Dr. Mark Winsberg, a former medical director of Rochester Regional Health chemical dependency department, talks about his addiction and how he was able to overcome it. P.12
Q & A with Diane Kuppermann
CEO of Make-A-Wish Central New York talks about the organization’s 40th anniversary P.5
Upstate New York vets report seeing more cases of drug-resistant heartworm P.15
Many Americans don't see anything wrong with taking daily low-dose aspirin, even though experts have concluded its risks outweigh its benefits, a new survey has found.
Nearly half (48%) of people incorrectly think that the benefits of taking low-dose aspirin daily to reduce the risk of heart attack or stroke outweigh the risks, according to the survey from the Annenberg Public Policy Center of the University of Pennsylvania.
“Habits backed by conventional wisdom and the past advice of health
care providers are hard to break,” Kathleen Hall Jamieson, the center's director, said in a news release. “Knowing whether taking a low-dose aspirin daily is advisable or not for you is vital health information.”
For years, healthy seniors were advised to take low-dose aspirin to reduce heart attack and stroke risk.
The rationale was that aspirin acts as a blood thinner, reducing the risk that a blood clot could cause a heart attack or stroke by clogging an artery. But in 2019, the leading heart groups — the American College of Cardiology and the American Heart
Association — reversed that recommendation in a set of new guidelines.
The groups concluded that daily aspirin for healthy seniors 70 and older wasn't worth the risk of gastrointestinal bleeding.
"If you're over 70, taking aspirin to prevent a first heart attack or stroke could do more harm than good," the AHA now says on its website.
Aspirin still is recommended for people with diagnosed heart disease who don't have an increased risk of bleeding. This updated guidance has failed to break through decades of advice supporting daily low-dose aspirin, the poll found.
Nearly 1 in 5 U.S. adults who have no personal or family history of heart problems report routinely taking low-dose aspirin. According to survey results:
• 10% say they take it “basically every day.”
• 6% take it “a few times a month.”
• 2% take it “a few times a week.”
Younger adults were more likely than older folks to correctly report that the risks of aspirin outweigh the benefits, the survey showed.
About 29% of 18- to 29-year-olds with no personal or family history of heart disease correctly said the risks of daily aspirin outweigh benefits, compared with 11% of those 40 to 59 and 7% of those 60 and older, researchers found.
That's likely because the younger folks haven't been exposed as much to the outdated guidance supporting aspirin use, researchers said.
The survey involved 1,771 people polled Nov. 14 to 24, 2024, and has a margin of error of plus or minus 3.3 percentage points.
Even diseases usually thought of as affecting older people, like heart disease and diabetes, are contributing to early deaths among young adults
Young adults keep dying at higher-than-expected rates, falling prey to drug overdose and poor health, a new study says.
The death rate among adults 25 to 44 was 70% higher in 2023 than it would have been had pre-2011 trends continued, researchers reported in a new study published Jan. 31 in JAMA Network Open.
“Although mortality rates decreased after the core pandemic years, excess mortality remained higher than expected based on prepandemic levels,” the research team led by Elizabeth Wrigley-Field, an associate professor of sociology at the University of Minnesota, concluded.
This trend started prior to the COVID-19 pandemic, with early deaths among adults 25 to 44 nearly 35% higher than expected in 2019.
Then during the pandemic, excess deaths among young adults nearly tripled compared with 2019, researchers found.
By 2023, the pandemic-era death surge among young adults had subsided somewhat, but early deaths remained 70% higher than expected.
“These results suggest the possibility of a worsening mortality crisis unless these trends are reversed,” researchers concluded.
Drug overdoses accounted for nearly 32% of deaths among young adults in 2023, researchers found. About 14% died in accidents, nearly 9% due to alcohol use and 8% in homicides.
“The largest portion of 2023 excess mortality was driven by drug poisoning, but many other external and natural causes exceeded what prior trends would have projected,” researchers wrote.
Even diseases usually thought of as affecting older people, like heart disease and diabetes, are contributing to early deaths among young adults, said physician Sanjey Gupta, senior vice president and director of emergency medicine for Northwell Health in Hempstead on Long Island.
“Unfortunately, we have a much higher percentage of our youth who suffer from some of the diseases that we used to attribute to old age," Gupta, who was not involved in the study, said in a Northwell Health news release.
"So hypertension and diabetes and obesity — we're encountering children with these illnesses. And as they are aging, they're getting the additive effect of having these diseases for long term,” he added.
The two distinct phases of increasing early deaths, before and after 2020, might indicate that the pandemic continues to stalk the health of young adults, researchers said.
Some young adults might be dealing with the long-term consequences of severe COVID infections, while others might have overlooked impending health problems because the pandemic disrupted usual medi cal services.
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the Upstate Advantage for your
As the region’s largest employer Upstate offers more jobs and more variety, with great
By George W. Chapman
It’s been said here several times that the U.S. gets the worst bang for the buck when it comes to the cost of care versus results.
With the cost per capita of more than $14,000 a year, we rank around 40th in overall mortality. And nothing says how poorly we perform more than Black infant mortality. Per 100,000 births, it is three
Deferred Resignation Offer to VA Nurses
If any group has earned the right to receive healthcare, it is our veterans. Yet the White House is offering VA nurses, the govern ment's largest group of employees, deferred resignations. This is being done before any valid analysis and done when half of our VA hospitals are operating under severe staffing shortages. The nurse union is encouraging their members not to take the bait. When care eventually deteriorates further due to nurse shortages and the VA is finally allowed to hire more nurses, where do the powers that be think they will come from? The VA cares for more than 9 million veterans.
times higher than the mortality rates for Whites (14), Hispanics (12) and Asians (11). The infant mortality rate for Black infants is astounding 50 per 100,000.
The mortality report leaked out just after the official "temporary pause" on external federal health agency communications. (Pausing all federal health communication is a to-
down certain web pages by the new administration. The agencies are: CDC, OPM, FDA and HHS. The lawsuit is brought by the Public Citizens Litigation Group. One can only hope that science, not politics, determines what information is available to us all let alone our providers and researchers. Will any of these agencies even exist in the future? Scary. A judge has since ordered the pages reinstated.
Doctors for America is suing several federal agencies over the removal of several web pages from websites covering a broad range of health-related (scientific and validated) data used daily by providers and researchers. In fairness, the agencies being sued were mandated to take
The leading cause of death among 18-45-year-olds remains fentanyl overdoses. In 2023, more than 107,000 of us died from an OD with 70% being from the opioid fentanyl. While measures are being taken to slow down, if not stop altogether fentanyl smuggling into the U.S., a new drug developed by the school of pharmacy at the University of the Pacific can save lives. naloxone is the chemical in Narcan which is used to counter overdoses. Narcan lasts up to two hours when delivered as a nose spray. Researchers at U of P found that the HD-5 molecule when added to naloxone allows Narcan to be delivered via
tally different problem. In the future, will we ever know what’s wrong?) Studies have shown that more Black docs lead to better outcomes. Unfortunately, the number of Blacks attending medical school has dropped off sharply the past several years. Attempts to curtail health insurance for at-risk populations will only exacerbate the mortality problem.
injection versus nose spray. Consequently, the medication lasts in the body for a week preventing overdoses for longer and more often.
No matter what the final outcome of the tariff war with Cana da, it will inevitably increase the cost of medical equipment we import from our friendly neighbors to the north. Medical equipment has typically been exempted from tariffs per the free trade agreement that existed between the US, Mexico and Canada. Guess who signed it? Anyway, unless the medical equipment exemption continues, we can expect higher costs for MRIs, ventilators, wheelchairs, pace-makers, insulin pumps and orthopedic implants. In 2022, Canada imported $5 billion of medical equipment from the US or 38% of their total medical imports. We imported $3 billion from Canada. Clearly, the trade imbalance favored the U.S. Any tariff on Canadian medical equipment will negatively impact both cost and access to both countries.
The U.S. could make substantial inroads toward reducing the exorbitant cost of care in the US by hundreds of billions if Congress would simply take the handcuffs off CMS negotiators and let them negotiate the price of all drugs with Big Pharma on behalf of all 335 million citizens. But our purchasing power has been stilted/controlled by the powerful drug lobby which has reluctantly agreed (gun to head) to striking deals per the Inflation Reduction Act (IRA) on 10 drugs for 2026 for our 60 million Medicare recipients. (We actually had to pass a law to allow Medicare the ability to get our consumers the best bang for our bucks.) Instead of taking the 10-drug limit as a win, Big Pharma continues to lobby for the repeal of the Inflation Reduction Act. Will our newly created Department of Government Efficiency dare take on the drug lobby and recommend negotiating all drug costs and not just a few at a time? We'll see. In the meantime, with the initial 10 prices to take effect in 2026, CMS has indicated the second round of 15 drugs to be negotiated per the IRA. These 15 new prices take effect in 2027. Among them are: Ozempic, Rybelsus, Wegovy and Trelegy. Instead of thwarting physician, hospital and nursing facility reimbursement, CMS should be laser focused on going after the fat in drug prices.
Uninsured Will Increase
To reduce costs, the White House is proposing to cut $2.5 billion from Medicaid by disen rolling 25 million people that qualified for coverage during the pandemic via expanded eligibility. Currently, Medicaid covers more than 70 million people. If the Affordable Care Act is repealed, even more than the 25 million on Medicaid will lose affordable insurance they purchased via the health exchanges. In 2023, our uninsured rate was at an all time low of 8%. If Medicaid is cut and the ACA repealed, the uninsured rate could jump up to 15% or four million per year through 2034. This significant loss of insurance will create more uncompensated care for already struggling clinics, emergency rooms, hospitals and health systems. Making matters worse, patients without insurance tend to postpone or delay care so when they finally seek care they are much sicker. To make up for these losses, providers will be forced to negotiate higher rates with commercial carriers thereby forcing commercial insurance rates up. Is it time we gave serious consideration to a national health plan? We can't stop a boat from sinking if we only plug some of the holes. We need a new boat.
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.
border to Pennsylvania and Herkimer and Cayuga. We employ eight people.
Q: How are you funded?
A: We’re funded by individual donations, by special event fundraising, both internal and external. We get corporate support. We receive money from national corporate partners. That’s one of the roles our national office plays. They’re unique in that they’re there to serve chapters, but together, our partnership really makes things come true. Any child, regardless of where they’re treated, when they reside in our footprint, we are responsible for their wishes.
Q: What determines a child’s eligibility?
A: There’s a national set of criteria that defines what a critical illness is. Basically, it’s an illness that is progressive, degenerative or malignant at the time of referral. Our kids are really battling very serious health issues and are typically treated by a specialist.
Q: You mentioned referrals. How does that work?
A: The doctors are one of the primary referral sources or a medical professional; but it can come from the parents; it can come from the child him or herself, but most often we prefer that the referral comes from the child’s parent or the medical professional knowing that they have spoken to the child’s parent. We are all about hope and the power of a wish come true. When a parent makes that referral, then we are confident that we’re being invited into the family’s life, which is really important to us. Some people think of us as granting wishes to kids who aren’t going to make it. And that’s never, never something that we want to talk about because the truth is nobody knows. What we do know is the power of a wish has the possibility of changing a child’s medical trajectory.
us that the wish is a turning point, something that increased compliance with treatment. It gave them a renewed strength to keep fighting their illness and to be forward-thinking. Eight out of 10 “wish kids” reported that their wish gave them the strength to fight their critical illness. It just changed their story in so many ways. They were no longer the kid who was sick. They were the kid that got to (fill in the blank with their wish). And the long-term impact that medical providers have shared with us is that they’ve observed that the wish experience has had a positive impact on the child’s physical well-being and overall quality of life.
Q: Is there an age range for the eligible kids?
A: Yes. The kids must have reached age 2-1/2 to be referred and they must be referred prior to turning 18 and they must have an illness that is verified by their child’s physician. It goes through a process through the medical referral process. The only other criterion is that the kids have never had a wish before from any other wish-granting organization. Other than that, it’s regardless of race, religion or economic status.
Q: What keeps you motivated after 33 years as director of the organization?
A: So many things keep me motivated. I think the number one thing that keeps me motivated is the gift of having two healthy children and that gratitude for their health. But seeing the impact that a wish has, not only on the child, but her family and her community, her peers, her physicians; the impact that wishes have on everyone at Make-A-Wish and the people that we get to involve in making wishes come true. It really is an unbelievable experience to see the power of hope and then the strength and joy that it gives to children and their families.
Q: Is there one wish that really tugged at you?
Make-A-Wish
By Mary Beth Roach
As the Make-A-Wish Central New York celebrates its 40th year, its president and CEO Diane Kuppermann discusses the organization and provides insights in how the agency grants wishes for children who are battling a critical illness in Central New York.
Q: How long have you been with MakeA-Wish?
A: This year, I am starting 33 years with the organization.
Q: Can you give us a brief overview of the organization?
A: It’s a global organization. Make-A-Wish America has 57 chap-
ters and each chapter is an independent 501(c)(3) organization. Our mission is simply that together we create life-changing wishes for children with critical illnesses and our vision is to ensure that every eligible child has a wish come true.
Q: What is your budget, your coverage area and the number of employees that you have?
A: This year, our annual budget is $2 million. It is the most aggressive budget that we have had to date; but that is necessary for us to continue to say yes to every eligible child. Our chapter serves 15 counties in Central New York. We go from the Canadian
Q: How many wishes has the organization granted?
A: Over the past 40 years, we have granted over 2,200 wishes to kids living here in Central New York. Last year, we granted a record number of 96 wishes in a single year and currently there are about 128 wishes in the pipeline — kids who are waiting to have their wishes come true. We were talking to Upstate Medical University Hospital and they’ve seen in the oncology unit, an unprecedented increase in their kids who were diagnosed with cancer. As we were looking at our year-over-year data through December (our fiscal year starts in September) — from September to December — our eligible referrals went from 16 to 30. We’re not quite sure why, but our hope is that every eligible child will receive a wish because it does make such a difference to their medical journey. And that’s certainly something that, we as an organization, have learned over the past 40 years.
Q: You talk about how it can change the trajectory of a child’s journey through whatever they’re battling. Can you give an example?
A: Nine out of 10 “wish kids” reported that the wish experience gives them relief from traumatic stress. Nine out of 10 “wish parents” saw their children’s emotional well-being improve during the wish process. For medical providers, they have told
A: I would say there are over 2,200 wishes that have tugged at my heart and primarily because the unique thing about the wish is when it is truly that child’s wish, when you see the change in the child from the time we get to meet them till the time that their wish is granted and for those who choose to stay in touch with us — which we hope is many, many of our wish families — when we get to see kids today who are thriving, who are parents, who are raising their own kids. It just really gives you a feeling of such incredible inspiration that the kids are so resilient and they are so full of hope and curiosity and often innocence. It never ceases to amaze me, also, the incredible power that we see when other people get to be involved in the wish experience, when you see the good in people every single day. All we have to do is ask, and we get a response because everybody wants to make a difference in the life of a child.
There have been some unique wishes that I was very surprised we were able to pull off. And yet I shouldn’t say that because nothing ceases to amaze me when you put together creativity and providing hope to kids. Volunteers who give everything of themselves to help us and our donors and this community. This community is so rich with support for not just Make-A-Wish, but for every organization.
By Gwenn Voelckers
Editor’s Note: The column below was published years ago and has been updated by the author in celebration of the 20th anniversary of her solo trip to Paris and the launch of her “Live Alone and Thrive” column. We think the column’s uplifting insights remain as timely and relevant as ever. Enjoy!
This year marks the 20th anniversary of my solo trip to Paris to celebrate turning 50. It also marks the anniversary of a decision I made that changed my life.
It was in the "City of Light" that I decided to create a workshop series designed to help women live on their own with more confidence and joy.
Since launching the workshop in 2005, I have learned and experienced so much. I have also been inspired by the courageous, resourceful women and men I've met along the way who are now living alone with pride and gusto.
They reinforce what I practice every day and what I shared in my Live Alone and Thrive workshop (now on hiatus since COVID -19) — namely, that the relationship with ourselves is the most enduring of all and that it is worth nurturing.
Most of these women and men have overcome some very real and often painful obstacles, but they now embrace their independence and are busy leading interesting, full lives.
They are making it on their own. They have challenged, as have I, the age-old belief that marriage, as it has been traditionally defined, is the only state in which we can be truly happy,
fulfilled, secure and complete.
Whether divorced, widowed or a confirmed bachelor or bachelorette, they are not spending their time bemoaning their fate. They have conquered uncertainty and adversity and are the stronger for it.
They have taken their lives into their own hands and have come to appreciate the choices and opportunities that living alone has to offer.
This much I know:
1. Living alone doesn’t mean being alone. A single text or phone call can bridge the gap and foster connections.
2. Rediscovering your true self and identifying those things that bring meaning and joy into your life can turn living alone into an adventure of the spirit.
3. Loneliness is not a state of being reserved for single people. Were you ever lonely while you were married?
4. Accepting party invitations is worth doing, even if you suspect the party will be mostly couples. Remind yourself that guests often separate into groups of women and men, so singles blend right in.
5. Figuring out how to hire a contractor, buy a car or even replace the flapper valve in your toilet — all by yourself — can be very gratifying!
6. Sitting in solitude allows you to listen to your inner voice, process loss and begin a journey of self-awareness and compassion. Enlightenment can follow.
7. Pursuing a volunteer activity, part-time job, academic degree or
deeper role in your congregation can be invigorating and fun.
8. The stereotyped image of single women and men as desperate and miserable is exaggerated and just plain untrue. Not a believer? Check out this article about an older adult living by herself and thriving: A Centenarian Thrives Living Alone, Active and Engaged. Simply Google the title and be inspired!
9. Traveling solo can awaken your sense of adventure and passions you never knew existed. Whether it’s Paris or Poughkeepsie, traveling by yourself creates space for these discoveries.
10. Doing a random act of kindness is a great antidote when you’re feeling lonely and sorry for yourself.
11. Friends matter. Reach out. Nurture your friendships. Honor your commitments.
12. Turning your home into a personal retreat that reflects your own tastes, without compromise, can be liberating. Energizing. Even healing.
13. Letting go of the idea that you need to be married to have any chance of being happy and fulfilled is essential. This idea will only keep you mired in self-pity. “Build thy home in thy heart and be forever sheltered.” Anonymous
14. Treating yourself well builds self-esteem. Prepare healthy meals. Get enough sleep. Exercise. You’re worth it. Tell yourself so by taking good care of yourself.
15. Managing your own schedule becomes easier on your own. You can prioritize your time however you want, leading to greater productivity and personal growth.
16. Getting out of your comfort zone is worth the discomfort. Try something new — tap dancing, a cooking class, book club, drumming circle — or whatever piques your interest. It’s a great way to have fun and meet new people.
17. Isolating on holiday, birthdays, Sundays, etc. is for the birds. Solitary confinement is punishment for criminals, not single people. Make plans.
18. Comb your hair. Lose the sweats. Put a smile on your face. It’s
lives was also gleaned from parents and other caregivers and school records.
Even if a teen is at a healthy weight, just thinking they are overweight can greatly raise their odds for self-harm, a new study finds.
“What we found was that the perception of being overweight has a much stronger effect of suicidal ideation than the objective measure of weight,” said study lead author Philip Baiden. He's associate professor of social work at the University of Texas at Arlington.
In the study, Baiden and colleagues looked at 2015-2021 data on more than 39,000 U.S. teens, aged 14 to 18, collected by surveys conducted by the U.S. Centers for Disease Control and Prevention (CDC).
Some of the data focused on key factors in these kids' lives: Their families' socioeconomic status, dynamics within the family, pressures at school and tough issues experienced in childhood.
Other information about their
important to create your own positive feedback. Looking your best can bring people, compliments and joyful energy your way.
19. There’s no shame in asking for help. It’s not a sign of weakness. On the contrary, asking for help shows courage and resourcefulness.
20. Self-confidence and humor can lead to rewarding relationships; neediness and desperation can thwart them.
21. Doing anything alone means you enjoy life and your own good company; it’s a reflection of your independence.
22. Expanding your definition of love beyond romantic love will stand you in good stead. Embrace passionate friendships — those relationships in which you can be yourself and feel completely comfortable.
23. Hanging out with negative people is a real downer. Put yourself with uplifting people who make you feel good about yourself and about life.
24. Living alone and loving it takes practice. Know that there is always someone you can call or something you can do to improve your situation.
25. Building your home in your heart can deliver peace as well as power. Harness that potential and your contentment will know no bounds.
Don’t I know it!
Gwenn Voelckers is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” She welcomes your thoughts on this column as well as topic suggestion for future essays at gvoelckers@rochester. rr.com.
The Texas team focused especially on any self-reports of suicidal thoughts (ideation). Teens who thought they were overweight had triple the odds of these intrusive thoughts, the study found.
“Even after adjusting for established suicidal ideation risk factors such as feelings of hopelessness, bullying, cyberbullying, substance use and demographic variables, we still found a connection between how adolescents feel about their weight and whether they are considering self-harm,” said study co-author Catherine LaBrenz.
“We also found that females were more at risk than males at perceiving themselves to be overweight," noted LaBrenz, an associate professor of social work at the university.
The team stressed, however, that parents, families, school and communities can all work together to boost teens' self image and prevent mental health crises.
“By investing in preventive measures and early-intervention programs,” Baiden said, “it is possible to reduce the long-term burden on the health care system and improve the quality of life for young people.”
If you or someone you love is in mental health crisis, help is at hand 24/7 at the 988 Suicide & Crisis Lifeline.
The study was published in the March issue of Psychiatric Research.
By David L. Podos
Approximately 24 million people in the United States suffer from an eating disorder, according to the National Association of Anorexia Nervosa and Associated Disorders.
The nonprofit states that eating disorders are among the deadliest mental illnesses, second only to opioid addiction, resulting in approximately 10,200 deaths each year.”
According to the National Alliance of Eating Disorders, there are five types of eating disorders.
1. Anorexia Nervosa
It is characterized by an obsessive fear of gaining weight, which often leads to distorted body image and difficulty maintaining healthy body weight. It carries a lifetime prevalence of up to 4% among females and 0.3% among males.
2. Bulimia Nervosa
It manifests as recurrent episodes of binge eating followed by compensatory behaviors, affecting up to 3% of females and over 1% of males over their lifetimes. The cycle of bingeing and purging can have a profound toll on both physical and mental well-being, necessitating comprehensive treatment approaches.
3. Binge Eating Disorder
It affects an estimated 3.5% of women and 2% of men and affects 30% to 40% of those seeking weight loss treatment. Characterized by recurring episodes of overeating in a short period, BED is the most common eating disorder among U.S. adults, affecting three times the number of those diagnosed with anorexia nervosa and bulimia nervosa combined.
4. Avoidant/Restrictive Food
Intake Disorder
Also known as selective eating disorder, ARFID is characterized by an eating or feeding disturbance, such as an apparent lack of interest in eating or food, avoidance based on the sensory characteristics of food or concern about aversive consequences of eating.
5. Other Specified Feeding and Eating Disorders
It encompasses a spectrum of eating disorders that fall outside the criteria for AN, BN or BED, yet still have significant health ramifications that can be just as severe as others. This category includes “atypical” anorexia nervosa, purging disorder, bulimia nervosa and binge eating disorder (of low frequency or duration) and night eating syndrome.
Many causes trigger disorders
Jim Davis, executive director of the Samaritan Counseling Center of the Mohawk Valley in Utica, has worked with clients experiencing eating disorders. And as a former high school counselor, he worked with a number of students having eating disorder issues.
“Eating disorders are often thought of as a person who for whatever reason overeats and needs to lose weight. It is pretty evident that we have an obesity problem in this country. However, eating disorders aren’t just about people overeating. Eating disorders can be people who have issues with both overeating as well as undereating. For instance, there may be someone who is eating less. They view their body in a different way. It is called body dysmorphic
disorder. So, when you or I look into the mirror we see ourselves as we are supposed to be. But with someone who’s dealing with body dysmorphic disorders they see themselves as a flawed person.”
There are many reasons why people suffer from eating disorders.
“For example, in the case of someone who is experiencing depression, when we see someone for the first time it’s part of our assessment to look at things like the persons sleep patterns and eating behaviors. Some people who are dealing with depression will not eat or eat very little. They are not motivated. They have difficulty getting out of bed in the morning and doing their normal routines. So a person who is experiencing depression certainly can manifest an eating disorder,” Davis said. “Anxiety is another factor that can illicit an eating disorder. As mentioned
earlier, the person can come pretty close to not eating much at all and or the opposite, they can overeat.”
These disorders can be caused by many factors like peer pressure for younger adults or any other life alternating situation such as death of a loved one or dealing with PTSD.
In helping someone with an eating disorder Davis said a team approach is the best.
“In a team approach we use a therapist, a medical doctor and a nutritionist. From my experience as a therapist, I tend to use cognitive behavioral therapy. This is a type of therapy we are looking at a couple of things. How people think and the associated behaviors that come from that thinking and work on changing a distorted and or negative thinking pattern to a more positive logical thinking pattern,” he said.
Our free services include:
◘ Private, one-on-one counseling about health insurance options
◘ Answering your questions related to Medicaid and long term care.
◘ Helping you decide what plan is right for you.
◘ Helping you solve problems with your managed care plan.
◘ Meeting with you over the phone or in-person.
◘ Conducting educational sessions for consumers, caregivers, and professionals
Periodontal (gum) disease is a broad term for conditions involving inflammation and infection of the tissues (gum and bone) that surround and support the teeth. Gingivitis is a type of gum disease that involves inflammation of the gums. It is largely preventable and treatable with a combination of routine oral hygiene and professional cleanings.
Periodontitis, which also involves bone loss around teeth, is an irreversible condition that can be
slowed down and managed with professional treatment.
Periodontitis is a very common type of gum disease among U.S. adults:
• About 4 in 10 U.S. adults 30 years or older had a mild, moderate, or severe level of periodontitis in 2009–2014.
• About 1 in 2 men and 1 in 3 women 30 years or older had some level of periodontitis.
Periodontitis is more common as people age. About 60% of adults 65
years or older had periodontitis in 2009–2014.
Two of the most common types of gum disease are gingivitis and periodontitis.
• Gingivitis
The mildest form of gum disease is gingivitis, an inflammatory condition where the gums become red, swollen and may easily bleed. Gingivitis is a reversible condition. But if left untreated, it can lead to a gum disease called periodontitis.
• Periodontitis
Periodontitis is a chronic inflammatory condition that leads to mild, moderate, or severe destruction of the supporting tissues around teeth. A main feature of periodontitis is bone loss around the affected teeth. Untreated periodontitis can also make other chronic conditions, such as diabetes, worse.
Periodontitis cannot be reversed, but it can be slowed down and managed with professional treatment. Periodontitis and cavities (tooth decay) are the two leading causes of tooth loss.
Gum disease can often become serious before a person notices that they have symptoms. A yearly dental checkup can help to detect and prevent this condition.
Signs and symptoms of gum disease may include:
• Red, swollen, or tender gums.
• Bleeding gums.
Flossing protects your brain as well as your gums, a new study suggests.
People who floss their teeth at least once a week are reducing their risk of stroke caused by a blood clot, researchers reported at a recent meeting of the American Stroke Association in Los Angeles.
Flossing is associated with a 22% lower risk of clot-caused stroke, and a 44% lower risk of a stroke caused by blood clots traveling from the heart, results show.
Flossers also had a 12% lower risk of atrial fibrillation (A-fib), an abnormal heart rhythm that increases risk of stroke.
• Gums that have moved away or downward from your teeth.
• Loose or sensitive teeth.
• Painful chewing.
• Any change in the way your teeth fit together when biting.
• Any change in how well your partial denture fits.
It is normal for some bacteria to live in a healthy mouth. Bacteria in the mouth constantly produce and dwell within a sticky, removable film on tooth surfaces called plaque. If plaque is left to build up on a tooth, it can lead to inflammation around the tooth and result in gingivitis. Plaque can be removed regularly with toothbrushing and flossing. If it is not removed, it will usually harden into tartar (also called calculus). Tartar buildup cannot be removed with toothbrushing. Professional treatment is needed to remove it.
Bacteria in buildup can spread below the gumline and lead to the formation of a periodontal "pocket." This pocket is an abnormal deepening of the space between tooth surfaces and gum tissues. Bacteria can release toxins in the pocket that make inflammation worse.
As this process continues, it contributes to the destruction of gum tissues and bone loss around the teeth, which is a main feature of periodontitis.
Source: Centers for Disease Control and Prevention (CDC)
“Oral health behaviors are linked to inflammation and artery hardening,” lead researcher, physician Souvik Sen, chairman of neurology at the University of South Carolina School of Medicine, said in a news release.
“Flossing may reduce stroke risk by lowering oral infections and inflammation and encouraging other healthy habits," Sen continued.
For the study, researchers analyzed data from a long-term study of the health risks posed by clogged arteries. More than 6,200 participants in the study reported whether they floss and how often.
“A recent global health report revealed that oral diseases — such
as untreated tooth decay and gum disease — affected 3.5 billion people in 2022, making them the most widespread health conditions,” Sen said.
During 25 years of follow-up, 434 participants suffered a stroke and nearly 1,300 developed atrial fibrillation.
Regular flossing lowered people's stroke risk, regardless of whether they regularly brushed their teeth or routinely visited a dentist, results show.
Flossing also was associated with a lower risk of cavities and gum disease.
“Many people have expressed that dental care is costly,” Sen said.
“Flossing is a healthy habit that is easy to adopt, affordable and accessible everywhere.”
Researchers said they were surprised by the reduction in A-fib linked to flossing. This irregular heartbeat increases a person's risk of stroke, because it allows blood to pool and clot in the upper chambers of the heart.
“This study offers more insights into the specific dental health behaviors that may be linked to stroke risks and potential risk reduction,” Daniel Lackland, a professor of epidemiology with the Medical University of South Carolina, said in a news release.
There is a distinct connection between your dental health and your overall health and wellness. Since we are all different, we each require specific measures to make sure our dental health is smile ready. Your dentist is part of your health care team to address your specific needs, so please make sure you keep your regularly scheduled appointments.
How can you take the best care of your mouth in between regular dental cleanings and visits? By creating a healthy balance of bacteria. Yes, your mouth is full of bacteria — some good and some bad. The bad bacteria can erode teeth and contribute to gum disease and when overly abundant can cause dental decay and periodontal disease. The good bacteria help to utilize vitamins efficiently and prevent pathogens from entering the body.
Let’s begin by using a tongue scraper in the morning before brushing your teeth. Consider purchasing a stainless-steel tongue scraper (not plastic) as the metal ones are easier to clean and won’t chip. By using a tongue scraper, you help in removing harmful toxins and bacteria creating a healthier environment in your mouth.
Brush your teeth at least twice daily for approximately two minutes.
By Deborah Dittner
Use a soft bristle brush at a 45-degree angle. This method will adequately remove the bacteria causing a plaque buildup and decay. Remember to replace your toothbrush every three months as the bristles wear down and bacteria from your mouth cling to the bristles. If you already have gum disease you will need to replace your toothbrush more frequently approximately every four to six weeks. If you have been sick or have had a strep infection of the throat, you will need to replace your toothbrush after the illness. You mustn’t forget to floss. Flossing removes food particles and bacteria that get stuck between your teeth. Some brands have added tea tree oil (antimicrobial) or coconut oil.
If you have bleeding gums, you may be brushing too hard or using a hard bristle brush. Bleeding gums can also be caused by improper flossing which you can review with your dentist. Worst case scenario, bleeding gums can be a sign of gum disease so make sure to talk with your dentist.
In addition to brushing and flossing, consider oil pulling. Studies have shown that oil pulling decreases the development of plaque and plaque-induced gingivitis in the mouth. Coconut or sesame oil is swished around in the mouth for 10 to 20 minutes daily. Consider oil
pulling while taking a shower to accomplish two tasks at once. Do not swallow and never spit the oils down the drain but into a waste basket. The oils distribute vitamins and lauric acid (anti-inflammatory and antimicrobial properties) while “pulling” bad bacteria from the mouth.
Adding salt water gargles to your mouth care helps to alkalize your mouth decreasing the number of bacteria and reducing inflammation. Gargle with eight ounces of warm water and ¼ teaspoon of salt added and mixed well.
If you drink lemon water or apple cider vinegar in water in the morning, consider using a straw. A straw helps to protect your teeth and gums from the acid.
A diet consisting of whole nutrient dense foods is essential as these foods affect your body’s immune system fighting against infection. Gum (periodontal) disease starts out as an infection and poor nutrition decreases the body’s capability to take action against it. Foods that are low in sugar and carbohydrates, vegetables and fruits, lean clean protein and nuts chewed well not only take care of the
body but also the teeth. Vitamin deficiencies put your teeth and your overall health at risk. Vitamin D, the sunshine vitamin, is important during pregnancy to prevent enamel hypoplasia in the child. Other vitamin deficiencies such as B vitamins, iron and folate have been linked to oral ulcerations and painful fissures at the corners of the mouth. Consult with your primary health care provider and ask for blood work to help determine any deficiencies and consider supplementation. At all times you should try to boost your overall health and wellness. These simple steps for mouth care will benefit not only your body but also help create a beautiful smile.
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
By Barbara Pierce
“Bed bugs are a growing problem in Central New York,” said entomologist Jody Gangloff-Kauffmann, who works at the New York State Integrated Pest Management Program of Cornell University.
This incredibly fast-breeding pest can enter your household unexpectedly. These tiny bloodsuckers are unrelenting; their bites can cause irritating red bumps and rashes.
Some people have no reaction to bedbug bites, while others experience an allergic reaction that can include severe itching, blisters or hives.
The bites usually clear up without treatment in a week or two. Bedbugs aren’t known to spread disease.
“Bed bugs are a problem for many because they are spread by human activity and migrate when they have no hosts (people),” explained Gagloff-Kauffmann. “They’re good at hiding from us; they’re stealthy and feed on us when we sleep. They reproduce quickly and many infestations are bed bugs that are resistant to common pesticides being used to control them, especially with low-quality pest control.”
As many struggle to find effective solutions, we asked Gangloff-Kaufmann to help us understand more about this alarming increase.
Q: Why are we hearing more about a resurgence?
A: Bed bugs have been a problem in probably all communities. The beginning of their resurgence was around 1999 and it happened among global travelers, then in hotels and transportation, in retail stores for a time, then homes of all types.
As the pest management industry developed the skills to eliminate bed bugs, people could throw money at the problem and be done with it. But not everyone could do that and people who live in rental properties are often stuck because they don’t have control over the property and may not have the money to pay.
Anybody can get bed bugs, but only those with resources can get rid of them.
Bed bugs are unique in that they depend almost exclusively on humans to survive. They only need blood — they prefer people to keep them going. They don’t even need water.
“Bed bugs became a problem after we went through the ban on organophosphates (pesticides) indoors,” said Gangloff-Kaufmann. “The new generations of bugs are highly resistant to any chemicals
By Barbara Pierce
used to treat them.”
Q: How do I know if I have them?
A: The first signs of a bed bug problem might be seeing bites, but many people don’t react or react right away. The thing many people see first is the black stains on bedding or the side of the mattress or headboard. Bed bugs eat blood and poop out black liquid. To investigate this, take a wet tissue and rub the dark stain to see if it rubs off a rusty color. That suggests there are bed bugs.
The bugs are tiny, the size of an apple seed. Their bites are red, raised bumps that itch and may be swollen, similar to mosquito or flea bites.
Q: How do I get rid of them?
A: You first need to understand bed bugs and how they behave. Hire a pest management company that is reliable and good quality to at least perform an inspection.
It takes a series of painstaking steps, performed correctly — usually with professional training — to control an infestation.
Gangloff-Kaufmann said treatments may include:
• Bed bug traps for monitoring and management
• Mattress encasements (essential to save your sleeping area)
• Conventional pesticide liquid sprays
• Pesticide dusts
• A biological control option, which is a fungus that kills bed bugs
• Steam treatments, especially good for children’s bedding and rooms
• Heat treatments, whole house or whole apartment heat treatment is the most expensive, but effective treatment. However, it doesn’t prevent bed bugs from returning.
There should be several follow ups on whatever was done. Get a guarantee from the pest management company.
Pest management won’t treat your belongings. You’ll need to treat and isolate your belongings to eliminate bed bugs.
Q: What should we NOT try?
A: Things that one should avoid using (I mean seriously avoid): are bug bombs. They are the worst tool, will exacerbate the problem and possibly hurt your health. Also don’t use rubbing alcohol as a pesticide.
Botanical-based over the counter sprays don’t work well, give false hope, are a waste of money, as are the ultrasonic plug-in devices that ‘repel bugs.’ They absolutely do not work. Many of the products that are marketed specifically to kill bed bugs do nothing to kill them.
To avoid getting an infestation, when staying in a hotel, place your bag on a suitcase stand rather than on the bed or floor. Keep the rack away from walls or furniture. When returning home, wash the clothes from your trip and put them in a hot dryer. Inspect furniture before bringing it inside. Look in seams, tufts and under cushions.
It does take time and persistence to get rid of bed bugs. It can be expensive, as well as exhausting. Remember, they’re more of a nuisance than a health concern.
In January we watched the news, horrified, as the giant furious flames consumed house after house, building after building, street after street, mile after mile in Los Angeles County.
More than 12,000 homes are gone, demolished by the flames — 12,000 families without a place to call home.
Nothing left of what was their home and all they possessed.
We watched people crying.
“We’ve lost everything!” we often heard. Many lost their homes and all their possessions. Many lost loved ones who didn’t get out in time.
Such great pain they must be enduring. Watching your home, belongings and neighborhood disappear in a tremendous wildfire is unimaginable.
How will they go on after such devastating losses? Facing a reality that no one should have to go through? How do they keep taking the next breath, getting through from one moment to the next?
Like most of us, I’ve had bad experiences that made it difficult to get from one moment to the next. But never nearly as bad as these people have experienced.
How would I cope if it was me?
Or what would I say to a friend or loved one who lost everything and is carrying a crushing emotional toll?
Whether we’re dealing with the loss of everything, the sudden death of a loved one, an unanticipated major change in our lives, what can we learn from these people about how to handle challenges suddenly hurled at us?
By Anne Palumbo
As winter drags on, many of us slump into a winter funk. Me? I’ve taken whining to an indecent level this year. And, honestly, it may have lasted indefinitely had I not spotted a bag of cheery clementines at the grocery store last week.
Clementines!
If there’s one fruit that brightens my mood, it’s the seedless clementine.
Clementines (like tangerines and satsumas) are a special variety of mandarin oranges. While both navel oranges and mandarins are healthy citrus fruits, they have some key differences that set them apart. Navel oranges are larger, more acidic and harder to peel, while mandarins are smaller, sweeter and a breeze to peel.
This potent little fruit delivers over a quarter of our needs for vitamin C, a powerhouse vitamin that contributes to wound healing, helps keep skin healthy and glowing, and boosts the immune system.
Although vitamin C won’t cure your cold, says research, it may shorten it. What’s more, vitamin C helps your body absorb “non-heme iron,” which is iron from plant-based foods like lentils and spinach.
If you’re worried about inflammation — a condition that can raise your risk of cancer, heart disease and other diseases — reach for a clementine. Particularly rich in antioxidants that help defend your body against an undesirable imbalance of free rad-
I was curious about that and did some research. Here is what I learned:
“You immediately go into shock, honestly,” said Annie Barbour on NPR.org, who lost her home in an earlier fire.
“Immediately you’re thinking, ‘What the hell just happened to my future?’ Or at least that’s what I thought,” Barbour said. “And then you vacillate between that and you know, thank God I got out. So there’s a real tug-of-war between being grateful and feeling destitute and rudderless.”
Expect to feel your emotions evolving and intensifying as you process the loss over the weeks and months following a disaster. After the shock, you will feel grief, fear and anger. Or, you may simply continue to feel numb.
“Right now, emotions are very raw,” Robert Rich, survivor of an earlier fire that claimed his home, said on psychologytoday.com. “There’s anger at the authorities, anger at the wind and a lot of anger directed towards insurance companies. I
icals, clementines may help reduce inflammation and prevent cellular damage.
Hearts love clementines, too. From the antioxidants that protect the heart from damage to the fiber that helps lower “bad” cholesterol to the potassium that can help regulate blood pressure, these li’l “Cuties” might be better nicknamed li’l “Superstars.”
Lastly, this tangy citrus charmer helps support a healthy weight or weight loss, thanks to many factors: its decent dose of fiber that promotes a full feeling, its high-water content, and its low calorie count (only 35 per clementine). Plus, they’re ideal for kids because they’re peelable, seedless and sweet!
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.
recall what later turned out to be an unfounded fear of being screwed by our insurance carrier. I wasn’t acting strategically or in my own best interests.”
Fight the adrenaline rush that kicks in during a sudden crisis, advised Michale Touglas on seniorplanet.org. Touglas has interviewed more than 100 survivors for his books. This adrenaline risk often prompts us to take quick action — many scammers take advantage of it.
Fight the urge to respond to someone who is asking for information from you and might be scamming you. Instead, just pause. The simple act of pausing gives you time to think of several options, rather than leaping into action.
Also, don’t waste time thinking about how and why this happened or who’s to blame. Instead, look at what you need to do right now. Begin to move forward, baby step by baby step.
Focus on getting through each hour, maybe each minute if that’s what you have to do.
“I was amazed to think that I
Look for fruits that are brightly colored, feel firm when gently squeezed, and smell strongly of citrus. Clementines will keep at room temperature for up to a week or in the fridge for up to two weeks. Wash clementines before eating to remove any residues. Like grapefruit, clementines may interfere with certain drugs: be sure to discuss concerns with your doctor.
Salad: 6-7 cups torn romaine
2 cups shredded chicken
1 large cucumber, peeled and chopped
½ cup shredded carrot
1 green onion, thinly sliced 2-3 clementines
¼ cup cilantro, minced
½ cup chopped nuts of choice
Dressing:
¼ cup olive oil
¼ cup rice vinegar
2 tablespoons sesame oil
1½ teaspoons soy sauce
2 teaspoons honey
could bear the unbearable,” said Cheryl Strayed in her book “Wild,” describing how she hiked the Pacific Coast Trail to ease the pain of losing her mother. “Every time I moved, it hurt. I counted steps to take my mind off the pain, ticking off the numbers to 100 before starting over again. The numbers made the walk more bearable, as if I only had to go to the end of each one.”
Yes, there’s power in little steps. Little steps give you the feeling of control, keeps away the helpless feelings and the temptation to give up.
“Accept help, if it’s offered. Ask for help if you can,” Alexander Haro who lost everything in a 2018 fire advised on gearjunkie.com. “A friend set up a GoFundMe after I lost my house. I desperately needed it, yet I was mortified. I was basically broke and had absolutely no idea what the future held and I needed time to figure it out.”
“Take advantage of programs designed for situations like these,” he continued. “I’m a prideful man and have a hard time accepting help, but there are times in life when you need
1-2 cloves garlic, minced ¼ teaspoon each: salt and coarse black pepper
1. In a large bowl, combine first 7 ingredients. Shake together all dressing ingredients. Just before serving, drizzle with ¼ cup dressing; toss to combine. Top individual servings with nuts; add more dressing if needed. Dressing will keep in fridge for up to 2 weeks.
Note: Save time with a rotisserie chicken.
it. Take it.”
“It’s easy to dwell on the things you lost — and I’m not telling you not to be sad for those losses — but it can be very, very hard to think of good things in your life when it seems as though everything is bad. Take a breath. You are alive. The sun will rise and set again and you will be there to see it. There are people who love you. You can restart, no matter how difficult it is.
And you will,” Haro added.
with many years of experience helping people. If you would like to purchase a copy of her book, “When You
or if you have questions for her, contact her at barbarapierce06@yahoo.com.
By Mark Winsberg, M.D
Iam the youngest of four kids born to my parents in the span of six years. My father, Cornell-educated with a master’s degree in soil science, was just finding his way into farming in South Florida when I entered the scene.
My mother, also a Cornell student in home economics, had to cut her college career one semester short of graduating when my oldest sister was born.
I still find it hard to fathom how my parents held it together while Dad went from college student to fertilizer salesman, to dairy farmhand, to partner with another farmer and eventually to buying our 300acre farm, while Mom almost single-handedly raised us four kids.
I was a good student, a good athlete and good at holding my own in almost any social situation. But maybe because I was the youngest child, I came to the erroneous conclusion that I wasn’t and
would never be smart enough, strong enough or good enough to truly fit into my family or anywhere else for that matter. Ignoring mountains of evidence to the contrary, I spent much of my life trying to prove that assumption true.
Maybe that’s why my past is made up of such a crazy array of social and work situations.
Like the dog in the kids’ story “Are You My Mother?” it seemed I could never find my place in the world.
I was a farm boy, drove tractors, baled hay, raised cattle and dug ditches.
My playmates were the Black and Puerto Rican farmworker kids on the farm and in town, the lawyers’ and doctors’ kids in the advanced classes at school. I worked on a dairy farm, did house construction,
spent two years as a welder-pipefitter, lived in a kibbutz in Israel picking bananas and learning Hebrew.
I went to three different elementary schools, two junior high schools, two high schools, four undergrad colleges, two medical schools (graduated from Stanford Medical School), completed a residency in family medicine and ended up working in and becoming the medical director of a small emergency room outside of Rochester for 17 years.
I did well in every one of those environments, but the loop playing in my head always said, “You’re stupid, you’re weak and you don’t belong here.”
Alcohol and drugs first entered my life when I was about 16.
The self-demeaning brain loop was becoming intolerable when I met Bob, the first-chair drummer in the marching band (I was second chair). Bob invited me to a “church party,” which turned out to consist of meeting in the church parking lot, going to 7-Eleven for dollar bottles of Strawberry Hill, then heading to the beach to get drunk. That kicked off a six-month period of getting stoned at Bob’s house every day before school, getting stoned at rock concerts on the weekend and finally feeling like I fit in.
However, by the end of that time, the loop was back, louder than ever. I didn’t feel like I fit in anymore and realized I was being used because I was the one who always had money and a car.
Addicts and alcoholics often try to stop this disease on our own — drinking beer instead of liquor, using weed instead of cocaine, only using on weekends, etc. Another common tactic is the “geographic cure.” At the end of my teenage drug phase, I opted for that one. I suddenly decided to attend a small private hippie high school in the wilds of British Columbia, Canada. I told my parents I
was going and since I had the money saved up from farm work and other jobs, I went. And it worked — at least for the alcohol and drugs.
It wasn’t until much later that I figured out I was really trying to flee the self-demeaning brain loop.
Drugs and alcohol didn’t play a significant part in my life again until my early 40s. If you looked at my life from the outside at that time, you’d wonder why anyone in that situation would start using drugs.
I was the medical director of the ER, well respected by my colleagues and patients. My wife, also a doctor and I had two wonderful daughters, had paid off our medical school loans and owned our home outright.
But what you wouldn’t see was that toxic brain loop that never quit playing. That loop, combined with the stress of working in the ER day after day, left me subconsciously searching for a pressure relief valve. That valve appeared in the form of a drug called Ultram (a combination of Tramadol and Tylenol), which hit the market in the late ’90s as a new non addictive pain reliever. The drug company’s reps would deliver grocery bags full of samples to the ER, encouraging us to hand them out to patients. I don’t remember exactly when I tried it for some ache or pain, but I do remember thinking it didn’t do much for pain. However, it did make my 12-hour ER shifts easier. It was quieting “the loop,” giving me a weird distance from the intensity of patients and a sense of calm amidst the ER storm. Later, researchers discovered tramadol has opiate-like and antidepressant-like effects, is highly addicting and is now classified as a narcotic.
Thus, I was inadvertently taking a narcotic and thinking I had everything under control.
Within a few months, I was taking three or four tablets at a time throughout the day, drinking tons of caffeine (standard ER fare) and adding a muscle relaxant to keep me from feeling too wired. When I got home, I drank wine and took Benadryl to sleep. This cycle continued for almost four years. My wife repeatedly asked if I was using drugs, but I always lied and would often turn the tables, acting hurt or angry that she would even ask.
Fortunately for me, the drugs I was using, combined with chronic sleep deprivation from constantly switching day and night shifts, resulted in me having a seizure in front of my wife, my daughters and my parents at a restaurant in Montreal in 2003. That night, frightened by what had just happened, I finally admitted to myself that I was in trouble, that my life was out of control. The next morning, I told my wife the truth.
What followed was truly miraculous. She didn’t leave me and take the kids. She helped me get in contact with and begin treatment through The Committee for Physician Health (CPH), an organization that helps doctors with substance use problems. I was mandated to go to AA meetings, which I initially resisted, then realized was a gift that’s turned into a lifetime “habit.” I told the CEO of the hospital, the medical staff director, and my ER colleagues what I was dealing with, and every one of them responded with encouragement and support. I felt like I’d been released from prison; my life was no longer controlled by drugs.
The rest is history. I left emergency medicine five years into my recovery. A friend told me he was leaving a part-time job at the JL Norris Clinic (inpatient rehab), which I took. There, I met Dr. Charlie Morgan, the rehab medical director, who became my teacher and mentor. That led to me getting board-certified in addiction medicine. And now I’m semi-retired with my own solo, part-time addiction medicine practice after 15 years as the clinical director and then medical director of Rochester Regional Health’s chemical dependency programs.
More importantly, I’ve regained the trust and love of my family. My two daughters, now grown, have loved me through every step of my recovery. My wife has never deviated from my side, treating me with love, care, and compassion that I’ll never be able to fully repay. I’ve learned to accept help from others.
And that brain loop?
It still plays occasionally, but not continuously. And I no longer believe its toxic message, nor do I have to try to silence it with drugs or alcohol.
By Mark Winsberg, M.D.
1. Acknowledge the Problem
The first step in recovery is admitting that there is a problem. Denial can be a significant barrier, and recognizing the impact of substance use on health, relationships and daily life is crucial.
2. Seek Professional Help
Addiction medicine specialists, therapists, and counselors can provide evidence-based treatments, including medication-assisted therapy (MAT) and behavioral therapies like cognitive-behavioral therapy (CBT) or motivational interviewing (MI).
3. Develop a Strong Support System
Surrounding oneself with supportive friends, family or support groups
like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) can provide encouragement, accountability and emotional support.
4. Identify and Avoid Triggers
Recognizing situations, places or people that contribute to substance use can help in developing strategies to avoid or manage them. Creating a structured and substance-free environment is essential.
5. Adopt Healthy Coping Mechanisms
Replacing substance use with positive activities such as exercise, meditation, yoga or creative outlets (e.g., music, art, writing) can reduce stress and cravings.
Many more Americans are turning to ketamine for kicks, a new study reports.
Recreational use of the anesthetic drug among U.S. adults increased 40% between 2021 and 2022, researchers say.
That follows a nearly 82% increase in ketamine use from 2015 to 2019, results show.
The more recent increase occurred mainly among young adults 26 to 34, as well as in people with a college degree, researchers found.
“These findings are consistent with other research indicating increased use among nightclub attendees in New York City along with increasing law enforcement seizures of illicit ketamine in the U.S.,” wrote the research team led by Kevin Yang,
6. Establish a Routine and Set Goals
Having a daily routine with scheduled activities helps reduce idle time and provides structure. Setting realistic, shortterm goals can provide a sense of accomplishment and motivation.
7. Address Underlying Mental Health Issues
Many people struggling with addiction also have co-occurring mental health conditions like depression, anxiety or PTSD. Seeking treatment for these conditions through therapy or medication can improve overall well-being.
8. Consider Medication- Assisted Treatment (MAT)
For some substance use disorders (e.g., opioid or
alcohol addiction), medications like methadone, buprenorphine or naltrexone can help reduce cravings and withdrawal symptoms under medical supervision.
9. Educate Yourself About Addiction
Understanding addiction as a chronic disease rather than a moral failing can help reduce guilt and self-stigma, making it easier to seek treatment and stay committed to recovery.
10. Practice Self-Compassion and Patience
Recovery is a journey with ups and downs. Being kind to oneself, acknowledging progress and learning from relapses instead of seeing them as failures can improve long-term success.
a third-year resident physician in psychiatry at the University of California-San Diego School of Medicine.
Ketamine — also known as “Special K” or Super K” — is typically used an anesthetic for people and animals.
In 2019, the U.S. Food and Drug Administration (FDA) approved the use of a nasal spray ketamine derivative called esketamine (Spravato) to treat depression in adults, according to the National Institute on Drug Abuse (NIDA).
Ketamine can cause changes in how people perceive reality, the NIDA says. Users might feel like they are floating outside their bodies or dissolving into their environment.
“At higher doses, a person may experience extreme detachment from
their body and reality, which is called being in a k-hole,” the NIDA’s website on ketamine says.
A ketamine overdose can cause potentially life-threatening slow and shallow breathing, particularly when combined with other drugs. Longterm use is linked to memory problems, depression and anxiety.
For the new study, researchers analyzed data gathered between 2015 and 2022 by an annual federal survey on drug use and health.
They found that the surge in ketamine use during the 2010’s was largely associated with people suffering depression. Adults with depression were 80% more likely to have used ketamine between 2015 and 2019, possibly self-medicating their mood disorder.
But the increase between 2021 and 2022 occurred only in people without depression, results show.
“These findings suggest a potential shift in the relationship between ketamine use and depression, such that recreational use became less associated with depression over time,” researchers wrote in study published recently in the Journal of Affective Disorders.
People with college degrees were more than twice as likely to have used ketamine during the latest surge, compared to those with a high school education or less, results show.
And young adults 26 to 34 were 66% more likely to have used ketamine than 18- to 25-year-olds, researchers found.
By Barbara Pierce
Almost everything we think we know about addiction is wrong. Whether it’s addiction to drugs, alcohol, cigarettes, porn, most of us don’t really understand the nature of addiction.
As these common myths hurt families and make it harder for people to get well, we asked Colleen Callaghan-Kirkland, program administrator at the Center for Family Life and Recovery, Utica, the truth about them.
MYTH: Addicts just don’t have enough willpower. If they were really motivated, they’d stop.
REALITY: “Addiction isn’t a failure of willpower — it’s a chronic brain disease,” said Callaghan-Kirkland. “Drugs change the brain’s chemistry and function, particularly in areas responsible for decision-making, impulse control and motivation.”
Alcohol and other drugs can lead to profound changes in the brain.
“Over time, substances such as alcohol, opioids and stimulants rewire the brain, making it extremely difficult to quit. This is why treatment, support systems and medical interventions are often necessary for recovery,” she continued.
“Using substances floods the brain’s reward system with dopamine, a neurotransmitter associated with pleasure and reinforcement,” she added.
Repeated substance use reduces the brain’s ability to produce dopamine naturally. This leads to compulsive substance use, not because a person wants to, but because their brain craves it.
Addiction changes the brain so that the person doesn’t have the ability to make good decisions, while sending powerful urges to take the drug or drink.
That’s why people keep using even when terrible things happen.
“The brain’s stress system becomes hyperactive, causing withdrawal symptoms and distress when not using,” Callaghan-Kirkland said. “The brain associates substance use with relief and reward, reinforcing the behavior even when it leads to negative consequences.”
MYTH: Addicted people have to hit rock bottom before they can recover.
REALITY: “This is one of the most dangerous misconceptions about addiction,” she added. “This suggests that someone struggling with substance use must lose everything — relationships, jobs, health — before they’re ready to seek help. In reality, waiting for rock bottom can be not only harmful but also deadly.
“Change can happen at any stage. Recovery doesn’t require complete devastation. People seek help for many reasons.”
“Instead of waiting for someone to hit their lowest point, we should focus on providing compassionate support, early intervention and accessible treatment options,” she added. “Recovery is possible at any stage and every step toward change matters.”
MYTH: Going into rehab will fix the problem.
REALITY: “Quitting is difficult,” stressed Callaghan-Kirkland. “Be-
cause addiction alters the function of the brain, simply deciding to stop is often not enough. People struggling with addiction may genuinely want to quit but find themselves trapped in a cycle of cravings, withdrawal and relapse. This is why professional treatment, peer support and medical interventions are necessary for successful recovery.”
“Treatment can be the first step toward wellness, but it’s often just the beginning,” she emphasized. “Many people need more than one treatment visit to get on a stable path to wellness. Staying well requires a long-term commitment to new coping skills and seeking the necessary support.
“Recovery is a lifelong process. Addiction is a chronic condition, not an acute illness. Addiction is not like an infection that can be cured with a single course of treatment. It is a chronic brain disease, similar to diabetes or hypertension, meaning it requires ongoing management. Completing a rehab program is just the beginning — long-term success often depends on aftercare, continued therapy, peer support and lifestyle changes.”
“Rehab provides a structured, controlled environment. Returning to everyday life means facing stress, triggers and old habits. Without ongoing support, relapse is more likely,” Callaghan-Kirkland explained. “Many people require multiple rehabs stays, therapy sessions or support groups to find what works best for them. Each attempt at recovery builds new coping skills and resilience.”
Getting well involves changing deeply embedded behaviors. This takes time and effort and sometimes results in setbacks or relapses.
“Try not to be too discouraged by a relapse, which is a recurrence of symptoms,” she said. Addiction
is a chronic illness that takes lifelong management.”
MYTH: Cold turkey withdrawal never killed anybody.
REALITY: This is not a good idea, said Callaghan-Kirkland.
“For most people, this is not only extremely difficult but can be dangerous, because substances like alcohol, opioids and benzodiazepines cause physical dependence. Suddenly stopping can lead to withdrawal symptoms ranging from nausea and insomnia to seizures and life-threatening complications,” she said.
Also, addiction is not just physical; it has deep emotional and psychological components, she added. Quitting without support often leaves people without the tools to manage triggers, stress and underlying issues that contribute to substance use. Using the guidance and support of professionals leads to a safer, longer lasting recovery.
MYTH: Prescriptions from a doctor are safe.
REALITY: As you probably know, many substance abuse addictions begin with prescriptions for painkillers, many of which can be highly addictive. Even if are prescribed by your physician, these drugs pose a risk.
“CFLR offers family support to help loved ones of those struggling with addiction,” Callaghan-Kirkland said. “If you’re impacted by someone’s addiction, we’ll help you.”
Have you heard about drug-resistant heartworm disease and its impact on dogs?
Plainly, it’s a condition where some heartworm microfilariae are no longer susceptible to the active ingredients in heartworm preventives.
While experts say the issue emerged two decades ago in the Mississippi Delta region, a quick Google search for “drug resistant heartworms” produces scant reporting. Check it out, here: https://tinyurl. com/2xm3bbam
While there is an apparent lack of recent reporting on the issue, the Upstate New York veterinary community is seeing cases of drug-resistant heartworm (also known as Dirofilaria immitis) and its range expansion to the northern parts of the United States.
When contacted for this story, Mohawk Valley veterinarians acknowledged that they are aware of the strain and its migration north as infected animals travel, often after being adopted.
Among them, Dr. Nickel’s Animal Hospital in Whitesboro pointed to the guidance from the American Heartworm Society and veterinary science programs at universities for the latest information.
As with most healthcare issues, there is ongoing study and searches for advanced therapies as medicine
By Jolene Cleaver
advances.
“Research exploring apparent resistance of populations of heartworms to medications is only in preliminary stages and much work remains before the issue is fully understood,” notes information from the American Heartworm Society.
Information from the heartworm society adds that year-round preventive medication is the core of heartworm disease prevention. However, more than 56% of dogs seen by veterinarians in the southern U.S. never receive a single dose of preventive.
Further, it is advised that preventive medications must be given every 30 days (with the exception of injectable moxidectin, which must be administered every 180 days).
As with most courses of medication, delays in administration will reduce product efficacy.
‘Cornell would be your best bet’ for raw data, local vets advise
There, Manigandan Lejeune, an associate professor of practice at the Department of Population Medicine & Diagnostic Sciences College of Veterinary Medicine at Cornell University, explained the nuts and bolts of canine heartworm infection.
The life cycle of heartworm involves various species of mosquitoes as the vectors that allow the baby heartworm (microfilaria) taken during a blood meal from an infect-
Excellus BlueCross BlueShield was ranked No. 8 on the Forbes list of America’s Best Midsize Employers 2025.
The health plan ranked No. 1 among midsize employers in New York state and among the insurance industry nationwide.
This is the third consecutive year that Excellus BCBS has been named to the list.
This award is presented in collaboration with Statista Inc., a global statistics portal and industry ranking provider.
America’s Best Employers 2025 are selected using an independent survey from a vast sample of more than 217,000 U.S. employees working for companies from all industry sectors employing at least 1,000 people within the U.S. More than 6.5 million employer evaluations
were considered.
The final ranking is based on two types of evaluations:
• Personal: Given by employees themselves.
• Public: Given by friends and family members of employees or members of the public who work in the same industry.
Personal evaluations are given a higher weighting.
The results are divided into two lists: one for the top large companies with more than 5,000 U.S. employees, and another for the top midsize companies with 1,000 to 5,000.
Based on the results of the study, Excellus BCBS has been recognized on the Forbes list of America’s Best Midsize Employers 2025.
See Forbes’ full list of America’s Best Employers on Forbes.com.
ed dog, to develop into an infective larva 3 (L3) that is then transmitted to a susceptible dog.
Lejeune adds that once transmitted, the L3 takes three to four days to grow as larva 4 (L4). The monthly heartworm preventatives (mostly macrocyclic lactone drugs) administered to dogs are aimed to kill L3 and up to 30-day-old L4 when these drugs are known to be 100% efficacious.
While non compliance with monthly preventives administered to dogs is noted as the major reason for the ‘lack of efficacy’ of macrocyclic lactones, drug-resistant strains of heartworm indeed occur. Unfortunately, commercial diagnostic labs lack the appropriate diagnostic tools to detect drug resistance or drug-resistant strains circulating in the United States, he said.
“Resistance to monthly preventives means the heartworm disease can spread to new geographical areas and establish wherever the right species of mosquito vectors occur. This indicates huge epidemiological risks. However, I do not see any impact on how heartworm disease is treated currently. Macrocyclic lactones are not effective against the mature and adult stages of heartworm. Melarsomine is the best adulticide drug and there is no known resistance to this drug. Though the Melarsomine treatment protocol is tedious and expensive, there is no effective alternative,” Lejeune added.
Elsewhere across the state, another veterinary science program, at Long Island University, weighed in. “... I do find in my experience animals that are tested negative on original intake end up being positive within one year of adoption. I find that this is likely all due to timing of the heartworm lifecycle. Dogs that are adopted out with a negative heartworm test should be re-tested again in six months, while continuing to take monthly oral macrocytic lactone,” said vet Victoria Bove, an assistant professor of clinical skills at Long Island University College of Veterinary Medicine.
When it comes to educating student veterinarians, Bove added, “We follow the American Heartworm Society guidelines for treatment (three injections) and in my clinical experience, I have not had any dogs be resistant to this treatment, when followed accordingly.”
The American Heartworm Society offers guidance to pet owners on effective treatment of heartworm for pups that notes:
• Clinic staff must provide specific administration instructions or treat the pet in the hospital.
• Client education is critical in order to ensure accurate product use.
• Compliance also includes timely and appropriate administration or application of the medication in the proper weight range. Loss of an oral product prior to absorption can occur with vomiting; and swimming or bathing immediately after application may affect the absorption of a topical.
• Review of patient history and age at initial preventive dose will also illustrate potential loopholes in prevention protocols.
For specific information relating to resistant strains of heartworm disease, visit: https://tinyurl. com/4r73hmjr
New
York state’s
‘Over my 30 years in the industry, I’ve seen challenges come and go, but this moment is unprecedented in its severity.’
By Joe Murabito
The care of our elderly is in crisis.
As the managing partner of Elemental Management Group, overseeing several nursing homes in New York state, I’ve witnessed firsthand the financial turmoil caused by the state’s unsustainable policies.
Over my 30 years in the industry, I’ve seen challenges come and go, but this moment is unprecedented in its severity.
I’m left questioning whether elected officials lack a fundamental understanding of the nursing home industry or if they simply do not care.
Regardless, there is an opportunity to educate them — as well as the public — on why this issue matters so deeply.
New York state’s nursing homes are being squeezed by two crushing forces: retroactive demands for COVID-era funding — money already spent on mandated staffing and care — and Medicaid reimbursement rates that fall far short of covering the cost of care. Together, these pressures are creating a perfect storm that threatens the future of elderly care in our state.
Consider the following:
• Morningstar Residential Care Center (Oswego): This facility is being asked to repay more than $127,000 in COVID-era funding, despite operating with a Medicaid reimbursement rate less than $200 per day. Rising operational costs make this an impossible financial burden.
• Waterville Residential Care Center (Waterville): A fourth-generation, family-owned facility now facing a demand to repay $97,495 — funds used to meet state mandates for safe staffing and quality care. With Medicaid rates also less than
$200 per day, the financial strain is overwhelming.
• Elcor Health Services (Horseheads): Managed by Elemental Management, Elcor has been notified it must repay more than $323,000. Like many facilities across New York, Elcor is grappling with severe financial instability fueled by unsustainable Medicaid rates and retroactive funding demands.
These stories are not isolated. They represent the experiences of nursing homes statewide. Hundreds of nursing homes run by operators that I consider colleagues and friends are facing similar challenges. This is a systemic problem that requires immediate attention.
When nursing homes struggle, the ripple effects impact everyone:
1. Displaced Seniors: When facilities close, elderly residents are uprooted, causing emotional and physical distress. Families are left scrambling to find alternative care, often far from home.
2. Strained Hospitals: Nursing homes play a critical role in transitioning patients out of hospitals. Without them, hospitals face discharge gridlocks, exacerbating an already strained healthcare system. We have proudly partnered with and support our local hospitals, including Oswego Health, to ensure continuity of care and better outcomes for our communities.
3. Diminished Dignity for Seniors: The state’s actions send a clear message that elderly care is no longer a priority, undermining the dignity and respect our seniors deserve.
New York’s nursing homes cannot survive without immediate relief. Policymakers must:
• Re-evaluate Repayment Demands: Retroactive claw backs of COVID-era funding are punitive and fail to consider the reality that these funds were spent to meet state-mandated requirements.
• Increase Medicaid Reimbursement Rates: The first step to solving the rate problem is to create better wage parity and reduce the gross disparity that exists today. Level the field by establishing base rate minimums for direct and indirect
nursing homes are being squeezed by two crushing forces: retroactive demands for COVID-era funding — money already spent on mandated staffing and care — and Medicaid reimbursement rates that fall far short of covering the cost of care.
rate components. This will prevent further closures. From there, begin the process to develop a methodology that captures reasonable costs including capital improvements and that can effectively respond to market changes.
Prioritize Elderly Care: A comprehensive strategy is needed to address the growing crisis in long-term care.
This issue is bigger than just numbers on a balance sheet. It’s about the dignity and care of our seniors, the stability of our communities and the future of healthcare in New York state. Facilities like Morningstar, Waterville and Elcor have served their communities for generations. Without intervention, their future — and the care of thousands of elderly residents — hangs in the balance.
To put it in perspective, a Medicaid reimbursement rate of less than $200 a day is unsustainable.
According to Nestment, the national average rate for a one-night stay in a hotel room is $206. Let’s remember, this is an overnight in a hotel and does not include food or entertainment. Nobody is responsible for exceptional care, nutritious meals and a meaningful quality of life for elderly residents. Yet, this is the reality faced by facilities across New York state.
I’ve spent my career advocating for quality care and the sustainability of our industry. But now, I’m calling on the state to do its part. Let’s work together to ensure that New York’s seniors receive the care they deserve and that the facilities entrusted with their care have the resources they need to succeed.
MURABITO is the managing partner at Elemental Management Group, which owns or operates several senior facilities in Upstate New York, including Morningstar Residential Care Center and The Gardens by Morningstar in Oswego.
By Jim Miller
Dear Savvy Senior,
What can you tell me about service dogs for seniors with disabilities? My 67-year-old father has chronic arthritis and Parkinson’s disease, and I’m wondering if an assistance dog could help make his life a little easier.
Dog Loving Leah
Dear Leah,
For people with disabilities and even medical conditions, service dogs can be fantastic help, not to mention they provide great companionship and an invaluable sense of security. But be aware that service dogs can be very expensive to purchase and the waiting list to get one can be long.
Here’s what you should know.
While most people are familiar with guide dogs that help people who are blind or visually impaired, there are also a variety of assistance dogs trained to help people with physical disabilities, hearing loss and various medical conditions.
Unlike most pets, assistance dogs are highly trained canine specialists — often golden retrievers and Labrador retrievers, and German shepherds — that know approximately 40 to 50 commands, are amazingly well-behaved and calm, and are permitted to go anywhere the public is allowed.
Here’s a breakdown of the different types of assistance dogs and what they can help with.
• Service dogs: These dogs are specially trained to help people with physical disabilities due to multiple sclerosis, spinal cord injuries, Parkinson’s disease, chronic arthritis and many other disabling conditions. They help by performing tasks their owner cannot do or has trouble doing, like carrying or retrieving items, picking up dropped items, opening and closing doors, turning light switches on and off, helping with balance, assisting with household chores, barking to indicate that help is needed and more.
Service dogs can also be trained to help people with medical conditions like epilepsy or other seizure disorders, autism, diabetes, PTSD and other psychiatric disabilities.
• Guide dogs: For the blind and visually impaired, guide dogs help their owner get around safely by avoiding obstacles, stopping at curbs and steps, navigate shopping centers and buildings, find doors, seats, pedestrian crossing buttons and more.
• Hearing dogs: For those who are deaf or hearing impaired, hearing dogs can alert their owner to specific sounds such as ringing phones, doorbells, alarm clocks, microwave
or oven timers, smoke alarms, approaching sirens, crying babies or when someone calls out their name.
If your dad is interested in getting a service dog, contact some credible assistance dog training programs. To find them, use the Assistance Dogs International website (AssistanceDogsInternational.org) which provides a listing of around 80 accredited members and 25 candidate programs in North America.
After you locate a few, you’ll need to either visit their website or call them to find out the types of training dogs they offer, the areas they serve, how long their waiting list is and what they charge. Most dog training programs charge anywhere from $10,000 to $40,000 or more for a fully trained service dog, however, most programs can assist with fundraising or grant applications for those in need. None of that cost is covered by health insurance or Medicare.
To get an assistance dog, your dad will need to show proof of his disability, which his physician can provide, and he’ll have to complete an application and go through an interview process. He will also need to go and stay at the training facility for a week or two so he can get familiar with his dog and get training on how to handle it.
It’s also important to understand that assistance dogs are not for everybody. They require time, money and care that your dad or some other friend or family member must be able and willing to provide.
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.
By Eva Briggs, MD
On Jan. 3, the United States Surgeon General Vivek Murthy issued an advisory regarding the link between alcohol consumption and cancer risk.
An important reason for this advisory is the general lack of awareness among the general population that alcohol increases the risk of cancer.
Less than half of people know that alcohol is a cancer risk factor.
It’s the third most common preventable risk factor after tobacco and obesity.
The data is not new. It is the culmination of many studies over the past several decades.
First the definition of what constitutes a serving of alcohol. A standard drink contains 14 grams (0.6 fluid ounce) of pure alcohol. This is the amount found in 5 ounces of wine, 12 ounces of beer, or 1.5 ounces of liquor.
Previous recommendations advised that up to one drink per day for women or two drinks per day for men, was a safe limit. But the evidence now shows that drinking even at low levels imparts an increased risk for cancer.
How can alcohol cause cancer? There are at least four known ways.
• First, alcohol breaks down in the body to a chemical called acetaldehyde. This substance harms DNA. Damaged DNA can allow a cell to grow uncontrollably leading to cancer.
• Second, alcohol also produces reactive forms of oxygen leading to oxidative stress which damages DNA, proteins and cells.
• Third, alcohol alters many hormones. It increases estrogen levels which increases the risk of breast cancer.
• Fourth, alcohol dissolves other cancer-causing chemicals such as those found in cigarette smoke. It also alters the cells of the mouth and throat. This makes those toxic substances more easily absorbed, raising the chance of mouth and throat cancers.
Drinking alcohol increases the risk of seven types of cancer:
1.
Over my career I have cared for patients with every one of these cancers.
Quitting or reducing alcohol won’t prevent all of these cancers. But all of them are so unpleasant that reducing the chance of acquiring any of these diseases is worth considering.
How significant is the risk of cancer from drinking alcohol?
The risk that a woman who drinks less than one drink per week will develop cancer in her lifetime is about 17 per 100 individuals. One drink per day increases that risk to 19 per 100 individuals and two drinks per day further increases the risk to 22 per 100 people. That means that five more women out of 100 (or one out of 20) who drink higher levels of alcohol will develop cancer during their lifetime.
For men, the risks are about 10% for those who drink less than one drink per week, to 11% for those who drink one drink per day and 13% for those who drink two drinks daily.
The surgeon general report made the following suggestions for steps to reduce alcohol-related cancers.
Update the health warning label on alcoholic beverages to warn about cancer risks. Reassess the recommended limits for alcohol consumption. Increase efforts to expand general awareness and educate the public. Inform patients during clinical encounters about the link between alcohol consumption and cancer risk.
We already know from past experience — prohibition — that making alcohol illegal is not the answer. But it’s up to us health care providers to make the public aware of these facts so that people can make informed decisions.
By Warren Beck Social Security District Manager in Syracuse.
Social Security imposter scams continue to be widespread across the United States. Scammers use tactics to deceive you into providing sensitive information or money. If you receive a suspicious letter, text, email, or call, do not respond.
We will NEVER:
• Text or email images of an employee’s official government identification.
• Suspend your Social Security number.
• Threaten you with arrest or other legal action unless you immediately pay a fine or fee.
• Require payment by retail gift card, wire transfer, internet currency, or cash by mail.
• Promise a benefit increase or other assistance in exchange for payment.
• Mail or email “official” letters or reports containing your personal information.
• We only send text messages in limited situations, including:
• When you have subscribed to receive updates and notifications by text.
• As part of our enhanced security when accessing your personal my Social Security account.
If you owe money to us, we will mail you a letter with payment options and appeal rights. Social Security employees do contact the public by telephone for business purposes. Ordinarily, the agency calls people who have recently applied for a Social Security benefit, are already receiving payments and require an update to their record or have requested a phone call from the agency. If there is a problem with a person's Social Security number or record, Social Security will typically mail a letter.
We encourage you to report suspected Social Security imposter
scams — and other Social Security fraud — to the OIG’s website at oig. ssa.gov/report. You can find more information about scams at www.ssa.
Q.: I recently retired and am approaching the age when I can start receiving Medicare. What is the monthly premium for Medicare Part B?
A.: In 2025, the standard Medicare Part B premium for medical insurance is $185.00 per month. Some people with higher incomes must pay higher monthly premiums for their Medicare coverage. You can get details at www.medicare.gov or by calling 1-800-MEDICARE (1-800-6334227) (TTY 1-877-486-2048).
Q.: Do we have to withhold Social Security taxes from our housekeeper’s earnings?
A.: It depends on how much you’re paying the housekeeper. If you pay a housekeeper or other household worker $2,800 or more in cash wages throughout the year, you must deduct Social Security and Medicare taxes. This holds true for a cleaning person, cook, gardener, babysitter, or anyone else who provides services for you. In addition, you must report these wages once a year. There are exceptions, for example, when you are hiring a company or independent contractor and paying them a fee for services instead of wages to a person. You can learn more about household workers and tax deductions by reading our publication, Household Workers at www. ssa.gov/pubs/EN-05-10021.pdf.
gov/scam. Please share this information with your friends, family, and colleagues to help spread awareness about Social Security imposter scams.
Q.: Can I get both Supplemental Security Income (SSI) and Social Security benefits based on my disability?
A.: Many people eligible for Social Security disability benefits also may be eligible for SSI. The disability decision for one program is the same as it is for the other, but you must meet additional resource and income limits to be eligible for SSI. Learn all about SSI and whether or not you may be eligible by reading the publication, "You May Be Able to Get Supplemental Security Income (SSI)" at www.ssa.gov/pubs/EN-05-11069. pdf.
Q.: What can I do at www.ssa.gov?
A.: There are many things you can do on Social Security’s website — you can find a list at www.ssa. gov/onlineservices. You can get an estimate of future benefits, find out when you are eligible for benefits, and even apply for benefits. You can complete other tasks online, too, including requesting a replacement Social Security card in most states. If you have a personal my Social Security account, you can get an estimate of your personal retirement benefits and see the effects of different ages to begin receiving retirement benefits. If you don’t have a personal my Social Security account, create one at www. ssa.gov/myaccount. You can create an account if you are at least 18 years old, a U.S. citizen, and have a valid email address and Social Security number.
No two women are alike. At Crouse, we believe you want — and need — healthcare that puts a continual focus on what matters most — you. Our hospital was founded by women, and more than a century later, services for infants and women of all ages remain at the heart of Crouse Health. Partner with women’s wellness providers who discover your individual needs by listening more closely and caring more deeply — and treating you with the respect and dignity you deserve.
crouse.org/women
At Hematology-Oncology Associates of CNY, you are never just a diagnosis or a number. We see you...the whole person, with passions, hopes, dreams, histories, and loved ones who share in your journey. From diagnosis, to treatment, to survivorship – our personalized care focuses on truly understanding and planning for your unique needs. We provide genuinely compassionate support, collaborating with you, your family, and caregivers every step of the way. Learn more about HOA today. We’ll see you and care for you – body, mind and spirit.
Hybrid Nurse Aide Training Program ELEMENTAL MANAGEMEN OUP
Hybrid Nurse Aide Training Program
Hybrid Nurse Aide Training Program ELEMENTAL MANAGEMENT ROUP
MANAGEMENT GROUP
Equip your facility with our unstoppable HYBRID CNA program, empower your team to deliver top-notch care with the strength of a champion.
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Are you looking for an innovative way to attract CNA students? We have your answer
Equip your facility with our unstoppable HYBRID CNA program, empower your team to deliver top-notch care with the strength of a champion.
Are you looking for an innovative way to attract CNA students? We have your answer
Are you looking to minimize and most importantly eliminate agency use? We have your solution
Are you looking for an innovative way to attract CNA students? We have your answer
Are you looking to minimize and most importantly eliminate agency use? We have your solution
Are you looking to improve morale by increasing your direct care PPD? Reach out to us to hear more
Are you looking to minimize and most importantly eliminate agency use? We have your solution
Are you looking to improve morale by increasing your direct care PPD? Reach out to us to hear more
Are you looking to captivate and motivate the newer generation by offering unique and rewarding training opportunities? Look no further contact us today
Are you looking to improve morale by increasing your direct care PPD? Reach out to us to hear more
Are you looking to captivate and motivate the newer generation by offering unique and rewarding training opportunities? Look no further contact us today
CONTACT:
Peg Reith BSN, RN
CONTACT:
Phone: 315-529-3267
Email: CNA_Training@elementalmgt.com
Peg Reith BSN, RN
Phone: 315-529-3267
CONTACT:
Email: CNA_Training@elementalmgt.com
Peg Reith BSN, RN
Phone: 315-529-3267
Email: CNA_Training@elementalmgt.com
Are you looking to captivate and motivate the newer generation by offering unique and rewarding training opportunities? Look no further contact us today
