Gv igh 103 mar14 by In Good Health: Rochester's Healthcare Newspaper

CAT BITE

Why getting a bite from a cat is much worse than getting one from a dog

in good March 2014 • Issue 103

priceless

Rochester–Genesee Valley Healthcare Newspaper

Trying to understand why the Amish have a significantly lower cancer rate

March

Time to Kick Butts

What’s Their Secret? Page 18

Men’sHealth Page 7

MEALS ON WHEELS Bringing food and human contact ro local residents since 1958

RV Travel Tips for Beginners Robotic Surgeries: Pushing the Limits Meet Your Doctor

Surgeon Claudia Hriesik talks about the risks of colon cancer, which affect both men and women.

Prostate Cancer Patient Creates Own Nonprofit Patrick Fisher lost his father and brothers due to various forms of cancer. It was something that he knew could travel down his hereditary genes. However it was still a shock when his doctors told him he had prostate cancer in 2010. “I was just devastated,” said Fisher, 63, of Penfield. “You are never ready emotionally to hearing the word cancer for the first time. You are just in shock honestly when it happens. Yet instead of simply staying devastated he got motivated. It just all took a little time. Page 16 March 2014 •

• Many Start Testosterone Therapy Without Medical Need Study finds increased testing among men with normal hormone levels

• Circumcision Rate Drops

Fewer baby boys in the US are being circumcised while in Europe countries are banning the practice outright. Page 15

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 1

5 Reasons Every Golfer Needs Sun Sleeves

Teens learn from their parents.

ccording to the National Golf Foundation, 29 million Americans play golf. That puts a lot of people outdoors for each game that they play, and if they want to get good at the game they are playing more than one round per year. What many of these golfers may not realize is the increased risk for skin cancer they have by being avid golfers. Skin cancer, according to the Skin Cancer Foundation, is the most common form of cancer in the country, with 2 million people being diagnosed with it each year.

What are you teaching your kids? Problem gambling habits can lead to serious financial difficulties, substance abuse, depression and anxiety.

Get the facts if you really want to win.

Risks. While many people brush off the idea of skin cancer, assuming it is not dangerous, it is actually one of the three types of cancer that is experiencing an increase in mortality rate for men. Roughly 9,500 people died from skin cancer in 2013.

Here are 5 reasons every golfer needs sun sleeves:

For information call (585) 719-3480 or visit www.ncadd-ra.org.

DEPAUL DePaul’s National Council on Alcoholism and Drug Dependence - Rochester Area (NCADD-RA) 1931 Buffalo Road | Rochester, NY | 14624

Time. The average time to play a round of golf is four hours, putting golfers in the sun for extended periods of time. In fact, the Skin Cancer Foundation reports that professional golfers end up getting an average of 217 times more ultraviolet (UV) radiation than is needed in order to cause a sunburn over the course of a year.

Age. Research shows that the majority of people who are diagnosed with skin cancer are over the age of 40, which also coincides with the typical ages of golfers.

Gender. On average, 78 percent of avid golfers are males, which is another skin cancer factor. The majority of people diagnosed with melanoma are white men over the age of 50.

Action. Rather than forget about playing golf, people can take steps to reduce their risks of getting skin cancer while playing the game. In addition to wearing a wide-brimmed hat and avoiding peak sun times, they can wear sun sleeves, which will protect their arms and hands from the harmful UV rays.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

March 2014 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 3

Gilda’s Club Rochester expanding into Hispanic community

ilda’s Club Rochester will kick off an expansion into the Hispanic community with a dinner and a Latin dance class at 5:30 p.m., March 8, at its location at 255 Alexander St. in Rochester.   The event will introduce attendees to Gilda’s Club, which offers free support to everyone living with cancer, along with their families and friends.   At the event, attendees will have a chance to pick up Spanish-language materials and learn more about a cancer support group that will start to take place in the Hispanic community.   The outreach into the Hispanic community is being supported by a $2,500 grant from Excellus BlueCross BlueShield.   “The Hispanic community sometimes views cancer as a private issue not to be discussed with others,” said Ingrid Colon, who is spearheading this effort at Gilda’s Club. “But I’ve seen the benefits of Gilda’s support groups. I truly believe that those in the Hispanic community would benefit from the support and knowledge that they’re not alone.”   Colon, who is from Rochester, is a senior social work major at SUNY Brockport. As an intern, Colon is helping Gilda’s Club create Spanish-language materials and is starting the support group for the Hispanic community.    “Unfortunately, minority groups are more likely to develop cancer and die from the disease,” said Joseph Searles, corporate director of diversity and inclusion for Excellus BCBS. “Our support of this program is our way of helping to ensure the Hispanic community has access to the support needed to overcome and recover from a cancer diagnosis.”    For more information about Gilda’s Club, visit www. gildasclubrochester.org or call 585-423-9700.

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CALENDAR of

HEALTH EVENTS

March 4

March 17

Program to focus on plant-based diet

Managing cholesterol focus of Rochester meeting

Rochester Area Vegetarian Society, a nonprofit, non-sectarian educational organization dedicated to promoting human and animal health and happiness, as well as to promoting the health of the planet, through the adoption of a vegan diet and lifestyle, will sponsor a six-week course focusing on plantbased diet. This will be the fifth year the course takes place and has been attended by nearly 200 people, including physicians, nurses and local residents. It will take place from 6:45 – 9 p.m. every Tuesday starting March 4 at the Jewish Community Center of Greater Rochester, 1200 Edgewood Ave. The course will end April 8. Course instructor is physician Ted D. Barnett, who will be assisted by Carol H. Barnett. Cost is $100 for JCC members, $125 for nonmembers. Additional cost to physicians taking course for credit: $125. To register, call the JCC at: 585-461-2000. New this year: optional supermarket visits will be integrated into the course at modest additional cost. All profits will be donated to charity. Complete syllabus and up to date information are available at rochesterveg.org click on “Course Resources.” A pdf file of this information is attached.

Gregory M Singer, an interventional cardiologist, will speak about “Managing Cholestsserol” during a free and open-to-the-public meeting sponsored by Mended Hearts Rochester. The event will be held at 7:15 p.m., March 17, at the Jewish Community Center, auditorium A, 1200 Edgewood Ave in Rochester. Singer received his medical degree from Rush Medical College and completed fellowships at Yale University School of Medicine. His practice includes internal medicine and treatment of cardiovascular disease. Mended Hearts Rochester is in its 48th year of giving support to people with heart disease and their families, by visiting those recovering from heart surgeries at Strong Memorial and Rochester General hospitals and through its informative monthly meetings. For more information, please visit www.mendedheartsrochester.org or contact Sharon Feldman at 585-544-1565.

March 13

“Understanding and Managing the Challenging Behaviors” will be the topic discussed in a series of seminars about Alzheimer’s and dementia organized by Chris Albee, executive director at Atria Greece. It will be held from 6:30 – 7:30 p.m. April 7 in the room 9 at Greece United Methodist Church, 1924 Maiden Lane, Rochester. It’s free and open to the public. The discussion is part of a program that started Feb. 3 and will continue until Dec. 1. It’s designed for anyone who is dealing with aging issues or parents or anyone

Clifton Springs Hospital to focus on sinus awareness In recognition of sinus awareness month, Clifton Springs Hospital & Clinic will host a free sinus education program. The event, sponsored by Entellus Medical, will be held from 5 – 7 p.m. on Thursday, March 13, at Warfield’s Restaurant & Bakery; 7 West Main St., Clifton Springs. The evening includes an educational program and dinner. The keynote speakers will be physicians Srinivas R. Kaza and Susan L. Fulmer, who will discuss “Sinus Disease – Evaluation and New Treatment Approaches.” Space is limited. Call for your reservation, 315-462-0120.

March 13

Cardiovascular health is topic of seminar Physician Audra A. Laing will speak about “Maintaining Cardiovascular and General Health” at a meeting sponsored by Mended Hearts Rochester. The event will take place from 7 – 9 p.m. at RG&E Family Room, in the M.M. Ewing Continuing Care Center, Thompson Health, 350 Parrish St., Canandaigua. Laing received her medical degree from the University of Auckland, Auckland, New Zealand, and completed her family medicine residency program at URMC. For more information, visit www.mendedheartsrochester.org or call Mary Allhusen at 585-396-6253

April 7

Seminar in Rochester to focus on Alzheimer’s

who wants to know more about Alzheimer’s and dementia. It takes place the first Monday of each week. For more information, call Deacon Dee or Sharon Neary at 585-225-1880

April 26

Event to raise awareness of pancreatic cancer Three local families, all personally felt loss in their lives from pancreatic cancer, are working to create awareness of this disease and raise vital research dollars toward finding a cure. They are promoting the Fifth Annual Luau for Lustgarten Fundraiser from 5 – 11 p.m., Saturday, April 26, at the RIT Inn & Conference Center, 5257 W. Henrietta Road, West Henrietta. All proceeds will benefit the Luau for Lustgarten Foundation. Last year 300 attendees raised nearly $16,000 for the Lustgarten Foundation. Organizers say the new event will be larger than last year’s with good food, music, auctions, raffles. For more information, call Cheryl Marrese at 585-225-3088 or email her at luauforlustgarten@yahoo.com. Those interested in the event may also visit www.lustgarten.org/luau2014.

May 4

Walk MS to take place in Greece The National MS Society Upstate NY Chapter will again sponsor the Walk MS 2014 in Greece. The event will be held from 9 a.m. – 2 p.m. May 4 at Olympia High School at 1139 Maiden Lane in Rochester. Walk MS connects people living with multiple sclerosis and those who care about them. Organizers say it is an experience unlike any other — a day to come together, to celebrate the progress that’s been made and to show the power of connections. Funds raised will help 12, 800 people living with MS in the community. Individuals may register for the event online at walknyr.nationalmssociety. org. People are encouraged to register and start fundraising today. The opening ceremony begins at 9:55 a.m. Route length: 1.2 and 3.5 mile. For more information call Kendra Chamberlain at 585-271-0801 (ext. 70330) or email her at Kendra.Chamberlain@NMSS.org.

National Writing and Arts Contests for Deaf and Hard-of-Hearing Students High school students may compete in writing, digital arts, film and animation contests. The deadline is March 17

eaf and hard-of-hearing students are eligible to compete for cash prizes and more in national contests sponsored by Rochester Institute of Technology, home to the National Technical Institute for the Deaf. The SpiRIT Writing Contest, now in its seventh year, encourages deaf and hard-of-hearing high school students to use the power of the written word. The contest will award the winners — two 10th and two 11th graders — their choice of a scholarship and travel expenses to the Explore Your Future program at NTID or $500. EYF is a six-day summer career exploration program for deaf and hard-of-hearing students that gives them the opportunity to sample different careers as well as college life. Complete contest guidelines and entry information are available at www.rit.edu/NTID/WritingContest-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

NR. For more information, contact WritingContest@ntid.rit.edu or call 585-475-7695 (voice) or videophone 585-286-4555. The second national competition is RIT’s annual Digital Arts, Film and Animation Competition for high school students who are deaf or hard-ofhearing. Students in grades 9-12 can compete for a $250 cash prize in each category. The competition recognizes students’ artistic expression with awards in the following categories: film, graphic media, interactive media, photo imaging, 3-D animation and Web page design. Students may submit up to two entries. Online entry forms, contest rules and other details are available at www. rit.edu/NTID/ArtsNR.

March 19:

Time to Kick Butts

ick Butts Day is March 19. The event, organized by the Campaign for Tobacco-Free Kids, is a national day of activism that empowers youth to stand out, speak up and seize control against Big Tobacco. Youth tobacco use is a problem. Thirteen percent of public high school students smoke cigarettes in Monroe County, according to the Monroe County Youth Risk Behavior Survey from 2011. The tobacco marketing that young people see in stores is a main cause of smoking initiation. A typical tobacco display exposes our youth to seeing 200 cigarette packs every time they visit the store. This is what one local student, Joseph Vassallo, has to say: “We are called ‘replacement smokers.’ As a youth living in America I feel insult-

ed that the tobacco company thinks teenagers are weak enough to be psychologically manipulated into slowly poisoning ourselves just by where they place their advertisements. So to my peers, I ask you — no, I beg you — fight back before it’s too late, before our children and grandchildren become the ‘replacement smokers.’” Youth in the community can become involved in activities and events that let Big Tobacco know they have seen enough. Contact the Smoking and Health Action Coalition of Monroe County (SHAC) at www.smokefreemonroe. com or www.SeenEnoughTobacco.org. Submitted by Cassie Gratton, director of Smoking and Health Action Coalition of Monroe County.

CVS Decision to Quit Tobacco, a Game-Changing Move

eff Niederdeppe, communication professor at Cornell University who studies health messaging — specifically how media, marketing and warning messages on tobacco products impact sales to youth — said that the CVS decision to stop selling tobacco products by Oct. 1 has far reaching consequences. “CVS Pharmacy’s decision to stop selling tobacco products is a groundbreaking move, albeit one that has come in response to increasing pressure from public health advocates for providers of health care products to halt their sales of these deadly products,” he said. “Nevertheless, it is an important decision with potential to have a domino effect in the industry.” “It also reflects an evolving social climate that has become less and less supportive of the marketing, sale, and use of tobacco products in the U.S. The announcement comes on the heels of a new, $100 million anti-smoking campaign being launched by the FDA that uses graphic imagery to depict the health and social consequences of cigarette smoking and addiction. Combined, these bold initiatives hold

potential to accelerate rates of decline in youth and adult smoking, both of which have plateaued in recent years.”

Long Overdue

CVS’s decision to stop selling tobacco products is great but long overdue, Butler University associate professor of pharmacy practice, Carrie Maffeo said. “This has been a ‘black eye’ in the pharmacy world, and public health groups have criticized pharmacies for the sale of tobacco products for a while,” Maffeo said. “Eliminating the sale of tobacco products is a significant public health decision that demonstrates the company’s commitment to promote the health and wellness of its customers. CVS should be commended for this important decision.” Butler economics professor Bill Rieber said by being the first pharmacy chain to ban tobacco, CVS has made a strategic marketing/public relations move. “If others follow, CVS will be known as the industry leader in this important public health endeavor,” he said.

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In Good Health is published 12 times a year by Local News, Inc. © 2014 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com 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, Ryan Hoefen, MD, Cassie Gratton • 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.

March 2014 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 5

Meet

cancer polyps.

Your Doctor

By Mike Costanza

Claudia Hriesik, MD Surgeon talks about the risks of colon cancer, which affect both men and women, and how easy it is to prevent it.

arch is National Colorectal Awareness Month. Why is it so important to be screened for colorectal cancer—cancer of the colon or rectum? About 150,000 people are diagnosed with either colon or rectal cancer every year. It is something that is highly curative, if you find and diagnose a colon and or rectal cancer in a timely manner. That means, for example, if you find a cancerous or precancerous polyp, you can at times remove that polyp and be done with your so-called cancer therapy, because it’s a local and found early. Is the risk of colon or rectal cancer different for men and women? That’s a very important question. Colon and rectal cancers are really opportunity killers—they affect men and women alike. For some reason, and I don’t really know why, many people believe that women don’t really get it as often. There are statistics that show there is no discrepancy that is of any significance. The general recommendation is that everyone should undergo a colorectal cancer screening at 50 years old and at least every 10 years thereafter. When should you be screened more often? In people who don’t fit a high risk group, don’t fit the profile of a high risk patient — you’re otherwise healthy, no bleeding, no pain no nothing — at age 50, that person should be screened for colon or rectal cancers. If we find nothing, and there is no risk profile, and nothing happens in the meantime, we tell that patient to come back in 10 years and get another one so we can stay on top of new polyps that may develop in the 10-year frame.

family history of colon or rectal cancer. Let’s just say there is a person coming to my office that tells me, “Oh, my mother was diagnosed with colon cancer when she was 45.” I would tell that person, “Well, you should be screened 10 years sooner than your mom was diagnosed.” We start at age 35 with that particular individual, or 10 years sooner than the first degree relative was diagnosed. We’d not only screen every 10 years, but every five years, so that we can make sure we are not missing anything or we detect new polyps that may want to grow. The goal is to take them away before they turn into

What is the primary method for screening for colon and rectal cancer? The primary form of screening is still the colonoscopy. It is still the screening tool of choice, and also the tool of choice when you see a polyp. If you do a colonoscopy you see a polyp or a mass, you remove the polyp. You biopsy the mass and get a lot of information, or at times, take care of the problem. Through CAT scans or barium enemas, you can see a polyp or a mass, but you can’t do anything about it. I understand that during a colonoscopy, a surgeon can insert some kind of wire into the colon or rectum, and use it to remove the polyp. Is that correct? You are most likely talking about a “snare,” that looks like a little loop. That can be one way to remove polyps. Some polyps look like a little cherry, and the “cherry” has a little stalk where it hangs on the cherry tree. If you have a polyp that looks similar to a cherry, you can take this loop, this snare, and put it around the cherry or polyp’s neck and then apply heat, or sometimes cut through it without heat, and take that away. There are many forms of polyps, and not every polyp turns into a cancer. Why remove all polyps? If you take a polyp out you take the polyp’s ability away to grow into a cancer. Certain polyps will do that if you let them sit there and grow. That’s the best treatment you can have, because after polyp removal that’s it, you’re done for at least the next couple of years. A lot of people that we do colonoscopies on have no polyps. What if a biopsy of the polyp finds that it is cancerous? It depends on what layers are infiltrated by the cancer. If it has gone into the deeper walls or layers of the colon or rectal wall, then people will at times need surgery and/or chemotherapy.

Can you tell us of one type of patient that might be at high risk of colon or rectal cancer? Patients with a

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

What if you don’t find and remove a precancerous or cancerous polyp in time? If you do not diagnose a colon or rectal cancer early, or if you don’t remove polyps

that can potentially crow into a cancer, your cancer can invade the colon or rectal wall into the adjacent tissue. It can actually invade or infiltrate surrounding organs, and also involve the blood or lymph stream and travel to other organs. Oftentimes, the colon or rectal cancers like to pick the liver, or [become a] more distant metastatic disease. That is something that can happen if you do not pick up on a cancer—if you let a polyp grow and advance itself into a full-grown cancer. What are the chances for remission of the cancer under such circumstances? If you have cancer in the colon or rectum, and are able to remove that completely, without leaving disease behind, and get adequate therapy as needed—maybe that can be chemotherapy, or radiation and chemotherapy for some of the rectal cancers—that can be cured through surgery. If you have a cancer that has outgrown into the adjacent structures surrounding the colon and or rectum you are basically not able to unfortunately cure these patients. However, there have been great advances being made with chemotherapy, and also radiation therapy. A lot of these folks who have had locally advanced colon or rectal cancers, or have had advanced metastatic cancers, get chemotherapy and can still prolong their lives. Has the incidence of colon and rectal cancer grown in recent years, decreased, or remained the same? I would like to tell you that we have made better progress in picking up these cancers early, but I don’t think that I have data available to do that. I don’t think that there has been any change in the number I have just given to you. Cancer is not going away at this point. What do you like about colorectal surgery? I like the variety of it. I like the fact that you have different surgical modalities. You can do laparoscopic surgery, which is technically more advanced and challenging. You can do robotic surgery. You can do open surgery, as indicated. You can do other procedures, like the colonoscopy, which I find very challenging, and I enjoy doing them. I find it satisfying to pick up on disease, and be able to treat disease then and there and prevent major surgeries, if I can, by polyp removal.

Lifelines: Current Positions: Rochester Colon and Rectal Surgeons PC. Education: MD, PhD, Clinical Education, Hannover Medical School, Hannover, Germany; Preclinical Education, Lübeck Medical University, Lübeck, Germany. Personal: Born in Bremen, Germany; lives in Pittsford, and likes to travel, run, paint and cook.

Heart Transplant Success Improving, Patients Living Longer

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Many patients are living 20 years or more after transplantation

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eart transplantation continues to be the “gold standard” treatment for end-stage heart failure, and a large number of patients now live 20 years or more after surgery, according to a study in the February 2014 issue of The Annals of Thoracic Surgery. Physicians Hector Rodriguez Cetina Biefer and Markus J. Wilhelm, from the University Hospital Zurich in Switzerland, led a research team that examined long-term outcomes in 133 patients from their institution who underwent heart transplantation from 1985 to 1991. Among those patients, 74 (55.6 percent) survived at least 20 years post-transplantation. The average age at transplant for the 20-year survivors was 43.6 years. Major causes of death in non-survivors were graft rejection (21 percent), malignancy (21 percent), cardiac allograft vasculopathy (an accelerated form of coronary artery disease; 14.5 percent), and infections (14.5 percent). “A remarkable number of patients

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survived 20 years or more following heart transplantation, confirming the procedure as the ‘gold standard’ for end-stage heart failure, at least for the time being,” said Wilhelm. “With continued improvements in immunosuppressive management in the coming years, we expect to see transplant patients living longer, healthier lives. It is still uncertain if mechanical circulatory support devices will be able to compete with heart transplantation in the future.”

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Does Coughing Help During a Heart Attack?

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By Ryan J. Hoefen, M.D., Ph.D.

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Heart Matters

here is a widespread rumor circulating in the Internet that suggests that you should cough forcefully and repeatedly if you think you are having a heart attack. Interestingly, this viral message (falsely) claims to originate from one of our local hospitals. However, this technique is not recommended by any professional medical societies and may even be harmful. Coughing momentarily creates a pressure within your chest that is exerted on your heart. While this is not normally sufficient to have a significant effect on the heart’s function, it has led to the idea that a person could essenHoefen tially perform CPR on themselves (termed “cough CPR”) if their heart stops with forceful coughs every 1-3 seconds to contract the heart and maintain blood flow. With proper coaching in a medical setting, patients with cardiac arrest have been

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able to delay loss of consciousness for about 30 seconds using this technique. Coughing is also known to stop other less dangerous types of arrhythmias (fast heart rhythms) in some situations. A heart attack, in which chest pain is caused by a clot blocking one of the arteries that supplies blood and oxygen to a part of the heart muscle, does not necessarily cause the heart to stop. In some cases, the loss of blood flow to part of the heart can send it into an arrhythmia, which stops the heart, but this does not occur in all cases and the timing can be quite unpredictable, so the proper timing of repeated coughs cannot be controlled without medical monitoring. Whether improperly timed coughing would reduce blood flow or be detrimental is also unclear. The most important thing to remember to do if you think you are having a heart attack is to call 9-1-1 for immediate medical care and to take aspirin.

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

‘Beware the Ides of March’ . . . or not! N o thanks to Shakespeare, the month of March has gotten a bad rap. Sure, it’s cold, it’s gray, it’s damp. But it need not be death knell of your contentment. If the month of March is stretching out in front of you as a big, dreary void to fill, you are not alone. For many, our winter wonderland is not so wonderful when cabin fever sets in. That’s when anxiety can make an unwelcome visit. You might feel yourself spiraling down, questioning the past and second-guessing your decisions. And that’s when you could be tempted to grab for the TV remote, a bag of cookies and head for the couch — or worse — for bed. Sounds familiar? I can remember many nights after my divorce, coming home after work to an empty apartment with hours on my hands and a heavy heart. The prospect of a long, lonely evening ahead was almost unbearable. I was fine during the day, but when the sun started to set or the weekend rolled around, I would start to panic. I was also fine when I was busy or in the company of friends or family. It was that uncomfortable time alone — when I was all by myself at home — that tested my resolve. After way too many nights on the couch watching mind-numbing reruns, I had finally had enough and started

making better use of my “me time.” I am now thoroughly comfortable spending time by myself and have come to enjoy my own company. In fact, it’s not unusual for me to pass on an invitation out, in favor of spending a nice quiet evening at home — relaxing or fully engaged in something I love to do. If you’re challenged by time alone this time of year, consider the suggestions below. You might even clip this column and put it on your refrigerator as a handy reminder. Read. In our busy lives and with so many electronic options vying for our attention, reading can fall by the wayside. It’s such a shame. Reading for enjoyment and enlightenment can turn a lonely evening into a lovely evening. Don’t know where to start? Ask a friend for a suggestion or select a book from The New York Times’ best- seller list. Snuggle up in a comfy, well-lit place and let a good book introduce you to new people, new places, and new ideas. We are never alone when reading. Write. Marcel Proust wrote, “We are healed of a suffering only by expressing it to the full.” Even if you

KIDS Corner Teens’ Stress Levels Rival Those of Adults, Survey Finds Top worries include post-graduation choices, financial concerns

f paying the bills and putting food on the table put adults’ nerves on edge, just imagine how today’s overscheduled, frequently tested teenagers must feel. Adolescents reported stress levels during the school year that surpassed those of adults, according to the American Psychological Association’s latest Stress in America survey. The survey, based on an August Page 8

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2013 Harris Interactive poll, is thought to be the first to focus on how stress is affecting the nation’s adolescents. It included more than 1,000 teens and nearly 2,000 adults. The findings suggest that teens’ sleeping and exercise habits feed into their stress levels and the stress affects their health habits, creating a vicious circle, said Norman Anderson, CEO and executive vice president of the

never look back at what you write, the act of committing thoughts and feelings to paper is therapeutic. Consider starting a journal, if you haven’t already done so. A few minutes in the evening or on the weekend is a perfect time to write. As you work through some of the issues associated with living alone, and you become more content, you will find that reading and rereading your journal entries will be a great way to see how much progress you are making. Clear Out The Clutter. I know this might sound silly, but clearing out the clutter can be very satisfying and a great way to spend a few hours alone. I spent one recent Tuesday night sorting out my closet and filling two bags for Volunteers of America. It felt terrific. I not only lightened my load, I did something for a good cause. As a result, I felt part of something bigger than myself and less alone. Pursue a passion. This can sound daunting, especially if you’ve yet to identify your passion, but hang in there. Many men and women in longterm relationships often sacrifice their own interests in favor of attending to the needs of others. The pursuit of your

American Psychological Association. “Those who experience high levels of stress tend to report that they exercise less and they don’t sleep as well, which feeds back into increasing their stress,” Anderson said during a recent news conference. “Conversely, those who say they exercise on a regular basis and get a good night’s sleep show a decrease in stress.” Another “alarming” finding: “Teens don’t appear to realize the impact stress has on their physical and mental health,” Anderson said. More than half of teens think stress has a slight or no impact, yet many reported symptoms of stress, the survey found. Forty percent said they feel irritable or angry and 36 percent said they feel tired. What’s more, the survey suggested that teens are poised to become even more stressed as they enter adulthood. Katherine Nordal, the APA’s executive director for professional practice, said during the news conference that school was the most common source of stress for teens. “Getting into a good college and deciding what to do after high school was also a significant stressor for about 69 percent of teens,” she said. Teens’ financial concerns for their families also ranked among the top stressors. “Children learn what they live, so I think that when there’s a lot of stress

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

own passions can be lost in the process. Now’s a good time to rediscover your “loves” and to dedicate your time alone to those pursuits. Do some digging and identify the things you loved as a child or young adult and make a conscious decision to pursue them now. Evenings or weekends spent doing what you love can be very fulfilling. Loneliness can dissipate and you can feel alive again. Reach Out. With time on your hands, you are in a great position to reach out and make connections with others, especially with long, lost friends. This can be a very meaningful way to spend an evening. Just yesterday, I received a hand-written note from a friend I hadn’t seen in a while. I was very touched and inspired to do likewise with my own old friends. Pick up the phone, send an email or send a “snail mail” note to someone with whom you’ve lost touch. “Veg out.” That’s right, veg out. Grab the TV remote, a bag of cookies, and head for the couch — or better — for bed. Again, sound familiar? But this time, do it without guilt, do it without beating yourself up. Everyone is entitled to an occasional night when they just hang out, do nothing and eat junk food. Indulge yourself and tell yourself you deserve it. Wake up the next morning — free of remorse — and ready to take on the day: alone at home and “at home” with yourself, even in the ides of March. 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 workshops or to invite Gwenn to speak, call (585) 624-7887 or e-mail: gvoelckers@rochester.rr.com.

in the household in regard to financial concerns that certainly it bleeds down to children as well,” Nordal said. The survey also found the following: • Teens reported sleeping just 7.4 hours on school nights and 8.1 hours on non-school nights — far less than the 8.5 to 9.25 hours recommended by the National Sleep Foundation. • One in five teens reported exercising less than once a week or not at all. • Nearly a third of teens said they eat to manage stress, while 23 percent reported skipping a meal due to stress. Anderson said parents can help teens by recognizing their stress levels and modeling good stress-management behaviors, such as eating a healthy diet and taking time to exercise. Parents also need to stay plugged in to their teenagers’ lives by taking every opportunity to communicate with them, Nordal said.

Smart Contact Lenses May Help Diabetics New lenses being developed will measure blood glucose level continuously By Deborah Jeanne Sergeant

hat if measuring your blood glucose level were as easy as wearing a pair of contact

lenses? That’s the goal of GoogleX researchers. The same brains behind Google Glass are now an estimated five years away from launching (with FDA approval) “smart” contact lenses that can measure blood glucose level based upon the user’s tears and warn wearers. Brian Otis and Babak Parviz, project co-founders, announced their ambitious project via the Google blog Jan. 16. They could be onto something big, thinks physician Stephen Hammes, chief of the Hammes division of endocrinology and metabolism at University of Rochester School of Medicine and

Dentistry. For one, the problem they are trying to solve is a big one. “Continuous glucose monitoring is not so easy to do,” Hammes said. Many current monitors reflect a 30-minute delayed reaction because it takes that long for the glucose to travel to other fluids of the body. “The real question is how accurate is it measuring and how well does it correlate to the glucose in the blood?” Hammes said. “We don’t really know whether these kinds of monitors will be accurate. It will be fun if it works. I don’t know of any data that says you can correlate glucose in tears with glucose in blood.” Current continuous glucose monitors require an electrode inserted under the skin and recalibration via finger sticks a few times per day. But if GoogleX’s contacts work, they would offer a less invasive solution. “I think patients would love the contacts,” Hammes said. “In general,

young people seem more interested in new technology, so I think it will be embraced more by the younger generations, but also by some older patients who have been sticking their fingers for 40 years. I think the only ones who would use it would be those on the pumps.” Otis and Parviz describe the sensors embedded in the lenses as looking like “bits of glitter, and an antenna thinner than a human hair.” Most ordinary contact lenses have the manufacturer’s name printed on it and it’s invisible to the user while it’s worn. Novelty contact lenses with visible colors and patterns have been available for years, so it’s easy to imagine embedding sensors. Currently, Otis and Parviz are testing prototypes that generates one reading per second. “We’re also investigating the potential for this to serve as an early warning for the wearer, so we’re

exploring integrating tiny LED lights that could light up to indicate that glucose levels have crossed above or below certain thresholds,” their blog entry stated. “It’s still early days for this technology, but we’ve completed multiple clinical research studies which are helping to refine our prototype. We hope this could someday lead to a new way for people with diabetes to manage their disease.” The two are also discussing the forthcoming technology with the Food & Drug Administration. They will also need to develop apps that will show the lens’ readings to patients and their doctors via smart phone or some other type of display. Hammes isn’t convinced of the five-year timeline. “Since I was a fellow in the 1990s, everyone was saying that we’ll have continuous monitors in just a few years, but they were just recently introduced,” he said. Time will tell.

COMPLEMENTARY MEDICINE Yoga Can Lower Fatigue, Inflammation in Breast Cancer Survivors In study, the more women practiced, the better their results

racticing yoga for as little as three months can reduce fatigue and lower inflammation in breast cancer survivors, according to new research. The more the women in the study practiced yoga, the better their results. At the six-month point of the study — three months after the formal yoga practice had ended — results showed that on average, fatigue was 57 percent lower in women who had practiced yoga compared to the non-yoga group, and their inflammation was reduced by up to 20 percent. The participants had completed all breast cancer treatments before the start of the study and only yoga novices were recruited for the randomized, controlled clinical trial. Participants practiced yoga in small groups twice a week for 12 weeks. Women making up the control group were wait-listed to receive the same yoga sessions once the trial was over. During the study, they were instructed to go about their normal routines and not to do yoga.

“This showed that modest yoga practice over a period of several months could have substantial benefits for breast cancer survivors,” said Janice Kiecolt-Glaser, professor of psychiatry and psychology at The Ohio State University and lead author of the study. “We also think the results could easily generalize to other groups of people who have issues with fatigue and inflammation,” said Kiecolt-Glaser, also an investigator in Ohio State’s Comprehensive Cancer Center and the Institute for Behavioral Medicine Research. Though many studies have suggested that yoga has numerous benefits, this is the largest known randomized controlled trial that includes biological measures, Kiecolt-Glaser said. Researchers recruited 200 women for the study. The study is published in the Journal of Clinical Oncology.

March 2014 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Think your kids won’t smoke?

Think again. They see more tobacco marketing than you realize.

1 2 3 4

Posters, displays and rows of tobacco products behind the counter are all forms of tobacco marketing. The Surgeon General’s Report warns that tobacco marketing is a known cause of youth smoking. And studies show, the more tobacco marketing kids see, the more likely they are to smoke. More than 135,000 New York teens are regular smokers.

1/3 of them will die prematurely from diseases caused by smoking.

The tobacco companies think there’s nothing wrong with this kind of marketing.

What do you think? The Smoking & Health Action Coalition of Monroe County works in Monroe County, NY, to eliminate exposure to secondhand smoke, to educate youth about tobacco marketing and to promote living tobacco-free.

A Community Partnership of the New York State Tobacco Control Program.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

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More Than a Meal Meals on Wheels program brings food—and human contact By Mike Costanza

or Meals on Wheels volunteer David Taber, bringing meals to homebound Monroe County residents is more than just handing out food. “It’s just like seeing your family,” the 79-year-old says, as he prepares to head out on his delivery route. “You become very attached to them.” Taber is just one of the many volunteers who deliver hundreds of meals a day to county residents for the local Meals on Wheels program. The program, which is part of the Visiting Nurse Service of Rochester and Monroe County, Inc, (VNS) helps county residents who are unable to make their own meals due to illness or disability avoid going hungry. “There’s no other service that provides these nutritionally balanced, home-delivered meals that are provided by a friendly volunteer,” says Phil Shipper, the program’s director. VNS’s Meals on Wheels (MOW) program opened its doors in 1958, the third such program to be created in the US. On the first day of its operation, local VNS nurses delivered hot meals to just seven Monroe County residents. The meals came in a very different form back then. “The meals were served on china plates covered in tinfoil on a hot water bottle in a cardboard box, and served with a thermos of coffee,” Shipper explains. Nowadays, MOW kitchen volun-

teers gather five days a week in the kitchen of the American Red Cross of Greater Rochester to prepare meals for about 650 people — the program calls them “participants.” The meals are placed on disposable dishes, shrink-wrapped and packed into containers designed to keep them cold or hot, depending upon the type of meal. Each participant is given a lunch, a dinner or both, and some receive additional meals on Fridays to help them get through the weekend. After the meals are packed, volunteers like Taber load the containers into their cars, and head out onto any of about 100 routes that stretch through the county. To ease the workload, they work in pairs. Local companies and organizations also adopt routes, creating teams of volunteers and sending rotating pairs out to service routes. It usually takes no more than three hours to load up and cover a route. Thousands of Meals on Wheels organizations now serve the homebound nationwide. The program has relatively few basic criteria for eligibility. According to Shipper, participants need to be at least 18 years old and live in the county in an area that is safe for volunteers to visit as they make their rounds. About 87 percent of participants are at least 60 years old. Many suffer from some degree of social isolation, and may not be able to reach out to others if they become ill or fall. Participants

have to agree to be home at the time the meals are delivered, so volunteers can check on them. “Oftentimes, it’s the Meals on Wheels volunteers that find people that need immediate medical attention,” Shipper says. “Our volunteers provide an important link to the community in which these seniors live.”

Federal and state subsidies cover part of the cost of 88 percent of the meals, according to Shipper. Those who receive such subsidies must have some kind of illness or disability that makes it difficult for them to physically attend to their own daily nutritional needs. “Typically, that could mean, perhaps, they can’t stand in front of a stove long enough to prepare a meal,” Shipper says. A long-term illness has left Ethel Parisi, who is on one of Taber’s routes, unable to easily perform such tasks. “I can’t cook, because I burn everything,” she says. Parisi says her illness also left her substantially thinner than she is now. Taber’s Meals on Wheels deliveries

79-year-old David Taber is just one of the many volunteers who deliver hundreds of meals a day to county residents for the local Meals on Wheels program. “It’s just like seeing your family,” the he says, as he prepares to head out on his delivery route. “You become very attached to them.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

have helped the divorced mother of four regain that weight. “I eat a little bit more than I normally would,” she explains. “I don’t know what I would do without it.”

High enthusiasm despite budget cuts

MOW has to match 10 percent of the federal subsidy for each meal, Shipper says. Though the program also asks the participants involved to contribute up to 50 percent of the $6.70 cost of a subsidized meal, it does not track their contributions, and no one is turned away. As a result, contributions come to about 95 cents per subsidized meal, he says. Participants can also pay for meals on an income-driven sliding scale, or pay the full price of $6.70. Despite the subsidies and contributions, MOW lacks the funding to cover all of the cost of the subsidized meals it distributes. In addition, federal support for the program has remained flat in recent years, or decreased. Sequestration resulted in a $22,000 funding cut in 2013, or about 6 percent of Washington’s total contribution for that year. As a result, even though demand has risen in recent years, the program has had to cut back its services—and there does not appear to be any relief in sight. “The 2013 sequestration resulted in us serving 4,200 fewer meals in 2013,” Shipper says. The cuts have also forced MOW to avoid signing up new recipients for subsidized meals—127 were on its waiting list as of last December. Shipper says he expects the cuts to continue in 2014, so relief—either for VNS’s Meals on Wheels program or its participants—is not in sight. Budget cuts haven’t sliced into the enthusiasm with which local volunteers serve the MOW participants on

their routes. Linda Karlnoski misses seeing them when they call and cancel their deliveries. “It’s just such a part of your day,” the 65-year-old retired teacher’s aide says. Karlnoski began volunteering after watching the MOW program in Gloversville, near the Adirondacks, help her late parents cope with their disabilities. At the time, her mother, who had Alzheimer’s disease, was taking care of her father, who was forced to use a wheelchair. “It was a full-time job for my mom do that, and fixing meals was just becoming a frustration for her,” Karlnoski explains. Last August, just after retiring from her job as a high school teacher’s aide, she headed off to VNS. “I knew when I retired I wanted to do some volunteering,” the Rochester resident explains. “The first thing I thought of was Meals on Wheels, because my parents had it.” Nowadays, Karlnoski loads up her car once a week and heads out on her route, accompanied by her grown daughter, Shari. Taber went from filling in for absent MOW delivery volunteers to running as many as eight routes five days a week. “That’s how I keep track of what day it is,” he laughs. The retired history teacher is sometimes willing to go far beyond just delivering a meal to his participants. One 80-year-old had been blinded in a violent attack, and was unable to take care of some tasks. Taber and his partner would deliver his meals, and then help out around the house. “I would change his storm windows and screens,” Taber said. “My

Last August, just after retiring from her job as a high school teacher’s aide, Linda Karlnoski headed off to VNS. “I knew when I retired I wanted to do some volunteering,” the Rochester resident explains. “The first thing I thought of was Meals on Wheels, because my parents had it.” partner and I would vacuum [the house].” Not everyone can find the desire— and the time—to help others, and the average age of a local MOW volunteer is 74. “The volunteer base that we have right now is extremely committed, but they’re aging out,” Shipper says. For this reason and others, the program is in need of new volunteers.

Karlnoski seems to think the time will be well worth it. “I know this will be a part of my life,” she says.

Want to Join MOW?

For more information on the VNS Meals on Wheels program, or to donate to the program, volunteer for it, or sign up for it, go to mow@vnsnet.com or call 585-787-8397.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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SmartBites

By Anne Palumbo

The skinny on healthy eating

Bowled Over by Barley

ntil I jumped on the whole-grain bandwagon a few years back, I never gave barley a second thought. Heck, I didn’t even know it was a whole grain. As far as I was concerned, it was a squishy white thing floating around in my canned soup. But knowledge is a beautiful thing, and now I can’t get enough of this tasty stuff. Barley, like other whole grains that have their nutrient-rich kernels intact, bursts with documented health benefits. Studies show that eating whole grains helps to lower the risk of many chronic diseases, such as diabetes, heart disease, and those associated with high blood pressure. While benefits are most pronounced with at least three servings daily, some studies show reduced risks from as little as one. On the fiber front, barley takes top billing among grains, delivering more fiber per serving than any other whole grain (one cup provides about a fourth of our daily needs). Fiber keeps us regular, helps with weight mainte-

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nance by promoting a full feeling and stabilizes blood sugars. It also helps to lower blood cholesterol levels by ferrying cholesterol-containing bile out of bodies, a benefit that reigns supreme for those concerned about cholesterol. Of course, barley’s high fiber content is just the tip of the nutritious iceberg. Whole grain barley brims with antioxidants — powerful compounds that mop up free radicals linked to a host of age-related diseases. It’s also a good source of niacin, an important B vitamin that helps convert food to energy, and an excellent source of manganese, a mineral that is essential to healthy metabolism and the formation of connective tissue, cartilage and bone. A toothsome grain with a slightly nutty flavor, barley is naturally low in

fat, sodium and cholesterol, clocks in at only 190 calories per cooked cup, and even serves up some protein: 4 grams.

Helpful tips If possible, buy hulled barley over pearl barley. Although pearl barley still boasts many health benefits, it has been polished or “pearled” of its outermost layer, has fewer nutrients than the hulled version, and is not considered a whole grain. Nonetheless, pearl barley, like its hulled sister, teems with fiber because the fiber in barley is distributed throughout the entire kernel.

Lemon Barley Pilaf with Pesto Adapted from Bon Appetit Serves 4 1 tablespoon olive oil 1 medium onion, chopped ¾ cup barley 2 cups low-salt chicken broth 1 large carrot, peeled and chopped 1 red bell pepper, chopped 2 cups kale (chopped) or baby spinach 2 tablespoons pesto 1 teaspoon grated lemon peel Salt and pepper to taste Heat olive oil in heavy medium saucepan over medium heat. Add onion; sprinkle with a little salt and

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

pepper. Sauté until onion is beginning to soften, about 5 minutes. Add barley; cook 3 minutes, stirring constantly. Add chicken broth and bring to boil. Reduce heat to low, stir once, and cover. Cook until barley is almost tender, about 30 minutes for pearl barley and 45 minutes for hulled. Add carrot, bell pepper, and kale; cover and cook until vegetables are tender, about 8 minutes. Remove pilaf from heat and stir in pesto. Cover and let stand 10 minutes. Season to taste with salt and pepper. Stir in lemon peel and serve.

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.

Men’sHealth Circumcision rates on decline Fewer baby boys in the US are being circumcised while in Europe countries are banning the practice outright

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he European Union is considering banning circumcision except for religious reasons. The Norway’s Health Ministry in November pushed legislation to regulate the circumcision in boys while some political parties in the country are calling on a complete ban of the practice on minors. Last year in Germany a court decreed that the practice is a form of “bodily harm” against boys who are “unable to give their consent.” Although the procedure has seen little legislative action in the US, except for a proposal in California that would block laws banning circumcision, American parents represent of mix of people who adamantly support or oppose circumcision and those who could go either way. Anti-circumcision groups — such as Intact America (www.intactamerica. org), Mothers Against Circumcision (www.mothersagainstcirc.org), and National Organization of Circumcision Information Resource Centers (www. nocirc.org) — may explain the decrease in circumcision compared with 30 years ago. A report by The Centers for Disease Control’s National Center for Health Statistics shows that two out of three baby boys born in the West were circumcised in the past. By 2010, the figure plummeted to 58 percent, or a bit more than one in two. The nation’s overall rate decreased by 10 percent in 32 years. Tom Campbell, family medicine doctor and instructor of clinical family medicine at University of Rochester Medical Center, has a few ideas about why the rate of circumcisions has decreased. “There are some small risks of side effects during the procedure since it’s surgical,” he said. Some parents worry about botched procedures also. “It can very rarely lead to nerve damage on the penis and it may not look the way parents want it to look,” Campbell said. “They may have a very specific idea on how they want it to look, but that’s a cosmetic problem and an expectation difference. “They have a sort of visceral fear of any surgical procedure on their baby.” Daniel Yawman, pediatrician with Rochester General Hospital Pediatrics, said that locally most parents still opt for circumcision. His organization, like most, adheres to the guidelines of the American Academy of Pediatrics, which encourages parents to explore the pros and cons of circumcision so

they can make an informed decision. “Most male babies at Rochester General Hospital are circumcised, but parents have to request it,” Yawman said. “It’s not something we do just because a male baby has been born.” He said that circumcision can lower the risk of urinary tract infection in the first year of life of the child, and some evidence indicates that acquiring HIV through heterosexual sex and contracting other sexually transmitted diseases is less likely with circumcision. “We can do it right here in the nursery at this point,” Yawman said. “Once it’s done, it’s not reversible. If an adult male wants it done, he can have it done with his own doctor.” Adults seldom opt for the elective procedure. Neutral on the topic, Yawman added that he encourages immunizations because of the strong data indicating their benefit. “With circumcision, it’s about risks and benefits,” he said. “Whether they choose to do it or not, I don’t have a strong opinion as long as they have all the facts on it. Some feel strongly it’s genital mutilation.” Doctors performing circumcisions use local anesthetic and oral medication may help with pain as well. Prematurity or illness can delay circumcision to a later date, but most baby boys’ circumcision takes place before leaving the hospital for the first time. Several organizations support men who wish to restore their foreskins, such as The National Organization of Restoring Men (www.norm.org), and My Foreskin Restoration Experience (blog.myforeskinrestoration.com). The process usually involves no surgery but stretches intact skin on the penis to form a new foreskin. March 2014 •

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Men’sHealth Prostate Cancer Patient Creates Own Nonprofit By Ernst Lamothe Jr.

ow can you prepare for something that changes your entire life in two minutes? Even if you suspect it could happen in the future, you are never fully ready to hear life-changing news. Patrick Fisher lost his father and brothers due to various forms of cancer. It was something that he knew could travel down his hereditary genes. However it was still a shock when his doctors told him he had prostate cancer in 2010. “I was just devastated,” said Fisher, 63, of Penfield. “You are never ready emotionally to hearing the word cancer for the first time. You are just in shock honestly when it happens. Yet instead of simply staying devastated he got motivated. It just all took a little time. Fisher’s story began with a routine physical. At that time at age 60, he figured his health would be paramount importance, especially since he would be retiring in a few years. After a digital rectal exam, the doctor noticed a lump in his prostate. They decided to do a PSA blood test and follow up with the results every three months. Each time he came back, issues with his blood test were starting to make doctors worried so they scheduled an appointment with a urologist and did a biopsy. There were multiple cancers growing on his prostate. Doctors gave him the choice of surgery, radiation or implanting radioactive seeds into the prostate to kill off the cancer. After doing endless research, he chose the surgery. “The good news is there are numerous options. But that is also the bad news because

you can drive yourself crazy with all the information,” said Fisher. “At the end, I chose to have surgery because the thought of putting something radioactive in my body didn’t sit well. Thankfully, I had so many choices because there was an early diagnosis.” The surgery went well, but even when you are out of the woods, that doesn’t mean life becomes problem-free. Men who recover from prostate cancer often have to deal with two side effects: sexual dysfunction and urinary incontinence. Fisher was affected with the latter. Urinary incontinence, which is the loss of bladder control, is a common and often embarrassing problem. The severity of the condition ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that’s so sudden and strong you don’t get to the bathroom on time. “Something as simple as papers brushing by me or other slight moment would cause an embarrassing action to happen. I had to quit my job because it was too much to handle on an everyday basis at work,” said Fisher. He looked for support groups through the Internet and found US Too chapters, which help men with cancer, located in Buffalo, Syracuse, the Southern Tier and even Batavia. But support groups in Rochester dedicated to solely prostate cancer survivors were non-existent. “Women will tell you that when they get breast cancer, one of the things they require most is support. Well, men are no different. It helps when we have others to talk with about our situa-

tions,” added Fisher. Enter Us Too Rochester NY. It was a venture that Fisher created in November 2012, an independent nonprofit believing no man should have to experience prostate cancer alone or rely on any single source for unbiased medical information. In one year, th group went from a start-up to having 200 members. The first meeting was simply getting a Monroe County urologist to attend and gathering information about the group. He also put fliers around town. It grew rapidly after doctors like urologist Louis Eichel and other officials like Holly Anderson, executive director of Breast Cancer Association of Rochester, started recommending Us Too Rochester NY to their clients. “I was shocked on how quickly it grew. It definitely exceeded all my expectations,” said Fisher. “Now we are helping survivors and their life partners with advocacy, education and peer support.” Anderson said professionally led support groups play a crucial role in assimilation and accommodation of a cancer patients, providing a safe environment for individuals to learn, question, express emotions, and share experiences with others. She believes Rochester’s US Too NY offers survivors a place where they can join together with other survivors, spouses, partners, family and friends to reduce the stress associated with the diagnosis. “Support through myriad life-altering events is an important part of healing, as well as learning to live in the aftermath,” she said. “ Cancer of any kind is often seen as a life-changing event. Loss of job? Death of a child?

Rochester’s US Too NY now offers prostate cancer survivors a place where they can join together with other survivors, spouses, partners, family and friends to reduce the stress associated with the diagnosis Page 16

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

Patrick Fisher standing behind a table with literature about prostate cancer. He is the founder of US Too NY a group that helps prostate cancer patients, their families and friends. Divorce? Pregnancy? Cancer? Who better to talk to than someone who has gone through it?” With any new venture comes challenges. Outside of gaining the trust of the at-large community and hospital organizations such as the University of Rochester Medical Center, Unity and the Wilmot Cancer Center, they had to gain the trust of African American and Latino communities, including health and faith-based organizations. They had to establish a social media presence and picking up the pieces when the American Cancer Society announced they would no longer fund men’s cancer support groups in Rochester and the Finger Lakes region. Rochester’s US Too NY holds monthly meetings with focus on education such as robotic surgery, nutrition, emotional well-being and radiation treatment for men newly diagnosed. Members staff information table at health fairs, visit or talk with other survivors in the hospital and at home. The group’s first year included finding a meeting space at the Jewish Community Center of Rochester, expand its research to other countries, staffed information tables providing prostate cancer information at 14 community-based or faith-based health fairs, established Rochester’s first Blue Glove Dance for prostate cancer and run a successful November drive, which highlights men’s health. They also assemble quarterly to share their personal experiences, challenges and struggles, providing the support component. “Wives and life partners are also affected. I know I couldn’t have made it without my domestic partner, Roger Vanhorn,” said Fisher. “When I received my diagnosis, he reminded me that I had time to focus on what would happen next and that I didn’t need to make a knee-jerk reaction. Over the first few days, I heeded his advice and got braver by the day.”

Men’sHealth Grooming Tips for Men: Cleanse, Moisturize and Exfoliate Men can have skin that’s more sensitive to ultraviolet exposure than women’s skin, which makes it more prone to skin damage like skin cancer

ontrary to popular belief, a growing number of men are requesting recommendations for skincare products, says physician Natalie Semchyshyn, assistant professor of dermatology at Saint Louis University. Even so-called tough guys can have skin that’s more sensitive to ultraviolet exposure than women’s skin, which makes it more prone to skin damage like skin cancer or brown spots. “We tend to think of male skin type as tougher, thicker, but actually it’s more sensitive,” says Semchyshyn. “Compared to women, their skin loses moisture faster, is more prone to dryness and doesn’t exfoliate as much.” She offers five grooming essentials for men that could make their skin healthy and glow.

The Basics

You can usually find several different skincare products on a woman’s dressing table, but that may not be a guy thing. Semchyshyn recommends a basic regimen for men. “A six-step program doesn’t work for men. They’re not used to putting on

layers of different things,” she says. Whether it is a shaving gel or a moisturizer, looking for products that have some antioxidants and therapeutic ingredients is a good start. Antioxidants such as phloretin, ferulic acid and vitamins C and E help protect the skin against damage from UV rays and pollution. Colloidal oatmeal helps to soothe sensitive skin and sunscreen helps guard against skin cancer and aging changes. “An all-in-one product that combines moisturizer, antioxidants and sunscreen is a good way to go.”

No Sweat

Men who work out or regularly play sports should take extra care of themselves, as sweating can clog and irritate the skin. “The first step is to wash your skin to get the sweat off,” Semchyshyn suggests. “A gentle cleanser is excellent because it doesn’t strip the skin, it just cleans. After washing the face, using a moisturizer can make up for the loss of moisture from washing.” Sweating can also cause the skin to

become more acne-prone. “Sweating clogs pores. So, along with washing, it’s important to use products with benzoyl peroxide on the chest, back and shoulders to unclog the pores as well as cleanse the skin,” she says.

Oil-free zone

For oily skin, Semchyshyn recommends using a cleanser with glycolic or salicylic acid. “These help exfoliate and balance the skin.” Moisturizers with oil control and sunscreen are great for this skin type. And a gel that combines benzoyl peroxide with oil absorbing ingredients is good for very oily skin.

Exfoliate some more

Most men exfoliate while shaving, but that still doesn’t exfoliate the entire face. “Dead skin cells can give the face a dull look,” Semchyshyn says. “Sonic cleansing brushes can help exfoliate the skin and are great for deep cleansing. They can be used daily and can even

help with flaky body skin.”

Fight dryness

Winter can be ruthless on the skin, more so if you shower multiple times a day, says Semchyshyn. “It’s important to moisturize the skin and use a cleanser that doesn’t dry your skin,” she says. “Using a product that has natural oatmeal will moisturize and soothe sensitive skin. Moisturizers with glycolic or lactic acid in it will keep the skin hydrated and also exfoliate.”

Many Start Testosterone Therapy Without Medical Need Study finds increased testing among men with normal hormone levels

lthough testosterone use has sharply increased among older men in the past decade, many patients appear to have normal testosterone levels and do not meet the clinical guidelines for treatment, according to new research accepted for publication in the Endocrine Society’s Journal of Clinical Endocrinology & Metabolism. Testosterone is a key male sex hormone involved in maintaining sex drive, sperm production and bone health. Since testosterone levels tend to

naturally decline as men age, lower levels of the hormone do not necessarily mean that an individual has hypogonadism, a condition that results from low testosterone. As the population ages and an increasing number of men struggle with obesity and diabetes, more men may experience low testosterone levels without meeting diagnostic criteria or displaying symptoms of hypogonadism. “Over the past decade, older and middle-aged men are increasingly being tested for low testosterone levels and being prescribed testosterone

medications, particularly in the United States,” said one of the study’s authors, J. Bradley Layton, a doctor of philosophy of the University of North Carolina at Chapel Hill. “While direct-to-consumer advertising and the availability of convenient topical gels may be driving more men to seek treatment, our study suggests that many of those who start taking testosterone may not have a clear medical indication to do so.” To study testosterone trends, the retrospective incident user cohort study analyzed commercial and Medicare insurance claims from the United States

and general practitioner health-care records from the United Kingdom during the period between 2000 and 2011. The study identified 410,019 American men and 6,858 U.K. men who began taking testosterone during this period. The analysis also found more than 1.1 million U.S. men and 66,000 U.K. men who had their testosterone levels tested during this time. The study was funded by the National Institute of Health’s National Institute on Aging.

Prostate cancer vaccines receive a boost in funding

of being “too small to be convincing,” explains MVI’s scientific co-founder, Douglas McNeel. In addition, the funding will enable safety studies of another of the company’s DNA vaccines (MVI-118) to go ahead. The MVI-816 vaccine is designed to treat prostate cancer patients who have undergone initial surgery or radiotherapy but have found that their prostate-specific antigen (PSA) level, a biomarker for prostate cancer, is on the rise again after treatment. Men who have rising PSA levels despite having undergone these initial therapies are at a particularly high risk of the cancer spreading beyond the prostate to other areas of the body. Currently, their only choice is to

“wait and see” whether their PSA continues to rise or to undergo a form of castration, either surgical or chemical. This castration, also known of as androgen deprivation therapy (ADT), deprives the body of testosterone, the hormone that prostate tumors rely on for their growth. The MVI-816 vaccine is hoped to provide a means of reducing prostate cancer growth that avoids the need for castration. “Our goal in developing MVI-816 is to significantly delay both the onset of metastases and the initiation of [castration] for these patients,” explains president of Madison Vaccines, Richard Lesniewski. “This $8 million financing will allow [us] to advance our efforts to establish a safe and approvable immune activation therapy for men with

early malignant prostate cancer.” The drug is a plasmid DNA vaccine comprising small pieces of modified bacterial DNA designed to induce the body’s immune system to mount an attack against prostate cells that display the prostatic acid phosphatase (PAP) antigen. “When the plasmid gets inside a professional antigen-presenting cell, it stimulates immune T cells that are responsible for killing tumor cells,” explains McNeel. McNeel also highlighted the significance of developing the start-up’s second vaccine, MVI-118, which targets androgen receptors, molecules that are critical in the progression of prostate cancer and also in the resistance of many current therapies.

he development of two new vaccines that are hoped to offer an alternative to castration therapy for men with recurring prostate cancer, is due for an $8 million boost in funding. The pharmaceutical company Madison Vaccines Incorporated (MVI) recently announced the success of a finance round led by Venture Investors, LLC, that has secured the funds to expand a Phase II trial of the MVI-816 vaccine that was otherwise in danger

March 2014 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

Why Do the Amish Have Significantly Lower Cancer Rates? By Deborah Jeanne Sergeant

mish people live simple, separated lives to benefit their souls. As it turns out, it seems to benefit their bodies as well. A cancer study stunned Ohio State University researchers when they found that their Amish subjects experienced 40 percent fewer incidences of cancer compared with Englishers (nonAmish) in Ohio and 44 percent fewer than the national rate. The figures are age-adjusted so that the comparison takes into account the age difference between the Amish people the researchers studied and the average age of the general population. Researchers had anticipated higher rates of cancer among the Amish because they do not marry outside their faith community, which limits their genetic pool. Amish don’t seek to convert people. The few outsiders who join their population do so through adoption. Researchers theorized that cancer-related gene mutation would increase cancer rates. Instead, it appears their conservative lifestyle and, perhaps, their restricted genetic pool may lower their cancer risks. The study, conducted from 1996 through 2003, studied 24 types of cancer. The journal Cancer Causes & Control recently published the results. The population of the study comprised 9,992 Amish: 90 percent of the population of Holmes County, Ohio. Most of these descended from the same 100 settlers who moved to the area

200 years ago. This helped researchers delve into family health information three or more generations back. The researchers confirmed information they gathered by comparing it with death certificates and cases reported to the Ohio Cancer Incidence and Surveillance System. No Monroe County-area health care providers contacted wished to comment on the story. Physician Joseph Gold, founder of Syracuse Cancer Research Institute, thinks that the Amish lifestyle has a lot to do with why their cancer rates are markedly lower than the general population’s. “They aren’t drinkers and smokers for the most part,” he said. “Smoking, of course, is associated with a lot of lung cancer, and drinking with breast cancer and various other types of cancer. People who avoid that, I would say their incidences of cancer would be much less.” Most Amish homestead, raising their own vegetable gardens, chickens, and pasture-fed livestock. Living independently is part of Amish teachings and culture. Without electricity, Amish complete all their daily chores through manual labor and rely on bicycles or horses for transportation. Their fresh and natural diet and physical labor could encourage a healthy immune system and help control weight. “They’re slender people in general,” Gold said. “In our population

What They Want You to Know: Oncology Nurses By Deborah Jeanne Sergeant

ncology nurses care for patients who have cancer. Their specialty enables them to provide greater comfort and care for their patients and their families. • “I enjoy meeting patients, helping them through a difficult time, helping them understand their disease, [and helping them deal] with the stress of the situation by sharing humor, life stories and tears. Each new patient becomes a new member of my family • “Call anytime. We are always available day or night. Do not hesitate. Be an active participant in your care and treatment decisions. Page 18

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• “Be open, honest and call with problems when they begin. Do not wait. Be honest about the obstacles that cancer care may create in your life, be it your ride to treatment, meals, finances, or support. All are part of your care, not just the treatment of your cancer. Lastly, you can decide where you get your cancer care. You do not have to go where your doctor tells you. If you want care in a particular place, then you need to advocate for that.” Denise Tyler, nurse manager at Finger Lakes Hematology & Oncology, Clifton Springs

today, two-thirds are overweight and half of the overweight ones are obese. Being overweight is linked to cancer. Most Amish are farmers and physical workers. They aren’t overweight.” Sexually transmitted diseases may be causal factors with some types of cancer, such as genital human papillomavirus causing cervical cancer, and cancer of genital areas. The rate of these types of cancer are also lower among the Amish, who forbid promiscuity and promote marital fidelity. Simple living — not keeping up with the Jonses — represents a tenant of Amish faith. Church bishops mandate the rules by which they live. Their dress is ordinary. They do not own electric devices or cars (though in some districts, use of such devices or ownership and use for business-only is permitted). All of these rules and more are meant to evoke humble demeanor and stamp out pride among church members. By eschewing materialism, Amish

families also avoid many stressors. “As far as I know, stress accounts for increasing incidences of both diabetes and cancer,” Gold said. “A person can have marked psychological or physical stress and six weeks to six months later can have cancer. We see that a lot. People who decrease stress will have a lesser risk of these diseases. “We tend to focus on the genetic aspects of cancer, but I’m not sure that factor outweighs the physical habits,” Gold said. “To think that cancer incidence is mostly due to genetic make-up is a mistake. It’s the lifestyle.” New York is home to more than 12,000 Amish and 92 Amish church districts. It ranks as the nation’s fifth-largest Amish population. According to AmishAmerica.com, the Empire State boasts the fastest growing population of Amish, including groups in the Mohawk Valley, and in Seneca and Wayne counties.

• “I help cancer patients and families manage symptoms at home, and I teach them how to cope with the disease itself. For example, I help mitigate nausea, teach medication management, provide IV hydration and work with physicians to ensure patient needs are met. I also offer emotional support by listening and troubleshooting and, if treatments are no longer deemed effective, I help the patient consider other options including hospice. • “I love working with oncology patients—they are typically the sickest patients who are still in their own homes. As a nurse it can be very challenging, but also extremely rewarding. I have to build strong relationships with patients and families to help guide them through the process, and when their quality of life improves, they are so thankful. It’s incredible to witness the progress and know I had a part in helping these people I care about. • “Many times patients will try to relieve symptoms by calling a doctor, but when we’re in the home we’re able to see what the patients are experiencing and how they’re living, which can help us more fully meet their needs. • “At one point, I started seeing a patient who spent 12 hours a week at a cancer center for IV hydration. When I suggested we provide the service in his home, he was surprised we could do it and was also very relieved. He no longer had to travel to the center multiple days a week, and while at home, he could visit with friends and family. He wasn’t so isolated.

• “We also have other professionals I can involve when appropriate such as social workers, a bereavement coordinator and chaplains, and when patients are unable to cook, I contact our Meals On Wheels program. • “Some cancer patients don’t realize they qualify for home care, but all they need is to be homebound, meaning they can’t leave home without the assistance of another person or a supportive device like a walker, and have a skilled need like symptom management. • “In addition to meeting patient needs, palliative care nurses in the home provide a lot of support to the families. Many times, because the patient is so sick, it is the family that is overseeing the care. So I teach them how to care for their loved one at home—how to manage medications, how to help the patient drink a little at a time so they don’t get sick, etcetera.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

Stephanie Abel, RN, palliative care case manager, Visiting Nurse Service of 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.

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RV Travel Tips for Beginners Dear Savvy Senior, Can you write a column on RV travel for beginners? My husband and I will be retiring in a few years and have always thought it would be fun to spend some of our time traveling around the country in an RV. What can you tell us? Ready to Retire

different types of RVs available today, along with various videos and other RV information.

Dear Ready, The affordability, combined with the comfort, convenience and personal freedom it offers has made recreational vehicle (RV) travel immensely popular among retirees over the past decade.

With around 14,600 public and privately owned RV parks or campgrounds across the country (see gocampingamerica.com and trailerlifedirectory.com), RVers can roam coastto-coast with no shortage of places to stop, or options to choose from.

According to the Recreational Vehicle Industry Association, there are approximately 35 million RV enthusiasts in the U.S., including a growing number of baby boomers. Some of the reasons RVing has become so popular is because of the freedom and flexibility it offers to come and go as you please. If you like where you’re at, you can stay put. Or, if your feet get itchy you pack up and move on. Another popular aspect among retirees is following the seasons. Snowbirds, for example, like to travel south for the winter, while southerners migrate north during the hot summer months. RVing is also a very affordable way to go. Even considering ownership or rental costs, RV travel is cheaper than traveling by car, plane or train — especially when you factor in lodging and restaurant costs.

RV Options

Most people, when they think of RVs, think of huge motorhomes, but RVs run the gamut from folding camping trailers and truck campers, to travel trailers and large motorized RVs. Cost, too, will range from as little as $4,000 for pop-up campers all the way up to $1.5 million for luxurious motorhomes. To learn more about RV options, check out gorving.com, a resource created by the RV travel industry that breaks down all the

The best way to ease into RV travel and find out if you like it is to rent. Renting can also help you determine which type of RV best suits your needs. Rental costs will vary greatly depending on what you choose, but you can expect to pay anywhere from $30 up to $300 per day. To locate one of the 500 or so RV rental outlets around the country check your yellow pages under “Recreation Vehicle” or search The National RV Dealers Association website at rvda.org.

Camping Options

Most RV parks are open to all comers and rent spaces on a nightly or weekly basis, much like a motel or hotel, with rates typically ranging from $15 to $50 per night, however some in city and country parks may be $10 or even free. RV parks can also range from rustic facilities with limited or no utility hookups, as are more often found in state and national parks, to luxury resorts with amenities that rival fine hotels. To research RV campgrounds, get a copy of the “Good Sam RV Travel Guide & Campground Directory” for $10 at goodsamclub.com/publications, or call 866-205-7451. This guide breaks down what each campsite offers, along with their policies and costs, and a rating system. Also see rvbookstore.com for dozens of books and DVDs about RVs and the RV lifestyle. There are also a number of RV clubs you can join, like the Good Sam Club (goodsamclub.com), that provide member discounts on parks and campgrounds, travel guides, fuel and propane, roadside assistance and more. Passport America (passportamerica. com) is another popular club that gives 50 percent discounts on more than 1,800 campsites across the U.S., Canada and Mexico. 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. March 2014 •

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Page 19

The Social Ask Security Office

When Cats Bite: 1 in 3 Patients Bitten in Hand Hospitalized, Infections Common Middle-aged women most common cat bite victims

Column provided by the local Social Security Office

In Iditarod and Retirement, Prep Is Key

ogs aren’t the only pets who sometimes bite the hands that feed them. Cats do too, and when they strike a hand, can inject bacteria deep into joints and tissue, perfect breeding grounds for infection. Cat bites to the hand are so dangerous, one in three patients with such wounds had to be hospitalized, a Mayo Clinic study covering three years showed. Of those hospitalized, two-thirds needed surgery. Middle-aged women were the most common bite victims, according to the research, published in the Journal of Hand Surgery. Why are cat bites to the hand so dangerous? It’s not that their mouths have more germs than dogs’ mouths — or people’s, for that matter. Actually, it’s all in the fangs. “The dogs’ teeth are blunter, so they don’t tend to penetrate as deeply and they tend to leave a larger wound

after they bite. The cats’ teeth are sharp and they can penetrate very deeply, they can seed bacteria in the joint and tendon sheaths,” says senior author, Brian Carlsen, a Mayo Clinic plastic surgeon and orthopedic hand surgeon. “It can be just a pinpoint bite mark

that can cause a real problem, because the bacteria get into the tendon sheath or into the joint where they can grow with relative protection from the blood and immune system,” Carlsen adds.

Raising Awareness of Problem Gambling NCADD-RA joins forces with the New York Council on Problem Gambling

ePaul’s National Council on Alcoholism and Drug Dependence-Rochester Area (NCADD-RA) has received funding from the New York Council on Problem Gambling (NYCPG) to increase the number of parents who are committed to talking to their children about the dangers associated with underage gambling in 2014. NCADD-RA has been a partner with NYCPG on these efforts since the it began awarding mini-grants to local providers for the purpose of reaching out to parents in 2012. The focus of the NYCPG’s 2014 parent outreach project is getting parents to talk to their children about problem gambling. Research surrounding youth gambling participation and parent responses show a significant gap in parental concern for youth gambling behavior and actual youth gambling problems. A study found that approximately

68 percent of youth between the ages of 14 and 21 report having gambled in the last year, while 11 percent report having gambled twice per week or more. Research also shows that that less than half of parents ever discuss gambling issues with their teen and that only 13 percent of parents believe that their teen actually gambles for money. The NCADD-RA provides education, resources and referrals for family members affected by the problem gambling of a loved one. Presentations are available upon request to parent, school and community groups to increase awareness to the potential risks of problem gambling with special emphasis on the risks associated with underage problem gambling. To schedule a presentation or for more information, contact Jennifer Faringer at 585-719-3480 or jfaringer@ depaul.org.

WOMEN’S ISSUES

Don’t miss the April edition of In Good Health—Rochester’s Healthcare Newspaper. Call 585-421-8109 to advertise. Page 20

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he Iditarod Trail Sled Dog Race, held each March in Alaska, is one of the harshest, most challenging races known to man (or dog). Mushers embark on a race from Anchorage to Nome that takes between nine and 15 days. Contestants bear sub-zero temperatures with gale-force winds that can cause wind chills as low as negative 100 degrees Fahrenheit. It takes endurance, preparation and careful planning to make it from start to finish. The same can be said for your race toward retirement and Social Security. No one would hit the trail without being ready for the challenges. Similarly, no worker today should be navigating toward retirement without a little bit of preparing, planning, and stick-to-itiveness. Choosing your steps is as important as selecting the right sled dogs. Your first step in planning for a comfortable retirement is to look at your Social Security Statement, which you can do online easily with a my Social Security account. The online Statement is easy to use and provides estimates you should consider in planning for your retirement. It provides estimates for disability and survivors benefits, making the Statement an important financial planning tool. Your Statement allows you to review and ensure your earnings are accurately posted to your Social Security record. This feature is important because Social Security benefits are based on average earnings over your lifetime. If the information is incorrect, or you have earnings missing from your record, you may not receive all of the benefits to which you are entitled in the future. Visit www.socialsecurity.gov/myaccount to set up a my Social Security account and get started. Before heading into the snowy

Q&A

Q: My neighbor said my kids, 8 and 15, might be eligible for survivors’ benefits since their mother died. Are they? A: Maybe. Their mother must have worked and earned the required number of Social Security credits. If she did, both you and your children may be eligible for benefits. Apply promptly for survivors benefits because benefits are generally retroactive only up to six months. You can apply by calling Social Security’s toll-free number, 1-800-7721213, between 7 a.m. and 7 p.m. on Monday through Friday. People who are deaf or hard of hearing may call our toll-free TTY number, 1-800-325-0778. Q: I’m expecting a baby this June. What do I need to do to get a Social Security number for my baby? A: Apply for a number at the hospital when you apply for your baby’s birth certificate. The state agency that

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

terrain, you want to make sure you have prepared for a number of different possible obstacles on the trail. For retirement planning, you’ll want to test out the Retirement Estimator to see how changes in your income, retirement age and other variables may change your overall plan. Use our Retirement Estimator, where you can get a personalized, instant estimate of your future retirement benefits using different retirement ages and scenarios. Visit the Retirement Estimator at www. socialsecurity.gov/estimator. Out in the cold, you’ll be thankful for the provisions you’ve brought along. In retirement, you’ll understand why it was so important for you to save early on. The sooner you begin your financial planning, the better off you will be. Social Security replaces about 40 percent of the average worker’s pre-retirement earnings, but most financial advisers say that you will need 70 percent or more of pre-retirement earnings to live comfortably. You also will need other savings, investments, pensions or retirement accounts to make sure you have financial security to live comfortably when you retire. Visit the Ballpark Estimator for tips to help you save. You’ll find it at www. choosetosave.org/ballpark. Use our online library of publications as your trail map or guidebook to help you when it comes to planning for retirement. Check out When To Start Receiving Retirement Benefits. It and many other useful publications can be found at www.socialsecurity.gov/pubs. As you mush, mush, mush toward retirement, remember that it’s not about the destination, but all about the journey. Spending a little time to prepare along the way will make all the difference when you cross the finish line into retirement.

issues birth certificates will share your child’s information with us, and we will mail the Social Security card to you. Q: My mother receives Supplemental Security Income (SSI) benefits. She may have to enter a nursing home later this year. How does this affect her SSI benefits? A: Moving to a nursing home can affect your mother’s SSI benefits but it depends on the type of facility. In some cases, the SSI payment may be reduced or stopped. Whenever your mother enters or leaves a nursing home, assisted living facility, hospital, skilled nursing facility, or any other kind of institution, you must tell Social Security. Call Social Security’s toll-free number, 1-800772-1213 (TTY 1-800-325-0778). We can answer specific questions and provide free interpreter services from 7 a.m. to 7 p.m., Monday through Friday. We also provide information by automated phone service 24 hours a day.

H ealth News UR Medicine recognized for stroke care UR Medicine’s Strong Memorial Hospital has been recognized by The Joint Commission and the American Heart Association/American Stroke Association as a Comprehensive Stroke Center. This designation, which has only been conferred on two other hospitals in New York state, places UR Medicine among an elite group of institutions that provide highly-specialized complex stroke care. This certification also coincides with the launch of a new program dedicated to providing intensive care to patients with severe neurological disorders such as stroke. “We are proud that The Joint Commission has recognized our dedicated team of neurologists, cerebrovascular and endovascular neurosurgeons, neuroradiologists, emergency department physicians, therapists, nurses, and staff,” said neurologist Curtis Benesch, the medical director of the Strong Memorial Hospital Stroke and Cerebrovascular Center. “This certification is a testament to their commitment to provide the highest and most comprehensive level of stroke care to our community.” “When treating stroke patients, time equals brain,” said physician Babak Jahromi, surgical director of the Center. “This requires a group of trained individuals that is ready at a moment’s notice to not only evaluate stroke patients and provide immediate care, but also has access to advanced surgical interventions that can help restore brain function when other methods fail.” Comprehensive Stroke Center certification recognizes those hospitals that have the state-of-the-art infrastructure, staff, and training to receive and treat patients with the most complex strokes. Strong Memorial Hospital underwent a rigorous onsite review last December. Requirements for Comprehensive Stroke Center designation include advanced imaging capabilities, 24/7 availability of specialized treatments, and staff with the unique training and skills to care for complex stroke patients, including access to endovascular treatments that can surgically remove clots from the brain. Stroke team members at Strong work closely with their counterparts at Highland Hospital to evaluate and coordinate care for the most severe stroke cases.

Farmington primary care physician joins Thompson A longtime Farmington primary care physician is integrating his medical practice into the network of family practices run by Thompson Health, an affiliate of the University of Rochester Medical Center. Board certified by the American College of Osteopathic Family Physicians, Marc S. Zarfes is a clinical associate professor in the department of family medicine at the University of Rochester School of Medicine. He has been practicing in Farmington since

1985 and will remain at his current location, 5505 Route 96, with his current office staff. In a recent letter to patients, Zarfes said becoming a part of Thompson will allow him “to draw upon the world-class resources and full range of speZarfes cialists at Thompson Hospital and the University of Rochester Medical Center to provide more integrated health care with ease of referral and care coordination.” In addition, Zarfes noted, his practice will now be able to convert all current paper records into electronic medical records to keep pace with modern healthcare technology. This conversion will allow Zarfes to e-prescribe medications, quickly obtain patients’ lab and X-ray results and access other information generated by patients’ other healthcare providers. Thompson, in turn, views the addition of Zarfes as an opportunity to broaden its outreach to Farmington and the surrounding communities. “A primary care physician of Dr. Zarfes’ caliber would be a welcome addition to any healthcare system, and we are extremely gratified he chose to align with ours,” said Thompson Health Executive Vice President Kurt Koczent.

Hurlbut Honors Mattie Turner, Helen Calus Mattie Turner of The Brightonian Nursing Home, Brighton, and Helen Calus of Penfield Place, Penfield, have been selected as the winners of the 2013 winners Robert H. Hurlbut “Living Our Values” Award. The award is given each year by the Hurlbut Care Communities to an individual who passionately embraces the core values of Hurlbut Care Communities, and who stands above all others in helping to provide the highest quality care

and support to residents and their families to enrich body, heart, mind and spirit. This year, based on superlative efforts and dedication, both Turner and Calus were selected, as each exemplified Hurlbut values in exceptional ways. Turner is a rehabilitation aide and Calus a certified nursing assistant. Each received a check for $500 at ceremonies held at both The Brightonian and Penfield Place.

Unity Health System has new provider Physician Geetha Koushik recently joined Unity Health System through Unity Geriatric Associates. The physician earned her Doctor of Medicine degree from M.S. Ramaiah Medical College in India. She completed her residenKoushik cy with Unity Internal Medicine at Unity Hospital. Koushik is a member of the American College of Physicians. She lives in Rochester.

Steve Turner, son of Mattie Turner, Doris Garcia, administrator of The Brightonian, and Mattie Turner.

Gastroenterololgy service expands in Clifton Springs Clifton Springs Hospital & Clinic announced that physicians Robert Helft and Daniel L. Biery have joined its new hospital-owned practice, Ontario Gastroenterology Associates. The practice has expanded to allow for increased patient access while continuing to provide the same quality of service and care that the community has received over the past 30 years. With the expansion, a central registration model at the front desk was chosen to improve patient flow for check-in and check-out and a physician team approach has been implemented to allow improved continuity of care for patients.

Ann Catalfano, administrator of Penfield Place, Helen Calus, and Robert W. Hurlbut, President & CEO of Hurlbut Care Communities.

VNS of Rochester achieves We Honor Veterans Level 3 Visiting Nurse Service of Rochester (VNS), UR Medicine’s home care agency, recently achieved Partner Level Three for the We Honor Veterans program. Level four is the highest partner level, which VNS expects to earn later this year. We Honor Veterans is a program through the National Hospice and Palliative Care Organization in col-

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laboration with the Department of Veterans Affairs. By voluntarily participating in We Honor Veterans, Visiting Nurse Service of Rochester ensures every veteran in its hospice program receives the proper care and a hero’s welcome home. During a ceremony, VNS officials publicly acknowledge the patient’s military service and present a flag pin, a personalized certificate and a flag blanket. They also meet veterans’ unique medical and emotional concerns that can result from combat, and connect families to organizations that can uncover veterans’ benefits.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Letters to the Editor

o G u o Y d l Shou

Sources Give Misleading Statements about Vegan Diet To the Editor: Thank you for the work you do informing the public on health topics and empowering people to take care of their own health. The January 2014 issue of In Good Health had a cover story titled “Should You Go Vegan?” The article certainly helped to normalize veganism, i.e. to increase its name recognition, to help people to view it as a viable dietary option and to encourage people to try it. Still, we take issue with some statements in the article, which were inaccurate or misleading. The author, Deborah Jeanne Sergeant, interviewed three area dietitians. In the article, one of them says: “It’s tricky for most people to find non-animal sources of protein.” This is simply not true. All plant foods contain some protein; many foods, such as beans, whole grains and green vegetables, contain a higher percentage of their calories from protein than is recommended by the World Health Organization for the overall diet. What’s more, there is no need to combine foods in order for plant protein to supply the body’s needs, as was once thought. In short, protein is a non-issue for vegans, which the author even acknowledges later in the article when she writes: “Eating enough protein is usually pretty easy for vegans.” Another of the dietitians says: “vegans . . . miss out on long chain

? N A VEG

omega-3 fats, the ‘fatty fish’ oils EPA and DHA found only in seafood. Short chain omega-3 is found in flaxseed and walnuts, but seafood is the best source.” This is very misleading. Flaxseed and walnuts are excellent sources of short-chain omega-3’s comparable to seafood; and the body can convert short-chain omega-3’s into long chain omega-3’s (our body needs both kinds). A crucial piece of missing information here is that fish do not produce longchain omega-3s: they eat them when they consume algae. If a person wishes to supplement with long-chain omega-3’s (EPA and DHA), there is no need to take fish oil capsules; you can get them from the original source — free of potential contamination from moving through the fish food chain, and free of cruelty to fish and damage to marine environments — by taking algae-based vegan omega-3 capsules containing EPA and DHA. These can readily be found in area stores or ordered from amazon.com (search “vegan DHA”). One of the dietitians, in her tips, says “If you’re eating at a less veg-friendly restaurant, consider ordering a meat-or-cheese-based appetizer and make the rest of the meal vegetarian, like shrimp cocktail and then a salad.” Vegans eating out do not have to surrender in this way. Almost any restaurant will make you a vegan meal if you call beforehand and talk to the manager or chef; so someone who wishes to eat vegan doesn’t have to

r. ore popula more and m e Is m . o y ec h b lt s ea a h rt h vegan diet p their hea few years, ght and kee ei w se s lo In the last ro p it helps them y? We talked to the a six-week course at the Jewish ComPeople say ld tr u o sh u o y g munity Center called “A Plant-Based it somethin

settle for a non-vegan appetizer. And may we point out: shrimp is not vegan or even vegetarian. One of the dietitians says, early in the article: “Going vegan requires a lot of reading and getting informed and educated about nutrition sources.” Of course people should inform themselves about vegan diet as they would before making any important step. But this comment tends to make going vegan sound difficult and risky, which it is not. The fact of the matter is that the standard American diet is risky, and is killing people on a daily basis by predisposing them to preventable diseases like cancer, diabetes, and coronary artery disease. People who want to go vegan can go to a few websites to learn what they need to know. Some we would recommend are veganhealth. org; pcrm.org; vrg.org, and the Rochester Area Vegetarian Society’s own site, rochesterveg.org. While these mistakes in the article may seem minor, they involve issues that many people are concerned about, and that can be an obstacle to their trying a vegan diet. For example, “Where do I get my protein?” is probably the most frequent question we get from the general public. Anyone who wants to learn more about the benefits of a vegan diet and how to make the change is welcome to join our group, come to our meetings, or contact us at rochesterveg@gmail or 585-234-8750. Also, we will be offering

Diet: Eating for Happiness and Health” on six successive Tuesdays from March 4 through April 8, from 6:45 – 9 p.m.; call the JCC at 461-2000 to register, or visit rochesterveg.org and click on “Course Resources.” Ted D. Barnett, M.D. and Carol H. Barnett are co-Coordinators, Rochester Area Vegetarian Society.

Vegan story needs clarification I appreciated the article about a plant-based diet in your recent edition. However, what the author was espousing was not a vegan diet. Being vegan is not just about food. A clarification is needed. Thanks! Mary Christo Editor’s Note: Thank you for your interest. In Good Health is a health-oriented periodical, so the article about a plantbased diet focused on aspects of veganism that relate to health (diet) not activism and animal rights (such as eschewing leather and other animal-derived products). The point of the article was not to define veganism but to explore its merits and caveats pertaining to an individual’s health.

The Magazine for Active Adults New issue just published. RECEIVE 55 PLUS AT HOME Subscribe today and get 55 PLUS magazine mailed to your home! Name_____________________________________________________ Address___________________________________________________ City / Town_________________________State_________Zip_________

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

$15 — 1 year $25 — 2 years

Program helps lower-income residents get control of their health   Excellus BCBS is supporting St. Joseph’s Neighborhood Center’s health empowerment program, providing $90,000 over four years.

depression and anxiety. A number of participants have also maintained their weight loss one year after the program ended.”  Since starting the program in early

2013, Debbie Trout, the Health Empowerment Program participant, has lost about 50 pounds, and she’s no longer pre-diabetic. She started a food diary and began walking. She started to eat

Want to Join the Program?

For more information about St. Joseph’s Neighborhood Center’s health empowerment program, call 585-3255260

Now Available in Monroe County

ebbie Trout had grown tired of battling with her health.  The Rochester resident suffered from depression, high blood pressure and was pre-diabetic. She was less than 5 feet tall, yet weighed 200 pounds.    A nurse at St. Joseph’s Neighborhood Center in Rochester suggested Trout enroll in the center’s health empowerment program. The goal of the Excellus BlueCross BlueShield-sponsored program is to help improve the health of lower-income residents struggling with pre-diabetes or weight issues.   Trout jumped at the opportunity.   “My life was out of control,” said Trout, 58. “I was ready to try anything at that point.” Trout began to get control of her life. Many program participants have started to do the same, even though many of them are lower-income, overweight or obese and battling chronic diseases or depression.    “We’ve begun to uncover the layers of work needed to overcome these barriers and achieve sustained and healthy weight loss,” said Sister Christine Wagner, executive director, St. Joseph’s Neighborhood Center. “Healthier people are emerging.”   Excellus BCBS began supporting the center’s health empowerment program in 2010, providing about $90,000 over four years. The program focuses on behavioral and clinical interventions.   Participants learn portion control and receive pedometers to encourage walking. They’re offered group support with a focus on mindfulness and mental health. Given participants’ limited income, they also learn about inexpensive community resources that are available to them. They learn about the advantages of farmers’ markets and the availability of free exercise DVDs at local libraries. They’re informed about inexpensive follow-up support, whether it’s through the center, the groups’ Facebook page, Overeaters Anonymous or Food Addicts Anonymous.    “Making healthy lifestyle changes that last is already a daunting challenge for many people,” said physician Martin Lustic, senior vice president, corporate medical director, Excellus BCBS. “This program offers unique support to individuals facing added challenges, whether they’re battling chronic conditions, unable to afford gym memberships or don’t have easy access to fresh fruits and vegetables.” About 100 individuals have completed the seven-week program, with many graduates continuing through monthly support sessions. “The seven-week program is not a magic bullet, and it’s not meant to be,” Wagner said. “Life changes take all of us a long time to achieve. But we’ve been encouraged by preliminary follow up data that shows overall improvements in cholesterol levels and time spent exercising and declines in

a healthy breakfast, a key part of any weight loss plan.   “The biggest thing I learned was to be mindful about what I’m putting on my plate,” she said. “I’m certainly feeling a lot better about myself, thanks to this program.”

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 March 2014 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Robotic Surgeries: Pushing the Limits Over the last decade robotic surgeries have expanded to a wide variety of procedures By Ernst Lamothe Jr.

decade ago physician Jean Joseph was one of the first in the region to begin doing urology robotic surgery. The da Vinci Surgical System was a new device named after the famed Italian artist. It offered minimally invasive surgery by integrating computer-enhanced technology. The 3D HD robotic system allowed skilled surgeons an opportunity to perform precise incisions in a manner never experienced before. It was a whole new frontier for the medical community. Today, it has grown at an unimaginable speed. Once only used for gallbladder and other urology surgeries, over the past few years it has been expanded to kidneys, removing tumors, hysterectomies and prostate cancer. Doctors say the patient benefits are boundless, including reduced pain and trauma to the body, less blood loss, less post-operative discomfort, shorter hospital stays and faster recovery. “Robotics allows us to get into areas that were very difficult to in the past to perform surgeries,” said Joseph, professor of urology and oncology for the University of Rochester Medical Center. “Before with Joseph surgery, your hands were working on the patient in one direction, but your eyes were looking at a screen in another direction.” When Joseph first performed robotic surgeries on the prostate, he instantly understood the impact the innovative technology would have on operations. He has found robotics better for suturing and especially useful in preserving more of the kidney during laparoscopic partial nephrectomy surgery. Kidney cancer, or renal cell carcinoma, is diagnosed in more than 58,000 people a year in the United States and is responsible for more than 13,000 kidney cancer deaths per year. The new technology integrates a fluorescent imaging system and the surgical console into one system. It also allows the surgeon to turn his or her attention back and forth from different types of images to the surgical tools, without stepping away from the console. “With this kind of surgery, you can have a patient hopefully avoid dysfunction in their kidney or going to

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dialysis treatment,” said Joseph. Slowly over the past five years, robotics has entered the world of gynecologic surgery. Physician A. David Peter, a board certified surgeon who does procedures at F.F. Thompson Hospital in Canandaigua, said the advancement in gynecological surgeries have been immense. Before complex surgeries could only be approached through open body cavity incisions. Peter said the new technology has helped improve many specific surgeries that require extreme preciseness such as reconstruction of a women’s uterus. Traditional open gynecologic surgery, using a large incision for access to the uterus and surrounding anatomy, was Peter the standard approach for years. Today, the robotic-assisted reproductive surgery uses four to five small incisions of one-quarter to one-half inch each in the lower abdomen and pelvis. A robot-controlled video camera, two or three robotic manipulating arms as well as conventional laparoscopic assisting instruments are then passed through these incisions. The surgeon sits at a console to manipulate the robot arms and direct the camera with hand-controls, while looking at the operative field with a high definition 3-D view. With the state-of-the-art equipment, women now experience fewer complications, lower risk of wounded infections and quicker recovery and return to daily activities.

“It is surprising how quickly robotics has taken off,” said Peter, who began his practice at Canandaigua Medical Group in November. “But the main reason it has taken off is because of the proven excellent results.” In addition, robotic surgery has been instrumental in cases of myomectomy, the surgical removal of fibroids from the uterus. It allows the uterus to be left in place and preserves fertility. With the assistance of the da Vinci Surgical System, surgeons can remove uterine fibroids through small incisions with unmatched exactitude and control. Patients have significantly less pain and scarring. Peter, whose field is general surgery, said the robotics has pretty much replaced open prostate surgeries. About 90 percent is now done with technology for all the obvious reasons such as less blood loss and better recovery. “The biggest advancements we have seen in the field is the miniaturization of the equipment,” said Peters. “We are able to do gallbladder surgery by doing one incision in the belly button. With the equipment getting smaller and more precise, it is boding well for the future.” He hopes the next generation of equipment has better sensory feedback when the surgeon is touching tissue and other organs. “Right now, the surgeon has to put both eyes inside console while they are operating and using three fingers. You have to use visual cues to know you are touching a bone or other areas of the body. In the future, if they make the robotics cues sensitive to touch, then it will enhance the process,“ added Peter. At Rochester General Hospital, the first da Vinci Surgical System was used in 2004. Since then, more than 1,000 procedures have taken place. Physician John Valvo, division chief of robot-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • March 2014

ics surgery at RGH, began doing the surgeries right after the system became available. He began seeing how the procedures were more meticulous than ever before and minimally invasive. “As soon as I did my first surgery, I knew it was a game changer,” said Valvo. “I just didn’t know how fast it was going to grow among other specialties as it has in the last few years.” Valvo recently took a trip to Toronto where robotics was a key discussion point among medical professionals. He understands the advancements will grow exponentially in the field describing the process as “building a bridge to the future while we are still standing on it.” However, the public seems confident in the procedure. “Once I explain to the patient that instead of doing it the traditional way, we are going to use new technology, I have never had a patient turn down the surgery. It is beginning to be universally accepted in our age of technology that science will continue to evolve so that doesn’t scare patients,” said Valvo. “And as we approach a decade of robotics, you are seeing that the surgical outcomes from the first wave of patients back in 2004 continue to show the success of robotics.” Joseph, who also heads the Center for Robotic Surgery and Innovation at the University of Rochester Medical Center, can’t wait to see what the next decade holds for the new technology. Canada, Germany and Korea are working on fresh technology that will advance the medium. “I’m very excited and will welcome more technology coming into our industry. It makes us better surgeons and it helps the patients,” said Joseph. “The evolution will continue to redefine what surgeons can do. This is not a fleeting phenomenon so robotic surgeries are obviously not going away.”