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INSIDE ATRIAL FIBRILLATION: Take your fluttering heart beat seriously LIVE ALONE: Don’t let this past year define you SENIORS: Staffing shortage affects Rochester senior living facilities PRIVATE PRACTICE: Why new doctors opt out

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SEPTEMBER 2021 • ISSUE 193

'Rowing Therapy'

Leaving Cancer Behind One Stroke at a Time — Cancer survivor women find great health benefits from rowing. They are all members of the Naiades Oncology Rowing. The Rochester-based club has three rowing sessions a year, the last one in mid-October. Some members share their experience. P. 10

Special Needs Issue WOMEN'S HEALTH Physician Jillian Babu, Thompson Health's chief of OB-GYN, talks about the use of the daVinci robot and how it changes the way she operates. P. 4

THINGS TO KNOW ABOUT EYE CARE Sungjun Hwang of the Eye Care Center. P.9

PEAK SEASON FOR ASTHMA ATTACKS

More Children with Disabilities? Various factors may have skewed the statistics, expert says

‘Special Needs’ vs. ‘Disabled’: A Search for Respectful Verbiage Disability Raises Depression Risk Seeking outside support when feeling depressive symptoms may help

CELEBRITIES IN THE NEWS

Christina Applegate Announces She Has Multiple Sclerosis

mmy award-winning actress Christina Applegate recently revealed she is battling multiple sclerosis. She is perhaps best known for her starring roles in “Married With Children,” “Dead to Me” and “Samantha Who?” “A few months ago I was diagnosed with MS,” Applegate tweeted. “It’s been a strange journey... It’s been a tough road. But as we all know, the road keeps going. Unless some a**hole blocks it.” “As one of my friends that has MS said, 'we wake up and take the indicated action,'” Applegate continued. “And that›s what I do. So now I ask for privacy. As I go through this thing.” The cause of multiple sclerosis is unknown, but research has suggested that both environmental and genetic factors may be at play. More than 2.3 million people have MS worldwide, including several other celebrities, according to the National Multiple Sclerosis Society (NMSS). “Multiple sclerosis is a disease in which the immune system attacks the central nervous system,” explained physician Asaff Harel, who directs the Multiple Sclerosis Center at Lenox Hill Hospital in New York City. “This condition can cause a variety of symptoms and affects each individual differently, depending on the severity and the location of injuries

Bob Odenkirk’s ‘Small’ Heart Attack? Doctors Say All Are a Big Deal

to the nervous system. MS is a spectrum, affecting some more severely than others.” Those diagnosed with MS typically have one of four types of the disease, according to the NMSS. The four types range in severity and progression, but there is no way to predict how the disease will unfold in a particular person. Applegate has not said which type of MS she has. This is not Applegate’s first health scare: In 2008, she had both of her breasts removed after a breast cancer diagnosis, CNN reported.

hen actor Bob Odenkirk collapsed on the set of “Better Call Saul” recently in New Mexico, fans held their breath — and obsessively checked for updates on social media — until word came that he was expected to be OK. “I had a small heart attack,” he tweeted, thanking the doctors who “knew how to fix the blockage without surgery.” Few other details about his health were available, but a small heart attack is still a big deal, said physician Donald Lloyd-Jones, president of the American Heart Association. “All heart attacks are important and have the potential to be big and possibly fatal,” he said. “So, we don›t mess around. It's not a small heart attack until we turn it into a small heart attack by appropriate treatment.” Lloyd-Jones, a cardiologist, epidemiologist and chairman of the department of preventive medicine at Northwestern University Feinberg School of Medicine in Chicago, was not involved in Odenkirk’s treatment. But he said the mechanism of all heart attacks is basically the same: An artery is blocked and that cuts blood flow to the heart muscle. If the blockage goes on long enough, heart muscle cells start to die.

The scope of the damage depends on the location of the blockage. “If there’s a big blockage in a big artery early in its course, there’s more heart muscle at risk,” he said. “If there’s a blockage in a small side branch, far downstream, there’s less heart muscle at risk.” Typical symptoms of a heart attack include heavy pressure in the chest, often accompanied by shortness of breath, sometimes with sweating or with pain that radiates into the neck, jaw or arm, Lloyd-Jones said. “But sometimes it can be more subtle, such as suddenly feeling lightheaded or significantly fatigued.” For Lloyd-Jones, the term “small heart attack” suggests Odenkirk was fortunate to have been quickly taken to a hospital with a cardiologist who could treat the blockage, probably by running a catheter through an artery in the wrist up to the heart.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

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Sleep Apnea Doubles Odds for Sudden Death

leep apnea may double your risk for sudden death, according to a new study. The condition — in which a person’s airway is repeatedly blocked during sleep, causing pauses in breathing — may also increase the risk for high blood pressure, coronary artery disease and congestive heart failure, new research shows. “This [study] adds to the growing body of evidence that highlights the importance of screening, diagnosis and treatment of sleep apnea,” said physician Kannan Ramar, immediate past president of the American Academy of Sleep Medicine (AASM). Ramar, who reviewed the findings, said they underscore the importance of recognizing a widespread and often underdiagnosed condition that has become a growing public health concern. For the study, a team at Penn State University reviewed 22 studies that included more than 42,000 patients worldwide. Their review revealed that people with obstructive sleep apnea had a greater risk of dying suddenly and the risk rose as patients aged. “Our research shows this condition can be life-threatening,” principal investigator Anna Ssentongo said in a university news release. She’s an assistant professor and epidemiologist at Penn State. The repeated lapses in breathing in sleep apnea cut off oxygen supply to cells, which can result in an imbalance of antioxidants in the body. This imbalance harms cells and may speed up the aging process, leading to many health problems, the researchers said. The study authors said the findings underscore the urgency of treating sleep apnea. Continuous positive airway pressure (CPAP) is the standard treatment for moderate to severe apnea, according to the AASM. CPAP provides a steady stream of pressurized air through a mask worn during sleep. The airflow keeps the airway open, preventing pauses in breathing while restoring normal oxygen levels. Other options include oral appliances designed to keep the airway open and, in some cases, surgery to remove tissue from the soft palate, uvula, tonsils, adenoids or tongue. Losing weight also benefits many people with sleep apnea, as does sleeping on one’s side. Generally, over-the-counter nasal strips, internal nasal dilators, and lubricant sprays reduce snoring, but AASM says there is no evidence that they help treat sleep apnea.

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Meet

Your Doctor

By Chris Motola

Jillian Babu, M.D.

OB-GYN chief at Thompson Health discusses minimally invasive surgeries and the role the daVinci robot plays in OB-GYN surgeries. ‘It has taken laparoscopic surgery to the next level,’ she says Q: We wanted to talk to you about minimally invasive OB-GYN surgeries at FF Thompson Hospital. A: Minimally invasive surgery is my passion. When we say minimally invasive, it usually encompasses a set of techniques that we use now, compared to 20 years ago, that have changed outcomes for patients. It could mean a nonsurgical option, which would be noninvasive, but there are ways to avoid having surgeries for certain types of menstrual or uterine-related complications. Q: What are some common gynecological surgeries? A: Mostly when we talk about surgery in relation to gynecology is something related to bleeding or fibroids, which are noncancerous growths inside the uterus that can cause a lot of pain and pressure. They can get very big sometimes. Or, something to do with chronic pelvic pain. Endomitriosis is very common; around 10% of women suffer from it. Women may have ovarian cysts that sometimes need to be removed. So those are where we employ a lot of those techniques. That’s where we start thinking about minimally invasive surgery.

duce the amount of time the patient is in the hospital and in the operating room, as well as their recovery times. Those are the types of things we’re talking about when it comes to improved outcomes. We use different sets of medication than we did 20 years ago. Thompson is very good about limited narcotic use after surgery, in light of the opiate epidemic. We give preoperative medications to help decrease the risk of postoperative pain. When we’re talking about the surgery itself, there are several types of minimally invasive surgery. There is laparoscopic surgery, which includes both the traditional way of using cameras fed through catheters to see inside the abdomen, moving the cameras around with our hands. That made some of the biggest changes initially, but now we also have robotic laparoscopic surgery, which is where the daVinci robot comes in. I don’t want to go as far as to call it life-changing, but it has taken laparoscopic surgery to the next level. It allows us to treat very difficult cases that would be very hard to treat with laparoscopic techniques, and allows us to treat more patients laparoscopically.

Q: How are outcomes affected? A: With these techniques and interventions, we can re-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

Q: How long have you been working with the robot? A: Thompson has been ahead of the game

with robotic systems as far as community hospitals go. They had one when I first got here back in 2012. Like any other technology, it ages out, which is why it’s so important that they upgraded to the new model last year, even in the middle of COVID. Q: Since you’ve had experience with both generations, what improvements have been made? A: My husband loves cars. I drive a car — I love heated seats — but cars today have so much more to offer than heated seats. I feel like the first robot was like the first car with heated seats. It had some perks, but I got to the point where my skills with laparoscopic surgery were good enough that it didn’t benefit me anymore, at least in some ways. Some of its features had aged out. But the new robot is like getting a Mercedes that has every feature you could think of. In terms of visualization, the camera definition; as a surgeon I get it and see the difference, but it’s harder to explain to someone who hasn’t been working with them. It’s like taking a picture with an iPhone 4 versus a current model. When we can see better, we operate better, we move more efficiently, we can see very small lesions. It improves outcomes. But also the tools that come with it. There are instruments that come with it that you couldn’t buy for the old model. They probably cut 15, 20 minutes off of my cases. That changes the patients’ outcomes immensely. A hysterectomy used to be three to five days in the hospital, now patients usually go home the same day. Q: What kinds of quality of life impacts does it have? A: In reference to long-term outcomes for a woman, it means being out of work for less time, especially if their job doesn’t involve heavy lifting. We’re talking two weeks instead of six weeks. I guess the second is, in terms of follow-up, is making it less necessary to come into the office. We can offer telemedicine post-operative checks. Q: What percentage of your operations use the robot? A: It varies by surgeon, but for me it’s about a 50-50 split. I use the robot almost as an additional instrument. If a patient has endometriosis or a very large uterus, I err on the side of the using the robot. It gives me more hands, gives me a little more control. We use it frequently and love it. There are other surgeons who have switched over to almost always using it, but that has a lot to do with how they were trained.

Lifelines

Name: Jillian Babu, M.D. Position: Chief of obstetrics and gynecology at F.F. Thompson Health Hometown: Belmont, New York Education: SUNY Buffalo; Daemen College Afﬁliations: F.F. Thompson Health, University of Buffalo Organizations: American Congress of Obstetrics and Gynecology; Medical Society of the State of New York; American Association of Gynecologic Laparoscopists Family: Husband, two children Hobbies: Cooking, hiking, traveling

Will COVID-19 Ever Be Eradicated?

ould COVID-19 one day go the way of smallpox and polio? New research suggests it might be possible to beat the coronavirus with high vaccination rates and rapid responses to immunity-evading variants, the study authors said. “While our analysis is a preliminary effort, with various subjective components, it does seem to put COVID-19 eradicability into the realms of being possible, especially in terms of technical feasibility,” according to Michael Baker, professor in the department of public health at the University of Otago, Wellington, in New Zealand, and colleagues. To assess the feasibility of eliminating COVID-19, the researchers used 17 factors to compare it with two other vaccine-preventable viral diseases — smallpox and polio. Smallpox was declared eradicated in 1980 and two out of the three serotypes of poliovirus have been eradicated worldwide. The factors used for analysis included: vaccine availability; lifelong immunity; impact of public health measures; effective infection control messaging; political and public concern about the economic and social impacts of the diseases; and public acceptance of infection control measures. The investigators used a threepoint scoring system for each of the 17 factors and concluded that the feasibility of eradication was higher for COVID-19 than for polio, but lower than for smallpox. The average scores in the anal-

ysis were 2.7 (43/48) for smallpox, 1.6 (28/51) for COVID-19, and 1.5 (26/51) for polio, according to the study published online Aug. 9 in the journal BMJ Global Health. Compared to smallpox and polio, the challenges of eradicating COVID-19 include low vaccine acceptance and the emergence of more highly transmissible variants that might evade immunity, the authors noted. “Nevertheless, there are of course limits to viral evolution, so we can expect the virus to eventually reach peak fitness, and new vaccines can be formulated,” Baker and colleagues suggested in a journal news release. “Other challenges would be the high upfront costs (for vaccination and upgrading health systems), and achieving the necessary international cooperation in the face of ‘vaccine nationalism’ and government-mediated ‘antiscience aggression,’” the team noted. But they added that there is worldwide will to combat COVID-19, because the staggering health, social and economic impacts of the virus have triggered “unprecedented global interest in disease control and massive investment in vaccination against the pandemic.” This is preliminary research and more extensive in-depth investigation is needed, and the World Health Organization would need to formally review the feasibility and desirability of trying to eradicate COVID-19, the researchers explained.

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Editor & Publisher: Wagner Dotto Writers: Deborah J. Sergeant, Chris Motola, Lynette Loomis, Kimberly Blaker, Ernst Lamothe Jr., John Addyman,Todd Etshman, Aaron Fields, Chelsi Santiago • Advertising: Anne Westcott, Linda Covington • Layout & Design: Joey Sweener • Office Manager: Nancy Nitz No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Don’t Let This Past Year Define You

ell, so much for that longed-for carefree summer. Just as we were getting a taste of normalcy, a fourth wave of coronavirus infections began to sweep across the U.S. And as I write this, we are seeing an uptick in cases. While many medical experts and the CDC warn things may get worse before they get better, they also say this can be turned around by getting vaccinated, wearing masks and continuing to practice social distancing. I’m all in. And hope you are, too. In the past, I’ve shared lots of “do’s” to help people live alone with more success. Here are a few “don’ts” — some lighthearted — that may also help you on your journey toward contentment in what continues to be changing and challenging times. • Don’t make isolation a habit. This is a tricky one, because the times we’re in have called for social distancing. Problem is, social isolation can slowly, subtly morph into social anxiety, which can lead to feelings of disconnection or, worse, depression. What started out as an essential mandate to keep ourselves and others safe has, for some, turned into an unhealthy habit. There’s no one solution to breaking the cycle of social isolation, but there are a few tips I can share: • Take a look at your situation and notice if you’ve stopped reaching out; and likewise, if people have stopped reaching out to you.

• Decide to ease back in slowly and suggest get-togethers (ideally outdoors) that feel safe to you. • Try to accept invitations when they do come your way, even if you don’t feel like it. • Ask for help, if you need it, by letting others know that you fear you are becoming a hermit. We humans are social animals; we’re meant to be with others. Solitary confinement is for criminals, not for people who live alone. Stay connected! • Don’t make Fruit Loops your main course for dinner. Well ... maybe on occasion. But as a general rule? No. Create a nice place setting, fill your plate with something healthy, light a candle, select a beverage of choice, and enjoy some well-deserved time to yourself. A favorite magazine, book or crossword puzzle can make for a nice dining companion. Bon appetit! • Don’t go on an online shopping spree to ﬁll an emotional void. Your savings account will thank you. • Don’t put too much stock in that dreamcatcher. If you find yourself wide awake in the middle of night worrying about COVID-19 or fighting demons, you might try meditation, journaling, or aromatherapy. When I can’t sleep, I fill my diffuser with lavender oil and do some deep breathing while I repeat the phrase, “Sleep is healing.” If that doesn’t do the trick, I get up and prepare myself “Sleepytime” herbal tea.

'Just as we were getting a taste of normalcy, a fourth wave of coronavirus infections began to sweep across the U.S. And as I write this, we are seeing an uptick in cases.' I return to bed with fingers crossed and eyes closed. If all else fails, consult your doctor. • Don’t jump into someone’s arms out of loneliness. Feelings of desperation can make you easy prey for a suitor with dubious intentions. It’s a risky place to be. Getting good at living alone will build your self-esteem and improve your chances of meeting someone who values and appreciates your strengths, not your weaknesses. • Don’t be afraid to travel alone. When the time is right, hit the road! Some of my best trips have been taken with my favorite traveling companion: myself. I create my own itinerary, go at my own pace, see incredible places and meet all kinds of interesting people along the way. Even a small jaunt can boost your confidence. On your own, you’ll discover your own resourcefulness, ability to solve problems, and capacity to spend enjoyable time alone. It can be an enlightening adventure in self-discovery. • Don’t act your age. You are free, unencumbered and on your own. What better time to spread your wings, be silly and otherwise express your glorious, awesome self. Put yourself with people who make you laugh. For me, that’s my sister Anne. So, keep your sense humor. Even in serious times, funny things can happen. I just read about a study that showed that laughing — even fake laughing — can reduce stress, dampen pain, lower your blood pressure, and strengthen your immune system. Now, that’s no laughing matter! • Don’t underestimate the

power of gratitude. I have found the process of reflecting on and writing down those things for which I’m grateful to be a fulfilling, even healing, exercise. Think back over your day. Identify those things or people or places that made an impression on you or that touched your heart. Great or small, it could be the sound of a breeze through the trees, a new assignment at work, your daughter’s decision to go back to school, or a stranger’s warm hello in passing. Start every day with an open heart and with a view to see the positive and the possibilities in life. If you bump into an obstacle, try to appreciate the opportunity it presents to overcome it. When you focus on the wonderful things in life, wonderful things begin to happen. It reminds me of the law of attraction. Your positive thoughts and energy can become a magnet and draw even more positive thoughts and energy in your direction. • Don’t take these “don’ts” too seriously. You are in the best position to decide what to do or not to do — no shoulds, musts, or other people’s agendas. That’s one of the best benefits of living alone. Don’t I know it. Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite Voelckers to speak, visit www.aloneandcontent.com

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

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Daily Half-Hour Walk Can Greatly Boost Survival After Stroke

fter a stroke, survivors can greatly increase their odds for many more years of life through activities as easy as a halfhour’s stroll each day, new research shows. The nearly five-year-long Canadian study found that stroke survi-

vors who walked or gardened at least three to four hours a week (about 30 minutes a day), cycled at least two to three hours per week, or got an equivalent amount of exercise had a 54% lower risk of death from any cause. The benefits were highest among

Atrial Fibrillation: Take Your Fluttering Heart Beat Seriously By Kimberly Blaker

ften, when we think of heart conditions, we associate them with age. Although atrial fibrillation (AFib) is found more often in those over age 60, it can affect people of all ages, even children. Two million Americans are affected by this serious condition, which increases the risk of health complications, including heart attack and stroke.

What is AFib, and what causes it? AFib makes the heart beat rapidly and irregularly. It commonly feels like a fluttering of the heart. According to the Mayo Clinic, “During atrial fibrillation, the heart’s two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two low-

er chambers (the ventricles) of the heart.” AFib, also known as arrhythmia, is not deadly in and of itself but is nonetheless a serious condition. It increases the risk of heart failure or can be the result of a serious underlying health problem. There are several causes associated with AFib. It can be genetic or may be caused by one of several heart-related diseases, previous heart surgery, sleep apnea, lung disease, infection or an overactive thyroid. Caffeine, heavy alcohol use, street drugs and certain medications can also cause AFib.

What are the symptoms, and how is it diagnosed? The most common symptom of AFib is a fluttering heartbeat or

younger stroke survivors. Those younger than 75 who did at least that much physical activity had an 80% lower risk of death, according to the study published online Aug. 11 in the journal Neurology. “We should particularly emphasize [physical activity] to stroke survivors who are younger in age, as they may gain the greatest health benefits from walking just 30 minutes each day,” study author physician Raed Joundi, of the University of Calgary, said in a journal news release. One U.S. expert in stroke care said more needs to be done to help people who survive a stroke get active. “It is important that stroke neurologists enroll their patients in exercise programs, because encouraging exercise/physical activity may not be sufficient,” noted physician Andrew Rogove, who wasn’t involved in the new research. He directs stroke care at Northwell Health’s South Shore University Hospital in Bay Shore, on Long Island. The new study included nearly 900 stroke survivors, average age 72, and more than 97,800 people, average age 63, who had never had a stroke. All of the participants were followed for an average of about 4.5

years. After accounting for other factors that could influence the risk of death (such as age and smoking), the researchers found that 25% of the stroke survivors and 6% of those who’d never had a stroke died from any cause during follow-up. Among the stroke survivors, 15% of the people who exercised at least the equivalent of three to four hours of walking each week died, compared to 33% of those who didn’t get at least that much exercise, Joundi’s group reported. The bottom line: “Our results suggest that getting a minimum amount of physical activity may reduce long-term mortality from any cause in stroke survivors,” Joundi said. “Our results are exciting, because just three to four hours a week of walking was associated with big reductions in mortality, and that may be attainable for many community members with prior stroke,” he said. “In addition, we found people achieved even greater benefit with walking six to seven hours per week. These results might have implications for guidelines for stroke survivors in the future.”

palpitations. Other symptoms also sometimes accompany the condition, such as: • fatigue • dizziness • thumping in the chest • anxiety • shortness of breath • feeling faint or confused • sweating • chest pain or pressure In the event of chest pain or pressure, you should treat it as a medical emergency because it could indicate a heart attack. If you do experience symptoms AFib, diagnosis is painless and relatively simple. Your doctor will perform a physical examination and an electrocardiogram. A patient-activated cardiac event recorder can also help with the diagnosis.

minimally invasive catheter ablation are usually considered. For this procedure, you’ll be given something to relax you and a local anesthetic to numb the groin or neck area where the catheter will be inserted. • Finally, permanent AFib occurs when longstanding persistent AFib is unresponsive to treatment. If treatment has been ineffective, your doctor might decide to discontinue the treatment. This form of AFib is associated with an increased risk of a heart attack and can also impact the quality of your life. So whatever the form of AFib, take the condition seriously. If you experience symptoms, seek medical attention without delay.

Types of AFib and treatment There are four types of AFib, although one form can progress into another. • Paroxysmal AFib is intermittent and can last for just a few seconds or up to a week. Symptoms may range from none to severe. Either way, this form of AFib goes away on its own within a week or less. • Persistent AFib doesn’t go away on its own. It lasts until it’s treated with either medication or electric shock. For those at high risk of a stroke or if there’s another known cause of the AFib, physicians will treat the source of the irregular heartbeat as well. • Longstanding persistent AFib doesn’t respond to the above typical treatments. So several forms of

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Healthcare in a Minute

The monthly Healthcare in a Minute column will return in October when author George W. Chapman returns from vacation. September 2021 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Peak Season for Asthma Attacks

f you have a child with asthma, now is the time to revisit their Asthma Action Plan (www. health.ny.gov/publications/4850. pdf) so that you are prepared for the annual increase in asthma attacks that occurs each year as kids return to the classroom. A dramatic rise in the number of asthma flare-ups occurs each year from late August through the end of September, according to an Excellus BlueCross BlueShield review of past claims data and public health records. “The annual spike is caused, in part, by kids being exposed to more germs once they return to school,”

says physician Lisa Y. Harris, vice president of medical affairs at Excellus BCBS. “It’s also the peak time of year for molds and pollen, which can trigger respiratory distress that can launch an asthma attack.” Harris, who is board-certified in internal medicine and pediatrics, advises parents to use the final weeks of summer to make sure that prescribed asthma control medications are being used as directed, and that a doctor’s note is on file with the child’s school so that a supply of those medica-

tions can be kept there in case of an emergency. Parents should also use these last few weeks of summer to consult with their pediatrician to develop or update their child’s asthma action plan. This is a written plan that details a child’s daily asthma treatment including which medicines to take and when, and the child’s specific attack triggers. The action plan also explains how to identify when the child’s asthma symptoms are severe enough to contact the pediatrician or to take the child to urgent care or a hospital emergency room. “All adults and schools or other sites that care for a child with asthma should have a copy of the asthma action plan and understand their responsibilities regarding the child’s care,” says Harris. Before the start of school: • Check with your pediatrician to make sure that prescribed asthma medications are up to date and working, and that permissions are in place for their use at school, if needed. • Make sure your child takes all asthma medications as directed. • Alert all adults at school and elsewhere who work with your child to recognize the signs of an asthma attack. • Empower your child to notice and report asthma triggers and signs of a pending attack. • Prevent the spread of germs by encouraging proper handwashing, social distancing, and making sure that every family member is current on all recommended vaccinations, including the annual flu shot. For information on asthma, visit excellusbcbs.com and type “Asthma” in the search box.

Endotracheal tubes ETT, are plastic tubes that are inserted into the trachea to allow artificial ventilation.

What the Anesthesiologist Wants You to Know By Lynette M Loomis

nesthesiology is one of those words that is extremely hard to spell, sometimes hard to pronounce, and can make the difference between pain or no pain and life and death. Physician Robert Young has been an anesthesiologist for more than 28 years. Practicing at Rochester General Hospital and Clifton Springs Hospital and Clinic, he has worked with dozens of COVID-19 patients in the last year and a half. Q: What is the main difference between intubating (opening the airway) of a person with COVID-19 and a patient undergoing surgery? A: Intubating any patient, whether COVID or not is usually a routine but invasive procedure. The majority of patients have adequate airways where intubation (placing the endotracheal tube into the trachea is

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routine. In 10%-15% of patients, their specific anatomy makes intubation more difficult, sometimes requiring special equipment. These patients may have an “anterior airway,” leading to difficult visualization of the vocal cords. COVID-19 patients are not necessarily more difficult, but are more precarious. Their oxygen reserve is diminished making oxygen desaturation a risk. We attempt to intubate these patients with minimal airway manipulation (avoid mask ventilation) to limit viral spread. In these instances, the anesthesiologist is standing only 12-14 inches from the patient’s airway, and airway manipulation placing the ETT causes a large viral release into the immediate vicinity. So, prior to the vaccine, intubation of COVID-19 patients was a very risky procedure to the anesthesiologist.

Q: How would you explain intubation to someone who has never had surgery? A: Intubation is placing a tube down a patient’s throat so that air can gent in and out of the lungs in a consistent way. In other words, it helps a patient breathe and makes sure the person has enough air to avoid brain damage. It might also help slow down breathing. Q: Why can’t patients eat or drink anything before surgery? A: The concern with eating before surgery is that there is a small, but very serious, risk of aspirating that food material into your lungs after the induction of anesthesia. This can lead to a complication known as an aspiration pneumonia. Aspiration pneumonia is often serious as food particles can obstruct airways and stomach acid destroys lung tissue. These patients may require a prolonged stay intubated in an ICU setting. Therefore, it is especially important to be honest with your anesthesiologist regarding the consumption of food or liquids in the eight hours preceding surgery.

Physician Robert Young has been an anesthesiologist for more than 28 years. He practices at Rochester General Hospital and Clifton Springs Hospital and Clinic. Patients should also ask about side effects so they will have a good understanding of what to expect post-op. Nausea is a potential side effect that can be treated with anti-emetic medications.

Q: What should you tell your anesthesiologist? A: You may have eaten a little something or had a drink and decide Q: What questions should you ask not to tell your anesthesiologist. you anesthesiologist? A: Nerve blocks are often utilized Think again. Make sure he or she knows everything that can help you as part of the anesthetic plan. These and your surgeon achieve a successblocks are performed either pre-op ful outcome. For example: or intra-op to reduce or eliminate Patients should always talk with post-op pain and reduce narcotic use. their anesthesiologist about the type Patients should always check with of anesthesia they will be receiving, their anesthesiologist to see if their including different options available. procedure is amenable to a block.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

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ye health is often overlooked until it’s too late. But your eyes are not something to take for granted at any time. Whether it is food, environmental or personal decisions, your vision can be incredibly affected by your day to day decisions. “Your eyes are a crucial part of everyday life, regardless of your age,” said Sungjun Hwang, an ophthalmologist at the Eye Care Center in Canandaigua and a clinical assistant professor at the University of Rochester Medical Center. “With your eyes, you are able to see, to connect to other individuals, view your surroundings, complete work and much more. In fact, 80% of what you perceive around you comes through your sense of sight. No matter how old you are, your eye health is important.” Regular visits will vary, depending on the patient’s age, family history and current health. A good idea is to see the doctor once every three years if you’re younger than 50 and once a year when you turn 50. Hwang offers five tips for vision health.

1 Disregard the Myths

There are many misconceptions out there about vision. Even being told as a child that your vision can be improved by eating carrots. In reality, foods that are rich in vitamin A do help you maintain good eyesight, but they won’t improve your vision. “We even hear the whole myth that sitting close to a computer screen or the TV can damage your eyes. That’s false,” said Hwang. “You’ll likely gain a headache or eye strain if you’re sitting too close, but you

won’t have permanent damage. Every 20 minutes, you may want to rest your tired eyes by simply looking across the room. Use artificial tears or blink regularly to ensure your eyes stay well lubricated.” Hwang said it is also a myth that reading in low light can be harmful to your eyes. Although it’s not critical to have good lighting, it will make it easier to see and it will keep your eyes from tiring out more quickly. He even added a fun one that dispels the myth that a blue-eyed child cannot be born from two brown-eyed parents. “In fact, you’re unable to predict eye color from parents’ eye colors. It’s possible that as many as 16 genes could be responsible for eye color,” said Hwang.

to learn about 2 Important diabetic retinopathy

Caused by diabetes, diabetic retinopathy is an eye disease that results in vision loss. Some loss of sight occurs when high blood sugar levels cause damage to blood vessels — swelling and leaking are two concerns. “On occasion, blood vessels are closed off completely, which prevents blood from passing through. Controlling blood pressure and blood sugar are important. Options for treatment include medication, laser surgery and surgery to remove leaking blood vessels,” said Hwang.

Overall, it is best to focus on dark leafy greens such as spinach and kale, yellow and orange fruits and vegetables, egg yolks and fish such as tuna, salmon and halibut. “These vitamins may help slow down the progression of cataracts and age-related macular degeneration, a disease that results in vision loss in the macula, where the eye controls central vision,” he said.

should people 4 What know about cataracts?

When your vision becomes hazy, blurry or less colorful, you may find you have a cataract. You might experience seeing double images, being extra sensitive to light and having trouble seeing well at night. Fortunately, an ophthalmologist can help you with cataract surgery if a new prescription isn’t helping you see well enough. “In surgery, the doctor will remove your eye’s cloudy natural lens, which is the cataract, and replace it with an artificial lens, which is called an intraocular lens,” said Hwang, who performs cataract surgeries. “What’s terrific about this surgery is that most patients experience significant improvement in their vision and they are often surprised at how easy the process is to get through. As technology has evolved, we have more sophisticated ways to perform cataract surgery, which results in improved patient outcomes and satisfaction.”

Food or natural remedies Facts about eye health? 3 for deterioration of eye 5 health? Important nutrients to help support healthy eyes include: vitamin A, vitamin C, vitamin E and zinc.

September 2021 •

To keep your eyes healthy, there are many steps you can take. The first is to get a dilated eye exam. You could have a problem and not

Sungjun Hwang is an ophthalmologist at the Eye Care Center in Canandaigua and a clinical assistant professor at the University of Rochester Medical Center. even know it because many eye diseases don’t have symptoms. It’s also important to take care of your overall health. Maintaining healthy eating habits, being active, knowing your family’s health history and quitting smoking all can contribute to good eye health. “Another excellent step is to protect your eyes. You can do this by wearing sunglasses even during the winter and on cloudy days; wearing safety goggles while doing home repairs or playing sports and resting your eyes when using the computer for a long time,” said Hwang. “For those who wear contact lenses, it’s important to remember to wash your hands before you handle your contact lenses. Don’t forget to disinfect your contact lenses and get new ones regularly.” He also recommends the 20-20-20 rule. “Individuals should take a break every 20 minutes to look at something about 20 feet away for 20 seconds. It’s also important to keep your monitor bright, so there is less “computer flicker,” which can lead to eyestrain and headaches,” added Hwang.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

The Naiades – Pulling Every Oar to Recovery You won’t know this is for you or not until you get in the boat By John Addyman

n the silence of your body, the war goes on. You’d like peace. You long for peace. You search for peace. And when you find it, the reward is like warm water flowing over you. A surge of energy can now slowly build. Cancer claims so much of a person. You end up fighting for your soul. In the midst of the struggle to destroy the cancer, you need help, all kinds of help. The effort to reclaim you, to marshal your strength and courage, is an effort for every waking moment. A respite would be wonderful. Unbidden and genuine support would be gratefully consuming. A path to the road back to you would be welcome. But where to start? How about rowing? Wait…what? Roxanne Zambito, from Hamlin, is a three-time cancer survivor. She rows with the Naiades Oncology Rowing, along with other cancer survivors, those in active treatment and supporters. “The club, when I first heard about it, I thought it was ridiculous, just ridiculous,” she said, shaking her head. “I went only because I had a friend who wanted to go and I figured if she could fall in the water, I could fall in the water, too. But I could get out easier than she could.” That was 12 years ago. She helped found the Naiades (female spirits who watch over waterways) in 2009. “Rowing is doing something that Page 10

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The Naiades: From left in front row: Meg Sarnoff, Andrea Mowrer, Leni Rayburn, Ann Link, Rose O’Keefe, Roxi Zambito and Laurie VanDerMeid. Second row: Nancy Harter, Lola DiLauro, Karen Files, Michele Lewis, Kathy Willison, Sue Stoev, Janice Tuschong, Sheila Wassink, Deb Cole you never thought you could do. Now I’m coming back again from my last cancer. On the boat, it is peace, it really is.” Zambito – Roxie is her nickname – confesses that she can be a little bossy and uptight. “Cancer can do that to you,” she said. “So I sit in the bow of the boat so I can steer.” “Being in this group is wonderful. They’re a wonderful bunch of women who support one another no matter what. We have a good time, we laugh about ourselves. It’s just peaceful for me,” she added. When you get in an eight-person

crew boat, grasp your oar and start to row, you have one thing on your mind: the precision required to keep the boat going smoothly. That concentration can remove a lot of that day’s issues and stresses. “You do concentrate,” Zambito said. “But this group can also holler out, ‘There’s a beaver on the shore!’ and we can all look at it and say, ‘There’s a beaver on the shore and look at what we got to see today.’ It’s not as intense as a lot of clubs might be. Other survivor clubs are intense. We’re a little more laid back.” Nancy Harter of Greece was another woman who got the club

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

started. She has survived breast cancer twice. “Support groups weren’t for me,” she said. “I tried and tried, but they didn’t work for me. I didn’t know that as soon as I got into this boat, I was hooked on the very first day. We come here to get our minds off what cancer has done and taken away from us. The club made me more physical again. It cleared my mind and helped me enjoy life more. It has improved my emotional well-being, my strength and endurance — what cancer took from me.” Being a Naiades rower has given Harter a podium and a role she didn’t expect. “I hope people see my love for it and that rowing has done so much for me. On the water, we don’t talk about cancer. They get to see who we really are on the boat. They get to see who we are off the boat.” The club has three rowing sessions a year — spring, summer and fall — beginning in April and extending into mid-October. The women row twice a week from the Genesee Waterways Center off Elmwood Avenue in Rochester, bringing out their boats around 5:45 p.m., on the water around 6 p.m., rowing for 90 minutes and done by 8 p.m. “After these hot days, everyone’s ready to go home and take a shower or get in the pool,” said Sheila Wassink of Chili, a supporter. Most of the club members have had cancer, Wassink explained, but supporters — daughters, quite often — are needed to fill a seat on the boat sometimes. In the winter months, the club holds training sessions at the

Pittsford Tanks, where rowers can actually row against a water stream or at the GWC, where there are “erg” (rowing) machines. The Naiades also host learn-to-row classes, graduating four or five new oarswomen each session. Rose O’Keefe of Rochester, a cancer survivor, is another pioneer who helped start the club. She read an article about rowing being offered at Camp Good Days in 2008 “and it was free. I thought, ‘That’s great! I’d love to learn that and free is even better,’” she said. “That program ended, but the group did rowing indoors over the winter at the Pittsford Tanks. I actually started in the Pittsford Tanks in the winter of 2008 and joined Naiades in the spring of 2009,” she explained. “I had the reputation that spring of having the greenest face on the water. Because rowing in the tanks is stable, but when you get on the river, it’s a completely different experience. It took me a while to get used to it.” O’Keefe said rowing with this group is incredibly special. “I’ve learned every one of us is willing to learn something new and different. It takes effort and practice, but the teamwork and synergy of it, oh, it’s so priceless. It keeps me coming back,” she said. Laurie VanDerMeid of Irondequoit, a cancer survivor, also read about the club and the rowers. “Nancy Harter was in that article,” she said. “I was about a year and a half out of my treatment and I thought that was such a cool thing. On a whim, I sent my name in. I never thought I would follow through. But I got a personal phone call and just started rowing.” “There’s a sense of community and pride. We’re all working together,” VanDerMeid added. “We don’t focus on our cancer at all; we focus on rowing together, synchronous, so that we can have a nice, steady, fast boat out on the water. Rowing is very difficult, much harder than it looks.” Cancer is also very difficult, VanDerMeid noted. “I had never done any rowing — it’s something I never thought of. I found out it takes practice, patience with yourself and fellow rowers. Everyone sort of embraces one another and helps each other,” she said. “Some of us are not strong, some of us have restrictions; we all take the part we need to get it done. “This club is a very good place (for cancer survivors). Some of our new rowers are not comfortable for a while. They might just ride along in the motor launch. Some have restrictions — they can’t lift the boat above

their heads. We’ll lift it for them. Some people need help getting in or out of the boat, based on age or how physically well they are. We kind of learn who those people are and what they need, and we all work to help each other out.” VanDerMeid works on the club’s Facebook and Instagram posting, “and our presence in the community. We do the Wilmot Warrior Walk. We do symposiums. We do the Breast Cancer Coalition Walk and Run. We plan breakfasts; all the things we can possibly do socially to keep us together. This year we’ve seen a good uptick in membership.” The club’s main fundraisers, Wassink pointed out, are a golf tournament at the Lima Country Club on Aug. 22 and a naming ceremony that occurred in July, when the names of loved ones lost to the disease were painted on boats and oars. “They are the spirits who row with us every time we’re on the water,” according to the Naiades brochure. “How fun to be out on the water. How fun to be with a group of people who have experienced some of the things I’ve experienced,” said Michele Lewis of Brockport, a survivor. “It’s neat, it’s fun, it’s hard. But, it’s worth it. You’re out on the water; it’s kind of a Zen moment.” If you’re thinking about other things and your head’s not in the boat, your boat’s going to be offset, you’ll miss your strokes. “Some people are going through treatments, some unfortunately are dealing with recurrences,” she said. “Off the water we support each other just like we do on the water.” For anyone who’s just a little bit curious about grabbing an oar, Lewis’ advice is simple: “Come out and try it. You won’t know this is for you or not until you get in the boat. It’s something you have to experience before you know.” Wassink summed up rowing on the Genesee (and the canal) with the Naiades: “It’s so relaxing. It takes their minds off their real problems and issues. It’s the camaraderie: people are from all different jobs and families, but their common health issue — that’s what they all have in common. They talk about how they handle this or that. It’s a real support group for everyone. They’re strong. It’s so peaceful on the river. Sometimes we head for the Ford Street bridge, where we see downtown Rochester and all the lights. It’s just so calming. Just being together relieves some stress. Everyone is so helpful.”

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Police Department (315.828.6771) North Street Pharmacy (315.787.5388)

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Village Hall (585.374.2111)

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Community Center (315.548.8484)

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Find details at www.NaiadesOncologyRowing.com or contact us at info@naiadesoncologyrowing.com n 585-739-3717 September 2021 •

396-4554 IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

Disabilities

More Children with Disabilities?

Number of kids with disabilities rises. Various factors may have skewed the statistics, expert says By Deborah Jeanne Sergeant

study by the Centers for Disease Control and Prevention shows more children today have been identified as having disabilities. The figures rose from 16.2% in 2009-2011 to 17.8% in 2015-2017, including ADHD, autism spectrum disorder and intellectual disabilities. All of these can affect children’s abil-

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(585) 271-0660 arcmonroe.org Page 12

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ity to learn. While it may appear that the number of children with developmental disabilities is rising, other factors may have skewed the statistics. “There’s increased awareness,” said Rachel Chalmers, master’s in education and coordinator of pre-K special education with Rochester Childfirst Network in Rochester. “There’s probably more diagnosing because of this awareness. There’s more of a sensitivity to support children where they’re at and to meet their needs.” Year-round, fir trees grow in a variety of places: parks, landscapes and personal properties. Yet only in December do people who celebrate Christmas notice all the “Christmas trees” on their daily commute. In a similar sense, understanding the characteristics of developmental and learning disabilities helps professionals and, to an extent, parents become aware to the point that they recognize when a child exhibits these traits that could indicate a disability. “The point isn’t to start diagnosing everyone, but noticing children who could benefit,” Chalmers said. “It’s a desire to help and support children to have happy, productive adult life. The sooner we can help children, the better results.” Chalmers does not preclude the possibility that environmental factors may influence the numbers, including diet, sensory input at the infant stage and lack of movement. “As a professional in the field for more than 30 years, that makes sense to me,” she said. “I can understand why there might be an impact on our children’s neurological systems. That’s my opinion.” The practice of having infants use iPads instead of interacting with the physical world may contribute to issues involving learning, cognition and behavioral health, for example. The definition of disabilities can also increase the numbers. Anna Castonguay, clinical director at Autism Learning Partners in Rochester, said that when the Diagnostic and Statistical Manual of Mental Disorders came out in 2014,

it “radically changed the criteria for diagnosing autism. It now encompasses other disorders that were called Asperger’s or ‘pervasive developmental disorder not otherwise specified.’ Those were previously not autism. They combined them all into autism. They also expanded the criteria. “There are a lot better screening tools,” Castonguay added. “There’s a decrease in the more generic learning disability diagnosis. It’s possible that a lot more children are getting a more specific diagnosis. Before, it was more a school diagnosis, not a medical diagnosis. It is all dependent upon severity.” Like Chalmers, Castonguay said that that insufficient research has been completed to rule out environmental changes affecting the numbers. She pointed to advanced parental age as one of the possible reasons. More people have delayed starting a family than ever to pursue educational and career opportunities. Advanced parental age is widely known to increase the risk of numerous disabilities in children. Yuliya Snyder, a doctor with the Neuroscience Institute in Rochester General Hospital, believes that “more work would need to be done to know why more children are identified as disabled. How we classify things is probably a major driver, including increased awareness by parents and the schools, physicians. It’s likely we’re picking up milder cases that would probably not be picked up or classified as such 10 years ago.” For example, 10 years ago, diagnosing a teenager with ADHD “was a bold move, but it’s not strange now for even a college student,” Snyder said. “The same is probably true for autism spectrum disorder. There’s more awareness out there. The milder cases are being picked up by doctors and school psychologists.” The wording of researchers’ questions has also changed. Instead of using vague phrases, pinpointing a specific diagnosis may make parents feel more comfortable in identifying their children.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

“Let’s say they went from asking just ‘autism spectrum disorder’ to including autism, Asperger’s and other developmental disorders,” Snyder said. “That itself could have inflated numbers some because they can see how a layperson or parent whose child is on the mild end of the spectrum, previously they could have said ‘no’ to a ‘disability’ and now enter ‘yes.’” Cultural influences may also affect the numbers. Snyder said that within some cultures, what is accepted as normal behavior may be identified as ADHD behavior with others. “Within the Hispanic population, the culture has been more accepting of active behavior, but now more are more bringing it to the attention of their pediatricians,” Snyder said. “With time, some of the more challenging, subtle cases could be picked up. ADHD may look different in someone who’s older.” Snyder also said that medical advances in maternal care and neonatology may have also increased the number of children who would classify as disabled. “Kids who are much more premature and lower weight are able to survive, but typically by the price of having a disability,” Snyder said. “Years ago, it would be a pregnancy loss.” She also warned that skimming a headline about more disabilities may sound much more significant to a layperson, as “developmental disability” can include a person who as an adult has barely perceptible autism and not major challenges to basic activities of daily living. “Kids who are mildly on the autism spectrum can live their life fully with minimal limitations and a few necessary adjustments,” Snyder said. The availability of screening and services normally begins in urban areas and takes time—even several years—to eventually extend to more rural areas. Snyder said that the increased numbers could reflect this rollout.

Disabilities

‘Special Needs’ vs. ‘Disabled’: A Search for Respectful Verbiage

Experts: avoiding the term ‘disabled’ only leads to stigmatization By Deborah Jeanne Sergeant

robably arising from the push for additional education supports for persons with disabilities, the term “special needs” has been used for years but is beginning to fall out of favor with some groups. “Most experts and advocates vehemently oppose the term ‘special needs’ and believe we need to eliminate it from our vernacular,” said David Oliver in a June 11 article in USA Today. “Furthermore, they say avoiding the term ‘disabled’ only leads to stigmatization.” The term “special needs” is not a legal or medical term and was likely coined to describe the support needed beyond what people who are non-disabled need. According to the Merriam-Webster dictionary, the first known use was in 1899. But these days, it is falling out of favor. Like many other similar organizations, the New York State Office for People With Developmental Disabilities in Albany, uses “person-first language” for the people it supports. “We agree that words or negative references can influence how the general public view people with disabilities and can also be damaging to a person’s mental health and wellbeing,” said Jennifer O’Sullivan, director of communications. Age may determine what phrase to use. Nancy Consul, Special Children’s Services coordinator with The Monroe County Department of Public Health, said that for the children they serve, birth through age 3, it’s not “special needs” but “children not having met developmental milestones” or “developmental delay” as some children eventually do and others don’t. “Disability” connotates permanency, which may not be true for some delays at this age. As with most other organizations, “it’s person-first,” Consul said. “The English language puts the adjective first, but they’re a person before the disability. Now there are people who say, ‘My disability is who I am and I don’t want to put it behind me.’” While embracing the differences that make one unique can be a healthy, proactive perspective, “it’s not necessarily the best for a family with an uncertain or new diagnosis,” Consul said. “Developmentally, many children we don’t know if they’ll have a disability, but we know they have a delay or need extra support for their development. We called that ‘special needs’ and as a society, we’re struggling to find a term because I don’t want to tell a mother of a premature baby that their child has a disability. You want to give hope, expectation and that is different at different stages.” The term “differently abled” may

sound upbeat. However, it may also lend a connotation that the individual possesses savant qualities not present. “Differently abled” may also gloss over the real struggles facing a person challenged by activities of daily living—a person who may need some accommodation or help to get through the day and to live as desired. At Autism Learning Partners in Rochester, Anna Castonguay, clinical director, said that among people with learning disabilities or another cognitive disorder, pushback against “special needs” has been strong among the many who advocate for themselves. “We work only with children with autism so we say ‘autism,’ not ‘special needs,’” Castonguay said. “Autism is quite frequently what makes them special. For children with lower verbal and communication skills, autism can be a deficit, but autism is part of their personality in a lot of ways. They don’t want to be seen as being needy. Some are reclaiming ‘autistic person.’” Inclusion is the reason behind some of the lingual shifts, according to Karen Zandi, president and CEO of Mary Cariola Children’s Center in Rochester, which serves individuals with developmental disabilities. “We all want to feel included and respected,” Zandi said. “That’s a different cultural push.” Since “developmental disability” is a medical diagnosis, that is the term the organization uses and is the term the New York State Department of Education uses for eligibility for educational assistance. The phrase may describe someone diagnosed at any point in life—from birth or after an injury—but it always refers to someone with a lifelong condition interfering with typical development. Zandi is more open to “differently abled” as she has observed numerous people with challenges demonstrate significant patience in learning to use adaptive equipment of all sorts. “Language is important,” Zandi said. “As advocates for people with developmental disabilities, it is something that is part of our culture and our staff at Mary Cariola. We’re passionate about respecting the individual person.” Some terms began as medical diagnoses, but became discarded after repeated misuse, according to Rachel Chalmers, coordinator of PreK Special Education at Rochester Childfirst Network. “Maybe upon hearing the term associated with something negative, inappropriate or inaccurate causes people to use different terminology,” she said. “Everyone wants to feel September 2021 •

accepted and valued.” Oftentimes, “special needs” is commonly used as shorthand for a large group with a broad variety of needs. However, when speaking of a specific individual or a more define group, using the accurate diagnosis is more desirable. For Chalmers, she usually addresses individuals and their families—not groups. “You’re at least demonstrating an awareness and sensitivity and determination to be as specific as possible,” she said. “If I were talking about the population I serve,

it would be ‘children with unique learning needs that warrant individualized services and supports.’” While not succinct, she uses this phrase to demonstrate that she and her organization want people to feel valued. She also hopes to teach others through the language she uses. “It’s about educating the public and keeping them current and demonstrating respect for the population that this terminology is no longer appropriate for,” she said. “It no longer reflects them.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

Disabilities

Disability Raises Depression Risk Seeking outside help and support when feeling depressive symptoms may help By Deborah Jeanne Sergeant

eople with disabilities are up to three times more likely to experience depression, according to the Centers for Disease Control and Prevention. Although limitations because of their disability may be part of the reason they experience depression, many other factors play a role. “The disabled community has some of their own challenges and risks,” said Missy Stolfi, area director for the American Foundation for Suicide Prevention, which serves the area between Buffalo and Utica. “Access of mental healthcare is part of that.” Although the law requires accessibility in public facilities, it is still more difficult to navigate with a disability that hampers movement than without one. For someone with communication challenges, finding a therapist who can easily communicate with them or a translator to facilitate sessions can also present barriers to care. Considering the pandemic, some may not want to venture out as much because of the risk of catching the virus. “Many people who live with disabilities, their disability can affect their immune system,” Stolfi said. “And that can influence their abil-

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ity to seek mental health care and contribute to isolation. Many live day to day with their particular barriers to care.” Some of these factors can also worsen depression, according to Gary Spink, PhD, psychologist, Rochester Regional Health. “Disability can lead to various factors that can exacerbate depression including loss of social contact, loss of social roles, decreased opportunities for response contingent positive reinforcement—a fancy way of saying rewarding positive experiences cued by the environment,” he said. While it may affect some life experiences, a disability does not predispose someone to depression. Focusing on what one can do can help reduce risk of depression. “One way to prevent or improve depression among those on disability would be to identify and engage in important and enjoyable tasks throughout the day (an actual treatment for depression we call behavioral activation),” Spink said. “It can be helpful to schedule such tasks throughout the day to help maintain daily structure, as well as have activities to look forward to. For instance, if family is important and enjoyable

Missy Stolfi is the area director for the American Foundation for Suicide Prevention for someone, they might schedule time to take their children outside or schedule a time to talk with their parents.” Spink also said that a person’s thoughts, beliefs and expectations about the disability can also affect risk of depression, such as hanging self-worth on what one can or cannot do. Or, persisting in overly negative thoughts. “Even though our minds like to consider our thoughts as factual, they are not always correct or accurate,” Spink said. “If you notice such thoughts, consider how to make that thought more helpful to you in your life. One way would be to consider what advice you would give a friend in your situation telling you they were having those thoughts. We tend to be very good at providing advice to close friends and family; however,

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

it is harder to follow our own advice when we are in the situation.” Seeking outside help and support from family, friends and providers when feeling depressive symptoms may head off a bout of depression. A provider may also offer treatments like psychotherapy or prescription medication for depression. “There are several online resources available for people with various disabilities to support such engagement,” he said. “A useful starting point for these would be talking with your providers and determine what—if any—limitations you have on engaging in such activities, then trying to identify activities within those limitations. For instance, if you cannot walk, I have had several patients talk with me about YouTube channels with upper-body only cardio exercise.” Eating a balanced diet and getting enough sleep may also promote better mood. While these lifestyle factors can support good mental health, they are not always enough to stave off depression. Brenda McKnight is a volunteer and presenter for I Am Isiah in Rochester, a grassroots organization raising awareness of suicide. She often speaks about depression and its role in suicide ideation. She also has a disability. “Medication plus therapy is the key to getting better,” she said of depression. “I truly believe that these will help. That’s the right road to be on to get a better outlook. There are doctors, lawyers and others with prominent roles who seek counseling and therapy and take medication on schedule.”

SmartBites By Anne Palumbo

The skinny on healthy eating

Your Stomach’s Best Friend? Fennel!

addled with a finicky stomach since forever, I’m always on the lookout for foods that aid digestion. Probiotic-rich yogurt, high-fiber whole grains, nausea-busting ginger, constipation-relieving apples: all have easily found their way into my weekly diet. My newest addition? Fennel. Sweet, crunchy, refreshing fennel. While I’m no stranger to fennel and have always enjoyed its licorice-like flavor, I’ve never really eaten it on a consistent basis. But these days, I now consume this bulbous vegetable with the feathery fronds several times a week — for the digestive benefits and so much more. How exactly does fennel keep our digestion humming? Fennel contains a unique antispasmodic agent that relaxes the smooth muscles in our digestive tract—a soothing action that helps to reduce bloating, cramping, and flatulence. In the early 20th century, fennel was actually listed as an official drug for digestion in the U.S. National Standard Dispensatory. And limited research suggests that fennel oil may reduce colic in infants. Maybe this explains why Indian restaurants offer a bowl of candy-coated fennel seeds to customers. Fennel also rocks with fiber: 11% of our daily needs in one cup of raw slices. Fiber-rich foods support healthy digestion by adding bulk to our stools and by helping food move through our system more easily and quickly. In other words, less constipation! High fiber intake has also been linked to a lower risk of developing heart disease and diabetes due to its ability to help lower blood pressure, cholesterol, and glucose levels. And contrary to its pale color, fennel boasts a good amount of vitamin C.

Adapted from Cooking Light Serves 4

2 fennel bulbs 1 teaspoon ground coriander 1 teaspoon ground cumin 1 tablespoon chopped fronds 1 tablespoon olive oil 3 cups chopped tomatoes 4 garlic cloves, sliced 2 tablespoons lemon juice ½ teaspoon kosher salt ¼ teaspoon coarse black pepper ¼ teaspoon red pepper flakes (optional) 4 tablespoons crumbled feta

Hearts love this essential vitamin for its cell-protecting antioxidant benefits; skin loves it for its wrinkle prevention; immune systems love it for its overall boost; and eyes love it because it may delay the onset of developing cataracts, as well as slow the progression of age-related macular degeneration. A versatile vegetable that’s as enjoyable raw as it is cooked, fennel is naturally low in fat, sodium, cholesterol and calories (only 30 per sliced cup) and a good source of potassium.

Try These 3 Tips to Lose Those Pandemic Pounds

f you’re like many people, your waistline has expanded during the pandemic. “The world shut down,” said Heather Tressler, a registered dietitian at the Penn State Celiac Clinic at Penn State Health’s Milton S. Hershey Medical Center. “Maybe you didn’t change what you ate, but you became less active.” Lately, Tressler says she’s seeing patients — adults and children — who have gained 20 to 40 pounds during the pandemic. A study published this spring in the journal JAMA Network Open found that among 270 mid-

Fennel, Tomato and Feta Skillet Bake

dle-aged men and women, they had gained an average of 1.5 pounds per month between February and June 2020. Now may feel like the right time to shed that extra pants size, but it’s important to approach it in a healthy way. Tressler offered three tips to safely get started: 1) forget the fads, 2) don’t become too obsessed with calories, and 3) exercise alone is not enough. Though fad diets might sound appealing and bring you shortterm weight loss, they’re not sustainable, Tressler explained. Some are September 2021 •

Helpful tips Look for large, tight bulbs that are white or pale green, minus signs of splitting, bruising or spotting. The root bottom should have little browning. To store: trim fronds (if still on) to two inches above the bulb, wrap loosely in a plastic bag, and place in fridge for up to 5 days. In season now, fennel can be found at local farmer’s markets.

even risky. A diet that emphasizes a high fat intake, for example, could lead to spikes in cholesterol. Don’t be entirely focused on weight. “A scale really only measures the Earth’s gravitational pull on your body,” Tressler said in a Penn State news release. It’s more important to know your numbers — cholesterol, triglycerides, blood pressure, she said. They’ll give you a better picture of your health and the safest ways to lose weight. Losing weight is basic subtraction and requires eating less than you need to maintain your weight. Age, gender and activity levels also make a difference in the number of calories you need to maintain or lose weight. App stores and websites offer calculators to help you keep track. Tressler suggested the Harris-Benedict equation, which can calculate how many calories your body would

Preheat oven to 375 degrees. Trim coarse bulb bottom; then cut bulbs vertically into 8 wedges each, separating wedges along the way. Sprinkle with coriander, cumin, and a pinch of salt. Chop fennel fronds to equal 1 tablespoon; set aside. Heat olive oil in a large ovenproof skillet over medium-high. Add fennel wedges; cook 6 minutes until lightly browned, stirring throughout. Add garlic slices and cook 1 minute more. Add chopped tomatoes, lemon juice, salt, pepper, and red pepper flakes (if using). Gently mix; then place entire skillet in oven for 15 minutes. Sprinkle with crumbled feta and garnish with fronds.

Anne Palumbo is a lifestyle colum-

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

need if it rested for 24 hours. Just don’t become too numbers-focused, she said. “It can become very restrictive,” Tressler said, and can lead to eating disorders. Tressler recommends “intuitive eating” based on lifestyle needs. “There are no bad foods,” she said, “only bad portions.” The vast majority of weight loss can be controlled by what you eat, Tressler said. Some websites and articles say losing weight is the result of 80% diet and 20% exercise. Exercise also is good for heart health, muscles and well-being. Tressler suggests 30 minutes per day, five days a week, of something you like such as dancing or walking, and then pairing that with a healthy, sensible eating plan. “Maintain a balance,” Tressler said.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

NATIONAL SUICIDE PREVENTION MONTH

Pandemic Not a Factor In Death by Suicide Rates By Deborah Jeanne Sergeant

he Centers for Disease Control and Prevention reports 47,511 Americans died by suicide in 2019. The CDC’s most recent statewide statistics from 2017 indicate that suicide is the second leading cause of death for New York state residents aged 15 to 34. From 2016 to 2018, death by suicide increased in Upstate by 3.2% among all age groups with the average age at death 47.3 years, according to the New York State Department of Health. Although little data has been gathered about the pandemic’s influence on suicide, area experts report that it appears that rates of death by suicide have not increased because of COVID-19. “Early indications have shown from some reporting states that there’s no change or else declines from previous years,” said Missy Stolfi, master’s in education and area director for American Foundation for Suicide Prevention. Her area covers Buffalo to Utica. “Suicidal ideation has increased during COVID, but we’ve also seen people reaching out to get help whether calling crisis lines, telehealth options for mental health.” She said that telehealth has helped break down mental healthcare barriers, including stigma, transportation, childcare, schedul-

ing conflicts and mobility. That has helped mitigate the negative factors the pandemic has brought, such as isolation, lack of regular coping mechanisms and normality, and anxiety about finances, the future and becoming ill. “One thing that’s important to keep in mind whether pre-pandemic or not, is suicide risk is complex,” Stolfi said. “It’s easy to point to one thing to say, ‘That brought about someone’s death by suicide.’ There are a lot of things we can do to mitigate risk.” One of the key things is to talk about and normalize mental health. The pandemic has promoted mental health as an important topic. Many people have become more active in checking in with one another and have demonstrated more understanding about others’ mental state. Self-care has also become more widely accepted. “More people checking in created a sense of connection,” Stolfi said. “People were more in touch with family and friends because they were not running around. People slowed down, reassessed and found new ways to connect. The patterns of taking care of ourselves shifted and they continue to.” She hopes these trends of connectedness continue long-term. As people begin to return to workplaces and normal activities,

new anxieties are arising such as worries about returning to work, new virus variants arising, and what other unknowns the future may hold. “These are all very valid feelings,” Stolfi said. “COVID has not gone away. We got used to being in our safe spaces with our dogs.” Brenda McKnight administrative volunteer and presenter with I Am Isiah in Rochester, a grassroots suicide awareness organization, also highlighted the pandemic’s “silver lining” of increased awareness to mental health. However, “the isolation has affected many households. The pandemic has brought out a sense of reality that they have been suffering. “We’ve gotten a lot of calls. For those who didn’t know they suffered, it’s brought changes in their lives. It’s brought out a lot of anxiety from the isolation,” she said. She added that the stress of isolation has given way to complacency among people who have become so accustomed to staying home that they no longer feel comfortable going out. They feel insecure going among other people to work or for recreation. I Am Isiah operated an appointment-only food cupboard throughout the pandemic to help relieve the stressors of a tight budget. The group also operates a self-help group for women and provides information on suicide to the public. “Death by suicide is a permanent solution to a temporary situation,” McKnight said. “That’s the devastating part. There’s no coming back. “I feel like everyone can be depressed at any time. It doesn’t mean you’re suicidal but if it gets to a clinical stage, it looks darker. You need to look at how to alleviate that earlier

on. Once an individual decides to take their life, they take their pain and give it to their family they leave behind. That pain is lifelong.” Anyone struggling should contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or contact the Crisis Text Line by texting TALK to 741741.

Signs a Person May Be Suicidal

he American Foundation for Suicide Prevention shared a few signs that a person may be thinking about suicide: • Talking about wanting to die. • Looking for a way to kill oneself. • Talking about feeling hopeless or having no purpose. • Talking about feeling trapped or in unbearable pain. • Talking about being a burden to others. • Increasing the use of alcohol or drugs. • Acting anxious, agitated or recklessly. • Sleeping too little or too much. • Withdrawing or feeling isolated. • Showing rage or talking about seeking revenge. • Displaying extreme mood swings. The more of these signs a person shows, the greater the risk. Warning signs are associated with suicide but may not be what causes a suicide.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

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Possible Effects of Alcohol and Other Drugs During Pregnancy By Jennifer Faringer

eptember is Fetal Alcohol Spectrum Disorders Awareness month. Every mother hopes to deliver a healthy baby. While many women know that drinking during pregnancy can potentially cause harm, they may hesitate seeking treatment if they fear the stigma and discrimination often faced if use is admitted. It is important that prenatal care include having an active conversation, as early in the pregnancy as possible, about the importance of eliminating the use of alcohol, tobacco, and other drugs during pregnancy. In one study published in the “Alcoholism: Clinical and Experimental Research Journal,” researchers found that women, when asked about their alcohol use, often underreported both the amount and the frequency of use. The study found that 20% reported drinking during special occasions, and 52% reported binge drinking the last time they consumed alcohol. When asked about the number of drinks consumed, they acknowledged four or more. Screening tools most often used are more effective detecting heavy chronic drinking but are less effective in detecting moderate or binge drink-

ing episodes. For that reason, both pregnant women and women intending to become pregnant are advised to abstain from alcohol, tobacco, and other drug use to ensure the safest, healthiest outcome for their pregnancy. The table below illustrates impact of use during pregnancy that varies depending upon the drug. [Source: Institute for Health & Recovery,

2021] “Of all the substances of abuse (including cocaine, heroin, and marijuana), alcohol produces by far the most serious neurobehavioral effects in the fetus,” according to a report by the Institute of Medicine. To ensure the health and safety of your child consider eliminating the use of alcohol, tobacco, and other drugs during your pregnancy. For further information and resources, visit the NCADD-RA’s website at www.ncadd-ra.org or their Facebook page at www.facebook. com/NCADDRA.

Jennifer Faringer is the director of DePaul’s National Council on Alcoholism and Drug DependenceRochester Area.

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Excellus BlueCross BlueShield is an HMO plan and a PPO plan with a Medicare contract. Enrollment in Excellus BlueCross BlueShield depends on contract renewal. Our Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-877-883-9577 (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-877-883-9577 (TTY: 711)。 A nonprofit independent licensee of the Blue Cross Blue Shield Association September 2021 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

Addiction

Addiction: Drug Overdose Deaths Jumped 30% Last Year in U.S.

2020 has highest number of overdose deaths ever recorded in a 12-month period

s America went into lockdown and treatment centers closed their doors, drug overdose deaths in the United States jumped by nearly a third last year, new data show. The estimated 93,331 drug overdose deaths recorded during 2020 are a sharp increase — a 29.4% rise — over the 72,151 deaths estimated in 2019, according to preliminary data from the National Center for Health Statistics (NCHS). The NCHS is part of the U.S. Centers for Disease Control and Prevention. Physician Nora Volkow, director of the National Institute on Drug Abuse, called the new numbers

“chilling.” “This is the highest number of overdose deaths ever recorded in a 12-month period, and the largest increase since at least 1999,” she said. “The COVID-19 pandemic created a devastating collision of health crises in America.” The new NCHS data also show that overdose deaths from opioids, specifically, spiked from 50,963 in 2019 to 69,710 in 2020, about a 27% rise. Overdose deaths from synthetic opioids (primarily fentanyl) and psychostimulants such as methamphetamine also rose from 2019 to 2020, the report found. There

were also increases in deaths from semi-synthetic opioids such as prescription pain medications and from cocaine. Volkow, who wasn’t involved in the new report, said the sharp and tragic rise in overdoses stems from a combination of factors.

Addiction: Substance Abuse Disorder No Reason to Ignore Pain Treatment ‘We can treat pain for those who are treated with addiction. It takes a more modern mindset’ By Deborah Jeanne Sergeant

ecause of the opioid epidemic, healthcare providers have become more careful about prescribing powerful pain medication. But when people with a history of substance use disorder need pain relief, that can cause difficulties. “It’s a very important issue,” said physician Ross Sullivan,. He is the medical director of Helio Health in Rochester, Syracuse, Utica and Binghamton, medical director of medical toxicology and the fellowship director of the medical toxicology fellowship at SUNY Upstate, and the director of the Upstate Emergency Medicine Opioid Bridge Clinic. “In general, there’s an expectation of pain. Sometimes, the important thing to talk about with therapy and counseling is there might be learning to live with some pain.” He advocates for treating pain both with medication and the right mental and emotional approach. People undergoing treatment for substance use disorder can use a multimodal approach to mitigate their pain instead of relying only upon medication. “Opioids are the first line for acute pain,” Sullivan said. “Transitioning from a full opioid as quickly as possible to methadone or buprenorphine may be a strategy. These are conventionally used only for pain but can be used by someone with an opioid addiction to also treat the dependency and pain. Previously people would say, ‘You’re an addict; you can get no medication.’ That’s not what’s right for the patient.” Sullivan said that the pain medication could include a muscle relaxer,

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NSAID such as ibuprofen, and pain patches to reduce pain and improve function. The provider could divide their suboxone regimen that is treating their substance use disorder from one daily dose to two smaller doses to help mitigate pain. “We can treat pain for those who are treated with addiction,” Sullivan said. “It takes a more modern mindset.” Non-pharmacological approaches may also help mitigate pain and

help the person recovering from an illness or injury improve. “Part of the answer is stretching, exercise and yoga,” Sullivan added. “The person could do physical therapy and any type of exercise program. It will always be beneficial. Acupuncture may help with chronic or acute pain. These are all things people should try. Our goal is to improve function. We want to be pain-free, but it’s not always going to be possible.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

“This has been an incredibly uncertain and stressful time for many people and we are seeing an increase in drug consumption, difficulty in accessing lifesaving treatments for substance use disorders, and a tragic rise in overdose deaths,” she said. Hemant Kalia, interventional pain and cancer rehabilitation consultant physician with Rochester Regional Health, believes that the opioid crisis intersects two public health challenges: reducing suffering and reducing harm from the use of opioid medication. “We have to follow a delicate path and balance between pain management and addiction medicine principles,” he said. The Comprehensive Addiction and Recovery Act of 2016 formed guiding principles for providers to address pain management issues. “The guideline principles are the approaches of main management focused on biopsychosocial model of pain management,” Kalia said. These must be individualized and multidisciplinary, but “more often than not, everyone gets focused on just the medication class for acute or chronic pain,” Kalia said. “Everyone gets focused on opioids. They key for successful pain management depends upon the plan being multimodal, individualized and multidisciplinary.” He encourages more providers to suggest modalities like massage therapy, behavioral health, counseling, coping skills, cognitive behavioral therapy as part of a pain management program. A team approach can also help. Kalia works with addiction medicine specialists, psychologists and physical therapist to develop a comprehensive plan to address acute and chronic pain. As needed, patients receive referrals to in-patient or out-patient chemical dependency programs before leaving the emergency room. “We also have a special program out of the ER where if someone comes in with active withdrawal from opioid medication, they don’t have to wait to see a provider for that,” Kalia said. “They get into the addiction program. “The key here is to focus on individualized, multimodal and multidisciplinary approach to pain management. It’s the key to success for acute and chronic pain.”

Sept. 5. In late July, St. Ann’s announced it would raise the minimum wage to $15 by the end of the year. It’s a necessary step but a difficult one to implement since Medicaid and government funding is the biggest source of revenue. Medicaid in New York State for long-term care has been chronically underfunded for years, said Perrotta. It pays about 70% on the dollar meaning they lose 30% for everyone on Medicaid and the vast majority of residents are on Medicaid. “Unlike other service businesses like fast food and retail, we can’t just raise our prices to cover the additional expense,” Perrotta lamented. “If the pandemic has shown us anything it’s that we need a really dedicated well-trained workforce and we need financial resources to show this is a viable career path.”

Staffing Shortage Affects Senior Living Facilities Many facilities in the region are struggling to attract new employees By Todd Etshman

any areas of American business found out just how hard it is to find and hire enough employees when they tried to reopen and recover from the pandemic. It’s been particularly difficult for senior care and living facilities, which made front page news with the challenge of protecting residents and staff from airborne virus in close quarters. The safety concerns of COVID-19 exacerbated the staffing shortage problem, but it began even before the pandemic. Senior living and care facilities here and across the country faced staffing shortage challenges before COVID-19 arrived in large part because geriatrics and senior care isn’t a field many choose to enter. The pandemic may or may not be over, but the staffing shortage isn’t likely to be resolved soon even as more people are vaccinated and worker safety isn’t as much of an issue.

Staffing shortage particulars It doesn’t help that extra unemployment benefits mean lower paid staff such as CNAs might make more money by not working. Senior home administrators hope the labor pool will increase when those benefits end in Robert Bourg September. “We’ll see,” said Robert Bourg, senior vice president of human resources at St. Ann’s. “Our unemployment numbers have skyrocketed in the past 18 months. It’s part of the challenge. You never know what’s coming next.” To make matters worse, nursing and training programs stopped training and providing the graduates

senior care facilities need when they needed them most. For the most part, remote learning isn’t suitable for training nurses and certified nursing assistants to work in a hands-on enviSusan Murty ronment. As Nancy Smyth, executive director of the Rochester Presbyterian Home, points out, senior care staff didn’t have the option of working remotely during the pandemic or of keeping a six-foot distance from residents. “We’re already seeing nursing home care facilities close their doors, not because they don’t have the residents, but because they don’t have the staff members,” said St. Ann’s vice president and administrator Susan Murty. Shortly after I spoke with her, Hill Haven Nursing and Rehabilitation, a Rochester Regional Health run home on Empire Boulevard in Penfield announced it was closing. “Not to be an alarmist, but this could be the beginning of a public health crisis if we can’t figure this out as a community,” she said. To help make up for the direct care staff shortage, even senior care home administrators were trained in CNA like duties and pressed into service no matter how high up the organizational ladder they are. “It’s one thing to think you understand what employees are doing day to day. But, to do it, you really get an appreciation of what the job is all about,” Bourg said. Obtaining enough certified nursing, assistants is among the biggest staffing challenges because senior care homes tend to hire more of them than other types of employees such as nurses. Food service, social workers and September 2021 •

Additional measures taken to attract more employees facilities maintenance workers are also in short supply.

Workers’ industry perception At the height of the pandemic, senior care employees at St. Ann’s facilities in Rochester and others across the nation became residents’ families and worked hard to meet the emotional and physical needs of their residents in a crisis situation. But, as Bourg explained, for the most part, the public only heard horrible things and the perception of working in senior homes took a huge hit. “Because of COVID a lot of people aren’t even going to consider a career in senior care. They’re just not going to do it,” he said. Michael Perrotta, vice president and administrator of Friendly Senior Living, said the challenge for senior care facilities is to overcome the stigma people have of working in the industry. “Senior care communities, nursing homes and assisted living facilities really got a black eye because of the way the virus spread in a communal living environment,” he said. Area senior care facilities are however, taking much needed steps to help get enough staff, ease the burden on existing staff and continue to provide the care their residents need.

Paying higher wages Pay rates are, not surprisingly, one of the biggest incentives to attract and keep staff. It doesn’t help that there are easier jobs in fast food, retail and other places that pay more. “There is no clear path out of this unless it’s more pay for entry level folks,” said St. Ann’s Murty. She wishes St. Ann’s and the industry could employ more people from the city where poverty is a real problem a living wage Michael Perrotta could help. Rochester Presbyterian Home is paying new CNAs a $500 sign-on bonus and rewarding existing CNAs for staying. They instituted hazard pay during the pandemic and other bonuses, too. In late June, Friendly Senior Living announced it would raise the minimum wage for new and current employees to $15 an hour effective

Job fairs were held long before the pandemic, but often to fill a specific need for one class of employee. Now they’re being held to fill all types of employees. A late June Friendly Senior Living job fair netted approximately 15 new employees to the staff of around 300. A fully staffed St. Ann’s has approximately1200 employees. It has roughly a thousand now. Friendly Senior Living isn’t the only senior living company to offer employees educational incentives but they took it a step further by offering to pay employees while they’re in school and studying, too. Friendly is also starting their own CNA Nancy Smyth training class so they don’t always have to rely on other programs to provide the CNAs they need. Partnering and engaging with local schools and programs is essential to solving staffing needs and encouraging students to consider a career in the senior home industry. Since new graduates aren’t exactly drawn to a career in geriatrics, Bourg said St. Ann’s has to be creative in educating students to consider opportunities they might not have considered otherwise. “We have to do things early at the high school level to educate young people about career opportunities and expose them to what we do,” Bourg said. Partnering with job assistance and placement services such as Rochester Works is also important. Temporary assistance staff is an avenue of last resort, mainly because they don’t know the residents and their special needs. Minor incentives like food and individual and group recognition might not seem like much, but it means a lot to staff members. It takes more than just dollars to create a work environment in which people feel they’re valued, appreciated and part of a great team, Bourg said. “Call us if you’re interested,” said the Presbyterian Home’s Smyth. “It’s a work of heart. It’s very rewarding work, emotionally rewarding the most. We just don’t have the labor.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

Dementia Cases Will Triple Worldwide by 2050

T say.

he global total of people living with dementia will rise nearly three-fold by 2050, researchers

Cases are projected to increase from an estimated 57.4 million in 2019 to an estimated 152.8 million in 2050, driven mainly by population growth and aging. This “emphasizes the vital need for research focused on the discovery of disease-modifying treatments and effective low-cost interventions for the prevention or delay of dementia onset,” said lead researcher Emma Nichols of the University of Washington School of Medicine. By 2050, 16% the world’s population will be people over 65. That compares with 8% in 2010, according to the U.S. National Institute on Aging. The researchers said the largest increases in dementia are expected to occur in eastern sub-Saharan Africa, North Africa and the Middle East. While positive trends in education access worldwide are expected to result in 6.2 million fewer dementia cases by 2050, smoking, excess weight and high blood sugar are predicted to boost cases by 6.8 million. The projections, covering 1999 to 2019, are based on data from the Global Burden of Disease (GBD) study, a set of worldwide health trend estimates. The findings were presented at a recent meeting of the Alzheimer’s Association, held in Denver and online. Research presented at meetings is typically considered pre-

liminary until published in a peer-reviewed journal. “Improvements in lifestyle in adults in developed countries and other places — including increasing access to education and greater attention to heart health issues — have reduced incidence in recent years, but total numbers with dementia are still going up because of the aging of the population,” said Maria Carrillo, chief science officer of the Alzheimer’s Association. “In addition, obesity, diabetes and sedentary lifestyles in younger people are rising quickly, and these are risk factors for dementia,” she added in a meeting news release. Nichols said these estimates would help policymakers and decision makers better understand the expected increases in dementia and what’s driving them. Her team used the same data to estimate that Alzheimer’s disease death rates rose 38% worldwide between 1990 and 2019. That study was published last year in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association. Carrillo said the numbers will grow beyond 2050 without effective treatments to stop, slow or prevent Alzheimer’s and all dementia. This will affect individuals, caregivers, health systems and governments. “In addition to therapeutics, it’s critical to uncover culturally tailored interventions that reduce dementia risk through lifestyle factors like education, diet and exercise,” Carrillo said.

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Some Diabetes Meds Might Also Lower Alzheimer’s Risk Study ﬁnds people taking the drugs have fewer biomarkers, slower cognitive decline

eople taking certain drugs to lower blood sugar for Type 2 diabetes had less amyloid in the brain, a biomarker of Alzheimer’s disease, when compared to both people with Type 2 diabetes not taking the drugs and people without diabetes. The new study, published in the Aug. 11 online issue of Neurology, the medical journal of the American Academy of Neurology, also found people taking these drugs, called dipeptidyl peptidase-4 inhibitors, showed slower cognitive decline than people in the other two groups. In people with Type 2 diabetes, the body no longer efficiently uses insulin to control blood sugar. Dipeptidyl peptidase-4 inhibitors, also known as gliptins, can be prescribed when other diabetes drugs do not work. They help control blood sugar when combined with diet and exercise. “People with diabetes have been shown to have a higher risk of Alzheimer’s disease, possibly due to high blood sugar levels, which have been linked to the buildup of amyloid beta in the brain,” said study author, physician Phil Hyu Lee of Yonsei University College of Medicine in Seoul, South Korea. “Not only did our study show that people taking dipeptidyl peptidase-4 inhibitors to lower blood sugar levels had less amyloid in their brains overall, it also showed lower levels in areas of the brain involved in Alzheimer’s disease.” The study involved 282 people with an average age of 76 who were followed up to six years. All had been diagnosed with either pre-clinical, early or probable Alzheimer’s disease. Of the group, 70 people had diabetes and were being treated with dipeptidyl peptidase-4 inhibitors, 71 had diabetes but were not being treated with the drugs and 141 did not have diabetes. Those without diabetes were matched to those with diabetes for age, sex, and education levels. All had similar scores on cognitive tests at the start of the study. Participants had brain scans to

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

measure the amount of amyloid in the brain. Researchers found that people with diabetes who took the drugs had lower average amounts of amyloid plaques in the brain compared to people with diabetes who did not take the drugs and compared to people who did not have diabetes. All participants took a common thinking and memory test called the Mini-Mental State Exam (MMSE) on average, every 12 months for 2.5 years. Questions include asking a person to count backward from 100 by sevens or copying a picture on a piece of paper. Scores on the test range from zero to 30. Researchers found that people with diabetes who took the drugs had an average annual decline of 0.87 points on their MMSE score, while people with diabetes who did not take the drugs had an average annual decline of 1.65 points. People without diabetes scored an average annual decline of 1.48 points. When researchers adjusted for other factors that could affect test scores, they found that the scores of the people taking the drug declined by 0.77 points per year more slowly than the people who did not take the drug. “Our results showing less amyloid in the brains of people taking these medications and less cognitive decline, when compared to people without diabetes raises the possibility that these medications may also be beneficial for people without diabetes who have thinking and memory problems,” said Lee. “More research is needed to demonstrate whether these drugs may have neuroprotective properties in all people.” A limitation of the study was that data were not available to show the accumulation of amyloid in participants’ brains over time. This study does not show cause and effect. It only shows an association. The study was supported by the Korean Healthy Industry Development Institute and the Korean Ministry of Health & Welfare.

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How to Replace Important Documents That Are Lost or Missing Dear Savvy Senior, Can you tell me what I need to do to replace a variety of important documents? Our house burned down a few months ago, and we lost everything including our home property deed, car titles, old tax returns, Social Security, Medicare and COVID-19 vaccine cards, birth certiﬁcates, marriage license and passports. Stressed Seniors

Dear Stressed, I’m very sorry for your loss, but you’ll be relieved to know that replacing important documents that are destroyed, lost or stolen is pretty easy once you know where to turn. Here are the replacement resources for each document you mentioned. • Birth certificates: If you were born in the United States, contact the vital records office in the state where you were born (see CDC.gov/nchs/ w2w/index.htm for contact information). This office will give you specific instructions on what you need to do to order a certified copy and what it will cost you — usually between $10 and $30. • Car titles: Most states offer replacements through a local department of motor vehicles office. You’ll need to complete a replacement title application form and pay the application fee, which varies by state. You’ll also need to show ID and proof that you own the car, such as your vehicle registration or your license-plate number and VIN (vehicle identification number). To get an application, go to DMV.org, pick your state, and print it or fill it out on the site. • Property deed: To access your house deed, contact your county clerk’s office, where deeds are usually recorded — you may be charged a small fee to get a copy. • Marriage certificate: Contact the vital records office of the state you were married in to order a copy (see CDC.gov/nchs/w2w/index. htm). You’ll need to provide full names for you and your spouse, the date of your wedding, and the city or town where the wedding was performed. Fees range from $10 to $30. • Social Security cards: In most states (except in Alabama, Minnesota, Nevada, New Hampshire, Oklahoma and West Virginia),

you can request a replacement Social Security card online for free at SSA. gov/myaccount. If you live in a state that the online service is not available, you’ll need to fill out form SS-5 (see SSA. gov/forms/ss-5.pdf to print a copy) and take it in or mail it to your nearby Social Security office along with a number of evidence documents that are listed on this form. For more information or to locate the Social Security office that serves your area, call 800-772-1213 or see SSA.gov/ locator. • Medicare cards: If you are enrolled in original Medicare, you can replace a lost or damaged Medicare card by calling Medicare at 800-6334227, or by logging into your MyMedicare.gov account. If, however, you get Medicare health or drug benefits from a Medicare Advantage Plan, such as an HMO, PPO, or PDP, you’ll need to call your plan to get your card replaced. • COVID-19 vaccination card: Your first step is to go back to your vaccination site and see if they’ll give you a replacement. Bring an ID and try to recall the date you were vaccinated. If that’s not feasible, contact your state health department immunization information system (see CDC.gov/vaccines/programs/ iis/contacts-locate-records.html) where you should be able to print out a replacement sheet. • Tax returns: To get copies of old tax returns start with your tax preparer, who usually keeps copies of your returns on file. You can also get copies of federal returns directly from the Internal Revenue Service. You’ll need to fill out and mail in IRS form 4506. To download this form IRS.gov/pub/irs-pdf/f4506.pdf or call 800-829-3676 and ask them to mail you a copy. The cost is $43 for each return requested. • Passports: You can apply for a replacement passport at a Passport Application Acceptance Facility. Many post offices, public libraries and local government offices serve as such facilities. You can search for the nearest authorized facility at iafdb. travel.state.gov. The fee is $145.

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. September 2021 •

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Page 21

Ask St. Annʼs

By Aaron Fields and Chelsi Santiago

Online Safety Tips for Seniors

ometimes the worldwide web can seem like the wild west. With stories regularly in the news about online scams, identity theft, and dangerous emails, it’s easy to feel intimidated about going online. If you’re a senior who’s new to technology, it can be especially scary. But there are simple, sensible steps you can take to keep yourself safe while enjoying the benefits the internet has to offer.

Emotion and excitement Internet scams often play on two factors: emotion and excitement. Don’t let these get the better of you. For example, a popular ploy is to send seniors a text or email message appearing to be from a grandchild or friend (often using the person’s real name) claiming to be in trouble and in need of money. “Don’t tell my parents, but I need $300 right away,” it might say. It will then invite you to transfer money from your bank account or credit card to this individual. Don’t fall for it. (If you’re worried about your grandchild, call them directly at a number you know is really theirs.) The best response to scams like this is to not respond at all. Most likely, these are computer generated messages seeking to get a response from a real person. Respond in any way —including writing back to say “Stop sending me these messages” — and you’ll be subjected to future attacks. Phone scams may tell you press 1 to opt out; again, it’s safer to simply ignore the message and delete it. Excitement is a second ploy used to obtain personal information. You may be told you’ve won a cash prize and need to enter your bank account to arrange the transfer, or that a service (such as car insurance) will end if you don’t act immediately. If you did not initiate the communication, don’t believe it. Legitimate businesses will not randomly ask you to share personal information through a text, email, or link.

your posts to friends only rather than the general public. These options are usually located under Settings or Privacy on the platform. And don’t post personal details about yourself or loved ones that could be used by scammers. • Don’t duplicate your passwords. Use different passwords for your bank account and your email account, for example. That way, if one gets hacked, the other will be safe. • Sign up for multi-factor authentication. This simply means that in addition to your user name and password, the company you’re doing business with will ask you to enter a one-time access code sent to you via text, email or phone. That’s an added layer of protection that allows you and no one else to access your account. Contact your bank, credit card company or online vendor to sign up. • Tell your bank if you see a charge you don’t recognize. Banks and credit card companies know the tricks of the trade and will be happy to cancel a charge that you dispute. So if there’s a purchase on your statement you don’t recognize, let them know. • Beware of suspicious messages. If you don’t recognize the sender, mark the email or text as spam and delete it. Don’t open it, reply to it, or click any links. The majority of the internet is legitimate and can be safely used for news, entertainment, shopping, and communication. Don’t let fear keep you from enjoying what’s available. Just be on guard and keep away from anything that doesn’t seem right. When in doubt, contact the friend, relative, or company directly to verify that the request you’re getting is really from them.

Common sense is careful sense Here are some other tips for reducing the risk of online scams: • Limit the amount of information you share online. Social media platforms like Facebook offer options for who can see things you post. It’s a good idea to limit the visibility of

Page 22

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Aaron Fields is chief information officer and Chelsi Santiago is security & data analyst at St. Ann’s Community. Contact them at afields@mystanns.com, csantiago@mystanns.com, or 585-697-6000.

Ask The Social

Security Ofﬁce

From the Social Security District Office

Retirement Planning Tips for Women

ne day in 1939, Ida May Fuller stopped by the local Social Security office in her hometown of Rutland, Vermont, to inquire about Social Security benefits. She knew she had been paying into Social Security, and wanted to learn more. The following year, she received the very first Social Security benefit payment — $22.54 — arriving as check number 00-000-001. Fuller’s story still holds lessons for women today — and it started with her getting the information she needed. Today, signing up for a personal My Social Security account at www.ssa.gov/myaccount can help you get information tailored for you to plan for your retirement. It’s never too late to start planning. Fuller was 65 years old when she started receiving benefit payments, but she lived well beyond her life expectancy of 65 years, 4 months. In fact, Fuller lived to be 100 years old, and received Social Security benefit payments for 35 years. It’s important to create your personal My Social Security account as soon as possible. With your account, you can view estimates of future

Q&A

Q: I have medical coverage through my employer. Do I have to take Medicare Part B? A: You are not required to take Medicare Part B if you are covered by a group healthcare plan based on either your employment or the employment of a spouse. When your coverage ends, you may contact Social Security to request a special enrollment for Medicare Part B. We will need to verify your coverage through your employer in order for you to be eligible for a special enrollment. For more information, visit www. medicare.gov. Q: My uncle states that he is considered to be 70% disabled through the VA. Does Social Security rate my disability on a percentage scale? A: Social Security does not rate individuals on a percentage scale for disability benefits. For Social Security purposes, a disability is defined as: • A medical condition(s) that must have lasted, or be expected to last, at least one year or ends in death. • The condition must prevent you from performing substantial work. For more information regarding disability benefits, please visit www. ssa.gov/benefits/disability.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

benefits, verify your earnings and view the estimated Social Security and Medicare taxes you’ve paid. Verifying earnings is important because your future benefit is based on your earnings history. Your Social Security benefit payments will provide only a portion of your pre-retirement income. You may have to save more to have adequate income for your desired lifestyle in retirement. Savings need to be an active part of your plan to take care of yourself and your family’s financial future. Fuller never married. She supported herself. However, you may find yourself widowed or divorced — and having to provide for yourself for several more years. Unlike in Fuller’s day, you can go online to see if you’re eligible at www.ssa.gov/retirement to receive a current, deceased, or former spouse’s benefits. It might make financial sense to claim those benefits instead of your own — since the payments could be higher based on the individual’s own earnings history. We encourage you to follow Ida’s example and plan for your financial future. Please share this information with your friends and family — and help us spread the word on social media.

Q: I have two minor children at home and I plan to retire this fall. Will my children be eligible for monthly Social Security benefits after I retire? A: Monthly Social Security payments may be made to your children if one of the following applies: • They are unmarried and under age 18. • Age 18 or 19 and still in high school. • Age 18 or older, became disabled before age 22, and continue to be disabled. Children who may qualify include a biological child, adopted child, or dependent stepchild. (In some cases, your grandchild also could be eligible for benefits on your record if you are supporting them.) For more information, see our online publication, Benefits For Children, at www.ssa.gov/pubs. Q: If I get Social Security disability benefits and I reach full retirement age, will I then receive retirement benefits? A: Social Security disability benefits automatically change to retirement benefits when disability beneficiaries reach full retirement age. In most cases, the payment amount does not change. The law does not allow a person to receive both retirement and disability benefits simultaneously on one earnings record. To learn more, visit www.ssa.gov.

Fewer Doctors Going Into Private Practices

Experts say some of the reasons doctors become employees at hospitals and other large employers is that they don’t have the hassle of handling the business part of running a practice, steady paycheck By Deborah Jeanne Sergeant

n American Medical Association survey shows more doctors are now working in larger health systems, such as hospitals, than in private practice. Of 3,500 physicians who responded to the survey, only 49% reported working in private practices. This is the first time the number has fallen below 50% and the trend will most likely continue, according to the medical association. A few different factors play into this shift from the physician working at a privately owned and operated practice to working at a facility owned by a hospital system, national chain such as CVS or Walmart or federally funded clinic. Many doctors want the security of a paycheck, said Wendy Rosen, a psychiatrist in Rochester who started her career as a doctor-employee at the University of Rochester Medical Center. “It was a sense of comfort,” she said. She also chose the hospital setting because she liked acute care and wanted to work at a teaching hospital. When a friend moving out of the area offered her the opportunity to take over his private practice, Rosen took over his office lease and patient load. “It was kind of scary at first,” she said. “I had never been outside the security of the hospital. He assured me I would enjoy it.” By that point in her career, she felt confident that she could handle the business aspects of operating her own practice. She was taking over an established practice with an office manager-biller and secretaries. At a hospital, documentation, billing and collections are all handled by the health system.

“It didn’t feel much different than an outpatient practice,” Rosen said. “I did try going back to the University of Rochester part-time. I feel like I was missing the camaraderie.” Though her private practice can be somewhat isolating, she enjoys the independence of operating her own practice. She can set her own hours and patient load, which is a big plus.

Malpractice insurance, lack of stability Another reason for the decrease in private practices is that fewer newly minted doctors can operate their own facility. As the cost of entrepreneurship has increased in many ways, including labor, real estate and supplies, the cost of medical malpractice insurance has also increased. Many new physicians are joining hospital systems to work as a hospitalist or at another facility to avoid footing this expense. According to Arthur J. Gallagher & Co., a medical malpractice insurance brokerage in Houston, the average annual cost of the insurance is $75,000 for a family practice physician in New York state. Although medical malpractice insurance is not required, most physicians want it to avoid financial ruin in case of litigation. For mid-career independent doctors, the additional rules added by changes such as the institution of electronic medical records has proven too onerous. Instead of spending most of their time caring for patients, they find that recordkeeping and documentation devours much of their day. Providers may face financial instability while establishing a new practice, along with long hours. The business side also challenges

many new physicians. According to the Harvard Business Review, “most doctors in the U.S. aren’t taught management skills in medical school. And they receive little on-the-job training to develop skills such as how to allocate short- and long-term resources, how to provide developmental feedback, or how to effectively handle conflict–leadership skills needed to run a vibrant business.” These educational shortfalls can make starting an independent practice very challenging. “There’s an economic certainty getting a paycheck every two weeks that’s attractive,” said Ken Schoetz, vice president of Health Care Association of Western and Central New York, which includes Rochester General Hospital, Rochester Regional Health, Geneva General Hospital, Finger Lakes Health and UR Medicine among its members. One of the challenges of working independently is the difficulty in negotiating sufficient reimbursement from payors. Larger organizations’ volume enables them to obtain better reimbursement from drug manufacturers and insurers, just as a big box store orders goods from manufacturers at a much higher volume than a small store and can receive volume discounts on the items. “It’s more beneficial to the physician than the hospital as scale moves the entire economy, including health care,” Schoetz said. “Better pricing benefits the provider and the patient.” The physician has a few personal “costs” by working for a larger health system, including the sacrifice of some freedom. Unlike the entrepreneurial model of the independent practice, the physician is not the boss. “You’re not running your prac-

tice the way you might want to,” Schoetz said. “You have to follow the hospital’s rules and use their technology, which you might not like. They may say to start the day at 8, not 10.” Physicians also have less say over who works under them. They also cannot determine their own salary, compared with if they start a practice and manage it well. Patients may also experience a few drawbacks. Perception is a big one. “Sometimes, I think that anything that’s big, whether it’s AT&T or Wegmans or Ford Motor Company, there can be some impersonality,” Schoetz said. “People still like the idea of a provider knowing who they are. They want a close, personal relationship. Doctors who go into these arrangements try to keep these relationships.” But the health care system may be able to provide a better level of care with the additional physicians on staff than without them. With more physicians, they can expand capacity to treat more patients, which can improve their finances and offer more specialized care. Patients needing multiple specialists may also enjoy a “one-stopshop” experience versus traveling from office to office. “Anytime a provider can reduce costs and by having the economic scale of a larger facility, patients benefit in terms of cost and the care they would receive,” Schoetz said. He added that this is a trend he does not foresee going away in the short-term or long-term. “There will be differences from what it used to be,” he said. “The hope is, you will get better care and make hospitals better able to withstand the challenges. The ultimate outcome will be better patient care.”

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Page 23

Health News

Excellus Addresses Health Disparities in Upstate New York with new Health Equity Awards

racism. Inclusion, diversity, equity and access are fundamental to our organizational culture,” says Excellus BlueCross BlueShield President and CEO Jim Reed. “We have and will continue to commit ourselves to the equitable treatment of all people and the elimination of discrimination in all its forms.” Excellus BlueCross BlueShield operates in 31 Upstate New York counties, organized into four regions: the Rochester region, encompassing Health Equity categoLivingston, Monroe, Onries include: tario, Seneca, Wayne and • Improving the comYates counties; the Central munity’s physical health New York region, which and mental health includes Cayuga, Cortland, • Reducing social disOnondaga, Oswego and parities in health care Tompkins counties; the • Ensuring access to Southern Tier region, inhealth care cluding Broome, Chemung, For additional informaChenango, Tioga, Schuyler tion and the online appliand Steuben counties; and cation, please visit www. the Utica region, comprisexcellusbcbs.com/coming Clinton, Delaware, Joseph Searles munity, scroll to “NEW! Essex, Franklin, Fulton, Health Equity Awards” and click Hamilton, Herkimer, Jefferson, Lew“Submit Application.” is, Madison, Montgomery, Oneida, Proposals that have detailed Otsego and St. Lawrence counties. scope, goals, rationale for support, The company’s corporate giving and measures will receive the stronfollows all applicable laws and regugest consideration. Award winners lations and does not support funding will be announced in late October. organizations that conflict with its “As a company, we condemn corporate mission, goals, policies or hatred, discrimination, violence and products. injustice. We believe we all have a role to play in dismantling systemic

Nonproﬁt organizations are invited to apply for grants of up to $30,000. Deadline is Sept. 17

ecognizing structural racism as a driving force of health inequities and a barrier to its goal of health equity, Excellus BlueCross BlueShield invites nonprofit organizations to apply for Health Equity Awards of up to $30,000 each to help fund health and wellness programs that address racial and ethnic health disparities in Upstate New York. Jim Reed The application period opened Aug. 17 and closes at midnight, Sept. 17. “Excellus BlueCross BlueShield made a pledge to our employees, members and communities that we will use our influence and resources to effect change,” says Excellus BlueCross BlueShield Corporate Diversity Relations Director Joseph Searles. “Through community investments

such as this, we strive to improve access to care, advance specific health outcomes and support organizations in our community that share our mission.” Nonprofit, 501(c)(3) organizations in Excellus BlueCross BlueShield’s service territory are invited to apply for Health Equity Awards. Proposals must include clear, defined goals for reducing health disparities and improving health equity in communities of color, especially within Black and Latino communities, where historic and current racism and discrimination continues to result in a higher burden of health inequities and social disadvantages. Organizations will be required to specify how funding will measurably assist in improving racial and ethnic health equity outcomes.

Pediatrician joins Canandaigua Medical Group

the surging COVID-19 Delta variant has resulted in our decision to make employee vaccinations mandatory,” said Michael King, president and CEO of Jewish Senior Life. Michael King “According to the CDC, the delta variant is much more contagious and more dangerous than other known versions of the virus. The past 17 months have been a time of tremendous personal and work-related stress for all of us. Jewish Senior Life has succeeded because of our hero employees who have persevered. Although over 80% of our staff are fully vaccinated, our organization must continue to do more to ensure the health and safety of our valued employees and all we serve.” Jewish Senior Life employs more than 1,000 individuals in the greater Rochester area. Serving people of all faiths and ethnic backgrounds, Jewish Senior Life is a Continuing Care Retirement Community (CCRC) guided by the values of honoring family and aging in place.

Physician Heena Joshi has joined the pediatrics department at UR Medicine Thompson Hospital’s Canandaigua Medical Group. Board-certified in general pediatrics and a member of the American Academy of Pediatrics, Heena Joshi Joshi completed residencies in pediatrics at both New York University (Woodhull Medical and Mental Health Center in Brooklyn) and Maharashtra University of Health (B.J. Medical College in Pune, India). Joshi’s previous experience includes work as a medical observer at Seattle Children’s Hospital and two practices in Bellevue, Washington., as well as work as a pediatrician at three hospitals in India. She will see patients at the Canandaigua Medical Group’s main location, at 335 Parrish St. in Canandaigua.

Jewish Senior Life mandates employee vaccinations Jewish Senior Life is requiring all employees to be fully vaccinated against COVID-19, effective Oct. 1. “The increasing concern with Page 24

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Thompson Health honors seven staff members UR Medicine Thompson Health’s service excellence team recently announced 2021’s third-quarter recipients of the health system’s Service Excellence Awards.

Individuals receiving the awards were as follows: • Radiology technologist James Ginett, Sodus Point, of radiology (Newark Urgent Care). • Sonographer Ayesha Javed, Victor, of ultrasound. • Patient care technician Cael Manning, Canandaigua, of floor 3 east. • Registered nurse Julia Mawdesley, Canandaigua, of floor 3 west. • Registered nurse Dorria Sinack, Phelps, of diagnostic imaging. • Sonographer Nicole Topoliuk, Victor, of ultrasound. • Registered nurse Audrey Wasnock, Farmington, of diagnostic imaging. Created in 2014, the Service Excellence Award acknowledges Thompson associates who consistently deliver exceptional service. The SET selects award recipients quarterly, after reviewing system leaders’ submissions of compliments from patients, families and coworkers. Each recipient of the Service Excellence Award is given points to be used on Thompson’s online shopping site and is featured in CEO presentations as well as on Thompson’s intranet site and in its internal newsletter.

RRH expands “Reach Out and Read” program More local children are going to get a head start on reading with the help of their pediatrician. Rochester Regional Health announced recently it is expanding its Reach Out and Read program to include Wilson Pediatrics. “It’s wonderful to see this pro-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

gram grow to another one of our Rochester Regional Health practices,” said Larry Denk, a pediatrician for Rochester Regional Health. “I have watched Reach Out and Read nurture so many of my youngest patients. When parents read aloud to children, they help accelerate the child’s brain development while building confidence, resilience, early literacy, and healthy bonds that can be felt over a lifetime.” Through a grant, Fidelis Care is helping Rochester Regional establish this newest location. Wilson Pediatrics is the fourth Rochester Regional Health practice to offer Reach Out and Read. “Our ability to think, understand, and solve problems is directly related to cognitive skills and development, which can be greatly improved by reading with children at a young age,” said physician Vincent Marchello, Fidelis Care chief medical officer. “Fidelis Care is excited for the opportunity to work with Rochester Regional Health to expand the Reach Out and Read Program by making culturally appropriate books accessible to families in our local community.” Reach Out and Read is a nationwide program that incorporates books into well-child exams for children from 6 months of age until they are 5 years old. The program increases the frequency and quality of reading in the home, readiness for kindergarten, and positive child-parent interactions that help combat the negative effects of adverse childhood experiences. Books provided by Reach Out and Read are available in multiple

Continued on next page

Health News Continued from previous page languages and represent a broad range of cultures, which help young children and their families feel valued, understood, and included in the community. Rochester Regional Health now offers the Reach Out and Read program at Genesee Pediatrics, Unity Pediatrics, Rochester General Pediatric Associates and Wilson Pediatrics.

Thompson again named ‘High Performing Hospital’ When U.S. News & World Report released its latest hospital ratings and rankings last week, F.F. Thompson Hospital again achieved the highest possible rating with regard to chronic obstructive pulmonary disease (COPD). This is the third consecutive year for this distinction. According to its website, in 2021,

U.S. News evaluated data from more than 4,300 hospitals to generate the procedure and condition ratings. An overall rating of high performing indicates a hospital was significantly better than the national average in a given procedure or condition, the site states. “To me, this designation demonstrates how patient-centered our associates are, and how dedicated they are to delivering excellence as a high-reliability organization,” said Thompson Health Director of Quality and Safety Wendy Blakemore. With regard to COPD, Thompson also holds advanced COPD certifications at four of its primary care locations and a standard certification at its hospital. These certifications are from The Joint Commission, the nation’s premier healthcare quality improvement and accrediting body. For more information about high performing hospitals, visit https:// health.usnews.com.

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Building C, Suite 105, 919 Westfall Road, Rochester, NY 14618 Tel1: 585-358-6186; Tel2: 315-378-5556; Tel3: 607-372-2082

Ancient Wisdom Integrated with Modern Medicine

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LIFE CHANGING MEDICINE, MOVING MEDICINE FORWARD

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021

I still find ways to volunteer! My life. My way.

We offer a full spectrum of senior services from independent living to skilled nursing. Most importantly, we have designed communities to help you embrace living your way. To schedule a virtual or live tour call 585-760-1300 or go to stjohnsliving.org. SJ IGH 2021.indd 1

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Page 27

We finally got our pool. We waited our whole lives, but with all that was going on we just never had the time. Now we do—and time for a lot more. Like cooking and fitness classes, relaxing dinners, and just enjoying our time together. Best part: it all happens right here at Chapel Oaks.

Come see our indoor pool and much more! Schedule a tour today: (585) 697-6606 St. Ann’s Community at Chapel Oaks, Irondequoit Page 28

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2021