In Good Health: Mohawk Valley #227 - January 2025

Get Off the Couch: Another Study Shows Sitting's Health Dangers

Time spent sitting, reclining or lying down during the day could increase a person's risk of heart disease and death, a new study warns.

More than 10 and a half hours of sedentary behavior is significantly linked with future heart failure and heart-related death, even among people who are getting the recommended amount of exercise, researchers report.

“Our findings support cutting back on sedentary time to reduce cardiovascular risk, with 10.6 hours a day marking a potentially key threshold tied to higher heart failure and cardiovascular mortality,” said co-senior researcher Shaan Khurshid, a cardiologist at Massachusetts General Hospital in Boston. “Too much sitting or lying down can be harmful for heart health, even for those

who are active.”

These results jibe with another study published recently in the journal PLOS One, which found that the aging of people's hearts hastened as they spent more time sitting. This occurred even if people met minimum daily exercise recommendations.

For the new study, researchers analyzed data on nearly 90,000 people participating in the U.K. Biobank ongoing research project. The average sedentary time per day was 9.4 hours for the participants.

After an average follow-up of eight years, about 5% developed an irregular heartbeat, 2% developed heart failure, just under 2% suffered a heart attack and about 1% died of heart-related disease, researchers found.

Sedentary behavior steadily increased people's risk of irregular

heartbeat and heart attack over time, researchers found.

People's risk for heart failure and heart-related death remained minimal until they clocked more than 10.6 hours of sedentary time daily. At that point, the risk rose significantly.

Sitting around increased a person's risk of heart failure and heart-related death even if they were getting 150 minutes of moderate to vigorous physical activity a week as recommended.

“Future guidelines and public health efforts should stress the importance of cutting down on sedentary time,” Khurshid said in a news release. “Avoiding more than 10.6 hours per day may be a realistic minimal target for better heart health.”

In an accompanying editorial, Dr. Charles Eaton, with Brown University in Rhode Island, noted that people

tend to significantly overestimate their amount of exercise and underestimate their sedentary behavior.

Replacing just 30 minutes of excessive sitting time each day with any type of physical activity can lower heart health risks, wrote Eaton, director of the Center for Primary Care and Prevention at Brown.

Adding moderate-to-vigorous activity cut the risk of heart failure by 15% and heart-related death by 10%, and even light activity made a difference by reducing heart failure risk by 6% and heart-related death by 9%.

The new study was published Nov. 15 in the Journal of the American College of Cardiology, and researchers presented their findings recently at the annual meeting of the American Heart Association.

Weight Loss: Move Over Wegovy

Zepbound bests Wegovy for weight loss in new trial

Zepbound, the new GLP-1 weight-loss drug from Eli Lilly & Co., has outperformed its main competitor, Wegovy, in a clinical trial funded by Lilly.

"Given the increased interest around obesity medications, we conducted this study to help health care providers and patients make informed decisions about treatment choice," physician Leonard Glass, senior vice president of global medical affairs at Lilly Cardiometabolic Health, said in an Eli Lilly news release announcing the trial results. "We are thrilled that today's findings showed the superior weight loss of Zepbound, which helped patients achieve 47% more relative weight loss compared to Wegovy."

In the study, 751 obese and overweight adults across the United States were randomized to get one of the two highest doses of either Zepbound or Wegovy.

Patients who got weekly injections of Zepbound lost an average of 20.2% (50.3 pounds) of their body weight after 72 weeks, compared with an average of 13.7% body weight loss (33.1 pounds) for those on Wegovy.

While this is the first randomized clinical trial comparing the two rival drugs, the findings haven't yet been peer-reviewed, the company noted. Earlier research had shown Zepbound outperforms Wegovy for weight loss, but that research relied on existing data.

Still, experts say both drugs deliver impressive results.

Susan Spratt, an endocrinologist and senior medical director for the Population Health Management Office at Duke Health in North Carolina, told NBC News that although Zepbound provided more weight loss than Wegovy, both drugs work

wonders.

“The amount of weight loss with both is astounding,” Spratt stressed.

Christopher McGowan, a gastroenterologist who runs a weight-loss clinic in North Carolina, told NBC News that the side effects for both Zepbound and Wegovy are comparable, although his patients tend to say they fare better on Zepbound.

Side effects from both drugs can include abdominal pain, nausea and vomiting.

Novo Nordisk, which makes Wegovy, did not respond to requests for comment from NBC News.

Zepbound contains the active ingredient tirzepatide, the same drug used in Lilly's diabetes drug Mounjaro. Wegovy contains semaglutide, the drug also used in Novo Nordisk's diabetes drug Ozempic.

Both drugs mimic a hormone that helps lowers food intake and appetite.

However, tirzepatide imitates a second hormone called GIP, which is believed to improve how the body breaks down sugar and fat.

Spratt said she'd like to see more data comparing the drugs to health outcomes beyond weight loss.

Wegovy, for example, has been shown to reduce the risk of heart disease in people who are overweight or have obesity, she said. Meanwhile, Zepbound has been shown to be a possible treatment for obstructive sleep apnea.

Importantly, McGowan said weight loss isn't the only factor patients have to consider when picking a weight-loss drug.

“Most patients who seek a GLP-1 treatment choose whichever they can obtain based on cost, availability and insurance coverage,” he said. “Very few patients can be choosy right now.”

My Turn Delay, Deny, Defend

By Eva Briggs, MD

A monthly newspaper published by Local News, Inc. 20,000 copies distributed. To request home delivery ($21 per year), call 315-749-7070.

In Good Health is published 12 times a year by Local News, Inc. © 2025 by Local News, Inc. All rights reserved. 4 Riverside Drive, # 251, Utica, NY 13502 Phone: 315-749-7070 • Email: IGHmohawkvalley@gmail.com

Editor & Publisher: Wagner Dotto • Associate Editor: Stefan Yablonski

Contributing Writers: Barbara Pierce, Deb Dittner, Gwenn Voelckers, David Podos, Deborah Jeanne Sergeant, Anne Palumbo, Jolene Cleaver, Eva Briggs (MD)

Advertising: Amy Gagliano: 315-402-3370 • Email: amyIGHmv@gmail.com

Layout & Design: Angel Campos-Toro • Office Manager: Allison Lockwood

A look at the state of insurance system

I’m writing this shortly after United Healthcare CEO Brian Thompson was murdered.

While of course I don’t condone murder, I understand the frustration of patients and medical providers alike with the current state of our country’s healthcare insurance system.

For example, on a recent podcast, physician Will Flanary (known on social media by the handle Dr. Glaucomflecken) described his experience with getting prior authorization for injectable testosterone.

He had both testicles surgically removed to treat cancer and therefore his body cannot make testosterone at all. And yet every year his insurance company delays refilling his prescription until he essentially proves that his testicles did not grow back.

Flanary has been outspoken, using humor and satire to expose the crazy world of insurance prior authorizations. In fact, he annoyed Aetna enough that they thought they could ask him to remove his videos from the internet.

Although I am now retired from the urgent care, I understand his frustration.

Insurance companies often issued denials of radiologic procedures (generally CT scans). On my very last day of work, I spent close to half an hour arguing with an insurance company peer reviewer about their denial of a CT scan. It was the patient’s third visit to an urgent care within a week for abdominal pain. She clearly had something wrong even though she didn’t meet the official criteria for ordering an abdominal CT — no fever, no known elevated white blood count (which we can’t obtain stat in the urgent care), no involuntary muscle spasms when her abdomen was examined. The CT was abnormal. It revealed the reason for the patient’s pain. That enabled me to offer the correct treatment and kept the patient out of the emergency room. Even so, the reviewer refused to budge and stated they would not pay for the CT scan.

We’ve also become victims of pharmacy benefit managers (PBMs).

They essentially act to interfere with the doctor-patient relationship, often denying what the physician feels is the best medicine and recommending a substitute that is in their formulary. That formulary medicine is often something that the company manufactures or has another financial relationship with the drug maker. In other words, their choice is based on profit not medical need. This

enables these companies to wiggle around the 15% cap on profits limit required by the Affordable Care Act.

In July 2024, the Federal Trade Commission issued a report about PBMs. It can be found at www.ftc. gov/system/files/ftc_gov/pdf/ pharmacy-benefit-managers-staff-report.pdf

The report describes “how amidst increasing vertical integration and concentration, these powerful middlemen may be profiting by inflating drug costs and squeezing Main Street pharmacies.” I’m sure the power of the big three PBM companies (Express Scripts by Cigna, Optum by United Healthcare and CVS Caremark) helped lead to the closure of our Main Street Pharmacy here in Marcellus.

Cigna responded by suing the federal government asking them to retract the report. Flanary points out that what Cigna may be forgetting is that the legal discovery phase of their lawsuit will likely require Cigna to reveal their business practices for public scrutiny.

United Healthcare’s profits were in the neighborhood of $6 billion in 2024. They deny 17% of claims — 850 million claims. And currently only 1% of those are appealed.

Warris Bokhari, a former practicing physician who worked for a while as an insurance company executive, estimates that this affects 80 million individuals every year. Bokhari decided to start a company that help patients file appeals for denied claims. It’s called Claimable www.getclaimable.com. I’ve never used this service so I can’t comment on its effectiveness. They charge a flat fee. I’m guessing around $75 as on the podcast I listened to, they stated “less than $80.” There are also many informative articles on their website.

I don’t have an answer to the mess our healthcare and insurance system is in currently. As tragic as Mr. Thompson’s murder was, perhaps it will spark some changes, improvements and transparency in the system.

Eva Briggs is a retired medical doctor who practiced in Central New York for several decades. She lives in Marcellus.

Healthcare in a Minute

By George W. Chapman

U.S. Healthcare ‘System’

Is it by definition a "system" or is it really a hodgepodge?

The definition of a "system" is a set of things working together as parts of a mechanism or an interconnecting network. It is a set of principles or procedures according to which something is done. It is an organized framework or method. The U.S. healthcare is hardly a cohesive system

The U.S. healthcare is better described as a hodgepodge (mess?). Instead of a singular system we have several unintegrated independent factions: Medicare, Medicaid, dozens

DOGE Will Audit CMS

The newly formed Department of Government Efficiency (DOGE) will serve as an advisory group to Congress. Healthcare is 28% of the federal bud- get, it includes Medicare, Medicaid, CDC and NIH. Physician, hospital, and nursing home reimbursements are already controlled by Congress. There is no "fat" to be trimmed there. Physicians have not had an inflation adjusted increase in 20-plus years. Hospitals and nursing homes operate below or slightly above breakeven. The DOJ has been successful at finding and prosecuting fraud. Since 1950, all cancer rates have dropped

of Medicare Advantage plans, the exchange, workers compensation disability and plain uninsured. Providers can choose to participate in some of the above or even none not at all. Most consumers and many providers are confused and frustrated (angry) with the U.S. hodgepodge.

We are the only economically developed country without a healthcare system. And while no system is perfect, at least everyone understands how it works. The U.S. is the only economically developed country without a universal system. Canada, United Kingdom. Australia, Norway,

thanks to the diligent work of the NIH and CDC. If the DOGE wants to have an easy, immediate and consequential impact on healthcare costs, just focus on what the U.S. pays for drugs. Since we don't have a healthcare "system" and are at the mercy of the drug lobby, the U.S. pays retail-plus for drugs while the countries with universal care negotiate all drug prices and pay less than wholesale. Any attempt by the DODGE to cut reimbursement to providers or benefits for seniors will devastate our already troubled hodgepodge. Any recommendations from DOGE, if enacted by Congress, will eventually impact all of us covered by any insurance as commercial carriers tend to mimic Medicare reimbursement to providers and benefits covered.

GLP-drugs will be more than offset by the reduced cost associated with heart disease, diabetes, strokes and knee and hip replacements.

Remote Patient Monitoring

Hospitals perform complicated procedures and save lives. But no one wants to be in one day more than necessary. Remote patient monitoring at home is being field tested and the results are encouraging. RPM reduces inpatient stays, readmissions and can prevent some inpatient stays altogether. This is a boon for inpatients and understaffed hospitals. The cost savings will be significant. Field testing includes video-based telehealth, device-intensive RPM and structured acute care at home initiatives. Field testing is promising and procedures are still being tweaked but we can expect RPM to be more utilized in the coming year.

Sweden, New Zealand (since 1912), France and Italy have healthcare systems. All but 43 of 195 countries in the world provide universal coverage for at least 90% of their citizens. The best healthcare in order are: Luxembourg, Singapore, Switzerland, Japan, Netherlands, Sweden, Hong Kong, Australia, Israel, Germany. We don't have to reinvent the wheel. Politics and special interest groups keep us from giving universal healthcare a serious look. We spend far more per capita than any country in the world.

Covering Obesity Drugs

Several commercial carriers may increase their cover age of GLP-1 (obesity) drugs. There is now a proposed rule to cover these drugs for Medicare and Medic- aid recipients. The proposed rule would have to be finalized by the new administration. Currently, 3.4 million seniors have Part D coverage. The cost to cover obesity drugs would be about $2.5 billion (non-negotiated price). CMS projects no short-term impact on Part D premiums. The Inflation Reduction Act caps outof-pocket expenses for seniors to $2,000 annually effective Jan. 1. CMS anticipates that the increased cost of

Artificial Intelligence

Almost three of four organization (health systems, insurers, government agencies) intend to increase their investment in AI according to a survey conducted by Define Ventures. Established governance structures will align AI incentives with corporate values, identify and prioritize use, ethics safety and date policies. AI advocates believe it will reduce costs, improve quality, increase access and free up providers from the mundane aspects of healthcare delivery.

Claim Denials

There is a wide disparity among insurers when it comes to denying claims. Again, a reflection of our healthcare non-system. The denial rate by an insurer should be considered by employers when selecting a plan for their employees, by individuals selecting a plan on the exchange or by seniors selecting an Advantage plan. Denial rates for Traditional Medicare, according to Forbes and other sources are: Kaiser Permanente, 7%; Oscar Health, 12%; Ambetter, 14%; industry average, 16%. Denial rates for Medicare Advantage: BCBS, 17%; Cigna, 18%; Molina, 18%; Aetna, 20%; Anthem, 23%; United Healthcare, 32%. On average, Medicare Advantage plans overturn 80% of their own denials if, and that’s a big if, the denial is appealed. But only 4% of denials are ever appealed. Consequently, CMS will require Medicare Advantage plans to be far more transparent about the appeal process. You are more apt to reverse a denial if your provider is actively advocating.

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.

Q

&

A

with Steven Bulger

ICAN’s leader talks about expanding toward Syracuse region,

adding home health services to its host of programs

By David L. Podos

Q: I interviewed you back in 2022. I am sure there have been a lot of changes with ICAN since then. But before we get into that, what is the mission statement of ICAN — or the Integrated Community Alternatives Network?

A: Sure, as an organization we have a mission of empowering individuals and families and a vision of keeping families together. So, everything we do is based on supporting families and that can be identified as a child and - or a baby or all the way into adulthood.

Q: I believe that the agency first started out in specializing services and assistance for just children, correct?

A: Yes, you are correct. We started out as a children’s mental health provider. But now our services really span the full age range and all of that would not be possible if we did not have a dedicated staff. So, while we constantly strive to bring empowerment to the people that we serve, we also strive to empower the

Q: Many professionals that I talk to mention how difficult it can be for a person and or family to navigate through the healthcare and social services system if they are in need of assistance, does ICAN offer an easier way?

A: Unfortunately trying to navigate through the system is oftentimes quite complex and can be discouraging to someone seeking help. So, we say if there is a need that you and-or your family has, just call us, we can point that person in the right direction to the many services that we provide and if it is a service that we don’t provide we will contact one of the many partnering agencies in our community that we work closely with to provide that service.

Q: Does ICAN work with the school system to provide services if needed?

A: Since the last time we met we have expanded our services especially into the Utica school district. So, the Utica school district is partnering with multiple nonprofits to provide and bring services to kids right at the schools. In essence, the school system has really turned into a safety net for their students, connecting them to services that will help them with their social and emotional needs and ICAN is in the forefront of that. We have more than 40 professional staff that is co-located right into the different schools ready and able to help any child.

Q: What’s on the horizon and coming down the road for ICAN in regards to any new programs?

A: We are very excited about two new initiatives for the upcoming year of 2025. First, we will be expanding into Onondaga County. This new program that we will partner with will be called the Jon Diaz Community Center, located in the hamlet of Nedrow. The center is named in honor of Diaz, a dedicated public servant of the community who passed in 2016. The center will provide a collaborative space for economic opportunities, coordinated social services, as well as health and wellness programs. Also and very exciting is the founder of this new program, Latavius Murray, an NFL running back [who played with the Buffalo Bills] as well as other NFL teams and grew up in Onondaga County.

About 1 in 10 U.S. Adults Have High Cholesterol

Nearly 1 in every 10 American adults is living with high levels of cholesterol in their arteries, according to the latest report from the U.S. Centers for Disease Control and Prevention.

The data, from 2021 through 2023, found that 11.3% of adults have high total cholesterol — a number that's held relatively steady since the introduction of cholesterol-lowering statins in the late 1980s and early 1990s.

"High total cholesterol prevalence declined from 19992000 to 2013-2014 and then did not change significantly" in the years since, according to a team led by CDC researcher Margaret Carroll.

There wasn't a big difference in rates of high total cholesterol between men (10.6%) and women (11.9%), the researchers noted.

The new data came from a large ongoing federal survey of Americans' health.

Besides the decades-long drop in rates of unhealthy total cholesterol levels, Carroll's team also found that fewer numbers of adults now have dangerously low blood levels of HDL "good" cholesterol than in decades past.

people that we are so grateful to have as our staff. The work that we do is not always easy, so taking care of our staff, being the best employer we can, makes for happy employees and that is seen in the incredible work, dedication and compassion that they show to all we serve.

Q: Speaking of your staff, how many employees do you have now?

A: We have 325 employees, as well as 350 sub-contractors [behavioral health professionals], so almost 700 people in all.

Q: Does ICAN still serve in multiple counties?

A: Absolutely. We have offices that are spread throughout the Mohawk Valley, through the 20 programs that we provide we are in seven counties. Since my first interview with you a few years ago, I am excited to say we have expanded. We now have an office in Amsterdam and that office serves both Montgomery as well as Schoharie counties.

Our second new program for 2025, [and this is an exclusive to the readers of In Good Health] for we have not yet announced this publicly, we will be working on what home health services will look like for an elder population. So, for us, when you think about keeping families together, there is a significant portion of the population that would like their elderly family members to be able to stay at home and not enter a nursing home. That will be a major addition to the ICAN family as we strive to keep families together. As an agency we believe by helping someone stay in their own homes (and) still receive quality care, will lend to a better quality of life for that person and be a benefit as well to their families knowing their loved ones are still home, safe, comfortable and receiving the care that they need.

For more information about ICAN, visit www.ICAN.family, as well as other social media platforms such as Facebook and Instagram. They can also be reached by calling 315-792- 9039.

A total of 13.8% of all U.S. adults had unhealthily low levels of this beneficial form of cholesterol in their blood from 2021 to 2023, the report found. That's a big improvement from the 22.2% rate recorded in 2007-2008, the CDC researchers noted.

There were certain anomalies by gender and age when it came to cholesterol levels, however.

For example, rates of total cholesterol peaked in middle age: 16.7% of adults ages 40 to 59 had high total cholesterol, the report found, but as they moved into their 60s and then into their "Medicare years," rates of high cholesterol fell to 11.3%.

Among those with low HDL levels, men were much likely to be affected than women, at 21.5% and 6.6%, respectively.

That's not a big surprise, since experts have long known that one of the health benefits of estrogen is a boost in levels of HDL cholesterol.

Health Career Massage Therapist: Healing for Pain

Licensed massage therapist talks about her profession

By Barbara Pierce

Q: What is your mission for Mohawk Valley Healing Therapies?

A: My mission is to provide relief for those with chronic pain and stress. I eliminate pain for people, by determining and addressing the exact cause of the issue. I’m passionate about what I do, as I hate to see people suffer needlessly. I make it my mission to inform and educate as much as possible and to ensure people get the right kind of care, even if that means referring them to someone else.

Q: How did you choose the career of massage therapist?

A: For many years, I had a desk job in IT. Most of those years, I suffered chronic low back pain and needed to see a chiropractor at least once a week. I tried massage therapy; it didn’t work for me. Then I had plantar fasciitis. The person who worked on my foot suggested I should see her friend who is a chronic pain LMT. She found the root cause of my back pain and relieved that as well as my plantar fasciitis. Finally, I had my life back! There’s nothing worse than being in pain and

feeling helpless to change your situation. I was intrigued by her specialized advanced techniques, because other massage therapists hadn’t been able to help me. By finding the root cause of my pain, she relieved it. At the same time, my job relocated to another state; I wasn’t willing to move; they laid me off. I knew what I wanted to do. Because of that special massage therapist who helped me so much, I decided to attend massage school and asked her to mentor me. I was blessed to be trained by her in her highly effective, advanced specialized massage techniques to relieve chronic pain.

Q: What training did you have?

A: To become a licensed massage therapist, New York state requires you have 1,000 hours of training, including 100 hours of hands-on practice. I attended Onondaga School of Therapeutic Massage in Syracuse. I trained in neural reset therapy and craniosacral therapy right out of school. Then, within my first three years in practice, I added manual lymphatic drainage, cupping, Gua Sha, more CST training and other

courses, as well as continued monthly training with my mentor. After training, I opened my own business, just before COVID hit. I knew this was what I was meant to do; I didn’t give up. Now my business is doing very well. My clients consider what I do to be healthcare, not relaxation massage.

Q: Can you tell us more about the specialized massage you offer?

A: I start with a full body assessment to see what is moving or not. I primarily target the fascia as that can create a lot of dysfunctions when restricted. I bring into each session all my training. CST works great on people who don’t like deep tissue work and for those with whose issues are not muscular. It’s a gentle, hands-on method. Most clients really like CST, not only is it calming and relaxing, but they can feel the shifts within their body and are amazed. Manual lymphatic drainage is also important. If we’re dehydrated, the lymph becomes thicker and can’t move through the body to do its job. Manual lymphatic drainage helps keep the lymph moving. I work with my clients to help them understand what’s going on with their bodies. I help them make the small changes to live pain-free.

Q: What are the rewards of your career?

A: I love it when people realize they can help how they feel. As you age, you’ll have aches and pain. This is not normal aging. Suffering with

aches and pains can be relieved. You’re more empowered in your health than you think. I love it when I watch someone come in in tears from pain and leave pain-free. Like the 88-year-old woman I worked with. Physical therapists said she had no range of motion and couldn’t help her. She couldn’t even carry a coffee cup; she was so weak. Her children said move in with us. She hated that option. A few weeks after she began seeing me, her muscles were able to move and function properly; physical therapy is now helping her regain her strength so she can continue to live independently. All the little tasks we do every day, she can now do.

Q: What else should we know?

A: When it comes to being in pain, it’s not hopeless. Every kind of massage has great benefits, yet some types of massage have much longer lasting results. Sometimes you need someone that specializes, like finding the right kind of doctor, sometimes you need to see a specialist.

MaryBeth Ritenour is a licensed massage therapist and the owner of Mohawk Valley Healing Therapies in Oriskany Falls and Clinton. She specializes in chronic pain and stress relief.

Addressing the Shortage of Veterinary Care in Mohawk Valley

Local vet says there was burnout during the pandemic and a lot of veterinary providers shuttered their practices or dropped down to parttime hours of operation

By Jolene Cleaver

Do you feel like finding a veterinarian to care for your pet is harder than doing your taxes?

Well, you are not alone. Area pet owners and care providers agree.

For Mohawk Valley area veterinarians like Evan Sandler, an owner of CNY Veterinary Medical Services in Westmoreland, the struggle is real.

“There’s definitely a shortage across the country,” he said.

According to a 2024 survey conducted by the American Pet Products Association, 82 million United States households own a pet.

Included in that total is a boost in the double-digit millions that Sandler and fellow veterinarians confirm was a product of the COVID-19 pandemic, as pet adoptions during that time rose dramatically.

However, due to that and a number of other factors, many pet owners are now scrambling to establish veterinary care for their pets.

In a recent Facebook thread discussing veterinary care in the Mohawk Valley region, Ally Priore Quigley posted, “I have one, but finding someone for emergency situations feels near impossible. Everyone refers you to Syracuse or Ithaca in those cases, which is a long drive in situations where every second counts.”

“I have a vet, but it’s hard to get a normal day appointment when

your pet is sick,” wrote another commenter, Kelly Mallery Vineall.

Overhead and workload

In examining issues being faced by the pet care industry, Sandler offered the anecdote that it’s known in professional circles that there was burnout during the pandemic and a lot of veterinary providers shuttered their practices or dropped down to part-time hours of operation.

“Right now about 79% [of veterinarians] are working full-time,” he said, speaking of averages.

This kind of situation is causing many veterinarians to work longer hours and not accept new patients.

Echoing Sandler’s statements, veterinarians in the Mohawk Valley reported sentiments like, “being slammed with patients non-stop” leading them to simply being “not able to accept new patients at this time. … definitely get vaccines done at pet clinics like at Tractor Supply… It’s not ideal, but it is what we are advising as a solution.”

“It’s going to take us years to get back to normal,” Sandler said during a recent interview.

“I can’t remember the last time I worked less than 60 hours per week,” he added.

Sandler graduated from veterinary school in 2005 and by 2011, he

kets or employment situations where there are larger sign-on bonuses.

“It definitely takes a specific person to do this work. It’s not a 9 to 5 job,” he said. “But I love what I do. This is the only field I have wanted to work in since I was 6 years old.”

Impacts

Tim Atkinson, executive director of the New York State Veterinary Medical Society, a nonprofit, professional member advocacy association, said the issue is not simple and not just limited to the Mohawk Valley or New York state.

“There are actually a variety of factors contributing to the current shortage of veterinarians. It’s a generally recognized problem,” across the United States, he said, adding that the current issue stretches farther back than a COVID-19-era pet adoption boom.

He said there are data collections that point to a steady growth of yearly pet ownership figures in this country, tallying a starting point of about 35 million existing pets in 1991 and reaching 60 million this year.

“That’s quite a tremendous growth over 30 years,” he said.

An analysis of veterinary service trends published in the Journal of American Veterinary Medical Association in November, estimated the existing educational infrastructure would meet demand in the United States for the next 10 years, barring major disruptions.

However, the study noted that while the pandemic created industry shifts, as society has returned to normal from the depths of the pandemic, “the likelihood of longer-term [veterinary] shortages is remote,” the authors concluded.

Solutions

To be proactive, Sandler advised those that are adding a new pet to their family to get veterinary care lined up before bringing the pet home in order to avoid scrambling to secure care.

and his wife, veterinarian Heather Sandler, launched CNY Veterinary Medical Services.

Now, he often has days where he sees 20-30 patients per day.

On a recent Thursday, which is his surgery day, he had completed seven surgical procedures by 2:30 p.m. With these jam-packed days, he maximizes every free minute to catch up on patient consult emails, phone calls and text messages.

“My goal in life is to make enough money to pay the bills,” Sandler said.

However, Sandler has more to worry about than just himself. There are more than 30 employees at his practice. He is always on the lookout for more help, he added.

In addition to a greater pet to care staff ratio, prices have gone up on medicines and necessary equipment and tools for clinics. “Inflation has hit us quite hard,” Sandler said, noting that the cost of medical supplies has risen.

He pointed out that one issue facing veterinarians fresh out of college right now is that they can expect to make just above the national salary average — but they are graduating with about $160,000 in educational debt.

With pay for veterinarians often based on patient volume, graduates are gravitating toward larger mar-

Also, many veterinarians are leaning on vaccine clinics being hosted at retail spots such as Tractor Supply to take the scheduling burden off veterinary providers for simple care such as vaccines, microchipping, deworming and other basic services.

Further, Atkinson said work is being done to open more veterinary education programs.

In addition to New York’s standard bearer Cornell University, Long Island University recently launched a veterinary science program. The College of Veterinary Medicine’s inaugural graduating class walked the stage this past May. Accredited in 2019, the college “filled an industry void as one of only four vet schools in the Northeast,” according to a statement.

Elsewhere in the United States, Colorado State University College of Veterinary Medicine & Biomedical Sciences is in the process of developing a degree program for this Master’s of Veterinary Clinical Care. It would be comparable to a student earning a degree that would be a rough equivalent to a nurse practitioner-style accreditation, except for veterinary care.

There’s also a lack of veterinary technicians, not just veterinarians, Atkinson said. But there may be a way to fix that such as devising ways to lure back those who have recently left the field.

Vet Evan Sandler checks over a cat at CNY Veterinary Medical Services in Westmoreland. (Photo by Jolene Cleaver)

Live Alone & Thrive

By Gwenn Voelckers

A New Year’s Gift to Yourself: Solitude

I’m craving some “me time.” How about you?

With the fireworks, holiday decorating, shopping, and socializing behind me, all I want for January is a little peace and quiet.

Don’t get me wrong, I love the holidays, but all the hustle and bustle can leave me feeling depleted and out of sorts. My daily meditation practice gets interrupted, and I miss my early-morning opportunity to clear my mind and focus on what matters.

I miss my solitude!

And I can appreciate how paradoxical that might sound.

You might wonder why and how I would be craving solitude, given that I live alone and have ample quiet time on my hands.

Simple answer: Solitude is not about the mere absence of others. It’s about intentionality. It’s about making a conscious choice to create space for personal reflection, growth and peace.

While alone time can often feel uncomfortable, solitude — when approached mindfully and with purpose — can be a precious gift. As we welcome a new year, I encourage you to think of this time as an opportunity to give yourself the gift of intentional solitude.

Solitude vs. Alone Time

Living alone after my divorce

brought on a confusing mix of emotions. On one hand, I felt freedom: freedom from the tension within my marriage, freedom to make my own decisions and the freedom to pursue my hopes and dreams on my terms.

On the other hand, living alone brought loneliness to my doorstep and an enormous sense of disconnection from the world and people around me.

This is where the concept of solitude becomes essential.

Solitude is a conscious choice to be alone with oneself, to seek moments of quiet reflection, rest and introspection. It’s about creating space for healing and rejuvenation, rather than simply enduring the empty silence that sometimes fills a home when no one else is there.

I discovered a restorative calm in solitude that allowed me to slow down and reconnect with the present moment. For me, solitude has been a way to recharge after life’s ups and downs and a sanctuary where I can pause and take stock of who I am and where I’m headed.

For others, it might be an opportunity to find clarity, to remember what it feels like to be at peace in one’s own skin, and to regain balance after an emotional upheaval in their lives.

The Benefits of Solitude

First and foremost, solitude

offers a safe space for healing. After experiencing a significant loss, such as the death of a spouse or a divorce, your emotions may feel scattered and overwhelming.

Solitude provides a refuge where you can process grief, reflect on the lessons learned and begin the journey of self-discovery and self-compassion.

Rather than keeping super busy to distract myself from the pain of my failed marriage, my therapist encouraged me to “sit with my feelings” as a way to listen to my inner voice, feel my grief and regain my emotional strength.

It was excellent advice. And it worked.

Solitude can also help to recharge your emotional batteries. If, like me, you are experiencing some post-holiday burnout, you may welcome time spent in solitude. When alone, we can relax and make sense of the day’s events without constant input and stimulation from others.

This allows our minds and bodies to rest and recover from fatigue.

And finally, solitude can offer a means of reconnecting with ourselves and others in deeper, more meaningful ways. When we take the time to be with ourselves, we are better able to show up for those around us.

As the poet Rainer Maria Rilke said, “The only journey is the one within.” When we embrace solitude, we discover more about who we are — our strengths, our desires, and our capacity for love.

This self-awareness can make us more empathetic, more present and more connected to others. And what could be more important than that?

Finding Solitude

Creating intentional solitude in your life can look different for everyone.

For me, one of the most powerful ways I’ve found to embrace solitude

is through daily meditation. Every morning, before the sun rises, I sit in quiet contemplation for 10 to 15 minutes. Often, my cat Shadow hops up on my lap.

I use this precious time to send prayers of love, hope, health, and peace out into the universe. It’s a practice that helps me center myself for the day and find clarity in the complexity of life and in this unsettling post-election year.

For others, solitude might come through journaling. A friend of mine starts her day with a cup of tea, pen, and paper. She writes whatever comes to mind: her hopes for the day, thoughts about her past, or observations about the people and world around her. It brings her comfort.

Still others choose solitude in nature, spending time outdoors. Many find that being surrounded by nature’s beauty provides a sense of inner peace, which helps them reset emotionally.

Whether it’s an afternoon spent reading a good book or an early morning walk through the woods, these small acts of intentional solitude can and will nurture your soul.

A Positive Start to the New Year

Let solitude be the gift you give yourself in this new year.

May it be a sanctuary of peace and your source of profound emotional and spiritual renewal in 2025. From me to you.

Happy New Year!

Gwenn Voelckers is the author of "Alone and Content," a collection of inspiring essays for those who live alone. She welcomes your comments about this column and topic suggestions for future columns at gvoelckers@rochester.rr.com

Wintertime Is Prime Time for Head Lice: What Parents Need to Know

Head lice can be a wintertime headache for families and schools, but simple precautions can stop the spread of these pesky parasites.

Every year, 6 million to 12 million children in the United States, aged 3 to 11, experience head lice infestations, according to the U.S. Centers for Disease Control and Prevention.

Contrary to popular belief, these tiny insects don’t jump or fly, said Ali Wurster, a nurse practitioner with the Texas A&M Health Mobile Health Clinic.

“They actually crawl,” Wurster explained in a university release. “A kid can be sitting in a classroom even

a foot away from another child, and if their heads don't touch, the lice are not going to jump onto someone else.”

While many believe individuals with dirty or unclean hair are more likely to attract lice, the reverse is true, Wurster said. The small, sesame seed-sized parasites prefer a clean scalp.

They spread most commonly among school-aged children through shared items like hats, coats, brushes or dress-up clothes, which present prime modes of transfer for the parasites.

To prevent head lice, avoid sharing hats, brushes or clothing. School staff should regularly sanitize

common items. Wurster also recommended keeping heads apart during nap time to further deter spread. While not harmful, head lice can cause significant discomfort and should be mitigated as soon as possible both to ease symptoms and stymie further spread.

If lice are found, treatment is straightforward. Over-the-counter and prescription topical creams such as Nix and permethrin work effectively, Wurster said. After applying the treatment, remove lice eggs (nits) with a fine-toothed comb, seal them in a plastic bag and repeat treatment in seven days if needed.

Wash clothing, bedding and other fabric items in hot water and dry on high heat. Non-washable items, like stuffed animals, should be sealed in a plastic bag for two weeks.

The CDC no longer requires children with lice to be sent home immediately; they can finish the school day, begin treatment after school, and return the next day.

Despite misconceptions, families and schools can quickly address and often prevent head lice with an accurate understanding of how the parasites spread and best practices for treatment.

The Balanced Body

The Arts for Healing

There is definitely a time and place for Western medicine. However, there are many options you can utilize to assist you in caring for many conditions that may develop. Think creativity along with critical thinking to develop an environment that may change your health for the positive. These solutions may not happen overnight but will create a positive destination for one and all.

1. Get out in NATURE. During the winter months, many tend to spend a good portion of their time indoors. Yes, it’s cold outside. However, dressing in many layers will eliminate that “too cold to go out” feeling. Going outdoors is excellent for your mental health — both adults and children. Walking around your neighborhood inhaling the fresh air is very uplifting. Being outdoors moves you into another zone creating distractions and focus on another level than that of indoor activities. Exploring the outdoors improves mindfulness and your overall well-being.

2. Find your COMMUNITY. While you are out and about in nature, discover your social connections as well. Relationships with a variety of people matters when it comes to living a longer life. You can join a

By Deborah Dittner

walking group, an art group, an herb group, a traveling group, a cooking group, an exercise group…just to name a few. What are your interests? Now look for groups with the same interest and enjoy the company and social interaction. You may even find a new best friend that you can share a variety of activities with.

3. While out in nature or community, reach out and VOLUNTEER. If you are an animal lover, volunteer at the local animal shelter or offer to walk a neighbor’s dog who has difficulty getting out in snowy weather. If you’re a foodie, volunteer at a local food kitchen or Meals on Wheels. If you’re heading to the store, ask a neighbor if they need anything while you’re out. By volunteering your time and services, your “feel good” hormones will escalate and you will feel better about you. Helping others provides a warm satisfaction and increased happiness.

4. Winter months can lead to less activity for some. Incorporating MOVEMENT into your everyday life will improve mental health, heart health and social connections. You may need to get out of your comfort zone by putting on those ice skates that have been collecting dust for years. Think of other activities you

enjoyed as a child and explore the possibilities. If it’s snowing and you see some neighbor kids building a snowman…join in.

5. If you like to be creative, consider ART. There are many art classes held at community and senior centers, libraries and continuing education centers. Art therapy is helpful for anxiety, trauma, depression and overall health. This too can lead you to outdoor activities in nature building community on many levels. Art helps you to be mindful and express emotion through poetry, painting and drawing. Other possibilities are scrapbooking, home decorating, baking and dance either through ballet or ballroom. Or just turn on some tunes and dance your heart out in your own living room. There are so many artistic ways to express yourself on your personal journey.

Coffee shops or small cafes often host small groups of all kinds. Ask the owner of the shop what groups meet there and when. I saw a group

of women at a coffee shop after I attended the local farmers’ market and now I meet with them on the first Saturday of the month. New relationships develop bringing more happiness into your life.

Incorporating a variety of arts into your life for healing is a prescription that needs to be written more frequently. The arts, whatever form or direction you decide to take, can improve mood, decrease blood pressure, improve sleep, decrease stress and anxiety, lubricate your joints for greater flexibility and connect you to long term health.

A new 21,000 square foot Cancer Center and Community Wellness Center is now open in Camillus at 5490 Cobbler Way! This modern, spacious new office replaces our Onondaga Hill location and Camillus Community Wellness Center – and offers a comprehensive range of services under one roof, with plenty of free parking. Use the QR code to learn more and see the services at our new Camillus location!

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. www. debdittner.com

New Year’s Resolutions — Why Bother?

By Barbara Pierce

It’s the new year. Many of us are making resolutions.

It seems that a new year triggers our motivation to make positive changes in our lives. We’ll resolve to lose weight, exercise more, spend less money, drink less or whatever.

We get a good feeling when we say we’re going to do all this amazing stuff and when we start picturing the results — even when we haven’t done anything yet.

Resolutions are promises we make to ourselves to improve our lives and they can be powerful if we make the right choice to ensure they’re reasonable and we keep ourselves motivated to follow up.

But experts say most of us won’t follow through. We won’t achieve the wonderful goals we set for ourselves. One study (by Baylor College of Medicine, Texas Medical Center) found that, by mid-January, 88% of us will fail to keep our resolutions.

“Yes, there’s a high rate of failure of resolutions,” agreed Wade Halverson, clinical social worker, founder of Cornerstone Mobile Counseling, Herkimer. “Our intentions are so good.”

Though there’s a high rate of failure, experts say it is still a good idea to make New Year’s resolutions. It’s a planned way to set goals for personal growth and motivates us to make positive changes. It gives us a sense of determination to see it through.

Here’s the thing: “Resolutions fail, not because people are weak. It’s because they make their resolutions too challenging, too complicated and the resolutions aren’t time limited,” Halverson explained.

So, before you give up on mak-

ing resolutions, consider these tips on how to make resolutions that will actually stick.

Chose resolutions that really matter to you. Having a compelling reason will help you to stick with your resolutions when you feel tired, unmotivated and just want to take the easy way out.

Pick just one or two goals for yourself.

A good goal should be specific, measurable, reasonable and time specific, advised Halverson.

Use the concept of SMART goals:

S: Specific

M: Measurable

A: Achievable

R: Reasonable

T: Time limited

“For example, the goal of ‘I’m going to get in shape’ is too vague,” he said. “It won’t work.

Instead, say, ‘I’m going to be able to walk 10 miles without stopping by June 1.’ That’s specific, measurable, time limited. You build up to that in reasonable increments: in January you walk a few blocks. In February, walk a mile. In March, walk two miles.

“Another example: the goal of ‘I’m going to quit drinking.’ That’s not reasonable. Instead, create something reasonable, like “I’ll limit myself to two drinks a week,’ or ‘I’ll have two sober days a week in January, then three in February.’’”

Set clear and specific goals so that you have a clear target to work towards.

It’s a good idea to break down your goal into smaller tasks so they’re easier to achieve. And celebrate small wins.

Meet the ‘New You’

By Shaina Zazzaro

New year, new you. How many times have you heard that? ‘Tis the season for weight loss goals!

Skip the magic shot that you don’t know what it’s doing to your body and trust me. I’ve lost more than 50 pounds three times and I know what I am talking about. It is simpler to lose weight than you think. I think social media just overcomplicates everything.

Science is science. Calories in vs. calories out.

There is a website — www.tdeecalculator.net — that you can visit to get an estimate of what your calories burned are daily. If you’d like to lose weight, you can also find out what your macronutrients (fats, carbs and protein) are for weight loss calories.

Put your goal in writing; most people who write their goals have a higher rate of success; writing them down helps us remember to focus on that goal.

“Another trick is rewards and consequences,” added Halverson. “We respond well to rewards. For example, if I stay sober until June 1, I’ll go on that cruise. If I don’t stay sober until June 1, I’ll do 100 push-ups.”

“Another helpful thing is accountability; make yourself responsible for achieving your goal to a friend or someone you respect. Have them check in with you or you check in with them regularly on the progress you’re making,” he said. “Or do it cooperatively, you both work on your goals and keep each other accountable.”

Let your family and friends know about your resolutions so they can help you. This is similar to searching for a new job. If people don’t know you’re open to new opportunities, they won’t think of you when they hear of a possibility.

And be ready for obstacles. No matter how small or straightforward

the goal is, there’s always a chance for an obstacle. They often happen. To keep your motivation, think ahead what obstacles you might run into and create a plan for dealing with them. For example, if you’re trying to lose weight and a friend encourages you to share a calorie-laden desert, how will you handle this? Thinking ahead on how to handle barriers limits the possibility of setbacks or failure.

Lastly, “Ask for help,” Halverson said. “Cornerstone can help. We’re about coaching, support and guidance. It’s OK to get help from someone who is a professional. It doesn’t mean you’re crazy; it just means you just want help. We can definitely make a difference!”

“At Cornerstone, we’re the Uber for mental health,” he added.

Cornerstone Mobile Counseling links people in the Mohawk Valley to local, licensed mental health professionals for counseling in their homes or via telehealth.

“Stay hopeful and believe it can be done!” he said.

This is not 100% accurate but is the best free web formula that I’ve found. Once you figure out your “macros” you can download the free app “My Fitness Pal” to program in what you eat daily. Remember: the key to weight loss is consistency. You cannot eat well for four days and then overeat for three and expect solid weight

loss results.

You must be patient. It is much easier to put on five pounds than to take off five pounds.

One tip I’ve learned is to watch for your “bites, tastes and licks.” Eating your kids’ extra chicken nuggets, having a couple of bites of a cookie, those extra licks of ice cream — those are calories, not magical free food (like celery), so watch out for them. Weighing your food and portion control will get you to where you need to be a lot faster.

I was able to lose and keep off more than 50 pounds

by eating Effortlessly Healthy Meal Delivery Service. The key was the food is portioned and weighed out.

Funny story about weighing food. If you look at my Instagram @ shainazazzaro you’ll see a viral video I created. It has more than 15 million views. It is literally me showing a proper portion of whipped cream on pudding.

So go watch that viral video. Follow those steps. Skip the weight loss drugs. Reach your goals. You have one life — let’s make this the healthiest year yet!

Shaina Zazzaro is a devoted wife and mother of two, blending her roles with a passion for health and wellness. She is the owner and chief executive officer of local meal delivery service, Effortlessly Healthy. For more information, visit www.ehmeals.com.

By Anne Palumbo

Why Cottage Cheese Has Made a Comeback SmartBites The skinny on healthy eating

Every January, food trends flood the news. Here’s a surprise:

Cottage cheese is one of this year’s list-toppers.

Yes, granny’s mainstay is back in the spotlight thanks to its nostalgic charm, versatility and impressive health benefits.

While cottage cheese comes packed with many nutrients, the nutrient that reigns supreme is protein.

A half-cup boasts an impressive 15-16 grams of complete protein, which, for many, is a significant chunk of daily needs. And, unlike some meat-based proteins, it can be consumed immediately, as in directly from the carton with a big ol’ spoon when no one’s looking.

Protein is vital throughout our entire lives. We need it to grow, to build and maintain tissues like muscles, bones and organs, and especially to see us through our later years as muscles begin to diminish.

Research shows, however, that many older adults don’t consume enough protein. Difficulty chewing, limited financial resources, a finicky gut, and reduced appetite all seem to play a role.

Cottage cheese—as easy on the teeth as it is on the pocketbook—can help address this diet deficit.

Cottage cheese is an excellent source of vitamin B12, which plays a key role in preventing anemia and combating fatigue. This crucial vitamin is our noggin’s best friend— helping with memory, concentration and mood regulation—and may also prevent heart disease by lowering homocysteine levels in the blood.

Bones covet dairy foods, like

cottage cheese, which play a key role in building and maintaining strong bones over your entire life. Key minerals in cottage cheese that promote bone health include calcium, vitamin D, phosphorous, potassium, and magnesium. These days, I’ve got that big ol’ spoon scooping nonstop to avoid falls and fractures.

Come January, after an indulgent December, many seek to lose weight. Thanks to this dairy-darling’s nutritional profile—low in both calories and fat, but high in protein—cottage cheese may help. Research shows that high intakes of protein, such as the casein in cottage cheese, may increase feelings of fullness, which can help thwart the urge to snack.

On the downside, cottage cheese does have more sodium than you’d expect from such a healthy cheese, ranging from 300 to over 500mg. Consume just one cup and you come close to knocking off a sizeable chunk of the Recommended Daily Intake. That said, choose lower-sodium versions if you’re watching your sodium.

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.

Helpful Tips

Read nutrition labels carefully, paying close attention to sodium and saturated fat. Although cottage cheese contains a moderate amount of lactose, some people with lactose intolerance may still tolerate it. However, there are lactose-free versions available.

COTTAGE CHEESE PIZZA

Serves 1-2 Adapted from coconutandbliss.com

Ingredients

1 cup cottage cheese

½ cup flour: white or whole wheat

2 eggs

Instructions

1. Preheat oven to 350 degrees F. Line a baking sheet with parchment paper.

2. In a medium bowl, whisk 2 eggs, then mix in cottage cheese and flour. Transfer mixture to prepared baking sheet. Using a wide spoon, spread mixture

1-2 tablespoons pesto

½ cup mozzarella cheese

½ cup cherry tomatoes, sliced salt and pepper, to taste fresh basil drizzle of olive oil (optional)

to resemble a round pizza crust, about ¼” thick. Bake for 25 minutes and remove from oven.

3. Next, spread pesto over crust, then evenly distribute cheese, tomatoes, and fresh basil. Bake for 10-15 minutes more, until edges look crispy. Remove from oven; salt and pepper to taste; drizzle with a little oil; enjoy!

Between You & Me

By Barbara Pierce

Ready for a Change in Your Life?

By Barbara Pierce

Now that the fireworks have ended; the hangovers have faded and 2024 is in the rearview mirror, you might be thinking of where you are in life and where you want to go.

January is the start of something new. It implies a fresh start.

Wondering if you’re ready for a fresh start, a change in your life?

Experts say these are the sure-fire signs that you may be ready for a change:

You’re going through a painful challenge, a life transition: Whether it’s your career, relationship, family or finances, this is usually an indication you need to consider whether to change something in your life.

For some, it’s the big life milestones that trigger change: Marriage or divorce, moving to a new city, committing to a new partner, buying a home, starting a family or becoming empty-nesters.

For others, change comes from

the significant changes that we all experience, like ending a relationship, getting laid off or fired, loss of someone close. It could be aging, retirement, a new career, moving across the country or another life-changing event.

Another sign that you may be ready for change is if you feel stuck in a rut: Doing the same things day in and day out, you feel generally blah, with nothing to get excited about. Life is boring; there’s no stimulation. Or if you’re feeling significant stress much of the time. Stress is one of the most common signs that you’re in need of a change. Can you figure out what is stressing you the most? Which areas of your life are stressful?

If you’ve said “Yes, I’m ready to change some things in my life,” then what?

The first step is making the decision that something needs to change. This may sound obvious, but it’s

tough to change your life.

It’s tough because you have to step outside of your comfort zone. I’ve had to do this more than I wanted; each time it’s been a challenge, but worth it.

Some things that might help:

First, figure out what aspects of your life aren’t working right. What needs fixing? What needs to change? Make sure you carve out the time. Sit down and examine yourself and your life. What do you notice?

Pin it down the change that sounds the most reasonable to accomplish. Define the thing you want to change.

Focus on one significant change you could make, like moving to a new city, changing jobs, a new relationship, better eating habits. If you try to change too much in one go, you’ll likely become overwhelmed, burn out and then go back to your usual way of operating.

Narrowing down your choices can be quite simple if you understand the psychology of decision making. After following your gut, you need to let go of all the other options and move on.

Trust your gut on this. There is a “crucial role of feelings in navigating the endless stream of life’s decisions,” says Daniel Goldman in his book “Emotional Intelligence.” “The key to sound personal decision-making in short: being attuned to our feelings.”

Brainstorm; get creative. Think of as many ways to solve this as you can. Ignore that voice in your head that tells you all the reasons why your ideas are ‘stupid,’ ‘unrealistic’ or ‘will never work.’

Set goals for yourself based on that one significant change you want to make. A good goal should be specific, measurable, reasonable and time specific. The article on New Year’s resolutions, elsewhere in this

issue, describes the process of making goals.

Resolutions fail because they’re too challenging, too complicated and they aren’t time limited, Wade Halverson of Cornerstone Mobile Counseling, Herkimer, explains in that article. Same thing for any goals you set for yourself.

Get your friends and family on board with your goal, provided they’re supportive. You’ll need their support. When you tell others about your goals, you’re more likely to stick to them because you know they are aware of your intentions and might ask about your progress; this can motivate you to keep going.

Prepare for the storms before they hit. Identify the things that may hold you back and prevent you from reaching your goal. Obstacles will come up; people you’re close to could hold you back from making life changes. You might sabotage yourself. Think about how what these obstacles might be and how you can get around them.

As it is difficult to change, you might consider consulting a life coach to help you through, to keep you motivated.

Finally, don’t wait to get started — start now. What changes in life do you want to make in this new year?

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.

Barbara

OMEN'S HEALTH

Yoga Helps Women Deal With the Mental Stress of Cancer

Acancer diagnosis can bring overwhelming stress and depression to women, but new research suggests yoga can help ease that emotional toll.

“A wellness intervention that integrates yoga and psychological

tools may strengthen the connections among the mind, body and spirit, leading to a better and more meaningful quality of life,” said study senior author Deidre Pereira. She's an associate professor of clinical and health psychology at the University

U.S. Preterm Births Are on the Rise

Rate has jumped more than 10%, in past decade

Over the past decade, rates of preterm birth in the United States jumped more than 10%, a new study of more than 5 million births shows.

The rise dovetailed with an increase in some factors that make an early delivery more likely, including rates of diabetes, sexually transmitted infections and mental health conditions, along with a corresponding decline in factors that protect against it.

Meanwhile, racial and economic disparities persist.

"These patterns and changes in risk factors should be setting off alarm bells," said lead study author Laura Jelliffe-Pawlowski, a professor at the NYU Rory Meyers College of Medicine in New York City.

Babies born before the 37th week of pregnancy have a higher risk for illness, intellectual and emotional difficulty and even death.

Factors that have been linked to an increased risk for premature

in-person, group intervention that used breathing and relaxation techniques, mindfulness meditation, psychotherapy skills and gentle yoga aimed at improving physical and mental quality of life."

Based on answers to detailed questionnaires, Pereira's team found women reporting a lowering of their symptoms of anxiety and depression after completing the program.

When it came to the physical symptoms of depression, the program was especially helpful to women of color, the researchers noted.

“Quality of life during and beyond cancer treatment is a critical component of whole-person cancer care,” explained study co-lead author Elizabeth Kacel, a recent graduate of the clinical psychology doctoral program at UF.

It's the program's use of yoga and meditation alongside psychotherapeutic training that really seemed to help, she added.

of Florida (UF) in Gainesville.

The new research involved 51 women who'd been diagnosed with some form of gynecological, gastrointestinal or thoracic cancer.

According to a university news release, they "enrolled in a 10-week,

“The combination of both perspectives provides a powerful foundation that patients can stand on in coping with the ups and downs of cancer survivorship,” said Kacel, who is now a clinical health and cancer psychologist at Chicago's Rush University Medical Center.

The study was published recently in the journal Integrative Cancer Therapies.

delivery include expectant mothers using tobacco or having diabetes, high blood pressure or an infection. Longstanding trends linked to years of racism also showed up in the new research.

"We found stark differences in terms of what it looks like to be a Black or Native American pregnant person compared with a white individual who is of middle or higher income," said Jelliffe-Pawlowski, who is also a professor emeritus at the University of California School of Medicine.

For the study, her team looked at more than 5.4 million births — not including twins or multiples — in the state of California between 2011 and 2022.

During that time, preterm births rose from 6.8% in 2011 to 7.5% in 2022, dovetailing with a similar nationwide surge between 2014 and 2022.

While rates grew across nearly all groups, they were highest

among Black women with public insurance (11.3%) and lowest among white mothers with private insurance (5.8%). While rates fell slightly among Black women who were privately insured, from 9.1% to 8.8%, they remained higher than rates among white mothers.

Among Native Americans with private insurance, preterm births rose from 6.4% to 9.5%.

Among low-income women, prenatal care and participation in the supplemental nutrition program for women and children called WIC were protective. But participation across most low-income groups fell over the study period, researchers found.

They said the findings point to the need to improve pregnancy care and promote treatments that address risk factors for preterm birth. They noted that these are often underused, especially by mothers of color.

"We need to do a better job of sharing information with pregnant

people about risk factors for preterm birth and interventions that may be able to help them address this risk," Jelliffe-Pawlowski said in a university news release. "Some providers report not wanting to scare or overwhelm pregnant people, but pregnant people tend to report wanting to have this information."

In particular, she said women who have had a preterm birth before or who have high blood pressure should discuss taking a low-dose aspirin during pregnancy.

The researchers are working to develop a digital platform to help women better understand their risk for preterm birth as well as programs that might help them, with an eye to developing a healthy pregnancy plan with their health care provider.

The findings were published Sept. 27 in the journal JAMA Network Open.

OMEN'S HEALTH

The Importance of Healthy Feet

By David L. Podos

There is an old saying that you might have heard, “nothing feels right if your feet are uptight.”

How true that is!

How many of us actually pay attention to our feet until they start to hurt?

We can become preoccupied with other health concerns, such as the health of our heart or the health of our kidneys or weight gain, for example. While those concerns are legitimate, sometimes we can forget all about the health of our feet, which literally carry us through life.

In an article by NIH (News in Health) March 2023, “ Focus on Your Feet,” podiatrist David G. Armstrong weighs in on the importance of your feet and the importance of keeping

them healthy.

“Our feet are usually covered with shoes and socks and they’re easy to forget about or we might take them for granted. Foot problems can really limit activity and make it hard to move through the world,” said Armstrong, a foot doctor and professor of surgery at the University of Southern California.

Feet are actually anatomically quite complex, with each foot having 26 bones, 33 joints, more than 100 muscles and a complex network of nerves and blood vessels.

“The foot’s complexity means there is a lot that can go wrong” said podiatrist Crystal M. Holmes, who heads the podiatry program at Michigan Medicine. “These can range from hammer toes, skin infections and

painful structural problems that may require surgery.”

Wendy Schara holds a Doctor of Podiatry degree and works at Foot Doctors in Utica. She has strong roots in the area. She completed her residency training at Little Falls Hospital in Little Falls and is board-certified with The American College of Foot and Ankle Surgeons, as well as a fellow of the board. Schara has been in practice for 25 years.

“In general, our feet are very important, from a purely structural standpoint they support the rest of our body, helping with balance, posture, walking and running, exercising, getting up and out of a chair and just simple daily activities of living,” Schara said.

What shoes we wear also aids in giving our feet support and comfort and can go a long way in keeping our feet healthy.

“It is important to wear properly structured shoes to offer support to the foot, this will also help with balance and shock absorption,” Schara added.

With the rise in diabetes in the U.S., diabetic patients especially need to wear properly fitted shoes, as diabetes often causes circulation and nerve damage in the feet.

“As we get older and our bodies start to change, if we gain too much weight then our balance changes, our muscular strength changes, all of this can have a negative affect upon our feet. Certainly, there are diseases that can affect the foot like diabetes causing neuropathy,” Schara said.

Schara also lends her expertise in surgery to patients that may require such an intervention.

“Some of the more common foot conditions that would require surgery that I see are patients with bunions, hammertoes, as well arthritic toe joints. Other conditions would be a patient experiencing heel pain where surgery is required to release the ligaments, as well as some

Achilles tendon surgical repair. These procedures are done outside of the clinical office at a local hospital and or surgery center,” Schara said. “In the clinical office I would say ingrown toenails are what we do most, along with wart removal, biopsies and treating trauma to the foot — for example, if someone dropped a heavy object onto to their foot.”

For some patients wearing an orthotic device (a foot pad or heel insert) is very important in maintaining healthy feet and reducing pain. A blog from Doctors United talks about the importance of proper orthotics for foot pain listing five key benefits.

1. Providing superior comfort

2. Assists in fighting off pain in the foot, ankle and leg

3. Improves balance

4. Helps to absorb shock

5. Enhances athletic performance. Schara also provides custom orthotic devices to her patients as the practice does their own casting utilizing 3D scanning. Once that is completed an order is sent out to a lab in Ohio which makes the final product.

Wendy Schara holds a Doctor of Podiatry degree and works at Foot Doctors in Utica.

OMEN'S HEALTH

Tips to Make it Easier to Say ‘No’

Don’t feel guilty about saying no. You alone know what’s best for you. Stand firm and know that boundaries are essential to your emotional health

By Barbara Pierce

It’s one small two-letter word: No.

This small word packs a lot of power in our lives if we learn how to use it.

Saying no keeps us sane. In an age of overload, a no gives us the space we need to live our lives the way we choose to.

The truth is, when we say yes to too many activities and responsibilities, we are, in essence, saying no to the people or priorities that mean so much to us, the things that should be first on our list of priorities.

“The word no is essential language,” said Dianne Stancato, CEO, YWCA Mohawk Valley. The YWCA provides domestic and sexual violence crisis services to Oneida County.

“The ability to comfortably and confidently say no at any time should always be present in any relationship,” she continued. “Open and honest communication is key to maintaining healthy boundaries, whether you are in a romantic relationship, platonic friendship or professional acquaintanceship. Everyone’s boundaries are different and each boundary deserves to be respected. Saying no is a clear communication of those boundaries.”

Saying no is a powerful skill that allows us to set boundaries, protect

our time and energy and prioritize our well-being. However, many of us struggle with saying no. It’s one of the hardest words for many women. We want to be helpful, to please others. We’re good at putting others first. These are good traits to have, certainly. But sometimes a no is necessary.

Saying no is hard for many because setting and enforcing boundaries can be intimidating, according to Stancato. For example, in an unhealthy relationship, saying no can be a risk factor for violence. Saying no may make us feel guilty for hurting the other person’s feelings or fear that our partner will leave, she added.

Stancato offers these strategies to make it easier to say no:

“Disregard the urge to apologize,” she said.

You don’t have to start by saying “I’m sorry, but…” or justified in any way. You don’t owe anyone an explanation as to why you’re saying no. So

don’t explain. Use as few words as possible.

The less you explain, give excuses and apologize the better. Say something like “Thank you so much for thinking of me, but this won’t work for me right now.” No further explanation is needed.

“Remember that saying no and setting boundaries doesn’t make you wrong or bad,” Stancato continued.

If the person you are saying no to becomes manipulative, punitive or abusive, don’t be afraid to do what is best for your safety.

Practicing setting boundaries and saying no in low- to no-risk situations makes it easier for us to start saying no to the higher-risk situations, she added.

It might help to make it easier to say no by saying something complimentary or disarming other experts suggest.

One way to do that is by thanking people for thinking of you — which reassures them that they didn’t do anything wrong by asking. Then, follow-up with a short explanation: “I wish I could, but I just don’t have the time right now.”

“Oh, it’s so good of you to ask me, but I’m sorry I just can’t.”

Leave yourself a way out, suggest other experts. When you are asked to do something, start by saying “I don’t know. I’ll have to think about it or I’ll have to check my calendar and get back to you” before you commit yourself. Buy time. That way you can think about the request and make the best decision for yourself. Plus, declining in a text is easier.

Adopt the broken-record tech-

nique. If someone won’t take no for answer, try the broken-record technique. Sticking to your answer — politely give the same answer again — usually after two or three times repeating yourself, even the most persistent people will get the message.

Don’t feel guilty about saying no. You alone know what’s best for you. Stand firm and know that boundaries are essential to your emotional health.

Saying no lets us say yes to the most important things in life, like spending time with our partner, our kids and our friends. And that’s what’s really important in life, isn’t it?

The YWCA of the Mohawk Valley is a certified provider of domestic and sexual violence crisis services, certified in residential and non-residential settings, Stancato said. All services are free and confidential. Domestic and sexual violence crisis services are available 24/7, 365 days a year, regardless of when the abuse occurred or if it was reported.

For general information, see ywcamv.org or call or text 315-797-7740 in Oneida County, 315-866-4120 in Herkimer County.

Dianne Stancato is the CEO of YWCA Mohawk Valley.

Raising Fertility

There’s an art and science in increasing fertility

By Deborah Jeanne Sergeant

About 9% of men and 11% of women of childbearing age in the U.S. have experienced fertility issues, according to National Health Statistic Reports.

When a couple has trouble conceiving a child, approximately one-third of the time, it stems from issues with the mother; another third relates to the man and the remaining one-third is a mix of both or an unknown cause. To give themselves the best chance for fertility, couples who regularly have sex should try to target what Rob Kiltz calls “the fertile window.”

“To effectively calculate when your body is most fertile, it is important to understand your menstrual cycle as no two women’s menstrual cycles are exactly the same,” said Kiltz, who is the founder of CNY Fertility in Rochester. “Your fertile window depends on the duration of your individual cycle.”

He explained that the first day of the cycle begins the first day of the menstrual period. For the next two weeks, during the follicular phase, the woman’s body focuses on egg growth and maturation and preparing the uterus for a potential pregnancy. For women with a typical 28-day cycle, the body ovulates — releases an egg — around the 14th day and she remains fertile for five days or so.

The cervical mucous becomes “clear, slippery, plentiful and the consistency of egg whites,” Kiltz said.

An at-home ovulation tester can also help pinpoint fertile days.

Once the egg is released, fertilization must take place within 12 to 48 hours. Having intercourse 72 hours before ovulation “gives sperm the best chance of successfully reaching the egg and fertilizing it in time,” Kiltz said.

Sperm can live in a woman’s body for up to five days.

If this strategy isn’t helpful, a few lifestyle changes can help improve fertility naturally.

“Inflammation is a major cause of infertility and diet, exercise and other lifestyle choices all play a role in improving or impairing fertility in

both men and women,” Kiltz said.

He elaborated that inflammation kicks off an immune response that may damage sperm, egg, embryo and even a developing fetus. Managing stress regularly — not just waiting for an annual vacation — is key for controlling this response.

While carrying too much fat is deleterious to good health, sufficient dietary fat is necessary to achieve pregnancy.

“It provides essential building blocks for our cells and helps synthesize vital reproductive hormones,” Kiltz said. “Dietary fat provides the body with energy and essential fatty acids that it can’t produce on its own. The fatty acids from animal meat assist with blood clotting and increase brain function. Fat also enables the body to absorb essential vitamins like A, D and E, which have all been shown to support fertility. The most important benefit of eating fat for fertility is that it helps to reduce inflammation.”

Foods containing omega-3 fatty acids, such as olive oil, walnuts and fatty fish such as salmon may help reduce inflammation. Kiltz also recommends eating more saturated fat, moderate protein and low to no carbohydrates to keep the lymphatic system running.

“Eating fat lubricates the lymphatics and helps filter out harmful pathogens, protecting the body from invaders that can cause illness. The lymphatic system is part of the circulatory and immune systems and is critical to maintaining optimal health,” Kilts said.

Nutrients known to support female fertility include zinc, choline, selenium, vitamin A and vitamin D. Sufficient calcium improves sperm production in men.

Kiltz warned against highly processed and fried foods as they’re typically high in trans fats.

“Trans fats that are high in omega-6 are the most damaging and they are formed when common cooking oils — vegetable, canola, soybean and corn — are chemically altered to remain stable at room temperature,” Kiltz said. “Research has shown that

trans fats are associated with ovulatory problems and other fertility issues.”

Limit caffeine, as too much can negatively affect fertility. Kiltz warned about eating too much fiber as a small study indicated that doing so may negatively affect hormones in women.

Soy products such as edamame, tofu meat alternatives and soy-based milk alternatives can reduce sperm concentration in men and affect women’s hormones.

Although exercise is important to maintain good health and the proper weight, Kiltz warned against over exercise for men and women, as it can affect hormones negatively.

“The good news for heavy exercisers is that research has shown that decreases in natural fertility likely only last as long as the hard training,” he added.

A couple wanting to conceive should avoid tobacco. Kiltz said that in addition to harming health in many other ways, smoking “can significantly impact both male and female natural fertility” and excessive alcohol can also impair fertility. Although the research is clearer on female fertility, men should also consider cutting back to help improve their overall health which boosts their fertility.

Too little or too much sleep also affects fertility in women, as it can affect menstruation, conception and pregnancy complications. In men, it can reduce sperm counts, motility and survival rates. Kiltz added that using hot tubs has also been shown to reduce sperm motility and increase the percent of sperm with defects.

He recommended mitigating the effects of stress — another fertility buster — and trying modalities such as acupuncture to help promote the ability to conceive.

In addition to leading a healthy lifestyle of minimal alcohol, a healthful diet and regular physical activity, physician Leslie James said that it may help to control environmental factors.

“Endocrine disruptors are chemicals found a lot of times in plastic,”

she said.

BPA is one example. Heating food in a non-approved container such as a plastic deli tub or single-use container instead of a glass container worsens the effect.

“Try to avoid those as much as possible,” she said. “Some are hard to avoid and it can create a lot of stress. Obviously, we can reduce our plastic use, but it’s ubiquitous. As much as possible, decrease it.”

“If you are trying to get pregnant but not having monthly periods or nearly monthly, this could be a sign that you are not ovulating regularly and there can be a variety of reasons for that,” said physician Jordana Gilman, an instructor of clinical obstetrics and gynecology at Highland Hospital and attending physician at Highland Women’s Health. “Talk to your OB-GYN for more information on your specific situation.”

For some women, engaging in aerobic exercise like walking 20 minutes a day and even 5% modest weight loss can kickstart ovulating again. To supplement egg health, Gilman recommends trying supplementation with coenzyme Q10.

Talking with a healthcare provider can help zero in on what’s going on and provide targeted resources for improving fertility.

Physician Rob Kiltz is the founder of CNY Fertility in Rochester.

MORE JOBS… MOREADVANTAGES

By Jim Miller

What You’ll Pay for Medicare in 2025

Dear Savvy Senior,

I know there will be a small 2.5% cost-of-living increase in Social Security benefits next year, but what about Medicare? What will the Medicare Part B monthly premiums be in 2025, and when do the surcharges kick in for higher income beneficiaries?

Medicare Beneficiary

Dear Beneficiary,

The Centers for Medicare and Medicaid Services recently announced their cost adjustments for 2025 and the increases for premiums and out-of-pocket costs for most beneficiaries will be moderate. But if you’re a high earner, you’ll pay significantly more. Here’s what you can expect to pay in 2025.

Part B Premium

While Medicare Part A, which pays for hospital care, is premium-free for most beneficiaries, Part B, which covers doctor visits and outpatient services does have a monthly premium.

Starting in January, the standard monthly Part B premium will be $185, up from $174.70 in 2024. That $10.30 bump represents a 5.9% increase, which is more than double the most recent Social Security cost-ofliving adjustment which was 2.5%.

But if you’re a high earning beneficiary, which makes up about 8% of all Medicare recipients, you’ll have to pay more. Medicare surcharges for high earners, known as the income-related monthly adjustment amount (or IRMAA), are based on adjusted gross income (AGI) from two years earlier, which means that your 2025 Part B premiums are determined by your 2023 AGI, which is on line 11 of the IRS tax form 1040.

Here’s how it breaks down. If your 2023 income was above $106,000 up to $133,000 ($212,000 up to $266,000 for married couples filing jointly), your 2025 Part B monthly premium will be $259.

Monthly Part B premiums for singles with an income between $133,000 and $167,000 ($266,000 and $334,000 for joint filers) will rise to $370. Individuals earning above $167,000 up to $200,000 ($334,000 to $400,000 for joint filers) will see their monthly Part B premium increase to $480.90.

Those with incomes above $200,000 up to $500,000 ($400,000 to $750,000 for joint filers), will pay $591.90 per month in 2025. And single filers with income of $500,000

or more ($750,000 or more for joint filers) will pay $628.90 per month.

ad will appear at the classification

Part D Premium

Rome NY with in Home Date 05/2014

If you have a stand-alone Medicare (Part D) prescription drug plan, the average premium in 2025 will be $46.50 per month for most beneficiaries, down from $53.95 in 2024. But again, for high earners with annual incomes above $106,000 ($212,000 for joint filers) you’ll pay a monthly surcharge of $13.70 to $85.80 (based on your income level) on top of your regular Part D premiums.

How to Contest Income

Beneficiaries that fall into any of the high-income categories and have experienced certain life-changing events that have reduced their income since 2023, such as retirement, divorce or the death of a spouse, can contest the surcharge. For more information on how to do this, see “Medicare Premiums: Rules for Higher-Income Beneficiaries” at SSA.gov/benefits/medicare/medicare-premiums.html.

Other Medicare Increases

In addition to the Part B and Part D premium increases, there are other cost increases you should be aware of. For example, the annual deductible for Medicare Part B will be $257 in 2025, which is $17 more than the 2024 deductible of $240. And the deductible for Medicare Part A, which covers hospital services, will increase to $1,676 in 2025. That’s $44 more than the 2024 deductible of $1,632. There are no surcharges on Medicare deductibles for high earners.

For more information on all the Medicare costs for 2025 visit Medicare.gov/basics/costs or call 800-6334227.

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.

Be Wary of Winter Heart Attacks

The risk of having a heart attack during the winter months is twice as high as it is during the summertime. Find out why

By Jim Miller

Everyone knows winter is cold and flu season, but many don’t know that it’s also the prime season for heart attacks too, especially if you already have a heart condition or have suffered a previous heart attack.

Here’s what you should know, along with some tips to help you protect yourself.

In the U.S., the risk of having a heart attack during the winter months is twice as high as it is during the summertime. Why? There are a number of factors, and they’re not all linked to cold weather. Even people who live in warm climates have an increased risk. Here are the areas you need to pay extra attention to this winter.

• Cold temperatures: When a person gets cold, the body responds by constricting the blood vessels to help the body maintain heat. This causes blood pressure to go up and makes the heart work harder. Cold temperatures can also increase levels of certain proteins that can thicken the blood and increase the risk for blood clots. So, stay warm this winter and when you do have to go outside, make sure you bundle up in layers with gloves and a hat, and place a scarf over your mouth and nose to warm up the air before you breathe it in.

• Snow shoveling: Studies have shown that heart attack rates jump dramatically in the first few days after a major snowstorm, usually a result of snow shoveling. Shoveling snow is a very strenuous activity that raises blood pressure and stresses the heart. Combine those factors with cold temperatures and the risks for heart attack surges. If your sidewalk or driveway needs shoveling this winter, hire a kid from the neighborhood to do it for you, or use a snow blower. Or, if you must shovel, push rather than lift the snow as much as possible, stay warm, and take fre-

quent breaks.

• New Year’s resolutions: Every Jan. 1, millions of people join gyms or start exercise programs as part of their New Year’s resolution to get in shape, and many overexert themselves too soon. If you’re starting a new exercise program this winter, take the time to talk to your doctor about what types and how much exercise may be appropriate for you.

• Winter weight gain: People tend to eat and drink more and gain more weight during the holiday season and winter months, all of which are hard on the heart and risky for someone with heart disease. So, keep a watchful eye on your diet this winter and avoid binging on fatty foods and alcohol.

• Shorter days: Less daylight in the winter months can cause many people to develop “seasonal affective disorder” or SAD, a wintertime depression that can stress the heart. Studies have also looked at heart attack patients and found they usually have lower levels of vitamin D (which comes from sunlight) than people with healthy hearts. To boost your vitamin D this winter, consider taking a supplement that contains between 1,000 and 2,000 international units (IU) per day.

• Flu season: Studies show that people who get flu shots have a lower heart attack risk. It’s known that the inflammatory reaction set off by a flu infection can increase blood clotting which can lead to heart attacks in vulnerable people. So, if you haven’t already done so this year, get a flu shot and COVID-19 booster for protection. And, if you’ve never been vaccinated for RSV or pneumococcal pneumonia, you should consider getting these vaccines too.

The Social Security Office Ask

From the Social Security District Office

5 Benefits You Can Apply For Online at SSA.Gov

We continue to make it easier for you to access our programs and benefits. Our website –www.SSA.gov– offers a convenient way to apply online for benefits.

You can apply for:

• Retirement or Spouse's Benefits — You must be at least 61 years and 9 months and want your benefits to start in no more than 4 months. Apply at www.ssa.gov/retirement.

• Disability Benefits — You can use our online application at www. ssa.gov/disability to apply for disability benefits if you:

– Are age 18 or older.

– Are unable to work because of a medical condition that is expected to last at least 12 months or result in death.

– Have not been denied disability benefits in the last 60 days. If your application was recently denied, you can appeal our decision online and request a review of the determination we made. Please visit www.ssa.gov/ apply/appeal-decision-we-made.

• Supplemental Security Income (SSI) — SSI provides monthly payments to adults and children with a disability or blindness who have limited income and few resources. People age 65 and older without disabilities who have limited income and resources may also be eligible for SSI. Some adults with disabilities who meet certain requirements may

Q& A

Q.: I will rely on Medicare when I retire. Can you explain the different parts of Medicare?

A.: The different parts of Medicare cover your specific needs. There are 4 parts, all of which work in tandem to deliver healthcare services:

• Part A (hospital insurance): This helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care, and hospice care.

• Part B (medical insurance): This helps pay for doctors’ and other health care providers services, outpatient care, home health care, durable medical equipment, and many preventive services (such as screenings, shots or vaccines, and yearly wellness visits).

• Part C (Medicare Advantage plans): If you have Medicare Parts A and B, you can join a Medicare Advantage plan. Private companies offer Medicare Advantage plans, which are approved by Medicare. These plans generally help you pay

complete the application process online. To learn more, visit www. ssa.gov/ssi. If you cannot visit our website, you can call 1-800-772-1213 to schedule an appointment. (If you are deaf or hard of hearing, you may contact our TTY/TDD number, 1-800-325-0778.)

• Medicare — Medicare is a federal health insurance program for: – People aged 65 or older.

– Younger workers who have received disability benefits for 24 months.

– People with end-stage renal disease (ESRD) or Amyotrophic lateral sclerosis (ALS). Note: They do not have a two-year waiting period.

If you are not already receiving Social Security benefits, you should apply for Medicare up to three months before turning age 65 at www.ssa.gov/medicare. You should consider your Medicare options even if you are still working and covered under an employer group health plan (or your spouse’s employer health plan through their active employment).

• Extra Help with Medicare Prescription Drug Costs — The Extra Help program helps Medicare beneficiaries with prescription drug costs, like deductibles and copays. People on Medicare who need assistance with the cost of their medications can apply for Extra Help at www.ssa. gov/medicare/part-d-extra-help.

Please share this information with those who need it.

the medical costs not covered by Medicare Part A and B.

• Part D (prescription drug coverage): This helps pay for prescription drugs (including many recommended shots and vaccines).

Q.: What are the requirements for receiving benefits for a surviving spouse with a disability?

A.: You may be able to get benefits as a surviving spouse with a disability at age 50 if you meet Social Security’s disability requirement. Your disability must have started before age 60 and within seven years of the latest of the following dates: the month the worker died; the last month you were entitled to survivors benefits on the worker’s record as a parent caring for a surviving minor child; or the month your previous entitlement to benefits for surviving spouse with a disability ended because your disability ended. To learn more, visit www.ssa.gov/benefits/ disability/qualify.html.

Jim Miller is the author of Savvy Senior, a column that runs every issue in In Good Health.

Studies have shown that heart attack rates jump dramatically in the first few days after a major snowstorm, usually a result of snow shoveling.

Resource Center for Refugees Receives Excellus Health and Wellness Award

Excellus BlueCross BlueShield

recently awarded Mohawk Valley Resource Center for Refugees a health and wellness award to support its women’s wellness group, which supports mental health and social engagement among the refugee and immigrant women.

The program, which is coordinated by Center for Refugees’ health access coordinator, focuses on small group activities, education, wellness and artistic activities, with a focus on socialization and community engagement.

Each two-hour program begins with a health topic which is presented either by an external agency or a program staff member from The Center. The women then participate in a craft or artistic activity, which research has shown to be therapeutic for populations that have experienced previous trauma.

“Many of the families that we encounter face the monumental task of starting their lives over in a new country with limited social and mental wellness support,” explains Shelly Callahan, executive director at the center. “This program provides these women with discussions around

health topics and provides activities that allows them to socialize with other women who are facing similar obstacles in a new country.”

The center assists refugees, immigrants, and those with limited English language proficiency throughout the integration process and helps them achieve independence by developing services that fosters a healthy community filled with many cultures.

Excellus BCBS’s Health and Wellness Awards support programs that conduct ongoing work or initiatives designed to improve community health and health outcomes. Health disparities are complex and can have many causes. These awards are given to programs that address specific health conditions or factors linked to health disparities.

“Helping to build a healthy community is core to our mission as a nonprofit health plan,” shares Tony Vitagliano, Excellus BlueCross BlueShield regional president. “We are proud to provide the center with this essential community health funding to support women in the immigrant and refugee population. The information they learn and the positive

from

visited the

Valley

Center for Refugees to present a Health and Wellness Award, which was used to support Women’s Wellness Groups for refugee and immigrant women. From left: Andrea MacDiarmid, Excellus BCBS community investments and partnerships lead; Jennifer VanWagoner, director of strategic initiatives for The Center; Shelly Callahan, executive director at The Center and Tony Vitagliano, regional president for Excellus BCBS join for a presentation of the award.

experiences they have will benefit their entire families.”

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

Maintain Muscle as You Age to Keep Brain Sharp

Maintaining muscle might be one way to help prevent dementia, new research suggests.

“We found that older adults with smaller skeletal muscles are about 60% more likely to develop dementia when adjusted for other known risk factors,” said study co-senior author Marilyn Albert. She's a professor of neurology at Johns Hopkins University School of Medicine in Baltimore.

Her team presented its findings at the recently held annual meeting of the Radiological Society of North America.

As the researchers explained, skeletal muscle makes up about a third of a person's body weight and does tend to shrink with age.

To find out how muscle loss might impact brain health, Albert and colleagues focused on the temporalis muscle, which helps move the jaw.

It's been long known that reductions in this muscle reflect a loss of skeletal muscle throughout the body.

“Measuring temporalis muscle size as a potential indicator for generalized skeletal muscle status offers an opportunity for skeletal muscle

quantification," lead author Kamyar Moradi said in a meeting news release. He's a postdoctoral research fellow in radiology at Hopkins.

The research team was able to gauge the size of the head's temporalis muscle by looking at brain scans of 619 people who averaged 77 years of age.

Folks were divided into two groups: Those with larger temporalis muscles and those with smaller ones.

Having a smaller temporalis (and, by extension, smaller skeletal muscles throughout the body) was tied to a significantly higher likelihood that the person was also diagnosed with Alzheimer's disease, the study found.

Smaller temporalis muscles were also linked to a higher risk for memory issues, declines in "functional activity," and shrinking brain volume, the researchers found.

The study wasn't designed to prove cause and effect, only that reductions in skeletal muscle are associated with dementia. And because these findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

But study co-senior author, physician Shadpour Demehri, a professor of radiology at Hopkins, said that once a person knows that they're losing vital muscle, they can use weight-training, diet and other means to slow that loss.

“These interventions may help prevent or slow down muscle loss and subsequently reduce the risk of cognitive decline and dementia,” Demehri said.

with its corporate mission, goals, policies or products.

Excellus BlueCross BlueShield’s Utica region encompasses Clinton, Delaware, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, Madison, Montgomery, Oneida, Otsego and St. Lawrence counties.

Officials

Excellus BlueCross BlueShield

Mohawk

Resource

to Stay Healthy in 2025 10 Things to Do

By Deborah Jeanne Sergeant

For the past 20 years, I’ve regularly written on wide variety of health topics. This involves interviewing health experts from across the spectrum of healthcare. The advice they offer most often are practical steps anyone can use to stay healthy:

1

Avoid tobacco. There’s no benefit and multitudinous reasons to avoid any tobacco use. Tobacco harms nearly every bodily process, system and cell. Although vaping doesn’t involve smoke, many vape liquids include tobacco and all are made from chemicals that are probably unsafe to inhale in vapor form (even if some are safe in other forms or for other uses). Most vape liquids come from countries like China that do not adhere to the same consumer protection guidelines as the US. Like tobacco use, vaping provides no benefit.

2

Skip alcohol. Studies in the late 1990s heralded heart health benefits for those who consume a glass of wine daily. However, more recent studies indicate those benefits were overstated and alcohol offers no real benefits. Alcohol consumption has also been shown to raise cancer risks. Relying upon it as a crutch to wind down or soothe disappointments or as the only means of enjoying yourself can place you at risk for alcoholism. Drinking alcohol can raise the risk of regrettable and dangerous behavior, such as driving under the influence. If you don’t want to be a teetotaler, at least cut back and save

drinking a modest amount of alcohol for only very special occasions.

Perform cardiovascular exercise. Regular aerobic exercise at sufficient intensity promotes good heart health (although anything is better than nothing). Most experts recommend 150 minutes of moderately paced cardio a week. Hate pounding the treadmill at the gym? Then don’t. You’ll stick with exercise if you find an enjoyable activity. Mine is martial arts. Find activities that you can do year-round.

4

Engage in strength training. “If you don’t use it, you lose it” applies to muscle. Even after midlife, it’s still possible to gain muscle although it’s harder. Weight machines tend to be safer than free weights as they usually offer charts showing how to use the equipment and the weight is more controlled. Many high schools offer free gym time for the community. Talk with a personal trainer to devise a safe and effective workout that’s right for you. Becoming injured will certainly derail your fitness plans.

3 5

Eat a balanced diet. Many dietitians would like to see their clients adopt the 80/20 rule, meaning that 80% of the time, they eat nutrient-dense foods and 20% of the time, they can indulge. But no foods are strictly off-limits unless there is some medical reason to eschew them. A balanced diet doesn’t mean buying special “diet” foods or things you

don’t like to eat. Instead, focus on an abundant, colorful array of whole fruits and vegetables. Choose at least half of your grains from whole grain sources. Eat lean sources of protein and a daily modest serving of nuts and seeds. Select fat from sources like olive oil. Cultured and fermented foods such as yogurt, kefir and kimchi can help promote good gut health.

6

Drink enough. Hydration supports all the body’s systems. The recommended quantity is half of one’s body weight in ounces daily. A 140-pound person would drink 70 ounces daily. Water should be the goto beverage. Adding a splash of fruit juice to water or drinking sparkling water or unsweetened, decaffeinated tea can help keep it interesting. Limit caffeine, as it’s diuretic.

7

Reduce intake of processed sugar and simple carbohydrates. More often than not, swap out snack cakes, pop, chips and candy for home baked treats, sparkling water or flavored sugar-free tea, air popped popcorn and fruit. When you do indulge, enjoy one serving thoughtfully and put the rest away.

8

Get enough sleep. Most people need seven to nine hours sleep per night. Sleep restores the body and helps promote a healthy immune system. If you don’t get enough sleep, try delegating responsibilities and improve your sleep hygiene. This concept refers to guidelines that pro-

mote good sleep, such as restricting naps to only 30 minutes and having them early enough in the day to not interfere with sleep; keeping the bedroom dark, cool and comfortable; reserving the bed for only sleep and intimacy; managing stressful thoughts through creating lists, journaling and as needed, seeking professional help; avoiding caffeine after 2 p.m. and going to bed and rising at the same time every day.

9

Keep up with routine healthcare. This should include regular physicals, healthcare screenings, dental cleanings and care and mental healthcare. Don’t wait until something goes wrong. By then, the effects are more expensive and tougher to fix. If you have a diagnosed health condition, follow your provider’s guidance.

10

Stay connected. As the pandemic demonstrated, it’s unhealthy to live isolated. Community involvement improves mental health and provides support for good health such as learning about resources in the area that can help you. Connectedness can also refer to staying in touch with what’s real. The social media world is so far away from reality that spending too much time there can create dissatisfaction with life and mental stress. Enjoy your not-so-perfect life with a sense of gratitude. Engage with what makes you happy.