In Good Health: Mohawk Valley #200 - October 2022

FDA Approves Botox Competitor That Lasts Longer

People wanting to keep wrinkles at bay will soon have a new option now that the U.S. Food and Drug Administration has ap proved the first competitor for Botox in decades.

Daxxify, made by Revance Ther apeutics Inc. in Nashville, Tennessee, is injected into the face along worry lines. It lasts longer than Botox, with about 80% of users seeing no or mild facial lines at four months after injec tion. For half of users, the treatment lasted six months, the company said

in a statement.

“Users do not have to go once every three months,” physician Balaji Prasad, who covers specialty phar maceuticals as an analyst for Barclays Investment Bank, told the New York Times. “In a world where time is of the essence, having a product with a long duration factor is extremely useful.”

The new drug now enters the $3 billion field of facial injection drugs. It is also a neuromuscular blocking agent and a botulinum toxin, like

Abbvie’s Botox.

“It also opens up the door for what we can do with therapeutics,” said Revance CEO Mark Foley, told the Times. “If you think of migraines, cervical dystonia [a neurological condition that affects the muscles in the neck and shoulders], overactive bladder, there’s a huge medical op portunity as well.”

The company has begun testing the drug on these other medical is sues, Foley said. While the company had been trying to create a product that needed no needle, it instead discovered a way to use peptide tech nology to keep the product stable. Typically, animal protein or human serum is used.

Botox is also used for more than just wrinkles. It has been an FDA-ap proved treatment for chronic mi graines since 2010.

Users of Daxxify in the Revance studies included some who expe rienced side effects. About 2% of people developed a drooping eyelid, while about 6% experienced head ache, the company said.

Toxin-based treatment can carry the potential for other side effects, such as general muscle weakness or breathing difficulties, the FDA cau tioned. Daxxify study participants showed none of those symptoms.

Revance had initially hoped for approval of its product in November 2020, but plans were postponed be cause of pandemic travel restrictions, the Times reported. An inspection finally conducted in June 2021 found problems with the quality control process and the company’s working cell bank, which contain the drug’s active ingredient. Those concerns were resolved, the Times reported.

A New Era in Addiction Treatment

Mary Ellen Greco, MD, FACS Breast Surgeon

Kristen A. McNeil, PA-C Breast Specialist

Meet Your Doctor

By Chris Motola

Devon J. Ryan, MD

New SOS orthopedic surgeon is all about hands, wrists, elbows

Q: Tell us about the new hand and wrist center you’re joining.

Dogs Have Died After Licking a Common Chemotherapy Cream, FDA Warns

Your dog may like to lick your hand or face, but if you’re using a chemother apy cream that treats certain skin conditions, you should not allow it, the U.S. Food and Drug Administration advises.

The medication fluorouracil is fatal to dogs when ingested. People who keep the cream on a nightstand or counter should put it out of reach of their dogs, who may ingest it if they chew the container, the FDA advised.

there are a multitude of other folks who can help with the patient. It’s a great collaborative environment. And while I wouldn’t say I’ve never been other places that are collaborative, I certainly wouldn’t say it’s the rule that private practices are collabora tive. It’s a nice thing about SOS.

Q: How big is the practice?

A: I’d say it’s around 25 or so across all specialties. So it’s a de cent-sized practice for sure.

Q: Was the collaborative aspect a major selling point for you?

The agency has received reports involving dogs that were exposed to the cream; all the dogs have died.

Although the FDA has not yet received any reports of fluorouracil poisoning in cats or other pets, it recommends that this drug be kept away from all pets.

The cream is used to treat some types of skin cancers and a condition called actinic keratosis, which can lead to skin cancer. It may also be used to treat warts in children. Occasionally it is used to treat certain cancers in horses.

A: I’m joining a small handful of — no pun intended — other hand surgeons. One of the nice aspects of it is it’s a core group of a bunch of folks with varying levels of experience, but everyone is early- to mid-career for the most part, with the exception of Dr. [Daniel] Murphy who is very experienced and planning to retire in the next couple years. So it’s essen tially a group that will be relatively intact for quite a long time, which is cool. And I definitely found it to be a very collaborative group, which is one of its appealing features. We already have a hand center, which is an office location where a lot of us see patients. But as it happens they’re also opening at the same location a large area that will accommodate even more providers. And the real benefit of that will be that the occu pational therapists will essentially be in the same location. Right now they’re down the road from us, but after the new section opens up they’ll be right across the hall. And hopeful ly that will give us more collabora tive opportunities. So if there’s ever something unusual going on with a patient or want to discuss a particular rehab program, it’ll be much easier to just send them across the hall. So, yeah, I think we’re looking for ward to it.

pretty wide range of pathologies. The most common things we see are nerve compression issues like carpal tunnel syndrome and small things like tendinitis and trigger finger. We see a lot of traumas, fractures of the hand, wrist, elbow. We also see trau mas that aren’t fractures, like if you have a laceration on your hand that cut a tendon or nerve. That’s stuff we see pretty commonly. There’s also plenty of uncommon pathology.

Q: How much does nerve repair and preservation figure into orthope dic subspecialties like yours?

A: The nerve compressions are very common, so fixing those could be considered a kind of nerve pres ervation. The main goal would be to improve what are often pain and sensory changes and to improve any further muscle deterioration. Certain ly the traumatic nerve injuries aren’t as common as the more chronic types of issues. But when they happen, they tend to be something we have to address with surgery because the sensations of the hand are so import ant to our functioning.

A: It was on our short list of destinations. I’m from Boston, my wife’s from Philadelphia, so we were looking at locations in the Northeast. As it happens, Syracuse ended up being a place where a lot of my fam ily transplanted. One of my brothers had taken a job here at Upstate and my parents a couple years ago made the move up to be close to their grandkids, and the cost of living is good as well. So it became a family hub. I got introduced to the practice through my brother. It always struck me as very well-run private practice. It seemed like a fun group to work with, both on the clinical and admin istrative side. And as far as the hand folks go, we take some calls over at Upstate, so we do get the oppor tunity to work with residents and trainees on call and stay a little bit engaged with the academic side of things. So it’s a good combination of those things.

Q: You’re offering a newer tech nique for basal joint arthritis. What is basal joint arthritis and how does the new technique work?

It can be dispersed as an in jection, or as a topical cream or a topical solution that’s applied on the skin. Brand names include Efudex, Carac, Tolak and Fluo roplex.

Pets who ingest fluorouracil may show signs of poisoning within 30 minutes. These signs can include vomiting, shaking, seizures, difficulty breathing and diarrhea.

Affected dogs can die in as little as six to 12 hours.

If you suspect your pet has consumed fluorouracil, imme diately get veterinary care and bring the container of cream with you. Also contact your vet or an emergency vet hospital immediately even if your pet just licks the area where you applied fluorouracil, and definitely call if your pet chews the container and consumes some of the fluo rouracil.

Q: What kinds of conditions do you usu ally treat?

A: It’s pretty var ied, which is one of the appeals of this specialty. You treat a

Q: And you’re mainly fo cused on the hand and wrist?

A: The upper extrem ities, really, so up to the elbow. To a lesser ex tent the shoulder. There are enough things that crossover across the arm that it’s convenient to patients for us to of fer treatment for issues that may go all the way up to the shoulder. That being said, within the group there are folks we deal with a lot of shoulder issues regularly. So if I ran into some thing that was outside of the types of things I general ly deal with,

Lifelines

Name: Devon J. Ryan, M.D.

Position: Hand and upper extremity surgeon at Syracuse Orthopedic Specialists (SOS)

Hometown: Bedford, Massachusetts

Education: NYU

Affiliations: St. Joseph’s Health; SUNY Upstate University Hospital

Organizations: American Academy of Orthopedic Surgeons; American Society for Surgery of the Hand;

Family: Wife (Rachel); son (Kelly), daughter (Cassie)

Hobbies: Running, pick-up sports, golf, skiing

Page 4 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • October 2022 A: Basal joint arthritis is a com mon type of arthritis that affects the thumb. There are several non-sur gical interventions, but for patients who need surgery there are a few operations that have longstanding good results. One of those is the LRTI, which uses some of your native ligaments to reconstruct the degen erating ligament. One of the ways I was trained to do it uses a very stout, secure device to suspend the meta carpal called a tightrope device. And, basically, it has a little bit of the role of replacing the native ligament. So for the right patient who needs the thumb to get moving again as quick as possible, it can be a great option. Traditionally with LRTIs patients are casted for up to six weeks. Not always, but that would be the histor ical way to do it. It fits with the trend of orthopedics trying to get patients moving again faster, since that’s what most patients want for very good reasons. The design of the implant can get patients moving again two to three weeks after operation.

How Many Steps a Day (and How Fast) to Lengthen Your Life?

There’s an easy way to reduce your risk for dementia, heart disease and cancer: Start walk ing.

Getting in those recommended 10,000 steps a day makes a real differ ence, new research affirms, but even fewer will pay big dividends. No matter how many you log, however, step up your pace for the biggest benefit.

For every 2,000 steps you log, up to about 10,000 a day, your risk of early death drops by between 8% and 11%, researchers found.

“So, 10,000 steps maximizes the chances of getting all these benefits, but also for inactive people who can’t engage in so many steps — any steps have benefits — every step counts,” said lead researcher Borja del Pozo Cruz of the Center for Active and Healthy Aging at the University of Southern Denmark in Odense.

And, he added, it’s never too late to get going.

“The range of participants that we had in the study went from 40 to 79,” Cruz said. “That means that any person can actually get the benefits.”

This study, however, doesn’t prove that walking 10,000 steps a day has a health benefit, only that number of steps is associated with a reduction in heart disease, cancer, dementia and early death.

Cruz said that the power of the study lies in its large size and in researchers’ ability to isolate walking from other exercises.

For the greatest health benefit, the sweet spot was 9,800 steps a day, which slashed dementia risk by 40%. But just 3,800 steps lowered it by 25%, the investigators found.

Over and above the number of steps, walking at a brisker pace — about 80 steps a minute — brought the greatest reduction in dementia, heart disease, cancer and premature death, Cruz noted.

But all that walking doesn’t have to happen all at once. It can be spread out during the day, the researchers said.

The study drew from data from 78,500 adults in the United Kingdom who were followed for a median sev en years, meaning half were followed even longer. They wore wrist sensors that measured their physical activity over seven days.

Cruz said that wearable devices like Apple watches and Fitbits that track steps can be useful if you use them faithfully.

“What we know about those devices is in the beginning people take them very seriously, but after a while,” use tapers off, he said. “We also know that you need to create the habit.”

How the Inflation Reduction Act Will Lower Your Drug Costs

By Jim Miller

$7,050 in 2022, you enter catastrophic coverage but are still responsible for 5% of your prescription drug costs, with no limit.

But in 2024, people with Part D coverage will no longer be responsi ble for any out-of-pocket drug costs once they enter catastrophic cover age. This is significant for seniors who use expensive medications for conditions like cancer or multiple sclerosis.

drugs will be capped at $2,000 per year. This will be a major savings for the more than 1.5 million beneficia ries who currently spend more than $2,000 out-of-pocket each year.

2026

The

climate, tax and health care bill known as the Inflation Reduction Act that was passed by Congress and signed into law by President Biden in August includes significant improvements to the Medicare program that will kick in over the next few years.

These changes will lower pre scription drug prices for millions of seniors by allowing the government to negotiate drug prices for the first time and capping seniors’ out-ofpocket drug costs at $2,000 annually. Some other popular changes will include free vaccinations, lower insu lin costs and expanded subsidies for lower income seniors.

Here is a breakdown of the changes to expect in Medicare and when they will roll out.

2023

Starting this January, all vac cines covered under Medicare Part D, including the shingles vaccine, will be free to beneficiaries. And the skyrocketing cost of insulin will be capped at $35 per month. This will be a significant saving for the more than 3 million Medicare enrollees who currently use insulin to control their diabetes.

Also starting in 2023, drug mak ers will be penalized in the form of rebates that they would be forced to pay to the government if they impose price increases that exceed general inflation.

2024

Cost sharing for catastrophic coverage in Part D will be eliminat ed. Under the current Part D benefit, once your out-of-pocket costs reach

Also starting in 2024 through 2029, Part D premiums will not be allowed to grow faster than 6% per year.

And for lower-income Medicare beneficiaries, eligibility for the Part D Low Income Subsidy (also known as Extra Help) will be expanded to 150% of the federal poverty level, from today’s limit of 135%. This change will mean about 500,000 more seniors will qualify for financial assistance to help pay some or all of their prescription drug premiums and deductibles.

2025

One of the biggest cost reduction measures for Medicare beneficiaries will begin in 2025 when out-of-pock et spending on Part D prescription

When Medicare’s Part D pro gram was enacted in 2003, negotiat ing lower drug prices was forbidden. But because of the Inflation Reduc tion Act, starting in 2026 Medicare will be empowered to begin nego tiating prices with drug companies for 10 of the most expensive drugs covered under Part D. In 2027 and 2028, 15 drugs would be eligible for negotiations and in 2029 and sub sequent years, 20 drugs would be chosen.

And, in addition to all the Medi care improvements, the Inflation Re duction Act also extends the Afford able Care Act (Obamacare) premium subsidies for three years that have helped millions of Americans gain coverage before they’re eligible for Medicare.

Jim Miller is the author of Savvy Senior column, which runs every month in In Good Health newspaper.

HealthcareinaMinute

By George W. Chapman

Hospitals Facing Shaky Finances. Outlook: From ‘Neutral’ to ‘Deteriorating’

After slowly climbing back from the devastation caused by the pandemic, July median hospital operating margins plunged a staggering 64% from June op erating margins, according to industry consultants Kaufman Hall.

Its survey of 900 hospitals revealed an average year-to-date margin of negative 1%.

KH attributes this trend to lower outpatient volumes, more acute and expensive inpatient cases and an end to COVID-19 relief and PPP from the federal government.

Financial services company Fitch Ratings has reduced its hospital out look from “neutral” to “deteriorat ing.” Shaky finances are the driving force behind hospital mergers and

Accountable Care Organizations

Typically, an ACO is a partner ship between physicians and one or more hospitals to participate in the Medicare Shared Savings Program (MSSP). The goal is to cooperate in exceeding quality benchmarks and reducing per capita cost benchmarks established in advance by Medicare. ACOs submit their bills, physician and hospital, to Medicare per usual. ACOs that reduce per capita costs will share in the savings with Medi care. If ACO costs per capita go up, the ACO must return money to Medicare. The MSSP is designed to encourage and reward the delivery of care by a cooperative of physicians

acquisitions. Not price fixing as skep tics have speculated. To survive and deliver care to their respective com munities, hospitals must be allowed to freely explore opportunities to increase fragile operating margins via shared over head, operating savings, and improved credit without onerous regulato ry oversight. At stake, in many cases, is the survival of smaller rural hospitals. While mergers might save hospitals, there could be a point where there are diminishing returns. For example, the 20-hospital Cleve land Clinic lost just over $1 billion the first half of 2022. While $628 million is attributed to investment losses, the system still lost close to $400 million on operations.

and hospitals working as a team to exceed common goals. An “every man for himself” model won’t work. And it never has. Medicare has learned that the more primary care physicians in the ACO, the better at reducing per capita costs. This makes sense. Effective primary care deliv ery can reduce illness, unnecessary referrals to specialists and overall hospitalization. Last year, 99% of ACOs beat quality benchmarks and 58% beat per capita costs. ACOs beat per capita costs benchmarks by $3.6 billion.

Apple Watch Study

In 2018, the FDA approved the

Apple watch for EKGs. Who would have thought? Now, the NIH has granted $37 million to researchers at Northwestern and Johns Hopkins (and others) to study it. By moni toring atrial fibrillation, the watch can prevent strokes and reduce the amount of expensive blood thinners patients with Afib are receiving. Afib affects 2.5 million to 5 million of us. That is predicted to be 12 million by 2030. The seven-year study will involve 5,400 people with Afib. Some in the study will continue to receive the standard regimen of continuous expensive blood thinners to prevent strokes. Others will have their Afib monitored by the watch and receive targeted blood thinner therapy only when at risk of a stroke.

No More Free Vax

Congress has discontinued fund ing the government’s COVID-19 vac cine program effective next year. That means it will no longer purchase the vaccine from manufacturers and distribute it for free. It has turned the keys over to Big Pharma. Pfizer and Moderna must be licking their chops. (Is this what it took for Big Pharma to finally agree to negotiate some drug prices?) The government has already dropped free home testing due to lack of funds. Both drug giants claim that with the feds out of the way, they can be “more competitive” in an open market versus a govern ment-controlled contract market. Both also claim they can now focus on “branded education” which is in their area of expertise. It remains to be seen if Medicare and commercial insurers will charge for the vaccine or make it available for free.

ACA Adds Navigators

The Biden administration and Congress has approved close to $100

million in funding for ACA naviga tors who help people select an insur ance that fits their needs and budget. The increased funding should add 1,500 new navigators. The ACA has been a widely successful program now insuring more than 36 million people. The uninsured rate is at an all-time low below 8%. Open enroll ment begins Nov. 1. To hamstring the ACA, the Trump administration slashed navigator funding to $10 million.

Medicare Advantage Plans

Just about half of all Medicare beneficiaries, or 28 million, are now covered by a commercially operated advantage plan. Sixty-six percent of the beneficiaries are individually covered; 18% are insured via employ er or union; and 16% are enrolled through special programs. Market shares for the largest carriers are Humana 28%; United 18%; and BCBS 14%. Cigna, Centene and Kaiser com bine for 24% market share.

Advantage plans are Part C Medicare. They draw members away from traditional Medicare by offering perks such as dental, vision, OTC drugs, transportation and even meals. Unlike traditional indemnity Medicare, most advantage plans require preauthorization for certain procedures.

George W. Chapman is a healthcare busi ness consultant who works exclusively with physicians, hos pitals and healthcare organizations. He op erates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapman consulting.com.

Q & A

with Victor Pearlman

Executive director of Jewish Community Center of Greater Utica talks about the organization, its programs and says the organization and its programs are open to all, regardless of race, ethnicity or faith

MP

By David Podos

Q: How long has the Jewish Communi ty Center been here in Utica?

A: We have been here in our present location, 2310 Oneida St., since 1972 as the Jewish Community Center. But there has been a presence of a Jewish Federation in Utica for quite a bit longer.

Q: What are your programs and ser

vices that you offer and does someone have to be Jewish to receive these ser vices?

A: Well, let me first give you a brief history on the beginning of Jewish Community Centers across the country and why it came to be.

the country. It was partly because back then there were no places in many of the major cities in the United States where the essence of what was going on was Jewish so Jewish peo ple wanted a place where they could congregate and share their heritage.

Also, in the mid-‘50s and ‘60s many Jews were not welcome to become members in many different country clubs as well as many differ ent community centers. So, Jewish community centers began to pop up throughout the country to fill that void.

Here in Utica, the Jewish Com munity Center still offers opportu nities for our Jewish neighbors and Jewish residents through out the area to come and meet other Jewish people and share their heritage while receiving all the services and pro grams that we offer. That said, it is critically important for our communi ty to know that the Jewish Commu nity Center is open to all regardless of ethnicity and or faith and that everyone has the opportunity to take advantage of all our services and programs.

Q: Thank you for that clarification and the historical background. So, what are the programs that the center provides?

A: We provide a number of services such as: education, physical fitness and cultural programming services for the residents of the greater Mohawk Valley area. As I just mentioned, it is open to everyone.

Jewish families who have supported the center for years. But now we are a pay-as-you- go center for services/ programs rendered. For instance, one of our big sources of income is our pre-school program. We have other sources of income from people rent ing our gym for basketball or volley ball. We have an auditorium that is available to the public for rental use from birthday parties to live musical events and so forth.

Q: This past summer the Jewish Com munity Center held its first Jewish cul tural festival called Jewtica. How did that work out and will this turn into an annual festival?

A: It was a great success—and yes, we are planning a second festival for next year and hopefully for many years ahead.

Proposal#

In regards to our educational services, I am proud to say we have one of the best pre-school programs in the area. Presently, we have 150 children in that program and out of 150 kids only two are Jewish, so, once again you can see that we are open to all. For adults we have some wonder ful services. We offer physical fitness training, yoga classes, Zumba classes, as well as basketball, volleyball and indoor soccer which both adults as well as children participate in.

Q: How many members do you have?

MP Order Proposal#

So, the Jewish community movement started in the mid-1900s throughout

A: We changed a bit on that. We used to be only a membership-driven organization. We still have some pay ing members who are primarily local

Letter

Q: How many staff do you employ?

A: At this time, we have 26 staff.

Q: What is your biggest challenge?

A: Our biggest challenge, as I see it, is to make sure the communi ty understands that we are a center serving all people, that we are not exclusive but inclusive. Also, to let everyone know who comes here (for what ever services) that we are a secure building and that everyone is safe.

To learn more about the Jewish Com munity Center, visit www.jccutica. net or call-315-733-2343.

©

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‘Our biggest challenge, as I see it, is to make sure the community understands that we are a center serving all people, that we are not exclusive but inclusive.’

By Gwenn Voelckers

October: The Perfect Time to Turn Over a New Leaf

Fall is such a special time of year. For me, it means all good things: relaxing in front of a cozy fire, making pumpkin soup on Sunday afternoons, donning my well-worn leather jacket for long walks and turning my attention to all those inside projects I neglected over the summer.

The brilliant colors, autumnal aromas and industriousness that arrive with the falling leaves really appeal to me. But this hasn’t always been the case.

After my divorce, the month of October left me feeling melancholy. I missed sharing the beauty of the season with a special someone. And I missed the sunshine as daylight waned.

Nostalgia and wistfulness would creep in, and I just wanted to retreat into myself. For those who live alone, the month of October has unique challenges.

Not one to wallow in a “poor is me” state of mind, I began to develop and employ some strategies to rekin dle my love of the fall season. It can be a great time to mix it up, get busy and expand your horizons.

Below are elements of my annual fall game plan. Take a look and see if one or more of these suggestions might not add a little color to your life palette this fall:

■ Tackle indoor projects. Fall is a great time to accomplish all those

nagging in door projects on your to-do list. I have a long list and I keep it right in front of me — a daily reminder that I have plen ty of home improvements to tackle, both large and small.

Too much idle time is not a friend at any time of year, but it can become downright unfriendly when gray clouds appear and the tempera ture drops. Now is the time to get busy: organize your storage space, do some touch-up painting, update your wardrobe, or clean the garage.

There’s nothing like being pro ductive to beat the autumn blues.

Don’t I know it. I just finished coating my flat-roof porch with a sticky tar sealant. Confession: it was messier than it was fun, but still ... I’m proud of my accomplishment. It lifted my spirits.

■ Get up and get going. Staying ac tive when there’s a chill in the air can be difficult. I can remember many a cold morning when all I wanted to do was hit the snooze button, pull up the covers, and stay in bed.

As nice as sleeping in can be

from time to time, I don’t recom mend it as a steady diet.

In my experience, there’s no better way to start your day than to wake up early. In the early morning’s peace and quiet, there is glorious time to reflect and feel gratitude. I use this important “me time” to meditate and set my intentions for my day.

As the morning brightens, my energy grows, as does my apprecia tion for the precious day ahead me.

■ Start moving and enjoy the great outdoors. Fresh air, sunlight and even a gentle rain can be invigorating first thing in the morning. I find a sunrise walk boosts my energy and kickstarts my day. Do I feel like layering up and taking a walk every morning? No. Do I feel better after I make the effort? Yes, without fail.

I love a long solitary walk to clear my head and be mindful. But I also love a walk with my sister Anne or good friend Kate to enjoy their company and avoid the siren’s song of isolation as the days grow short and get colder.

■ Learn something new. Going back to school and fall go hand-inhand. Who among us isn’t reminded of the nervous excitement associated with returning to school in the fall? It’s a great time to expand your intel lectual horizons.

Each fall I identify a new skill or subject to learn. Last year, I re searched how to divide and relocate perennials (my irises and peonies); this fall, I’m signing up to learn French on Duolingo, the free lan guage-learning app.

Continuing education opportuni ties are abundant in this community and online. Check out colleges and universities, community centers, arts and cultural institutions, your local library, and workshop listings for class and workshop offerings.

■ Invite people in. Over the years,

I’ve discovered a few simple and manageable ways to bring people into my world and into my home. One way is to organize a gathering around a TV show or series — yes, around the TV, as odd as that might sound.

For years, I invited my single friends over to watch “Downton Abbey” with me on Sunday nights. I provided the soup and salad; they provided the good company.

So, what’s your pleasure? Wheth er it’s football, a favorite weekly sitcom, or “Ted Lasso” on Apple TV+ — all of these and other TV shows can become reasons to bring friends and family together. The benefits? You’ll hone your cooking skills (boy, do I now have some great soup reci pes!) and you’ll connect with people you care about.

What better way to enjoy a nice fall evening.

There are so many wonderful and meaningful strategies to enjoy the fall season and to ward off the blues that can sometimes emerge during this changing time of year. But these strategies require effort –conscious, creative effort.

If you are feeling sluggish, lonely, or isolated, try a few of the strategies above. They have stood me in good stead and have reinvigorated my love for the fall season.

If you, too, are ready to turn over a new leaf, October is the perfect time!

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

One App Is Especially Bad for Teens’ Sleep

sleep outcomes, researchers said.

Many

teens look at screens at bedtime, but some apps are more likely to keep them awake than others, leading to sleep problems.

That’s the upshot of a new study in which researchers found YouTube fans experienced consistent and neg ative effects on sleep. Surprisingly, traditional TV was associated with earlier bedtimes.

“We’ve been seeing teenagers who have sleep problems in our clin ic,” said co-author Michael Gradisar, head of sleep science at Sleep Cycle in Adelaide, Australia. “A lot of them have tried refraining from using technology, and clearly that hasn’t worked for them. Many of them mentioned that they would watch YouTube as they try to fall asleep. They find it entertaining without it

being overly stimulating.”

While many studies have been done on devices, little research has looked at the effects of specific apps on sleep, he said.

“We wanted to learn if there were specific apps that people should avoid, so that they could continue using their devices in a healthy way that didn’t affect sleep,” Gradisar said.

For the study, the researchers asked more than 700 12- to 18-yearolds how much time they spent using technology. That included mobile phones, gaming consoles and TV, as well as apps before going bed and in bed before falling sleeping.

While the study looked at the streaming service Netflix as well as YouTube, YouTube was the only app consistently and negatively related to

For every 15 minutes teens spent watching YouTube, they had a 24% greater chance of getting fewer than seven hours of shuteye. Watching YouTube and using gaming consoles both were associated with greater odds of getting insufficient sleep.

Contrary to the classic advice to keep TV out of the bedroom, tradi tional TV was associated with earlier bedtimes.

Gradisar said that might be because teens don’t interact with a TV in the same way they do with a phone. Instead, they just sit back and watch.

A half-hour in bed using phones, laptops, tablets and watching You Tube delayed lights out by seven to 13 minutes.

The issue with YouTube in partic ular may be that it’s so easy to finish

one video and click on a related one, said physician Alon Avidan, director of the UCLA Sleep Disorders Center.

Even homework done on screens late at night can be harmful, added Avidan, who reviewed the findings.

Watching Netflix was also asso ciated with greater sleepiness during the day.

Gradisar said one takeaway for parents is that not all technology use before bed is bad for their teen. Mom and Dad can also apply the findings to their own sleep health, he said.

“We often recommend that people do their own experiments with their tech use before sleep,” Gradisar said. “Find something that’s enjoyable so you don’t develop a bad relationship with your bed or bed room. The tech you’re using should be relaxing, but also be aware if it’s controlling your bedtime.”

Practical tips, advice and hope for those who live alone

Playing Video Games for 24 Hours to Raise Money, Help Local Hospitals

Students from Mohawk Valley Community College Strategic Gaming Club plan a 24 hour gaming marathon to raise money for the Children’s Miracle Network

By Daniel Baldwin

It is common for people to play video games for hours. But have they ever done it for 24 hours straight?

College students have the chance to go through that experience this November, as the Mohawk Valley Community College Strategic Gam ing Club will host its annual Extra Life 24-Hour Gaming Marathon.

The event will take place on the MVCC campus at Wilcox Hall. The marathon starts 5 p.m. Nov. 11 and ends at 5 p.m. Nov. 12.

Students who attend will play different console, PC, board and card games during the span. For 24 hours, gamers get to do the things that they love for a good cause. Students are doing this to help the local and chil dren’s hospitals financially.

“There are a lot of specific things hospitals need,” Melissa Barlett, ad viser for the club, said. “A lot of pedi atric medicine is at a very high cost. I know we [MVHS hospitals] helped a lot of children in our area. We’re the closest general hospital outside of the big cities, so we’re able to help children here without having to send them away for every single thing.”

This 24-hour marathon is a fund raiser. All the money raised will go to Children’s Miracle Network Hospi tals, the non profit organization that

raises funds for local and children’s hospitals in the U.S. and Canada, according to childrensmiraclenet workhospitals.org

“All of our local (Children’s Miracle Network) teams donate to MVHS,” Barlett said. “Any donations made through our team will go to the (MVHS) foundation, and specifical ly for the children (at these MVHS hospitals).”

The MVCC Strategic Gaming Club has found different ways to raise money at this event. People can show up in person and donate by cash. Although most students who participate in the marathon lives tream their playthroughs on Twitch or YouTube, and ask the people watching their stream to donate.

People can also donate on the club’s fundraising page www. extra-life.org/index.cfm?fuse action=donordrive.team&team ID=60924

“Most of the students don’t have money of their own,” Barlett said, “but they can go out and ask the people (at the marathon) for dona tions. They can stream on Twitch. They can get other people to join them (on stream). They’ll do some games where it is like, give us a little more money and we’ll do something funny on stream. They can host

tournaments, where people have to pay to get into the tournament and the tournament money all goes to the charity. They don’t have a lot of their own money, but they can work to get this.”

The MVCC Strategic Gaming Club may be the only gaming orga nization in New York state and even the U.S., to host a 24-hour gaming marathon.

Barlett said this type of gaming event is rare.

“There aren’t as many gaming events like this,” Barlett said. “A lot of people do walk-a-thons and tele-a-thons for all different stuff. But 24-hour gaming marathons are pretty rare.”

Students who attend the mar athon do not have to stay and play games the entire 24 hours. They can take breaks. They can come in and play for as long as they please, whether it is three to four hours or 10-15 hours.

There were a few MVCC stu dents in past marathons who burned the midnight oil and played games the entire 24-hour stretch.

“A lot of students do stay for as much of the 24 hours as they can,” Barlett said. “We always have a crew of somewhere between eight and 12 (students) who usually make it to 24 hours. Gamers will play games for 24 hours, even if they don’t have a charitable reason.”

Playing video games for one day is impressive, Barlett noted. But this 24-hour gaming marathon is not a competition on who could play video games the longest. It is about the students using their gaming skills to raise money and donate it to the Children’s Miracle Network.

“I like this because our college students get to do what they do best; stay up late and play games,” Barlett said. “But they get to help out the community and children while doing so.”

Students who want to participate in this year’s marathon should email Barlett at mbarlett@mvcc.edu or call 315-792-5471.

Golden Years & Senior Special

Don’t miss the next issue of In Good Health. Some of the stories we’re working on:

■ Free online hearing tests you can take at home ■ Mistakes to avoid when choosing a Medicare plan ■ Top senior discounts to improve good health ■ Home sharing: A growing trend among baby noomers ■ Vistion awareness — How to stay sharp

To advertise in this special issue of In Good Health, please call sales representative or send an email to editor@MVhealthnews.com

MVCC Strategic Gaming Club members and MVCC students competing in Magic Card Tournament during last year’s Extra Life 24 Hour Gaming Marathon at Wilcox Hall. Students and club members have hosted card tournaments and other gaming events, during the 24-hour marathon in an effort to raise money for Children’s Miracle Network hospitals.

SmartBites

By Anne Palumbo

The skinny on healthy eating

What Makes Apples Such a Nutritious Fruit?

Helpful tips

To get the most out of ap ples, leave the skin on, as it con tains half the fiber and most of the polyphenols. Eat them raw, if possible, since cooking can deplete some nutrients. Wash all apples (including organic) before preparing or eating. Apples stored in the refrigerator can last six to eight weeks. Kept at room temperature, apples last about a week.

When

my kids were young, I used to call all fruit “na ture’s candy.” The nickname won them over, especially when it came to apples. As a family, we de voured apples by the bushelful!

Although the kids are long gone, apples continue to be my go-to fruit and here’s why: they’re delicious; they’re always available; they last forever in the fridge; and they’re loaded — absolutely, positively load ed — with powerful health benefits.

Let’s begin with apple’s most bountiful nutrient: fiber.

Apples are a good source of both soluble and insoluble fiber, with one medium apple providing about 20% of our daily needs. Soluble fiber protects against heart disease by lowering bad cholesterol, while insoluble fiber keeps us regular and feeling full. Both fibers, along with an apple’s high-water content, help with weight control, which further benefits the heart by lowering the risk of high blood pressure.

Apples are packed with polyphenols, an import ant group of antioxidants that might help prevent cancer. Antiox idants protect our bodies from disease and accelerated aging by

neutralizing free radicals — harmful by-products of daily living— that can wreak havoc with healthy tissues.

Many studies suggest that eating an apple a day (or more) is associated with a reduced risk of certain can cers, including colorectal, oral, lung, prostate and breast cancers. Al though the results so far look prom ising, researchers point out that more studies are needed.

Eating apples may also reduce your risk of Type 2 diabetes, a chron ic condition that results in too much sugar circulating in the blood stream. Even though apples taste sweet, they have a low glycemic index, which means your blood sugar levels don’t spike when you eat them. Research ers at Tufts University found that people who ate one or more apples a day had up to a 23% lower risk of Type 2 diabetes than non-apple eat ers. Experts say the fruit’s fiber helps stabilize blood sugar, along with its high concen tration of antioxi dants.

Just under 100 calories, nutrient-rich apples are also a decent source of im mune-boost ing vitamin C and have no fat, cholesterol or sodium.

Are Big Breakfasts the Key to Weight Loss?

Dieters who believe that eating a big breakfast followed by a small dinner is the surest way to lose weight will likely be very dis appointed by the findings of a new, small study.

What did the researchers dis cover? Eating the largest meal early in the day is unlikely to make any difference.

“The notion of timing of eating to influence health has been around for a long time,” said study author Alexandra Johnstone, a registered nutritionist and professor in the school of medicine, medical sciences and nutrition with the Rowett Insti tute at the University of Aberdeen in Scotland.

Johnstone acknowledged that the advice to “breakfast like a king and dine like a pauper” has plenty of adherents.

And prior research has in fact “suggested that eating earlier in the day enhanced weight loss, affecting energy metabolism, compared to

eating later in the day,” she noted.

Still, “chrono-nutrition” — the relationship between food intake and time of day — “is a relatively young science,” Johnstone cautioned.

To try to separate myth from fact, she and her colleagues decided to conduct a diet test involving 16 men and 14 women. For a month, each participant was randomly assigned to follow a morning-heavy diet or an evening-heavy diet, the study authors explained.

All meals were based on a 30% protein, 35% carbs and 35% fat break down, while total daily calorie intake was fixed.

But those on the morning-heavy diet consumed 45% of their daily calories at breakfast, followed by 35% and 20% at lunch and dinner, respec tively.

In contrast, those on the eve ning-heavy diet followed a 20%, 35% and 45% daily calorie split.

At the end of the month, all participants took a one-week break,

Apple Walnut Quinoa Salad

Adapted from twopeasandtheirpod.com

Serves 4-6

Maple-mustard dressing:

¼ cup olive oil

1 tablespoon fresh lemon juice

2 tablespoons apple cider vinegar

½-1 tablespoon pure maple syrup

2 teaspoons Dijon mustard

1 clove garlic, minced

Kosher salt and black pepper, to taste

Apple quinoa salad:

2/3 cup quinoa, rinsed

1¼ cups water

4 cups mixed greens

2 cups chopped apples

½ cup dried cranberries

½ cup crumbled goat, feta or Gor gonzola cheese

½ cup chopped walnuts Kosher salt and black pepper, to taste

which was then followed by a switch: for the following month all the morning-heavy eaters became eve ning-heavy eaters, and vice versa.

The result: “We found weight loss was similar with both diets,” Johnstone said.

All participants did lose a nota ble amount of weight, with an aver age loss of about 7 pounds during each of the one-month periods. It’s just that neither dietary pattern prompted more weight loss.

However, Johnstone and her colleagues did identify one big differ ence between the two styles of eating: diminished hunger among those on the morning-heavy diet.

While “there was no impact on energy expenditure,” she noted, “there was a positive influence of big breakfast to control appetite through out the day, with less hunger.”

And that could give a morn ing-heavy diet a leg up in the long run, she said.

“Hunger is one of the main reasons that people fail to comply to a weight-loss or calorie-restricted diet,” said Johnstone. “So if we have diet strategies that can help control hunger, then it would be beneficial in the real world.”

Johnstone and her team also

First, make the quinoa. Combine the quinoa and water in a medium pot. Bring to a boil, cover, reduce the heat and simmer for 15 minutes. Remove from the heat and let it sit, covered for 10 more minutes. Fluff with a fork.

While quinoa is cooking, make the maple-mustard dressing. In a small bowl, whisk together all the dressing ingredients. Set aside.

In a large bowl, add the mixed greens, cooked quinoa, apples, dried cranberries, crumbled cheese, and walnuts. Toss until the salad is combined. Then, drizzle with dressing (add the amount that suits you) and toss again. Season to taste with more salt and pepper, if needed.

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.

stressed that there is unlikely to be a one-size-fits-all approach to how dietary planning affects metabolism. Yet broadly speaking, “our work sug gests that the distribution of calories throughout the day does not influ ence energy metabolism or weight loss,” she said.

The findings were published online Sept. 9 in the journal Cell Metabolism.

Advances in Cancer Treatment Offer Hope

By Barbara Pierce

Oncologist Daniel Thomas, Upstate Cancer Center, assistant professor of surgery, SUNY Upstate Medical University, has a special interest in the treatment of patients with melanoma, sarcoma and diseas es of the endocrine system including thyroid cancer, parathyroid disease and adrenal tumors.

His primary research interest is improving the care of elderly and frail patients who undergo cancer surgeries.

We asked him about the outlook in cancer treatment, whether there is hope for those affected by this disease.

Q: Are rates of death from cancer decreasing?

A: We’ve seen a decrease in the risk of Americans who die from cancer in the last three decades. Over that time, there’s been about a one third decreased risk of dying from cancer, once it’s diag-nosed. Further more, a recent report from the Na tional Cancer Institute showed that, even in the last five years, the overall cancer death rate for Americans has fallen even more sharply.

It’s important to put these numbers into context when you consider how many people in U.S. are diagnosed with cancer every year. In 2020, it was estimated that almost two million people would be

diagnosed with cancer, and 600,000 would die.

A decrease of one-third the risk of dying means that our current preventive strategies and cancer treatments are making a significant impact.

Q: What is the reason for the de crease in death?

A: There are many reasons why the risk of dying from cancer has decreased. One of the biggest con tributors has been public health and cancer prevention programs that focus on preventing cancer and early detection of cancers.

For example, smoking rates have plummeted in the last several decades which clearly decreased the number of Americans dying from lung cancer. Also, our ability to detect early cancers has improved with screening programs, such as mammography for breast cancer or colonoscopy for colon cancer.

When patients are screened, can cers can be detected earlier, at an ear lier stage, and therefore have a better chance of being treated successfully before the cancer can spread to the rest of the body. Early detection and early treatment translate into pro longed survival.

The second and most exciting reason for the improvement in cancer survival is our ever-improving treat

Strides Against Breast Cancer Walk: Oct. 3 at MVCC

ment options. We all hope that the patient’s cancer will be at the early stage when discovered, but even patients who have advanced stage cancer, new treatment discoveries are allowing patients to live longer after their diagnosis. Lung cancer and melanoma are two great examples of how cancer discoveries have led to prolonging survival for patients, compared to even just 10 years ago. The discovery of cancer treatment such as targeted drug therapies and immunotherapies have drastically changed the landscape, especially for patients with advanced or metastatic disease.

Q: What are the most promising new therapies for cancer patients?

A: The discovery and advance ment of immunotherapy has been groundbreaking and quite literally life-changing for cancer patients. Immunotherapy is a type of cancer treatment which can be used to treat many different types of cancer and can be used alone or often in com bination with chemotherapy and other cancer treatments.

Immunotherapy has really come to the forefront in the last decade. These cancer treatments help the patient’s own immune system fight cancer by boosting the im mune system’s response to the presence of cancer cells. And since your immune system goes throughout your whole body, this type of treatment can attack cancer cells anywhere in the body. This has been proven to be a game-changer in the treatment of patients with advanced or metastatic cancers.

I’m an expert in the treatment of melanoma, a type of skin cancer which can have a poor prognosis in patients who have advanced or metastatic dis ease. However, immunotherapy

advances in the last five to 10 years have allowed patients with advanced and metastatic melanoma to live longer. It’s very exciting that the five-year survival rate for melanoma patients has doubled over the last 10 years.

There is much hope for the future of cancer treatments. Patients should maintain hope when facing these difficult diagnoses. Here at Upstate Cancer Center and at cancer centers across the world, we continue to study new and innovative cancer treatments like immunotherapies and continue to make headway in our struggle to fight cancer.

As an example of hope, a recent ly a study in the New England Jour nal of Medicine reported the results of 14 patients with advanced rectal cancer who were treated with a new immunotherapy medication. With only six months of treatment with this new immunotherapy drug, all 14 patients had a complete response to treatment and so far, have

tion, or surgery. This is ground breaking, and just one study

to treat patients

The American Cancer Society

Making Strides Against Breast Cancer walk presented by Up state Cancer Center will be held on Sunday, Oct. 23, at Mohawk Valley Community College in Utica. Regis tration for this event begins at 8:30 a.m. and the walk is set to start at 10 a.m.

Since 1993, the American Can cer Society Making Strides Against

Breast Cancer campaign has unit ed communities, companies, and individuals with a collective goal to end breast cancer. Over the past two decades, the 3- to 5-mile noncompet itive walks have collectively grown into the nation’s largest and most im pactful breast cancer movement, pro viding a supportive community for courageous breast cancer survivors and metastatic breast cancer thrivers,

caregivers, and families alike.

This year, Making Strides Against Breast Cancer celebrates its 30th anniversary and will take place in more than 150 communities nationwide.

Making Strides Against Breast Cancer celebrates survivors and thrivers, funds lifesaving breast cancer research and is committed to advancing health equity through programs and services, believing that all people have a fair and just oppor tunity to live a longer, healthier life free from breast cancer — regardless of how much money they make, the color of their skin, their sexual orien tation, gender identity, their disabili ty status, or where they live.

Dollars raised help the Ameri can Cancer Society fund innovative breast cancer research; provide edu cation and guidance to help people reduce their risk; and offer compre hensive patient support to those who

need it most.

Since 1993, supporters have raised nearly $1 billion nationwide. Last year, over a thousand walkers in the Mohawk Valley helped to raise more than $105,000.

As a way to recognize and cele brate those who have battled breast cancer, all survivors who register for the walk will be sent a link for a free breast cancer survivor or thriver T-shirt. To register, just go to the event website at www.making strideswalk.org/utica or call 1-800227-2345.

To learn more about the Making Strides Against Breast Cancer event and how you can become involved either as a participant or volunteer, visit MakingStridesWalk.org/Utica or contact Robert Elinskas at 315-7415409 or Robert.Elinskas@cancer.org.

A celebration of courage and supportive communities is the hallmark of the Making Strides Against Breast Cancer experience

Cancer

Breast Cancer Awareness: Emphasis Should Be on Mammograms

InNew York state, 83% of indi viduals who are recommended to have a mammogram are follow ing the state’s screening guidelines, a percentage that’s been stable for two decades, according to a review of state data by Excellus BlueCross BlueShield.

That means a persistent number of individuals (17%) are non com pliant and putting their lives at risk. According to data self-reported to the state, of those who have not had a mammogram within the past two years, 92.2% had health insurance and 83.4% had a regular health care provider.

“Maybe we should change October from Breast Cancer Aware ness Month to Mammogram Month since, while awareness is important, detecting breast cancer early with a mammogram can save someone’s life,” says physician Lorna Fitzpat rick, Excellus BCBS vice president of medical affairs and senior medical director. A mammogram can detect breast cancer at its earliest stages when treatment is most successful.

According to the Centers for Disease Control and Prevention, for every 100,000 women in the United States, there will be 124 reported

“With so much attention given to breast cancer awareness, and so many barriers removed to getting a mammogram, there should be 100% compliance with screening guidelines. Sadly, that’s not the case.”

cases of breast cancer and 20 deaths from the disease. In New York state, breast cancer is the most diagnosed form of cancer, with approximately 16,500 new cases and 2,500 deaths each year.

New York state guidelines rec ommend a mammogram every two years for individuals aged 50 to 74 who should be screened. Those who are 40 to 49 years of age, those with a family history or other risk factors for breast cancer, and those who have any symptoms or changes in their breasts should talk to their health care provider about the most appro priate screening schedule.

New York’s “Get Screened, No Excuses” legislation, signed in 2017,

eliminated out-of-pocket costs and many access issues associated with breast health care and services, including mammograms (the law does not apply to self-funded health insurance plans).

“With so much attention given to breast cancer awareness, and so many barriers removed to getting a mammogram, there should be 100% compliance with screening guide lines,” says Fitzpatrick. “Sadly, that’s not the case.”

Mammography rates across the 14 county Utica region average 78.3%, or about five points lower than the state average (83%) for indi viduals aged 50 to 74.

County Percentage of People Screned for Breast Cancer Aged 50-74

Clinton 81.7% Delaware 61.5%

Essex 78.4%

Franklin 78.9%

Fulton 80.6%

Hamilton 75.5%

Herkimer 79.9%

Jefferson 69.4%

Lewis 77.7%

Madison 76.9%

Montgomery 86.4%

Oneida 88.2%

Otsego 74.2% St. Lawrence 87.3%

Utica Region 78.3%

Source:wwws.health.ny.gov

Says Fitzpatrick, “It’s great that so much energy is directed toward breast cancer awareness, but aware ness needs to translate to action.

Mammograms detect breast cancer early, when treatment has a high er rate of success and lives can be saved.”

Physician Lorna Fitzpatrick, Excellus BCBS .

Physician Lorna Fitzpatrick, Excellus BCBS vice president of medical affairs and senior medical director.

Cancer

Chittenango Practice Offers

Complementary Approaches to Cancer Treatment

By Barbara Pierce

Learning that one has cancer can be devastating, said Heidi S. Puc, founder and physician owner of Integrative Medicine of Central New York in Chittenango.

“Sometimes patients see me with a new diagnosis of cancer after they’ve seen their conventional oncologist. For most patients, the diagnosis is overwhelming. At my consultations, we sit down, go over their story and their records and we discuss their options.”

With more than 20 years’ experi ence in conventional medical hema tology and oncology, merged with 10 years’ experience in integrative med icine and integrative oncology, Puc has a unique ability to serve patients in any stage of cancer.

“We see patients in all different stages of cancer,” she said. “Those who have been newly diagnosed with cancer, those undergoing treat ment, those recovering, or those at risk of for developing cancer.”

Integrative medicine offers a different approach to care, integrat ing conventional and natural heal ing practices to empower patients in their own healing. Integrative medicine is care of the whole person. It focuses on the patient as a whole person, and not just their disease.

Recognizing the interwoven nature of mind, body, spirit and community, it addresses each of these aspects of the whole person through out their healing.

Integrative medicine is not an alternative to conventional medicine; it integrates natural and conventional approaches and it is patient-centered care, following the patient’s lead.

Those who have been newly diagnosed with cancer see Puc to clarify the issues and the challenges they will face and to discuss treat ment recommendations and options.

Some wish to merge more natu ral remedies with conventional. An integrative approach to cancer care may involve treatment with surgery, chemotherapy, radiation and other conventional tools, while supporting patients’ strength, stamina and qual ity of life with evidence-informed therapies to achieve optimal health and healing.

Many patients underestimate how dramatically cancer will affect them, both physically and emotion ally. Symptoms like nausea and vom iting, sleep disturbances, dry mouth and neuropathy are common side effects of treatment for cancer. Many patients become malnourished, with deficiencies in nutrients and often severe weight loss; many experience fatigue.

Natural remedies are designed to address these side effects.

Some patients prefer to have no conventional treatments and desire to only be treated with natural reme dies.

Natural remedies can help patients handle the disease better,

improve their overall quality of life and can improve their odds of sur vival. Natural remedies can include oral or intravenous herbal or vitamin therapies.

Available therapies at IM of CNY include high dose IV vitamin C and mistletoe therapy (viscum album). For example, with mistletoe therapy, “We’re seeing very good results with this therapy,” said Puc. “It’s very exciting!”

Mistletoe extracts may stimu late the immune system to improve symptoms, reduce the side effects of cancer treatments and improve survival rates.

“At IM of CNY, we now have IV alpha-lipoic acid available, which can help chemotherapy induced neurop athy (numbness and tingling) as well as cognitive problems and it also can have an anti-cancer effect. Cogni tive issues related to chemotherapy, called ‘chemo brain’, is a big issue for patients,” Puc added.

Chemo brain refers to a wide range of cognitive impairments, estimated to impact 80% of those being treated for cancer according to the University of Rochester. About a third continues to struggle long after treatment.

“We have neurofeedback avail able for dealing with the brain fog of cancer treatment. We have the ability to do neurofeedback in our office as well as in the patient’s home,” she explained. “This expands our ability to help people for whom distance is a problem. Conventional oncologists don’t always let people know this is available.”

For all patients who are strug gling with cancer, Puc focuses on strengthening the patient’s “terrain,” the support structure and elements of the body that are dealing with the cancer, including the immune system, the detoxification system, or

ganisms in the intestines, antioxidant and anti-inflammatory potential, and nutrient levels.

In addition, patients with cancer consult with Puc specifically for a medical marijuana certificate.

“Medical marijuana is very helpful,” she said. “It’s good that the state of New York has expanded its use. They’ve opened it up to the discretion of the doctor about which patients would benefit.”

Many patients come to see Puc because several of their family mem bers have had cancer or they have been diagnosed with a known genet ic risk. They come to her to learn how to minimize their risk of developing cancer.

Also, those who are cancer sur vivors and want to reduce risk for a recurrence of cancer or for the devel opment of a new type of cancer come to see Puc to reduce their risks.

Out-of-Pocket Costs for Cancer Care Keep Climbing

Cancer

patients already have a lot to deal with emotionally and physically. But research shows that insured patients under 65 are also paying more for their treat ments out-of-pocket than ever before.

The study highlights the “grow ing financial burden for non-elderly patients with cancer with private health insurance coverage,” said senior study author Robin Yabroff, scientific vice president of health services research at the American Cancer Society (ACS).

“Policy initiatives to mitigate financial hardship should consider cost containment as well as insurance reform, as most Americans will not be able to afford such an unexpected expense,” she said in an ACS news release.

Researchers from the ACS and the University of Texas MD Ander son Cancer Center found that as costs of cancer treatments rise, this led to greater out-of-pocket costs for the four most common types of cancer in patients younger than 65 who were privately insured.

Those out-of-pocket costs went

up more than 15% between 2009 and 2016, to more than $6,000 for those being treated for breast, colon and lung cancers, and to $4,500 for those receiving treatment for prostate cancer.

To study the issue, researchers analyzed 105,255 breast, 23,571 colon, 11,321 lung, and 59,197 prostate cancer patients using claims from the Health Care Cost Institute.

The data included cancer-relat

ed surgery, intravenous systemic therapy and radiation. The research team calculated associated total and out-of-pocket costs.

The study found that the total mean costs per patient increased from $109,544 to $140,732 for breast cancer patients, an increase of 29%. Costs increased from $151,751 to $168,730 for lung cancer treatments, or 11% jump. Those costs grew from $53,300 to $55,497 for prostate cancer,

about 4%. The increase for colon can cer, went from $136,652 to $137,663, which was not considered statistical ly significant.

“This trend of rising OOP [out of pocket] costs among patients with private insurance is concerning because high-deductible plans are becoming more common in the pri vate insurance market,” said study author Ya Chen Tina Shih, a professor of health services research at MD Anderson.

“The recently passed Inflation Reduction Act is a step toward ad dressing this challenge, focusing on reductions in pricing for high-cost Medicare drugs and limiting out-ofpocket costs for seniors,” Shih said in the release.

Researchers found that the use of intravenous systemic therapy and radiation statistically significantly in creased, except for lung cancer. Can cer surgery costs increased for breast and colon cancer, while decreasing for prostate cancer.

The findings were published Sept. 13 in the Journal of the National Cancer Institute.

Heidi S. Puc, founder and physician owner of Integrative Medicine of Central New York in Chittenango.

The Balanced Body

By Deborah Dittner

Children and Wholesome Eating

The fall routine is in full swing.

Schooling, including those home-schooled, private and public, is under way. Fall sports are also in full gear from soccer, field hockey, volleyball and more. The most important aspect of the begin ning of a new school and sport year is the whole, nutrient-dense foods provided for the children to learn and grow with all the best intentions.

The healthiest foods are plantbased, supplying the gut and brain with optimal nutrients and fiber. These foods will also reduce the risk for later-in-life chronic diseases, obesity and constipation, a common problem for young children, and feed the healthy gut bacteria to help digest food and boost immunity. Incorporating 9-11 servings of mostly veggies and fruit daily will provide the needed nutrition.

Children can sometimes be picky eaters, so incorporating these nutri ent-dense foods can be a challenge. Let’s look at some great possibilities.

Apples

The old phrase “an apple a day keeps the doctor away” means apples will provide fiber, crunch and sweetness supporting heart and gut health. An apple can be eaten alone, or cut up and dipped into nut butter, adding protein and fat to create balance. With apple season also comes applesauce. Ap plesauce is easy to make by simply cutting up the apples, adding a stick of cinnamon and a little water to the pot then slowly cook it down. Yum! Apples can also be added to smooth ies and in baking.

Avocado

I also like to say “an avocado a day keeps the doctor away” providing nutrients for brain health and heart-healthy fats. An easy breakfast can be avocado on toast. Cut up, avocado can be add ed to a salad for lunch. Celery and carrots can be dipped into guacamole as a snack. And the creaminess does

wonders to smoothies.

Carrots

A sweet and tasty crunch packed with beta-carotene and nutrients for brain health. Great for teething babies and teaching them to develop healthy taste buds. Later, dip carrots into hummus or guacamole for a balanced snack. Add sliced carrots to soups and stews, or roast with other veggies for a side at dinner.

Berries

Raspberries, blueberries, blackberries, strawberries and cranberries are anti-inflamma tory, full of fiber, sweet to taste and great as a snack. Instead of using sugar-laden jams or jelly on toast or PB&Js, consider making this easy spread.

CHIA SEED FRUIT SPREAD

Ingredients: 2 cups berries

2 Tbsp. raw, local honey or ma ple syrup

1 tsp. fresh lemon juice

¼ cup chia seeds

Preparation: Combine first 3 ingredients in a bowl to mash the berries and combine. Or use a blender

Add in chia seeds and stir to combine

Place in a clean jar, cover and refrigerate

Chia seeds

As noted in the recipe above, chia seeds are full of fiber, vitamins, minerals, and omega-3 fatty acids beneficial in heart and brain health, decrease stress and boost emotional health.

When combined with a liquid, chia seeds “swell” and thicken mak ing a tasty pudding. To make chia pudding in a jar, combine 1 cup nondairy milk, 1 tablespoon of maple syrup, ½ teaspoon of vanilla extract and 3 tablespoon of chia seeds. Shake well and refrigerate. Adding 2 3 tablespoon of cocoa powder for those

craving chocolate is another option.

Bananas

High in fiber and po tassium helping to regulate the bowels and possibly boost one’s mood, Bananas are to eat alone or add to smoothies. A great snack: slather banana with nut butter of choice (great for brain health); roll in sunflower seeds or hemp seeds then slice and freeze. Over-ripe ba nanas can also create yummy banana bread.

Sweet potatoes

Full of antioxidants, vitamins, minerals and fiber, and anti-inflam matory, this brightly colored tuber is extremely versatile. Slices of sweet potato can be toasted then topped with avocado. Mashed sweet pota toes can be made into “burgers.” Cut up sweet potatoes can be added to soups. Baked sweet potatoes can be filled with a variety of veggies. And don’t forget to eat the skin which is also packed with nutrients.

Oats

This whole grain provides fiber, supports heart health, aids in di gestion and may boost immunity. A great way to start the day:

OVERNIGHT OATS IN A JAR

Ingredients: 1/3 cup oats

Toppings: 1/2 banana small handful of almonds or walnuts

1/3 cup plain non dairy yogurt of choice

NUT BUTTER

1/3 – 1/2 cup non-dairy milk cocoa powder or cacao nibs

1/4 teaspoon cinnamon, maple syrup or honey

3/4 tablespoon chia seeds

Preparation: Mash banana in a bowl

Stir in oats, yogurt, milk, cinna mon and chia seeds

Mix until well-combined Place in a jar, cover and store in the fridge overnight

In the morning, add toppings of choice

Beans

A plant-based protein high in fiber, vitamins and minerals come in a variety from chickpeas, black beans, edamame and more. Add to soups, roast with spices, topping for tacos and making hummus gives numerous ways to enjoy. Green peas are also a great finger food for babies and toddlers.

Beets and Beet Greens

So much goodness consisting of fiber, iron, vitamins A and C, folic acid and more. Beets can be eaten raw in salads, roasted to bring out the sweetness and pickling adds tang. Steam the greens and add a splash of vinegar to boost extra nutrients.

Pears

Sweetness mul tiplied…and immune- boosting antioxidants, too. Eat a pear as-is for a snack. Add to salads or put in a smoothie. Slice and sauté in a little coconut oil with cinnamon for a scrumptious dessert.

Introducing children at a young age to whole, nutrient-dense foods sets them up for a lifetime of eating healthy nutritious foods. Start them young and they will prosper in the classroom, on the field and in life.

Deborah Dittner is a family nurse practitioner and health consultant. Her mission is to transform as many individuals as possible through nutrition and lifestyle changes. For more information, check out her website at www.debdittner. com or contact her at 518-596-8565.

Kids and Foods: Tips for Parents

By Barbara Pierce

As a parent, you’re the most important influence on your child. They learn about food and how to eat it from you. How they make food choices and how they eat throughout their life stems from you.

Kids need the right foods, in the

right amounts, to help their bodies and their minds grow, to help them learn in school, to sleep well and play well. Healthy eating in childhood means they’ll have less chance of becoming an overweight child, less chance of developing high blood pressure, diabetes, high cholesterol and other issues as an adult.

Registered dietitian Crystal Hein, owner and operator of Crystal Clear Nutrition in Herkimer, offers these tips for parents:

• Make healthy choices: “The best way that parents can instill good eating habits in their children is to be a role model,” she said. “If you make healthy food choices, your child will have a good example to follow.”

If your child had to choose a can dy bar or an apple, which would they choose? What if you changed the choice to either crackers and cheese or an apple? The point is that you decide which foods to keep regularly on hand. You control the supply line.

Have healthy foods accessible for your child. Make less-healthy foods less accessible, Hein suggested. If you keep food choices healthy, your child is more likely to eat healthy. They’ll eat what’s available. It’s that simple.

Healthy choices to have available include fruits, vegetables, unsalted nuts and seeds, and whole grains. Also, fat-free or low-fat dairy prod ucts such as milk, yogurt and cheese. Include a variety of protein foods like seafood, lean meat and poultry, eggs, beans and peas, nuts, seeds and soy products.

Your child should eat less of food

that contains refined grains and add ed sugars, such as white bread, pizza dough, pasta, pastries, white flour, white rice, sweet desserts, many breakfast cereals and fast food. And food with saturated fats and salt, like chips.

• Involve your children in the meal planning, shopping and meal preparation process. Make it fun for them and involve them in making choices. When kids are involved in planning and preparing healthful meals (with age-appropriate tasks), they are more likely to try new foods. Also, they’ll have a better greater understanding of nutritious, healthful foods that will benefit them for a lifetime.

“Make healthy eating part of the conversation,” said Hein. For example, discuss the choices they see on TV or the internet. Focus on the benefits of making healthy food choices, like growing up to be strong or having energy to play outside.

Use your child’s food choices as teaching moments. Praise your child for making healthy food choices. Don’t make them feel guilty about their choices of food or drinks.

Start exposing them to a variety of foods when they’re young. Chil dren need nutrients from a variety of food groups to support their growing bodies and minds. They are more likely to try new foods and to like more foods, if they’re exposed at an early age.

• Rethink the drink: Encourage fat-free or low-fat milk and water first, said Hein. Rather than fruit juice, offer the whole fruit. If you do have juice, make sure it’s 100% juice

without added sugars and limit how much they have. Kids don’t need much of it: four to six ounces a day is enough for preschoolers.

So many so-called “kid-friendly” drinks are loaded with extra sugar. Soda and other sweetened drinks only add extra calories and get in the way of good nutrition.

Water and milk are the best drinks for kids.

• Share meal times as a family: Eat together, suggested Hein. Have sitdown meals with your family; serve everyone the same meal. Don’t eat in front of the TV or while using your phones; focus on the process of eating.

Also, this will do much to increase family bonding. When a family sits down together, it helps support each other in handling the stresses life and hassles of everyday life. Eating together also promotes better eating habits.

• Reward good behavior with things other than food: When we use food to reward kids, we’re teaching them a bad habit; they may start to use food to cope with stress and other nega tive emotions. Instead of food, offer praise, attention or fun activities, said Hein. Focus on the activity: bake muffins together as a family instead of just eating muffins.

Be a role model and make physi cal activity part of your day. Do out door activities as a family. Start when your kids are toddlers. Get active as a family. Take a walk together after dinner, plan fun activities every week such as a family bike ride.

Dealing with Urinary Tract Infections

By Barbara Pierce

Ifyou’re a woman, your chances of getting a urinary tract infection are high.

More than half of women will have at least one UTI at some point in their life, according to the CDC. About one in 10 men will get a UTI in their life. Many women get reoc curences.

A UTI is an infection in your urinary system, which includes the urethra, ureters, bladder and kid neys. UTIs happen when bacteria get into the urethra, travel up to the bladder, and multiply. This triggers an inflammatory response in your body which results in the symptoms you associate with a UTI. Women are more likely to get a UTI than men because they have shorter urethras so bacteria don’t have to travel as far to reach the bladder.

“UTIs are common; many wom en get them frequently,” said Brent Carlyle, urologist with the Rome Health Urology practice. “Some women get them more frequently, due to structural anomalies, aging, or other reasons.”

“Most women know when they have a UTI,” he added. Symptoms typically include the need to urinate more often, sudden urge to urinate, pain when urinating, stomach pain, side, or lower back, unpleasant smell to urine, or generally feeling unwell, achy and tired.

When is it time to see a health care professional?

“If your symptoms don’t resolve quickly,” said Carlyle.

If your symptoms haven’t gone

away after 24 to 48 hours, see a health care professional.

Blad der infec tions are the most common type of UTIs. If an infection is limited to the bladder, it can be painful and annoying. But it’s easily treatable with antibiotics said Carlyle.

Take the antibiotics exactly as your healthcare professional tells you and take the whole course even when symptoms go away. Do not share your antibiot ics with others; do not save antibiot ics for later.

“Most bladder infections are treatable with antibiotics,” stressed Carlyle. “However, for those women who have frequent UTIs, it can be a sign of more serious urologic issues. I struggle to treat these women; I try different techniques until I find what works.”

Left untreated, UTIs can lead to serious consequences. If a UTI spreads to the kidneys, serious health problems can result. Kidney infec tions are less common, but more serious than bladder infections.

The signs and symptoms of a kidney infection or a more serious urinary tract infection can include: a high temperature, fever, nausea, low er abdominal pain, pain in your sides or back, shivering and chills, blood in the urine, foul smelling urine, cloudy

urine, burning during urination, the urge to urinate frequently, inconti nence and even confusion.

If you have any of these symptoms, contact your health care professional.

UTIs can be found by ana lyzing a urine sample. The urine is examined under a microscope for bacteria or white blood cells, which are signs of infection.

Your health care provider may also take a urine culture. This is a test that detects and identifies bacteria and yeast in the urine, which may be causing a UTI.

If you ever see blood in your urine, you should call your health care provider right away. Blood in the urine may be caused by a UTI, but it may also be from another problem in the urinary tract.

If you have a fever and symp toms of a UTI or symptoms that won’t go away despite therapy, you may need further tests, such as an ultrasound or CT scan, to check the urinary tract.

Sometimes other illnesses, such as sexually transmitted diseases, have symptoms similar to UTIs. Your healthcare professional can deter mine if a UTI or different illness is causing your symptoms and deter mine the best treatment.

How to lower your chances of getting a UTI in the first place:

“Cranberry tablets help,” said Carlyle. Your grandmother was right. For whatever reason, something about cranberries protects against UTIs. Perhaps they make it harder for infection-causing bacteria to stick to the urinary tract walls; experts

aren’t sure.

Drinking enough water is im portant.

“So many women don’t drink enough water,” added Carlyle. “Es pecially as we age, the body doesn’t communicate that we need to drink more water. But it’s important to get enough, for several reasons.”

“The solution to pollution is dilu tion,” is a phrase Carlyle likes.

Stay well hydrated.

Other factors that can increase the risk of UTIs: sexual activity, menopause, pregnancy, aging, struc tural problems in the urinary tract or poor hygiene.

CDC also suggests ways to pre vent UTIs include urinating after in tercourse, taking showers instead of baths, minimizing douching, sprays, or powders in the genital area and teaching young girls when they’re being potty trained to wipe front to

Brent Carlyle, an urologist with the Rome Health Urology: “UTIs are common; many women get them frequently,” he says.

By Jim Miller

Daily Check-In Services for Seniors Living Alone

Dear Savvy Senior,

Can you recommend any services that check in on elder ly seniors who live alone? I live about 200 miles from my 82-yearold mother and worry about her falling or getting ill and not being able to call for help.

— Worrywart Daughter

Dear Worrywart,

There are actually several differ ent types of check-in services, along with some simple technology devices that can help keep your mom safe at home while providing you some peace of mind. Here are some top options to look into.

• Check-in app: If your mom uses a smartphone, a great solution to help ensure her safety is Snug (SnugSafe.com), a free app that would check in on her every day to confirm she’s OK. This app is used by thousands of elderly seniors who live alone and want to make sure that if something happens to them, their loved ones will be notified quickly so they can receive help in minutes, rather than days.

Here’s how it works. After downloading the app, your mom will choose what time(s) throughout the day she’d like for Snug to check in. Snug will send a push notification at those times asking your mom to check in by tapping the big green check button on her smartphone screen. If she doesn’t check in within 10 minutes or respond after multiple pings, Snug will notify her emergen cy contacts and share her last known location so that she can receive fast help.

For extra peace of mind, your mom can purchase Snug’s premi um plan ($10 per month) where in addition to notifying her emergency contacts, Snug will request an in-per son wellness check by a police officer who will visit her house to confirm she’s OK and provide assistance as needed. The app works with iPhone and Android smartphones.

• Check-in calls: If your mom doesn’t use a smartphone, another option to help ensure her safety is a daily check-in call service program. These are telephone reassurance programs usually run by police or sheriff’s departments in hundreds of counties across the country and are usually provided free of charge.

Here’s how they work. A com puter automated phone system would call your mom at a designated

time each day to check in. If she an swers, the system will assume every thing is OK. But if she didn’t pick up or if the call goes to voice mail after repeated tries, you (or whoever her designee is) would get a notification call. If you are not reachable, calls are then made to backup people who’ve also agreed to check on your mom if necessary.

The fallback is if no one can be reached, the police or other emergen cy services personnel will be dis patched to her home.

To find out if this service is avail able in your mom’s community, call her local police department’s none mergency number. You should also check with the local county office of the aging in your mom’s area — call 800-677-1116 for contact information.

If, however, her community doesn’t have a call check-in pro gram, there are businesses like CARE (Call-Reassurance.com) and IAmFine (Iamfine.com) that offer similar ser vices for under $15 per month.

• Technology devices: You may also want to invest in some simple technology aids to keep your mom safe. One of the most commonly used devices for this is a medical alert sys tem that cost about $1 per day. These systems come with a wearable “help button” that would allow her to call for help 24/7.

Another option that’s becoming increasingly popular is smart speak ers, like Amazon Alexa or Google Home. These devices work with third-party applications — AskMy Buddy.net and MySOSFamily.com — that would let your mom to call multiple emergency contacts with a simple verbal command.

And be sure to check out Ama zon’s Alexa Together (Amazon.com/ AlexaTogether), a new $20 month ly subscription service that helps families support and keep tabs on their older loved ones who live alone through an Alexa-enabled device.

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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Many veterans who return home struggle with both physical and mental injuries and many end up jobless and homeless. The Nation al Coalition for Homeless Veterans reports nearly 13% of the homeless adult population are veterans. And according to the U.S. Department of Veterans Affairs, veterans are more than twice as likely to be food inse cure. “Feed Our Vets believes it is our duty to give back to these men and women who have given so much for our country,” said Synek.

Through a competitive appli cation process, Excellus BlueCross BlueShield’s Community Health Awards provide funding to launch, expand, and sustain programs and services that promote health. These investments advance health equity by extending the reach of preventive health services or health-promoting programs to vulnerable populations.

The health plan’s corporate giving follows all applicable laws and regu lations and does not support funding organizations that conflict with its corporate mission, goals, policies, or products.

Feed Our Veterans Receives Excellus BCBS Community Health Award

Excellus

BlueCross BlueShield recently awarded Feed Our Vet erans (Feed Our Vets) a Com munity Health Award of $2,000. Feed Our Vets helps put food on the tables of our local veterans and active-duty military through their food pantry in New York Mills. Veterans in need can shop for a variety of food including fresh fruits and vegetables, meats, and dairy products free of charge at

Long-time Mohawk Valley cardiologist joins MVHS

Physician Fred L. Talarico, has recently joined the Mohawk Valley Health System (MVHS) Medical Group and will become MVHS Car diovascular and Preventative Medi cine with Fred Talarico, MD, FACC.

A long-time cardiologist in the Mohawk Valley community, Talarico has been named medical director for cardiac services at MVHS.

“In our continuing efforts to help meet our community’s health care needs for many years to come, we have decided to merge with the MVHS Medical Group,” said Talari co. “I, along with nurse practitioners Pat Rosati and Taylor Unser look forward to making this transition.”

MVHS has been working to enhance comprehensive cardiac services it provides — from preven tion to interventional services, from surgery to rehabilitation.

In August 2021, MVHS received the prestigious HeartCARE Center: National Distinction of Excellence from the American College of Car diology (ACC). MVHS is further

the pantry.

“Feed Our Vets offers a wide va riety of healthy foods that allow our veterans and their families to live the lifestyle they deserve,” explains Rich ard Synek, Founder and Executive Director of Feed Our Vets. “Many veterans suffer from mental health issues and having a reliable source of food can help eliminate the addi tional stress caused by food insecu

rity.” The pantry offers a welcoming environment of dignity and respect where veterans can connect with others who have shared their expe rience. Feed Our Vets also invites nutritionists onsite to help veterans learn healthier ways to cook meals.

The mission of Feed Our Vets is to feed hungry and homeless military veterans, their spouses and children throughout New York State. Since 2009, Feed Our Vets has provided free food assistance to more than 37,918 Veterans and their family members, distributing 2,797,294 lbs. of food.

“The company’s Community Health Awards demonstrate a cor porate commitment to support local organizations that share our mission as a nonprofit health plan,” said Eve Van de Wal, Utica regional president of Excellus BlueCross BlueShield.

“We recognize that addressing social determinants of health, such as food insecurity, is vital to the health and wellbeing of our communities and we are pleased to support Feed Our Veterans with this essential commu nity health funding.”

Several other groups in the re gion received the Community Health Award, including Clinton Chamber of Commerce, Make-A-Wish Cen tral New York, the Midtown Utica Community Center and the Rescue Mission of Utica, Inc.

strengthening its cardiac service line for the upcoming transition to the new Wynn Hospital in 2023.

Rome Health starts building a women’s surgical suite project

Rome Health in September celebrated the start of construction of its new women’s surgical suite with a beam signing ceremony on the 135th anniversary of the hospital.

The new dedicated C-section suite is being constructed adjacent to the maternity department on the fourth floor. The majority of the $3.9 million capital project is being fund ed through the county’s investment of $3 million in federal American Rescue Plan Act (ARPA) funds.

“We are grateful to County Ex ecutive Anthony Picente for helping Rome Health ensure that the best maternity care is easily accessible to the women of Rome and the sur rounding rural communities,” said Rome Health President and Chief Executive Officer AnneMarie Czyz. “The county’s investment will help

us to accelerate our plans for expand ing access to the best care out there, here in Rome.”

“We are also pleased to announce that the women’s surgical suite will be named in honor of Dr. Lauren Giustra and Dr. Ankur Desai, two obstetrician/gynecologists who have served this community since they opened their practice in Rome more than 25 years ago,” Czyz said. “Throughout their careers, Drs. Giustra and Desai have maintained a singular focus on delivering the high est quality of care to those we serve.”

Construction of the new dedicat ed C-section suite is expected to be completed in the spring of 2023. Ap proximately 2,000 square feet of existing space will be renovated and converted to a modern surgical suite adjacent to the maternity Ddepart ment for enhanced patient safety. The project will also provide additional capacity for the growth in general surgical services by freeing up one of the hospital’s four operating rooms on the first floor.

Family nurse practitioners join MVHS Primary Care

Mohawk Valley Health System (MVHS) has announced two fam ily nurse practitioners have joined MVHS Primary Care.

• Karissa Madden sees patients at Washington Mills Medical Office. She received her Bachelor of Science in nursing and her Master of Science in family nurse practitioner from Uti ca University in Utica, New York.

Prior to becoming a family nurse practitioner, Madden worked at the MVHS Washington Mills Medical Office as a registered nurse. She has more than five years of experience.

• Rebecca Hughes sees patients at Little Falls Medical Office. Hughes received her Bachelor of Science in nursing from University of Phoenix and her Master of Science in nursing as a family nurse practitioner from Utica University.

Prior to joining the MVHS, Hughes worked as a registered nurse in the intensive care unit at Rome Health. She has more than six years of experience.

Excellus BCBS Community Investments and Partnerships Manager Shayna Keller, Founder and Executive Director of Feed Our Vets Richard Synek, Excellus BCBS Utica Regional President Eve Van de Wal, and Feed Our Vets Volunteer Carl Davis gather for an Excellus BCBS Community Health Award presentation.

By Barbara Pierce

‘I’m a Survivor!’ Why it’s Important to Make This Your Mantra

The little boy in the cart cried loudly as his mother wearily paid for her groceries.

“Is he OK?” asked the cashier.

“Oh, he’s just a brat,” said the mother. “Shut up Tony,” she said.

He ignored her and kept crying. His older sister stood next to the cart, looking like she was in her own world, tuning out her brother.

I was behind her in line. The cashier rolled her eyes, giving me a look that said, “We know this is bad but what are you gonna do?”

Yes, it’s bad for Tony and his sister for so many reasons. One can only hope that Mom was having a really, really bad day. Or maybe they have a dad at home who will help Tony learn to regulate his emotions and give both kids loving attention. Or maybe a grandparent.

If not, these kids are in trouble. Chances are they’ll grow up to be screwed-up, unhappy adults. Grow ing up in what is probably a dys functional family, they’ll have a lot to overcome.

Coming to terms with a crappy childhood and overcoming it isn’t easy.

“I was born a little broken,” said author Glennon Doyle in her memoir “Untamed.”

“Broken means it doesn’t func tion as it was designed to function,” she continued. “A broken human is one who doesn’t function the way humans are designed to function.

“We hurt people; we are hurt people. We feel left out, envious, not good enough, sick and tired. We feel certain that we were meant for more and that we don’t even deserve what we have. We feel ecstatic and then numb. We wish our parents had done better by us. We wish we could do better by our children…”

Sadly, so many grow up this way, living with parents who should never have had children. Always feeling like we’re missing something; living in a world of pain much of the time.

A few are resilient, they do OK despite the odds. Most don’t do OK. The characteristics (skills) that helped us survive as a child don’t work so well when we’re adults.

From my own experiences, those of my family and friends, and through working as a psychothera pist with people that were hurting, here are a few things you might find helpful if this describes you.

It takes much courage to face this.

“Although it’s terrifying to say yes to yourself, it’s also a tremendous

relief when you finally stop and face your own demons,” said Ellen Bass in her book “The Courage to Heal.” “There’s something about looking terror in the face and seeing your own reflection, that’s strangely re lieving. There’s comfort in knowing that you don’t have to pretend any more, that you’re going to do every thing within your power to heal.”

Look it in the face and accept that things happened to you that weren’t OK. You don’t have to forgive any body, just accept it.

Looking it in the face is terrify ing. It threatens to change your life— your relationships, your position in the world, even your sense of iden tity.

Changing your identity from be ing a victim of others, to a survivor— one who overcame bad stuff and is now in charge of her life—can make a huge difference in how you see yourself. Resolve to not call yourself a victim, broken, flawed or imperfect anymore. Instead, you’re a survivor.

Doing everything you can may mean becoming involved in some kind of therapy or support group. Maybe evaluating your use of alcohol or drugs.

Leah saw me for therapy the first time when she was 73. She was final ly ready to confront the demon.

“I keep seeing my father in my mind,” she said that first time I saw her. “His eyes, his cruel eyes. Sitting there with a rifle on his lap, ready to shoot Santa Claus when he ap peared.”

When she was a teenager, she found alcohol helped get rid of that

image. It helped her cripple through most of her adult life. Five years before, she had stopped drinking through AA. But now she wanted more. She wanted to get rid of those cruel eyes.

I suggested that, while she couldn’t stop the abuse she got from her father, she could stop the image that kept playing in her mind. “Every time those eyes pop into your head, change the channel. Switch to some thing pleasant, something that makes you happy,” I said. We identified what might work for her.

“Wow! You’ve given me such a gift!” she said when I next saw her. Switching images worked.

Katie, sexually abused by her fa ther as a child, kept seeing the image of him coming into her bedroom. She changed that image to imagining him small, like Jiminy Cricket. She bashed that cricket over the head time and time again.

This is too important to squeeze into one month; more on this next month.

Barbara Pierce is a retired licensed clinical social worker with many years of experience helping people. If you would like to purchase a copy of her book, “When You Come to the Edge: Aging” or if you have questions for her, contact her at barbarapierce06@yahoo.com.

EXERCISE

TRY SOMETHING NEW

Upstate New York Poison Center: 65 Years

Helping Keep People Safe

One of two centers in the state, the Syracuse operation serves 54 counties

By Norah Machia

A total of 16 registered nurses and pharmacists with specialized training in toxicology answer calls for the poison center. They determine if a person should be monitored at home, seen at a physician’s office or taken to an emergency department at a nearby hospital.

The poison center also has toxicologists and pharmacists with advanced training on call who may be consulted for a complicated poi soning emergency.

“There are layers of clinical expertise behind every call,” Caliva said.

Approximately 90% of calls for children aged 5 and younger, howev er, can be managed at home without a visit to a physician or hospital.

“The primary goal of every poison center is to reduce any serious illnesses or deaths that could result from an accidental poisoning,” said Caliva.

But there is also a focus on preventing unnecessary visits to the hospital, which could place a strain on the health care delivery system, particularly the emergency department staff and the ambulance services, she added. It’s also better for the parent and child not to risk unnecessary exposure to illness by going to a hospital if they don’t need emergency care.

Staff have recently seen an alarm ing increase in the number of calls for children who have ingested edible marijuana gummies and in those cases, hospitalization is required, said Caliva.

A bag of marijuana gummies left on a counter top is an open invitation for a young child to try them, she warned.

When

the Upstate New York Poison Center opened 65 years ago in Syracuse, the primary focus was to help children suffering from lead poisoning.

At the time, it was known as the Central New York Poison Cen ter and it served 14 surrounding counties. The center operated as a “physician-to-physician” service to help doctors caring for children with high levels of lead detected in their bloodstreams, said T. Michele Caliva, Upstate New York Poison Center administrative director.

In those days, children could be exposed to lead-based paints and other dangerous substances that have since been taken off the market. Doc tors in the community could contact a physician at the poison center if they needed help in managing treat ments, said Caliva.

“At the beginning, there was a lot of pediatric focus,” she said. But as the center expanded, it also started to serve an increasing number of adults and senior citizens with a wider range of emergency poisoning and prevention calls.

In 2011, the center increased its coverage to 54 counties statewide. At the time, there had been five poison centers serving the entire state, but they were consolidated into two operations. The state’s other poison center is based in New York City and covers the five boroughs, Westchester County and Long Island.

Funding for the poison center is provided through the New York State Health Department and Upstate Medical University (the center is located on the campus).

There is no charge to call the poison center hotline at 1-800-2221222. All information provided by the caller remains confidential.

The Upstate New York Poison Center handles more than 50,000 calls each year and is open 24 hours a day, 365 days a year. It also serves as a site for medical student rotations.

“We take calls about anything that should not be in your body, on your skin, or in your eyes,” said Caliva.

Many of those calls are made by worried parents whose children have gotten into medications, personal care products or household clean ers. In some cases, the children have swallowed foreign objects such as coins or batteries.

The packaging of these types of products often attracts the attention of children, who can mistake them for food or candy, Caliva explained.

Callers don’t usually need to provide identifying information, although they may be asked to give a name and call back number if staff offer to check on a child being mon itored at home. If the caller requests help for an ambulance transport, the staff can make those arrangements. The caller’s zip code is requested only for record-keeping purposes.

“We don’t share the caller’s information,” said Caliva. “We don’t want any parent or caregiver to be afraid to call us about an uninten tional poisoning.”

The same advice goes for adults and senior citizens, who may feel embarrassed because they have, for example, taken the wrong dose of their medication.

Top five poisonings for children aged 5 and younger

Accidental poisonings of these gummies, other medications and per sonal care products may be avoided if they are kept out of reach of young children. The poison center recom mends lock boxes for all medications, particularly for senior citizens who have grandchildren visiting them in their homes. Children are natural explorers and have a strong curiosity to learn more about new things, so it’s best to keep anything harmful out of their sight, Caliva said.

Phone calls from adults often involve unintentional overdoses of prescription or non-prescription drugs. Sometimes a person has mistaken a medication for a personal care product, and it could just be a matter of not wearing reading glasses at the time.

The highly trained poison center staff also consults on calls from hospitals, nursing homes and private practices, along with 911 operators, school officials and industry repre sentatives, said Caliva.

Top five poisonings for adults aged 20 and older

They may consult with a physi cian in an emergency department if a patient has intentionally taken an overdose of drugs, but it’s not clear what drugs were actually taken, she said. The center also receives calls about dangerous street drugs, such as fentanyl, and handles calls about exposures to hazardous chemicals or materials.

The Upstate New York Poison Control Center has management staff employed throughout the state as well, along with public educators who speak to community groups, schools and organizations about a variety of poison prevention topics.

For more information on the cen ter, visit: www.upstatepoison.org

T. Michele Caliva is Upstate New York Poison Center administrative director. “The primary goal of every poison center is to reduce any serious illnesses or deaths that could result from an accidental poisoning,” she says.