IGH CNY 224 August 2018 by In Good Health: CNY's Healthcare Newspaper

PRICELESS

Meet Your Doctor ConnextCare’s chief medical officer, physician Patrick Carguello, talks about the organization’s growth, new name and the services it provides to rural Oswego County

Migraine’s Cure?

Daith Piercing: Can it reduce migraine pain? Some say yes, but what do experts say?

Alzheimer’s Vs. Dementia What’s the difference between the two? INSIDE: SPECIAL ‘GOLDEN YEARS’ ISSUE

CNYHEALTH.COM

Smart Phone Addiction

AUGUST 2018 • ISSUE 224

Experts say overuse of mobile devices can be called an addiction and can be harmful. Are you a smartphone addict? See our test on page 12

BIKING IN SYRACUSE Cycle in the City promotes monthly bike rides around Syracuse. Leaving from Armory Square on Sundays, the public is invited to join the three remaining events this season. Page 27

Things you need to know about cancer & food

Children’s Hospitals

U.S. News ranks nation’s best children’s hospitals in 2018

Cherry Tomatoes Like all tomatoes, cherry tomatoes often make superfood lists. Find out why you should eat more of them

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Bike Accidents 25 U.S. kids treated in ERs every hour for bike injuries Page 7

Nationally Recognized Stroke Care. Say “Take Me to Crouse.” As one of just 10 hospitals in New York State to have earned Comprehensive Stroke Center certification, Crouse Health is proud to provide the full range of stroke care services.

Minutes Matter Comprehensive stroke centers are the best-equipped medical centers in a geographical area that can treat any kind of stroke or stroke complication. At Crouse, receiving fast stroke diagnosis and treatment starts even before patients arrive at the Emergency Room. Once on the scene, our Emergency Medical Services partners start communicating with our ER and stroke teams, providing information vital for immediate treatment. Working together, we’re consistently meeting — and exceeding — aggressive door-totreatment times that surpass the U.S. average. Crouse provides options for post-stroke rehabilitation, as well as continuing education to patients, our EMS partners and the community about the risks factors and signs of stroke.

Advanced Stroke Rescue Crouse is the only hospital in the region equipped with two hybrid operating room suites, allowing our multidisciplinary stroke team to provide the most advanced endovascular stroke rescue capabilities 24/7.

Exceeding Stroke Treatment Standards Median Time (minutes)

2016

38.5

2017 2018

YTD

Source: AHA/ASA Get With the Guidelines

If tPA is given within three hours of symptoms, the effects of stroke decrease significantly. Crouse has earned the American Heart/Stroke Association’s Target: Stroke Honor Roll Elite Plus recognition for meeting — and exceeding — AHA guidelines for giving tPA within 45 minutes.

Community Partner KNOW YOUR STROKE SIGNS

F. A. S. T.

FACE DROOPING

ARM WEAKNESS

SPEECH DIFFICULTY

TIME TO CALL 911

As a New York State-designated Primary Stroke Center since 2007, we’ve worked to raise awareness in our community about the warning signs of stroke. With our designation as a DNV Comprehensive Stroke Center and home to the region’s newest ER, Crouse Health continues to deliver superior stroke care to Central New York patients.

STROKE? CALL 911.

crouse.org/stroke

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

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

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John Karatzas 315-766-5290 (TTY: 711) 8 a.m. to 6 p.m., Monday – Friday A licensed sales agent will answer your call. KaratzasJ@aetna.com

Aetna Medicare has plans that work hard for you. Our plans offer you: • $0 monthly plan premiums • $5 copay for primary care physician and $35 copay for specialist office visits • Allowance for eyewear and dental

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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SUPPLEMENTS More Evidence They Won’t Help Your Heart

here’s another study suggesting that the vitamin and mineral supplements bought by millions of Americans do nothing to stave off heart disease. This time, the finding stems from an analysis of 18 studies conducted between 1970 and 2016. Each one looked at how vitamin and mineral supplements — which are not reviewed by the U.S. Food and Drug Administration for either safety or effectiveness — affect heart health. After tracking more than 2 million participants for an average of 12 years, the studies came up with a clear conclusion: they don’t. Still, “people tend to prefer a quick and easy solution, such as taking a pill, rather than the more effortful method to prevent cardiovascular disease,” said study author, physician Joonseok Kim. “Simply put, multivitamins and mineral supplements do not improve cardiovascular health outcomes, so [they] should not be taken for that purpose, added Kim. He’s an assistant professor of medicine at the University of Alabama at Birmingham’s division of cardiovascular disease. The Council for Responsible Nutrition, a trade association representing supplement makers, stressed that

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the products are meant as nutritional aids only, not as a means of preventing or treating illness. “CRN stresses that multivitamins fill nutrient gaps in our less-than-perfect diets and support a host of other physiological functions,” senior vice president Duffy MacKay said in a statement. “They are not intended to serve as magic bullets for the prevention of serious diseases.” In the study, Kim and his colleagues reported that after accounting for both smoking histories and physical activity habits, they saw no evidence that taking a multivitamin or mineral supplement lowers the risk for dying from heart disease, experiencing a stroke, or dying from a stroke. The lack of any apparent heart health benefit was seen across the board, regardless of age or gender. Physician Gregg Fonarow helps direct the UCLA Preventive Cardiology Program in Los Angeles. He noted that upwards of 100 million American men and women take vitamins or supplements “frequently based on the misguided belief that doing so can improve their heart and vascular health.” The largely unregulated supplement industry is doing a booming

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

business, with a projected value of $278 billion by 2024, Kim’s team noted. This, despite the fact that prior studies have “consistently demonstrated no benefit” from supplements when it comes to heart health, Fonarow said. In fact, both Kim and Fonarow believe supplements may actually do harm. How? According to Kim, placing one’s faith in supplements “could deviate the public from following measures that are proven to be beneficial for cardiovascular health.” By way of example, he pointed out that while 50 percent of the American public consumes dietary supplements, just 13 percent meet federal recommendations for fruit and vegetable consumption. “We know that fruit and vegeta-

ble intake improves cardiovascular health,” Kim said. Fonarow concurred, adding that “the false belief that these supplements are providing some level of protection distracts from adopting approaches that actually lower cardiovascular risk.” “The evidence-based, guideline-recommended approaches to reduce the risk of fatal and non-fatal cardiovascular disease include maintaining a healthy blood pressure, cholesterol levels, body weight, not smoking, and engaging in daily physical activity,” Fonarow added. “There are also widely available and inexpensive once daily cardiovascular protective medications such as statins that, in eligible individuals, can safely and effectively lower risk,” he said.

91881_CC_Ad_Vert

T: 9.75” x 13.75”

B: none

Say hello to healthy. NOCHSI is now ConnextCare. Say hello to ConnextCare, Oswego County’s largest connected primary care network. And while our name may be new, our physicians and staff are the same familiar faces from NOCHSI. They’re just a little more connected. To you. Learn more at connextcare.org, or better yet, stop in to one of our six main sites and say hello.

August 2018 • 91881_CC_Ad_Vert.indd 1

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5/23/18 11:34 AM

Meet

Your Doctor

By Chris Motola

Patrick J. Carguello, D.O. ConnextCare’s chief medical officer talks about growth of organization, new name and the services it provides to rural Oswego County

A 3-Pronged Plan to Cut Type 2 Diabetes Risk

he Type 2 diabetes tide remains unchecked in the United States, as does pre-diabetes — having a blood sugar level higher than normal, but not high enough for a diabetes diagnosis. A U.S. Centers for Disease Control and Prevention report found that about 30 million Americans — roughly 10 percent of the population — have Type 2 diabetes. What’s more, over 80 million have pre-diabetes, which, if not treated, often leads to diabetes within five years. That puts these people at risk of heart and blood vessel disease, nerve damage, and kidney and eye damage, among other health threats. While Type 2 diabetes is more common among certain ethnic and racial groups — including American Indians, Alaska Natives, African Americans and people of Hispanic descent — no one is immune. And though you can’t change your heritage, you can change diabetes risk factors like carrying too much weight and being sedentary. A multi-year U.S. National Institutes of Health study of more than 3,000 overweight or obese adults with blood sugar at pre-diabetes levels found that lifestyle changes can have a profound effect. Achieving a 7 percent weight loss and doing 150 minutes of moderate intensity activity every week lowered the rate of Type 2 diabetes by 58 percent, compared to people who didn’t make these changes. What you eat counts, too. Focusing on fruits and vegetables, whole grains and low-fat dairy cuts Type 2 diabetes risk. By contrast, eating a lot of refined grains (like baked goods made with white flour and white rice), processed meats and added sugars increases it. So aim to rebalance your diet. Finally, rethink your drink. One very simple step is to cut out sugar-sweetened beverages. Sodas and similar drinks may lead not only to Type 2 diabetes, but also to overweight and more belly fat in particular.

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Q: It’s been awhile since we’ve talked. Since then, Northern Oswego County Health Services has become ConnextCare. What brought about the change? A: I think we last talked about 10 years ago? We’ve gone through a lot of changes over the past few years. ConnextCare is a really exciting place to work. We’ve expanded throughout Oswego County after working on stabilizing other healthcare facilities that were having financial difficulties. Our federal designation gives us some financial stability and gives us a lot of federal dollars to take care of patients regardless of their ability to pay. So this helped us assist some health centers is Fulton, Oswego, Parish, Mexico and Phoenix. Now we’ve really become this network with 13 locations throughout the county. We all now share this federal designation and that financial stability that allows us to help patients who are uninsured or underinsured. This rebranding is meant to show that we’re not just northern Oswego County anymore. We’re a bigger entity connecting the entire county. Q: Can you elaborate on what the federal designation is? A: We are a federally-qualified health center. The designation came about in the ‘60s and ‘70s when the federal government realized urban and rural poor locations had a major disparity in health outcomes. So they stepped up to either open or improve health centers to help improve these outcomes. We’ll be at our 50-year mark next year for this designation. We’ve been getting stronger over the years and getting more federal support to help

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

us improve healthcare for our patients. So now it’s throughout our whole county. Q: How were you able to get those other clinics federal status? Did you absorb them? Are they still semi-autonomous? A: It was a few-year process that evolved. Due to their financial struggles, they recognized that our federal status would be beneficial to them. They’ve more or less fallen under our governance, so we’re all the same team now. It used to be Oswego Hospital running some clinics, Oswego County Opportunities operating some clinics. Now we’re all running under the original Northern Oswego County Health Care location, but are now known as ConnextCare. And we’re all part of the same federally qualified health center. Q: With more locations, have you been focused on providing the same care at each location or having locations specialize? A: Initially it was about stabilization, but now it’s about expanding care and maximizing the ability of each location to take care of the relentless demands of patients. There’s a national shortage of primary care providers. By stabilizing these locations, we’re keeping care in these communities, especially smaller ones like Mexico and Parish. They’re hard to keep going without a larger network that can assist. So we’re keeping care in these communities, but supporting larger staffs. It’s a battle in primary care to see all the patients you need to see, and there are less and less of us. We’ve been able to, over the years, train and recruit some really outstanding nurse practitioners and teammates to assist given the shortage of primary care physicians. We’ve added some additional services over the last few

years. We have a behavioral health program and even some psychiatric services, which are usually really hard to deliver to rural areas. Q: What are the major health challenges facing rural Oswego County? A: Unfortunately, Oswego County statistics do not look the best. Smoking rates are pretty high. Obesity rates are pretty high. Higher levels of diabetes. Higher risk of cardiovascular disease. As we’ve grown we’ve added certain quality designations like being a patient-centered medical home (PCMH) level 3, which is really a significant quality benchmark for a health center. We have a very robust quality program, which helps us reach out to all of our providers across our network, to look at health outcomes, look at control of our diabetic patients, drill down into our digital medical records, and see which location offers the best care for their diabetes. We can also work together to share best practices across our networks. So it’s not just one provider just helping their patients, but helping providers throughout the county care for their patients. Q: And that’s kind of the purpose of the health center? A: Absolutely. As we’ve grown, our quality program has helped us grow care teams and managers. One healthcare provider, for example, needs lots of assistance with complex patients with diabetes, high-blood pressure and who smoke to get those outcomes that we want in rural and urban underserved areas. We can look at our best practices, study that, help to apply it at a different location and get all teammates — not just medical staff—to help that patient meet their healthcare goals. Q: Do you see ConnextCare being a model for other rural health clinic networks? A: Absolutely. We’ve been on electronic health records for more than 10 years. Many centers are on different systems that don’t communicate as well, that lack the interface. We have all of our providers on the same system throughout the county, so we have pretty seamless communication. So if a patient is seen at Pulaski one time and then Oswego, we can still track testing and results. Back in the day, you’d order a mammogram, hope the patient follows through with the test, hope I got the results back. But now we can track the test electronically. If they’re not getting the test, we can follow up with the patient. If they do get it, we can get the results.

Lifelines Name: Patrick John Carguello, D.O. Position: Senior vice president/chief medical officer at ConnextCare, based in Pulaski. With the organization since 2003 Hometown: Rochester; currently lives in Sandy Creek Education: New York College of Osteopathic Medicine; Syracuse University; residency: Sisters of Charity Hospital, Buffalo Affiliations: ConnextCare Organizations: American Osteopathic Association; American College of Osteopathic Physicians; American Academy of Family Physicians Family: Married to Wendy, three children Hobbies: Skiing, boating, fishing, hiking

Customer Appreciation Day!

LEBRATING CE

Saturday, August 18th • 9 AM-6 PM

YEARS

25 U.S. Kids Treated in ERs Every Hour for Bike Injuries

ore than 2.2 million American children a year — or about 25 an hour — were treated in emergency departments for bicycle-related injuries over a 10year period, a new study finds. “The good news is that the rate of injury declined over the course of the study. Still, far too many children are being seriously hurt on their bikes,” said lead author Lara McKenzie. She’s principal investigator at the Center for Injury Research and Policy at Nationwide Children’s Hospital in Columbus, Ohio. “The best place to start is with a well-fitted helmet. The study found that children who were not wearing a helmet when they were injured were more likely to suffer traumatic brain injuries and to be hospitalized,” McKenzie said in a hospital news release. Parents should look for a helmet with a sticker showing it is certified by the U.S. Consumer Product Safety Commission. McKenzie said it’s a good idea to let children help with the shopping so they can pick a hel-

met they like and will want to wear. Proper fit is important. The helmet straps should form a “V” around the ears. The chin strap should be snug, but children should be able to fully open their mouths. A space about the width of two fingers between the eyebrows and the edge of the helmet will ensure it’s protecting the front of the head but not blocking their view, McKenzie said. “Once they have a fitted helmet, parents should also make sure their kids have the proper education before they pedal away, especially if they are going to be riding in the street,” McKenzie advised. She noted that injuries involving motor vehicles more than doubled the odds of a traumatic brain injury and more than quadrupled the odds of hospitalization. Children should use bike paths where available. But experts say local officials need to make roads safer for cyclists through “Share the Road” initiatives, dedicated bike lanes and bicycle education programs.

Dermatology Consultants in Syracuse (Dr. Madhavi Menon, Dr. Jasmine Ahmadi, Dr. Daniel Bryan, and Travis Hayden, PA) is currently accepting new patients. Please call our office at 315-701-0070 today to schedule your new patient appointment.

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CNY’s Healthcare Newspaper

A monthly newspaper published by Local News, Inc. 5,000 copies distributed throughout more than 1,000 high traffic locations, including all Wegmans stores.

In Good Health is published 12 times a year by Local News, Inc. © 2018 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Chris Motola, Beth Roach, Ernst Lamoth Jr., Carol Radin, Joseph M. Jacob (MD) D E• Advertising: STINATION Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas D E S T I •NOffice ATION Assistant: Kimberley Tyler

SEPT. 15 10 AM FREE t-shirt for those who pre-register by August 30! http://runsignup.com/race/ny/ sherburne/wildgoosechase5ktrailrun

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express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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Visit www.chenangoNY.org 607-334-1400 Visit www.chenangoNY.org or or callcall607-334-1400 August 2018 •

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‘U.S. News’ Ranks Best Children’s Hospitals

or the fifth year in a row, Boston Children’s Hospital is the No. 1 children’s hospital in the U.S., according to latest rankings by U.S. News & World Report. Ten hospitals earned a place on the magazine’s 2018-2019 honor roll of children’s hospitals, with a few changes from last year. Taking the No. 2 spot this year is Cincinnati Children’s Hospital Medical Center, up from No. 3 in last year’s ranking, while Children’s Hospital of Philadelphia drops to No. 3 this year, down from No. 2 last year. Texas Children’s Hospital, Houston, remains in the No. 4 spot. Children’s National Medical Center in Washington, DC, made the biggest jump, going from No. 9 to No. 5 on the honor roll. Children’s Hospital of Colorado is a newcomer to the top 10 this year, taking the No. 9 spot from Children’s

Hospital of Pittsburgh of UPMC, which dropped out of the top 10 this year. Ann and Robert H. Lurie Children’s Hospital of Chicago dropped from No. 7 to No. 10. Here is the complete list:

1 – Boston Children’s Hospital 2 – Cincinnati Children’s Hospital

Medical Center 3 – Children’s Hospital of Philadelphia 4 – Texas Children’s Hospital, Houston 5 – Children’s National Medical Center, Washington, DC 6 – Children’s Hospital Los Angeles 7 – Nationwide Children’s Hospital, Columbus, OH 8 – Johns Hopkins Children’s Center, Baltimore 9 – Children’s Hospital Colorado,

Aurora 10 – Ann and Robert H. Lurie Children’s Hospital of Chicago Each year, U.S. News & World Report ranks the top 10 children’s hospitals for each of 10 specialties: cancer, cardiology & heart surgery, diabetes & endocrinology, gastroenterology & GI surgery, neonatology, nephrology, neurology & neurosurgery, orthopedics, pulmonology, and urology. The top children’s hospitals in the 10 specialties are as follows: n Cancer: Cincinnati Children’s Hospital Medical Center n Cardiology & heart surgery: Texas Children’s Hospital n Diabetes & endocrinology: Children’s Hospital of Philadelphia n Gastroenterology & GI surgery: Cincinnati Children’s Hospital Medical Center n Neonatology: Children’s National Medical Center n Nephrology: Boston Children’s Hospital n Neurology & neurosurgery: Boston Children’s Hospital n Orthopedics: Boston Children’s

Hospital n Pulmonology: Texas Children’s Hospital n Urology: Children’s Hospital of Philadelphia “Having a child who is born with or develops a serious illness is one of the most difficult situations a parent can face,” Ben Harder, chief of health analysis at U.S. News & World Report, says in a news release. “Our best children’s hospitals rankings are designed with parents and young patients in mind. By having access to the most comprehensive data available to supplement guidance from their pediatrician, families are able to make better-informed decisions about where to seek high quality care for their children,” Harder says. For this year’s rankings, U.S. News & World Report analyzed data from 189 pediatric centers, of which 86 were ranked among the top 50 in at least one specialty. RTI International, a research and consulting firm based in North Carolina, collected the data and analyzed the results with assistance from more than 100 medical directors, pediatric specialists, and other experts.

Healthcare in a Minute By George W. Chapman

Oops! The Doctor Is Out-ofNetwork. You Pay the Bill Now

here are the bills you receive unexpectedly from “out-of-network” providers. The best example is when you go to your participating “in-network” hospital emergency room only to find that the physicians working in the ER are, unbeknownst to you, out of network. So you must pay the difference between their charge and what your insurance company typically pays for in network physicians. This can also happen with anesthesia bills. The trusting consumer logically believes if their hospital is “in-network,” so would

be the physicians who work there. The Harvard Global Institute thinks this is absurd and let a Senate committee know it, arguing it’s unethical if not illegal. It’s asking Congress to do something about it. Way back in 2011, a NYS study revealed patients paid an average $3,800 to out-of-network emergency room physicians. This would not be a problem in the first place if hospital CEOs either refused to do business with out-of-network physicians or at least paid for the difference since the patient is rarely informed in advance.

ACA 2018 Thanks to market uncertainty and the end of the individual mandate to have insurance, enrollment is going down. No one is surprised. A total of 11.8 million people signed up for coverage to begin 2018, but 1.1 million decided not to pay the premium. That left 10.7 million participants as of February 2018. Industry experts believe the number will drop further throughout the year as the current federal administration continues to undermine/sabotage the law, wanting to end the federal exchanges by 2020. Since the feds have yet to come up with a viable alternative for people seeking adequate health insurance coverage, many states will take on the charge.

ond time this year Pfizer has raised prices. Industry experts say this is another example of a drug manufacturer protecting profits from being negatively impacted by potential government intervention and the increasing bargaining power of pharmacy benefit managers that purchase drugs on behalf of huge health plans with millions of members. While PBMs “brag” they negotiated a 25 percent discount, that is only after drug manufactures raised their prices by double digits. No one really knows what the actual price of any drug is anymore. While the White House has basically paid lip service to controlling the exorbitant prices of drugs in the US, the American Association of Insurance Plans (AHIP) is taking matters into its own hands. They have promoted Matt Eyles to be their CEO. Before joining the AHIP three years ago as an analyst, Eyles worked as a lobbyist for the pharmaceutical industry. He now sits on the other side of the fence. He wants to

Big Pharma Pfizer recently raised the price of 40 drugs, (including cancer pills, blood pressure pills and pain pills), by 9 percent. This is already the secPage 8

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

make drug pricing a primary focus as drugs account for almost 30 percent of what an insurance plan pays out in claims. Over the years, out-of-pocket costs for consumers for drugs have increased substantially. Lobbyists Control Washington… …and even when it comes to mother’s milk. At the recent convocation of the World Health Assembly in Geneva, Switzerland, US representatives, caving to pressure from baby formula manufacturers, refused to endorse a simple resolution promoting a mother’s natural milk as the healthiest choice for babies. The US threatened to sanction or withdraw military protection from any country that attempted to introduce the resolution. OB-GYN Shortage According to a recent study by Doximity, a social network for physicians, the predicted shortage of OB-GYNs has already hit several large metropolitan areas, including Las Vegas, Los Angeles, Miami and Orlando. These cities also tend to have higher-than-average numbers of women in child bearing years. The shortage is being exacerbated by over worked physicians retiring earlier from the delivery component of their practices to focus on more schedule-friendly gynecology. Certified nurse midwives could be a partial solution but physicians and hospitals still typically oppose that solution. CNMs are more prevalent in other countries. Currently, 60 percent of OB-GYNs are women and the percentage of male OB-GYNs drops every year. Cost of Care in the US. We outspend every developed country in the world… by far. All agree it costs way too much and something needs to be done before healthcare bankrupts the US. It is now 20 percent of our GDP. With so many vested interests (Big Pharma,

insurance companies, hospitals, device manufacturers and even baby formula producers), experts don’t have many solutions. On average, our utilization of healthcare is on par with other developed countries. We just spend two to three times more for services than they do. Ashish Jha, MD, director of the Harvard Global Health Institute, resignedly said, “There is nobody I know that has all the answers, and what we need is a lot more experimentation.” Other countries have shown they can provide similar quality for far less. Until we address lobbying in Congress, real change in our costs will not be brought about by continued “experimentation” which unfortunately ignores the elephant in the room. Googled health problems. Here are the most “googled” health problems by selected states. (Draw your own conclusions.) New York: breast cancer. Minnesota: hemorrhoids. Missouri: ADHD. Nebraska: anorexia. South Dakota: insomnia. Utah: Hashimoto’s disease (basically inflamed thyroid). Vermont: opioid addiction. West Virginia: porn addiction. Yes, porn addiction. Connecticut: “quarter” (not mid) life crisis. Iowa: binge drinking. And finally….California, Colorado, Georgia, Illinois, Pennsylvania: syphilis.

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.

Welcoming New Patients! Associated Medical Professionals welcomes Hadley Narins, MD, to our practice Dr. Narins joins us in September and will be working at our Syracuse office. She will be developing the Female Urology and Pelvic Reconstruction Program at Crouse Health. Dr. Narins’ professional interests include management of urinary incontinence and pelvic organ prolapse. She specializes in minimally invasive surgery, including robotic sacrocolpopexy. HADLEY NARINS, MD

For more information visit ampofny.com 1226 East Water Street | Syracuse, NY 13210 | (315) 478-4185 August 2018 •

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

‘Tis the Travel Season: Be it Near or Far — Go It Alone

t’s that time of year — the travel season — and I’m already contemplating an August adventure with just “me, myself and I.” It might be a weekend away for a change of pace or a slightly longer excursion to clear my head and broaden my horizons. I look forward to my solo summer retreats, and always return home feeling rejuvenated and ready to take on what’s next. If you’ve never traveled alone, I highly recommend it. Time with yourself on the road is ripe with opportunities for self-discovery and growth. And it can be great fun! Here are a few good reasons to pack your bags and head out on your own: nYou call the shots. When you travel alone, you are free to see and do whatever tickles your fancy. Your decisions and itinerary are your own. And when that’s the case, you are reminded of who you are, what you enjoy doing the most and what you

like least. When you travel with others, their interests may not always align with yours, and precious time can be consumed with the inevitable negotiations that come with trying to satisfy everyone’s needs and desires. Travel alone, and you’ll discover the joy of listening to and following your own heart. n You meet new people more easily. I’ve discovered this time and time again. On my own, I’m more inclined to strike up a conversation with other travelers and “locals.” As a result, I’ve met so many nice, interesting and helpful people. And I often come away with great ideas and tips on new things to do, places to visit and restaurants to try. When traveling with friends and family, we have a natural tendency to stay focused on each other and may, therefore, lose the chance to meet people we might otherwise have met and enjoyed.

irement s for Ret orst State W g n o m free Ranks A New York

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

n You can release your adventurous spirit. On your own (with no one watching), you may be willing to try some things outside your comfort zone — take a balloon ride, soar on a zip line, join a “for singles only” biking tour or swim with dolphins. While not exactly a thrill seeker, I have sampled some pretty exotic food, wrestled Old Paint into submission on a horse trail in Costa Rica, repelled down a Colorado cliff, and white-knuckled it in a white-water raft. n Likewise, you can find some heavenly time to yourself. As a solo traveler, the opportunity for a tranquil, soul-soothing retreat is within your grasp. This is a little more up my alley, and I welcome the chance to spend as much quiet time — “me time” — as I wish. Solo trips afford this guilt-free opportunity. Want to sleep in until noon, sip tea with a good book all afternoon in a Paris cafe, enjoy a spa day or take a peaceful hike by yourself ? Go for it, because you can. n You learn a new language faster. Je peux en témoigner! (I can vouch for that!). When traveling alone in France, I was forced to make sense of the language. It was either that or go hungry. Without a traveling companion to help with translation, I was on my own. While I am far from fluent in French, I can now express simple greetings, ask for directions, and order a croque-monsieur — a popular French hot ham and cheese sandwich. Want to learn a language more

quickly? Travel alone. Here’s a tip: Download a language translation app or tool. There are many excellent (and free) options available. Check ‘em out! n You build your confidence and sense of independence. Even a small jaunt can boost your self-confidence. All the decisions are yours, including your budget. You decide how to get where you’re going, where to stay, and how much to spend on transportation, food, accommodations, and things to do. In no time, you’ll discover your own resourcefulness, ability to solve problems, and capacity to spend some time alone. The experience will challenge your limits, creativity, and coping ability — all of which will help you become a stronger person and grow as a traveler. So, I hope you’ll consider a little solo travel this month. Set out on an adventure with a spring in your step and anticipation for all the hidden treasures you’ll discover. Be it near or far . . . go it alone!

Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive empowerment workshops for women held throughout the year in Mendon. To purchase her new book “Alone and Content” visit Amazon.com. For information about her upcoming workshops or to invite her to speak, visit aloneandcontent.com, call 585-624-7887, or email gvoelckers@ rochester.rr.com.

Testicular Cancer Problem is commonly seen in men between ages 15 and 35, but chance for cure is high By Joseph M. Jacob, MD

esticular cancer is a rare type of cancer that develops in the sperm-producing cells of the testis. Men usually present to the doctor with a lump on their testicle or new testicular pain. Unfortunately, delays in diagnosis are common since men are reluctant to talk about issues that develop in this area of the body. Testicular cancer is most commonly seen in young men between the ages of 15 and 35 and can be very aggressive. However, great advances have been made in this disease and most testicular cancers are now curable. If a man is found to have a solid testicular mass, they should be referred to a urologist immediately. The urologist will remove the entire testicle from the groin. Testicular cancer does have very specific tumor markers and these will be checked frequently since it is a simple blood test. After the testicle is removed, the urologist will obtain imaging of the chest and abdomen to identify the extent of disease. Based on this and the type of testis cancer, various treatment regimens will be recommended. Fortunately, even if the extent of the cancer is great, most patients have one of the highest rates of cure for any type of cancer. Overall, the chance of cure is 95

percent; however, common types of testis cancer have cure rates close to 99 percent. To achieve these very high cure rates, patients and referring physicians should make it an absolute priority to consult with a urologist who has strong expertise in testicular cancer since this is a rare cancer. This expert will ensure that all the treatments and diagnostic methods available are offered in the appropriate sequence. Mistakes in treatment can decrease these cure rates dramatically. Our department is prepared to help these young men receive the highest quality care that they deserve. Physician Joseph M. Jacob is a fellowshiptrained urologic oncologist who is part of the Upstate Department of Urology. His clinical interests include treating cancers of the bladder, testes, penis, kidneys, and prostate.

3 of 4 Black Americans Have High Blood Pressure by 55

startling 75 percent of black people in the United States develop high blood pressure by the age of 55, a new study finds. That’s a far higher rate than seen among either white men (55 percent) or white women (40 percent), the researchers said. “We started to see differences between blacks and whites by age 30,” said lead researcher S. Justin Thomas. “We need to start focusing on preventing hypertension [high blood pressure], particularly in blacks, at an early age,” he added. Thomas is an assistant professor at the University of Alabama at Birmingham’s department of psychiatry. It isn’t known why black Americans are more prone to high blood pressure at an earlier age than white Americans, Thomas said. But he speculated that a combination of lifestyle and genetics may explain why. Thomas said preventing high blood pressure needs to start with getting kids to develop healthy habits. “I don’t think you can start too early,” he said. “It should start at elementary school. If kids are told

frequently that this is important, they will adopt it.” High blood pressure can lead to serious health problems over time, the researchers noted. For the study, Thomas and his colleagues collected data on nearly 3,900 young adults who were part of a heart disease risk study. The participants were enrolled in the study when they were 18 to 30 years old, and they didn’t have high blood pressure at the time. Excess weight was the biggest risk factor for developing high blood pressure, regardless of sex or race, the researchers found. Blacks and whites who kept to a DASH (Dietary Approaches to Stop Hypertension) diet were able to lower their risk for high blood pressure, the study findings showed. The DASH diet is rich in fruits, vegetables, whole grains, low-fat or fat-free dairy, fish, poultry, beans, seeds and nuts, and low in red meat and salt. The report was published online July 11 in the Journal of the American Heart Association.

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Smart Phone: Addiction or Harmless Pastime? Excessive use of digital devices “falls into a behavioral addiction similar to gaming,” says expert By Deborah Jeanne Sergeant

emember when car phones were a novelty business tool? Now it seems like everyone over 5 totes a smartphone or tablet everywhere and uses it constantly. That impression isn’t far from the truth. eMarketer, a market research company based in New York City, released a study in 2016 stating that mobile device users spend more than four hours a day on their devices — tablets and smartphones. The study

did not distinguish between leisure use and business use; however, four hours a day is a lot of time regardless of why. Dessa Bergen-Cico, PhD, is an associate professor in the department of public health and coordinator of the addiction studies program and faculty in the interdisciplinary neuroscience program at Syracuse University. She said that researchers are trying to determine if smartphone use can be classified as addictive.

“Neuroscience looks at activation in the brain,” Bergen-Cico said. “The same areas that light up with other rewards like food, sex, gambling and cocaine light up with social media, as with other types of cell phone use.” The novelty of what people experience also gives a burst of dopamine, she added. The reason for use, length of use and the consequences of use all help determine if smartphone use has become a problem.

“It falls into a behavioral addiction similar to gaming,” Bergen-Cico said. “It becomes a habit they use to avoid unpleasant mood states and emotions, like if they’re feeling anxious, bored or depressed. It’s their go-to.” Like other addictive behaviors, such as gaming, using mobile devices provides positive reinforcement to reward their use. It differs from an obsession, which is fixating on something that’s irrational. What makes it difficult to understand is that plenty of people use devices for extended periods of time without becoming addicted. The difference lies in the reasons for and the consequences of their use. Some people use their smartphones for business, research and keeping up with friends for hours at a time and don’t exhibit addictive behavior. “If you’re going on with a goal to see how people are doing, that’s one thing,” said Whitney Wood, Ph.D., who teaches at LeMoyne College. “If you keep clicking next, next, next to get satisfied, that tends to be associated with more negative outcomes.” Mobile devices have progressed from novelty to necessity, displacing the need for other means of entertainment, communication, information, and accomplishing an ever-widening array of tasks. Since devices can do more, people become more reliant upon them. Telling the difference between harmless smartphone use and addictive behavior may have to do with the effect of use on others. Wood also added that the amount of time spent is another factor in determining addictive behavior, as well as how important that time becomes to users. Bergen-Cico said that tracking apps may help people self-regulate use. She foresees that as smartphone use becomes recognized as possibly addictive, similar to gaming, more treatment options will be developed.

You Are A Smartphone Addict When…

sychguides.com offers the following self-assessment for smartphone addiction. This self-assessment is not meant to officially diagnose you with cell phone addiction. If you are concerned about your problematic behaviors, speak to your doctor or mental health professional about possible treatment. 1 Do you find yourself spending more time on your smartphone than you realize? 2 Do you find yourself mindlessly passing time on a regular basis by staring at your smartphone even though there might be better or more productive things to do? 3 Do you seem to lose track of time when on your cell phone? 4 Do you find yourself spending more time texting, tweeting or emailing as opposed to talking to real-time people? 5 Has the amount of time you spend on your cell phone been increasing? 6 Do you secretly wish you could be a little less wired or connected to your cell phone? 7 Do you sleep with your smartPage 12

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phone on or under your pillow or next to your bed regularly? 8 Do you find yourself viewing and answering texts, tweets, and emails at all hours of the day and night, even when it means interrupting other things you are doing? 9 Do you text, email, tweet, or surf the internet while driving or doing other similar activities that require your focused attention and concentration? 10 Do you feel your use of your cell phone actually decreases your productivity at times? 11 Do you feel reluctant to be without your smartphone, even for a short time? 12 When you leave the house, you ALWAYS have your smartphone with you and you feel ill-at-ease or uncomfortable when you accidentally leave your smartphone in the car or at home, or you have no service, or it is broken? 13 When you eat meals, is your cell phone always part of the table place setting? 14 When your phone rings, beeps, buzzes, do you feel an intense urge to check for texts, tweets, or

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

emails, updates, etc.? 15 Do you find yourself mindlessly checking your phone many

times a day even when you know there is likely nothing new or important to see?

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Daith piercing involves the innermost fold of ear cartilage. Some believe it can prevent migraine. Photo by Deborah Jeanne Sergeant.

Daith Piercing: Can It Reduce Migraine Pain? By Deborah Jeanne Sergeant

ost people obtain body piercings because they like the style; however, a few seek a specific piercing because it’s believed to help reduce the symptoms of migraine headaches. Anecdotally, piercing the daith (some pronounce it to rhyme with “goth”; others rhyme it with “faith”) is said to lessen the pain, nausea, light sensitivity and other migraine symptoms. Those who use it claim that piercing the ear in its innermost fold of cartilage just above the ear canal turns off migraine pain in a similar way to acupuncture. Jeffrey A. Carmen, Ph.D, and licensed psychologist, practices in Manlius and address migraines, stress and other issues. “Some people seem to have had benefit from it,” Carmen said. “It’s not a miracle cure, but sometimes you get a benefit. It’s hard to know why. It’s always possible it’s a placebo.” Carmen works with migraine clients by helping them train their brains so the front part is more dominant. He added that he has not seen any research on daith piercing for migraines, possibly because too many variables can cause or mitigate the effects of migraines. Plus, a controlled study on daith isn’t possible because participants would definitely know they’ve received the piercing. According to Karen Gana, Ph.D, licensed acupuncturist and owner of Your Health Acupuncture in Syracuse, there are no acupuncture points on the ear for migraine. “In Chinese medicine, there are probably 10 different patterns that cause migraines,” Gana said. “Every symptom we have is related to some-

thing going on inside the body. One piercing, even though it’s not on an acupressure point anyway, wouldn’t affect everyone’s headaches.” Like Carmen, she thinks it could be a placebo effect. The acupuncture points used for migraine depend upon what type of migraine the client experiences. But Gana said that acupuncture treatments may require several visits to provide lasting relief and an occasional visit as maintenance. “Western medicine is, ‘Take this pill and the pain will all go away,’” Gana said. “People think acupuncture is like that. The migraine might come back unless we take care of the root of the problem.” People performing the piercing most likely have no training in treating migraines or in acupuncture. Before obtaining a daith piercing, it’s also important to realize how different it is from standard earlobe piercing. Many shopping mall jewelry stores perform only lobe piercing because of its low rate of infection and other complications but refuse to pierce cartilage because it’s more complicated — and painful. People seeking a daith piercing must go to a stand-alone piercing business. The daith piercing is tricky to keep clean because for many people, their hair touches the piercing more often and because it’s tucked into the innermost crease of the ear. The position also makes turning the piercing stud difficult. Should the daith piercing not help reduce migraine pain, the earring may be removed to allow the piercing to close; however, it will likely leave a scar. Before undertaking a daith piercing, discuss the possibility of complications with a health care provider.

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Things You Need to Know About Cancer & Food By Ernst Lamothe Jr.

ood is fuel for your body. And just like in cars, if you put the wrong fuel inside, something unfortunate is likely to occur. Bad eating habits can lead to an array of bad medical outcomes, including cancer. What you decide to consume for breakfast, lunch, dinner and snacking can have a detrimental outcome on your quality of life. Cancer risk reduction starts with a healthy diet. “There are many food and lifestyle choices that can greatly decrease your chance of cancer,” said Susan Branning, manager of clinical nutrition at St. Joseph’s Health in Syracuse. “There are various tips that we tell our patients that will enhance their quality of life surrounding their eating habits.” Here are five things you should know about food and cancer.

Increase your intake of fruits and and vegetable

If you want to know if you are eating healthy, then half your plate should be incredibly bright with nutritious fruits and vegetables. The United States Department of Agriculture came out with the My Plate, which is a reminder to find healthy eating styles and build it throughout your lifetime with the right mix of food in variety, amount and nutrition. “Fruits and vegetables are relatively lower in calories than other food and are high in fiber and loaded

with vitamins and materials,” said Branning. “It has also been known to lower the risk of colon cancer and disease.” She added that even frozen vegetables and fruits can offer healthy alternatives for those who don’t have access to fresher options. “Eating these kinds of healthy foods also fill you up more because of the fiber which helps you avoid making poor food choices in other areas of your day,” said Branning.

Choose whole grains instead of refined grains

Half of your grains should be whole grains instead of the processed grains that tend to have less fiber. It can be as simple as going with 100 percent whole wheat bread or brown rice over white bread and white rice. “Here at St. Joseph, we switched our hot sandwiches to a whole grain roll instead of a white roll and we purposely didn’t advertise it. We maybe had one person that noticed it meaning that sometimes we don’t even notice little changes as much as we think we might,” said Branning. “I know it is difficult when we have a habit of doing something for 20 to 30 years but making slight changes can make all the difference in the world.”

Don’t eat too much meat

Now we are not saying that you can’t enjoy an occasional trip to a Brazilian steakhouse.

The problems is when it comes to red meat eaters, very few things are occasional in both quantity of times and portion sizes. If you eat meat don’t eat too much. “We are not telling people to be vegetarians even though that would be a healthy way to go. But there has been research saying processed meats and a lot of red meats can lead to cancer. If you have too much of that, bacon, sausage and deli meats, it can be a problem,” Branning added. The American Institute of Cancer recommend 18 ounces of red meat per week. For example, a deck of cards or the palm of a women’s hand is typically about three ounces. Many times a person will have more than half of the recommended ounces in one sitting or the whole thing. “We know that we like our steaks big and our portions sizeable,” she said. “But if you are going to be a regular meat eater then at least go with lean meats such as ground beef or pork loin that is 93 percent lean.”

Include healthy fats

There is such a thing as healthy fats such as avocados, olive oil, salmon, nuts and seeds. These fats are associated with improving heart health and lowering blood pressure. “Back in the 1990s, everyone was trying to cut calories and cut fats. But they were also limiting the healthy fats that their bodies needed,” said Branning. “We have returned to the time where physicians and dietitians are explaining to people the need for these fats.” But once again, she cautions on portion size which is the biggest culprit of how people handle tip four. For example, the recommendation for nuts is simply a handful for an entire day not half the trail mix bag. When too much of these saturat-

Susan Branning, manager of clinical nutrition at St. Joseph’s Health. ed fats are put into the body, it can clog the arteries and overload the body. “If you double and triple your recommended intake it can cause a lot of issues, weight gain and health problems,” said Branning.

Don’t drink your calories

Often times many beverages outside of water have a significant amount of sugar. Sugar, also known as glucose, is found in many of the foods that we consume regularly. It can consistently cause issues, especially if consumed at high amounts. Sugar is all around us. There are 156 different names for sugar so even though the public is aware of the term high fructose sugar, that doesn’t mean that a company just isn’t using another kind of sugar that is just as bad. If you walk through a grocery store you would be astonished at the percentage of food that have a high level of sugar. “People are drinking hundreds of calories per day in soda and many don’t know the adverse effects it can have on the body,” said Branning. “The easiest way to improve your diet is cut down those drinks. I don’t even recommend diet soda. If you need a little bit of taste it is better to have fruit-infused water.”

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For More Information Callfor 315-464-2807 For example, we’re currentlyPlease looking people to join a new clinical study called GRADUATE II. The study will assess how safe and effective an investigational drug is at slowing the progression of early (also known as ‘prodromal’) or mild Alzheimer’s disease. And we are looking for people like you to take part.

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

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New Opioid PSAs Local professionals say new national campaign to curb use of opioid won’t work By Deborah Jeanne Sergeant

emember the public service announcements (PSAs) from the Partnership for a Drug-Free America in the 1980s depicting an egg in a hot pan to show “your brain on drugs” as it fried? New PSAs released by Office of National Drug Control Policy (ONDCP) to address the opioid crisis, the Truth Initiative and the Ad Council, also discuss drug abuse in a dramatic fashion. Based on true stories, they show people purposefully hurting themselves to obtain more prescription pain medication. For example, it shows people smashing their hand with a hammer or driving a car into a dumpster. Though the spots warn “opioid addiction can happen after just five days,” area experts contest the effectiveness of the new PSAs, which debuted on TV and social media in June. “If we look at addiction for what it is, which is a disease, then putting out this type of PSA is also criminalizing and blaming those that do struggle with addition and maybe are doing the hard work of battling and addiction,” said Niccole R. Lorenzo, mental health counselor and owner of Branches of Growth, LLC in North Syracuse. “It creates more separation.” While she does think that the new PSAs raise awareness, she be lieves that the message they contain doesn’t clearly connect the dots between how some people start taking opioids, as prescription medication after surgery, which Lorenzo eventually leads to medicating for feelings of depression and hopelessness. She wants more attention on different options for pain management. Patients have the right to ask for other, non-addictive means to manage pain than opioid medication when they’re injured or about to undergo surgery. “Medication can be a crutch to get you thru the pain, but it became an epidemic where people become addicted to it,” Lorenzo said. Lorenzo volunteers at the Wounded Warrior program at the Veteran’s Administration. She has observed the effects of breathing exercises and mindfulness in pain

control. “It’s unfortunate to take so long for people to realize there are natural pain control methods and the innate wisdom of our bodies,” she said. While the PSAs do grab attention, Dessa Bergen-Cico, Ph.D., a fellow of the American Academy of Health Care Providers in the addictive disorders, thinks that the ads are ineffective. Bergen-Cico serves as associate professor department of public health and coordinator of the addiction studies program at Syracuse University. She authored “War and Drugs: The Role of Military Conflict in the Development of Substance Abuse.” Bergen-Cico acknowledged that the ads are more informative than the frying pan ads, because they show the extent to which people will go to get drugs; however, she thinks that people who aren’t addicted to drugs may not readily identify with the extreme examples of self-harm depicted in the videos. The ads also don’t show the signs and symptoms of addiction before they reach that desperate level. “This is one of the perpetual challenges on substance abuse and addiction,” Bergen Cico said. “Prevention is a science and is complex. The spots create buzz but don’t express the complexity. It misses the mark in prevention as it focuses on those who are in the midst of dependency. It may raise awareness of intervention but won’t reach the person who has the addiction, because that person isn’t likely to see or hear that message.” Understanding why and how people become addicted to opioids, such as a legitimate need for pain control after surgery, would help more people realize that anyone could become addicted as they become emotionally dependent after the physical need for pain control has subsided. Like Lorenzo, Bergen-Cico thinks that opioids have been prescribed too carelessly since pain became a fifth vital sign in the 1990s. Helping the public understand the means of this addiction can help them reduce risk of dependency. Bergen-Cico would like to see a PSA that’s written with the input of addiction experts who can help guide the content to prevention instead of chiding patients struggling with addiction with “PSAs that are quippy and memorable but ineffective,” she said.

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Page 15

SmartBites

The skinny on healthy eating

Why Cherry Tomatoes Are So Good for You

herry tomatoes, like all tomatoes, often make superfood lists, a designation that cheers my heart, my eyes, my skin and my constant worry about cancer. Since my husband and I eat a lot of cherry tomatoes, it’s great to know that this portable superfood can do more than just help us meet our nutritional needs — it can also help us achieve better health, prevent chronic disease, keep aging at bay and improve the way we feel. Cherry tomatoes are antioxidant superstars, boasting impressive amounts of the particular vitamins (A and C) and phytochemicals (lycopene) that protect us from cancer and other debilitating diseases by preventing the growth of harmful free radicals. Although free radicals are produced naturally in the body, lifestyle factors — such as exposure to pesticides, smoking, alcohol and fried foods — can accelerate their production. Many experts agree that eating a diet rich in fruits and vegetables can make a healthy difference.

These little globes of goodness are also a decent source of potassium, providing nearly as much potassium as a medium banana. Eating more potassium-rich foods lowers blood pressure, decreases the risk of stroke, reduces the formation of kidney stones, and supports bone and muscle strength. What’s more, cherry tomatoes are really good for eyes, thanks to their unique mix of nutrients — from vitamin A that retinas depend on to function to the nutrients lutein and zeaxanthin that protect eyes from harmful ultraviolet rays. One study showed that people who ate foods rich in zeaxanthin may be half as likely to get cataracts, while another study showed that increased consumption of lutein and zeaxanthin may slow the progression of macular degeneration. Remarkably low in calories for such a nutrient-dense food, waistline-friendly cherry tomatoes are also low in sodium, fat and cholesterol.

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Helpful tips Choose cherry tomatoes with firm, bright skins and a fresh tomato-y scent. Store them at room temperature, out of direct sunlight, for best flavor and to avoid the mealy texture that can result from refrigeration. If, however, your tomatoes are ripe and you won’t be eating them in the next few days, you might want to store in the refrigerator to keep them from spoiling quickly. Before eating refrigerated tomatoes, put them out at room temperature for at least an hour.

Cherry Tomato and Avocado Salad 4 cups cherry tomatoes, halved 2 avocados, diced 1 medium carrot, shredded ½ red onion, diced (optional) 1 jalapeno pepper, minced (optional) 1 lime, juiced 1 clove garlic, minced 1½ tablespoons olive oil Salt and pepper to taste 2-3 tablespoons minced fresh basil or cilantro ½ cup chopped, toasted walnuts

salad bowl. In a small bowl, whisk lime juice, garlic, olive oil, and salt and pepper until blended; stir in herbs. Pour over tomato mixture and gently toss. Top with toasted walnuts and serve immediately.

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

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

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wanna see whitecaps!” Whitecaps in a blue-tiled, indoor chlorine-filled pool? Why not? Fifteen people in the pool stir and bubble the water as hard as they can, as the diminutive curlyhaired woman on the deck yells genial orders over the din of the busy swimming pool complex. That woman is Anne Foerster, their water instructor. As she does jumping jacks, deep knee lifts, and kicks in place, the men and women in the water imitate all of it, spurred on by Foerster’s exclamations: “You guys are working hard today! You’re doing great!” This is Aqua Blast, one of 15 water exercise classes Foerster teaches per week at the Northeast YMCA, classes that vary by ability level and wellness needs. On her busiest day, she teaches five classes, starting as early as 8:30 a.m. and ending as late as 6 p.m. In a day, she can switch gears from Aqua Blast to Deep Water to Golden Fit to the warm-water arthritis class, covering a spectrum of physical needs. They range from adults who want to maintain and enhance conditioning to those who want to overcome physical limitations and improve flexibility for their muscles and joints. Though the number of participants can fluctuate from week to week, many people return to take the class that fits their skill level. “She makes it so much fun,” one of the regulars comments. All are familiar with Foerster’s firmly planted knees-apart stance and the twinkle in her eye, the rousing “hellos,” and the rallying cries such as “How you all doin’?” “OK, start walking! Do wooden soldiers! Straight arms, straight legs!” Then more directions, polite but firm: “You may stop. Now, roll your shoulders.” Everyone goes quiet, almost meditative, as Foerster rotates her shoulders along with them. How Foerster manages her instruction for a range of abilities each day and what makes her sensitive to not only the needs of a particular class but the needs of each individual in a given class comes partially from her training, but mostly from who she is. “I have a knack,” she says. “I’m always concerned about the ability. If one person can’t do something, I won’t point people out. I just tweak it,” she said. So if only one person in a class struggles with an exercise, particularly in her Golden Fit and arthritis classes, Foerster will simply modify the motion in a way that everyone can still benefit while the individual she’s concerned about will not feel limited in comparison to others. This is key for Foerster. While improving physical wellbeing, strength and mobility for everyone is the concrete goal, her ultimate aim is to build each individual’s self-esteem. Indeed, Foerster’s own lifelong struggles with self-esteem most likely shaped her sensitivity to people who need to balance their physical well-being with their sense of who they are. Foerster knows she is classified as a “dwarf”, technically a physical

Walking Tall Anne Foerster: Water instructor at Northeast YMCA finds her niche By Carol Radin condition where short stature and disproportionate limbs are characteristic. Foerster is 4 feet 3 inches tall. Ask her how she self-identifies outside that medical classification, and she just shrugs and says, “I just think of myself as a person who is the same as everyone else and as different as everyone else.” Challenging upbringing Everyone else did not see her that way, though, as she was growing up and as she entered into adulthood and the professional world. The daughter of a military officer, Foerster moved with her family every two years. That meant that every two years, she would deal with a whole new set of classmates whose first impressions were not always kind or tolerant. Yet, she realizes, “If we hadn’t

moved every two years, I wouldn’t be as strong as I am.” She credits the constant love and support of her parents and sister for getting her through the many changes of childhood and adolescence. She is especially close to her sister. Foerster experienced more challenges after college. She attended Hanckock Air Base, extension of Columbia College in Missouri, where she earned a Bachelor of Science degree in business management with a minor in accounting. In spite of possessing marketable skills, she had a difficult time getting a job and advancing within a job. She was certain that employers’ assessments of her were related to her appearance rather than her abilities. Yet she didn’t let this stop her. In one instance, when Foerster wanted to work in a hospital, she volunteered in their medical records department until a temporary position opened up August 2018 •

and she got it. When a full-time position opened up, though, and someone else got the job, she took the initiative to have a candid discussion with the human resources department about evaluating her solely on her qualifications and credentials. She eventually obtained a full-time position, but she wonders in retrospect if she would have gotten that position had it not been for her self-advocacy. How did Foerster do a reset from accountant to water fitness instructor? Especially when, as she says, “I wasn’t even thinking of being a water instructor!” It actually started in the water, when she herself was a participant in one of the arthritis classes. “An instructor teaching the class asked if I’d ever considered teaching a class,” she said. Erin Coelho, the instructor, was also the Y’s wellness coordinator at the time. Reflecting back on it, Foerster says, “She planted a seed and she let it grow. She saw a lot in me.” With Erin’s encouragement and mentorship, Foerster undertook training to become a certified water instructor by engaging in program certification classes, CPR, First Aid, automated external defibrillators, as well as an extensive Arthritis Association program, which provides strict exercise guidelines and a knowledge base for working with people with arthritic conditions. While the certification process qualified her professionally, Foerster also brought her own set of personal goals to her new position. Just as the instructor who saw a lot in her endowed Foerster with confidence, she now seizes the opportunity to endow others with that confidence. Thinking back on the rewarding aspects of her instruction, she recalls examples. “I had a woman in a walker who said she needed it because her balance was poor. In the last two weeks, she hasn’t used the walker! And she said to me, ‘Not only do I feel stronger, but I have balance!’” Foerster also senses that some people who come to class do not see many people all day. Some are in pain or recovering from surgery. Some are elderly. They may feel limited both physically and socially. “Some people begin down in the dumps. They’re not feeling good. Not talking to people. You can see the difference after a while. They start smiling. They can do more of the movements. You can see they’re feeling better about themselves,” she said. Foerster creates that atmosphere where people thrive. She approaches her instruction as a physical and emotional process for her exercisers — and for herself, for she too thrives in her role. “Life wasn’t easy,” she said while reflecting on her past. Yet she pressed on and never let herself get discouraged. That spirit led her to the YMCA pool. Foerster has found a place for herself and for others to achieve wellness and self-esteem. Oh! And to make those whitecaps!

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2.5 Million U.S. High School Kids Had a Concussion Last Year

he damaging effects of a concussion are well-known, and new research finds the injuries are common among U.S. high school students. In a representative survey of nearly 15,000 kids in grades 9 through 12, just over 15 percent — equal to 2.5 million American youths — said they had suffered at least one concussion over the prior year. The survey was conducted in 2017, and echoes results from prior surveys, according to researchers led by Lara DePadilla of the U.S. Centers for Disease Control and Prevention. What’s more, 6 percent of respondents “reported two or more concussions” over the past 12 months, and 2 percent said they’d experienced four or more of the head injuries. And the new figures — based on anonymous interviews with high schoolers — may be undercounting concussion frequency. “Underreporting of concussions among athletes remains an important issue,” DePadilla’s group noted. In another study, 40 percent of high school students who believed they had suffered a concussion said that “their coach was unaware of their symptoms,” the CDC researchers said. One emergency physician agreed that too many concussions go unreported. “The public needs to understand that you don’t have to lose consciousness to have a concussion. In fact, body impacts that transmit force to the head and neck can also result in concussive symptoms,” said physician Robert Glatter, who works in the ER at Lenox Hill Hospital in New York City. In the CDC study, boys were more prone to concussion than girls, and the injuries were highly linked with team sports. In fact, “the odds of reporting a concussion increased significantly with the number of sports teams on which students played,” the researchers said. “It’s simply a matter of increasing the risk for collisions and contact, along with added risk of falls related to contact,” said Glatter, who was not involved with the new research. He stressed that a concussion can have lifelong effects as tragically illustrated in cases of late-life mental illness among retired National Football League players. That might be especially true for injuries sustained by teens, Glatter said. “Because children’s brains are rapidly developing, they are more vulnerable to the effects of blunt trauma, with neurological symptoms presenting in a delayed fashion as they age,” he explained. The study was published in the June 22 issue of the CDC journal Morbidity and Mortality Weekly Report. Page 18

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

Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

You Can Learn a Lot From the Animals

ecently, my family decided we needed more kittens in our lives. As card-carrying cat people, we already have two lovely cats. So, instead of going straight for adoption, we decided to foster some kittens. My husband and I haven’t fostered since our pre-child days, but we decided there was no time like the present to dive back in. We took in a mother and three kittens from the home of a hoarder. The kittens were only 6 days old. Their eyes weren’t open yet and they were deaf. They couldn’t walk. Our family was smitten. I hadn’t fostered kittens this young before; as such, I was fascinated by Mama cat. After all, she is a fellow mammal, and I couldn’t help but study her mothering ways. After three or four days of watching Mama cat, I realized something — we humans could learn a lot from animal moms. It’s been almost four years since I had a new baby, but I remember (as clearly as an overwhelmed and sleep-deprived person can) what it felt like. It felt like pressure and worry. If you aren’t careful, and you let

the world in, being a new mom can feel impossible. There are so many expectations competing for your attention. Most of them are a complete waste of time, but society would never clue you in to that. That’s why I want to share what I learned from Mama cat. Have two priorities. From the moment we brought her in our house, it was clear Mama cat had just two priorities — her kittens and herself. She had very little regard for anything else. She knew she had to protect herself to protect her kittens. She understood she had to sleep, eat and drink enough to take care of her babies. Gobble down your food. Mama cat snarfing down food was a sight to behold. She shamelessly ate all the kibble she could. When I brought wet food to her right after a kibble snack, she had no problem helping herself to second dinner. She had babies to feed, and she wasn’t worried about how soon she would get back to her pre-kitten weight. She ate until she was full and didn’t think twice about it. Breastfeed when you need to. Mama

cat had no problem dropping whatever she was doing to nurse her kittens. When her kittens signaled they needed milk, she gave it to them. She wasn’t worried about who caught a glimpse of her nipple before a kitten had the chance to latch on. She didn’t care if she had visitors. She didn’t try to cover her nipples with a blanket, just in case someone might be looking. She didn’t care if her kittens had just eaten. She just let them eat. Necessities first. I put toys in mama’s pen, but I didn’t see her playing with them. She had kittens to nurse and kittens to clean. She had sleep to get and food to gobble. She wasn’t worried about adventures outside of her pen. She wasn’t worried about outings and expectations. She was worried about herself and her kittens. She realized the world could carry on around her and without her while she focused on the task at hand. Don’t try to keep up appearances. If anyone watches a cat long enough, chances are they will bear witness to some amount of grooming. I didn’t see Mama cat grooming once. I’m sure she did, but she wasn’t holding herself to her pre-kitten standards of beauty. She recognized she had more important things to tend to. If her fur was a little out of alignment, she didn’t sweat it. Don’t worry about the perfect picture. I tried to get many pictures of Mama and her adorable litter, but Mama wasn’t interested. She didn’t care about her social media feed (possibly because she doesn’t have one). She wasn’t vying for likes on her kitten pics. She wasn’t worried about what filters put her kittens in the best light. She was too busy just being present. Don’t be afraid to take a minute. Every so often, especially when the

Learning from Mama cat. kittens were sleeping, I would find Mama outside of the carrier where she kept her kittens. She wouldn’t be eating, cleaning or playing. She was just resting and relaxing. As much as she loved the kittens, she knew it was necessary and perfectly normal to step away and take a little time for herself. Make time for treats. When I shook a treat bag, Mama knew it was time to drop everything. She knew she deserved some cat treats. She would stop nursing, stop giving baths and gently roll a sleeping kitten off to the side to make way for treats. Love, love, love. Our kittens must have felt like the most beloved kittens on the planet. Not because they had two adults and two children constantly fawning over their existence but because Mama took immaculate care of them. She let them nurse when they were hungry. She kept their bodies clean. She snuggled them when they were sleeping. She even looked happy and content while doing it. She was likely able to pull off a zen-like composure because she wasn’t worried about all the unnecessary stuff human parents worry themselves with. May we all try to be a little more like Mama cat.

Study Shows 35% Decline in Opioid Prescriptions Filled in NYS

rom 2013 to 2017, New York state had a steeper decline in the number of opioid prescriptions filled by commercially insured Blue Cross Blue Shield members than the nation as a whole, according to a national report highlighted today by Excellus BlueCross BlueShield. Excellus BCBS highlighted the following New York state findings from a national Blue Cross Blue Shield Association report, “The Opioid Epidemic in America: An Update.” The report studied the pharmacy and medical claims of more than 41 million BCBS commercially insured members, including those in New York state. • From 2013-2017, New York state had a greater decline in the number of opioid prescriptions filled (35 percent) than the nation as a whole (29 percent). • In 2017, the opioid prescription rate (total number of opioid prescriptions filled per 1,000 members) in New York state was third-lowest among all states included in the study. Last year, 230 opioid prescriptions were filled per 1,000 members in New York state, versus 394 per 1,000 members nationwide. • In 2017, 71 percent of BCBS members in New York state filled their first opioid prescription within the dose and duration guidelines set by the Centers for Disease Control and Prevention. • In 2017, the rate of opioid use

disorder diagnoses was lower in (metropolitan statistical area data) New York state (5.0 diagnoses per 1,000 Percent members) than the Opioid prescriptions per 1,000 BCBS members 2013 2017 change nation (5.9 diagnoses per 1,000 members). Albany-Schenectady-Troy 392 257 -34% “Today’s report Binghamton 390 248 -36% by our national association is helpful Buffalo-Niagara Falls 371 233 -37% in measuring the progress made Elmira 457 291 -36% in addressing the Glens Falls 409 305 -25% opioid crisis,” said physician Martin Jamestown 361 288 -20% Lustick, Excellus BCBS corporate New York-Northern New Jersey-Long Island 357 222 -38% medical director. “New York state Rochester 363 245 -33% health care providers are making great Syracuse 376 252 -33% strides in promoting the safe and approUtica-Rome 376 251 -33% priate prescription of New York state 354 230 -35% opioids.” Lustick credits National 558 394 -29% the decline in the number of opioid Source: Blue Cross Blue Shield Association. prescriptions filled Confidential — Do Not Distribute in New York state in 4 ing requirement that helps enforce part to new prescripreport shows that state efforts have tion requirements passed by the state the state restrictions. The health plan helped to reduce the number of opialso has been working to address in 2016. oid prescriptions filled,” said Lustick. the crisis by providing individuals Those requirements restricted For more information regarding the initial fill rates of opioid prescrip- diagnosed with opioid use disorder the BCBS study from The Health of access to various treatment options. tions to be within CDC-recommendAmerica Report series, visit www. “While all areas of the country still ed guidelines. bcbs.com/the-health-of-america/ have a long way to go in improvEffective July 1, Excellus BCBS reports/the-opioid-epidemic-amerialso implemented an opioid prescrib- ing how opioids are prescribed, the ca-update.

Opioid Prescription Rates 2013-2017

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Golden Years Jane Friedel, left, and her aide, Pat Weaver: “It gives her some entertainment, gets her out of the house,” Weaver said of the Syracuse Memory Café. “She takes part in the singing. She loves it.”

Café Offers Respite for Caregivers, Those Suffering from Memory Problems

Syracuse Memory Café in DeWitt gathers 30 to 40 people each month. They come for socialization, relaxation By Mary Beth Roach

t’s late morning on the second Wednesday of the month and the hall on the lower level of the Pebble Hill Presbyterian Church is set up with chairs situated around brightly covered tables. On the tables are boxes of Cracker Jacks and songbooks. A volunteer is playing some “golden Oldies” on the piano, and a couple of other volunteers are at the doors of the Syracuse Memory Café, welcoming guests with memory changes and their caregivers to the monthly program. On this particular morning, local magicians, The Jackman Twins, are meandering among the tables, showing off some of their magic tricks to the guests. The Syracuse Memory Café is especially designed for those with memory changes, like dementia and Alzheimer’s, and their caregivers to provide them with 90 minutes of relaxation, entertainment, a light lunch and, most of all, the opportunity for socialization. The café opens at 10:30 a.m. and is free. No reservations are required. It is located next the church’s parking lot, with a sloping walkway to the

front door, allowing for easy accessibility. “The Syracuse Memory Café is purely a social time at a time when many social connections are severed because the caregiver is overwhelmed with what they’re going through, it’s difficult to get the individual out or people don’t know how to interact with someone with memory changes,” said Tim Frazee, café organizer. The local project has been running since January 2017, by a ministry out of the Pebble Hill Presbyterian Church on Jamesville Road in Dewitt. The church had a capital campaign a few years ago, Frazee said, and 10 percent of that was tithed, according to Frazee. “We wanted to do something significant. We reached out into the community, and after some research and talking, this is what we came up with,” Frazee said. The group, Frazee continued, had decided they wanted to do a program that was centered around the senior population or was health-related. Then, one of the members who had been in Colorado at the time,

sent an email about a memory café he had read about. The ministry began doing some research and learned that these memory cafes had begun in The Netherlands, had spread throughout Europe and currently there are several hundred in the United States. They also learned of a memory café in Cortland at the time, so the two groups met several times. “We then went down and visited their café and we all looked at each other and said, ‘this is us. We can do this. We want to do this,’” Frazee said. The Cortland program no longer exists, so the café in Dewitt is the only one of its kind in Central New York. One of the crucial aspects of the café program is its focus not only on the individual with the memory change but his or her caregiver, as well. “Most people in general, when they think of an individual with Alzheimer’s or any form of dementia, immediately think of that individual with the memory changes,” Frazee said. “We learn very quickly that something like this is as important to

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

the caregivers as it is to the individual with the memory changes. This allows the two of them to get out and socialize, interact with each other in a way that they used to and get them out of their dementia-centric home. And enjoy each other’s company in a different environment.” The socialization that the café provides is key for Bob Poorman, who has been bringing his bride of 66 years, Joan, to the café for the past nine months. “You get to talk to other people,” Poorman said. And sitting at one of the tables in the first row, the couple would soon be participating in the magic act that morning. At the conclusion of the show, when one of the Jackman Twins literally pulled a rabbit out of his hat, he set it down in front of Joan to pet for a few moments. Jane Friedel and her aide, Pat Weaver, are relative newcomers to the café, having visited about four times. “It gives her some entertainment, gets her out of the house,” Weaver said. “She takes part in the singing. She loves it.” Another key to the success of the café is the corps of volunteers: it has more than 20, all members of the Pebble Hill Presbyterian Church, who interact with the guests, join them in the sing-alongs, and prepare and serve the luncheon treats. One of those volunteers is Nancy Stewart, who’s been involved for about a year. “I believe in the purpose of it, which is to bring connections for people,” she said. “It’s a tremendous group to work with. Everybody does their part here. It’s a completely compatible group of people doing it.” Currently, the café serves between 30 and 40 people each month, and can accommodate more guests, Frazee said. He also noted that they would like to help develop other cafes in Central New York. “Growth is going to come from fostering other cafes. People told us very quickly we need to do this more than once a month, which is a challenge. Our goal right now is to foster other cafes in other locations throughout the Syracuse area so we can have one every week,” he said. For more information on the Syracuse Memory Café, visit www. syracusememorycafe.com or call 315446-0960.

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Golden Years

Upstate Medical Opens Geriatric Department

Geriatrics is now a department of its own at Upstate Medical University By Deborah Jeanne Sergeant

n consideration of the ever-growing baby boomer population, Upstate Medical University has recently opened geriatrics as a clinical department, joining the ranks of other Upstate specialties like surgery, psychiatry, neurology and neurosurgery. Geriatrician Sharon Brangman, a SUNY distinguished professor, has led Upstate’s sub-division of geriatrics for the past 20 years and as of July 1, she is chairwoman of the department of geriatrics. She has also served as a past president of the American Geriatrics Society. She views geriatrics as a multi-faceted specialty. “I think the mission of geriatrics is broad enough to intersect at all the departments, except maybe pediatrics,” Brangman said. “I’m hoping to work with the others specialists to focus care on older adults and look at the hospital environment to make sure it’s welcoming and appropriate for older adults since we live in a part of the state with a high concen-

tration of older adults.” During her tenure at Upstate, Brangman has led Upstate in developing its geriatric emergency medicine care to provide emergency care to older adults. The organization has also received recognition as a NICHE (Nurses Improving Care for Healthsystem Elders) for its service by geriatric-trained nurses. Upstate also developed multi-faceted ACE (Acute Care for the Elderly) health care team. Upstate also offers a transitional care unit for patients doing well, yet not ready for discharge. Brangman said the department will work to develop new curriculum to provide other departments more education in and exposure to geriatric patients and to include interns and residents in more interactions with older patients. “Everyone will be taking care of older people,” Brangman said. “That is the reality of medical care. Since people are living longer and we’re in the midst of an aging baby boomer population, older people will receive

all sorts of care. Every aspect of our medical system needs to identify their needs to do well.” Previously, geriatrics was a sub-division under the department of medicine. The move to an independent geriatrics department marks SUNY Upstate’s recognition of the growth among the baby boomer generation. According to the US Census Bureau, the baby boomer generation will all be older than 65 by 2030 — just 12 years away. That shift seems even more important when compared with the number of young people in the near future. By 2035, the nation will have more people over 65 than people younger than 18. The National Council on Aging states on its website that 80 percent of older adults has at least one chronic disease. Many of those have more than one chronic disease to manage. Among those is Alzheimer’s disease. According to the Alzheimer’s Association, 5.7 million Americans currently have Alzheimer’s. The

Geriatrician Sharon Brangman

Upstate also plans to increase its emphasis on Alzheimer’s research and treatment. Plans to break ground for a new building for this purpose are in the works. organization projects that by 2050, that figure will increase to almost 14 million. Upstate also plans to increase its emphasis on Alzheimer’s research and treatment. Upstate plans to break ground for a new building for this purpose at the corner of Almond and East Adams streets, Nappi Longevity Institute. The facility is named for benefactors Sam and Carol Nappi.

Practice Debuts New Version of CyberKnife to Fight Cancer Hematology-Oncology Associates adopts new version of equipment it says is even more precise and effective in the fight against certain cancers

fter 10 years of impressive clinical outcomes, remarkable pain relief and new hope for cancer patients, Hematology-Oncology Associates of Central New York (HOA) recently replaced its original CyberKnife with an updated, even more precise, faster and effective version known as the CyberKnife M6 Series. The new CyberKnife (CK) remains the only FDA-approved completely robotic stereotactic radiosurgery system available in the world that targets and destroys previously inaccessible tumors. The new CK delivers dose with sub-millimeter accuracy, even to moving targets. The radiation dose adjusts automatically in real-time to respiration and other changes in tumor position. It has anatomy-specific tracking and treatment delivery solutions for brain, spine, lung and prostate.

“In addition to being a proven and effective alternative to surgery or conventional radiation for many types of cancer, patient throughput advancements, reduced treatment times and greater efficiency is also seen with this updated model,” said physician Tracy E. Alpert, board-certified radiation oncologist, partner and director of the radiation oncology program at HOA. Sub-millimeter accuracy means effective treatment with less harm to healthy tissue and long term negative effects. The CyberKnife continues to demonstrate the efficacy and longterm success of treating cancers, according to Alpert. “It has become a standard option for prostate cancer treatment,” the physician said. Compared to conventional radiation/IMRT, CyberKnife has a fiveday treatment regime instead of a 45-day treatment regime for prostate

The new CyberKnife M6 Series installed at Hematology Oncology Associates. cancer. This not only saves patients time and anxiety, it cuts down on copays and the overall costs of treating prostate cancer. In addition, over 9 years of data shows profiles on sparing healthy tissues, namely rectum and bladder, to be better than IMRT when the CyberKnife was used for prostate treatment. Collaboration with physicians of other specialties, such as neurosurgery, thoracic surgery, urology, GI, ENT, and general surgery continues at HOA. Specialists maintain their relationship with their patients by August 2018 •

being involved in the planning of this procedure. Multidisciplinary teams of physicians and clinical staff also review cases and discuss treatment options and the management of care. Alpert said HOA is privileged to provide this cutting-edge treatment option to patients. “It provides opportunities in cancer care that do not exist at any other facility in Central New York,” she said. Hematology-Oncology Associates is also the only cancer practice in Central New York certified for quality by ASCO, The American Society of Clinical Oncology.

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Golden Years

Excessive Heat Poses Risks for Older Adults By Deborah Jeanne Sergeant

or most people, extremely hot weather is a bit of a nuisance and fodder for light conversation. For elderly people, hot weather can be deadly. According to the U.S. Environmental Protection Agency, “people aged 65-plus have been several times more likely to die from heat-related cardiovascular disease than the general population.” “Our bodies are designed to maintain a steady temperature, but in extreme temperatures, the body’s thermoregulation may fail,” said Natina Reed, a nurse specializing in gerontology at St. Joseph Health. “Heat exposure may cause a variety of conditions in older adults as their body’s internal temperature rises,” Reed said. “This can include heat stroke, heat cramps, heat exhaustion or syncope related to overheating. These can quickly become life threatening conditions in older adults. It is important to be aware of medications that may create an increased sensitivity to sunlight as well, as this can increase risk of burning, thus overheating.” Reed said that the signs of overheating can include painful muscle cramps, nausea, vomiting, racing pulse, thirst, lack of sweating, increased anxiety or headache.

So why are older adults more prone to heat exhaustion and heat stroke? “Our body’s ability to adapt to extremes in weather can change,” said geriatrician Sharon Brangman, chief of the department of geriatrics at Upstate University Hospital. “It can take a long time to feel thirsty, even though you’re dehydrated.” She said that sensitivity for heat worsens the more dehydrated the person becomes; that’s why sufficient hydration represents the first step in combating heatstroke. Some older adults take diuretic medication. They should discuss with their doctors about adjusting the dose during hot weather. Drinking caffeinated beverages Free AC For Qualified People

People who need an air conditioner but cannot afford one may be eligible to receive up to $800 in help purchasing and installing a unit through the HEAP Cooling Assistance benefit through Aug. 31 or until funding runs out. Visit http://otda.ny.gov/programs/ heap/contacts to find your county’s contacts.

Some seniors don’t have a normal thirst mechanism and don’t recognize when they’re dehydrated, according to experts, who emphasize the need for seniors to drink plenty of water. these organizations can arrange for like cola, tea or coffee or drinking pick-up if requested, she said. alcohol tend to further dehydrate Physician Az Tahir practices people since they are diuretics. “I encourage older adults to have holistic integrative medicine at High Point Wellness in Syracuse. He said a drink of water even if they’re not that for seniors who don’t have or thirsty, to keep hydration going,” don’t want an air conditioner, an “InBrangman said. dian air conditioner” can help. Wring For people who don’t like the out a wet cloth and hang it in front of taste of water, adding slices of lemon a fan so it can blow cooled air. or cucumber can flavor it. “Use wet towels to keep the skin Staying indoors can help reduce and head cool,” he said. “Keep your the effects of extreme heat. In addilegs in cool water with Epsom salts tion to cooling the air, air conditionin it. It helps keep the body cool. You ing reduces humidity, which can can take more frequent showers.” make breathing easier. Avoid outdoor activity during For those with a single window hot part of the day.” air conditioner, Brangman suggested For example, garden very early having the conditioner in a room in the morning or closer to sunset or where the most time is spent. consider hiring temporary help for “I tell people if they don’t have weeding, pruning and mowing. an air conditioner, go to the movies Exercise in an air conditioned or the mall, or the library,” Brangman environment or go swimming. Many said. communities open their school pools Churches and senior centers also for free recreational use. usually air conditioned, and some of

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Incontinence, urethral stricture disease, vesicovaginal fistula, reconstructive surgery, transgender care DMITRIY NIKOLAVSKY, MD Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities MATTHEW D. MASON, MD Reconstructive urology, incontinence, prosthetics, urinary fistula, neurogenic bladder, urinary diversion. Robotic surgery STEPHEN BLAKELY, MD

General urology, endourology and laporoscopic surgery EDWARD IOFFE, MD

Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities JONATHAN RIDDELL, MD General urology, male health, urologic oncology, enlarged prostate, kidney stones. At Upstate Urology of Auburn. RYAN SIDEBOTTOM, DO Urologic oncology, robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

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FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500 Page 22

•

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

Golden Years

Hidden Problem: Mental Health Problems Among Seniors Mental issues affecting senior population are largely overlooked By Deborah Jeanne Sergeant

ore than 15 percent of adults aged 60 and older experience mental health disorders, according to the World Health Organization. Many of those don’t receive proper treatment for conditions such as depression and anxiety. “Depression is both under-diagnosed and undertreated in primary care settings,” the World Health Organization states on its website. “Symptoms are often overlooked and untreated because they co-occur with other problems encountered by older adults.” Locally, that rings true as well. “Anxiety and depression are very overlooked in older adults,” said physician Az Tahir, who practices holistic integrative medicine at High Point Wellness in Syracuse. He said as an example, depression and dementia can overlap and be both misdiagnosed. Plus, some older adults don’t express their mental state accurately — few health care providers ask about it during visits. “We find many times that patients will look OK, but when we do questionnaires on depression, we

find that depression is present,” Tahir said. Mental health issues are different from temporary adjustment to aging. For example, the American Psychiatric Association states that depression’s symptoms last two weeks or longer. An occasional feeling of sadness or grief from loss is different. “When an older adult is experiencing a loss or death of a loved one, people say, ‘I’d be depressed too’ but don’t see it as something that can need attention,” said physician Sharon Brangman, chief of the Department of Geriatrics at Upstate University Hospital. She added that one reason it’s overlooked is that older adults can present different symptoms of depression, perhaps not openly crying but feeling confused, lacking energy and struggling to focus. Young people experience depression, anxiety and other mental health issues, yet their age isn’t blamed for their conditions. But older adults may be more prone to mental health issues because of their life stage and the life changes that often come at

Alzheimer’s Vs. Dementia: What’s the Difference? By Jim Miller

any people use the words “Alzheimer’s disease” and “dementia” interchangeably, but they are not the same thing. In fact, you can have a form of dementia that is completely unrelated to Alzheimer’s disease. Here’s what you should know. Dementia versus Alzheimer’s Dementia is a general term for

a set of symptoms that includes memory loss, impaired communication skills, a decline in reasoning and changes in behavior. It most commonly strikes elderly people and used to be referred to as senility. Alzheimer’s disease is a specific illness that is the most common cause of dementia. Though many diseases can cause dementia, Alzheimer’s — which affects 5.7 million Americans

that stage. People with lifelong mental health issues may find that the medication that worked well in their 40s and 50s isn’t working as well as it used to, since the body’s ability to metabolize medication decreases with age. Or, they may need medication to address physical health issues that affect the efficacy of their mental health medication. “Now Medicare doesn’t really cover psychiatric issues,” Brangman said. “Older adults may have trouble paying for these services or finding a mental health professional who accepts Medicare. It was really meant to take care of problems ‘from the neck down’ not mental health issues.” Many older adults possess fewer resources that support good mental health, such as a network of nearby loved ones, the ability to exercise vigorously, overall good physical health and purposeful, engaging activity. Life changes such as retirement, loss of peers to death and relocation, encroaching physical limitations, and age-related physical issues all affect today — accounts for 60 percent to 80 percent of dementia cases, which is why you often hear the terms used interchangeably. But there are many other conditions that can cause symptoms of dementia like vascular dementia, which is the second most common cause, accounting for about 10 percent of dementia cases. Vascular dementia is caused by a stroke or poor blood flow to the brain. Other degenerative disorders that can cause dementia include Lewy body dementia, Parkinson’s disease, Frontotemporal dementia, Creutzfeldt-Jakob disease, Chronic Traumatic Encephalopathy (CTE), Huntington’s disease and Korsakoff Syndrome. Some patients may also have more than one form of dementia known as mixed dementia. Dementia is caused by damage to brain cells, but the symptoms can vary depending on the cause. In the case of Alzheimer’s disease, protein fragments or plaques that accumulate in the space between nerve cells and twisted tangles of another protein that build up inside cells cause the damage. In Alzheimer’s disease, dementia gets progressively worse to the point where patients cannot carry out daily activities and cannot speak, respond August 2018 •

mental health. Susan Hartman Brenizer, licensed marriage and family therapist practicing in Fayetteville, encourages older adults and their care providers to review medication and receive a thorough exam by a physician trained in older adult issues. She said that although older adults may be more at risk for depression, “anxiety usually gets lower as we get older,” Brenizer said. “We find ways to cope and we’re not as anxious in life because of experiences.” Less obvious symptoms of depression could include fatigue, sluggishness and lack of interest and motivation. But since some of these can indicate physical health issues, a medical evaluation can be very helpful. “People who really fare well in older age have some grit to them,” Brenizer said. “Mental health issues can hide behind actual health issues. We might see an older parent saying, ‘I’m too tired to do my chores’ or ‘I’m too tired to make a full meal for myself. I’m just going to eat cereal.’ It can mean ‘I’m depressed’ or ‘I’m lonely.’ Are they too tired and that’s related to a health issue like a thyroid disorder or autoimmune disease? Or do they not see the use in moving forward?” Brenizer thinks that one of the top causes of mental health issues for older people is loneliness, which can also turn into lack of purpose and lower well-being. She encourages older adults and their loved ones to stay better connected, both virtually and in person and look for reasons to get out such as joining a group activity or club. Consulting with a health care provider for screening and possible referral to a mental health professional can also help.

to their environment, swallow or walk. Although some treatments may temporarily ease symptoms, the downward progression of disease continues and it is not curable. But some forms of dementia are reversible, which is why it’s important to be evaluated by a physician early on. Vitamin deficiencies, thyroid problems, brain tumors, depression, excessive alcohol use, medication side effects and certain infectious diseases can cause reversible forms of dementia. Another treatable form of dementia is a condition known as normal pressure hydrocephalus, which is caused by a buildup of cerebrospinal fluid in the brain that can be relieved by surgically implanting a shunt to drain off excess fluid. This type of dementia is often preceded or accompanied by difficulty walking and incontinence. To learn more about the different types of dementia, including the symptoms, risks, causes and treatments visit the Alzheimer’s Association at ALZ.org/dementia. Jim Miller is the author of Savvy Senior, a column published every issue in this newspaper.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 23

Golden Years

Geriatric Syndromes Require Special Care As we age, we become more likely to develop several co-occurring health problems that feed each other. These are called â&#x20AC;&#x2DC;geriatric syndromesâ&#x20AC;&#x2122; By Deborah Jeanne Sergeant

ach individualâ&#x20AC;&#x2122;s health differs; however, â&#x20AC;&#x153;geriatric syndromesâ&#x20AC;? describe a group of health concerns experienced by many older adults that often have multiple causes and involve different bodily parts and systems. These can include continence, sleep issues, cognitive issues, falls, osteoporosis and weight loss/frailty. For an older adult, incontinence could contribute to sleep issues and falls. Or weight loss and frailty from poor eating is often linked to osteoporosis, which would worsen the effect of a fall and lead to further frailty after a hip fracture. Physician Sharon Brangman serves as chief of the department of geriatrics at Upstate University Hospital. She said that a general

practitioner may not connect the syndromes as causal or even relational, but view them as separate conditions. â&#x20AC;&#x153;Geriatric syndromes arenâ&#x20AC;&#x2122;t associated with any one system and often overlap,â&#x20AC;? Brangman said. â&#x20AC;&#x153;You have a very complex issue you have to evaluate. It needs a comprehensive approach.â&#x20AC;? She offered falls as an example. High blood pressure medication thatâ&#x20AC;&#x2122;s too strong may lower seniorsâ&#x20AC;&#x2122; blood pressure to the point where theyâ&#x20AC;&#x2122;re at fall risk. Older people donâ&#x20AC;&#x2122;t metabolize medication the same way as younger people do. Poor vision may affect their ability to stay on their feet. Taking a water pill may make them use the bathroom at night, which raises fall risk since they must navigate in low lighting at a time when most people feel at least a little disoriented. Most falls

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by elderly people occur in bedrooms and bathrooms. People who sit a lot may lose strength in their legs and experience more balance issues. Brangman said that geriatricians tend to look at the bigger picture, such as how medication affects seniors, how not eating and drinking properly may affect balance â&#x20AC;&#x201D; do memory issues affect their compliance with taking medication or using a walker as needed? Treating all of these facets as separate issues may reduce the overall effectiveness of the care provided to patients. It can also contribute to secondary issues as more medications bring more side effects. Geriatricians receive training to recognize the relationships among various geriatric syndromes and the issues involved. Not every senior can see a geriatrician because the US lacks geriatricians and not all general practitioners or internists possess training for geriatrics. â&#x20AC;&#x153;Geriatricians are the No. 1 specialty for head hunters and recruiters in medicine,â&#x20AC;? Brangman said. She also wants more general providers and non-geriatric specialists to receive more training in geriatric issues to handle basic issues, â&#x20AC;&#x153;so geriatricians can take care of more complex cases,â&#x20AC;? Brangman said. With more providers looking for measurable symptoms like falls and osteoporosis, non-geriatricians can help patients prevent more complicated medical issues and, as needed, refer patients to geriatricians for more complex cases, where conservative measures seem less effective. Physician Az Tahir practices holistic integrative medicine at

High Point Wellness in Syracuse. He believes that family members and caregivers should understand the concept of geriatric syndromes as well. For example, many different factors can influence an older person to fall. Tahir listed cataracts, muscle weakness and slower reaction time. He added that the outcome of falls can also relate to many other health concerns, such as broken bones because of osteoporosis, bedsores and further frailty. â&#x20AC;&#x153;Falls are major cause of fractures and mortality and morbidity in old people,â&#x20AC;? Tahir said. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s important to prevent falls.â&#x20AC;? This can involve many aspects of care, too, such as reducing environmental hazards, balance improvement programs, eye exams and bone density testing. While some of these issues may be part of the normal aging process, geriatric syndromes arenâ&#x20AC;&#x2122;t, according to Natina Reed, bachelorâ&#x20AC;&#x2122;s trained nurse specializing in gerontology at St. Joseph Health. When not treated properly, a seemingly small and unrelated issue can cause what Reed calls a â&#x20AC;&#x153;waterfall of issues,â&#x20AC;? since it affects so many things. â&#x20AC;&#x153;A urinary tract infection or pneumonia can cause a total lifestyle change due to decreased mobility, changes in cognition and frailty,â&#x20AC;? said Reed. â&#x20AC;&#x153;After suffering a fall, one can experience sleep issues, incontinence, trying to get to the restroom safely and changes in nutrition which can increase how frail they become. After a fall a person can also experience chronic pain and changes in mobility which often changes their daily activities.â&#x20AC;?

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Simple Gadgets That Can Help Older Drivers Dear Savvy Senior, Are there any specific auto gadgets you can recommend that can help senior drivers? Both of my parents are in their 80s and still pretty good drivers, but due to arthritis and age they’re very stiff, which causes them some driving problems.

Researching Daughter Dear Researching, To help keep senior drivers safe and prolong their driving years, there’s a plethora of inexpensive, aftermarket vehicle adaptions you can purchase that can easily be added to your parent’s vehicles to help with many different needs. Here are some good options. Entry and Exit Aids To help arthritic/mobility challenged seniors with getting into and out of their vehicle, there are a variety of portable support handles you can buy, like the “Emson Car Cane Portable Handle” ($12), which inserts into the U-shaped striker plate on the doorframe. And the “Standers CarCaddie” ($13) nylon support handle that hooks around the top of the door window frame. Another useful product is the “DMI Deluxe Swivel Seat Cushion” ($22), which is a round portable cushion that turns 360 degrees to help drivers and passengers rotate their body into and out of their vehicle. Enhanced Rear Vision To help seniors with limited upper body range of motion, which makes looking over their shoulder to back-up or merge into traffic difficult, there are special mirrors you can add as well as back-up cameras. For starters, to widen rear visibility, eliminate blind spots and even help with parallel parking, get an oversized rear view mirror like the “Allview Rearview Mirror” ($50) that clips on to the existing mirror. You should also purchase some “Ampper Blind Spot Mirrors” ($7.50), which are 2-inch adjustable convex mirrors that stick to the corner of the side view mirrors. Another helpful device is the “Auto-vox M1W Wireless Backup Camera Kit” ($110). This comes with a night vision camera that attaches

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to the rear license plate, and a small monitor that mounts to the dash or windshield. When the vehicle is in reverse, it sends live images wirelessly to the monitor so you can see what’s behind you. Seat Belt Extenders To make buckling up a little easier, there are a variety of seat belt extension products offered by Seat Belt Extender Pros like the “Seat Belt Grabber Handle” ($8), which is a rubber extension handle that attaches to the seat belt strap to make it easier to reach. And the “7-inch Rigid Seat Belt Extender” ($20) that fits into the seat belt buckle receiver to add a few inches of length, making them easier to fasten. Gripping Devices If your parents have hand arthritis that makes gripping the steering wheel, turning the ignition key or twisting open the gas cap difficult or painful, consider these products. The “SEG Direct Steering Wheel Cover” ($15) that fits over the steering wheel to make it larger and easier to grip. The “Ableware Hole-In-One Key Holder” ($9), which is a small plastic handle that attaches to the car key to provide additional leverage to turn the key in the ignition or door. And for help at the pump, the “Gas Cap & Oil Cap Opener by Gascapoff” ($12) is a long handled device that works like a wrench to loosen and tighten the gas cap. All of these products can be found online at Amazon.com. Just type the product name in the search bar to find them. Safety and Security To help ensure your parents safety, and provide you and them peace of mind, they should also consider an in-car medical alert system like “splitsecnd.” Offered through Bay Alarm Medical (BayAlarmMedical. com, $30/month), his small device plugs into the vehicle’s cigarette lighter to provide 24/7 roadside and emergency assistance at the push of a button, automatic crash detection and response, and GPS vehicle location and monitoring capabilities.

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

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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

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hile it may be best known for retirement, Social Security is also here to help you get back to work if you are disabled. For millions of people, work isn’t just a source of income, it’s a vital part of who they are — it gives them purpose and pride — it’s a connection to community. If you’re getting Social Security disability benefits, we have good news for you. Social Security’s work incentives and Ticket to Work programs can help you if you’re interested in working. Special rules make it possible for people receiving Social Security disability benefits or Supplemental Security Income (SSI) to work and still receive monthly payments. The Ticket to Work program may help you if you’d like to work. You can receive: • Free vocational rehabilitation; • Training; • Job referrals; and • Other employment support. You can read more about working while collecting disability bene-

Q&A

Q: My daughter just joined a nonprofit charity and is helping victims of natural disasters. She gets a salary. We were wondering if she has to pay Social Security tax. A: Yes, people who work for nonprofits and who receive a salary must pay Social Security tax just like everyone else. It is commendable that she is helping people in need. But the fact is that she is also a wage-earner. Those wages and the Social Security tax she pays on them will offer her financial relief in the future, when it comes time to apply for Social Security. So she is really helping herself, too. For more information, visit our electronic publication, How You Earn Credits at www.socialsecurity.gov/ pubs. Q: A few years ago, I lost my Social Security card. Now my credit report shows that someone might be using my Social Security number. I’m afraid they might ruin my credit. What should I do? A: Identity theft and fraud are serious problems, not just for you, but for the financial integrity of our agency. It also puts our national security at risk if someone dangerous is using your number to obtain other forms of identification. It’s against the law to use someone else’s Social Security number, give false information when applying for a number or alter, buy or sell Social Security cards. Keep in mind, you should never carry your Social Security card with you.

Page 26

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

fits at www.socialsecurity.gov/work. Work incentives include: • Continued cash benefits for a time while you work; • Continued Medicare or Medicaid while you work; and • Help with education, training, and rehabilitation to start a new line of work. If you’re receiving Social Security disability benefits or SSI, let us know right away when you start or stop working, or if any other change occurs that could affect your benefits. If you returned to work, but you can’t continue working because of your medical condition, your benefits can start again — you may not have to file a new application. You can read more about the Ticket to Work program in the publication titled “Working While Disabled: How We Can Help” at www.socialsecurity.gov/pubs/EN05-10095.pdf. Part of securing today and tomorrow is giving you the tools to create a fulfilling life. Getting back to work might be part of that. We’re here with a ticket to a secure tomorrow. If you think someone is using your Social Security number fraudulently, you should report it to the Federal Trade Commission (FTC) right away. You can report it at www.idtheft. gov or you can call FTC’s hotline at 1-877-IDTHEFT (1-877-438-4261) TTY: (1-866-653-4261). Q: I served in the military, and I’ll receive a military pension when I retire. Will that affect my Social Security benefits? A: You can get both Social Security retirement benefits and military retirement at the same time. Generally, we don’t reduce your Social Security benefits because of your military benefits. When you’re ready to apply for Social Security retirement benefits, go to www.socialsecurity.gov/ applyonline. This is the fastest and easiest way to apply. For your convenience, you can always save your progress during your application and complete it later. And thank you for your military service! Q: I’ve decided I want to retire. Now what do I do? A: The fastest and easiest way to apply for retirement benefits is to go to www.socialsecurity.gov/onlineservices. Use our online application to apply for Social Security retirement or spouses benefits. To do so, you must: • Be at least 61 years and 9 months old; • Want to start your benefits in the next four months; and • Live in the United States or one of its commonwealths or territories.

Biking in Syracuse Cycle in the City promotes monthly bike rides around Syracuse. Public is invited to join remaining events By Mary Beth Roach

t’s about 8:45 on a Sunday morning in downtown Syracuse’s Armory Square area. While most people in this neighborhood might just be waking up, there’s a little area — at the Onondaga Creekwalk trailhead on Jefferson Street, behind the MOST — filled with people who are already wide awake. About 30 cyclists are gathered there, gearing up for the Cycle in the City bike ride, which takes place on the second Sunday of the month, from May to October. The event, which is a free and guided bike ride through Syracuse, began in 2011 as an initiative between Onondaga County, the City of Syracuse Department of Parks and Recreation, Syracuse Metropolitan Transportation Council and some members of local bike clubs. The riders can choose between a short ride, about 10 miles, or a longer ride, which is about 20 miles. John Allen leads the longer ride, although he laughingly admits that being 78 years of age and on a hybrid bike, sometimes the other riders pass him on the hills. He also puts togeth-

er most of the routes through the season. Bob Dougherty, another local bike enthusiast, leads the shorter ride. “I try and move it around through the city, since it’s ‘Cycle in the City,’” he said. The July ride took cyclists along the outer edges of the Syracuse University area before moving over into Eastwood. While there are inevitably some hills, organizers say that the riders are allowed to walk their bikes up those inclines. And there’s always someone or a “sag wagon” at the end the route, so no one is left behind. Barb Smorol joined in the ride during its second year. A native of Camillus, she said she never saw much of the city growing up. This allows her to see different areas of the city and some of the changes being made, along with getting some exercise, she said. “It gets me out early in the morning,” she said. “It’s a fun way to see the city from a different perspective than just buzzing by in your car.” The ride was developed seven years ago, as a new and different

way to introduce physical activity, according to Kathy Mogle, program coordinator with the Onondaga County Health Department, one of the partners in Cycle in the City. At the time, too, Mogle said, they were working with the city to adopt a complete street policy, showing a real need for bike lanes and trails and to raise awareness. Since it started, the city does have a complete street policy, but it’s a “never-ending challenge to encourage people to become and stay physically active,” she said. This ride is pedaling in the right direction, according to Mogle. For those who might be interested — or are interested yet hesitant —

about taking part, Mogle, Allen and Smorol shared some advice. Allen noted that riders know that they can finish 10 miles. Mogle encouraged them to get a good night’s sleep; eat breakfast, including a carb or two; bring a helmet and water; and ride at their own pace. “Don’t be afraid because you don’t think you have the ability,” Smorol said. “I was a little nervous about keeping up with everybody. But they wait for you.” The routes will vary, and maps for each ride are posted on the Cycle in the City website during the week leading up to that ride: https://healthyliving.ongov.net/2016/04/25/ cycle-in-the-city/.

Cycle in the City Bike Ride Cycle in the City, which started in May, will hold three more events this season. The remaining rides will be Aug. 12; Sept. 9. and Oct. 14. They are free of charge and bikers are welcome to join. All Cycle in the City rides begin and end at Onondaga Creekwalk trailhead on Jefferson Street (behind MOST in the Armory Square area) with a start time of 9 a.m. and they last about an hour. August 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 27

“Today, I Saw My Grandson Walk.” Miniature Telescope glasses for Macular Degeneration and other Low Vision Conditions Now Available

Imagine the heartbreak for someone who gradually loses the ability to see her grandchildren, husband, and the people who mean the most to her. Now imagine her joy when she can see them again. Dr. George Kornfeld, optometrist, member of the International Academy of Low Vision Specialists (IALVS), is using miniaturized telescopes which are mounted in glasses to help people who have reduced vision see better. Dr. Kornfeld is using this groundbreaking optical technology to make this dream a reality for patients with age related macular degeneration (AMD), the leading cause of blindness in older Americans.

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Rescue Mission to Build Expanded Food Service, Culinary Education Facility Facility to serve individuals experiencing hunger and homelessness

he Rescue Mission Alliance recently broke ground on a $5.8 million capital project to renovate and expand the Clarence L. Jordan Food Service and Culinary Education Center. “Believe: a Warm Meal and a Way Home” is a two-phase capital campaign on the nonprofit’s 8.5-acre campus in Syracuse to meet the need for meals and emergency housing in Central New York. The organization’s vision is to establish a place where basic needs of individuals experiencing hunger and homelessness can be met in a respectful and encouraging environment. Completed in 2015, phase one included the renovation of the mission’s former recreation center into the Alice C. Barber Day Center and Kiesewetter Emergency Shelter. Capacity was increased from 132 beds to 183 beds and essential services were centralized in one location. Phase two includes the expansion and enhancement of the food service

center. “This project is long overdue and, when completed, will have a tremendous impact on the people we serve,” said Rescue Mission Chief Executive Officer Dan Sieburg. “Our new food service center will allow us to meet the growing need in the community and will ensure those we serve will continue to be treated with dignity and respect.” The mission still needs to raise $1 million to achieve its $5.8 million goal for the Clarence L. Jordan Food Service and Culinary Education Center. To date more than 170 foundations, companies, churches and individuals have contributed to the capital campaign. “Now we are relying on the public to help us the rest of the way to our goal,” said Capital Campaign Committee Chairman David Allyn. “This building is of such importance to the community that we have to do everything possible to make sure the project is fully funded.”

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

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H ealth News ConnextCare announces leadership promotions ConnextCare, a private, federally funded nonprofit organization that provides Oswego County and surrounding county residents with a variety of comprehensive health care and related services, recently announced the following Clark promotions among its leadership team: • Tricia Peter Clark, the organization’s vice president/chief operating officer, was promoted to executive vice president/chief operating officer; • Nancy Deavers, the vice president/ chief nursing officer, was promoted to senior vice president/ Deavers chief nursing and quality officer; • Tracy Wimmer, controller, was promoted to vice president/ chief financial officer. “Tricia, Nancy and Tracy have been invaluable recruits for ConnextCare’s leadership team and their promotion is Wimmer recognition of their outstanding performance and our commitment to retaining them as valuable leaders,” said ConnextCare’s President/CEO Daniel Dey. Dey said a key goal was to update the health center’s recruitment, retention and succession plan. According to Dey, these promotions reflect efforts in addressing that goal. Clark previously served as director of health center operations for Oswego County Opportunities and coordinator for the Rural Health Network of Oswego County prior to joining ConnextCare six years ago. Deavers was previously director of clinical services for East Hill Family Medical and vice president/chief operating officer for Oswego Hospital. Wimmer served as director of internal review and finance for Upstate Cerebral Palsy in Utica prior to joining ConnextCare two years ago. Established in 1969 as Northern Oswego County Health Services, Inc. (NOCHSI), the organization recently changed its name to ConnextCare. It operates health centers in Fulton, Mexico, Oswego, Parish, Phoenix and Pulaski. It also operates six school-based health centers located in the APW, Mexico, Pulaski and Sandy Creek school districts. ConnextCare is accredited through the Joint

Commission and is recognized by the National Committee for Quality Assurance as a Level 3 Patient-Centered Medical Home.

Crouse gets American Heart Association award Crouse Health has received the Mission: Lifeline Gold Receiving Quality Achievement Award for implementing specific quality improvement measures outlined by the American Heart Association for the treatment of patients who suffer severe heart attacks. Every year, more than 250,000 people experience an ST elevation myocardial infarction (STEMI), the deadliest type of heart attack, caused by a blockage of blood flow to the heart that requires timely treatment. To prevent death, it’s critical to restore blood flow as quickly as possible, either by mechanically opening the blocked vessel or by providing clot-busting medication. The American Heart Association’s Mission: Lifeline program’s goal is to reduce system barriers to prompt treatment for heart attacks, beginning with the 9-1-1 call, to EMS transport and continuing through hospital treatment and discharge. The initiative provides tools, training and other resources to support heart attack care following protocols from the most recent evidence-based treatment guidelines. Crouse earned the award by meeting specific criteria and standards of performance for quick and appropriate treatment through emergency procedures to re-establish blood flow to blocked arteries in heart attack patients coming into the hospital directly or by transfer from another facility. “Crouse is dedicated to providing optimal care for heart attack patients,” said Lynne Shopiro, cardiac services administrator. “We are pleased to be recognized for our dedication and achievements in cardiac care through Mission: Lifeline.”

Nascentia Health announces new employees Nascentia Health, a local leader in home healthcare services, announced the addition of the following individuals to its team of healthcare professionals. • Certified Home Health Agency (CHHA) — Keisha Boyd, licensed practical nurse; Amy Ernst, registered nurse; Diana Farneti, quality

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Officials from Roswell Park Comprehensive Cancer Center and Oneida Healthcare celebratethe breaking ground on Oneida’s new radiation oncology center.

Roswell Park, Oneida Healthcare Break Ground on Radiation Center Two organizations, collaborating since 2016, to expand oncology services in Oneida, Madison County

oswell Park Comprehensive Cancer Center and Oneida Healthcare recently marked two milestones: the full implementation of a new medical oncology facility and ground-breaking at the site of a state-of-the-art radiation oncology center on the same campus. Both developments are part of a collaborative initiative to provide increased local access to the services of a National Cancer Institute (NCI)-designated comprehensive cancer center to residents of Central New York. Construction of the radiation oncology center, to be named in honor of the late Dorothy G. Griffin, will begin in the late summer. When completed, the center will occupy a 6,079-square-foot building, slated to open in 2019. It will contain four exam rooms, a consultation room, a CT scanner for treatment planning, a linear accelerator for radiation therapy and required support facilities on a single level in an outpatient setting. The center will accommodate oncology patient treatment planning, radiation therapy sessions and patient treatment monitoring. “Congratulations to Oneida Healthcare and Roswell Park Comprehensive Cancer Center on this exciting partnership that delivers the highest quality cancer treatment services,” says Sen. David J. Valesky. “Having these services available in Central New York means our community has the best possible care available right here, close to home.” Gene Morreale, president and CEO of Oneida Healthcare, said, “Today marks an important day for us, and we are excited to be partnering with Roswell Park Comprehensive Cancer Center to further develop our campus with the singular vision of delivering the best care locally for those in our region who require cancer care services. “Roswell Park and our local team will provide our region with quality cancer care that meets NCI guidelines, creating local access to some August 2018 •

of the latest treatment options from a nationally ranked cancer center,” Morreale said. The collaboration marks the first time such a broad array of cancer services will be united on a single site in this part of the state; previously, area families had to travel several hours to seek the services of a National Cancer Institute-designated comprehensive cancer center. “Everyone deserves access to great health care. We’re so proud of this affiliation because it represents two great healthcare organizations coming together to address this community’s needs while complementing existing resources, enabled by both public investment and the private donors who supported our vision,” says Candace S. Johnson, PhD, president and CEO of Roswell Park. Oneida Healthcare and Roswell Park are already providing care at a medical oncology center at 604 Seneca St. in Oneida on Oneida Healthcare’s campus. That facility, now fully operational with the recent appointment of physician Mohamed El-Naghy as medical director, includes 12 infusion suites, four exam rooms, a telemedicine conference center, a consultation room and a resource center. In 2016, Oneida Healthcare was awarded a grant from the NYS Department of Health for $6.75 million to expand oncology services to CNY in partnership with Roswell Park. That investment has been further supported by regional donors who have contributed over $2.3 million to the project over the past year. Oneida Healthcare also plans to expand its outpatient imaging center, the Alice M. Gorman Imaging Center, which represents the third step of its three-phase project to offer the highest quality of cancer care to CNY residents. The project will include the installation of a new state-of-theart MRI, PET/CT and a second 3-D mammography unit. This project is expected to be completed by the end of 2018.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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H ealth News Ward W. O’Hara

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assurance coordinator; Rachael Grosvenor, registered nurse; AnnMarie Mesick, home care coordinator; Laura Roberts, home health aide training coordinator; Danielle Sheriff, registered nurse; Justin Waters, physical therapist; and Aimee Williamson, registered nurse. • Licensed Home Care Service Agency (LHCSA) — Courtney Brown, Beth Cunningham, Billie Jo Fuller, Sarah Gonzalez, Christina Groesbeck, Abu Massalay, Lynnesia Morris, Anna Padilla, Kelsi Shoop, Tina Spaulding, Nathanial Stahl, and Carla Vazquez — all home health aides. • Managed Long-Term Care Program (MLTC) — Sharon Jones, care coordinator; and Selena Nicholson, transportation member services representative. “We are thrilled to welcome such talented and experienced individuals to the Nascentia Health team,” said President and CEO Kate Rolf. “Their fresh perspectives and unique skills and talents will help elevate and expand our capacity to pursue our mission of being the premier home and community-based care system for the regions we serve.”

Oswego Health medical imaging locations pass inspections Oswego Health’s four digital mammography imaging sites recently passed the Mammography Quality Standard Act (MQSA) inspection with 100 percent compliance, and not one issue or concern was noted on the inspection. The MQSA requires mammography facilities across the nation to meet uniform quality standards. The MQSA assures high-quality mammography for early breast

cancer detection, which can lead to early treatment, a range of treatment options, and increased chances of survival. The health system’s four mammography locations are in place in the Oswego Health Services Center, the Fulton Medical Center, the Central Square Medical Center and the Pulaski Health Center. “Our medical imaging staff is highly trained and very knowledgeable of the MQSA’s high standards,” said Arlene Young, Oswego Health’s radiology manager. “Just as important is ensuring that each patient has a comfortable, high quality patient experience.”

TriValley Family Practice joins Oneida Healthcare Effective July, TriValley Family Practice, a privately owned primary care practice with offices in Vernon and Canastota, officially joined Oneida Healthcare as an employed practice. Previously, TriValley operated independently as a member of Oneida Healthcare’s Circle of Care network. With the new arrangement, TriValley’s operations will be managed by Oneida Healthcare’s practice management team, Oneida Medical Practice (OMP). As part of the agreement, Oneida Healthcare will be employing all current and future staff at both locations. “They are a highly successful practice with an excellent reputation, we are excited for the TriValley Physicians and staff to be joining our dedicated team,” said Gene Morreale, president and CEO of Oneida Healthcare. “Our expanded partnership will provide them with the management support required in today’s healthcare landscape to ensure

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continued viability while allowing them to continue to offer convenient access to high quality primary care.” For TriValley the expanded partnership will allow them to continue to keep their focus on patient care. “New federal and state healthcare regulations have increased the need for additional management resources,” said physician John Wight, founder of TriValley. “We have had a long and successful partnership with Oneida Healthcare. We’re confident that our new arrangement will allow our staff to continue to be fully invested in providing the highest quality of care while Oneida Healthcare supports the management of our practice.” Oneida Healthcare currently employs three additional primary care practices and one internal medicine location covering the greater surrounding areas of Canastota-Lenox, Chittenango, and Verona. “Maintaining and increasing access to preventive care services in our area is key to the health of our communities,” said Morreale. “This new partnership will allow us to maintain local access while creating opportunity for expanded growth of services to meet organizational health initiatives.” Oneida Healthcare plans to invest in the current TriValley Canastota location later this summer with the construction of a 1,900 square foot addition which will include seven new patient exam rooms. The increased space will accommodate the addition of physician Michael Siegenthaler, who will be joining the Canastota location in mid-August. Siegenthaler’s twin brother, physician Matthew Siegenthaler, both of Vernon, will also be joining the practice in the Vernon location in mid-August.

Employees and officials at Crouse Health celebrate the opening of the hospital’s newly expanded main entrance.

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

ollowing several months of construction, Crouse Health recently re-opened a newly expanded main entrance and reception area in the Irving building. The space includes additional seating for visitors, a larger Jazzman’s Café with more nutritious offerings and a single entrance and exit area, which will help to better coordinate visitor flow in the main lobby area. In addition, work on the front of the Irving lobby is complete, which includes two new vehicle lanes to improve traffic flow and reduce congestion in this area. New, larger sidewalks — heated in the winter for safety — have also been installed in this area. As part of a larger project, in early October, phase 2 of the Pomeroy Emergency Services Department will open. This entails the re-location of Crouse PromptCare from across the street into the main emergency department. According to the hospital, this move will result in all emergency services — acute care and treatment for minor illnesses or injuries — being located in one location, which will be a convenience for patients.

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