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n Long, Regular Sleep Key to Kindergarten Success P. 12 n Setting limits for Kids Is a Though Tasks of a Parent P. 14 n About 1 in 7 U.S. Kindergarten Kids Now Obese P. 14
MVHEALTHNEWS.COM
AUGUST 2022 • ISSUE 198
BACK TO SCHOOL SPECIAL
Back to School Struggles Returning to school can often make kids anxious Page 13
CORD BLOOD BANK Physician Matthew Elkins is in charge of Upstate Cord Blood Bank in Syracuse. He explains what the bank does and how donated umbilical cord blood (usually discarded) can save lives. P 4
CHANGE YOUR LANGUAGE, CHANGE YOUR LIFE The words we use to others and to ourselves do make a big impact! P. 10
Video Game Therapy Aids Stroke Patients MVHS offers video game therapy to its stroke patients — with positive results, according to nurses. P. 20
Brad Pitt Believes He Has Rare ‘Face Blindness’ Disorder — What Is It?
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ward-winning actor Brad Pitt believes he suffers from a rare condition that interferes with his ability to recognize people’s faces. In a new interview with GQ magazine, Pitt said that he thinks he has prosopagnosia, an extremely rare neurological condition that makes it difficult to tell faces apart. “Nobody believes me!” said Pitt, 58, who has not been officially diagnosed. “I wanna meet another [person with it].” Pitt said the condition is why he stays home so much. Folks with the condition can have a difficult time telling family members apart or even recognizing their own faces in group photographs. They also have difficulty recognizing people out of context, such as seeing a work colleague in a grocery store. About 2.5% of babies and young children are born with the condition, said physician James Galvin, director of the University of Miami’s Comprehensive Center for Brain Health. People also can develop prosopagnosia as a result of a brain injury, and degenerative forms of the disease have been associated with conditions like Alzheimer’s, Galvin said in a university news release. It can be caused at birth from damage in a part of the brain called the fusiform gyrus, which is consid-
ered a key structure for high-level visual interpretation like facial and object recognition. For people who acquire the condition through brain damage or disease, it’s usually due to something gone wrong in the right temporal or occipital lobes of the brain, which are critical for memory and visual processing.
Children with prosopagnosia may have difficulties following the plots of television shows and movies because they have trouble recognizing the different characters. However, they do better with cartoons because the characters are simply drawn with clearly defined features and outfits they wear in every scene.
- ON N SIGONUS B
crouse.org/careers/RN
Registered Nurses, Nursing Assistants & Student Nurse Assistants
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Page 2 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
There are no specific therapies for the condition. Instead, people adapt to it by using other clues to recognize people — clothes, voice, body shape, hair style, and skin color and tone, Galvin said. Clinical trials are underway exploring the use of computer-assisted learning to assist with facial recognition.
THESE THESE FLOWERS FLOWERS HAVE A HAVE A LOT OF LOT OF FIGHT IN FIGHT IN THEM. THEM. The Alzheimer’s Association Walk to End Alzheimer’s®Association is full of flowers, each The Alzheimer’s Walk to carried by someone committed to each ending End Alzheimer’s® is full of flowers, this disease. Becausecommitted like flowers, carried by someone toour ending participants stoplike when something’s this disease. don’t Because flowers, our in their way. don’t They stop keep when raisingsomething’s funds and participants awareness a breakthrough in the and fight in their way.for They keep raising funds against Alzheimer’s and all other awareness for a breakthrough in dementia. the fight It’s timeAlzheimer’s to add yourand flower to thedementia. fight. against all other It’s time to add your flower to the fight.
Join us at alz.org/walk Join us at alz.org/walk
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August 2022 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 3
Meet
Your Doctor
By Chris Motola
Matthew Elkins, M.D. Post-Stroke Memory Loss Can Resolve for Some Patients
M
emory loss is a common symptom after a stroke, but there’s hope for some that those memories could return. A new study from Norway examined 86 patients with relatively mild strokes and found many had improved mental functioning after 12 weeks. “Our study shows that around half of patients suffering a stroke had various forms of memory impairment one week after the stroke. But by three months after the stroke, about one-third of those with memory impairment had improved memory function,” said physician Ramune Grambaite. She is a psychologist and head of the neuropsychological outpatient clinic at the Norwegian University of Science and Technology (NTNU). Nearly 800,000 Americans suffer a stroke each year, according to the U.S. Centers for Disease Control and Prevention. While more stroke patients survive now than they did in the past, stroke remains a serious and potentially deadly condition. Survivors may experience anxiety, depression and fatigue afterwards, in addition to memory loss and a reduced ability to learn. Bente Thommessen, chief physician at Akershus University Hospital, said the proportion of patients seen with mild strokes has increased in recent years. “But the consequences in terms of concentration problems, reduced stamina and changes in memory function are common even in patients with mild strokes,” Thommessen said in an NTNU news release. The study was published July 12 in the journal Nevropsykologi (Neuropsychology). “Memory improvement is common after a stroke, but there are large individual differences,” Grambaite said. “Some stroke survivors continue to experience memory impairment and need to learn to live with it.” The researchers noted that good follow-up and support from friends and family is important in the recovery process.
Doctor in charge of Upstate Cord Blood Bank explains what the bank does and how donated umbilical cord blood (usually discarded) can save lives Q: What is the Upstate Cord Blood Bank? A: So the Upstate Cord Blood Bank is a public cord blood bank where we are collecting, processing and storing umbilical cord blood that’s donated from donors at Crouse Hospital, St. Joe’s and Community campus. And those cord blood stem cells are then available for use for patients who need bone marrow transplants. So that’s the short, short version. Q: I’m old enough to remember the initial excitement over stem cells many years ago, but it fell off pretty quickly. What are we now able to use stem cells to do? A: I just want to clarify that we’re not using embryonic stem cells, which have gotten a lot of bad press. That’s not what we’re talking about. These are stem cells in umbilical cord blood that would otherwise be thrown away. We’re not damaging an embryo or taking a life. The promise of stem cells actually is looking greater and greater. As with anything, we hope that it will be instantaneous that we’ll get everything we ever wanted, but the primary use of stem cells from cord blood is for bone marrow transplants. Bone marrow transplants using cord-derived or adult-derived bone marrow stem cells have been done for decades and they are life-changing and life-saving for patients who have leukemia, lymphoma or have other cancers that are so destructive or require so much chemotherapy that their own marrow fails. Or for people who have genetic defects and their own cells don’t work that well. Those are all proven and mainstream, standard- of-care treatments. In addition to that, there are some 80 diseases that have potential treatments using cord stem cells. That includes things like recovery after heart attack, neural degeneration after stroke, cerebral palsy. A lot of this is in the research phase, in clinical trials. They’re
looking great and patients are gaining benefits off those clinical trials, but they’re not mainstream yet. Q: What does a new parent have to do to get their kid’s cord blood to you? A: We do have our website, upstatecordblood.com, and we describe everything there. But we’ve also connected with all of the clinicians who deliver at each of the three hospitals: obstetricians, midwives. The doula program we’re trying to connect with. So they all have the information if expectant mothers and families are interested in donating. Donation is relatively simple. There is a booklet we provide on cord banking that answers most of the frequently asked questions, but also included in that book is a consent. Because this is a medical procedure with medical and legal responsibilities, we want to make sure that no one has mistakenly said yes or no when they didn’t. So we have a formal document for consent. There’s also a questionnaire in there that’s about seven pages long, but you’d recognize a lot of the same questions if you’ve ever donated blood. Those are required, mainly to avoid risks from infectious diseases. We don’t want to tell a patient at the other end that they have brand new bone marrow and HIV. That’s frowned on for some reason. So we try to keep the questions brief, but we ask all the ones the FDA requires. Q: Are there any medical risks involved in donating? A: No. Less even than donating blood to the Red Cross. There’s no real risk to Mom or baby. After the baby’s out, the cord is clamped and cut. The blood we’re collecting is actually in the placenta. It’s not mom’s, it’s not the baby’s. It’s just the blood that’s left. So the main difference is just that, rather than throwing it away, we’re keeping it.
Page 4 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
Q: Why isn’t collection standard operating procedure?
A: There are countries and states where the default is to collect it with patients allowed to opt out. Here it’s opt-in. Which is unfortunate, because the general rule is about 20% of people will opt-in if the default is not to donate, and about 20% will opt-out if the default is to collect it. Nobody likes doing paperwork. So New York state is an opt-in state, but even if it wasn’t we’d still want people to be informed and comfortable with their decision. But it would be easier if we were an optout state. Q: Do donors get a say as to what it can be used for? A: Yes and no. If someone donates, there isn’t a way to restrict who it’s used for; it’s put into a pool. Parents are giving up legal ownership. And we’re talking about our primary use, which is clinical use. Now, for units that do not actually meet criteria for clinical use, we actually have a question on the consent form that asks if the cord turns out to not be able to be used for clinical purposes, can we divert it to some of our researchers who are doing research into uses for medical cord blood. There are other groups that buy it to test cosmetics or as a manufacturing starting point. There’s nothing wrong with those uses, but they aren’t our mission, so we only partner with researchers who are looking into other medical uses for cord blood. So there’s a checkbox on the form if Mom’s not comfortable with the cord blood possibly being used for research. If the blood meets the criteria for clinical use, there’s no problem. If it doesn’t, and Mom has checked no, then it will be discarded. Q: How much of a yield do you get out of each donation? A: So if you’re looking at stem cells for a bone marrow transplant, the other source is adult donors, which you collect by literally sucking it out in the OR, or a process where you give donor medication to produce a lot more stem cells. Those both have downsides, but you can get a larger amount of stem cells from them than you can from a single cord blood donation. So even though cord blood is rich in stem cells, adults are much bigger. So from a single cord blood donation, we’re getting about enough for one bone marrow transplant if they’re a child. Adults will typically get two cord blood units. There’s not enough for multiple patients from one donation, although there is research that suggests it may be possible in the future, but we don’t know that yet.
Lifelines
Name: Matthew Brian Elkins, M.D. Position: Laboratory director and medical director of the Upstate Cord Blood Bank Hometown: Livonia, Michigan Education: University of Illinois; University of Michigan Affiliations: SUNY Upstate Medical University Hospital Organizations: Association for the Advancement of Blood & Biotherapies; American Society for Apheresis; Blood Bank Association of New York State; College of American Pathologists Family: Wife (a family physician), two children Hobbies: Helping with his church’s sound and electronics
Pig Hearts Successfully Transplanted Into 2 BrainDead Patients
Free, easy, local access to information and assistance about long term care services and supports… regardless of age, income, or payor source. Get help with community services/supports designed to help people remain healthy and independent for Older Adults, Adults or Children with Disabilities as well as their Families and Caregivers.
G
enetically altered pig hearts could soon become a viable transplantation alternative for people with life-threatening heart disease, new experiments show. A team at NYU Langone Health has successfully transplanted two such pig hearts into brain-dead humans on life support, making advances that may soon help address the nationwide organ shortage. No signs of early rejection were observed in either organ, which were transplanted in surgeries performed over several hours on June 16 and July 6, doctors report. The hearts functioned normally for three days without additional mechanical support, using standard post-transplant medications. After three days, the experiment ended and the patients were taken off life support. “It was, I think, one of the most incredible things to see a pig heart pounding away, beating inside the chest of a human being,” physician Robert Montgomery, director of the NYU Langone Transplant Institute, said during a recent media briefing. “It is a great privilege for me to have witnessed that in my lifetime.” The goal of these experiments is to create a pig heart that can be transplanted using techniques and medications nearly identical to the procedures now used to implant donated human hearts, said physician Nader Moazami, surgical director of heart transplantation for NYU Langone’s division of heart and lung transplantation. “It brings me great excitement to tell you that the function of the heart was excellent,” Moazami said at the briefing. “We did have to make some tactical surgical modifications at the time of transplantation. Part of that is because the pig heart is very similar, but it’s not identical to the human heart.” If progress continues, the first transplant of a genetically modified pig heart into a live human using NYU Langone’s procedures could take place by 2025, Montgomery said. A steady supply of functional pig hearts could be critical in saving the lives of tens of thousands of patients
HOW CAN NY CONNECTS HELP?
of MADISON COUNTY
on the verge of dying from heart disease, said physician Alex Reyentovich, director of the NYU Langone advanced heart failure program. “There are 6 million individuals with heart failure in the United States,” Reyentovich said during the briefing. “About 100,000 of those individuals have end-stage heart failure. And we only do about 3,500 heart transplants a year in the United States, so we have a tremendous deficiency in organs. There are many people dying waiting for a heart.” The hearts were procured from pigs that had undergone 10 genetic modifications, including four pig gene alterations intended to prevent rejection and abnormal organ growth, and six human genes added to make the hearts more compatible with human biology. The first whole-body donor to receive one of the pig hearts was Larry Kelly, a 72-year-old Vietnam veteran. “He was an organ donor and would be so happy to know how much his contribution to this research will help people like him, with heart disease,” said his partner, Alice Michael, who’d been with him for 33 years. Michael said she didn’t know it was possible for someone to donate their whole body, even if their individual organs aren’t suitable for transplant, until NYU Langone approached her. “I didn’t even have to think about the decision,” Michael said. “I knew he would want to do it, and I had to do it.” A new infectious disease protocol developed by NYU Langone also prevented any sign of porcine cytomegalovirus, which is considered a risk to successful transplantation.
(800) (315) 342-9871 697-3092
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For answers to all your questions Contact us at 800-342-9871 or call one of the NY Connects partnering agencies at 315-697-5700. You may also look for services and support at www.nyconnects.ny.gov
S I M P LY PIONEERING Rural roots run deep among us. We’ve proudly cared for a century of patients. And we’ll be here for you for generations to come. Thank you, friends!
DR. MARY IMOGENE BASSETT was the inspiration for and a key figure in the formation of what is now Bassett Healthcare Network.
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In Good Health is published 12 times a year by Local News, Inc. © 2022 by Local News, Inc. All rights reserved. 4 Riverside Drive, Suite 251, Utica, NY 13502 Phone: 315-749-7070 • Email: IGHmohawkvalley@gmail.com Editor & Publisher: Wagner Dotto Contributing Writers: Barbara Pierce, Deb Dittner, Gwenn Voelckers, David Podos, Deborah Jeanne Sergeant, Anne Palumbo, Daniel Baldwin • Advertising: Amy Gagliano Layout & Design: Kris Adams • Office Manager: Bernadette Driscoll No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement — not to take the place of — the recommendations of your health provider.
A M O R E E X C E L L E N T WAY
FriendsOfBassett.org Bassett Medical Center, Cooperstown, NY | Cobleskill Regional Hospital, Cobleskill, NY | A.O. Fox Hospital, Oneonta, NY | Little Falls Hospital, Little Falls, NY | O’Connor Hospital, Delhi, NY | Valley Health Services/ Valley Residential Services, Herkimer, NY
August 2022 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 5
Celebrating 40 years
of proven cancer expertise in CNY.
Auburn | Syracuse | East Syracuse Page 6 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
Julie Flack has been a Hematology-Oncology Associates of CNY patient since 2006. Flack praises HOA for both its quality of care and collaborative spirit. Next to her is husband Irwin Flack, also a patient at the practice.
Hematology-Oncology Associates of CNY Celebrates 40 Years By Deborah Jeanne Sergeant
F
or the past four decades, Hematology-Oncology Associates of CNY has cared for patients with cancer and blood disorders as a private, community-based practice. Much has changed since 1982, when doctors John J. Gullo and Santo M. DiFino established the practice. Not long after, two other doctors, Jeffrey J. Kirshner and Anthony J. Scalzo, joined the practice. “I was their first employee,” Scalzo recalled. Since then, the practice has grown to 16 medical oncologists, four radiation oncologists and nearly 300 others, including nurse practitioners, physician assistants and administrative staff among its locations in East Syracuse, Syracuse and Auburn and Camillus. Since his joining the practice in 1982, Scalzo has observed cancer changing from a death sentence in many cases to becoming a curable or manageable chronic illness in many cases. “Many of the treatments we use now had not even been invented in 1982,” Scalzo said. One changes since then includes development of monoclonal antibodies. Scalzo explained that the body produces antibodies to fight off infections. “Monoclonal antibodies are artificial antibodies that can coat cancer cells and that leads to the destruction of the cancer cells,” he said. Identifying gene mutation represents another advance in oncology. Scalzo said that certain mutations in normal cells cause them to become cancerous. Treating them with new
Anthony J. Scalzo, is board-certified in internal medicine and medical oncology, and joined Hematology-Oncology Associates of CNY in the early 1980s. “I was their first employee,” Scalzo recalls.
Maryann Roefaro is the CEO of Hematology-Oncology Associates of CNY. She has been with the practice for 20 years. “The patient is in the center of all we do,” she says.
medication that can block the activities of mutations means that cancer cells lose their ability to continue to grow. Another big discovery is immune checkpoint inhibitors. “These are the medicines you see advertised on TV,” Scalzo said. “Cancers block our immune systems from attacking the cancer. They produce substances that put the brakes on our immune systems. With these new medicines, it allows us to take the brakes off the immune system and it becomes more active to attack the
cancer. It harnesses our own immune system to attack the cancer cells.” These advances help Scalzo and his colleagues achieve better outcomes with patients. The practice has also developed an integrated approach to patient care, including the social, psychological, dietary, physical therapy, spiritual and emotional aspects. As more cancer patients are surviving and living longer, HOA developed a survivorship program that cares for patients throughout their entire treatment and beyond.
“Our goal is not just to help you live longer but to live better,” Scalzo said. “You have got to have a good quality of life.” Julie Flack has been his patient since 2006. She takes medication that turns off her cells’ cancer-causing mutation which otherwise would have caused her death within a couple years of her diagnosis of lung cancer, according to Scalzo. “I’m metastatic and have been from the day I was diagnosed,” Flack said. “Nine to 12 months was my prognosis. I was 48 at the time.” She receives checkups every four months, which may seem stressful. However, she feels reassured that her providers can catch progressions of the cancer in time. She has had surgery, oblation, Cyberknife, chemotherapy and her ongoing regimen of medication. Flack praised HOA for both its quality of care and collaborative spirit. She has sought care from specialists in her type of lung cancer at different facilities and received only encouragement from her team at HOA, “which means a lot for anyone going through this. I know many people who’ve had cancer and that’s not always the case.” Flack also appreciates the support group at HOA. Since her husband, Irwin Flack, received a diagnosis of multiple myeloma five years ago, they both attend a support group, along with other HOA patients and patients treated by other facilities. The group is for people who are treating cancer to prolong quality and length of life, not those who anticipate full remission. “This is really helpful,” Flack said. “We’re facing death every day. We need to be with people who are in the same boat. It was wonderful for them to recognize we need a place. As time goes on, metastatic people are living longer than ever.” She also lauded HOA’s creation of Cancer Connects, which links mentors with people newly diagnosed for one-on-one support. “The organization also provides financial support for economically disadvantaged patients and free services like acupuncture and massage to patients in four counties,” Flack said. The patient-centered care is one of the aspects of HOA that makes the practice stand out, according to Maryann Roefaro, CEO of HOA, who has been with the organization 20 years. “The patient is in the center of all we do,” Roefaro said. “We are very much a culture of compassion and accountability, and we have very high standards for how our employees treat other employees and our patients.” She believes that employees are very much in touch with the fragility of life and that hones their ability to express empathy in a variety of ways, from verbalization to thoughtful, caring acts. “Everyone is dedicated to patient care and a very high level of compassion to our patients,” Roefaro said. “We have every certification you can possibly have to underscore our quality and commitment to patient care. All our equipment and instruments are cutting-edge. Because we’re an independent practice, we can develop new programs and we have incredible flexibility in what we do. Put it all together and it’s a recipe for success.”
August 2022 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 7
988 Suicide and Crisis Lifeline Already in Operation
I
f you or someone you know is contemplating suicide or having a mental health crisis, you can dial just three numbers — 988 — to get help. Callers will be connected to a trained counselor at a local call center and ultimately routed to potentially lifesaving support services. The three-digit code for the 988 Suicide and Crisis Lifeline replaces the 10-digit number for what was formerly known as the National Suicide Prevention Lifeline. The new three-digit number is easy to remember, free, available 24/7 and confidential, said Thea Gallagher, a clinical assistant professor in the department of psychiatry at NYU Langone Health in New York City. “If 988 becomes just as ubiquitous as 911, we are saying that mental
health and physical health are on the same level, and that breaks stigma,” she said. The need for such access and services has never been greater, Gallagher said. “With the ongoing pandemic, we have seen an increase in depression, anxiety and suicidal thoughts and behavior, so we know mental health has never been more negatively impacted,” she said. In 2020, more than 47,000 Americans died by suicide, a 33% increase from
2000, according to The Pew Charitable Trusts. The new number will also accept texts, and live chat is available, said physician May Lau. She is a pediatrician at the University of Texas Southwestern Medical Center and the medical director of the Adolescent and Young Adult Clinic at Children’s Medical Center Dallas. Crisis counselors speak multiple languages and are culturally competent at counseling members of the LGBTQ community. There are also resources available for people who are deaf
or hearing-impaired, Lau said. “The text function is only in English for now, but most of the people who feel comfortable texting are younger, and many of them are bilingual,” Lau noted. The new line is not just for people who are contemplating suicide. Counselors are also skilled in discussing self-harm, addiction, domestic violence and other mental health issues. If a caller needs immediate medical attention, 988 will collaborate with local police or hospitals to dispatch services. “We are trying to help people deal with crises before they become life-threatening,” said Anthony Wood, interim CEO and COO of the American Association for Suicidology. The group has been calling for a three-digit suicide hotline for years.
respondents) revealed what they consider to be the most important social determinants of health: access, 85%; substance abuse, 66%; gun violence, 53%; climate change, 51%.
ed by COVID-19, early retirements and a recession. Consulting firm Kaufman Hall says a solid one-third of their clients are suffering with no end in sight. Ninety percent of KH clients cite labor shortages as their No. 1 threat followed by overall rising expenses, supply chain problems, diminished consumer demand impacted by COVID-19, cyber threats and resulting pressure on remaining staff.
Healthcare in a Minute
By George W. Chapman
CMS Initiative Designed to Protect Local Rural Hospitals
O
ne in five of us lives in a rural community. Since 2010, 138 rural hospitals have closed, typically for financial reasons. Nineteen rural hospitals closed in 2020 alone. People that live in rural areas are subject to shorter life spans and higher mortality than those living in urban and suburban areas. Consequently, CMS is proposing a new designation, “rural emergency hospital,” to bolster services and financial viability. In addition to supporting emergency services, Center Medicare & Medicaid Services is looking to support and stabilize maternal, behavioral and addiction services. While this is well intentioned, few rural hospitals, despite the REH designation, will survive alone.
Recruiting and retaining qualified physicians, nurses and ancillary service providers like pharmacists and techs, will still be a struggle. To survive, REHs must affiliate or integrate with a larger healthcare system. Otherwise, staffing shortages will be their downfall. In addition to protecting rural hospitals per se, CMS must also protect rural EMT services. EMTs are overworked and underpaid, especially those servicing rural areas. Once you have been stabilized at a rural facility, it is the EMT who cares for you when you are transferred to a larger hospital post -accident, -heart -attack, -stroke, -overdose or -complicated delivery. The REH designation would be affective January 2023.
ACA: 30 Million Are Now Covered By It
develop back-up plans if the ARP is not renewed by Congress.
More than 35 million Americans, or one in 10, are covered by the Affordable Care Act. Millions rely on expanded Medicaid or income-based subsidies. Originally, for those who don’t qualify for Medicaid, premium subsidies ended once you earned more than 400% of federal poverty guidelines. (In 2022, the individual poverty level is $13,590; for a household of three it’s $23,000.) Once over than the 400% threshold, you paid the full premium. Consequently, millions of people dropped insurance. Consequently, Congress passed the American Rescue Plan which gave relief to those making just more than 400% of poverty guidelines. It limited the amount spent on insurance to 8.5% of income. If not renewed, the ARP will expire end of this year. The Kaiser Family Foundation estimates premiums would double for 3.4 million people causing most to drop coverage altogether. Savvy states are scrambling to
Social Determinants of Health Your family history and your genes have a lot to do with how long you will live and your overall health. But the social determinants of health can easily negate your family history and the best of genes. Physicians and insurers agree that without addressing these social determinants, the best efforts of providers can be for naught. Among the social determinants impacting health status are food and shelter security, access to care, gun violence, climate change and addiction. Large insurers are investing in food and shelter for members in need. For example, United Health has invested $45 million in goods and resources for at-risk populations, saving the member $1,200 to $1,500 in out-of-pocket expenses annually. Keeping healthcare costs down helps everyone, not just the insurance company. A recent Medscape survey of physicians (2,342
Over 380,000 Mental Health Apps
Since COVID-19, both apps on your phone and companies offering services online or via telehealth have increased exponentially. Digital Healthcare Elsewhere mental health, for better or worse, has become the darling of venture I just returned from touring Scotcapitalists. The potential benefits are land, England and France. All three clear: access, privacy, personal, low countries have universal coverage, cost. There are more than 380,000 direct-to-consumer apps on your Apple basically “Medicare for all” in our or Android phone and 20,000 are spe- parlance. Naturally, (of course!), I queried unsuspecting tour guides, cific to mental and behavioral health Uber drivers, wait and hotel staff, like Talkspace and Calm. There are and anyone I befriended at bars and apps by which providers can prescribe like reSET. There are platforms restaurants about their healthcare. The vast majority were satisfied designed for employers and insurwith access, providers, quality and ance companies like Ginger, Lycra their overall care. There were the Health and Modern Health. But do usual complaints about government they all work? Naturally, the rapid bureaucracy. But then again, don’t proliferation of digital mental health we complain about our insurance has engendered a lot of skepticism among traditional face-to-face mental companies? The one thing everyone stressed, (once realizing I was Amerhealth providers, academia and ican), is citizens are covered and lack insurers. Many of the startups went of money is not a barrier to getting bankrupt, leaving patients stranded. care like in the U.S. They cannot But to be fair, access to traditional fathom why such an advanced counface-to-face care is difficult so you try as the U.S.A. doesn’t guarantee can’t blame someone for trying healthcare for all. They expect their digital. Unless the severe shortage of mental health professionals improves, government to guarantee care and even when complaining about their digital is the answer for millions system, they became very defensive of consumers. The digital industry when I poked holes. The prevailneeds validation, which comes from ing attitude was there are plenty of research and then academic publicathings to worry about in this life and tion. A more global issue with digital getting healthcare should never be a mental health is integration and worry. coordination with a patient’s primary care provider, healthcare system and electronic medical record. If this George W. Chapman is not effectively accomplished, we is a healthcare busiare just continuing down the road ness consultant who of expensive, disjointed, ineffective works exclusively healthcare. with physicians, hospitals and healthcare Labor Shortages organizations. He operates GW Chapman According to a survey of hospital Consulting based in and medical group CFOs, their No. 1 Syracuse. Email him concern effecting financial viability, at gwc@gwchapmanaccess and patient experience is the consulting.com. continuing labor shortage exacerbat-
Page 8 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
Q: What do you see in the future or what would you like to see in the future regarding health and physical education in the educational system? A: Change takes time. So, as more older teachers retire and new younger teachers enter into the workforce, more emphasis will be placed on student health. Also, students have so much more to choose from in regards to curriculum as I previously alluded to, so they are having a different experience (hopefully a more positive and healthier one) than, say, their parents did when they were in school.
Q: How did the agency come to be and when was it initially established? A: Well, it all happened 98 years ago in 1924. A group of professionals at that time recognized the importance of physical and health education for children. We say when it comes to children, the most important thing is their health. When you wake up in the morning and your feet hit the ground and you’re feeling good, you’re starting off your day in a positive way. Q: What challenges does the organization face? A: The struggle that we face as an agency is that both of these disciplines, health and physical education, are not always valued. So, does that mean they are not valued in society at large as well? In some ways, yes. However, things have changed through the years. I do think people, parents and families are more aware on the importance of being physically active, to eat healthier, to be more concerned overall about their health and wellness, as well as their children’s, and that is a good thing as it helps us as educators. On the other hand, we have a long history of fighting the uphill battle in terms of value of what we do.
Q A &
with Colleen C. Corsi
Promoting health and physical education in schools is the main mission of Little Falls-based NYS Association for Health, Physical Education, Recreation and Dance, says executive director
Q: How many staff do you have, and where do you get your funding from? A: Here at our Little Falls agency, we have five staff. In regards to our funding, our funding comes from our annual conference as well as annual membership dues. Q: What is your educational and professional background? A: Prior to being the executive director for AHPERD, I was the associate in physical education and athletics for the NYS Education Department in Albany. I held that position for eight years. Prior to that position I was a physical education teacher. I have a master’s degree in education.
Q: How has the physical education curriculum changed over the years and what added health benefits are now available for students? A: It used to be that the physical education curriculum was more sports-focused, where now, and at least the past 10 years, we have shifted more toward a lifetime activity basis in physical education.
Q: You mentioned an annual conference. What is that all about; where and when will it take place? A: Our annual conference will be held at the Turning Stone Convention Center located in Verona, from By David L Podos Nov. 16-19. It is the premier event for professionals in the field of physical activity, physical education, school- Propo Q: Many readers may not know through high school. We also have MP Order Q: Can you give based health and wellness. We will This ad will appear of:me examples of about your agency, the New York members who are training at newthe classification lifetime activities? be offering our members an extenState Association for Health, Physical health educators and new physical A: Absolutely—things that do Rome NY sive menu of events and programs Education, Recreation and Dance, Inc. education teachers as they come into not require a team effort, such as golf, that will cover a wide range of topics Give us a little background about the the system. So, we basically provide with in Home Date 05/2014 tennis and kayaking for instance. agency and what are the primary regarding the most recent findings professional development through So, it’s just a different type of PE services you provide? on how students engage in physical Date: March 17, 2014 Acct# A1ZGFE Sales Rep: GRIMALDI, JENNIFER L Size: HCN6 Ad Id: AM conferences, workshops, newsletters and part of our responsibility is to A: We are a professional assoeducation and activity programs. (at one time) but now we use an make sure our members have that ciation that provides development MP Order Propo online platform for that. professional development so they for our members who are physical This For more information on NYS Asad will appear at the classification of: are comfortable in recreating their education teachers and health edusociation for Health, Physical Education, Rome NY Q: How many members do you curriculum. We also have learning cation teachers located throughout Recreation and Dance, call 315-823-1015 in New New York state and right here in or toll-free line at 877- 473-7398. Email: w ihave th in H oYork? m e D a t e 0 5 / 2 0 1 4 standards in both health and PE A: Presently, we have 2,000 mem- which are approved by the New York ccorsi@nysahperd.org, website: www. the Mohawk Valley. These teachers Date: March 17, 2014 Acct# A1ZGFE Sales Rep: GRIMALDI, JENNIFER L Size: HCN6 Ad Id: AM bers in New York. nysahperd.org teach from kindergarten all the way State Board of Regents.
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Between You & Me
By Barbara Pierce
Change Your Language, Change Your Life
T
he words we use when we talk to ourselves or others are important; they do directly influence us. Changing just a few of the words we use can make a big difference in our mood, our feelings, our relationships and our actions. When you change your words, you change your state of mind. For example, saying “I don’t” instead of saying “I can’t” may make all the difference when you’re trying to give up an unhealthy habit. If I said “I don’t eat ice cream,” instead of saying “I can’t eat ice cream,” the temptation to cheat and eat it anyway is less. Saying “I don’t” gives me more self-control and I don’t feel as deprived. When I’m offered my favorite Oreo cookies, if I say, “Oh thanks, but I don’t eat cookies,” it feels like it’s my choice. If I say “I can’t eat cookies,” I feel deprived, different, left out. It’s better to feel that I am choosing to rule cookies out of what I eat than to feel deprived. By saying “I don’t…,” it makes me feel stronger in my determination to avoid unhealthy foods. If I say “I can’t …,” it feels like “poor me” and makes me feel left out.
Or, if the boss asks me to stay late and finish a project when I know I won’t get paid overtime, if I say “I can’t,” then he’ll say “Why? Little hubby waiting for his dinner?” or something equally as demeaning. If I say “I don’t work when I’m not on the clock,” it’s a firm response about my choices and he’s not as likely to come back with a response to try to
be doing “all-or-nothing thinking,” or black-and-white thinking. This is not accurate; life is rarely completely one way or another. You are setting yourself up to discredit yourself endlessly. Instead, be more accurate in what you say, for example: “Sometimes I get the numbers wrong on that report; I need to be careful and double check.”
‘The words we use to others and to ourselves do make a big impact!’ talk me into staying late. Just replacing that one word, “can’t,” by the word “don’t,” goes a long way toward reinforcing what you want to accomplish. The words we use to others and to ourselves do make a big impact! Some tips on others words to watch out for in that dialogue running in your head or when you talk with others: • “Always” — If you say things like: “I always screw up on that report; I never get it right!” you might
Or, there’s a traffic light on my way to work; it’s a very long light, and I often run late. I sit there, fuming, saying, “This light is always red!” Instead, I should say “This light is often red; I need to leave a few minutes earlier.” • “Should” — That is another word to avoid. I know you’ve heard that before. We try to motivate ourselves by saying “I should do this,” or “I shouldn’t do that.” That kind of statement makes us feel pressured and resentful. We usually aren’t
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Page 10 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
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.
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motivated to do what we should do anyway. When we direct a “should” statement toward another person, we feel frustrated. People sometime do what we think they should, but often they don’t. For example, if I say to myself “My doctor shouldn’t keep me waiting so long! He should do a better job of scheduling patients!”, I feel resentful and annoyed, even angry. It would be better for me if I said “He’s running behind because he spends so much time with each patient. That probably means he’ll spend more time with me.” • “I’m sorry” — Some women say this far too often. We use “I’m sorry” far too often when we haven’t even done anything wrong; this makes us come across as a pushover. Apologizing for something when there is no need can undermine your credibility. • “Can you help me?” — This is one thing you do want to say. Admitting when you need a hand — and saying yes to an offer of help — can be transformative. Whether you’re reluctant to ask for support a largerthan-you-can-chew work project or for some babysitting reinforcement during those bleary-eyed days of caring for young children, it’s natural to fear looking weak, needy, or incompetent. But not asking for help, or declining an offer of it, can sometimes let the problem spiral out of hand. It’s definitely a fact that the words we use do shape our moods, our feelings, our actions and our relationships. Become aware of how you talk to yourself and others. Notice how often you use the above words and phrases; see if you can change your words. You might be amazed to see what happens!
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SmartBites By Anne Palumbo
Helpful tips
The skinny on healthy eating
Latest Buzz on Beets I f you haven’t eaten beets in a while, you might want to head to the nearest farmer’s market. This in-season veggie, known for its luscious colors and earthy flavor, is packed with a bounty of nutrients and antioxidants, enough to grant it superfood status. A beet’s color contributes to many of its unique health benefits. Betalains, the pigments responsible for this tuber’s jewel-like hues, are plant compounds esteemed for their antioxidant and anti-inflammatory properties. While antioxidants help to protect cells from free-radical damage, anti-inflammatories help to suppress inflammation that can damage arteries, organs and joints. Although more research is needed, recent studies suggest that betalains could help lower the risk of heart disease, cancer, Type 2 diabetes, obesity and more. Worried about your blood pressure? Reach for a beet! Beets are rich in two nutrients that may lower blood pressure: dietary nitrates and folate. In your body, dietary nitrates are converted into nitric oxide, a molecule that dilates blood vessels and lowers blood pressure. Folate, a B-complex vitamin, is thought to reduce the risk of high blood pressure by helping blood vessels relax and improve blood flow. Folate also reduces levels of homocysteine, a protein
in the blood that has been linked to heart disease. If you’re thinking all this improved blood flow is good for brains, you are correct! More blood means more oxygen, and more oxygen means improved mental performance. Of course, beets have many more nutritional perks that make them a great addition to most diets. First, they’re super low in fat and calories (only 40 calories per average serving), but high in water, which keeps you hydrated and satiated. Second, despite their meager calories, they contain moderate amounts of protein and fiber, two more nutrients that promote feelings of fullness. In other words, beets may help with both weight maintenance and weight loss. And while beets do have more carbs than your average vegetable, they’re the good-for-you carbs that take longer to digest and that have been linked to healthier weight, happier guts, and lower risks of Type 2 diabetes and heart disease. On the subject of diabetes, the American Diabetes Association encourages the consumption of this non-starchy vegetable, as there are no known risks to eating beets if you have diabetes. Since their glycemic index is medium and their glycemic load is low, beets should not have a major effect on blood sugar levels.
Your Salt Shaker May Prove Deadly, Study Finds
Roasted Beet Salad with Goat Cheese and Toasted Walnuts Serves 4 3-4 medium beets, scrubbed and ends trimmed 2 tablespoons balsamic vinegar 1 teaspoon Dijon mustard 1 clove garlic, minced Kosher salt and coarse black pepper, to taste 3 tablespoons olive oil 4-6 cups baby arugula or other fresh greens mix ½ cup toasted walnuts ½ cup crumbled goat cheese fresh basil for garnish Preheat oven to 400 degrees. Drizzle beets with scant amount of olive oil, season with salt and pepper, wrap in foil, and place on a baking
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eople who douse their meals in salt may have a shorter life than those who rarely reach for the salt shaker, a large new study suggests The study, of more than 500,000 British adults, found that those who always sprinkled salt on their food at the table were 28% more likely to die prematurely than people who rarely added salt to their meals. On average, salt lovers shaved about two years off of their life expectancy at age 50. The findings do not prove the salt shaker is a deadly weapon. But they do support going lighter on the condiment, said lead researcher, physician Lu Qi, of Tulane University School of Public Health and Tropical Medicine in New Orleans. “It’s a simple behavior people can modify,” Qi said. Processed foods and ready-togo meals are often heavy in sodium, and best limited. But, Qi noted, it can be tricky to avoid the sodium lurking in prepared foods. Resisting the salt shaker on your kitchen table is straightforward. Health experts have long advised limiting sodium in the diet — largely to help control blood pressure levels. Yet studies have been mixed as to whether that lengthens people’s
Beets that are small or medium-size are more tender and tastier than large ones. They should be heavy for their size and firm, with no nicks or cuts. If the edible greens are still attached, they should look bright and fresh, not wilted. Beets, unwashed and placed in a tightly sealed bag, will last up to two weeks in the refrigerator. Note: Raw beets and their greens contain high levels of oxalates, which can contribute to kidney stones and also hinder the absorption of certain nutrients. When boiled, however, a beet’s oxalate content is markedly reduced. sheet. Bake until beets are fork-tender, about 55-60 minutes. Let cool for 10-15 minutes. Meanwhile, whisk together the vinegar, mustard, garlic, salt, pepper, and olive oil and set aside. Peel cooled beets with a small sharp knife, then cut into wedges, slices, or bite-sized pieces. Place the arugula or greens in a separate bowl and toss with enough vinaigrette to moisten. Put the salad on a serving platter or individual plates, then arrange the beets, walnuts, and goat cheese on top. Drizzle with additional vinaigrette if desired, sprinkle with salt and pepper to taste, and then garnish with fresh basil. Serve immediately.
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.
lives. One likely reason is the way that studies measure sodium intake, Qi said. Some have measured sodium in participants’ urine samples, which only reflects their recent salt intake. Others have asked people about the foods they’ve eaten in the past month or so, which is also an imperfect estimate. In contrast, Qi said, a habit of topping every meal with salt says something about a person’s longterm taste preferences. The findings are based on 501,379 adults taking part in the UK Biobank Study. When they were recruited, between 2006 and 2010, they answered questionnaires on their diet and lifestyle habits. Over nine years, more than 18,000 participants died prematurely — which the researchers defined as before age 75. When they assessed each person’s life expectancy, they found that the risk of an untimely death was 28% higher among people who’d said they “always” used salt at the table, versus those who never or rarely did. Of course, there may be many differences between those groups of people. The “never” group is likely to have other healthy habits, for example.
August 2022 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 11
BACK TO SCHOOL
Failure to Launch: When Parenting Doesn’t End This trend has been increasing since the 1960s By Barbara Pierce
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wenty-eight-year-old Robert still lives with his mother; he’s never been on his own. She works at Burlington Coat Factory and supports the two of them on her meager salary. She explains that he can’t get a job, and when he does, he never keeps it long. Robert’s father was an alcoholic who left them years ago. “His father wasn’t a good father. I should have never hooked up with him. It’s my fault Robert’s the way he is,” the mother believes. Adult children living with their parents is an increasing problem, said Ward Halverson, a licensed clinical social worker and director
of Cornerstone Mobile Counseling in Herkimer. Cornerstone supports and guides people as they undertake major life changes; counselors connect directly and rapidly to those in need, where they are, and how they need it. Often called “failure to launch,” Halverson said it’s named after the movie, where a man in his 30s still lives happily with his parents. As the parents aren’t happy with this, they hire an interventionist to launch him into real life. The movie was funny; in real life, it’s not funny. For the first time in recent history, more adults live with their parents than are cohabitating or married. While the economic downturn from COVID-19 explains some of
the growth, this trend has been increasing since the 1960s. “I see this a lot,” Halverson said. “1 in 10 of the families I work with.” As a society, we’ve moved from caring for our children to caretaking. Caretaking is anything we do for our children that they can do for themselves. It means fixing or solving a problem for your child rather than teaching him how to do it himself. Like doing his homework for him, cleaning his room. The result is the primary coping skill they learn is to go to their parents when there’s a problem. When they’re adults and a parent isn’t there to fix things, they don’t know what to do. They come back to their one coping skill—ask Mom or Dad for help. Many of these adult kids remain at home, on the couch, playing video games. Parents step in, pay rent and utilities, buy the food, and pay their insurance. Add substance abuse to the mix and the caretaking shifts into high gear; we’re driven to save them from the risks of drinking and drugs. Young adults enter adulthood ill-equipped to cope with disappointment. They haven’t learned persistence; they haven’t learned to deal with adversity. They can’t manage the day–to–day responsibilities and inevitable conflicts of a marriage or a job. “It’s called ‘enabling,’” said Halverson. “Often, it’s a young man in his 20s with a mother. Almost always, the mother is raked with guilt; her guilt drives the problem.” Enabling is protecting others from experiencing the full impact and consequences of their behavior, making it easier for that behavior to continue. If you have an adult child living at home, they can still launch—they just haven’t launched yet. Halverson and other experts offer concrete steps to initiate a launch: First, change the way you view your adult child. Instead of seeing him as a little bird whose wings won’t hold him up when he leaves the nest, think of him as fully capable
of flying. Your child will probably become uncomfortable with the steps you’re taking to encourage responsibility, but that’s OK. Discomfort is what they need to have to change. “Develop a plan,” suggested Halverson. “A detailed, move-out plan, with steps.” You must become increasingly unbending; you must not give in to prevent discomfort. Make it clear what the new limits are. The plan should include how you will notify your child, a moveout date and how you will help your child prepare. If you need to start small and work your way up, that’s OK. Some parents can’t stop buying groceries because they don’t want their child to eat at soup kitchens or wherever. If that’s the case, start with eliminating things like phones, haircuts, cigarettes, internet—non-necessities. If they don’t have the money for a phone or cigarettes, they don’t get them. Turning off the parent ATM is probably the biggest step toward launching your adult son or daughter. Make it their responsibility to locate resources: friends, churches and government assistance. Government programs such as disability benefits are an option if they are truly unable to support themselves. Create a contract that specifies the terms of the help you will give, an agreement between adults. Don’t think of them as your children — think of them as tenants. If your tenant gave you a sob story about why she couldn’t pay the rent, would you buy it? And just let her get by? It’s OK for your adult child to be uncomfortable; we’ve all been uncomfortable and survived. It’s actually necessary for change. How successful are these steps? “We have an 80% success rate,” said Halverson. However, like Al Anon, people come when they’re motivated to change.
Long, Regular Sleep Key to Kindergarten Success
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ong, restful and — most importantly — regular sleep is key to helping kindergarteners adjust to school, and a new study urges parents to start forming good sleep habits a full year ahead of time. Researchers found that kids who regularly got 10 hours of sleep or more before beginning kindergarten reaped big benefits. These children were more engaged learners and had better social and emotional skills than drowsier classmates, the study found. They also had better executive functioning, meaning they were more focused, able to remember instructions and juggle multiple tasks effectively, and their academic outcomes were also better. The finding that sleep regularity in the year before kindergarten was so important was a surprise, said lead author Douglas Teti, a
professor of human development and family studies at Pennsylvania State University, in University Park, Pennsylvania. “It was the regularity of 10-plus hours of sleep before kindergarten began that was especially predictive,” Teti said. “What that tells me is that if we’re going to be intervening and working with families with kindergarten children who have sleep problems, we really need to be starting significantly before kindergarten begins.” Sleep is a bodily process as important as healthy eating and exercise, Teti said. People who get better sleep tend to do a better job of regulating their emotions and behavior, are more organized and function better. The new study included 221 families. For seven days at a time, children wore wrist devices to clock
their sleep at four points during the year: July and August (pre-K); late September (early K); late November (mid-K); and mid to late April (late-K). The researchers also got feedback from teachers and had observer assessments.
Page 12 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
“We looked at the transition across the entire kindergarten year, which very few people have done,” Teti said. The findings were published online July 11 in the journal Pediatrics.
BACK TO SCHOOL
Back to School Struggles Returning to school can often make kids anxious
By Barbara Pierce
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his is a challenging time for kids returning to school, said Anne Lansing, CEO of Safe School Mohawk Valley. Safe Schools Mohawk Valley is a nonprofit organization that works to keep kids in school by reducing barriers to learning while supporting their social and emotional well-being. Partnering with schools, community agencies and parents, Safe Schools staff—who are housed in 10 local schools in Oneida, Herkimer and Madison counties— identify kids who are at risk of dropping out and provide necessary interventions. “We’ve seen an increase in kids not returning to school because of the pandemic,” she said. “They’ve lost a year and a half. What does this do to them socially and emotionally? I’m glad I’m not a kid these days!” “Some kids thrived with online learning; they did really well,” she added. “Others did very poorly. What can we do? We can’t hold them back a grade; the schools would be flooded. We spend time with the kids, learning what their concerns
are. It’s interesting what they come up with.” Maybe they put on weight during the pandemic and are embarrassed to come back. Or they don’t know whether to wear a mask. Or, they say “no one’s seen my face for two years,” which makes them anxious. Returning to school can often make kids anxious. It’s a stressful time for them, especially now. There are some common struggles they face. By thinking ahead and preparing, parents can set their kids up for success. Show you support and have confidence, say the experts. If you’re feeling anxious for them and somehow communicating it to them, they’ll pick up on it. You’ve helped them through transitions before. Remember what worked then for your child and use the same strategy. Kids show that they’re anxious by their behavior. They may become argumentative about returning to school, they may want to avoid getting on the school bus or in the car to go to school, or they may show indifference to school.
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Help your kids identify what they’re afraid of, suggested Lansing. Talk about what’s going on in their heads. Her staff helps kids identify their fears. Kids often say things like “If I take my mask off, will I die?” And the school shootings: “Will I be next?” fearing they will be shot at school. Give them time to express their thoughts and feelings. Assure them that they have the strength to handle these stressful things. Being bullied is another concern kids have, said Lansing. “Thanks to social media, they can be bulled 24/7. It used to be that you were safe once you went home from school; that’s not true anymore,” she said. Bullying is most frequently reported in middle school and drops off in high school. It’s often more prevalent at the beginning of the school year when kids try to climb the social ladder. They can be incredibly cruel to one another for the sake of popularity. Before your kids head back to school, you may want to have an honest chat with them about peer pressure. They may look apathetic and roll their eyes at you, but rest assured, it’s important. You are your child’s primary protector. To prevent bullying, you need to know the warning signs to look for, what your school does to address it and how to handle it if your child experiences or contributes to bullying. Bullies tend to pick on people they can get a reaction from. They choose kids who get upset and
Anne Lansing is CEO of Safe School Mohawk Valley, a nonprofit organization that works to keep kids in school by reducing barriers to learning while supporting their social and emotional well-being.
who take the teasing to heart. They also look for kids who won’t stand up for themselves, or kids they can overpower. It’s important to teach your child how to react and who to go to if they feel unsafe. Another issue kids face as they go back to school is loss, said Lansing. Many kids lost so much during the pandemic—they lost grandparents, even parents. As a parent, you can’t take their pain away, but you can help them cope in healthy ways. Kids respond to death differently than adults. How your child behaves and how you respond depends on their age. Help them express their feelings. There are a lot of good books on death for kids. Reading books and telling stories, or looking at pictures of the person who died can help kids express their feelings. Also, expressing your own sadness lets them know it’s OK to be sad. “Protect them and give them coping skills,” summed up Lansing. “They are our next generation. They are the leaders of the future. What do we need to do to make sure they have the knowledge and skills to lead?” “Kids are resilient,” she concluded.
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BACK TO SCHOOL
Discipline that Makes Sense
Setting limits for our kids is one of the toughest tasks of a parent By Barbara Pierce
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s parents, one of our most important jobs is helping our kids learn how to behave—at home, at school, with friends and in public. Kids aren’t born knowing this. The challenge for parents is to guide their children to become responsible, said parent educator Virginia Pry of Catholic Charities of Oneida/Madison Counties. To teach them self-control. The way we do that is through limits, setting guidelines for their behavior. When parents set limits, they’re showing their children what to do and what to say, as well as helping them cope with their impulses and learning to tolerate frustration. Limits make children feel safe. Setting limits for our kids is one of the toughest tasks of a parent. Think of it as simply teaching your child which behaviors are OK and which aren’t. Parenting experts Greg Kovacs, owner and operator of Greg Kovacs, Upstate Marriage of Upstate and Family Marriage and Therapy in Family Therapy Utica and parent in Utica. educator offered tips on setting limits: • Help your children learn from their mistakes without criticizing or blaming them, suggested Kovacs. Help them learn from their successes and failures. • Provide choices. Instead of giving orders, set limits,” said Pry. “Give your child a choice within those limits. Having a choice helps your child have some control.” For example, ask your child “Would you like to do your homework before dinner or after dinner?” said Kovacs. This clearly
indicates what needs to be done but acknowledges that the child may have insight into what could work best for them. This gives them the opportunity to think. You’re not giving them the option to do the homework or not do the homework; you’re simply giving them an opportunity to think for themselves. • Tell them what they should do instead of what they shouldn’t do—don’t just say what the wrong thing is. For example, instead of saying “Don’t jump on the couch!” say “The couch is for sitting. Go outside and jump on the grass.” • Give consequences. “Consequences for breaking rules should be given consistently and fairly,” said Kovacs. “The consequences should make sense, should be tied to the behavior. If he throws a toy across the room, it makes sense he is not allowed to play with that toy again for a time. It wouldn’t make sense to send him to his room for an hour. In fact, if he throws a toy and the toy breaks, you don’t have to do anything! The consequence is that the toy is broken, can no longer be used, and won’t be replaced—that’s a natural consequence and a powerful lesson.” • Be consistent so kids can count on what will happen if they do something wrong. When you say there will be a consequence to bad behavior, follow through with it so it’s not an empty threat. • Catch them being good. Children need to know when they do something bad—and when they do something good. Notice good behavior and praise
it. Be specific; for example, “Wow, good job putting that toy away!” • Ignoring bad behavior can be an effective way of stopping it. For example, if she keeps dropping her cookies on purpose, she won’t have any more cookies to eat. If she throws and breaks her toy, she can’t play with it. She’ll learn not to drop her cookies and throw her toys. • Listen to your kids, advised Kovacs. Let them express their opinions. Though you have the final say, there’s tremendous value when kids know that their opinions are heard and considered. This helps children to grow the confidence that they can solve problems on their own. • Find alternatives to physical punishment. “Spanking plays no role in raising healthy children,” said Kovacs. ‘While spanking may stop a behavior, the negative effects far outweigh the positive. The same is said of yelling at children—it doesn’t work; it only makes things worse.” If you’re so angry with your child that you’re ready to explode,
take a few moments to calm down before trying to discipline them. Go in another room if needed, count to 10, take deep breaths. Then think about how to handle the problem so you will discipline your children in a way that helps them learn from their mistakes and still feel loved. Their behavior is bad, not themselves. “Talk to your child when you and your child are calm,” suggested Pry. “Don’t fight or give in. Make sure the consequence fits the misbehavior. Stay consistent and follow through.” If you’re having trouble controlling your child, call a parenting hotline or join a parenting class where you can learn more about time-outs and nonviolent ways to discipline. Catholic Charities offers free parenting classes; call 315-724-0120, extension 2528. For more information on Kovacs and Upstate Marriage and Family, see www.upstatemarriageandfamily. com or call 315-527-7936.
About 1 in 7 U.S. Kindergarten Kids Now Obese
D
espite reports that rates of childhood obesity are decreasing, kids seem to be packing on pounds at younger ages. In 1998, just under 73% of children entering kindergarten in 1998 had a normal body mass index (BMI), while 15.1% were overweight, and 12% were obese. However, fast forward 12 years and just 69% of kids started kindergarten at a normal BMI, a new study finds. And while the percentage of kids entering kindergarten who were overweight in 2010 didn’t change from 1998, the percentage who were obese jumped to 15.3%, the study showed. That’s about one in every seven kids. “We were hoping we would see a
Page 14 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
decrease in the incidence of obesity,” said study author Solveig Argeseanu Cunningham, an associate professor of global health and epidemiology at Emory University in Atlanta. “We were negatively surprised to find that this newer [group] of kids was experiencing obesity even younger and reaching higher levels of obesity than they were 12 years ago.” The new findings suggest that efforts aimed at getting kids to move more and make healthier food choices aren’t working as well as hoped, she said. For the study, the researchers compared rates of obesity in kids from kindergarten through fifth grade during two time frames: 1998 to 2004, and 2010 to 2016.
sensory challenges. “Impulsive and unpredictable behavior is a feature of autism and taking children out of their usual environment is often too stressful for both child and parent,” Wright says. Wright’s team conducted interviews with eight families paired with an autism assistance dog (AAD) as a support for their child. The study revealed
A Wet Nose and a Wagging Tail Opens Up a New World for Autistic Kids
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new Australian study looking at the impact of an autism assistance dog for children and their parents has made an unexpected discovery: the dog has expanded their world, literally. The presence of a specially trained therapy dog for autistic children is giving families the confidence to venture further afield and
to many more locations, according to researchers from the University of South Australia. UniSA researcher and occupational therapist Shelley Wright, who supervised the study, says the freedom to explore new places is something most of us take for granted, but for children with autism and their parents, this is normally fraught with
• On average, families visited 8.5 more places and traveled 15 miles further from their home after having the dog for more than a year. • Parents reported greater freedom for young children with severe autism who were normally strapped in a pram for safety when leaving home. An AAD replaced the pram but still acted as a natural restraint. • Prior to receiving an autism assistance dog, parents were reluctant to leave the family home because of the stress involved, leading to feeling trapped and isolated. The dog allowed them to venture out because their child was calmer and safer in its presence. • Parents reported fewer meltdowns among their children who sought out the dog when feeling overwhelmed. • Children on the autism spectrum often get lonely as they find social interaction and communication difficult. The dog gave them much needed companionship. “The parents we interviewed were much happier and more at ease leaving their home with their child after getting an autism assistance dog,” said “Wright. The study is published in the journal Health and Social Care.
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August 2022 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 15
The Balanced Body
By Deborah Dittner
Breastfeeding…Taking Care of You and Your Baby At farmers’ market earlier today I sat on a bench in the shade to enjoy the herbal ice tea I purchased. Next to me sat a woman to breastfeed her baby. I fondly remember the days of breastfeeding my three children. My first child slept through the night from day one leaving me quite full come that first morning feeding. My second was up at every two hours so easier on the breast fullness but more difficult on getting decent sleep. My third woke one to two times a night which, for me, was ideal on all accounts. Breastfeeding allowed me to go anywhere at any time and provide my children with the best quality nutrition. But each child is different and we as moms need to adjust accordingly. Such wonderful memories of bonding with each of them. The grasping of my finger or laying a hand on my breast, looking up at me with big bright eyes, dozing off as the nights were a challenge, and the occasional “bite” …ouch! I loved every aspect of those days. Of course, it was important that the babies get the best nutrients possible. But in order for that to happen, mom needs to maintain good hydration and excellent nutrition. Eating nutrient-dense, plantbased foods and having water by your side at all times is an important step in providing for a baby.
Take note as to how the baby responds. For example, if they spit up, consider looking at what you may have eaten or drank. With my second child born in June, I looked forward to the fall and eating apples, making homemade applesauce, and drinking apple cider. Well…he didn’t like apples and would spit up every time after I had one of those tasty morsels. Better luck next year! Continuing an exercise program is another important aspect of a healthy mom (mind, body and spirit) and breastfeeding. Exercise allows for increasing fitness, going to the
gym or hitting the road either by oneself for a little peace and quiet or with others allowing for socialization, bone health and maintaining a healthy lifestyle. Research shows that exercising is also helpful in the prevention of postpartum depression. Exercise while breastfeeding does require increased energy exertion and an increased number of calories. Eating about 500+ more calories daily will help in maintaining adequate milk production. Proper sleep is needed as fatigue from exercise and babies’ nighttime demands play a role. Remembering to hydrate with the addition of exercise will aid in maintaining milk production as well. If there is a decline in milk production once exercising begins, increasing fluids and nutrient-dense calories usually does the trick. Postpartum and breastfeeding with exercising can, in some women, increase the risk of stress fractures. Calcium from mom’s bones acts to meet the increased needs for
calcium in mom’s milk causing bone loss in the hip and lumbar spine during breastfeeding. This bone loss reverses once breastfeeding stops in approximately 12 to 18 months. During this time stress fractures especially in runners may occur, so proceed cautiously. As in everyone who exercises, proper hydration, whole nutrientdense foods in quantities needed, adequate sleep and listening to your body are key factors in maintaining a healthy and injury-free body and providing proper nutrition for your baby. The benefits of exercising while breastfeeding definitely outweigh any risks that may develop otherwise. Therefore moms…enjoy your run or exercise class. You will be so happy that you did! 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.
CARING FOR THE WHOLE YOU. BODY AND MIND. Now more than ever, your emotional wellbeing is key to overall health. Having meaningful connections with others is important for both physical and mental health.
CONNECT
EXERCISE
TRY SOMETHING NEW
Spend time with family and friends. Connections and support are important for your emotional health.
You don’t have to pump iron or run a marathon. Short walks around the block throughout the day have big benefits.
Find a new hobby or old one. Or sign up to volunteer somewhere. You’ll give your brain and mood a boost.
Check out our podcast episode, “An Honest Conversation About Mental Health” in the Community Check-in. Find it wherever you listen to podcasts. A nonprofit independent licensee of the Blue Cross Blue Shield Association
Page 16 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
By Jim Miller
How to Sell Unwanted Burial Plots Dear Savvy Senior, How do I go about selling unwanted burial plots in my hometown cemetery? When my parents died about 25 years ago my husband (at the time) and I bought two plots near them in the same cemetery. But we’ve gotten divorced since then and have both moved out of state. Besides that, I would like to be cremated instead of buried. — Looking to Sell
Dear Looking, Life changes such as relocating, family disputes and divorce, along with the growing popularity of cremation in the U.S., is causing more and more people to sell previously purchased burial plots they don’t intend to use any longer. But depending on where you live and the location of the cemetery, selling a plot can be difficult. And, if you do sell it, you’ll probably get less than what you initially paid for it. Here’s are a few tips to get you started. • Contact the cemetery: Your first step in selling your unwanted burial plots is to contact the cemetery and find out if they would be interested in buying them back, or if you’re allowed to sell them yourself to another person or family. And if so, what paperwork will you need to complete the sale and is there a transfer fee? Some states require sellers to offer the plot back to the cemetery before selling it to others. • Selling options: If you find that it’s OK to sell your plots yourself, many people choose to use a broker. There are a number of companies — like PlotBrokers.com
and GraveSolutions.com — that will list your plots for sale and handle the transaction for a fee and possibly a commission. If you go this route, you’ll sign paperwork giving the broker permission to work on your behalf. Listings can last up to three years or until the plots sell. Alternatively, or simultaneously, you can also list them yourself on sites like The Cemetery Exchange, GraveSales.com along with eBay and Craigslist, and handle the transaction yourself. In the ad, be sure to post pictures, describe the area where the cemetery is located and give the plot locations. • What to ask: Appropriate pricing is key to selling your plots. It’s recommended that you find out what the cemetery is selling their plots for today and ask at least 20% less. If you’re pricing too close to what the cemetery charges, there’s no incentive for potential buyers. • Beware of scammers: If you choose to sell your plots yourself, it’s not unusual for scam artists to reach out and try to get your personal financial information. Phone calls tend to be more genuine than emails and text messages. • Donate them: If you don’t have any luck selling your plots, and if money isn’t an issue, you can donate them to charity such as a religious congregation, a local veteran’s group or an organization that aids the homeless. To get a tax deduction, you’ll need an appraisal, which a cemetery or broker may supply for a fee.
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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August 2022 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 17
Health News Edwards named CNO at Rome Health
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shley Edwards, a native of Westernville, has been selected as Rome Health’s chief nursing officer As CNO, she will provide clinical and administrative leadership for planning, organizing, directing, monitoring and evaluating safe high-quality patient care to advance the mission of Rome Health. Multiple stakeholders, including the medical staff and nursing staff, participated in the process to define the essential qualities for Rome Health’s next CNO and shared detailed feedback during the interview and selection process. “Ashley is a trusted and approachable leader, who possesses both the passion and clinical competencies to support a dedicated workforce and foster continuous quality improvement through multi-disciplinary collaboration,” said AnneMarie W. Czyz, Rome Health’s president and chief executive officer. Under her leadership, Rome Health has been recognized nationally for exceptional patient care in emergency and maternity departments. After graduating from St. Elizabeth College of Nursing in 2012, Edwards joined the hospital as a graduate nurse in the intensive care unit. She earned her bachelor’s degree in nursing in 2013 and her Master of Science in nursing: nursing management and executive leadership in 2020. Since she was named nurse manager of the emergency department in 2017, she has assumed increasing levels of responsibility, gaining critical clinical and operational experience. Edwards has a passion for learning and has earned multiple credentials and special certifications to maintain her clinical competencies. In 2022, she earned board certification as a nurse executive. “My goal was never to be just a CNO anywhere, it was to be the
Cooperstown Food Pantry receives Excellus BCBS Community Health Award Excellus BlueCross BlueShield recently awarded Cooperstown Food Pantry a Community Health Award of $2,000 to support their farmers market voucher program. This program, which began in 2009, provides farmers market vouchers to families who participate in the Cooperstown Food Pantry to purchase fresh produce at the Cooperstown Farmers Market. Families may pick up vouchers at their monthly visit to the food pantry from May through October. Students participating in the pantry’s backpack program will also receive vouchers. “The farmers market voucher program is one of the key ways that we provide equitable and inclusive service to our clients,” said Will
Ashley Edwards CNO here at Rome,” Edwards said, “It truly feels like a family here, where people care about each other and work as a team.” Edwards embraces a servant leadership style, where she focuses on developing and empowering her team to unlock their own potential.
MVHS ranks among top 5 in New York for joint replacement The orthopedics program at the Mohawk Valley Health System (MVHS) was recognized recently by a national healthcare company. MVHS ranks among top 5 in New York for joint replacement, according to a new analysis released by Healthgrades, the leading resource that connects consumers, physicians and health systems. Additionally, MVHS is a recipi-
Kleffner, director of the Cooperstown Food Pantry. “By providing the funds needed to purchase fresh, local fruits and vegetables, we help remove one of the barriers to community health. We believe that everyone should have access to fresh, healthy food options!” The mission of the Cooperstown Food Pantry is to address issues of food insecurity and poverty in northern Otsego County. Currently in its 45th year, the Cooperstown Food Pantry provides an important safety net for area families facing food insecurity. “The company’s Community Health Awards demonstrate a corporate 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
ent of the Joint Replacement Excellence Award. For the state ranking analysis, Healthgrades evaluated clinical performance for nearly 4,500 hospitals nationwide focusing on eight key specialties across a mix of chronic, urgent and planned clinical areas. “This award demonstrates the continued commitment of our surgical staff at MVHS to quality and excellence,” said Darlene Stromstad, president and CEO of MVHS. “I am so proud of our team for always putting the patient first and providing quality healthcare to our community. This award helps those outside our system know the great work being done right here at MVHS.” Healthgrades specialty excellence awards recognize hospitals with superior performance in specific specialty lines and specialty focus areas. For example: from 2018-2020, patients treated at hospitals receiving the Joint Replacement Specialty Excellence Award have, on average 61.1% lower risk of experiencing a complication while in the hospital than if they were treated in hospitals that did not receive the award. And patients treated at hospitals which did not receive the Joint Replacement Specialty Excellence Award have, on average 2.57 times more likely to experience one or more complications in the hospital than if they were treated at hospitals that did receive the award. “We want to provide information to make finding a healthcare specialist an easier experience for consumers,” said physician Brad Bowman, chief medical officer and head of data science at Healthgrades. “Patients can feel confident knowing that hospitals that are recognized for their performance in joint replacement provide high-quality care and superior outcomes. MVHS was also recognized with the Surgical Care Excellence Award,
placing the hospital in the Top 10 percent in the nation for surgical care.
Carbone Subaru of Utica donates to MVHS Cancer Center Carbone Subaru of Utica recently joined with Subaru of America, Inc. and The Leukemia & Lymphoma Society (LLS) to donate blankets and messages of hope to patients fighting cancer at the Cancer Center at Mohawk Valley Health System (MVHS). “In 2021, our outpatient infusion unit provided more than 13,000 treatments to members of our community,” said Tracy L. Hilderbran, director of clinical operations for the MVHS Cancer Program. “We are very thankful for this wonderful donation from Carbone Subaru and the LLS. The blankets are going to make such a difference for our patients.” Chris Cardello, sales manager at Carbone Subaru of Utica, was pleased to once again coordinate this effort locally. “I have been surrounded by cancer my whole life with a number of family members so when Subaru offered me an opportunity to get involved with “Subaru Loves to Care” I saw it as a great way to give back,” Cardello said. “From past experiences, I know that patients receiving chemotherapy often fight the chills while receiving treatment. Carbone Subaru was grateful to be able to donate warm blankets to help provide an extra layer of comfort to the outpatient infusion unit patients at MVHS.” Donations made to the Cancer Center are coordinated through the MVHS Foundation. If you are interested in learning how you can make a difference, call the MVHS Foundation at 315-624-5600 or visit mvhealthsystem.org/foundation.
Excellus BCBS Utica Regional President Eve Van de Wal presents Excellus BCBS Community Health Award to Cooperstown Food Pantry Executive Director Will Kleffner. vital to the health and wellbeing of our communities and we are pleased to support the Cooperstown Food
Page 18 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
Pantry with this essential community health funding.”
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August 2022 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • Page 19
Video Game Therapy Aids Stroke Patients MVHS offers video game therapy to its stroke patients — with positive results, according to nurses By Daniel Baldwin
S
trokes can affect a person’s mobility, coordination and speaking. People may not feel their arms, hands and legs. They may also lose the ability to speak clearly. Those who had and are recovering from strokes, should find a therapist and go through physical therapy as the best way to improve their condition and avoid becoming physically handicapped, according Shari Bolton, an MVHS stroke outreach nurse. “Any type of therapy, following a stroke, is going to help decrease their longevities of disabilities,” Bolton said. “Any activity is going to help and increase their coordination and their ability to decrease any deficits they may have from the stroke.” There are many types of therapies, but the one kind that is liked and enjoyed by many patients is the video game-based therapy. Stroke patients can improve their mobility and coordination through the art of gaming. They can regain the feeling in their hands and arms just by pressing buttons on a game controller. For this type of therapy, patients are still trying to walk, move their arms and bend their fingers. Instead of working out at a gym, patients are playing virtual golf, bowling, tennis
Maria Santa Maria, MVHS doctor of physical therapy. Shari Bolton, a stroke outreach nurse at MVHS.
and boxing on the Nintendo Wii or on a VR (virtual reality) gaming headset. MVHS offers this sort of therapy to its patients. Stroke patients have a far better experience playing games and rehabbing through a VR headset. “When you participate in virtual reality with those headsets, you are immersed in that,” said Maria Santa Maria, MVHS doctor of physical therapy. “When we compare the virtual reality one to the nonimmersive, the Wii, the virtual reality one is actually a better experience because it is more integrated. It’s more realistic than the Wii. Plus there is some research out there that says that it is better than conventional therapy all alone because it’s more
integrative.” Unfortunately, MVHS doesn’t have VR headsets, as Santa Maria and her staff cannot afford them. So, they instead use the Wii for this type of therapy. “We offer the Wii unit for sports with a combination of balance involved,” Santa Maria said. “Unfortunately, that [VR headset] system is very expensive and the Wii is more accessible to our patients. They understand how to use the Wii. You’re alleviating some of that anxiety that’s involved with using a virtual reality system because they have to learn how to use it.” MVHS stroke patients don’t have the chance to see the amazing virtual world on a VR headset. But they still have the chance to improve their
Page 20 • IN GOOD HEALTH – Mohawk Valley’s Healthcare Newspaper • August 2022
condition, coordination and motor skills playing sport games on the Wii. “What they are using these things for is to improve their balance and range of motion,” Maria said. “They have the remote-control sticks that they’re moving their arms with. They have the balance board that they’re weight shifting with. They’re trying to improve their motor control by playing these different sporting activities and they could either play by themselves and increase their skills that way, or they can play with a family member or with a therapist to try to get the excitement of playing a game with someone else.” Patients are also improving their posture and body alignments playing Wii sports. “They’re building their neuromuscular movements, their posture control and voluntary control,” Santa Maria said. “They’re improving their body alignments by using that tool, the Wii.” The best thing about video gamebased therapy, according to Santa Maria, is that it is fun and less taxing for the patients. Stroke patients are more motivated to start and complete this therapy. “The nice thing about the gaming systems, like the Wii and virtual reality, is that it can provide creative fun reality for the patient,” Maria said. “Therefore, it’s more motivational than you might see in conventional therapy because they can get their head around the task and get excited about doing the task. It’s really creative and fun.” While conventional therapy is not as fun or enjoyable than playing Wii games, Santa Maria feels they offer different advantages. “The combination of both of those techniques is the best rehab experience for the fastest recovery,” Maria said. “In conventional training, we will build strength with them. We’ll stretch them. We’ll build the range of motion they may have lost from a stroke, but the Wii gives you speed. It gives you problem-solving because you have to determine where that ball is going to go. It gives you more repetition because things are happening faster and it tries to duplicate the activity and make it as real as it can. So when you combine both aspects of care you get faster neurologic changes.” Video game-based therapy does have its flaws, and is not for all stroke patients. “Even if they [stroke patients] do the video games, they still have to be cleared by their physician to be able to do video games,” Bolton said. “A lot of times with the virtual reality video games, patients that had strokes, it takes them a few more seconds to react than it does with a normal person. Sometimes the lights and the flashing and the different things that may pop in front of their eyes could cause a seizure-type activity to happen. So those are some of the disadvantages. Although some patients don’t mind the lighting and love this type of therapy.” “We choose which patients we introduce this to because we get to know our patients very well,” Santa Maria added. “The ones that we introduce [the Wii] to, they love it. They really do because it’s something that they’re used to, but most importantly, they’re returning to a sport that they really enjoy. They also love the fact that they make improvements quickly through the use of it.”