healthcare offers hearing aids to their beneficiaries through HealthInnovations for $799 to $999 each. You should also know that some federal workers, as well as residents of Arkansas, Connecticut, New Hampshire, and Rhode Island can get their hearing aids covered by health insurance, as can eligible veterans through the Department of Veterans Affairs. Or, if your husband is a Medicare recipient, about half of all Medicare Advantage plans offer at least partial coverage or discounts on hearing exams and devices. So, be sure you check your husband’s insurance coverage to see if it offers any type of

A new law will allow people with mild to moderate hearing loss to buy hearing aids without consulting an audiologist, and the devices could sell for $250 to $300 at drugstores. Problem is, these OTC hearing aids will only be available to consumers in about two years. hearing aid benefit.

Shop Around

To help you save money, consider shopping at Costco, which offers no-cost screenings at certain locations, as well as very competitive prices. Hearing aids at Costco range between $500 and $1,500 each. You can also shop online at websites like EmbraceHearing.com and Audicus. com, which can save you up to $2,000 per pair. Then visit a local specialist to make any necessary adjustments. Another option worth a look is over-the-counter personal sound amplification products (or PSAPs). Unlike hearing aids, the Food and Drug Administration does not regulate PSAPs. And PSAP manufacturers are not allowed to call these products hearing aids or claim that they help hearing. But these devices are very effective for people with mild to moderate hearing impairment, and typically cost between $350 and $450 each. To find a wide variety of PSAPs see assistive listening sites like Harris Communications (HarrisComm.com, or call 866-476-9579).

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Page 27

The Social Ask Security Office By Deborah Banikowski District Manager, Syracuse

Your Contributions Help Millions

S Income Tax Filing Requirements for Retirees By Jim Miller

hether or not you are required to file a federal income tax return this year will depend on how much you earned last year (in 2017), and the source of that income, as well as your age and filing status. Here’s a rundown of this tax season’s (2017) IRS tax filing requirement thresholds. For most people, this is pretty straightforward. If your 2017 gross income — which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately — was below the threshold for your filing status and age, you probably won’t have to file. But if it’s over, you will. Here are the thresholds: • Single: $10,400 ($11,950 if you’re 65 or older by Jan. 1, 2018). • Married filing jointly: $20,800 ($22,050 if you or your spouse is 65 or older; or $23,300 if you’re both over 65). • Married filing separately: $4,050 at any age. • Head of household: $13,400 ($14,950 if age 65 or older). • Qualifying widow(er) with dependent child: $16,750 ($18,000 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-8293676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554), or see IRS.gov/ pub/irs-pdf/p554.pdf.

Online

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Check Here Too

There are other financial situations that can require you to file a tax return, even if your gross income falls below the IRS filing requirement. For example, if you had earnings from self-employment in 2017 of $400 or more, or if you’re receiving Social Security benefits and half your benefits plus all other income, including tax-exempt interest, exceeds $25,000 (or $32,000 if you are married filing jointly), you’ll probably need to file. To figure this out, the IRS offers an interactive tax assistant tool on their website that asks a series of questions that will help you determine if you’re required to file, or if you should file because you’re due a refund. It takes less than 15 minutes to complete. You can access this tool at IRS. gov/filing – click on the “Do I Need to File?” button. Or, you can get assistance over the phone by calling the IRS helpline at 800-829-1040. You can also get face-to-face help at a Taxpayer Assistance Center. See IRS.gov/ localcontacts or call 800-829-1040 to locate a center near you.

Check Your State

Even if you’re not required to file a federal tax return this year, don’t assume that you’re also excused from filing state income taxes. The rules for your state might be very different. In New York, if you earned more $4,000 you have to file. For more information, check www.tax.ny.gov/ pit/file/do_i_need_to_file.htm

Tax Preparation Help

If you find that you do need to file a tax return this year, you can get help through the Tax Counseling for the Elderly (or TCE) program. Sponsored by the IRS, TEC provides free tax preparation and counseling to middle and low-income taxpayers, age 60 and older. Call 800-906-9887 or visit IRS.treasury.gov/freetaxprep to locate a service near you. Also check with AARP, a participant in the TCE program that provides free tax preparation at around 5,000 sites nationwide. To locate an AARP Tax-Aide site call 888-227-7669 or visit AARP.org/findtaxhelp. You don’t have to be an AARP member to use this service.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2018

eeing taxes taken out of your paycheck can be confusing when you get your first paycheck. But understanding how important your contribution is can help. Your taxes are helping millions of Americans — wounded warriors, the chronically ill and people with disabilities — as well as protecting you and your family for life. You can take pride in knowing you’re making an important impact with each paycheck. By law, employers must withhold Social Security taxes from a worker’s paycheck. While often referred to as “Social Security taxes” on an employee’s pay statement, sometimes the deduction is labeled as “FICA” which stands for Federal Insurance Contributions Act, a reference to the original Social Security Act. In some cases, you will see “OASDI” which stands for Old Age, Survivors, and Disability Insurance. The taxes you pay now translate to a lifetime of protection — for retirement in old age or in the event of disability. And if you die, your family (or future family) may be able to receive survivors benefits based on your work as well. Because you may be a long way from retirement, you might have a tough time seeing the value of benefit payments that could be many decades in the future. But keep in mind that the Social Security taxes

Q&A Q: Now that my husband and I have a large family, we’ve hired a housekeeper that comes once a week. Do we have to withhold Social Security taxes from our housekeeper’s earnings? A: It depends on how much you’re paying the housekeeper. If you pay a housekeeper or other household worker $1,900 or more in cash wages throughout the year, you must deduct Social Security and Medicare taxes. This holds true for a cleaning person, cook, gardener, babysitter or anyone else who provides services for you. In addition, you must report these wages once a year. There are exceptions, for example, when you are hiring a company or independent contractor and paying them a fee for services instead of wages to an individual. You can learn more about household workers and tax deductions by reading our publication, “Household Workers,” at www.socialsecurity.gov/pubs. Q: Can I delay my retirement benefits and receive benefits as a spouse only? How does that work? A: It depends on your date of birth. If you were born on or before

you’re paying can provide valuable disability or survivors benefits now in the event the unexpected happens. Studies show that of today’s 20 year olds, about one in four will become disabled, and about one in eight will die before reaching retirement. If you’d like to learn a little more about Social Security and exactly what you’re building up for yourself by paying Social Security taxes, take a look at our online booklet, How You Earn Credits, at www.socialsecurity.gov/pubs/10072.html. If you have a friend who lost a parent when they were a child, they probably got Social Security survivors benefits. Social Security helps by providing income for the families of workers who die. In fact, 98 of every 100 children could get benefits if a working parent dies. And Social Security pays more benefits to children than any other federal program. You can learn more at www.ssa.gov/benefits/survivors/. Do you prefer videos to reading? Check out the webinar, “Social Security 101: What’s in it for me?” The webinar explains what you need to know about Social Security. You can find it at www.socialsecurity.gov/ multimedia/webinars/social_security_101.html as well as on YouTube at www.youtube.com/watch?v=5hkLaBiavqQ. Social Security is with you through life’s journey. You can learn more at www.socialsecurity.gov.

Jan. 1, 1954, and your spouse is receiving Social Security benefits, you can apply for retirement benefits on your spouse’s record as long as you are at your full retirement age. You then will earn delayed retirement credits up to age 70, as long as you do not collect benefits on your own work record. Later, when you do begin receiving benefits on your own record, those payments could very well be higher than they would have been otherwise. If your spouse is also full retirement age and does not receive benefits, your spouse will have to apply for benefits and request the payments be suspended. Then you can receive benefits on your spouse’s Social Security record. If you were born on or after Jan. 1, 1954, and you wish to receive benefits, you must file for all benefits for which you are eligible. The Social Security Administration will determine the benefits you are eligible for and pay you accordingly. For individuals born on or after Jan. 2, 1954, there is no longer an option to select which benefit you would like to receive, even beyond your full retirement age. Widows are an exception, as they can choose to take their deceased spouse’s benefit without filing for their own. For more information, please visit www.socialsecurity.gov.

H ealth News Crouse names clinical quality medical director

Nurse practitioner joins Nephrology Associates

Crouse Health has recently appointed physician Allison Duggan as clinical quality medical director for the health system. Duggan is an accomplished healthcare leader dedicated to clinical and operational excellence. Most recently she served as Duggan executive vice president and chief operating officer for Oswego Health, where she helped lead a number of quality initiatives leading to enhanced patient, physician and employee satisfaction. Prior to that, she was vice president of medical affairs for the hospital. In her new role at Crouse, Duggan will work collaboratively across departments in the development and oversight of medical care quality improvement initiatives, including new projects in support of the hospital’s culture and mission of providing the best in patient care. She will work closely with Tom Hartzheim, surgical quality medical director, as well as other providers, nursing and quality team members. A fellow in the American College of Surgeons, Duggan completed her medical training at Howard University Hospital in Washington, DC. She previously worked as a general and breast surgeon in Oswego.

Joanna A. Woodruff has recently joined Nephrology Associates of Syracuse PC., where she will provide care to dialysis and chronic kidney disease patients. Woodruff has more than 28 years’ experience working in various settings, including acute Woodruff care, home care case management, emergency medicine, and perioperative nursing for a level one trauma center. In her last role, she served as a health coach for a family practice of St. Joseph’s Health assisting patients and families in the management of chronic illness and promoted patient centered care. She completed her post master’s degree at Keuka College and is a board-certified adult/gerontology nurse practitioner. She holds a master’s degree in nursing/education, and certification in medical surgical.

Crouse names VP for revenue cycle management Crouse Health has named Carolyn Hastings as vice president for, revenue cycle management for the health system. Hastings joined Crouse in 1985 and served as director of health information management from 2002 to 2016. She most Hastings recently was director of coding and health information management for Palmetto Health in Columbia, S.C., where she provided strategic leadership and oversight for the 1,439-bed health system. A highly regarded team player and leader, Hastings oversees all aspects of the revenue cycle to ensure full reimbursement for the services for the community. This includes patient access, health information management, clinical documentation, billing and collections. She also oversees strategic direction of the business office, health information management and patient access functions of the organization.

Nascentia Health recognizes employees Nascentia Health, a local leader in home health care services, honored employees with five or more years of service at its Fourth Annual Employee Recognition and Holiday Celebration at the Turning Stone Resort Casino Jan. 13. Lapel pins were awarded to em-

ployees in recognition of their years of service. Pins were awarded for service in five-year increments. Employees recognized for five or more years of service were as follows: Five Years: Aimee Allen, Darlene Arney, Ryan Blehar, Debra Boltz, Mary Cavanagh, Elisabeth Gahler, Victoria Gakdut, Selma Glover, John Heinrich, Marta Hewitt, Bingyu Hirvela, Tanya Howe, Janice Jackson, Tracy Kimball, Carol Korcz, Donna Lennox, Teresa Lore, Astride Mistiva-Santos, Eric Riesterer, Jennafer Rolf, Janet Rollis, Mary Lou Rotella, Carol Russo, Daniel Vega, Barbara Wicks and Mariya Zaborskaya. Ten Years: Tracey Barkins, Maureen Bitz, Kristin Buchanan, Elizabeth Caruso, Melissa Catalano, Mary Cohen, Kathryn Cole, Patricia Fralick, Marcia Hansen, Kimberly Jackson, Celestine Lacey, Marina Okhman, Michael Platt and Veronica Wleh. Fifteen Years: Jeffrey Boyer, Marcy Lake and Vardit Smith. Twenty Years: Sharon Cwikla, Suzanne Ginestro, Sally Pohl, Patricia Seymour and Rosemary Vulcano. Twenty-Five Years: Maria Giannino and Charisse Tarnacki. Thirty-Five Years: Karen Grenga and Cynthia Parkinson. “The commitment and dedication shown by each of these employees is an inspiration to us all,” said Kate Rolf, president and chief executive officer. “They are a continuing source of confidence and pride, and they are an essential element of our continuing success.”

Nascentia Health nurse gets telehealth award Nascentia Health registered

From left are American Heart Association Executive Director Franklin Fry, American Heart Association SVP of Field Operations and Development Stephen Milliti, St. Joseph’s Health Director of Primary Care Administration Denise Dann, St. Joseph’s Health President and CEO Leslie P. Luke, and American Heart Association Community Health Director Gina Rivers.

St. Joe’s Recognized for Efforts to ReduceHeart Attacks and Strokes The American Heart Association and American Medical Association have announced the

310 physician practices and health systems nationwide being recognized for their commitment to reducing the heart attacks and strokes that result from adults with uncontrolled blood pressure and improving health outcomes associated with heart disease. St. Joseph’s Health is among this group of first-time recipients, and March 2018 •

nurse Kenneth Chrestler has been recognized as a 2017 Telehealth Honors awardee. Presented by New Jersey-based Health Recovery Solutions , a pioneer in high-risk patient monitoring and telehealth, the Telehealth Honors are the first awards in the nation to showcase outstanding stories of successful home-based patient care using telehealth technologies. Chrestler, a Minoa resident, Chrestler joined Nascentia Health in 2014 and has been a part of the system’s telehealth care monitoring program for two years. He utilizes telehealth technology as a tool to support patient and family engagement, enhance the patient experience and reduce hospital readmissions. In nominating Chrestler for the Telehealth Honors award, Associate Director of Patient Services Kathleen Salvaterra, RN, noted that he has mastered the efficient use of the Health Recovery Solutions telehealth platform and become a true steward of Nascentia Health’s telehealth care monitoring program. “Ken embraced telehealth from the very beginning,” Salvaterra stated. “He immediately recognized the technology’s potential and quickly became one of its biggest advocates. Due to his hard work and tireless dedication to his patients and the program, he has achieved a hospital readmission rate well below the national and state average of 5.56 percent.” is the only organization in Upstate New York to receive the AHA and AMA’s Target: BP Recognition Program award, according to the hospital. Launched in 2017, the Target: BP Recognition Program is an extension of the national Target: BP initiative between the AHA and AMA aimed at addressing the growing burden of high blood pressure in the U.S. “Of the 103 million Americans with high blood pressure, only about half of them have it controlled to a healthy level despite the fact that high blood pressure can often be managed effectively when patients work with their physician to create and follow a treatment plan,” said Peggy Thomas, director of medical surgical services at St. Joseph’s Health. “No single risk factor has more impact on the nation’s death rates from cardiovascular disease than blood pressure.” St. Joseph’s Health was honored during the AHA board meeting in Syracuse Feb. 6 and will also be featured in upcoming Target: BP materials. This includes appearing in print ads, on TargetBP.org, and the Target: BP Wall of Recognition that will be displayed at AMA and AHA events throughout the year.

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Crouse, Le Moyne Expand Nursing Education Partnership

he Pomeroy College of Nursing at Crouse Hospital (PCON) and Le Moyne College have announced that beginning this fall, general education courses PCON nursing students are required to take will be offered through Le Moyne College and taught by their faculty on the PCON campus. PCON Associate Dean Patty Morgan states the new partnership will enable PCON students enrolled in academic courses delivered by Le Moyne to have access to all student services at the college, including libraries, computing facilities, career services, student support and recreational facilities. Morgan also emphasizes that the new partnership coincides with the recent signing by Gov. Andrew Cuomo of legislation requiring each nurse in New York state to earn the Bachelor of Science in Nursing degree within 10 years of becoming an RN. “We are endeavoring to make it as seamless as possible for our students to complete their RN degrees and transition into a high-quality BSN program.” Completing the RN degree and passing the NCLEX-RN exam is

required before a BSN program can be pursued. PCON students who sat for the exam during 2017 had a 100 percent pass rate on the first try, according to Morgan. “We are pleased to have been selected to provide general education courses to PCON students,” says Margaret Wells, interim dean of the Purcell School of Professional Studies. “This new development is a natural progression in the educational partnership we’ve established with the Pomeroy College of Nursing. The advantage to PCON students is the close working relationship we’ve developed with the administration and faculty at Crouse, which has been instrumental in understanding and responding to the needs of their students.” While the per-credit hour charge of general education courses offered by PCON will increase slightly, the partnership with Le Moyne will enhance the overall experience and quality of the college investment. “The bottom-line financing of a PCON/LMC education is still less expensive than other local, state and national nursing programs,” according to Morgan.

Health News

Maternity Center Receives Blankets Made by Oswego High School Interact Club Oswego Health’s Maternity Center staff welcomed members of the Oswego High School Interact Club who recently delivered blankets they had made. The Interact Club is affiliated with the Oswego Sunrise and Oswego Noon Rotary clubs and focuses on community service. Making the blankets and then delivering them to Oswego Hospital has become a tradition for the club. In the photo’s front row from left are Cynthia Tascarella, Oswego Health senior accountant and Sunrise

Club secretary/treasurer; Kevin Hill, Sunrise Club president; Kim Spurling, Maternity Center director; and Amanda Carswell, unit secretary. In the back row are Kathryn Pagliaroli, Oswego Health director of quality and patient safety and Sunrise Club vice president; Matthew Bock, club adviser; Kyle Kon and Allyson Becker, registered nurses; and members of Interact Club: McKinley Thompson, Isabella Sabatini, Zachary Cary, Reagan Thompson and Joshua Thomas.

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