In Good Health: CNY #267 - March 2022

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MARCH 2022 • ISSUE 267

KIDS’ HEALTH Special Issue

Children have been through an awful lot in the past two years: online classes; social isolation; constant stress from family finances, work and school changes; plenty of negative news media coverage; ever-shifting COVID-19 protocols; and fear of the virus itself. For kids and teens, it’s been hard to go back to the conventional way of doing things STORY ON P. 14.

UPSTATE MEDICAL VACCINOLOGIST Stephen J. Thomac, MD, played a key role in the Pfizer COVID-19 vaccine. Now, he’s working to develop vaccines for heroin addiction, influenza, HIV, and more. P. 4

EVA BRIGGS, MD: EXCITING ADVANCES IN THE FIGHT AGAINST CANCER NO MORE SURPRISES! The No Surprises Act protects patients from unexpected medical bills. P. 14

Nonprofits Face Challenges Fighting Food Insecurity The Food Bank of Central New York's warehouse in Van Buren includes 61,000 square feet of storage for refrigerated, frozen and dry goods. The food bank is the main distribution hub for an emergency food network that includes 11 counties in central and northern New York. P. 12

Humans’ Sense of Smell May Be Getting Duller

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new study that tested volunteers’ perceptions of various smells — including underarm odor — adds to growing evidence that people’s sense of smell is declining, little by little.

“Genome-wide scans identified novel genetic variants associated with odor perception, providing support for the hypothesis,” the researchers said in a news release from the journal PLOS Genetics. The study was published there Feb. 3.

Individuals experience smells differently, and the same scent may be pleasant, too intense or undetectable to various people. By combining differences in scent perception and people’s genetics, scientists can identify the role of various scent receptors.

In this study, researchers in the United States and China analyzed the genomes of 1,000 Han Chinese people. They were looking for genetic variations associated with how individuals perceived 10 scents. The investigators then repeated the experiment for six odors in an ethnically diverse group of 364 people.

From these experiments, they pinpointed two new scent receptors — one that detects a synthetic musk used in fragrances and another for a compound in body odor.

Study participants had different versions of the receptor genes for musk and underarm odor, and those variations affected how they perceived the scents.

These findings and previous

research show that people with ancestral versions of the brain’s scent receptors tend to find the corresponding odor more intense.

Ancestral versions are those shared with non-human primates, the team explained.

The researchers, led by Joel Mainland of the Monell Chemical Senses Center in Philadelphia and Sijia Wang of the Chinese Academy of Sciences in Shanghai, said it all supports the theory that our sense of smell has weakened over time due to gene changes.

This study also confirmed three reported links between genes for scent receptors and specific odors.

Those earlier studies included primarily Caucasian participants. The new findings from East Asian and diverse groups suggest that genetics underlying the ability to detect odors are constant across people of different backgrounds.

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Page 2 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

MEET THE UPSTATE UROLOGY TEAM Chairman Urologic oncology; robotic and laparoscopic surgery of prostate, kidney, bladder and adrenal

General urology, andrology

GENNADY BRATSLAVSKY, MD ZAHI N. MAKHULI, MD

Male infertility, erectile dysfunction, andrology, general urology, prosthetics, and Peyronies

OLEG SHAPIRO, MD

Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities

MATTHEW D. MASON, MD

JC TRUSSELL, MD

General urology, female and reconstructive urology

ELIZABETH FERRY, MD

General Urology, Endourology and Laporoscopic Surgery

EDWARD IOFFE, MD

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

General urology, male health, urologic oncology, enlarged prostate, kidney stones At Upstate Urology of Auburn.

RYAN SIDEBOTTOM, DO

Reconstructive urology; incontinence, prosthetics, urinary fistula, neurogenic bladder, urinary diversion. Robotic surgery.

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

RUBEN PINKHASOV, MD, MPH Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities

ANTHONY J. TRACEY, MD, MPH, FAAP

DMITRIY NIKOLAVSKY, MD

IMAD NSOULI, MD

MAHMOUD CHEHAB, MD

Female and reconstructive urology, urinary incontinence in women, pelvic floor treatment and neurourology

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

NICK LIU, MD Urologic Oncology; robotic and laparoscopic surgery of prostate, kidney, bladder, and adrenal

Urologic oncology; robotic surgery of prostate, kidney, bladder

TOM SANFORD, MD

Pediatric urology, treatment of hernias and hydroceles, robotic surgery, urinary tract infections, penile abnormalities

JEFF VILLANUEVA, MD

TIMOTHY K. BYLER, MD

General urology, male health, urologic oncology, enlarged prostate, kidney stones , and robotic surgery

Kidney Stones, Minimally Invasive Kidney Surgery, Enlarged Prostate

SCOTT WIENER, MD

MRI fusion, male health, prostate cancer and kidney stones

General urology

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

JOSEPH JACOB, MD

STEPHEN BLAKELY, MD

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

HANAN GOLDBERG, MD, MSc

General urology

ROBERT FLEISCHER, MD

UROLOGY

FOR QUESTIONS OR TO MAKE A REFERRAL, CALL 315.464.1500 March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 3

Meet

Your Doctor

By Chris Motola

Stephen J. Thomas, M.D.

Almost All Americans Are Now Within 1 Hour of Good Stroke Care

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ine in 10 Americans now live within an hour of lifesaving stroke care, researchers say.

That’s up from about 80% a decade ago, due to an increase in hospitals with specialized staff, tools and resources, as well as expanded use of telestroke services that use the internet to link small and rural hospitals with stroke specialists in large facilities.

“Investments in improving stroke systems of care have been successful, and we are seeing improved access to stroke expertise and improved health care for patients who are remote from centers of expertise, so it’s a message of hope,” said study lead author, physician Kori Zachrison, an associate professor of emergency medicine at Massachusetts General Hospital and Harvard Medical School in Boston.

The analysis of 2019 and 2020 national data showed that 91% of the U.S. population can reach an acute stroke ready hospital or center within an hour by ambulance. That rises to 96% if telestroke-capable emergency departments are included.

“There is a narrow window of time for delivering disability-reducing stroke treatments,” Zachrison said in a meeting news release.

“Improving poststroke outcomes for patients depends on a patient’s ability to access that care,” she said.

“With increased implementation of telestroke, optimal stroke care has been made possible for an estimated 96% of the U.S. population, which is remarkable, considering the geographic span of our country.”

The findings were presented at a conference of the American Stroke Association, held in New Orleans and virtually, Feb. 8-11.

Upstate Medical University vaccinologist who played key role in Pfizer COVID-19 vaccine now working to develop vaccines for heroin addiction, influenza, and new treatments for staph infections, HIV. He recently was honored

by NYS Senate for his work Q: You recently were awarded the Liberty Medal from the NYS Senate for your work on the COVID-19 pandemic.

Tell us a bit about your work.

A: I’m the interim chair of the department of microbiology and immunology at Upstate and the director of the Institute of Global Health and Translational Science.

Q: So you’ve been pretty busy lately.

A: Yes. In the beginning, as early as January 2020, the university was incredibly busy planning for the arrival of COVID to Central New York, because we knew it had reached New York City and would soon be Upstate. Once we had established plans for how to best care for our patients and keep our staff safe, then the vaccine and treatment trials started and the Global Health group would end up playing key roles in testing the Pfizer vaccine and bringing experimental treatments to the hospital. Now we are responding to surges associated with different variants, continuing with vaccine trials, and trying to re-establish the portion of our research portfolio which was paused.

Q: After two years, what do you consider the successes, missteps and surprises? It’s not necessarily over yet, but what would your postmortem be on this period?

A: I think one of our collective successes was that the region was quick to acknowledge the problem was here, and that it was going to be a problem. Sometimes people have trouble doing this. I felt like there was pretty good alignment between the university and our regional and community leaders about what we had to do to try and reduce the effects of COVID. I think we did a good job at developing plans to reduce the spread of COVID, find infections, maintain our PPE supplies, and then execute those plans. The Global Health group did a great job testing the Pfizer vaccine and different experimental therapies. There is also Dr. Frank Middleton, his group, and the Quadrant Biosciences partnership, which invented an excellent and high throughput saliva-based COVID diagnostic test. This test was a game changer for SUNY and the system’s ability to bring students back to campus and the classroom.

Page 4 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

Q: What could have been improved?

A: As far as what could have been improved, this is not so much a local comment as a national one: I think we could have done a better job communicating important health, science and medical information to the public. I think people were often confused about their individual risk of infection, the outcomes of infection and how to best avoid infection.

Information about vaccination and wearing masks was also confusing at times. Communicating health information is a very specific skill and expertise, and most people in science and medicine don’t have it.

When you’re not effective at communicating it creates information voids, and the voids get filled by misinformation, and people can make bad decisions as a result.

Q: In terms of communication, how do you go about coordinating teams and information globally?

A: My role as the coordinating principal investigator for the Pfizer-BioNtech vaccine trial is not an operational position. Meaning, I’m not actually coordinating the different sites participating in the trial, this is accomplished by Pfizer and Pfizer’s partners. My role, in addition to leading the Upstate site, is to be an external reviewer of the data, which will be submitted to regulatory agencies for consideration of emergency use authorization or licensure.

Coordinating principal investigators provide a fresh set of eyes and help to identify any potential

questions about the data or how to interpret the data.

Q: Rochester tends to get the glory when it comes to research in Upstate New York, but there’s clearly important research being done in Syracuse.

What do you think the state of research in Syracuse is like right now?

Has it been rising in that regard?

A: Yes, I think so. It’s one of the reasons I came here. Dr. Tim Endy was the infectious diseases chief at Upstate and recruited me here, as well as a number of other people.

His vision was to build a robust clinical research program. Upstate has always had a number of very successful individuals, but we really wanted to build a research platform which could increase the number of research opportunities for everyone.

This is what the Global Health group has been doing the last 10 years or so.

We now have over 50 people in the Global Health group and have more than 10 active projects at any given time. We are working on developing COVID vaccines and drugs, conducting community-based trials following COVID survivors, developing tests for Lyme disease, developing vaccines for heroin addiction and influenza, exploring treatments for staph infections, testing new therapies for HIV, and advancing new educational opportunities for medical students and doctors in the US and abroad.

Q: How accurate is Dr. Middleton’s saliva based COVID test compared to the nose swab I think almost all of us have had the pleasure of experiencing by now?

A: As accurate, if not more. What is great about this test is not only can it detect even very small amounts of virus in saliva, but because of how it is collected, preserved, and tested, it is very convenient, stable, can be easily and safely shipped, is high throughput, and there are a number of different tests which can be performed on the sample.

Q: Are you working on any additional research involving mRNA vaccines? Either for COVID-19 or other conditions?

A: Yes, we’re executing an influenza vaccine trial with Pfizer. The technology is also being applied by numerous companies to other diseases such as HIV and Zika. One thing people don’t necessarily understand about mRNA is that it’s not a brandnew technology. It’s been around for about 30 years, has been in numerous human trials, but never had the opportunity which COVID provided to show that it could work. You’ll be hearing a lot more about mRNA.

Lifelines

Name: Stephen J. Thomas, M.D. Position: Director of the Institute for Global Health and Translational Science and interim chair of the Department of Microbiology and Immunology at SUNY Upstate Medical University Hometown: Colonie, New York Education: Albany Medical College Affiliations: SUNY Upstate Medical University Current hospital privileges: Upstate University Hospital, Crouse Hospital, VA Medical Center Family: Wife (Erica); son (Charles), son (Cormac, deceased), daughter (MacLane); Hobbies: music (jazz); lake life (camp, swimming, boating); golf

Deadly Type of Stroke Increasing in Young and Middle-Aged

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ew cases of a debilitating and often deadly type of stroke that causes bleeding in the brain have been increasing in the U.S., growing at an even faster rate among younger to middle-aged adults than older ones, new research shows.

The findings show an 11% increase over the past decade and a half in intracerebral hemorrhage strokes, referred to as ICH strokes.

“From a public health perspective, these results are troubling and indicate risk factors are not being well managed in young adults in the U.S.,” said physician Karen Furie, chief of neurology at Rhode Island Hospital and chairwoman of the department of neurology at Brown University’s Warren Alpert Medical School in Providence. Furie was not involved in the research.

“Earlier onset of this disease is very alarming and indicates we need to be more aggressive with primary prevention,” she said.

ICH strokes occur when blood vessels in the brain rupture and bleed. They are the second most common type, accounting for 10%-15% of the estimated 795,000 strokes each year in the U.S. Globally in 2020, 18.9 million people had an intracerebral hemorrhage, according to the AHA’s most

recent heart and stroke statistics report. They are more deadly and more likely to cause long-term disability than other types of stroke.

Smaller previous studies have reached conflicting conclusions about whether the rate of ICH has been rising or falling in the U.S. In the new study, researchers found an 11% increase in the rate of ICH among U.S. adults over the 15-year study period. ICH increased at a faster rate for adults under age 65 compared to those 75 and older.

The rate of increase also varied by region, climbing faster in the South, West and Midwest than it did in the Northeast. ICH stroke rates were 43% higher for men than women.

Among those who had ICH strokes, the percentage of people who had high blood pressure also rose, from 74.5% to 86.4% over the study period.

High blood pressure is a major risk factor for an ICH stroke, as is increasing age. The findings are alarming, Furie said, because they suggest blood pressure is so poorly controlled among younger adults that they risk losing the most productive years of their lives.

“ICH occurs after decades of vascular damage from unmanaged high blood pressure,” she said. “It’s terrible that this is occurring.”

Mental health, autism, integrative medicine...

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Consult your physician before making major changes in your lifestyle or health care regimen.

March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 5

Nonprofits Encouraged to Apply for Excellus BCBS Community Health Awards Deadline for grants of up to $5,000 is March 17

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onprofit organizations in Upstate New York can apply for Excellus BlueCross BlueShield Community Health Awards that the company is offering to help fund health and wellness programs in the region. The application period closes Thursday, March 17. There will be up to 50 awards available with funding up to $5,000 each.

“As a nonprofit health plan, our mission is to provide access to affordable health care and continually work to improve the health and health care of residents in the communities we serve,” said Mark Muthumbi, Excellus BCBS’s Central New York regional president. “The company’s

Community Health Awards are an opportunity to help support organizations in our community that share our mission of improving access to care and advancing specific health outcomes.”

All nonprofit, 501(c)(3) organizations in Excellus BCBS’s Central New York region are invited to apply for an award. Funding is intended to support programs that improve individual and population health and reduce ethnic and racial disparities by impacting: • Economic Stability: Food availability and security and health care workforce development.

• Education Access and Qual-

ity: Early childhood education and development, enrollment in higher education, high school graduation, and language and literacy.

• Social and Community Support: Caregiver, youth mentorship, and reintegration.

• Healthcare Access and Quality: Access to health care, access to primary care, health literacy (health education), and healthcare provider pipeline programs.

• Neighborhood and Built Environment: Neighborhood crime and violence (including domestic violence and bullying), availability and quality of housing, and access to transportation.

• Racial, Ethnic and Cultural Competency: Educational initiatives to address bias, and discrimination and racialized medicine.

Funding requests can also support programs that focus on community needs and impact quality gap closures in behavioral health, women’s health, chronic condition management, preventative care, well-child visits, osteoporosis and fall prevention.

“This is just one way we are continuing to advance health equity, and foster our mission in its entirety, to help people lead healthier more secure lives by working together,” said physician Gina Cuyler, Excellus BCBS vice president of health equity and community investments.

For additional information and the online application, go www.excellusbcbs.com. Award winners will be announced in May.

Healthcare in a Minute

By George W. Chapman

Physician Burnout at Worst Levels in Decades

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t no time in the past several decades has physician burnout and stress been worse.

A recent survey of 13,000 physicians, published by Medscape 2022, revealed one in four (26%) physicians describes themselves as “unhappy” versus just one in 10 (9%) prior to the pandemic. The unhappiness percentage is much higher among hospital-based physicians.

The two-year-old, and counting, pandemic has taken its toll on physician relationships at work and

Telehealth Extended In January 2020, at the beginning on the pandemic, Congress declared a public health epidemic, which directed more funding to physicians and hospitals. It was scheduled to expire January 2022. Thankfully, it has been extended through April 16, 2022. What this means, primarily for consumers, is the continuing financial, operational and philosophical support for telemedicine.

The pandemic has significantly accelerated the use, acceptance and effectiveness of telemedicine which, prior to the pandemic, was largely underutilized primarily because of payment issues with Medicare and commercial insurers. The PHE authorized Medicare to pay physicians the same for virtual visits as in-person visits. Commercial payers followed suit. Telemedicine has increased or improved access to care for millions of senior, infirmed, disabled, incapacitated consumers as well as those living in rural and remote areas.

As an example, United Health Group saw its telemedicine visits soar from 1.2 million in 2019 to a staggering 34 million in 2020. An HHS study found that telehealth

at home. Many physicians indicated they will either retire early or reduce hours, which will only exacerbate the looming physician shortage.

The burnout is attributed to staffing shortages, longer and stress-packed hours, the spike in patient deaths and non-ompliant, demanding and outright ungrateful patients. Last December, six large Ohio healthcare systems, including the Cleveland Clinic, ran ads in local papers stating, simply, “HELP.” (See Help Wanted! below)

usage ran between 21% and 28% among various demographic subgroups. Understandably, the usage rate among the uninsured was only 9%. Somewhat surprisingly, the usage rate among technology-savvy 1824 year olds was only 18%. However, when they used telehealth, 73% of them used video. Income was a major determinant as 69% of households over $100,000 income incorporated telemedicine into their care.

Healthcare System Clogged The combination of higher acuity (and length of stay) of COVID-19 patients with system-wide staffing shortages has clogged or delayed hospital discharges to nursing homes, home care agencies and even hospices.

On the front end, when a hospital can’t discharge patients on a timely basis, it backs up the emergency department. Consequently, waiting times increase, ambulances are stacked up in the parking lot and ED hallways are jammed with patients on gurneys waiting for a bed.

On the back end, with nursing homes, home care agencies and hospices facing their own staffing shortages, their ability to safely accept a

Page 6 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

discharge and relieve the pressure on hospitals is severely curtailed.

According to a poll of 14,000 skilled nursing facilities by the American Healthcare Association, 58% are facing severe staffing shortages.

SNFs have lost 234,000 employees or 15% of their workforce since the pandemic. At the same time, hospital discharges to SNFs, primarily due to COVID-19, have increased 32%. Discharges to home health care agencies have increased 42% and discharges to hospices have increased 15%. According to the Kaiser Family Foundation, more than 200,000 SNF residents and employees died from COVID-19. Your patience, understanding and cooperation will go a long way with stressed out staff and your treatment.

mary care physicians and 43% cited need for specialists. Adding to the list of concerns were: patient safety, behavioral health and addiction, government mandates, access to services, patient satisfaction, physician and hospital relations, technology, population health management and reorganization.

It will take more expertise and a lot more cash than your average hospital has to reimagine and reorganize how care is delivered. Unless there is some sort of leveling of the playing field, for profit corporations with plenty of expertise and cash (like CVS, Walmart, Amazon, etc.) will gradually dominate the industry within the next decade.

It Takes a Shark

President Biden has resurrected the Cancer Moonshot Campaign, which aims to reduce the cancer death rate by 50% in 25 years. While COVID-19 has claimed 800,000 lives the past two years, cancer continues to claim 1.2 million lives every year.

Biden has directed more funding to the National Cancer Institute and the National Institutes for Health.

Industry analysts estimate close to 10 million cancer screenings have been delayed during the pandemic.

The Community Oncology Alliance has continually emphasized the fact that regular cancer screenings are inextricably linked to health disparities such as income, insurance, race, access to care and education.

Two cancer screenings that have been proven to be both clinically and financially effective are mammography and colonoscopies.

While the ubiquitous drug lobby has ramped up its efforts to prevent congress from fairly negotiating prices (versus “setting” prices per their misleading ads), billionaire philanthropist Mark Cuban of TV’s “Shark Tank” has started his own on-line generic drug pharmacy called “Mark Cuban Cost Plus Drug Company.”

There are currently 100 generic drugs on his formulary. Several popular generic drugs are offered at around half the price of the competition. Unlike typical pharmaceutical industry practices, he has vowed to be totally transparent. In general, prices are based on the manufacturer’s price plus a flat 15% fee. He has eliminated the middle man. It will be on a cash-only basis to keep out predatory pharmacy benefit managers.

Help Wanted!

For the first time, hospital CEOs cited staffing shortages as their No. 1 priority and concern. Perennial front runner finances fell to second place.

Three-hundred ten hospital CEOs responded to the most recent survey conducted by the American College of Healthcare Executives.

Ninety-four percent of them cited need for RNs, 85% cited need for therapists, 45% cited need for pri-

Cancer Prevention Campaign

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.

Left Diane Cooper-Currier has been executive director of Oswego County Opportunities since 2009, having started there in 1984. Today, she oversees an agency that serves about 15,000 people with more than 50 programs and an annual budget of $35 million for 2022.

Q A &

with

Diane Cooper-Currier Oswego County Opportunities executive director on how her agency is fighting poverty in Oswego County

By Mary Beth Roach Q: Can you give our readers an overview of what your agency does?

A: We are what we call an anti-poverty or community action agency. We were born out of [former President] Johnson’s War on Poverty to address, at the local level, the impact poverty was having on the local community and its members.

Poverty has all sorts of faces to it.

People can be impoverished in their ability to access health care; impoverished in lacking education, housing, social, emotional support, positive role models. When the agency was formed, we saw poverty as being more than just working with people who lacked income, but who lacked resources in a lot of different areas.

As a result, OCO provides access and support to resources that people may lack. We provide health care. We have reproductive healthcare services and community health services to help link people to health care through insurance navigators, through cancer services.

We help people who lack resources in transportation. We have educational services for preschool to adults to help people develop skills, educational skills, readiness skills to get into school and be successful; while they’re in school helping to support them through after-school programs; and then to adult education and services as well as job training and education and support. We also provide crisis, housing and case management services. A very wide variety that really is focused on helping people to address their immediate needs and then longer-term needs to help lead a more self-sufficient and self-reliant life.

Q: What is number of employees that you have?

A: If we were fully staffed, we would be at about 640 employees, but COVID-19 has definitely hurt us there. So we’re right now, about 550.

Q: How do you, as executive director, oversee such a large organization?

A: By having good people in

place all over the organization who are really committed to the mission and who care. Hiring that type of a person is so important to assure that the mission is continuing. We also have lots of systems in place for reporting, evaluating and making sure that we are being good stewards of that money we receive to provide those services, that we’re using that money in the way in which it’s intended to and that we’re achieving the outcomes and achieving the activities that we’re required to do.

Q: How are you funded?

A: We are funded through a variety of local, state and federal grants and contracts. About 50% of our funding comes from grants, that we have to demonstrate the need in Oswego County and then hopefully, do a good job in demonstrating that need and telling what we’re going to be doing with the funding, if awarded. Then we have contracts in place with the state, and sometimes local government, to provide and deliver a particular service. Out of that $35 million annual budget, we’re infusing about $32 million to $33 million of state and federal or other resources into Oswego County to deliver the services that we provide. I’d say close to the $32 million. Back when OCO was first formed [in 1966], it didn’t want to be a drain on the local community resources but to be a conduit to bring those resources into help this community and I think that we have stayed really true to that practice of our founders. We’re helping to bring resources into the community to address local community needs as much as possible and not be a drain on the local county tax base.

Q: What is the biggest challenge you’re facing now and how are you meeting it?

A: COVID-19, but I think we’re meeting it very well, moving from the state of crisis two years ago to now. The norm is we’re delivering some services virtually and some in person, creating hybrid services and creating those for our staff as well.

With crisis comes opportunity, and I think, with COVID-19, we’ve had an opportunity to be able to flex and develop in a way that we didn’t think we could do before. It’s still an ongoing challenge, trying to keep people well, keep people working. We run many residential programs that operate 24 hours, seven days a week, and we can’t close the doors when people get sick. Those residential programs

are really challenged with getting enough coverage to take care of some of our community’s most vulnerable people and keeping them safe. Bless those staff who worked inordinate amount of hours trying to keep their residents safe.

From a service component need, affordable housing. Our homeless population is homeless because they can’t afford the cost of rent. It’s not that that they’re not working or trying. When you’re paying 50% of your income toward your housing costs, that’s a losing battle. Affordable, decent, safe housing is critical.

Transportation: a lot of lower-income individuals can’t afford a car, or a car they can afford falls apart all the time. Getting around and having reliable transportation to get to a job or to maintain that job is difficult.

Q: What do you consider your biggest accomplishment as the executive director?

A: My accomplishments are my employees’ accomplishments. Everything that we do is because of our employees and the work that they’re doing day in and day out to make things happen, to serve those 15,000 people who have better outcomes and better lives as a result of touching OCO. One is leading through COVID-19 and helping people to feel that we got their back, both client and staff. But I didn’t do that alone.

That took a lot of people.

The second is being able to provide and partner with a housing development company out of Rochester, to be able to build affordable housing units in Oswego County. We were able to bring 60 units online, Champlain Commons in Scriba.

We’re partnering with another developer on a similar project in Pulaski called Selkirk Landing. [The agency is anticipating it’ll begin renting in late spring.]

Q: What do you see for the future of the organization?

A: There’s a lot changing in the landscape in terms of how services get delivered, whether that be healthcare, social services. In terms of our future, it’s being on the forefront of those changes. It’s really about ensuring better coordination and collaboration. I see strengthening our collaboration, strengthening our collaborations around housing, and ensuring we’re being flexible and creative in our solutions for helping people in this community change their lives.

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March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

‘Beware the Ides of March’ ... or Not!

I

n William Shakespeare’s “Julius Caesar,” a soothsayer warns Caesar to “Beware the Ides of March.” That immortal phrase portends gloom and doom. It has also given the month of March, a rather wearisome month to begin with, a bad rap.

Will this cold, rainy weather ever end? Will tender tree buds ever appear? Will we ever grill out again?

If March is stretching out in front of you as a big, dreary void to fill, you are not alone. For many, a prolonged winter wonderland is not so wonderful when cabin fever sets in.

Anxiety and restlessness can make unwelcome visits. You might feel yourself spiraling down, questioning the past and second-guessing your future dreams. And that’s when you could be tempted to grab for the TV remote, a pint of Ben and Jerry’s, and head for the couch — or worse — for bed.

Sounds familiar?

I can remember many nights after my divorce, coming home after work to an empty apartment with hours on my hands and a heavy heart. The prospect of a long, lonely evening or weekend ahead was almost unbearable.

After far too many nights on the couch, way too much TV, I had finally had enough. Both wanting and needing to make better use of my “me time,” I made some intentional changes to reduce my stress and restore my energy.

Today, I am thoroughly com-

fortable spending time by myself and have come to enjoy my own company. In fact, it’s not unusual for me to pass on an invitation to go out in favor of spending a nice quiet evening at home — relaxing or fully engaged in something I love to do.

If you are challenged by time alone this time of year, consider getting back to basics this March by following the “Three Rs” below: Reading, ‘Riting, and ‘Rithmatic.

Reading When is the last time you read a good book?

In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely evening for those who live alone.

While I’m reluctant to credit the pandemic with anything positive, I did discover a silver lining: Sheltering in place kick-started a reading binge for me that has yet to subside.

Reading “by ear” has become my preferred medium. I listen to audiobooks in my car, on my walks, while exercising, and when doing mundane tasks. Folding laundry comes to mind.

Beyond the convenience of audiobooks, a good narrator can bring the text to life. When I listen to my books, I experience a more intimate and emotional connection to the

characters and a deeper understanding of the story. Audiobooks have reinvigorated my love for reading.

Whether you enjoy reading a book in your hands, on your laptop, or through your earbuds, I’m confident you will feel less alone.

Don’t know where to start? Ask a friend for a book suggestion or make a selection from The New York Time’s best-seller list. My most recent favorite is “The Midnight Library”

by Matt Haig.

Snuggle up in a comfy, well-lit place and let a good book introduce you to new people, new places, and new ideas as we transition from winter to spring.

‘Riting I have found that putting pen to paper often lends clarity to the issues I face as a single woman. When I put things down in words, I can better organize my thoughts and embrace life’s challenges with less apprehension and more objectivity.

While I don’t keep a diary or journal, I am a tried-and-true list maker. Almost nothing gives me more satisfaction than checking things off my list — from paying bills to practicing meditation to returning emails.

I’m also a believer in capturing on paper the pros and cons of bigger life decisions, such as ending a longterm relationship, moving across the country to be closer to loved ones or to buying a new versus a used car.

These bigger, more profound decisions often trigger emotions and fears that can intrude on clear thinking. One helpful resource I have discovered is the “3-minute Positivity Journal” by bestselling author Kristen Butler. In her book, Kristen maintains that a daily habit of physically writing out our thoughts, feelings, intentions, reflections, goals and wins can change your life.

Excepted from the book jacket: “Each entry is quick, yet powerful —

March is National Kidney Month

To prevent kidney disease, control blood pressure, blood sugar levels, maintain a healthy body weight and avoid smoking

By Philip T. Ondocin, M.D

M

arch is National Kidney Month, and it is a great time to remind the community of the importance of our kidneys.

Nephrology is the branch of medicine that deals with the functions and diseases of the kidneys.

The kidneys serve many important functions, including filtering blood and wastes, regulating blood pressure, producing vitamin D, and controlling production of red blood cells.

Nationally, over 37 million people suffer from kidney disease, however most are unaware. This is a

serious concern, as by the time symptoms appear, kidney disease may have progressed to a more serious stage.

The potential symptoms of kidney disease include fluid retention in the legs and face, difficulty breathing, decreased appetite, difficulty sleeping, difficulty concentrating and skin itchiness.

Diabetes and high blood pressure are the major causes of kidney disease. Other risk factors include heart disease, obesity, and a family history.

The only way to find out if a person has kidney disease is through

Page 8 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

blood and urine tests to measure kidney functioning and check for protein in the urine. Lab test results are extremely important to measure kidney function, and the convenient, on-site lab at Nephrology Associates of Syracuse provides most results at the time of the office visit.

Our physicians and providers work together to develop an individualized care plan to slow the progression of kidney disease. A personalized path for preventing and treating kidney disease includes one-on-one in-person care. Care after a hospitalization and monthly chronic care services are available to monitor kidney functioning. Patient education visits that focus on the patient’s condition, options for care, diet, exercise, and

only three minutes in the morning and three minutes in the evening — to keep you on track with your mindset, health and goals.”

I encourage you to check it out.

March won’t be so bad after all!

‘Rithmatic Yes, arithmetic. Math is all about patterns and relationships. And relationships are key to our happiness as we get older. But don’t take my word for it.

In the Harvard “Study of Adult Development,” one of the world’s longest studies of adult life and health, researchers uncovered a surprising finding: That our relationships and how happy we are in our relationships have a powerful influence on our health. This is according to Robert Waldinger, director of the study and professor of psychiatry at Harvard Medical School.

The study revealed that close relationships, more than money or fame, are what keep people happy throughout their lives.

My readers have heard me say this many times: Mastering the art of living alone is not about mastering the art of isolation. It is about mastering the art of engagement and connection with yourself and with others.

Our journey to contentment is one we make with companions. Relationships are what bring purpose and meaning to our lives.

So, hug those dear to you and embrace the month of March — doldrums, slush, Ides and all!

Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com

how best to manage kidney health are available.

To prevent kidney disease and lower risk for kidney failure, control blood pressure and blood sugar levels, maintain a healthy body weight, avoid smoking, and check with your doctor before taking certain medications.

I recommend that individuals with risk factors or who are experiencing symptoms should be screened by their primary care physician. If warranted, your provider will make a referral for a kidney consultation at our office.

Physician Philip T. Ondocin practices at Nephrology Associates of Syracuse, PC. For more information, call 315-478-3311 or visit www.nephrologysyracuse. com.

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March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 9

My Turn

By Eva Briggs, MD

Exciting Advances in the Fight Against Cancer

Two patients with chronic lymphocytic leukemia (CLL) appear to be cured 10 years after receiving CAR-T therapy

W

hile driving last week, I caught part of the NPR radio show Science Friday.

The story discussed a type of cancer treatment called CAR-T. This form of immunotherapy modifies a patient’s own immune cells to find and destroy their cancer cells.

This story was newsworthy because two patients with chronic lymphocytic leukemia (CLL) appear to be cured 10 years after receiving CAR-T therapy.

This piqued my interest because both my father and brother died from CLL. Current treatments for CLL control the disease for a while but don’t cure it.

CLL is the most common form of leukemia in adults. The lifetime risk for the average adult is 1 in 175. It’s often slow growing. CLL can be present for years without requiring treatment. Some forms of CLL are more aggressive. Even people with the slowly progressive form often reach a final stage where the leukemia grows quickly and needs treatment.

Many asymptomatic CLL patients discover their disease when routine blood reveals an elevated white blood count. More advanced CLL causes fever, fatigue, susceptibility to infections, swollen glands, or unexplained weight loss.

CAR-T stands for chimeric antigen receptor T-cell therapy. It’s

Page 10 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

been studied and used most often for leukemias and lymphomas that affect a type of immune cell called B-cells. These cancers arise when a patient’s B-cells mutate to become malignant, growing and reproducing out of control. B-cells have proteins on the surface called antigens. The idea behind CAR-T therapy is to take a patient’s own T cells, modify the T cells to find those antigens, latch onto them and destroy the cancerous B cells. The antigen best studied so far is CD19.

Currently CAR-T is used mainly for acute lymphocytic leukemia and for non-Hodgkin’s lymphoma that has failed treatment or relapsed after standard chemotherapy. The patient’s own white blood cells are harvested via a process called leukapheresis. Blood is removed and passed through a machine that separates out white blood cells. The remaining blood is returned to the patient.

This takes approximately three to six hours. The collected cells are sent to a special lab.

The lab separates the T cells from the other white blood cells. A special virus inserts new DNA into the T cells. This DNA instructs the T cells to make a receptor specific for the target antigen. This new receptor’s shape exactly fits the antigen, like a lock and key fitting together. The modified T cells grow and multiply in the lab, a processing requiring up to several weeks. During this time period, some patients receive low dose chemotherapy. This chemotherapy reduces the quantity of the patient’s white blood cells to allow the

CAR-T cells to better thrive. The lab ships the CAR-T cells to the patient’s treatment center. The cells are given via a single infusion and immediately begin to seek and destroy the cancer cells.

It’s a powerful treatment, capable of causing side effects. One side effect is called cytokine release syndrome (CRS). Cytokines are powerful chemicals produced by T-cells when they are working to destroy harmful cancer cells. So, CRS means the therapy is working. Symptoms include fevers and low blood pressure. Doctors have discovered supportive treatments to reduce the severity of CRS. CAR-T cells may also destroy the patient’s functional noncancerous B-cells, increasing the risk of infection. This can be treated with immunoglobulin therapy. CAR-T therapy often causes neurologic side effects such as confusion or seizures.

Fortunately, neurotoxicity seems to be short-lived and reversible.

While this treatment was developed too late to help my father or brother, it was exciting to hear about a potential cure for the common cancer CLL. Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.

5

Things You Should Know About Colon Cancer

By Ernst Lamothe Jr.

C

olon cancer remains one of the most preventable cancers around.

It occurs when there is beyond control growth of cancerous cells in the colon.

Your colon is a tube-like structure in the large intestine connecting to the small intestine, which removes water, few nutrients and electrolytes from partially digested food. The American Cancer Society estimated that about one in 25 women and one in 23 men develop colorectal cancer during their lifetime.

“This is an important topic for discussion because colon cancer is the second most diagnosed cancer in men and third most common in women,” said Suri Karthikeyan, gastroenterologist for Oswego Health and board-certified physician. “Screening has significantly decreased the mortality rate because early detections create better outcomes.”

Karthikeyan talks about five aspects of colorectal cancer and prevention that you need to know.

1.Misconceptions

There are myriad misconceptions when it comes to colorectal cancer. Anything from only people with family history get colon cancer to the idea that it is always fatal. It may be curable when detected early.

More than 90% of patients with localized colorectal cancer are alive five years after diagnosis. However, only around a third of all colorectal cancers are diagnosed at this early stage.

Another myth is that the disease only strikes the older population.

“People think this is a disease of the elderly and that is untrue. We are seeing younger patients being diagnosed whether that is because

of family history and being a genetic risk or other factors,” said Karthikeyan.

Karthikeyan also said he wants to discourage people to think that symptoms are the only reasons to receive a colonoscopy.

“You can’t wait for symptoms to develop before you start taking precautions,” he said. “We have to be proactive because it is difficult to have good outcomes by the time someone has rectal bleeding or abdominal pain.”

2.Get a colonoscopy

In 2021, there were about 150,000 colon and rectal cancers.

A colonoscopy is an exam used to detect changes or abnormalities in the large intestine colon and rectum.

During a colonoscopy, a long, flexible tube is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the entire colon.

“We have to do everything we can to educate people to prevent colon cancer. We know with studies that people who have colonoscopies have extremely low mortality rates,” said Karthikeyan. “People perceive the prep as possibly painful, but the procedure is rather painless and patients are sedated without discomfort.”

3.You have options

There are a variety of tests that people can take if they don’t want to go through a colonoscopy.

There are stool-based tests called fecal immunochemical test which checks stool for signs of cancer. These tests are less invasive and easier to have done but need to be done more often. Another option is a virtual

exam that looks at the structure of the colon and rectum for any abnormal areas by special imaging X-ray.

“FIT testing is 74% effective and virtual colonoscopy is 84% effective in detecting larger abnormalities but only 50% when it comes to detecting smaller polyps,” he added.

4.Stages of cancer

Colorectal cancer grows from stage 0, which is the earliest stage to stage 4, the most advanced.

At stage 0, the abnormal cells are only in the inner lining of the colon or rectum. At stage 1, the cancer grows through the inner lining and reaches the muscle layer of the colon or rectum. At stage 2, the cancer grows through the wall of the colon or rectum but won’t spread into nearby tissue or lymph nodes. At stage 3, the cancer will move to the lymph nodes but not to other parts of the body. At stage 4 the final stage, the cancer will spread to other major organs, such as the liver or lungs.

People with stage 1 and stage 2 may experience symptoms like constipation, diarrhea, change in stool color or shape, blood in stool, bleeding from rectum, excessive gas, abdominal cramps and abdominal pain. Some people may not experience any symptoms in the earlier stage which makes it even more difficult to predict the condition. But, the symptoms are noticeable in stages 3 and 4 such as excessive fatigue, weakness, weight loss, vomiting, and feeling like your bowel is not completely empty.

“Stage 4 colon cancer means it has metastasized various organs and these patients have very little chance of cure in this condition,” he said.

Suri Karthikeyan is a gastroenterologist and a member of the Center for Gastroenterology and Metabolic Diseases at Oswego Hospital. “Colon cancer is the second most diagnosed cancer in men and third most common in women,” he says.

guideline 5.Colonoscopy changes

In May 2021, the U.S. Preventive Services Task Force issued new recommendations for colorectal cancer starting at an earlier age.

Now that we are seeing an increase of colon cancer between 40 and 50, the American Cancer Society has approved the age of colon cancer testing to 45.

The recommended age was lowered from 50 to 45 because colorectal cancer cases are on the rise among young and middle-age people.

Deaths of people younger than 55 increased 1% per year from 2008 to 2017; even though overall colorectal cancer rates have dropped.

May Change Your Life Forever Learn about prevention & treatment.

315-551-2551 • CNYLymeAlliance.org March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 11

Meals prepared for homebound seniors.

Oswego County Opportunities prepares and distributes meals to more than 500 homebound seniors across Oswego County every day. The meals are produced at OCO’s kitchen facility in Mexico.

Workers prepare meals for homebound seniors. Oswego County Opportunities prepares and distributes meals to more than 500 homebound seniors across Oswego County every day. The meals are produced at OCO’s kitchen facility in Mexico.

Nonprofits Face Challenges Fighting Food Insecurity They’re doing their best to prepare for whatever is coming up next without knowing what that is

By Ken Sturtz

T

he line of cars began forming at the state fairgrounds at 8 a.m.

— four hours ahead of time — and grew longer and longer until it seemed to snake on forever.

It was May 2020 and in the midst of the crippling coronavirus pandemic, the Food Bank of Central New York was preparing for the largest one-time delivery of food in its history. By day’s end it had handed out more than 59,000 pounds of food to a thousand families, half of whom said they were accepting donated food for the first time.

In the early months of the pandemic, as millions of Americans found themselves out of work, nonprofits dedicated to fighting hunger were roundly praised for providing food on an unprecedented scale. Donations of food and money poured in along with billions of dollars in

federal stimulus money.

“At the beginning of the pandemic we were in the spotlight, but we’re not the focus anymore,” said Lynn Hy, chief development officer for the Food Bank of Central New York. “We’re still doing the same work we were doing a year ago.”

The worst of the pandemic may be over, but many Americans have continued struggling to get by. Some were in trouble before the pandemic, but others simply haven’t fully recovered. Now rising food prices coupled with supply chain issues are putting pressure on both low-income families and the organizations charged with helping them.

Food insecurity decreased last year across the country as the rollout of the COVID-19 vaccine allowed many sectors of the economy to reopen, but experts have warned that the need for food support is still greater than it was before the pan-

Page 12 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

demic.

The cost of meat, poultry, fish and eggs has shot up. The prices of dairy products, fruits and grains have also increased. Many Americans have struggled to absorb the rising cost at the grocery store. And higher fuel prices have only increased pressure on low-income families.

Lori Halstead understands firsthand the pressure rising food costs and supply challenges are placing on nonprofits.

As coordinator of Nutrition Services for Oswego County Opportunities, Halstead oversees a kitchen in Mexico that produces two meals each for more than 500 homebound seniors every day. The meals are delivered across the county. OCO also operates six dining and activity centers where seniors can socialize and receive hot meals. During the pandemic the centers were temporarily closed and OCO switched to

a grab-and-go model. The facilities have since begun reopening.

OCO also runs programs that provide meals to children during summer and meals and snacks for children in afterschool programs.

Many of those programs were disrupted by the pandemic and had to be halted or reconfigured.

Halstead said that throughout the pandemic she’s had to deal with hit-or-miss food availability and roller-coaster prices.

Some of the shortages and price increases have left her perplexed.

The price of meat skyrocketed, she said, but the price of dairy products has gone up and down. The price of canned fruit, usually an afterthought, has doubled.

Halstead doesn’t have a lot of flexibility in her budget — the largest portion of OCO’s meal program is funded by a contract with Oswego County to provide meals to seniors — or her staff. There are five fulltime workers in the kitchen and one part-time employee. They also rely on volunteers. All of this has necessitated getting more creative to keep prices down.

For example, Halstead said, they might want to use a pre-cooked chicken breast. But it’s cheaper to buy raw chicken breasts, trim them and cook them. Instead of using individually-packaged cups of yogurt or fruit in meals, they’ve bought the yogurt and fruit in bulk, portioned it out and packaged it themselves. It’s more work, but it saves money.

“We just have to be very careful in our production methods,” Halstead said. “We have to be careful with waste and tight with what we’re producing.”

Nonprofits have found other ways to deal with rising food costs and supply issues.

The Rescue Mission Alliance serves three hot meals daily from its recently expanded food service center in Syracuse. Meals are available to anyone who walks through the door.

For a time, the Mission served meals to-go, but it has since reopened its dining room.

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Meals are distributed at the Hannibal Dining and Activity Center. Oswego County Opportunities operates six centers where seniors can socialize and receive hot meals.

The centers temporarily closed during the pandemic and OCO switched to a graband-go meal model. The centers have since begun reopening. said.

Zach DeRose, director of Food The food bank has also had to Services, said the Mission has been deal with many of the same price serving meals to an average of 400 increases and supply issues as other people a day, a figure that has renonprofits, but on a larger scale. The mained fairly consistent.

“As far as availability of product, food bank is the main distribution hub for an emergency food network we are in a unique situation where if that includes more than 400 commusomething we order is out of stock, nity partners. Its warehouse in Van we will go a different path,” DeRose Buren includes 61,000 square feet of said. food storage.

The food service center doesn’t Donations from food manufachave a set menu, so they utilize food turers, grocers, wholesalers, busidonations as they come in and nesses, and individuals supplement them when supplement the food necessary. The Mission bank’s inventory also receives donaand it receives tions from several The worst of the commodity of the area’s foods from grocers and pandemic may be over, the USDA — food vendors. but many Americans have meats, vegDeRose said donations continued struggling to get by. etables and — that are also Now rising food prices coupled fruit it distributes picked up with supply chain issues are to its partner during the agencies. holidays. putting pressure on both lowBut it also “So that income families and the purchases is one of food wholesale the ways we organizations charged and is suscepavoid some of with helping them. tible to the same the inflation in supply challenges the cost of prodand price increases as ucts, but ultimately others. everyone is in the same The food bank has been boat,” he said. monitoring supply chain issues In many cases the pandemic throughout the pandemic and has forced nonprofits to adapt. For changing or substituting items when example, Hy said it became evident necessary to ensure it can maintain a during the pandemic that the food steady supply of needed food items bank needed to find a way to better to its partner agencies. serve seniors. That population was Hy said the food bank has conparticularly reluctant to leave their tinued its SNAP outreach program, homes, which made it difficult for helping people in need with applying them to receive food at pantries and for the federal food benefit. That has soup kitchens.

The solution was a new program. proven even more important as temporary government assistance related The food bank began working with to the pandemic has faded. The food county government to provide food bank has also focused on helping its assistance on site at low-income partner agencies expand their capacisenior housing communities. The food bank would find out how many ty; especially after many struggled to serve the growing number of people people lived in the facility and boxes in need early on in the pandemic. of food would be dropped off.

Besides supply and price difficulThe program started in Ononties, Hy said that the pandemic has daga County and proved so successshown it’s impossible to guess what ful that it was expanded. The food might be around the bend. bank plans to scale the program up “We’re doing the best that we can to include each of the 11 counties it to prepare for whatever is coming up serves. next without knowing what that is,” “We think it’s really important she said. for the seniors we’re serving,” Hy

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March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 13

The No Surprises Act Protects Patients From Unexpected Medical Bills Crowdfunding for Medical Costs Almost Always Fails

Y

ou have almost certainly seen the pleas while scrolling through social media: Called crowdfunding, folks try to raise money to pay for their sick loved one’s mounting medical bills.

But new research shows these grassroots campaigns rarely raise enough money to make a difference.

According to GoFundMe, which corners over 90% of the U.S. crowdfunding market, more than one-third of its fundraisers are for medical needs.

Crowdfunding for medical bills has often been talked of as an “ad-hoc” safety net — a place for the uninsured or underinsured to turn to in times of need.

But the new findings, published Feb. 3 in the American Journal of Public Health, reveal a different reality.

People dealing with medical debt are often facing “astronomical” costs, explained lead researcher Nora Kenworthy, an associate professor at the University of Washington, Bothell.

So, even a crowdfunding campaign that goes relatively well may still fall far short of getting people out from under medical bills.

The investigators found over 437,000 fundraisers listed for medical needs between 2016 and 2020. Altogether, those campaigns raised an impressive-sounding $2 billion.

But campaigns varied wildly in their success: The top performer raised $2.4 million, from over 70,000 donors, while 16% of all campaigns raised nothing.

When campaigns made money, they typically had modest success, pulling in a median of $1,100 in 2020.

And across all study years, almost 90% of campaigns failed to meet their goals; half reached 25%, while one-third raised half of what they’d hoped.

Who was most successful at fundraising? The people who already had some advantages.

The study found that more campaigns were launched in U.S. states with the highest rates of medical debt and lowest rates of insured residents. Yet, those same campaigns earned the least.

A look at the data by income found a similar pattern: Campaigns in the one-fifth of U.S. ZIP codes with the highest incomes raked in a total of $152 million in 2020. That compared with $70 million in the one-fifth of ZIP codes with the lowest incomes.

Patients can more knowledgeably weigh their options and make informed choices

By Deborah Jeanne Sergeant

H

ave you ever received an unexpected medical bill weeks after you arrive home from the hospital?

Or feel sticker shock when the tab for the specialist is much higher than you imagined it would be?

That should seldom happen again, thanks to the No Surprises Act (H.R.3630).

It is part of the Consolidated Appropriations Act, 2021 (CCA), which passed with bipartisan support in Congress and was signed by President Trump. The law took effect Jan. 1, 2022.

The Congressional Budget Office estimates that the act will lower health insurance premiums by between 0.5% and 1%, which can amount to a savings to taxpayers of $17 billion over the next decade. Consumers should save about twice as much between the savings on health insurance premiums and cost sharing for out-of-network expenses.

The No Surprises Act applies to commercial insurance, since programs like Medicare and Medicaid already have this kind of protection built in. The one big exception is ground ambulances. Providers and facilities outside the patient’s commercial insurance network cannot bill patients above the in-network cost sharing amounts for emergency facilities and services; post-stabilization care until they can be transferred to an in-network facility; air transportation; services ordered by an in-network facility. The exception is if the provider offers notification of the billing and obtains the patient’s written consent more than 72 hours before the service is delivered. But services such as emergency medicine, anesthesiology, pathology, radiology, neonatology, and diagnostic testing are not included, as patients normally cannot give consent.

“It lowers emergency services, particularly if you have out-ofnetwork costs,” said Steve Wood director of insurance programs for ACR Health in Syracuse.

“You’re not hit with massive hospital bills that can really devastate you.

It’s always been a tricky situation in the past and I’m glad it’s been rectified.”

He believes that the No Steve Wood Surprises Act represents a big step toward better transparency in healthcare because it offers important information that can affect how patients receive care and how the care will affect their finances. Instead of blindly plunging forward into costly healthcare options, patients can more knowledgeably weigh their options and make informed choices more favorable to their financial situation.

“Doctors occasionally take on shifts at hospitals where they are

Page 14 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

The No Surprises Act establishes new federal protections against surprise medical bills that take effect in 2022.

Surprise medical bills arise when insured consumers inadvertently receive care from out-ofnetwork hospitals, doctors, or other providers they did not choose. not in network,” Wood said. “That’s where the issue is.”

Specialists called in from other networks would also ratchet up the bill. Wood likens the scenario to purchasing a car and then receiving the true cost, once additional warranties, undercoating application, dealer fees and other costs are added to the price of the car.

“They tell you one price and at the end of the meeting with the salesperson, it costs more because of the added things,” Wood said.

Now with the No Surprises Act, patients without health insurance can know what to expect. Any good faith estimates they receive that are $400 or more higher may be contested within 120 days of the date on the bill.

Wood stressed the importance of the No Surprises Act to family finances.

“We’ve been working on this for a few years,” he said. “I’m glad to see it come through. It’s a step in the right direction for consumers and not fall to predatory behavior by insur-

ance companies. It’s a great move towards equity in healthcare.”

Caitlin Donovan, senior director of the Patient Advocate Foundation in Hampton, Virginia, said that price transparency will help reduce the cost of care, though it will not solve the problem of the high cost of care.

“Healthcare is forever unexpected,” Donovan said. “Building in more certainty is better for patients and caregivers.”

She said that one loophole in the No Surprises Act is ground-based ambulance services, which are quite complex. Depending upon the municipality, the ambulance service may be within or without the patient’s insurance network.

“I’ve seen people with $1,500 ambulance bills, or horror stories of people trying to take an Uber to the hospital,” Donovan said. “You don’t have a lot of power over who 911 will send.”

But once the ambulance parks at the hospital, the rest of the patient care will no longer be subject to surprise billing.

Donovan said that since the No Surprises Act is so new, many healthcare consumers do not know they should receive advanced notice of out-of-network bills.

“They need to know it’s out there, so they don’t get bamboozled by a bad actor,” she said. “Your insurance company and provider should let you know if that bill is covered by the No Surprises Act. Look over your explanation of benefits. That should be where you’re made aware you’re covered. Once you’re to the point of a bad actor who’s not following the law, it becomes your responsibility to stick up for your rights.”

Unfortunately, about half of medical bills have mistakes in them.

Donovan said that when her son was born two years ago, her bill had an extra $650 on it. It took her eight months to get the money back. On average, it takes her case managers about 20 phone calls to resolve issues such as this.

“It’s easy to be cynical and say that’s why the system is set up that way, that they hope you give up,” she added.

SmartBites

The skinny on healthy eating Prune’s Other Benefits May Surprise You

By Anne Palumbo

S

hould we pity the poor prune?

It’s shriveled, wrinkled and puckered.

It’s best known for relieving constipation. It’s granny’s favorite fruit. It’s never in restaurants but always in nursing homes. And its sexy makeover — from dowdy prune to provocative dried plum — never gained enough traction to stick.

But, no, we should not pity the humble prune. We should take a cue from granny and get to know this delicious dried fruit even better!

Boasting an impressive array of nutrients — over 15 different vitamins and minerals — a prune’s health benefits go way beyond the bathroom.

Ready for some surprises?

Prunes are great for bones. Yes, bones! Current studies suggest that simply eating a serving of five prunes a day may help slow and prevent bone loss. While it’s not entirely clear why prunes promote bone health, this mighty dried fruit has many properties to consider: good amounts of vitamin K and potassium (both vital for strong bones), a wealth of antioxidants that may protect bones from cell damage, and the potential to increase certain hormones that are involved in bone formation. No wonder Granny’s doing the Rumba with Gramps into the wee hours!

Another startling perk from this toothsome dried plum? Prunes benefit heart health. Their fiber helps lower cholesterol; their powerful antioxidants keep inflammation at bay; and their potassium helps lower blood pressure and ease tension in the walls of blood vessels. Indeed, a trifecta of nutrients to help keep our tickers tocking longer.

Lastly, prunes are good for guts in more ways than one. While the insoluble fiber in prunes promotes regular bowel movements, the soluble fiber helps to moderate digestion and absorb nutrients from our food.

What’s more, prunes contain sorbitol — an ingredient known to have a laxative effect — which can increase stool frequency. Feeling blocked-up and sluggish? Passing stools as hard as golf balls? You know what to reach for!

An average serving of four prunes has 90 calories, 3 grams of fiber, and no fat, cholesterol or sodium. Final surprise? A recent study found that people who snacked on prunes felt less hungry and ate fewer calories overall than people who ate other foods.

Helpful tips Look for prunes that have no added sugars and are preservative-free. Tightly reseal opened packages and store in a cool, dry place. Prunes do not need to be refrigerated. If you’re not used to eating prunes or other fiber-rich foods, you may want to start slow with one to two prunes a day and slowly work your way up.

The Mediterranean Diet: the Diet for a Healthy Heart

By Nelly Kazzaz, M.D.

T

he Mediterranean diet is rated

by U.S. News as a Best Diets of 2022 for many reasons.

It is healthy, easy to follow and, more importantly, it is ideal for cardiovascular health. Low in saturated fats like red meat and dairy products, it is rich in monounsaturated fats like olive oil which are believed to be anti-inflammatory properties.

The Mediterranean diet is also rich in minimally processed foods with plenty of fruits, vegetables, legumes, tree nuts and whole grains.

Eating healthier and smarter is traditionally considered a main predictor of cardiovascular health. Most diets work, meaning they can accomplish short-term goals of weight loss and control. But those results are also usually short-lived and not necessarily heart-healthy.

Alternatively, the Mediterranean diet has been repeatedly recognized

as the best diet for its nutritional values, its flexibility, its ease to follow and maintain over time and, most importantly, its evidence-based health benefits.

Comprehensive and international research has directly linked the Mediterranean diet to better heart health, a lower risk of diabetes, less inflammation, and even a possibly lower risk of age-related cognitive decline.

Simply put, it can help us achieve longer and healthier life.

I encourage all of you to try a little olive oil on your bread instead of butter; grab a handful of unsalted nuts to snack on instead of a bag of chips. Next time you’re shopping, try a new whole grain bread or pasta, or even couscous. Try a new recipe with legumes like chickpeas or lentils. Buy a little less red meat and a little more fish. Your heart deserves it and your life is worth it. As a heart doctor, I do what I preach, but I also know

½ teaspoon Dijon mustard ½ teaspoon salt ¼ teaspoon coarse black pepper 1-2 tablespoons water to thin, as needed Make the salad Rinse the quinoa (to remove bitterness) and drain well. Combine the rinsed quinoa and water in a saucepan. Bring the mixture to a boil over medium-high heat, then decrease the heat to low to maintain a gentle simmer. Cook until the quinoa has absorbed all the water, about 15 to 20 minutes. Remove the pot from heat, cover, and let quinoa steam for 5 minutes. Transfer the quinoa to a medium bowl and fluff with a fork.

Cut the peppers into small chunks, finely chop the parsley, and cut the prunes into quarters. Drizzle vinaigrette over fluffed quinoa and mix well. Add the peppers, parsley, prunes, lemon zest, lemon juice and slivered almonds and gently mix again. Adjust seasonings and serve.

Make the vinaigrette

Quinoa Salad with Chopped Prunes and Prune Vinaigrette

Adapted from californiaprunes.org Serves 4-6 For the salad: ¾ cup quinoa 1½ cups water ½ cup chopped red pepper ½ cup chopped yellow pepper ¼ cup parsley, finely chopped 5 prunes, zest from 1 lemon 1-2 tablespoons lemon juice ½ cup slivered almonds, toasted For the vinaigrette: 4 prunes ½ cup water 2 tablespoons olive oil 1 tablespoon balsamic vinegar that sometimes life gets in the way.

Give yourself some grace, and just do the best you can as often as you can, even if it’s just a little at a time.

As a cardiologist, I am passionate about the prevention of cardiovascular diseases, and have an ethical duty toward my patients to both help them identify their risks for cardiovascular disease and to help modify them. I dream of the day when patients confront their fears, know their numbers (blood pressure, cholesterol levels, waistline, and blood sugar) and actively seek advice to reduce their risks by lifestyle modification and, when necessary, medications.

I’m frequently asked about who should see a cardiologist and when.

If you are having symptoms of cardiac issues, the answer is obvious— as soon as possible. For patients living with risk factors for heart diseases such as — but not limited to — age, hypertension, diabetes, high cholesterol smoking, weight issues or family history of heart disease, I recommend routine visits with a cardiologist for aggressive preventive measures. If you are experiencing any symptoms of a heart problems, do not ignore it or try to self-diag-

While quinoa is cooking, make the vinaigrette. Cut prunes in half and put in a small pan with ½ cup water. Bring to a boil and then decrease the heat to low to maintain a gentle simmer. Simmer, uncovered, for around 10 minutes until the water is almost gone. Stir occasionally while prunes are cooking.

Remove from heat and transfer to a small food processor. Add oil, balsamic vinegar, Dijon mustard, salt and pepper and blend until fairly smooth. Add 1 to 2 tablespoons water to get a pourable thickness.

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.

nose. Call your doctor or 9-1-1 if the symptoms are acute or resemble a heart attack.

I implore you to prioritize your own physical and mental health, to know your numbers, to eat healthy, stay active, get some sleep, stay mindful of stress relief practices, and see your doctor with the focus on prevention of cardiovascular disease.

Nelly Kazzaz is a cardiologist at St. Joseph’s Health.

March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 15

Addiction

In-Patient Care Only Part of Substance Use Recovery

By Deborah Jeanne Sergeant

F

or a patient struggling with a substance use problem, a stay in an inpatient facility may represent only part of the recovery process.

Not everyone begins at inpatient, said Kathleen Gaffney-Babb, executive vice president and chief operating officer of Helio Health in Syracuse.

“I think there are a lot of misunderstandings and stigma,” said Gaffney-Babb. “One is that treatment for substance use is ‘one-and-done.’

We don’t think of any other health situation like that, like diabetes: you go to your doctor and get insulin and eat right and expect the person to never need more care. We don’t do that with any other health conditions but substance use disorder. A lot of people think if you get treatment, you should be all better. That is a disservice to people in recovery to

think that.”

Gaffney-Babb said that initially, patients may not need inpatient care, but outpatient treatment, meeting with a counselor weekly with medication.

Care begins with an assessment, looking at the patient’s functioning and needs. Providers take an integration approach: medication, nutrition, socialization, housing, employment and whatever else the person needs to achieve a healthy level of functioning.

“We’d look at their substance use history and what problems that has caused in their life,” Gaffney-Babb said. “We base their level of care on that assessment.”

For those who need inpatient care, the journey toward wellness may have only begun once their two to three weeks of inpatient care has ended. In some cases, a stay at a residency for three to four months may be in order and then treatment as an

outpatient or at a halfway house for weeks afterwards.

Unfortunately, this may take several years and attempts at completing a treatment program, and the patient’s insurance coverage may not cover the necessary amount of treatment. At hundreds of dollars a day, it is not cost effective to keep people in inpatient programs for months or even several weeks. For certain patients with the right supports, that level of care is not even necessary. Insurance companies look at the individual’s ability to function independently and within the limits of their coverage pay for care based upon their function.

“Sometimes, incorrectly, insurance companies may look at the number of days instead of functioning,” Gaffney-Babb said. “The provider needs to advocate for their care.”

In addition to services offered

by Helio, the organization can refer patients to outside care that can help support the patient’s recovery.

Most insurers do not cover inpatient care unless lower levels of care have not been tried first. During inpatient stays, patients develop a plan for their follow-up treatment to increase their chances of success.

This can include finding housing, a local therapist, group meetings or a sponsor.

For patients forced to go to inpatient treatment by a family member or judge, treatment likely will not progress to success.

Gaffney-Babb said that preparing for discharge is important because patients must eventually go back to the world where they used substances. If they do not enact changes in themselves first, they will likely begin using again.

As with patients at Helio Health, patients at Cazenovia Recovery in Buffalo also develop a discharge plan and receive referrals before they leave inpatient treatment.

“As soon as they come, we ask

VA Improves Access for Disabled Veterans

T

he Syracuse VA Medical Center recently completed a newly redesigned and improved DAV (disabled American veterans) entrance, which will help disabled veterans access the services the center offers.

The state-of-the-art, extra-large, revolving door accommodates large mobility devices such as wheelchairs and scooters. The $1.1 million entry redesign project also vastly improves energy efficiency by replacing sliding doors with the new revolving door and separate Americans with Disabilities Act (ADA)-approved bypass door. The project also improves physical security with the addition of security cameras, card reader and bollards.

“I want to thank our dedicated DAV volunteer drivers and office staff led by Ed Rogers,” said Frank Pearson, Syracuse VA Medical Center director. “We know how proud you are of what you do for our veterans and we know this improvement will make you even more proud of the effort that we make as a team to provide best care anywhere for this special group of veterans.”

Page 16 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

Kathleen Gaffney-Babb is the executive vice-president and chief operating officer of Helio Health in Syracuse. about their plans after discharge and how can we support those plans,” said Edward Cichon, director of marketing and communications for Cazenovia Recovery. “They have a structure set up for referrals and they feel supported and empowered so they make good choices when they leave us.”

This includes referrals to an outpatient provider and housing. While dictating what patients should do next may seem a good idea, Cazenovia Recovery has found that working with patients to develop their plans works better than telling them what to do next in their recovery process.

A sense of support and community is also necessary for patients’ success. That is why Cazenovia works with patients’ families.

“Family involvement is huge,” said Angela Angora, director of reintegration. “By having family members come in, we can have expectations about when this person can leave.”

KIDS & TEENS

Top 10 Issues Teens Face Today

By Deborah Jeanne Sergeant

I

n addition to the normal issues teenagers face, the pandemic has added an additional layer of stressors and pressure. Area experts weighed in on what they believe are the top issues of young people.

1. Eating habits.

“It’s horrible how they eat,” said Michelle Dougan, personal trainer at Elevate Fitness in Liverpool. “Natural foods are where it’s at: fruits and vegetables, lean protein and whole foods, not boxed and fried foods. Pizza is fine if you make it but don’t get it at Domino’s.”

2. Activity level.

“Fitness is very important, but teens have to find something that they like. I have four children. Two of them love to work out. The two that like to work out: awesome. For the other two, I encourage them to find a sport or activity they will do for a half hour a day. It would change everything if teens would do this.

They have to get moving and get off their phones. I know that is where things have gone since the pandemic, but they need to get moving and do something they like, even like walking or tennis or basketball.”

sleep, they can focus better,” Irri said. “They will learn better at school and feel healthier.”

5. Limited screen time.

“Two hours’ screen time is maximum,” Irri said. “Now with Zoom classes and remote learning, they may need more computer time, but this two-hour limit is games, computer time and television.”

6. Hydrating with water.

4. Sufficient sleep.

“If they have a good nine hours’

“They should balance schoolwork with other things,” Irri said.

8. Mental health.

3. Regular check-ups.

“I do educate families that they should have regular doctor and dental visits,” said Chakrapani Irri, pediatrician with Children’s Health Specialists in Auburn. “If they have concerns about vision, they should see an optician. If they do not do that, their schooling will suffer. They need to feel well and see well to do well in school.”

7. Sufficient down time.

“Try to drink more water and little milk and little fruit juice,” Irri said. “Most kids do not drink enough water and want fizzy drinks and energy drinks. They need water. Cut fruits up and put them in a jug with water in the fridge. Throughout the day, they have some flavor from a natural fruit. Prepare a new jug each day.”

“We are in an adolescent mental health crisis that was percolating prior to the COVID-19 pandemic, but has worsened significantly since 2020,” said physician Karen Teelin, associate professor of pediatrics and director of adolescent medicine at Upstate Golisano Children’s Hospital. “Suicide is the second leading cause of death for youth ages 10 to 24 years old.”

9. Eating disorders.

“Rates of eating disorders have also increased dramatically. These are serious, potentially life-threatening disorders that affect the physical and psychological development of adolescents,” Teelin said.

10. Bullying.

“Bullying can harm a youth’s physical and emotional health,” Teelin said. “It is associated with depression, suicide, poor school performance and/or attendance and substance use. It’s important for parents and guardians to guide their children so that they are neither the perpetrator nor the victim of bullying. Parents can help youth build coping skills to deal with challenging situations and can model positive behavior toward others.

“It’s important for youth to feel they have at least one adult in their lives that they can trust with their problems. This could be a parent, another family member, a teacher, a clergy member, a therapist, a pediatrician, or someone else. Parents can stay in touch with their child by asking how things are going at school, whether any kids get picked on, and whether they have seen any mean comments online. It’s important to keep open lines of communication.

For youth who are neither bullied nor perpetrators of bullying, we can help them learn to stop bullying by not giving it an audience, walking away, helping the victim and telling a trusted adult. The American Academy of Pediatrics has an excellent publication called ‘Bullying: It’s Not OK’ that can be found online.”

March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 17

KIDS & TEENS beneficial. A lot of times, ‘educational’ games are not as active as you would like. That’s where it takes parental supervision to see how meaningful it is. It can help you discern that healthy screen time versus what is more passive or harmful screen time.”

Catching up

For kids and teens, it’s been hard to go back to the conventional way of doing things. By Deborah Jeanne Sergeant

C

hildren have been through an those serendipitous interactions they awful lot in the past two years: would experience at school do not online classes; social isolation; happen during Zoom and Facetime few in-person social outlets and “playdates” arranged with their preinteractions; constant stress from COVID-19 friends, Winnett said. family finances, work and school Children have missed life lessons changes; plenty of negative news me- such as how to make friends with dia coverage; ever-shifting COVID-19 someone new, settle small squabbles protocols; and fear of the virus itself. with children they do not know or These factors can all contribute to develop understanding with somea host of issues for children, includone from a different background. ing stunted social skills, developmen- Oftentimes, these situations occur tal delays, learning issues, anxiety on the playground, while waiting in and depression. line or during other incidental, un“It’s a little too early to underplanned times during a school day. stand long-term impacts of the past While the isolation may have felt two years on youth,” said Monique like a godsend to more introverted Winnett, clinical psychologist with children, isolation prevents them St. Joseph’s Hospital Health Center. from becoming as social as they “There will likely be some long-term could be. impacts. There have been a lot of “The more that parents can carve changes for kids.” the time out to engage with kids The acute issues presenting at her that’s not centered around the screen practice relate to socialization and re- such as family game time or sports lating to others in a meaningful way. and clubs, you’ll help them fill up Young children struggle to time that gives them a sense of conunderstand sharing, taking turns nection,” Winnett said. and resolving minor conflict because For older children who are home

by themselves more, the lack of structure in their school day followed by the shock of returning to in-person classes has been challenging.

In addition to life lessons, children’s academic lessons are less than ideal for most children. As children exhibit different learning style— some are more hands-on, others prefer the explanation inherent to a lecture, still more like reading over doing or hearing—virtual learning has hamstrung teachers to instruct in fewer styles than they could in the classroom.

“The pandemic has forced educators to use technology at their disposal to use to help educate their children,” Winnett said.

She encourages parents to help make up for any academic gaps by engaging their children in learning activities at home.

“You can ask teachers about games or activities that are beneficial and age-appropriate and grade-appropriate,” Winnett said. “They can guide you towards programs that are

Nearly all children are expected to have some degree of lag in their schooling, so an amount of remedial work is normal.

Parents can use the summer to help make up for lost time. Bringing home more library books, engaging in educational outings such as to places like museums, open houses and cultural points of interest and using educational media such as games, documentaries and puzzles can help children feel better prepared for the next school year.

To help children mitigate social isolation, Anne Reagan, pediatric psychologist and assistant professor with Golisano Children’s Hospital department of pediatrics, encourages parents to find family members and friends with whom they are comfortable for socialization.

“Now that kids are back in school, they have more access to friends,” she added. “With home testing being more available, you can take a home test before kids come over. Continue to find some safe, healthy socialization. It can be outside with sledding or skating. Kids can get some typical, normal experiences.”

Keeping communication open can help children feel like they have input and that they can do something to feel more in control.

Using up-to-date information about what is going on and suggesting ways they can stay safe, such as washing their hands and taking care of their bodies, will help anxious children feel better about becoming more social.

“Don’t say they will never get sick but assure them you will take care of them,” Reagan said. “Normalize living with this disease is the next step. Talk about ‘Should we continue to use hand sanitizer, eat fruits and vegetables or take vitamins?’ Focus on those types of things. It’s not a false sense of control, but these are all things to help your body get strong.

Continue to sit at the table with kids and have these conversations. They have a way to express their concerns.”

SUMMER

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Page 18 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

MEETING YOU WHERE YOU ARE

KIDS & TEENS

Poor Body Image Affects Teens’ Mental Health Body image in particular for females has always been an ongoing problem

By Deborah Jeanne Sergeant

T

eens who view their body image negatively experience an increased risk of low self-esteem, depression, nutrition and growth issues, eating disorders and having a higher body mass index of 30 or higher, according to the Mayo Clinic.

Some may try to control their weight by less than healthful methods and/or seek body modifying procedures to achieve the look they want.

Oftentimes, teens base their ideal body image on what they see in the media—only now instead of just movies, magazines and television, teens can access media anytime, anywhere.

This helps add to “the misconception that there is one ‘good’ body type, and lack of respect for body size diversity,” said physician Karen Teelin, associate professor of pediatrics and director of adolescent medicine at Upstate Golisano Children’s Hospital.

Via social media, anyone has the ability to post and see unrealistic images and videos that portray perfect lives. The software used to improve posts is ubiquitous.

Unfortunately, young people tend to view these posts as reality and the ideal to which they should aspire, whether that’s a svelte figure,

chiseled abs or high cheekbones.

Teelin encourages parents to “avoid talking about diet foods, body size and shape and calories,” to help their children develop a healthy body image.

“Instead focus on health, energy and happiness,” she added. “Model healthy body image and dietary habits and avoid fad diets, instead focusing on overall healthy lifestyle. Meet your youth where they are, listen and support them, help them be themselves, and provide them space while remaining aware and involved.”

The new Disney movie, “Encanto,” offers positive body images that parents can use to draw attention to different body types. The movie features Mirabel, a teen with a typical body type, and Luisa, a supporting character whose physical strength is her special magical power. Luisa’s body composition befits her power, as she is tall and muscular. Neither is like the clichéd Disney female with a slim, willowy body type.

Parents do not necessarily need to point out the body types in media but acknowledge positive aspects that may not have to do with appearance.

Children should take breaks from social media and to spend more of their down time engaging in activities that build their confidence.

Accomplishing goals allows teens

to develop a sense of worth outside of their physical appearance. Building meaningful relationships, both familial and among friends, can help teens’ self-image, too.

It can be tough for young people in a society that prizes appearance as a measure of worth to not do so themselves when they consider their own appearance or others’ appearance.

Michelle Dougan, personal trainer with Elevate Fitness in Liverpool, was overweight as a child.

“It’s really tough because being a woman, everyone looks at her for her jiggle,” Dougan said. “My nickname was ‘Fatty Fatty Fat Face.’ I started going to the pool and riding my bike one summer and lost weight.”

Despite her weight loss so many years ago, she still views herself as overweight because of the verbal arrows slung at her.

“Kids are mean,” she said. “Parents need to speak with their kids about it. I feel that if I had someone to talk about it, like a parent, that would’ve helped.”

Parents should praise their children for their character and other traits beyond appearance.

Modeling healthy behavior can also help children develop a better body image. For example, complaining about one’s weight, going on extreme diets, calling food “bad” or

“good” or making derogatory comments about appearance can contribute to body image issues.

Instead, parents should emphasize improving health, such as exercising regularly and eating a healthful, balanced diet. Regular exercise does not have to be a gym-based regimen but can include enjoyable physical activities and sports.

No foods are “bad” or “good,” but a healthful diet focuses on plenty of fruits and vegetables, whole grains, lean sources of protein, dairy and a few healthful fats, but with minimal processed foods.

In addition, a pediatrician can discuss healthy body weight during a well child visit.

Chakrapani Irri, pediatrician at Children’s Health Specialists in Auburn, said that he can help parents look up their child’s body mass index to present facts that they are in fact a healthy weight for their height.

For teens who need to lose some weight, “they sometimes try to lose weight in unhealthy ways,” Irri said.

Instead of purging, laxatives, diet pills and extreme eating plans, consuming a balanced diet can lead to lasting, healthful weight loss, along with regular aerobic exercise and strength training.

Committed to exceptional, family-focused care – provided by over 60 physicians and 40 nurse practitioners and physician assistants from 29 locations across CNY – FCMG is one powerful ally in the care of your growing family. Our comprehensive range of services includes: • General family care & internal medicine • Nutrition • Immunizations, annual check-ups • Behavioral health • Ear, nose and throat • Other specialties needed • Ophthalmology by growing families All supported by our own clinical lab and other in-house diagnostic resources. For expert pediatric care provided in a family-friendly atmosphere – make an appointment with FCMG, today: New patients and families welcome!.

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March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 19

Parenting

By Melissa Stefanec

MelissaStefanec@yahoo.com

Childless Doesn’t Mean Less

S

ince becoming a parent, nothing has been the same.

My sense of reality has been forever altered. I’ve discovered emotional high and lows that I couldn’t have conceived of before having children. My children are part of my being.

Despite the exhaustion, self-sacrifice, frustrations, self-doubt and seismic shifts in my self-perception, I would do it again. I’m all in on being a mother.

I truly believe being a parent has enriched my life in a way I simply can’t express. However, my ability to have this perspective is based on one simple truth: I wanted to become a parent. I had no idea what I was in for, but I chose this path anyway.

This path isn’t for everyone. Being a parent means a lot of guts and not a lot of glory. But instead of saddling up my high horse to talk about how amazing parents are, I want to take a moment to reflect on that other path — the one where someone chooses not to be parent.

It’s an awesome path, but many people seem to have problems with

it. If you are one of those people and have ever made someone feel guilty for their choice, you need to read this column. Being childless (whether by choice or circumstance) doesn’t make someone less of a whole being. Every line you’ve been fed that has tried to persuade you otherwise is an injustice and a lie.

I know there are many people who don’t agree with me. There are people who, whether tacitly, unwittingly, or aggressively, bully the childless. If you are one of these folks, I don’t think anything I could write would persuade you that being a parent doesn’t make you better or special.

However, maybe something I can write will persuade you to keep your opinions to yourself. To do that, I want you to imagine how childless people are often treated by society. I want you to imagine if people treated parents that way.

• Imagine if when you gathered socially, someone cornered you and asked you why you chose to have children.

• Imagine if at any given family

dinner, someone, between mouthfuls of mashed potatoes, asked why you went ahead and reproduced.

• Imagine if when out having coffee or drinks, you had to defend your choice to become a parent.

• Imagine if society thought there was something wrong with you for choosing to have children of your own.

• Imagine if everyone implied you were selfish because you continued to populate an already overpopulated world.

• Imagine if society labeled you as being greedy because your choice to have kids is further depleting the Earth’s resources.

• Imagine if people made you feel shame for giving up or scaling back your hobbies and passions instead of investing in them, just because you are too busy raising a family to nurture them.

• Imagine if people implied that you were an incomplete being, because you chose to give pieces of yourself to others.

• Imagine if having children was viewed as a slight to society, because you couldn’t possibly contribute in the same way someone without a child could.

• Imagine if every time you said you had children, you knew most other humans would perceive you in a more negative manner or wonder if there was something “wrong” with you.

• Imagine if you were viewed as less of a woman or man because you became a mother or a father. Imagine if “parent” was somehow less than “woman,” “man” or “person.”

If you can even begin to imagine some of those scenarios, maybe you can understand why nobody should be made to feel inferior because of

WE’VE DOUBLED OUR HEART TEAM

‘Being childless (whether by choice or circumstance) doesn’t make someone less of a whole being.’ their choice not to have children.

As hashtags about inclusion and equity trend on social media and difficult conversations are being had at dinner tables around the country, I invite you to evaluate how society marginalizes and maligns those who are childless by choice. It isn’t right; we owe our fellow humans more.

Whether or not to have children is one the most monumental choices in a person’s life. That choice will have permanent implications.

As with many monumental choices, there isn’t a clear right or wrong. There are just two, wildly different paths. Neither of these paths is better, wiser or inherently elevated.

Debating that would be like arguing whether strawberries or cherries are the better fruit. There isn’t an answer; there is just a preference.

So, the next time you want to corner someone and belittle them for their reproductive choices or stand idly by as someone else does this, flip the tables on your own narrative. Imagine if somebody made you feel small for being a parent. Then, apologize for anyone you’ve belittled and mind your own business. Let good people make good choices for themselves.

Thanks for listening.

THE CARDIOVASCULAR GROUP OF SYRACUSE JOINED UPSTATE CARDIOLOGY FACULTY.

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UPSTATE PHYSICIANS FROM LEFT: Timothy D. Ford, MD Robert L. Carhart, Jr., MD Debanik Chaudhuri, MD Hani Kozman, MD Sakti Pada Mookherjee, MD Amy Tucker, MD Daniel Villarreal, MD

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Page 20 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

KIDS & TEENS even discover more cures for cancer.”

Comito’s optimism is shared by physician Kara Kelly, chairwoman of the Roswell Park Oishei Children’s Cancer and Blood Disorders Program. She calls it “a very exciting time in cancer therapy” for innovations like immunotherapy.

It acts like a sharpshooter, targeting the cancer while sparing the healthy cells. One kind of immunotherapy is chimeric antigen receptor T-cell (CAR-T cell) therapy, FDA approved for children whose B-cell acute lymphoblastic leukemia has not responded to conventional therapy.

Medical providers collect and modify a patient’s own T cells so once they are reinjected, they home in on receptors on the surface of the cancer cells. This clears out the cancerous cells.

Advances in Pediatric Cancer Treatment

One of the latest ways to treat childhood cancer includes immunotherapy

By Deborah Jeanne Sergeant

I

n 1970, fewer than 5% of pediatric cancer patients would be cancer-free five years later.

Today, about 80% of childhood cancer cases are.

While that certainly represents a big improvement, it is not high enough.

Myia Hill, executive director of Paige’s Butterfly Run in Syracuse, wants to see 100% of cancers curable.

“It’s important to support research so we can ultimately have a cure,” Hill said.

Paige’s Butterfly Run is a 501(c) (3) organization that provides funding to Upstate Golisano Children’s Hospital for research on pediatric cancer and supports families to access clinical trials.

Curing only 80% “leaves 20% of children who will ultimately die of their cancer,” said physician Melanie Comito, chief of hematology/oncology and chief of the Center for Children’s Cancer and Blood Disorders at Upstate Cancer Center. “There is about 70 years of life lost for every child who dies from cancer versus 15 years for an adult. For those who survive, nearly 50% will develop some type of chronic medical problem.”

The 80% figure is for all types of cancers. Comito said that some types of childhood cancer still have a lower than 30% cure rate.

Even for survivors, the long-term effects can be significant because of the toxic chemicals used to kill cancer. A few emerging treatments show promise for beating cancer while reducing the long-term health implications of traditional treatments like chemotherapy and radiation.

Comito said that these improvements stem from a better understanding of cancer biology. For example, the survival rate for acute lymphoblastic

leukemia (ALL) has increased from 75% to greater than 90% in the past 30 years.

“We have found that radiation therapy to the brain is not needed, which decreases late effects such as infertility, endocrine problems and second malignancy risk,” Comito said.

Gathering large amounts of data has proven helpful in discovering patterns that have improved treatment protocols. Treatment of Wilms’ tumor, a rare childhood kidney cancer, has been improved through a renal biology study through the Children’s Oncology Group. By enrolling nearly every child with Wilms’ tumor into the study “we are able to determine biological features and now nearly every child with favorable histology Wilms’ tumor is now cured with their first line therapy through this information we have obtained,” Comito said.

Comito said that as another example, a certain type of ALL with the Philadelphia chromosome used to be essentially incurable with chemotherapy alone. Even with bone marrow transplant with all its risks cured fewer than 50%.

A medication, Imatinib, targets the Philadelphia chromosome.

Comito said that pairing Imatinib with chemotherapy is more than 80% effective after two years’ treatment.

“These are just three examples of what I have seen over my 30-year career in treating children for cancer,” Comito said. “To me, the ultimate definition of cure is that once children are finished with their treatment of childhood cancer, that they look at themselves in the mirror as they grow up and no one can tell they were ever treated. They can grow up, marry and have children of their own if that is what they desire to do. They will contribute to society and may

Fewer than 10% of the patients receiving CAR-T cell therapy would have survived without it. But receiving the therapy spares 65% to 70% of patients.

“Immune therapy requires specialized care,” Kelly said. “In a way, the analogy is like what’s happening with COVID. Some get sicker from the immune response than the virus.

T-cell therapy can cause children to get very sick until that passes.”

While children receive CAR-T cell therapy, they can mount a serious immune response, like they have a very serious infection. Some require a ventilator or experience neurologic toxicity with seizures. The therapy increases the risk of certain types of infection, but these are typically manageable.

Because these are still recent therapies, researchers have only eight or so years of follow-up to tell them about patient longevity. More time is needed to track and monitor patients so researchers can better understand the long-term effects.

“Building on this success in leukemia, we and others are now using this T-cell approach in other types of diseases and using them at an earlier time point,” Kelly said. “Perhaps someday we can use these therapies instead of long courses of chemotherapy. We won’t know until we complete all the clinical trials. We offer some of these clinical trials to help us get the information we need to make a standard of care recommendations.”

Other kinds of immunotherapies use medication to stimulate the body’s own T-cells to work better against illnesses such as Hodgkins lymphoma, melanoma and lung cancer, for example. The therapies are being used earlier and earlier in treatment as they have lower risks than radiation and chemotherapy.

“We’re still testing these medications in clinical trials,” Kelly said.

“We’re accumulating the knowledge, so hopefully it will change what our current practice is. They are not without side effects.”

Hypothyroidism is one example.

Medication can replace the hormone that the thyroid would naturally generate. Kelly said that rarely, inflammation of the lungs or heart can also occur. Further research on side effects is ongoing.

“As we learn more about it, we’ll be better able to use which medications in which patients at which doses,” she said.

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March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 21

KIDS & TEENS

Family, Pandemic Stress Having Affect on Kids

Children should be made aware stressors aren’t their fault and they aren’t responsible for trying to fix it

By Deborah Jeanne Sergeant

S

tress is a part of life, whether it is acute stress, such as a car accident, or chronic stress, such as completing daily tasks on time.

Stress can be unpleasant, like the aforementioned car accident and even enjoyable, such as planning a surprise party, bringing home a new baby or receiving a promotion.

The pandemic has brought

nearly ubiquitous stress and nearly all of it is difficult stress. Regardless of the cause, stress affects children negatively.

“There are many stressors in families, plus peer pressures,” said Chakrapani Irri, pediatrician at Children’s Health Specialists in Auburn.

He said that these stressors contribute to the widespread anxiety and depression among youth. He screens for these mental health issues and

encourages families to communicate openly about what is bothering them.

For teens, speaking one-on-one about issues with a trusted adult or parent is usually easier than in front of the whole family.

“Have open, honest conversations,” said Monique Winnett, clinical psychologist with St. Joseph’s Hospital Health Center. “When parents are stressed and worried, they try to not worry their children by keeping them out of things but from an early age, children are far more perceptive than we give them credit for.”

She added that as children absorb negative stress, they may act out, skip school, take risks and experience more depression and anxiety.

While children likely do not need many details, they need to know what is happening. Assurance that their parents will keep them safe is also vital.

Winnett said that parents should “own their stress” and model healthy ways of managing it, such as exercise, hobbies, time with friends and, as needed, seeking mental health help.

To decrease stress about world events, Winnett recommends limiting the extent to which children are exposed. But when they are exposed, help them understand that the media often shows the most extreme example.

For stress generated by a disagreement, couples need to ensure children understand that it’s not about them. Pretending it is not happening will not work.

“It’s OK to have an argument with your partner,” Winnett said.

“Say, ‘We are sorry; we’re frustrated and it’s not about you at all.’ Do things to nurture your relationship and your relationship with your

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Page 22 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

children.”

Children should also be made aware that stressors are not their fault and that they are not responsible for trying to fix it, especially family problems.

Especially if one child is struggling and needs extra attention, take times to give one-on-one attention to the other children, too. Acknowledge their strong points.

Professional help may be necessary to help cope with stress. While pushing on boundaries a bit is developmentally normal, going beyond what is developmentally appropriate could indicate help is needed.

“We lately have been saying to seek professional support as early as possible if parents see changes in behavior,” said Anne Reagan, pediatric psychologist and assistant professor at Golisano Children’s Hospital Department of Pediatrics. “Don’t say, ‘We’ll see where this goes.’ If something doesn’t seem quite right for this kid and the family has had these conversations and things don’t change, seek professional support.”

Pediatricians can refer patients to a therapist or parents can directly contact mental healthcare providers.

To support good mental health, parents should encourage a regular routine, exercise, outdoor activities and creative endeavors.

“Journaling is helpful for older kids,” Reagan said. “Write thoughts and feelings and using that as a platform to talk with parents. Art can be very therapeutic, like adult coloring books. Use sensory stimulation for little kids like Play Doh, beads and kinetic sand. Anything sensory offers stress relief, like pop-its. Find a hobby that relaxes you to work through stressors.”

Turning 65 or just confused about Medicare?

By Jim Miller

Approaching 65? Here’s What to Know About Enrolling in Medicare Dear Savvy Senior, Can you give me a brief rundown of Medicare’s enrollment choices along with when and how to sign-up?

— Approaching 65

Dear Approaching, The rules and timetables for Medicare enrollment can be confusing to many new retirees, so it’s smart to plan ahead. Here’s a simplified rundown of what to know.

First, a quick review. Remember that original Medicare has two parts: Part A, which provides hospital coverage and is free for most people, and Part B which covers doctor’s visits and other medical services, and costs $170.10 per month for most enrollees in 2021.

When to Enroll: Everyone is eligible for Medicare at age 65, even if your full Social Security retirement age is 66 or later.

You can enroll any time during the “initial enrollment period,” which is a seven-month period that includes the three months before, the month of, and the three months after your 65th birthday. It’s best to enroll three months before your birth month to ensure your coverage starts when you turn 65.

If you happen to miss the seven-month sign-up window for Medicare Part B, you’ll have to wait until the next “general enrollment period” which runs from Jan. 1 to March 31 with benefits beginning the following July 1. You’ll also incur a 10% penalty for each year you wait beyond your initial enrollment period, which will be tacked on to your monthly Part B premium. You can sign up for premium-free Part A, at any time with no penalty.

Working Exceptions: Special rules apply if you’re eligible for Medicare and still on the job. If you have health insurance coverage through your employer or your spouse’s employer, and the company has 20 or more employees, you have a “special enrollment period” in which you can sign up. This means that you can delay enrolling in Medicare Part B and are not subject to the 10% late-enrollment penalty as long as you sign up within eight months of losing that coverage.

Drug Coverage: Be aware that original Medicare does not cover prescription medications, so if you

don’t have credible drug coverage from an employer or union, you’ll need to buy a Part D drug plan from a private insurance company (see Medicare.gov/plan-compare) during your initial enrollment if you want coverage. If you don’t, you’ll incur a premium penalty — 1% of the average national premium ($33 in 2022) for every month you don’t have coverage — if you enroll later.

Supplemental Coverage: If you choose original Medicare, it’s also a good idea to get a Medigap (Medicare supplemental) policy within six months after enrolling in Part B to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles.

See Medicare.gov/medigap-supplemental-insurance-plans to shop and compare policies.

All-In-One Plans: Instead of getting original Medicare, plus a Part D drug plan and a Medigap policy, you could sign up for a Medicare Advantage plan instead (see Medicare.gov/ plan-compare) that covers everything in one plan. Nearly half of all new Medicare enrollees are signing up for Advantage plans.

These plans, which are also sold by insurance companies, are generally available through HMOs and PPOs and often have cheaper premiums, but their deductibles and co-pays are usually higher. Many of these plans also provide coverage for extra services not offered by original Medicare like dental, hearing and vision coverage along with gym fitness memberships, and most plans include prescription drug coverage too.

How to Enroll: If you’re already receiving your Social Security benefits before 65, you will automatically be enrolled in Part A and Part B, and you’ll receive your Medicare card about three months before your 65th birthday. It will include instructions to return it if you have work coverage that qualifies you for late enrollment.

If you’re not receiving Social Security, you’ll need to enroll either online at SSA.gov/medicare or over the phone at 800-772-1213.

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

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March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 23

5 Types of Food Delivery Services for Older Adults

Food delivery services are on the rise, offer convenience, nutritious food

By Kathleen Squires

A

s people age, their nutritional needs change. And, their food preferences evolve as well.

Many older adults note that they don’t have the vigorous appetite that they once had; replacing three large meals a day with smaller portions and more frequent snacks.

They don’t enjoy the same foods as when they were younger and they may even face restricted diets due to health concerns.

This can present a challenge for older adults, but maintaining a healthy diet is so vital as we age.

Now layer in the grocery shopping, food prep, cooking and washing dishes. It can be overwhelming to many seniors.

Eating a balanced diet can be tricky for any lifestyle. Preparing nutritious meals each day may pose additional challenges for older adults who live at home. The good news is that there are plenty of options for seniors who may struggle with getting healthy meals on the table.

Food delivery services are on the rise, with their popularity growing significantly over the past few years.

With this growth comes more options that can make meals easier for seniors.

Here are five different types of food delivery services for every unique lifestyle: 1. Meal Kit Subscriptions: For seniors who still enjoy cooking but want to simplify the process, these types of plans are ideal. In most of these kits, you will receive pre-por-

tioned ingredients and recipes to follow to prepare your meal.

2. Prepared Meal Subscriptions: Want to skip the cooking?

If you are someone who no longer cooks, these kits could help. These types of plans provide meals that are pre-prepared for you. All you have to do is heat them and eat them!

3. Meal Plans for Special Diets: If you have a health condition or a dietary restriction, it can be challenging to maintain at times. Luckily, there are meal subscription plans which cater to specialized diets, including vegan and other food restrictions.

4. Grocery Delivery Services: If you want to cook and pick out your groceries, a great option is a grocery delivery service, like Instacart. You can shop from your favorite grocery stores right from your phone or computer. The groceries are delivered right to your door.

5. Third-party food delivery services: If you’re not ready to try a meal service, there are great options for one-time deliveries. There are plenty of food delivery services like DoorDash, UberEats, GrubHub and more that you can use to order food from local restaurants right to your home.

No matter your needs or lifestyle, consider trying a food delivery service to make it simpler to have a healthy and balanced diet.

Kathleen Squires is the director of nutrition at PACE CNY.

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Page 24 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

Submit Your Social Security Disability Update Report Online

W

e are required to periodically conduct continuing disability reviews for beneficiaries with disabilities. This process requires that beneficiaries complete a continuing disability review packet, that we mail to beneficiaries, to help us update information about their medical conditions and recent treatments.

Additionally, we offer an online option for beneficiaries to complete the disability update report form and provide any supporting documents about their medical treatment or work activities.

We designed this form with convenience in mind — and to save you time. You can access the online

Q&A

Q: I want to apply for Medicare Part B (medical insurance) this year. When is the deadline to apply?

A: If you didn’t sign up for Medicare Part B (medical insurance) when you first became eligible for Medicare, you have an opportunity to apply during the general enrollment period, which runs from Jan. 1 through March 31 each year. If you miss the deadline, you may have to wait until next year to apply. Medicare Part B covers some medical expenses not covered by Medicare Part A (hospital insurance), such as doctors’ fees, outpatient hospital visits and other medical supplies. You can learn more by reading Medicare at www.ssa. gov/pubs/10043.html.

Q: I lost my Medicare card. How can I get replacement?

A: The easiest and newest way to get a replacement Medicare card is by using your my Social Security account. Go to www.ssa.gov/myaccount for more information on how to create an account. You also can get a replacement Medicare card by calling us toll-free at 1-800-772-1213 (TTY 1-800-325-0778). Keep your card in a safe place. You don’t want anyone getting hold of your Social Security number. They could steal your identity.

Q: My child is disabled, but when I applied for SSI, I was told that my child was ineligible because my spouse and I earned too much money? Why does our income make my child ineligible?

A: If a child is living with either their natural or adopted parents, then some of the income that the parents earn deems to the child. We use these amounts to determine whether or not your child meets the non-medical requirements for SSI. For more information, visit www.ssa.gov/ssi/

form at www.ssa.gov/ssa455-onlineform. (Use either Microsoft Edge or Google Chrome for the best online experience.)

When you complete your continuing disability review, you will need your Social Security number, current address and phone number, and a valid email address to complete the form. Also, you must have received a request for an updated disability report in the mail.

Once you “Click to Sign,” you will receive an email from echosign. com asking you to confirm your digital signature. Check your junk folder if you don’t receive it within a few minutes. If your signature isn’t complete your form won’t be processed.

Please be sure to let your friends and loved ones know about this new online option. spotlights/spot-deeming.htm.

Q: I saw a poster that advised people 65 or over with limited income and resources to apply for Supplemental Security Income (SSI). Next month I’ll turn 65, and I thought I’d be eligible for SSI. I planned to apply until my neighbor told me I probably would be turned down because I have children who could help support me. Is this true?

A: Whether your children are capable of helping to support you does not affect your eligibility. SSI eligibility depends solely on your income and resources (the things you own). If you have low income and few resources, you may be able to get SSI. However, if you are receiving support from your children or from anyone living inside or outside of your home, it may affect your eligibility or the amount you can receive.

Support includes any food or shelter that is given to you, or is received by you because someone else pays for it. Learn more about SSI at www.ssa. gov/ssi.

Q: I have been collecting disability benefits for a few years, but I’m getting healthy enough to work again.

Can I return to work while getting Social Security disability benefits?

A: Yes, you can return to work while receiving Social Security disability benefits. We have special rules to help you get back to work without lowering your initial benefits. You may be able to have a trial work period for nine months to test whether you can work. If you get disability benefits and your condition improves or you return to work, you must report these changes to us. Call us at 1-800-772-1213 (TTY 1-800-3250778) or contact your local Social Security office. You can find your local office by visiting www.ssa.gov/ locator.

Health News Oswego Hospital appoints new medical leadership

The medical staff at Oswego Hospital recently appointed new leadership for 2022-2024.

Physicians Elizabeth Bozeman and James Syrett have been appointed as president and vice president respectively.

• Bozeman is a urologist at Associated Medical Professionals in Fulton. She earned her medical degree from the Medical University of South Carolina. She has been a member of the medical staff at Bozeman Oswego Hospital since 2014 and as the newly elected president she will also serve as chairwoman of the medical executive committee and as a member of the Oswego Health board of directors. In this role, she is responsible for communicating and representing the opinions and concerns of the medical staff and its members on organizational and specific matters affecting hospital operations to the board. She will also oversee compliance on the part of the medical staff with the procedural safeguards and rights of its members in all stages of the hospital’s credentialing process.

• Syrett is board-certified in emergency medicine and joined the medical staff in 2009. He earned his medical degree at the University of Edinburgh, Scotland, and completed his residency training at the University of Rochester. He holds an MBA Syrett from the University of Rochester, has additional board certification in EMS medicine, has previously served as a consulting physician for NASCAR, and has authored several EMS textbook chapters. As vice president of the medical staff, Syrett will chair the Oswego Health quality assurance and process improvement committee

Excellus BCBS Awards Hospitals $30 million for Quality Improvements

T

hirty-one Upstate New York hospitals and health centers earned a combined $30 million in quality improvement payments from Excellus BlueCross BlueShield last year as part of the nonprofit health insurer’s Hospital Performance Incentive Program.

Since 2005, Excellus BCBS has paid out more than $371.2 million in quality improvement incentives.

“It’s part of our mission to ensure that all in our communities have equitable access to high quality health care,” said Melissa Gardner, execu-

and will also serve as a member of the medical executive committee.

“We are fortunate to have both doctors Bozeman and Syrett leading the medical staff here at Oswego Hospital” said physician Duane Tull, chief medical officer. “Their commitment to safety and quality of care is exemplary.”

Loretto has new senior outreach coordinator

Loretto has hired registered nurse Kate Conan as senior outreach coordinator.

Formerly an outreach coordinator for Loretto, Conan was rehired in 2021 to head a new admissions program to assist families in finding the right level of service where and when they need it.

Conan, a Skaneateles resident, studied business at Syracuse University and Niagara University before receiving her associate degree in applied science in nursing from Cayuga Community College to become a registered nurse.

Conan brings years of diverse experience to Loretto. She previously worked at Crouse Hospital, where she received clinical training in the neonatal intensive care unit. In addition to clinical experience, she brings business insight to her new role, with previous experience selling enzymatic wound ointments for Knoll pharmaceutical as an RN and sales Kate Conan representative.

As senior outreach coordinator, Conan will work closely with referral sources, hospitals, outside agencies, providers and families to help identify individuals in need of services - and work collaboratively to direct them to the most appropriate facilities and level of care.

“I look forward to assisting families and residents as they navigate through the health care system and transition into Loretto’s facilities with different levels of care and services — ensuring the process is seamless for them.”

tive vice president, chief population health engagement officer at Excellus BCBS. “The foundation for achieving that is a collaborative relationship with our local hospital and physician partners.”

Six hospitals in Central New York participated in this program in 2021, sharing $6.4 million in quality improvement incentive payments.

Participating hospitals are Auburn Community Hospital, Crouse Hospital, Guthrie Cortland Medical Center, Oswego Hospital, St. Joseph’s Hospital Health Center and Upstate University Health System.

“In 2021, Excellus BCBS’s Hospital Performance Incentive Program evaluated participating hospitals on projects that are in alignment with and responsive to the ever-chang-

Research-focused oncologist/hematologist joins HOA Board-certified oncologist and hematologist Ajeet Gajra has recently joined Hematology-Oncology Associates of CNY (HOA).

In addition to extensive cancer-research experience, Gajra also is board-certified in hospice and palliative care His cancer research includes serving as a principal investigator for more than 40 clinical trials, including pharmaceutical sponsored, US cooperative group and investigator-initiated studies. In addition, he served as medical director for oncology at ICON research, a top 3 global clinical research organization. There he led design, oversight, clinical development and regulatory interactions for phase I-IV trials in oncology and hematology, including immuno-oncology, and CAR-T cell therapy.

“Adding Dr. Gajra’s expertise to our team increases our ability to expand our therapeutic research efforts for patients in Central New York,” said Maryann Roefaro, HOA’s chief executive officer. “By providing convenient, world-class

Madison Rural Health recognized for diabetes program

The Madison County Rural Health Council (MCRHC) has been recognized as a Medicare Diabetes Prevention Program Provider (MDPP) by the Centers for Disease Control (CDC). Through the MDPP, the Rural Health Council has also partnered with Cayuga Health ing health care environment,” said physician Stephen Cohen, senior vice president and corporate medical director at Excellus BCBS. “Although COVID is still a dominant issue for the hospitals, the best evidence that this collaboration is a success is that our partners are able to maintain focus on continuous quality improvement.”

Areas targeted for improvement in 2021 included: •Clinical Processes of Care — Focused on improvements in follow up after hospitalization, diabetes, chronic obstructive pulmonary disease (COPD), surgical care, and other measures unique to each participating hospital •Patient Safety — Centered on reductions in hospital-acquired

care in our community, patients can receive treatments close to their loved ones without added costs of time and travel.”

Having most recently served as the chief medical officer at Cardinal Health, Gajra was previously associate director of the Upstate Cancer Center, where he also served as medical director. In addition to providing clinical care to patients with all types of cancers and blood disorders, Gajra has served on the medical faculty at SUNY Upstate Medical University as a professor of medicine and program director for the hematology/ oncology fellowship.

Gajra received his medical degree in internal medicine from Delhi University, India, and completed his residency at SUNY Upstate Medical University, where he also completed his fellowship in medical oncology and hematology.

A member of Alpha Omega Alpha honor society, Gajra has received numerous patient-care quality awards, including the Anita Award from Hospice of CNY. He also was awarded fellowship

by American College of Physicians in 2011, and served on the lung cancer guidelines committee of the American Society of Clinical Oncology (ASCO).

Gajra has published over 110 peer-reviewed manuscripts in journals, including Journal of Clinical Oncology, Cancer, Lancet Oncology, New England Journal of Medicine and Blood. He also has co-authored or presented more than 160 abstracts at notable scientific meetings, including ASCO, the American Society of Hematology (ASH) and the American Association for Cancer Research (AACR).

Network and Seven Valleys Health Coalition, meaning that more CNY residents can take part in this proven and successful diabetes prevention program.

Medicare participants in and around Madison, Cayuga and Cortland counties who want to take part in the program can now have it paid for by their Medicare insurance.

The MDPP is specifically de(continued on next page) infections, readmissions, and other adverse events or errors that affect patient care •Patient Satisfaction — Used the hospital consumer assessment of healthcare providers and systems survey, which is a national, standardized, publicly reported survey of patients’ perspectives of hospital care In addition to meeting required clinical and patient safety measures in 2021, other nationally endorsed measures and target outcomes were jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, the Institute for Healthcare Improvement, and others.

March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • Page 25

Health News signed to help Medicare beneficiaries who have symptoms of prediabetes develop healthy habits to prevent Type 2 diabetes. The Centers for Medicare and Medicaid Services (CMS) oversees the program on a federal level, and organizations that achieve this certification have submitted 36 months (12 months for CDC Preliminary Recognition and up to 24 additional months for full recognition) of data from year-long diabetes prevention lifestyle change programs.

If you have been diagnosed by your healthcare provider with prediabetes or are at high risk of developing Type 2 diabetes, you may want to register to learn more about diabetes and its prevention and control. If you are unsure if you may be at risk for prediabetes, take a quick Prediabetes Risk Test at https://doihaveprediabetes.org.

For more information, call 315313-4399.

and CEO. Nascentia Health has implemented a robust employee health and wellness program, including opportunities for employees to engage in physical activity both in and out of the office, healthy eating programs, healthy weight programs, and more.

The American Heart Association, created the Index with its CEO Roundtable, a leadership collaborative of more than 45 members from some of America’s largest companies.

The index is a web-based scorecard that evaluates the overall quality and comprehensiveness of a company’s workplace health program through a combination of best practices and a snapshot of a company’s aggregates employee heart health.

Nascentia Health is a nonprofit provider of in-home healthcare services, Medicare Advantage Plans, and managed long-term care plans, serving 48 counties across New York.

The organization is headquartered in Syracuse with offices in Tonawanda, Greece, Rome, and Latham.

Nascentia receives American Heart Association award

Hematology-Oncology Associates recognized by oncology group

(continued from previous page)

Nascentia Health has achieved gold recognition from the American Heart Association in the 2021 Workplace Health Achievement Index.

This award identifies companies that take significant steps to build a culture of health and well-being for their workforce. Nascentia also received a gold level recognition in 2019. More than 450 companies nationwide participate in the AHA’s index assessment, with gold being the highest level of achievement.

“As a healthcare company, the wellness of our employees is so important, and the American Heart Association gives us the tools we need to make our workplace healthier for everyone,” said Kate Rolf, president

Hematology-Oncology Associates of CNY (HOA) has been recognized by the QOPI Certification Program LLC, a wholly owned subsidiary of the American Society of Clinical Oncology, Inc. (ASCO), as successfully completing a three-year certification program for outpatient hematology-oncology practices that meet nationally recognized standards for quality cancer care. The certification program builds on ASCO’s Quality Oncology Practice Initiative (QOPI).

“Our mission is to provide the highest level of quality care in a healing environment for the mind, body and spirit of patients dealing with cancer and blood disorders,”

Crouse Health Promotes Diversity and Inclusion Crouse Health’s diversity and inclusion committee in February highlighted the diverse workforce in the organization.

Through fundraising support of the Crouse Health Foundation and board member Melvin Stith, Ph.D., the committee commissioned five local artists to contribute works of art for a mural displayed on the wall in the basement level of the hospital’s Irving building.

“The goal of the collection is to visually underscore the importance, value and contributions of our diverse workforce. This display continues our commitment said physician Daniel Bingham, HOA board president. “Renewing our QOPI certification re-affirms our commitment to excellence, and demonstrates how our team goes the extra mile to achieve the best possible outcome for every patient.”

HOA is the only cancer center in Central New York with the QOPI designation, and only one of 11 in New York state. QOPI certified practices routinely evaluate practice performance against quality

to the healing power of art and has formed new and ongoing partnerships with local artists of color,” said Twiggy Eure, director of diversity and inclusion and chairwoman of diversity and inclusion committee.

Jaleel Campbell, Tasha Fain, London Ladd and husband-andwife duo Macienne and Estaban Trotman have contributed works which show their artistic views of diversity and inclusion at Crouse.

Eure says she hopes the mural will be one that will grow over time.

Solon Quinn Studios collaborated with Crouse on the project by creating a new video highlighting Crouse’s commitment to diversity and inclusion. It can be viewed at www.crouse.org/di-art. measures and standards established by experts in the oncology field.

To become QOPI Certified, practices have to submit to an evaluation of their entire practice and documentation standards.

The QOPI Certification Program staff and committee members then verify through an on-site survey that the evaluation and documents are correct and that the practices met core standards in areas of treatment.

$7.6 Million Renovations Completed at Oswego Hospital’s MedicalSurgical Unit After two years of halted construction due to the pandemic, Oswego Health has announced that the $7.6 million renovations are complete on its medical-surgical unit at Oswego Hospital and it is now open for inpatients.

“Patient-centered care is the core of our mission at Oswego Health,” said President and CEO Michael Harlovic as he gave remarks at an internal ribbon cutting to staff, commemorating the opening of the units. “We made these investments to ensure the highest level of quality healthcare needed is provided right at home in Oswego County.”

As part of this gut renovation on the third and fourth floors of Oswego Hospital — the first renovation of this space since it was built in 1969 — each patient room offers a “hotel-like” feel and is equipped with a new HVAC filtration system purchased through HealthWay Family of

Each patient room at Oswego Hospital’s medical-surgical unit offers a “hotel-like” feel and is equipped with a new HVAC filtration system.

Brands that will greatly improve the indoor air quality within the patient rooms. Each floor provides comfortable areas for family members to gather. The nurses’ station on both floors will be relocated allowing for

Page 26 • IN GOOD HEALTH – CNY’s Healthcare Newspaper • March 2022

more immediate access to the care staff.

Construction began in early 2020, however, like many things that were impacted by the pandemic, construction was forced to stop, as the need

for critical patient beds increased in the event of a surge. The $7.6 million renovations were secured in part through the support of The Campaign for Oswego Health.

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1:54 PM March 2022 • IN GOOD HEALTH – CNY’s Healthcare Newspaper12/21/21 • Page 27

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