In Good Health: ROC #211 - March 2023

Cutting Calories May Slow Aging in Healthy Adults

The key to living longer could be eating less.

In a new study published in the journal Nature Aging, researchers found that a calorie-restricted diet had substantial health benefits, including delayed aging.

“The main take-home of our study is that it is possible to slow the pace of biological aging and that it may be possible to achieve that slowing through modification of lifestyle and behavior,” said senior study author, physician Dan Belsky, an assistant professor of epidemiology at Columbia University's Mailman School of Public Health in New York City.

The phase 2 clinical trial included 220 adults who either made a 25% calorie cut to their diet or no changes at all. The body mass index (BMI) for participants ranged from 22 to 27 (a BMI of 30 is the threshold for obesity).

In the first month, those in the calorie-restricted group were given three prepared meals each day so they would be familiar with portion sizes. They were counseled about their diet for the first 24 weeks of the two-year study.

The other group had no counseling or restrictions.

Despite the plan to cut about 500 calories in a 2,000-calorie daily diet, most cut only half that, said physician Evan Hadley, director of the geriatrics and clinical gerontology division at the National Institute of Aging (NIA), which funded the study.

“But that 12% was enough to have significant changes,” Hadley told NBC News.

Researchers used an algorithm based on past data for 1,000 people who were followed for 20 years, to see how certain DNA biomarkers changed in the study group.

The algorithm was like a “speedometer,” Belsky explained, to help gauge the pace at which participants aged.

Those who cut their calories slowed their aging by 2% to 3%, reducing the likelihood of dying early by 10% to 15%.

"We all have the power to change the trajectories of aging," Belsky contends.

Researchers plan to follow those on the calorie-restricted diet for 10 years.

It's not clear why eating less would slow aging, though it may prompt cellular changes, Belsky said.

"It may induce sort of mecha-

nisms of survival responses in the body that have the effect of cleaning up intracellular garbage," Belsky explained. “It's a signal to the body, saying, 'Hey, pay attention. There are resource stresses in the environment. We need to make sure that we are using all of the resources available to us most efficiently.'”

Still, long-term limits on calories have been shown in animals to be harmful, including reduced muscle strength, slower metabolism and an impaired immune system, Valter Longo, director of the Longevity Institute at the University of Southern California, told NBC News. Longo

was not involved in this study.

“It may cause powerful anti-aging effects, but also probably some degree of frailty or other issues that may not be so beneficial,” Longo said.

People should not starve themselves, Pankaj Kapahi, a researcher at the Buck Institute for Research on Aging, told NBC News. He was not involved in the study.

Kapahi noted that exercise and balanced eating are important for aging.

"Calorie restriction has to be done at a marginal level," he said.

Mark Cuban Pharmacy Could Save Billions on Prostate Cancer, Bladder Drugs

A new drug company founded by entrepreneur Mark Cuban could save patients $1.29 billion a year based on 2020 Medicare Part D expenditures on just the nine most popular urological drugs, according to a study published in the Journal of Urology.

The study, led by Vanderbilt University Medical Center (VUMC) researchers, examined the potential savings if Medicare prices for generic drugs were as low as those offered under the Mark Cuban Cost Plus Drug Company, which provides a standard template pricing of the cost of manufacturing the drug plus a 15% markup, plus standard $5 fees for dispensing and $3 fees for shipping.

“We found that if the U.S. government used Mark Cuban’s cost-plus drug pricing model to supply urological drugs to Medicare patients, they would save taxpayers an estimated $1.29 billion,” said lead author physician Ruchika Talwar, a fellow in urologic oncology at VUMC.

“It means that patients would be able to get their drugs more affordably, but also means that taxpayer funds could go toward other important issues and hopefully save us all some money in general.”

The nine commonly-prescribed urological drugs that were studied — tamsulosin, finasteride, oxybutynin, alfuzosin, solifenacin, tolterodine, sildenafil, tadalafil, and abiraterone — are used to treat conditions including prostate cancer, overactive bladder and prostate enlargement.

For the 90-day prescription prices, all drugs generated cost savings for Medicare, ranging from 48.7% to 99.2%. The savings for abiraterone alone amounted to $656 million, or nearly 52% of all potential Medicare savings for urological drugs in both 30-day and 90-day prescription models. Abiraterone is used to treat prostate cancer that has spread to other parts of the body by blocking testosterone, which is the hormone that drives prostate cancer growth.

“Just by changing the way one commonly prescribed drug (abiraterone) was purchased, we could convey a benefit of more than $650 million in cost savings to taxpayers,” Talwar said. “The impact of this could be astronomical across all cancers … any sort of oral, generic drug available through Mark Cuban’s company can be a lot cheaper for many patients, not just Medicare patients, through this program. And taxpayers are the ones who fund Medicare drug spending.”

Meet Your Doctor

By Chris Motola

Jason Pacos, M.D.

Chief of cardiology for Highland Hospital: People need to manage their stress on a healthy and meaningful level to decrease the negative effect on their heart

Q: Tell us a bit about your specialty.

A: I would be considered a non invasive cardiologist. In the field of cardiology, there are lots of different aspects to the care of the cardiovascular system, the heart, the blood vessels. Invasive cardiologists would do angiograms and stents. I don't do that. I do more management of chronic conditions, coronary conditions, hypertension, hyperlipidemia, arrhythmias, as well as evaluation of the heart with non invasive methods like nuclear stress tests or ultrasounds of the heart and monitoring heart rhythm over time.

Q: What does your patient base look like?

A: I see patients between the ages of 18, and I believe it's currently 104. So it's quite a diverse group of patients with a number of different issues. As you can imagine, the vast majority of my patients are older. As we age, it's more common to see more cardiovascular issues to emerge. But, of course, we do see people who develop issues much earlier in life. And we look after them as well.

Q: There's been a lot of talk in the media lately about myocarditis in the context of COVID-19 and the COVID-19 vaccines. Would treating issues like that fall under your um brella?

A: Yes. Myo carditis is a term that means in flammation of the heart, which is something we've been dealing with for a long time. It's not an uncommon finding. It's something that we dealt with before COVID-19, but is more prom inent in the media after COVID-19. Historically, most cases of

myocarditis are caused by viruses, so it's not all that surprising that COVID-19, which is a virus, affects organs like the heart. Often with myocarditis a virus will attack the heart and cause inflammation of the heart. That can manifest in a number of different ways: chest pain, shortness of breath or symptoms of heart failure. So patients will present with those symptoms and then through blood tests and other imaging, we can determine if patients do have myocarditis. While it's more prominent recently, it's still a fairly rare condition.

Q: What other viruses commonly cause it?

A: It can be caused by a number of reasons, including viruses. Historically it's been caused by the flu virus. It's also caused by a number of viruses that are more difficult to detect.

Q: When it comes to stress on the heart, what differentiates healthy and unhealthy stress?

A: I think stress of any level can affect that heart. Physical stress, such as exercise, is typically a good thing for the heart and improves your cardiovascular activity when it's done at the appropriate level for the appropriate amount of time. That kind of stress on your heart can improve your conditioning. We can also see that physical stress on the heart can be a bad thing when it's a level of activity that people do fairly intensely but is out of proportion to what their body is used to. Other types of stress that can cause issue are emotional and psychological issues, which certainly do have an impact. The mind-body connection is a real thing. We know that people who are prone to high stress levels for any number of reasons over time are more at risk of cardiovascular complications over time. So decreasing those stressors and improving mindfulness can be very beneficial to the well-being of the heart.

Q: What does the mechanism for that look like? Is it detectable in tests as a chemical? A type of inflammation?

A: I think it's a bit of all of the above. Certainly, whenever there's an emotional stressor there's a cortisol release, which affects all of the hormones of the body and leads to physiological responses in the body like an increase in heart rate, blood pressure. Typically those things you'd see in a flight or fight response, which is an evolutionary adaptation we've had since the beginning of mankind. And often that response does cause stress on heart. So being under constant stressful situations it can put undo stress on the heart over time.

Q: What should the average person be looking for when it comes to monitoring the type of stress their heart is under?

A: I'm not sure there's a black or white answer to that. I see a lot of people from all walks of life, from CEOs of large companies to people who work as cashiers or manual laborers and who are under stresses of all kinds, most of the time. I think we all have stress. There's not any magic pill we have to relieve stress, so people need to find ways to manage their stress on a healthy and meaningful level in such a way to decrease the effect on their health and heart health. That's different for everyone, and there are a lot of ways in which it can be done from mindfulness and meditation to religion, to medical or talk therapy. All of those things or combinations of those things can be helpful.

Q: Are patients generally referred to you or do they come see you directly.

A: The vast majority of my patients are referrals from primary care physician who has determined there's a problem with their heart health, their blood pressure, their cholesterol. There are a smaller number of patients we see who had been admitted to the hospital who have identified issues with their cardiovascular health, who we see in those settings.

Q: What kinds of non-invasive interventions can you do?

A: I'm a part of the larger cardiovascular team. My role is different than, say, a cardiac surgeon who typically operates on patients after we've identified a need for urgent surgical intervention. I typically would be involved in their care both before and after, and be involved in medical therapy, rehabilitation and diagnostic testing for surgeries or stenting if those were indicated.

Lifelines

Name: Jason Pacos

Position: Chief of cardiology at Highland Hospital; associate professor of clinical medicine

Hometown: Forestville

Education: State University of New York-Buffalo School of Medicine & Biomedical Sciences; fellowship in cardiology at University of Rochester Medical Center; residency in Internal Medicine at University of Rochester Medical Center

Affiliations: Highland Hospital; Strong Memorial Hospital, Strong West Hospital

Organizations: American College of Cardiology; American Heart Association

Family: Wife, three children

Hobbies: Golf, skiing

Pain, Tingling or Numbness in Your Feet?

By Andrea Ide

Pain, Tingling, or Numbness in your hands, feet or legs may be due to Nerve Damage. If left untreated this small annoyance can lead to big problems. Unfortunately, most people have no idea what to do abut this problem and some don’t even realize how big of a problem it is. They tell their doctor who gives them drugs and injections which only mask the pain and there is no surgery, other than amputation, that will heal/stop neuropathy from progressing.

Neuropathy is a term used to describe damaged nerves, primarily in the hands and/or feet, that are progressively breaking down due to a lack of blood supply, nutrients and oxygen reaching the nerves along with a lack of communication from the brain. Since the nerves are what the brain uses to communicate with the area and they are breaking down, the brains ability to communicate with the area lessens over tine, allowing for the progression of more breakdown and worse symptoms. It can be caused by Diabetes, Poor Ciculation, Poor Nutrition, Chemotherapy, Agent Orange, Misaligned Spinal Bones Placing Pressure on the Nerves, along with over 100 other causes. “Patients experience extreme sensations, loss of feeling, even No Feelings in their Hands and/or Feet along with muscle spasms, pain, weakness, numbness, tingling, and burning and many have a very hard time with balance” says Dr. Nathan Riddle of Riddle Wellness, a Neuropathy testing and treatment clinic.

This condition can eventually lead to further nerve damage, causing complete loss of legs or arms leading to amputation, death or brain injury due to falls, burns or other injuries that will not heal, along with organ failure in some cases.

Are you or someone you love suffering with loss of balance, numbness or pain from Nerve Damage in your hands and/or feet that just won’t heal? You don’t have to any longer. This local clinic right here in Rochester, NY is helping people find lasting relief without the use of drugs or surgery! That’s BIG EWS!

HEALING IS POSSIBLE

More than 20 million people in the U.S. Are dealing with some form of Neuropathy. Most commonly noticed first in the hands or feet, causing weakness, numbness, tingling pain and debilitating balance problems, often frustrated with no place to turn to and no hope of recovery. “By the time they come to see us, they feel like they have tried everything. Their MD put them on Anti-Seizure or Epilepsy meds like Gabapentin, Neurotin, Cymbalta or Lyrica and told them they will just have to live with the pain,” said Dr. Riddle.

ADVANCED TECHNOLOGY

With recent advancements in nerve regeneration technology and treatment options, clinics all over are seeing larger success rates and faster results with their neuropathy patients.

“This new technology paired with our multifaceted approach, has been life altering for our patients and our clinic,” said Dr. Riddle.

The development and success of these new, highly effective Neuropathy Protocols by Dr. Riddle and his team at Riddle Wellness have been the talk of the town in recent months. “Neuropathy patients have been coming in from all over the state and the results that they are getting is truly amazing,” said the Patient Coordinator at the Clinic. There are some things people can do at home to aide in the healing process of their neuropathy however, healing neuropathy is an all-encompassing process that ill require lifestyle changes, home care and may or may not include chiropractic, (varying from patient to patient) along with guidance from a medical professional that is experienced, skilled and trained to treat neuropathy.

Dr. Riddle and his skilled care team in Rochester have been treating neuropathy for years now in and judging by their 5 Star patient reviews, and all their patient video testimonials, they have been doing a very good job providing excellent patient care. One person had all but given up, they were crying in their testimonial. They were so thankful and its all because of this amazing new treatment option! They state it

New Treatment Options for Neuropathy

ing pain, numbness, tingling, pins and needle sensations, cramps and burning in your feet, or hands, along with the many other bodily symptions this horrible condition plagues people with, take action because it will progress.

Not everyone is able to start care at the clinic but, those who do are thankful! Find out if you are a candidate for their Neuropathy Protocols so they can help you regain the feeling in your hands or feet, stop the pain and start living life again! “Our Neuropathy Protocol is a multifaceted approach to heal neuropathy by nurturing the nervous system, increasing circulation, blood and oxygen, working to rebuild, strengthen and balance the body, all while stimulating the damaged nerves. Revitalizing and healing the damaged areas, enabling them to reactivate and function at an increasingly higher rate over time, all while increasing the patients quality of life dramatically,” said Dr. Riddle.

has about a 98% effective rate!

FIND

LASTING RELIEF

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Call 585-670-0020 and use Code NUMB0021. They have agreed to reduce their usual cost of $250.

But hurry, due to the number of patients the office can see, this is a limited time offer, with only 25 spaces at this exclusively discounted rate. These will be on a first come, first serve basis, messages left will count. My advise, don’t suffer any longer, waiting around for it to get worse... If you or your loved one is experienc-

Over the years they have treated thousands of patients with chronic conditions of Neuropathy, Sciatic nerve pain, Back & Neck problems, Whiplash Injuries along with Knee Pain. The office is well known and has a good reputation. Patients drive hours to this clinic and the vast majority enjoy superior, lasting relief. In fact, many who have suffered and tried other treatment options with no luck, only to have been told that they are just stuck with their pain and discomfort, have credited the care team at Dr. Riddle office for giving them their lives back!

Call them now at their Rochester, NY location, for a full, thorough Consultation and extensive Neuropathy Consultation at $49. Use Code: NUMB0021 (saving you over $200) to determine if and how Dr. Riddle and his team can help you recover, just as they have helped so many others that suffer with the Pain and Numbness of Nerve Damage.

“I feel like myself again. The pain is gone and I am even sleeping through the night”

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Nearly 1 in 5 American Adults Takes Sleep Meds

Nearly 20% of American adults use a drug to help them sleep, either occasionally or regularly, health officials recently reported.

Sleep medications, sold both over-the-counter and by prescription, are a common treatment for sleep problems, said senior report author Lindsey Black, a health statistician at the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

"Our report details patterns of use of medication to inform patterns of use among subgroups of the U.S. population," Black said. "We do hope

by dissemination of this report it can lay the groundwork for more work in this area and our understanding of sleep health among adults."

Using data from the 2020 National Health Interview Survey, Black and colleagues found that among adults ages 18 and older, 8.4% used medication to help them fall or stay asleep on most nights or every night. Another 10% said they used medication on some nights.

Women were more likely than men to take medication for sleep and the percentage doing it generally increased with increasing age.

Specifically, 10% of women used sleep medication, compared with 6.6% of men. White adults were more likely to use sleep medications, and Asian adults were least likely to do so. Also, the percentage of men who used medication for sleep dropped as family income increased, Black's team found.

The findings were published Jan. 25 as an NCHS Data Brief.

One expert wasn't at all surprised by the number of Americans who rely on sleep medications.

"I work in a sleep center. And you know, I certainly see a lot of sleep medication use," said Lauren Broch, a clinical sleep psychologist at the Northwell Health Sleep Disorders Center in Great Neck.

Broch thinks not only are sleep medications (both prescription and over-the-counter) overused but also

poorly used.

Prescription drugs like temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), eszopiclone (Lunesta) and zolpidem (Ambien, Edluar, ZolpiMist) were designed to be used in the short term, not as a long-term crutch.

The same is true for over-thecounter sleep aids, many of which contain the antihistamine diphenhydramine, the active ingredient in Benadryl.

People who use these medications habitually come to rely on them, Broch said.

"Many people start believing that the sleep medication is what is making them sleep," she said. "There's a dependence on them, and sometimes tolerance, and they believe that they must use it or they won't sleep. That's never a good thing."

HealthcareinaMinute

By George W. Chapman

The Pandemic Is Over!

Well, not really. The administration has declared an end to the public health epidemic as of this May. The government is not saying the clinical pandemic is over, although it is on the decline. The declaration officially puts an end to the PHE originally declared by the previous administration in 2020 in response to COVID-19. The PHE has been extended several times since 2020. Among other things, it authorized expanded telehealth services and improved payment for providing services (paid same as in-person visit). The PHE also expanded Medic-

2022 Bad for Hospitals

Last year was the worst year for financially ravaged hospitals since the onslaught of the pandemic.

A study published by industry advisory group Kaufman Hall revealed the average hospital started off the year with operating margins hovering around minus 3.5%. Hospitals gradually dug their way out negative operating margins by December 2022, but about half of the nation’s 7,000 hospitals finished in the red for the year in total. Analysts predict some improvement or relief in 2023 due to better management of staffing issues, improvement in the supply chain, continuing leveraging of outpatient services, increased alliances or ventures with physicians and stronger commercial payer negotiations. Related to the bad year fiscally: 50% of hospital-based physicians and nurses reported job-related distress and 25% reported depression.

Private Equity in Rural Hospitals

Desperate for capital, rural hospitals are easy pickings for aggressive profit- at- all- costs private equity

aid eligibility to cover more of the indigent. So, the end of the PHE in May will at least create confusion, if not chaos. States will be forced to reconsider and reconfigure Medicaid eligibility. Physicians and hospitals may lose improved payment for telehealth services. (As of this writing, Medicare is extending behavioral telehealth for seniors through 2024.) While PHE declarations only impact Medicare and Medicaid, commercial insurers typically follow suit. Late night TV comedians have tongue in cheek made light of “government declares pandemic over!” Funny, but not.

(PE) companies. They approach financially vulnerable hospitals with management and consulting contracts with no investment or assuming any risk. PE firms own or manage about 130 rural hospitals mostly in southern states like Texas, Kentucky and North Carolina. The purely forprofit firms typically strip out many needed services, close beds, slash staffing and all but eliminate charity care. They quickly turn around the profit and loss statement, grab their fees and get out. This has put additional pressure on surrounding urban and suburban facilities that end up providing the care discontinued at the rural hospital. Medicare, state Medicaid agencies and provider organizations are investigating the negative impact of PE on their rural providers.

Long COVID-19 Decreasing

good news is the number of individuals suffering with long COVID-19 declined from 19% in June of last year to 11% this year. In addition, 17% of those who had long COVID-19 no longer have symptoms. The Kaiser Family Foundation report was based on analyzing CDC

data. The issue, however, remains a serious concern. The bad news is the best practices to treat long COVID-19 have yet to be finalized. There is no singular test to definitively determine if long COVID-19 is caused by covid alone. Post COVID-19 conditions are NOT due to just one illness. Your health history plays an important factor. It is estimated that 500,000 to 4 million individuals in the workforce have long COVID-19.

Behavioral Health Crisis Among Our Young

Behavioral healthcare has long been besieged by the opioid epidemic (suicides, addiction, depression). Then COVID-19 struck three years ago, further highlighting the shortcomings of our behavioral health system.

COVID-19 (along with social media) has had the most negative impact on our young. A survey of parents, conducted The Pew Research Center, revealed they now rank their children’s mental health status as a primary concern (anxiety, depression, suicide). The study also revealed what many employers are experiencing: the mental health of children directly impacts the well-being and productivity of their parents. All agree that government and commercial insurers must expand the access to, quality of, and affordability of behavioral health. Regulatory barriers must be removed, including anachronistic–redundant state licensing requirements that make it unnecessarily complicated for professionals to provide telehealth services across state lines. The nonprofit National Alliance of Healthcare Purchasers Coalition, which represents 12,000 employers and purchasers covering more than 45 million employees, is dedicated to promoting effective programs and strategies to improve our behavioral healthcare system for all and especially for the young.

CVS–Aetna Expand Mental Health

This alliance and similar commercial ventures and alliances, continue to distance themselves from traditional hospital and provider-based delivery systems by pio-

neering innovative, consume-friendly delivery systems. CVS–Aetna has been offering basic virtual and in person primary care services since May of 2022. Effective spring 2023, CVS–Aetna will be expanding telehealth behavioral health services to Aetna members, including appointments with licensed therapists and psychiatrists (MDs). Currently, the average appointment for a virtual, in person or at home primary care visit is out 24 days. The average appointment for an in person behavioral health service, before telehealth is introduced, is out 48 days. Time will tell how popular and effective these corporate healthcare delivery systems are.

US Healthcare Again Fares Poorly

The recent report from the Commonwealth Fund once again illustrates how poorly we are doing when compared to 37 other wealthy countries. Here are some of the low points. As of 2020, our average life expectancy was 77. The average life expectancy among our 37 counterparts was three years more at 80. We have the highest rate per 100,000 of avoidable deaths, infant and maternal deaths and gun related deaths. The latter being 7.4–100,000 versus 2.7–100,000 average in the other 37 countries. We spend, by far, more than any of our counterparts. The US spends close to 18% of its GDP on healthcare. That’s just over TWICE the average of the other 37 countries. The closest to our 18% of GDP were Germany at 13% and France at 12%. The major difference? Most of the 37 countries that clearly outperformed us in just about every category have single-payer healthcare systems.

Hundreds of U.S. Doctors Lost Their Lives During Pandemic

Many of America's doctors who were heroes on the front lines of the pandemic paid the ultimate price for their efforts, a new analysis shows.

An estimated 622 extra deaths occurred among U.S. doctors aged 45 and over from the pandemic's onset in March 2020 through December 2021, researchers say.

Older doctors who provided direct care to patients battling COVID-19 were at especially high risk.

These excess deaths to physicians didn't subside until April 2021, soon after the introduction of COVID-19 vaccines, concluded a team led by Mathew Kiang, an epidemiologist at Stanford University's School of Medicine in California.

The findings were published Feb. 6 in the journal JAMA Internal Medicine.

The only good news coming out of the new study: Despite the tragic loss of so many doctors' lives, death rates among physicians were still lower than that observed among the general population.

That suggests "personal protective equipment use, vaccine requirements, infection prevention protocols, adequate staffing and other workplace-based protective measures were effective" in preventing more deaths among doctors, the authors wrote.

They conducted the study by comparing pre-pandemic data on deaths to older (aged 45 and above) physicians from 2016 through Febru-

ary 2020 to data collected during the pandemic itself.

Almost 800,000 physicians were included in the analysis. The team excluded younger physicians from their analysis because deaths among that group were very low (fewer than five deaths per month).

Deaths to U.S. doctors peaked in December 2020, the study found, with 70 excess fatalities occurring that month. Deaths began to decline through 2021.

Among the 622 excess deaths recorded during the pandemic, certain factors seemed to raise the risk that a doctor might die, the study found. Men made up about two-thirds (65.3%) of those who passed away, and the odds that a doctor might die during the pandemic rose with his or her age, the report found.

Older doctors who cared for COVID-19 patients appeared to be at especially high risk, suggesting that hospital "workplace policies should prioritize mitigating risks in this group" in the future, Kiang and colleagues wrote.

Of course, the deaths of working physicians may have exacerbated a wider tragedy: more deaths to patients as hospitals faced staffing shortages caused (at least in part) by the loss of these valuable crew members.

That's why "preventing excess deaths among physicians is an important component of mitigating excess deaths in the general population," the study authors concluded.

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By Gwenn Voelckers

Practical tips, advice and hope for those who live alone Live Alone &

The Power of Faith: One Woman’s Spiritual Journey

Life after a divorce or the death of a spouse can leave you reeling and wondering about practically everything — your judgment, your future, your fears, and your faith.

Below is an interview I conducted with one of the most thoughtful and inspiring women I've met through my “Alone and Content” workshops.

Caroline (not her real name) was divorced when I met her and has since remarried, “happily,” she added with a smile.

Her faith lifted her up and carried her through the hardest times following her separation. It is my hope that her journey will inspire yours.

• Would you care to share a little bit about your faith?

I’m a Christian... I've looked at other religions and have made a conscious decision to remain a Christian, even though I don’t understand it all. I am learning to embrace the mystery.

• What role did your personal faith play in your adjustment to living alone?

My Christian beliefs hold to the tenet that I am never alone — that Christ is with me wherever I am. I’ve prayed a lot and have found indescribable peace in that praying.

• What was the biggest challenge you faced living alone and how did your faith help you heal?

Grieving the end of my marriage caused me the most pain while

alone. All the 'if onlys' and 'why me?' really tore at my heart. The Bible was my constant companion. I was also inspired by “The Purpose Driven Life,” by Rick Warren, and other Christian books and radio programs, which helped me put things into perspective.

Talking with others in my congregation was also a huge part of my healing. I get emotional when I think about the support and caring that surrounded me, rescued me.

• Is there a particular experience you had that captures the power of your faith?

My youngest son was 7 at the time. After dinner he brought me his homework book to sign, as was his teacher’s daily requirement. He’d been at his dad’s house the previous three days and I saw his dad’s girlfriend’s signature on the parent line in the book. My heart stopped.

Then, something in me snapped — all the times my precious children were away from me ... all the awfulness ... all the anger and injustice and fear. I sucked it up and forced my shaking hand to sign my name next to hers. I made my way outside,

For Baby's Sake, Momsto-Be Need the Whooping Cough Vaccine: CDC

Pregnant women can help protect their newborns from whooping cough by getting a Tdap vaccine during the third trimester of pregnancy. The U.S. Centers for Disease Control and Prevention tracked cases of infant whooping cough between Jan. 1, 2000, and Dec. 31, 2019.

The researchers found a link between reduced rates of whooping cough in newborns under 2 months of age and Tdap (tetanus, diphtheria, pertussis) vaccination during pregnancy.

Whooping cough, or pertussis, is highly contagious and can be serious

for infants who are too young to be vaccinated. The CDC recommends babies get their first Tdap shot at 2 months of age.

“Getting Tdap during pregnancy offers infants the best protection before they are old enough to receive their whooping cough vaccines,” physician José Romero, director of CDC's National Center for Immunization and Respiratory Diseases, said in a CDC news release. “This protection is critical because those first few months are when infants are most likely to have serious complications, be hospitalized or die if they get whooping cough.”

stumbling, and collapsing under the maple tree in my back yard.

I laid on my back clutching my chest, my heart. No tears. Just intense pain. I did not, could not, make a sound or move. But after a while, my mind prayed a lament, begging God for relief from this excruciating pain.

In that instant, a 'peace that passes all understanding' moved over me and I felt my golden retriever appear and quietly curl up next to my body.

• Did you ever lose faith or struggle to regain your faith?

I did not lose my faith but, boy, did I ever have a few words with God! One morning during breakfast with my two boys, I ran to the garage and grabbed my bike after learning of the girlfriend’s ongoing involvement my boys’ lives.

I needed to get out of the house so the boys wouldn’t hear my rant at their father. I tore down the road, enraged and screaming at God, 'How could you let this happen?!'

About a half mile from home, I saw a doe quietly standing by the side of the road. I calmed down immediately and just sobbed. I turned the bike around just as the sun burst over the horizon, washing the sky, the quiet country road, and me in the warm morning light. I was reminded again 'You are never alone.'

• What advice would you give to those whose suffering has challenged their faith?

Remember a time when you risked it, trusted God, and felt a measure of serenity after you did. Remember that, 'This, too, shall pass.' Remember that there are things we can only learn when in solitude. That God has a bigger plan than our plan.

• What role does prayer play in your life?

Prayer is the great wireless communication connection to God. God speaks to us in three ways, through the Bible; through people, which in-

cludes books people write and teachers like you; and through prayer, which may encompass comforting things embodied in nature, dogs, deer, sunrises, and so much more.

• How can those who live alone activate their faith more fully?

It’s like exercise and eating right. You get out of it what you put into it. You prepare yourself for the years ahead by continuing to move and by putting good things into your body.

You prepare your heart and soul for the times ahead by studying your faith of choice and by nourishing your mind and actions with uplifting words and passages, helpful deeds, gratitude, and inspirational music and images.

• Was there a favorite scripture passage that lifted you up during your challenging times that you'd like to share with my readers?

"Do not be anxious about anything, but in everything by prayer and supplication, with thanksgiving, let your requests be made known to God. And the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus." — Philippians 4:6-7

I hope you have found this interview helpful and supportive. While I find my spiritual bearings in nature, meditation, love and a humanist philosophy, I am inspired by the words and wisdom expressed by Caroline. We can all be strengthened by a spiritual life, wherever that path leads us. Embrace it.

Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com

The researchers had not looked at U.S. population level trends in infant whooping cough cases since this maternal vaccination strategy began in 2011. The CDC recommends all women get Tdap vaccines between their 27th and 36th week of each pregnancy.

Newborn whooping cough rates decreased significantly since vaccination of pregnant women began, according to the CDC. Maternal Tdap vaccination prevents more than three-quarters of cases of whooping cough in infants under 2 months of age.

Tdap vaccination during pregnancy dropped off during the COVID-19 pandemic, and the CDC and its partners are working to in-

crease rates.

The CDC said that all people in close contact with infants should be up to date with their whooping cough vaccines.

“Everyone who is pregnant should feel confident in knowing that the Tdap vaccine is safe and effective,” said Dr. Linda Eckert, the American College of Obstetricians and Gynecologists' liaison to CDC's Advisory Committee on Immunization Practices. “Knowing that Tdap vaccination during pregnancy protects 9 in 10 babies from being hospitalized with whooping cough, I strongly recommend this vaccine to all my pregnant patients for their peace of mind and for their family's health and well-being.”

5

Things You Need to Know About Kidney Disease

By Ernst Lamothe Jr.

It’s a condition that arises gradually, but it can cause tremendous pain and affect quality of life. Chronic kidney disease, also called chronic kidney failure, involves a measured loss of kidney function.

A kidney’s function involves filtering wastes and excess fluids from the blood, which are then removed in your urine.

Advanced chronic kidney disease causes dangerous levels of fluid, electrolytes and wastes to build up in your body.

“People should care about kidney disease individually because it is likely to affect someone they know,” said nephrologist Rebecca Levy, an assistant professor of nephrology at University of Rochester Medical Center.

“As a community, we should care about CKD [chronic kidney disease] because it’s expensive. Medicare spent more than $87 billion on treating people with CKD and more than $37 billion on dialysis care,” according to the Centers for Disease Control and Prevention.”

Levy discusses five aspects of kidney disease.

1.Kidney issues for youth and adults

Some common kidney issues that affect children and adults are kidney stones, kidney infections, acute kidney injury and chronic kidney disease. Chronic kidney disease is especially important because more than one in seven US adults — and as many as nine in 10 adults — have the condition.

“In the US, the two leading causes of chronic kidney disease are high blood pressure and diabetes,” said Levy. “Even though most people with CKD will not go on to kidney failure, it can worsen with other health conditions.”

In addition, there are racial, ethnic, and socioeconomic status disparities in both incidence of CKD

and risk of progression to kidney failure that should be considered.

2.Misconceptions

There are various misconceptions when it comes to the condition. Sometimes people consider the word chronic and believe it means severe. In actuality, it means long term. Chronic kidney disease progress slowly and people may not notice for some time until their kidneys are seriously damaged.

“What I have come across is that people think kidney disease is rare. But, as I mentioned earlier, it is not,” said Levy. “Also most people with chronic kidney disease don’t feel sick and have normal levels of urine output. The only way for most people to know they have CKD is to have blood and urine testing.”

Serving Men, Women

3.Kidney disease signs

Children

There are very few signs of early or moderate CKD that only blood or urine testing will show. In very advanced CKD, people may experience the symptoms of toxin buildup, confusion, loss of appetite or foul taste, nausea and vomiting, or itching. They may also notice the effects of fluid accumulation, including leg swelling and shortness of breath.

“Kidney stones are usually present with flank pain and blood in the urine. People suffering from kidney infections may have fever, vomiting and pain with urination,” she added.

4.Family history

Some kinds of kidney disease are directly inherited on a single gene, like polycystic kidney disease. Other kidney diseases come about as a combination of many genes in addition to environmental factors, which also tend to run in families.

“The two main causes of kidney disease in the US, hypertension and diabetes, also run in families. For all these reasons, we often see a family history of CKD,” said Levy.

She added the best things you can do to avoid kidney problems are likely the same things you do for the rest of your health. Eat a balanced diet that includes more plants than animals. Try to get moderate exercise most days of the week.

“If you already have hypertension or diabetes, follow your doctor’s advice and prescriptions to control these diseases as tightly as possible. Don’t smoke and maintain a normal body mass index. Ask your doctor if you should be tested for CKD,” she said.

5.How does dialysis work?

Dialysis is a procedure that replaces kidney function in people

with kidney failure. It doesn’t fix the kidneys themselves. Dialysis gets rid of the extra fluid. You can get dialysis treatments in a number of different ways: blood dialysis or belly dialysis (peritoneal dialysis), in a dialysis center or at home. They all serve the same purpose and work equally well to do that.

Nephrologist Rebecca Levy, an assistant professor of nephrology at University of Rochester Medical Center.

Be a Savvy Health Care Consumer

Managing your health care, or the care of a loved one, can be overwhelming, especially if complex medical conditions are involved, or the list of providers and prescriptions is long. Here are easy ways to keep it all under control.

• Get organized. “Create a health care binder with the names and contact information for your health insurer, each provider you see, and the pharmacy and lab you use,” says phsycian Mark Brown, medical director at Excellus BlueCross BlueShield. He recommends a three-ring binder so you can add and remove pages. Pick one that is brightly colored and label it clearly so it stands out from your other important documents. Include a calendar and extra pages so you can keep a running log of office visits and topics covered.

If you have a family member or trusted friend who assists with health care paperwork or transportation to appointments, show them your binder and explain your record keeping system. It’s good to have backup.

• Get connected. Create a member login for your insurer’s website and download the mobile app if it has one. Establish accounts with each of your providers’ online patient portals. These tools provide easy two-way communication with your care team and allow you to receive email and text reminders about appointments, screenings, and even lab results. Store the usernames and passwords in your binder.

“Make sure your providers are connected with each other by consenting to Rochester RHIO (Regional Health Information Organization),

Could You Have a Thyroid Problem and Not Know It?

By Jim Miller

If your thyroid is out of whack, it can cause a number of health issues that can be tricky to detect because the symptoms often resemble other age-related health problems. In fact, as many as 30 million Americans have some form of thyroid disorder, but more than half aren’t aware of it.

What to Know

The thyroid is a small butterfly-shaped gland located at the base of your neck that has a huge job. It produces hormones (called T3 and T4) that help regulate the rate of many of your body’s activities, from how quickly you burn calories to how fast your heart beats. It also influences the function of the brain, liver, kidneys and skin.

If the gland is underactive and doesn’t produce enough thyroid hormones, it causes body systems to slow down. If it’s overactive, and churns out too much thyroid, it has the opposite effect, speeding up the body’s processes.

The symptoms for an underactive thyroid (also known as hypothyroidism) — the most common thyroid disorder in older adults — will vary but may include fatigue and weakness, unexplained weight gain, increased sensitivity to cold, constipation, joint pain, a puffy face, hoarseness, thinning hair, muscle stiffness, dry skin and depression.

Some patients may even develop an enlarged thyroid (goiter) at the base of the neck. However, in older adults, it can cause other symptoms like memory impairment, loss of appetite, weight loss, falls or even incontinence.

And the symptoms of an overactive thyroid (or hyperthyroidism) may include a rapid heart rate, anxiety, irritability, fatigue, insomnia, increased appetite, weight loss, tremors of the hand, frequent bowel movements, sweating, as well as an enlarged thyroid gland. Too much thyroid can also cause atrial fibrillation, affect blood pressure and decrease bone density, which increases the risk of osteoporosis.

the Finger Lakes region’s secure health information exchange,” says Brown. “Ask your provider to supply you with the form.” Rochester RHIO supports authorized medical providers and over 1.5 million residents in over 14 counties across Upstate New York including Monroe, Livingston, Ontario, Seneca, Wayne, and Yates counties. Consenting allows your medical care team to securely share records across connected institutions and practices, making your patient information available wherever and whenever needed for your care.

• Get support. Anyone, at any time, could need someone they trust to get involved in their care. Add a family member or friend to your caregiver team by signing HIPAA authorization forms allowing your providers to share information with them. “Having that extra set of ears will help ensure that you clearly understand your provider’s instructions,” says Brown. He also recommends patients select a health care agent to make decisions on their behalf if they are unable to speak for themselves. This is done by completing a health care proxy form, available from any health care provider.

Keep a copy in your binder and share copies with family members.

“Managing your health care can be so much easier if you follow these simple suggestions,” encourages Brown. “You can do this!”

For more health and wellness information visit ExcellusBCBS.com.

Those with the greatest risk of developing thyroid disorders are women who have a family history of the disease. Other factors that can trigger thyroid problems include: autoimmune diseases like Hashimoto’s or Graves disease; thyroid surgery; radiation treatments to the neck or upper chest; and certain medications including interferon alpha and interleukin-2 cancer medications, amiodarone heart medication and lithium for bipolar disorder.

Get Tested

If you have any of the aforementioned symptoms, or if you’ve had previous thyroid problems or notice a lump in the base of your neck, ask your doctor to check your thyroid levels. The TSH (thyroid-stimulating hormone) blood test is used to diagnosis thyroid disorders but depending on what they find, additional blood tests may be necessary.

If you are diagnosed with a thyroid problem, it’s easily treated. Standard treatment for hypothyroid-

ism involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid and others), which is an oral medication that restores adequate hormone levels.

And treatments for hyperthyroidism may include an anti-thyroid medication such as methimazole and propylthioracil, which blocks the production of thyroid hormones. Another option is radioactive iodine, which is taken orally and destroys the overactive thyroid cells and causes the gland to shrink. But this can leave the thyroid unable to produce any hormone and it’s likely that you’ll eventually become hypothyroid and need to start taking thyroid medication.

For more information on thyroid disorders, visit the American Thyroid Association at Thyroid.org.

Mark Brown, MD

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

Where Refugees Are Welcome

Adults and families from about 60 countries turn to The Center for Refugee Health for treatment

By Mike Costanza

Zahraa Alnuaimi remembers how she felt in 2015, when she came to Rochester to escape the dangers of life in Baghdad.

“It was a huge difference being…away from family, away from everybody, starting again,” said the 43-year-old Iraqi.

Alnuaimi has gone on to make a new life for herself and her two children in Rochester. The Center for Refugee Health, a part of Rochester Regional Health, has helped her make that journey.

“Its general mission is to meet the needs of refugees locally, to introduce them to health care, to establish them with a primary care practice [and] to provide them with a lot of the social determinants of health they need to be successful,” said Tonya Erdle, a family nurse practitioner who has been with the center since 2018 and counts Alnuaimi as a patient.

Alnuaimi is just one of the approximately 5,000 refugees who currently turn to The Center for Refugee Health for medical care, case management services, help with mental health issues and other assistance. Though 40% of the center’s current patients are from the South Asian countries Bhutan and Nepal, the organization also serves those from the Democratic Republic of the Congo, Somalia, Iraq, Syria, Afghanistan, Cuba, Ukraine and many other parts of the world. All have made their way to the center through local refugee resettlement programs, such as the one run by the Catholic Family Center.

During their first two visits to The Center for Refugee Health, new patients are given any immuniza-

tions they need and screened for identifiable medical conditions.

“We go from those two visits identifying anything that we have to, whether it’s like a metabolic disease process or anemia or a vitamin deficiency, post-traumatic stress, all kinds of different abuse,” Erdle said.

Some of those diseases and conditions are endemic to their home countries.

“We get a lot of different GI [gastrointestinal] parasites and bacteria,” Erdle said. “A lot of it has to do with clean water availability.”

Many incoming patients have had little experience with modern medical systems.

“A lot of our patients aren’t familiar with a primary care system,” Erdle said. “They have little or no health literacy.”

Whether they are new or in treatment, patients may have needs that can’t be met by medical care.

“They struggle with everything,” Erdle said. “Complicated social issues and dynamics within their families, housing problems, other resource problems like clothing, food, all types of things.”

Finally, those the center serves may not speak English and sometimes have customs or social mores that could hinder their treatment. For example, men from Middle Eastern countries might not be comfortable being treated by or interacting with female medical personnel.

The Center for Refugee Health tackles those challenges by a variety of means. Some of its 20-or-so employees speak multiple languages, and offsite interpreters are available when a patient’s language is not

Zahraa Alnuaimi, a refugee from Baghdad in Iraq, moved to Rochester in 2015 seeking a new life. One month after she and her family arrived, they became patients of The Center for Refugee Health in Rochester. “I wasn’t feeling I’m alone anymore,” she says. “They were listening, they were helping.”

among those spoken in-house.

In addition, Erdle and the center’s other staff educate themselves about their patients’ cultures and strive to develop the kinds of relationships with them that facilitate treatment.

“A lot of it’s really us just taking our time and getting to know the patients,” Erdle said. “Not just in the health context, but also their family context, their cultural context, their social context.”

Many of the center’s medical staff are board-certified in family medicine, and most treatment is given in-house.

“We tend to treat the whole family,” Erdle said. “My youngest patient this week was 2 days old. My oldest was 91.”

When necessary, the center refers patients to outside specialists. Though the facility once had a therapist who treated mental health issues, it now refers patients to offsite mental health treatment providers. Two social workers stand ready to arrange such services and help patients obtain the housing, food and other resources they need.

Alnuaimi was living in Baghdad when conditions forced her, her husband, their two children and her brother, Karam, to leave Iraq. She had once worked for the US embassy, her brother was an American-trained pilot who had worked for the Iraqi army and all in her family are Sunni Muslims. After US forces withdrew in 2011, both ISIS and the Shiite-dominated government began watching the family and they came to fear for their lives. They managed to escape

Tonya Erdle is a family nurse practitioner who has been with The Center for Refugee Health in Rochester since 2018. “[Our] mission is to meet the needs of refugees locally, to introduce them to health care, to establish them with a primary care practice [and] to provide them with a lot of the social determinants of health they need to be successful,” she says.

to Jordan in 2014.

Karam was denied permission to emigrate to the US and has since died. Alnuaimi, her husband and their children secured permission to come to America and arrived in Rochester in September of 2015.

“We came over here with no money, nothing at all, only ourselves and our clothes,” Alnuaimi said.

One month after she and her family arrived, they became patients of The Center for Refugee Health. Alnuaimi soon came to feel secure with its staff.

“I wasn’t feeling I’m alone anymore,” she said. “They were listening, they were helping.”

In addition to seeking medical care for herself and her family, Alnuaimi turned to the center’s therapist for mental health treatment and support when her husband became abusive.

“She used to make a lot of time for me,” Alnuaimi said. “Sometimes when I feel I need to run away from home, I had issues with my ex, I would go there even without an appointment.”

Alnuaimi eventually divorced her husband and now lives in Rochester with her boyfriend and her two children.

“I’m doing very well. I’m working full-time job. I have my own house. I have my own car. My kids are having fun,” she said. “We’re having amazing life.”

For more information go to: www.rochesterregional.org/Locations/Alexander-Park/The-Centerfor-Refugee-Health

Dental Work for Less

‘Turkey teeth’ and other dental tourism may cost less but present risks, say local providers

By Deborah Jeanne Sergeant

The desire for a perfectly symmetrical, snowy-white smile seems to have become even greater in recent years, giving rise to “dental tourism,” in which Americans travel to other countries for cosmetic dental work, like whitening and veneers.

Typically not covered by dental insurance, these procedures are much less expensive in many other coun-

tries.

Turkey has become a particular destination.

It offers procedures at 50% to 70% off the cost of US-based providers. One procedure in particular has become widely reported on social media, known as “Turkey teeth,” in which patients have entire rows of teeth treated to result in an instant Hollywood-worthy smile.

Local providers warn that non-domestic work can lead to unwanted outcomes.

Kami Sobey, dentist at Finger Lakes Dental Care in Canandaigua, said she can’t assess the quality of the work done in other countries or if it would be any different from here.

“When you have major work done, follow-up care needs to happen. If you’re having something done in a place where it makes follow-up unrealistic, you’re taking some chances.”

The quality of the work, hygienic and safety practices of the dentist and the materials used may not meet the same standards as in the US.

American dentists must be licensed to practice and complete a specified level of education.

“If price is the guiding factor, it’s buyer beware,” Sobey said. “You may get what you pay for. If you’re chasing a cost, beware that the quality may be the same.”

In particular, the “Turkey teeth” procedure is not advisable. It may involve shaving off a thin layer of enamel to fit a veneer to the teeth— the typical method for applying veneers—but some Turkish providers remove up to 70% of the enamel to completely crown the teeth. The provider grinds down the patient’s natural teeth to tiny nubs before the crowns are applied.

“Any kind of dentistry has longevity, whether minimally invasive or not, when done to healthy teeth,” Sobey said.

She encourages anyone considering cosmetic dentistry to completely

Turkey has become a particular destination.

Dentists at this country offers procedures at 50% to 70% off the cost of US-based providers. One procedure in particular has become widely reported on social media, known as “Turkey teeth,” in which patients have entire rows of teeth treated to result in an instant Hollywoodworthy smile.

understand the procedure, know the provider, obtain references and seek a few different opinions before proceeding.

“Don’t base it solely on hearsay through the internet; talk to your local dentists,” she added.

Veneers and crowns need replacing over time, losing so much enamel as in the case of Turkey teeth can shorten the natural teeth’s longevity.

Paul Sussman, dentist and co-owner of Center for Cosmetic Dentistry in Rochester said that the lifespan of a crown may be as short as seven years.

“Once this has to be replaced, there will be very little to work with,” Sussman said.

Because a Turkey teeth procedure may leave little enamel, it can damage the nerve of the tooth, causing extreme pain and increase the risk of extraction shortly after the procedure.

Sussman said that there’s also the danger that shoddy work can allow saliva, bacteria and food to leak under the restorations, which can break down the natural teeth.

Sussman has treated patients who have received treatment overseas and without knowing what material was used, correcting or repairing their teeth may be more challenging.

“I’ve had patients go to Mexico,” he said. “Maybe they get it done quickly. When we do treatments, we want it to look natural, not like Chiclets. We don’t want people to know you’ve had anything done to your teeth like it’s artificial. Typically, when patients go out of the country, they come back with white, Chiclet-looking things that don’t look natural.

“Natural teeth have surface texture and slight variations of color, so it looks natural.”

Sussman encourages patients who want to improve their smile to talk with their dentists about affordable options, such as replacing a silver filling with a natural-looking one, whitening or recontouring. A combination of procedures can dramatically improve appearance. Sussman also sometimes applies veneers a few at a time to help patients spread out the cost.

Most dentists and orthodontists provide installment plans to help patients better afford care.

Cheap Dental Treatment Overseas

So why are dental procedures so inexpensive in Turkey? According to www.dentalhubatalya.com, a Turkish website about dental care:

• The currency: Lira, Turkey’s currency has a lower value than the pounds, euro or dollars. This ensures those with strong currencies obtain dental care at a very cheap price due to the exchange rate.

• Cost of living: Owing to the low value of the country’s currency, living in Turkey is more affordable than in most European countries. There’s the low cost of material, low cost of labor and cheap structures, all of which impacts the overall cost of getting a dental veneer, making it cheap.

• Government incentives: Turkey has recognized the potential of medical tourism and is tapping into it, investing heavily in the development of the sector. To help boost the sector, the government offers incentives such as monetary aid, loans, tax reductions and so on.

• High competition: There are a lot of dental clinics in Turkey. The competition keeps the prices lower. And with the number of foreign patients always coming in, most clinics can afford to maintain the standard while lowering the price.”

We’ve got your back, so you can have theirs.

Most screenings and immunizations are no cost when you visit a participating plan provider.* Common preventive services include:

• Annual routine checkup

• Well-woman visit

• Well-child visit

• Immunizations

• Mammography screening

Nearly 2 Million New Cases of Cancer Expected in 2023

American Cancer Society states we will likely see about 609,820 deaths as a result of cancer

By Deborah Jeanne Sergeant

In January, the American Cancer Society published its annual cancer outlook statistics

Among the findings, the society stated that in 2023, 1,958,310 new cancer cases and 609,820 cancer deaths are projected to occur in the United States.

Other findings include:

• Prostate cancer increased by 3% annually from 2014-2019 after declining for two decades, which means 99,000 new cases.

• Lung cancer in women decreased at one-half the pace of men, 1.1% vs. 2.6% annually between 2015 and 2019.

• Cancers of the breast, uterine, liver and melanoma increased.

• Cervical cancer decreased by 65% between 2012 and 2019 among women in their early 20s.

• The death rate of cancer declined by 1.5% between 2019 and 2020, contributing to an overall 33% reduction since 1991, an estimated 3.8 million deaths averted.

• Cancer is still the second-leading cause of death in the US.

Heredity plays a role in 5%-10% of all cancers, according to the National Cancer Institute. Health habits can reduce the risk of many kinds of cancer.

Sarah Merritt, project coordinator with Wilmot Cancer Center’s Com-

munity Outreach and Engagement Office, said that although one cannot select his genes, “think of lifestyle factors, which you can control.”

One important factor is bodyweight. Merritt said that obesity contributes to the risk for pancreatic, liver, colorectal, esophageal, endometrial, kidney and post-menopausal breast cancer.

“There’s a combination of factors,” she added. “When you have excess bodyweight, you often have high blood pressure, gallstones, breathing problems, heart disease, Type-2 diabetes and other conditions that stress the body. That can hinder your cells’ ability to repair.”

In addition, the extra weight is associated with hormone release, which Merritt said can spur cancer growth.

To help control both weight and hormone levels, Merritt said to engage in 150 minutes of moderate physical activity or 75 minutes of vigorous activity per week.

Moderate activity could include walking, dancing, gardening or biking. Jogging, running, aerobic dance, swimming laps or shoveling snow all represent vigorous activity.

“Being physically active reduces risk of breast, colon and endometrial cancers,” Merritt said. “It can also improve survival rate if diagnosed

How Many Calories a Day Can Safely Spur Weight Loss?

The key to losing weight sounds simple — eat less.

Regardless of the diet you follow, dropping the pounds means burning more calories than you eat.

That begs the question, how many calories should I eat to lose weight?

According to the U.S. National Library of Medicine, for most people, cutting about 500 calories a day is a good place to start. If you can eat 500 fewer calories every day, you should lose about a pound a week.

Another easy way to figure out how many calories you should eat is to multiply your weight by 15, Harvard Health advises. That number will give you the number of calories you need to maintain your current weight. To lose weight, simply cut that number.

But counting calories isn't enough, says Samantha Heller, a nutritionist at NYU Langone Health

in New York City.

"Everyone wants a quick fix, but weight loss is not an overnight proposition. We do not gain weight nor will we lose weight quickly," she said.

"If you want to lose 10 pounds, one important tool is keeping a food diary," Heller said. Keep track of everything you eat for five to seven days. Then review your food record.

See where you can cut back on sweets, snacks, large portions and alcohol. Let those discoveries help you make a plan for losing weight.

How to cut calories in a healthy way

"Many of us need support and structure to help us on our journey, so programs like Weight Watchers or seeing a registered dietitian may be helpful," Heller said.

You can lose weight by eating

with cancer.”

Diet is also important. Reducing processed, sugary, saturated and trans-fat and salty foods and increasing whole grains, legumes, lean sources of protein, fruits and vegetables “helps improve your immune system,” Merritt said.

Whole grains and whole fruits and vegetables are rich in fiber, which promotes a healthy digestive system so cell-bolstering nutrients are more readily absorbed.

Although a few minutes of sun exposure weekly and vitamin D supplementation can help ensure sufficient vitamin D levels, too much sun exposure raises risk for skin cancer.

“If you’re out in the sun, wear 30 SPF sunscreen,” Merritt said. “It’s a really simple way to reduce your risk of getting skin cancer.”

Wearing broad-brimmed hats, sunglasses and protective clothing also helps.

Cancer screenings can prevent cancer from developing in the case of colon cancer because providers can remove polyps before they become cancer. Self-exams and screenings can also catch cancer early, when it is most treatable.

Merritt wants people to talk with their physician about when to start screening, as some people with family history of cancer may be advised

to start earlier than others. Cancer screenings are available for breast cancer, cervical cancer, lung cancer, colorectal cancer and prostate cancer, among others.

William Dahut, chief scientific officer with the American Cancer Society, said that 42% of cancers are preventable.

“If this was a new drug it would be truly incredible,” Dahut said.

In addition to seeking appropriate screening, exercising and maintaining a healthy weight, he encourages people to eliminate or minimize alcohol.

“Alcohol can cause direct damage to cells and tissues and impact hormone levels increasing the likelihood of cancer,” Dahut said.

Ceasing tobacco use also lowers the risk for many kinds of cancer— not only lung cancer.

“Tobacco is made of thousands of chemicals, including at least 70 that cause cancer,” Dahut said.

The website nysmokefree.com and most healthcare providers offer free tools and resources to support smoking cessation for those who want to quit.

anything as long as you are consuming fewer calories or burning more calories than you were previously.

"But it is far more important to be healthy, not skinny, and to find a sustainable lifestyle," Heller said.

How to eat healthy?

Eat more vegetables such as car-

rots, tomatoes, broccoli, spinach, lettuces, peppers and kale; add legumes such as kidney, pinto, white beans, lentils, split peas and edamame; use whole grains including whole wheat, oats, farro, quinoa and brown rice; and include some daily fruits and nuts, Heller said. Replace high-calorie foods with low-calorie, healthier alternatives.

William Dahut

By Anne Palumbo

SmartBites The skinny on healthy eating

How Avocados Improve the Health of Your Skin

At this time of year, when my skin is as dry as dust, as flaky as shredded wheat, and as supple as wood, I’m always on the lookout for foods that boost skin health. Lucky for me, a standout food that promotes healthy skin is also one of my favorite fruits: avocado.

In a recent study at UCLA Center for Human Nutrition, researchers concluded that daily avocado consumption could lead to improved elasticity and firmness in the facial skin of healthy individuals.

According to Zhaoping Li, Ph.D., chief of clinical nutrition at UCLA,

helps to moisturize and soften skin, as well as increase elasticity and reduce the appearance of wrinkles. One study of over 700 women concluded that a high intake of fat—especially monounsaturated fat—was linked to more supple, springy skin.

Avocados teem with two skin-preserving vitamins: vitamin C and vitamin E. Both are powerful antioxidants that help protect skin cells from damage caused by environmental stressors, like sunlight, air pollution, and cigarette smoke. What this could mean for us avocado-aficionados—in the best-case scenario—

Helpful tips

Ready-to-eat avocados should dent when slightly squeezed. If hard, place in direct sunlight or in a sealed paper bag to speed ripening. Once ripe, they can be refrigerated for up to a week. Avocados quickly turn brown once exposed to air. Although unappetizing to see, the brown flesh is perfectly safe to eat. To slow or reduce browning, try these tips: cover the flesh with lemon or lime juice or wrap tightly with plastic wrap and store in the refrigerator.

For the dressing:

3 tablespoons fresh lime juice (2 small limes)

2 tablespoons olive oil

2 teaspoons honey

2 cloves garlic, minced

½ teaspoon kosher salt

½ teaspoon black pepper

In a small bowl, whisk together the dressing ingredients: lime juice, olive oil, honey, garlic, salt, and pepper.

In a large bowl, place the cucumbers, onions, tomatoes, avocado, half of the feta, and cilantro. Pour the dressing over the top, then gently stir to combine. Sprinkle the remaining feta over the top. Enjoy immediately or cover the bowl with plastic wrap and refrigerate for up to 4 hours (stir just before serving).

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

The State of Opioid Abuse — How

Bad Is It?

Deaths by overdose still going up in Rochester, year after year

Three years ago, area experts could only guess the effects of the pandemic on the area’s opioid abuse problem.

Early data recently released in a report by the Office of the Medical Examiner Monroe County show that the number of opioid-related deaths in Monroe County increased by 62% between 2019 (181) and 2021 (293).

The increase represents an upward trajectory from the previous several years, a trend that the report from the Office of the Medical Examiner Monroe County associated with fentanyl use.

“Fentanyl remains by far the most common opioid associated with overdose deaths,” the report said.

“Fentanyl and analogs were present in 97.6% of these opioid deaths in 2021. In contrast, the heroin and morphine prevalence continued a sharp decline from its peak in an earlier wave of the opioid crisis, from 42.3% in 2017 to 5.8% in 2021—having been superseded and largely replaced by the more potent fentanyl in recent years. Only four (1.4%) of the overdose deaths contained heroin and morphine in the absence of fentanyl, consistent with 2020.”

This is largely because those using drugs are now aware of the presence of fentanyl in any given dose. Its extreme potency contributes to accidental overdoses.

Ashley Tomassini, coalition coordinator for Substance Abuse Prevention Coalition of Ontario County and The Partnership for Ontario County, said that opioid use continues to be a big problem for the county, despite less airtime given to opioid use lately.

“The pandemic happened and it took a lot of people’s attention away from opioids,” Tomassini said. “Opioids are still an issue we’re looking to address. It’s a key part of our prevention strategies.”

These efforts include encourag-

By Deborah Jeanne Sergeant

ing residents to monitor their supply of medication, secure them and dispose of them properly. Providing medication drop boxes and anonymous “take back” events in coordination with the Ontario County Sheriff’s Department has helped curtail the flow of legal medication into misuse.

“We are reducing the access,” Tomassini said.

She said that the Ontario County Sheriff’s Office has begun administering Sublocade (buprenorphine) to individuals who are incarcerated and have opioid or heroin use disorder. A monthly injection appears to help them remain abstinent from drugs.

“We continue to experience the worst overdose crisis in the history of the nation, which is devastating individuals, families and communities,” said Evan Frost, assistant director of communications and public information for the New York State Office of Addiction Services and Supports in Albany. “Fentanyl continues to be a major factor in overdoses and deaths in New York state. In 2021, the vast majority of overdoses involved synthetic opioids like fentanyl. The main danger from fentanyl is that it is often added to a substance without the user’s knowledge, which can substantially raise the risk of an overdose since the person using the substance has not built up a tolerance.”

Administering naloxone (such as Narcan) to counter the effects of an opioid overdose is saving lives. In 2020, emergency medical services in Monroe County administered naloxone 695 times, 623 in 2021 and through the third quarter of 2022 (the most recent data available), 409 times. Law enforcement personnel also administered naloxone 71 times through the same time period and the Registered Community Opioid Overdose Prevention program

reported 393 events. Actual numbers may be higher, as not all events are reported.

Ontario County experienced a decrease in overdose deaths. In 2017, 30 died by overdose of an opioid, but by 2022, that number was halved. Just as with Monroe County, naloxone may indicate part of the reason why. Emergency medical services administered the life-saving medication 76 times in 2020, 69 times in 2021 and 21 times by the end of the third quarter in 2022, the most recent data available. Law enforcement personnel also administered naloxone 45 times through the same time period and the Registered Community Opioid Overdose Prevention program reported 27 events. Actual numbers may be higher, as not all events are reported.

Statewide, the introduction of telehealth and mobile treatment in recent years has helped reach people who may otherwise not have accessed services.

“These initiatives have allowed us to meet people where they are and deliver individualized, person-centered services to meet their needs,” Frost said. “We are also collaborating with the office of Mental Health on efforts to treat co-occurring substance use and mental health disorders, including through certified community behavioral health clinics, which provide an array of coordinated services to address substance use and/ or mental health, and crisis stabilization centers, which provide support, assistance and urgent access to care for individuals experiencing a crisis situation related to substance use and/or a mental health condition. We plan to build on these efforts in the coming year.”

Frost said that OASAS will continue with street level outreach teams, outreach and engagement services, shelter in-reach programs

In 2021, there were 6,037 overdose deaths in New York State. This is an increase of approximately 101% since 2015.

and ensuring providers have access to naloxone and fentanyl test strips. The strips can help a person using opioids know if fentanyl is present.

“Other harm reduction programming is included in these efforts,” he added.

OASAS also plans to “improve treatment equity. Historically, addiction treatment has not been as available to minority communities,” Frost said.

On Feb. 8 this year, New York state announced it will make available to 18 providers statewide $8.6 million to develop integrated outpatient treatment initiatives targeting opioid use. The money comes from a more than $2 billion fund received from settlements with opioid manufacturers. Some of the fund will be distributed to municipalities and the rest to support opioid programs.

The New York State Department of Health recently reported that in 2021 statewide:

4,766 overdose deaths involving opioids, a 14% increase over 2020.

10,430 outpatient emergency department visits due to opioid overdoses, a 12.6% increase over 2020.

19,139 instances of naloxone being administered by emergency medical services, an 11.8% increase over 2020.

Anyone struggling with addiction or a family member can call the HOPEline 24/7 at 1-877-8-HOPENY (1-877-846-7369) or by texting HOPENY (Short Code 467369).

NYS OASAS treatment availability dashboard at FindAddictionTreatment.ny.gov or through the NYS OASAS website, www.oasasd.ny.gov, lists treatment options.

Anyone struggling to file a claim or who has been denied a claim can contact the CHAMP helpline at 888614-5400 or ombuds@oasas.ny.gov.

Emerging Drug ‘Tranq’ Making Inroads in Rochester Region

Drug used as horse tranquilizer increasingly seen in cases of opioid overdose deaths

By Deborah Jeanne Sergeant

Since 2021, a newcomer to substance abuse disorder has been making inroads in the area: xylazine.

Known as “tranq” on the street, the horse tranquilizer is not FDA approved for use in humans and is not under the jurisdiction of the Controlled Substance Act.

It is available as a veterinary sedative under the brand names of Rompun, Sedazine and AnaSed.

“Tranq or xylazine is not routinely tested for in toxicology testing or by medical examiners, so we are not able to speak to its overall prevalence in New York state,” said Evan Frost,

assistant director of communications and public information with the New York State Office of Addiction Services and Supports in Albany. “We do know that it has been found in testing conducted in New York City and there have been instances of wounds and skin ulcers related to xylazine in other regions of the state, so we know it is also outside of New York City in some capacity.”

According to a report by the Office of the Medical Examiner Monroe County, xylazine “has also appeared frequently in opioid overdose deaths, taking off notably in 2021 with 19.1% of the cases containing this com-

Is Vaping the Cigarette for the Next Generation of Those Addicted to Nicotine?

By Jennifer Faringer

During the pandemic, there were increases reported across several drugs of misuse among youth to include alcohol, marijuana and nicotine in the form of vaping. School districts are continuing to struggle with how best to effectively respond to the increase in vaping not only among teens, but also pre-teens and more recently among elementary school-aged youth.

Key findings from the 20212022 School Year Monroe County Youth Risk Behavior Survey (YRBS) pertaining to vaping among youth include:

• 3% of students reported vaping

• 43% of students who vaped in past 12 months reported quitting and no longer vape

• 22% tried to quit and but still vape

• 81.5% reported they think vape products are addictive

https://www.monroecounty. gov/files/health/health-action/ MC%20YRBS%202021-22%20FINAL. pdf

When students were asked why they use, over 28 percent said to destress, 14 percent to get a nicotine buzz, nearly 14 percent vape because their friends vape, and eight percent said they have experienced cravings and are unable to quit.

Big tobacco has once again nor-

malized use with electronic cigarettes or vapes, creating trendy and attractive products with multiple flavors that attract youth.

"Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes,” said Centers for Disease Control Director Tom Frieden, M.D., M.P.H.

Despite the many myths surrounding electronic nicotine devices or vapes, they are:

• Not proven to be safe

• Not proven effective as nicotine replacement therapy

• Not harmless water vapor

• Addictive, can harm brain development

• Harmful not only to the individual using but also harmful as secondhand smoke and vapor

• Used to vape not only nicotine, but also marijuana and its high potency concentrates

The more recent fourth generation vape products are far more potent than the earlier versions, containing as much as 50 to 65 percent or more of nicotine (similar to three to four packs of cigarettes) and are therefore far more addictive. High potency nicotine is not the only risk with vape products as they also contain propylene glycol, lead,

pound.”

The report further stated that xylazine is most often used as a cutting agent for illegal fentanyl mixes. A cutting agent is a cheap and readily available drug — xylazine in this case — mixed with the more expensive and harder to obtain drug such as fentanyl.

Sometimes cutting agents heighten the effect of the more expensive drug. With xylazine, the unintended effects can include bradycardia (slow heart rate), blurry vision, central nervous system depression, unsteady gait, slowed or stopped breathing, low blood pressure, hypothermia, high blood glucose levels, severe withdrawal, pinpoint pupils, necrotic skin ulcerations (may occur at other areas beside injection site with repeated exposure), coma and death. Because xylazine is a sedative, it is sometimes combined with stimulants like methamphetamine and cocaine.

use synthetics in opioids to increase the high and it can be fatal. I haven’t seen a ton of tranq in Western New York, but every use is a chance they’ll overdose.”

Ontario County has not seen rampant use of xylazine so far.

“As with everything, we get new information as it emerges,” said Ashley Tomassini, coalition coordinator for Substance Abuse Prevention Coalition of Ontario County and The Partnership for Ontario County. “Some evidence shows that it is in Ontario County. It’s possible that it’s not widely used at this point.”

Because of the many equine businesses and farms in Ontario County, it may be easier to access xylazine.

“It’s something we’re going to assess and keep monitoring,” Tomassini said.

Because xylazine is often used to cut fentanyl and other drugs, it may be even more dangerous than

Addiction

Rachel Mahar: A Professional in Substance Abuse Prevention

By Deborah Jeanne Sergeant

Currently serving as director of the prevention program at The Community Place of Greater Rochester, Inc. in Rochester, Rachel Mahar had always been interested in this field.

A Canandaigua native, she remembers when pain pills became a popular recreational drug.

“I saw a lot of people go through horrible things and I wanted to join a field where I could help those people and their families,” she said.

After completing an associate degree in addiction counseling at Finger Lakes Community College in 2007, she worked in treatment at Finger Lakes Addiction Counseling and Referral Agency, headquartered in Clifton Springs. Eventually, she decided that prevention was a better fit for her. She began working at Community Place in 2010 as a prevention counselor.

“I had never done prevention before, so it was very different in terms of working with youth in the city of Rochester with the goal of giving them the skills to refuse the pressure to use drugs or alcohol,” Mahar said.

Her early experiences there convinced her she made the right move.

Mahar finished a bachelor's in human services through Empire State College in 2012 and passed an exam through the New York State Office of Addiction Services and Supports (OASAS) to become a credentialed prevention professional. As she progressed in her experience and knowledge, she received a promotion to prevention manager in 2016 and this year to director of prevention.

In the 1980s

and ‘90s, prevention was all about telling youth to say no to drugs and exposing them to the negative outcomes of substance abuse through testimonials and graphic images.

Prevention has changed a lot since then.

“Prevention uses a framework to use evidence-based curriculum, programs that have proven efficacy of having a positive impact on the individuals you’re delivering it to,” Mahar said. “We want to address the risk factors adolescents are facing and help them build skills to overcome those, like decision making and choosing the right friends.”

These programs can vary by community. For some communities, the program must address the effects of witnessing violence so that youth build resilience and do not choose to use substances as a coping mechanism.

Mahar said that a 2019 youth risk behavioral study in the Rochester City School District indicated that 30% of respondents had witnessed some-

one being stabbed, beaten or shot. Teaching young people healthy ways to cope with that trauma can help them resist drugs and alcohol.

Mahar said that the pandemic caused an uptick in marijuana abuse and also emotional difficulties as children began adjusting to going back to school. Many have needed additional emotional support in this transition.

“It’s still hard to get them in the rhythm of how to behave in school and how to better themselves,” she said. “This also affected the adults in their lives.”

Although the pandemic did increase access through telehealth, which health insurers still cover, Mahar believes that “in-person contact with a counselor is really beneficial for most young people,” she said.

Since she started in the field, Mahar has observed a shift from addressing substance use with teens to beginning at the kindergarten level. But it’s not so much education about drugs or mental health but “focusing on enhancing the youth’s skills and helping them with things they might not even realize they need help with.”

Mahar hopes to continue her education with a master’s degree, as it’s been a decade since she attended college. She also hopes to continue to grow the programming at Community Place to “reach as many youth as we can,” she said.

“I like the feeling that you are making a difference, even if you reach one student. It’s better than zero. I like seeing my counselors come back with energy and feeling they’re making an impact on the community.”

Rachel Mahar is the director of the prevention program at The Community Place of Greater Rochester, Inc. in Rochester.

Q & A with Andriana Lozier

Mental Health Association VP discusses the organization’s mission, highlights its peer support treatments

By Mike Costanza

Q: Please tell us about your position at Mental Health Association of Rochester/Monroe County Inc.

A: I am the vice president of operations, which means I oversee the day-to-day flow of the agency. It is my responsibility to ensure that all of our programs and community initiatives are consistent with the overall mission of our organization.

Q: What does peer-led, peer support mean?

A: Peer support is what sets us apart from other mental health agencies. A peer-led supportive relationship is one between people who have shared mental health experience. A majority of our employees identify as peers and are the ones who deliver our services. Combined with skills often learned in formal training, their experience puts them in a unique position to offer support. Our employees all model recovery, share their knowledge and relate in a way that have made this evidence-based practice rapidly grow in the field.

Q: What makes peer support effective?

A: In all areas of life, no matter what your background may be, we know relationships are crucial to well-being. We may call friends in hard times or we may seek support groups for people who’ve experienced similar challenges like chronic disease or loss of a loved one. In the same way that we reach out to someone who we think will

understand, peer specialists can provide that understanding during a time when many feel alienated and hopeless. They provide an important connection and hope that recovery is possible.

Q: Can you describe the broad scope of MHA services?

A: The programs we offer include: life skills, creative wellness opportunities, employment support services, family support services and transitional coaching. We also have our self-help drop-in center which offers support and crisis intervention, from 5-9 p.m., seven days a week. If anyone is interested in becoming a certified peer, and believes they best thrive in a classroom setting, we also have our peer training academy. Our programs aim to provide support, diverse resources and help develop social-emotional skills. This empowers individuals to make informed decisions about their path to mental wellness.

Q: What are the agency's biggest challenges?

A: In general, I don’t think it’s emphasized enough in public health services just how much the implementation of peer support services can significantly impact a person’s wellness and recovery journey. Both quantitative and qualitative evidence indicates that peer support lowers the overall cost of behavioral health services by reducing re-hospitaliza-

tion rates and days spent in inpatient services. Peer support improves quality of life, increases engagement with services and increases whole health and self-management.

Q: How is MHA funded? Is patient care covered by insurance?

A: We offer services to everyone, regardless of their ability to pay. Our life skills program, creative wellness opportunities department, employment support services, self-help drop-in center and transitional coaching services are completely free of charge. Programs like these are only possible because of the generous donations from community allies. Our family support services and CORE services do utilize insurance and our team is always willing to help if assistance with insurance enrollment is needed.

Q: Are there more mental health needs in our dark, dreary winters?

A: The winter season is known for reduced sunlight, potentially causing a drop in serotonin and decreasing our vitamin D levels which may trigger depression-related symptoms. Those who already have a depression-related disorder may experience a worsened version of their symptoms.

The cold weather coupled with the darkness can also cause people to avoid activities that were once fulfilling to them (like exercising, seeing friends, outdoor activities, etc.) Staying indoors for prolonged periods can exacerbate existing depression symptoms. With that said, it is crucial to actively utilize resources to mitigate these mood shifts in the wintertime. The MHA of Rochester is here to help identify those resources and serve as a place of respite during those cold months, if needed.

About the MHA

The Mental Health Association of Rochester/Monroe County Inc. is an independent nonprofit organization that has been promoting mental wellness in the community since 1932. MHA of Rochester promotes mental wellness through a spectrum of culturally competent programs and services. MHA fosters an environment to build skills and support people facing mental health challenges, empowering them to make informed decisions on their self-directed path to wellness.

MHA programs aim to overcome the stigma that often accompanies mental illness and seek to recognize mental illness as a common and treatable condition. The agency serves as a clearinghouse of current information for people seeking answers to mental health-related questions.

Today, MHA serves Monroe, Livingston and Ontario counties.

For more information, go to www. mharochester.org.

Ask St. Ann’s

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Formal dining room sets, silver flatware, Noritake china and Waterford crystal have done their part, serving friends and family at countless baby showers and fancy dinner parties. Sturdy bookshelves full of atlases, dictionaries and volumes of encyclopedias provided your children with the facts they needed to complete their schoolwork. You invested in these items and they did their job — wonderfully.

But today, those things might not be as needed as they once were. Family gatherings tend to be more casual. Grandchildren have no idea what an encyclopedia is — they are accustomed to finding every song, world fact and map on the device in the palm of their hand. Your house, while loved for its cozy familiarity, isn’t meeting your needs anymore.

Rightsizing to a cozier cottage home or apartment would eliminate a lot of worry and stress for both you and your family. Senior living communities are designed to be the perfect fit. At St. Ann’s Community we have cottage and apartment homes with handicapped-accessible bathrooms, security and the modern finish and features that make life comfortable. If you don’t want to part with a cherished hutch or grandfather clock, we can help you find the perfect spot with the right planning. We want you to bring what you love the most and what makes your home feel like home.

By Laura Stamski

Ask

f you have lived in your home for the last 40-50 years, chances are you have accumulated a few things and those things have served you well.It’s easy for anyone to become overwhelmed with tackling clutter. Several businesses in our community offer assistance with reducing, donating and planning how your furniture will fit in your new space. A moving assistant can help you decide what to keep and how to fit it into your new home. They have connections with local businesses that can accept donations, auction off antiques, artwork and remove unwanted bulky items. But most importantly, they can help you organize your thoughts and start the process. Nothing will change until you decide to take the first step. Part of my role at St. Ann’s is providing advice on what to do with all the stuff. I am always happy to help, even if it’s guiding you in the direction of a different apartment or senior living community. Our maintenance staff is happy to mount your flat screen TV and hang framed artwork in any one of our beautiful apartments. We are happy to put you in touch with a moving assistant and show you how our senior apartments can reduce stress and anxiety — and that is priceless!

Not a Subscriber? NAME ADDRESS CITY/TOWN STATE ZIP 1 YEAR (12 ISSUES) $21.00 $35.00 2 YEARS (24 ISSUES) Clip and Mail with payment to: In Good Health P.O. Box 525, Victor, NY 14564 Subscribe and get In Good Health: Rochester’s Healthcare Newspaper right to your home or office!

Social Security Launches Redesigned Website at SSA.gov

H

SSA.gov is visited by over 180 million people per year and it is one of our most important tools for providing efficient and equitable access to service. Whether providing service in person or online, our goal is to help people understand what they may qualify for and seamlessly transition them to an application process.

Now, with improved self-service accessibility to online services, you might not have to call or visit an office to get what you need. This helps our staff focus on serving customers who need in-person assistance.

• Reimagined website prioritizes customer experience

The redesign is intended to provide a clear path to the tasks you need to accomplish. Many of the most visited sections of SSA.gov are now live with a more user-friendly and task-based approach. New pages and improvements based on public feedback will continue to be unveiled in the coming months, as part of our ongoing efforts to improve how the public can do business with us.

When you visit SSA.gov, you can use interactive tools to:

• Check eligibility for benefits

The new benefit eligibility screener is a convenient and simple way for you to learn if you might be eligible for benefits.

• Save time on Social Security number (SSN) and card online services

If you lose your SSN card, you may not need a replacement. In most cases, simply knowing your SSN is enough. If you do need a replace-

The Social Security Office Q&A

Q.: Why is it so important that my baby have a Social Security number?

A.: Your child may need a Social Security number if you are planning to open a bank account, buy savings bonds, obtain medical coverage, or apply for government services for the child. Your child will also need a Social Security number if you are going to declare him or her on your taxes. Getting a Social Security number for your newborn is voluntary, but it is a

ave you visited the redesigned SSA.gov yet? In December 2022, we updated our homepage with a new design to help you find what you need more easily.ment card, you may be able to request it online by visiting our Social Security Number and Card page at www.ssa.gov/ssnumber.

You can also start an application for an updated card or request an SSN for the first time. You may never need to go to an office, but if you do need to visit an office to complete the application then you can save a lot of time by starting online.

• Start an application for Supplemental Security Income (SSI)

You can start the application process online and request an appointment to apply for SSI benefits by answering a few questions on our SSI page at www.ssa.gov/ssi.

• Apply for Social Security benefits and other online services

For most benefits, you can apply online or start an application online. In many cases, there are no forms to sign. We will review the application and contact you with any questions or if we need more information. Visit our online services page at www. ssa.gov/onlineservices to apply for retirement, disability or Medicare.

Many Social Security services do not require an office visit. If you have a personal My Social Security account, you can start or change direct deposit, request a replacement SSA1099, or print or download a current benefit verification letter if you need proof of your benefits.

If you’re not yet receiving benefits, you can use your online account to get a personalized Social Security statement, which provides your earnings information as well as estimates of future benefits. The portal also includes a retirement estimator tool and links to information about other online services. We encourage people without a personal My Social Security account to create one today at www.ssa.gov/myaccount.

Please share this with your loved ones and post it on social media.

Laura Stamski is a sales and marketing representative at St. Ann’s Community at Cherry Ridge. Contact her at lstamski@mystanns. com or 585-697-6703.

By Jim Miller

How to Cover Dental Care in Retirement

Dear Savvy Senior, I had dental insurance through my work for many years but lost it when I retired and joined Medicare. Where can retirees find affordable dental care?

Uninsured Al

Dear Al,

Unfortunately, about two-thirds of U.S. retirees don’t have dental insurance today. Without coverage from traditional Medicare, and with private dental insurance typically costing too much to be feasible, most seniors are stuck paying full out-ofpocket prices every time they visit a dentist. While there’s no one simple solution to affordable dental care there are a variety of options that can help cut your costs. Here’s where to look.

• Medicare Advantage: While dental services are mostly excluded under original Medicare, many Medicare Advantage plans do provide coverage for dental care, but it’s usually very limited. Medicare Advantage plans are government approved health plans (usually HMOs and PPOs) sold by private insurance companies that you can choose in place of original Medicare. To shop and research Advantage plans in your area visit Medicare.gov/plan-compare or call 800-633-4227.

• Dental insurance: If you have gum problems and need extensive dental care, a dental insurance plan may be worth the costs versus paying for care yourself. Monthly premiums for individual plans range from about $20 to $80. A typical plan includes two or three cleanings and checkups per year, but these plans will likely have a waiting period — anywhere from a few months to a few years — before coverage for more expensive procedures kicks in. To find dental plans in your area, see eHealthInsurance.com.

• Dental savings plans: While savings plans aren’t as comprehensive as insurance, they are a good option for those who don’t have dental insurance. How this works is you pay an annual membership fee — around $80 to $200 a year — in exchange for 10% to 60% discounts on service and treatments from participating dentists. To find a savings plan, go to DentalPlans.com (or 888-632-5353) where you can search for plans and participating dentists, as well as get a breakdown of the discounts offered.

• Veterans’ benefits: If you’re a veteran enrolled in the VA health care program or are a beneficiary of the Civilian Health and Medical Program (CHAMPVA), the VA offers a dental insurance program that gives you the option to buy dental insurance through Delta Dental and MetLife at a reduced cost. The VA also provides free dental care to vets who have dental problems resulting from service. To learn more about these options, visit VA.gov/dental or call 877-222-8387.

• Cheaper dental care: Because prices can vary by dentist, one way to ensure you get a good deal on your dental care is to call multiple provides and compare prices. To get an idea of what different dental procedures cost in your area, see FairHealthConsumer.org. If you’re paying cash, it’s also perfectly reasonable to ask your dentist for a discount.

There are also a number health centers and clinics that provide low-cost dental care to those in need. And all university dental schools and college dental hygiene programs offer dental care and cleanings for less than half of what you would pay at a dentist’s office. Students who are supervised by their professors provide the care. See TeethWisdom.org to search for a center, clinic or school near you.

Part

To hear more of Frank’s story and learn if CyberKnife is right for you, visit hoacny.com

Frank chose non-surgical CyberKnife® at HOA –offering 5 treatments instead of 35!

“The original diagnosis was to treat my prostate cancer with seven weeks of radiation, five days a week. I was kind of upset that I was never given the option of CyberKnife,” said Frank. “The precise radiation achieved by CyberKnife, far fewer treatments, and the personalized care I received from Dr. Chin and his team made my decision an easy one. Better, the treatment was a real success!”

Do what you love. Even if it’s nothing at all.

As one of the most important people on earth, you should have nothing to worry about but choosing today’s activity, outing or dining option. Or just enjoying quiet time in beautifully maintained surroundings with 24-hour security.

St. Ann’s Community at Chapel Oaks has no entrance fee, only a low, monthly service fee for all your amenities. You also have complimentary transportation for appointments and activities, and access to higher levels of care if you ever need it. 1- and

•

Frank Guido couldn’t be happier he had a choice for treating his prostate cancer!