IGH - Rochester, #190 JUNE 2021

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JUNE 2021 • ISSUE 190

✓ IS IT SAFE to send your kids to camp this summer? ✓ SUMMER SOCIALIZING for children is more essential than ever ✓ MEDIA TIME doubled for kindergartners during the pandemic

Kids' Health Special Tactics for Easing Back Into Life

MEET YOUR DOCTOR Physician Mary Ma has recently been named chief of OB-GYN at Highland Hospital

U.S. BIRTH RATES CONTINUE TO FALL

What it means to mingle, socialize, and be doing things again Page 6

U.S. Birth Rates Continue to Fall The 2020 rate, the lowest since 1979, raises concern about the economic effects of declining population levels

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he baby “boom” that some expected during last year’s pandemic lockdowns has turned into a baby “bust.”

The U.S. birth rate continued to drop in 2020, marking the sixth consecutive year with fewer babies born in America and raising concerns about the economic effects of declining population levels.

There were about 3.6 million babies born in the United States last year, down 4% from the 3.75 million born in 2019, according to researchers from the U.S. National Center for Health Statistics.

It’s the lowest number of births

in America since 1979, the report noted.

“Early on, some experts had speculated that births might increase due to people having more time at home, but as the pandemic worsened it became clear the rate was falling,” said physician Scott Sullivan, professor of obstetrics and gynecology at the Medical University of South Carolina.

“A 4% drop is in the mid-range of what people expected,” Sullivan continued. “I think a combination of fear, economic insecurity, families dealing with actual infections and recovery, disruptions in health services

and other factors likely contributed to the decline.”

The general fertility rate in the United States in 2020 was about 55.8 births per 1,000 women, down 4% from the rate of 58.3 births in 2019 and another record low for the nation, said the researchers, who were led by natality expert Brady Hamilton.

And the projected number of births U.S. women might expect to have in their lifetimes — also known as the total fertility rate — declined again in 2020.

The total fertility rate for the United States in 2020 was 1,637 births per 1,000 women, down 4% from the 1,706 projected lifetime births in 2019.

These numbers are below what’s known as the “replacement level” — the level at which a generation can exactly replace itself and maintain the nation’s population level, the report said.

There must be 2,100 births per 1,000 women to meet this level. U.S. birth rates have been generally below replacement levels since 1971 and consistently below replacement since 2007, the report said.

“It could result in serious economic issues in the future, as there may not be younger workers to drive the economy or even help [take] care of the older generations,” Sullivan said.

Waiting longer This continued decline in birth rates “has been observed around the globe,” Sullivan said. “Japan and Russia have seen longer and more severe declines, for example.”

The cost of having and raising kids — day care, housing, education

— has been a contributing factor that has led many young couples to delay starting a family or choose not to have kids at all, Sullivan said.

“We have the worst family leave in the developed world, for example,” Sullivan said. “Day care is expensive and sometimes hard to get. The cost of education and levels of student debt are high and getting worse.”

But one expert believes many women, and couples, simply may be putting their focus on things other than child-rearing.

“There are a multitude of reasons people are waiting,” said physician Nicole Noyes, chief of endocrinology and infertility at Northwell Health in New York City. “The number one reason to delay childbearing is the desire to experience life and reach goals before being saddled with the responsibilities of early child rearing.”

“Let’s face it, having children is a commitment, in time, energy and emotion,” she added. “In addition, people most often don’t want to have children unless they are in a relationship conducive to childbearing.

Other major reasons include the perceived need to advance one’s career or having greater financial security before parenthood. To that end, more and more people are freezing their eggs [or embryos] to try to up the odds of having a child later–when they are “ready.”

There’s some evidence from the new data that couples are indeed delaying having kids until later in life.

Birth rates for women between 40 and 54 remained essentially unchanged between 2019 and 2020, even as the rates fell for younger age categories, the report found.

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

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Page 3

Meet

Your Doctor

By Chris Motola

Mary Ma, M.D. Stressed, BurnedOut Nurses Make More Medical Errors: Study

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ritical care nurses with poor mental and physical health are more likely to make mistakes, but a more supportive work environment could improve the situation, a new study suggests.

“It’s critically important that we understand some of the root causes that lead to those errors and do everything we can to prevent them,” said lead author Bernadette Melnyk, dean of the College of Nursing at Ohio State University.

For the study, researchers surveyed nearly 800 members of the American Association of Critical-Care Nurses. Sixty-one percent of respondents reported subpar physical health and 51% reported subpar mental health.

About 40% of the nurses screened positive for depressive symptoms and more than half for anxiety.

Those who reported worse health and well-being were between 31% and 62% more likely to make medical errors.

Nurses who said their employer provided greater support for well-being were more than twice as likely to have better personal health and professional quality of life than those whose workplace provided little or no support.

The findings were published May 1 in the American Journal of Critical Care.

“It’s clear that critical care nurses, like so many other clinicians, cannot continue to pour from an empty cup,” Melnyk said in a university news release.

“System problems that contribute to burnout and poor health need to be fixed,” she said. “Nurses need support and investment in evidence-based programming and resources that enhance their well-being and equip them with resiliency so they can take optimal care of patients.”

Researchers noted that the study was conducted before the COVID-19 pandemic, so it’s likely that levels of stress, anxiety and depression among critical care nurses are even higher now.

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New Highland Hospital chief of OB-GYN wants to address inequalities in maternity care and disparate maternal outcomes based on race and ethnicity Q: Can you tell us a little about the path you took to becoming the new chief of OB-GYN at Highland Hospital?

A: I joined the faculty here in 2016 and have been at Highland this whole time. In 2019 I took on the role of the division director for Highland Women’s Health. And then last summer I took on the role of interim chief of OB-GYN. And just this past month I’m no longer interim, but official chief of OB-GYN here at Highland.

Q: How do you divide your time between administration and practice?

A: It is a hard balance because of course the position comes with a lot of administrative responsibility, but at the end of the day our job is to take care of patients as a clinician. It’s a hard split because you have to keep your skills sharp for patient care, so it’s a matter of fitting it in where you can for both responsibilities.

Q: You’ve been educated in both Canada and Ireland, so I’m guessing you had some exposure to other systems.

How does that inform your practice and position?

A: With Canada, most of that was my pre-university education so I didn’t have exposure to the healthcare system beyond what I experi-

enced just living there. My medical school was in Ireland and its system has some components that are similar to Canada’s and some that are similar to the U.S. It has components of a public healthcare system as well as components of a private healthcare sector. In terms of comparison, it’s pretty difficult to directly compare due to the scales of the system.

Ireland’s a much smaller country, and America is very different in regards to available resources. But it did give me an appreciation for just how diverse and different healthcare systems can be, and in how to navigate these different systems.

Q: What are some of the areas do you think Highland can improve upon when it comes to OB-GYN care?

A: One thing that is very much a local conversation, a regional conversation and a national conversation is addressing inequalities in maternity care and disparate maternal outcomes based on race and ethnicity.

And I think that’s a conversation we need to keep having to make sure that we’re ensuring good care to all of our patients.

Q: What are some of the stumbling blocks that create those disparate outcomes that you are in a position to address?

A: I think it’s multi-fold. Access to care is a component of this, whether it’s being able to get to appointments, whether the patients have infrastructure around them to be able to attend care. It’s also a matter of whether the patients feel they can trust the system and the recommendations given to them, as well as willingness to engage with the system and providers. I think we’d be remiss if we didn’t talk about systemic racism in this country and how it impacts outcomes.

I think it’s up to us to engage our patients as best we can and meet them where they are.

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

Q: At the level of the hospital, what do you think can be done to address systemic racism?

A: I think being flexible in terms of how patients access care. So during COVID we’ve had a lot of restrictions on visitors in the office, but

for patients without a lot of social supports may not, for example, be able to come to an appointment without bringing their children along. So being able to address their particular needs while also keeping our patients and staff safe is important. But we need to be willing to engage in ways that allow their unique needs to be addressed.

Q: Has COVID-19 made it harder to address these concerns?

A: COVID’s impact has been so wide-reaching. Its impact on care is not just restricted to our patients with difficulties with social supports. With schools being affected, with lockdowns, with changes in healthcare availability, patients with fewer resources and supports are often more affected. With the initial lockdowns, a lot of people’s care was put on hold if it wasn’t considered essential. A lot of appointments were postponed, so we’re playing catch-up. We also are trying to reassure patients that we’re in a different place; we have more understanding about how COVID is transmitted. We have masking everywhere. We know how to screen for symptoms. So any care that patients have been putting off, it’s probably worth reaching out to their providers now.

Q: Is there anything you’re doing to incentivize patients to come back?

A: I think the best we can do is reassure patients that we’re taking safety as seriously as they are. All employees are masked, everyone who comes is screened for symptoms, we have rigorous cleaning protocols between patients, we have hand sanitizer everywhere. We want patients to know we’re taking all possible measures to keep everyone safe while they’re getting their care.

Q: What additional impacts would you like to have on your program?

A: A lot of our surgeries were canceled in the beginning of the pandemic. Anything that was medically urgent still went ahead, but many issues that weren’t life-threatening but still impacted quality of life were delayed. So that was a big impact on our gynecology department, and we’d like to catch up with all of that.

Q: Does your practice lean more toward obstetrics or gynecology?

A: I’m a healthy mix of both. I’m a generalist, so I deliver babies, I see patients in the office, and I operate.

I get to do a little bit of everything, which is wonderful.

Lifelines Name: Mary Ma, M.D. Position: Chief of obstetrics and gynecology at Highland Hospital Hometown: Richmond Hill, Ontario Education: Medical degree from Royal College of Surgeons, Ireland; residency in OB-GYN at University of Vermont Affiliations: Highland Hospital Organizations: American Board of Obstetrics and Gynecology, American College of Obstetrics and Gynecologists Highlights: Assistant professor in obstetrics and gynecology at the University of Rochester Medical Center since 2016; Recognition of excellence in minimally invasive gynecology, 2016 Family: Husband, daughter Hobbies: Snowboarding, time with family

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 5

Tactics for Easing Back Into Life It’s good to mingle, socialize and be doing things again

By Melissa Stefanec

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t this point, most of us miss people.

Even the most introverted or curmudgeonly among us have shed many of our anti-social tendencies over the past year and a half. This pandemic has made us realize how much the people in our lives matter to us. From family, to friends, to neighbors, to coworkers, to acquaintances and strangers, we discovered we need each other.

However, many of us spent more than a year being isolated or socially distanced from most other human beings. As people start getting vaccinated and we resume some portions of our pre-pandemic lives, real-life interaction can feel unnatural.

If you’re having some difficulties reentering the world you once knew, you aren’t alone. For many people, the social anxiety that flared during the pandemic doesn’t immediately disappear after you get a vaccine and the restrictions are lifted.

If you’re one of those people, here are some ideas for reentering society. Using tactics that work for you can help reacclimation be a joyous occasion. On a side note, if you’re having a lot of difficulties, you should talk to your doctor or a healthcare professional. They can help you devise a helpful and healthy plan.

Discuss your boundaries As you start to gather with people again, talk to those people Page 6

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about your boundaries. If you aren’t up for large gatherings, ask the host how many people will be there. If you want to be in control, set up an event where you’re the only one who invites people. Respect your own boundaries and expect others to do the same.

If vaccination status is important to you, ask!

If you don’t feel safe being around unvaccinated people, ask for people’s vaccine statuses. If they don’t want to share that information, make a judgment call. Do what is right for you. Your loved ones should understand, even if they don’t agree.

Visit places where there are a lot of people (but where you can keep your distance) If you’re ready for people but not quite ready to socialize, you can try an outdoor event or a large indoor open space where there are numerous people. Not having to engage with these people might help you reacclimate to large groups.

Embrace outdoor events Outdoor events can be a great segue for returning to society. Fresh air and open spaces can really help a person feel safe. Things like outdoor markets, outdoor dining or parks and hiking trails might be a good place to start.

Gather with people whom you trust Sometimes, it just makes sense to start small. If you’re nervous about being around a lot of people, start with people whom you trust to respect your wishes and boundaries.

Don’t be afraid to ask for what you need.

Understand that you can’t control your environment If you venture outside of your home, you’re no longer in control of your environment. So, assume a level of risk that is appropriate for your tolerance. Understand that you don’t live in a risk-free world. When you’re out and about, people will do things you’re uncomfortable with, because we all have different comfort levels.

Try your best to control the controllables and let other things slide.

Feel empowered to turn down invitations If you aren’t ready to attend a specific event, don’t attend it. Give yourself leeway as you reacclimate to social events and outings. If you aren’t up to it, now more than ever, it’s perfectly acceptable to politely decline an invitation.

Make a bucket list If you’re having trouble motivating yourself to get out there again, make a favorite’s list. Create a bucket

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

“

This pandemic has made us realize how much the people in our lives matter to us.

From family, to friends, to neighbors, to coworkers, to acquaintances and strangers, we discovered we need each other.

”

list for 2021 and put all of your pre-pandemic favorite things on it.

When you’re ready, start checking off the things that make you happy.

Make plans in the very near future Now that you have some ideas, make some plans. Don’t make those plans for weeks out; that will give you time to agonize over them.

Instead, make plans for a small and accomplishable outing and do that thing. Sometimes, you just have to shed the fear and embrace life.

U.S. COVID-19 Outlook Shows Improvement by July

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he United States could see a sharp decline in COVID-19 cases by the end of July, according to a new report from the U.S. Centers for Disease Control and Prevention.

Six research teams asked to project future COVID-19 trends have concluded that new infections will drastically drop in July and continue to fall through September, the researchers reported May 5 in the Morbidity and Mortality Weekly Report.

However, “substantial increases” in hospitalizations and deaths from COVID-19 are expected to occur if people stop taking basic pandemic precautions, such as wearing masks and maintaining social distance from others.

The CDC asked the research teams to estimate future COVID-19 cases, hospitalizations and deaths based on four scenarios, including high or low vaccination rates, and

high or low adherence to mask wearing, social distancing and other infection control measures.

COVID-19 cases are projected to increase through May, the teams found. That’s due to the increased prevalence of the British B.1.1.7 coronavirus variant, as well as the relaxation of pandemic restrictions across the nation.

But a sharp decline in COVID-19 cases is expected to occur in July, despite vaccination rates or personal adherence to infection control measures, the teams reported. The decline will be faster in scenarios featuring high vaccination rates.

“We are not out of the woods yet, but we could be very close,” CDC director and physician Rochelle Walensky told the Associated Press, noting that variants of the coronavirus are a “wild card” that could set back progress.

Woman Gives Birth to Nine Babies

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Malian woman who had been expecting seven babies gave birth to nine instead, and the mother, five girls and four boys «are all doing well,» Mali›s health minister said last month.

The babies were born by cesarean section in Morocco, where their 25-year-old mother, Halima Cisse, had been sent for special care, the Associated Press reported.

The nonuplets were placed in incubators in the private Ain Borja clinic in Casablanca.

The case appears to be the first on record of a woman giving birth to nine surviving babies at once, the AP reported.

Cisse gave birth prematurely at 30 weeks and is now in stable condition after heavy bleeding for which she was given a blood transfusion, the AP reported.

The Guinness Book of World Records told the AP that its current record for most living births at once is eight, and that it is verifying the Morocco births.

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In Good Health is published 12 times a year by Local News, Inc. © 2021 by Local News, Inc. All rights reserved.

P.O. Box 525, Victor NY 14564.

Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., John Addyman, Melissa Stefanec, Kimberly Quartieri 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.

June 2021 •

• High blood pressure • Memory problems • Impotence • Cardiovascular disease • Weight gain • Headaches • Depression

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Cocoon No More: It’s Time to Get Our Hands Dirty!

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he COVID-19 pandemic has inspired a rebirth of interest in all things gardening. So, let’s dig in!

As we emerge from over a year of cocooning, time spent outdoors with our flowering friends is providing a welcome respite from the feelings of isolation many of us have been experiencing. It sure has been for me.

What better time than now to reflect on the life lessons that gardening offers to those who live alone or have been sheltering in place. It has taught me the value of planning, preparation, patience, and pleasure — four essential “P’s” for a bountiful garden and ... a bountiful life.

Fertile ground exists in each of us, and a little tending can produce glorious results.

Here’s what I have learned: • Plan. Realizing the garden of your dreams begins in your imagination, followed by careful planning.

Diagram your garden and it will help you avoid planting bulbs on top of

bulbs or mistaking a poppy for a weed.

Likewise, envisioning your life goals and committing them to writing can help you flourish and grow.

• Cultivate. Good, cultivated soil promotes healthy, deep roots. When you add fertilizer to your garden you are rewarded with abundance. Adding essential ingredients to the foundation of your dream garden (and your dream life) will nourish all that follows.

You can’t go wrong with good, nutritious food; a walk in nature; a good book; soothing music; or saying “yes” to a new adventure that’s been tugging at your heart.

• Plant. So many choices! Revisit your plan and embed your carefully selected seeds or seedlings with a tender, loving touch, being careful not to overcrowd or plant more than you can manage.

And remember: We reap what we sow, so follow your plan. Plant a rose and you get a rose; plant a dandelion and you get a dandelion. Seed

We may think we are nurturing our garden, but of course it’s our garden that is really nurturing us.”

Jenny Uglow your future with healthy choices that promote well-being.

• Weed. We all need room to breathe and positive space in which to blossom. It holds true for your garden and your life. Gardening is all about consistent caretaking. Slack off, even for a few days, and all things unwelcome show up and take root.

Weed out the negativity and any dream-stealing toxins that contaminate your life, dash your hopes, or spoil your fun. When you pull out the bad, you can more easily focus on the good in your life.

• Prune. When weeding is not enough, a major pruning may be just what the arborist ordered. A job, relationship or home that no longer satisfies or meets your needs may need a hard look. It may be time to pull out that pair of “life loppers.”

• Mulch. Mulching keeps weeds at bay and the ground moist, and returns nutrients to the soil. It also adds a finishing touch.

Mulch offers a blanket of pro-

tection, in the same way that regular doctor appointments, insurances, and safety measures protect our lives. We can learn a lot from mulching.

• Wait. We’ve all heard that “good things come to those who wait.” When we exercise patience, go slowly, and enjoy the gradual unfolding of a flower, an idea, or a friendship, your life can be savored and more deeply appreciated.

Each year, I look to my garden to remind me that growth takes time.

• Enjoy. Before you know it, your labor of love and patience will pay off. Take pleasure in the transformation as the colors, textures, and fragrances emerge. Too often, we fail to “stop and smell the roses” in our gardens and in our lives.

By osmosis, gardening has taught me how to take better care of myself. I have absorbed its rich messages and learned how to nurture my inner garden and growth as a woman on her own.

I encourage you to grab a spade and join me. Beauty, growth, and an energizing sense of renewal can be yours this month.

It’s June and time to get our hands dirty!

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

Refocusing on Getting Fit? Heart Experts Offer These Tips

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ant to get rid of all that weight you put on during the pandemic?

To help out, the American Heart Association (AHA) is launching an initiative called Move More.

One in four U.S. adults is sitting for longer than eight hours each day, which can harm one’s mental and physical health, according to the AHA. “For too many of us, our daily routines have become more sedentary over the past year due to the pandemic, making it even more important to find ways to increase

physical activity in our day,” said physician Eduardo Sanchez, the AHA’s chief medical officer for prevention.

“Any movement is better than no movement, and more is better. Even small breaks of activity throughout the day will benefit health and reduce stress,” Sanchez said in an AHA news release.

The association outlines ways to get more active: • To avoid long stretches of inactivity, set reminders to move around for five minutes multiple times a day.

• Find more ways to get off the couch. For example, take a walk

around the house or do a few pushups between episodes of a TV show.

If you have a pet, take breaks to play or go for a walk outside. Active chores such as vacuuming and tidying up clutter also help.

• Reduce screen time. Schedule a time each day for the whole family to unplug and take an activity break. Take a walk, play a game of hide-and-seek inside, or put on your favorite music for a dance party.

• Move more while working at home. Try to reduce meetings by five minutes when possible and use that time to do basic strength exercises like squats or crunches, move

to different part of your home to do stretches, or stand every time you create or answer an e-mail.

• Find types of exercise you enjoy and that fit your schedule.

The AHA recommends that adults get at least 150 minutes a week of moderate intensity aerobic activity such as brisk walking or gardening, or 75 minutes of vigorous intensity aerobic activity such as running or aerobic dancing, or a combination of both intensity-level activities.

It also recommends two days of moderate-to high-intensity muscle strengthening activity weekly, such as resistance training.

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

U.S. Adults Gained Average of 2 Pounds a Month During Lockdowns

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merican adults under COVID-19 lockdowns gained an average of more than half a pound every 10 days, which works out to 2 pounds a month, a small study shows.

That means that adults who maintained lockdown measures could easily have gained 20 pounds since the start of the pandemic a year ago, study senior author Gregory Marcus, a cardiologist and professor of medicine at University of California, San Francisco, told the The New York Times.

The study included fewer than 300 people nationwide and used weight measurements from Bluetooth-connected smart scales. The

findings were outlined in a research letter published Monday in the journal JAMA Network Open.

“We know that weight gain is a public health problem in the U.S. already, so anything making it worse is definitely concerning, and shelterin-place orders are so ubiquitous that the sheer number of people affected by this makes it extremely relevant,” Marcus, told the Times.

Many of the people in the study were losing weight before shelterin-place orders were issued in their states, Marcus noted.

“It’s reasonable to assume these individuals are more engaged with their health in general, and more disciplined and on top of things,”

he said. “That suggests we could be underestimating — that this is the tip of the iceberg.”

Excess weight has been linked to a greater risk of developing more severe COVID-19 disease, and the United States already has among the

highest rates of overweight and obesity in the world. Some 42 percent of American adults over age 20 have obesity, while another 32 percent of Americans are overweight, the Times reported.

profitable commercial insurers begin to gobble up the competition. It is rarely, if ever, a question of survival.

The American Anti-trust Institute is urging the DOJ to disapprove insurance giant United Health Group’s $13 billion acquisition of data analytic company Change Healthcare.

UHG already owns data analytic company Optum. Both the AAI and the AHA fear the untoward impact of the massive consolidation of healthcare data under one company.

informed decisions. Some hospitals posted charges or prices while others posted negotiated insurance rates.

Some hospitals did nothing. Consumers that are part of an organized healthcare system have little choice as to where they receive care so shopping around for prices is a fool’s errand. Consequently, CMS no longer requires hospitals to post negotiated prices with commercial Medicare Advantage plans. If nothing changes, this may be the harbinger of the end of the well intentioned pricing transparency requirement altogether.

Healthcare in a Minute

By George W. Chapman

Private Practices Continue to Shrink in Numbers

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he number of physicians in private practice continues to decline. According to an AMA survey of 3,500 physicians, 49% responded they were in private practice. This is down from 54% in 2018. It is the first time the number has fallen below 50% and the trend will most likely continue. Younger physicians and recent grads show a preference or proclivity for employment, eschewing private practice altogether throughout their careers.

Employment options for physicians are numerous, including: hospital systems, federally sponsored clinics,

independent urgent care practices and national chains like CVS, Walgreens and Walmart expanding into primary care. Baby boomer physicians, at or approaching retirement, are more apt to sell their practices to hospitals systems as their exit strategy because younger physicians show little interest in buying into private practice. Competition from better financed large hospital systems and corporations, increasing overhead costs and ever-changing reimbursement and regulations, have contributed to the virtual surrender of private practice.

Drug Ads: $147 Million in April

es. Families struggling to make ends meet often delay getting care due to high out-of-pocket expenses. 3. Invest more money in research and development to cure cancer, Alzheimer’s and diabetes development. Priorities No. 2 and No. 3 are easily paid for by the billions saved by priority No. 1.

But with Washington gridlocked by partisan politics, seemingly nothing gets done.

While hospital and physician prices are established and controlled by Medicare and commercial insurers, drug costs are not. Specialty drug costs are especially out of control, now accounting for 52% of overall drug costs. Drug companies spent a combined $147 million in just April on the top 10 specialty drugs which generate huge profits. Anyone, who watches even a minimal amount of TV, will recall these top seven ubiquitous ads ranked by spending: No. 1 Humira for Crohn’s disease; No. 2 Dupixent for inflammation; No. 3 Rybelsus for diabetes; No. 4 Trulicity for diabetes; No. 5 Rinvoq for rheumatoid arthritis; No. 6 Skyrizi for psoriasis; and No. 7 Tremfya for psoriasis.

Biden’s Healthcare Priorities 1. Let CMS finally negotiate drug prices which would save us billions a year. 2. Lower the deductible for insurance plans sold on the exchang-

Mergers, Acquisitions and Anti-trust Hospitals mergers have often resulted in sole provider of care in a market. Consequently they are under Department of Justice scrutiny. The fear is, without competition, prices will begin to rise ultimately costing consumers. But in many of these cases, without merging, several smaller hospitals in underserved areas would close. It is a case of survival versus anti-trust. Because hospital reimbursement is virtually set by both government and commercial insurers, there is negligible profit in the hospital business. It is an entirely different situation when highly June 2021 •

Hospital Rating System Overhauled CMS has employed a five-star rating system for both hospitals and nursing homes. Stakeholders (providers, consumers and payers) have criticized the logic, methodology and predictability of the five star system.

Consequently, CMS has overhauled the system to make it less complex, easier to understand and more useful. Five basic measures now form the foundation: mortality, safety, readmissions, overall patient experience and timeliness/effectiveness of treatment. The AHA said it is happy with the changes, but more needs to be done. There are 4,580 eligible hospitals for the rating system. Of those rated, 14% received five stars; 29% received four stars; 30% received three stars; 21% received two stars; and 6% received just one. 26% of the 4,580 eligible hospitals were unrated.

Businesses Frustrated Businesses have long preferred free market solutions to industry problems, but not so much when it comes to healthcare. They are frustrated with out-of-control costs and pouring more money into our fragmented and inefficient healthcare system. A recent survey of more than 300 businesses, jointly sponsored by the Kaiser Family Foundation and the Purchaser Business Group, revealed an astounding 85% want the government to increase its role in managing costs and coverage during the next 10 years. 92% want the DOJ to step up its anti-trust activities as mergers and acquisition have tended to reduce competition and increase prices.

Hospital Pricing Transparency There was a PSA aired during the recent Oscars broadcast advocating hospital price transparency. “Powerto thepatients.org.” It is certainly well intentioned. But as discussed in my previous columns, the requirement for hospitals to post online their prices for 300 shoppable procedures is fraught with problems. There is no standardized reporting format, making it virtually impossible for consumers to navigate and make

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

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

What’s the volunteer situation at Strong Memorial Hospital now that COVID-19 restrictions are easing? next year we will be able to welcome new volunteers and high school students back into our programs.

By John Addyman

T

hree leaders at Friends of Strong Memorial – Director Sandy Arbasak, Interim Volunteer Program Manger Karen Keating, and Awareness and Events Coordinator Matt Ulakovic — discuss the work of volunteers, during and after the peak of COVID-19.

How did Strong operate without volunteers during COVID-19? Were there some instances where you had volunteers in certain areas?

Before the pandemic, our volunteer programs were really taking off, adding new roles in various areas.

We had maybe 600 active volunteers at any given time working in 30-plus units. We had to abruptly pause all of our volunteer programs at the outset of the pandemic, when there were so many uncertainties about what was emerging.

It wasn’t until July of 2020 when we felt confident and safe in slowly welcoming back a very limited number of volunteers to five or six of our more meaningful service roles, such as patient discharge and in our main lobby. They’ve largely remained outside of inpatient areas, which still have limited visitation. With strict safety protocols in place, an estimated 170 dedicated volunteers have logged more than 10,000 hours since last July. Most recently we have been helping with primary care vaccinations with 125 volunteers — most are current volunteers in our pool we brought back — they have loved that.

They started in January and have donated thousands of hours to that cause.

Surely volunteers wanted to come back before now, but were there some concerns, given COVID-19’s presence in the community?

Terrence Anderson said, “I strongly believe that everyone who walks this earth has a divine purpose in life and mine happens to be helping people. I don’t view volunteering

Friends of Strong Director Sandy Arbasak, Interim Volunteer Program Manager Karen Keating, and Awareness Event Coordinator Matt Ulakovic. during the pandemic as a challenge, but as a privilege and an honor to serve.”

Volunteer Mary Wagner said the pandemic brought lemons and lemonade. One advantage? “Getting a parking spot is easier than ever.”

She also said interacting with the smaller pool of volunteers encouraged a stronger sense of comraderie.

“I feel like I’m part of a family. With COVID, there are fewer of us, and I’ve had the opportunity to get to know other volunteers more closely.

I really feel like I’m a valued part of the team.”

Hazel Pugh, volunteer coordinator for Wilmot Cancer Center, said when volunteers were not there last year, patients and staff asked how they were doing and when they would be able to come back: they were missed and appreciated. “It’s especially important for our patients to have our volunteers here again,” she said. “They’re always a bright light for patients, giving them an opportunity to have a brief friendly chat, an in-depth conversation or just get a little something to eat or drink during their time here. They’re great.”

CALENDAR of

HEALTH EVENTS

June 1, 8, 17

Hearing loss group presents June programs

Hearing Loss Association of America (HLAA) Rochester Chapter offers a selection of virtual programs for anyone interested in hearing loss.

All use the Zoom platform. Preregistration is required by visiting the HLAA website at http://hearinglossrochester.org. All are free and in real time. Closed captioning is an option for all participants as well.

• June 1, noon. Tela Palmer will discuss “What We Do With What We Hear: Hearing and Processing Sound and Speech.” Palmer is a clinical Page 10

•

audiologist with Rochester Hearing & Speech Center. Her talk will cover auditory processing and its possible disorders. She will explain hearing sensitivity, the mechanism of the peripheral hearing system and recognizing a person’s auditory processing disorder. If diagnosed through any of several tests, what remediation steps can be taken?

• June 8. 1 a.m. Joseph Kozelsky will discuss “”Hearing Other People’s Experiences (HOPE).” Prospective, new, or experienced hearing aid users can share their experiences, questions, and hearing loss journeys in an informal virtual round table discussion facilitated by Kozelsky is

We are extremely welcoming of all our volunteers; we’re very sad we can’t welcome everybody back right now.

Have you had inquiries about people coming back to serve?

We have heard from many of our preexperienced Friends of Strong volunteers, as well as some newly interested folks who’ve expressed a desire to help in any way they can. It’s truly been amazing to see the outpouring of support from so many people in our community. We regularly keep in touch with them via email and survey tools so we can keep them updated and let them know we are not yet prepared to restart all of our programs. We’re really focusing on a slow, thoughtful and safe approach to bringing individual volunteers back. We don’t want to turn people away, but unfortunately, right now, we just can’t bring in new volunteers.

We are receiving many inquiries about our popular summer high school volunteer program, but due to the safety precautions still in place, we are not able to offer that program this summer. We are hopeful that a retired audiologist and hearing aid user. Real hearing aid users discuss real problems and concerns.

• June 17, 10 a.m. HLAA-Rochester technology team members will discuss “Virtual ALD Demo Center.”

This is a continuing orientation to the online “Virtual Demo Center” website. It is a review of selected assistive listening devices, captioning-capable and amplified telephones, signaling-alerting devices and smart phone APP’s related to hearing enhancement and gives the opportunity for the presenters to answer questions from those joining the Zoom meeting.

More information can be found by visiting the web site http://hearinglossrochester.org.

• Class about hearing aids for beginners — The organizations will also present a program titled “Hearing Aids for Beginners.” The three-session Zoom class will take place at 10 a.m. June 3, June 7 andJune 10. Preregistration is required through the HLAA web site: www. hearinglossrochester.org to receive the meeting link.

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

What kind of process does a volunteer go through before starting?

We start with an information session about our programs and the types of roles and responsibilities involved with volunteering in a healthcare setting. From there, they’re invited to complete an application, an interview, a background check, a health history review with one of our nurses, and then orientations and training programs to prepare them for success as a hospital volunteer.

It’s a very robust onboarding process for the safety of our patients and for the volunteers.

Are there any requirements—vaccine, for instance?

No. At this time, COVID vaccination is not a requirement.

What’s the profile of a typical volunteer?

Our volunteers are civic-minded, humanitarian, charitable folks. Many are retired, while some are just looking to serve their community in their free time. We also see a lot of college students seeking ways to help the community, as well as gain valuable real-world, volunteer experience as they prepare to become contributing members of society—many with an eye toward healthcare careers; others just want to do something meaningful.

How do people raise their hand to volunteer?

When we are actively recruiting, our website fos.urmc.edu, directs them to call our office to sign up for a group information session during our recruitment periods, which are typically July through August, and December through January. For the summer high school program, students can begin looking for information on our website in early April 2022.

June 28-30

Free bereavement camp for children to promote hope, healing

Camp Heartstrings / Camp Dreams is a three-day camp for children (entering grades 2-11 in September 2021) who are adjusting to the death of a loved one. Developed by licensed master social workers, this camp promotes understanding, acceptance, healing and hope through a comprehensive program of activities, as well as plenty of fun. It is staffed by credentialed professionals and trained volunteers.

This camp is sponsored by UR Medicine Hospice (a program of UR Medicine Home Care), Pittsford Youth Services and Dreams from Drake. It takes place noon to 5:30 p.m. daily, June 28-30, at Nazareth College, 4245 East Ave., Rochester.

There is no cost to campers or their families. For questions, call Michele Allman at 585-274-4069 or send an email to URMHC-CampHeartstrings@URMC.Rochester.edu.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

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Massage Therapy: More than Relaxation Experts: massage therapy 'is a wonderful tool for managing pain and many conditions'

By Sol Nunez-Torres and Lynda Rohlfs

H

ow many times have you laid awake at night physically uncomfortable or unable to turn off your mind so that you can sleep?

If this sounds like something you or someone you know is going through, did you know that there is help? This help is oftentimes one of the last things a person turns to for relief, if they think of it at all — and that is massage therapy.

Most people are familiar with massage therapy as a tool for relaxation, and a great tool it is. Massage therapy for relaxation has the benefit of reducing stress hormones, anxiety and muscle tension, and improving circulation. As you may imagine, relief from these stressors feels wonderful and promotes a better night's rest, but that is not all.

What most people do not realize is that massage therapy is a wonderful tool for managing pain and many conditions.

Massage therapy is used to manage low back and fibromyalgia pain, tension headaches and migraine frequency, and decrease pain from rheumatoid arthritis and osteoarthritis. It also eases carpal tunnel related symptoms by reducing inflammation, pain and numbness.

Post-operatively, massage therapy also assists in the healing process by stimulating the lymphatic system, aiding in joint mobility and flexibility as well as recovery of soft tissue (from surgery or injury).

Lastly, but certainly not least, from a mental health perspective, massage therapy is used to alleviate depression, seasonal affective disorder, anxiety disorder and psychological stress.

Whew! We hope your interest has been piqued and we encourage you to discover how massage therapy can play an active role in your pain management and self-care regimen.

Per New York state guidelines, massage therapists are required to observe PPE and disinfection protocol. Massage therapy is safe to receive and we urge you to reach out to your therapist with any questions.

Remember, massage therapists have your back.

Lynda Rohlfs and Sol Nunez-Torres are licensed massage therapists and operate InTune Therapeutics, located at 1732 E Ridge Road, lower level, Irondequoit.

Reach them at 585-434-0523 or at intunetherapeutics@gmail.com. For more information, visit www.MassageBook. com/biz/InTuneTherapeuticsNY

Medication Drop Box Locations BRISTOL

Town Hall (585.229.4523)

Only YOU can secure your meds.

Monitor

Count your medications regularly.

Secure

Lock up any medications you don’t want anyone to access.

Dispose

Dispose of medications you are no longer using.

CANANDAIGUA

DMV Office (585.396.4210) FLCC, near gym (585.785.1000) Police Department (585.394.3311) The Medicine Shoppe (585.337-4300) Thompson Hospital, lobby (585.396.6000)

GENEVA

Police Department (315.828.6771) North Street Pharmacy (315.787.5388)

HOPEWELL

Ontario County Mental Health Clinic (585.396.4363)

NAPLES

Village Hall (585.374.2111)

PHELPS

Community Center (315.548.8484)

CLIFTON SPRINGS

RICHMOND

EAST BLOOMFIELD

RUSHVILLE

Hospital & Clinic, lobby (315.462.9561) Town Hall (585.657.6515)

FARMINGTON

State Trooper Barracks (585.398.4100)

Town Hall (585.229.5757) CVS Pharmacy (585.229.2285) Village Hall (585.554.3415)

SHORTSVILLE

Red Jacket Pharmacy (585.289.3002)

VICTOR

Mead Square Pharmacy (585.924.7970)

Questions?

Call us at (585)

396-4554 Page 12

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

SmartBites

Helpful tips

The skinny on healthy eating

Lean Flank Steak Boasts Abundant Nutrients

S

ome folks never forget their first kiss: I’ll never forget my first flank steak. It happened in a Mexican restaurant. The lights were low, the guitars were thrumming, and the thin slices of steak in my fajita made me weak in the taste buds.

Since that fateful night—and especially now during grilling season—I often reach for flank steak.

But taste alone is not driving this meat crush: nutrition is, too. Deemed a “lean” cut, flank steak has less fat and fewer calories than, say, some of the beef cuts marbled with fat (porterhouse, ribeye, strip steak).

Flank steak is packed with protein, with a 3.5-ounce portion delivering over half of our daily needs. Protein is often referred to as the building block of life because of its central role in the growth, development and maintenance of cells.

Not getting enough of this powerhouse nutrient can lead to a variety of health issues: muscle loss, fatigue, thinning hair, a weakened immune system, and more. Adequate protein intake is especially important as we age to help maintain strength, posture and mobility.

This flavorful steak, like most beef, sizzles with impressive amounts of niacin and respectable amounts of vitamins B6 and B12. All

together, these essential nutrients aid in red blood cell production, help convert food to energy and promote healthy nervous and digestive systems. Since B12 deficiency is common among the elderly—whether through diet or poor absorption—it’s good to know that beef is an excellent source of this beneficial B vitamin.

Eating flank steak also boosts your intake of selenium, zinc, phosphorous and iron. These important minerals each provide a valuable function: selenium gobbles up cell-damaging free radicals; zinc fortifies the immune system; phosphorous keeps bones and teeth strong and healthy; and iron provides energy and mental clarity.

What this cut doesn’t sizzle with is fat, particularly saturated fat. An average serving contains 7.5 grams total fat, with only 3 grams saturated fat. As a comparison, ribeye steak has 22 grams total fat, with 9 grams saturated fat. Foods that are high in saturated fats raise our total blood cholesterol and unhealthy LDL cholesterol levels—levels that, over time, contribute to clogged arteries and an increased risk of heart disease or stroke. Consuming no more than 15 grams of saturated fat a day is the recommended amount.

Flank Steak Fajitas with Sautéed Peppers 2 teaspoons chili powder 1 ½ teaspoons cumin 1 teaspoon onion powder 1 teaspoon garlic powder 1 teaspoon paprika ½ teaspoon Kosher salt ½ teaspoon coarse black pepper cayenne pepper to taste (optional) 1 ½ pounds flank steak 2 ½ tablespoons canola or olive oil, divided 3 bell peppers (multiple colors), cut into strips 1 medium red onion, sliced Flour tortillas, warmed Optional toppings: salsa, guacamole, shredded cheese, chopped cilantro Preheat grill to medium high.

Heat oven to 350F; wrap a stack of five tortillas in a packet of foil and put in oven for 15 minutes (can do multiple packets at same time).

In a small bowl combine chili powder, cumin, garlic and onion powders, paprika, salt, pepper, and cayenne (if using). Brush steak with 1 tablespoon oil, then rub about half the spice mixture into both sides of the meat. Add steak to grill and cook, flipping once until desired doneness (about 4-5 minutes per side). Let rest

Contrary to popular belief, marinating meat for hours on end does not equal greater tenderization, since marinades don’t really penetrate much beyond the surface of the meat. Long soaks, in fact, can turn the outermost layer of meat mushy, not tender.

Much like dry rubs, marinades mainly add flavor. For lean meats like flank steak, chefs recommend using a meat tenderizing mallet, grilling over high heat (about 4-5 minutes per side), and cutting the meat across the grain into thin slices. Overcooking your flank steak will render it tough; and slicing with the grain will result in an unpleasantly chewy steak. for 10 minutes.

While steak is resting, heat remaining oil in large skillet over medium-high heat. Add bell peppers, onion and remaining spice mixture; sauté until tender crisp, about 6-8 minutes. Transfer to a serving dish.

Thinly slice steak against the grain and serve on a warm tortilla with bell-pepper mixture and desired toppings.

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.

Eat Smart: Mediterranean Diet Could Ward Off Dementia

A

diet rich in vegetables, fruits, olive oil and fish — the socalled Mediterranean diet — may protect the brain from plaque buildup and shrinkage, a new study suggests.

Researchers in Germany looked at the link between diet and the proteins amyloid and tau, which are a hallmark of Alzheimer’s but are also found in the brains of older people without dementia.

“These results contribute to the body of evidence that links eating habits with brain health and cognitive performance in old age,” said lead researcher Tommaso Ballarini, a postdoctoral researcher from the German Center for Neurodegenerative Diseases in Bonn.

Eating a Mediterranean-like diet might protect the brain from neurodegeneration and therefore reduce the risk of developing dementia, he said.

“However, further research is needed to validate these findings and to better understand the underlying mechanisms,” Ballarini said, since this study could not prove a causeand-effect relationship.

For the study, he and his colleagues collected data on more than 500 people, of whom more than 300 had a high risk for Alzheimer’s disease. The participants reported their diets and took tests of language,

memory and executive function.

They also underwent brain scans, and more than 200 had spinal fluid samples taken to look for biomarkers of amyloid and tau.

After adjusting for age, sex and education, the researchers found that each point lower on the Mediterranean diet scale was linked to nearly one year more of brain aging, seen in the part of the brain closely tied with Alzheimer’s disease.

People who didn’t follow a Mediterranean diet had higher levels of markers of amyloid and tau, the researchers found. Also, people who didn’t follow a Mediterranean diet scored lower on memory tests than those who did.

“Overall, a closer adherence to a Mediterranean-like diet was associated with a preserved brain volume in regions vulnerable to Alzheimer’s disease, fewer abnormal amyloid and tau and better performance on memory tests,” Ballarini said.

One limitation of the study is that people self-reported their diet, which could lead to errors in recalling what and how much they ate, the researchers noted.

One U.S. expert said diet is only one aspect in the Alzheimer’s picture.

“We continue to see literature revolve around nutrition and diet and what it might mean in later life,” said Heather Snyder, vice president for June 2021 •

medical and scientific relations at the Alzheimer’s Association.

Diet, however, isn’t the only lifestyle factor that might lower the risk for Alzheimer’s disease, she said.

“I think the data continues to evolve and demonstrate that lifestyle interventions are likely beneficial for reducing cognitive decline,” Snyder said.

Other lifestyle components, such as exercise, are also important, she said. It’s not clear yet how diet and exercise reduce the risk of Alzheimer’s disease.

“I think the key is to really understand what that recipe is, because it’s unlikely to be any one thing,” Snyder said. “It’s more likely going to be a combination and the synergy of those behaviors that is most beneficial.”

Snyder noted that these same lifestyle factors help reduce the risk of cardiovascular disease and even some cancers. “But there is the need to tease out how and what might be the most beneficial for each of those,” she added.

“When we look at Alzheimer’s and cognition and cognitive decline, we have consistently seen diets like the Mediterranean diet are associated with lower risk in later life. What they all have in common is that a bal-

anced diet makes sure your brain has the nutrients that it needs,” Snyder said.

“I think what we know is what’s good for your heart is good for your brain, so eat a balanced diet,” she said. “There’s no one right diet, but make sure you get all the nutrients you need, but also get active, get moving and stay engaged.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

Kids Special Is it Safe to Send Your Kids to Summer Camp?

Parents are encouraged to carefully review the camp’s COVID-19 protocols before sending a child to camp

By Deborah Jeanne Sergeant

S

unny days spent exploring the outdoors, learning new skills and undertaking new challenges are all part of the summer camp experience.

COVID-19 shut down overnight camps last year while day camps operated much differently than in 2019.

The 2021 camping season should include overnight camps and day camps with a few protocols. If your children are attending day camp or overnight camp this summer, carefully review the camp’s COVID-19 protocols. They may be different then compared with now.

“A lot of the recommendations are changing day by day,” said Michael G. Martin, pediatrician at Gladbrook Pediatrics in Rochester.

“Most of the school camps are for kids not eligible for vaccine, but most of the counselors are eligible, so that would be a recommendation. Even when they did screenings on camps last year and kids were negative, they somehow had outbreaks. That was before the vaccine. I think if the counselors are all vaccinated and they had screening to get into camp that would be better.”

He thinks day camps may be an easier setting for any outbreaks to occur, as the children return home daily, mingling with other people, before returning to camp.

“The only way I could see around exposing the whole camp is daily testing on admission back to camp,” Martin said. “That presents logistical problems with adding cost and test availability.”

Overall, the benefit to children camping outweighs the risk, since few children have experienced severe illness because of COVID-19. Martin said the psychological benefit of being outdoors and with other children “is way more important than the small risk of getting COVID. Most people who have had bad reactions are the elderly and those with other medical problems.”

The only issue is if the children raise the risk of infecting those more

vulnerable populations. Going to a summer camp within New York may be a good idea this year. Other states abide by different COVID-19 protocols than New York. In addition, should an outbreak occur and the camp sends children home, a spontaneous couple hours’ drive is easier than arranging cross-country travel.

Susie Lupert, executive director of The American Camp Association of New York and New Jersey based in New York City, said that her organization bases its recommendations to camps on their respective state’s guidelines.

“We’re in a little bit of a holding pattern,” she said in mid-May. “We’re working with the governors’ offices and the Department of Health on ways to open that is safe. We want to make sure our industry can thrive.”

The most conservative guidelines at present include keeping children in dedicated cohorts, such all children who sleep in a particular a cabin, or for day camps, chosen groups, who will not mingle with the rest of the camp.

This strategy can limit the reach of an outbreak should one occur.

“For overnight camps, there will likely be testing protocols and for day camps, daily health screenings,” Lupert said. “There will likely be various cleaning protocols throughout the day.”

Last summer, day camps opened in New York and experienced very few issues. However, overnight camps did not open.

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Page 14

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Lupert said that this year, there will likely be masks worn while indoors and in a larger group.

“Anyone eligible should receive the vaccine,” she added.

She recommends that parents send their children only to camps accredited with the American Camp Association and licensed by the New York State Department of Health.

“That’s a better level of security that a camp is dedicated to the safety and health of their campers,” Lupert said. “They have to have medical staff and have Department of Health representatives who check on them before and during camp.”

The benefit of being outdoors and with other children “is way more important than the small risk of getting COVID. Most people who have had bad reactions are the elderly and those with other medical problems.”

Michael G. Martin, pediatrician at Gladbrook Pediatrics in Rochester

Too Few Young Men Have Gotten the HPV Vaccine he HPV vaccine isn't reaching enough young American men, researchers report.

The vaccine protects against reproductive area warts as well as cancers caused by human papillomavirus (HPV), the most common sexually transmitted infection in the United States.

Fresh air fun!

Photo provided by Susie Lupert.

Many young women get the HPV vaccine to help protect them against cervical cancer, but numbers are much lower among young men, the Michigan Medicine-University of Michigan researchers found. The U.S. Food and Drug Administration approved the vaccine for women in 2006 and expanded it to men in 2009.

When the HPV vaccine was first introduced, the main goal was to prevent cervical cancer. But oropharyngeal cancer — which occurs in the throat, tonsils and back of the tongue — has now surpassed cervical cancer as the most common cancer caused by HPV. Men account for 80% of those diagnoses, the researchers noted.

Study author, physician Michelle Chen, a clinical lecturer in the department of otolaryngology-head and neck surgery at Michigan Medicine, noted that “young adult men especially, who are less likely to have

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

While the Centers for Disease Control and Prevention offers guidelines for camps on its site, it is up to camps to follow New York State guidelines for how they operate this summer.

“Children need to be outdoors, have social interactions, get away from screens and have a great time,” Lupert said. “It’s of the utmost importance to get them into new and challenging situations. Mental health issues are on the rise, as is obesity.

We know it’s a result of children being locked indoors for the better part of a year. Going to camp really can be an antidote to what they have experienced and encourage them to be more active for the rest of the year.”

To read the New York State Department of Health’s general guidelines for children’s camps, visit https://www.health.ny.gov/ publications/3603. The Centers for Disease Control and Prevention’s guidelines on COVID-19 and camping are at https://www.cdc.gov/ coronavirus/2019-ncov/community/ schools-childcare/summer-camps. html.

a primary care doctor, are often not getting health education about things like cancer prevention vaccines.”

The analysis of data from the 2010-2018 National Health Interview Surveys revealed that only 16% of men aged 18-21 had received at least one dose of the HPV vaccine at any age, compared with 42% of women in the same age group.

Two doses of the vaccine at ages 11 or 12 are recommended by the Advisory Committee on Immunization Practices, but the vaccine still provides protection for people who get three doses by age 26.

Kids Special Summer Socializing for Children is Essential Play is more than just fun; it is a big part of a child’s development

By Deborah Jeanne Sergeant

C

hildren’s play is more than fun and games.

In a piece in the September 2018 issue of the journal Pediatrics, it states, “developmentally appropriate play with parents and peers is a singular opportunity to promote the social-emotional, cognitive, language, and self-regulation skills that build executive function and a prosocial brain.”

While the pandemic limited child-to-child contact at school for the past year, children need interaction with peers to promote proper social development. That is why socializing this summer is vital.

But parents also need to balance that need with continuing concern over COVID-19, keeping current protocols in mind.

“It’s a toughie,” said Michael G. Martin, pediatrician with Gladbrook Pediatrics in Rochester. “The kids

are probably eager to get outside and play and see their friends. The whole idea of maintaining masking and social distancing is going to be a problem.”

He said that even before any changes in the mask mandate occurred, he had problems with people entering his medical practice unmasked.

Although the Centers for Disease Control and Prevention has lifted some of the protocols for people who have received a full vaccination, the vaccine has not been approved for children under age 12. Parents will need to closely supervise when their children play with other children this summer. By scheduling playdates at their home or at others’ homes with only a limited number of children they know, such as a few families from their neighborhood, parents can more closely monitor who is in

Posture Important for Children When we ask our bodies to stay in one posture through the day … it can lead to aches, pains and weaknesses.

By Deborah Jeanne Sergeant

C

hildren’s poor posture is more than appearance; it can affect their health, both short-term and long-term.

In the past 15 months, as children spent more time hunched over screens and less time active, the effect has become more pronounced.

“With all the devices they’re using for online learning, it’s easy to be in poor posture throughout the day,” said chiropractor Erica Callahan, who holds a master’s degree in applied clinical nutrition and teaches at New York Chiropractic College in Seneca Falls. “We need to be cognizant of posture. We don’t want aches and pains to start earlier than they should.”

She said that children should sit with their bottoms to the back of the chair, with their back in a natural posture, hips and knees bent at 90 degrees and the feet flat. As supportive as that seated posture is, children also need variation, such as sitting on an exercise ball and breaks to stand, stretch and move.

One example Callahan calls the butterfly stretch: stand up straight, put their arms out like wings and

move them up, forward and back to stretch the arms and shoulders.

“Even overhead stretching and side to side can help,” Callahan said.

Yoga stretches such as “child pose” may help. To perform this move, children sit on the floor with their legs folded under them and move their arms and chest forward to the floor.

She recommends that children take a short break to get up and move every hour of the day and engage in a physical activity each day.

“When we ask our bodies to stay in one posture through the day, it shortens the muscles in the front and stretches the muscles in the back,” Callahan said. “It can lead to aches and pains and weaknesses. You might not notice it until you’re older.

Then those aches and pains are more magnified.”

Chiropractor William Ferris, who practices at Modern Chiropractic & Pain Relief in Victor, said that poor posture can strain muscles, ligaments and tendons.

“It translates into strain on the skeletal system,” he added. “It leads to chronic pain syndromes. That June 2021 •

contact with their children. Or they could limit their socialized playtime to children of whose parents have been vaccinated.

“That might be a reasonable strategy for some people,” Martin said.

Young children should only play outdoors under a caregiver’s watch irrespective of the pandemic. That makes it easier for parents to know who is in contact with their children and prevent unwanted contact.

The CDC has established that activities outdoors are less likely to result in spreading the virus than indoor activity. Transmission by surface contact has also been proven very rare. For these reasons, going to the playground is fine. However, close contact with other, unknown children at the playground is likely the only issue.

Where Martin sees the greatest

danger is in allowing older children and teens to roam the neighborhood to play with unknown kids at playgrounds or other crowded areas.

Camping is one way to Susie Lupert allow children the opportunity to interact with other children more safely, whether going to day camp or overnight camp.

“You could meet kids from all over the world, which is vital to their understanding of the world,” said Susie Lupert, executive director of The American Camp Association of New York and New Jersey. The organization is based in New York City.

Just as schools have done, camps are making plans for opening for the summer based upon the state’s guidelines. Since children will be much more supervised than at a random playground, their risk while interacting is mitigated.

“There will be smaller group sizes,” Lupert said. “It’s not going to be a typical summer where hundreds of kids are interacting all at once.”

Providing a camp uses the proper screening and testing protocols, along with keeping children in smaller “pods,” she sees no reason why camping cannot form part of a child’s socializing for the summer.

Parents concerned about the safety of their children’s socializing should consult with their child’s pediatrician and pay attention to the state-issued recommendations.

leads to an inability to child’s body weight,” focus for the kids.”

Peshkin said. “Shoulder He has observed more straps should be padded, patients coming in lately adjusted and not worn with slumped posture only over one shoulder. and the accompanying Backpacks should have an posture-related pain internal frame to distribsyndromes, including ute the weight evenly headaches, neck pain and like a hiking backpack. back pain. Like Callahan, The best one is a wheeled he recommends hourly backpack, like you’d take movement in addition to on an airplane.” regular exercise.

One negative outChiropractor Larry come of poor posture is William Ferris, DC Peshkin, with Irondequoit upper crossed syndrome, Chiropractic Center, said that the in which opposing muscles in the poor posture in children has become front and back of the neck, chest and chronic because of the pandemic. shoulders are under and overused.

“When people sit for long peri“Ninety percent of the patients ods of time in a home environment who walk in here have upper crossed that’s not properly set up ergonomisyndrome,” Peshkin said. cally, it’s problematic,” Peshkin said.

The condition may manifest with “We’re seeing problems younger numbness in the hands, headache, and younger. We constantly run into vertigo and rounding of the shoulissues with patients developing early ders. It can even cause issues with onset joint diseases. The first reason the rotator cuff of the shoulders. Peis poor posture and poor ergonomshkin said that over time, upper cross ics.” syndrome can contribute to early In addition to slumping over arthritis, poor breathing and reduced devices, Peshkin points blame at physical performance. overly heavy backpacks. While He encourages people to visit a many children have been schooling chiropractor for an evaluation in the remotely for at least part of the time, routine way that they should visit when they attend school inperson, their dentist for regular cleanings, their backpacks are often stuffed with not just when they’re in pain. At too much. That problem has worshome, children need more movement ened because some schools have not in their day, especially while they are allowed children to visit their lockers educating at home. because of the pandemic.

“I tell our patients with children with backpacks they should never weigh more than 5% to 10% of the IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

•

Page 15

Kids Special

Screens Diminish Children’s Sleep Quality Encourage children to wind down with a predictable routine prior to bedtime

By Deborah Jeanne Sergeant

W

hile you may feel you readily wind down in the evening by watching television—and perhaps fall asleep while binging watching a favorite show—it is not the ideal way to induce sleep, especially for children.

As an additional drawback of too

much screen time, watching videos or playing games just before bedtime can inhibit children’s sleep.

Screen time may not delay children’s bedtime; however, a study from The National Sleep Foundation indicates that people who use devices with screens just before bed

experience poorer sleep quality than those who did not use the devices.

“It’s a well-known fact that the blue light from screens can affect sleep-wake cycles,” said physician Edward D. Lewis, fellow of the American Academy of Pediatrics, board certified pediatrician and owner of Lewis Pediatrics in Rochester.

“Kid shouldn’t be on screens within an hour or so of wanting to fall asleep. Staying off screens helps their bodies to get settled down to sleep.”

Lewis is the current president of the American Academy of Pediatrics NY Chapter 1.

Allowing children to keep devices in their rooms is inadvisable.

While your children may say that they stay off their phones or tablets at bedtime and keep them away from their beds, Lewis said that may not be enough. Not only is the temptation strong to check for messages “one more time,” but just the presence of the phone in the room may be detrimental to good sleep.

“Some studies have shown if your phone is in your room you don’t sleep as well because you’re wondering who’s messaging you and wondering if it will ring,” Lewis said.

He also views evening screen time as adding yet more screen time to children’s day. Since many children still have several hours of screen time for school a few days per week, adding more screen time during their leisure hours cuts into time for hands-on activities.

Michael G. Martin, pediatrician at Gladbrook Pediatrics in Rochester, also recommends limiting screen time, particularly screen time before bed and especially if it involves social media.

“It opens up a whole area of social abuse,” Martin said. “I’ve always felt strongly that my kids should not be on social media until well into their teen years. By and large, this kind of thing can be detrimental.”

Stressing over likes and posted comments can certainly make it difficult to sleep.

While up to an hour or so of gaming or watching a video each day is fine, excessive gaming prevents children from interacting with people in-person. Those interactions are important for understanding how to get along with others.

For those who will not reduce their late-night texting, Martin said that their device’s dimming feature can help mitigate the effects of the screen. However, setting it aside well before bedtime is ideal.

Instead of engaging with screens before bed, encourage children to wind down with a predictable routine such as a bath or shower, reading and a light snack before they prepare for bed.

While physical activity is vital for good health, vigorous activity directly before bed can elevate body temperature and energize children rather than cause them to settle. It is better to exercise earlier in the day.

Screen time was higher in homes with more children. Girls spent more time than boys using media to connect with family and friends. Dore said caregivers should be encouraged to offer boys more support in maintaining relationships through technology when they can’t meet in person.

Laura Justice is professor of educational studies and executive director of The Crane Center. She said, “Importantly, we saw increases in media use in a lot of areas often considered positive, such as learning and fostering friendships, suggesting that caregivers may have been using media to supplement children’s educational and social experiences at

a time when in-person options were not safe.”

But, she added, “these families don’t have some of the resources that more advantaged families have to help with children while the parents work or do other things. For low-income families, occupying a child’s time may also be very important and necessary at times.”

It is not clear whether the high levels of media use found in this study would also be found in more affluent families, the researchers noted.

The findings were published online recently in the Journal of Developmental & Behavioral Pediatrics.

Media, TV Time Doubled for Kindergartners During Pandemic

W

hen the COVID-19 pandemic kept young kids indoors, their time spent watching TV and other screens rose dramatically.

That’s the finding of a new study that investigated the screen time of kindergarteners from low-income families in Ohio. The researchers found that their use of television, video, movies, short clips, and apps or games on any electronic device topped six hours a day in May and June of 2020.

That was nearly double previous levels of screen use reported in earlier studies.

“We found a high level of media use compared to what many experts think is appropriate for this age group,” said lead author Rebecca Dore. She is senior research associate at Ohio State University’s Crane Center for Early Childhood Research and Policy, in Columbus.

“Some of that time spent using media was positive: watching educational videos and connecting with friends and family. But the amount of time they spent is something we should be aware of,” Dore added.

Managing screen time while childcare was shut down may have been harder for caregivers from low-income households than for others, the study authors suggested.

Page 16

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“Increased screen time may be particularly concerning for children from low-income households who had higher levels even before the pandemic: over three and a half hours per day compared with less than two hours for children from high-income homes,” Dore said.

The study included 151 low-income caregivers of kindergarteners who responded to 12 questions about kids’ media use on the most recent weekday and weekend day.

The kids averaged 6.6 hours a day of media use (6.8 hours on weekdays and 5.8 on weekends), the findings showed.

Forty-seven percent of respondents reported increased entertainment use; 45% said use had increased as a way to occupy the child’s time; 42% were using media more often to maintain relationships with remote family and friends; and 34% said their child was spending more time using screens for family bonding.

About 61% of caregivers said the child was using media for learning more than usual, which researchers suggested may have included watching educational TV or using educational apps unrelated to formal schooling. About 84% of kids had direct contact with their teachers once a week or less, with 53% reporting none.

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

Kids Special

Getting Kids to Eat Veggies Overall, it may take persistence when introducing—and reintroducing—vegetables to children

By Deborah Jeanne Sergeant

Y

ou may have heard it yourself and now tell your children, “Eat your vegetables.” That is good nutritional advice.

“Vegetables are packed with nutrients,” said chiropractor William Ferris, functional medicine nutritionist at Modern Chiropractic & Pain Relief in Victor. “You get a few calories and a lot of nutritional value, along with fiber, which is important to keep the digestive tract moving.”

Children need between one to two cups of vegetables daily, depending on their ages, according to www. myplate.gov. Unfortunately, some children do not enjoy the flavor of vegetables, which demotivates them to eat enough of them. Ferris said that serving raw vegetables with dip may help children eat more, but

avoid sugary condiments. For example, hummus contains no sugar.

“My mom never allowed us to have snacks before dinner except vegetables,” Ferris said.

Keeping washed baby carrots and pepper strips in the fridge may inspire more veggie snacking between meals.

Ideally, parents should start their children on vegetables even before they’re born. Heather Carrera, doctor of clinical nutrition in the office of Lesley James, MD, in Pittsford, said that babies can sense flavors in the womb.

“If the mom is eating a lot of sweets and not a lot of bitter foods, they develop a taste for that,” Carrera said. “Likewise, when breastfeeding, babies get a flavor profile. Moms

need to eat a variety of bitter vegetables to prime the baby to eat vegetables. A study showed that moms who ate carrots and drank carrot juice, during the latter half of pregnancy, the babies were more likely to accept carrots when introduced to solid foods.”

Once it is time for solids, serve baby pureed avocado instead of rice cereal or pureed fruit mixed with vegetables. But if that window of opportunity has been missed, parents can still encourage their children to eat more vegetables. Carrera recommends adding vegetables to foods children already like, such as broccoli florets to macaroni and cheese, puréed squash or carrots in pasta sauce or carrots or spinach in a smoothie.

“That can serve a purpose, but there’s a lot to be said for getting kids to appreciate the texture of vegetables,” Carrera said. “If they’re sneaked in their whole life, that’s not good, either.”

Overall, it may take persistence when introducing—and reintroducing—vegetables at the table.

“Parents oftentimes get frustrated and give up too quickly,” Carrera

said. “Expose it multiple times.”

When not serving them raw, avoid overcooking vegetables.

Steamed, tender/crisp vegetables taste much better than limp, boiled ones. Try additional ways of preparing vegetables, such as seasoning with sea salt and garlic and roasting them in the oven.

Inviting children to help grow or buy and prepare vegetables can make a difference in whether they eat them. It may help to acknowledge “Emma’s salad” or “Cooper’s broccoli” at the table to the whole family so the children feel pride in their culinary creations. Even small children can wash and tear up lettuce for a salad, wash raw vegetables or sprinkle on a dash of sea salt.

“Let them have a sense of ownership,” Carrera said.

“That’s not something kids have a lot of.

Eating shouldn’t be a control game, where parents are making them eat Heather Carrera something. The parents are in control of when and what, but the child is how much and whether or not they eat a food. Don’t force them to finish their dinner.

“A lot of parents are in the trap of preparing separate meals. Children may need things cut or puréed, but they should be able to eat the same things you’re eating. Children will eat if hungry. The control aspect can set them up for disordered eating.”

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Page 17

Kids Special Night Terrors Differ From Nightmares

You don’t have to face hearing loss alone.

The Rochester Chapter of the Hearing Loss Association of America (HLAA) invites everyone in Upstate and Western New York to use its resources in support of people affected by hearing loss.

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Unlike nightmares, they aren’t generally associated with stress or from watching a scary movie

By Deborah Jeanne Sergeant

A

wakening to the sound of a child screaming is upsetting to any parent, especially if the child cannot be roused readily. That can indicate a night terror, which differs from a nightmare.

Those who experience night terrors cannot easily be awakened. That is because they have entered rapid eye movement (REM) sleep, a deeper state of sleep than when one first falls asleep.

“Night terrors typically happen within an hour of falling asleep,” said Edward D. Lewis MD, fellow of the American Academy of Pediatrics, board certified pediatrician and owner of Lewis Pediatrics in Rochester.

Lewis is the current president of the American Academy of Pediatrics NY Chapter 1.

Unlike a nightmare, “they won’t remember anything about it,” Lewis added.

No parent wants to hear their child crying in the night. While rousing children from a night terror seems like a good idea, it is both ineffective and unnecessary. If awakened from a night terror episode, children often feel temporarily confused, disoriented and irritable.

With a nightmare, children awak-

What Works Best to Ease Recurrent Ear Infections in Kids?

F

requent middle-ear infections are the nemesis of many parents and young children.

Now a new study suggests that a common treatment — “ear tubes” — may not prevent future bouts.

Middle-ear infections (or acute otitis media) are second only to the common cold in creating childhood misery.

They occur when the air-filled space behind the eardrum becomes infected and fills with fluid, which can cause pain, fever and obstructed hearing.

Some babies and young children are prone to frequent infections. One treatment option is to surgically place a tiny tube in the eardrum, to help drain fluid built up behind it.

But the new study, published

Page 18

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May 13 in the New England Journal of Medicine, found that the tactic did not thwart future infections.

Among 250 babies and toddlers researchers followed, those treated with ear tubes suffered about as many middle-ear infections over the next two years as those who received only antibiotics for each bout.

The good news is that infections in both groups dissipated over time, said lead researcher, physician Alejandro Hoberman of UPMC Children’s Hospital of Pittsburgh.

Kids normally outgrow the infections, he explained. Babies and toddlers are prone to them because of the structure of their eustachian tubes, which help drain fluid from the middle ear. As little ones grow older, that changes.

en to call for help. They can usually tell what they dreamed and why they feel upset. Parents’ efforts to comfort them can readily lull them back to sleep within a few minutes.

“There’s really nothing you can do about night terrors other than make sure they’re safe,” Lewis said.

Some children also thrash and move around during a night terror episode. Others may leave their beds, so it is important to ensure that they cannot hurt themselves.

Why night terrors happen is still not largely understood. Most of the time, they happen with young children.

“You often see night terrors during phases of growing or if sleep schedules are disrupted,” Lewis said.

“If they’re happening frequently, wake the child up within 45 minutes of falling asleep.”

While waking a sleeping child seems counterintuitive for ensuring a good night’s rest, this strategy has proven successful in disrupting the sleep cycle and preventing night terrors. Most children at this age can easily fall back asleep from a peaceful awakening.

Night terrors represents a parasomnia condition like sleepwalking

and sleep talking. As such, night terrors may run in families.

Lewis added that night terrors may also happen when a child is undergoing a major change in development, such as when their language improves in a short period of time.

Night terrors, unlike nightmares, are not generally associated with stress or from watching a scary movie with an older sibling. Fortunately, children do not later remember what frightened them during a night terror episode and the experience will not bother them the next day.

“It’s an impact on the people around them, not the children,” said Michael Martin, MD, pediatrician with Gladbrook Pediatrics in Rochester. “I counsel parents to see if their child is awake. If they say they’re scared, offer comfort. If they’re not awake, just make sure he or she is safe. Wait for it to end and not worry about it. It doesn’t cause damage to the person experiencing it.”

He added that in most cases, night terrors may last a few weeks before children outgrow them. If not, they can always consult with the pediatrician to screen for any other issues.

According to Hoberman, the new findings suggest that for many children, tubes can be avoided.

But, he added, some may need tubes if their rate of ear infection does not wane over time.

Physician Steven Sobol is chairman of the American Academy of Pediatrics’ section on otolaryngology-head and neck surgery. He said the study “supports the well-established belief that many children with recurrent acute otitis media eventually grow out of their symptoms, regardless of whether they've been managed medically or surgically.

But decisions on treatment, Sobol said, depend on various factors. They include whether infections are impairing a child’s hearing and speech development.

That point was emphasized by physician Maura Cosetti of Mount Sinai’s New York Eye and Ear Infirmary in New York City.

“The age of children in the study ... coincides with what’s felt to be the sensitive period for speech and language development,” Cosetti said.

Unlike antibiotics, she explained, ear tubes “may provide immediate relief from hearing loss related to middle-ear fluid — the value of which may be difficult to quantify in the current study.”

To Sobol, the study “emphasizes the importance of creating an individualized approach to management.”

The trial included 250 children, ages 6 months to nearly 3 years, who had suffered recurrent middle-ear infections — at least three within six

months, or four within a year.

Hoberman’s team randomly assigned them to have either an ear tube surgically placed or receive oral antibiotics whenever a new infection struck.

Kids given ear tubes also received antibiotics when a new infection arose — but by ear drop. If that didn’t work, they switched to oral antibiotics.

One potential advantage of ear tubes, Hoberman noted, is that they allow ear-drop antibiotics. That could reduce the risk of bacteria elsewhere in the body developing antibiotic resistance.

Over the two-year study, though, there was no clear advantage of ear tubes when it came to new infections, or antibiotic resistance.

The average rate of recurrent ear infection was around 1.5 per year in the ear-tube group, and 1.7 in the comparison group. Infections declined in the second year in both groups.

Children with ear tubes did spend fewer days on oral antibiotics, the study found.

But the two treatment groups showed no difference in the likelihood of harboring antibiotic-resistant bacteria in the nose or throat.

Still, Sobol pointed out, there were some other advantages in eartube group.

For one, they tended to remain infection-free longer before their first recurrence. They also generally had fewer days with infection symptoms—with the exception of drainage from the ear.

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

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Medicare Coverage Options for Retirees Eager to Travel Dear Savvy Senior, What are the best Medicare coverage options for COVID-19 vaccinated retirees who are eager to travel? My wife and I will both turn 65 over the next few months and would like to know which Medicare plans are best for extensive travelers.

Almost 65

Dear Almost, The best Medicare plans for retirees who plan to travel will vary depending on your destinations. But before you book a trip make sure you know the current CDC COVID-19 travel recommendations (see CDC. gov/coronavirus/2019-ncov/travelers), and research your destinations too so you can know if restrictions apply wherever you’re going.

Medicare Review

Before we dissect how Medicare works for travelers, let’s start with a quick review of your different Medicare options.

One option is original Medicare, which covers (Part A) hospital services and (Part B) doctor’s visits and other medical services.

If you choose original Medicare, you may also want to get a Medicare (Part D) prescription drug plan (if you don’t already have coverage) to cover your medications, and a Medicare supplemental (Medigap) policy to help pay for things that aren’t covered by Medicare like copayments, coinsurance and deductibles.

Or, you could get a Medicare Advantage (Part C) plan instead, which is sold through private insurance companies, and covers everything original Medicare covers, plus many plans also offer prescription drug coverage and extra services like vision, hearing and dental care all in one plan.

To help you evaluate your options contact your state health insurance assistance program (see ShiptaCenter.org), which provides free Medicare counseling.

You can also shop and compare Medicare health and drug plans and Medigap policies at Medicare.gov/ find-a-plan.

Also note that whatever Medicare plans you choose to enroll in, if you find that they are not meeting your needs or your needs change, you can always switch to a different plan during the open enrollment period, which is between Oct. 15 and Dec. 7.

U.S. Travel

If you and your husband are planning to travel domestically, original Medicare may be the better option because it provides coverage everywhere in the U.S. and its territories as long as the doctor or hospital accepts Medicare.

Medicare Advantage plans, on the other hand, which have become very popular among new enrollees, may restrict your coverage when traveling throughout the U.S. This is because most Medicare Advantage plans are HMOs or PPOs and require you to use doctors, hospitals and pharmacies that are in the plan’s network within a service area or geographic region. So, if you’re traveling outside that area you may need to pay a higher fee, or your services may not be covered at all.

If you do decide to enroll in a Medicare Advantage plan, be sure you check the benefit details carefully to see what costs and rules apply when traveling outside your service area.

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Traveling Abroad

If you’re planning to travel abroad much, a Medicare Advantage plan may be a better option because many Advantage plans today offer emergency care coverage outside the U.S. But be sure you check before you choose a plan because not all plans offer it.

Original Medicare, on the other hand, does not provide coverage outside the U.S. and its territories except in rare circumstances (see Medicare.gov/coverage/travel), and Medicare drug plans will not cover prescription drugs purchased outside the U.S. either.

But if you do choose original Medicare, you can still get some coverage abroad through a Medigap policy. Plans D, G, M and N plans will pay for 80% of medically necessary emergency care outside the U.S. to new enrollees, but only for the first 60 days of the trip, and you have to meet an annual $250 deductible first. There’s also a lifetime limit of $50,000, so you’d need to cover any costs above that amount.

Some beneficiaries, regardless of their Medicare coverage, purchase travel medical insurance for trips abroad, which you can shop for at InsureMyTrip.com or SquareMouth. com.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.

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Page 19

Ask St. Annʼs

What to Consider When Choosing Senior Living Communities

E

xploring senior living communities is a process that’s best started while you’re enjoying life. Knowing which options can accommodate your needs and desired lifestyle before a health event forces your move puts you in control and offers peace of mind.

Living spaces Our region is fortunate to have many senior living communities, so you have choices. These living spaces come in all shapes and sizes, from single homes and cottages to apartments and duplexes located in urban, suburban, or rural settings.

A worthwhile community provides the comforts of home without the responsibilities and worries of homeownership, as well as activities, programs, services and amenities. St. Ann’s Community, for example, roots its offerings in the Seven Dimensions of Wellness to help residents lead expansive and balanced lives.

Start your search by location. Do you want to be close to your family and support network? Also, consider the activities and destinations you currently enjoy so you can help yourself remain active and engaged in your community and nurture your social connections. Having easy access to public transportation may make it easier for you to get around town, connect with air and train travel, and be less dependent on a car.

Inclusive community Seniors thrive when they feel connected, engaged and included. In addition to offering a warm and vibrant environment, see if the residence welcomes diversity and cultivates interactions between staff and residents to build community.

Inclusivity also means giving residents a voice in decision-making.

Ask prospective communities how they seek input from residents to meet their changing needs.

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Ask The Social

By Kimberly Quartieri

Care continuum While independent living is your next step, what happens when your needs change? Communities with a full continuum of care give you easy access to different levels of care for more stability.

St. Ann’s Community offers its independent living residents access to personal supports and athome services to age in place. If needs ever change, residents receive priority access to healthcare services including assisted living and skilled nursing care. Memory care for those living with Alzheimer’s disease or other cognitive issues, as well as on-site rehabilitation and hospice care, are available.

Ask questions Speaking directly with residents and staff will tell you what you need to know. Most communities will offer you the opportunity to meet current residents to ask about their likes, dislikes, and other factors. Also, attending an event is an excellent way to experience the people and culture.

Look for a positive attitude among staff members about their work, employer, and day-to-day responsibilities.

Get started Narrow down your list of communities to explore by visiting their websites first. Prioritize accredited communities because they can demonstrate their ability to meet or exceed a prescribed standard of care with transparency.

By keeping what’s suitable for you and your family at the center of your senior living community search process, you’ll be sure to find the place you can call home.

Kimberly Quartieri is a sales and marketing representative for St. Ann’s Community at Cherry Ridge, an Independent Living Community.

You can reach her at 585-697-6703 or via email at kquartieri@mystanns.com.

ADVERTISE! For advertising information: editor@GVhealthnews.com

Security Office

From the Social Security District Office

Replacement or Corrected Social Security Cards During COVID-19

S

ocial Security offices are currently open only for in-person appointments for limited, critical situations, depending upon local office conditions. However, you can continue to apply for a replacement Social Security card online and by mail. Before requesting a replacement card, please remember that you might not need the physical card.

Most of the time, simply knowing your Social Security number is enough.

If you have a critical situation that requires you to have a physical card and you cannot apply by mail or online, you should call your local Social Security office. Please visit our coronavirus (COVID-19) updates page for more information at www. ssa.gov/coronavirus.

Applying Online

If you don’t need any changes to your Social Security number record (such as a name or date of birth change), applying for a replacement card online is your most convenient option. You don’t need to mail proof or visit an office.

You can use our online application if you are an adult, have a state-issued drivers’ license or non-driver identification card, and live in the District of Columbia or one of the 45 states that verifies state-issued documents for us. All you need to do is create a my Social Security account to access and complete the online application at www.ssa.gov/myaccount/replacement-card.html.

If you live in one of the five states that do not participate — Minnesota, Nevada, New Hampshire, Oklahoma and West Virginia — know that we are working hard to bring this service to you as soon as possible.

Q&A Q: How does Social Security decide if I am disabled?

A: For an adult to be considered disabled, Social Security must determine that you are unable to do the work you did before and that, based on your age, education and work experience, you are unable to adjust to any other work that exists in significant numbers in the national economy. Also, your disability must last or be expected to last for at least one year or to result in death. Social Security pays for total disability only.

No benefits are payable for partial disability or short-term disability

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

Applying by Mail

We require proof of your identity with your replacement card application (www.ssa.gov/forms/ss-5.pdf), usually a state-issued drivers’ license or non-driver identification card, or U.S. passport. We call these documents “primary” identity proofs. We understand mailing primary identity proofs with your replacement card application can be challenging. To help, we are temporarily expanding our policy to accept alternative identity documents — or what we call “secondary proofs” — when you cannot mail primary proof.

Acceptable secondary proofs include, but are not limited to: employee identification card, school identification card, health insurance card (not a Medicare card) and U.S. military identification card.

These proofs must be current (not expired), show your name and identifying information (such as your date of birth or age), and be an original or a certified copy.

If you need to change your name, when you mail your replacement card application, you will need to submit proof of identity plus proof of the name change. The proof of identity can be primary or secondary proof. Proof of the name change could be a marriage certificate, divorce decree, certificate of naturalization showing the new name, or a court order approving the name change.

You may be able to submit one document to serve as proof of your name change and identity. For example, you may submit a marriage certificate as proof of name change and identity if the certificate shows the marriage occurred within the prior two years and includes your prior name; includes your age, birth date or parents’ names; this information matches your Social Security number record.

We will return any documents you send us.

(less than a year). For more information, read our publication, Disability Benefits, at www.ssa.gov/pubs.

Q: My daughter receives SSI and child support from her father. Does the child support have to be reported?

A: Yes. The child support your daughter receives is countable income for SSI purposes. As with any income received for an individual or a parent, if the child is under 18, it needs to be reported to your local Social Security office. For more information regarding the SSI program, visit www.ssa.gov/disabilityssi/ssi. html.

Health News Excellus BlueCross BlueShield announced in May that James R. Reed has been appointed chief executive officer of the $6.2 billion health plan and its parent company, The Lifetime Healthcare Companies.

Reed has been serving as president and CEO-elect since July 2020 and succeeds Christopher C. Booth who retired after leading the company since 2013.

“Jim is strategic in his approach, has a strong sense of mission and brings a wide array of experience to the job,” said Marianne Gaige, chairwoman of the company’s board of directors. “He has been a leader in this company for 25 years and has been instrumental in shaping the company’s future in today’s ever-changing health insurance industry.”

Jim Reed, new President and CEO of Excellus BCBS.

Reed joined Excellus BlueCross BlueShield in January 1996. Prior to serving as president and CEOelect, his roles included executive vice-president of marketing and sales, and Central New York regional president. As president and CEO, he assumes responsibility for the entire operation, including fulfilling the company’s mission and fostering the company’s corporate culture.

“Our focus remains on providing access to high-quality health care to as many people as possible at a price they can afford,” Reed said.

“As a locally based health plan, we are partners with those who provide care and those who pay for it and we want to build on that going forward.”

The Lifetime Healthcare family of companies includes its nonprofit health plan, with 1.5 million members in 39 New York counties and about 3,900 employees. The health plan does business as Excellus BlueCross BlueShield across the Roch-

Judy Reader elected Thompson Health guild president

Nurse receives Margaret Ecklund Spirit of Nursing Award

YAP graduate named President and COO of Ohio hospital

During recent elections within the Thompson Health Guild, Judy Reader of Victor was named president of the guild, which is the auxiliary for UR Medicine Thompson Health.

Reader, who retired after a 31-year career with Canandaigua National Bank & Trust Co., first joined the guild over a decade ago. She held the office of treasurer for one term and also served on Judy Reader the committee for the guild’s annual fashion show for four years. Having retired, she now has more time to devote.

“I am proud to serve as president of the guild and look forward to continuing to support the strong relationship with Thompson Health system,” said Reader, who noted priorities include fulfilling the guild’s financial pledges toward the hospital’s new intensive care unit and renovation of the health system’s skilled-nursing facility, the M.M. Ewing Continuing Care Center.

The following Thompson Health Guild officers were also chosen in the recent election: Katie Outhouse of Bloomfield, vice president; Gail Herman of Canandaigua, secretary; and Lou Loy of Canandaigua, treasurer.

Outgoing president, Robert Locke of Canandaigua, had served in the role for six years and will remain a member. As the retired director of pharmacy for Thompson, Locke said being on the guild’s board has kept him connected to many of his former colleagues, and he has enjoyed the opportunity to help the health system and community. “One of my favorite projects has always been the annual scholarships we give out,” he said.

Patty Trickey of UR Medicine Thompson Health recently received the Margaret Ecklund Spirit of Nursing Award from the Greater Rochester Area Finger Lakes (GRAFL) Chapter of the Patty Trickey American Association of Critical-Care Nurses.

A Canandaigua resident who is certified as a critical-care registered nurse, Trickey is a “float nurse” within Thompson. She was the hospital’s nurse of the year in 2003 and, in 2020, marked 45 years with the health system. During her tenure at Thompson, she has worked in nearly every hospital unit, including medical/surgical floors, telemetry, the emergency department, critical care, cardiology, observation and diagnostic imaging.

“No matter where she is, Patty is always the first person to lend a hand or a shoulder to lean on,” said Mary Kate Corey, the director of the intensive care and observation units at Thompson. “Her patients appreciate her compassion and empathy while her teammates adore her for her advocacy and knowledge.”

According to GRAFL, The Margaret Ecklund Spirit of Nursing Award is presented annually to a member of the chapter who exhibits the dedication to acute and critical-care nursing, the passion for the chapter and the major contribution to patient care embodied by the chapter’s founding member and second chapter president. The award was announced during the chapter’s April 21 Linkages event. It was a virtual conference this year, but Corey expects to receive the award from GRAFL soon so she can formally present it to Trickey.

Jim Reed Takes Over as New Excellus BCBS President and CEO

June 2021 •

Jeremiah Kirkland

TriHealth in Cincinnati, Ohio, appointed Rochester General Hospital youth apprentice program (YAP) graduate Jeremiah Kirkland president and chief operating officer of Good

Samaritan Hospital.

TriHealth said Kirkland will also continue to serve as executive director for women’s services as well as the interim chief diversity officer.

Kirkland was a part of the YAP from 2001 to 2003 while a Rochester City School District student. The YAP, based out of Rochester General Hospital, allows students to work in the hospital to explore potential careers in healthcare.

Kirkland earned his bachelor’s degree in healthcare administration from SUNY Brockport and his master’s degree at Roberts Wesleyan College. He served as manager of human resources, director of women’s health services, and manager of clinical innovation at Rochester Regional Health before his tenure at TriHealth.

Stamps receives national recognition for diversity Deborah Stamps, executive vice president chief nursing education and diversity, equity and inclusion officer at Rochester Regional Health, is of the honorees for the 17th annual DiversityFIRST National Diversity and Leadership Conference.

Stamps is among 50 leaders across the country recognized in May with the Leadership Excellence Award at the “Be a Changemaker” four-day conference.

ester region, Central and Northern New York, the Utica region and the Southern Tier and operates as Univera Healthcare in eight counties surrounding the Buffalo area.

Related entities include the national long-term care insurance company, MedAmerica Inc., and the employee benefit firm, Lifetime Benefit Solutions, Inc. Over the course of his career, Reed has been involved in the community through various nonprofit organizations. He serves on multiple committees and boards in the regions, including CenterState CEO, ROC 2025, Greater Rochester Chamber of Commerce, and the BlueCross BlueShield Association.

Reed earned his bachelor’s degree in business administration and his master’s degree in business administration from Le Moyne College in Syracuse.

Reed, age 50, and his wife reside in Skaneateles and have three children.

As the leader of the diversity, equity and inclusion office at Rochester Regional Health, Stamps has taken an active role in encouraging all members of the Rochester community and Deborah Stamps beyond to get the COVID-19 vaccine through a “community conversations” initiative. These virtual conversations give community members a chance to learn more about vaccine and vaccine safety from Stamps, other diversity leaders, and medical experts. The conversations were tailored to specific communities like the deaf and hard of hearing, LGBTA+, veterans, disabled, and Latinx.

Stamps began her career in 1989 as a licensed practical nurse at Rochester General Hospital. From there, she continuously advanced her professional credentials as well as her clinical and management roles obtaining associate’s and bachelor’s degrees in nursing; master’s degrees in gerontological nursing and business administration; and an education doctorate. She is nationally certified as a nurse executive by the American Nurses Credentialing Center.

She has served as a nurse manager and chief nursing officer at RRH, and most recently as vice president of quality, safety, and innovation.

She led the strategy to meet the needs of the Rochester Community, through the expansion of the Isabella Graham Hart School of Practical Nursing as well as providing home health aid and certified nursing assistant training programs.

She currently leads the newly instated Rochester General College of Health Careers, a continuing education institution offering innovative and hands-on programs where students can earn an associate of applied science degree with a major in nursing as well as other healthcare education.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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LIFE CHANGING MEDICINE, MOVING MEDICINE FORWARD

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

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I’VE GOTTEN MY COVID-19 VACCINE, NOW WHAT? If you’ve received a COVID-19 vaccine, you may wonder what’s next, and how quickly things can go back to “normal”. Here are some of your questions answered

by Dr. Lorna Fitzpatrick, Vice President of Medical Affairs.

Q. CAN I STOP WEARING MY MASK? If you’ve been fully vaccinated you can now safely participate in a number of activities without wearing a mask. The CDC and New York state recently updated guidance about wearing masks. Fully vaccinated people can now resume activities both indoors and outdoors without wearing a mask or physically distancing. There are exceptions based on federal, state and local regulations and local businesses and workplaces may have their own policies you will be asked to follow. Visit CDC.gov for more information.

Q. IF I’M FULLY VACCINATED, CAN I TRAVEL? Fully vaccinated travelers are less likely to get and spread COVID-19, so people who are fully vaccinated with an FDA-authorized vaccine can travel safely within the United States. Negative tests are not needed unless the destination requires it, nor is self-quarantining. However, still follow the recommendations of wearing a mask, washing your hands often and social distancing.

LORNA K. FITZPATRICK, MD Vice President of Medical Affairs

She is board-certified in pediatrics and pediatric hematology-oncology and obtained her medical degree at Jacobs School of Medicine, Buffalo, New York, and continued on to residency in pediatrics at St. Louis Children’s Hospital/Washington University, St. Louis. She completed a fellowship in pediatric hematology-oncology at Johns Hopkins University. While there, she participated in the graduate training program in clinical investigation at the Bloomberg School of Public Health.

Q. IS THERE AN UPDATE ON WHEN KIDS CAN GET VACCINATED? DOES THIS AFFECT THEM RETURNING TO SCHOOL? All residents of New York ages 12+ are now eligible for a vaccine. The Pfizer/BioNTech vaccine is approved for ages 12+ and the other vaccines are currently being tested to make sure they are safe and effective. As a pediatrician and mother, I know how important it is for children to return to school for both their social and educational development. Vaccines are one more tool to keep our children and teachers safe in the classroom.

Read our full Q&A with Dr. Fitzpatrick at

ExcellusBCBS.com/COVID19

The information in this document is current as of May 20, 2021. For the latest information on COVID-19, visit the Centers for Disease Control and Prevention online at CDC.gov.

A nonprofit independent licensee of the Blue Cross Blue Shield Association

June 2021 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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