PRICELESS
Meet Your Doctor
Tucker M. Harris, new ENT at St. Joe’s, discusses vertigo, allergy and problems in the ear, throat, sinus, and the incidence of arthritis in the ears
HOW CONTENT ARE YOU?
Quiz from author of “Live Alone & Thrive” assesses degree of contentment
What health questions people ask Google the most
CNYHEALTH.COM
Taking Antibiotics?
MARCH 2019 • ISSUE 231
You may not need to. Study shows a quarter of antibiotics prescriptions unnecessary. See what local doctors say about it. Story on page 11
ALSO INSIDE: The measles outbreak and the ‘anti-vax’ movement Page 8
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Hot Health Apps
Upstate Golisano Children’s Hospital Welcomes New Administrator
Colon Cancer
Five things you need to do to prevent one of the deadliest cancers
Region mobilizes to continue fight against lead poisoning in children
Millet
Fluffy like couscous or creamy like polenta, millet has many things going for it. Page 17
High Price Price of insulin, MS drugs skyrocket. Find out why. P.age 13
EMERGENCY SERVICES
When trust is critical, say,
“Take Me to Crouse.”
Open for You: Our New Pomeroy Emergency Services Department • •
The region’s newest, most up-to-date ER One convenient access and evaluation point for acute care and treatment of minor illnesses and injuries 24/7
Advanced Facility, Advanced Care • •
High-quality care delivered promptly and with Carepassion® Modern design allows us to move patients faster – and more comfortably
All this adds up to superior emergency care from the hospital you trust – Crouse Health.
Official healthcare provider of Syracuse Athletics ®
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
TAKE CHARGE Get Informed More than 60 million Americans have some form of heart disease. Heart disease is hereditary in some cases. But in many cases, making healthy lifestyle choices may help reduce the risk of getting heart disease. If you have more questions, you should talk to your provider.
Partner with Your Provider
Be Heart Smart
To determine whether you have a heart condition, your health care provider will do diagnostic tests and procedures. If you have heart disease or have had a stroke, members of your family may also be at higher risk of having the disease. It’s very important to make healthy choices now to lower risk.
A healthy diet and lifestyle are your best weapons in the fight against heart disease. Here are healthy tips that help protect your cardiovascular system. ♥Get Active ♥Eat Better ♥Lose Weight ♥Control Cholesterol ♥Manage Blood Pressure
New to Medicare? Let WellCare help you live healthier. Jason Hollister, Sales Manager 1-716-846-7900 www.WellCareNow.com
Always talk with your doctor(s) about the care that is right for you. This material does not replace your doctor’s advice. Source: www.Heart.org.
65505
WellCare (HMO) is a Medicare Advantage organization with a Medicare contract. Enrollment in WellCare (HMO) depends on contract renewal. A sales person will be present with information and applications. For accommodation of persons with special needs at sales meetings, call 1-877-699-3552 (TTY 711). There is no obligation to enroll. Please contact WellCare for details. WellCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATTENTION: If you speak a language other than English, language assistance services, free of charge, are available to you. Call 1-877-374-4056 (TTY: 711) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-374-4056 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務 。請致電 1-877-374-4056 (TTY: 711) 。 Y0070_NA029115_WCM_FLY_ENG CMS Accepted 05242015
March 2019 •
©WellCare 2015 NA_03_15_WC IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 3
CALENDAR of March 11
Alzheimer’s Association announces support group meetings
HEALTH EVENTS T
Meeting will address ‘mama worriers’
The weight of all the responsibilities of parenting may weigh on you like a 500 lb. backpack and you just can’t seem to keep afloat. Your mind constantly races with worry and the anticipation of the worst case scenario in all situations. All you want is to be able to feel present with your children and enjoy family time without the burden of fear and anxiety. Join social worker Stephanie Straub, owner and therapist at CNY Therapy Solutions, in an evening to determine what’s “normal,” what’s not, and how to begin to feel like yourself again. The meeting will take place from 6 to 7:30 p.m. at CNY Healing Arts, 195 Intrepid Lane, Syracuse. Light snacks and refreshments will be provided. Parking and entrance in the back of the center’s second building. Registration is recommended. Call 315-707-8097. Free.
March 23
Expo celebrates national nutrition month
Onondaga County Executive J. Ryan McMahon, II announced that the annual Nutrition & Health Expo for Seniors will take place 10 a.m. to noon, March 23, at the CNY Regional Market “F” shed located at 2100 Park St. in Syracuse. The annual event attracts hundreds of seniors from across the region. The event will give Central New York seniors the opportunity to see available community resources, partake in health screenings and massages as well as exercise classes. A light and healthy breakfast will be served and there will be healthy cooking demonstrations and samples. McMahon said, “This annual expo is a great opportunity for the seniors in our community to see all that Onondaga County and the Office for Aging has to offer. Whether
it is signing up for one of the many classes offered or taking part in a health screening, this year’s expo is sure to be the best yet.” Registration is required for this event. For more information or to register, please call 315-435-2362 ext.4987. The deadline to signup is March 15. Local businesses are welcome to be a sponsor or exhibitor. To be a sponsor or exhibitor, businesses are asked to call 315-435-2362 ext. 4942 by March 8.
Free Income Tax Service for Seniors in Madison County
Free income tax preparation services are available to seniors in Madison County through the Tax Counseling for the Elderly (TCE) program. Seniors aged 60 and over and those with disabilities can use the service. There are no income limits. This year, the service will be available at seven locations within the county six days a week through April 15. The sites are: • Canastota Library. Service available from 9 a.m. to noon each Friday; • Oneida Library. Service available from 9 a.m. to noon on Mondays and Wednesdays; These are walk-in sites with no appointment necessary, serving clients on a first-come basis. To get service in the sites below, an appointment is necessary. • Cazenovia and Hamilton area sites. Call 315-684-9333, leave your name and number and a volunteer will return your call. • Chittenango Library. Service available Tuesdays and Thursdays Bridgeport Library: service available Saturdays. Call 315-687-3471. • In Morrisville call 315-684-3001, leave your name and number and a volunteer will contact you to schedule an appointment.
he Alzheimer’s Association, Central New York chapter, welcomes those impacted by Alzheimer’s disease or another dementia to attend one of its support groups that meet throughout the region. Support groups are a community of peers that exist to support one another. These peer- or professionally-led groups for individuals, caregivers and others dealing with Alzheimer’s disease or a related form of dementia. Caregiver support groups promote an open forum of sharing and discussion among people facing many of the same issues. The group’s power rests within its members’ ability to show compassion, develop strategies and empower its members to provide the highest quality care possible. Additionally, the chapter offers support groups for individuals living with early-stage dementia and their caregivers, LGBT caregivers and caregivers of those with younger-onset Alzheimer’s disease. All support groups are free of charge to attend and facilitated by trained individuals. For more information, call 1-800-272-3900 or email cnyprograms@alz.org.
Upcoming meetings CAYUGA COUNTY
• Auburn (new location) Sts. Peter and John Episcopal Church, 69 Genesee St. 2 p.m., March 7 and April 4
MADISON COUNTY
• Canastota Madison County Office for the Aging, 138 Dominic Bruno Blvd. 10 a.m., March 15 and April 19 • Cazenovia Community Resources for Independent Seniors, Cherry Valley Professional Plaza, 2662 Route 20 East 6 p.m., March 13 and April 10
ONONDAGA COUNTY
W. Genesee St. 6:30 p.m., March 12 and April 9 • DeWitt Pebble Hill Presbyterian Church 5299 Jamesville Rd. 4:30 p.m., March 20 and April 17 For individuals with early-stage Alzheimer’s disease or other dementia and their care partners; call 315-472-4201 for advance screening. • Liverpool Liverpool First Presbyterian Church, 603 Tulip St. 11 a.m., March 9 and April 13 • Manlius Manlius Public Library, 1 Arkie Albanese Way 6:30 p.m., March 26 and April 23 • North Syracuse NOPL North Syracuse, 100 Trolley Barn Lane 3:15 p.m., March 19 and April 16 • Skaneateles Grace Chapel, 1674 U.S. Route 20 2 p.m., March 28 and April 25 • Syracuse Alzheimer’s Association, Central New York Chapter, 441 W. Kirkpatrick St. 5:30 p.m., March 13 and April 10 Support group for caregivers of people living with younger-onset (under 65 years old) Alzheimer’s disease or other dementia The Centers at St. Camillus, 813 Fay Rd. 5:30 p.m., March 19 and April 16 The Dunbar Center, 1453 S. State St. 6:30 p.m., March 18 and April 15 The Hearth on James, 830 James St. 1 p.m., March 6 and 20, April 2 and 16 SAGE Upstate, 431 E. Fayette St. 6 p.m., March 5 and April 2 LGBT caregivers support group Syracuse V.A. Hospital, 800 Irving Ave., Room B9051 p.m., March 6 and April 3 Non-veterans welcome
OSWEGO COUNTY
• Central Square First Universalist Church of Central Square, 3243 Fulton Ave. 7 p.m., March 25 and April 22 • Oswego The Manor at Seneca Hill, 20 Manor Dr. 6 p.m., March 27 and April 24
• Baldwinsville Baldwinsville Methodist Church, 17
Your Regional Specialist in Integrative Oncology Amy Lazzarini, MD, MSHS
Integrative Gastroenterology Integrative Lyme Disease Treatment Mold Related Illness (CIRS)
Check us out Online @ www.cnyhealth.com Page 4
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
Two teams, one goal: Get stronger Central New York.
“If you’re rehabbing from surgery, a stroke, a sports injury or any other kind of injury, choose Onondaga Center, Oneida Center or Carthage Center.” –MARTY BIRON, former goaltender for the Buffalo Sabres
Onondaga Center 217 East Ave Minoa, NY 13116 315 656 7277
Oneida Center 1445 Kemble Street Utica, NY 13501 315 732 0100
Carthage Center 1045 West Street Carthage, NY 13619 315 493 6523
Trusted Rehab Partner of the Buffalo Sabres
March 2019 • In Good Health Central NY Region - March 2019 - 9.75”x13.75”
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 5
Meet
Your Doctor
By Chris Motola
Tucker M. Harris, M.D. New ENT at St. Joe’s discusses vertigo; allergy and problems in the ear, throat, sinus; and the incidence of arthritis in the ears
Emergency Rooms the Destination for Many Electric Scooter Users
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ented electric scooters have become all the rage in getting around larger cities, but they are also accidents waiting to happen, a new study reveals. In two Southern California emergency departments, nearly 250 people were seen for injuries linked to electric scooters in a single year, researchers found. “Riders of electric scooters share roads with fast-moving vehicular traffic and share sidewalks with lots of pedestrian traffic and uneven curbs, and riders seem to underestimate hazards,” said senior study author Joann Elmore, a physician and professor of medicine at UCLA’s David Geffen School of Medicine. Injuries associated with these electric scooters are a new phenomenon, she noted. “While the injuries vary in severity, some are serious, including fractures and head injuries,” Elmore said. These data are likely a conservative estimate because the researchers only included patients seen in emergency rooms. “Our findings do not cover the many patients seen in our outpatient clinics,” Elmore added. “Electric scooters are an innovative and inexpensive method of transportation for short distances,” she pointed out. The companies offering these electric scooters are rapidly expanding in the United States and internationally. “This is now a billion dollar market, with ride-sharing companies like Uber and Lyft recently entering the market,” Elmore explained. For the study, Elmore and her colleagues used medical records from University of California, Los Angeles-affiliated hospital emergency departments to look at accidents associated with standup electric scooters over one year. In all, 228 patients were injured as riders and 21 as non-riders. The report was published online Jan. 25 in JAMA Network Open.
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Q: A lot of people don’t realize how expansive ear, nose, and throat (ENT) is as a specialty. What kinds of issues do you take care of? A: My specialized training is in ear surgery, meaning complicated ear disease, surgery for vertigo and hearing implant surgery. I also have some subspecialty certification in allergy treatment and diagnosis, ear infections, tonsil disease, facial and skin lesions, and some bumps and tumors in the head and neck. I take care of all of that. Q: Are those issues grouped together because their systems are interrelated? A: Yeah, a lot of the disorders we treat are kind of interrelated. Sometimes what feels like an ear problem is occurring because of a sinus problem. And a lot of ear, throat and sinus problems can be related to allergies. So, yeah, they can be very interrelated if that’s what you’re getting at. Q: What do allergy treatments look like these days? A: For whatever reason — it’s probably multifactorial — the Central New York area is a hotbed for allergy-related disorders. But we’ve come a long way with allergy treatments. There are a lot of options. It’s helpful to patients to see a specialist and figure out which of these options will help them. Each treatment option has advantages and disadvantages, whether it’s just using medicine, or using allergy shots, prescription tablets that act like allergy shots. There is a wide variety of treatments and we’re planning on offering all of them through our office very shortly. We’re working on getting all of that stuff set up and ready to go. Q: How long are the shots effective? A: The shots are once a week for about a year, then they taper down to once every two weeks or once a week for another year or two.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
With some people it’ll be a permanent cure. Even if it’s not, it’s usually effective for a decade or more. There are a handful of patients for whom it won’t work, or there will be too many side effects, but the vast majority of patients get a good benefit out of it. It’s also one of the few truly homeopathic treatments that conventional doctors use. Let’s say someone’s allergic to cats or dogs. What we’re doing is using a serum that takes a really tiny amount of the dander or proteins and injecting it into the human body to build up a tolerance. It’s pretty cool if you think about it. The great thing is, it usually works very well, particularly for ears, nose, and throat-related allergies. Q: And that’s both animal and plant allergies? A: We can treat allergies to pollen, trees, weeds, grass, mold, cat, dog. We can also treat dust mite allergies, which act a bit like mold. At some point in the future, we hope to be working on doing the same thing for stinging insect venom, but that’s a little further down the road. But those are the things we can do the allergy shots for. Q: What causes vertigo and how do you treat it? A: Vertigo is basically the sensation of motion or movement when there isn’t any occurring. You may feel like you or the world is spinning even if there’s no motion. A lot of times it’s related to an inner ear problem. Sometimes you can treat it with physical therapy, sometimes it requires medication, sometimes surgeries are beneficial. It depends on each
individuals’ symptoms and circumstances. Q: How do you treat hearing loss? A: There are numerous causes of hearing loss, some of which are treated with a hearing aid, some with medication and even some with surgery. I’m trained in the full gamut of those procedures, whether it’s an implantable hearing device, repairing a hole in the ear drum or surgically repairing some arthritis of the tiny little bones in the inner ear. Q: You can get arthritis in your ear? A: Yeah. It’s not related to the type you get in your hips, knees or shoulders, but they can get a kind of arthritis. We can identify which of the three tiny bones is having a problem and replace it with an implant. The success rate is very high and has a pretty short recovery time. And it greatly improves quality of life. It’s amazing how socially isolating even a little bit of hearing loss can be. It keeps people out of conversations because they’re not sure what people are saying. So that can make a big difference. That, along with curing a certain kind of vertigo with inner ear surgery, are two of my favorite surgeries to perform. Q: What can patients do to keep these systems healthy? A: The things to watch for would be hearing loss, vertigo, sinus infections, sore throats, sleep problems, nasal blockage. All those kinds of things people should be watchful of. Allergies. As far as keeping them healthy, that’s easier said than done. A lot of the disorders we see don’t really have much of a way to prevent them, or they’re congenital or hereditary in some way. Of course, one of the best things people can do is, if they’re using nicotine in some way, cutting it out of their diet is extremely helpful and the best preventive thing you can do.
Lifelines
Name: Tucker M. Harris, M.D. Position: Otolaryngologist and
allergist at St. Joseph’s Health, Northeast Medical Center in Fayetteville; previously worked as an otolaryngologist for Arnot Medical Services and Arnot Ogden Medical Center in Elmira, where he served as medical director of otolaryngology and medical director of otology Hometown: Clancy, Mont. Education: Oregon Health and Science University; completed his residency in the department of otolaryngology and communication sciences at SUNY Upstate Medical University and Veterans Administration Medical Center in Syracuse; completed his fellowship in otology/neurotology at SUNY Upstate Medical University. Affiliations: St. Joseph’s Health Organizations: Otolaryngology-Head and Neck Surgery (ABOHNS); fellow in the American Academy of Otolaryngic Allergy (AAOA); holds a NYS Medical License, Drug Enforcement Agency certification and is certified in basic life support. Family: Wife, three children (ages 9, 5 and 2) Hobbies: SU sports; playing drums, spending time on boat, spending time with family
Hospital-Acquired Conditions Declined By Nearly 1 Million
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ew data released in January by the Agency for Healthcare Research and Quality (AHRQ) and Centers for Medicare & Medicaid Services (CMS) show reductions in hospital-acquired conditions such as adverse drug events and healthcare-associated infections helped prevent 20,500 hospital deaths and save $7.7 billion in health care costs from 2014 to 2017. AHRQ’s preliminary analysis estimates that hospital-acquired conditions were reduced by 910,000 from 2014 to 2017. The estimated rate of hospital-acquired conditions dropped 13 percent; from 99 per 1,000 acute care discharges to 86 per 1,000 during the same timeframe. AHRQ’s new report quantifies trends for several hospital-acquired conditions, including adverse drug events, catheter-associated urinary
tract infections, central-line associated bloodstream infections, Clostridioides difficile infections, pressure injuries (pressure ulcers), and surgical site infections. The report showed that harms decreased in several categories, such as adverse drug events, which dropped 28 percent from 2014 to 2017. However, opportunities for improvement exist in other harm categories, such as pressure ulcers. “CMS is delivering on improving quality and safety at America’s hospitals,” said CMS Administrator Seema Verma. “Our work isn’t done and we will continue our efforts to hold providers accountable for delivering results.” AHRQ Director Gopal Khanna, MBA, added, “The updated estimates are a testament to the successes we’ve seen in continuing to reduce
hospital-acquired conditions. There’s no question that challenges still remain in addressing the problem of hospital-acquired conditions, such as pressure ulcers. But the gains highlighted today were made thanks to the persistent work of many stakeholders’ ongoing efforts to improve care for all patients.” The continued decline in hospital-acquired conditions is a signal that patient safety initiatives led by CMS are helping to make the nation’s health care safer, federal officials said. AHRQ, CMS, the Centers for Disease Control and Prevention, and
other federal and private partners throughout the field support ongoing improvements in health care and are establishing a growing foundation of knowledge about how to keep patients safe. CMS has set a goal of reducing hospital-acquired conditions by 20 percent between 2014 and 2019. If achieved, AHRQ projects the 20 percent reduction would result in 1.8 million fewer hospital-acquired conditions over this period, potentially resulting in 53,000 fewer deaths and saving $19.1 billion in hospital costs.
Healthcare in a Minute By George W. Chapman
State of the Union — Five Major Healthcare Initiatives
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resident Trump delivered his SOTU address on Feb. 5. Here are some of his plans. 1) Obliterate the “HIV epidemic” within 10 years by focusing on geographic hotspots; funding an HIV health force; improving access to testing and proper medication. 2) Cure childhood cancer by providing $500 million of research over the next 10 years. 3) Produce a plan for a national paid family leave act, which has been the pet project of Ivanka Trump. 4) Pass legislation to prohibit late
term abortions. 5) Continue to focus on lowering drug prices and mandating pricing transparency among drug manufacturers, hospitals and physicians. Surprisingly, there was little mention of how he would lower overall healthcare costs, making premiums more affordable. Trump also promised to protect pre-existing conditions. Ironically, he has systematically dismantled the Affordable Care Act, which protected pre-existing conditions.
Opioid epidemic
Anthem insurance. Anthem includes rides as a benefit to Advantage members. Ninety percent of Anthem’s non-emergent patient transportation is booked with Lyft. As a result, Anthem’s ride costs have decreased 39 percent and wait times for a ride have decreased 40 percent. This clever benefit could benefit physicians by reducing patient no-show rates.
Thirty-five states are suing opioid manufactures. Recently, the state of Massachusetts attorney general filed a lawsuit against Purdue Pharmaceutical and its owner family, the Sacklers, for knowing their pain killer OxyContin was highly addictive and for deceiving physicians and consumers alike. Several incriminating internal emails and documents from Purdue have been subpoenaed. Roughly 130 people per day, or about 47,000 people per year, die from opioid addiction. The worse states for opioid-related deaths per 1,000 are: West Virginia 50; Ohio 39; District of Columbia 35; New Hampshire 34; Maryland and Oregon 32. New York ranks 24th with 16/1,000. The state with the least opioid deaths per 1,000 is Nebraska at 3.
Need a Lyft?
The ride provider Lyft (vs. Uber) sees Medicare Advantage plans as a good market for their business. Lyft’s first Advantage plan partner was
Fewer People Have Employer-Sponsored Insurance
Twenty years ago, 67 percent of us received health insurance through our employer —Today, the percentage has dropped to 58 percent, according to research conducted by the Kaiser Family Foundation. Some experts surmise the gradual decline over 20 years could be due to retiring baby boomers and employees of small businesses purchasing their insurance on the exchange. Recently, the Trump administration struck down the individual mandate to have insurance which may fuel the downward trend going forward.
About 156 million people, or slightly less than half of the US population, were covered by employers in 2017. The other half of us were covered by Medicare, Medicaid, the VA, federal employment, co-ops, the Bureau of Indian Affairs and the exchanges.
Smaller Hospitals Seek Affiliations
In order to enhance their reputations, remain independent and provide their communities access to the best care, let alone survive, smaller community hospitals are affiliating (versus merger or acquisition) with larger, more prestigious hospitals. In return, the larger hospital increases its market for the specialized services that most smaller hospitals can’t provide. Most of these affiliations have eventually resulted in a complete merger or acquisition of the smaller by the larger. Because today’s consumers are far more savvy and demanding, smaller hospitals need to shed their local or “community” reputation and rebrand as part of a larger more comprehensive health system.
Drug Costs
Uncontrolled, skyrocketing and mysterious drug costs are a bipartisan issue. Trump mentioned this in his State of the Union. But few of the invited drug CEOs bothered to show up, voluntarily, at a Senate Finance Committee meeting to discuss drug costs. The CEOs who failed to show told committee chairman Chuck Grassley they would prefer to meet in private versus in public. (Talk about transparency.) The committee is threatening to force the CEOs to testify if they continue to balk. There have been several suggestions on controlling drug costs. But most are convoluted and difficult to monitor and enforce. The best solution for controlling drug costs would be to allow CMS (Medicare/Medicaid) to March 2019 •
use its massive purchasing power to negotiate drug costs. This solution is not favored by the powerful drug lobby. Bowing to pressure from the lobby, Congress is still dancing around the real solution.
Artificial Intelligence in Healthcare
The healthcare industry is slowly incorporating artificial intelligence — AI — when it comes to assisting physicians in determining a diagnosis or treatment plan. AI is already being used in radiology, pathology and dermatology. It assists physicians with faster and highly accurate diagnoses. Combining AI with physician experience and judgment results in higher diagnostic confidence. Telehealth continues to be perfected and more widely accepted. Robots and 3-D printers are being used in operating rooms. AI in psychotherapy is becoming more prevalent due to the limited availability of psychiatrists, the cost of treatment and the greater willingness of patients to be honest about themselves, especially when it comes to socially deviant behavior, with a computer versus a human. The integration of AI in healthcare will lessen, if not negate, the impact of the projected physician shortage.
George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.
IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Page 7
As U.S. Measles Outbreaks Spread, Why Does ‘Anti-Vax’ Movement Persist?
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easles outbreaks across the United States — including one in Washington state where 50 cases have now been identified — have again shone the spotlight on parents who resist getting kids vaccinated. These outbreaks are a clear sign of the fraying of “herd immunity,” the overall protection found when a large majority of a population has become immune to a disease, said physician Paul Offit. He is director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. “Measles is the most contagious of the vaccine-preventable diseases, so it’s always the first to come back when you see a drop in herd immunity,” Offit said. The World Health Organization has taken notice, and recently declared the anti-vax movement a major threat to public health. Given this, why does anti-vaccine sentiment continue to thrive in certain locales throughout America? Offit suspects it’s because people have forgotten just how bad diseases
like measles, chickenpox and whooping cough can be. “It’s happening because people aren’t scared of the diseases,” Offit said. “I think vaccines in some ways are victims of their own success.” But other factors come into play, including a reluctance to give a slew of vaccines to a young child so early in life, now-debunked fears of a link to autism, a feeling that diseases are a natural part of childhood, and a deep-seated distrust of the medical community. Measles outbreaks were “inevitable,” said physician Dawn Nolt, an associate professor of pediatric infectious disease at OHSU Doernbecher Children’s Hospital in Portland, Ore. She lives close to the Washington border, where the biggest current measles outbreak rages. “Pockets of communities where there are low vaccine rates are ripe to be ground zero for an outbreak,” Nolt said. “All you need is one person in that community. We knew this was going to happen.” That’s particularly true of mea-
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sles, which is incredibly virulent. Offit explained that “you don’t have to have face-to-face contact with someone who has measles. You just have to be within their air space within two hours of their being there.” According to Nolt, despite its power to spread, there are three questions that typically come up with parents who are hesitant about having their children vaccinated against measles: Is the vaccine safe? Is the vaccine needed? Why shouldn’t I have freedom of choice regarding my child’s vaccinations? “I think what’s important is to really understand that families have certain concerns and we need to understand those concerns,” Nolt said. “We can’t lump them all together and think that that one conversation serves all of their concerns.” Parents’ concerns regarding vaccination are often first sparked by the recommended vaccine schedule, Offit said. “What’s happened is we ask parents of young children in this country to get vaccines to prevent 14 different diseases,” Offit said. “That can mean as many as 26 inoculations during those first few years of life, as many as five shots at one time, to prevent diseases most people don’t see, using biological fluids most people don’t understand.” So, it’s important that doctors explain to parents that these vaccines are “literally a drop in the ocean” compared to the myriad immune system triggers a child encounters each day, Offit said. “Very quickly after birth, you have living on the surface of your body trillions of bacteria, to which
you make an immune response,” Offit explained. “The food you eat isn’t sterile. The dust you inhale isn’t sterile. The water you drink isn’t sterile. You’re constantly being exposed to bacteria to which you make an immune response.”
Vaccine and autism Doctors also still have to deal with an erroneous 1998 study that linked vaccinations and autism, said physician Talia Swartz, an assistant professor of infectious diseases with the Icahn School of Medicine at Mount Sinai, in New York City. The study was later found to be fraudulent and withdrawn, but “significant press has continued to raise concern about this, even though these concerns have been refuted based on large-scale population studies,” Swartz said. It’s important to emphasize that these vaccines are heavily tested for safety, said Lori Freeman, CEO of the National Association of County and City Health Officials. As to whether vaccines are needed, outbreaks provide a powerful argument in favor of that premise, experts said. However, some parents still greet outbreaks with a shrug. Nolt said that “some people think vaccines aren’t needed because the disease is more ‘natural’ than the vaccine.” And arguments based on altruism — vaccinating your child to protect the rest of the community, especially kids who can’t be vaccinated — only go so far, she added.
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March 2019 •
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Quiz Time: How Content Are You? M erriam-Webster defines contentment as “the state of being happy and satisfied.” This dictionary definition sounds like a nice way to feel, doesn’t it? Oh, if we could just snap our fingers and be happy with who we are and what we have. Wouldn’t life be grand? I’ve had the privilege of meeting and talking with a lot of women and men who live alone, and our conversations often turn to the subject of contentment: how to find it, how to keep it and how to find it again once it has been lost. Those on their own often feel a lack of something in their lives, and many have trouble letting go of a craving for things to be different. I know. I’ve been there. For years after my divorce, I had trouble seeing the good in myself and in my life. But with time, intention and practice, I was able to stop yearning for what I didn’t have and start appreciating what existed right in front of me. It all began with an important first step — taking a hard look at myself. While I’m no expert in survey design, I created the simple quiz be-
YOUR SCORECARD Calculate your total points using this scale:
low to help you assess where you are on the road to contentment. Your results may light a new and hopeful way forward.
How Content Are You?
Circle the choice that best answers the questions below:
If asked, how many positive personal qualities come immediately to mind? A. 5 or more B. 1 to 4 C. Nothing really comes to mind
1.
How would you describe your home? 2.own! A. Very “me” — I’ve made it my
B. It’s fine. I keep meaning to redecorate, but just haven’t gotten around to it C. It’s a place to sleep
How would you describe your suc3. cess in letting go of old ways of thinking and of negative thoughts or behaviors
that keep you anchored in the past? A. I live in the present; it’s full steam ahead! B. I still go “back there” from time to time C. I can’t let go, I obsess about the past
Could you imagine planning a trip 4. by yourself and traveling alone to a favorite destination? A. In a heartbeat! B. Maybe someday C. I can’t imagine that
Does the thought of going alone to a 5. cafe for a cup of coffee, or grabbing a bite to eat in a local restaurant, feel perfectly comfortable — even enjoyable?
A. I do it all the time B. Occasionally, but I’m not at ease C. I’m just not ready you exercise, get enough sleep, 6.A. Doand stay on top of health screenings? Of course B. I know I should, but I don’t always take care of myself C. I’m too preoccupied to think about my health
How often do you pamper or reward 7. yourself by taking some time just for you or by purchasing that little something
special you’ve had your eye on? A. As often as I can! B. More often than not, I put others’ needs first C. I can’t remember the last time I pampered myself
you imagine your life without a 8.A. Can special someone on your arm? I would enjoy sharing my life with someone special, but could also find contentment with my “family of friends” B. Maybe, but not for long; I feel incomplete without a “one and only” C. Life doesn’t feel worth living when I’m not in love
3 points for each A answer 2 points for each B answer 1 point for each C answer 8 points: Contentment may feel elusive at the moment — beyond your grasp. But it can be found. You may benefit from talking with a professional or your pastor. Help and encouragement might also be found in grief support groups and other gatherings that offer emotional support. 9-15 points: You experience feelings of contentment, but you know there’s more to be found. Continue to stretch yourself. Reach out to others. And “try on” healthy pursuits outside your comfort zone. Success and achievement breed contentment. You might also find inspiration and a needed jump-start in workshops, classes, and lectures devoted to personal growth and development. 16 points: Good for you — what you have is precious. Being content with yourself opens up all kinds of possibilities. It enables you to feel peace and joy, whether you are alone or with others. It is an invaluable inner springboard on which you can launch all things imaginable! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon. She is also the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” To purchase her book, learn about workshops, or invite her to speak call 585-624-7887, e-mail gvoelckers@rochester.rr.com, or visit www.aloneandcontent.com.
s d i K Corner
Almost All U.S. Teens Falling Short on Sleep, Exercise
T
oo little sleep. Not enough exercise. Far too much “screen time.” That is the unhealthy lifestyle of nearly all U.S. high school students, new research finds. The study, of almost 60,000 teenagers nationwide, found that only 5 percent were meeting experts’ recommendations on three critical health habits: sleep; exercise; and time spent gazing at digital media and television. It’s no secret that many teenagers are attached to their cellphones, or stay up late, or spend a lot of time being sedentary. But even researchers were struck by how extensive those issues are among high school students. “Five percent is a really low proportion,” said study leader Gregory Page 10
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Knell, a research fellow at University of Texas School of Public Health, in Dallas. “We were a bit surprised by that.” In general, medical experts say teenagers should get eight to 10 hours of sleep at night, and at least one hour of moderate to vigorous exercise every day. They should also limit their screen time — TV and digital media — to less than two hours per day. The new findings show how few kids manage to meet all three recommendations, Knell said. It’s easy to see how sleep, exercise and screen time are intertwined, he pointed out. “Here’s one example: If kids are viewing a screen at night — staring at that blue light — that may affect
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
their ability to sleep,” Knell said. “And if you’re not getting enough sleep at night, you’re going to be more tired during the day,” he added, “and you’re not going to be as physically active.” The report was published online Feb.4 in the journal JAMA Pediatrics. Ariella Silver is an assistant professor of pediatrics and adolescent medicine at Icahn School of Medicine at Mount Sinai in New York City. She offered some advice for parents: • Instead of telling kids to “get off the phone,” steer them toward alternatives, like extracurricular activities, community programs or family time. “Their screen time will go down by default,” she noted. • Be a good role model. Get off
your phone and demonstrate healthy habits, including spending time being physically active with your kids. • Talk to teenagers about the importance of healthy habits. “Ask them, ‘How do you feel when you don’t get enough sleep?’” Silver suggested. “Ask, ‘How do you feel when you don’t get outside in the sun and get some exercise?’” It’s important, she said, that kids notice how their bodies feel when they do or don’t engage in healthy habits. • Set some clear rules around screen time, such as no devices in the two hours before bedtime. “Make sure your kids realize these devices are a privilege, and not a necessity to living,” Silver said.
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A Quarter of Antibiotics Prescribed Unnecessary
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By Deborah Jeanne Sergeant
T
he Centers for Disease Control and Prevention states that 25 percent of antibiotic prescriptions aren’t necessary. But it’s more than simply wasting medication for a case where it cannot help. Over-prescribing antibiotics contributes to a major health issue: antibiotic resistance. “It’s a never-ending battle between bacteria and fungi,” said physician Phillip Gioia, with Children’s Health Specialists in Auburn. “When we use antibiotics, it creates resistance. Part of it is humans are using more and more of them. Part of it is medical. They’re not working like they’re used to.” He added that countries where antibiotics are available without a prescription experience many more bacterial infections that resist antibiotics. “If every time you have a sniffle you get an antibiotic, it’s not a good thing,” Gioia said. “There’s a greater chance you’ll have resistance.” Overuse can cause both individual resistance, when a particular person discovers antibiotics don’t work as well as they used to, and universal resistance, when bacteria mutate to the point where no antibiotics can treat them, regardless of a person’s history of taking antibiotics. Dubbed “super bugs,” these more aggressive bacteria are tough to kill. As one example, Mark McSwain, pediatrician and internal medicine doctor with Auburn Internal Medicine & Pediatrics, said that in Auburn, about 30 percent of ear infection cases are resistant to the antibiotics the office regularly uses. “Antibiotics are being overused, used to treat viral symptoms and people aren’t completing the course of the antibiotic when it is needed,” McSwain said. “You don’t kill that infection but expose it to the antibiotic.” Some people like to save antibiotics they don’t use in case they’re sick later and want an antibiotic, but McSwain said that often leads to people taking an antibiotic when they don’t need it or taking the wrong antibiotic. This practice also contributes to super bugs. Because antibiotics kill both good bacteria and bad, patients are more susceptible to yeast infections, diarrhea and stomach upset. The natural flora of the gut and, in women, vagina, are negatively affected. Their use can disrupt the gut flora for months. “The antibiotics attack not only the bad bacteria but will attack the good bacterial we carry in our bodies that protect us from serious illness,” said physician Jana Shaw, associate
professor of pediatrics at Upstate Golisano Children’s Hospital and epidemiologist at pediatric infectious diseases at SUNY Upstate Medical University. “They can cause severe colitis and fevers that can be extremely difficult to treat.” So why are doctors prescribing antibiotics to patients who don’t need them? Undue patient pressure on physicians represents one reason, according to Shaw. Pediatricians often face upset parents who want something they think will help their sick, crying children. “Parents often demand antibiotics for their children because they feel their children are sick enough and antibiotics are warranted,” Shaw said. “They often don’t understand the difference between viral and bacterial illnesses. They believe the antibiotics will make their child feel better.” To appease parents, some providers routinely prescribe antibiotics for illnesses such as ear infections; however, an increasing number of providers are becoming more stringent in when they’ll prescribe the medication. The requirement of electronic medical records may also influence prescribing. They tend to focus on patient satisfaction, as does media feedback. Shaw said that reducing unnecessary prescription relies upon education. Antibiotics cannot help viral infections. Anti-viral drugs can help for rare, serious viral illnesses for people prone to complications, but are not prescribed for routine cases. For those, Gioia suggests watchful waiting. Vital signs such as breathing problems obviously indicate an emergency, but otherwise, parents should monitor temperature to ensure it’s not higher than 100. Goioa recommended using salt water nose drops and humidifiers to help clear congestion from the nose of small babies. “They’re nose breathers, so congestion in the nose can put them in the hospital,” he said. For symptoms like sore throat, try cool foods like applesauce, soup, clear liquids and juice. Shaw recommends warm liquids like tea with honey to treat colds. Children under 1 year old should not have honey. “Give them chicken soup and have them rest,” Shaw said. “There’s really not much more you can do in terms of targeting the virus. You have to help your body get through it.
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My Turn
By Eva Briggs
Shingles: New Drug Helps Prevent Its Occurence Those who had chickenpox more prone to the condition
C
hickenpox. Where did that name come from? The prevailing theory is that the individual spots resemble garbanzo beans, a.k.a. chickpeas. There’s been a vaccine available to prevent chickenpox since 1995. If you are 55-plus, there’s a good chance — almost 100 percent — that you had chickenpox long ago, probably during childhood. Even though chickenpox goes away within a week or two, the varicella-zoster virus that causes it hangs around indefinitely. It lies dormant inside clusters of nerve cells called neurosensory ganglia. They’re involved in detecting pain and are located in the spine or in the nerves of the face and head. Like Sleeping Beauty, this virus remains in suspended animation for years. Even without the kiss of a handsome prince, the virus sometimes wakes up. When it does wake up, it travels from its bed in the nerve ganglia, down the adjacent nerves, and to the skin or other structures normally served by that nerve. There it replicates itself, forming new virus particles that erupt in a painful rash called
herpes zoster — or shingles. What stimulates this awakening? Scientists don’t know for sure. It appears to be related to declining cellular immunity. That’s the defense against infection carried out by cells, rather than by circulating antibodies. Shingles certainly occurs more frequently as people age and their cellular immunity naturally declines. It’s also more common in people whose immune systems are compromised by infections like HIV or by chemotherapy drugs. Do other factors contribute to shingles outbreaks? Stress, perhaps? Probably, but doctors don’t know for sure. I seldom know why a particular patient experiences a shingles outbreak at a particular time. Shingles often starts with a prodrome, a cluster of symptoms that precedes the rash. Patients may have fever, headache and a general feeling of illness called malaise. Next comes pain, on one side of the body, localized to the area served by the affected nerve. People often describe the pain as burning, sometimes with itching. The area can be hypersensitivite to touch. It may be so severe that
it disrupts sleep. In the right location it can mimic a kidney stone or heart attack. Within a few days most people develop the typical shingles rash. Like chickenpox, the individual lesions start as red bumps called papules. These quickly turn into small blisters filled with clear fluid, termed vesicles. The vesicles progress to pustules when the fluid turns cloudy. Finally, the pustules break open and crust over. The entire rash is almost always localized to a single dermatome, the skin area served by the ganglion that initiated the outbreak. Shingles lesions contain live varicella-zoster virus, which can be transmitted to people who have never had chickenpox. When that happens, the susceptible patient comes down with chickenpox, not shingles. Shingles only occurs in a person previously infected by the virus, when that patient’s own personal store of virus is reactivated. Shingles is much less likely to spread chickenpox than chickenpox disease itself. There are far fewer virus particles in the blood and secretions of a shingles patient than a chickenpox patient. Still, as many as 15 percent of exposed susceptible people contract chickenpox when exposed to a shingles patient. So anyone with shingles must avoid people who have never had chickenpox, never received the chickenpox vaccine or who have a weakened immune system. When diagnosed early, antiviral medicines (acyclovir, valacyclovir and famciclovir) shorten the course of the disease and reduce the risk of complications. The most common complication is postherpetic neuralgia, pain that lingers at the site of the outbreak long after the rash resolves. This can
be very severe, but may respond to a variety of medicines. One dangerous complication is damage to the eye. This can happen when shingles affects the nerves that go to eye structures. This may permanently damage the eye. Anyone with shingles that affects the area near the eye or causes eye symptoms needs to see an ophthalmologist. Zostavax, the first shingles vaccine, was licensed in 2006 to prevent shingles in people aged 60 and older. It was billed as cutting the risk of shingles by about half, and lowering the risk of post herpetic neuralgia by two thirds. But there’s a new kid on the block, Shingrix, as of October 2017. What’s good about it? It lowers the risk of both shingles and postherpetic neuralgia by about 90 percent. So it’s much more effective than Zostavax. Shingrix does not contain any live virus. And it can be given at age 50; the recommended age for Zostavax is 60. That’s good news since the risk of shingles starts rising by then. The downside is that two doses are needed. And because it stimulates a more robust immune reaction, there are more side effects. Your arm is more likely to become red, swollen and sore. Many people get headaches, fatigue and achiness that may last a few days – severe enough to interfere with usual activities in 10 percent of patients. But it still beats contracting shingles. 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 • March 2019
Full Circle for Greg Conners, M.D. Rochester native moves to CNY to work as administrator at Upstate Golisano Children’s Hospital By Mary Beth Roach
T
he Upstate Golisano Children’s Hospital in Syracuse recently welcomed a new administrator. Physician Gregory P. Conners is now chairman of the department of pediatrics at Upstate Medical University and serves as executive director of Upstate Golisano Children’s Hospital. He succeeds Ann Botash, who had been interim chairwoman since last May. Conners had been associate chairman of pediatrics at Children’s Mercy Hospital, University of Missouri-Kansas City School of Medicine, in Kansas City, Mo. During a recent telephone interview, he shared his thoughts on his new position, and as a native of the Rochester area, he discussed what he looks forward to on his move to the Central New York area. As chairman of pediatrics at Golisano, Conners is responsible for a variety of aspects of that program, including the provision of health care for children; the pediatrics residency program; a faculty that numbers several dozen members; and research. The three big missions of an academic children’s hospital are health care, education and research, he said. “Then there’s a fourth that I like to pay attention to, and that’s to be a good partner with the community,” he said. “If I can get those four things done well, I’ll be successful.” He praised the management and administration of the Golisano facility. “I’m starting with something really good and trying to make it even better,” he said. One of the missions he’s been tasked with by Dean Julio Licinio, senior vice president for academic health affairs and dean of Upstate Medical University’s College of Medicine, is to grow the research component of the department of pediatrics. Conners said he wants to recruit someone with solid research leadership to coach and mentor others in that field. In addition, he wants to work with staff to help them realize the “hidden research,” as he calls it, in what they’re already doing. While some may think labs and test tubes when discussing research, Conners looks at it differently. Hospital staff “take good care of patients and they learn how to take care of them in exceptional ways that maybe other folks haven’t figured out,” he explained. “I’ve had experience in helping people who thought they were just clinicians actually develop a more scholarly aspect of their work. I’m glad to be bringing that to Upstate.”
‘Champion of quality’
New York to lead the department of pediatrics and Upstate Golisano Children’s Hospital. “With the appointment of Dr. Conners, we are gaining an outstanding physician-scientist, collaborative leader and champion of quality,” Licinio said. Some of Conners’ accomplishments at Children’s Mercy Hospital occurred while leading a division that grew significantly. Hospital staff attends to 115,000 pediatric emergency visits per year in its Missouri and Kansas emergency departments, as well as educates a wide variety of trainees and conducts substantial research and advocacy. Conners helped create one of the nation’s premier academic pediatric urgent care groups serving nearly 100,000 children annually. He also has held faculty and teaching positions at the University of Rochester and George Washington University. Conners considers his work in helping to grow pediatric urgent care as one of his major achievements at Children’s Mercy Hospital, as well as developing one of the first academic divisions of pediatric urgent care in a children’s hospital. Often urgent care comes under emergency, Conners said, but at Children’s Mercy, staff was able to expand it to the point where it became its own division. Over his nine-plus years there, the number of nurse practitioners between emergency and urgent care has grown from six to 52, enabling them to expand their capabilities. As a native of Pittsford, a suburb of Rochester, and a former
faculty member at the University of Rochester for 15 years, Conners looks forward to returning to the area, where he still has a lot of family. He and his wife Jan have a daughter, Libby, who lives in Rochester, and triplets, Margaret, Jackson and Luke, who are all in college. His parents and two brothers still live in this region. Winter weather, however, did not draw him back home. He said while he didn’t come for the snow and ice, he especially enjoys the summer and autumns here.
Accomplished author Conners has been a member of the editorial boards of three peer-reviewed, professional journals. He has authored or co-authored about 100 papers, as well as 17 book chapters and a peer-reviewed book. Conners earned his bachelor’s degree at Amherst College in Massachusetts (1983) and his medical degree from SUNY Stony Brook (1989). He also holds a Master of Public Health degree (1998) and a Master of Business Administration degree (2003), from the University of Rochester. He did his residency in pediatrics and a fellowship in pediatric emergency medicine at Children’s National Medical Center, Washington, D.C. His numerous honors and awards, include the 2013 SUNY Stony Brook School of Medicine’s distinguished alumnus award. He also has appeared on numerous “best doctors” lists, including America’s Top Pediatricians by the Consumers’ Research Council of America.
Physician Gregory P. Conners is now chairman of the department of pediatrics at Upstate Medical University and serves as executive director of Upstate Golisano Children’s Hospital.
Licinio said he was pleased Conners will be returning to Upstate March 2019 •
Insulin Price More Than Doubles in U.S.
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ome Americans with Type 1 diabetes have cut back on their insulin usage as the cost of the lifesaving drug nearly doubled over a five-year period. The annual amount that people with Type 1 diabetes spent on the drug rose from about $2,900 in 2012 to about $5,700 in 2016, according to a new analysis from the nonprofit Health Care Cost Institute (HCCI), CBS News reported. Those are gross amounts and don’t factor in the use of rebates or coupons, which can reduce costs for some people. The cost of living rose 6.5 percent between 2012 and 2016. A study published last year found that more than one-quarter of people with diabetes said they reduced their use of insulin due to the rising cost. Doctors warn against cutting back on insulin usage, CBS News reported. “There has been a flurry of news reports sharing stories of individuals with diabetes rationing their insulin because they cannot afford higher and higher prices,” according to HCCI.
MS Drug Costs Skyrocket After Medicare Rule
M
edicare rule changes could trigger a spike in out-of-pocket drug costs for patients with multiple sclerosis (MS). Due to rules that restrict access and require patients to cover more of the cost, those without low-income subsidies can expect to spend almost $6,900 a year out of pocket for MS medicines, researchers reported. “It’s a dysfunctional market that lacks the typical incentives for most other consumer products,” said lead author Daniel Hartung. “Aside from the public optics, there are few incentives for companies not to raise prices. Most intermediaries in the drug distribution channel, including drug companies, benefit from higher prices.” MS is an unpredictable disease of the central nervous system, resulting in symptoms that include vision problems, muscle weakness, tremors and difficulty with balance and coordination. Out-of-pocket drug costs are often tied to undiscounted list prices, and there appears to be a link between rising prices for MS drugs and more use of restrictive policies by Medicare drug plans, according to the researchers. For example, they found that patients who are prescribed the only generic drug in one class — glatiramer acetate — will pay more out of pocket than patients using any brand-name drugs in the same class. Medicare rule changes last year were meant to reduce patients’ out-of-pocket costs through increased discounts from brand-name drug manufacturers.
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Getting the Lead Out Region mobilizes to continue fight against lead poisoning in children By Mary Beth Roach
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he region’s battle against lead poisoning among children is a public health success story, according to physician Howard Weinberger, medical director of the Central/Eastern New York State Regional Lead Poisoning Research Center. But it’s a story that’s not done, he added. More chapters to the story are being added all the time, as government and local agencies continue to make progress in the battle and improve efforts at eradicating the problem. Children in Onondaga County with elevated blood lead levels over the Centers for Disease Control reference value of 5 have been on the decrease, said Debra Lewis, lead program coordinator for Onondaga County. According to the Onondaga County Health Department’s annual report, data shows 11.1 percent of the children tested in 2017 had lead poisoning, compared to 17.1 percent in 2012. The needle has shifted in the eight years that Lewis has headed the agency. At the time, she said, most of the agency’s focus was on those children at the highest levels. But today, there is a greater concentration on forming partnerships between gov-
ernment and community agencies to attack the issue. “Now that time has gone on, the intent and purpose are being fulfilled, and we’re making really great strides and making sure we have the right people around the table, having the right conversations, and figuring out how to continue to add more building blocks to this process to keep homes safe for children,” Lewis explained. Weinberger, who has been involved in lead poisoning prevention work for 50 years, provided some perspective to show the progress that has been made over the last five decades. “When I first started, it was a mystery,” he said. When testing first started in the early 1970s, there were no labs doing it properly, so results were mixed. The state health department then developed a standard test for lead. At this same time, lead was being removed from gasoline, and later in the 1970s, the federal government banned the amount of lead in household paint. At that time, there were a lot of kids with high lead levels. The CDC level established the acceptable level at 40. Over time, those thresholds went from 40 to 5. However, there is no acceptable
level, Weinberger said.
On housing front The biggest challenge can be found in Syracuse’s relatively old and deteriorating housing stock. Weinberger estimated that 90 percent of Syracuse’s homes were built prior to 1980. The federal government banned lead in household paint in 1978. In so many of these older homes that are not well maintained, the paint is now chipping away, and it’s sweet tasting. The more layers of paint, the sweeter it is. This is seductive to infants aged 1 or 2 who are just learning to walk and so often discover their surroundings by putting everything in their mouths. Compounding the housing problem are the landlords who do not maintain their properties. Since many do not live in this area or are in limited liability companies, it can be difficult to determine who the responsible party is, Lewis explained. But partnerships between various government entities are on the increase, Lewis said, better enabling them to deal with compliance. “We’re all communicating about the same properties, and we’re all working together to try to hold land-
Doctor Urges Testing Children, Home Testing for leading poisoning is critical since in most cases the child who has been exposed to lead actually does not exhibit any symptoms, according to physician Howard Weinberger, medical director of the Central/Eastern New York State Regional Lead Poisoning Research Center. “This is why it is so important to do the recommended blood lead testing of all children at 1 and 2 years of age, the age of the highest risk for exposure,” Weinberger said. Blood lead testing at this young age will identify lead exposure early, identify the source of the exposure and prevent continued exposure. This is why testing housing for the presence of lead should be done before children are exposed Page 14
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to it, he said. To medically manage treatment, Weinberger outlined three steps. The first step would be to identify and remove the source of the lead exposure. He said the county health department, with its team of public health nurses and environmentalists, can identify sources during home visits and provide education and assistance to those families of affected children. Secondly, tests for iron deficiency and anemia need to be done. These conditions, Weinberger said, often coexist in children who are exposed to lead associated with poverty. The use of medication to reduce elevated blood lead, known as chelation therapy, is generally limited to those whose blood lead level is over 45 mcg/dL and requires hospitaliza-
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
tion and treatment for at least five days, Weinberger said. In cases where the blood lead level is lower than that 45mcg/dL threshold, each patient may need frequent blood tests to ensure the lead level comes down to acceptable levels. “Consequences of lead exposure depend on many factors including the length and severity of exposure,” Weinberger noted. It has been associated with learning difficulties in school, including effects on IQ level, behavioral issues, such as hyperactivity disorders and violent behavior in adolescents and young adults. “In any individual child it is not easy to demonstrate a causeand-effect relationship of a particular blood level with any of these problems,” he emphasized.
lords responsible and accountable for maintaining the properties in a safe and healthy condition,” she noted. “The city and county meet regularly to discuss properties that have both code and health violations and determine what the next step is — whether to offer the property owner some assistance with making the repairs, and if the property owner is non-compliant or not interested in receiving assistance, then finding a way to compel compliance through legal means,” Lewis said. Furthermore, the health department has an agreement with the county’s Department of Social Services that works through the city’s code enforcement database. If property owners who receive rent payments through Section 8 or Social Services rental assistance are notified that there are problems with those properties and they don’t correct the hazards within a timeline established by the county, the county can generate a rent-hold request, Lewis said. Adding some muscle to addressing the housing dilemma, the Central New York Community Foundation announced last fall that it would pledge $2 million over four years to combat the issue. The first round of funding allocated more than $439,750 to the Greater Syracuse Land Bank; Home Headquarters; Housing Visions Unlimited; PEACE, Inc. and Tomorrow’s Neighborhoods Today. The focus is on new housing, renovation of existing housing, education and awareness, landlord education, and serving as an advocate for public policy and legislation. “It affects our neighborhoods and quality of life in the city. This really motivated us to go deep in this one particular issue,” according to Peter Dunn, president and CEO of the Central New York Community Foundation.
The testing process Testing for infants aged 1 and 2 are state-mandated, but not all doctors comply. No county in the state has 100 percent testing, Weinberger said, pointing out some barriers to full compliance. Because their patients live in suburban areas with newer leadfree housing, some doctors are not as concerned. They forget, however, that their young patients might be visiting areas where they could be exposed. Also, people living in rural areas might not have the means to travel to a community to get tested, and there is no penalty for non-compliance. Lewis also noted providers who are not necessarily pediatric providers need to be engaged and make sure all children in their care are tested. There are no penalties for non-compliance. Key is primary prevention, and while housing and replacing windows and doors with lead-free materials is on the top of that list, there are other measures that can be done. “I think it’s important for people to understand that a lot of childhood lead poisoning prevention is in their hands. People can take very simple steps in their home to keep their family and themselves safe, even if the health department has done an inspection and found hazards,” Lewis said. Cleaning practices at home
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Lead Poisoning Down According to data, 11.1 percent of the Onondaga County children tested in 2017 had lead poisoning, compared to 17.1 percent in 2012. include: — With wipes that are wet and disposable, clean the surfaces that family members come in contact with. — Wash children’s hands and toys, and before they eat, wipe their faces. — Remove shoes before entering the house to avoid tracking in lead dust. — Wipe down surfaces, especially horizontal ones, regularly and consistently. Good nutrition and a balanced diet are helpful as a preventive measure, both Weinberger and Lewis stated. “Full bellies don’t absorb lead as readily. Healthy children who eat a nutritionally balanced diet and eat frequent small meals throughout the day do not absorb lead as readily,” Lewis noted. Calcium will interact and prevent lead absorption, and those children who might be anemic can be more susceptible to lead poisoning than those children who are not, Weinberger added. There is more of an emphasis on prenatal testing, particularly those who are at risk, are low-income patients and new Americans, Weinberger said. The refugee population entering the country comes from many different areas of the world where lead is used in different ways. The standard is that every child under the age of 16 who comes into this country should have a lead test prior to their arrival and then 3 to 6 months later. Literature provided by the county health department points out that spices and some herbal and Ayurvedic medicines, imported from the Middle East, Latin America, India and China, can contain lead, and cosmetics can also contain lead, with one example being kohl, also known as surma or kajal. One positive note in all this is the region’s water is good, Weinberger said. “Our water is alkaline. Acid water will absorb lead from the pipes much more than alkaline, so we’re very fortunate,” he noted.
Keto Diet, ALS Top
Searches
By Angela Underwood
G
oogle it —and Google we did. On the eve of 2019, CNN reported that “Dr. Google” spat out more information on health-related questions regarding a fad diet and ALS more than any other ailment in 2018. Along with other health concerns — including endometriosis, the flu, how long marijuana stays in the system, implantation bleeding, heartburn and high blood pressure — the ketogenic diet and ALS were the top two health-related searches. Keto, the high-fat low-carb diet, may be proven to shed weight, but it is not a way of life, according to nutritionist Lisa Drayer. “It doesn’t teach you how to acquire healthy eating habits,” Drayer said. “It’s good for a quick fix, but most people I know can hardly give up pasta and bread, let alone beans and fruit,” she said. Whether or not the death of world-renowned physicist Stephen Hawking in March 2018 death contributed to the spike in searches
about ALS — also called Lou Gehrig’s Disease — is unknown, just like ALS itself, of which “little is known about the causes of the disease, and there is no cure,” reported CNN. Lupus topped the list in 2017 as the top searched disease, along with mental illness, both of which have a direct link to singer Selena Gomez. As the producer of “13 Reasons Why,” a Netflix series dealing with mental health and suicide and as a lupus sufferer herself, Gomez brought her creative direction and health concerns to masses, especially since the Netflix series reportedly sparked an interest in suicide ideology. Unlike the last year, opioid addiction did not dominate the search engine questions as it did in 2017 after it was declared a national public health emergency by President Donald Trump. However, three health related questions that did remain the same in 2017 and 2018 concerned the flu, blood pressure and lethargy. Speaking of the flu, Marie
Nonprofits Urged to Apply for $100,000 in Grants Offered by Excellus BCBS Deadline for applications is March 5
N
onprofit organizations in Upstate New York can apply for Excellus BlueCross BlueShield Community Health Award grants that add up to a total of $100,000, which the company is offering to help fund health and wellness programs in Upstate New York. Nonprofit, 501(c)(3) organizations in Excellus BlueCross BlueShield’s 31-county Upstate New York region are invited to apply for an award of up to $4,000 each. The award can be used for programs that have clear goals to improve the health or health care of a specific population. Programs that improve the health status of the community, reduce the incidence of specific diseases, promote health education and further overall wellness will be considered.
The deadline to submit an application to be considered for an Excellus BlueCross BlueShield Community Health Award is Tuesday, March 5. For additional information and the online application, go to www. excellusbcbs.com/wps/portal/xl/ news/company-information/corporate-giving. Award winners will be announced in the spring. “The company’s Community Health Awards demonstrate a corporate commitment to support local organizations that share our mission as a nonprofit health plan,” said Jim Reed, regional president, Excellus BlueCross BlueShield. “These awards complement our existing grants and sponsorships with agencies that work to enhance quality of life, including health status, in Upstate New York.”
Claire magazine points out that Googling the illness can literally leave you feeling worse than when you clicked search. “We’ve all typed in flu symptoms only to have the internet suggest that it’s anything from pregnancy to ebola,” reports the magazine. “Which, unsurprisingly, leaves you feeling anxious, upset and confused.” The reason why “a whopping 1 in 4 people,” Google their illnesses, according to Marie Claire Magazine, is because of doctor availability and work schedule conflicts; however, that is still no excuse for not “being seen by a trained professional, rather than, well y’know, your own imagination and a bunch of random web searches.” Only time will tell what Dr. Google who tracks health-related questions annually from January to mid-December will report the top 2019 health concerns are, so until then, maybe go to the doctor rather than the search engine for the answer to what ails you.
Earlier this year, seven Central New York organizations received Excellus BlueCross BlueShield Community Health Awards from last fall, when close to 30 applications were submitted by organizations in the five-county Central New York region. The winning organizations were Cayuga Centers and Cayuga Community Health Network, both in Auburn; Food Bank of Central New York, Helio Health, REACH CNY and the Rescue Mission, all in Syracuse; and the Retired and Senior Volunteer Program, Oswego. Excellus BlueCross BlueShield divides its 31-county Upstate New York operating area into four regions: the Central New York region, which includes Cayuga, Cortland, Onondaga, Oswego and Tompkins counties; the Central New York Southern Tier region, including Broome, Chemung, Chenango, Tioga, Schuyler and Steuben counties; the Rochester region, encompassing Livingston, Monroe, Ontario, Seneca, Wayne and Yates counties; and the Utica region, comprising Clinton, Delaware, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Otsego and St. Lawrence counties.
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through an easy-to-use database that offers nutrition information for over 5 million different foods,” according to Men’s Health magazine. Available on Android and Apple, MyFitnessPal is like having your best friend nudge you to go to the gym or put down that candy bar when bikini season is right around the corner. “There are about 5 million foods in their database to choose from so you’re not just typing in ‘chicken’ — which means you can determine how many calories you’re actually taking in and burning off,” reports in article in Marie Claire magazine. The app costs $9.99 monthly or $49.99 for the year.
Fooducate
5
of the Hottest Health Apps
By Angela Underwood
I
n a day and age when “there’s an app for that,” there is no excuse not to be fit and healthy. That is why it is important to point out the five of the hottest health apps to start using. So that if you used the excuse that there were too many apps, we’ll try to narrow it down for you.
MyFitnessPal
It’s as simple as it sounds. It’s a fitness friend in the form of an app. It’s ranked as the No. 1 health and fitness app on iTunes, reports Men’s Health of the Under Armour-sponsored service. “This app pushes users to keep tabs on their diet programs
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
Calories, fat grams, carbohydrates and protein are key items to track when maintaining a healthy lifestyle but standing in the grocery store aisle adding and subtracting said numbers on the side of packages just doesn’t cut it anymore. That is where Fooducate comes in. Simply type in the product of your picking and moments later you will know what the best brand is to buy. “As the app’s name suggests, its goal is to teach you about the products you buy at the grocery store,” reports Men’s Health. And the advice is free, unless you want the ad-free version or allergy-related health advice. In that case, it will respectively cost $3.99 or 4.99 monthly.
Couch to 5K
Don’t let the app’s title intimidate you. No one says you have to run a 5K, but this app will set you up for success if you so choose. “It only
requires sweating for 30 minutes per day, three days a week for nine weeks,” according to Marie Claire. magazine. Breaking down each day with a personal avatar trainer, users can track their time and distance during their warm up, jog and walk or cool down. The app is free at first, but after a couple of runs, it costs $4.99 to continue the service.
Charity Miles
The app works like it reads. Sponsors like Johnson & Johnson, Chobani, and Humanity donate a few cents for every mile you move biking, running or even walking to charities, according to Marie Claire magazine. Needless to say, when you are not in the mood to work out, this app helps the hungry, homeless, veterans or other nonprofits. So, if you don’t want to work out for yourself, do it for someone else at no cost a month. Now that’s charity.
Headspace
Can’t sleep, stressed out or just out of the groove? Then the app Headspace will put you right back where you need to be. The initial free 10-day program promotes mindfulness, proven to ramp up work productivity. And be warned, it really works. “Look out for improved mental acuity, patience, productivity and sleep with daily use,” according to New Jersey-based physician Chirag Shah, quoted in Men’s Health magazine. After the free 10-day trial, Headspace costs anywhere from $7.99 to $19.99 monthly depending on the level of meditation you choose to access.
SmartBites
The skinny on healthy eating
Whole-grain Millet: Good for Hearts (and More!)
F
luffy like couscous or creamy like polenta, millet has many things going for it: it’s gluten-free (appealing for those trying to avoid gluten), a good source of protein, and loaded with health benefits. So why aren’t we consuming more millet on a regular basis? Especially when it’s so versatile, inexpensive, and easy to prepare? One word: birdseed. Most people equate this delicious whole grain with birdseed, even though the millet for human consumption differs from what our feathered friends eat. Like other whole grains that retain all parts of the seed (bran, germ and endosperm), millet helps protect the heart and it does so in more ways than one. Millet’s fiber helps prevent heart disease by lowering both blood pressure and bad cholesterol. Hearts also benefit from millet’s rich supply of magnesium, an essential mineral for maintaining a steady heartbeat and normal blood pressure. And because millet is relatively low in calories (only 200 per cooked cup), this satisfying grain helps hearts by assisting us with weight loss and
maintenance. Extra pounds, as many know, put significant strain on your heart and worsen several heart-disease risk factors. Millet may reduce your risk of developing Type 2 diabetes, thanks to its healthy concentration of two minerals that regulate blood sugar: magnesium and manganese. According to the Centers for Disease Control, nearly 10 percent of the U.S. population has diabetes, and the majority have Type 2. Studies have shown that low blood levels of both minerals can increase insulin resistance, which leads to diabetes. Of course, millet’s overall nutritional profile — high in filling fiber; low in fat, sugar and salt — is just as important in keeping diabetes at bay. One cup of cooked millet serves up six grams of protein, an important building block of bones, muscles, cartilage, skin and blood. You also use protein to make enzymes, hormones and other body chemicals. Millet, however, is not a complete protein because it lacks the amino acid lysine. The addition of lysine-rich beans to any millet dish easily creates a complete protein.
Lemony Millet Salad with Fresh Asparagus, Mini Peppers and Black Beans 3/4 cup millet 1 1/2 cups water 1/2 bunch asparagus 8 mini peppers 1 can black beans, rinsed and drained 3 tablespoons olive oil juice and zest from 1 lemon 1 large garlic clove, minced salt and pepper to taste 1 cup flat-leaf parsley, rinsed, dried and roughly chopped 1/2 cup slivered almonds, toasted Combine millet with water in a medium saucepan. Bring to a boil, reduce to a simmer, cover, and cook until water is absorbed (about 20 minutes). Remove from heat and let it sit, covered, for 10 minutes, before fluffing it with a fork. While millet is cooking, cut the asparagus, including the tips, into
March 2019 •
thin slices, crosswise, and place in a medium bowl. To prep the mini peppers, cut off the end, cut out the seeds, and then slice the peppers into rings, about 1/8-inch thick. Add black beans, millet and chopped parsley to vegetables; lightly toss. Make the dressing by whisking together olive oil, lemon juice and zest, minced garlic, and salt and pepper. Drizzle over millet mixture, mix well, adjust seasonings, and top with toasted almonds.
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.
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Where Marijuana Is Legal, Many Teens Drive While High
I
n states where marijuana is legal, teens smoking pot and then getting behind the wheel of a car is common, a new study finds. “There’s a general public zeitgeist that marijuana is a pretty safe drug,” said study co-author Darin Erickson, an associate professor at the University of Minnesota’s School of Public Health. “In actuality, there hasn’t been a lot of research regarding how marijuana is used, its safety or its harms,” he added in a university news release. For the study, Erickson and his team surveyed 50 local enforcement agencies in the states of Colorado and Washington in 2016 and 2017 to find out if underage marijuana use (under 21) and marijuana-impaired driving are problems in their cities. In addition, the researchers asked about the types of enforcement used to tackle those problems, and the resources available to do so. All of the agencies said that underage use is somewhat or very common, and most said that marijuana-impaired driving is somewhat or very common. Thirty percent said they conducted enforcement targeting underage use or possession or marijuana, and 20 percent said they conducted underage compliance checks at licensed stores, with a higher rate in Colorado (32 percent) than Washington (8 percent), the findings showed. One local enforcement agency in each state specifically targeted marijuana-impaired driving, according to the study published recently in the International Journal of Drug Policy. “In general, we found that enforcement is not a high priority for most places,” Erickson noted. “That said, we know enforcement strategies work to curb illegal substance use. Enforcing alcohol laws reduces underage drinking and related problems – and it could be used to improve the situation with marijuana,” Erickson said. Solutions recommended by Erickson include states using tax money from retail marijuana sales to fund policy enforcement programs. Other suggestions include conducting further research to develop roadside tests for marijuana-impaired driving, as well as studies to learn how people typically use marijuana, such as in conjunction with alcohol. Page 18
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
EDITOR@ CNYHEALTH.COM
Things to Ask When Checking Out Chiropractors such as ‘Syracuse Chiropractic’ and it will offer a list of names. Following that are reviews, which are very important. The majority are usually good or the chiropractor wouldn’t be in practice. People talk about their complaints anonymously and how they responded to treatment protocols. • “Look at their integrity, longevity. Are they keeping up with new developments in the industry? What seminars do they go to? What is their focus on different parts of their practice? Are they accomplished in nutrition, kinesiology, physiotherapy modalities, cold laser technology and Bemer technology, which uses magnetic energy to increase circulation throughout the body?”
By Deborah Jeanne Sergeant
If you need a chiropractor, keep in mind these questions to ask as you look for a provider. Ed Galvin, chiropractor, Port City Chiropractic, Oswego • “Look for a chiropractor that offers options for care that support the patient’s health goals. It depends upon what you’re looking for. Lower back, neck and headache is what a lot of people look for, but there are a lot of specialties, depending upon what a patient needs. • “Look for someone who can offer instruction on prevention, with exercises for strengthening and posture. Adjustment is a primary focus but also education to prevent problems. • “What can the doctor offer as far as nutrition advice? Some do and some don’t. • “Look for someone who will work as a team player and coordinate
with your other health care providers. • “Look for an office that also has a friendly, caring and well qualified staff that assists the doctor. • “The majority of people look at Google reviews. • “Personal referrals from friends and family of the patient are 95 to 98 percent of my business.”
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Vincent Sportelli, chiropractor, Sportelli Chiropractic Health & Wellness Center, Syracuse
• “A lot of people are unfamiliar with the different techniques. There are manual and mechanical. The manual is hands-on and the mechanical involves equipment for adjustment and spinal treatment. That’s important. • “Look into their level of education. Most chiropractors have a website that explains their education and the services they offer and background, the staff, their protocols, fees and things of that nature. That’s the best place to look. • “Google the specific category
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Richard Tesoriero, chiropractor, Tesoriero Chiropractic Office PC, Oswego • “You want someone who provides evidence-based care. • “Obviously, the person should be licensed in the state of New York and have a good reputation. • “They should be willing to adjust the course of treatment. If you’re a family practice doctor and you prescribe a medication, and you don’t see the results you want, you change the course of treatment. The same holds true for a chiropractor.”
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5
Things You Should Know to Prevent Colon Cancer
By Ernst Lamothe Jr.
T
he numbers are scary. For those who are diagnosed with late stage colon cancer, the fiveyear survival rate is an abysmal 12 percent, according to the American Cancer Society. Colorectal cancer can start in the colon or in the rectum and begins as growths in the inner lining. The growths — called polyps — can change into cancer over time, although not all polyps become cancer. This year alone, more than 145,000 new colon and rectal cancer cases are expected to be detected and more than 51,020 people will die from the disease. That figure takes on even more weight considering what medical experts have been telling patients for decades — colorectal cancer is highly preventable. “With early screening programs, precancerous growth in the colon can be detected and removed,” said Borys Buniak, gastroenterologist at St. Joseph’s Health. Buniak offers five pieces of information people need to know about colon cancer.
1.
Family history is important
There is no way to know for certain if you will develop colon or rectal cancer, but there is a variety of factors that may increase your risk for these cancers. One is age — the risk of cancer of the colon and rectum increases with age. You are at a higher risk if you are over the age of 50, for example. Having a close family member (parents, brothers, sisters, or children) with colon and rectum cancer history is another risk. Understanding the importance of early screening, the American Cancer
Society and the American College of Gastroenterology recommend beginning screening for colon cancer at the age of 45. “If there is a strong family history of colon cancer, screening should start even earlier,” said Buniak.
2.Different types of screenings
Screening tests can detect colon and rectal cancer at its earliest, most treatable stage. A colonoscopy looks for precancerous growths or polyps by placing a thin tubular camera into the rectum and passing it through three to four feet of colon. The procedure is usually performed under anesthesia and typically takes 10 to 15 minutes to complete. It is important to consult your doctor if you experience a change in bowel habits — such as diarrhea or constipation — or have a feeling that your bowel is not emptying completely or there is a narrowing of the stool. Other feelings include an enlarged abdomen, weight loss for no known reason, nausea or feeling of bloating. The five-year survival rate for colon cancer found at the early stage is 90 percent, according to the Colon Cancer Alliance. Once a person reaches 50 years of age, most routine, preventable screening colonoscopies are covered with no co-pay under the Patient Protection and Affordable Care. “Screening may involve something as simple as submitting a yearly stool specimen at your doctor’s office,”said Buniak. “Colonoscopy, virtual colonoscopy and barium enema examines the colon directly. Recently, a more sensitive screening tool
was introduced, called Cologuard. For this test, your doctor will order a container delivered to the privacy of your home where a stool sample is submitted and mailed back to the company for genetic testing. They will alert you if you are high risk of having a polyp or cancer. This test could be repeated every three years.”
3.Trends are going down
The death rate from colorectal cancer has been dropping in both men and women for several decades. In addition, treatment for colorectal cancer has improved over the last few decades. As a result, there are now more than one million survivors of colorectal cancer in the United States. “The death rate from colon cancer has declined from 54.5 per 100,000 individuals in 2000 to 38.6 per 100,000 in 2014, thanks to early detection and screening,” said Buniak. Although the overall death rate has continued to drop, deaths from colorectal cancer among people younger than age 55 have increased 1 percent to 2 percent per year from 2007 and 2016, according to the American Cancer Society. It’s expected to cause about 51,020 deaths during 2019.
colon cancer is not 4.Early cancer
A colon polyp is a small clump of cells that forms on the lining of the colon. Most colon polyps are harmless. But over time, some colon polyps can develop into colon cancer, which is often fatal when found in its
Stress Urinary Incontinence: A Patient’s Perspective By Natasha Ginzburg, M.D.
M
any women live and suffer with stress urinary incontinence on a daily basis. Stress urinary incontinence — or SUI — involves loss of urine with activities. For some women, SUI can be a minor nuisance with sneezing or coughing; for others, it can have a significant effect on their lifestyle and quality of life. It can occur with many activities, including exercise, walking, jumping, laughing, etc. There are multiple options for treatment and many women elect to have surgery to deal with the problem. Veronica S. is a patient at Upstate Urology. She describes her problem: “I’ve been dealing with this incontinence for many years. It started just a few years after the birth Page 20
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of my child, and I’m now in my 60s. At first, it was annoying only when I would cough, but not too bothersome. I worked on doing my ‘kegel’ exercises and tried to strengthen my pelvic floor on my own. This worked for many years, but overtime, things got worse and worse. I started to wear a light pad every day. I didn’t want to exercise or go dancing with my husband for fear that I’d have a major accident. The pads got thicker. It was a slow process, but suddenly I realized that I was holding back from doing the things I loved. So I decided it was time to do something about it. “I spoke to my gynecologist. He is a lovely man, and has been my doctor for many years. He offered to help me with surgery, but I was hesitant. I wasn’t sure if I really wanted
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
surgery. Also, although I love my gynecologist, I felt more comfortable with a bladder specialist (a urologist) doing surgery on my bladder. “So I did my research. I actually live about 90 miles from Syracuse, but I learned that Upstate Urology is one of the only groups in the area with multiple urologists who are female and interested in women’s urology issues. One of these urologists is also the only woman urologist in the area who is board-certified in both general and female urology. So I thought, if I have to have surgery, I would want a surgeon who really knows what they’re doing. “My first visit at Upstate Urology was very informative! I learned a lot about incontinence and what could have caused my issue. And I was
Borys Buniak, gastroenterologist at St. Joseph’s Health. later stages. Colon polyps often don’t cause symptoms. “People with early colon cancer or polyps have no symptoms,” said Buniak. “That’s why early screening is so important. In later stages, you may develop blood in the stool, change in bowel habits, anemia or weight loss. Colon cancer, when it’s detected early, is curable”
number of people get 5.Low screened
Only 58 percent of people are screened regularly. “Many decline screening due to embarrassment of the examination or fear of complications like perforation of the colon or bleeding,” said Buniak. “ If a small polyp is found and removed during the colonoscopy, or if there is a family history of colon cancer or polyps, colonoscopies are recommended every five years. If polyps are not found and there is no family history of colon polyps, colonoscopies could be performed every 10 years.” given a number of options for treatment, including specialized physical therapy. But I decided that I’ve been living with this long enough and chose to have surgery. The surgery was easier than I expected — I was back up on my feet the same day and felt back to normal just a few days later. The best part was, I didn’t need pads any more. It felt so liberating. Now, I am so happy I decided to have the surgery. I wish I’d done it 10 years sooner.” -Veronica S. Natasha Ginzburg is a board-certified urologist at Upstate Urology. Her practice focuses primary on female urology. She completed her fellowship in female pelvic medicine and reconstructive surgery at Drexel University College of Medicine in Philadelphia and her general urology residency at Montefiore Medical Center in the Bronx
What’s Behind the Drop in Cancer Rates? Despite dramatically drop, cancer rates are on the rise for certain groups of people. One of the culprits? Obesity By Deborah Jeanne Sergeant
T
he rate of cancer mortality has decreased by about 25 percent for many types of cancer over the past two decades, according to the American Cancer Society. Today, fewer die from lung, breast, prostate and colorectal cancer. Unfortunately, not all types of cancer have experienced a decrease in that timeframe. Physician Leslie Kohman, board chairwoman of the American Cancer Society for Upstate New York and professor of surgery and director of outreach at Upstate Cancer Center, said that the cancer death rate is increasKohman ing for liver cancer, endometrial cancer, brain cancer and head/neck cancers. She said said that socio-economic status plays a role in the disparity of cancer survival rates. “The death rate in the poorest New York county is far greater than in the wealthiest,” she said. “Everyone should have health insurance but they don’t. Not everyone has equal access to transportation. Poverty is a barrier to medical treatment and screening.” To address these issues, her organization takes an approach of bringing greater availability to health care, including mobile mammography vans, community outreach, and community education. “Almost half the cancers can be prevented by what we know now,” Kohman said. One of the biggest pushes from health care providers for the past 20 years has been tobacco cessation, according to physician Jonathan Friedberg, director of Wilmot Cancer Institute and a lymphoma specialist. Friedberg said that tobacco use contributes to “many, many cancers,” including bladder cancer and head and neck cancers. For many years, smoking rates have decreased, which has reduced rates for many types of cancers. Occupational exposure harmful to lungs, such as applying pesticides on farms, handling asbestos in construction and welding, has also decreased, thanks to more safety standards and material regulations. Friedberg points to improved screening as a big factor for detect-
ing cancer earlier and more curable, such as mammograms, in some cases, pre-cancerous lesions, such as colon cancer and cervical cancer screenings. From 1989 to 2015, breast cancer deaths decreased 39 percent from 1989 to 2015 and colorectal cancer went down 52 percent between 1970 and 2015. Friedberg predicts that HPV vaccine should eventually eliminate cervical cancer “for a whole generation” once providers reach complete compliance among patients. Improved screening rates and availability for screening represents a big factor for detecting cancer earlier and more curable, such as mammograms, in some cases, pre-cancerous lesions, such as colon cancer and cervical cancer screenings. The American Cancer Society suggests that obesity-related cancers such as colorectal, pancreas, uterine, kidney, and gallbladder cancers are increasing in people aged 25 to 49 and that the youngest adults, age 25 to 29, are seeing the biggest rise in obesity-related cancers. It’s uncertain whether it’s obesity itself or causes of obesity — such as poor diet, stress and sedentary lifestyle contribute to cancer. Friedberg said that an estimated 15 percent of cancers are related to obesity. “Obesity is a risk for developing cancer, and once you have cancer, treatment is more complicated for those who are obese,” he said. Rachel David, a hematologist and oncologist with Rochester Regional Health, echoed that thought. “These obesity-related cancers are actually increasing in some age groups,” she said. To sum it up, Kohman said that avoiding tobacco, sun exposure and obesity, and minimizing alcohol and red meat, especially cured and processed meat, can greatly reduce cancer incidences. Mothers should breastfeed as long as possible to protect both mom and baby. Discuss screenings with a healthcare provider. Each New York county is part of the Cancer Services Partnership, which covers screening for colorectal, cervical, and breast cancer for those who are uninsured. “Everyone can reduce their own risk of developing cancer,” Kohman said. “The good news is if you develop cancer now, your chance is much better than 25 years ago.”
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Parenting By Melissa Stefanec MelissaStefanec@yahoo.com
Information: Friend or Foe?
P
arents today have access to so much information. Generations before us had to rely on a combination of people, books, magazines and wholesome television or radio shows to get parenting information. Those of us who became parents in the digital age are suffering from information overload. It’s not all bad. A lot of this information is valuable. Some of it is complete garbage. However, even the good information has it downside. Living with so much mental stimuli has some nasty side effects. Today’s parents can be better informed than any generation before us, but we also have more priorities and expectations. Having insights into all the things we should be doing inevitably shines a spotlight on all the things we aren’t doing right. If you read enough articles, listen to enough podcasts and talk to the wrong kinds of people, the information overload and the demands it encompasses can leave you feeling like a total failure. It can make you feel like everyone else has their act together while you alone are fum-
bling. Here’s a little secret: we are all fumbling. When I am lucky enough to find an honest and frank parent, the stories they share with me are so similar to my own. Just like me, they are struggling, giving it their all and in love with their parenting journey. So, to prove that none of us is a perfect parent, I am going to share some solid parenting recommendations that I am in the habit of flouting. I think most of these items help raise happy and healthy kids, but, because of various circumstances, I’m not pulling them off. n Supposed to: Eat family dinners Most nights of the week, my family is not together for dinner. Between me and my husband’s work schedules and other obligations, my family of four often sits down as a family of three. I think a family dinner every night is a great idea, but it’s also not attainable for many people for a variety of factors. I put this recommendation on the nice-to-have list and find special joy in the times everyone is there for dinner, which is
three times a week at best.
ers will learn the same ‘grace.’
n Supposed to: Skip sweets On numerous occasions, I’ve fed my children the following items for breakfast: cookies, pie, cake, doughnuts, chocolate croissants, sugary cereals, ice cream and (god forgive me) whipped mascarpone. My kids are lucky to be in the third percentile for weight and height, so I just want them to eat something, even if that something isn’t the “right” thing. As long as they keep devouring their vegetables, I give them sweets.
n Supposed to: Listen to Disney Radio and Kidz Bop I know kids love kid’s songs. I know they help their development, but I refuse to believe Kidz Bop is the mother goose of the 21st century. Until my kids demand otherwise, I am rocking music I can stand to listen to and, heaven-forbid, enjoy. There will likely come a day when the soundtrack of my life is peppered with songs I want to avoid, but that day is not now. My kids get enough Kidz Bop at school.
n Supposed to: Go a whole day without yelling When I am my best self, I rarely yell. When I am over-extended and over-challenged by work and tantrums, I yell. I know yelling isn’t good. I know it has a lot of negative sides effects. However, there are days when I can’t say, “please put your boots on so we can get to daycare” in a Mary-Poppins tone seven times in a row. I do often apologize when I yell. When I calm down, I find a way to convey my frustration in my normal voice instead of my kraken voice. n Supposed to: Not say anything inappropriate around my kids Once in a while, I say stuff I shouldn’t around my kids. With all of the world events, bad drivers, politics and my unusual sense of humor, inappropriate stuff slips through my lips. My most-frequent offenses come when I am on Bluetooth in someone’s car and don’t know there are children present. When I say something I shouldn’t, I recognize that and self-correct, hoping the wee bystand-
n Supposed to: Fundraise at work All the causes are great, and I should be doing my part for them. The thing is, kids aren’t really allowed to sell door-to-door anymore, so there is an expectation that parents become wrapping-paper pushers at their day jobs. However, I’ve been getting the vibe that bringing in order forms for the latest candles or frozen cookie dough is more and more unwelcomed around the office. Thus, I order stuff myself, give most of it as gifts, and make sure to support other, non-commercial fundraisers throughout the year. This list is hardly all-encompassing, but I hope it makes someone out there feel less alone. There’s a fine line between keeping yourself informed and keeping yourself insecure. I recommend taking each piece of parenting information in moderation. Don’t expect too much of yourself, don’t label yourself as a failure and try to let the information you get be guidance instead of gospel.
A Man’s Journey With Grief By Walt Stein
M
y journey began on May 17, 2005 when my dad died from a stroke that initially left him paralyzed down the left side of his body. In less than a year later my partner was diagnosed with small cell lung cancer. My life at that point was visiting doctors, taking him for treatments, and still looking after my mom. Unfortunately in January 2009 my partner died after the cancer hit the brain. The days after the funeral I felt so alone, not certain what to do. My life had been flipped upside down. I struggled with focusing and wondering how I would move on. The evenings were cold and lonely and I just wanted so badly for someone to remove the pain. In April 2009, three months after to the exact date of his death, I lost my job due to a company consolidation. I remember sitting at my home computer attempting to put together a resume and trying to doing all the necessary steps required for reemployment. But one morning I woke up, got out of bed and stood in the middle of the floor in tears. I had no clue what to do, where to go or how to feel. I was totally numb and frightPage 22
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‘Men are told to be stoic and tough. We are told from an early age that men don’t cry, you pick yourself up, dust yourself off and move forward. That is not true. We are men but we are also human’ ened. While driving around I came across a building with a sign outside that read Center for HOPE — HOPE For Bereaved. I gave them a call to inquire about their services but all I could do was cry. The woman who answered just allowed me to talk and cry and told me that what I was experiencing was the pain associated with grief. I started going for one-on-one counseling and attending a grief support group. I didn’t realize at that time how much I would learn about men grieving and myself. I’ve learned that grief is a process, a reaction to a death, not something you can turn off and on like a light switch. In order to move
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
forward I had to acknowledge my feelings of loneliness, anger, fear, uncertainty and sadness. Society frowns on men who show feelings and emotions — we are not given that right. Men are told to be stoic and tough. We are told from an early age that men don’t cry, you pick yourself up, dust yourself off and move forward. That is not true, we are men but we are also human. I found it difficult in the beginning to share my pain with others but as time passed I realized that I was not alone. Others in the support group encouraged me to open up and allow my emotions to come out. I watched around the room as other men cried and shared their stories.
It is through time, talk and tears that I began the process of healing my grief. I was given permission to develop ways of making my departed loved one a part of my life but without the severe pain. Some of the ways were simple things such as lighting a candle, writing them a letter and just talking with them. If you are a man grieving a deceased loved one I encourage you to seek help, share your feeling, be gentle with yourself and grieve. You will find solace, peace of mind and strength that you never felt before. You don’t have to grieve alone. Give HOPE For Bereaved a call —315475-9675 — to schedule a counseling appointment or come to a group. HOPE’s services are free of charge to the bereaved. Walt Stein has been with HOPE For Bereaved for 10 years. He holds the position of development director and educator. He is also a trained bereavement support group facilitator and provides peer counseling on an individual basis.
Legacy Nursing & Homecare, PLLC Generations Caring For Generations By Jim Miller
Do I Need to File a Tax Return This Year? Dear Savvy Senior, What are the IRS income tax filing requirements for retirees this tax season? My income dropped way down when I had to retire last year, so I’m wondering if I need to file a tax return this year.
Retired Ron Dear Ron, Whether or not you are required to file a federal income tax return this year actually depends on several factors: how much you earned last year (in 2018); the source of that income; your age; and your filing status. Here’s a rundown of this tax season’s IRS tax filing requirement thresholds. For most people, this is pretty straightforward. If your 2018 gross income — which includes all taxable income, not counting your Social Security benefits, unless you are married and filing separately — was below the threshold for your filing status and age, you may not have to file. But if it’s over, you will. • Single: $12,000 ($13,600 if you’re 65 or older by Jan. 1, 2019). • Married filing jointly: $24,000 ($25,300 if you or your spouse is 65 or older; or $26,600 if you’re both over 65). • Married filing separately: $5 at any age. • Head of household: $18,000 ($19,600 if age 65 or older). • Qualifying widow(er) with dependent child: $24,000 ($25,300 if age 65 or older). To get a detailed breakdown on federal filing requirements, along with information on taxable and nontaxable income, call the IRS at 800-829-3676 and ask them to mail you a free copy of the “Tax Guide for Seniors” (publication 554) or see IRS. gov/pub/irs-pdf/p554.pdf. Check Here Too There are, however, some other financial situations that can require you to file a tax return, even if your gross income falls below the IRS filing requirements. For example, if you earned more than $400 from self-employment in 2018, owe any special taxes like an alternative minimum tax, or get premium tax credits because you, your spouse or a dependent is enrolled in a health insurance marketplace (Obamacare) plan, you’ll need to file. You’ll also need to file if you’re receiving Social Security benefits, and one-half of your benefits plus your other gross income and any taxexempt interest exceeds $25,000, or $32,000 if you’re married and filing jointly.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
Medicare: Rules for Those With Higher Income
I
f you have higher income, the law requires an upward adjustment to your monthly Medicare Part B (medical insurance) and Medicare prescription drug coverage premiums. But if your income has gone down, you may use form SSA-44 to request a reduction in your Medicare income-related monthly adjustment amount. Medicare Part B helps pay for your doctors’ services and outpatient care. It also covers other medical services, such as physical and occupational therapy, and some home health care. For most beneficiaries, the government pays a substantial portion — about 75 percent — of the Part B premium, and the beneficiary pays the remaining 25 percent. If you’re a higher-income beneficiary, you’ll pay a larger percentage of the total cost of Medicare Part B, based on the income you report to the Internal Revenue Service (IRS). You’ll pay monthly Part B premiums equal to 35, 50, 65, 80, or 85 percent of the total cost, depending on the income you report to the IRS. Medicare Part D prescription drug coverage helps pay for your prescription drugs. For most beneficiaries, the government pays a major portion of the total costs for this coverage, and the beneficiary
Q&A
Q: I’m gathering everything I’ll need to file my taxes this month. Do I have to pay taxes on Social Security benefits? Also, where can I get a replacement 1099? A: Some people who get Social Security must pay federal income taxes on their benefits. Still, no one pays taxes on more than 85 percent of their Social Security benefits. You must pay taxes on some portion of your benefits if you file an individual federal tax return and your income exceeds $25,000. If you file a joint return, you must pay taxes if you and your spouse have combined income of more than $32,000. If you are married and file a separate return, you probably will have to pay taxes on your benefits. You can read more about tax preparation in relation to Social Security at www. socialsecurity.gov/planners/taxes. htm. Social Security benefits include monthly retirement, survivors, and disability benefits. They don’t include Supplemental Security Income (SSI) payments, which are not taxable. You can also get a replacement 1099 or 1042S when you open your own personal my Social Security account at www.socialsecurity.gov/ myaccount.
pays the rest. Prescription drug plan costs vary depending on the plan, and whether you get Extra Help with your portion of the Medicare prescription drug coverage costs. If you’re a higher-income beneficiary with Medicare prescription drug coverage, you’ll pay monthly premiums plus an additional amount, which is also based on the income you report to the IRS. Because individual plan premiums vary, the law specifies that the amount is determined using a base premium. Social Security ties the additional amount you pay to the base beneficiary premium, not your own premium amount. If you’re a higher-income beneficiary, we deduct this amount from your monthly Social Security payments regardless of how you usually pay your monthly prescription plan premiums. If the amount is greater than your monthly payment from Social Security, or you don’t get monthly payments, you’ll get a separate bill from another federal agency, such as the Centers for Medicare & Medicaid Services or the Railroad Retirement Board. You can find Form SSA-44 online at www.socialsecurity.gov/forms/ ssa-44.pdf. You can also read more in the publication “Medicare Premiums: Rules For Higher-Income Beneficiaries” at: www.socialsecurity.gov/ pubs/EN-05-10536.pdf.
Q: I got an email that says it’s from Social Security, but I’m not so sure. They want me to reply with my Social Security number, date of birth, and mother’s maiden name for “verification.” Did it really come from Social Security? A: No. Social Security will not send you an email asking you to share your personal information, such as your Social Security number, date of birth, or other private information. Beware of such scams — they’re after your information so they can use it for their own benefit. When in doubt, or if you have any questions about correspondence you receive from Social Security, contact your local Social Security office or call us at 1-800-772-1213 (TTY 1-800325-0778) to see whether we really need any information from you. Q: I know that Social Security’s full retirement age is gradually rising to 67. But does this mean the “early” retirement age will also go up by two years, from age 62 to 64? A: No. While it is true that under current law the full retirement age is gradually rising from 65 to 67, the “early” retirement age remains at 62. Keep in mind, however, that taking early retirement reduces your benefit amount. For more information about Social Security benefits, visit www. socialsecurity.gov/planners/retire.
Gray and Addicted: How Substance Abuse Affects Seniors Baby boomers ‘are the largest growing age group of drug users and abusers,’ says Loretto physician By Deborah Jeanne Sergeant
A
ngst-ridden teens and anxiety-ridden young adults seem easy examples of typical substance abusers; however, a growing number of seniors turn to alcohol and prescription and illicit drugs. They’re seldom identified as having a substance abuse problem. According to the National Institutes of Health (NIH), the rate of people over 50 who abuse substances is expected to top 5.7 million by 2020. The baby boomer generation grew up in the era of widespread drug experimentation. To those who used drugs recreationally in the ‘60s and ‘70s, the current growing expansion of acceptance of medical and recreational marijuana tacitly condones using substances to self-treat physical and mental health issues. The NIH also states that alcohol predominates as this age group’s substance of choice, although abuse of illicit and prescription drugs has risen in recent years, too. Physician Cheryl Morrow, assistant medical director at Loretto Health & Rehabilitation Center in Syracuse, said that baby boomers “are the largest growing age group of drug users and Marrow abusers.” Morrow, who is board-certified in internal medicine, believes that substance abuse is highly under-diagnosed among older adults, in part
because of respect for elders and the generational mindset of minding one’s business may keep substance abuse problems taboo to discuss. Ironically, more older people visit a physician for chronic health issues than healthier younger people, yet a substance abuse issue often goes unnoticed by their physicians. Even family and friends may not notice, suspect something else or choose not to say anything if they do suspect. Morrow wants more providers to screen for substance abuse and to look deeper at psychological issues. For some older adults, chronic pain from an illness or injury initiated a prescription for pain control such as an opioid medication. “Many, many doctors don’t do the taper plan,” Morrow said. “They start a prescription and just don’t stop.” She added that many baby boomers want a quick fix in a pill form, not a long-term plan such as exercise and weight loss after a surgery or to ease arthritis pain. She also said that some older adults can be very manipulative about obtaining habit-forming pain medication. Once the refills end, other’s prescriptions, illicit drugs or alcohol may stand in for pain control or to ease loneliness, depression or anxiety. It’s not uncommon for seniors abusing prescriptions to “borrow” extra pills from a neighbor or family member who has hoarded medication from their own prescriptions. Feeling sympathetic, they unknowingly enable further substance abuse. The opioid crisis has influenced more physicians to minimize opioid
use and help patients develop a plan to use habit-forming pain medication in smaller amounts and for shorter duration. This also helps reduce the number of hoarded pills. Shawne Steiger, licensed clinical social worker and post-traumatic stress disorder and substance treatment services team lead at VA Health in Syracuse, believes that the opioid crisis, combined with other factors, has influenced the growth in Steiger substance abuse among seniors. “Family and children might move farther away and there’s a high incidence of depression in aging adults,” she said. “We as a society stop seeing people clearly as they age.” As a result of feeling depressed and with no one noticing, many older adults continue to abuse substances. “We certainly know that depression and access to alcohol, opioids and anti-anxiety medications contributes to substance abuse,” Steiger said. She added that these issues often go unnoticed with retirees because they don’t have to go to work, may not drive and could experience few social interactions in a week. Those who were occasional drinkers may look to alcohol more frequently to dull loneliness, pain or boredom. Drugs and alcohol may affect March 2019 •
older adults differently than when they were younger, “especially when drugs are combined with alcohol,” Steiger said. For instance, muscle mass declines decade by decade as the body ages. For some frail elders, their tolerance can be much lower for alcohol and drugs than when in their physical prime, which can contribute to faster onset of addiction. Brian Johnson, director of addiction medicine and professor of psychiatry/anesthesia at SUNY Upstate Medical University, said that medication for anxiety can exacerbate cognitive impairment and increase the risk of a fall. “A patient comes in, is anxious, and gets put on these drugs,” Johnson said. “They will increase their risk of hip fractures by 50 percent. The mortality the first year after a hip fracture is 20 percent.” Johnson calls opioids the “worst treatment you can give for chronic pain” and “how so many patients are being killed by their doctors.” He said that a patient is 4.5 times more likely to have fractures if using opioids. He urges anyone with a substance abuse problem to seek help at an addiction or pain center. Unfortunately, few programs exist to help those who abuse substances. Many older adults may feel uncomfortable in a typical group setting with mostly younger people. One-on-one help may be too costly for seniors on fixed income. For some of these, accessing care is complicated by affording co-pays and transportation three times a week well.
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Suicide Rates Increasing Among Farmers Rate substantially higher than that of the general population By Deborah Jeanne Sergeant
T
he Centers for Disease Control and Prevention (CDC) reported in November that from 2000 to 2016, the U.S. suicide rate among adults 16 to 64 years increased 34 percent, from 12.9 per 100,000 population to 17.3. Among male farmers, that rate multiplied by 1.5 times. In other words, farmers commit suicide at the alarming rate of 29.95 per 100,000. Although suicide represents a very complex health crisis, the CDC identified occupational factors that affect suicide risk, including job insecurity, access to lethal means on the job, working conditions and stress. All of these factors can intersect with farming — and more. Kate Downes is programming coordinator at New York FarmNet in Ithaca, a statewide organization that offers on-farm analysis, business planning and well-being services. “Farmers are really incredible people and incredibly Downes dedicated,” she said, “sometimes, to a fault.” Many small farms are family Page 26
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run with traditional roles, meaning husbands are responsible for many of the chores and business operations. If they hire outsiders, the farmer is also an employer. Often, the wife and sometimes the husband may work off the farm to help bring in more income and health benefits. That arrangement may help with income, but it also takes away time from the farm, which can generate more stress. Farm income and longevity relies upon weather, plant and animal health and consumer whims, all of which farmers can’t control much, if at all. Farming is inherently physically taxing, dirty and dangerous at times, even at the most advanced, cleanest and safest farms. With dairying, farmers truly never get a break. With limited finances, taking a vacation is out of reach even if they could get help to take over chores. Cows require milking and feeding twice daily. There’s also planting, tending and harvesting crops, maintaining equipment and buildings, and cleaning the animals, barn and equipment. Farmers must carefully monitor animal health and calving. For all that work, farmers receive less for their herd’s milk today than they did in the early 1980s because of government price controls. Other commodities have been struggling as well for the past several years. “With any farmer, they don’t get
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
to set a price to be paid for what they produce unless they direct market their items,” Downes said. Going that route takes additional education and a sizable capital investment in new facilities and licenses for most farmers. Quitting farming may seem an easy out; however, it’s not so easy for farmers to give up their family heritage. “It’s not just losing their job,” Downes said, “but land that’s been in the family forever. They likely employ family members. Usually, their farmhouse is on the property. Farming is an identity. There’s an immense amount of loss, akin to losing a family member, to quit.” Smaller farmers who have exhausted their lines of credit may not be capable of selling readily. Who wants to buy into an industry that’s been struggling so desperately? Larger farms usually don’t want to buy smaller scale equipment and that’s where smaller farmers invested most of their money. “They don’t know what to do or where to turn,” Downes said. “Their hands are tied.” Most farmers own weapons and have access to many other potential means of self harm because of the inherent dangers farming involves. That’s one reason that some experts believe the suicide rate statistics for farmers are actually underestimated:
some “accidental” deaths weren’t counted. Farms’ rural location can exacerbate feelings of isolation and limit access to mental health help. “One of our personal consultants said it’s okay to meddle and ask them pointedly how they’re doing,” Downes said. “Otherwise, they could brush it off. If a neighbor notices someone is really doing badly, confront them. “Help connect them with behavioral health providers like the county mental health office.” FarmNet also offers a free referral line that’s manned by a live operator 24/7 every day of the year. The organization also dispatches consultants to the farm to help with finances and licensed clinical social workers for coping with the stress on the farm. “If there is a situation where there’s more advanced behavioral health concerns, we can make outside referrals,” Downes said. “We can help call and make appointments and wait with the farmer in the waiting room.” Kim Fortin, licensed clinical social worker in Weedsport, also operates 4 Tin Fish Farm, a 100-goat dairy in Conquest. She understands farming firsthand. “If you look at this occupation, it is very high-stress, often more individualized and isolated,” Fortin said. “Traditionally, our culture says are supposed to be tough, keep it together and provide for the family. You don’t ask for help.” Combining that stereotype with farming’s many variables, hard work and low remuneration, it’s a recipe for despair for many. “If the weather is good and you’re a crop farmer, you don’t rest for three or four days because you have to get it all in,” Fortin said. “You stay up until it’s planted. People don’t make good decisions running on two hours’ sleep.” She encourages loved ones and friends to ask about what’s going on. “You won’t put the idea of suicide in their head,” Fortin said. “Say, ‘I recognized this to be true and some people may think of suicide. Is this something you’re thinking about?’ If the answer is yes, say, ‘Let me help you go get help.’” Many express relief that others have identified how stressed and hopeless they feel. Mosey said that supporting another person emotionally can go a long way towards seeking help and finding relief. Cheryl Giarrusso, director of crisis intervention services at Contact Community Services in East Syracuse, said that for some, “giving them the opportunity to share how they feel” makes a world of difference. “If it’s hard for you to hear it, find someone who can hear them. That’s important to share how deep and dark things have gotten for them. “When you’re in that dark place, you just don’t have the kind of vision. But to reach out and share your situation with someone, they might be able to see something you’re unable to see because you’re so low.” For someone in imminent danger, get emergency help by calling 911 or taking the person to a hospital emergency room. “People can present as a real crisis, but with the time and space to talk, they can feel better,” Giarrusso said.
Mystery, Malt and Merlot Event to Raise Funds for Clark Burn Center at Upstate
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he 21st annual Mystery, Malt and Merlot, featuring live and silent auctions, local craft beer and wine tastings, dinner, a mystery to solve and more will be presented by Advocates for Upstate Medical University starting at 5:30 p.m. Friday, April 12, in the ballroom at Nicholas J. Pirro Convention Center at Oncenter Complex, 800 S. State St., Syracuse. Proceeds from the event will benefit Upstate Medical University’s Clark Burn Center and the Upstate Trauma, Burn and Emergency Medicine EMS program. “We invite Central New Yorkers to join us for this wonderful event that offers a fun way to mingle, to solve a mystery and the opportunity to win our mystery gift,” said Barbara LaBarge, event chairwoman. “Attendees will enjoy a delicious dinner that includes vegetarian and gluten-free options and bid on a myriad of quality items, including artwork, attractions, products and services and selections of the region’s finest wines and brews. Among the auction items are works by local artists and artisans that will be displayed in an art walk.” Proceeds benefitting Clark Burn Center will be used to purchase items to aid in the emotional and mental recovery process for pediatric and adult burn patients, such as pictured mirrors, CD players, iPods and tab-
lets. The region’s only burn center, it serves nearly half of New York state and provides service to 40 counties. The Upstate EMS program will use proceeds to support its prehospital trauma life support advanced provider and first responder courses, to be delivered in local jurisdictions throughout the trauma region. The national awareness campaign from American College of Surgeons, Stop the Bleed, will be included as a course offering. Bleeding simulators will also be purchased for these courses. The Upstate EMS program delivers the most current training and education for prehospital providers within its 14-county trauma region. Now in its 21st year, Mystery, Malt and Merlot has provided more than $380,000 to support healthcare and scholarship at Upstate Medical University. Reservations will be accepted through March 29. Tickets are $90 per person; businesses and organizations are invited to take advantage of sponsorship packages. For ticket or sponsorship information, visit www.upstate.edu/advocates of call 315-464-5610. Advocates for Upstate Medical University is a volunteer membership organization supporting healthcare and scholarship through fundraising and service.
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H ealth News Hutchinson named community engagement manager
Alzheimer’s Association, Central New York Chapter Chief Executive Officer Catherine James has announced that Martha Hutchinson has been named community engagement manager, a newly created position at Alzheimer’s Association, Hutchinson Central New
York chapter. In this role, Hutchinson will oversee the chapter’s volunteer program, grassroots outreach and engagement of diverse and underserved communities. She will also direct Alztogether, the chapter’s social engagement program for individuals living with Alzheimer’s disease or other dementia. Alztogether facilitates museum visits, cultural experiences and hands-on activities intended to create meaningful connections between the individual living with the disease and their caregiver. She joined the chapter in 2016 as its volunteer and outreach coordinator. Previously, she was the youth and community programs manager for the Peninsula School of Art in Door County, Wisc.
Samantha Cleveland (right), project director for RSVP of Oswego County, was on hand recently to receive a 2019 Community Health Award from Excellus BlueCross BlueShield Regional President Jim Reed. The award carries with it a monetary allocation, which RSVP intends to use to support its Osteo Bone Builders program.
RSVP’s Grant to Boost Osteo Bone Builders Program
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recent regional award from Excellus BlueCross BlueShield will benefit hundreds of people who attend Osteo Bone Builders classes offered by the Retired and Senior Volunteer Program of Oswego County, a division of SUNY Oswego’s Office of Business and Community Relations. RSVP was one of seven winners among 30 community nonprofits applying for the 2019 Community Health Award, which carried an allocation of up to $4,000 per award to help fund health and wellness programs in the company’s five-county Central New York region. “On behalf of RSVP, we are grateful to be chosen for a Community Health Award from Excellus BlueCross BlueShield,” said Samantha Cleveland, project director of RSVP of Oswego County. “This is
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a great honor. The award is being used to update program materials and instructor training for Osteo Bone Builders. We hope this will also bring more attention about osteoporosis, and ways to reverse the effects through education and participation.” RSVP offers Osteo Bone Builders classes two to three times a week, at several sites in Oswego County. The educational exercise program helps participants rebuild bone density and improve balance through weight training and exercise. To learn more about Osteo Bone Builders, other RSVP programs, the agency’s Mature Living newsletter and the many opportunities available to volunteers, visit oswego. edu/rsvp or call 315-312-2317.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
Hutchinson, a native of Ellison Bay, Wisc., earned a bachelor’s degree from the University of Minnesota-Twin Cities.
St. Joe’s, URMC create Concordia Healthcare
Extending prior strategic partnerships, and following more than 18 months of development work, leaders of St. Joseph’s Health in Syracuse and the University of Rochester Medical Center (URMC) recently announced formation of a new organization to work with health systems across the state. Concordia Healthcare Network LLC is a super-clinically integrated network (CIN) created to help other health systems, hospitals and provider groups transition to value-based care, an increasingly common payment approach that requires systems to comprehensively monitor and manage the overall health of their population in addition to billing for services. Concordia is jointly operated by Accountable Health Partners (AHP) — the CIN that serves URMC faculty members, affiliated hospitals and other providers in the Finger Lakes and surrounding areas — and St. Joseph’s Health, a regional nonprofit health care system based in Syracuse that offers primary, specialty and home care, a Magnet-recognized hospital, and collaboration with community partners. The formation of Concordia does not change the structure of either network or its services to providers. Instead, it will serve as a “super CIN” that shares collective expertise and resources with health systems in other parts of Upstate New York, helping all members to increase patient access to services and improve the quality of clinical care, while keeping costs as affordable as possible. “We believe the whole of Concordia Healthcare Network will be greater than the sum of its parts,” said physician Robert M. McCann, chairman of the 10-member Concordia Healthcare Network board. McCann is also the CEO of Accountable Health Partners and chief of medicine at Highland Hospital in Rochester, a URMC affiliate. “The Concordia name will not be widely known to patients, but they will see benefits from their local health systems through expanded access to providers, improved preventive care, better clinical integration and more affordable health-plan options.” “This alliance of CINs—known as a ‘super CIN’—is motivated by our common desire to expand our value proposition to larger populations and further strengthen our population health management capabilities while retaining healthy system independence. This complex collaboration is only achievable as a result of the mission and leadership congruence of Concordia Healthcare Network’s providers,” said physician Paul Fiacco, Concordia vice-chairman and president of CNY Accountable Integrated Medicine, a CIN operated by St. Joseph’s Health. Three health systems have already committed to participation in
Concordia — Family Health Network of Central New York, a federally funded community health center serving residents of Cortland and contiguous counties; Lourdes Hospital and its physician network, serving Binghamton and the Southern Tier; and Innovative Health Alliance of New York (IHANY), serving Albany and the Capital Region.
Nascentia among Best Companies to Work For
Nascentia Health, a local leader in healthcare services focused on providing integrated care and in-home service delivery, has been named one of the 2019 Best Companies to Work For in New York by the New York State Society for Human Resource Management (NYS-SHRM). Created in 2007, the Best Companies to Work For in New York state awards are part of a distinctive program designed to identify, recognize and honor the best places of employment in New York, whose practices benefit the state’s businesses, economy and workforce. The annual awards are a partnership of NYS-SHRM, Best Companies Group and BridgeTower Media. A total of 75 companies with operations in the state topped this year’s list and were divided into three categories based on size: 26 small employers (5-99 employees); 23 medium employers (100-249 employees); and 26 large employers (250+ employees). To be eligible for participation, organizations had to meet specific registration requirements and partake in a two-part employee engagement and satisfaction survey, which determined company strengths in areas such as leadership and planning, role satisfaction, and work environment. Best Companies Group, an independent firm that manages Best Places to Work programs on state, regional and national levels around the world, conducted the survey, evaluated the results and determined the best places of employment in the Empire State. “We’re honored to be named one of the best places to work in New York state, particularly because our ranking is based on employee feedback,” said President and Chief Executive Officer Kate Rolf. “Our employees are our most valuable resource and the key to our continued success. This award is further evidence of our long-term commitment to them, and to building an exceptional workplace by continually investing in them.” Nascentia will be honored at a public awards dinner to be held at the Albany Marriott April 24.
St. Joe’s achieves Magnet recognition
St. Joseph’s Health has once again attained Magnet recognition, a testament to its continued dedication to high-quality nursing practice. The American Nurses Credentialing Center’s Magnet Recognition Program distinguishes healthcare organiza-
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H ealth News tions that meet rigorous standards for nursing excellence. This credential is the highest national honor for professional nursing practice. According to a hospital news release, receiving Magnet recognition for the third time is a great achievement for St. Joseph’s Health as it celebrates its 150th anniversary of providing a higher level of care to all members of its growing community. This designation places St. Joseph’s among the top hospitals in the nation for quality outcomes and both patient and nursing satisfaction. St. Joseph’s Health is the only health system in the greater Central New York region to meet the rigorous standards to receive Magnet recognition. Only 8 percent of U.S. healthcare organizations have achieved Magnet recognition. “Magnet recognition is a tremendous honor and reflects our commitment to delivering the highest quality of care to this community,”
said AnneMarie Czyz, chief operating officer and chief nursing officer. “To earn Magnet recognition once was a great accomplishment and an incredible source of pride for our nurses. Repeating this achievement underscores the foundation of excellence and values that drive our entire staff to strive harder each day to meet the health care needs of the people we serve.” According to the hospital, research demonstrates that Magnet recognition provides specific benefits to health care organizations and their communities, such as: Higher patient satisfaction with nurse communication, availability of help and receipt of discharge information; lower risk of 30-day mortality and lower failure to rescue rates; higher job satisfaction among nurses; lower nurse reports of intentions to leave their positions; and preference among physicians to work with Magnet-level nurses.
Loretto’s Kimberly Townsend earns top credential
K
imberly Townsend, president and CEO at Loretto, recently became a Fellow of the American College of Healthcare Executives (FACHE), the nation’s leading professional society for healthcare leaders. “The healthcare management field plays a vital role in providing high-quality care to the people in our communities, which makes having a standard of excellence promoted by a professional organization critically important,” said Deborah J. Bowen, president and CEO of ACHE. “By becoming an ACHE fellow and earning the distinction of board certification from ACHE, healthcare leaders demonstrate a commitment to excellence
in serving their patients and the community.” Fellow status represents achievement of the highest standard of professional development. Only 9,107 healthcare executives hold this distinction. To obtain fellow status, candidates must fulfill multiple requirements, including meeting academic and experiential criteria, earning continuing education credits, demonstrating professional and community involvement, and passing a comprehensive examination. Fellows are also committed to ongoing professional development and undergo recertification every three years.
Onondaga, Oswego, Cayuga and Madison Counties
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In Good Health is published 12 times a year by Local News, Inc. © 2019 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, Mary Beth Roach, Angela Underwood • 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.
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IN GOOD HEALTH – CNY’s Healthcare Newspaper
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Crouse Health Foundation Announces $250,000 Little Fighters Regional Challenge Effort to help in the renovation region’s largest NICU
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he Crouse Health Foundation reports an anonymous donor has committed to a $250,000 challenge grant to support the renovation of Crouse’s Baker Regional Neonatal Intensive Care Unit (NICU). Known as the Little Fighters Regional Challenge, the grant will match gifts and pledges — dollar for dollar — up to $250,000. In an effort to encourage regional support, only donations received from outside Onondaga County will count toward the challenge. “Fifty percent of the babies in Crouse’s NICU each year are from outside Onondaga County,” said Carrie Berse, president of Crouse Health Foundation. “The Little Fighters Regional Challenge will engage our neighbors from a region that stretches as far north as Canada and south to Pennsylvania. We hope to shine a light on the number of infants from those distant communities who receive lifesaving treatment here in Syracuse at the regional NICU at Crouse.” More than 1,000 critically ill and premature infants from 14 counties receive care in the New York state-designated regional NICU at
Crouse each year. While it is the highest level — and largest — in the region with 57 bassinets, more space is required to provide the best care possible to its tiniest patients, affectionately known as “Crouse Little Fighters,” and their families. The Crouse Health Foundation seeks to raise a total of $10 million toward the $31 million cost of the NICU renovation and expansion project, identified as a priority for its CrouseCares comprehensive campaign. The proposed renovation will incorporate lifesaving technological advances, while also providing more space for families to bond with infants, a tangible expression of the NICU’s focus on family-centered care. “We are so grateful to this anonymous donor for recognizing the tremendous impact Crouse’s NICU has on babies in our 14-county region, which includes families in the North Country, Southern Tier, Finger Lakes and the Mohawk Valley,” said Berse. To make a contribution, visit crouse.org/littlefighters. Contact Director of Philanthropy Jeff Comanici or jeffrycomanici@crouse.org at 315-470-7054 to learn more.
SOS to Open New Specialists’ One-Day Surgery Center
St. Camillus Introduces New Breathe Well – Live Well Pulmonary Rehab Program
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T
yracuse Orthopedic Specialists (SOS) recently announced it will open its new Specialists’ OneDay Surgery Center (SODS) in April. The 47,000 square foot, state-of-theart surgery center will be located on East Taft Road in Syracuse. SOS will be moving current orthopedic operations from the SODS center on Intrepid Lane to this new location. This new center will feature eight operating rooms, 16 pre-op beds, 27 recovery beds and eight extended stay rooms. SOS surgeons specializing in all areas of orthopedics including foot and ankle, hand and wrist, joint replacement, spine, and sports medicine will provide the care. The center will offer expanded space and services to allow for outpatient joint replacement procedures. “We are excited to move to this new surgery center that will be focused on the patient experience,” said orthopedist Brett Greenky. “The space allows us to offer joint replacement patients the most current technology in a comfortable setting.” The joint replacement team began offering one-day procedures within the past year and it is becoming a preferred option for some patients. “There is evidence that outcomes of joint replacement in outpatient surgical centers and the level of satisfaction for outpatients is equal to and often greater than inpatient joint replacement,” said Greenky. The six members of the SOS Joint Page 30
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Replacement Team, all of whom will perform procedures at the new SODS, have a combined 17 decades of proven, quality patient care and have consistently been on the cutting edge of procedures and services. Team members consisted of orthopedic surgeons Stephen Bogosian, Michael Clarke, Brett Greenky, Seth Greenky, Tim Izant, and Kevin Kopko. These fellowship-trained surgeons are nationally recognized and rate exceptionally high in patient satisfaction scores. The members of SOS’ joint replacement team will continue to perform joint replacement surgeries at Crouse Health, St. Joseph’s Health and Upstate University Hospital Community Campus. “For some patients it is most optimal to have surgery in a hospital setting,” commented surgeon Kevin Kopko. “We put patient safety, comfort and satisfaction first and will make the right choice with each patient about where they should have their surgery.” Soon after the opening of the new SODS at East Taft Road, SOS will move staff and operations from the current office in North Medical Center into the same building, as SODS. The location has ample room for medical offices and suites and provides more amenities than the North Medical office. Three miles away from the current office, it remains convenient for patients.
IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019
he Centers at St. Camillus, in collaboration with S. El Bayadi, board-certified pulmonologist and program medical director, and Pulmonary Health Physicians, PC, now offers a new, short-term inpatient pulmonary rehabilitation program with an integrated team approach. The focus of the newly established Breathe Well — Live Well Pulmonary Rehabilitation Program at The Centers at St. Camillus is to improve patients’ control and management of their chronic lung disease. Learning to manage COPD (chronic obstructive pulmonary disease) can increase an individual’s confidence, capabilities and quality of life. Pulmonary rehabilitation is a focused program to teach, provide tools and partner with patients to make positive strides to breathe and live better with their lung disease. The Breathe Well – Live Well health care team includes skilled
nursing, respiratory therapy, pulmonary medical providers, physical, occupational and speech therapies, psychology/psychiatry, physiatrist, social services/case management, nutritional counseling and pharmacist. “We work closely with patients that are motivated to participate in our comprehensive rehabilitation program,” said Michael Schafer, vice president for the nursing facility at The Centers at St. Camillus. “Our health care team and partnering physicians are passionate and dedicated to support patients and help them achieve their goals. We guarantee a simple, one-step process.” For more information about the new program, contact Patricia Winship, admissions coordinator at 315488-1500 and learn more online at www.st-camillus.org/programs-services/pulmonary-rehabilitation.
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18.XXX_Urology_MeetTheTeam_Horiz.qxp_Layout 1 11/14/18 9:28 AM Page 1
MEET THE UPSTATE UROLOGY TEAM Chairman Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
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JOSEPH JACOB, MD
OLEG SHAPIRO, MD
General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn.
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MATTHEW D. MASON, MD
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RYAN SIDEBOTTOM, DO
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NATASHA GINZBURG, MD
EDWARD IOFFE, MD
MRI fusion, male health, prostate cancer and kidney stones
TIMOTHY K. BYLER, MD
Reconstructive urology; incontinence, prosthetics, urinary fistula, neurogenic bladder, urinary diversion. Robotic surgery.
General urology, female and reconstructive urology
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SERGEY KRAVCHICK, MD
RAKESH KHANNA, MD
Female and reconstructive urology, urinary incontinence in women, pelvic floor treatment and neurourology
General urology
IMAD NSOULI, MD
Urologic oncology robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal
Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities
STEPHEN BLAKELY, MD
Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal
General Urology; Female Urinary Incontinence
MICHAEL CASTELLO, DO
RUBEN PINKHASOV, MD, MPH
UROLOGY FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500
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IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2019