Gv igh 102 feb14 by In Good Health: Rochester's Healthcare Newspaper

in good Assaults at schools across the nation send 90,000 kids to ER each year

Winners

& Losers

priceless

Marijuana February 2014 • Issue 102

Rochester–Genesee Valley Healthcare Newspaper

New York state about to allow use of marijuana for medical purposes. Find out how perceptions about the drug have gradually changed and the impact of having it Page 11 available to patients

Two hospitals in the region — Strong and Highland — get bonus from government; all others here and in Buffalo are penalized based on performance

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Experts Discuss Key Things You Need to Do to Live Longer Why you should eat more peppers. See ‘Smart Bites’ inside (Hint: they are highly aphrodisiac)

Meet Your Doctor

URMC doctorresearcher gets $2M to train HIV patients to manage their health.

Unity Health Expects Banner Year This year will be a grand new year for Unity Health Systems. Whether you are talking about finalizing a merger, new facilities opening up or initiatives being launched, the organization is priming itself for sweeping changes. An exclusive interview with CEO Warren Hern

Patient’s Parents: Marijuana Bill Doesn’t Go Far Enough Parents unhappy Gov. Cuomo’s measure doesn’t expand to pediatrics

Julia Emerson, 7, a Chili resident, suffers from refractory symptomatic epilepsy. Said her mom Christine: “While we are grateful for Gov. Cuomo coming forward, this is going to fall short of what we need to help thousands of New Yorkers who are suffering. This is not going to help my daughter, and it doesn’t help any child who has serious medical issues.”

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In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

February 2014 •

In Good Health – Rochester / Genesee Valley Healthcare Newspaper

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Highland Breast Imaging — in conjunction with the Breast Cancer Coalition and the Cancer Services Program of Monroe County — will offer free mammograms to women 40 and older who do not have insurance. The event runs from 8 a.m. – noon Saturday, Feb. 8 at Highland Breast Imaging, 500 Red Creek Drive, suite 130. Appointments are required and can be made at 585487-3304 or 585-487-3305. The Highland Breast Imaging Center has been offering free mammograms for the past nine years and served hundreds of women who may not have been screened otherwise. A reiki practitioner will be on hand to give 10-minute reiki sessions. Parking is free and refreshments will be provided. Music will provide a relaxing atmosphere for this annual Valentine’s Day-inspired event at the Breast Imaging Center. Women who cannot make the screening are encouraged to schedule an appointment for a different day.

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Renee Morgan, a technician from the Elizabeth Wende Breast Care clinic, will discuss breast and bone health from 7 – 8:30 p.m. Feb. 11 at Greece Town Hall Meeting Center, 1 Vince Tofany Blvd. in Rochester. The seminar is part of the monthly meeting sponsored by Fibromyalgia Association of Rochester New York (FARNY), which serves people in Monroe, Wayne, Ontario, Livingston, Genesee, Wyoming and Orleans counties. The meeting is free and open to the public. For more information, visit www.farny. org, email publicity@farny.org or call 585-225-7515

March 22

‘Integrative Medicine in Women’s Health Care’ The Monroe County Medical Society’s Integrative Health Care Committee will host the 7th Annual Jeffrey K. Harris, MD Memorial Integrative Health Care Series Saturday,

March 22. The accredited continuing education conference, “Integrative Medicine in Women’s Health Care,” will be held from 8 a.m. – 5 p.m. at the TWIG Auditorium at Rochester General Hospital. Integrative medicine focuses on the whole person, mind-body-spirit, and acknowledges that the relationship between patient and provider in itself can be healing. Continuing education credits will be available to physicians, physician’s assistants, advanced practice nurses and nurses. Approval for chiropractic continuing education credits is pending. The conference format will include lectures, breakout sessions and question and answer sessions. Attendees will hear from speakers on a variety of topics, including menopause management, preconception care, bioidentical hormones and osteoporosis prevention, among other topics. Participants will learn about different integrative modalities in women’s health and the interplay of adrenal, ovarian and other regulatory hormones. Epigenetic factors, such as dietary choices and environmental toxins, and their impact on women’s health will be discussed. Attendees will also learn about the use of traditional Chinese medicine and chiropractics as it relates to pelvic pain. Registration is now open. The early bird registration rate is $150 (CME) or $100 (no CME) and is available through Feb 15. After that date, the conference will cost an additional $20. The registration fee includes breakfast, lunch, and snacks. Visit www.mcms.org to download a brochure and registration form. For more information, contact Ginny Ruderman at 585-473-7573 or gruderman@ mcms.org.

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diet-related behavior changes and lose weight. The service was also launched in New Orleans but those participants were not included in the study. While the program seemed to work well for those who completed it, only 39 percent stuck through all 14 weeks. The findings appear in two new studies published online in December in the Journal of Medical Internet Research. “We found that this method of health intervention had potential to significantly influence people’s health habits and have great reach — however, sustained participant engagement across the 14 weeks was lower than

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desired,” says lead author of both studies Lorraine R. Buis, Ph.D., assistant professor at the U-M Medical School. “It’s clear that a text message program may not be appropriate for everyone; however, for a large subset of people, this may be a feasible, acceptable, and useful strategy to motivate positive behavior changes.” Most participants reported that after completing the program, they were more likely to replace sugary drinks with water (78 percent), have a piece of fresh fruit instead of dessert (74 percent), substitute a small salad for chips or fries when dining out (76 percent), buy healthier foods when grocery shopping (80 percent), and eat more grilled, baked, or broiled foods instead of fried (76 percent). The majority of survey respondents also reported that text messages were easy to understand (100 percent), that the program made them knowledgeable of their risk for developing type 2 diabetes (88 percent) and more aware of their dietary and physical ac-

In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

tivity habits (89 percent). Eighty-eight percent also said they enjoyed participating in the program. The txt4health initiative is a large, public health focused text message-based program that aims to raise type 2 diabetes risk awareness, as well as facilitate weekly weight and physical activity self-monitoring to lower diabetes risk. Both pilots were supported by the Office of the National Coordinator for Health Information Technology.

Assaults at Schools Send 90,000 Kids to ER Each Year Number of intentional injuries is ‘concerningly high,’ researcher says

hildren and teenagers who are assaulted at school account for nearly 90,000 emergency-room visits in the United States each year, new research finds. Although school shootings garner much attention, it was rare for kids aged 5 to 19 to be injured by guns on campus, according to the study. Forty percent of injuries were bruises and scratches, and few injuries overall required hospitalization after a trip to the ER. “[The number of injuries] appears to be concerningly high, especially when you realize that such a substantial number of injuries are occurring in the school setting, where safety measures are already in place,” said study lead author Siraj Amanullah, an assistant professor of emergency medicine and pediatrics at Brown University’s Alpert Medical School. “There is a need to continue addressing this issue at various levels — at home, at school and in the medical care setting — and there is a need to ramp up our existing prevention and safety strategies,” Amanullah said.

For the report, which was published online Jan. 13 in the journal Pediatrics, the researchers looked at statistics regarding emergency-room visits by young people in 66 U.S. hospitals from 2001 to 2008. They then estimated the number of injuries nationwide during that time based on those limited statistics. Overall, more than 7 million ER visits were made because of injuries at school during the eight-year study period. More than 700,000 of those injuries were considered deliberate, the researchers said, accounting for about 92,000 ER visits a year on average. And nearly all — 96 percent — of the injuries were from assaults, rather than self-harm or harm from someone like a police officer, the researchers said. This led to the conclusion that school assaults were behind an average of 88,000 ER visits a year. The researchers found that kids aged 10 to 14, non-whites and boys had higher risks of being injured intentionally at school compared to kids of other age groups, whites and girls, respectively.

U.S. Smoking Rates Drop to Historic Lows: CDC

ess than 20 percent of Americans still smoke cigarettes — a breakthrough called a “milestone” by federal health officials. Following years of smoking rates that had hovered around 20 percent, that number finally dropped to 18.1 percent in 2012, statistics from the U.S. Centers for Disease Control and Prevention show. “This is a milestone. We have seen a steady decline in recent years, and so the stall is no longer occurring,” said report co-author Brian King, an epidemiologist in the CDC’s Office on Smoking and Health. “But the progress is still not as strong as we would hope.” King said several developments on the “national level helped to galvanize tobacco efforts, and help reduce smoking rates.” “In 2009, the Family Smoking Prevention and Tobacco Control Act was implemented, which gave the FDA [U.S. Food and Drug Administration]

the authority to regulate tobacco,” he said. “Also, in 2009 the federal tax rate for cigarettes increased from 39 cents a pack to $1.01 a pack. We know that increasing tobacco prices is the single most effective way to reduce smoking.” Another factor might have been the “Tips from Former Smokers” advertising campaign, which the CDC launched in 2012, King said. In the ads, a dozen or so ex-smokers offered harrowing personal tales on the devastating health consequences that can come from years of tobacco use. “Among people who smoke the most, those who smoke 30 or more cigarettes a day, there was a decline from 12.6 percent to 7 percent,” he said. And among people who smoke every day, the average number of cigarettes they smoked dropped from 16.7 in 2005 to 14.6 in 2012. The findings were published in the Jan. 17 issue of the CDC’s Morbidity and Mortality Weekly Report.

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Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers and Contributing Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Mike Costanza, Jessica Youngman • Advertising: Donna Kimbrell, Amber Dwyer Layout & Design: Chris Crocker Officer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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February 2014 • In In Good – Rochester / Genesee Valley Healthcare Newspaper Good Health |Health 5"W x 6.75"H | release 9/17/2012

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Meet

Your Doctor

By Mike Costanza

Kevin A. Fiscella, MD URMC doctor-researcher gets $2M to train HIV patients to manage their health Q. What do you and your team want to accomplish through this threeyear, $2 million study? A. What we hope to do is give patients the tools and skills to more effectively manage their health in collaboration with their HIV clinicians. Q. What do you mean, “manage their health?” A. The traditional medical model has been for doctors to tell patients what to do. In the last decade or so, there’s been a movement for not just patient-centered care, which involves the patient figuring out what the patient wants, but also empowering the patient to take on a self-management role for whatever their condition is. That means improved [patient] understanding of not just the condition, but what various lab tests mean, what medications are doing, being able to keep track of appointments, being able to ask the right questions. These are things that I think any patient often will struggle with, but particularly for chronic conditions like HIV, that often involve lots of visits, lots of medications and potential interactions on top of that. Ultimately, it is the patient who is managing their condition. This program is designed to help them do it more effectively. Q. What is the structure of the study, and how could it help patients monitor and manage their care more effectively? A. In order for a person to be able to manage their health, particularly someone with HIV, they need to have data and information on hand. One way is to use what we call a “personalized health record,” a handheld personal health record. This is a personalized health record that we designed. It’s actually a new app that’s interactive. If you have a provider in the URMC [University of Rochester Medical Center] system, you can apply and get access to a portion of your health records through MyChart. MyChart is an online portal that the URMC uses as part of e-records. The problem with that, of course, is you need to log in, you need to have an Internet connection, and you need to be able to navigate to that online personal health record. The alternative is to store a personal health record in an electronic device. In this case, the device that we’ve been using is the iPod Touch. It’s essentially an iPhone without a phone. It’s Web-enabled, and it has the same operating system but it doesn’t encumber somebody to a phone contract. Patients can password-protect the device itself, as well as the health record. The study pays for the iPod Touch for participants completing the training. Page 6

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Q. How would new treatment information make its way into the patients’ records? A. The patients’ training will go over the different aspects of the personal health record, and how to use it, and what it means. Part of the training is teaching the patients how to input their own data. We also will ask and encourage patients to confirm things. When they’re entering their medications, we ask them to open up their personal health record, share it with their clinician, and make sure it’s correct. They’re reconciling what they think they’re taking with what their clinician thinks they’re taking—and so on. We train patients to get the data either as a printout from their doctor or they can go online. We also want to elicit from patients questions that they will have for their doctors. Although we have

prompts that ask them about evidence-based things, part of the training will be to help patients think about “What do you really want to get out of your visit? What are the questions that are most important to you?” Say it’s a woman who’s over 40, it [the iPad Touch] might also ask them, “Are you past due for your latest mammogram?” Patients can also put in reminders of when they should call their pharmacy or their doctor and ask for refills. Q. How could ready access to his or her medical records benefit a patient? A. In order for a person to be able to manage their health, particularly someone with HIV, they need to have data and information on hand. The study’s subjects would have a handheld device that secures their information, and allows them to access to it anytime, anywhere. Q. Your study also seeks to determine whether the patients involved in your study will gain a greater sense of empowerment through learning to use and using their medical records to help guide their treatment. What does that mean?” A. The first aim of our project is to improve patient activation, which is a sense of empowerment and a sense of self-efficacy in managing their conditions, and to assist the patients’ ability to make decisions in collaboration with their clinicians, to improve their knowledge, and to assume a greater sense of control and partnership with their clinicians. Q. Is there a lower level of empowerment among HIV patients, in comparison to others? A. In general, I would say that patients who have less income and less education often feel less empowered. They go in knowing less because they have lower literacy, they don’t have access to the Web, and so forth. At the same time, they feel less empowered to ask, so they’re not keeping up. Because HIV patients are disproportionately poor, I think there is an empowerment issue there. Q. How might they come to feel more empowered through participating in your study, and using their medical records to help guide their treatment? A. It, first of all, improves self-efficacy. This is very much a hands-on, groupbased training.

In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

We’ve done pilots with 96 people here, so we have quite a bit of experience to date. We’ve found that patients are very good at helping each other. People are coming together around something positive. They’re talking about how can we live healthier lives, and how can we do that together as a group. That, also, is empowering. Q. Could learning to use the iPhone also be empowering? A. A significant portion of the patients have never used a electronic device beyond a basic cell phone, never used a smartphone or laptop or computer—anything like that. Patients who have never been able to use a device, they sort of feel like they’re on the outs. Take somebody who probably has some anxiety about it, and really didn’t believe they could do it, and suddenly find out they can do it, that is quite empowering. Q. You have said that your study, which is funded by a grant from the Patient-Centered Outcomes Research Institute, was borne through the efforts of a number of local organizations. Can you tell us about that? A. This was very much a collaborative effort. We had a stakeholder group that involved all of the major HIV practices in Rochester across systems— Trillium Health, McCree McCuller Wellness Center-Unity Health System, URMC Infectious Disease Unit, University of Rochester Center for AIDS Research, Catholic Charities, and the Clinical Directors Network. We have physicians involved, we have members of community-based organizations involved and we have HIV patients involved. Without involvement of the actual end users, you can design something that’s not going to work. Q. How many patients will be involved in the study, and when do you hope to start? A. Three hundred and sixty patients. The latest [start date] would be in the spring. Q. What drew you to the study of medicine—and to work of this kind? A. I went into medicine because it offers a way to really make a profound difference in people’s lives. I also had a long-standing interest in working with underserved patients. That’s where I derive the greatest satisfaction, and where I can also make the biggest difference, because that’s where the need is greatest.

Lifelines: Current Positions: Professor, department of family medicine, University of Rochester Medical Center; associate director, Rochester Center to Improve Communication in Health; co-director of Community Engagement for the Rochester Clinical Translational Science Institute; co-director of the Greater Rochester Practice Research Network and HIV Clinical Coordinator for Westside Community Health Center. Education: MPH, University of Rochester School of Medicine and Dentistry, Rochester; MD, Medical College of Virginia, Richmond, Va.; bachelor’s, psychology, Antioch College, Yellow Springs, Ohio; fellowship, University of Rochester Department of Family Medicine. Residencies/Internships: Residency in family practice; internship in family medicine, Buffalo General Hospital, Buffalo. Personal: Married. Enjoys traveling, fine food, visiting his two grown children, and attending musical and dance performances and other cultural activities.

Raw Food:

Health Danger or Savior? By Deborah Jeanne Sergeant

awism — eating raw food as a diet for losing weight or boosting nutrition — may turn off some as a restrictive means of dining. But it bears some merit. Adherents typically eat only minimally prepared foods. Typically, food is never cooked or, if it is, never above 104 to 115 degrees. The US Department of Health and Human Services’ Department of Food Safety recommends heating meat to an internal temperature of 145 to 165, depending upon the type of meat and cut, and other perishables such as leftovers to similar hot temperatures. Some raw foodists eat vegan; others inFischer clude in their diet sushi, non-pasteurized dairy (a few dairies in New York are licensed to sell raw milk), and meat dishes such as carpaccio, steak tartare and kibbe. Some raw food adherents dehydrate foods for preservation and for making ready-to-eat food in advance. Artificial seasonings, flavoring agents and coloring agents are taboo. “Although most people don’t follow it with the purpose of losing weight, most raw foodists end up losing weight after a while,” said Suellen Pineda, registered dietitian with the

cardiac rehabilitation program at Geneva General Hospital. Eschewing processed foods also means nixing many calorie-packed foods. Raw foodism promotes eating raw produce, nuts, seeds and sprouted grains in the belief that foods’ naturally occurring enzymes are still present and that they are more nutritious than cooked foods. “In that sense, that might be true for foods like fresh fruits and vegetables, that are encouraged to be consumed with minimal processing to preserve most their nutrients intact, especially vitamins and minerals that are very susceptible to heat and the rest that occur during the...cooking process,” said Pineda. That’s not always the case, however. Tomatoes become more nutritious from cooking. Tomato’s lycopene, a cancer fighting carotenoid, becomes usable by the body after cooking, as does spinach’s nutrients. The raw food diet promotes eating more produce; however, Pineda is concerned with cutting out “very nutritious foods such as meats, poultry, pasteurized dairy products, canned fruits and vegetables, all breakfast cereals and many more,” she said. “That is why it can be very challenging to find variety when eating only raw foods.” Animal products, avoided by some raw foodists, contain nutrients such as vitamin B-12, iron, vitamin D, zinc,

iron, and omega-3 fatty acids, some of which are difficult, if not impossible, to obtain from plant sources. Fortunately, following a completely raw diet isn’t necessary for achieving a nutritious diet. Reducing consumption of processed foods and overcooking produce can improve one’s diet, however. “In general, the more heavily a food is processed, the less nutritious it becomes,” said Lisa Fischer, registered dietitian and pediatric GI nutrition specialist at Strong Memorial Hospital. “Certain minerals and water-soluble vitamins are quickly lost in water during the cooking process, vitamin C and folate being two examples.” She recommends steaming vegetables, which causes much less if any loss of nutrients. Fischer added that although enzymes exist in plant foods, “they are not available in the large quantities we require for digestion, and most are deactivated by acid in the stomach.” With proper cleaning, raw produce may be eaten safely; however, foodborne bacteria common to raw or undercooked animal products is unsafe. “Many of the potentially life-threatening bacteria that cause food borne illness are found on raw and undercooked meat products,” Fischer said. Meat isn’t the only culprit. “Not only do raw eggs have a 50 percent chance of being contaminated

with salmonella, but raw eggs contain something called avidin, which blocks the absorption of biotin,” Fischer said. Raw milk may also harbor “organisms that cause serious disease such as listeriosis, typhoid fever, tuberculosis, diphtheria and brucellosis,” Fischer said. “Some people believe that raw milk is higher in nutrients, but the effect of pasteurization on vitamin levels in milk is minimal.” Ninety percent of the vitamin D in milk has been added as a supplement. Raw milk does not contain any supplements. Danielle Bonsignore, registered dietitian with Clifton Springs Hospital & Clinic, implicated raw grains as a possible source of food borne illness. “Grains, such as rice, contain a protective outer layer which can harbor bacteria and is poorly digested in humans,” she said. “Cooking the rice damages the protective layer making the rice easier to digest, making nutrients more available for the body to absorb, and safer to consume as the bacteria is killed by high temperatures used during the cooking process.” Bonsignore advised that steaming vegetables can help them retain more nutrients while making them more palatable. “With fruits and vegetables, a combination of both cooked and raw will ensure the consumption of the necessary nutrients,” she added.

Children’s Hospital in Philly Bans Use of Dietary Supplements

he Children’s Hospital of Philadelphia (CHOP) recently announced that its Formulary — the list of medications approved for use — will no longer include most dietary supplements. The hospital said the action was being taken because the Food and Drug Administration (FDA) does not routinely review the manufacturing of dietary supplements, and therefore cannot guarantee their safety and effectiveness. The move makes CHOP the first hospital in the United States to discourage patients from using these products without a doctor’s provision as a matter of policy. “Because vitamins and dietary supplements are essentially unregulated, there is no sound information about adverse side effects, drug interactions, or even standard dosing for the vast majority of them,” said Sarah Erush, pharmacy clinical manager and a member of the hospital’s therapeutic standards committee. “Administering these medications — particularly to children with serious health complications — is unethical

when the risks are unknown, and when there are alternative treatments that have been proven in clinical trials to be safe and effective.” Dietary supplements are defined as vitamins, minerals, herbs, botanicals, amino acids, enzymes and animal extracts meant to “supplement” the diet and are not intended to replace a healthy diet or to treat, diagnose, prevent, or cure diseases. Melatonin, Echinacea, chondroitin sulfate, glucosamine, CoEnzyme Q10, milk thistle, and probiotics are some of the most commonly used supplements. The hospital’s updated policy acknowledges that there are certain medical conditions that may require supplementation of vitamins or nutrients. To that end, the hospital has determined a very limited and carefully selected list of acceptable products that are proven to be of high quality and safe. Under the hospital’s updated policy, parents or guardians will be asked upon admission whether the patient is taking any medication or supplements. If so, the attending nurse or physician will review the hospital’s policy discouraging the use of supplements

and inform parents or guardians of the potential risks associated with the supplement. Potential risks include contamination, mislabeling, interactions with medications, or potential unforeseen adverse effects. If, after receiving this information, a parent or guardian insists on continuing to give their child a dietary supplement that is not on the CHOP Formulary, they must sign a hospital waiver stating that they agree to be responsible for providing the product.  “Educating families is one of the most important reasons for implementing this new policy. Most people assume that supplements they buy at the health food store or online are strictly monitored or are safe because they are ‘all natural’,” said Erush. “But supple-

February 2014 •

ments are only subject to FDA review if an adverse event is reported, so there are many for which we have no reliable data. We’d much rather treat children with what we know works than provide them with a substance that may at best do nothing, or at worst, cause harm.”

In Good Health – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Winners: Strong, Highland Losers: All Other Hospitals Two hospitals in Rochester get bonus from government; all others here and in Buffalo are penalized based on performance

By Ernst Lamothe Jr.

or the second straight year, most Western New York hospitals failed to meet the new federal government standards for Medicare patient services, which resulted in losing some of its funding. University of Rochester Medical Center, which encompasses Strong Memorial and Highland hospitals, was the only healthy system in Monroe County or Buffalo that wasn’t penalized. In fact, both hospitals received bonuses in funding based on performance for the second year in a row. The federal government gave Strong Hospital around $185,000 increase and Highland Hospital $250,000 for performing above standards. Other area hospitals received a mixed bag. While Unity, Rochester General and F.F. Thompson in Canandaigua saw improvements Salipante over a year ago, all were still penalized and received a decrease of Medicare reimbursement. “We are very proud of our results,” said physician Robert Panzer, chief quality officer for the Strong Memorial Hospital. “One of the reasons we have done so well the last two years is that we anticipated some of these changes years ago and started working with staff before the federal government changes were implemented. We knew there were measures being collected by Medicare that compared hospitals.” Panzer said improvement was essential for the good of the patient and also because information was going to be readily available for the public to compare each hospital. One of the changes they made years ago involved surgical care. A patient is supposed to receive the right antibiotics to help them one hour before surgery begins and all antibiotics must be completed within 24 hours. University of Rochester Medi-

cal Center’s leadership team met to discuss the best practice guidelines to make sure patients weren’t getting their antibiotics too early or too late, which helped its overall numbers. The government penalized nearly every hospital in the area for the second straight year under a program created by the federal Patient Protection and Affordable Care Act. It ties hospital performance to federal funds for Medicare, which is a health insurance program for people 65 years and older or disabled citizens. Every hospital sets aside 1.25 percent of its Medicare allotment, which goes into an incentive pot that this year totaled $1.1 billion. Best case scenario they get their money back. However, most hospitals, even those that improved this year, failed to recoup the funds. More than 1,200 hospitals were granted an increase in payment rates this year. Yet nationwide, almost 1,500 hospitals received penalties, many seeing their Medicare reimbursement deceased two consecutive years, which can take a toll on a hospital. Last year Unity Hospital, which is part of Unity Health System, received 0.41 percent less or a decrease of $90,000. This year, the hospital received 0.40 percent decrease so they expect to lose around the same amount. Rochester General Hospital decreased. 0.33 percent, the second year in a row they will lose money. Physician Joseph Salipante, chief quality and patient safety officer for Unity, said that despite the decrease he supports the initiative to tie Medicare reimbursement with bonuses and penalties for hospitals. He said anything that makes hospitals more accountable is a good thing. “We certainly support the process and anything that improves care to patients,” said Salipante. “But as important as these penalties are, we have always been about improving patient care and providing the best possible outcome regardless of any plans by the federal government. Organizations should be in itself in the business of improving quality, and this is just one more reason to keep providing quality

Top Winners

Strong Memorial Hospital Highland Hospital

Losers

Unity Health System F.F. Thompson Hospital Rochester General Hospital

care.” He said the hospital saw 40 percent improvements in its readmission rate, which are patients who return back within 30 days of first coming to the hospital. He credits the medical team working together, including daily rounds by nurses, advanced practitioners, social workers, nutritionists and physical therapist who discuss every patient’s’ care. In addition, Salipante said the hospital has improved in giving families the information they need to care for patients after they leave the hospital. “But obviously there is room for us to improve and that is something we take seriously,” he added. F.F. Thompson Hospital decreased 0.43 percent in Medicare reimbursement this year, a reduction of $30,670, according to Mark Prunoske, Thompson Health vice president of finances. Last year, they went down 0.32 a year ago, which was a decrease of $22,280 Lakeside Hospital in Brockport, which closed down its emergency department wing, decreased .27 this year. Even with the decrease it was an improvement from last year when they lost .79 percent of their Medicare.

How hospitals are judged

The way the system currently works is that hospitals are given incentives based on their performance in 24 categories. If a hospital consistently receives too many readmitted patients within a month, they will likely see

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less Medicare reimbursement. Hospital were tracked from October 2012 to September 2013. The most a hospital can gain is 1.25 percent in bonuses, while it cannot receive a penalty more than 3.25 percent. With each year, the percentage that a hospital could lose or gain will increase. Hospitals are still paid by the government for the hospital’s Medicare capital expenses and to treat large numbers of low-income patients, regardless how they were graded, according to the Centers for Medicare and Medicaid Services. Panzer said maintaining the good results have become harder with every year. “Before the top performing hospitals were performing correctly 60 percent of the time. Now the top performing hospitals are performing at 99.5 percent of what is expected of them,” he added. “It’s much harder to excel today.” He also supports the Affordable Care Act initiative that ties Medicare reimbursements even if it is not a perfect system. “It does give hospitals incentives to do the right things for the good of the public and that is something that should be on the forefront of our minds anyway. It makes everyone pay attention.” he said. “It’s doing the right thing for patients, and if hospitals are penalized, it gives all of us an opportunity to improve and make a difference.”

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Prenatal Genetic Testing Offers Hope and Help By Deborah Jeanne Sergeant

f you’re a mom-to-be, don’t panic if your OB-GYN suggests prenatal genetic testing. More likely than not, everything’s fine. “There are many reasons an OB/ GYN doctor might offer genetic counseling or testing,” said physician Neil Seligman, acting director of reproductive genetics at University of Rochester Medical Center. “Common reasons are to discuss concerns a women may have about birth defects or genetic diseases.” Many obstetricians routinely start the conversation about family genetic history by offering genetic testing and counseling as an optional part of prenatal care. Which tests, if any, parents decide to include depend upon Seligman their family health history, maternal age, ethnicity and their personal comfort level with genetic testing. Some couples desire peace of mind that all is well with their baby. Others want to know so they can prepare just in case. “Finding out that a baby has a problem is a very difficult and stressful situation no matter when it happens,” said Jeanne Peterson, a genetic counselor with University of Rochester Medical Center. “However, finding out before the birth can be beneficial to parents in many ways.” Parents can adjust their expectations and learn more about their child’s possible health needs. They may discuss their baby’s health with the specialist who will care for their child after his birth. The pregnancy may receive special care if it will improve the outcome, too. The mom may deliver at a hospital equipped with a neonatal intensive care unit (NICU) if the baby’s care requires newborn specialists. If so, she can visit the NICU prior to delivery and meet with a neonatologist. Ultimately, the mothers make the decision whether or not to undergo testing, but the advice of her medical providers may help. The type of test performed depends upon the condition for which it is testing. Ultrasound, and testing samples of cord blood, amniotic fluid, and placenta are among the types of tests. Prenatal genetic counseling may help prepare parents for what to expect; however, some conditions may be prevented or treated before birth to improve baby’s outcome. For example, if the mother has congenital adrenal hyperplasia (CAH), because of an enzyme deficiency, or phenylketonuria (PKU), a disorder affecting amino acid metabolism, treatment can help prevent the usual damage to the baby’s physical or mental development. Doctors may also treat the baby himself. “Transfusion of blood or platelets into the umbilical cord can be used to treat babies that become anemic [low blood count] or develop thrombocytopenia [low platelets] during pregnancy,” Seligman said. “Medications can also be injected into the amniotic fluid surrounding the baby. This technique can be used to treat an abnormal heart rate or thyroid disease in the fetus.” Fetal surgery represents a more recent development for treating ba-

bies in the womb. Specialists in fetal surgery can treat birth defects such as spina bifida, in which the vertebrae do not form and close properly. Diaphragmatic hernia (a hole in the baby’s diaphragm), certain types of heart disease, bladder obstruction and other conditions may be treated by intrauterine surgery, too. “Some of these surgeries are performed through a thin tube passed through the mother’s abdomen,” Seligman said. “Others require surgery similar to a C-section to gain access to the baby. Fetal surgery is only done by specialists and does pose a risk to the pregnancy; however if successful, can result in a much healthier baby.”

February 2014 •

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Alone and Content: To Be or Not to Be? “Reinvention can be a matter of being reintroduced to yourself in a new light.” Jane Pauley, author of “Your Life Calling: Reimagining the Rest of Your Life”

uring the month of February, which glorifies “couplehood,” I am always reminded of those heart-wrenching days and months after my divorce. At the time, I found it hard to imagine a life of contentment on my own. I clung to an old tape: that I could only be content if I were married or had a significant other on my arm. Is that same tape playing in your head? If so, you’re not alone. It takes discipline and determination to rid ourselves of preconceived notions about what contributes to contentment. These days, I’ve thrown away negative, outdated beliefs about being single, and have instead adopted a philosophy of living that enhances my well-being. I choose to be content. You can, too. Here’s how: Take stock. Be on the lookout for negativity. When you start spiraling down about living alone, don’t go there. Stop the old tape and replace it with something more positive and reinforcing. Try this: “I can make this work. I am reimaging my life and I can envision

a promising, new future. I am becoming more independent and resourceful and — at the end of the day — I am a survivor and proud of myself.” Don’t fake it. If you’re having a tough day, admit it. Share it. We’re all human. Sharing your challenges with close friends and family will only bring you closer together. Feeling connected and loved . . . isn’t that what makes our lives and relationships worthwhile? And real? It happens best with honest communication and mature, mutual sharing. Give yourself a break. Getting good at and ultimately enjoying life on my own didn’t happen overnight. It took practice. Years of practice. Give yourself time to adjust to the single life. After all, this is foreign territory if you’re coming out of a long marriage. Celebrate your newfound independence. This can be a time of self-discovery, no matter what your age. Striking out on your own will expand your horizons and build self-confidence, whether you’re 44 or 84. Don’t be afraid to travel, relocate or try something new. Identifying those things that bring meaning and joy to your life can turn living alone into an

KIDS Corner Doctors Unaware That More Teens Are Turning to E-Cigarettes

he use of electronic cigarettes, battery-operated devices that often look like cigarettes and deliver vaporized nicotine, is on the rise, including among minors. In a survey between 2011 and 2012, 10 percent of high school students reported ever using an e-cigarette. However, many clinicians are unfamiliar with or uncomfortable with addressing the use of e-cigarettes with their young patients, finds a new study in the Journal of Adolescent Health. “The scientific community is still learning about e-cigarettes, and while there is much that we don’t know, most people would probably agree that minors should not be using them,” said Page 10

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lead author Jessica K. Pepper, of the University of North Carolina Grillings School of Global Public Health. Pepper and her colleagues analyzed feedback from an online survey of 561 Minnesota health care providers who regularly see adolescent patients.

adventure of the spirit. Find (or deliver) something joyful every day. Be purposeful about this. Bright spots are everywhere and can be found every day. Notice and appreciate them. Share them. Be the one who creates a joyful moment for others. Don’t wait for happiness to find you. I’ve made this mistake. It’s a big one: waiting for the phone to ring, waiting for the invitation, waiting for some wonderful thing to happen to lift me out of my doldrums. Instead, make your own happiness. And make someone else happy along the way. When’s the last time you reached out and added a little happiness to someone’s day? Stay current. No excuses, now. We live in a technologically sophisticated world. Computers are how many of us communicate these days. It’s how we stay in touch. And when you live alone, it can be a godsend. If you’re technologically challenged, know this: It’s not that hard to come up to speed. Resolve to be an open-minded student, and invite a friend or family member to show you the basics: texting, email, Facebook, Twitter, Tumblr, or Instagram. Stay connected; it’s a key to contentment.

Give it up. The stereotyped image of single men and women as desperate and miserable is exaggerated and just plain untrue. Recent studies on the subject bear this out. Loneliness is not a “state of being” reserved for people who live alone. Were you ever lonely while you were married? Choose to treat yourself well. It builds esteem. Prepare and eat decent meals at home. Get enough sleep. Exercise. Indulge in guilty pleasures: a nap, a piece of chocolate, a good book, a day trip. You deserve it. Avoid isolation. Isolating on holidays (including Valentine’s Day), birthdays, Sundays, etc. is for the birds. Solitary confinement is punishment for criminals, not for people who live alone. Make plans. Pick up the phone! Expand your definition of love beyond romantic love. This will stand you in good stead, especially if you are not ready to find another mate. Embrace “passionate friendships” — those relationships in which you can be yourself and feel completely comfortable. I’ve said it before and I’ll say it again: living along doesn’t mean being alone. Embrace your “new normal.” Living alone can be a wonderful, meaningful, and — dare I say it? — desirable option to marriage for some people. Accept and explore your singlehood. Living alone might surprise you and become your preferred new normal. Embrace it! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, call (585) 624-7887 or e-mail: gvoelckers@rochester. rr.com.

Conversations on Sex Lacking Between Doctors and Teens

octors are missing a prime opportunity to share information about sex with their teenage patients by failing to broach the subject during checkups, according to researchers at Duke Medicine. The study, published Dec. 30 in JAMA Pediatrics, found that less than two thirds of doctors and teenage patients talk about sex, sexuality or dating during annual visits, and the conversations that occur last less than a minute on average. “It’s hard for physicians to treat adolescents and help them make healthy choices about sex if they don’t have these conversations,” said lead author Stewart Alexander, associate professor of medicine at Duke. “For teens who are trying to understand sex and sexuality, not talking about sex could have huge implications.” During annual visits, doctors can promote a range of healthy behaviors to teenage patients by talking about issues such as smoking, drinking and wearing seatbelts. Sex is another topic that the American Academy of Pediatrics recommends physicians address with

In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

teens. While these conversations may be uncomfortable for the patient and provider alike, they are important opportunities to discuss sexual development, sexually transmitted infections and pregnancy prevention. One-on-one confidential time during annual visits is recommended to allow for these sensitive conversations. Confidential discussions help establish trusting relationships between doctors and patients and foster candid disclosures from adolescents.

Marijuana

TV Ads Nutritionally Unhealthy for Kids, Study Finds

State about to approve its use for medical purposes. Find out how perceptions about the drug have changed By Ernst Lamothe Jr.

veryone has an opinion on medical marijuana or marijuana in general. In the early days, few in society or the medical community voiced support about using it as treatment. It was still seen as a stoners’ method to forgetting their problems more than a pain-reducing remedy. Slowly opinions began to thaw. Physician Sanjay Gupta, CNN’s chief medical correspondent in a recent show told viewers he had changed his mind on the drug, citing its beneficial uses in medical cases. He is even working on a new documentary called “Weed.” But not everyone’s on board. Just this summer, outgoing New York City Mayor Michael Bloomberg, who is considered very liberal on social issues, called medical marijuana “one of the great hoaxes of all time.” Just recently Gov. Andrew Cuomo did an about face and announced an executive action that would allow medical marijuana in limited form for those with serious illnesses that meet standards set by the state Department of Health. Marijuana is such a hot topic that several doctors in Upstate and Central New York didn’t want to go on record discussing the issue for In Good Wiegand Health newspaper. “I’m not surprised because historically some doctors have perceived they will be labeled as “pro-pot” even when simply discussing any potential benefits of medical marijuana,” said physician Timothy Wiegand, the University of Rochester Medical Center’s toxicology director. “There has been a lot of media and press attention regarding marijuana in general and medical marijuana in particular. For example, when Dr. Sanjay Gupta changed his viewpoint on national television it put an even stronger focus on the issue.” Either way, Alaska, Arizona, California, Colorado, Connecticut, D.C., Delaware, Hawaii, Illinois, Maine, Massachusetts, Michigan, Montana, Nevada, New Hampshire, New Jersey, New York, New Mexico, Oregon, Rhode Island, Vermont and Washington have all legalized some form of medical marijuana. Illinois was the last state on the list to enact the law, which went into effect in January. While Illinois permits individuals with serious diseases, including HIV and multiple sclerosis, to buy the drug in limited quantities, it has one of the strictest measures around. After being issued a state identification card, patients every two weeks can purchase up to 2.5 ounces of marijuana. The drug will be grown in 22 cultivation centers throughout the state, and Illinois patients will not be allowed to grow their own marijuana, which is allowed in other states. In addition, medical marijuana users from other

states will not be allowed to use their ID to buy in Illinois. Meanwhile, New

York had remained on the outside. While the state Assembly has passed a medi cal marijuana law four times, the state Senate and Gov. Andrew Cuomo spent most of last year staying away from the issue. That was until Cuomo made a sudden shift and announced his executive order during his State of the State address. Twenty hospitals, which have not yet been named, would be able to administer medical marijuana. “Marijuana is not a panacea. I work with people who struggle with their use of marijuana. Some people find that they have difficulty stopping or decreasing their use, or that it’s affecting their lives in ways that are not healthy,” said Wiegand “I’ve worked with individuals that had been involved in car or other accidents after their use. Marijuana, like many other psychotropic drugs, can impair reaction time and concentration.” Despite this and from a variety of reasons Americans are slowly changing their viewpoint overall about marijuana and especially about medical marijuana.” It is still yet to be determined if Cuomo’s action will be the first step to legalizing marijuana. New York has had an issue resulting in 450,000 misdemeanor charges in connection with marijuana, according to the Drug Policy Alliance. Annette Simiele, associate director of the Multiple Sclerosis Resources of Central New York Inc. in East Syracuse, supports legislation for medical marijuana. Founded in 1998, her organization helps more than 1,500 people in several counties who are afflicted with the chronic, often disabling disease that attacks the central nervous system made up of the brain, spinal cord, and optic nerves. The majority of the organization’s clients are from Onondaga County and the use of marijuana would help relieve the pain from some of their symptoms, officials said. “They tell us that it gives them a clearer head to focus and eases some of the neurological pain just so they can live the rest of their lives in some comfort,” said Simiele. “These are people who now have to take a large amount of pills a day just to eat and function which does have side effects who would greatly benefit from medicinal marijuana. They have to worry about the risk of getting arrested for something that makes their lives manageable that is grown naturally outside.”

The tides though are changing on marijuana as whole. Two states, Colorado and

Washington, have legalized the recreational use of cannabis for anyone following the approval of state referenda in the 2012 elections. A similar ballot measure failed in Oregon. “People have seen that it hasn’t been the end of civilization when medical marijuana was enacted in now over 20 states and there are good arguments for overall legalization like in Colorado and Washington. These states are going to get tens of millions of dollars from the tax they put on marijuana, which is also going to fund schools and other public infrastructure,” said Wiegand, who is also past director of the Finger Lakes Poison Control and Drug Center at the University of Rochester Medical Center. “The current system regulating marijuana doesn’t seem to work too well or keep people that want to use it from getting it.” Weigand understands that talking about marijuana as a whole can be problematic because many people have already decided which side they are on. And during discussions, neither corner is in a rush to budge to the happy medium of the issue or acknowledge that the other side has solid, relevant points. He said there are legitimate concerns about marijuana. Weigand believes that more medical studies are needed to examine marijuana’s effect for specific diseases instead of simply anecdotal stories. He also knows legalization could also cause a burden to the society and the health care system. But there are also legitimate medical conditions that have been helped with its use. “Like any medication there can be side effects from marijuana use and medicalization can be a difficult to regulate. There will be people who claim to need marijuana for their pain or other symptoms when they really only want to use it as an intoxicant,” said Wiegand. “In any event, at some point, people are going to have to be honest and ready to have a conversation about decriminalization or legalization of marijuana.” Simiele said she was encouraged to see Gov. Cuomo take a step forward on this issue; however, the executive order is too limited. “We have a bill in the state legislature that is comprehensive and has all the safety controls that are needed that we hope the governor eventually decides to push,” she said. “I don’t know why New York is lagging behind other states. We want to be leaders.”

February 2014 •

he nutritional value of food and drinks advertised on children’s television programs is worse than food shown in ads during general air time, according to University of Illinois at Chicago researchers. The study is published in the December issue of the journal Childhood Obesity. Using Nielsen TV ratings data from 2009, UIC researchers examined children’s exposure to food and beverage ads seen on all — both adult and children’s — programming. It also looked at the nutritional content of ads on children’s shows with a child-audience share of 35 percent or greater, the first study to do so. The researchers assessed the nutritional content of products advertised — cereals, sweets, snacks, beverages and other foods — and whether they fit the proposed voluntary nutrition guidelines recommended by the Interagency Working Group on Food Marketed to Children. The proposed federal guidelines, a joint effort of the Federal Trade Commission, the Food and Drug Administration, the Centers for Disease Control and Prevention and the U.S. Department of Agriculture, would limit saturated fat, trans fat, added sugars and sodium, due to their potential negative effects on health or body weight. The study also noted which ads were from food companies that pledged to promote healthier products to children or to refrain from targeting children in their advertising, under the Children’s Food and Beverage Advertising Initiative. CFBAI began in 2006 and currently includes 16 companies that signed on, but also set their own nutritional criteria for foods advertised to children. “We found that less than half of children’s exposure to ads for food and beverage products comes from children’s programming, meaning that a significant portion of exposure is not subject to self-regulation,” said Lisa Powell, professor of health policy and administration in the UIC School of Public Health and lead author of the study. The researchers found that more than 84 percent of food and beverage ads seen by children, ages 2 to 11, on all programming were for products high in fats, sugars and sodium. On children’s programming, more than 95 percent of ads were for products high in those unhealthy contents. Nearly all CFBAI ads seen on children’s programming failed to meet recommended federal nutrition principles; more than 97 percent were for products high in fats, sugars and sodium. While many foods made by CFBAI companies meet federal nutrition guidelines, the study suggests that the companies choose to market less-nutritional products to children more heavily. “The self-regulatory effort has been ineffective so far,” Powell said. The CFBAI has proposed new, uniform nutrition criteria for member companies beginning Dec. 31, to replace the varying nutrition standards set by each company currently.

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Patient’s Parents: Marijuana Bill Doesn’t Go Far Enough Parents unhappy Gov. Cuomo’s measure doesn’t expand to pediatrics By Ernst Lamothe Jr.

bill going through the New York state legislature last year was going to determine whether Christine Emerson moves out of the state. Less than a week into the New Year, she thought the governor gave her a gift. But on further review, she still may have her bags packed. Gov. Andrew Cuomo announced an executive action that would allow medical marijuana in limited form for those with illnesses such as cancer, glaucoma and serious diseases that meet standards set by the state Department of Health. It was a surprising shift for a man who had yet to wrap his arms around legalizing medical marijuana. The order gives 20 hospitals throughout the state the power to prescribe marijuana. However, the measure doesn’t expand to pediatrics, which is why Emerson is still pushing for a more expansive bill such as the one offered by Sen. Richard Gottfried (D-Manhattan). He has been diligently working all of last year on the Compassionate Care Act that would allow children suffering from refractory epilepsy to access medical marijuana to treat their seizures. It comes in the form of an oil taken with food instead of inhaling. The act would allow New Yorkers with debilitating medical conditions to obtain 2.5 ounces of marijuana at a time. The program would be monitored by the state Health Department and taxed with 50 percent of revenue going to the county where the drug is dispensed. Medical officials said since this specific cannabis has such low levels of THC, there is no psychotropic effects unlike the prescription medications patients are currently treated with. “While we are grateful for Gov. Cuomo coming forward, this is going to fall short of what we need to help thousands of New Yorkers who are suffering,” said Emerson, of Chili. “This is not going to help my daughter, and it doesn’t help any child who has serious medical issues.” Three years ago after dealing with a viral illness that resulted in a high fever and multiple seizures, Tim and Christine Emerson took their then 4-year-old daughter, Julia, to the emergency room. She had just had a seizure that lasted for 20 minutes and the family was scared. She would soon be diagnosed with refractory symptomatic epilepsy. Doctors told the family that Julia Page 12

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has bad seizures and, if medication doesn’t work, then the family is in big trouble. However, the state Senate has been slow to take up the issue let alone pass it. If it were to become law, New York would join 19 states and the District of Columbia to have legalized medicinal cannabis since California led the charge in 1996. Among those states are Connecticut, Massachusetts, Vermont and New Jersey, all bordering New York. “I’ve had to take up temporary residence in Colorado where I have family so that my daughter, Julia, can receive the medication for her seizures,” said Emerson. “Whenever we have to go down there for treatment, I have to take a leave from my job, leave my family at home to take Julia to Colorado and it’s devastating to break up your family. If the law isn’t passed soon, we will have to uproot our family to go to Colorado which will be sad because our immediate family is here in New York. But I’m willing to move because I will do anything for my daughter.” Emerson has become a strong advocate for allowing children with severe conditions such as her daughter to use medical marijuana. She has met dozens of parents who share the same uphill battle of trying to educate lawmakers, the public and even family and friends about the issue. “The kids in Colorado who have used this treatment have experienced huge reductions in seizures,” said Emerson. “But all people hear is the word marijuana and they think about kids getting high. This is such a small amount and in oil form that I just want to educate people and tear down the myths. Sen. Gottfried, who is Assembly health committee chairman, held a hearing a few months ago on the possibility of allowing a medical marijuana system in New York. Physician Jeffrey Reynolds, executive director of the Long Island Council on Alcoholism and Drug Dependence, testified at the hearing urging lawmakers not to legalize. He expressed concern that approving marijuana use—no matter whether it was smoked outright or its active ingredients were taken in a pill—would open the door to drug abuse and worse social problems. “While we have the utmost respect for members of the NYS Legislature, none to our knowledge are physicians or researchers,”

said Reynolds. “We question the wisdom of political interference in the scientific process, especially as some bill sponsors have now made it clear that the end game here really is legalization.” Reynolds would support federal action that creates large regional research programs where patients could safely obtain standardized pharmaceutical grade products under medical supervision. But he says the law is far more overreaching. “The bill, as currently written, places significant responsibilities on the New York State Department of Health at a time when the state workforce is at an all time low and the department is wrestling with a variety of new requirements,” added Reynolds. Physician Sunil Kumar Aggarwal, executive science director for the Center for the Study of Cannabis and Social Policy, also testified at the hearing but he supports the Senate bill and wants to see medical marijuana as an option for his patients. He has studied Washington State’s medical cannabis program, along with conducting

In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

his own research and clinical trials. Through his research with patients, he discovered how medical marijuana helped people who had a wide range of chronic and debilitating medical conditions such as chronic neuropathic pain, spinal cord injuries, multiple traumas, cancers, HIV, inflammatory bowel diseases, and had varying degrees of functional limitations “There are cases that have been published in U.S. National Library of Medicine indexed journals showing that marijuana, orally administered in extract form, can treat intractable pain in cancer and improve mobility and symptom control in multiple sclerosis,” said Aggarwal, who is also vice-president of the New York Physicians for Compassionate Care. “Additionally, cannabis plant material is one of the best studied and characterized plant materials in science. As of 2008, there were over 15,000 articles alone on the chemistry and pharmacology of cannabis. The fact that federal health regulators are not acting is all the more reason for state governments to act.”

SmartBites

Helpful tips By Anne Palumbo

The skinny on healthy eating

Turn Up the Heat with Hot Peppers

t’s February, and you know what that means: Valentine’s Day, romance, dinner for two by a crackling fire. On that steamy note, I thought I’d feature a lesser-known aphrodisiac that Cupid might serve if he were out of his magical arrows: chile peppers. Though perhaps not as sexy as oysters or figs, chile peppers hover near the top of love’s leader board thanks to the chemical responsible for their heat: capsaicin. Yes, the same chemical used in hot-pepper spray. So, what exactly does capsaicin do to put us in the mood? One, it causes us to release endorphins, the pleasure hormone. Two, it quickens the pulse and induces sweating, which mimic how we feel when aroused. And three, it can increase nerve sensitivity. In addition to lighting love’s fires, capsaicin holds other potential health benefits, as well. According to the latest research at UCLA, this sizzling ingredient may aid weight loss efforts in two ways: by slightly curbing appetite and by boosting metabolism. What’s more, capsaicin may fire a lethal blow at cancer cells, according to physician H. Phillip Koeffler, director

The amount of capsaicin varies with pepper type, with fiery habaneros containing a lot; hot jalapenos, a good amount; and mild poblanos, just a little. So, choose wisely. Since the white veins inside a pepper contain the most capsaicin, you can always remove those to reduce the heat. Be sure to wash your hands carefully after cutting hot peppers. Mouth on fire? Reach for bread, milk or a spoonful of sugar; water is the least effective remedy.

Spiced Chicken Breasts with Sauteed Pepper Medley Adapted from Bon Appetit; serves 4

of hematology and oncology at Cedars-Sinai Medical Center and professor of medicine at UCLA. In a recent prostate study, capsaicin caused the death of about 80 percent of prostate cancer cells in mice. Another surprising feature of these hot little gems? Most are super high in vitamin C. While the amount varies with each pepper, a good number meet our daily needs for this important vitamin. Some varieties also provide respectable amounts of vitamin A, a powerhouse nutrient that’s essential for all-around good health. What’s not surprising is that, like most vegetables, chile peppers are low in fat, cholesterol, sodium and calories. Put it all together and what have we got? One heart-thumping-waist-trimming-immune-boosting-mood-inducing bite of pure pepper heaven. Arriba!

2 ½ teaspoons ground coriander 2 ½ teaspoons ground cumin salt and pepper 4 skinless, boneless chicken breasts 2 tablespoons olive oil, divided 1 medium red onion, halved, sliced ¼-inch thick 2 large fresh poblano chiles, cut into 1 ½ x ¼-inch strips 2 large fresh Anaheim chiles, cut into 1 ½ x ¼-inch strips 1 red bell pepper, cut into 1 ½ x ¼-inch strips 2 cherry chile peppers, diced (optional) 1 jalapeno, diced (optional) 2 cloves garlic, minced 2-3 tablespoons fresh lime juice 1/3 cup chopped fresh cilantro or 1 tablespoon dried

February 2014 •

Mix coriander and cumin. Sprinkle

chicken with salt, pepper, and half of spice mixture. If breasts are particularly thick, either pound to flatten or slice in half horizontally. Heat 1 tablespoon oil in large nonstick skillet over medium-high heat. Add chicken, cover, and cook until cooked through, 6 to 8 minutes per side. Transfer to plate; cover with foil. To same skillet, heat another tablespoon oil over medium heat. Add onions and sauté for about 4 minutes, until soft. Next, add all the peppers and garlic and sauté for about 8 minutes, adding some water if the mixture starts to stick to pan. Stir in remaining coriander mixture, lime juice and cilantro. Season to taste with salt and pepper. Return chicken to sautéed-pepper mixture, cover and heat up for about 2 minutes. Good served with brown rice. 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.

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Page 13

This is tobacco

marketing. Kids who see it are more likely to smoke.

It’s a fact:

Research shows that kids who shop at stores with tobacco marketing two or more times a week are 64% more likely to start smoking than their peers who don’t.

Our kids have seen enough. Take action to protect them at

Source: Henriksen, Schleicher, Feighery and Fortmann. Pediatrics: The Official Journal of the American Academy of Pediatrics, July 19, 2010. DOI: 10.1542/peds.2009 3021

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In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

23584_1025x14_Ad_F.indd 1

1/10/14 3:20 PM

Golden Years

The Aging Digestive System By Deborah Jeanne Sergeant

e tend to notice the outward signs of aging at first — an age spot here, a wrinkle there — but our insides age, too. Many older adults notice that their digestion isn’t the same as it used to be. They may experience more indigestion, sensitivity to certain foods and constipation. Digestion starts with the saliva in the mouth. As many as half of older adults experience dry mouth. Having less saliva hampers digestion. Medication causes dry mouth for some of these seniors, so it pays to ask your doctor if you can change medication. Heartburn plagues many older adults. Taking antacids may seem a sensible solution; however, recent studies indicate that most older adults have the right amount of acid. Mechanical problems may be the problem. The esophagus may not close as tightly as it used to. Some seniors don’t have the sensitivity to pain in the esophagus as they used to, so they may suffer severe

acid damage before they are aware of it. Many older adults take medications and some of these impair digestion, causing more upset stomach, sensitivity to certain foods and constipation. These medications could include non-steroidal anti-inflammatory medications or bisphosphonates. Older adults may also be susceptible to conditions such as lactose sensitivity or intolerance, in which dairy food is hard to digest because they lack sufficient lactase, the naturally-occurring enzyme that breaks down milk. This can cause bloating, gas and upset stomach. Over-the-counter enzyme supplements may help make dairy more tolerable. Constipation plagues many older adults. Medication can be one cause; however, diet may be another. “Stay hydrated by drinking a lot of water,” said Cindy Fiege, natural health consultant and owner Harmony

Health Store, LLC, in Spencerport. Some older adults don’t like drinking water because they want to avoid rushing to the bathroom; however, sufficient water is vital to proper bowel function and especially if you take over-the-counter fiber powder. Obtaining fiber from natural sources is ideal, however. Beyond whole grain products and prune juice, look to the produce section. “Load your diet with fiber,” Fiege said. “Veggies are an important part of everyone’s diet. They contain dozens of important nutrients and contain dietary fiber.” She added that for general digestive health, it’s important to limit fats in your diet, and maintain a healthy body weight. Stick to healthy portion sizes and avoid overeating. “Get regular exercise,” Fiege said. Manuel Enecilla, Jr., an internal medicine physician with a specialty in geriatrics with Essential Wellness

in Rochester and a hospitalist with Geneva General Hospital, recommends that older adults take further steps to improve digestion. These include regular bowel movements, staying up-to-date with age-appropriate screening such as colonoscopy, and, as Fiege suggested, staying active. “The more sedentary you are the more prone you will for constipation,” he said. “Keep medication intake to a minimum. Polypharmacy often affect gut flora and motility.” Of course over-the-counter remedies may alleviate digestive symptoms; however, to resolve the problems, it’s important to discuss the issues with your primary care physician. Be upfront with your symptoms, diet, lifestyle, medication and supplements because they all make a difference. Follow advice and ask questions about strategies that don’t make sense to you.

Experts Discuss Keys to Healthy Aging By Deborah Jeanne Sergeant

e all know there’s no fountain of youth; however, it seems like it the way some seniors age. They’re full of vitality even into their 90s. Anyone can maximize his elderly health by taking a few steps in mid-life or anytime. “We start to age the day we are born,” said Manuel Enecilla, Jr., an internal medicine physician with a specialty in geriatrics who serves as a hospitalist with Finger Lakes Health. “There is no right age or time to adopt a healthful lifestyle. It should be now.” He believes that the top changes anyone should make to age more healthfully and lower medical risk factors are stop smoking, avoid a sedentary life style, keep a healthy weight (preferably BMI — body-mass index — between 21 to 25), keep a healthy diet (a good place to start is with the USDA food ladder, www.choosemyplate.gov), avoid stress, avoid depression. “Especially with the retired population, who is used to being very busy and productive but currently have nothing to do, depression is prevalent,” Enecilla said. “Choose a hobby that would keep [you] interested and involved. One study has shown people who ballroom dance have a lesser incidence of dementia.” What may seem like the ordinary changes that occur with aging could be the sign of a more serious problem, such as forgetfulness may be the sign of early dementia or unexplained weight loss could signal cancer. Keep regular appointments with a primary care physicians to discuss any concerns you have such as traits you have not noticed before or sudden changes in your body. It’s easy to give up and say that

your genetics “doom” you to whatever health fate has in store; however, you have more control over how you age than you think. “I firmly believe that a person’s health is the byproduct of both his genetic make-up and his environment,” Enecilla said. “Though you cannot modify your genome, you can modify a lot of environment stressors.” William Hall, internist with a specialty as a geriatrician at University of Rochester Medical Center, agrees

that you can do a lot to influence your health in later life. “The earlier one starts to take responsibility for health, the better,” he said. He strongly recommends patients to engage in a half hour of exercise three times per week minimally. “It should be something that makes you a little bit uncomfortable, not breathless, but not a stroll,” Hall said. “It should be something a bit strenuous.”

At every age, at every stage of living…

He also advises older adults to stay mentally active. Once retired, it’s easy to slide into familiar routines and not challenge the mind. Hall encourages seniors to perform mental gymnastics such as solving puzzles and staying socially active. “Older people lose friends and spouses,” Hall said. “For most people serious about this, you’re not alone. It’s not a rare phenomenon. It’stime to get involved in a church group or other interest group.

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Golden Years Tips and Tools to Help Seniors Regain their Flexibility By Jim Miller

f all possible exercises, stretching tends to be the most overlooked and neglected among seniors, yet nothing is more vital to keeping an aging body limber and injury free. Here’s what you should know along with some tip and resources to help you regain some flexibility. As we age, our muscles naturally lose their elasticity if they not active, which can make common day-today activities like reaching down to tie your shoes, or looking over your shoulder to back your car out of the driveway difficult. But the good news is, by incorporating some simple stretching exercises into your routine (at least three times a week) you can greatly improve your

flexibility, as well as enhance your balance, posture and circulation, relieve pain and stress, and prevent injuries. In addition, stretching is also important as a warm-up and cool-down for more vigorous activities, and leg stretching is an excellent way to prevent nighttime leg cramps too.

Stretching Basics

Stretching exercises should focus on the muscles in your calves, front and back thighs, hips, lower and upper back, chest, shoulders and neck. If you’ve had hip or back surgery, you should talk to your doctor before doing lower-back flexibility exercises. If you don’t have any experience with stretching, there are books like “Stretching for Dummies” and “Stretching for 50+” that you can purchase at your local bookstore or amazon.com that provides instructions and illustrations of proper techniques.

There are also a number of DVDs and videos you can buy to guide you through a series of stretching exercises you can do at home. Collage Video (collagevideo.com, 800-819-7111) sells several at prices ranging between $10 and $20, as does iefit.com and amazon. com. Also see go4life.nia.nih.gov, a resource created by the National Institute on Aging that offers a free exercise DVD and booklet that provide illustrated examples of stretching exercises. You can order your free copies online or by calling 800-222-2225. While stretching, it’s very important to listen to your body. You want to stretch each muscle group to the point where the muscle feels tight. If it hurts, you’ve gone too far. Back off to the point where you don’t feel any pain, then hold the stretch for 10 to 20 seconds. Relax, then repeat it three to five

times, trying to stretch a little farther, but don’t bounce. Bouncing greatly increases your chance of injury. It’s also a good idea to warm up a little before you start stretching by walking in place and pumping your arms. And remember to breathe when you stretch. Also keep in mind that muscles that have not been stretched in a while take time to regain their flexibility. So be patient and go slow.

Eastern Options

Another popular way to improve your flexibility is through gentle yoga or chair yoga. In chair yoga you replace the yoga mat with a chair where most poses can be duplicated. This is much easier on tight, inflexible muscles. To get started, there are DVDs and videos that offer yoga instructions and routines for seniors that you can do at home. Some good resources for finding them are peggycappy.net and yogaheart.com, or check with your local public library. Tai chi is another good exercise option for improving flexibility and balance. To learn it, it’s best to work with an instructor who can teach you the correct movements and breathing techniques. To locate a class in your area, call your local senior center, health club or wellness center or check your yellow pages. If nothing’s available, tai chi DVDs for seniors (see amazon.com, collagevideo.com and iefit.com) is a good alternative. Jim Miller is the author of “Savvy Senior” column, which appears monthly in In Good Health.

Heart-Healthful Foods By Deborah Jeanne Sergeant

atmeal, walnuts, mushrooms, olive oil, salmon: it’s not a strange recipe, but a short list of the many foods touted as “heart healthy.” It’s easy to see why marketing companies promote their clients’ foods as good for the ticker. As of 2010, the most recent year recorded by the Centers for Disease Control, 236.6 American adults died from cardiovascular disease per 1,000. Although the rate has been steadily declining since 2000, ask any surviving family member and the rate remains too high. Simply put: Eating right can help decrease the risk of cardiovascular disease. Caitlin Sexton, registered dietitian Sexton with Clifton Springs Hospital & Clinic, said that a “hearthealthy diet is one that follows very closely to the USDA Dietary Guidelines for Americans which emphasizes fruits, abundant vegetables, whole grains and fat-free or low-fat dairy products. It includes protein from a variety of sources such as lean meats, poultry, fish, beans, eggs, and nuts and is low in saturated and trans fats, cholesterol, sodium and added sugars.” In general, eating a well-balanced diet represents a good step toward Page 16

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heart health. Instead of homing in on a handful “magic” foods, broaden your diet to include a variety of healthful foods. “Looking at the reason why a food became popular for its heart-healthy benefits will allow you to find other foods that provide the same benefit and may actually suit your tastes and needs better,” Sexton said. Omega-3 fatty acids, found in canola oil, olive oil, walnuts, flaxseeds and salmon and other fatty fish like albacore tuna and mackerel, help support good heart health. This doesn’t mean fixing fish every night for dinner. Serving fish a couple meals a week will do. “It is recommended for the average person to consume two four-ounce portions of fish on a weekly basis,” Sexton said. Tourtellotte High fiber foods also offer benefit by lowering cholesterol. Sexton said that four to five cups of fruits and vegetables a day and consuming at least half of one’s grains as whole grains should provide sufficient fiber. “The recommendation is 20 to 30 grams per day, but it is necessary to gradually build up to this and drink plenty of fluids in order to avoid dis-

comfort,” she said. High fiber foods can include popcorn, whole-grain bread (not just “wheat” bread, which may have little fiber), whole fruits and vegetables. “Soluble fiber works like a sponge in the lower digestive system picking up excess cholesterol for excretion,” said Amanda Tourtellotte, dietitian for Finger Lakes Health’s Cardiac Rehabilitation programs Diabetes Services program. She also recommends olive oil as part of a healthful diet. “It is a great source of monounsaturated fats which are shown to provide protection against heart disease,” she said. “By using monounsaturated fats—olive and canola oils and avocados and nuts—you are replacing the unhealthy saturated fats that can be harmful, like butter.” Of course, fat from any source is high in calories. To stay in balance and consume enough carbohydrates and protein, follow the American Heart Association’s recommendation of no more than 25

In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

to 35 percent of your daily calories to come from fat. “In practical experience, I am seeing a lot more consumers using olive and canola oils in place of butter,” Tourtellotte said. “I think as the general public we are still consuming more saturated fat than recommended.” She encourages clients to research on the Internet at sites such as the American Heart Association (www. heart.org), The Academy of Nutrition and Dietetics (www.eatright.org), Choose my Plate (choosemyplate. gov) or the Dietary Guidelines for Americans (www.cnpp.usda.gov/ DGAs2010-PolicyDocument.htm). In addition to eating well, maintaining a healthful weight, engaging in regular exercise, avoiding tobacco products and managing stress can help lower risk of cardiovascular disease.

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How to Choose a Continuing-Care Retirement Community Dear Savvy Senior, Can you give me some tips on picking a good full-service retirement community that offers all levels of housing, from independent apartment-style to nursing home care? My wife and I are both approaching 80 and are looking to downsize from our current home, but we want our next move to be our last. One More Move Dear One, If you want your next move to be your final one, a full-service retirement community — better known as a continuing-care retirement community (or CCRC) — is a good option to consider, but they aren’t cheap, so you need to be prudent when choosing.

CCRCs are different from other types of senior housing because they provide all levels of housing, services and care in one convenient location. While they vary greatly in appearance and services, most CCRCs offer apartments or sometimes single family homes for active seniors who need little if any help with their daily needs. In addition, they also offer on-site assisted living for people who require aid to bathe, dress or perform other basic tasks, and nursing home care for residents who need full-time skilled nursing care. CCRCs also provide a bevy of resort-style amenities and services that include community dining halls, exercise facilities, housekeeping and transportation as well as many social and recreational activities. But be aware that all these services come at a hefty price. Most communities have entry fees that range from $20,000 to $500,000 or more, plus ongoing monthly service fees that can vary from around $1,000 to over $5,000 depending on the facility, services and the long-term care contract option you choose.

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With nearly 1,900 CCRCs in operation throughout the U.S, finding a facility that fits your lifestyle, needs and budget can take some legwork. Here are some steps you can take to help you proceed. • Make a list: Start by calling the county’s office for the aging (call 800-677-1116 for contact information) in the area you want to live for a list of CCRCs. You can also search online at leadingage.org/findmember.aspx or carf.org/aging that has a national listing of accredited CCRCs. • Call the facilities: Once you’ve located a few, call them to find out if they have any vacancies, what they charge and if they provide the types of services you want or need. • Take a tour: Many CCRCs encourage potential residents to stay overnight and have a few meals in their dining hall. During your tour, notice the upkeep and cleanness of the facility, and talk to the current residents to see how they like living there. Also, check out the assisted living and nursing facilities and find out how decisions are made to move residents from one level of care to another. To check up on a facility, call the state long-term care ombudsman (see ltcombudsman.org) who can tell you if the assisted living and nursing facilities within the CCRC have had any complaints or other problems. Also, use the Medicare nursing home compare tool (medicare.gov/nursinghomecompare), which provides a ranking system. • Investigate fees: During your visit, get a rundown on the different kinds of contracts that are available and their costs. Also, find out what types of services are included and what costs extra. What yearly price increases can you expect? How much of your entry fee is refundable to you if you move or die? And what happens if you outlive your financial resources? • Research the community’s financial health: Find out who owns or sponsors the facility and get a copy of their most recently audited financial statement and review it, along with the copy of the contract with your lawyer or financial advisor. Also get their occupancy rate. Unless it’s a newer community filling up, occupancy below 85 percent can be a red flag that the facility is having financial or management problems. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. February 2014 •

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The Social Ask Security Office

Heart Matters Understanding Blood Pressure By Ryan J. Hoefen, MD

ypertension (high blood pressure) is a potent risk factor for a future heart attack, stroke, congestive heart failure, aneurysm or kidney failure. However, there are no symptoms associated with high blood pressure, making proper screening and treatment an essential part of preventive medicine. Blood pressure in the arteries goes up as the heart is pumping and falls as the heart relaxes. Blood pressure is expressed as the peak pressure during the pumping phase (“systolic pressure”) over the minimum pressure during the relaxation phase (“diastolic pressure”), both of which are measured in millimeters of mercury (mm Hg). Research shows that the risk of developing heart Hoefen disease increases steadily with blood pressures greater than 115/75 mmHg, doubling with each additional 20 mmHg systolic or 10 mmHg diastolic pressure. Therefore, blood pressures less than 120/80 mmHg are considered normal. The best way to lower blood pressure is to make healthy lifestyle changes. A diet with plentiful fruits and vegetables and limited sodium and saturated fats can reduce blood pressure by up to 20 mmHg. Regular exercise can also have a significant blood pressure lowering effect. For those who are overweight or obese, weight loss can be very effective, lowering blood pressure by up to 1 mmHg with each pound of weight loss. The level at which medications are warranted to help lower blood pressure is still a focus of research. Past guidelines suggested a threshold of 140/90 mmHg for most people and an even more aggressive threshold of 130/80 mmHg for people with diabetes or kidney disease. A recent guideline update increased the threshold to start medica-

tions to 150/90 mmHg for people over 60 years old and 140/90 mmHg for people with diabetes or kidney disease while keeping the level at 140/90 mmHg for people under 60 years old. Blood pressure varies throughout the day, responding to level of alertness, activity, stress, pain and diet. Blood pressure goals discussed above refer to measurements taken in a rested, relaxed state. Mildly elevated measurements in the setting of shortterm stress, pain or sleep deprivation may not necessarily warrant starting blood pressure lowering treatment. As such, blood pressure readings at your doctor’s office may not reflect usual blood pressure levels for people who tend to experience anxiety in a medical setting. Additional measurements taken at home or at a pharmacy may be helpful to provide a better sense of your typical blood pressure levels. Home blood pressure measurements should be taken in a rested and relaxed state. Don’t get in the habit of checking only when you don’t feel well since your blood pressure is not likely to be representative of your true baseline at these times. Write the results in a log and take it to your doctor’s appointments for review. Bring your home blood pressure cuff to your doctor’s appointments as well so it can be checked for accuracy. If you’re shopping for a blood pressure cuff, look for one that fits around the upper arm since they tend to be the most accurate. Be sure the cuff is properly sized to your arm since inappropriate sizing reduces accuracy. Cuffs that fit around the wrist can also give reasonable results but must be held at the level of the heart for accurate readings. Discuss any questions or concerns about blood pressure with your doctor. See the cardiovascular risk assessment tool at UCVA.com to learn more about your blood pressure and other risk factors. Ryan J. Hoefen, MD, PhD, FACC is a cardiologist with UCVA Comprehensive Cardiovascular Care (ucva.com).

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Your Spouse May Be Covered By Social Security

f you have a spouse who does not earn an income or who earns less than you do, your spouse (including a same-sex spouse) may be entitled to Social Security spouses’ benefits based on your record. Social Security can be an important financial asset for married couples when the time comes to apply for retirement benefits. In many cases, one spouse may have earned significantly more than the other or may have worked longer. Or it could be that one spouse stayed home to do the work of raising the children, caring for elderly family members or managing the household while the other focused on a career. Whatever your situation, Social Security will look at all possibilities to make sure both spouses receive the maximum Social Security benefits possible, whether based on each spouse’s earnings record or the higher wage-earner’s record. Your spouse can apply for benefits the same way that you apply for benefits on your own record. He or she can apply for reduced benefits as early as age 62 or for 100 percent of the full retirement benefits at full retirement age. Not sure what the full retirement ages are? To learn your and your spouse’s full retirement ages, based on birth year, visit www.socialsecurity.gov/ pubs/ageincrease.htm. The benefit amount your spouse can receive at full retirement age can be as much as one half of your full benefit.

Q&A Q: My spouse died recently and my neighbor said my children and I might be eligible for survivors benefits. Don’t I have to be retirement age to receive benefits? A: No. As a survivor, you can receive benefits at any age if you are caring for a child who is receiving Social Security benefits and who is under age 16. Your children are eligible for survivors benefits through Social Security up to age 19 if they are unmarried and attending elementary or secondary school full time. If you are not caring for minor children, you would need to wait until age 60 (age 50 if disabled) to collect survivors benefits. For more information about survivors benefits, read our publication Survivors Benefits at www.socialsecurity.gov/pubs. Q: I run a bed and breakfast. By this time every year, I am tired of all the paperwork involved with filing taxes. Is there an easier way for small businesses to file W-2s for their employees? A: Absolutely. If you are a small

In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

If your spouse opts for early retirement, the benefit may be as little as a third of your full benefit amount. Note that benefits paid to your spouse do not decrease your benefit amount. If you have already reached full retirement age but continue to work, you can apply for retirement benefits and request to have the payments suspended until as late as age 70. This would let you earn delayed retirement credits that will mean higher payments later, but still would allow your spouse to receive a spouse’s benefit. People can also apply for spouse benefits based on the earnings record of an ex-spouse or deceased spouse if married for at least 10 years. Spouses can consider a number of options and variables. We make it easier to navigate them. A good place to start is by visiting our benefits planner at www. socialsecurity.gov/planners. Take note of the “Benefits As A Spouse” section. If you are ready to apply for benefits, the fastest, easiest, and most convenient way is to apply online! You can do so at www.socialsecurity.gov/ applyonline and complete your application in as little as 15 minutes. Due to a Supreme Court decision, we now are able to pay benefits to some same-sex couples. We encourage people who think they may be eligible to apply now. Learn more at www. socialsecurity.gov/same-sexcouples. Whether you receive benefits on a spouse’s record or your own, rest assured we will make sure you get the highest benefit for which you qualify. Learn more at www.socialsecurity.gov.

business owner or entrepreneur, you should check out Social Security’s Business Services Online (BSO) website. There, you can file your employees’ W-2s and W-2cs electronically and print out the W-2s to provide paper copies to your employees. You also can verify the Social Security numbers of your employees. Our online services are easy to use, fast, and secure. Visit our BSO page at www.socialsecurity. gov/bso. Q: Will my military retirement affect my Social Security benefits? A: No. You can get both Social Security benefits and military retirement. Generally, there is no offset of Social Security benefits because of your military retirement. You will get full benefits based on your earnings. The only way your Social Security benefit may be reduced is if you also receive a government pension based on a job in which you did not pay Social Security taxes. You can find more information in the publication Military Service and Social Security at www.socialsecurity. gov/pubs. Or call us at 1-800-772-1213 (TTY 1-800-325-0778).

Want to Slow Mental Decay? Play a Video Game

here may be a way for older people to prevent natural aging of their minds, and it could be as simple as playing a video game. That’s according to a study from the University of Iowa, which found that elderly people who played just 10 hours of a game priming their mental processing speed and skills delayed declines by as many as seven years in a range of cognitive skills. “We know that we can stop this decline and actually restore cognitive processing speed to people,” says Fredric Wolinsky, professor in the UI College of Public Health and lead author on the paper published in May in the journal PLOS One. “So, if we know that, shouldn’t we be helping people? It’s fairly easy, and older folks can go get the training game and play it.” The study comes amidst a burst of research examining why, as we age, our minds gradually lose “executive function,” generally considered mission control for critical mental activities, such as memory, attention, perception and problem solving. Studies show loss of executive function occurs as people reach middle age; other studies say our cognitive decline begins as soon as 28 years of age. Either way, our mental capacities do diminish, and medical and public health experts are keen to understand why in an effort to stem the inexorable tide as much as possible. Wolinsky and colleagues separated 681 generally healthy medical patients in Iowa into four groups—each further separated into those 50 to 64 years of

age and those over age 65. One group was given computerized crossword puzzles, while three other groups were exposed to a video game called “Road Tour.” Briefly, the game revolves around identifying a type of vehicle (displayed fleetingly on a license plate) and then reidentifying the vehicle type and matching it with a road sign displayed from a circular array of possibilities, all but one of them false icons. The player must succeed at least three out of every four tries to advance to the next level, which speeds up the vehicle identification and adds more distractions, up to 47 in all. The goal, naturally, is to increase the user’s mental speed and agility at identifying the vehicle symbol and picking out the road sign from the constellation of distractors (which are rabbits, by the way). “The game starts off with an assessment to determine your current speed of processing. Whatever it is, the training can help you get about 70 percent faster,” says Wolinsky, who has no financial stake in the game. The groups that played the game at least 10 hours, either at home or in a lab at the university, gained at least three years of cognitive improvement when tested after one year, according to a formula developed by the researchers. A group that got four additional hours of training with the game did even better, improving their cognitive abilities by four years, according to the study. “We not only prevented the decline; we actually sped them up,”

Wolinsky says. Improving people’s processing speed is considered important for a host of reasons. One widely accepted benefit is widening a person’s field of view. “As we get older, our visual field collapses on us,” Wolinsky explains. “We get tunnel vision. It’s a normal functioning of aging. This helps to explain why most accidents happen at intersections because older folks

February 2014 •

are looking straight ahead and are less aware of peripherals.” “It’s the ‘use it or lose it’ phenomenon,” Wolinsky says. “Age-related cognitive decline is real, it’s happening, and it starts earlier and then continues steadily. The good news is we can do something about it. The question is will we?”

In Good Health – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

A communications center (formerly known as a nurses station) on one of the newly renovated areas at Unity Hospital, 1555 Long Pond Road. Photo submitted by Unity Health Systems.

Unity Health Expects Banner Year Major changes in store for health provider By Ernst Lamothe Jr.

his year will be a grand new year for Unity Health Systems. Whether you are talking about finalizing a merger, new facilities opening up or initiatives being launched, the organization is priming for sweeping changes. Unity and Rochester General Health systems board of directors voted last year to approve an affiliation agreement where the two organizations would come together to form a singular health care system with equal representatives from both sides. The merger, which is expected to occur by July 1, must go through several regulatory approvals. Hospital officials had to explain to state and federal organizations exactly what the new hospital system would resemble and what benefits were expected for the larger community. “Then they perform their analysis and determine whether the merger would improve the competitive environment or impact it negatively,” said Warren Hern, CEO of Unity. “We have confidence that this will be something that the greater public will benefit from.” As one organization, RGHS and Unity will build and combine its information technology, primary care and community-based care management resources. They will consolidate duplicate infrastructure, streamlining overhead costs and avoid additional expensive building projects. Both hospital systems offer dialysis so it allows them to buy bulk equipment and supplies at a lower cost. Hospital representatives plan on spending the next few months further understanding each other’s strengths and weaknesses. “The merger will allow us to strengthen our clinical services,” said Hern. “Rochester General has a really good cardiology department. Unity has a strong neuroscience and joint replacePage 20

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ment. We have the opportunity to save on expenses just by coming together and combining our volumes.” The Rochester General Health System operates Rochester General Hospital and Newark-Wayne Community hospitals as well as two long-term care facilities, Hill Haven and DeMay Living Center. The Unity Health System operates Unity Hospital on the Unity Park Ridge Health Care campus in Greece and Unity St. Mary’s campus in Rochester. Rochester General is the area’s third largest employer with 8,100 employees. Unity is sixth with 5,358. In May, Unity will open its new hospital, which was part of $150 million modernization and expansion project. The renovation updates its existing facility that is about 40 years old, including installing new air conditioning units and windows. The project adds 35

new beds. “All the patients’ rooms will be private and essentially we will have a brand new facility,” said Hern. “And with the rooms being private, we can cut down on potentially infectious situations. We also put a lot of emphasis on sound management so that patients can have quiet during the day and night.” Construction for the project began with phase I in 2010, which included the opening of Wegman Family Cottages at Park Ridge Living Center and the McCormick Transitional Care Center. In addition, the new Golisano Restorative Neurology and Rehabilitation Center, and a new joint replacement center are scheduled to open this year. The Golisano center offers state-of-the-art care focusing on restorative technologies, comprehensive rehabilitation services including inpatient and outpatient traumatic brain

Warren Hern, CEO of Unity Health Systems

In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

injury and spinal cord services. When the project is complete, the goal is for patients to see improvements in a range of services from cardiology and pharmacy to better nursing stations and larger parking lots. In the new year, Doug Stewart takes over as president of the health care service division. Previously he was senior vice president of the division. “Doug did a great job in focusing our attention on behavioral health and making sure it was financially viable,” said Hern. “He is also one of the reasons why we have seen improvement in our patient satisfaction.” He replaces Stewart Putnam, who spent three decades of leadership at Unity Health systems and the former St. Mary’s Hospital. “It’s a great honor to be able to succeed someone like him and I’ve had the privilege of working with him for the last eight years and he’s been an incredible mentor,” said Stewart, who joined Unity in 2005 as vice president of behavioral health and has overseen operations of inpatient, ambulatory and support services at Unity Hospital since 2012. Stewart said he is looking forward to three priorities for the new year: continuing to develop a highly engaged workforce that delivers consistently outstanding patient and resident experiences, advancing commitment to patient care and building on the improvements of last year’s efficiency and effective care in the emergency center and throughout the hospital. He credits the success to staff and setting specific objectives. “I place great value on recruiting and retaining exemplary performers and giving them the structure and support they need to achieve measurable results,” he added. “ I believe in providing clear goals and achieving them through highly effective and accountable teams.” This year, the hospital system also begins renovating the Edna Tina Wilson Living Center, a 120-bed skilled nursing facility located on Island Cottage Road in Greece. The $5.8 million project will include renovating approximately 29,000 square feet of interior common space. Renovations involve more private space for elders and their families, as well as providing more open space that is currently divided by glass panes and doors. In addition, all acoustic and light features will be updated to be more sensitive to those with dementia. Construction has begun and will be completed about 13 months from now. “Instead of it looking like a nursing home, it will feel more home-like,” said Hern. “We have an increasingly-aging population in this community who will need these facilities and others. We are also investing in memory care units for seniors who are physically healthy but may have some memory issues like Alzheimer’s.” Unity also opened its thyroid center. Within one to two days, patients will see an endocrinologist and receive necessary diagnostic tests. By the end of that day, the endocrinologist will contact the patient with their test results and provide a treatment plan for follow up. The normal process previously took two weeks or more. “Thyroid cancer is one of the fastest growing cancers in the United States,” said Hern. “When it comes to cancer, early warning, even by a few weeks, can be potentially life saving.” In the past three years, Unity Health Systems has invested more than $200 million in its existing or projected facility.

H ealth News Rochester General Hospital Fairport Baptist Homes Unveils new logo, website tries to go ‘flu free” With the number of influenza cases increasing in the Rochester area, Rochester General Hospital is taking precautionary steps to protect the health of its patients, staff and visitors. Effective Jan. 14, the provider began hospital-wide restrictions, which include a maximum of two visitors per patient on all units; all visitors must be at least 14 years old; and a strong recommendation that anyone with symptoms of illness not visit patients in the hospital. These restrictions will remain in place until further notice.

VNS of Rochester appoints new chief clinical officer

Visiting Nurse Service of Rochester (VNS), an affiliate of the University of Rochester Medical Center, recently appointed Denise Fitzgerald Burgen to VNS’s new position of chief clinical officer. Burgen will accelerate implementation of VNS’s strategic initiatives by assuring VNS’s consistency in clinical delivery across the organization, helping coordinate full clinical collaboration across the University of Rochester Medical Center’s (URMC) health system, Burgen and benchmarking best practices in both traditional home care and new models of community-based care. Burgen will also work on a URMC-wide effort to develop centralized care management structures and processes to support high-risk, high-cost patient populations, including those in health homes. “We are thrilled that Denise has joined the VNS of Rochester team,” said Vicky Hines, president and CEO of VNS. “She is uniquely qualified to support not our only home care strategy, but as an affiliate of URMC, our role within the larger health system. She is a high caliber professional and a compassionate individual, ensuring patients receive the best care possible.” Burgen, a Chili resident, previously headed Corporate Health and Global Wellness at Bausch and Lomb. She is a vascular nurse practitioner, a Simon MBA graduate, Harvard Business School Managing Health Care Delivery Program-certified, and an assistant professor at the University of Rochester School of Nursing and Roberts Wesleyan College. She served as director of operations and executive administrator for the Rochester General Medical Groups, chief executive officer of the Midlakes Management Corporation (a physician services company), and senior director of cardiovascular and ambulatory services for Kaleida Health in Buffalo. She also has home care experience conducting geriatric home visits for the frail elderly for Complex Care Solutions.

Fairport Baptist Homes announced a new identity and marketing program around a key ingredient of its culture — “care, by caring people.” According to the organization, care is central to the programs and services offered at Fairport Baptist Homes and the new identity, website (www.fairportbaptisthomes.org) and advertising campaign are based on the stories of caregivers. Care is also an important part of the new tagline: “Caring. Vibrant. Vital.” “The tagline reflects our philosophy and the seniors we care for,” says Thomas H. Poelma, CEO and president of Fairport Baptist Homes. “Though we’ve been at the forefront of senior care for more than 100 years, we realize that not everyone knows how we have changed to meet the needs of seniors. However, one thing has never changed: our philosophy of caring and a lifestyle that is centered around our seniors. We were the first in the area to create the ‘household’ concept, eliminating the hospital-style corridors and creating small ‘neighborhoods’ of 10 or 12 residents. These same seniors share meals together in their country kitchen. They are vibrant individuals and we recognize this new stage of their lives at Fairport Baptist Homes.” After interviewing many of the caregivers at Fairport Baptist Homes, the organization said it became apparent that the kind of care from caring people was going to be a central theme of this new initiative. No matter what the amenities offered to seniors, it always comes down to who is caring for your loved one. “We wanted to change the conversation about the realities of caring for seniors. We feel our caregivers have compelling stories to tell. So through photography and videos, we’re telling those stories online and in our marketing campaign,” said Clayton Cloen, chairman of the board, Fairport Baptist Homes.

Neighborhood gets award from Health Foundation Greater Rochester Health Foundation presented the Robert Oppenheimer Impact Award to the residents of Project HOPE for creating positive change in their Northeast Rochester neighborhood. The Ibero-American Development Corporation (IADC), recipients of Neighborhood Health Status Improvement Initiative grant funding since 2008, work with numerous community partners to make the HOPE neighborhood a strong and healthy place for individuals and families to live, work and play. Project HOPE residents and community partners are engaged in collective action to improve their neighborhood and create a new context for healthy living. In the HOPE neighborhood, the housing is healthier now; more than 60 vacant houses have been demolished and 50 new homes have been built in El Camino Estates. Residents, city officials and the Rochester Police Department are working together on strategies to increase public safety. Community gardens, Fresh Wise Farm Stand and a Foodlink Mobile

Awards worth $35,000 available in the Finger Lakes region   Nonprofits and municipalities in the Finger Lakes region can apply for $35,000 in community health awards for programs targeting chronic diseases, including diabetes and heart disease, and mental health conditions.    Nonprofit, 501(c)(3) organizations and municipalities in Excellus BlueCross BlueShield’s six-county Finger Lakes region are invited to apply for awards of up to $5,000 each. Grants can be used for programs that have clear goals to improve the health of a specific population in the community through the prevention of chronic diseases or mental health conditions.   “Our Community Health Awards for health and wellness programs in the Finger Lakes Re-

Market now provide HOPE residents with access to fresh, healthy, and affordable food. In partnership with the Genesee Land Trust, residents built a playground at a community park next to the El Camino Trail, and families now have access to opportunities for healthy exercise in the form of walking, biking, and children’s play. Neighborhood residents are increasingly engaged in health-promoting activities in these transformed community spaces. Joggers and groups such as Conkey Cruisers now bike along the El Camino Trail. Project HOPE also engages older adults in the neighborhood via the Tienes Salud? (Got Health?) educational series and through intergenerational activities with local youth. “Project HOPE is part of the Health Foundation’s Neighborhood Health Status Improvement initiative, a longterm strategy that acknowledges that where you live, the social, economic and environmental conditions of your neighborhood, and personal health habits, impact your health and ability to engage in a healthy lifestyle,” says physician Louis Papa, chairman of the foundation’s board program committee.

Lynne Maquat named Athena Award winner Lynne E. Maquat, Ph.D., the J. Lowell Orbison endowed chairwoman and professor in the department of biochemistry and biophysics at the University of Rochester School of Medicine and Dentistry, was recently named the 2014 Athena Award winner at a special luncheon at the Rochester Riverside Convention Center. The award, presented annually by the Women’s Council of the Rochester Business Alliance, recognizes women who excel in their professions, give back to their communities and mentor other women for leadership roles. Maquat is an internationally rec-

February 2014 •

gion helps us fulfill our mission to improve the health and health care of the residents of the communities we serve,” said Bob Thompson, vice president of community health engagement, Excellus BCBS.   To be eligible, the organization must be a 501(c)(3) nonprofit or a municipality located in Monroe, Wayne, Ontario, Livingston, Seneca or Yates County.   The deadline to submit an application to be considered for an Excellus BCBS Community Health Award is Feb. 17. Applications and additional information are available online at Community Health Awards or by emailing Community.Health. Awards.ROC@excellus.com. Awards will be distributed in March 2014.

ognized expert in the field of RNA biology in which she works to discover new cellular pathways and clues to the molecular basis of human disease. She is the founding director of the University’s Center for RNA Biology and in 2011 received one of the highest honors posMaquat sible for any scientist — election to the National Academy of Sciences. Elected for her exceptional research, which has been published in more than 110 peer reviewed scientific journals, Maquat is one of only three faculty members from the University of Rochester Medical Center who have been appointed to the academy and the only woman. Maquat spends a great deal of time on peer review — reviewing research papers submitted to scientific journals and grant submissions to funding agencies in the US and abroad — as a way to give back to the scientific community. She has been a member of the RNA Society, which encourages the sharing of experimental results and emerging concepts in RNA research, since its formation in 1993 and has held every elective office from director, to secretary/treasurer, to president. Having spent her career advocating for young women in the sciences, Maquat founded the University of Rochester Graduate Women in Science program (GWIS) in 2003. The goal of GWIS is to address the “leaky pipeline”, which describes how fewer women than men who earn a Ph.D. degree in science go on to use that degree in a career. Each month, GWIS hosts a round-table discussion of high-profile speakers who are using advanced degrees in traditional and non-traditional ways. Twice a year, active GWIS members can apply for travel awards to attend a conference, seminar or other external event that will help them advance their career.

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Now Available in Monroe County

Remain safely at home with help from HomeFirst.

More and more people on Medicaid who might otherwise be in a nursing home won’t have to because of HomeFirst. HomeFirst is one of the oldest managed long-term care (MLTC) plans in the state. Our Personal Care Workers provide assistance with bathing, dressing and meals. You can keep your own doctor, and we provide transportation to medical appointments. There is no cost to participate. HomeFirst is an affiliate of MJHS, which was founded on the core values of compassion, dignity and respect for every culture. Those core values date back to 1907, when MJHS began a tradition of caring every minute, every day.

Call 1-866-384-3509 or visit homefirst.org

Services covered by HomeFirst are paid for by New York State Medicaid. The services not part of HomeFirst benefits continue to be covered by Medicaid and/or Medicare benefits. All services are coordinated, even those not included in the MLTCP benefit package. EPHF13197 12062013

men’s health • cancer complemenary medicine • diabetes pets • nutrition Special March Issue of In Good Health Call 585-421-8109 to place your ad.

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In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014

Do Hearing Aids Always Cost a Small Fortune?

hy are hearing aids so expensive? That question comes up often. And, sadly, we know that many people with hearing loss suffer in silence because they think they can’t afford the hearing aids they need. But there are many options, and many prices, depending upon each person’s unique hearing situation and lifestyle. Top-of-the-line digital hearing aids can be expensive. These sophisticated devices incorporate advanced mini-computer technology that can be programmed to amplify only those frequency ranges specific to a client’s unique needs. These are “smart” hearing aids that can distinguish between speech sounds and background noise, so Perkins they can reduce what you don’t want to hear and amplify what you do want to hear. All of this computer intelligence is being packaged in incredibly tiny and comfortable hearing aids that easily fit into active lifestyles. For executives who need to hear every nuance in a conference room or meeting or for people in regular social settings such as parties or restaurants, buying top-of-the-line hearing technology is a critically important investment in professional career and quality of life. For a retiree who wants to converse with his or her grandchildren, enjoy a symphony or simply hear rain on the roof, expensive aids may not make as much sense. It’s important for all folks to know that, much like buying a car, there is an incredible range of styles and prices available, depending upon needs and lifestyle. You’ll need professional help for testing and determining just which type precisely fits your needs. The trick is in understanding a client’s lifestyle and needs. How does hearing loss interfere with a person’s relationships and their favored activities? Professional audiologists will spend time getting to know each client on a personal level, recommending the solution that best enhances quality of life. Sometimes there are solutions other than hearing aids. There are Bluetooth TV listening devices, amplified phones, smoke detectors and alarm clocks available. All of these offer a variety of aids to solve hearing challenges and improve enjoyment of day to day living. When faced with hearing challenges, make sure you seek qualified audiologists who’ll do the homework needed to help you select a satisfactory and affordable solution. Scott Perkins is director of marketing for Rochester Hearing and Speech Center. A Fairport resident, he also owns Agility Group, a marketing and advertising consultancy. For more information email sperkins@rhsc.org or visit www.rhsc.org.

What They Want You to Know:

Nutrition Counselors By Deborah Jeanne Sergeant

ore people are paying closer attention to what they eat these days. Nutrition counselors and nutritionists can provide very helpful information. Whether working as independent consultants, for a health foods store or fitness center or selling supplements, many nutrition counselors are very well-read and experienced in natural health. They’re not credentialed like registered dietitians or certified diabetes educators (though some of these work in these venues). New York does not require or offer licensure for a person to offer nutrition advice, as long as he does not diagnose or treat disease or use titles such as “certified dietitian,” “certified nutritionist” or “certified dietitian-nutritionist.” “How about the topic of the guy who lost 37 pounds after eating McDonald’s for 90 days? Truth is that you can lose weight on any fad diet, but the problem is that the body needs vital nutrients and McDonald’s and fad diets do not promote healthy food choices. “Healthy food choices include whole grain foods including oatmeal, whole-wheat bread and brown rice. Consuming whole grains food reduces the risk of heart disease and contains fiber necessary for the intestines. Plant oils, including olive oil, avocado oil, sesame oil, and sunflower seed oil... are necessary for hormones, skin, etc. There is more energy in fats than in carbohydrates or proteins. Plant oils are unsaturated. They tend to lower cholesterol. They do add calories, they help foods metabolize and taste better. “You need vegetables in abundance — five or more each day. By getting your daily quota of five to nine servings, you help build your body’s immunity to things like cancer, heart disease and diabetes. “Eat five or more servings of fruits. Each serving equals one piece of fruit or four ounces. Beyond their great taste, fresh fruits are full of important nutrients that can help you maintain a healthy lifestyle. Fiber, potassium and vitamins found in fruits are a daily necessity, while high concentrations of antioxidants may help ward off a host of chronic diseases. “Eat three servings of nuts or legumes. Nuts provide appetite-satisfying flavor and crunch to your healthy diet. Though high in fat, nuts contain mostly healthy, unsaturated fats, some of which are in short supply in the average American diet. Eating nuts has cardiovascular benefits as well as contribute to brain health. “Eat one to two servings of calcium. It’s needed for strong bones and teeth.

“You need three to six servings of protein. Include poultry, fish, grassfed beef and eggs. Protein builds and repairs muscle. Cindy Fiege, natural health consultant and owner Harmony Health Store, LLC, in Spencerport “I’m not certified. I don’t have credentials so I can’t prescribe or diagnose, but what I try to do is help people promote their health through better eating habits and life habits like exercise. “It starts in organic produce. There are no chemical sprays or fertilizers. Start eliminating the bad stuff first. People who eat organically get a better nutritional value, plus they aren’t putting bad things into their bodies. The residue from the chemicals gets in our bodies and stresses our bodies. “When it comes to supplementation, people should be just as careful as when choosing medicines with their doctor. We do everything we can to educate customers without diagnosing or prescribing. It’s a tough balance. It really can be helpful. What we really, really try to do is help people find supplements that will be most helpful for them and minimize the chance of side effect or interactions. I ask every customer that if they’re on any medications, they need to run any new supplement by their pharmacist and/ or doctor. We want to work with the medical community, not against them. “So many people come back and are genuinely grateful that we take the time to discuss things, identify their needs as best we can. All the time, people come back with success stories. It’s a great feeling to have a positive effect on someone else’s life and health. I cherish every day and every day I learn something new, mostly from my coworkers and staff.

Call now for our new patient specials

Greg Beutschbein wellness supervisor, Lori’s Natural Foods Center, Rochester

Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves. February 2014 •

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Wishes bring hope, joy at continuing care center

Wish Upon a Star program at Thompson grants wishes of its skilled nursing facility residents By Jessica Youngman

lake Reed loved rodeos, big trucks and was an up-and-coming stunt man who’d appeared in major motion pictures like “Lethal Weapon 2” and “Born on the Fourth of July.” But five days after Thanksgiving 1989 his life was derailed by a car crash near Syracuse. He survived, but was left severely brain injured and needing specialized care his family was unable to provide. In the 20-plus years since, he has made strides: He can communicate enough to let staff at his home, Thompson Health’s M.M. Ewing Continuing Care Center in Canandaigua, know his likes and dislikes. The former is obvious from Reed’s trademark thumbs up. His contentment was evident during an outing to see monster trucks smash cars and bounce over ramps at the Blue Cross Arena in Rochester. “He was smiling, putting his thumbs up and was rooting for the trucks,” said Wendy Ubbink, recreation manager at the care center. “He really enjoyed every second of the show. He didn’t even want me to turn him to get a picture for his mom because he was afraid he would miss something. He drank a beer, bought a hat and had a souvenir picture taken.” The excursion was the result of a small, dedicated army of care center volunteers and an innovative program called Wish Upon a Star. Launched in October 2010, Wish Upon a Star is an initiative of Thompson Health to enrich the lives of its continuing care center residents while helping dispel the notion that skilled nursing facilities are devoid of hope and joy. Wishes range from a simple trip to the supermarket or dinner with family to outings like Reed’s that require much planning and coordination. They’re drawn during a quarterly celebration by a staff member dressed as a genie — turban, wand and all. “When they told me Blake’s name

had been drawn for a wish, it overwhelmed me,” said his mother, Judy Sibble, who lives in Oklahoma.

Zapping a Klingon

It was early 2010 when a few Thompson employees returned from a conference and told Sharon Pepper, the then-senior vice president of senior living services, about a program they’d heard about that granted wishes of skilled nursing facility residents. “The more we talked,” she said, “the more we said we have to figure out a way to make this happen. We didn’t want residents to feel their lives were over once they entered the continuing care center.” A committee was formed. Research was conducted on everyPepper thing from funding to legal matters. Several months later, Wish Upon a Star was a reality. The first wish granted was that of a resident who had to flee her native Ukraine during World War II, and who wanted a celebration of her Ukrainian heritage, complete with dancers and Ukrainian food. Thompson staff worked with the Ukrainian Arts Foundation of Rochester and the Ukrainian Cultural Center of Rochester, as well as the resident’s family. All of M.M. Ewing’s residents were invited to see the elaborate dance performance and many of them stayed for the dinner. For another wish, an 82-year-old care center resident traveled to Citi Field to see his beloved Mets with his nephew. The Mets played 13 innings and the game went past midnight. While they lost, he still had a blast, by all accounts. For yet another wish, it’s hard to tell who had more fun: the recipient or the organizers. “We had a gentleman that really loved Star Trek,” explained Ubbink. “His wish was to zap a Klingon.” And so, on the man’s birthday, staff dressed as characters from the original sci-fi series. One donned a In addition to drawing wishes quarterly, the Klingon costume and Wish Upon a Star committee also works with mask. Using a phaser the palliative care committee at the M.M. Ewing gun provided by an Continuing Care Center to make special things area comic book store, happen for residents placed on end-of-life care. the resident took aim at Called Butterfly Wishes, they have included a his target. Beatles-themed birthday party for a woman who “The Klingon fell to loved the British rockers. Two musicians played the ground and started cover tunes, while the menu included “Yellow to get back up, and he Submarine” cakes and strawberries. For another was able to zap him Butterfly Wish, staff reached out to area law again,” said Ubbink, enforcement agencies, resulting in an outpouring noting that the wish of visitors and cards for a longtime state trooper recipient also received suffering from dementia. a Star Trek birthday

‘Butterfly Wishes’ Designed for End-of-life Patients

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Blake Reed with Wendy Ubbink, recreation manager at the M.M. Ewing Continuing Care Center in Canandaigua. Reed, a resident at the center, recently saw one of his dreams come through thanks to Wish Upon a Star program created by the center. cake, a life-size cut out Dr. Spock and a gift package from a major star of the original series.

The winner’s circle

Not all of the more than 80 wishes granted to date have been elaborate as the Ukrainian celebration, the Mets game or the Star Trek party. In fact, they are often simple. One resident, confined to a wheelchair, wanted to see his wife’s second-floor apartment. The wish committee found a crew of local firefighters who were more than happy to help get him up the stairs. One of Mona Carro’s favorites was for a resident who had owned a flower stand for many years and wanted to spend a day at Sonnenberg Gardens and Mansion State Historic Site in Canandaigua. “She and her son enjoyed the gorgeous flowers, the sun and a delicious luncheon in the café,” said Carro, social work supervisor at the care center. “She left with a beautiful bouquet of flowers from the gift shop to bring home.” As a committee member, Carro has a hand in many of the wishes granted. She coordinated a pre-Christmas luncheon for a resident and her family at a local restaurant managed by the woman’s grandson. To make the day extra-special, the wish committee offered some enhancements of their own, like a corsage for the wish recipient. But sometimes the unplanned occurrences are the most heartening. Ubbink was at the Finger Lakes Casino and Race Track in Farmington with resident Frank Bottorf, who’d worked there for many years, when a group of men suddenly picked up his wheelchair and carried it to the winner’s circle. “He raised his hands in the air and shouted, ‘I won! I won!’” said Ubbink, of the late Mr. Bottorf.

‘Blessed to have them’

Pepper retired in 2011, after seeing dozens of wishes granted. “The wishes may not seem that big,” she said, but they make a world of difference, “when your life has taken

a detour and your health has changed and you can’t be as independent as you were.” Added Pepper, “To help the residents to be able to age with dignity and to be able to fulfill a dream — that’s what they aim to do.” A planning committee that includes Pepper’s successor, Dona Rickard, her executive assistant, Debra Gardner, and Thompson staff and foundation members meet quarterly to plan wishes and how best to bring them to life. Wishes are funded largely by proceeds from an annual holiday bazaar at the M.M. Ewing Continuing Care Center. For the past three years, the Canandaigua Moose Riders have held a poker run to raise money for the program. Because of her role bringing Wish Upon a Star to life, the program was renamed the Sharon M. Pepper Wish Upon a Star program upon her retirement, and the Thompson Health Guild made a donation in her honor to help ensure its continuation. “I was blown away,” said Pepper. Pepper said the credit goes to folks like Lois Schenk, her former executive assistant, who helped start the program, as well as the core group of Thompson employees who keep it running, often volunteering time offthe-clock. Those staff include, among others, Ubbink, Carro and corporate writer and marketing coordinator Anne Johnston. “We are blessed to have them,“ said Pepper. Although granting wishes can be time-consuming and even stressful at times, the rewards keep employees involved. “Seeing the positive reactions and the faces of the residents is so motivating,” said Ubbink. “Every smile recharges our batteries and makes us ready to fulfill another wish.” Pepper echoed her sentiments. “ It’s not work, it’s a display of love and that love is what our associates feel for residents. They will go the extra mile everyday, whether it is something simple like getting a milkshake from McDonald’s or going to a granddaughters’ wedding.”

How To Help To make a donation to help fund the Wish Upon a Star program at the M.M. Ewing Continuing Care Center, visit the Thompson Foundation online at www. ThompsonHealth.com (be sure to designate Wish Upon a Star) or call the Foundation at 585-396-6155.

In Good Health – Rochester / Genesee Valley Healthcare Newspaper • February 2014