IGH CNY 226 October 18 by In Good Health: CNY's Healthcare Newspaper

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Meet Your Doctor

CNYHEALTH.COM

OCTOBER 2018 • ISSUE 226

WOMEN’S HEALTH

Urologist Po N. Lam is on his way to perform his 1,500th robotic surgery in CNY, more than any other surgeon in the region, he says

YOGA

Five things you have to know about it

SPECIAL ISSUE

n Sports concussions: Much worse for women n Vaginal rejuvenation: FDA cautions about procedure n Are urinary tract infections a part of your life? n Cancer survivor: Paying it forward PLUS: Breast Cancer Awareness Month See stories starting on page 20

Why some people catch a cold and others don’t n Related: Savvy Senior: Which flu shot is right for you

$169,330

That’s the annual average salary for certified registered nurse anesthetists (CRNA). The job growth within the career is projected at 31 percent, nearly twice that of registered nurses

Upstate’s Uninsured Rate Remains at Historic Low

RAISING KIDS Counseling and psychological services professor at SUNY Oswego just published a book on how to raise wll behaved kids. Page 13

Acorn Squash Acorn squash, of all the winter squashes, has many of the most important vitamins we need. See SmartBites inside

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Handy Tool or Bacteria Haven? Tips on how to sanitize one of the filthiest items in your home. Yes, the kitchen sponge.

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BREAST HEALTH CARDIAC CARE WEIGHT-LOSS SURGERY UROLOGY PELVIC PHYSICAL REHAB GYN GYN ONCOLOGY

Women’s services at Crouse. As individual as you are.

o two women are alike. At Crouse, we believe you want — and need — healthcare that puts a continual focus

on what matters most — you. Our hospital was founded by women — and more than a century later, services for infants and women of all ages remain at the heart of Crouse Health.

Partner with women’s wellness providers who discover your individual needs by listening more closely and caring more deeply — and treating you with the respect and dignity you deserve.

crouse.org/women

LOW & HIGH-RISK OB REGIONAL NICU LACTATION CONSULTANTS PERINATAL ANXIETY & MOOD DISORDER SPIRIT OF WOMEN Page 2

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

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T: 9.75” x 13.75”

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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.

October 2018 • 91881_CC_Ad_Vert.indd 1

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CALENDAR of Oct. 3

HEALTH EVENTS

Senior fair to be held in Skaneateles

Nancy Aureli of Community Living Advocates has teamed up with Skaneateles YMCA to host a senior information fair from 10 a.m. to noon, Wednesday, Oct. 3, at the Skaneateles YMCA. The fair is geared toward seniors, caregivers and potential caregivers. Various representatives from Onondaga County Office for Aging, Laker Limo Transport, Serving Seniors, QOL Home Medical Equipment and others will be available during this time. There is no fee for this event. It is simply an opportunity for people to gather information from local organizations.. Community Living Advocates is a local CNY online directory for caregivers, seniors and people with disabilities. Its website — at www. CommunityLivingAdvocates.com —provides senior-friendly events, volunteer opportunities and classes. It also provides information and links to services and resources in our community from transportation and in-home aids to chimney repair and county office for aging services. For additional information, send an email to nancy@communitylivingadvocates.com.

Oct. 5

Cayuga County offers class to explain Medicare options

Are you turning 65 soon? Are you overwhelmed by all the mail, calls and Medicare options? The Cayuga County Office for the Aging offers complimentary monthly classes to help people make sense of Medicare. Classes are designed to provide

unbiased information about the topic. Here you will learn how to determine whether the plan you are considering will give you peace of mind or potential headaches. You’ll learn about how Part D drug plans work and whether EPIC co-pay assistance is an option for you. If your income is limited, the office will provide information about programs to help pay for your insurance coverage, as well as a listing of the free and low cost preventive care under Medicare. The class will be held from 2 to 4 p.m., Oct. 5, in the basement training room of the Cayuga County Office Building, 160 Genesee St. in Auburn. This will be the last class until January 2019. Registration is required. For more information or to register, please call the Cayuga County Office for the Aging at 315-253-1226, or visit www. cayugacounty.us/aging under the News & Activities section.

Oct. 9

JCC offers fall tap dance classes

Adult tap dance classes will start up again at the Sam Pomeranz Jewish Community Center on Tuesdays beginning Oct. 9. Four class levels will be offered each evening: remedial starts at 6:30 p.m., beginner at 7 p.m., intermediate at 8 p.m. and advanced at 9 p.m. The weekly group sessions will run through Dec. 18. The JCC’s tap classes are open to anyone age 12 and older. No prior dance experience is necessary. The cost is $5 per person each night. No RSVP is necessary and plenty of free parking is available. The remedial and beginner classes are for newcomers and teach from the beginning. A limited number of tap shoes are available to borrow each night on a first come, first served ba-

• Care Management for Adults and Children

• Assertive Community Treatment

• Home and Community Based Services for HARP Plans

• Peer Services

• Outpatient Behavioral Health Treatment

• Vocational Services • Care Coordination and Crisis Intervention for Youth and Families

620 Erie Blvd West Suite 302 620 Erie Blvd. West, Suite 302 Syracuse, NY 13204 315.472.7363 http://cir.care 315-472-7363 http://cir.care 458-014_InGoodHealthAdvert_D100.indd 6/19/17 9:08 AM Page 4 • IN GOOD HEALTH1 – CNY’s Healthcare Newspaper • October 2018

sis. Class registration is not necessary, although tappers are asked to arrive early to sign in. Local attorney and choreographer Barry Shulman, who practices law at Mackenzie Hughes LLP, will once again lead the classes. Shulman, who has held the tap classes each fall and spring at the JCC for many years, teaches “New York City” style. Students do not need to commit to every class and can attend as much as they’d like. For more information about the adult tap dance classes, contact the JCC’s Sports and Fitness Center at 315-234-4522 or visit www.jccsyr.org.

Oct. 11

Conference focuses on living with Parkinson’s

Pete Headd, executive director at Onondaga County Office for Aging, recently announced the sixth annual Living an Active Life with Parkinson’s Disease Conference will be held from 9 a.m. to 2:15 p.m., Thursday, Oct. 11, at the Holiday Inn, 441 Electronics Pkwy., Liverpool. This free day of learning, offered by the Onondaga County Office for Aging and Upstate University Hospital’s HealthLink, will feature three experts in the field. Physical therapist Sarah King will discuss “Redefining Your Diagnosis,” “How to Build Your Parkinson’s Plan of Attack,” and “Exercise is Medicine — Movement Workshop.” Physician Michelle Burack will highlight “Gut-Brain Connections in Parkinson’s.” The third expert, neurologist Fahed Saada, will discuss “Psychological Issues with Parkinson’s Disease.” Pre-registration is required as space is limited. To register, please call Upstate Connect at 315-464-8668. The deadline for registration is Friday Oct. 5.

Oct. 13

Addiction Awareness Walk to be held in Oswego

The VOW Foundation will host the Third Annual Addiction Awareness Walk Event from 10 a.m. to 6 p.m., Saturday, Oct. 13 starting at the Lake Ontario Event & Conference Center in Oswego.

This free family-friendly event will feature a walk around Oswego for addiction awareness, rain or shine. New this year will be the addition of the first sober celebration of recovery, which will include popular local band Dirtroad Ruckus. Organizers hope to highlight the impacts of addiction on the communities, and show that sober living is both fun and rewarding. After the walk, attendees are encouraged to engage with providers from across Oswego County. Local speakers will also share their stories of addiction and recovery, and the impacts of substance use on their lives and loved ones. Narcan training will be provided at the event by COCOAA’s Prevention Director Karyn Grow and will include a Narcan kit. Registration is free and open online. Please visit the website www. vow-foundation.org, the Facebook event page or contact Teresa Woolson for more information at 315-402-6119.

Oct. 18

Office for Aging holds public hearing

The Onondaga County Office for Aging will hold its annual public hearing from 1 to 2:30 p.m., Thursday, Oct 18, at Bethany Baptist Church, 149 Beattie St., Syracuse. Onondaga County seniors, senior service providers and the general public are invited to attend, to help plan the future of aging services. The Onondaga Office for Aging will share information on its programs, services and offer a “Senior Scam Prevention” presentation given by Scott Kapral, vice president and senior investigator with BNY Mellon Corporate Security Global Investigations Group. Kapral has extensive practical experience both in conducting and supervising fraud and financial crimes investigations. The Office for Aging will also ask for input on its 2019 service plan. Input is requested on the following questions: 1) What one area, pertaining to Onondaga County seniors, would you like to see changed? And 2) How can the Office for Aging help? No reservation needed. For more information, call 315-435-2362, ext. 4945 if special accommodations are required.

We Do The Same Walk Every Day. So Why Do I Keep Forgetting The Way? If you have just been diagnosed with Alzheimer’s disease, or think you might have early signs of the condition, it may be difficult to think about what comes next. But thinking about your future is exactly what researchers around the world are doing-right at this moment. For example, we’re currently looking for 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.

For More Information Please Call 315-464-2807

E M PAT H E T I C Women are intuitive and empathetic. At St. Joseph’s Health, we’ve designed our Breast Care and Surgery Program to have these strengths, too. We’ve brought our services together, under one umbrella, and backed them with the most-experienced surgeons and specialists in the region. Our Nurse Navigators support you through the entire process, coordinating every facet of your diagnosis, treatment and recovery — while answering your questions and helping you process new information. We partner with St. Joseph’s Imaging to offer the latest technologies, caring for both your physical and emotional well-being.

HEALTH CARE FOR WOMEN THAT IS FEMALE BY DESIGN | visit womenshealthsjh.org to learn more © 2018 St. Joseph’s Health. © 2018 Trinity Health. All rights reserved. October 2018 • SJH18034.02_Womens_Health_Phase_II_Print_Ad_In-Good-Health_7.2563x11.9444_No-Bleed_v01.indd 1

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9/17/18 5:52 PM

Meet

Your Doctor

By Chris Motola

Po N. Lam, M.D. Urologist performs about 200 robotic surgeries a year at Crouse, Community General and other hospitals in CNY — he is on his way to perform his 1,500th surgery since 2007, more than any other surgeon in CNY, he says Q: How long have you been practicing urology? A: I’ve been in practice for about 12 years. I do mostly robotic surgery for prostate cancers, kidney cancers and bladder cancers. I also do some reconstruction for both kidney and bladder malformations. I operate about two-and-a-half, three days a week. I operate on about 125 prostates a year and about 200 total robotic cases. I’ve actually done the most robotic surgeries in Central New York, and that’s including all other specialties. I think I’m hitting 1,500 this year. That’s the total number of robotic cases I’ve performed in CNY along the years.

So what you’d do is remove the bladder and then reattach the kidneys to either a new bladder — which is constructed from a piece of intestines — that stay inside the body. And then you have to learn to push and squeeze it to empty it. Another option is putting a pouch inside the body and, through the bellybutton, you catheterize to empty it. A third option is to use a shorter piece of intestines, hook it up to the kidneys, the other end you hook up to a hole like a colostomy. It’s not something you want to go through if you can help it.

Q: How effective is surgery on those types of cancers? A: It’s one of the options for treatment. For kidney cancer, it’s the primary source of treatment; radiation doesn’t really work and chemo is mostly reserved for end-stage circumstances. For prostate cancer, about 50 percent of people go for radiation, most of the rest go for surgery, and a select few go for cryo. Q: Does this usually mean organ removal? A: For prostate it’s total organ, the prostate along with the seminal vesicles. For kidneys it could be partial; sometimes you have to take the whole kidney out. With bladders it’s usually the whole organ. On very few occasions we can remove a part of the bladder, but that’s for a certain type of cancer in a certain location, or if the person is too old to withstand a more comprehensive surgery. Q: Can you survive without a bladder? A: That’s the only way you can survive sometimes. The cancer can be so aggressive that it’s eating away the bladder and causing bleeding and pain.

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

Q: Yeah, I can’t see too many people signing up for that electively. A: A very small number of patients do. They aren’t so much cancer patients as patients who have a bladder that causes them pain and discomfort, they’re constantly peeing. Patients who have had radiation for prostate cancer can have a side effect where the bladder just constantly bleeds. So on rare occasions people ask for it. Q: There’s a perception of urologists as fulfilling a role for men comparable to what OB-GYNs do for women. To what degree is that accurate? A: A lot of people see the urologist as a male doctor. It’s true to the degree that if you’re having a problem with your male anatomy, you’re going to see a urologist. On the other hand, I see both men and women. It’s not quite 50/50, but it’s around 60/40. Believe it or not, kidney stones aren’t selective. Prostate cancer is, of course, unique to males but bladder and kidney cancers affect women as well. We also take care of patients who are incontinent, which is more frequently a problem for women, especially as they get older. There are some urologists who choose to only see male patients, and they’ll be focused on prostate issues and erectile dysfunction. Q: Seeing as you hold a local record in robotic surgery, how did you come to start using it? A: I was one of the first in Syracuse to be fellowship-trained in robotic surgery. I came in 2006 after a year of fellowship down in Oklahoma for robotic surgery. When I was finishing up my residency, I had a chance to start working with a robot. I thought this was a pretty promising new technique for surgery. When I first got to Syracuse, a few people were offering it, but not to the level that would support fellowship training. St. Joe’s and the University had a robot, but the other hospitals were a little shy about getting into it. So my partners and I helped start the program at Community General and, indirectly played a role in getting it into Crouse. Tom Quinn, who was the CEO of Community back then, was very eager. Paul Kronnenberg, the former CEO of Crouse, was very interested, but Community said yes two weeks before Crouse did. I started the

program at Community, but kept a good relationship with Crouse. So I was one of the early physicians in this area to buy into the concept. Q: What were some of the features that attracted you to it? A: It’s beneficial to the patient in every aspect. Smaller incision, less blood loss, precision and magnification. But what you hear less about is that it’s also good for the surgeon. After a few hours of doing non-robotic laparoscopic surgery, you get fatigue, you’re in a lot of unergonomic positions. Robotic surgery allows you to sit comfortably in a chair and operate the surgery like a video game. A lot of surgeons, after years of laparoscopic surgery develop neck and hand problems. It’s very taxing on the body. Q: That kind of leads into my last question. Why are urologists so hard to come by? A: The urology residency program is limited to an extremely small percentage of the medical class. About 200 urologists are accepted into a residency program every year. In comparison, thousands of general surgeons are. Emergency medicine, it’s tens of thousands. So there literally aren’t that many of us. Then, with the aging of America, there’s a higher demand for urologists. In your 30s and 40s, you’ll have almost no demand for a urologist. Once you hit 50 or 60, your prostate starts acting up, you see more kidney stones, you start to leak. The third thing is that, with the constant changes to healthcare, whether it’s reimbursement or adopting new electronic medical records, a lot of older urologists retire early. Given that there aren’t that many of us to begin with, that can be a big deal. It’s almost impossible to find a urologist in Alaska, or even Idaho. This is a big problem when you consider that American Cancer Society found that over 40 percent of the solid-organ cancers affecting Americans are urological.

Lifelines Name: Po N. Lam, M.D. Position: Urologist at Associated Medical Professionals Hometown: Dallas, Texas Education: Medical degree from the University of Texas Southwestern Medical Center at Dallas; completed surgical training from the University of Louisville Health Sciences Center. Went on to receive urologic training at the University at Buffalo School of Medicine and Biomedical Sciences. Diplomate of the American Board of Urology. Has authored several peerreviewed scientific publications and presented his work at national and international meetings Affiliations: Crouse Health, St. Joseph’s Hospital, Oneida Healthcare Organizations: a member of the American Urological Association, Endourological Society, Society of Laparoendoscopic Surgeons, Society of Urologic Robotic Surgeons, and Minimally Invasive Robotic Association. Family: Wife, son Hobbies: Travel, running, finding new restaurants.

Upstate’s Uninsured Rate Remains at Historic Low U pstate New York’s health insurance uninsured rate continued to hold at the historic level of 4 percent, while the state’s uninsured rate hit its lowest level in history, according to an Excellus BlueCross BlueShield analysis of the U.S. Census Bureau’s 2017 American Community Survey issued in September. The 4 percent rate for Upstate New York compares favorably to a statewide uninsured rate of 5.7 percent. The national rate is 8.7 percent. “More people than ever before are reporting they have coverage that provides them with access to the high-quality health care available in Upstate New York,” said Christopher Booth, chief executive officer of Excellus BCBS. “We’ve never seen these percentages of the population with

coverage.” The American Community Survey is the largest and the U.S. Census Bureau’s recommended source for examining uninsured data at national, state and regional levels. It reports the yearly uninsured rate for geographic areas with populations of 65,000 or more. The county-level data were aggregated to calculate the Upstate uninsured rate cited by the health plan. “We believe the historically low uninsured rates for Upstate are a result of lower-cost health care in this market of nonprofit health plans and nonprofit hospital systems,” Booth said. By comparison, the 2016 uninsured rate for the state was 6.1 percent, while the U.S. rate was 8.6 percent.

Upstate New York’s 2017 uninsured rate is:

30% lower + 54% lower than the U.S. rate

than New York’s rate

2017 Uninsured rates 4.0% Upstate

5.7% New York state

8.7% United States

5.0% 3.4% 3.7%

4.0%

4.9%

Illustration by Excellus BlueCross BlueShield

Healthcare in a Minute By George W. Chapman

Source: 2017 American Community Survey, 1-Year Estimates https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_16_1YR_S2701&prodType=table

More NPs and PAs Assuming Role as Main Care Providers

he collective term “advanced practitioner” refers to nurse practitioners and physician assistants. They are assuming an increasing role in the provision of care every year. It is projected that they will account for two-thirds of the new providers (MDs included) added to the workforce over the next decade. (It should be noted that the number of physicians entering the workforce is somewhat limited by the number of residency positions available.) The number of NPs/

PAs per 100 MDs has been rapidly increasing since 2000 and will be 55/100 by 2030. The workforce projections for 2030 are about 1,076,000 MDs, 397,000 NPs and 184,000 PAs. The Association of American Medical Colleges continues to predict a shortage of 120,000 MDs by 2030. Many believe that is vastly overstated because the prediction doesn’t account/acknowledge the increase in the aforementioned advanced practitioners, technology, super drugs and artificial intelligence.

Genetic Testing

many employers who are increasingly taking matters into their own hands. More and more employers are contracting directly with narrow, high-performing provider networks to both shift and lower costs. Some companies are investing in primary care clinics and setting up preferred provider networks for their employees. Seventy percent of employers responding to a survey by the National Business Group believe a new entrant from outside the healthcare industry is necessary to really disrupt the unsustainable and unaffordable status quo protected by too many vested interests. Hospital Ratings Conundrum

A recent article in the Wall Street Journal points to a huge gender gap in genetic testing. By a 3 to 1 margin, more women were tested for inherited gene mutation (like cancer) than men. Genetic counselors also report having far more women than men as clients. Experts have speculated: women are very concerned about breast cancer and more in tune with their health; men have historically been less likely to seek medical care; and men are less likely to embrace the results of genetic testing. Employers Taking Charge On average, employers cover two-thirds of an employee’s health premium. The rising cost of care has become an existential threat to the future of many businesses. The well-publicized joint effort by Amazon, Chase and Berkshire Hathaway to redesign how care is delivered and paid for has actually detracted from what is already happening with

CMS established a “hospital compare” site so consumers can check a particular hospital’s ratings on measures such as mortality, safety, cost, timeliness of care, patient experience and readmissions. While this is all well and good, it begs the question: “What is one to do when a particular hospital rating is below

average and that is where my physician admits?” This is becoming more of a dilemma as consumer choices are being limited by employers contracting with narrower networks, increased government incentives for hospitals and physicians to develop alliances; more physicians becoming employees of hospital systems; and insurance plans favoring particular hospitals. Going “out of network” is rarely a good option because you will lose your physician — and out of network co-pays are intentionally prohibitive. The best advice is to discuss your concerns/trepidations about a hospital with your physician. The physician may have an alternative for you. All hospitals are very concerned about their ratings and will take your concerns (and especially a physician’s concerns) seriously. Med School Tuition-Free The medical school debt students carry averages $200,000. This on top of their college debt. The other cost to consider: physicians don’t start earning money until their late 20s due to four years of medical school plus at least three years of residency. Magnanimously, the NYU school of medicine will begin to cover the cost of tuition regardless of the student’s financial situation. NYU is the first and only top 10 ranked medical school to do so. Incoming students this year will have all their tuition paid for and existing students will have the remainder of their tuition covered. Physicians are still No. 1 when it comes to income. According to a recent report from Glassdoor, the median base salary for physicians is $196,000, about 4 percent higher than 2017. NPs and PAs averaged about $108,000. Controlling Drug Prices The federal government regulates and determines what it will pay October 2018 •

for physician and hospital services delivered to Medicare and Medicaid patients, government employees, and veterans. Most commercial payers tend to follow their lead and closely mirror those fees. The drug lobby has been particularly effective in avoiding government regulation of their fees and most agree the government should avail itself of its purchasing power (Medicare, Medicaid, VA, etc.) and get price concessions from drug manufacturers. In an effort to do just that, control Medicare Part D drug prices, CMS would give Medicare Advantage plans more flexibility in determining what drugs are on their formularies. It is called “indication based formulary design” and, obviously, cost would be an indication/ consideration. But provider and patient advocacy groups are not happy with the Administration’s efforts to get Part D drug costs under control, which would eventually help commercial plans. The AMA argues this is a detriment to patients by introducing unfair complexity to Medicare patients and gives more power to insurers to decide on treatment plans. There is special concern about limiting the formulary for cancer treatment. It should be noted that physicians and hospitals received $8.4 billion in payments from drug companies in 2017 for research, “related expenses” and ownership/investment interests held by physicians and immediate family members. 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.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

October Can Be a Perfect Time to Change It Up!

all is my favorite time of year. For me, it means all good things: relaxing in front of a cozy fire, making soup on Sunday afternoons, donning my well-worn leather jacket for long walks and turning my attention to all those inside projects I neglected over the summer. The colors, aromas and industriousness that come with the fall season really appeal to me. But this hasn’t always been the case. After my divorce, this time of year and all its romantic charm would leave me feeling melancholy. Nostalgia and wistfulness would creep in, and I just wanted to retreat into myself. For those who live alone, the month of October has some unique challenges. Not one to wallow in a “woe is me” state of mind, I began to develop and employ some strategies to rekindle my love of the fall season. It can be the perfect time to mix it up, get busy and take some risks. Below are elements of my annual fall “game plan.” Take a look and see if one or more of these suggestions might not add a little color to your

life pallet this fall: Tackle indoor projects. Fall is a great time to accomplish all those indoor projects that fell by the wayside in the warmer months. I have a long list and keep it right in front of me — a reminder that I have plenty to do. Idle time is not a friend at any time of year, but it can become downright unfriendly when the days grow shorter. Now is the time to keep busy: organize your storage space, do some touch-up painting, update your wardrobe, or redecorate a tired bedroom or bath. There’s nothing like feeling productive to beat the October blahs. Get up and get going. Staying active when there’s a chill in the air can be difficult. I can remember many a dreary morning when all I wanted to do was hit the snooze button, pull up the covers and stay in bed. As nice as sleeping in can be from time to time, I don’t recommend a steady diet of it. In my experience, there’s no better way to start your day than to wake early. In the peace and quiet, there is glorious time to read, think and breathe. I use this important time

to myself to plan my day, write and answer emails. As the day brightens, so does my mood and gratitude for the precious day before me. Enjoy the great outdoors. Sunshine, fresh air and even a light rain can be invigorating, especially if you’ve been cooped up all day. I’m grateful every day for Scout, my adorable springer spaniel, who needs to be walked twice a day. Do if feel like walking her all the time? No. Do I feel better after taking her out? Yes, without fail. Whether you have a dog to walk or not, make an effort to leave your house and get outdoors. It will help relieve feelings of isolation during this cooler month. Learn something new. Going back to school and fall go hand in hand. Who among us isn’t reminded of the excitement (OK, perhaps nervous excitement) associated with returning to school after the summer break. Each fall I like to identify some new skill or subject to master. Last year, it was flower arranging; this year I’m looking at various lecture series. Continuing education opportunities are abundant in the community. Check out offerings by colleges and universities, libraries, community centers, and arts and cultural institutions. You’ll also find workshop listings online and in local newspapers. Start your search today! Invite people in. Over the years, I’ve discovered a few simple and manageable ways to bring people into my world and into my home. One way is to organize a gathering around a TV show or streaming movie.

Years ago, I invited my single friends over to watch West Wing with me on Wednesday nights. I provided the soup and salad; they provided the good company, refreshments and an uplifting mid-week change of pace. Football games, your favorite weekly sitcom/drama, a recent release on Netflix — any of these can become reasons to gather together with friends. The benefits? You’ll hone your cooking skills (boy, do I now have some great soup recipes!) and you’ll connect with people. What better way to enjoy a nice fall evening? There are so many wonderful and meaningful ways to enjoy this season and to ward off the blues that can sometimes emerge during October. If you are feeling sluggish, lonely, or isolated, try a few of the strategies above. They have stood me in good stead and have reinvigorated my appreciation for change and the possibilities and personal growth that can come with it. With a little “elbow grease,” as my father would say, these strategies can work for you, too. 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.

AMERICANS WALK 5,000 STEPS A DAY ONLY HALF THE RECOMMENDED AMOUNT Let’s get stepping! ExcellusBCBS.com/LiveFearlessNation Page 8

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

Things to Know About Yoga By Martine Burat

he practice of yoga can make an enormous difference in a person’s life. Below are a few important points to understand about the long-term benefits from yoga.

Yoga Is A Holistic Practice. Physical pos-

tures (“asanas”) are only one aspect of a larger practice, which also comprises conscious breathing, deep relaxation, meditation, sound, lifestyle changes and the study of texts. A carefully designed practice helps to bring greater balance to both body and mind. Over time, it cultivates the equanimity needed to remain clear and calm in the face of life’s inevitable challenges.

injuries and will bring about the balance between focus and relaxation, which is the goal of practice.

Yoga Postures Can Be Adapted to Meet the Needs and purposes

of each student. It is essential in yoga that each person start the practice exactly where they are, taking into account their strengths, limitations, body type, age, etc. Some postures may not be in one’s best interest due to stiffness, lack of strength, etc. The teacher is responsible for providing the necessary adaptations and modifications to ensure a safe practice.

Breath Is Central To Yoga Practice.

Once we step onto the mat, every movement should be informed and guided by the breath. Using breath as a bridge between body and mind gives life to the practice of postures and deepens its impact on health, well-being and longevity. The breath also acts as a barometer for regulating our effort in practice. The breath will become irregular if we are practicing too intensely, or we will lose track of it if we are too relaxed. This level of attention will help avoid

The Practice of Yoga Evolves As a Practitioner Ages.

The style of yoga where one flows from one strong posture to the next was originally designed for children and young people in order to help them develop their potential. In mid-life, the goal of practice is to maintain good health and a steady mind so that one can fulfill family and/or professional responsibilities. At this stage, postures and sequences will be tailored to the person’s abilities and more attention will be placed on seated conscious breathing (“pranayama”) and meditation. Later in life, practices will be directed at maintaining mobility and inner peace in the face of aging, placing more emphasis on meditation and going inward (“dhyana”.)

Yoga Is Not A Substitute For Medical Treatment,

physical therapy or psychotherapy. Yet, at the appropriate time, and through one-on-one lessons with a teacher who is experienced in the therapeutic aspects of yoga, people can learn to support their health and well-being through personalized yoga practice. The benefits of yoga have now been documented by scientific studies for a range of health concerns that include chronic low back pain, anxiety, depression,

Martine Burat began practicing and studying yoga in 1982 while finishing her post-graduate degree in clinical psychology in France. She has operated Upstate Yoga Institute in Fayetteville since 1995. To contact her, visit https:// upstateyogainstitute.com or email buratm@twcny.rr.com. recovering from injury, surgery, chemotherapy, heart disease, etc. The sages of long ago knew the value of yoga. Under the guidance of a good teacher, yoga continues to be a relevant practice for navigating life in our times.

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Handy Tool or Bacteria Haven? Tips on how to sanitize one of the filthiest items in your home By Deborah Jeanne Sergeant

very home has one and it’s the most bacteria-laden surface under the roof. The toilet seat? The garbage can? Try the kitchen sponge that you use to wash utensils, wipe counters and scrub plates. It’s likely dripping with disease-causing pathogens. A study by German researchers revealed 362 different types of bacteria present on household kitchen sponges — and half of those types were harmful bacteria. While to most healthy people, the bacteria they encounter in their everyday life doesn’t unduly affect them, people who are immuno-compromised must remain vigilant about keeping bad bacteria at bay. And, for those who can’t stand the “yuck” factor of germy kitchen sponges, here are a few options. • Ditch sponges altogether. “The majority of food borne illnesses people experience are almost always preventable,” said Nancy Rissler, a ServSafe certified instructor and proctor in Onondaga Community College’s hospitality management

major. “A lot of people think you can throw a sponge into the microwave and it will kill anything on it. It may kill bacteria like bacillus cereus, Listeria, or E. coli, but viruses are different. The most important preventive measure to control viruses like hepatitis A and noroviruses is to practice good personal hygiene when handling food and food-contact surfaces.” • Know the difference between cleaning and sanitizing. “Cleaning is removal of debris on non-food contact surfaces, like the walls and floor,” Rissler said. “Cleaning and sanitizing is for items that have food contact: any utensils, pans, plates, cutting boards.” • Realize how hard pathogens are to detect. “The three types of hazards from the environment that make our food unsafe are biological, chemical and physical,” Rissler said. “Some come from the air, water, soil, animals or dirty surfaces. “When it comes to pathogens, we can’t always see them, smell them or taste them,” Rissler added. “That’s the problem. It’s a whole other

world.” • Choose clean-up tools wisely. “Anything that absorbs and harbors bacteria, we don’t want that material,” Rissler said. “It may be time to rethink cotton towels and cloths. We want to start cooking with a clean slate. Why even have something that’s so absorbent and collects bacteria? I really believe in microfibers that will not harbor bacteria to use to clean and sanitize. As for bottle brushes, go with something non-absorbent, like nylon, not sponges or anything that will wick or absorb pathogens. • Use disposable cloths. “Cotton cloths, they’re like wicks, collecting and harboring pathogens,” Rissler said. “I use single-use cloths. A Handi-wipe is a synthetic, non-absorbent cloth. They don’t wick like a cotton cloth.” • Don’t use the “five second rule” for a dropped cleaning tool. “Norovirus is very contagious,” Rissler said. “It takes only 18 viral particles in your food or on your hand to make you sick. The amount of particles that fit on the head of a pin can infect 1,000

people. It’s like going through the kitchen and pick out of their food. We have so much control of the daily practices of our lives to eliminate food borne illnesses.” • If you do use dishcloths, get out clean, sanitized, designated cloths often. “You wouldn’t use that same cloth to clean your toilet,” Rissler said. “Designate it as a kitchen cloth. Clean it with detergent and hot water cycle on the washing machine to clean it and to sanitize it, the hot water cycle and the heat of the dryer would also help kill any pathogens when it comes to bacteria.” Of course, after the cloth has been exposed to a known germy surface, like raw meat juice, grab a clean cloth. • Clean dish cleaning tools properly. “Put them through the dishwasher,” Rissler. “Soak in bleach water with the correct concentration. On the back of the bleach bottle, it says how many ounces of the bleach you should use. Read the instruction. It isn’t the more, the better.” • Limit germy messes. For example, many people believe they must wash their raw, whole chicken before roasting it. Rissler said that doing so spreads bacteria, since the rinse water splashes around the sink. Anyone worried about the chicken’s cleanliness should realize that processors clean the birds before wrapping them for selling. • Keep kitchen surfaces clean. “To prevent bacterial growth, use warm and soapy water and/or a bleach solution to clean up surfaces that are used for food preparation,” said registered nurse Wendy Kurlowicz who serves as director of community environmental health, Onondaga County Health Department.

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My Turn

By Eva Briggs

What’s the Big Deal About Getting Bitten by a Kissing Bug?

patient recently was concerned about an insect pest that I’d learned about in medical school but hadn’t thought about since. While out for a walk, a flying insect landed on her arm, stung or bit her, then flew away. She caught a glimpse of something red and black, googled, and soon worried that she had been bitten by a kissing bug. These insects belong to a subfamily called Tratominae and have a host of other common names: reduviid bugs, conenose bugs, assassin bugs and vampire bugs. In Latin America they may be called barbeiros, vinchucas, pitos or chinches. Eleven species of kissing bugs live in the United States, mostly in the south, though they’ve been reported as far north as Pennsylvania. The name kissing bug refers to their habit of biting the face near the eyes and mouth. So what’s the big deal about getting bitten by a kissing bug? At least 50 percent of the bugs harbor “Trypanosoma cruzi.” This protozoan parasite causes Chagas disease. The initial infection, or acute phase, encompasses the first few weeks of infection. Often there are no symptoms, or symptoms so mild that they’re overlooked and unrecognized. Symptoms, when present, include fever, fatigue, body aches and rash. The patient might have a local swelling, called a chagoma, where the parasite entered the body. Romaña’s sign is swelling of the eyelids on the side of the face near the kissing bug bite. Patients can also have swollen glands and an enlarged liver or spleen. Even without treatment, the initial symptoms fade in weeks or months. But the trypanosome remains in the body. It may exist for decades without notice during the chronic phase. About 30 percent of chronically-infected people eventually develop complications affecting the heart or intestinal tract. Cardiac symptoms are enlarged heart, heart failure, heart rhythm abnormalities, or even cardiac arrest. Intestinal symptoms include a massively dilated esophagus (megaesophagus) that makes swallowing

difficult, or enlargement of the colon (megacolon) interfering with stool passage. Probably 8 million people in Mexico, Central America, and South America have Chagas disease, and most don’t know they are infected. Perhaps 300,000 people in the U.S. have Chagas disease, mostly acquired in other countries. The infection doesn’t come directly from the insect bite, but from insect feces containing trypanosomes. Rubbing the insect bite can inoculate the bite with trypanosomes, or can spread them to the mucus membranes of the eye or mouth. Chagas disease can be passed from an infected mother to her baby, or acquired from blood transfusions. The disease is diagnosed by a blood test. There are two medicines for treatment, benznidizole and nifurtimox. In U.S. both are available only through the Centers for Disease Control. Back to my patient, is it likely that she was bitten by a kissing bug? No, for several reasons. First, Central New York is far enough north to be outside, or at best on the fringes, of the kissing bug’s range. Second, these insects live in dark cracks and crevices, often found in substandard housing. They crawl out at night and feed. So an insect flying around during the day probably is not a kissing bug. But it was a red and black bug so what else could it be? It turns out that there are many similar critters: wheel bugs, the western corsair, the leaf-footed bug and may more. Texas A&M University has a web page with photos of 17 insects that have been confused with kissing bugs. So, we don’t have to worry about kissing bugs here — at least not yet. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

Onondaga, Oswego, Cayuga and Madison Counties

CNY’s Healthcare Newspaper

SURGERY AND RADIATION FOR BREAST CANCER IN AS LITTLE AS ONE DAY

The Upstate Cancer Center is the first in the region to offer intraoperative radiation therapy (IORT) as a treatment option for early stage breast cancer. IORT can reduce or completely eliminate the need for weeks of follow-up radiation treatments. This means patients can get back to their normal lives, sooner. With IORT, the breast surgeon removes the tumor during the operation, then the radiation oncologist delivers a concentrated dose of radiation to the site. The localized, single treatment means healthy tissue is less impacted by radiation, thus reducing side effects. Talk to your provider to see if you are a candidate for intraoperative radiation therapy or call the Upstate Cancer Center.

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, Ernst Lamoth Jr., Eva Briggs (MD), Natasha Ginzburg (MD), Maria Pericozzi, Martine Burat, Mary Beth Roach• Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

October 2018 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

Program Offers Healthcare to Homeless Population in Syracuse By Mary Beth Roach

new program between the Rescue Mission Alliance and Helio Health (formerly Syracuse Behavioral Healthcare) is offering another gateway to providing more accessible healthcare treatment to the homeless population. Launched in June and called the Shelter Health Partnership, two certified recovery peer advocates are at the Rescue Mission’s homeless shelters three mornings a week. There, advocates from Helio Health’s Center of Treatment Innovation (COTI) and Liberty Resources reach out to the residents, helping them access primary health care, as well as mental health and substance use providers in the area. They help them develop recovery plans, coping skills and even bring them to appointments when needed. “As a person-centered program, we work to identify recovery goals, which often include connecting individuals to formal treatment programs and community-based recovery organizations that help to support long-term recovery,” said Ron Wood, program director at Helio Health’s COTI. The goal is to get the individuals staying in the Rescue Mission’s homeless shelter connected to treatment, said Amber Vander Ploeg, Res-

cue Mission’s chief program officer. “We have found for homeless people that bringing services to them is the best way to get them to engage,” she said. The rapport between the peer advocates and the homeless individuals is critical, both Vander Ploeg and Wood said. Currently, the advocates are working with 25 individuals at the Rescue Mission, who have utilized a series of recovery-based supports, including referrals to detox, inpatient, outpatient, housing, medical, self-help, Vander and to the Syracuse Recovery Center the ‘Cuse Center. Key to the treatment is that it is being brought to homeless individuals by peer advocates who have shared many of the same life experiences as the people they serve. “The peers are individuals who themselves are in recovery, so they have that shared, lived experience,” Wood said. “When they’re meet-

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

The Rescue Mission’s Kiesewetter Emergency Shelter on Dickerson Street in Syracuse, with 183 beds, is the largest such shelter in Onondaga County. In 2017 it provided more than 90,000 overnight stays. ing people where they’re at, and in this instance, the individuals who are homeless, they may have that shared experience of having been homeless. They know what it’s like to experience withdrawal symptoms. They understand what it’s like working with DSS [Department of Social Services] and how to navigate what could be a complex system. So they’re able to help people and advocate through each step of that process so the individual doesn’t feel alone. They know that they’re going through this with someone who’s experienced it too.” The peer advocates go through a 46-hour training program in which they learn how to share their experiences in such a way to build a relationship with an individual, Wood said. They are currently working to expand the on-site hours to provide additional outreach, Wood indicated, and Vander Ploeg noted that there are plans to open up the services to all homeless individuals, and to those who are in other area shelters operated by Catholic Charities and the Salvation Army. “We are going to be moving this project out to the streets, she said. Case managers from the Rescue Mission’s street outreach team, together with the peer advocates, will go out to provide those services. The work of the partnership extends beyond the 25 people currently working with embedded peers, according to Wood. “This partnership has helped to educate and inspire many other individuals in our local community to start a conversation surrounding “recovery” and how the local community can be supportive of this life-long journey. This conversation helps to foster an environment of

hope that recovery is truly possible and our community is supportive of ensuring that people receive the compassion and care that they rightfully deserve,” he noted. The partnership is part of a multi-faceted approach that New York state is undertaking as part of Gov. Andrew Cuomo’s aim at addressing substance abuse in homeless shelters, Vander Ploeg said, and as Wood explained, homeless is often an unintended consequence of substance abuse. Onondaga County, Vander Ploeg said, was selected as one of the counties that would do a pilot project since it has a larger homeless population than some of the small counties and because the county has a good working relationship with the Rescue Mission’s Office of Temporary Disability Assistance. The Rescue Mission’s Kiesewetter Emergency Shelter on Dickerson Street, with 183 beds, is the largest such shelter in Onondaga County and in 2017 it provided more than 90,000 overnight stays. While the partnership is beneficial to the individuals it serves, it also benefits the overall health of the community since it reduces the number of avoidable visits to area hospitals and frees up shelter beds for others that need them, Wood explained. In terms of working to help that population, both Vander Ploeg and Wood see the Syracuse and Onondaga County area as having a wide variety of services for those battling substance abuse. “I think in certain circumstances, people seek out this community because we have such expansive programming to help with substance abuse treatment, with mental health treatment, establishing that recovery network,” Wood said.

& QA

with Jodi Mullen

Counseling and psychological services professor just published a book on how to raise kids By Maria Pericozzi

odi Mullen, an Oswego State alumna and counseling and psychological services professor, has used her experiences through working as a therapist, researcher and with children to write her new book, “Raising Freakishly Well-Behaved Kids: 20 Principles for Becoming the Parent Your Child Needs.” Mullen has been in Oswego since she was a student in 1988, and has two children, a freshman in high school and a freshman in college. Q. Why did you decide to write the book? A. I was really lucky enough to be trained in counseling and play therapy before I became a parent and used those little lessons in my own parenting. It formed so much of what I did as a parent and I felt like I should share this with other people and they should know about these things. Q. What is one of the most important things parents can do to create well-behaved kids? A. The most important thing parents can do is to create stability and consistency for their children. Regardless of why people need mental health counseling, eventually, whether they are children, adolescents or adults, is because something in their life has become unstable or inconsistent. Even if your life is chaotic for whatever reason, if you can create things that make your child feel stabilized, they will always have that to come back to. For example, if you’ve just moved or changed jobs and the kids have to change schools, and there is all this other stuff going on, keeping some things stable, like always having dinner together or always reading a book before going to bed, just having things that are stable in the child’s life keeps them regulated. It will help keep them grounded and it will help keep them feeling like even though life is kind

of chaotic, they still have something to come back to. Q. What do you mean in the title when you say “well-behaved”? A. I came to that title because one of my friends, that I have been friends with since I was a child, when he met my children, that’s how he described them. He said they were freakishly well behaved. I loved that because I thought, I have good kids and he are well-behaved. By that I don’t mean they’re quiet and always do what I want them to do, or anything like that. I think that by freakishly well-behaved, I’m talking about that kids know that they are loved, and they know they are accepted, and they act that way in their interactions. Their interactions and how they hold themselves in the world is from that place of feeling connected, important, loved, and loved unconditionally. Even when my kids make mistakes, when they lie, when they do all those things the rest of us do, they know ultimately they are loved and when they are out there in the world that is how they act. Q. What message would you like to convey to the readers, most specifically the parents? A. First of all, I want parents to know even with all that preparation and specialized education, I still made mistakes. There is no such thing as perfect parenting. I made an effort in the book to share some of my own bloopers and challenges as a parent because I think that is really important. I don’t want to create an illusion that I am perfect or that my children are, because we are wonderfully flawed. Beyond that, the primary message I want them to take away is that this isn’t about what you do for your children, it’s about who you are in connection to your children. It doesn’t matter what you buy them or where you take them, it matters who you are to the child. The relationship is the key.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

SmartBites

The skinny on healthy eating

Nature’s Vitamin Pill:

Nutrient-Rich Acorn Squash

ome foods serve up a little amount of a lot. While no superstar in any one nutrient, these foods boast decent amounts of many. Acorn squash, of all the winter squashes, falls into that commendable category. Of those “many,” however, acorn squash does shine with a few standouts. Though not as rich in beta-carotene (a precursor to vitamin A) as other winter squashes, this nutrient-dense squash is a very good source of vitamin C, potassium and manganese, and a pretty good source of some B vitamins, fiber and magnesium. One cup of acorn squash delivers nearly 25 percent of our daily vitamin C needs. A multi-tasking vitamin (and powerful antioxidant!) that’s essential for good health, vitamin C plays a vital role in collagen production, helps speed wound healing and may even lower our risk of many

chronic diseases by inhibiting the activity of cell-damaging free radicals. Another noteworthy perk: Acorn squash may contribute to heart health, thanks to its potassium and magnesium. While potassium helps to regulate blood pressure by lessening the negative affects of too much sodium, magnesium helps the heart maintain a healthy rhythm. Many studies have found that people with a higher dietary intake of both potassium and magnesium have a lower risk of heart disease and stroke. This dark green squash is a great source of thiamin (B1), an essential vitamin that contributes to healthy nerve and brain cells and helps convert food to energy, and a respectable source of folate, another important B vitamin that helps to reduce birth defects, maintain a healthy heart, and possibly thwart depression. Mellow-tasting acorn squash is low in fat, cholesterol, sodium and calories (about 60 per cubed cup),

and offers a modest amount of fiber: 8 percent of our daily needs. As for carbs, acorn squash boasts the good ones—the complex carbs that provide a steady stream of energy because they take longer to digest.

Roasted Parmesan Acorn Squash Serves 2-4 1 acorn squash, washed 2 tablespoons olive oil 1/4 cup grated Parmesan 1 teaspoon garlic powder 1 teaspoon dried thyme ¼ teaspoon coarse ground pepper ½ teaspoon kosher salt (or, to taste) Preheat oven to 400 degrees. Trim ends from squash. Position squash upright on widest end and cut in half, using a large serrated knife (rind is tough!). Scoop out seeds and slice each half into ½” half moons. In a large bowl, mix together olive oil, cheese, garlic powder, thyme, pepper and salt. Add squash and, using your hands, toss to coat slices with mixture. Lay the squash out on a baking sheet and bake for 30 minutes. Serve immediately.

Certified Nurse Anesthetist. Average Salary: $169,330 The job growth for between 2014 and 2024 is projected at 31 percent, nearly twice that of registered nurses By Deborah Jeanne Sergeant

f you’ve experienced in-patient surgery, you likely have received care from a certified registered nurse anesthetist (CRNA). Cheryl Spulecki, president of New York State Association of Nurse Anesthetists, works as a professor at University at Buffalo. The association represents more than 1,600 CRNAs statewide. “The reason many are interested in the program is they think they’d find it a very satisfying career if they’ve worked in acute care, the emergency room or intensive care unit and they’d like to advance their career,” Spulecki said. CRNAs administer all types of anesthesia in the operating room. Their care begins at the pre-operation Page 14

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assessment, throughout the surgery, preparing the patient for awakening to recovery and follow-up post-surgery to make sure they’re comfortable and their pain is managed safely. In addition to more skills, the degree prepares CRNAs for leadership, administrative or education roles. Like other nursing specialties, CRNA candidates beginning in 2020 will need to complete a higher degree — a doctorate in this case — by 2025. That degree allows CRNAs to transition into education. To apply to a CRNA program, candidates must have a Bachelor of Science in nursing or any appropriate bachelor’s degree, a license as a registered nurse, and a minimum of one year acute care nursing. Most

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

master’s programs take 26 months to complete. The doctorate takes 36. After completing the education required, candidates must pass national board examinations and then recertify every eight years. Four continuing education credits are also required every four years. “We advise nurses or undergraduates to understand the prerequisites,” Spulecki said. “They should have critical care experience. They should enjoy the autonomy of working in that environment, working under supervision and medical direction of a physician and caring for patients with all types of anesthesia.” Corrinne Sherman is an acute care nurse practitioner and CRNA with CHAG Anesthesia, PC, a private

Helpful tips

Choose squash with a dull, dark green rind: a shiny rind means it was picked too early (will taste less sweet) and an orange rind means the squash is overripe (will be tough and fibrous). Store in a cool, dry place for up to a month. Squash that has been cut or cooked may last up to two weeks in the refrigerator. To maximize its nutritional benefits, steam or bake acorn squash to prevent the nutrients from being lost in the cooking water.

Anne Palumbo is a lifestyle colum-

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

anesthesia group in Syracuse. She had worked as a nurse since 2000 and the anesthesiologist where she worked at the time suggested she might enjoy working as a CRNA. Sherman said she had been feeling bored with her job and wanted a change. She received letters of recommendation from her boss and was accepted into a CRNA program. In 2007, Sherman completed her program and moved back to Syracuse. “I enjoy it,” Sherman said. “It’s very rewarding. It’s still involved nursing and I have contact with patients like I did in the ICU.” While some opportunities for nurses to advance removes them from personal interaction with patients, such as educational or managerial roles, CRNAs interact with patients every day. Sherman thinks that nurses interested in coming a CRNA should have solid organization skills, a strong work ethic, a good background in nursing in general, experience in multiple nursing situations, and leadership skills. “If something goes wrong, it’s our responsibility to look after the patient’s vitals and we have to get people to listen and follow directions,” Sherman said. “It’s like being the leader of a team. The surgeon relies on you to take over watching over the patient so they can focus on the surgery.” Sherman enjoys the variety of patients she sees as she works at hospitals and ambulatory centers, since her group contracts to various surgical facilities. According to the Bureau of Labor Statistics, the average CRNA in New York makes an average annual salary of $169,330. The job growth between 2014 and 2024 is projected at 31 percent, nearly twice that of registered nurses.

Tracey Burkey of Liverpool was diagnosed with breast cancer in 2015. Now cancerfree, she spends a great deal of time working on causes to promote cancer prevention and awareness.

A Cancer Survivor Pays it Forward Following a roller coaster cancer treatment, Liverpool resident now devoted to helping others

racey Burkey’s battle against breast cancer has made her see blessings in a new light and has taught her what it means to pay it

forward. After having been diagnosed with estrogen-based breast cancer in 2015 at the age of 52, Burkey underwent 16 chemotherapy treatments and five surgeries in about 10 months. Now at the age of 55, she has committed herself to providing other women with the same kind of support that she found crucial during her journey. That journey began on a Tuesday morning in March of 2015. Syracuse University was hosting the Eastern Regional of the NCAA March Madness tournament later that month, with thousands of visitors and fans coming in to the Syracuse area. As vice president of sales for Visit Syracuse, which led the NCAA local organizing committee, it was Burkey’s responsibility to lead that group. In short, she was busy — so busy, she almost canceled a previously scheduled mammogram. But she thought better of it and kept the appointment. That day the radiologist told her that she saw something that was a little suspicious, and even though she didn’t think it was anything to be concerned about, she opted to send Burkey for a biopsy. In less than an hour, Burkey said, her gynecologist was calling to set up an appointment for the biopsy that coming Friday. Burkey had the biopsy done, and waited for the results. The following Tuesday — the week of the NCAA regional in Syracuse — she received the call at her downtown Syracuse office. Her co-worker and friend, Carol Eaton, was with her to offer some moral support. Burkey recalled the conversation. “We got the doctor’s nurse practitioner on the phone, and she said, ‘I’m shocked and I’m sorry to tell you, you have breast cancer.’ And then it just became a blur.”

By Mary Beth Roach When she got home on the same day, her husband had placed a dozen pink roses in their bedroom. She and Fred had only been married eight months when she got the diagnosis. Fred would become her No. 1 cheerleader, among a large team of friends and supporters, and her medical team: her doctor/surgeon Kara Kort, who’s affiliated with St. Joseph’s Hospital Health Center; her oncologist Anthony Scalzo with Hematology Oncology Associates of Central New York; and Enrique Armenta, her plastic surgeon. Burkey was told that it looked like that her best course of treatment would be a lumpectomy and radiation. So she started to put her plans in motion, including telling her children. She has three children from an earlier marriage — Michael and Andrea, who were in their 20s at the time, and Justin, who was only a sophomore in high school. “Being the planner that I am, I had it all it set time-wise. I’d be a little tired, I wouldn’t have to take any time off from work. I wouldn’t miss my son’s sports. I had it all planned. That was Plan A.” But there were to be many more plans. Doctors were not able to get all of the cancer in the first lumpectomy, so a second procedure was scheduled. That, too, was not as successful. So her doctors decided to do a mastectomy, but just days before the mastectomy was to take place, Burkey got a call from her doctor, who told her she would need to do chemo first, before the surgery, as a means to shrink the mass. Chemo was her biggest fear, Burkey said. She had watched her father, Richard Carpenter, go through a very aggressive form of chemo for 12 years, off and on, and although he had had a different form of cancer than hers, the treatments were still daunting. She was told she would lose her hair, which she said was traumatic for her. The treatments would consist of four sessions — one every other week during June and July and then

a series of 12 treatments weekly, from August through October 2015. She reached out to a friend and business colleague, who had gone through chemo. The two met, and her friend told her what to expect. “She had me so uplifted,” Burkey said of the meeting. She had asked her friend, ‘I don’t know what to do to say thank you to you,’ and she said, ‘Pay it forward.’ I didn’t realize at that moment what that meant.’” She would soon find out. And also learn and appreciate what she calls blessings. She soon learned that ABC TV personality Amy Robach would be speaking at a cancer luncheon event in Rochester. Robach had had an on-air mammogram and learned she had breast cancer. “I had always admired her and Robin Roberts and how they publicly went through it,” Burkey said. On the day of the luncheon, she had just completed her first chemo treatment and was not feeling all that well, but her husband encouraged her to attend, and she was seated at a table of other breast cancer survivors. “It was the best day ever,” she said. “I sat with these women who were amazing. I needed that lift. I got a meet-and-greet with Amy. And she grabbed my arms and she was like, ‘You can do this. We’re with you.’” “Where I’m going with this,” Burkey said, “is that through this journey that’s been up and down and all over the place, what I remember most out of it is these little blessings. Things I wouldn’t have experienced had I not had this.” On her last day of chemo in October 2015, Fred and a friend filled her car with 16 pink balloons and 16 pink roses, signifying each of her chemo treatments. And there was a little note, telling her to celebrate, reflect and think about all she’d done to get through it all. The note also instructed her to release the balloons when she got home as a way of putting it behind her and looking forward. When she and Fred got home, they went to the backyard and reOctober 2018 •

leased the balloons. “It was a therapeutic moment,” she said. “It was a much-needed moment. Another blessing.” She has since offered the same gesture for two others who have completed their treatments. Following her chemo, Burkey had a double mastectomy the week of Thanksgiving in 2015, reconstructive surgery a few weeks later and by January she was back to work. Because hers was an estrogen-based form of cancer, it hadn’t reached the lymph nodes. She said that the disease is less likely to come back now because she is on tamoxifen, which is an estrogen blocker, she said. Several weeks later — during her first appointment with her oncologist following chemotherapy — she not only received a blessing, but she also had the opportunity to pay it forward. While in the waiting room, she noticed a young woman. “I saw the chemo bag. I just said, “Are you starting chemo?’” she recalls asking. When the girl indicated that she was, Burkey said to her, “I’m so sorry, but I’m done with it, and I’ll tell you, you’re going to get through this. And you can do this.’” Burkey gave the girl her card and told her to contact her. Several weeks later, Burkey learned that she and this girl had some mutual friends and lived just minutes from each other. One of their mutual friends called Burkey and told her that the young patient was having panic attacks and asked if Burkey could offer some support. Burkey readily agreed; the two met for coffee and they became fast friends. During one of her treatment sessions, she saw a brochure for the local “Making Strides” fundraising event by the American Cancer Society. It was to happen about a week later, but despite the short timeline, Burkey was able to organize a team of more than 20 walkers, including Fred; her son, Justin; many of Justin’s friends and their parents, along with her friends. Her participation in that event would lead her to becoming involved in the regional chapter of the American Cancer Society. “After that, I felt like I want to get involved somehow,” Burkey said. So she reached out the American Cancer Society. She took part in the 2016 Making Strides walk, and in 2017, she was invited to join the board, which she has done. She is committed to her efforts with Making Strides, seeing that program grow and fundraising to help research, she said. But her real focus is in working with the local branch of the American Cancer Society on its support services. “There are people out there who did not have the support system or weren’t as fortunate to have an understanding employer, insurance or husband, people to drive them to treatment,” she remarked. “That’s what really my passion is — how do we help these people?” Through her contacts in the hospitality industry, she has been able to help secure hotel rooms, when available, for patients who need a place to stay while in the Syracuse area for treatments. Whether it’s serving on the local ACS board, finding hotel rooms, creating balloon bouquets, having chats over coffee, or walking in the Making Strides events, Burkey continues to pay it forward.

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Things You Should Know About Cancer Prevention By Ernst Lamothe Jr.

hen it comes to a disease such as cancer, it can hit anyone at any time. Yet medical professionals do believe that despite family history and other factors, there are many things people can do to help with the prevention and treatment of cancer. Physician Kara C. Kort, medical director of breast care and surgery at St. Joseph’s Physicians and Surgical Services, has five recommendations she makes to patients. Exercise The importance of exercising cannot be understated. It helps with many conditions from cardiac to cancer. Those who exercise regularly have lower blood pressure, more energy and are one step ahead in fighting future potential diseases. Inactivity often accompanies advancing age, but it doesn’t have to. Even 20 minutes of activity a day, three times per week, provides benefits. Thirty minutes every day is even better. “Exercise or higher levels of physical activity are linked to lower risk of breast cancer and colon cancer,” said Kort. “There are many studies showing this association. Physical activity is also thought to reduce inflammation and improve the immune system.” Maintain a healthy weight Being overweight or obese go hand in hand with in-

creased risk of many cancers. There is also risk of hypertension, which has the ability to strain the heart, damage blood vessels and increase the risk of heart attacks, strokes and kidney problems. There continues to be more evidence in the medical studies where maintaining a healthy weight makes all the difference in the world. “To name only a few, cancer of the esophagus, stomach, uterus, breast, colon and thyroid are all associated with increased body fat,” said Kort. “Research shows obese people tend to have a chronic inflammatory state that can alter cells, making them more likely to become cancerous.” Kort added that fat also produces certain hormones like estrogen and insulin known to promote cancer growth. Excessive alcohol Doctors are not saying that people should stop drinking. But in some cases the need to stem the amount of alcohol consumed is paramount to living a better life. While alcohol consumption has been reported to be good for our heart for many years there is unfortunately a clear correlation between alcohol consumption and the development of certain cancers — specifically, cancer of the esophagus, colon, head and neck and breast. “The evidence appears clear that the more alcohol a person drinks, especially regularly, the more like-

ly they are to developed certain cancers,” said Kort. “Some of the breakdown products of alcohol could be toxic to our cells and DNA making cancer more likely. Plus alcohol makes it harder to absorb important nutrients and vitamins that are associated with cancer risk and prevention.” Excessive Sun Exposure Skin cancer — the abnormal growth of skin cells — most often develops on skin exposed to the sun. But this common form of cancer can also occur on areas of your skin not ordinarily exposed to sunlight. “While the sun is great for that healthy tan and can also increase our vitamin D levels that are notoriously low in Central New York, excessive sun exposure and, more specifically sunburn, can significantly increase our risk of skin cancers,” said Kort. “Melanoma can be particularly dangerous. Sunburn damages the DNA in your skin cells making them prone to developed cancer. Even a sunburn every couple of years markedly increases your risk.”

Positivity and support Not all solutions have to be medical. While positive thinking does not cure or prevent recurrence of cancer, many studies show it can help patients come through treatment with less side effects and complications with some

Same-day Surgery, Radiation Treatment at Upstate New same-day surgery and radiation treatment option now available in CNY for women with early breast cancer

pstate Cancer Center is now offering a same-day surgery and radiation treatment option for women with early stage breast cancer. Intraoperative radiation therapy (IORT) administers a targeted, concentrated dose of radiation directly to the tumor cavity at the time of lumpectomy. This therapy gives women the option to complete both cancer surgery and radiation treatment at the same time, according to

an Upstate news release. IORT is an innovative alternative to traditional external beam radiation therapy. Its benefits include significantly shorter treatment times, fewer side effects, reduced costs, added convenience and improved quality of life. Upstate Cancer Center is one of the few centers in the state offering this therapy. For the patients who meet the criteria for IORT, their radiation visits are decreased from as many as 15

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treatments over three weeks, down to one — at the same time as surgery. “Normally after a lumpectomy you would wait four to six weeks for healing and then you would start three weeks of daily radiation,” said Upstate breast surgeon Lisa Lai. “Now it can all happen at the same time.” IORT is a new tool for Upstate doctors working with women who have breast cancer. “It eliminates the need for multi-

Physician Kara C. Kort, medical director of breast care and surgery at St. Joseph’s Physicians and Surgical Services.

studies showing it seems to strengthen the immune system. There has been more research that shows the power of positivity having an essential aspect in our lives. The reverse is all shown as true. “By the same token, sadness, guilt and grief are all normal emotions and hard to ignore. It is not possible for most of us to stay positive at all times. Lean on others and accept their help and support,” said Kort. “People want to help, let them, we are not meant to be alone in our suffering. It makes them feel good and it will make you feel better than you think.” ple visits to radiation therapy centers, it eliminates some of the cost and it makes it less anxiety-provoking,” said Upstate breast surgeon Mary Ellen Greco. “One time, one visit, one treatment can make everything a lot more efficient.” Studies of early-stage breast cancer treatment have shown that performing a lumpectomy by removing the cancerous tissue and a small rim of tissue surrounding it, plus radiation therapy, provides women the same survival outcomes as a total breast removal or mastectomy. In recent years, significant advancements have been made in the detection and treatment of breast cancer. IORT offers patients a less-invasive, breast-conserving option with valuable benefits. “The patient is essentially recovering from the lumpectomy,” Lai said. IORT is “a nice, quick treatment to get them back on their feet and back to their daily routine and their lives.”

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Cancer survivor and retired firefighter Mahlon Irish, Jr., tells his story to help promote prostate cancer awareness and encourage men to be tested. Diagnosed with prostate cancer in his late 50s after a routine physical revealed high PSA, he decided to treat his disease with surgery and hormone therapy, which kept the cancer at bay for months. A few years after his treatment, Mahlon’s doctor discovered the cancer had spread. After 39 radiation treatments and a drastic lifestyle change, Mahlon’s health was restored. In fact, he has been healthy enough to participate in A.M.P.’s annual June ZERO Prostate Cancer Run/Walk for the past three consecutive years. “Every time I speak to men about prostate cancer awareness, I tell them: ‘Get your PSA checked. It saved my life.’ That’s why events like the Run/Walk are so important, to raise awareness to our local communities,” says Mahlon. “Hopefully men in the near future won’t have to go through what I—and other cancer patients—have been through. I am fighting for that future.”

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Cancer

Breast Care Partners Initiates Pink Porches Campaign Goal is to raise funds for the organization and increase awareness for the value of early detection

reast Care Partners, LLC (BCP) presents its first annual Pink Porches Campaign to light Central New York pink during October, breast cancer awareness month. To make porch lighting convenient, BCP has a supply of pink, LED bulbs available for a $5 donation each. All donations directly benefit local breast

cancer patients through the BCP patient support fund managed by Cancer Connects. “This program draws attention to the value of mammography and early detection of breast cancer, when it is most treatable,” said physician William Schu, Central New York Surgical Physicians PC, who serves

Susan Bertrand, a Baldwinsville resident, started nonprofit Maureen’s Hope Foundation 14 ago after her sister Maureen Humphrey, died of cancer at age 31. “I consider the work we do to be a privilege,” she says.

Organization Supports Medical Journey By Deborah Jeanne Sergeant

usan Bertrand wants to bring more comfort and hope to people facing cancer or life-altering diseases and their families. She founded Maureen’s Hope Foundation in Baldwinsville as a 501(c)(3) nonprofit to offer practical support and aid shortly after her family’s own cancer journey. Bertrand named the organization to honor sister, Maureen Humphrey, who died from an aggressive form of cancer at age 31, after two years fighting cancer. “I learned first hand what a family goes through,” Bertrand said. “It’s been a very healing experience for myself and my family. I consider the work we do to be a privilege.” Founded 14 years ago, Bertrand works fulltime at the organization,

which doesn’t focus on a specific type of life-altering illness or age group, though some of its outreaches do. The organization offers practical support such as a cleaning service to help take care of the home so the family has more time to support their loved one who’s ill. Maureen’s Hope treats moms of children with life-altering diseases to an annual free spa day to allow them to connect and unwind. There’s also Easter baskets for pediatric patients and comfort gift baskets for people of all ages. The organization has put together 2,400 of those baskets, each containing a minimum of $100 value of items donated to or purchased by Maureen’s Hope.

as the BCP board president. “Catching breast cancer in its earliest stages often prevents the need for extensive treatment for advanced cancers and improves chances of breast conservation. We are very grateful to National Grid for supporting this effort.” Alberto Bianchetti, National Grid’s Central New York regional director, said the use of energy-efficient LED pink light bulbs adds a special feature to this worthy program. “The “Every basket is made specifically for that person depending on their type of cancer, age and interests,” Bertrand said. A Syracuse University sports fan may find lots of Orange goodies in his basket. An angler might receive fishing magazines. None of these efforts offer a cure or represent another earth-shaking discovery, but that’s not the point. “The little things in life can make a difference,” Bertrand said. “You don’t have to have a million dollars or do things on a grand scale to make a difference.” Many businesses donate to the organization; however, individuals of modest means can get involved, too, through the Carry a Bead program. “We’ve had sports teams or schools involved and members of the Dave Matthews Band, but anyone can do it, whether you’re five or 95,” Bertrand said. Athletes with the Syracuse Crunch, Syracuse University and LeMoyne College have participated by pinning beads on during a practice (regulations forbid them during games). Afterwards, they write a note to the children and keep one bead to carry with them as a reminder. “You think of how hard a college athlete works,” Bertrand said. “They send some positivity.” The note card goes in a bag with a bead and comes back to the organization to distribute to any one of 60,000 children in the program. To provide a visual symbol of their cancer journey, thousands have become part of Beads of Courage, an organization that collaborates with volunteers in 250 hospitals worldwide. “When children are diagnosed,

lives of many National Grid employees and their families have been impacted by breast cancer,” Bianchetti said. “Raising awareness about the value of early detection, and using energy efficient LED light bulbs to do so, send two very important messages.” Bulbs are available in several locations locally, including the Boutique at the Brittonfield location of Hematology-Oncology Associates of CNY, and can be purchased with cash or checks made payable to Cancer Connects. For additional locations and more information, people can check the BCP website at breastcarepartners.com, contact breastcarepartners@gmail.com or call 315-559-6803. they usually go through a horrible treatment, they get a bead after each treatment,” Bertrand said. “It’s all nice, handmade glass. Each one is different for chemotherapy or radiation or whatever treatment they receive. You can see if a child has 10 beads or 400 beads. They’d know if the others have just arrived or they’ve been here a while.” For some patients, receiving a new one helps distract them and the string of beads becomes a badge of honor. Some beads represent a milestone achieved. The You and Me Bears are another example of how Maureen’s Hope helps connect people. For children experiencing extended hospital stays, the identical teddy bears — one for themselves and one for a loved one help them feel closer together. A card accompanying the toys reads: “A cuddly bear to keep us close At night time when I miss you most One for me and one for you Filled with hugs and kisses, too XOXO.” The You and Me Bears project is named after a song by the Dave Matthews Band and is supported through their foundation Bama Works. The organization receives support from personal and corporate donations, grants and fundraising events. “People need to know they’re not in the fight alone,” Bertrand said. “Support doesn’t have to come in a monetary way. Kindness from a stranger makes a difference.” For information on upcoming events, visit the Maureen’s Hope Foundation Faceook page or www. maureenshope.org.

The Long-Term Financial Toll of Breast Cancer

Study suggests that the high health care costs after breast cancer continue long after diagnosis

he financial fallout from breast cancer can last years after diagnosis, particularly for those with lymphedema, a common side effect from treatment, causing cumulative and cascading economic consequences for survivors, their families, and society, a study led by Johns Hopkins Bloomberg School of Public Health researchers suggests. Excluding productivity costs, those with lymphedema were estimated to have an average of $2,306 Page 18

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in out-of-pocket costs per year, compared to $1,090 for those without lymphedema—a difference of 112 percent, the study found. When factoring in productivity costs, those with lymphedema spent an average of $3,325 in out-of-pocket costs, compared to $2,792 for those without lymphedema. “That extra $2,000 or so may not break the bank in one year,” says study leader Lorraine T. Dean, ScD, assistant professor in the Department

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

of Epidemiology at the Bloomberg School. “But it can take away discretionary spending, or whittle away retirement savings. If it’s a recurring burden each year, how can you ever rebuild? That extra $2,000 in spending can cripple people over the long term.” The findings, published Aug. 18 in the Journal of Supportive Care and Cancer, are a call to action for policymakers to develop new ways to curb costs after cancer, the authors say.

A growing body of research highlights the “financial toxicity” of cancer, a term that pertains to the harmful personal economic burden caused by cancer treatment, explains co-author Kala Visvanathan, a professor in the Bloomberg School’s department of epidemiology. The financial consequences of cancer have been shown to affect mental health and a variety of other health outcomes, including rates of death.

Competitors Partner to Elevate the Standard of Care for Cancer Patients Breast Care Center is a virtual program that gathers physicians from different practices in CNY. The goal? To offer better cancer care By Mary Beth Roach

hen patients enter a breast cancer care center, most often they expect to find all the doctors and treatments in one structure. And one certainly doesn’t envision a program in which the providers might be considered competitors. But the Breast Care Program, which began about five years ago, is just that. It is, as one doctor called it, a system without walls, and is comprised of some entities which might be looked upon as rivals. This program is virtual, as opposed to vertical, according to physician William Schu of Central New York Surgical Physicians, PC, who developed the concept for the center with another physician, John Gullo, and serves as its medical director. “Most breast centers are vertical,” Schu explained. “You go to a building. Everything’s in the same building.” In proposing his vision, he said, “We could set up a system that’s virtual, that’s connective, that has all the components, but it’s going to

be spread out over the footprint of Syracuse.” To accomplish this goal, he said, the components of breast care throughout the community would have to work together — hospitals, surgeons, radiologists, pathologists, oncologists and radiation oncologists. Its partners are Crouse Health; the Falk Breast Care Center at Crouse Hospital; Crouse Radiology Associates; CNY Surgical Physicians; Hematology-Oncology Associates of CNY; St. Joseph’s Health Hospital; and St. Joseph’s Imaging. It has full accreditation by the National Accreditation Program for Breast Centers, a program administered by the American College of Surgeons. “In essence, we’re competitors, but in reality we’re colleagues in the system of care,” Schu noted. The point is they all wanted to elevate the standard of care and the only way to do that, he explained, was to bring in other systems. Physicians Schu, James Sartori,

Physicians James Sartori, Tammy Congelli and William Schu of CNY Surgical Physicians. They are also part of the Breast Care Program. and Tammy Congelli see the partnership as beneficial to both the patient and the provider. All three are from CNY Surgical Physicians, and Crouse is the hospital with which the group is affiliated. “We all agreed to adhere to these high principles, these high standards and cohabit this partnership,” he continued. “As long as we have the components in place and meet regularly to discuss our cases and so on, we’re doing everything we can and should be doing for breast care. And that’s what it comes down to.” The partners meet and discuss as many cases as possible, Schu explained. “When we do meet to discuss them, there’s a lot of back and forth. There are discussions, maybe disagreements, agreements and at the end of the day we come up with a plan that’ll be the best plan for that patient,” he said. Sartori sees the partnership as a centralization of care. “You can’t practice in a bubble anymore,” he said. “This is a nice

opportunity for a patient to feel that they’re getting state-of-the-art care, and if they have a difficult case, that the community’s contributing for this.” From the minute the patient steps into the office, they’re part of the system, no matter where their entry point is. Most patients enter the system through a surgeon’s office, but it might be through a radiologist, it might be through an oncologist. A navigator within the system coordinates the patient’s care, guiding them through the process and setting up appointments, for example. Physician Congelli calls it “a system without walls.” “When patients walk in here they can honestly feel like we’re going to take care of them. I basically say to them, ‘we’ll drive the bus,’” she said. “This is an overwhelming process. It’s very emotional for women. I think a lot of times, they’re scared to death. We have this large group of people that are all here for you and we’re going to help you.”

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Sports Concussions Much Worse for Women In sports played by both men and women with the same rules, like soccer and basketball, women have a 10 percent higher rate of concussion, says expert By Deborah Jeanne Sergeant

he injury caused by concussion appears to be worse for women than for men, according to research presented in the July journal Radiology. While part of the phenomenon may include women’s general willingness to discuss medical issues and a better ability to accurately describe physical condition, non-subjective measures also correlate. MRI scans used in the study show greater damage among female soccer players who “head” the ball than males. Heading the ball accounts to 25 to 30 percent of concussions among female and male soccer players, respectively. Brian Rieger,

Ph.D, director of Upstate Concussion Center, said that the difference starts with the vulnerability to the injury. “In sports played by both men and women with the same rules, like soccer and basketball, women have a 10 percent higher rate of concussion consistently across a number of studies,” Rieger said. While he maintains that women are more likely to report a concussion and when they do. They’ll likely report their symptoms more accurately and in greater detail, “good research now shows hormone differences might play a role in vulnerability of concussion and the course of injury and how long it takes to recover.” He said that some research points to the difference between male and female neck strength. A stronger neck can absorb more of the force of the blow to the head than a weaker neck. “There may still be other differences that we don’t understand,” Rieger said. “Brains of men and women are more similar than different.” Following a strict return-to-play policy after a concussion is vital to

minimize the risk of lasting damage. At most schools, athletes receive a baseline test before playing so that if they suffer a concussion, they can compare their steps of recovery to their baseline reading. Those recovering from concussion must meet with trainer from the athletic department daily for further testing on factors such as balance. Apps usually tests visual and verbal memory and reaction time. Trainers can also test athletes on the sideline right after a hard hit. In addition, knowing the students well can help coaches and trainers recognize when players are hurt and when they’re not. “Compared to 10 to 15 years ago, schools are doing a much better job in managing concussion,” Rieger said. “Most schools have procedures in place for getting students back to sports and physical activity.” Most back-to-play plans gradually return players with sufficient rest followed by incrementally increasing activity levels. If players regress and exhibit symptoms, they may have to repeat a step. Rieger said that the return-toplay protocol has shifted toward returning to light, normal activities while the patient still experiences symptoms. Especially for very driven students, remaining completely inactive can become very stressful, which can hamper healing. He added that permitted, light activity, so long as the student doesn’t experience symptoms worsening, can help students feel more in control of their recovery and less stressed. If the player hasn’t fully recovered after two weeks, he may need to see a doctor. Most players injured by concussion recover within that timeframe. “We still have a ways to go in schools supporting kids academically after concussion,” Rieger said. “When we have a non-athlete concussion, the student may not be followed.”

Vaginal Rejuvenation: FDA Cautions About Elective Procedures By Deborah Jeanne Sergeant

hildbirth, menopause and the passage of time can affect both the appearance and function of women’s vaginal tissues. For some, dryness and lax tissue make intercourse less pleasurable and even painful. Some health care providers, including gynecologists, dermatologists and plastic surgeons, now offer non-surgical treatments to restore both vaginal moisture and tightness. In July, the FDA issued a cautionary statement about providers using energy-based devices for elective vaginal procedures. The FDA statement read that “the safety and effectiveness of energy-based devices for treatment of these conditions has not been established” and that “non-surgical vaginal procedures to treat symptoms related to menopause, urinary incontinence, or sexual function may be associated with serious adverse events.” The FDA has approved energy-based devices — radiofrequency or laser — for dermatological and general purposes, including removal of genital warts, growths or Page 20

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pre-cancerous tissue. The FDA has not specifically approved some of these devices for vaginal procedures. It states that using the devices for cosmetic reasons may cause “vaginal burns, scarring, pain during sexual intercourse, and recurring/chronic pain.” Robert A. Jason, board-certified gynecologist and cosmetic gynecologist, believes that the FDA statement has caused a great deal of confusion, though there’s merit in warning women to approach vaginal rejuvenation carefully. “They should go to a gynecologist who understands the benefits and pros and cons of non-invasive vaginal rejuvenation equipment,” Jason said. Jason serves as medical director and owns the Laser Vaginal Rejuvenation Institute of New York, in New York City and Lake Success on Long Island. He said that vaginal rejuvenation should be overseen by a gynecologist or cosmetic gynecologist physician in charge. Patients should also maintain realistic expectations. Women seeking tighter tissue, for example, should

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

understand that non-invasive procedures may not offer the tightness they want. Jason said that he and other gynecologists use certain lasers or radiofrequency devices as a scalpel or knife. He added that there are also other lasers and radiofrequency devices on the market that are used as non-invasive, non-surgical devices that gynecologic and non-gynecological physicians use for non-invasive vaginal rejuvenation. “That is the confusing part,” Jason said. “After careful examination, if the right candidate uses non-invasive procedures, myself as well as many colleagues across the country have had excellent results, over 90 percent success rates. “The problem is that when women need more involved surgical repairs, their expectations were not met and that non-invasive procedures done by offices not well-versed in vaginal health, can have less-than desired or harmful results.” He said that many women had procedures that were not appropriate for them and were hurt, prompting the FDA’s warning. “To truly put this in prospec-

He added that school nurses are an excellent resource when it comes to concussion. “I would encourage all parents who have a child with a concussion to let the school nurse know.” The school nurse can help monitor if the child is improving or not and coordinate with the teachers to ensure students receive any accommodations they may need. Above all, students need to tell coaches if they’ve been injured. Faking wellness and continuing to play puts student athletes at risk for a secondary concussion. That can result in symptoms that last for many weeks and even permanent damage. Todd Nelson, assistant director of the New York State High School Athletic Association in Latham, encourages parents to help their young athletes to reduce their risk. “If they can get with a strength conditioner, they may be able to strengthen their neck muscles,” Nelson said. “That may help reduce risk of a potential head injury.” He said that’s also important to play by the rules and regulations of the particular sport and to use the safety equipment properly. “In soccer, a lot of players during practice won’t wear shin guards that are required during competition,” Nelson said. “We expect students to wear gear during practice.” If there’s a hard hit, the officiate should stop play and remove the injured player. Athletes, coaches and officiates should understand the signs and symptoms of concussion and what happens when they don’t report concussions and try to keep playing while injured. “Unfortunately to high school athletes, that’s a detriment that they go back before fully healed,” Nelson said. The National Federation of High Schools offers a free concussion management course to students at www. NFHSlearn.com.

tive, laser hair removal in the wrong person’s hands can cause burns and harmful results also,” Jason added. Joyce Farah, board-certified dermatologist and fellow of the American Academy of Dermatology, is an assistant professor of Medicine at SUNY Upstate Medical University and in private practice at Farah Dermatology in Syracuse. She said that the devices her office uses were not listed among those criticized by the FDA. “Any time you do use a heat source, there is a potential to get a burn or blister,” she said. “If devices are used within the parameters of how it should be used, it’s fine. We have encountered no problems.” Farah Any woman seeking vaginal rejuvenation must present clearance from her gynecologist or Farah won’t offer the procedure. “We want to make sure that they don’t have any contraindications like an infection and that they’re good candidates,” Farah said. “We’re one of the few that does this, from what I understand.”

Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

Commanding One’s Vessel

It’s time women reclaimed their bodies

am about to write some contentious things. If you are the sort of person who likes a spirited opinion piece, read on. If you are the sort who is easily ruffled, tired of hearing about women’s issues or fed up with all the women’s movements occurring in our society, please also read on. Feel free to get annoyed with me. If you must be irked, wait until the end of this article to get fired up. I can handle that, because you heard me out, and that counts for a lot these days. For women, there are some universal truths. One is that our bodies are not merely for ourselves. Most men (and I say most not to marginalize, because there are exceptions to every generalization) have the distinct privilege of their body being their property. They get dressed each day only for themselves. They get to make impressions with their personalities, not their looks. People gen-

erally treat men based on how they treat others. As a woman, I am often judged by my aesthetics, and the rest of my being is diminutive. Most men don’t worry about stretch marks, makeup trends, the hottest wardrobes, counting calories, a little bit of belly fat, whether or not they appear too conservative or too easy, whether or not they will be taken seriously based on their physical appearance, whether or not an associate’s touch was creepy or a thousand other matters that are related to aesthetics and being a woman. Most men wake up, go about their lives and use their bodies as vessels. They command their bodies and use them to get things done. That’s it, and that’s exactly how it should be. As a woman, it’s very hard to not worry about those thousands of things. It’s difficult to command my own vessel. From the time I was a little girl, people (women and men) have

dwelled on my appearance. I’ve been taught that my appearance is a very important part of me because, for many people I meet, it nearly defines me. Having a body define a person is petty, but it’s a daily occurrence. Looks matter in a way they shouldn’t, and that is especially true for women. And, the saddest part is, to some degree, I was OK with all this. I had accepted it as a women’s lot in life. I am loud, sassy and a fighter, but even I fell victim to the status quo. Now, I have two beautiful children and I think about things differently. More than ever, I want to improve myself. A better me means a better world for them. I am no longer OK with the status quo; it’s time for a shakeup. It’s time women reclaimed their bodies. Here is where you need to hear me out. They need to reclaim them from men. They need to reclaim them from women. They need to reclaim them from themselves. The world needs to turn the conversation away from how women look and start talking and thinking about them like they do men. I am not just talking to the guys out there; I am talking to all of us. We can do better. It’s called progress, and it’s gotten us this far. If we can’t reprogram ourselves, because old habits die hard, we need to raise our kids better. We can start small. We need to stop talking to girls about their appearance. Challenge yourself to ask a little girl what her favorite sport or subject is. Challenge a little boy to take no as his answer the first time he hears it. Ask a little boy what makes him smile. Take whatever you usually say to one

gender and say it to the other. If it sounds reasonable, keep saying it. Challenge yourself to not ask about appearance when it comes to prospects in a kid’s burgeoning love life. Instead, ask if a prospective partner makes them feel happy and safe. Challenge yourself to be a role model. Don’t comment on people’s appearances, whether they are your family or perfect strangers. No matter the relation, focus on a person’s deeds or misdeeds. Talk to your kids about how people make them feel, not what people look like. Because, let’s face it, it’s not what someone looks like that keeps you up at night. I have this crazy idea we should all feel safe in our skin. We should be judged by who we are and what we do. I owe it to my kids to teach them they own their bodies. Their bodies are here to transport their souls around this beautiful earth. Their bodies aren’t here for anyone else’s pleasure or displeasure. Their being cannot be boiled down to aesthetics. If we can impart this on our kids and get it through our own thick skulls, this world will be lighter for our efforts. No one owes another human being anything when it comes to the way we look. We need to get over appearance, because, at its best, it’s fleeting and a really unsafe bet. It’s nearly useless, unlike character. We need to remind ourselves that after we are gone, we will be defined not by what our bodies looked like, but what they accomplished while they we here. How will you judge the women in your life? How will you judge yourself? Will you command only your vessel? Thanks for reading.

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Women’s Health What to Do If Urinary Tract Infections Are a Part of Your Life rinary tract infections can be a painful and sometimes serious problem for many women. For some women, infections seem to come on at regular intervals. While many women may have only a handful of bladder infections in their lifetime, others seem to suffer from them almost constantly.

What causes urinary tract infections? The vast majority of UTIs are caused by bacteria that ascend (go up) the urinary tract from the urethra. These bacteria are found normally in the area between the rectum and vagina, but sometimes are able to work their way into the bladder. Most typical UTIs (about 80 to 90 percent) are caused by the bacteria E.coli.

What is a urinary tract infection? These infections of the bladder or urinary tract are sometimes called “UTIs” or “bladder infections.” The symptoms of typical UTI include burning and pain during urination, feeling the urge to urinate much more frequently throughout the day, and having significant urgency to urinate. Some people may also experience low back or lower abdominal pain.

What do you do if you get frequent UTIs? Some patients will have recurrent urinary tract infections — those with more than two or three infections in a six-month period. There can be many reasons for someone to have frequent UTIs. A very important first step is to ensure that all the infections are properly diagnosed. A urine “dip” in the office is not sufficient to diagnose a urinary tract infection — the only true test to confirm infection is a

By Natasha Ginzburg, MD

urine culture. It is critical to obtain urinary cultures for patients who have symptoms of frequent UTIs. There are other diseases that can masquerade as urinary tract infections. In those patients, treating the UTI over and over again will never solve the problem, because something else entirely is causing the symptoms. Additionally, knowing which type of bacteria is responsible for the infection can help to tailor the most appropriate treatment. Some patients will need specialized testing to determine if there is an specific reason that is putting them at risk for the infections. For patients with UTIs that are proven by repeated abnormal urine cultures and normal urologic testing, there are a number of methods to prevent recurrences. For many post-menopausal women, estrogen cream can significantly decrease the

risk of infections. Preventive treatments with cranberry tablets, vaginal probiotics, vitamin C, methanamine and D-mannose have also been explored. If you suffer from frequent UTIs, it is important to talk with your primary care physician or urologist. She or he can ensure that all avenues to minimize your risk of recurrence are addressed. Natasha Ginzburg is a urologist at Upstate Urology who specializes in the care of female urologic patients.

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Which Flu Shot Is Right for You? Dear Savvy Senior, I’ve been reading that there are a bunch of different flu vaccines for seniors this flu season. Which flu shot is right for me?

Flu-Conscious Carol Dear Carol, It wasn’t that long ago that if you wanted to get protected from the flu, you simply got a flu shot. But now days, there are so many flu vaccine options you might feel like you are ordering off a menu. To help you decide which flu shot is right for you, you need to consider your health, age and personal preferences. Here’s what you should know. Flu Shot Options Just as they do every year, the Centers for Disease Control and Prevention (CDC) recommends a seasonal flu shot to everyone 6 months of age and older, but it’s especially important for seniors who are at higher risk of developing serious flu-related complications. The flu puts more than 200,000 people in the hospital each year and kills an average of 24,000 — 80 to 90 percent of whom are seniors. Here’s the rundown of the different vaccine options. You will only need to get one of these: Standard flu vaccines: If you want to keep things basic, you can’t go wrong with a “standard (trivalent) flu shot,” which has been around for more than 40 years and protects against three different strains of flu viruses. This year’s version protects against two A strains (H1N1 and H3N2), and one influenza B virus. Or, for additional protection, you should consider the “quadrivalent flu vaccine” that protects against four types of influenza — the same three strains as the standard trivalent flu shot, plus an additional B-strain virus. Senior specific vaccines: If you’re age 65 or older and want some extra protection, you should consider the “Fluzone High-Dose” or “FLUAD.” The Fluzone High-Dose has four times the amount of antigen as a regular flu shot does, while the FLUAD contains an added ingredient

called adjuvant MF59. Both vaccines provide a stronger immune response for better protection. Egg allergy vaccines: If you’re allergic to eggs, your flu shot options are “Flucelvax” or “FluBlok.” Neither of these vaccines uses chicken eggs in their manufacturing process. Fear-of-needle vaccines: If you don’t like needles, and you’re between the ages of 18 and 64, your options are the “Fluzone Intradermal” or “AFLURIA” vaccine. The Fluzone intradermal flu shot uses a tiny 1/16-inch long micro-needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shot. While the AFLURIA vaccine is administered by a jet injector, which is a medical device that uses a high-pressure, narrow stream of fluid to penetrate the skin instead of a needle. You should also know that if you’re a Medicare beneficiary, Part B covers all flu vaccinations, but if you have private health insurance, you’ll need to check with your plan to see which vaccines they do or don’t cover. Pneumonia Vaccines Two other important vaccinations the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. Around 1 million Americans are hospitalized with pneumonia each year, and about 50,000 people die from it. The CDC recommends that all seniors, 65 or older, get two vaccinations — Prevnar 13 and Pneumovax 23. Both vaccines, which are administered just once at different times, work in different ways to provide maximum protection. If you haven’t yet received any pneumococcal vaccine you should get the Prevnar 13 first, followed by Pneumovax 23 six to 12 months later. Medicare Part B covers both shots, if they are taken at least one year apart. To locate a vaccination site that offers both flu and pneumonia shots, visit Vaccines.gov and type in your ZIP code. 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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any people working nowadays have more than one job, so it’s not uncommon for them to have several sources of income. Owning multiple small businesses, seasonal jobs and the gig economy add to the mix — and complexity — of our modern day economy. It’s important to keep in mind that having multiple sources of income can sometimes affect your Social Security benefits. Disability payments from private sources, such as private pensions or insurance benefits, don’t affect your Social Security disability benefits. Workers’ compensation and other public disability benefits, however, may reduce your Social Security benefits. Workers’ compensation benefits are paid to a worker because of a job-related injury or illness. These benefits may be paid by federal or state workers’ compensation agencies, employers or by insurance companies on behalf of employers. Public disability payments that may affect your Social Security benefits are those paid from a federal, state or local government for disabling medical conditions that are not job-related. Examples of these are civil service disability benefits, state temporary disability benefits, and state or local government retirement benefits that are based on disability. Some public benefits don’t affect

your Social Security disability benefits. If you receive Social Security disability benefits, and one of the following types of public benefits, your Social Security benefits will not be reduced: • Veterans Administration benefits; • State and local government benefits, if Social Security taxes were deducted from your earnings; or • Supplemental Security Income (SSI). You can read more about the possible ways your benefits might be reduced at www.socialsecurity.gov/ pubs/EN-05-10018.pdf. Be sure to report changes. If there is a change in the amount of your other disability payment, or if those benefits stop, let us know. Tell us if the amount of your workers’ compensation or public disability payment increases or decreases. Any change in the amount or frequency of these benefits is likely to affect the amount of your Social Security benefits. An unexpected change in benefits can have unintended consequences, but not if you’re informed and have financially prepared yourself. Visit our benefits planner webpage at www.socialsecurity.gov/planners for information about your options for securing your future.

Loretto’s Daybreak to Expand in New Location

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

aybreak, a Loretto adult medical day program in Syracuse, has moved to a bigger location at the Loretto Syracuse campus and will expand its physical space in this new location to accommodate the increased demand for the program’s services. The new location is on the first floor of the Cunningham building at 700 E. Brighton Ave. This is approximately one mile from Daybreak’s previous location, 161 Intrepid Lane in Syracuse. Loretto’s Daybreak program is running at full capacity most days and needed more room to provide the best service to program participants, according to information from Loretto. While social day programs offer structured activities, meals and the benefit of social interactions for older adults, medical day programs like Loretto’s Daybreak provide much more assisting adults with medical conditions through a network of nurses, registered dietitians, thera-

pists, case managers and recreation staff. Daybreak helps adults 21 and older to live independently for as long as possible by supplementing the services they are already receiving. According to Loretto, the program provides a safe and comfortable environment six days a week that includes physical, occupational and speech therapy, medication management, nutritional services, transportation services, recreational activities, and more. Loretto’s new Daybreak location provides a newly renovated space, a separate dining room and activity area, and connection to an outdoor walking path, gazebo and grassy picnic and outdoor activity area. The new location in Loretto’s Cunningham building was formerly occupied by Loretto’s PACE CNY program, which has also been growing. Loretto recently opened a new PACE CNY location in East Syracuse, in addition to the PACE CNY location in North Syracuse.

H ealth News Ed Barno appointed to Crouse’s board of directors

Patrick J. Mannion, chairman of Crouse Health’s board of directors, has announced the appointment of Syracuse business executive Edward Barno to the health system’s board. An active community leader and volunteer, Barno currently serves Barno as a partner with Rockbridge Investment Management, LCC, in Syracuse, which provides investment management and financial planning services, including retirement, tax, estate and business succession planning. Barno holds an MBA from Syracuse University and is a honorary member and committee chairman for Christian Brothers Academy. He also serves as a member of Onondaga Community College’s finance committee. He lives in Skaneateles. “As Crouse Health continues to position itself for the future, we are especially pleased to be strengthening our board with the addition Ed Barno” said Mannion. “His talents, leadership and expertise will serve the organization well and we look forward to his contributions.”

Crouse NICU receives grant for parent education Crouse Health Foundation has received $2,300 from the Women’s Fund of Central New York to continue providing education and support for the parents of infants who are cared for in the hospital’s Baker Regional Neonatal Intensive Care Unit (NICU). Since 1975, Crouse Health has

served as the region’s only New York state-designated regional perinatal center. In 2017, over 1,000 premature and critically ill infants were admitted to the NICU from 14 counties in Central and Northern New York. Some infants are in the NICU for a few days but many are in the unit for 30 days or more. This funding will support the programs provided to moms (and dads) of NICU babies to help them learn how to care for their infant and how to cope with a highly stressful situation. Crouse provides these programs in a dedicated space where topics include handling holidays with a baby in the NICU, struggles with ups and downs, staying positive and bonding with their premature infants and addressing grief.

Stopper appointed new Sedgwick Heights administrator

Amanda Stopper has been promoted to role of administrator for Sedgwick Heights, a Loretto assisted living community. Formerly the assistant administrator of the Bernardine, another Loretto assisted living facility, Stopper holds a bacheStopper lor’s degree in political science from Le Moyne College and a master’s degree in public administration with an emphasis in healthcare management from Grand Canyon University. Stopper has been with Loretto for four years, with various roles in human resources. For the past two years she has been the assistant administrator for The Bernardine. She lives in Cicero.

Member of the Cayuga County’s 2017 Harmful Algal Bloom (HAB) Response Team have been honored by the state Department of Health.

Cayuga County Health Department Staff Honored

he New York State Department of Health (DOH) has recently selected Cayuga County’s 2017 Harmful Algal Bloom (HAB) Response Team for its 2018 Honor Roll. Cayuga County’s selection is part of DOH’s Health Works! campaign, which raises awareness of the essential services that public health workers and the public health system provide to the residents of New York state. In 2017, the Cayuga County Health Department’s HAB Response Team worked prior to the bloom season to educate health department staff, community partners and the general public about the harmful effects of HABs. The Team created innovative preparedness tools, informational campaigns, and urgent response messaging. Members of the HAB Response Team worked seven days a week taking and shipping water samples for analysis, educating waterfront operators, and responding to calls from

concerned citizens that needed help identifying and sampling potential HABs. “The Public Health Works! campaign raises awareness about the important work health departments perform in keeping our residents safe,” said Public Health Director Kathleen Cuddy. “As the county health department continues addressing HABs, we appreciate this recognition and the role the campaign can play in promoting HAB outreach, education, and responses.” Members of the Cayuga County Health Department HAB Response Team are sanitarians Mary Jump, Kris Scholl, Duane Ross, Lisa Jones and Kris Scholl; Sharon Blowers, principal typist; Chrisann Hunt, senior typist; senior public health educators Kim Abate and Deanna Ryan; Deb Green, office manager; Megan Bell, principal typist; Scott King, senior sanitarian; Eileen O’Connor, environmental health director; and Kaitlyn Salato, registered nurse.

IInn your retirementyears, years,weweinvite invite your retirement

“ContinueUnited”. United”. you you to to “Continue Your ofUnited UnitedWay Wayofof CNY Your support support of CNY will createaabright brightfuture future will help help create forfor your andfor for your grandchildren grandchildren and generations tocome! come! generations to Mail your yourcheck checkpayable payable Mail to:to: UnitedWay WayofofCNY CNY United PO Box Box 2129, 2129,Syracuse SyracuseNY,13220 NY,13220 donatetoday todayonline online or donate at:at: www.unitedway-cny.org www.unitedway-cny.org October 2018 •

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“Your airway lining protects against viruses but also other harmful substances that enter airways,” senior study author physician Ellen Foxman, an assistant professor of laboratory medicine at Yale School of Medicine in New Haven, Conn., said in a statement. “The airway does pretty well if it encounters one stressor at a time. But when there are two different stressors, there’s a trade-off,” Foxman explained. “What we found is that when your airway is trying to deal with another stress type, it can adapt, but the cost is susceptibility to rhinovirus infection.” The study was published Sept. 11 in the journal Cell Reports.

Why Some People Catch a Cold and Others Don’t

hether you catch a cold this winter or make it through the season scot-free may depend in part on how many “stressors” your nose and airway passages encounter, a new study suggests. The research looked at two defense mechanisms that cells in a person’s airway use to protect themselves from threats: one that protects against viruses like the common cold virus and another that protects

Defense trade-off

against “oxidative stress.” This form of cell damage is triggered by viruses and other irritants, such as cigarette smoke or pollen. The study found that there’s a trade-off between these two defenses: more protection against oxidative stress damage (for example, damage induced by cigarette smoke) means less protection against invaders like rhinovirus, which is the main cause of colds.

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Respiratory viruses cause an estimated 500 million colds and 2 million hospitalizations in the United States every year, the researchers said. However, some people can be exposed to a virus without getting sick, because the cells that line their airways clear the virus before it causes symptoms. But for other people, this clearance doesn’t happen, and they wind up sick. To better understand why some people get sick from cold viruses while others escape illness, the researchers examined airway cells

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from healthy human donors. The cells were obtained from the lining of people’s nasal passages or of their lungs. Researchers found that the nasal cells had a stronger inherent defense response to viruses, while the lung cells had a stronger defense against oxidative stress. Later experiments revealed that there was indeed a trade-off between these two defense mechanisms. For example, when the researchers exposed nasal cells to cigarette smoke to trigger an oxidative-stress response, the cells became more susceptible to rhinovirus. “They survive the cigarette smoke but can’t fight the virus as well,” Foxman said. “And the virus grows better.” The finding might explain why cigarette smokers tend to be more susceptible to rhinovirus infection compared to people who don’t smoke, the researchers said. The results also suggest that finding ways to protect the cells lining the airway from oxidative stress “may lead to effective strategies to enhance natural defense against rhinovirus infection,” the researchers concluded. However, more studies will be needed to investigate this idea.

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