IGH CNY 229 January 19 by In Good Health: CNY's Healthcare Newspaper

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Meet Your Doctor

CNYHEALTH.COM

JANUARY 2019 • ISSUE 229

Ruth Weinstock, a SUNY Upstate physician, will be recognized for her innovative work toward treatment and cure of diabetes. She talks about her projects

A GUIDE TO COMFORT FOOD

What to do during the long winter months when our comfort-food cravings are besting our better judgment? Check inside for some nutritious makeovers that may satisfy your longings without compromising your health. Page 16

Women’s

Health

Milk: Are They All the Same? Oat milk, soy milk, coconut milk, hazelnut milk — alternative options for dairy milk have grown in popularity in the last two decades. But how do they compare to dairy milk? P.18

• More women than men reporting higher levels of stress • You’re not alone: Half of older women suffer incontinence • C-section rates have nearly doubled since 2000 • Alcohol and breastfeeding: Do they go well together?

Fitness Trends for 2019 Find out what’s hot, according to local experts

Arugula Super low in calories and rich in fiber, this ‘carcinogen killer’ is a healthy choice for those looking to lose or maintain their weight.

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Into Saunas? Love your time in the local sauna? Your heart may love it, too, according to a new study recently released.

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Had a Stroke. Back on Stage.

Musician Todd Hobin KNOW THE SIGNS • CALL 911 IMMEDIATELY

Central New York music legend Todd Hobin knew nothing about stroke — but he does now. That’s why he’s raising awareness about stroke risk factors and its signs and symptoms.

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Fact: Stroke is the fifth leading cause of death and a leading cause of disability in the U.S. Important to know: Stroke can happen to both men and women — at any age. Good news: Stroke is preventable by managing medical risk factors and healthy lifestyle choices. What to do: Time lost is brain lost. So it’s vital to know the signs of a stroke — F.A.S.T. Four words to live by: Call 911 and say, “Take me to Crouse.“ When it comes to stroke, every moment matters. As one of just 10 hospitals in New York State to have earned Comprehensive Stroke Center status, and with the region’s newest ER and hybrid ORs, Crouse offers the most advanced technology for rapid stroke diagnosis and treatment

Read Todd’s story and learn more: crouse.org/toddhobin.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019

TIME TO CALL 911

January 2019 •

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ove your time in the local sauna? Your heart may love it, too. New research from sauna-loving Finland suggests that for people aged 50 and older, saunas may lower their odds of risk of dying from heart disease. Specifically, just 5 percent of Finns in the study who spent more than 45 minutes in a sauna each week died of heart disease over the 15-year study period, compared to 10 percent of those who spent less that 15 minutes a week in saunas, the researchers said. Of course, the study couldn’t prove cause-and-effect — it’s possible that sauna-loving folk have other heart-healthy habits that might explain the findings. Still, “there are several possible reasons why sauna use may decrease the risk of death due to cardiovascular disease,” said study co-author Jari Laukkanen, physician and head of cardiology at the University of Eastern Finland. His team published its findings Nov. 28 in the journal BMC Medicine. “Our research team has shown in previous studies that high sauna use is associated with lower blood pressure,” he noted in a journal news release. “Additionally, sauna use is known to trigger an increase in heart rate equal to that seen in low- to moderate-intensity physical exercise.”

One U.S. expert who looked over the findings agreed that heat can often be therapeutic to the human body, but the sauna experience might differ a bit in America. “The greatest benefit [in the study] was observed in individuals who took four to seven saunas per week, a frequency that Americans are unlikely to achieve,” noted Cindy Grines, who directs cardiology at Long Island Jewish Medical Center in New Hyde Park on Long Island. “In addition, this study used dry heat, and whether the results are similar with steam baths or hot tubs is not known,” she said. Laukkanen’s team agreed that because the data came from one area in Finland, the findings might not apply to other populations. The study relied on data from nearly 1,700 Finnish men and women. Participants were asked about their use of saunas, and these data were compared with deaths from cardiovascular disease. Data for the study were collected between 1998 and 2015 and the average follow-up was 15 years. Frequency of sauna use did seem tied to heart health. Among people who used a sauna four to seven times a week, 3 percent died from heart disease over 15 years, but that number rose to 10 percent for those who used the sauna just once a week, the study found.

WE SPEND AN AVERAGE OF 13 HOURS A DAY SITTING STAND UP! More than half of your

day is likely spent sitting. Too much sitting is linked to heart disease and other serious issues. Sit all day at work? Set a reminder to stand every hour. Stand when on a conference call or eating lunch. Or, try a walking meeting with a co-worker.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019

Most Americans Lie to Their Doctors. No Kidding!

s many as four out of five Americans withhold important information from their doctor that could prove crucial to their health, a new study shows. Between 60 and 80 percent of people admit they avoid telling their doctor details that could be relevant to their well-being. “I know at some level this is a ‘no duh,’ of course, people mislead, but I was surprised how pervasive it is,” said senior researcher Angela Fagerlin, chairwoman of population health sciences at the University of Utah in Salt Lake City. “A lot of people are not fully honest with their provider.

They don’t tell them all the information they could tell them.” Shame and fear appear to be at the root of this lack of communication, the researchers found. Patients don’t want to admit that they disagree with their doctor or don’t understand what the doctor has told them, Fagerlin said. People also don’t want to fess up about their unhealthy behaviors. But keeping this information secret can lead to some very dire consequences. American Academy of Family Physicians President John Cullen recalled a situation years ago when

a patient with apparent appendicitis was being prepped for surgery. “Unfortunately, methamphetamine can sometimes present the same way as appendicitis,” said Cullen, a family physician in Valdez, Alaska, with more than 25 years of experience. “As we’re getting ready to take him to the operating room, I remember saying, ‘We’re about to cut you open here. Are you sure you don’t want to tell me anything else?’ “That’s when we found out about the methamphetamine use,” Cullen continued. “Indeed, that was the cause, and we stopped the surgery.” Sharing information can also help doctors prevent drug interactions, or change a patient’s treatment plan so he or she will be more likely to comply with it, Fagerlin said. For the study, Fagerlin and her colleagues surveyed two different pools of patients, 4,510 in all. One group had an average age of 36, while the other had an average age of 61. The younger group of patients consistently tended to withhold information more often than the older folks, 81 percent and 61 percent, respectively. The most common thing people don’t tell their doctor is that they don’t agree with the physician’s recommended course of treatment, the researchers found. About 46 percent of people in the younger group and 31 percent in the older group said they’d done this. This is not good because people who disagree with their doctor might not follow through on taking prescribed medications or receiving recommended follow-up tests, Fagerlin said. Second most often, people

wouldn’t admit that they didn’t fully understand the instructions a provider gave them. That happened with 32 percent of younger patients and 24 percent of older patients. After that, patients most often withheld information about personal habits that could be unhealthy: poor diet (24 percent for younger and 20 percent for older patients); not taking medication as prescribed (22 and 18 percent); not exercising (22 percent in both groups); or taking someone else’s prescription medication (14 and 9 percent). The researchers also asked why patients didn’t tell the whole story, and the No. 1 reason was that they didn’t want the doctor to give them a hard time about their behavior (82 and 64 percent); “They didn’t want to get a lecture from their doctor,” Fagerlin said. “They didn’t want to get scolded.” Other reasons included: • I didn’t want to hear how bad a behavior is for me (76 and 61 percent). • I was embarrassed to admit something (61 and 50 percent). • I didn’t want the provider to think I’m a difficult patient (51 and 38 percent). • I didn’t want to take up any more of the provider’s time (45 and 36 percent). • I didn’t think it mattered (39 and 33 percent). • I didn’t want the provider to think I’m stupid (38 and 31 percent). • I didn’t want this information in my medical record (34 and 31 percent). The new study was published Nov. 30 in the journal JAMA Network Open.

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Couch Potato Nation 1 in 4 adults sits more than 8 hours a day

early half of Americans sit for far too many hours a day and don’t get any exercise at all, a new study finds. A survey of some 5,900 adults found that nearly 26 percent sit for more than eight hours a day, 45 percent don’t get any moderate or vigorous exercise during the week, and about 11 percent sit more than eight hours a day and are physically inactive. “Being sedentary increases the risk for heart disease, high blood pressure and dying early,” said lead author Emily Ussery. She is an epidemiologist at the National Center for Chronic Disease Prevention and Health Promotion, part of the U.S. Centers for Disease Control and Prevention. Ussery pointed out that sitting may not be bad in itself, but is a proxy for not getting enough exercise. Study co-author Peter Katzmarzyk added, “In recent years, we have begun to understand the

health hazards of excessive sitting.” Although all the reasons why prolonged sitting is unhealthy aren’t known, Katzmarzyk speculates that “when people sit, they deactivate the large muscles in their legs, and this has a host of metabolic consequences that seem to be harmful.” More and better efforts are needed to get people moving, said Katzmarzyk, who is associate executive director of population and public health sciences at the Pennington Biomedical Research Center in Baton Rouge, La. “Programs that increase physical activity and reduce sitting might be especially effective at reducing health risks,” he noted. A few minutes can help The new edition of the U.S. Physical Activity Guidelines for Americans says that any amount of physical activity — even two minutes’ worth — can add up to huge health benefits. When the new guidelines were released recently, Adm. Brett Gi-

roir, assistant secretary for health at the U.S. Department of Health and Human Services, said, “Physical activity is about finding opportunities to add movement throughout the day as part of a bigger commitment to healthy living.” Being inactive causes 10 percent of early deaths in the United States, according to Giroir. If 25 percent of inactive people got at least the recommended 150 minutes of moderate exercise a week, nearly 75,000 premature deaths could be prevented. According to the new guidelines: • A single bout of physical activity can sharpen your mind, reduce

your anxiety, lower your blood pressure, improve your sleep and strengthen your body’s ability to convert blood sugar into energy. • Regular physical activity can improve your brain health, reduce your risk of eight different forms of cancer, and lower your risk for excess weight gain. • Chronic health conditions improved by physical activity include osteoarthritis, high blood pressure, Type 2 diabetes, anxiety and depression. The latest report was published Nov. 20 in the Journal of the American Medical Association.

Healthcare in a Minute By George W. Chapman

Healthcare Consolidation: Fewer Options for Consumers, Higher Price

hether hospitals or insurance companies, most consolidations have resulted in fewer choices and higher prices for consumers. The healthcare watchdog group The Commonwealth Fund estimates 90 percent of metropolitan statistical areas are “highly” or “super” consolidated. While some consolidations should create economies of scale and lower prices, most have resulted in market dominance and price increases. Many experts believe that the government’s attempts to foster competition may be too late. To boost competition, the FTC needs greater resources to evaluate proposed consolidations and then to break them up if prices go up and consumers choices go down. In defense of hospitals, most are operating precariously close to

break-even and the very survival of some hospitals, especially in rural areas, may depend on merging with a larger hospital system. If hospitals do not consolidate in markets dominated by a single insurer/ payer, they will lose negotiating power. Moody Investor Services paints a semi-gloomy outlook for 2019. Hospitals are experiencing decreasing inpatient operating revenues as more and more care transitions to outpatient venues. Hospitals are also facing competition from new, non-traditional providers like for-profit urgent care centers, retail store based clinics and independent physician operations. New players in the industry, like Google, Amazon and Apple are determined to drive down costs and reinvent how care is delivered.

Feds Fostering Competition In Healthcare Responding to an executive order from the President, a working group of members from the departments of HHS, Labor and Treasury issued a 119-page report on how to promote choice and competition in our healthcare system. Among some of the recommendations/suggestions were: broaden the scope practice for nurse practitioners, physician assistants and hygienists so they can be paid directly and operate with less physician supervision; increase

reimbursement for telemedicine; allow multistate medical licenses and across state lines for telemedicine; reallocate funding for residency programs based on the most in demand specialties like family practice, pediatrics, internal medicine, OB-GYN and psychiatry; reduce restrictions on physician-owned hospitals (none in NYS); allow hospitals to expand or contract without certificate of need approval from the state; scale back the ACA’s employer insurance mandates; expand the use of health savings accounts to all, including those

on Medicare; increase price transparency; make it easier for patients to access their records. Reactions from the American Hospital Association and the American Medical Association were both expected and mixed. Telemedicine Increasing According to the AMA, telemedicine has been embraced the most by radiologists (40 percent), psychiatrists (28 percent) and cardiologists (24 percent). The average across all specialties is 15 percent. The acceptance of telemedicine is expected to increase due to a shortage of physicians, reduced costs for the technology, consumer preference and improved reimbursement to physicians. It is far too early to tell what the long range impact of telemedicine is on a person’s overall health versus face to face office encounters. NYS Bans Short-Term Plans With the slow dismantling of the ACA and associated penalties for not having insurance, many states are allowing the sale of cheap, short-term health insurance good for three years. NYS is not one of them. The ACA mandated minimum coverage/benefits for bronze, silver and platinum plans. So consumers could confidently shop around for the best price because all insurers had to offer the same mandated benefits per bronze, silver or platinum plan. Short-term plan shopping is a gamble because you have to compare both price and benefits across divergent plans. As with anything else, you will get what you pay for. Short-term plans do not cover pre-existing conditions. Primary Care Physician Visits Decline According to a study of claims data from 2012 to 2016, the Healthcare Cost Institute reported an 18 percent decrease in office visits to primary care physicians. Visits to January 2019 •

advanced practitioners, (nurse practitioners and physician assistants), increased a staggering 129 percent over the same four years. There is plenty of speculation why. Since more medical students are favoring specialties over primary care, the influx of new primary care physicians into the market is declining while older primary care physicians are retiring. Consequently, the role of APs in providing primary care, by necessity, has increased. Convenience may be a factor. Younger/healthy patients don’t want to wait for an appointment with their physician, so gladly schedule sooner with an AP. Many consumers are electing to get primary care from walk-in retail clinics or urgent care centers which are staffed primarily with APs. Finally, more and more states are loosening their requirements for physician supervision of APs, allowing the APs more latitude in scheduling patients. Top Healthy New Year’s Resolutions We all make them. Here are the most popular ones regarding health: More exercise, 38 percent; lose weight, 33 percent; eat healthy, 32 percent; be more active, 15 percent; learn a new skill/hobby; spend more time on personal well-being; consume less alcohol; stop smoking. By picking just one, you will accomplish some of the others. 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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Q: You recently received a the Samuel Eichold II Memorial Award for Contributions in Diabetes. Tell us more about it. A: That's a national award from the American College of Physicians. It was established to recognize either a physician who has made important healthcare delivery innovations for diabetes patients or done research that's significantly improved the quality of care for diabetes patients. It can be given to a physician or an organization. I was nominated, and physicians across the country wrote letters of support. Over the past 30 years, my research has focused on the study of new approaches for the prevention and management of diabetes and its complications. We were one of the first to do major work in the area of telemedicine. I have over 200 publications and have been in an investigator in over 100 clinical research projects. Q: What areas of research that you participated in do you feel had a big impact on the way diabetes care is delivered? A: I think one is in the area of telemedicine. That work started almost 20 years ago. We were involve very early on. Now it's becoming more common. But we were one of the first to show its utility in providing diabetes education to patients who lived far from centers, also for provider education. Also for patient management, like older adults who might have access issues that prevent or hinder them from reaching a diabetes center or their physicians. One study we did helped primary care physicians better take care of their patients. We showed that it helped patients improve their blood sugar control, their cholesterol, their blood pressure control. We did a telemedicine project involving children. We showed that it can help visits to emergency rooms, for urgent care and help their school nurses better control the children's diabetes in school. We've

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IN GOOD HEALTH â&#x20AC;&#x201C; CNYâ&#x20AC;&#x2122;s Healthcare Newspaper â&#x20AC;˘ January 2019

done projects in skilled nursing facilities. We've been delivering telehealth for diabetes to the prison population. We've also done research on preventing complications from diabetes. Q: Is this for Type 1 for Type 2? A: I've also done a lot of work with Type 1 diabetes. Many people think of it as childhood diabetes, and that's usually when it has its onset, but what's less known is that it can also have its onset in adulthood. Type 1 is not associated with obesity. It's an autoimmune disease where the body has a triggering event that causes it to start destroying its insulin-producing cells. There have been many advances in Type 1, so the life expectancy is a lot longer. We've been involved in critical trials with some of the newer therapies: insulin pumps, glucose-monitoring devices. One of our contributions showed that with older adults with Type 1 hypoglycemia, blood sugar that's too low, can be a problem. So we've been doing work with continuous glucose-monitoring. These are relatively new devices where patients wear a sensor, which is a thin filament that goes under the skin, and a transmitter that goes over it that transmits their sugar or glucose levels to a receiver. That receiver can alarm when the blood sugar is too low or too high. In addition, some of them can communicate with insulin pumps to prevent low blood sugar by cutting off insulin infusion. It's a great safety feature we didn't used to have. And we've been involved in the study of all those devices and finding ways to make living with Type 1 diabetes safer. Q: How about Type 2? A: We've also done a lot of work with Type 2 diabetes, testing new

medications and devices. Now that's a type that's largely related to obesity, as well as the pancreas not being able to make enough insulin. We've also been involved in studies on the prevention of Type 2 diabetes. All of the reasons we have an increase in diabetes aren't completely clear. And it's not just Type 2, but Type 1 as well. So the increase in Type 1 is not related to obesity. Whether it's related to a virus or an environmental toxin or some combination, that's being researched. We do know Type 2 â&#x20AC;&#x201D; being overweight or obese does increase your chances of developing Type 2, although there are people who aren't obese who do develop Type 2. Q: How does weight affect development of Type 2? A: What happens when you gain weight, particularly around your belly and organs, that tends to make you more insulin resistant. That means you need to make more insulin to keep your blood sugar normal. So even if your insulin-producing cells are working at 80 percent capacity, that might be enough if you're thin, but if you're obese and insulin resistant, your pancreas may not be able to make enough insulin to keep your blood sugar under control. Q: Is Type 2 reversible? A: Very early if you lose weight or get bariatric surgery, your blood sugar levels can return to normal without medication. Whether they'll stay normal for the rest of their lives, we don't know yet, but they can stay normal for many years. It depends at what point you lose the weight. Earlier is usually more effective. If you've been obese and needed insulin for many years and then lose the weight, you may still need insulin. Not as much, but still some. Once the destruction of the insulin-producing cells starts, it tends to continue. Q: So the cells are also destroyed with Type 2? A: Not all of them like in Type 1, where over 90 percent are destroyed. With Type 2, it can vary, but you're not functioning with 100 percent. Q: Where do you see your career going from here? A: Iâ&#x20AC;&#x2122;ll continue doing research. We have several grants pending. We want to do as much as we can to help take care of patients, increase access to treatments. And the ultimate goal, of course, is prevention and a cure. There are many people working on that and we try to make as much of a contribution as we can. And another important thing for me at this stage of my career is teaching the next generation.

Lifelines Name: Ruth Weinstock, M.D. Position: Medical director of the

clinical research unit at SUNY Upstate; medical director of the Joslin Diabetes Center at Upstate Hometown: Queens, NY Education: Columbia University Affiliations: SUNY Upstate University Hospital Organizations: Juvenile Diabetes Research Foundation; American College of Physicians; American Association of Clinical Endocrinologists Family: Two daughters, two sons-inlaw, two grandchildren Hobbies: Time with grandchildren, walking, hiking, outdoor activities

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OLEG SHAPIRO, MD

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Urologic oncology and endourology, robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal; kidney stones

RYAN SIDEBOTTOM, DO

Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

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Incontinence, urethral stricture disease, vesicovaginal fistula, reconstructive surgery, transgender care

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Electronic Health Records Bogging Down Docs

lectronic health records are supposed to help doctors, but stress from using them may lead to burnout — and primary care doctors are at greatest risk, new research suggests. “You don’t want your doctor to be burned out or frustrated by the technology that stands between you and them,” said study author Rebekah Gardner. She’s a physician and an associate professor of medicine at Brown University’s Warren Alpert Medical School in Providence, R.I. “In this paper, we show that EHR [electronic health record] stress is associated with burnout, even after controlling for a lot of different demographic and practice characteristics,” she added in a university news release. In the study, Gardner’s team analyzed the responses of nearly 1,800 doctors in Rhode Island who took part in a state health department survey about health information technology-related stress. Of the 91 percent who reported using EHRs, 70 percent reported at least one measure of EHR-related stress. Those measures included frustration with using EHRs, spending time on EHRs while at home, and not having enough time for documentation while at work. Doctors who didn’t have enough time for documentation while at work were 2.8 times more likely to have burnout symptoms than those without that pressure. The other two measures were associated with about a two-times higher risk of burnout symptoms. The researchers also found that all three measures were reported by more than one-third of dermatologists (36 percent) and primary care doctors, including general internists (40 percent), family medicine physicians (37 percent) and pediatricians (34 percent). Nearly 31 percent of hospital medicine specialists reported all three measures. Meanwhile, less than 10 percent of anesthesiologists and radiologists reported all three measures, according to the study. The findings are “a signal to health care organizations that if they’re going to ‘fix’ burnout, one solution is not going to work for all physicians in their organization,” Gardner said. “They need to look at the physicians by specialty and make sure that if they are looking for a technology-related solution, then that’s really the problem in their group,” she concluded. The study was published Dec. 5 in the Journal of the American Medical Informatics Association.

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“Drs. Jay and Pat, as they are affectionately known, are extraordinary health care providers and citizens. Their impact on all the patients’ lives they touch and on the health and well-being of our community as a whole are immeasurable. Through their long and distinguished tenure, they’ve come to exemplify the values that ConnextCare has built into its mission and vision, and guides how each of us operate on a day-to-day basis. They are and will always continue to be an inspiration for all of us at ConnextCare.” Dan Dey, president and CEO, ConnextCare.

Physicians Patricia and Jay Chapman have cared for generations of patients in Northern Oswego County, Southern Jefferson County. They will retire in July after 35 years on the job.

Chapmans Set to Retire After Combined 70 Years in Rural Medicine Doctors have worked in North Dakota, Caribbean, Alaska, Kentucky but decided to settle in Pulaski 35 years ago

love for the community, medicine, patient care and each other have combined for a successful and fulfilling life for local physicians Jay and Patricia “Pat” Chapman. The husband and wife have made their home and careers in Pulaski, combining for 70 years of experience in rural medicine. The Chapmans, who work under the ConnextCare umbrella in Pulaski, serve patients primarily from northern Oswego County and southern Jefferson County. For them, the opportunity to serve patients in rural communities has been a rewarding experience. “We spent two years working in all kinds of different places — North Dakota, St. Lucia, Alaska, Kentucky — and so we got to see a little of different kinds of practices,” Jay said. “Originally, we thought it wouldn’t be as fulfilling to work in a non-hospital setting because when you’re in training, it seems like that’s where all the really important stuff goes on. But after being out in all those different settings, it became clear that there was plenty of really cool stuff that happens right in the office, and that’s where you really could make a difference.” With the desire to make a differ-

By Sarah McCrobie ence and focus on family medicine, the pair landed in Pulaski in 1984 after connecting with William “Ted” Prescott. Prescott was a founder and director of Northern Oswego County Health Services, now ConnextCare, and had stayed in touch with Pat, who was a Sandy Creek High School graduate before earning her medical degree from SUNY Upstate. “We wanted to come here, it felt like the right place for us. They were extremely flexible with us because having two doctors in one family working full time is too much. We were able to stay home with our kids for a few days and then work for a few days. It was the perfect balance,” the Chapmans said. “I hope they’ll be able to continue that flexibility and understanding with folks moving forward, because it really has made a difference. It’s made the place feel family-like. For the people who work here, it’s always felt family-like,” Jay added. The sense of community and family atmosphere are reflected in the way the Chapmans interact with their patients. They said they have a deep feeling of pride and care in their work. Their commitment hasn’t gone without recognition, as the duo has received multiple awards spanning their careers.

In September, SUNY Upstate Medical University, their alma mater, awarded Jay with the President’s Award for Outstanding Voluntary Faculty Service. The award recognized him “for being a vital part of the community, having taught SUNY medical students the critical roles of patient advocacy and community leadership for many years.” Through his work with Upstate’s Rural Medical Education Program, he has trained 28 students in the Oswego and Pulaski communities and offers teaching experiences that highlight the importance of providing care to vulnerable populations in underserved communities. “To receive that award from the medical school that you went to, that’s quite an honor,” Jay said of the award. “When you go through as a medical student, you feel like you’re pretty small compared to the whole medical school, so it was a real thrill to get that honor.” In addition to the individual award from Upstate Medical Center, both doctors have received several awards together. In 2014, they were named Rural Practitioners of the Year and also received the Rosemarie Forstner Award, a statewide honor that recognizes efforts and advocacy to ensure quality health care to January 2019 •

underserved populations. Although the awards and honors are a nice touch, the Chapmans find more satisfaction knowing they are taking care of their patients and delivering a high level of care. “I went into medicine because I just love the idea of helping people and I love science,” Pat said. “I think that combination and the fact that it was a challenge made it appealing.” “In family medicine, it’s about taking care of people as deeply as you can and referring them to whoever you need to refer them to if [the issue warrants a specialist],” Jay added. “The reason we both went into family medicine is that during your training you do — these four weeks or six weeks or eight weeks in all these different specialties — we just both liked them all. We just couldn’t decide,” Pat said. “We didn’t want to leave any of them behind.” As difficult as their decision was to select an area of practice, their decision to retire July 1 proved to be as challenging. “We have seen some patients for 35 years, since we started,” Pat said. “It’s quite a bond that you get with people. That positive vibe is really sweet. We’ll really miss the patients and staff; it really is a wonderful place to work.” The Chapmans said they will cherish the memories they have serving patients at the Pulaski location and in school-based health centers throughout Oswego County, but noted the time was right to announce their retirement. “We’re both healthy and this puts us in control of our time,” Pat said. “We would like to do some traveling, hiking, cycling and birding. We’re also in a Celtic band, the Tug Hill Players, so we’ll keep busy.” Even when they retire, the couple plans on remaining in the community that they served for 35 years. They live in Pulaski and enjoy summers on Sandy Pond.

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 11

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Make the Most of This New Year by ‘Letting Go’

re you convinced you’ll never be good at relationships? Or, do you regret the way you behaved in your marriage? Still angry at your ex? Or yourself? Holding on to past hurts, slights, negative thinking, or lost opportunities can compromise your sense of well-being and ability to live alone with contentment. Whether it’s emotional baggage or tangible reminders that keep you from moving forward, I encourage you to let them go in favor of a fresh start. “Letting go” is a beautiful thing.

And not just for those who live alone. Letting go of old ways of thinking, of a poor self-image, or of destructive thoughts or behaviors can free you up to embrace life’s blessings and the possibility of feeling whole and complete on your own. I discovered the power of letting go quite by accident. It was years ago, after I purchased my country cottage, which sits on six acres of wooded and open land. One of my first home-improvement projects was to carve out a fire pit in my backyard. I’ve always loved a

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bonfire: the warm glow it casts on the faces of those gathered around it, the earthy scent of burning branches, the flames that invite inspection ... and, importantly, introspection. Little did I know that when I built my fire pit that it would also become the ceremonial dumping ground for my “old baggage” — those useless memories, beliefs and feelings that were holding me back and keeping my life small. I remember one evening in particular. I’d been holding on to my old Day-Timers — large, leather-bound calendar/planners that were used in the ‘90’s before everything went digital. In those Day-Timers, I made calendar entries that captured “the good, the bad, and the ugly” over the course of what turned out to be a dismal and highly disappointing decade. Why I hung onto these Day-Timers I’ll never know. Maybe out of misplaced sentimentality. But this I do know: Whenever I looked at the neat stack of volumes stashed away in my closet, I would wince inside. But then I decided, no more. On an early spring evening, I held my first letting-go ceremony. I grabbed my Day-Timers, made my way to the fire pit and built a bonfire. There I sat with my memories (and glass of wine) while I slowly, deliberately leafed through each bound year of my life, before tossing it on the hot embers. It was a moving experience. Sad at times. But, mostly, I began to feel lighter, freer. And I felt something I didn’t expect: a sense of peace and self-satisfaction for having taken control and done something good for myself. That evening set the stage for many letting-go ceremonies to come. I look forward to them and the release of the pent-up, negative energy they promise. Might you consider holding your own letting-go ceremony? Here are some tips: n First: Identity what is holding you back or keeping you stuck. Be honest. Ask yourself what negative beliefs or thoughts are getting in the way of your ability to feel hopeful and enthusiastic about yourself and your life. What do you need to release to move forward? Resentment toward

something or someone? Regret over a past mistake? Guilt? A negative self-image? A bad habit? Or deep sadness? n Second: Identify something tangible (as I did with my Day-Timers) that conjures up painful or disappointing memories. This negative “something”— a photograph, gift, letter or other reminder — can be powerful. Even if it’s out of sight, you know it’s there and just having it in your possession may keep you tethered to a painful past. If nothing tangible comes to mind, try describing your negative belief or thought in a “Letter to Self.” Put it down on paper and get it out of your system. n Third: Hold your own letting-go ceremony, in whatever style or fashion that suits you. I like the bonfire approach, but you may prefer another method. Tying your Letter to Self to a stone and throwing it into a lake may be more fitting and symbolic. Or perhaps you’ll prefer to bury your anger in your backyard. You decide. On your own or in the company of friends or family, let go of what’s holding you back and keeping you stuck. Doing so may help liberate the hope, passion and power residing deep inside you. It can be a meaningful step toward independence. Needless to say, letting go ceremonies aren’t a cure-all. Believe me, my long-held feelings about my difficult decade didn’t magically dissipate with the burning of my Day-Timers. But I did feel better and more empowered afterwards. I could go on and on, but you’ll need to excuse me. It’s a new year. I have a bonfire to build and some baggage to burn.

Gwenn Voelckers leads “Live Alone and Thrive” empowerment workshops for women in Mendon, Monroe County, and is the author of “Alone and Content: Inspiring, Empowering Essays To Help Divorced And Widowed Women Feel Whole And Complete On Their Own.” For information about workshops, to purchase a book or invite Voelckers to speak, call 585-624-7887, email gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com

Onondaga, Oswego, Cayuga and Madison Counties

CNY’s Healthcare Newspaper

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

In Good Health is published 12 times a year by Local News, Inc. © 2018 by Local News, Inc. All rights reserved. Mailing Address: P.O. Box 276, Oswego, NY 13126. • Phone: 315-342-1182 • Fax: 315-342-7776. Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Contributing Writers: Jim Miller, Gwenn Voelckers, Deborah Banikowski, George W. Chapman, Deborah Sergeant, Anne Palumbo, Melissa Stefanec, Chris Motola, Ernst Lamoth Jr., Eva Briggs (MD), Mary Beth Roach, Sarah McCrobie, Timothy Byler, MD • Advertising: Amy Gagliano, Cassandra Lawson • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

Meet Your Provider

Regenerative Spine & Musculoskeletal Medicine Great alternative for individuals considering orthopedic surgery or joint replacement due to arthritis or injury Q: What is regenerative medicine? A.: Regenerative injection treatments offer a great alternative for individuals considering elective orthopedic surgery or joint replacement due to arthritis or injury. Patients experience very little down time and they typically avoid the long, painful rehabilitation periods that can follow surgery. The goal of these non-surgical procedures is to help heal the source of pain, not to simply mask it. Since 2014, Regenerative Spine & Musculoskeletal Medicine in Syracuse has provided state-of-theart regenerative cellular therapies to help patients find relief from pain without invasive surgeries. Q: Athletes like Tiger Woods, Kobe Bryant and many other professional athletes have had PRP and stem cell injections. What are these injections, and how does a patient choose what to do? A.: These athletes chose a more holistic, natural approach to help heal their injuries using their bodies own repair mechanisms. There is great variability in the way the PRP (platelet rich plasma) or cells are

processed and the end product that is injected into the patient. The experience level and training of the provider helping you decide what treatment is best for you and performing your injection is extraordinarily important. Q: How does platelet rich plasma injections work? For PRP injections, blood is drawn through a needle from your vein and placed into a centrifuge to spin it quickly and separate the different types of cells. Different centrifuges and spinning protocols are available, which create different concentrations of platelets. Science is telling us that some damaged tissue like arthritis heals better with higher levels of platelets, while some things like tears heal better with lower levels. Q.: How about stem cell injections? A.” “Stem cell” injections are even more variable in source and quality of content. There are products available a provider can buy, that are sterilized and frozen and marketed as “stem cell” injections. Scientific studies have actually proven that these products contain no viable stem cells. At Regenerative Spine & Musculoskeletal Medicine, we use only the patient’s

own bone marrow cells, drawn up with a needle from their own bone in the pelvis. The bone marrow contains stem cells and growth factors, which your body uses to stimulate healing of damaged tissue. Q.: What’s your experience with regenerative medicine? Two years of my training was an interventional fellowship, spent learning and performing all types of spine and orthopedic injections. Numbing medicines like lidocaine used at high concentrations can injure or kill off the platelets or cells. Your provider must know what concentration and what numbing agent is safe for the viability of the cells. Since 2002, I have performed thousands of injections, most guided by use of an X-ray machine to confirm precise placement of the injection to optimize your results. Your procedure at Regenerative Spine & Musculoskeletal Medicine is carefully chosen based on review of the latest evidence based medicine, and performed by me, personally.

Renée S. Melfi, M.D. in CNY to offer Vampire Aesthetic Procedures and sexual health restorative procedures, using PRP. I completed training with the inventor of the procedures, Dr. Charles Runels, at his office in Alabama. I am a licensed provider for the O-Shot, Priapus Shot, Vampire Facelift, Vampire Facial, Vampire Breast Lift, Vampire Hair Growth. Q.: In which way do these treatments help? A.: Improving sexual health, and reducing wrinkles and scars are just some of the possibilities of these treatments. More information can be found on our website at rsmmd.com.

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Prostate Cancer and MRI Biopsy Use of MRI biopsy gives men more confidence in the treatment of prostate cancer By Timothy Byler, MD

rostate cancer is the most common cancer in men and is diagnosed in about one in every nine men, according to American Cancer Society. It is generally found after an elevation in a routine blood test, prostate specific antigen (PSA) or after a bump is felt on the prostate during a doctor’s examination. When one of these two situations occur, men are often sent to see a urologist to discuss the situation further. Once one of these concerns arise, the only way to determine if there is cancer present is to biopsy the prostate. In the past, many men had multiple of these biopsies due to continued concerns that their first biopsy could not answer. In the past 10 years, magnetic resonance imaging (MRI) has emerged as an imaging tool that helps detect cancer and help limit the number of biopsies patients have. The MRI allows doctors to see areas in the prostate that may not normally

be seen and specifically target them for biopsy. Many men with negative biopsies but continued concern over their PSA have opted for this new technology to help clarify their situation. After these MRI-guided biopsies, patients and their doctors feel much more confident that patients have chosen the right path for their prostate health. A new diagnosis of prostate cancer can be frightening, and many men feel like they must proceed to aggressive treatment. With the confidence given by MRI biopsies, many men with low-risk prostate cancer now chose to observe and not treat their cancer. Observation of low-risk prostate cancer with blood tests and repeat MRI biopsies is called “active surveillance of prostate cancer.” These repeat biopsies help determine if their low-risk cancer has worsened or there is more than we initially knew about. Traditionally, these biopsies have been done using ul-

trasound, but more recently the MRI biopsy has been added for increased accuracy. The addition of MRI-guided fusion biopsy to prostate cancer observation really helps patients feel more confident and guide them to deciding their treatment option. Since 2013, Upstate has been able to offer these special prostate biopsies using the MRI known as “fusion biopsy.” More than 800 such biopsies have been done to date and it has greatly enhanced the prostate cancer program. As a leader in the field, Upstate serves a large area and receives patients for this special biopsy from all over Upstate New York and parts of Pennsylvania. If you are interested in learning more about MRI fusion biopsy or general evaluation, don’t hesitate to call Upstate Urology at (315)-4641500.

Physician Timothy Byler is an assistant professor of urology and member of Upstate Urology at Upstate University Hospital.

In Good Health, CNY’s Healthcare Newspaper

Read it in print, online at www.cnyhealth.com In 2019, make In Good HealthJanuary your advertising choice 2019 • IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 13

My Turn

By Eva Briggs

Paraneoplastic Syndromes

Strange and bizarre problems cancer can cause

ancer is a dreaded disease that nobody wants. Actually, cancer isn’t just one disease; there are more than 200 types. Many people are familiar with the seven warning signs of cancer, which I’ll review. I’m also going to write about some strange and bizarre things cancer can do: paraneoplastic syndromes. First a recap of seven common warning signs of cancer:

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he National Safety Council suggests how you and your loved ones can skate safely: • Wear skates that fit comfortably and provide enough ankle support. • Sharpen your blades professionally each season. • If outdoors, skate only on prepared areas where you are sure the ice is strong enough to support you. • Always check for cracks, holes and obstacles on the ice that could make you fall. • Wear warm clothing. • Take a rest or consider stopping for the day if you are cold or tired. • Never skate alone.

1. Change in bowel or bladder habits. 2. A sore that does not heal. 3. Unusual bleeding or discharge. 4. Thickening or lump in the breast or

elsewhere.

5. Indigestion or difficulty in swallowing. 6. Obvious change in a wart or mole. 7. Nagging cough or hoarseness. Paraneoplastic syndromes (PNS) are symptoms distant from where the cancer arises. They’re not caused by a tumor growing or pushing on nearby tissues. They arise when a cancer secretes substances that travel elsewhere in the body. If the patient develops PNS before their cancer is diagnosed, it can be challenging to recognize. The most common organ systems affected by PNS are the endocrine (hormone) system, immune system, skin and neurologic system. Endocrine effects occur when a cancer creates a substance that is either a hormone or similar enough to a hormone to act like one. PNS development doesn’t correlate with the stage of the cancer or its prognosis. Most improve when the underlying tumor is treated. But additional treatment directed at the endocrine abnormality is also needed. Some typical endocrine PNS

include: • SIADH. The acronym stands for syndrome of inappropriate antidiuretic hormone secretion. The effect is the opposite of taking a water pill. The kidneys hang on to extra water instead of excreting it. This dilutes the salts in the blood causing headaches, falls, nausea, muscle cramps and in severe cases confusion and coma. • Hypercalcemia. This means too much calcium in the bloodstream, It can cause mental changes, weakness, nausea and vomiting, high blood pressure and slowed heart rate. • Cushing’s syndrome. This results from too much cortisol, which leads to weight gain, weakness, high blood pressure and leg swelling. • Hypoglycemia. Low blood sugar levels causes sweating, weakness, nausea, anxiety, tremors, confusion, and when severe, coma. • In neurologic PNS, the body produces onconeural antibodies, which attempt to fight the cancer. They are directed against tumor substances that resemble nervous system components, and therefore attack the nervous system as well. Once the body has begun producing these onconeural antibodies, they often linger after the cancer is treated. So their treatment requires drugs that suppress the immune system. Depending upon which part of the nervous system is affected, symptoms might include trouble thinking, personality changes, balance problems, problems with the nerves controlling the face and head, weakness, or numbness. • Skin and rheumatologic PNS include syndromes that often also occur in the absence of any underlying cancer. Some typical conditions include:

and thickened skin, often on the neck and armpits, that also may be associated with diabetes. Dermatomyositis. Rash on the face as well as on shoulders, upper back and upper chest. There is associated muscle weakness, muscle pain and trouble swallowing and breathing. • Erythroderma. Red, peeling, itching rash. • Leukocytoclastic vasculitis. Bruises that are palpable (can be felt) on the legs, kidney impairment, and nerve damage in the extremities (peripheral neuropathy). My own father developed this when he had leukemia. • Paraneoplastic pemphigus. Severe blisters on the skin and erosions in the mucus membranes such as inside the mouth. • Polymyalgia rheumatic. Muscle pain and stiffness of the shoulders and hips. • Sweet syndrome. Tender red nodules on the face, extremities, and upper trunk, often with fever and pus. Lesions can resemble boils. And that is just a brief description of some of the things cancer can do. You can’t prevent all cancers, but giving up smoking, eating a healthy diet, getting regular exercise and getting age-appropriate cancer screening can reduce your risk. Eva Briggs is a medical doctor who works at two urgent care centers (Central Square and Fulton) operated by Oswego Health.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019

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SmartBites

The skinny on healthy eating

Open Your Eyes to Arugula’s Many Benefits

ating healthier tops many New Year’s resolutions lists, and who can blame us? We’ve been forced to consume all kinds of sinfully rich treats throughout the holidays and now can’t seem to fasten our waistbands. Go figure! When the urge for clean, simple, healthy food strikes our household in January — and it always does — we load up on leafy salad greens, the darker the better. Lately, we’ve been reaching for arugula (pronounced uh-roo-guh-la), a nutrient-dense green with a distinct peppery flavor and aroma. Super low in calories (only 8 calories per 2-cup serving) and rich in fiber, arugula is a healthy choice for those looking to lose or maintain their weight. Not only is it flavorful and filling, but it’s packed with an impressive array of nutrients. Like many of the darker greens, arugula delivers decent amounts of vitamins K and A. While both vitamins contribute to overall bone health — a boon for boomers with looming osteoporosis — vitamin K also helps blood clot properly and vitamin A promotes a healthy immune system and good vision. Worried about age-related macular degeneration (AMD)? Consuming

arugula may help protect against this disease, as it also contains substantial amounts of two carotenoids that further support eye health: lutein and zeaxanthin. In fact, according to the National Eye Institute, studies have found that dietary intake of lutein and zeaxanthin is associated with a lower risk of developing advanced AMD. Arugula, along with cabbage, Brussels sprouts and broccoli, is a cruciferous vegetable. These protective vegetables — a.k.a. “carcinogen killers” — teem with anti-cancer compounds that neutralize free radical damage and slow the aging process. Since studies support a strong link between cruciferous vegetables and a reduced rate of certain cancers, many health agencies—including the American Cancer Society—recommend regular consumption of this kind of vegetable. Lastly, arugula is super good for hearts, thanks to many factors: its inflammation-lowering antioxidants, its unique arsenal of minerals that help control blood pressure (calcium, magnesium, and potassium), and its healthy dose of folate, a B vitamin that helps to reduce arterial hardening.

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Lemony White Bean-and-Arugula Salad Adapted from Cooking Light

2 tablespoons extra-virgin olive oil 1 teaspoon grated lemon rind plus 3 tablespoons fresh juice (from 1 lemon) 1 garlic clove, minced 1 teaspoon Dijon mustard ½ teaspoon kosher salt ¼ teaspoon coarse black pepper 1 (15-oz.) can unsalted cannellini beans, rinsed and drained ¼ cup thinly sliced red onion 3-4 cups firmly packed baby arugula

Helpful tips

If buying fresh, select arugula that looks vibrant and green, avoiding leaves that are wilted, yellow or slimy. If buying prepackaged arugula, check the bag for excess water, as moisture can cause arugula to rot quickly. When stored properly in the refrigerator—in a plastic bag with a dry paper towel—arugula can last up to two weeks.

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.

Combine oil, lemon zest, juice, garlic, mustard, salt and pepper in a large bowl, stirring with a whisk. Add beans and onion; toss well to coat. Add arugula; toss gently to combine.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 15

Guide to Comfort Food By Anne Palumbo

Satisfy comfort-food cravings with healthy makeovers

omfort food is food that soothes the soul and satisfies the appetite. Often, it’s food that’s associated with the security of childhood, like Mom’s grilled cheese, Grandma’s chicken potpies or Dad’s mashed potatoes — food that brings back a good memory, a warm feeling or a special relationship. Stress sometimes triggers our hankering for certain comfort foods. Bad day at the office? Only pizza will do! A fight with your significant other? Bring on the ice cream! A stretch of dreary weather? More mac and cheese, please! And while there’s no requirement that these foods be rich, heavy or unhealthy, research shows that our goto comfort foods tend to be. Perhaps we lean in this direction because our physical response to comfort foods is grounded in food science: many c o m m o n comfort foods have a higher fat or sugar content, which in turn provides a short-term physiological boost. Comfort foods may help raise our body temperature, provide a burst of energy and even improve our moods. We all crave different comfort foods. When I’m feeling out of sorts, all I want is grilled cheese and Campbell’s tomato soup. My husband, on the other hand, longs for his mom’s beef stew. My sister pines for chocolate chip cookies. Plus, we seem to crave these foods more during the cold winter months.

Why does winter affect our cravings?

Hopkins University, people tend to gain five to seven pounds on average during winter months. Weight gain aside, many comfort foods are simply not all that healthy to consume on a regular basis — from super-salty French fries to high-fat ice cream to empty-calorie candy. What to do during the long winter months when our comfort-food cravings are besting our better judgment? Read on for some nutritious makeovers that may satisfy your longings without compromising your health.

Grilled Cheese

Ah, grilled cheese…nothing says “mom” quite like a grilled sandwich

•

Pizza

Unless you make it yourself, it’s tough to eat pizza you feel good about. On average, one slice of pepperoni pizza serves up around 300 calories, 12 grams of fat, 30 grams of cholesterol and more sodium than four small bags of potato chips. Yikes! Fortunately, you can turn takeout pizza into a healthier pizza with just a few tweaks: Order a smaller size for fewer calories per slice; choose a thinner crust over a deep-dish or regular crust (and don’t get it stuffed!), request whole-wheat if it’s offered; ask for reduced cheese; skip the dipping sauce; and pile on the veggies.

Mashed Potatoes

of white bread, slathered with butter on the outside and loaded with bland American cheese on the inside. But must you stick with those exact ingredients to conjure images of mom? Of course not! Try fiber-rich whole-grain bread instead of white; use a mix of cheeses that includes low-fat mozzarella and fullflavored cheddar, and substitute some of the cheese with sliced tomatoes, salsa or whatever healthy ingredient your heart desires. To create a nice golden

Some researchers suspect fewer daylight hours may play a significant role in why we crave for comfort food during the winter. Since sunlight is one of the factors that triggers the release of the hormone serotonin, a known mood booster, and we’re getting less of it during winter months, we’re more inclined to reach for foods that also prompt the release of serotonin: carbohydrates. People who suffer from seasonal affective disorder, a type of depression that’s related to changes in seasons, are particularly vulnerable. Boredom, inactivity and being cooped up inside can all have a pronounced affect on what and how much we eat. When “cabin fever” strikes our house, we eat a lot more cheeseblanketed nachos — my kids’ favorite comfort food — than at any other time of year. Same goes for pizza, mashed potatoes and hot chocolate: They all just taste so darn good and comforting during the dark days of winter. Of course, there are consequences to an uptick in winter munchies, especially if your munchies involve comfort foods that run higher in calories, fats and carbs. According to studies at Johns Page 16

outer crust — without all the butter — try this: Heat one teaspoon canola oil in a medium nonstick skillet over medium heat. Roll it around to coat the pan and then cook your sandwich until golden, about two minutes per side, slightly depressing each side with a spatula.

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019

Even though plain potatoes are low in calories, mashed potatoes — especially those made in restaurants — aren’t always healthy. Typically made with whole milk and butter, mashed potatoes run about 250 calories per serving; add gravy and your total intake could exceed 400 calories. Here are just a few tricks to make your mashed potatoes healthier: Mash your potatoes with Greek yogurt, low-fat sour cream, 1 percent milk or chicken stock; bump up the flavor with garlic, chives or spice of choice; and use olive oil (full of healthy monounsaturated fat) instead of butter (full of unhealthy saturated fat). Eating

out? Order a plain baked potato and mash it with salt, pepper and a drizzle of olive oil.

Mac and Cheese

When prepared traditionally, mac and cheese is not so comforting. Low in nutrients and high in fat, mac and cheese dishes up about 400 calories per cup. And who eats just a cup? It’s easy, however, to turn this popular dish around. Use whole-wheat pasta for added fiber and lots of B vitamins; tuck in some roasted veggies; skip the buttery crumb topping or simply replace it with crunchy whole-wheat breadcrumbs; add flavor to the cheese sauce with fresh or dried herbs; use reduced-fat milk and cheese; and replace some of the cheese with plain Greek yogurt.

Chocolate Chip Cookies

While it seems sacrilege to even think about tampering with this classic cookie, it doesn’t take much to make it a tad healthier. Consider the following easy-to-implement changes: Replace some (or all) of the refined white flour with white whole-wheat flour; add oats and nuts; reduce the sugar and chocolate chips by half; and replace some (not all) of the butter with tahini — a sesame seed paste. More nutritious makeovers of favorite comfort foods abound on the internet. If, however, you must have the “real deal,” then do what the French do and practice portion control, limiting yourself to smaller servings and just one cookie not three.

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

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Central New York’s Healthcare Newspaper January 2019 •

Just over half of Americans know how to perform the emergency procedure.

f someone collapsed in front of you, could you perform CPR? If you answered no, you’re hardly alone. Just over half of Americans know how to perform the emergency procedure. And even fewer know the recommended hands-only technique for bystanders, a new Cleveland Clinic survey reveals. The survey also found that many Americans can’t tell the difference between heart attack and stroke symptoms. This could lead to delays in patients receiving proper treatment. “When someone is suffering from cardiac arrest, time is not on their side,” physician Steve Nissen, chairman of cardiovascular medicine, said in a clinic news release. “Immediate CPR can be the difference between life and death, doubling or even tripling a person’s chance of survival. It’s a skill that can be easily learned, and we encourage everyone to equip themselves with this knowledge and not be afraid to use it during an emergency,” Nissen said. The online poll queried more than 1,000 U.S. adults. Fifty-four percent of respondents said they know how to perform cardiopulmonary resuscitation. However, only one in six knew that hands-only (just chest compressions, no breaths) is the recommended CPR method for bystanders. And only 11 percent knew the correct rate (100 to 120 a minute) for chest compressions. An automated external defibrillator (AED) can also be a lifesaver when someone suffers cardiac arrest, but only 27 percent of respondents said there is an AED where they work, the survey found. The survey also found that heart attack and stroke symptoms were frequently confused. Fifty-nine percent falsely believed that sudden numbness or weakness of the face, arm or leg is a symptom of a heart attack. And 39 percent incorrectly thought that slurred speech is a heart attack symptom. These actually are common stroke symptoms.

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Oat milk, soy milk, coconut milk, hazelnut milk. Alternative options for dairy milk have grown in popularity in the last two decades. But how do they compare to dairy milk?

Dairy Milk Vs. Non-Dairy Milk. Are They All the Same? By Deborah Jeanne Sergeant

or the past 15 years, plant-based “milk” beverages have offered alternatives to dairy milk, which originates from animals. While those choosing plantbased beverages may have different reasons for selecting them — including lactose intolerance, allergy to milk protein, vegan lifestyle or concerns about animal welfare — milk offers more nutrition compared with alternative beverages, according to local experts. For someone who is allergic to dairy milk or lactose intolerant, drinking milk can bring significant gastrointestinal discomfort. Milk is among the top eight food allergens, according to the US Department of Agriculture. For people able to drink milk who are looking strictly at the nutritional profile, milk is a far better beverage than its alternatives, according to sources interviewed for this story. “The nut, bean, coconut and oat milks fall short in certain nutritional aspects,” said Laurel Sterling, registered dietitian, nutritionist and educator with Carlson Laboratories in Canastota. Protein is Sterling the biggest difference. One eight-ounce serving of Page 18

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milk contains eight grams of protein that’s biologically complete so that the body can readily use it. It’s even better than beef. Plant-based alternatives contain vegetable-based protein, which isn’t as readily absorbable as milk’s protein. Milk also contains naturally occurring magnesium, manganese and zinc. “Nut, bean and oat milks have fiber, where dairy doesn’t,” Sterling said. “They have less saturated fat, if someone’s watching that for health reasons.” While plant-based beverages may seem a nutritious choice, they don’t contain the same nutrients as their sources because they’re highly processed. Many of the nutrients in nuts, for example, don’t end up in nut-based beverages. Milk includes naturally occurring calcium and also vitamin B-12, which is hard to find in a plant-based food except for nutritional yeast. Nearly every brand of milk is fortified with vitamins A and D. Coconut alternatives contain little protein but have been touted for improving the metabolism; however, since it contains high levels of saturated fat, it shouldn’t be a go-to milk. Nut-based beverages do represent good sources of polyunsaturated fats, and are sources of vitamins A and E. Hemp beverages provide omega-3 fatty acids and magnesium. Alternatives boasting a similar nutrient panel as milk are fortified

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019

with supplements. “It’s better to get nutrients in food itself rather than through supplement,” said Julie Mellen, registered dietitian and nutrition counselor with Upstate Medical University. “The different milksare all good for their own reasons. The big thing is to look out for beyond protein is the sugars added to these products.” Among plant-based milk alternatives, rice milk contains less sugar than others but it shouldn’t be consumed exclusively because of the FDA’s warning about the levels of arsenic absorbed by rice. Since many non-dairy milk alternatives contain sweeteners, those looking for the most healthful beverage should look at milk again. It contains no added sugar, unless it’s a flavored milk such as chocolate or strawberry. Milk does contain lactose, which is the natural, inherent sugar that causes problems for those who are lactose intolerant or lactose sensitive. Mellen said that for people who don’t like milk or have an allergy or sensitivity, soy is the Mellen closest to milk for nutrients such as protein. Milk alternatives usually boast fewer calories than milk. Skim milk

contains 90 calories, compared with the 30 to 40 calories in plant-based beverages. U.S. milk is highly regulated for safety concerns. Milk sold commercially must be pasteurized, which kills any bacteria. But before it even leaves the farm, all milk is tested for bacteria and antibiotics. Any batch found contaminated is thrown away, as mandated by law. Some non-organic farmers use rBST, a synthetic growth hormone, to help cows produce more milk. The hormone is specific to species, meaning it doesn’t affect humans drinking the milk. Pasteurization destroys 90 percent of any traces of the hormone present in milk and the rest is broken down during digestion. The Food and Drug Administration has deemed the use of rBST with dairy cattle as safe and their stance has been approved by National Institutes of Health, World Health Organization/Food and Agriculture Organization and American Medical Association. Though organic milk bears an identical nutritional panel as traditionally produced milk, grass-fed milk offers higher levels of beneficial omega-three fatty acids. Grass-fed herds also have access to pasture in season. “You want to get calcium in some way,” Mellen said. “It’s a good thing to include the recommended serving per day, which is three servings.”

Women’s Health

Baby in the Box Is a cardboard box better than a crib for newborns? By Deborah Jeanne Sergeant

arents anticipating the birth of their first child usually shop extensively for the perfect bassinet or crib in the right color to match the nursery. In Finland, it could be a corrugated cardboard box, not because they necessarily can’t afford a crib. It’s believed boxes are the cause behind the reduction in the nation’s formerly high rate of infant mortality. Could a box instead of a crib make a difference? In the 1930s, Finland introduced the program in which income qualifying parents received a box containing baby essentials. Pre-natal care was required to obtain the box. Eventually, the income requirement was dropped and the program continues to this day. The rates of infant mortality dropped, coinciding with the program; however, there’s no magic in sleeping in a box. Once at home, co-sleeping in the same bed was commonplace in the 1930s when Finland’s rate of infant

deaths was high. This was especially true for families struggling financially. While providing any option safer than co-sleeping is likely to decrease mortality rates, other factors helped drop infant mortality rates. “Finland has nearly free health care and one of the lowest poverty rates in the world,” said Elizabeth Sapio, pediatric injury prevention coordinator and Safe Kids coordinator at Upstate Golisano Children’s Hospital. “It’s the best place to be a parent. They support new parents with boxes filled with new items. Parents have extended time off, too.” A host of life-saving vaccines, increased prevalence of breastfeeding, and improved maternal nutrition, and education have all helped decrease mortality rates since the 1930s. Sapio also said that a safe sleeping environment and safe sleep practices are vital for infant health and that these have influenced lower infant mortality rates. Laying babies on their backs to sleep has demonstrated a 50 percent

Using a cardboard box instead of a crib is not a good option, according to Heather Shimer, perinatal clinical nurse specialist, and Cassandra Mazza, registered nurse and clinical coordinator for the NICU — both at St. Joseph’s Health.

reduction in SIDS (sudden infant death syndrome) since introduced 30 years ago. This indicated that a baby’s sleep position has something to do with SIDS. Babies lack the strength to easily move their heads from obstructions, one factor related to SIDS. Overheating may represent another factor. “It slows down their respiration rate and babies don’t have the same circulatory system like we do,” Charlamb said. “They need just one more layer than we do, like a bodysuit and a sleep sack, but no blanket.” Pacifiers, white noise, and sleeping in the same room but not the same bed may also decrease risk. Cribs sold in stores must pass the same safety standards, so spending more doesn’t necessarily mean safer. “As long as it’s an empty space, firm mattress and fitted sheet, it can be a safe sleep space,” Sapio said. The crib itself should either be purchased new from a store (and thus up to current safety standards) or carefully examined for adherence to safety standards, including nonlead-based paint, fixed sides, the proper distance between rails and other considerations. The mattress should not gap from the bed’s sides. Heather Shimer, perinatal clinical nurse specialist at St. Joseph’s health, pointed out a lack of safety standards and research on baby boxes. “If you put the box on the floor, a toddler could knock something onto it,” Shimer said. “I wouldn’t want my dog jumping into the space. How can you really sanitize something that’s made out of cardboard? We wouldn’t use that in a hospital setting for infection control.” There’s also the chance that the baby would face the solid side of the box and inhale less oxygen than

optimal. If a family delivering at St. Joseph’s lacks a crib and the ability to purchase one, the hospital would give them a portable crib such as the Graco Pack ‘n Play, according to Gael Gilbert, a registered nurse and service line administrator for Women and Children’s Services at St. Joseph’s Health. “The baby can sleep there, it can be used as playpen and it can be used when the baby gets older,” she said. “We had looked at the box on another committee I was part of. There were concerns as to how it would be used. We made the decision to give a Pack ‘n Play.” Cassie Mazza, registered nurse and clinical coordinator for the NICU at St. Joseph’s Health, pointed out that parents may also set the box down on a high surface and allow it to fall off when it’s unattended. She added that the crib “should have “no rolls under their head or sleep positioning device, stuffed animals or crib bumpers.” The American Academy of Pediatrics promotes the ABC acronym to explain how babies should sleep: • A: alone, not in bed with a parent or caregiver, but in the same room. • B: on their backs, not facing down. Sleeping on the stomach can close off their airway. • C: in a safety-approved crib containing nothing but a firm mattress and fitted sheet. Avoid placing crib bumpers, stuffed animals, sleep positioning devices, pillows, blankets or anything else in the crib. Additionally, parents should keep the room smoke-free, a comfortable temperature and use a sleep sack style pajama to keep the baby warm, not blankets.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Women’s Health Compared to men, women usually complete more cooking and housekeeping tasks, manage the household’s social calendar and primarily care for their children or elderly relatives, all on top of working a job.

More Women Than Men Reporting Higher Levels of Stress Stress is on the rise for women — nearly 50 percent of women in survey said their stress has increased over the past five years, compared with only 39 percent of men by Deborah Jeanne Sergeant

tressed out? How you perceive it and respond to it can vary depending upon your gender, according to the American Psychological Association. The organization’s website states that men and women report different reactions to stress, both physically and mentally. “They attempt to manage stress in very different ways and also perceive their ability to do so — and the things that stand in their way — in markedly different ways,” according to the site. For example, women are more likely to report physical and emotional symptoms to which stress is contributory, including headache, feeling as though they could cry, upset stomach, interrupted sleep and more. According to the association, stress is on the rise for women. Near-

ly 50 percent of women surveyed said that their stress has increased over the past five years, compared with only 39 percent of men. “Women today are living more complex lives than ever,” said Randy Sabourin, team leader at Metro Fitness in Syracuse and Fayetteville. “The conversations that I am currently having with women about health are focused on balance. They are constantly juggling multiple roles with serious demands on Sabourin both their skills and time. Frequently, women are left

feeling depleted and stressed out.” Compared with men, women usually complete more cooking and housekeeping tasks, manage the household’s social calendar and primarily care for their children and/or elderly relatives, all on top of working a job. According to the Bureau of Labor Statistics American Time Use Survey in 2015, adult women spend an average of two hours, 15 minutes on household activities daily, compared with men’s one hour, 25 minutes. Both indoor and outdoor chores were included. The bureau also states that women spend twice as much time caring for others in the household than men. About 72 to 75 percent of adult women have worked full-time since 1968. Sabourin sees some progress in women managing stress better. “Women are proactively making time for self care to build resilience and improve contentment,” Sabourin said. “Women are looking to health plans to be more comprehensive and personalized.” He believes that forming a strategy is a “productive and manageable response to feeling overwhelmed.” Physician Rob Kiltz heads CNY Healing Arts and CNY Fertility in Syracuse. He said that women’s stress “is a very important area that I’ve been involved with a long time. Healing Arts is about stress reduction,” he said. He said that the emotions directly affect the health of the coronary system, gastrointestinal system and other bodily systems. “Stress hormones affect every organ system,” he said. “It causes fatigue, exhaustion, pain and increases inflammation. Ultimately the core

Take at Least a Year Between Pregnancies: Study

omen should wait a year or more between having babies, to reduce health risks to themselves and their infants, researchers report. “Our study found increased risks to both mother and infant when pregnancies are closely spaced, including for women older than 35,” said lead author Laura Schummers, a postdoctoral fellow in the department of family practice at the University of British Columbia (UBC). “The findings for older women Page 20

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are particularly important, as older women tend to more closely space their pregnancies, and often do so intentionally,” Schummers explained in a university news release. The researchers analyzed data on more than 148,000 pregnancies in the Canadian province of British Columbia, and concluded that 12 to 18 months was the ideal length of time between giving birth and getting pregnant again. Women over 35 who got pregnant six months after a previous birth

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019

had a 1.2 percent risk of serious complications or death. The risk was only 0.5 percent among those who waited 18 months before getting pregnant again. Among these older women, the risk of preterm labor was about 6 percent among those who got pregnant within six months of giving birth. That risk dropped to 3.4 percent among those who waited 18 months before starting a new pregnancy. With younger women, aged 20 to 34, the risk of preterm labor was 8.5

of all diseases is related to inflammation. It’s the foundation of every disease.” Though the body can experience physical stressors from illness, injury, environmental attacks or depletion, emotional stress can contribute to physical stressors that Kiktz cause “pretty much every disease we suffer from,” Kiltz said. Cutting back on commitments, controlling screen time, eliminating or setting boundaries on toxic relationships and lowering self expectations can lower possible sources of stress; however eliminating stress isn’t possible. Plus, some circumstances that contribute to stress are generally pleasant — a promotion, new baby, or surprise party. Managing stress is vital for reducing its ill effects. Maintaining a positive outlook really does make a difference. In the midst of a difficult circumstance that could be stressful, look at possible solutions and what’s going right. Taking time for pleasurable pursuits can help manage stress. It’s important that the activities don’t require a specific outcome. For example, if bowling a perfect game makes the activity stressful, walking in nature or taking yoga would provide greater stress relief. Carol Sames, Ph.D., program director for Vitality at Upstate Medical University, said that physical activity “has a fairly strong correlation to reducing low to moderate levels of depression. In individuals with low to moderate levels, when they engage in physical activity, you see the same benefits as medication. Higher levels needs a different medical management, a combination of physical activity and medication. Physical activity is used as a treatment.” Sames also said that physical exercise can help improve the areas of health correlating with chronic stress, such as high blood pressure, elevated blood sugar levels, inflammation, sleep issues and cardiovascular health.

percent among those who got pregnant again within six months. That compared to 3.7 percent among those who waited 18 months before getting pregnant again. The findings, published Oct. 29 in the journal JAMA Internal Medicine, provide guidance for older women who are planning families, said study senior author Dr. Wendy Norman. She is an associate professor in the department of family practice at UBC. “Older mothers for the first time have excellent evidence to guide the spacing of their children,” Norman said. “Achieving that optimal oneyear interval should be doable for many women, and is clearly worthwhile to reduce complication risks.”

Women’s Health Alcohol & Breastfeeding.

Do They Go Well Together? Occasional drink planned between nursing sessions is OK for nursing moms, say local experts by Deborah Jeanne Sergeant

hould nursing moms avoid alcohol? While alcohol doesn’t offer any benefits, lactation experts agree that those who drink may do so — with limitations. “It’s a topic moms ask about all the time,” said physician Jayne R. Charlamb, international board certified lactation consultant. “Moms are really discouraged to not have alcohol at all while pregnant. It’s different during breastfeeding.” Charlamb serves as associate professor in the department of obstetrics and gynecology and director of the division of breast health and breastfeeding medicine for SUNY Upstate Medical University. “Early on, it can inhibit letdown,” she added. “Later on, the amount of alcohol in blood parallels that in breast milk.” A woman consuming 1/2 to 1 ounce of liquor or 8 ounces of wine or two 12-ounce beers should wait two to three hours before breastfeeding, depending upon her size and tolerance level. Unlike during pregnancy, the alcohol doesn’t go directly to the baby. Pregnant women should never drink alcohol. But while nursing, the baby’s not continuously connected to Mom for nutrition. Most providers agree that for nursing moms, an occasional drink planned between nursing sessions is OK. The time it takes for alcohol to leave the body depends upon the individual’s tolerance level, which can lower after abstaining from alcohol for nine months, as well as through changes inherent to pregnancy. Charlamb said that babies who consume breast milk tainted by alcohol experience disrupted sleep and, with long term exposure, exhibit mildly affected motor development. “Especially with a young baby, we want to avoid getting any alcohol into that baby,” she said. “Moms should make sure their infant is under the safe care of someone not drinking.” Even three drinks can decrease the amount of breast milk by 20 percent and the time it takes for letdown by 30 to 40 seconds. That may not sound like a long time, unless parents are holding a hungry, inconsolable infant. Women who regularly drink are more likely to discontinue breastfeeding earlier because of decreasing supply and the disruption to the baby of switching back and forth between breast and bottle. While drinking water during and after alcohol consumption may aid in minimizing hangover symptoms, water won’t clear alcohol out of the system faster. Expressing breast milk with a

pump and disposing of it (known colloquially as “pump and dump”) doesn’t help moms get clean milk faster. “Alcohol passes into the breast milk through her blood stream,” said Kathryn Rome, a registered nurse and a board-certified lactation consultant with St. Joseph’s Hospital Health Center. “Her blood alcohol level and breast milk alcohol level are the same. If you pump and feed your baby while there’s still alcohol in the bloodstream, there’s still alcohol in the milk. “People think alcohol is stored in the breast milk but it passes through the bloodstream into the milk. The safe way is that a mother feeds her baby, has her one drink and allows two hours for her system to get back to normal,” said Rome. Pumping may help keep breasts at a comfortable level of fullness. Moms who pump while drinking should not bottle feed their babies with that milk. Some moms mistakenly think that drinking coffee will help them sober up faster. Laurel Sterling is a mom and registered dietitian, nutritionist and educator with Carlson Laboratories in Canastota. She said that strategy only dehydrates the body more. “You’d need more water to compensate,” she said. She also said that drinking a beer to stimulate milk production is a myth. “Relaxation can help with letdown,” she said. “You could get that through Mother’s Milk tea,” she said. She added that stress is a huge part of problems with milk letdown. Instead of rushing around while nursing, moms who relax, get a big glass of water, take their time, and nurse regularly find that they develop a better milk supply. Alternating between bottle feedings and nursing can make nursing more difficult. January 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Parenting By Melissa Stefanec MelissaStefanec@yahoo.com

Mommy’s Resolutions: The $$ Edition

or all of those parents out there who don’t spend their valuable time following the Chinese zodiac, 2019 is the year of the pig. In Chinese astrology, pigs are a sign of good fortune and wealth. Although the whimsical part of me can conjure up a plotline where I randomly come into a great fortune this year, the pragmatist in me recognizes I will simply have to save more money than I spend to accumulate some monetary wealth. However, being a mom presents the unique and awesome opportunity to constantly acquire junk, stuff, clutter and crap. Kids want a lot of stuff. Grownups want a lot of stuff. Kids like to do fun and costly activities. Adults like to have fun and expensive hobbies. The opportunities to spend money on stuff and fun are as seemingly endless as the amount of ‘I want that’ I heard during the holiday season. To that end, this year I am going to share some financial resolutions. Small changes in routine become habits, and careful financial habits add up to money in the piggy bank

(practicing self-restraint regarding dad-joke-level puns will be on my resolutions next year). Resolution: Cut back on food waste I am usually pretty good at this and have consumed many almost-expired lunches in the name of this endeavor. However, lately, I find my husband and me slipping. It usually starts something like this: One of my children decides the only food they will consume is _____. We buy loads of ____, but then my child quits the stuff cold turkey. Or, I buy a bunch of food, with the best intentions of cooking some awesome stuff, only to eat out more than we should or succumb to dinners of lunch meat, cheese and chopped veggies. I need to limit my groceries. No one will go hungry. Resolution: Just say no to sales I love a good sale. When it comes to finding cheap and quality clothes for my kids, I deserve some sort of

In fact, most of my kids’ so-called meals out are actually consumed at our kitchen table (in the form of reheated leftovers) or over my or my husband’s desk (in the form of a working lunch). Why should I, as a grown woman, spend money to eat macaroni and cheese with tidbits of cold french fries in it? It’s just as easy to make some PBJs with a side baby carrots and ranch at home as it is to eat out; it’s a lot cheaper too.

statewide recognition. This means my kids end up with too much clothing. I am not really saving money on clothes if I buy a lot more than they need. I am actually spending the same amount of money I likely would if I didn’t bargain-hunt and waste time. At best, that seems like some pretty faulty logic. How am I going to say no to sales? I am going to unsubscribe from emails from kids clothing stores. Then, I will only hunt sales when my kids actually need something.

Resolution: Clean out and stay out

Resolution: Hit the garage sales in the summer

Most of us spend a gross amount of money on stuff. That stuff then moves into our homes, garages and yards. It requires upkeep. This spring, I’m planning a huge cleanout of my cluttered spaces. I did it last year, but I didn’t go far enough. I told myself if an item made the cut last spring but wasn’t used in the upcoming year, that item was to be donated. Cleaning out may not save me money, but not replacing that stuff with other stuff will.

If I happen to buy too many 50cent or $1 clothing items, I resolve to totally forgive myself. I’d better hit garage sales and cash in on cheap clothes while my kids still think it’s cool to spend a morning going to garage sales and then sporting their finds in public. Resolution: Keep on consigning A few times a year, I sell items at a local pop-up consignment sale (enough mystery, I sell all my used goodies at Polka Tot — the fine people at Polka Tot have no idea I’m writing this). This not only forces me to keep unused stuff moving out of my house, it also puts some dollars in my bank account. One year, we used our earning to pump out the septic tank! Living the dream, folks.

Resolution: If I were moving to Europe... I usually apply this thought process to my stuff purges. I start looking around at all the stuff in my house. If it’s not something I use regularly, I ask myself: If I were moving to a faraway place, would I keep this item? It helps me truly assign value to things. However, I can apply this principle to things I want. When I want to buy something, I will think about its long-term utility and how often I will use it. That should keep adorably useless items from making their way into my home and add some padding to my bank account.

Resolution: Eat out strategically I know this one seems like a low-hanging fruit, but hear me out. It seems like half the time we eat out, my kids don’t bother eating.

Fitness Trends for 2019 More personal training, increasing use of wearable devices among some of trends for new year, say local experts

By Deborah Jeanne Sergeant

hat’s new for fitness in 2019? Local fitness experts offer their top picks for the coming year’s hottest trends. • “In 2018 we saw a huge boom with interest in HIIT-[high intensity interval training] style training, what I’m reading in my industry magazines now leads me to believe this will continue but we will also see more express style workouts and classes for those short on time. You can get a lot done in 30 minutes if you know what you’re doing. • “Personal training will continue to be popular as I believe people will always have the need for personal accountability and to ensure they are exercising safely. As we age ,our bodies change. It’s exciting to exercise in a large group but when you have old injuries or specific functional goals you’ll be better off under the direct supervision and instruction of a degreed, certified personal trainer.” Randy Sabourin, Team Leader, Metro Fitness in Syracuse and Fayetteville. Page 22

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• “They’re not always ‘new’ trends, but moving up or down in popularity. I think in 2018, we’ve seen wearable tech, but this year, it’s getting so much better in its ability to track multiple domains and provide feedback and they’re getting much more accurate. When the new Apple watch came out, that got a lot of publicity. There’s also FitBit, and Garmin has things out there, smart watches and heart rate monitors and GPS tracking. They can do so many more things. The trackers can work when you’re on indoor equipment. Now it can track when you’re on an elliptical. They can track calories, amount of sleep, sitting time — which is a big deal now. • “Group training, not necessarily at a facility, but there are a lot of online group training opportunities, like a treadmill that connects remotely to a class for listing rankings. It’s for individuals who are competitive and want to be the fastest in the group. For others, they want to feel they’re in a group. there’s a motivational leader there. Or you could be

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019

in the Alps or Bermuda virtually. Or it could be going to the Y and being part of a class. • “More are seeking out certified fitness individuals. Because they want to do something for fitness but they don’t know how.” — Carol Sames, Ph.D., program director for Vitality at Upstate Medical University.

• “No longer are the days of killing yourself with intense amounts of cardio as a punishment for letting yourself go, but rather a holistic wellness plan to help give the strength you need to navigate a joyful life of balance.” — Kate Flannery, licensed psychotherapist, Metro Fitness in Syracuse and Fayetteville

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BRIGHTON PHYSICAL THERAPY The new Upstate Family Birth Center at Upstate University Hospital at the Community Campus offers a variety of ammenities.

University Hospital’s Family Birth Center By Mary Beth Roach

ith the new year comes new changes at the Upstate University Hospital at the Community Campus. In January, its Upstate Family Birth Center will be fully open and accommodating mothers and their babies throughout the 21-bed unit. Begun in 2016, the $9.2 million construction project was done in two stages, allowing the hospital to keep caring for mothers and babies during this project. The first part was done in the fall of 2017, with the phase two wrapping up in December. Labor and delivery will still occur at its current location on the second floor, but the renovated 29,000-square-foot unit for post-partum care, is referred to as the Family Birth Center. And that title – Family Birth Center – underscores the family-oriented theme in planning for all the amenities. Barbara Bennett, RN, and nurse manager for the new area, pointed out some of the features during a recent tour of the facility. “It was a long-time coming,” she said, emphasizing that the approach was to make the new rooms more “hotel-like” versus clinical. According to a statement from University Hospital, the original post-partum floor had not been renovated or updated since long before Upstate acquired Community General Hospital in 2011, which it was eager to give the birth center a modern upgrade. Called couplet rooms, they are private spaces for the mom and newborn and family. They are furnished with a bed for mom and a bassinet nearby for the baby, a computer; a

flat screen TV; a glider; a sofa that pulls out to a full-size bed; a charging station; and even a specially contoured sink for bathing the baby. Each room has a large bathroom, including a walk-in shower. This compares to the old rooms, which were semi-private, had one bathroom without a shower and limited closet space. Currently, there’s a lot of national focus on a “baby-friendly” initiative, which fosters breast-feeding, Bennett said. “To promote that as a hospital, we have a lactation office, so the lactation consultants can do one-on-one training with moms,” she explained. The renovated space also has two nurses stations; a six-station nursery; and a family lounge, with a fireplace and a kitchenette where families can prepare meals of their own. This birthing center is considered a Level 1, so it’s prepared for lowrisk pregnancies. St. Joseph’s Health Care Center and Crouse Hospital are rated Level 3 and 4, respectively, and can handle deliveries and post-partum care that might be higher-risk. Nonetheless, the new Family Birth Center at Upstate-Community has a six-station nursery to tend to those newborns that might be mildly sick, with new monitors and space to accommodate mothers. The upgrades have also enhanced the working environment for the staff, Bennett pointed out, especially with the new level of technology that has come about. In 2018, the hospital saw 1,056 deliveries, which is an increase for them, Bennett said. This also included 10 sets of multiple births.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 23

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

5 I

Tips to Help Prevent Caregiver Burnout

f you’re the main family caregiver for an elderly loved one, you already know the stress and worry that comes with this responsibility. But this stress may have doubled during the holiday season — making it even more important for you to take time for yourself right now. According to caregiver.org, more than 30 million caregivers have provided unpaid care to an adult over the age of 50 in the United States. As a caregiver, it can be easy to forget to take care of yourself with all the responsibilities you shoulder. Not doing so can lead to complete burnout — which isn’t good for you or your loved ones. As you recover from the holiday season, here are five tips to help you prevent caregiver burnout: Take care of yourself

1. You’ve likely heard it said before

— you need to take care of yourself first to take care of others — and it’s true. If you aren’t taking care of yourself, you’ll be far more likely to become overtired or sick, which isn’t helpful for anyone. Make sure you’re getting enough sleep, eating well and making time for exercise or activities you enjoy doing. Doing so will allow you to be the best possible version of yourself, and those under your care will benefit.

Join a support group It can be easy to feel alone 2. with your responsibilities, even

when you have friends and family surrounding you. Joining a support group with other caregivers who know exactly what you’re experiencing can be a great reminder that you’re not alone at all. If you can’t

find the time to meet with a group in person, there are plenty of online groups and forums that can help too. time for yourself and take 3.ItMake breaks can be easy to get swept up in

the schedule of the loved one you’re caring for, but it’s important to carve out some time during the day for yourself as well. Even if it’s 15 extra minutes of alone time in the early morning before everyone else is up, making a point to have this time for yourself can set the tone for the rest of the day and put you in a better mood.

Stay organized With so many appoint4. ments, medications and daily

routines, it can be easy to become frazzled quickly. While you can’t have control over everything, staying organized can help you prevent some of the unnecessary frustrations. Utilize a calendar or helpful reminder tools and apps to help you keep everything straight.

Don’t be afraid to ask for help At the end of the day, one of 5. the most important takeaways from

this list is to ask for help when you need it. Whether you need additional assistance with your loved one at home during the day for a few hours at a time, or it’s time to make the switch to assisted living, there are options. While it can be difficult, by asking for help you’re ensuring that your loved one is living the best life possible. Submitted by Loretto. For more information, visit LorettoCNY.org.

Disagree With Your Disability Decision? We Will Take Another Look

ocial Security is here to help secure today and tomorrow by providing benefits and financial protection for millions of people. This assistance allows people with severe disabilities and health conditions to take care of the necessities of living, such as food, shelter, and medications. It is imperative that we continue to protect the integrity of the disability program for everyone by ensuring we make the correct decision on each claim. However, if you do not agree with our decision, you can ask us to take another look by filing an appeal. Generally, there are four appeal levels: 1) Reconsideration, 2) Hearing, 3) Appeals Council Review, and 4) Federal Court Review. At the reconsideration level, someone who did not make the first decision on your claim will conduct a review and accept any additional evidence. Please note, in some states, appeals may proceed directly to the next step — the hearing. If you disagree with the reconsideration decision, you can file another appeal and your case will go to the hearing level. You, and any witnesses you bring, may present your case in front of an administrative law judge during this stage. The judge will then make a decision based on the information. If you disagree with the hearing decision, you can ask for a review by the Social Security Appeals Council. The Appeals Council can either make a decision or return your case to the judge for further review. If you disagree with the Appeals Council’s decision or they decide not to review your case, the last step in the appeals process is filing a lawsuit

in a federal district’s court. You will be notified of our decision in every step of the process and the notice will have the information needed should you decide to appeal the decision. If you receive a denial notice, you have 60 days from that date to file an appeal. There are several ways to obtain the proper appeal forms. The easiest and quickest way is filing online by visiting www.socialsecurity. gov/benefits/disability/appeal.html. You will be able to submit documents electronically to associate with your appeal request. You can also call us at 1-800-772-1213 or visit your local Social Security office to obtain the forms. Many people wonder if they need a lawyer when filing and appealing disability benefits. Whether you choose to appoint an attorney or authorized representative is completely up to you. However, it is not required that you have one in any part of the process or in conducting business with Social Security. If you decide to appoint a representative, be sure to complete the necessary documents to authorize us to speak to them on your behalf. You can also read our publication Your Right to Representation at www.socialsecurity.gov/pubs/EN-05-10075.pdf. Social Security takes considerable pride in administering program benefits timely and accurately. The disability program is no exception. This is why we encourage you to contact us as soon as possible if you disagree with our decision. Give us a call, visit the local office, or go online at www.socialsecurity.gov/benefits/ disability/appeal.html so we can take another look at your claim.

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Almost 65

Dear Almost, Medicare’s coverage of dental care is extremely limited. It will not cover routine dental care including checkups, cleanings or fillings, and it won’t pay for dentures either. Medicare will, however, cover some dental services if they are required to protect your general health, or if you need dental care in order for another health service that Medicare covers to be successful. For example, if you have cancer and need dental services that are necessary for radiation treatment, or if you need surgery to treat fractures of the jaw or face, Medicare will pay for these dental services. Although Medicare’s coverage of dental services is limited, there are other ways you can get coverage and care affordably. Here are several to check into. Consider a Medicare Advantage plan While dental services are mostly excluded under original Medicare, some Medicare Advantage plans do provide coverage for routine dental care. If you are considering joining a Medicare Advantage plan, find out what dental services, if any, it covers. Also, remember to make sure any Medicare Advantage plan you’re considering covers the doctors and hospitals you prefer to use and the medications you take at a cost you can afford. See Medicare.gov/find-aplan or call 800-633-4227 to research plans in your area. Purchase dental insurance If you have frequent gum problems and need extensive dental care, a dental insurance plan may be worth the costs versus paying for care yourself. Expect to pay monthly premiums of $15 to $40 or more for insurance. To find dental plans, go to NADP.org and use the “find a dental plan” tool. Then review a specific plan’s website. Consider dental savings plans While savings plans aren’t as comprehensive as insurance, they’re

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a good option for those who can’t get covered. How this works is you pay an annual membership fee — around $80 to $200 a year — in exchange for 10 to 60 percent discounts on service and treatments from participating dentists. To find a savings plan, go to DentalPlans.com (or 888-632-5353) where you can search for plans and participating dentists, as well as get a breakdown of the discounts offered. Check veterans’ benefits If you’re a veteran enrolled in the VA health care program or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA offers a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost. The VA also provides free dental care to vets who have dental problems resulting from service. To learn more about these options, visit VA.gov/ dental or call 877-222-8387. Shop around FairHealthConsumer.org and HealthcareBlueBook.com lets you look up the cost of different dental procedures in your area, so you can comparison shop – or ask your regular dentist for a discount.

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Try community health centers or dental schools There are many health centers and clinics that provide low-cost dental care to those in need. And all university dental schools and college dental hygiene programs offer dental care and cleanings for less than half of what you would pay at a dentist’s office. Students who are supervised by their professors provide the care. See ToothWisdom.org to search for a center, clinic or school near you. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 25

H ealth News CNY Behavioral Health Care has new director

Helio Health, which has been awarded $2,418,000 over three years to fund the work of a group of four entities coming together to form a Behavioral Health Care Collaborative (BHCC) IPA, has hired Katie Weldon as director. “It is an honor to be named director for the CNY Weldon BHCC and to be a member of such a progressive team of colleagues and organizations. Behavioral health in New York state is in the midst of some of the most significant changes we will see within our systems of care. I am excited to be in a role that helps to move that change forward and for the opportunity to collaborate with so many great partners, “said Weldon. The CNY BHCC is a part of the transformation of the state’s Medicaid system that will aid behavioral health providers in transforming to a business model of value-based payment, which rewards quality of care and better health outcomes, rather than the volume of services they provide. “On behalf of our 32 affiliate and 21 network partner agencies, we are looking forward to building a better behavioral health system of care with Katie leading our efforts,” said Helio Health President and C.E.O. Jeremy Klemanski.

Cardiologist joins Crouse Medical Practice

Central New York native Joshua Harrison has joined Crouse Medical Practice — Cardiology. Board-certified in cardiovascular disease, Harrison received his medical degree from SUNY Upstate Medical University in Syracuse. He also completed Harrison his residency at SUNY Upstate and went on to complete a fellowship in cardiology at University of Connecticut, Hartford Hospital in Hartford, Conn. Harrison is a member of the American College of Cardiology and the American Heart Association. His clinical interests include heart failure, hyperlipidemia, coronary artery disease and echocardiology.

Nascentia Health announces new employees Nascentia Health, a local leader in home healthcare services, recently announced the addition of the following individuals to its team of Page 26

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healthcare professionals. • Certified Home Health Agency — Valerie Dorsey, registered nurse; Marcia Finizio, customer service center coordinator; Jennifer Harwood, registered nurse; Tammy Lindsay, executive strategy adviser; Kelsey Schoen, occupational therapist; Erin Snyder, health information coordinator; Daniel Stauffer, care navigator; Christine Volles, customer service center coordinator; and Robert Wimler, report writer/data validation specialist. • Licensed Home Care Service Agency — All of the following joined the organization as home health aides: Tajour Brown, Patricia Buck, Ashley Finnerty, Lorraine Gaffney, Amanda Goodrich, Lorri Hannigan, Michelle Hilton, Dana Lofthouse, Bettie Prettyman, Bonnie Prime, Jenna Smith, Gayle Sojda, Ashley Viscosi, Jenna Waggoner, Stephanie Wells-Koegel, and Alissa Whaley. • Managed Long-Term Care Program — Rebecca Alder, care coordinator; Wanda Antos, care manager; Mary Fischer, care manager supervisor; Marissa Gruskoff, care manager; Abbigael Horan, care manager; Elaine Kemner, care manager; Bonnie Lee, education coordinator; Marissa McAlpine, care coordinator; Nicholas McCreary, transportation member services representative; David Prete, provider relations representative; Suzanne Skelton, care manager; and Shannon Wright, provider relations coordinator. “We’re honored to welcome these individuals to the Nascentia Health team,” said President and CEO Kate Rolf. “As our system continues to evolve to meet the changing needs of our community, their new perspectives and unique skills and talents will be essential to our continued success.”

St. Joe’s selected as ‘guardian’ of preemies

St. Joseph’s Health Hospital has been named a 2018 Guardian of Excellence Award winner for Neonatal Intensive Care Patient Experience by Press Ganey for the second year in a row. The Guardian of Excellence Award recognizes top-performing health care organizations that have consistently achieved the 95th percentile or above in their performance. The Press Ganey Guardian of Excellence Award is a nationally-recognized symbol of achievement in health care. Presented annually, the award honors clients who consistently sustained performance in the top 5 percent of all Press Ganey clients for each reporting period during the course of one year. Only three hospitals across the country received the Neonatal Intensive Care Patient Experience Guardian of Excellence award (including St. Joseph’s Health), out of more than 200 hospitals that are surveyed nationwide. St. Joseph’s Health is the only hospital in New York state to receive the Guardian of Excellence award for NICU Patient Experience from Press Ganey this year. “What makes this award truly special is that it is awarded based on the feedback from actual NICU

IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019

parents,” said Jonathan Chai, pediatrician for St. Joseph’s Health. “St. Joseph’s has invested significant resources into our NICU to ensure the highest-quality care and patient experience for our tiniest patients and their families. Recognition like this speaks to the heart. It is reassuring to know that our NICU families are recognize our commitment to them at such a critical time and trust us to provide excellent health care.” St. Joseph’s Health Hospital NICU cares for sick or premature infants from 16 Central New York counties.

St. Joe’s recognized for total knee replacement

St. Joseph’s Health Hospital has been named a Five-star recipient for total knee replacement for the 13th year in a row (2007 through 2019), according to the 2019 study released by Healthgrades, the leading online resource for comprehensive information about physicians and hospitals. According to the hospital, St. Joseph’s Health is the only hospital in Central New York to be recognized with the Five-star in total knee for 13 consecutive years. St. Joseph’s Health Hospital has also received the Five-star rating for valve surgery for eight years in a row (2012 through 2019), coronary bypass Surgery for two years in a row (2018 and 2019) and total hip replacement in 2019. These achievements are part of new findings and data featured in the Healthgrades 2019 Report to the Nation. The new report demonstrates how clinical performance continues to differ dramatically between hospitals regionally and nationally. Variation in care has a significant impact on health outcomes. For example, from 2015 through 2017, if all hospitals as a group performed similarly to hospitals receiving 5 stars as a group, then on average 222,210 lives could potentially have been saved and 157,210 in-hospital compli-

cations could potentially have been avoided. A Five-star rating indicates that St. Joseph’s Health Hospital’s clinical outcomes are statistically significantly better than expected when treating the condition or performing the procedure being evaluated. “This rating is important because knee and hip joint replacement surgeries are two of the most common surgeries performed in the United States,” said Seth Greenky, orthopedic surgeon and director of the joint replacement program at St. Joseph’s Health. “And with the rise in the number of baby boomers reaching retirement, coupled with increasing demands on athletes, the number of total joint replacement surgeries is expected to increase each year.”

Providers join Port Byron Community Health

Finger Lakes Community Health recently welcomed two professionals to its Port Byron Community Health, 60 Main St. in Port Byron. They are: • Meghan Hutchings, a family nurse practitioner. She comes from a family of nurses and has been a registered nurse for more than 10 years. • Nirmala Tasgaonkar, a dentist. He has more than 30 years of experience and will provide a wide range of services including extractions, restorations, endodontics, and complete and partial dentures. They join Daniel Dennis, a family nurse practitioner, who started his career 20 years ago. The modernized and expanded Port Byron Community Health is a-in-one health center for primary care and dental services. Finger Lakes Community Health is an independent healthcare organization, not affiliated with any hospital, founded in 1989 as a provider of healthcare for agricultural workers. Services are now expanded to provide comprehensive healthcare for everyone, with numerous health centers in the region, including Bath, Geneva, Newark, Ovid, Penn Yan, Port Byron, and Sodus, and Dundee Dental.

Mah-jongg cards fundraiser to benefit JCC Seniors Program The Sam Pomeranz Jewish Community Center is taking preorders for 2019 National Mahjongg League cards. Available in standard size for $8 and large print for $9, sales of the cards will benefit the JCC’s senior meal program. The order deadline is Jan. 11. “Anyone can order Mahjongg cards through the JCC,” says the Cindy Stein, JCC director of adult and senior programming. “It’s very convenient and you’ll be helping to support our senior program. You don’t have to be a JCC member or play MahJongg at the JCC to place an order.” All card orders will be

mailed by the National Mahjongg League directly to purchasers’ homes by mid-March. Card purchasers will automatically receive a one-year membership in the National Mah-jongg League. Mah-jongg is played at the JCC of Syracuse on Tuesdays, Wednesdays and Thursdays starting at 12:30 pm. New players are always welcome to join the fun. For more information about ordering Mah-jongg cards or playing Mah-jongg at the JCC, contact Cindy Stein at 315-4452040, ext. 104, cstein@jccsyr.org or visit www.jccsyr.org.

FIRST IN NEW YORK

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ONE OF 13 IN U.S.

Upstate University Hospital and its Community Campus Orthopedics program is New York state’s first DNV-certified Center of Excellence for hip and knee replacement - and only one of 13 in the nation with this distinction. The program excelled in a number of areas including the quality of orthopedic surgery, surgical outcomes and post-surgical follow-up. Community Campus Orthopedics — a collaboration between talented and experienced physicians from both Upstate Orthopedics and Syracuse Orthopedic Specialists — now features Swift Knee, allowing patients the option of outpatient knee-replacement surgery.

MORE INFORMATION CALL: 315.464.8668 OR VISIT UPSTATE.EDU/COMMUNITYORTHO

January 2019 •

IN GOOD HEALTH – CNY’s Healthcare Newspaper

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Page 27

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IN GOOD HEALTH – CNY’s Healthcare Newspaper • January 2019