In Good Health: Mohawk Valley #203 - January 2023

Brian Zylinski, a new physician at Falcon Clinic, talks about osteopathic medicine and his experience living in a nursing home as a ‘patient’ for 10 days.

‘I learned what it’s like to push a call button and nobody comes because they’re too busy.’ P. 4

Study: Children Are Ditching Alcohol for Marijuana

A 20-year national US study shows a 245% increase in use of marijuana

Adolescent cannabis abuse has increased 245% since 2000 in the U.S., while alcohol abuse has steadily declined over the same period.

That’s according to a national, peer-reviewed study tracking intentional misuse and abuse reported to the National Poison Data System (NPDS) up until 2020.

Findings, published in December in the peer-reviewed journal Clinical Toxicology, find over 338,000 instances of intentional abuse or misuse among American children aged 6-18.

The majority of ingestions occurred in males (58.3%), and more than 80% of all reported exposure

cases occurred in young people aged 13 to 18.

In total, over 32% of instances resulted in “worse than minor clinical outcomes”.

The new report demonstrates a change in patterns over time. For instance, in 2000 the largest number of abuse cases involved exposure to ethanol, yet since then child alcohol abuse has steadily declined over the years.

In contrast, marijuana exposure cases remained relatively stable from 2000 to 2009, then steadily rose from 2011, with an even more dramatic rise in cases from 2017 to 2020.

Experts analyzing the data attribute the rise in marijuana use to the increased popularity of edible cannabis products, now widely available across the country.

“Ethanol abuse cases exceeded the number of marijuana cases every year from 2000 until 2013,” says physician Adrienne Hughes, assistant professor at Oregon Health & Science University, one of the authors of the study.

However, by 2014 this trend had reversed.

“Since 2014, marijuana exposure cases have exceeded ethanol cases every year, and by a greater amount each year than the prior,” says Hughes.

While rates of all marijuana abuse increased, edible marijuana showed the highest average monthly increase compared with all other forms, suggesting that adolescents have moved away from smoking weed onto alternative modes of consumption. Marijuana extracts, such as those used in cannabis vaping products, were also increasingly popular.

“These edible and vaping products are often marketed in ways that are attractive to young people, and they are considered more discrete and convenient,” says Hughes.

However, although they may be perceived as less harmful, studies show this is not the case.

“Compared to smoking cannabis, which typically results in an immediate high, intoxication from edible forms of marijuana usually takes several hours, which may lead some individuals to consume greater amounts and experience unexpected and unpredictable highs,” says Hughes.

The dramatic increase in child cannabis use since 2017 coincides with a wave of decriminalization legislation in the US. As of 2022, cannabis is legal for adult recreational use in 19 states and for medical use in 36 states.

While cannabis is only legal for adults and not children, the authors of the study argue that it has rendered the drug more accessible to children and adolescents and contributed to a perception that the drug is safe.

“Our study describes an upward trend in marijuana abuse exposures among youth, especially those involving edible products,” says Hughes.

“These findings highlight an ongoing concern about the impact of rapidly evolving cannabis legalization on this vulnerable population.”

As well as cannabis, the study reveals high levels of over-the-counter medication abuse among teenagers. Between 2001- 2016, the highest number of drug abuse cases related to dextromethorphan, an over-thecounter cold and cough medicine. Oral antihistamines were also among the most commonly misused substances in this study.

Deaths from drug abuse were rare, occurring in 450 young people (0.1% of cases). Deaths were more common in males, and in older teens aged 16-18. They were also most likely to occur after abusing opioids.

And, although there were 57,488 incidents involving children aged just 6 to 12, these cases did not usually include ‘traditional’ drugs but rather vitamins, plants, melatonin, hand sanitizers and other objects.

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Lasik Surgery Should Carry Warnings

FDA drafts guidance that warns of potential complications

Lasik eye surgery is a common vision-correcting procedure that many Americans view as safe and effective, but the U.S. Food and Drug Administration has now drafted guidance that warns of potential complications.

Although many patients are happy with the results after surgery, the recommended new guidance says complications can include dry eyes, double vision, difficulty with night driving and, in rare cases, chronic eye pain. Even after surgery, some patients will still need eyeglasses.

The draft also notes that certain types of patients may be at higher risk of problems, including people with chronic conditions such as diabetes and those who take certain medications.

Since the recommendations were first released this summer, more than 600 people and professional organizations have weighed in on the issue.

“All we’re asking for is balance,”said Vance Thompson, incoming vice president of the American Society of Cataract and Refractive Surgery, told the Times. “This document mainly emphasizes the dangers and complications of Lasik, with no mention of the advantages, and the tone is negative enough that it will scare patients.”

Thompson noted that more than 90% of patients in the FDA’s studies were satisfied because they were “achieving good vision without spectacles, which is the goal of most patients.”

Surgeons and device manufacturers have sought to have the draft recommendations withdrawn.

But a professional organization representing optometrists recommended adding even more precautions to the draft, to include pregnant women and those with irregular astigmatism.

Lasik is typically a procedure completed in just 15 minutes per eye, where the surgeon reshapes the cornea with cuts and a laser to correct poor vision. Often the procedure is not covered by insurance and can cost patients thousands of dollars out of pocket.

Still, more than 500,000 adults opt for the surgery each year and many ophthalmologists declare it safe, with complications happening very rarely.

To arrive at the draft recommendations, the FDA both collaborated on and analyzed studies on Lasik outcomes published in the past decade.

One of those studies found that three months after Lasik nearly half of patients who had previously not had visual symptoms did after the procedure. This included seeing halos around lights. About one-third of the patients had dry eyes.

“Patients undergoing Lasik surgery should be adequately counseled about the possibility of developing new visual symptoms after surgery before undergoing this elective procedure,” the study authors wrote.

The FDA has not said when the guidance will be finalized.

SERVING ONEIDA, HERKIMER, & MADISON COUNTIES

Meet Your Doctor

By Chris Motola

Brian Zylinski, DO

Cats Now Have an FDA-Approved Pill to Treat Their Diabetes

Owners whose cats have diabetes now have a new option to care for the condition in their otherwise healthy pets.

The U.S. Food and Drug Administration in December approved the first pill to improve control of diabetes in some cats.

The drug, called Bexacat (bexagliflozin tablets), is not insulin and is not meant for cats who have the type of diabetes that requires treatment with insulin. Rather, it is what is called a sodium-glucose cotransporter 2 (SGLT2) inhibitor.

Bexacat is a once-daily flavored pill given with or without food to cats who weigh at least 6.6 pounds.

The active ingredient in this pill prevents the cat’s kidneys from reabsorbing glucose into the blood. This excess glucose leaves the body through the urine, lowering blood sugar levels.

As part of the approval, the FDA requires that Bexacat labels include a boxed warning about the importance of patient selection. Only certain cats should take the drug, determined through careful screening.

Potential patients must be screened for kidney, liver and pancreatic disease, as well as ketoacidosis, a high level of a type of acids known as ketones in the blood.

Cats who are treated with Bexacat may be at an increased risk of serious adverse reactions, including diabetic ketoacidosis, the FDA said. This can be fatal and should be treated as emergencies.

In a news release about the approval, the FDA explained that like in humans, the cells of a cat’s body need sugar in the form of glucose for energy. Cats with diabetes can’t properly produce or respond to the hormone insulin. Insulin helps cells use glucose for normal function.

The FDA cited two field studies that were six months long and an extended field study in its approval. The studies found the medication was more than 80% effective in improving blood sugar control in cats with diabetes.

Q: You are described as a family medicine–osteopathic neuromusculoskeletal physician. Just what does that mean?

A: I integrate both components— family medicine and osteopathic medicine. I’m half primary care and half osteopathic manipulation. In 2021, I finished my fellowship in family medicine at St. Elizabeth’s. Family medicine is primary care medicine. I offer basic healthcare, treat most ailments and provide full health care to people of all ages.

Today, when you go into primary care, you don’t always get to combine it with osteopathy. I’m board certified in osteopathy. Osteopathy and osteopath manipulation emphasizes the treatment of medical disorders through the manipulation and massage of the bones, joints and muscles.

As a D.O., doctor of osteopathic medicine, I’m a fully trained and licensed doctor. I completed four years of medical school in an osteopathic medical school. I took all the classes — anatomy, pharmacology, biolo gy — all scien tifically based.

I also learned osteopathic manipulation, which MDs don’t learn.

I have the abil ity to prescribe medication and to refer people to other special ists. However, in our training, we’re taught to focus on the non-phar macologi cal solu tions first, like

manipulation and stretching. Because of that training, we reach for those solutions first. The other options are there and are available, but we use non-invasive options first. I definitely see the benefits of this approach.

Q: You’ve recently begun seeing patients at the Falcon Clinic. How did you choose the Falcon Clinic?

A: I choose the Falcon Clinic, as owner Dr. Richard Chmielewsk is a DO like me, and strongly supports osteopathic medicine. The Falcon Clinic offers me the opportunity to integrate my osteopathic training with primary care. I’m happy to be here, doing both primary care and osteopathic manipulation.

Q: How did you decide to become a physician?

A: The light bulb went off in my head when I took biology in the ninth grade. I had a charismatic teacher who got me interested in how biology relates to medicine, that is, how insulin helps diabetics. Something just clicked in my head and I knew I was really interested in this. This teacher encouraged me to follow my interest; she encouraged me to shadow medical professionals, go to nursing homes, etc. The snowball of interest kept getting bigger. In college, I took pre-med and biology, and got a master’s degree in

Q: What attracted you to

A: It’s not that I choose osteopathy. I’d really have to say it choose me. I knew I really

tor and applied to several medical schools. I was accepted by an osteopathic college.

When I first started there, I was skeptical about osteopathy, as were many of my classmates. However, it grew on me as I learned, as I saw how much holistic medicine benefited the patients.

Q: We’re impressed by the learning experiences you’ve had, impressed that you were open to having these experiences, such as geriatric immersion, living as a post-stroke patient in a nursing home. What was the takeaway for you from these experiences?

A: For 10 days, I lived as a hypothetical 85-year-old post-stroke patient in a wheelchair, with COPD and a nasal cannula, with no ability to use my right hand, and I’m strongly right-handed. I had to learn to eat with my left hand, brush my teeth with my left hand, etc. I learned what it’s like to push a call button and nobody comes because they’re too busy.

I believe that all heath care providers should have this experience. Often, I find doctors preach from “on high.” We haven’t experienced the things that our older patients are going through; we have no idea what it’s like. I’m 32, young, healthy and haven’t had to have significant interactions with the medical community.

One of my professors said “As a physician, everything that you can write an order for, you should first experience it for yourself. If you’re ordering a walker or a wheelchair, what does it feel like to be dependent on that equipment? What does it feel like to need help to transfer from a wheelchair to your bed or to the toilet?” He was right; we should experience it ourselves.

Though I had this training experience in 2017, not a day has gone by where it hasn’t permeated me; it was grounding. It was hard, but I’m glad I did it.

Q: What else would you like our readers to know about you?

A: I’m happy to be here at the Falcon Clinic, where I can offer good holistic medicine. We also do addiction medicine; we treat alcoholism and opioid addiction, and hepatitis C. Our patients appreciate that we’re as close to being a one-stop-shop as possible.

Lifelines

Name: Brian Zylinski, D.O

Position: Family medicine/osteopathic neuromusculoskeletal medicine physician at the Falcon Clinic for Health, Wellness and Recovery, New Hartford.

Hometown: Buffalo, New York

Current Residence: North Utica.

Education:B.S. degree in biology, Canisius College, Buffalo; M.A. in biology, State University of New York, Buffalo; D.O. degree, University of New England College of Osteopathic Medicine, Biddeford, ME.; Residency, St. Elizabeth Medical Center, Utica; Residency, Trinity Health Muskegon, Michigan State University College of Osteopathic Medicine, East Lansing

Organizations: American Society of Clinical Oncology; American Society of Hematology, American College of Physicians

Personal:Single, no children.

Hobbies: Plays ice hockey weekly; avid runner; sings, play the guitar, likes country music. Practicing Roman Catholic; the church is an important part of his life.

New doctor at Falcon Clinic talks about osteopathic medicine and his experience living in a nursing home as a ‘patient’ for 10 days. ‘I learned what it’s like to push a call button and nobody comes because they’re too busy,’ he says

U.S. Gun Deaths Reach Highest Level in Decades

More Americans are dying from gun violence, in both homicides and suicides, than they have in decades, a new report shows.

The U.S. gun death rate hit its highest level in nearly 30 years, with the sheer number of people dying from guns reaching 47,000 in 2021, the highest in 40 years, according to the study.

Increases were higher for women than men, and especially for Black women. Among Black women, firearm-related homicides have tripled

since 2010, while suicides have doubled since 2015.

“Women can get lost in the discussion because so many of the fatalities are men,” study co-author, physician Eric Fleegler, an associate professor of pediatrics and emergency medicine at Harvard Medical School in Boston, told the Associated Press.

Researchers found a 71% increase in the number of women killed by guns, from four per 100,000 in 2010 to seven per 100,000 in 2021. Women comprise about 14% of overall gun

deaths.

In Black women, suicides rose from a rate of 1.5 per 100,000 in 2015 to about three per 100,000 in 2021. Homicides in Black women were 18 per 100,000, while they were four per 100,000 in Hispanic women and just two per 100,000 in white women.

More than 1.1 million people were killed by guns during the study’s 32-year timeframe.

Researchers found a steady increase in gun deaths beginning in 2005, and then a sharp jump from 2019 to 2021, when deaths rose 20%.

Fleegler said that asking why gun deaths would rise during the pandemic was “a straightforward question with probably a complicated answer that no one really knows the answer to.”

Experts said it could be a mix of higher gun sales, stress, mental health issues and disruptions at home and work.

Men also saw an increase in gun deaths, and Black men continued to have the highest gun death rates.

The findings were published Nov. 29 in the journal JAMA Network Open.

HealthcareinaMinute

By George W. Chapman

Healthcare Inpatient Bottleneck

Since the outbreak of COVID-19 three years ago, the average length of stay (ALOS) in a hospital has increased 19% according to the American Hospital Association.

It has increased 24% specifically for patients waiting to be transferred to a post-acute facility like a nursing home or psychiatric facility.

The increased ALOS for patients waiting to be transferred is due in large part to staffing shortages at post-acute facilities. These patients have been clinically cleared for discharge. They are literally lingering in hospital beds which in turn delays admissions from hospital emergency rooms.

Consequently, patients are being treated in ER hallways due to lack of available beds.

Hospitals are asking Medicare and commercial insurers for relief. Hospitals are not paid by the day or per diem. They are paid by DRGs (diagnostic related groups). Each DRG payment is based on acuity and procedure and an ALOS. The DRGs were established well before the pandemic. The AHA is suggesting a temporary resurrection of per diem payments, especially for those patients cleared for discharge but are waiting to be transferred to another facility.

While most nonprofit hospitals ran an operating deficit every month through October in 2022, the nation’s three largest for-profit systems reported healthy operating profits through the same period. HCA Healthcare was 11%; Tenet was 8%; and Community Health Systems was 1%.

Impact of the Pandemic

The United Health Foundation, affiliate of health insurance giant United Healthcare, just issued its annual report on the changes in our overall health from 2020 to 2021. There is very little good news. There was an 11% increase in people describing their mental health as “poor” and a 15% increase in people reporting they were in “frequent mental distress.” There was a 20% increase in drug-related deaths (28/100,000). There was an 18% increase in premature deaths (before age 75). There was a 13% increase in gun related deaths. The number of people with multiple chronic conditions increased 5%. While there was a 7% decrease in the uninsured, part of this gain may be lost if pandemic related insurance flexibilities and incentives expire in 2023. The “good news”? United’s profit was $17.3 billion in 2021.

CMS Demands Faster Authorizations

Nothing is more aggravating and

frustrating to physicians and their patients alike than having to wait for an insurance company to approve what the physician has ordered to care for their patients. Prior authorization for designated procedures and drug referrals is required by insurers. Purportedly, It is a cost containment tool to deny ineffective or unnecessary drugs and procedures. Approval or denial can often take weeks, which delays care. Typically, 95% are approved anyway, so prior authorization is more of a cost delaying tool. Consequently, CMS has jumped in to speed up and improve the process.

By 2026, Medicare Advantage plans, Medicaid Managed Care plans, and Affordable Care Act commercial plans on the insurance exchanges must implement electronic authorization, eliminating the labor- intensive paperwork seemingly designed to slow things up. There will be incentives for providers to implement this as well. The goal is to improve the patient experience, speed up the delivery of care, decrease patient anxiety and get frustrated providers out of the middle. Insurers must give specific reasons why something was

denied within seven days.

Coalition to Improve Care

The Institute for Healthcare Management and the AMA recently announced the creation of the “Rise to Health Coalition.” Along with the American Hospital Association and Race Forward, advocates for reducing racial inequities if healthcare, the coalition will recruit providers, payers and drug manufacturers to share solutions on improving outcomes and expunging racial inequities in healthcare. The group will focus on access, workforce, cost, quality, safety and social determinants of healthcare (income, race, nationality, transportation, housing, unemployment, food insecurity and education). Each organization must also develop measurable reductions in inequities within their organization. The coalition has laudatory goals. It remains to be seen how much cooperation can be engendered between not-for-profit organizations and for-profit businesses.

Senate Exploring Mental Health Bias

The negative impact of the pandemic on our mental health is undisputed. The Senate Finance Committee is in the early stages of examining the inequities in how insurance plans, both governmental and commercial, treat mental health. The committee is concerned about inaccurate and outdated provider directories, (referred to as “ghost networks”), pay rate disparities between medical/surgical versus mental health providers and disparities between patient cost sharing or out of pocket for mental health services versus all other. The committee has asked the General Accounting Office to investigate payment and consumer out of pocket disparities. Consumers that have selected a plan based upon participating mental health providers are often thwarted by wrong or out of date provider contact information and/or providers not accepting new patients. More mental and behavioral health providers would participate in various insurance plans if reimbursement was fair and reasonable. The committee expects to file a report early 2023.

Patient Portal Billing

Hospitals, physicians and ancillary providers have encouraged their patients to set up an account with their patient portal to communicate, bypassing clogged phone lines. The portals are designed for patients to verify, schedule and cancel appointments, update insurance and demographics, seek information about the practice, or what might be required before a visit.

Unfortunately, patients seeking to avoid an office or telehealth visit are abusing the portal by seeking medical advice for free. Consequently, providers like the Cleveland Clinic have begun charging patients for a provider’s time and expertise, usually about $50. Many hospital systems, physician practices and other professionals are contemplating also charging for medical advice sought via their patient portal. I do not know how insurance is viewing this recent phenomenon.

COVID-19 and Pregnancy

The CDC and the AMA are recommending(and imploring) pregnant mothers to get vaccinated. Since the beginning of the pandemic, pregnancy related deaths are up 80%. Unvaccinated pregnant women and their unborn children are at far greater risk for complications, severe illness or even death. Right now, infants younger than 6 months are being hospitalized for COVID-19 at the same rate as seniors older than 65. Unfortunately, only 45% of pregnant women are vaccinated and only 52% of women who are breast feeding.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

Q & A

with Lorene Bass and Connie Helmer-Jordan

ARC of Herkimer officials talk about the agency’s work on behalf of those with disabilities

By David Podos

Q: Lorene: What are some of the main services that ARC of Herkimer provides?

A: We have a 24-hour care service for our residential programs. These are homes where our clients live. The facilities are spread out within our local Herkimer County communities. We also have a supportive apartment program where clients live. They receive staff support as well, but not as intensive as our 24-hour residential care program.

We also offer day programming and pre-vocational services for our clients through various integrative paid worksites throughout our community. On our career services side if any of our clients are looking for gainful employment — and this can be with our integrative worksites) but also any other worksites in our area which are seeking employees. We can assist our clients in their pursuit of gainful employment. Of course, this is just a sampling of what

DRIVERS WANTED

we offer. More information on other services and programs that we provide can be found on our website.

Q: Specifically, what is the demographic that you serve?

A: Overall it is people with developmental disabilities, and to a lesser degree, we offer mental health services to appropriate clients as well.

Q: Connie, recently your agency received a grant, where did the grant come from. How much did the agency receive and what was the money used for?

A: Well, first off, we are certainly fortunate to have been awarded this grant, which is from the Awards Committee of the Community Health Outreach Project, which is a grant funded program administered by Cerebral Palsy Associates of New York State Inc. The total amount was for $50,117.37.

Q: I am sure there are plenty of areas of need that the agency could apply this money to. Was it used for multiple projects or was there a certain project that needed to be addressed?

A: The idea of the grant was to find a need within our services that wasn’t funded in any other way. So, we used the money towards purchasing additional transfer lift equipment. Unfortunately, most transfer

lift equipment that is required for our people with disabilities, there are no funding sources for it.

Q: Are we talking about lifts that are on transfer vehicles where a person in a wheelchair can be safely lifted into the car, bus, van, etc.?

A: While those lifts are very important, the grant money we received is being spent for lifts and similar safety equipment that are utilized in the houses where the clients live. For example, you have to have some kind of mechanical device to safely transfer a person from their wheelchair to the toilet or from the toilet into a shower chair and back into bed.

Q: I assume that this kind of equipment is expense, correct?

A: It is very expensive; another reason why we are so grateful to have been awarded this grant. Some equipment costs as much as $15,000.

Q: Will there be an opportunity for the agency to re-apply in hope that you can receive another grant to further help you purchase more of this kind of needed equipment for 2023?

A: Yes, we are planning on reapplying if the monies are available.

Q: Let me turn my attention back to you Lorene. How many employees do you currently have?

A: We have about 350 employees.

Q: What is your projected operational budget for 2023?

A: Around 28 million.

Q: What has been the biggest challenge for you and your staff this year?

A: I would have to say getting beyond the COVID-19 crisis. Getting back to providing services to every person who needs it, increasing our staffing levels back to where they were prior to the pandemic. We have an absolutely outstanding and dedicated staff who stepped up and put in the needed hours to make sure our clients had the care they needed and deserved during the pandemic. Of course, that kind of staff dedication has always been there before and after the pandemic.

ARC of Herkimer is located at 350 S. Washington St., Herkimer. It can be reached at- 315-574-7000. More information about the agency and the services they provide can be found at www.archerkimer.org

Connie Helmer-Jordan

By Gwenn Voelckers

Finding Your ‘True North’ in 2023

I’ve discovered that a key to living alone successfully is to determine who you really are and what you want from life.

My own path to contentment took some time, some growing pains — setbacks as well as successes — and some aching losses before I found my “true north.” It hasn’t always been easy, but it’s been well worth the journey.

The reward has been a life on my own filled with more peace, freedom and joy than I could have imagined.

The journey began with a set of soul-searching questions (below) to identify and clarify my beliefs, values, likes and dislikes. I was careful to focus on what matters to me and to steer clear of “shoulds” and other people’s agendas.

The result? I created a list of personal principles and preferences that illuminated a way forward and shaped my future as a self-sufficient, independent woman.

Now, in the happy third chapter of my life, I am comfortable being me and expressing my true self.

In no particular order, below are just a few examples of my insights

(some profound, others practical) that have inspired and guided me:

n Gratitude, forgiveness and loving kindness are life staples to embrace, practice and model on a daily basis.

n Gathering with friends and family around a fire, kitchen counter or dining room table enhances life. It’s warm, relaxing, and relevant — life essentials in my book.

n If I am unhappy with an aspect of my life and choose to stick with the status quo, nothing will get better.

n Hardship, failure and loss can build strength and self-awareness.

Taking time to turn inward can create space for reflection and renewal of the spirit. Remember: After a rain there are rainbows.

n An honest-to-goodness listener (not a pretend listener) melts my heart.

n An honest-to-goodness friend who shares her joys, deepest fears, regrets and dreams melts my heart even more.

n Music makes life better. I enjoy playing and listening to all genres of music, but I always return to the Great American Songbook.

n As an introvert, I find that solitude, nature and meditation recharge my batteries. But that’s me. Others may be energized by morestimulating experiences and venues.

n Letting go of old ways of thinking, a poor self-image or of destructive thoughts, behaviors and habits can free you up to embrace life’s blessings.

n Gardening is a great teacher. Fertile ground exists in each of us, and a little planning, caretaking and patience can produce beautiful results.

n Solo travel is an adventure not to be missed. It’s good for the mind, deepens the soul and fosters confidence.

n Living alone doesn’t mean being alone. We are social beings. We need each other. Relationships are the glue.

Compiling my full list of insights took time and thought. For those coming out of a long relationship or deep loss, determining or rediscovering “who you really are” can be a daunting process.

After years of focusing on the needs and desires of a spouse and family, many discover that, somewhere along the way, they have disappeared around the edges and lost their own sense of self.

Rediscovering yourself and identifying those things that bring joy and meaning in your life can turn living alone into an adventure of the spirit.

Once you establish your individual interests and means of self-expression, you may find that time alone and quieter moments no longer feel empty.

Below is an exercise to help you get back in touch with your true self. These are but a few of some probing questions to contemplate on your road to self-discovery.

SPEND SOME TIME ANSWERING THESE 10 QUESTIONS

1. Search back. What hobbies did you pursue as a child that gave you joy? What did you do particularly well or (perhaps secretly) take pride in?

2. More recently, when do you completely lose yourself in something? What activities make you feel alive and complete, as though

nothing is missing?

3. What do you hold most dear?

4. How do you want to be remembered?

5. What is your biggest regret? If you could have a “do-over,” what would you do differently? Maybe seek help sooner? Or embrace and share a truth about yourself or situation?

6. How would your life change (or get better) if you were a more curious and open person?

7. What brings tears to your eyes?

8. If you were to dedicate your life and resources to a particular cause or charity, what would it be?

9. What does your perfect day look like?

10. How do you want to describe yourself and your life a year from now?

THEN, TAKE ACTION

After answering these questions, ask yourself how you can use these insights to influence the direction of your life. What can you do today to reconnect with a past love or pursuit, to delve more deeply into an existing interest or to fulfill a new healthy lifestyle or passion?

When you identify your values and the things you love or need to do, and pursue them, you will feel more integrated and in touch with your true self. You’ll be spending your time immersed in pursuits that bring you personal satisfaction and strength — pursuits that reinforce who you are and who you want to become.

Those of us who live alone have the gift of abundant time to ourselves. Use it wisely. Use the time to get to know yourself all over again.

With each passing day, I am confident you’ll find your internal compass, unique to you, pointing north — your true north.

Practical tips, advice and hope for those who live alone

Experts

Stay Warm Without Running Up Your Heating Bill

By Barbara Pierce

What will the rest of our winter be like? According to Almanac.com, our winter will be colder than usual, with the coldest temperatures in late-January to mid-February. The snowiest period will be the first half of January.

Other experts say it will be colder than normal, predicting we’ll have a rough winter.

That means it will be a tough season for health. Even an ordinary cold season poses threats to our health. Cold temperatures come with an increased risk of cardiac issues, like heart attack and stroke, as blood pressure tends to stay higher throughout the cold season.

Cold weather can have harsh effects on the respiratory system and worsen respiratory diseases. Breathing in cold air can irritate the airway and trigger symptoms like trouble breathing, coughing and mucus production.

Viruses like the flu and COVID-19 are spread more easily in the winter when we spend more time inside. Some evidence suggests that these viruses remain active longer in the winter.

In the U.S., heating our homes requires four times more energy than cooling them; warm air costs four times more than cool air! The surging costs of natural gas means that many of us will struggle to afford to heat our homes. According the businessinsider.com, we can expect a 30% increase in the cost of natural gas this winter.

Jack Spaeth, economic develop-

ment specialist at HeatSmart Utica offers these tips to stay warm without running up your heating bill.

HeatSmart Utica, a campaign directed by the city of Utica, is designed to encourage home energy efficiency.

• Program your thermostat so you don’t have too big of a fluctuation.

For example, Spaeth said, “In my house, we keep the thermostat at 62 degrees at night, 68 degrees during the day. Some might prefer a higher temperature during the day, like 70 or 72.”

“In general, keep the temperature range within 6 degrees,” he continued. “Don’t go from 62 at night to 72 during the day; that’s too big of a fluctuation. At the lower temperature, everything in the house cools down, including the walls, the furniture, etc. They all cool down and they all have to heat up. If you’re heating everything up by 10 degrees, that puts a too big a burden on your furnace. Keep the range within six degrees.”

• Check for gaps around windows and door.

Gaps let warm air escape and cold air come in. You can have leakage out or in; it’s a two-way street, said Spaeth.

Once you’ve detected the air leaks in your home, use weatherstripping to seal the leaks of the

moveable parts. For stationary parts, caulk is the appropriate material for filling gaps.

• Good insulation is important, stressed Spaeth.

Evaluate your home, from the top down. When your walls are insulated, the heat loss goes up to the ceiling and the roof is often where greatest heat loss happens.

• Make sure to maintain your furnace, Spaeth recommended.

Filters trap dust as air is drawn through the filter and into the furnace; change your filter regularly. The fresher the filter, the more efficiently your furnace runs, resulting in a lower energy bill. The general rule is to change a furnace filter at least every 90 days.

Some furnaces exhaust directly into a chimney. Make sure the chimney and the pipe that leads into it are clean.

If you’re financially able and have the yard for it, install a Geothermal heat pump that uses the relatively constant temperature of the earth as the exchange medium instead of the outside air temperature. It pulls heat from the ground, below the frost line, three to four feet down, explained Spaeth.

The temperature here stays at 5055 degrees, around the world. When your furnace pulls air from outside, if that air is zero degrees, your furnace has to convert it to air that is 68 or 70. If it pulls it from the ground, it only has to convert 50 degrees to 68, using considerably less energy.

These systems are costly, around $25,000. However, the value of your property will go up and you’ll save on heating bills, even cutting them in half, said Spaeth.

• Dress in layers; add mittens and warm socks, maybe a hat.

• Warm your bed with an electric blanket or a hot water bottle.

• Leave the oven open after you use it.

• Sip hot beverages or soup throughout the day.

• Keep active — clean out closets, garages, run up the stairs, etc., anything to keep active. You’ll boost your overall health and stay warm at the same time. Try to move around for five to 10 minutes every hour.

• Spend time upstairs. As heat rises, your second floor tends to retain more heat throughout the day. Setting up a home office or entertainment room upstairs may keep you more comfortable.

Tips on surviving with your thermostat at a lower temperature in your house:

say it will be colder than normal, predicting we’ll have a rough winter.

Jack Spaeth, economic development specialist at HeatSmart Utica.

Why Are You Hearing So Much About RSV?

From a surge in RSV cases to COVID and the flu, the news headlines can feel overwhelming. Excellus BlueCross BlueShield’s physician Lisa Y. Harris has answers to common questions about RSV and staying healthy this winter.

Q: We are hearing a lot in the news about respiratory syncytial virus — or RSV — and how cases are soaring. What is RSV and who should be worried about it?

A.: RSV is a respiratory virus that usually causes mild cold-like symptoms in otherwise healthy children and adults. While this virus is commonly associated with infants or young children, the Centers for Disease Control [CDC] reports anywhere from 60,000 to 120,000 older adults in the United States are hospitalized with RSV each year. For older adults with chronic heart or lung disease

— or those with weakened immune systems — RSV can be fatal if it turns into bronchiolitis (lung inflammation) or pneumonia (lung infection).

Q: What are the symptoms of RSV and how does someone know if they need to see a doctor?

A.: Early symptoms of RSV include a runny nose, loss of appetite, a cough which may include wheezing, and sometimes a fever. RSV can make conditions like asthma, COPD, and congestive heart failure worse. You’ll want to see a doctor immediately if you begin to have problems breathing. Also, if after a couple of days your symptoms are getting worse instead of better, you should see your doctor.

Q: We are also hearing a lot about the flu, and we know COVID is still around. What is the latest on those illnesses?

A.: We are in “flu season” from November until at least February. The flu can be serious especially in older adults, young children, pregnant women, and nursing home residents. The CDC recommends the flu vaccine for everyone 6 months and older. This will help protect you as well as anyone who is particularly vulnerable. And while COVID cases are down, you should stay up to date on vaccines to help prevent a more serious infection if exposed. Talk to your doctor if you have questions about which vaccine is best for you. The good news is getting a flu vaccine or COVID booster is as simple as stopping by your local pharmacy. Visit vaccines.gov to find a vaccination site near you.

Q: What’s your best advice for everyone on staying healthy this winter?

A.: Stay up to date on your vaccinations. Even if you do get sick, being vaccinated can help keep your symptoms mild. Make sure you wash your hands often for 20 seconds with soap and warm water. Frequently use hand sanitizer when out at the grocery store — maybe carry a sanitizer in your purse or car, too. Many people are choosing to continue to wear masks in public or in large gatherings to help protect themselves and others – this is a great idea especially if you have a weaker immune system. Fi-

Physician Lisa Y. Harris is vice president of medical affairs at Excellus BlueCross BlueShield. She is a fellow of the American College of Physicians, fellow of the American Academy of Pediatrics and a certified physician executive through the American Association of Physician Leaders. Board-certified in internal medicine and pediatrics, Harris has been in clinical practice since 1995.

nally, avoid close contact with people who are sick and stay home if you are not feeling well.

Submitted by Excellus BlueCross BlueShield.

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SmartBites

By Anne Palumbo

The skinny on healthy eating

Whether you’ve had a bad day, a painful break-up or a normal day dogged by the chills, we all have comfort foods that we turn to when we need some extra TLC.

They could be dishes that are creamy and warm, or recipes that mom used to make, or simply foods that cheer us up!

But which foods are considered comforting can be vastly different based on where you live, what your sex is, and how old you are.

According to the Harris Poll, an American research company that has been tracking the behaviors of American adults since l963, America’s favorite comfort food is…pizza!

Pizza?

Frankly, I thought pizza was America’s all-time favorite food, no matter the need for comfort; but apparently it’s our go-to comfort food, as well.

When we’re not reaching for pizza, Harris noted, we’re getting our culinary hugs from chocolate, ice cream, mac and cheese, chips and hamburgers.

Another research company, which broke down Americans’ favorite comfort foods by state, begged to differ. Basing their study on comfort recipes with the highest Google search volume, the lighting retailer e-conolight revealed that grilled cheese was the most popular comfort food overall and chosen as the top pick in six states: California, Illinois, Maryland, New Jersey, New York and Virginia. Fried chicken was the second most-searched comfort food, winning out in Delaware, Georgia, Louisiana and Texas, followed closely by chicken and waffles, chili and pot roast.

A few unconventional favorites? Iowa’s monkey bread and Tennessee’s chess pie.

Comfort food cravings differ between the sexes. In a study published in the Physiology & Behavior journal, researchers from the University of Illinois Food and Brand Lab concluded that “a person’s comfort-food preferences are formed at an early age and are triggered, in addition to hunger, by conditioned associations and gender differences.”

The study illuminated that while men find comfort in foods associated with meals prepared by their mothers (mashed potatoes, pasta, meat and soup) women find comfort from less labor-intensive foods (chocolate, ice cream and candy).

Put another way, what is comfort for men is work for women. Me? I scream for ice cream and so did my mom. My husband? Pasta and stew will only do.

Age also affects our comfort-food leanings. Research shows that younger people preferred more snack-related comfort foods compared to those older than 55. And that folks older

than 70 will take steak and potatoes over pizza any day!

In addition, the time of year affects our cravings, with winter months rousing our need for comfort foods most. Some researchers suspect fewer daylight hours may play a significant role. Since sunlight promotes the release of serotonin, a known mood-booster, and we’re getting less of it during the winter months, we’re more inclined to reach for foods that also prompt the release of serotonin: carbohydrates.

Other studies, however, suggest that nothing more than “feeling cooped up” is what’s sending us straight into the arms of serotonin-boosting comfort foods. Our family can certainly relate to that! When cabin fever strikes our house, we consume more popcorn, pasta, chips and bread than at any other time of year.

Of course, there can be consequences to easing the winter blues with food, especially if those foods involve comfort foods that run higher in calories, fats and carbs. On average, say researchers at Johns Hopkins University, we tend to gain five to seven pounds during winter months due to increased calorie intake. Weight gain aside, many comfort foods are not all that healthy to chow down on a regular basis, from salty chips to high-fat ice cream to refined-flour breads and pizza.

COPING WITH

How to cope during the long winter months when the urge to devour the entire casserole is besting your better instincts? Experts weigh in with some helpful tips to keep you on track.

• Let in the light

Early morning light is the most potent energy booster, so open those curtains and take an early morning walk. As mentioned, sunshine increases serotonin levels, which may help calm your food cravings. Also, consider changing your light bulbs to bright, full-spectrum bulbs that mimic bright summer sunlight.

• Keep moving

When it’s chilly outside, the desire to become one with the couch is monumental. But, all agree, staying active during cooler months is key to controlling weight, whether you walk with friends, head to the gym or work out with someone online. A new study, published in the journal Health Psychology, found that physical activity helps to suppress your appetite and boost your mood.

• Fill up first

Oh, those tempting party spreads full of warm, comforting food! Don’t

you just want to eat everything in sight? One way to manage intake is to fill up before you head out. Nutritionists recommend eating high-fiber foods, such as fruits and veggies that take longer to digest, and drinking a big glass of water. Same holds true for other outings and events where temptations abound: grocery shopping, dining out, food festivals, and Sunday football.

• Get plenty of ZZZs

Ever notice how hungry you feel after a poor night’s sleep? Or how strong your cravings are for certain foods like pancakes and donuts? It’s not your imagination. Studies show that even a single night of poor sleep changes your hunger and appetite hormones, leading to increased hunger and an uptick in calories consumed. When people got more sleep, researchers found, they were not only less hungry during the day; they were less likely to reach for sweet and salty foods.

• Give comfort foods a makeover Whether warm and gooey or rich and sweet, many comfort foods are not so comforting when it comes to calories, fats, sodium, and nutrition. But here’s the good news: it’s relatively easy to turn these diet-busters into healthier dishes without sacrificing taste. A few swaps to consider: substitute evaporated skim milk for cream, lower-fat ground turkey for ground beef, baked chicken for fried chicken, whole-wheat pasta (or veggies) for refined-wheat pasta, and low-fat plain yogurt for mayonnaise.

Adapted from skinnytaste.com 6 servings (250 calories each)

1 large head cauliflower, cut into 1-inch florets

1 tablespoon butter

2 teaspoons olive oil

½ cup diced onion

3 tablespoons whole-wheat flour

¼ cup water

2 cups 1% or 2% milk

1½ teaspoons Dijon mustard

1-2 teaspoons hot sauce (optional)

2 cups shredded reduced-fat cheese of choice, divided

1 teaspoon salt

½ teaspoon coarse black pepper ¼ teaspoon garlic powder (or more)

½ cup whole-wheat panko breadcrumbs

Preheat oven to 375 F. Lightly oil a 9 x 13” baking dish.

Fill a large pot with enough water to cover the bottom about 1 inch; season with salt; bring to a boil. Add the cauliflower, reduce to a simmer, and cover; cook until tender crisp, 6 to 7 minutes. Drain, pat between paper towels to dry, and transfer to the baking dish.

Heat butter and oil in a medium saucepan over medium-low heat. Add onions and cook about 3 minutes. Stir in flour and water, then reduce heat to low and cook, stirring continually, for 1 minute more.

Raise the heat to medium, then gradually whisk in the milk, mustard and hot sauce until combined and smooth. Lower heat and continue cooking, stirring throughout, until it becomes thick, about 5-6 minutes more. Remove from heat and stir in 1½ cups of the shredded cheese (¼ cup at a time), along with the salt, pepper, and garlic powder. Mix well, then pour over the cauliflower and gently stir to combine.

Top with breadcrumbs and remaining ½ cup cheese; bake until bubbly and golden, about 15 to 20 minutes. Switch to broil for 2-3 minutes to brown the top.

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

Baked Cauliflower “Mac” And Cheese

Can I Prevent Heart Disease?’

Doctors give men and women different advice to head off heart disease, even though guidelines for both are the same.

Men were 20% more likely to be prescribed statins to lower blood levels of bad cholesterol compared with women, a new study found.

Women, meanwhile, were 27% more likely to be advised to lose weight or reduce their salt intake, and 38% more likely to receive recommendations to exercise.

Women were also 11% more likely to be advised to cut fat and calories.

The study findings were presented in December at a meeting in Singapore organized by the European Society of Cardiology (ESC), the Asian Pacific Society of Cardiology and the Asean Federation of Cardiology.

“Following our analysis, we conducted a review of the literature to find possible explanations for the

Fish Oil, Minerals, Vitamin D, Magnesium, Selenium

— What Works?

Manufacturers make all kinds of health claims, but can taking a dietary supplement actually lower your heart disease risk?

A comprehensive analysis of prior research suggests that in certain cases the answer is yes. Some types of supplements — such as omega-3 fatty acids, folic acid and coenzyme Q10 (CoQ10) do provide a cardiovascular leg up.

But many supplements were found to offer no heart health benefit of any kind, and others were potentially harmful.

“We evaluated 27 different types of supplements, and found that there are several that offered cardiovascular benefits,” said study author physician Simin Liu, director of the Center for Global Cardiometabolic Health at Brown University in Providence, Rhode Island.

These included omega-3 fatty acids, which reduced the risk of early death due to heart disease.

Other supplements that were shown to benefit the heart included folic acid, L-arginine, L-citrul-

line, Vitamin D, magnesium, zinc, alpha-lipoic acid, melatonin, catechin, curcumin, flavanol, genistein and quercetin.

But some common supplements had no long-term effect on heart disease outcomes or risk for Type 2 diabetes, Liu noted. They included vitamins C, D, E and selenium.

Beta carotene supplements, meanwhile, were associated with an increase in early death from all causes.

The findings are an outgrowth of a research review prompted by what Liu and his colleagues described as lingering confusion in the heart health community as to just how effective supplements can be at preventing heart disease.

The fact that foods rich in micronutrients can protect the heart has not been in question, said Liu, who noted that several large studies have linked a healthy diet to heart health benefits.

For example, micronutrients like antioxidants — which are present in the heart-healthy foods featured in

results. This demonstrated that a potential root of the discrepancy in advice is the misconception that women have a lower risk of cardiovascular disease than men,” said study author, physician Prima Wulandari of Harvard Medical School and Massachusetts General Hospital in Boston.

“Our findings highlight the need for greater awareness among health professionals to ensure that both women and men receive the most up-to-date information on how to

maintain heart health,” Wulandari said in an ESC news release.

Previous research had shown that women with heart disease received less aggressive treatment compared with men.

For this study, researchers used data from a U.S. federal health and nutrition survey conducted from 2017 to 2020.

It included more than 8,500 men and women between 40 and 79 years of age with no history of heart disease. More than 2,900 were eligible to receive statin drugs because they had an increased risk for heart disease.

ESC guidelines recommend adults of all ages do at least 150 to 300 minutes of moderate intensity or 75 to 150 minutes of vigorous intensity, aerobic physical activity each week.

Diet recommendations emphasize plant-based foods such as whole grains, fruits, vegetables, legumes and nuts, and limiting salt intake to less than 5 grams per day.

People who are overweight or obese should lose weight to lower blood pressure, lipids and the risk of diabetes, reducing their risk of heart disease, the guidelines say.

Statins are recommended based on individual characteristics, including age and heart disease risk, according to the ESC.

Findings presented at medical meetings are considered preliminary until published in a peer-reviewed journal.

the Mediterranean diet and DASH (Dietary Approach to Stop Hypertension) — have long been linked to a reduction in oxidative stress. Because cell tissue damage brought on by such stress poses a threat to heart health, antioxidant-rich diets are thought to be protective, reducing the risk for a number of serious diseases, including diabetes.

What’s been less clear, however, is whether consuming vitamins, minerals, phytochemicals and antioxidants in the form of supplements might offer a similar advantage.

For the new study, Liu’s team poured through 884 prior studies

of supplements, some published as recently as this year. Collectively, the studies involved nearly 900,000 men and women.

In the end, the team concluded that some of the 27 micronutrient supplements under review did demonstrate some benefit.

Those included a number of omega-3 fatty acid supplements – including n-3 and n-6 fatty acids— which were found to help to reduce the risk for heart attacks and coronary heart disease, as well as the overall risk for dying as a result of heart disease.

Research shows some supplements have no effect on heart’s health and can even be harmful

‘How

Docs give different answers to men, women

Heart Disease is Often Subtle in Women

Know the signs, what to do and how to prevent It

By Kimberly Blaker

Heart disease is the leading cause of death among women in the United States. According to the Centers for Disease Control and Prevention (CDC), it accounts for 20% of female deaths.

Coronary artery disease, also commonly known as coronary heart disease or atherosclerosis, is the most common type of heart disease. More than 6% of women over the age of 19 are afflicted by it, which can lead to a heart attack or heart failure.

Heart conditions for which women are at higher risk than men include cardiac syndrome X, angina (chest pain), and broken heart syndrome (stress-induced cardiomyopa-

thy). Women can also be affected by several other heart conditions. These include heart failure, heart valve disease, arrhythmia (irregular heartbeat), and atrial fibrillation (Afib).

Prevention

cholesterol

• reduce your blood pressure if it is high

• keep diabetes under control

• maintain a healthy body weight

• eat heart-healthy foods

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Heart attack signs

Women can experience all the same symptoms as men. Often, however, women experience heart attacks differently. Most notably, women don’t always experience crushing chest pain. Instead, they may feel tightness or pressure in their chest. As a result, symptoms can go unnoticed or are easily brushed off. If the pain or discomfort goes away and then comes back or lasts for more than a few minutes, it could be a symptom.

Other symptoms include:

• shortness of breath

• pain, discomfort, weakness, or heaviness in either arm

• discomfort in the neck, jaw, upper back, shoulders, or stomach

• indigestion, nausea, or vomiting

• cold sweats

• fatigue

• sleep disturbance

• dizziness or lightheadedness

What to do if you’re having a heart attack

Call 911 immediately and have them dispatch emergency medical services (EMS). This is usually faster than having someone drive you to the hospital.

Also, if you’re in a public place, such as work or a store, a defibrillator may be available. Ask whoever you see first to check. Defibrillators come with easy instructions and could save your life.

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Several risk factors for heart disease cannot be modified. Family history, race, gender, menopause, and age all play a role in heart disease. Still, many risk factors can be changed, according to Cleveland Clinic. To reduce your risk for disease:

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• lower your total cholesterol, LDL, and triglycerides

• increase your HDL (good)

Also, a drink a day may offer some benefit to your heart by increasing your HDL cholesterol. But medical experts caution against more than one drink per day. Studies have found high alcohol consumption can damage the heart. Although some studies suggest alcohol may be beneficial in moderation, others have shown the opposite. Cleveland Clinic recommends if you don’t already

Finally, take an aspirin, says physician Anthony Komaroff, editor-in-chief of “Harvard Health Letter.” He recommends a standard dose of 325 mg that isn’t coated. “Chew it, and then swallow it with a glass of water,” says Komaroff, to quickly get it into your system. This can slow blood clotting and limit damage to your heart.

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Face Yoga: Look 3 Years Younger

By Deborah Jeanne Sergeant

If you want to look up to three years younger, facial yoga may be the answer.

Purported to tone the facial muscles and provide facial rejuvenation, facial yoga involves following a regimen of facial movements and poses to provide results.

Gary Sikorski, founder of the Happy Face Yoga method (happyface.com) in Cleveland, Ohio, has been training adherents in the practice since 2006.

“The Effects of Facial Exercise on the Appearance of Aging,” a small study by Northwestern University Medicine published in JAMA Dermatology in 2018, demonstrated that a 30-minute daily then alternate-day

Images show a woman after going through a face yoga treatment and before. Provided Gary Sikorski, founder of the Happy Face Yoga.

bring a more youthful appearance as it lifts the cheeks and strengthens the jawline. Also, it can improve blood circulation to improve the complexion. As those muscles are lifted and toned instead of sagging, it tightens the skin which helps soften those fine lines. It’s all these things that add to aging.”

He eschews gadgets advertised online as he believes these are inef

His program uses the fingers, hands and, for resistance, the teeth.

One of the criticisms of face yoga is that repeatedly making the same facial expressions will cause wrinkles. However, Sikorski said that in 16 years, no one has complained about wrinkles forming from following his program.

He said that how quickly adherents see results depends upon the condition of their face initially and their age. Factors such as smoking, drinking alcohol, lack of sun protection and poor diet can affect the skin also. Those following the program should perform the exercises daily for six-10 weeks.

“The more exercises you do, the faster and better the results,” Sikorski said. “Once you achieve the maximum success, then maybe one or two times for 20 minutes per week.”

He likened the effects to people who work out at a gym. Stopping the workouts will mean lower muscle tone.

“As we age, facial muscles weaken and begin to sag,” Sikorski said. “Weakened muscles will cause many aging problems in the face.

Rochester, offers among her services spa facials, microdermabrasion, chemical peels, oxygen infusion therapy, LED red light therapy and high frequency treatments. In addition to these, she believes that jade rollers and stone can help improve the skin’s appearance.

“They can reduce puffiness used every day by relaxing the inflamed area,” Hall said.

Although she stated that calling it face “yoga” is inaccurate, since yoga involves breathing exercises and a meditative, spiritual element, she can see how “it could be beneficial, as they’re moving lymph” and tone facial muscles. But does not think many people will stick with a face yoga regimen and remains skeptical that face yoga could reverse lines on the skin from facial expressions.

Most skin damage comes from sun damage, smoking, pollution, consuming too much sugar and alcohol and skimping on water.

“The sun is the number one free radical, which damages skin,” Hall said. “Avoiding the sun will benefit you. From day one, protecting with

Living With Scleroderma

By Jessica Arsenault Rivenburg

On a cold November day in 2005, while doing some outdoor construction work, John Salamone realized his hands and fingers got much colder than usual.

In fact, they began to go numb and look blue.

He took a break and went inside to warm them up and put on thicker gloves.

He later researched the incident and discovered it to be a symptom of Raynaud’s Phenomenon, a condition in which blood vessels in the fingers overreact to cold or stress, causing them to constrict and cut off normal blood flow to the digits. But Raynaud’s was only the beginning.

At the time an active 53-year-old, Salamone began feeling more and more fatigued after less exertion. So he went to his primary care physician. His doctor ordered a complete bloodwork panel, the results of which showed an elevated white blood cell count.

Next came a rheumatologist and a diagnosis: scleroderma.

“I had never heard of it before,” Salamone recalled. “So I said, ‘Ok, how do we cure it?’”

The rheumatologist informed Salamone there is no cure.

“Then my heart started pounding,” Salamone said. “I’d just been told I have a rare disease and there is no cure.”

Scleroderma, or systemic sclerosis, is an autoimmune disease with symptoms that vary greatly and can range from minor to life-threatening. From the Greek “sclero,” meaning

hard, and “derma,” meaning skin, the primary effect of the disease is a thickening and hardening of the skin. A build-up of scar tissue can also cause damage to the stomach, lungs, kidneys, heart and blood vessels.

According to The National Scleroderma Foundation, approximately 300,000 people in the United States are living with some degree of scleroderma.

Following his diagnosis in 2005, Salamone, a Herkimer resident, visited a specialist in Syracuse.

“He told me all about the disease and how my life and body would change in the future,” said Salamone.

As it would for most people, the thought of losing physical abilities proved a difficult one for Salamone, who, following is 1971 graduation from Frankfort-Schuyler High School, had developed a passion for entertaining. After being introduced to the art of miming during his senior year of high school, Salamone trained under renowned mime Tony Montanaro. He went on to perform in international art contests, tour with a circus and visit schools to share the art of miming.

Salamone also spent a number of years working in the cable television industry, traveling the country and installing cable wires in Boston, Baltimore, Wilmington and beyond.

He returned to the Mohawk Valley in 2003 and got involved in the local music scene, making the rounds with such well-known local names as Steve Rigo, Salamone Seymour and Joe Rossi.

For a few years following his diagnosis, things for Salamone were quiet and his life continued relatively unchanged. Then, in 2009, the disease began affecting his lungs and eventually moved into his vascular system and heart. Salamone’s life had to slow down dramatically.

In February 2021, Salamone suffered multiple mini heart attacks, forcing doctors to perform emergency open-heart surgery.

“The doctors couldn’t close my chest back up again because scleroderma tightens the tissue,” Salamone explained. “They had to put in a metal plate to fill the gap.”

For a time following surgery, Salamone was unable to swallow and relied on a tube for sustenance. Thankfully, he said, that complication cleared up after a few months and he is able to swallow again.

Now 70, Salamone has been living with the disease for 17 years. While it has vastly changed his life and what he is able to do, he has not let it change who he is or his sense of humor.

“I face it head on,” Salamone said. “Any of these new manifestations of the disease in my body, I adapt.”

He can no longer walk like he used to, nor use his fingers as he used to. That has meant a serious reduction in his abilities as an entertainer. Salamone can no longer play an instrument or perform his old miming skits. But he hasn’t let that get him down.

“I’m a fighter with a warrior mindset,” he said. “I live by the saying, ‘Lay down and die or stand up and fight.’ I’m not ready to lay down, so I’m fighting.”

That’s not to say Salamone never feels discouraged. Taking the advice of his doctor and the National Scleroderma Foundation, however, Salamone built himself a strong support network, which has helped him greatly.

“I recommend that to anyone going through health issues,” he said. “I have a small circle of support that I can call on any time.”

What he wants now is to spread awareness about Scleroderma.

“A lot of people really don’t know about scleroderma,” he pointed out. “Maybe they’ve heard the name but they don’t really know what it is. We’re working to get it out there so people will know and understand a little bit about it,” he said referring to himself and Boehringer Ingelheim Lungs & You mentor program, who sponsors his outreach work.

Salamone went on to say that he wants those facing a diagnosis of scleroderma to know that while it can seem daunting at first, they shouldn’t let the disease scare them. While it will mean changes in one’s way of life, it doesn’t necessarily mean an end to the things they enjoy.

“I am still known for the impromptu miming,” he continued. “That’s always with me. It’s fun and it brings laughter. And laughter is the best medicine.”

Herkimer resident has been living with scleroderma, an autoimmune disease, for 17 years. He explains how the condition changed his life

The Balanced Body

By Deborah Dittner

Healthy Habits for 2023

By Deborah Dittner

Let’s begin the new year with some health habits that you can implement easily into your daily routine.

I don’t mean New Year resolutions but strategies that can be for everyday life.

And, since many of you experience stress whether it be stress from your job, from family life, financial, school, or plain old everyday stress, these helpful lifestyle changes can benefit everyone.

Stress affects us all in different ways. It can affect sleep (or lack of sleep). It can affect relationships. And, it definitely can affect your digestive system as the gut and brain are connected.

If you are experiencing symptoms such as diarrhea, constipation, gas, bloating, heartburn, nausea, vomiting and more, you need to explore the reasons behind your discomfort. Often you may find stress being the leading factor.

As we explore these symptoms, let’s look at what you are eating — when you are eating, how fast you are eating, are you eating in the car, are you eating alone or with others, are you sitting at a table or eating in front of the computer or the television? You may want to jot down a food and lifestyle journal as this can be beneficial in seeing the causes of some of those issues.

All of these possibilities can either interfere with or aid with proper digestion. Where do your eating habits fall?

Digestion actually begins in the brain telling the gut that it’s ready to digest food. When at rest, digestion occurs easily. When you are stressed, the body is in “fight or flight” mode making digestion difficult causing all sorts of symptoms as listed above. You can make and create the choice as to how this meal will go.

Location

Create a dining area where you can comfortably sit to enjoy your meal. Soft music can be playing in the background. Relax your body by taking in a few deep breaths which in turn aids in digestion. You want the area free of distractions where you can focus on the nutritious food prepared.

Habits

Concentrate on your meal. Aim for your sit-down meal to last a minimum of 20 minutes which allows for the gut and brain to communicate and for you to enjoy your food. Chewing your food starts the digestive juices flowing so try to aim for 30 chews (or more) per bite. Put your fork or spoon down between bites to slow things down allowing the body to communicate. There’s no need to rush. Only eat when you are 80% satisfied as this allows the brain and gut time to catch up with each other avoiding overeating and feeling overly full. If you are truly still hungry, then you can consider seconds. Drink

a minimal amount of liquids as needed to allow the stomach acid, digestive enzymes and bile to do their job in proper digestion.

Time between meals

Allow three to four hours between meals. Your gut needs time to fully digest and utilize the nutrients from the meal previously eaten. Some of you may have incorporated intermittent fasting so consider your last meal of the day no later than 7-8 p.m. and break the fast 12 hours later. The timing can be adjusted according to your schedule, but you would want a minimum of 12 hours between meals.

Many of you have struggled with digestive issues. Looking at what you eat (consider eating whole nutrient dense foods aiming for lots of vegeta bles, some fruit, whole grains), plenty

of water (many are often dehydrated), when, where and how you eat your meals and decreasing stress around mealtime, will help those sneaky digestive issues disappear. Be patient with your healthy, stress-free way lifestyle changes of eating as time is needed to heal all wounds.

For more information, check out her website at www.debdittner. com or contact her at 518-596-8565.

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.

By Barbara Pierce

I’m Packing: Box by Box

“We are the champions, my friends. We’ll keep on fighting to the end; we are the champions of the world…”

I sing along with Queen’s classic hit as I carefully wedge another book into the cardboard box.

I’m moving. And I’m determined not to get stressed out and overwhelmed. Though I do get that feeling of anxiety in the pit of my stomach when I think of this huge task I’m doing and doing completely by myself. I’ve vowed to keep that feeling from overwhelming me.

I’m keeping my anxiety under control by breaking the job down into small parts. Into box by box.

Right now, I’m emptying my bookcase into a couple of boxes. Then I’ll do something enjoyable like reading a chapter in the latest Elizabeth George’s murder mystery. Or go for a walk, to get re-energized by being outside. Later, I’ll pack another box or two.

Now I focus on filling two boxes with books. I don’t think about all the other boxes I will need to pack up. Right now, my goal is only to box up my books.

This isn’t as unpleasant as I imagined. In fact, it’s a good feeling to watch the big black garbage bag growing full with stuff I’ll take to the Salvation Army. And the other bag, full of trash. You know how it’s supposed to go: you weed out as much as you can, to throw away or give to

an organization that will recycle it.

As long as I zero in on the current box, instead of thinking about the dozens of boxes I have yet to fill, I feel OK about this. Whenever my mind starts to drift and I start to feel overwhelmed, I say to myself: “Just this box. All I’m doing is just packing this one box. It’s not a big deal.”

I’m saying this to myself because there is a big difference between packing one box and packing up a whole apartment. Packing one box is a small, easily accomplished task. Packing a whole apartment is overwhelming.

Of course, the difference is only in my mind. But what’s in my mind does matter. It matters a great deal, because it sets the stage for how I feel. If I look at the whole picture of all I have to accomplish, I’d be completely overwhelmed from the start, thinking I’m doing a huge, exhausting job. If I tell myself I’ve only got only these one or two boxes to fill with books, that feels manageable.

“One can change things by the manner in which one looks at them.” I’m a firm believer in this quote from author Tom Robbins. We do create real emotional pain for ourselves with our thoughts.

Experts advise us to break a big job down to 15-minute increments. They advise us to focus on small steps; accomplish small, manageable steps at a time. When you look at

The Social Security Office

New Start Dates for Medicare Part B Coverage Coming In 2023

What is not changing:

If you are eligible at age 65, your initial enrollment period (IEP):

• Begins three months before your 65th birthday.

• Includes the month of your 65th birthday.

• Ends three months after your 65th birthday.

If you are automatically enrolled in Medicare Part B or if you sign up during the first three months of your IEP, your coverage will start the month you’re first eligible. If you sign up the month you turn 65, your coverage will start the first day of the following month. This won’t change with the new rule.

What is changing:

Starting Jan. 1, 2023, your Medicare Part B coverage starts the first

day of the month after you sign up if you sign up during the last three months of your IEP.

Before this change, if you signed up during the last three months of your IEP, your Medicare Part B coverage started two to three months after you enrolled.

If you don’t sign up for Medicare Part B during your IEP, you have another chance each year during the general enrollment period (GEP). The GEP lasts from Jan. 1 through March 31. Starting Jan. 1, 2023, your coverage starts the first day of the month after you sign up.

You can learn more about these updates on our Medicare webpage at www.ssa.gov/medicare and our Medicare publication at www.ssa. gov/pubs/EN-05-10043.pdf.

Please pass this information along to someone who may need it.

small, individual steps, the larger task doesn’t seem as intimidating.

Another fact of life is that work expands to fit the time allotted to it. For example, if you give yourself an hour to get a certain task done, it will usually take you an hour to do it.

When you work in small increments of time, you will work more effectively as you race against a deadline. You can stay focused for 15 minutes.

You can accomplish more than you imagine during a 15-minute time span. We tend to under estimate how much we can get done in a short burst of time. I’ve found it does take me about that long to pack up one box.

If 15 minutes feels like too much for the task you are doing, shorten the time period for whatever works best for you and this task.

Experts also suggest delegating any aspects of the task that you can delegate. That will also free your time to focus on what you do best. Going through my stuff with the goal of discarding as much of it as possible is something I have to do myself. However, I do intend to delegate the task of carrying boxes into the truck and into my new apartment to my grandkids.

Now I’m singing along: “Lay, lady, lay. Lay across my big brass bed.” I love Bob Dylan — the words

Q.: When a person who has worked and paid Social Security taxes dies, are benefits payable on that person’s record?

A.: Social Security survivors benefits can be paid to:

• A widow or widower—unreduced benefits at full retirement age, or reduced benefits as early as age 60.

• A disabled widow or widower—as early as age 50.

• A widow or widower at any age if he or she takes care of the deceased’s child who is under age 16 or disabled, and receiving Social Security benefits.

• Unmarried children under 18 or up to age 19 if they are attending high school full time. Under certain circumstances, benefits can be paid to stepchildren, grandchildren, or adopted children.

• Children at any age who were disabled before age 22 and remain disabled.

• Dependent parents age 62 or older.

Even if you are divorced, you still may qualify for survivors benefits. For more information, go to www.ssa.gov.

Q.: I plan to retire soon. When are Social Security benefits paid?

A.: Social Security benefits are paid each month. Generally, new retirees receive their benefits on either the second, third or fourth Wednesday of each month, depending on the day in the month the retiree was born. If you receive benefits as a spouse, your benefit payment date will be determined by your spouse’s birth date.

Here’s a chart showing how your

and music energize me as I sort through stuff in my desk.

I’ll continue this process, sorting through all the stuff I’ve collected, loading it into boxes and bags, one box at a time, until I get to the end. I’m not having a bad time at all. The expected overwhelming exhaustion, which could so easily have been a part of this process, should never arrive.

monthly payment date is determined:

Day of the Month You Were Born Social Security Benefits Paid On

1st-10th Second Wednesday 11th-20th Third Wednesday 21st-31st Fourth Wednesday

For a calendar showing actual payment dates, see the Schedule of Social Security Benefit Payments at www.ssa.gov/pubs.

Q.: Will my Social Security disability benefit increase if my condition gets worse or I develop additional health problems?

A.: No. We do not base your Social Security benefit amount on the severity of your disability. The amount you are paid is based on your average lifetime earnings before your disability began. If you go back to work after getting disability benefits, you may be able to get a higher benefit based on those earnings. In addition, we have incentives that allow you to work temporarily without losing your disability benefits. For more information about disability benefits, read our publications “Disability Benefits and Working While Disabled — How We Can Help.” Both are available online at www.ssa. gov/pubs.

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.

From the Social Security District Office

By

How to Reduce Your Medical Bills

Dear Savvy Senior,

What tips do you recommend to Medicare beneficiaries dealing with hefty medical bills? My husband recently had open heart surgery and is recovering slowly, but the medical bills are coming in fast and furious and they’re putting us in medical debt.

— Struggling in Springfield

Dear Struggling,

I’m sorry to hear about your billing struggles, but medical debt has unfortunately become a chronic problem in this country. According to U.S. Census data 19% of Americans households carry medical debt, including 10% of households headed by someone 65 or older. Even seniors on Medicare can easily get snagged in a web of complicated billing and coverage problems.

To help you slash your medical bills, here are some tips recommended by health care experts that you should try.

• Double check your bills: Almost half of all medical bills contain at least one error, including duplicate charges or charges for services you never received. If you’re facing a high bill and are on the hook for some portion of it, request itemized invoices from the hospital and other providers that detail everything you were charged for and go through them line by line. If you find something you don’t understand or find fishy contact the provider for an explanation or a correction.

• Wait for your EOB: Doctors’ offices and hospitals may mail initial bills to you before they even submit them to your health insurer. So, hold off on any payment until you receive an explanation of benefits (EOB) from your provider — Medicare, supplemental Medicare, Medicare Advantage or private insurer. This will show what you owe after your insurance has paid its portion.

If your EOB shows that your insurer is refusing to pay for services that you think should be covered, call them to see whether it’s a correctable mistake, such as a coding error for a certain test or treatment. If it’s truly a denial of coverage, you may need to file an appeal. For details on how to file a Medicare appeal, see Medicare. gov/claims-appeals/how-do-i-filean-appeal.

• Ask for a discount: Call the hospital’s accounting office or the billing staff at your doctor’s practice and ask if they can reduce your bill. You’d be surprised how often this works. Or if

you have the funds to pay the entire bill, ask the hospital or provider for a “prompt pay” discount which may save you 15% or more.

If it’s best for you to pay your bills over time, ask the billing office to set up a no-interest payment plan for you. It’s in the provider’s interest to work with you to obtain payment.

You can also call the hospital where your husband had his surgery and ask a billing specialist if the facility offers financial assistance. According to the American Hospital Association, about half of U.S. hospitals are nonprofit. This means they are required to offer free or discounted services in some instances. This is usually reserved for low to moderate income patients who have limited or no health insurance, but requirements vary from hospital to hospital.

• Get help: If you’ve gotten nowhere on your own, contact the Patient Advocate Foundation (patientadvocate.org, 800-532-5274) who can help you understand and negotiate your medical bills, free of charge. Or consider hiring a medical billing professional to negotiate for you but be aware that these services can cost upward of $100 an hour. You can find potential candidates through the Alliance of Professional Health Advocates (advoconnection.com). Be sure to choose someone who is credentialed by the Patient Advocate Certification Board.

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.

Jim Miller

Excellus appoints new chief administrative officer

Lisa White has been appointed

as chief administrative officer and executive vice president at Excellus BlueCross BlueShield. White, in her new role, has also joined the company’s executive leadership team.

White started her career at the health plan 31 years ago as a customer care representative. She’s since held a variety of positions throughout the company. White, for example, helped start the company’s first compliance department, focusing on government regulations, mandates and more.

She now oversees about a dozen departments whose primary responsibilities support the enterprise, including legal, audit, facilities, governance, strategy, corporate development, corporate communications, business resilience, risk management and ethics, privacy and compliance.

“Lisa brings years of experience and expertise overseeing complex administrative support functions, and we’re proud to have her join our executive leadership team,” said Jim Reed, President and CEO, Excellus BCBS.

“We’ve been lucky over the years to have Lisa at the helm, especially during COVID-19,” Reed added. “Lisa played a pivotal role in our organization’s response to the pandemic, helping us focus on supporting our members through challenging times.”

A graduate of Syracuse University, White earned her master’s degree from the New England College of Business and Finance. She serves on the board of trustees for the MakeA-Wish Foundation of Central New York.

White and her husband reside in Syracuse. They have three children.

MVHS recognized for weight loss surgery

Physician William Graber, director of metabolic and bariatric surgery and a weight loss surgeon at Mohawk Valley Health System (MVHS), announced that the MVHS bariatric surgical program achieved national accreditation as a comprehensive center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a joint program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).

The MBSAQIP program standards, outlined in the 2019 Optimal Resources for Metabolic and Bariatric

Surgery, ensure that bariatric surgical patients receive a multidisciplinary program, not just a surgical procedure, which improves patient’s outcomes and long-term success. The accredited center offers pre-operative and post-operative care designed specifically for its severely obese patients.

“This accreditation formally acknowledges MVHS’s continued commitment to providing quality care and supporting patient safety efforts for metabolic and bariatric surgery patients,” said Graber. “Our accredited program works hard to address the needs of those affected by the disease of obesity — through multidisciplinary, high-quality, patient-centered care. It is our honor and privilege to continue to provide safe and effective treatments in this community, in a program whose excellent patient outcomes are nationally recognized.”

MVHS’s commitment to quality care begins with appropriately trained staff and leadership of surgeons who participate in meetings throughout the year to review the program’s outcomes. They seek continuous improvement to enhance the structure, process and results of the center.

To earn the MBSAQIP designation, the MVHS Bariatric Surgery Program met essential criteria for staffing, training and facility infrastructure and protocols for care, ensuring its ability to support patients with severe obesity. The center also participates in a national data registry that yields semi-annual reports on the quality of its processes and outcomes, identifying opportunities for continuous quality improvement.

Rome Health’s new medical center opens

Rome Health opened its new $11.4 million medical center in Novemberon the hospital’s main campus.

Primary care physicians Michael Attilio and Lwin Win are the main providers seeing patients in the new center.

Over the next three months, providers from Rome Medical Group (adult and pediatrics) and the bariatric and general surgeons from Rome Health Surgical specialists will move into the new 31,000-square-foot, two-story nedical center.

For convenient access, patients should use the parking lot off of Oak Street and enter the medical center through the “Bartlett Entrance.” A guided tour of the new facility is available online at romehealth.org/ Rome_Health_Primary_Care/.

The new medical center brings together primary care, surgical specialists, diagnostic testing and retail pharmacy under one roof for convenient, accessible, coordinated patient care.

The medical center design supports providers and their care teams in delivering patient-centered care that is efficient and convenient. There

are six care team pods with a total of 42 exam rooms. The innovative pod design includes six exam rooms with adjacent space for the care team and the providers to collaborate.

The proximity of adjacent services at the hospital, including medical imaging, cardiopulmonary services and cardiology further enhances accessibility for patients who may need multiple services.

Excellus supports local food banks

Excellus BlueCross BlueShield has donated a total of $4,500 to nine food banks located in the organization’s Utica region service area. Excellus BlueCross BlueShield’s Utica region encompasses Clinton, Delaware, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Otsego and St. Lawrence counties.

“There continues to be a great need for programs that combat food insecurity,” said Eve Van de Wal, Excellus BlueCross BlueShield Utica Regional President. “We are pleased to provide funding to these organizations who work tirelessly to improve the lives of individuals in the communities we serve.”

Each of the following organizations will receive a donation of $500:

• Herkimer County Office for the Aging – Herkimer

• Lowville Food Pantry –Lowville

• Johnson Park Center – Utica

• Karing Kitchen – Oneida

• Hope House – Utica

• Feed Our Vets – New York Mills

• Utica Rescue Mission – Utica

• Lewis County Opportunities –Lowville

• Cooperstown Food Pantry –Cooperstown

“Social determinants of health, such as food insecurity, negatively affect quality of life and health outcomes,” explained Van de Wal. “Excellus BlueCross BlueShield is proud to partner with community-based organization who address these important issues in order to help reduce health disparities within the communities we serve.”

Excellus BlueCross BlueShield is committed to supporting local organizations that improve community health. The company’s corporate giving follows all applicable laws and regulations and does not support funding organizations that conflict with its corporate mission, goals, policies or products.

Department of Veterans Affairs recently announced the appoint- ment of Frank Pearson as the new director of the VA San Diego VA Medical Center. Pearson has served as the Syracuse VA Director since June of 2020.

“It has been my great honor and privilege to be part of the Syracuse VA family and I am grateful to have worked with so many professional and dedicated staff. Syracuse is a unique place and I am very thankful for the many opportunities I have had here” said Pearson.

Under Pearson’s leadership the Syracuse VA has been consistently recognized as one of the highest performing Medical Centers in the VA system in the areas of high quality medical outcomes and patient satisfaction.

Pearson earned both his Doctorate and Master of Physical Therapy degrees from Baylor University and a Master of Physician Assistant Studies degree from A.T. Still University’s Arizona School of Health Sciences.

Michael DelDuca, Syracuse VA associate medical center director, will serve as interim director during the search for Pearson’s successor.

Lisa White

Syracuse VA director selected as new director of the San Diego VA

The

Step Out of Boring Routines and Reignite Your Life

By Barbara Pierce

If they made a movie about your life, what it be called? “The Dull and Dreary Life of (insert your name)” or “The Awesome Adventures of (insert your name)?”

It’s a New Year. Maybe you’re thinking “I’m in a rut. How can I spice things up a notch or two, get rid of boring?”

Here’s the thing: drastic changes aren’t even necessary to reignite your life. The sparks are there; you just need to learn how to see them more closely, see them through a different lens.

“The real voyage of discovery consists, not in seeking new landscapes, but in seeing with new eyes,” said French novelist Marcel Proust years ago.

According to research, finding new, quirky ways to interact with a familiar person, place or thing can make every day experiences give you that feeling of excitement.

Spending too much time in the same environment can cause a boredom buildup. So, if you’re bored at work, do your work somewhere different and new to you. If you work from home, mix things up by working somewhere else — a coffee shop or the library. If you work in an office, change the layout of your desk or work area.

Rearrange the furniture in your office or in your home. Check out thrift and consignment stores to pur-

chase unusual accessories so it will feel like new all over again! Change the arrangement of your furniture until you find a new position that works for you.

Adding spice to your life doesn’t entail any extreme changes — just some subtle or not-so-subtle changes to your everyday routine can add excitement.

Change how you do the different aspects of your job; do them in a different way. For example, if you lead regular morning meetings, look for unique ways to change the meeting to keep it from becoming overly routine, like start at an odd time (8:48 a.m. instead of 9 a.m.), offer food, toss balloons, add sharing (everyone be asked to say one interesting thing they did over the weekend or brag about one accomplishment at work), meet in an unconventional location (instead of the conference room, the picnic table outside).

Finding creative ways to keep your job interesting can create a mindset that will increase your energy and make it exciting. Different is exciting.

• Mix up your commute. Take a different route home or listen to a new podcast or audio book. Open your windows and look around; simply observing your surroundings can be interesting with the right mindset.

• Explore somewhere new; drive or stroll down a street or area you’ve

Spice Up Your Life!

never been before. A new location will pique your interest and make you feel like you did something interesting that day.

• Explore your neighborhood or the towns around you that you haven’t had time to get to know. We have a wealth of hidden gems here in the Mohawk Valley, such as Fort Stanwix National Monument, an Erie Canal cruise, or walk along the path next to the Erie Canal, learn about its history, visit the Union Station in Utica, do a scavenger hunt in Syracuse, see the waterfall at Pixley Falls. Find a place that you haven’t been to and explore.

• Never stop learning: One of the most important ways to get your life out of a rut is to learn something new. Learn a new skill, like cooking exotic food, a new language, astrology, how to grill the perfect steak — whatever appeals to you. Stimulating your brain by learning new things has really positive benefits.

• Eat lunch with chopsticks, figuratively speaking, that is. Eating in unconventional ways makes it feel more novel. While this might sound like advice just for those who are tired of bringing tuna in Tupperware to the office for lunch, it applies to so much of our lives where boredom with the routine has taken the joy out of it. Finding new ways to do routine things signals the brain to pay more attention, making it more interesting.

“It all comes back to your mind-

set,” is how life coach April Cacciatori sees it. The owner and operator of Zensations Therapeutic Massage in Rome, advises us to “Slow down and become mindful, be truly in the moment. When you’re truly in the moment, the ordinary becomes extraordinary. It’s all a mindset.”

Make the ordinary extraordinary. That’s the key.

We get bored with the ordinary, with things as they are, with stability. Though stability is a good thing, you can consider it a call to action, a stimulus that you need to shake things up in your life. Or, maybe just develop a different mindset, to look at the ordinary and find the extraordinary.

It’s January. What can you do differently to spice up your life this year?

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.

Barbara Pierce is a retired licensed clinical social worker with many years of experience helping people.