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Doctor’s Orders

A physician explains what’s best to order at a fast food restaurant

Rochester–Genesee Valley Healthcare Newspaper

February 2012 • Issue 78

New Study Shows Americans’ Heart Health Needs Improvement

Will you be mine? Dating tips for finding that special someone

A New Trend: Smoke-Free College Campus

Cardiovascular diseases still account for one in every three deaths in the US. Learn how to get your heart in shape.

SUNY Brockport the first college campus to go smokefree. Will others follow suit?

Chief medical officer at Finger Lakes Health, Dr. Jason Feinberg, discusses recruiting efforts, hospital branding and the importance of computerized physician orders

Number of Cancer Cases Growing in Monroe County

Rochester Heart Institute’s Big Star Dr. Ronald Kirshner (center) leads what is rated “best hospital in New York state for overall cardiac care”

r. Ronald Kirshner can’t stand the New England Patriots, a familiar sentiment for many who live in Western New York. However, he can appreciate their consistency season after season, their teamwork despite unforeseen circumstances and their drive

to achieve perfection in every aspect of the game on every play. That’s the way Kirshner runs the Rochester Heart Institute and his staff as chief of cardiothoracic surgery at Rochester General Hospital. It’s one the reasons RGH is considered near the top of cardiovascular hospitals.

February 2012 •

Taking Control of Your Life in 2012 Lynette M. Loomis, a certiﬁed life and business coach based in Pittsford, discusses steps you can take to lead a more productive life this year. “Step over those pre-conceived notions about yourself and dig into life with both hands,” she says in a special article for In Good Health.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

News & Notes Male Nurses More Masculine than Other Guys Despite the old stereotype that nursing is a “women’s profession,” male nurses display more typically masculine traits than men who work in other vocations, a new study suggests. The results show male nursing students scored higher on tests to measure masculinity than college men studying other subjects. “The nursing profession is attract-

Study ﬁnds surge in number of young nurses

ing males who hold a high degree of masculinity,” the researchers wrote in the November issue of the American Journal of Men’s Health. “Efforts should be made to counteract the prevailing belief that male nurses are effeminate.” The idea that male nurses are more effeminate has existed for generations, and is re-enforced by popular culture, according to the study. The stereotype may discourage men from entering the profession, and cause anxiety and tension among those who choose to pursue it.

According to a report published in December in the journal “Health Affairs,” over the past decade the number of younger registered nurses entering the workforce increased 62 percent. The influx of young nurses is especially notable because at least 900,000 of the nations’s roughly 3 million nurses are older than 50, and are near retrenchment. At the same time, the U.S. population is aging, getting more chronic diseases, and bringing an increased demand for care and nurses. The number of 20-something

February 2012 •

nurses dropped steadily through the 1980s and the 1990s, and reached a low in 2002. But, by 2009, there were 165,000 full-time equivalent nurses aged 25 to 35, according to data from RAND Health. There has been a national campaign for more nurses in recent years with advanced degrees, and other programs aimed at attracting both young nurses and second-career ones in their 30s. Adding to nurse shortages is the distance many nurses must travel to a job. Census data shows that nursing is one of the least mobile professions, partly due to the fact that many second-career nurses have family obligations by the time they switch jobs.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Jan. 31

Free skin cancer screening event in Clifton Springs Clifton Springs Hospital & Clinic will be the site of a free skin cancer screening event hosted by Dermatology Associates of Rochester Jan. 31. Open to the general public, this event will offer individuals the opportunity of a free assessment and overview of their skin type, the risks associated with sun exposure and an opportunity to be screened for pre-cancerous and cancerous skin conditions at no cost. Physician John Tu and health professional Travis Hayden will be conducting this screening from 3–6 p.m. The screening will be held in the Dermatology Associates of Rochester offices, suite 41, Clifton Springs Hospital. While walk-ins are welcome, an appointment for this event is advised. Call 315-462-1495 to make arrangements to be seen. Clifton Springs Hospital & Clinic is located at 2 Coulter Road, Clifton Springs.

Feb. 1, 8

Unity Diabetes Center hosts vegan classes Learn how to lead a healthy vegan life style with Unity Diabetes Center’s “Seeds of Change.” The popular series of classes provides a hands-on and simple way to learn about vegan diets. Lead by registered dietitians and certified diabetes educators, these classes started in January but will continue from 6-8 p.m. on Feb. 1 and 8 at Unity Diabetes Center, 2655 Ridgeway Ave., suite 220. Total cost of attendance is $120 per person and includes cooking demonstration, samples, and start up kit. Call 368-4560 or visit unityhealth.org to register today — space is limited!

Feb. 4

‘Cycle For Hope’ Spinning Marathon

The newspaper targeting those who care about healthcare. Readers include health professionals and health consumers. Please consider advertising in it. Call 585-421-8109 Page 4

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The Eighth Annual Cycle for Hope, a spinning event to benefit Camp Good Days and Special Times and Golisano Children’s Hospital, will be held from 8 a.m. – 2 p.m., Saturday, Feb. 4, at a number of fitness clubs and gyms throughout Rochester, Buffalo and Ithaca. Cycle for Hope is a six-hour spinning marathon and a unique opportunity for everyone to enjoy, from the avid cyclist to the beginner. Participating clubs in Rochester are: Bally Total Fitness, Eastside YMCA, Penfield Fitness & Racquet Club, Ironworx Gym, Midtown Athletic Club, Cycledelic Indoor Cycling Studio, Rochester Athletic Club Brighton-Henrietta, Rochester Athletic Club Pittsford and Rochester Athletic Club Greece Ridge.

Feb. 6

Weight loss support group in Clifton Springs Clifton Springs Hospital health professionals will start a new weight loss support group at Clifton Springs Hospital this year. The group will meet noon-12:30 p.m. on the first Monday of every month, beginning Feb. 6, in the hospital’s diabetes health center classroom. Dietitians and other professionals will coordinate the sessions, which are free of charge. Call 315-462-0220 or 315-462-0257 for more information. Clifton Springs Hospital is located at 2 Coulter Road, Clifton Springs.

Feb. 7

Hearing loss and iPhone, hearing dogs’ use Hearing Loss Association (HLAA) Rochester chapter will sponsor two meetings Tuesday, Feb 7, in the vestry room at St. Paul’s Episcopal Church, East Avenues at Westminster Road. • At 11 a.m. Lori Timney, Sprint Relay outreach specialist, will share information about Sprint’s technology that is available for people with hearing issues. In addition to the smart phones available at the Sprint Relay Store, the company has captioned telephone, Web cap tel, and other devices. She’ll tell participants about Sprint IP and how current electronics can improve communications for people with hearing loss. • At 7 p.m. Linda Panko, representing International Hearing Dog, Inc., will address how a hearing assistance dog can enhance its deafened human’s independence and quality of life. These dogs are intensively trained to alert their human to sounds such as telephone, smoke detector, doorbells, and noises, like baby cries or window breaking. The dogs will lead the human toward or away from the source of the noise, depending on what it is. For more information visit www. hlaa-rochester-ny.org or call 585-2667890.

Classes begin Tuesday, Feb. 7, and are held from noon–12-30 p.m. in the diabetes health center classroom, suite 60, Clifton Springs Hospital. Cost is only $5 per class or $25 for the entire sixweek series. For more information, call at 315-462-0257.

Feb 15

Susan B. Anthony House luncheon to feature RPO Arild Remmereit, 11th music director of the Rochester Philharmonic Orchestra, will be the keynote speaker for the Susan B. Anthony annual birthday luncheon from 12–1:30 p.m., Wednesday, Feb. 15 at the Rochester Riverside Convention Center. The event celebrates Susan B. Anthony’s life, work, and legacy, and is held each year near her February birthday—this year on the date itself, the 192nd anniversary of her birth. The presenting sponsor of the birthday luncheon is Van Bortel Ford—Van Bortel Subaru. Maestro Remmereit to speak at our luncheon. “We are excited about his leadership of the RPO and especially his enthusiasm for women in music,” said Deborah Hughes, executive director of the Susan B. Anthony House. “He is celebrating his new home in Rochester and its great history as the home of Susan B. Anthony and center of the women’s rights movement by featuring women composers in all of his concerts this year.” For more information, visit www.susanbanthonyhouse.org.

Feb. 16

The Labyrinth Society holds event in Rochester The Labyrinth Society of Rochester is sponsoring its Community Labyrinth Walk from 7–9 p.m., Thursday, Feb. 16, at the First Unitarian Church of Rochester, 220 S. Winton Road, Rochester. The event is free but organizers will accept donations. Organizers say the event will provide free energy work, chair massage and music. They say participants will experience the transformational power of the labyrinth combined with the restorative energies of reiki and chair massage. The event is free, however, donations are appreciated to help cover expenses. A 15-minute orientation from 7-7:15 p.m. will be available. For more details, contact Deborah Roller at (585) 469-4818.

March 7, 14, and 21

Feb 7

Living Alone: Survive and Thrive on Your Own

Dieting can be so confusing — which foods are good for you, what portion is right, how many calories do you really need — that healthcare professionals at Clifton Springs Hospital decided to organize a program to teach participants the best way to lose weight and be healthy while you lose it. Registered dietitian Rose CopperBrown, certified diabetes educator and Paige Jablonski, an outpatient nutritional counselor will coordinate the program. Titled “Weight Loss Class,” it will be offered as a series of six weekly lunchtime sessions and will include a weigh-in, short program with one of our dietitians, and a discussion period.

Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own” is a three-part workshop offered for women who want to gain the knowhow to forge a meaningful and enriching life on their own. Participants will discover how to think differently about living alone, overcome loneliness and other emotional pitfalls, rediscover their true selves, and socialize in a couples’ world. The workshop takes place at House Content Bed & Breakfast in Mendon from 7–9 p.m. on three consecutive Wednesdays: March 7, 14, and 21. The workshop fee of $125 includes a Living Alone manual, empowerment exercises and lots of helpful resources. To register, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@rochester.rr.com

Hospital offers six-week weight loss class

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

Report: 3.9 Million Calls to Poison Centers Nationwide

merica’s 57 poison centers fielded 3.9 million calls in 2010, an average of nearly 11,000 per day, according to the recently published 2010 Annual Report of the American Association of Poison Control Centers’ National Poison Data System. According to the report, poison experts at the nation’s poison centers treated 2.4 million human poison exposures and handled 1.5 million information calls in 2010. Children younger than 6 accounted for about half of all the poison exposure calls; however, adults 20 and older accounted for 92 percent of all deaths reported. A total of 1,730 deaths were reported in 2010; of those, 139 were younger than 20, including 55 younger than 6. Sedatives/hypnotics/antipsychotics, cardiovascular drugs, opioids, and acetaminophen combinations were most frequently associated with poison-related deaths. Poison exposures with serious outcomes increased 4.5 percent over the previous year. Eighty-one percent of poisonings were unintentional, and 15 percent were intentional. Of the 15 percent, 9 percent were suspected suicides. “Poisonings continue to be a significant cause of illness and death in the U.S.,” said Alvin C. Bronstein, lead author of the report. “The NPDS provides a nationwide infrastructure for public health surveillance of poison exposures, including drug, consumer product, environmental and food poisoning. This report supports the value of poison centers and the need for specialized medical toxicology expertise

across the country.” The 2010 report also highlights the vital role of poison centers in the nation’s public health system. For example, poison centers tracked the health impact of the 2010 Gulf of Mexico oil spill and raised the alarm about the emerging public health threats of designer amphetamines (bath salts) and designer marijuana (spice and variants). Other findings in the report include: • About 75 percent of all calls to poison centers originated in people’s homes. • About 71 percent of the 2.4 million people who called with poison emergencies were treated at home, saving millions of dollars in medical expenses. • The top five substances most frequently involved in human poisonings were analgesics (11.5 percent), cosmetics/personal care products (7.7 percent), household cleaning substances (7.3 percent), sedatives/hypnotics/antipsychotics (6 percent) and foreign bodies/toys/miscellaneous (4.2 percent). “This report comes at a time when poison centers across the country are facing budget crises and underscores the valuable service poison centers provide,” said Deborah Carr, AAPCC executive director. “America’s system of 57 poison control centers is one of the most successful and cost-effective public health programs in the nation. Poison centers save countless American lives and millions of American taxpayer dollars every year.”

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Robotic Surgery with One Small Incision, U.S. First

n Tuesday, Dec. 20, Santiago Horgan, chief of minimally invasive surgery at UC San Diego Health System, was the first surgeon in the United States to remove a diseased gallbladder through a patient’s belly button with the aid of a new FDA-approved da Vinci Si Surgical System. With one incision, Horgan removed the gallbladder in 60 minutes. The patient returned home five hours after the groundbreaking surgery and reported minimal pain. “Our goal is to offer surgery options that reduce discomfort, shorten hospital stays and minimize scarring,” said Horgan, a robotic surgery expert

and director of the UC San Diego Center for the Future of Surgery. “With the aid of this robotic system, we can accomplish all three. This is a significant advancement for the 750,000 patients who need gallbladder removal each year.” Intuitive Surgical, Inc. received FDA-approval on the new operating platform specifically for cholecystectomy procedures, the surgical removal of the gallbladder. The system enables surgeons to reduce the traditional number of incisions from 4-6 down to one incision that is less than an inch in length.

SERVING MONROE, ONTARIO AND WAYNE COUNTIES in good A monthly newspaper published by

Health Rochester–GV Healthcare Newspaper

Local News, Inc. Distribution: 30,000 copies. To request home delivery ($15 per year), call (585) 421-8109.

In Good Health is published 12 times a year by Local News, Inc. © 2012 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: Eva Briggs (M.D.), Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, Ernst Lamothe Jr., Krista Ingerik, Tom Mahoney (M.D.), Joseph DiPoala Jr. (M.D.), Jamie Kerr (M.D), Lynette M. Loomis Advertising: Marsha K. Preston, Donna Kimbrell Layout & Design: Chris Crocker Ofﬁcer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Chris Motola

Dr. Jason S. Feinberg Chief medical officer at Finger Lakes Health discusses recruiting efforts, hospital branding and the importance of computerized physician orders Q: Can you tell me a bit about your background and how you came to your position as VP of Medical Affairs at Finger Lakes Health? A: I went to medical school in Syracuse and I did my residency in San Francisco at University of California at Stanford. I was in the Navy for active duty from 1993 to 1999 and was last with them in Beaufort, South Carolina. I came up here and worked as a primary care physician until 2006. In 2006, I left primary care to start the hospitalist program in Geneva, taking care of hospitalized patients only. Then about two years, I stepped into an interim role as chief medical officer here at Finger Lakes Health. Last year I was asked to take on the role as a permanent position. I still run the hospitalist program in addition to my role as chief medical officer. Q: With Syracuse immediately to east and Rochester to the west, is it difficult to attract physicians to a more rural hospital like Geneva’s? A: It’s definitely an effort to attract physicians to a rural hospital. The challenges associated with that are physicians having to be on call. You really need to establish enough physicians to share calls if you want to have someone available 365 days a year, 24 hours a day. The number of physicians required to maintain a reasonable call schedule and available is, at a minimum, three. Ideally it’s as large as your volume allows. You can imagine being one of two surgeons, being on call every other day for 36 hour shifts is a lot. When you recruit someone here, the first thing they ask isn’t necessarily how much money they’re going to make, but how often they’ll be on call. It’s a real quality of life issue.

and fellowships. With the establishment of a good call schedule, they feel a lot better sharing the bigger cases amongst them. If you were a surgeon that didn’t have a lot of support and you were on call all the time for your patients, you wouldn’t want to take a case that requires a lot of phone calls and a bunch of visits to the hospital. But now they can take on bigger cases because they’re more rested. I also see big growth in orthopedics. Our joint center will be open in January [2012], which is a dedicated unit for joint replacement. We anticipate significant growth in that department. We’re also seeing growth in cardiology services. Q: Do hospitals need to create a brand for themselves nowadays? Do you need to be the “heart care hospital” or the “joint replacement hospital?” A: I think to a certain extent the smaller area hospitals may need to consider that. We don’t do

cancer treatment at our hospital, so that could be a niche for a smaller hospital in our region. I think Geneva General is bigger than a really small hospital and it’s growing. It’s somewhere between a rural hospital and a small city hospital. It’s pretty much a medium sized hospital. So our brand would be doing what small hospitals should be able to offer, a wider range of service that can be safely done in a small hospital supported by a threshold of volume. By threshold of volume, I mean that if you do a procedure once a year, you probably don’t want to be branded that way and advertise it in that way. But a lot of generalized care can be at a community hospital, and that’s what we want to be. Whereas a lot of the other facilities, because of affiliations, a lot of patients hit their doors and they get shipped off to Rochester or Syracuse. I think our brand would be to provide the services that a hospital should be able to do here and do them better than the city hospitals. Q: What does Geneva, the city, have to offer physicians? How do you sell it to recruits? A: Number one, it’s central Finger Lakes. That means four distinct seasons, a lot of great, beautiful lakes. It means outdoor opportunities like skiing, fishing, hunting, boating, sailing, all of those things are at your finger tips. You don’t have to commute far or spend much. It’s a very affordable place to live and a very comfortable place to live. It’s a great place to raise children. I think the opportunities my kids have are more diverse, in many aspects, than they would have growing up in a big city.

Q: What kinds of solutions have you come up? A: You can recruit enough physicians in that specialty to provide that service or bring existing physicians in those specialties together. Most recently that occurred here with two orthopedic groups coming together into one call group. It’s bringing people together to provide the service. Q: What services do you see as growth areas? A: I see growth in general surgery. Newly trained physicians that we have are much more likely to take on bigger cases as they’re closer to their residency Page 6

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

Q: What is it like being in medicine in the Navy compared to being a civilian physician? A: That’s a great question. I can sum it up really quickly: it’s about leadership. The military immediately asks you to assume a leadership role. You get trained on leadership really early on and they have ongoing leadership courses. They have this chain of command that means being responsible for x amount of people and x programs. They basically toss it in your lap and you have to perform. I think it’s allowed me to take the role I have today. Not all physicians in the civilian world are leaders. I don’t mean that in a bad way. A lot of people just didn’t get that training. In the military, you really don’t have that option. Q: Can you talk a bit about the Computerized Physician Order Entry (CPOE) system, of which you’ve been an advocate. A: One thing I learned in the Navy; we were completely electronic at that point. It’s a way you order medications electronically, which provides a higher level of accuracy than written orders. It translates to improved safety. You know the saying about physicians’ handwriting? Not just physicians’ but handwriting in general, can be hard to interpret. When we’re using handwriting to interpret important things like the type of medication, the dosage and the frequency with which it should be taken, the way medical language is built, a lot of names look and sound alike. Punctuation can make a difference. You might get 50 mg when you want 5.0. In CPOE, these are preformed strings that doctors type in and then choose a dose, so it’s not as open to interpretation. It’s a driving force towards safety.

Lifelines Name: Jason S. Feinberg, M.D. Position: Named vice president, medical affairs & chief medical ofﬁcer for Finger Lakes Health in Geneva in February 2011. He is also the medical director of Seneca Lake Terrace and Finger Lakes Visiting Nurse Service, and also served as Ontario County Coroner from January 2008 to December 2010. Education: A native of Miller Place, NY, he received an undergraduate degree in chemistry from Hobart and William Smith Colleges in Geneva, He attended medical school at Syracuse Health Science Center in Syracuse, and completed his internship at Naval Hospital in Oakland, Cal. He completed his internal medicine residency at the University of California San Francisco Medical Center, and is certiﬁed by the American Board of Internal Medicine. He served in the U.S. Navy from 1990-1999, where he achieved the rank of Lieutenant Commander. Family: Married, three children Associations: American College of Physicians, American College of Physician Executives, Society of Hospital Medicine Hobbies: Fishing, Hunting, Skiing

Number of Cancer Cases Growing in Monroe County Monroe County’s aging population cited as a factor By Ernst Lamothe

ith no warning, Holly Anderson’s life changed in an instant. She was just a 40-yearold mother of four kids going to the doctor when she was diagnosed with stage three breast cancer. It’s a cancer where Monroe County ranks in the top three each year in New York state for all new cases. “I was just going about my business and then you find out this news and it is world rocking and world transforming,” said Anderson, of Rochester, who was diagnosed 13 years ago. “I had no family history at all.” Today, she is a survivor. But since 2008, cancer overall is the leading cause of death in Monroe County. About 4,000 new people are diagnosed with cancer in the county annually, and more than 1,500 people die every year. “Heart disease used to be No. 1 in this area for many decades. Because of a lot of hard work, we made marked improvements and it went down,” said Bryon Kennedy, deputy health director for the Monroe County Department of Public Health. “Now we are looking to

do the same thing with cancer.” Public health law requires that all physicians, dentists, laboratories, and other health care providers report every case of cancer or malignant disease to the Cancer Registry of the New York State Health Department. Since the 1980s, the organization has been publishing county and reports that contain incidence and mortality numbers. With Monroe County having an aging population —14 percent of the county residents are over 65 years old according to the latest census — cancer rates are rising. According to the latest statistics, the most diagnosed cases of cancer for men in Monroe County is prostate cancer, averaging 642 new cases each year. Whether it’s because of fewer early detection screenings, doctors say African Americans not only die earlier but also have a higher rate of colorectal cancer. The average age of African Americans who are diagnosed with colon cancer is 61 years old, while it’s 76 years old for their white counterparts. “We have to keep working to have African Americans know the risks because they are dying in significantly worse numbers,” said John Ricci, senior public health educator at the Monroe County Department of Public Health. “There is also a high mortality rate for cancer in African Americans in this community as well. The key is always going to be getting people to prescreen.” Doctors recommend a colonoscopy every 10 years starting from age 50. Increased physical activity, nutritious meals and the adequate amount of fruits and vegetables lowers the risk of colon cancer. Lung and bronchus cancer with 272 new cases each year placed second in men, followed by colorectal with 188, urinary bladder with 166 and non-Hodgkin Lymphomas with 85 round out of the Michaela Deeg’s junior year was supposed to be about prom, top five, according studying for the ACT and embracing the joys of ﬁnally being an to the New York upperclassman. Yet, she had more on her plate to worry about State Department than the average 16-year-old at Greece Athena High School. of Health. She was diagnosed with Hodgkin’s lymphoma, a cancer of the For women, lymphatic system.

the most newly diagnosed form is breast cancer, averaging 597 new cases each year. There are more than 12,000 new cases of breast cancer and 3,500 deaths reported each year, according to the Breast Cancer Coalition of Rochester. At this time, one in eight women can expect to be diagnosed with breast cancer during their lifetime. Even with those figures, breast cancer mortality in Monroe County has gone down at least 40 percent from the mid-1970s. Holly Anderson accepting a bouquet on her 10th anniversary with “Women are the Breast Cancer Coalition of Rochester. She was diagnosed with more likely to go cancer when she was 40 years old. see their doctors,” said Ricci. “Men view themselves as macho and tough fever and chills, loss of appetite and and they think they don’t need to go to soaking night sweats. the doctor. That is an unwise approach “It was hard hearing the diagnosis that we need to change.” at first,” said Deeg. “But I had to find a Anderson said while breast cancer way to deal and stay positive. awareness and knowledge about early Deeg is now in remission and she screening remains high, the focus on had to go through weeks of chemotherprevention is lacking. As part of the apy and radiation. Her hair is slowly Breast Cancer Coalition of Rochester, growing back as well as her spirits and she helped pioneer a local law where energy. companies had to give 48-hour notice if “She is able to hang out with they were spraying pesticides around friends again and go back to school neighborhoods. regularly,” said Lori Luther, her “We know there are a lot of enmother. “It can be isolating when you vironmental evidence that is conare sick or when you are in a hospital. nected to diseases we have today,” said Adults would have a hard time dealing Anderson. “It’s not just about quitting with this let alone someone young.” smoking, exercising and just eating In both men and women, lung and more fruits and vegetables. We have bronchus cancer is the leading cause things like pesticides in our food that of death with more than 400 Monroe can cause us sickness.” County residents dying from that canLung and bronchus cancer with cer every year. Forty-six million U.S. 253 cases is second among women, citizens smoke; half will die from their followed by colorectal with 198, uterine habit, according to the Monroe County cancer with 125 and non-Hodgkin Department of Public Health. lymphoma with 80 round out of the top “This is something that is killing five, which can be diagnosed in young both genders, which is rare to find in women. That was the case for Michaela a disease,” said Kennedy. “Ninety perDeeg. cent of people who have lung cancer, Her junior year was supposed to got it from smoking. If you want to prebe about prom, studying for the ACT vent people from getting lung cancer, and embracing the joys of finally being you have to stop people from smoking an upperclassman. Those are enough in the first place.” things to keep a teenager busy. Yet, MiIn somewhat of a surprise, lung chaela had more on her plate to worry cancer incidents and mortality rates are about than the average 16-year-old at increasing for women, while declining Greece Athena High School. for men. Forty to 50 Monroe County She was diagnosed with Hodgkin women die each year from lung cancer, lymphoma, a cancer of the lymphatic double the amount from 35 years ago. system, which is part of the immune The rate of women contracting lung system. With Hodgkin lymphoma, cancer has increased each decade since cells grow irregularly and may spread the 1970s. The rate of men being diagbeyond the lymphatic system. As it nosed with lung cancer and its mortalprogresses, it compromises the body’s ity rate has decreased every decade ability to fight infection. Someone sufsince the 1970s. fering from the disease faces fatigue

February 2012 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Will you be mine? Dating tips for finding that special someone

’m often asked by readers and those who attend my “Live Alone and Thrive” workshops whether I ever date. My answer is unequivocally “yes,” and more often than not, people are surprised by my answer. I like the question, because it gives me a chance to remind everyone that being successful at living alone doesn’t mean one needs to abandon the idea of building and sharing a life with someone special. I’ve said it before and it bears repeating: Living alone doesn’t mean being alone. Many people satisfy their need and desire to be with people by developing a great group of friends, including family members. Others want more, and long for romance and the exclusive domain of a loving relationship. It is to this latter group that I dedicate this column. If the idea of dating in mid-life following the loss of a long-term relationship or marriage seems daunting, know that you are not alone. I’ve talked with many older women and men who have resigned themselves to “terminal single-hood,” after having tried unsuccessfully to enter the dating scene. It only takes a few disappointments and rejections to send people running for cover. But like any challenge, if you approach dating with thoughtfulness and

care, a satisfying and lasting relationship is possible at any age. Below are a few tips I’ve assembled from my own experience and the experiences of others that may help you jump-start your search for a loving companion: Define what dating means to you. If you haven’t dated in years (perhaps in decades), the term “dating” may suggest the first step in a predictable path to marriage. These days, dating is, well, dating. And you can define it anyway you like. Maybe you just want a date for a work event. Perhaps you’d be happy with a number of companions with whom you could enjoy movies, dinner, intimacy, etc. Or you may be on a serious quest to find a new life partner. Your definition — your dating goal — will shape the style and pace of your search. Know what you’re looking for. I remember reading a magazine article recently in which the author detailed her experience of writing down 100 things she wanted in a man, and then — lo and behold — having the man of her dreams stroll right into her life. Was it coincidence? Magic? Who knows, but the exercise has merit. Thinking about what you want as well as what’s

KIDS Corner Feelings of Depression and Binge Eating Go Hand in Hand in Teen Girls By Laura Kennedy

eenage girls who feel depressed are twice as likely to start binge eating as other girls are, according to a new nationwide study. The reverse is also true: Girls who engage in regular binge eating have double the normal risk of symptoms of depression. The findings suggest that young women who display signs of either depression or binge eating should undergo screening for both disorders. “Binge eating prevention initiatives should consider the role of depressive Page 8

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symptoms … and incorporate suggestions for dealing with negative emotions,” reports the article, which appears in the current issue of the Journal of Adolescent Health. This study could provide important new opportunities to address the nation’s obesity epidemic, according to senior author Alison Field, an epidemiologist at Harvard Medical School and the Harvard School of Public Health. The new study is the largest to

Find out more about a new “Live Alone and Thrive” empowerment workshop for women, which will be held in March. Check the calendar page in this issue of In Good Health. unacceptable will help you refine your search and improve your chances of finding a compatible partner. Be yourself. This is no time to try and become the person you wish you were or you think others will find attractive. One of the advantages of being a little older is increased self-awareness and the confidence to be who you truly are. Accept and embrace yourself “as is.” Pretending to be otherwise will only compromise your chances of meeting someone who loves you just the way you are. Spread the word. If you want to meet someone, make your search a priority and let friends and family know you’re looking. Don’t be apologetic about expressing your desire to find a companion. It might sound like this: “You know it’s been a while, and I’m feeling ready to meet someone. May I ask a favor? Would you keep me in mind if you run into someone you think might be a good fit for me?” Other ways to initiate your search include joining a matchmaking website or by subscribing to a dating service. Having had no

look at the relationship between binge eating and depression during adolescence, when most eating disorders surface. The study authors defined binge eating as eating a large amount of food in a short amount of time and feeling a lack of control over eating during the episode. The study labeled girls who ate large amounts of food but did not feel out of control “overeaters.” The findings rely on surveys conducted as part of the nationwide Growing Up Today Study. The authors focused on girls because eating disorders and depression are more common in females than in males. The researchers analyzed data from nearly 5,000 girls aged 12 to 18 who answered questions in 1999, with follow-up surveys in 2001 and 2003. Teens and young women who reported in the first survey that they always or usually felt “down in the dumps” or “depressed” were about twice as likely as others were to start overeating or binge eating during the following two years. “The most common approach to obesity has been to focus on eating better and exercising more, but many

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

experience with these methods, I can only offer this bit of cautionary advice: It’s potentially risky, so take precautions. There’s a lot written on this subject, so look for books and articles, or conduct a Web search to learn how best to protect yourself. Put yourself with like-minded people. Do you like to dance? Are you an athlete? Is reading your passion? We all like being with people who share our interests and one way to kick-start your dating adventure is to attend social functions that attract the kind of partner you are looking for. Now’s the time to join clubs and groups whose members include potential partners. It could be a book club, a hiking group just for singles, dance lessons that don’t require partners, or support groups or organizations that cater to divorced or widowed men and women. To be successful, you need to get out of the house. Have fun and keep your expectations in check. We’ve all suffered the occasional bad date or rejection. Try not to let that stop you from meeting new people and pursuing that special someone. Dating, just like networking for a new job, can put you in the company of interesting, stimulating people. Even if your heart doesn’t go pitter-patter, you’ll be out in the world and expanding your experiences and circle of friends. So give it a whirl. Muster your courage, pick up the phone and enjoy finding your very own Valentine! 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 March workshop, check out the Calendar of Health Events in this issue, call 585-624-7887 or email: gvoelckers@rochester.rr.com.

pathways can lead to being overweight,” said Marian TanofskyKraff, a clinical psychologist at the Uniformed Services University of the Health Sciences in Maryland. “There is a group of people where it may be more psychologically driven. Targeting some of these psychological factors might help prevent obesity.” “Binge eaters or overeaters can be very secretive, so parents may be unaware that there’s a problem. That’s a really important message for clinicians,” adds Field. “If they have patients who are depressed, they need to ask about disordered eating patterns and vice versa.” The authors note that survey respondents include few youths belonging to ethnic minorities or lower socioeconomic groups, so the study findings might not apply to all populations. In addition, the surveys did not include information on use of medications, such as antidepressants, which might affect outcomes. Laura Kennedy is a contributing writer with Health Behavior News Service.

Taking Control of Your Life in 2012 By Lynette M. Loomis

Step over those pre-conceived notions about yourself and dig into life with both hands

e often look for quick fixes, potions and pills to make us happy or content. In truth, our level of contentment with our life is a conscious choice, a purposeful decision, our responsibility. How we deal with a disappointment in a relationship, an economic downturn or a dream not realized is a matter of choice. We can feel like a victim and let it dictate our sense of self and our future or we can decide to be in control of our reaction and choose our own path forward. So for 2012, let’s make a resolution to practice some new ways of thinking about and reacting to the events in our life and regain control. We will practice them until they become habits. And when we falter and return to familiar, albeit ineffective, patterns, we won’t despair. We’ll say “Next time I will…”

Re-Phrase Our Inner Messages

We will eliminate the phrases “If only…” and “I just wish that…” from our vocabulary. “If only” is a trap that weighs us down and makes us feel ineffective and powerless. It is the sense that a child has that someone else has to make it all better. “I just wish that…” creates a helpless frame of mind that really says “I want it to be my way without me having to do anything.” So this year, we will take charge. We will do everything we can to be creative and resourceful to fix a situation directly. We will rephrase our self-talk to be positive. “If I do this, then I can…” Failing that, we will change our view of the situation.

Shifting How We Choose to View Our World

This brings us to one of the most important keys to our satisfaction with life — how we view our world. Each of us is the product of everything we have experienced in our life. We likely hold onto some beliefs that hold us back from being the best person we can be. We unconsciously harbor negative selftalk “I could never do this...” or “I will never be good enough for…” and “If I fail I will die.” Our negative self-talk stops us in our tracks and convinces us not to even try. If we don’t try, we cannot possibly succeed. In 2012, we will identify our negative inner messages that stem from childhood, carried us through gawky adolescence, or moved us through a failed relationships or financial turnaround. We will replace those messages with realistic, positive phrases that will inspire us to move ahead with confidence and optimism.

Accepting and Adapting to Change with Optimism and Grace

Generally, we are creatures of habit and find comfort in routine. But change is inevitable. Sometimes the world around us shifts and thrusts us into an unwelcome place such as the loss of a family member or close friend, elimi-

Lynette M. Loomis is a certiﬁed life and business coach and may be reached at www.yourbestlifecoaching.com. nation of a job, or a change in health status. We go through predictable, and painful, stages of grieving and most of us come out the other side eventually, saddened but whole. We can’t plan for the loss of a relationship we cherish. We can do everything we can to remain healthy. And we can plan for a change in our employment status by keeping abreast of trends in our field, anticipating what could happen, figuring out how we will react to possible changes, maintaining our networking, and living below our means and setting money aside “ just in case.” Another type of change involves us changing the way we think or behave. We often fear that if we change we won’t be successful or we might fail. (If Thomas Edison let that hold him back we would be probably reading this by candlelight.) We might be concerned that if we change, our friends and family won’t accept our changed behavior and we will be lonely. Or perhaps we fear the loss of control when we step outside of our familiar patterns. Yes, we might need to add some new friends who share our new views or aspirations. And some of our greatest life lessons and insights come from our failures. When I pass, I don’t want one of my last thoughts to be “I had all of these opportunities in front of me and I wasted every one of them.” In our own way, let us be able to say “I went for it.”

Healing Ourselves by Forgiving Others

And in 2012, we will tackle one of the hardest things to do — forgive. Forgiving someone for hurting you is not to suggest you approve of or condone what they did. (In this article we are not taking about crimes against you but those inevitable hurts and disappointments that accompany family or

work life or friendship.) Forgiving does not mean forgetting. We mistakenly believe that if we harbor anger we can make another person feel guilty. We might snub them or be curt in our conversations. (Mind you, a goodly portion what we let hurt our feelings is unmemorable to the other person.) But holding onto a hurt is emotionally exhausting for us — it hurts us more than it hurts our offender! Holding onto a hurt forever can prevent us from moving ahead, being open to new experiences, or trusting again. It negatively impacts our physical and emotional health. It can isolate us from the world. (Bitter people are not particularly engaging conversationalists.) It lets us feel like a victim, all the time. Mahatma Gandhi has been quoted as saying “The weak can never forgive. Forgiveness is the attribute of the strong.” Forgiveness is not about the offender. It’s about us. It’s about letting go of something that eats away at us. Forgiving allows us to take back control and regain our personal power. It doesn’t mean we have to invite a person back into our life or trust them the way we once did. It does mean allowing ourselves to move on. How do we forgive? Compassion. Consider what circumstances, life experience, insecurities or carelessness that may have led a person to offend or betray you. Forgiveness requires that we look at the situation more broadly and with greater imagination and empathy. It is not easy, but it is possible. In 2012, let’s think of a grudge we may have been holding on to, or some anger or resentment we have been harboring, and just let it go. Yes, simply let it go. Let us each free up a negative thought and replace it with greater inner peace. The surge of energy we will experience will be remarkable.

February 2012 •

Doctors, Nurses Often Use Holistic Medicine for Themselves By Milly Dawson

.S. health care workers, especially doctors and nurses, use complementary and alternative medicine (CAM) far more than do workers in other fields, according to a new study. CAM includes diverse therapies outside the realm of conventional medicine. Overall, 76 percent of health care workers report CAM usage, compared with 63 percent of the general working population. Health care workers use chiropractic treatment, massage and acupuncture for conditions that conventional medicine does not address well, said study co-author Lori Knutson, executive director of the Penny George Institute for Health and Healing with Allina Hospitals and Clinics in Minneapolis. While conventional providers often treat common issues such as back pain with pain medication, holistic providers address root causes, she said. The researchers used data from the 2007 National Health Interview Survey, analyzing responses from 14,329 working adults. Their findings appear online in the journal Health Services Research Among respondents, 1,280 worked in health care and fell into four categories: (1) providers including doctors and nurses; (2) technicians, for instance, sonographers; (3) support workers such as nursing assistants and (4) administrative personnel not providing patient care. The study looked at practitioner-based CAM, such as acupuncture; self-treatment with CAM, such as practicing Pilates; and any CAM usage such as following a vegetarian diet, meditating and taking certain herbs. Doctors and nurses had more than twice the odds of having used a practitioner-based CAM method during the prior year and nearly three times the use of selftreatment with CAM than support workers. “As insiders, health care workers understand what’s missing in our medical system. They’re more educated than others about orthodox and alternative medicine,” said Joya Lynn-Schoen, a psychiatrist by training who instead practices alternative medicine, offering patients homeopathy, nutrition and chelation therapies. “Mainstream medicine will say, ‘Here’s a pill’ or ‘Have an operation” or ‘There’s nothing wrong with you. You’re just tired.’ “We may be opening Pandora’s box by disclosing utilization of CAM by conventional providers,” Knutson said. “I prefer to believe that this will create an opening for both provider and patient in optimizing health for the whole person.” Milly Dawson is a contributing writer with Health Services Research Health Behavior News Service.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

My Turn

By Eva Briggs

Tricks learned at urgent care — and at home

obert Burns wrote in 1785, “The best-laid schemes o’ mice an’ men gang aft agley.” I guess that’s an early form of Murphy’s law, “Anything that can go wrong will go wrong.” It certainly keeps us busy at the urgent care. Below I will describe two little known tricks, just in case you find yourself in the predicaments described. I learned a new trick this past week, thanks to Google and YouTube. A young man came in with a ring that was too tight, and he couldn’t get it off his finger. That’s a common occurrence, so we went to plan one: immerse the hand in ice water to reduce any swelling and use dish soap to wiggle the ring off. That didn’t work, so we proceeded to plan two: wind string tightly around the finger, slip the end under the ring, then unwind, working the ring up and off. Alas, no luck again. We got out the ring cutter and my nurse went to work. She returned a short

time later, and reported that the ring was made of something so hard that it might take weeks to saw through it with the ring cutter. The patient didn’t know what his ring was made of. We had exhausted the methods that came quickly to mind. But I didn’t want to send the man to the emergency room, because I figured that we have the same tools as an emergency room. I turned to Google, and learned that perhaps the ring was made of tungsten. The YouTube video in the search results showed a man shattering a ring easily with vice grips. Usually things that look that easy turn out to be trickier than suspected, but I thought we’d give it a whirl. Luckily my nurse drives a typical Central New York winter rat. She had a pair of vice grips in her car to use when popping the hood because her hoodlatch lever was rusted out. We followed the video directions carefully. First, adjust the vice grips to just close down on the ring. Remove them, turn the

adjusting screw one-half revolution, and grip again. Repeat as needed. After just two adjustments, the ring shattered — exactly like the ring on the YouTube video. If you try this at home, wear safety goggles. The pieces will go flying. To reduce the chance of a stuck ring, be sure to remove all rings if you injure any part of the arm on which you wear the ring. An injured finger, hand, wrist, arm or elbow can cause your finger to swell. It’s better to get rings off before swelling creates an urgent situation. Here’s a second trick, for removing cactus spines, that I read long ago in some forgotten magazine. I never really thought that I would need this in Central New York. It’s not exactly the hot dry climate one associates with cacti. Years ago I won a houseplant, a prickly pear cactus, in a fund raising raffle from my local nature center. The plant lived several years on a tall narrow bookshelf in the corner of our

kitchen. One day, a particularly klutzy and ill-behaved dog that we owned, ran into the shelf, knocking the whole thing and its contents in a diagonal across our kitchen table, narrowly missing injuring any dining humans. I instinctively threw up my hand to block the falling plant. I was rewarded with a handful of tiny cactus spines. It might have required all day and a powerful magnifying lens to pull them out with tweezers. Then I remembered that magazine article. Following their directions, I slathered on some white glue, like Elmer’s glue. One of the perks of having children at home is that glue always seems to be a required school supply. When the glue dried to a flexible film, I peeled it off, pulling out the cactus spines. It took several applications, but my hand was soon restored to a relatively pain-free functional unit.

Eva Briggs, a board-certiﬁed physician, works on the staff at Cayuga Medical Center in Ithaca, in its two urgent care centers: one in Ithaca, and the other in Cortland.

For the Right Care in the Right Setting, Your Doctor Knows Best “If one-quarter of commercially insured patients currently going to the ER for non-emergency medical problems instead sought treatment in a primary care setting, annual health care spending in Upstate New York could be reduced by as much as $50 million.” By Tom Mahoney, M.D., Joseph DiPoala Jr., M.D. and Jamie Kerr, M.D.

fforts to make health care more efficient, improve clinical outcomes and temper rising costs should include reviewing the appropriate use of hospital emergency rooms. Too often, patients show up at the ER for nonemergency medical conditions, such as sore throats and earaches, which could have been treated as effectively and more affordably in a primary care setting by a doctor who knows the patient best. Emergency rooms are vital community resources with the expertise and technology to evaluate and treat medical and surgical emergencies. Any patient experiencing a life threatening medical problem — such as a stroke, heart attack or severe bleeding — should go directly to the nearest ER. However, patients with non-life threatening medical conditions can overcrowd ERs. They can face long wait times since sicker patients are treated first. And they can waste valuable health care resources because a trip to the ER costs significantly more than a primary care office visit. Excellus BlueCross BlueShield took ER data that hospitals report to the state and applied a widely accepted formula to identify the number of visits that potentially could be addressed in Page 10

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a primary care setting. It found one out of four ER visits in which patients were treated and released on the same day was for a medical issue that could have safely waited more than 12 hours for treatment. Another 19 percent of visits were for medical conditions that needed treatment soon but could have been addressed in a primary care office. Across Upstate New York annually, more than 700,000 potentially avoidable ER visits were for non-emergency medical problems, including 31,000 visits for back disorders, 32,000 visits for acute upper respiratory infections, 25,000 visits for ear infections and 22,000 visits for sore throats. Treatment of non-life threatening medical problems for commercially insured patients can cost $600 to $1,000 more when handled in the ER instead of a primary care physician’s office. If one-quarter of commercially insured patients currently going to the ER for non-emergency medical problems instead sought treatment in a primary care setting, annual health care spending in Upstate New York could be reduced by as much as $50 million. Given the magnitude of the issue, the Monroe County Medical Society, Finger Lakes Health Systems Agency and Excellus BCBS launched a public

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

awareness campaign to encourage patients experiencing non-emergency medical problems to first call their doctor for guidance on the appropriate steps to get care. We also encourage patients, at their next doctor visit, to discuss how best to respond to medical problems that aren’t serious or life threatening. We want patients to ask their doctor about last-minute or after-hours appointments and get recommendations for urgent care centers for when their doctor isn’t available. Many offices have handouts detailing how patients can get advice from the physician after usual office hours. For non-emergency medical conditions, no one is better equipped to determine best steps for care than a patient’s own doctor. • Tom Mahoney, M.D., is director of community health improvement for the Finger Lakes Health Systems Agency • Joseph DiPoala Jr., M.D., is a primary care physician with Ridgeview Internal Medicine in Irondequoit and member of the Monroe County Medical Society’s Quality Collaborative • Jamie Kerr, M.D., is vice president and chief medical ofﬁcer, utilization management, for Excellus BlueCross BlueShield

Fast Food:

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ounting calories doesn’t have to end when facing a fast-food menu. Between shopping excursions to the mall, juggling school activities or taking long car trips, swinging into a convenient burger or taco joint doesn’t have to mean you are entering a nutritional wasteland. “The average American consumes close to 50 percent of his or her meals outside of the home and fast-food restaurants are abundant,” said Jessica Bartfield, internal medicine who specializes in nutrition and weight management at Gottlieb Memorial Hospital, part of Loyola University Health System. “By following a few rules, you can keep any fast food meal in calorie check.” Bartfield likes sandwich shops that allow customers to load up on vegetable toppings, which adds nutritional value, and also pass on higher-calorie ingredients like cheese and dressings. “I am also a fan of fast-food places that offer soup or even chili as soup can be a terrific option, particularly ones loaded with veggies, lean meats and beans,” she said. “Be careful to avoid the cream- or cheese-based soups and beware the bread bowl, which can increase the calories by up to 1,000.”

Bartfield’s Fast-Food Favorite Five

1 — “Select grilled rather than fried. A fast-food grilled chicken sandwich has 470 calories and 18 grams of fat

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while the fried version has 750 calories and 45 grams of fat.” 2 — “Hold off on cheese, mayonnaise and salad dressings unless lowfat options are available. Cheese can add an additional 100 calories or more per serving, as does mayonnaise and, often, you won’t miss the taste when ordering the plainer versions.” 3 — “Order the smallest size available. Go for the single burger rather than the double and for the small fry rather than bonus-size.” 4 — “Skip sugar-sweetened drinks, which are usually absent in nutritional value and don’t make you feel more satisfied. These calories quickly add up leading to excessive calorie consumption, especially at restaurants offering free refills on drinks.” 5 — Save half of your order for your next meal. You save calories, save time and also save money.”

Top 5 Winter Activities that Land You In The ER

he return of snow to Upstate New York means that many people are ready to hit the slopes, the ski stations, the snowmobiles trails and other places for their dose of outdoor activities. According to orthopedic surgeon Daryl O’Connor, who formerly cared for U.S. Olympic ski and winter sports athletes in Salt Lake City, Utah, this is the time when we see many winter-related accidents. Here are O’Connor’s evaluations of the top five winter sports and the problems they pose: 1. Sledding — “More than 700,000 injuries are reported each year in the United States due to sledding. More than 30 percent are head injuries, caused by collisions,” O’Connor said. 2. Hockey — “Lacerations, as well as neck, shoulder and knee injuries are common in hockey. Many injuries are caused through contact with another player, the ice, a puck or actual skate blade,” he said. 3. Ice skating — “Injuries to the wrist as well as head and neck are most common and most injuries are caused by falls,” he said.

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4. Snowboarding — “Wrist and elbow injuries are caused by falls on outstretched hands,” he said. 5. Skiing — “Knees really take a pounding and injury is often caused by extreme twisting force-propelled by the skis,” he said. February 2012 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

SmartBites

By Anne Palumbo

The skinny on healthy eating

Lots to Love About Lentils

ong before I became acquainted with lentil’s nutritious ways, I was smitten with the little legume. Cheap, easy to prepare, and possessing a shelf life that suited my lackadaisical single life, lentils were my constant dining companion. Since then, I have continued to consume lentils on a regular basis — for all of the above and a whole lot more. Though small in size, lentils pack a powerful protein punch, yielding 18 grams per cup. For most, this supplies nearly a third of our daily protein requirements. In addition, lentils are loaded with folate, a B vitamin especially important to women of childbearing age because it reduces the risk of birth defects. Just how loaded? We’re talking a whopping 90 percent of our daily needs in one cup. Benefits to new moms notwithstanding, folate helps the rest of us by producing and maintaining new cells, along with preventing changes to DNA that may lead to cancer. Like most beans, lentils are rich in dietary fiber, both the soluble and insoluble kind. Soluble fiber helps to stabilize blood sugar levels and lower cholesterol, while insoluble fiber promotes regularity. Both contribute to a

full feeling that helps curb snacking between meals. More good reasons to befriend this tiny bean? Lentils are easy to digest and have no saturated fat or cholesterol. They’re relatively low in calories (only 230 per cup). And, they’re an excellent source of iron, providing about as much per ounce as spinach. Do you hear that Popeye? All things considered, it’s no wonder “Health” magazine included lentils in its top five healthiest foods on Earth.

Helpful Tips

Lentils are a snap to cook and, unlike dried beans, do not need to be presoaked. Rinse, check for debris, and then boil until tender, about 20 to 30 minutes. Lentils placed in already boiling water will be easier to digest than those brought to a boil. Store dry lentils in an airtight container in a cool, dark place and they will keep for up to 12 months (some say longer). Prefer canned? The difference in the nutrition-

The difference between the good and the bad fat — and what that means to your heart By Deborah Jeanne Sergeant

Page 12

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Hearty Lentil and Escarole Soup Adapted from Cucina Rustica cookbook (Serves 4 to 6)

Fat, Fat and Fat ou’ve probably seen heart icons and the term “heart-healthy oil,” “no trans-fats” or “no hydrogenated oil” on products lately. With all the labels’ various claims, it can be confusing to know what oil is healthful for the heart and what’s not. Understanding the difference is important. “The more harmful fats are saturated fat and trans-fat,” said Janel Welch, registered dietitian and clinical nutrition manager for Unity Health System. Saturated fat will increase total cholesterol as well as LDL, the low-density lipoprotein. I call it ‘the lousy protein.’ The HDL high-density lipoprotein is the healthy one. Increased levels of LDL can increase chance of cardiovascular disease.” Exercise and maintaining a healthful weight may seem like the solution to combat the impact of saturated and trans-fat; however, even slim, fit people can impact their heart health by consuming too much of the artery-clogging fats. Beyond reading labels for saturated fat, remember that any sources of fat that are animal based contain saturated fat, including eggs, animal fat (such as in bacon, sausage, and chicken skin),

al value of canned lentils versus those you cook yourself is negligible.

and whole dairy items. Any fat source that is solid at room temperatures such as butter and lard contain saturated fat, too. Trans-fat also helps clog arteries. Look on labels for words like coconut oil, palm oil, palm kernel oil, and partially hydrogenated oils. “These consist mostly of saturated fats which are associated with an increased risk of heart disease since they increase LDL and total cholesterol,” said Paige Jablonski, outpatient dietitian at Clifton Springs Hospital. Many commercial items such as pastries, cookies, and crackers contain these oils because they are inexpensive and enhance the flavor and texture of the foods. Meal “helpers” such as noodle and rice side dishes and many prepared “heat-and-eat” frozen entrees contain high levels of saturated fat. Since the unhealthful effects of these foods have become widely publicized, some manufacturers, fast food chains and restaurants are eliminating “bad” oils in favor of heart-friendly ones. Some labels say “Zero grams of trans-fat per serving.” This means that the product contains traces of tran-fat if you consume only the package-recommended portion size.

1 tablespoon extra-virgin olive oil 1 small onion, finely chopped 2 carrots, peeled and cut into small dice 3 to 4 garlic cloves, minced 1 14-ounce can diced tomatoes with juice ¼ teaspoon red pepper flakes (optional) 1 teaspoon each: thyme; parsley (or basil; parsley) 1 cup lentils, washed and picked over 6 cups water 6 cups escarole, roughly chopped Salt and coarse black pepper to taste Heat the olive oil over medium heat in a large soup pot. Add the onion and carrots and sauté until soft, about 6 to 8 minutes. If vegetables start to stick to pot, toss in a little water. Add the garlic and sauté for 1 minute more. Add the tomatoes and spices and cook, stirring frequently, until the tomatoes have cooked down slightly, about 6 minutes. Add the lentils to the tomato mixture and stir. Allow the lentils to absorb the juices of the vegetables for 1 to 2 minutes, then add the water. Bring the soup to a boil, turn down the heat to a simmer, cover, and cook for 20 minutes.

Just as trans-fat and saturated fat harm the body, other oils can benefit it. “Healthful oils include both monounsaturated oils like olive, peanut, and canola oil, and polyunsaturated oils likes safflower, sunflower, corn, and sesame oil,” Jablonski said. “These oils consist of mostly unsaturated fats, which protect against heart disease by lowering LDL and total cholesterol.” As you cook and bake, use these oils as a healthful way to incorporate healthful sources of fat in your diet. Of course, any type of oil has lots of calories, so it’s wise to use them in moderation. “Apple sauce or mashed bananas, depending upon the flavor you want to give it, can substitute for part of the fat,” Welch said. “Tofu can substitute for about half the fat and gives it a beany or nutty flavor. You can also substitute two egg whites for one egg in recipes.” Incorporating more healthful oil in your diet to raise HDL levels can be easy if you use the right oil for the right food. Bridget Bigelow, registered dietitian with Rochester General Hospital, likes using canola oil for baking, since it is bland and does not impact the flavor of the food. But canola oil breaks down when exposed to high temperature. For making a vegetable stir fry on high heat in wok, for example, Bigelow switches to peanut oil. “It has a higher smoke point,” she said. “It’s also low in polyunsaturated fat. The ones higher in polyunsaturated fat are generally less stable so they can degrade at high temperatures. “Olive oil smokes at high tempera-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

Stir in the escarole, cover, and continue cooking at a simmer until the lentils are soft and the escarole is tender, about 20 minutes more. Add salt and pepper to taste. Optional: Top with shredded Parmesan cheese. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

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tures, too. It won’t taste good and can be a health concern.” She likes olive oil for lower temperature sautéing or cold as a salad dressing or for dipping bread. Jablonski recommended roasting vegetables in olive oil with herbs and seasonings and sautéing meats and vegetables in oil. These would be good alternatives to using butter. She also suggested using oil based salad dressings instead of creamy salad dressings. “Try sautéing broccoli in sesame oil for a tasty Asian side dish,” Jablonski said. “Oil can be substituted for butter or margarine in many baked goods without altering the taste or consistency too much.” Decrease the amount of oil you use in baked goods by 1/4 since oil contains more liquid than butter, so if a recipe calls for one cup of butter, use 3/4 cup of oil. Otherwise, the texture may be a little off. “Our body needs to have fat,” Welch said. “Too much fat in the diet can cause weight gain regardless as to the type of fat.” Fat is calorically dense, so it’s easy to consume too many calories when eating fatty foods. Keep daily intake of any kind of fat within 20 to 30 percent of your total food consumption. Keep saturated fat less than 7 to 10 percent of your fat intake and trans-fats less than 1 percent (2 grams). “By reducing your total fat intake by approx 10 percent, you’ll see a significant change in your lipid levels depending upon how you’re eating before,” Welch said.

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February 2012 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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New Stats Show Americans’ Heart Health Needs Improvement Cardiovascular diseases still account for one in every three deaths in the US

merica’s heart and blood vessel health is far from ideal, according to new data in the American Heart Association’s “Heart Disease and Stroke Statistical Update 2012,”published in Circulation: Journal of the American Heart Association. The update provides insight into our less than ideal cardiovascular health. For example, obesity continues to be a major problem for many Americans. More than 67 percent of U.S. adults and 31.7 percent of children are overweight or obese. Over the past 30 years, the prevalence of obesity in children has increased from 4 percent to more than 20 percent. The American Heart Association defines ideal cardiovascular health based on seven health factors: smoking status, weight, physical activity, healthy diet, cholesterol, blood pressure and fasting glucose levels, as well as the absence of a diagnosis of heart or blood vessel disease. Based on that definition, the new data shows that 94 percent of U.S. adults have at least one and 38 percent have at least three of the seven factors at “poor” levels. Half of U.S. children 12 to 19 years old meet four or fewer criteria for ideal cardiovascular health. Between 1971 and 2004, our average calorie consumption has increased by 22 percent in women (from 1,542 to 1,886 kcal/d) and by 10 percent in men (from 2,450 to 2,693 kcal/d). Many

of these increased calories come from consuming more carbohydrates, particularly starches, refined grains and sugars; larger portion sizes and calories per meal as well as consuming more sugar-sweetened beverages, snacks, commercially prepared meals (especially fast food) and high-calorie foods. Burning those calories is also an increasing challenge — 33 percent of adults engage in no aerobic leisuretime physical activity. Furthermore, in 2009, among adolescents in grades nine through 12, 29.9 percent of girls and 17 percent of boys had not engaged in 60 minutes of moderate-to-vigorous physical activity — the recommended amount for good health — even once in the previous seven days.

There is some good news in the update — the death rate from cardiovascular diseases (CVD — all diseases of the heart and blood vessels) fell 30.6 percent from 1998 to 2008, possibly due to better treatments for heart attacks, congestive heart failure and other acute conditions. The stroke death rate fell 34.8 percent during that time period, dropping it from the third to the fourth leading cause of death. While the drop in ranking is mostly driven by decreases in the number of stroke deaths, likely due to better treatment options for acute stroke, reclassifying some respiratory diseases into one category also played a role. For example, deaths from chronic obstructive pulmonary disease (COPD), bronchitis and pneumonia are now grouped under the larger category, “respiratory diseases.” Unfortunately, other statistics in the update illustrate America’s continued cardiovascular disease burden: • Cardiovascular diseases accounted for one in every three deaths in the United States in 2008; more than 2,200 Americans die of cardiovascular diseases every day an average of one death every 39 seconds.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

• The cost of cardiovascular care and treatment increased over $11 billion from 2007 to 2008. • The direct and indirect cost of CVD and stroke in the United State for 2008 was an estimated $297.7 billion. “By monitoring health, as well as disease, the update provides information essential to public health initiatives, patient care and for people to take personal responsibility for their health and for their lives,” said Dr. Véronique L. Roger, lead author of the update and professor of medicine and epidemiology at the Mayo Clinic College of Medicine in Rochester, Minn. The American Heart Association has set a goal for America — to improve the cardiovascular health of all Americans by 20 percent and reduce deaths from cardiovascular diseases and stroke by 20 percent by 2020. “If we’re to reach this goal, we’ll need to engage every segment of the population to focus on improved health behaviors,” said Donald Lloyd-Jones, an author of the statistical update and chairman of the department of preventive medicine, Northwestern University Feinberg School of Medicine in Chicago. “In particular, more children, adolescents and young adults will need to learn how to improve and preserve their ideal levels of health factors and health behaviors into older ages. Moving people who are at poor health to make small changes in their behavior and reach intermediate health is a step in the right direction that can make a big difference,” said Lloyd-Jones.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

Rochester Heart Institute’s Big Star Dr. Ronald Kirshner leads what is rated “best hospital in New York state for overall cardiac care” By Ernst Lamothe

onald Kirshner can’t stand the New England Patriots, a familiar sentiment for many who live in Western New York. However, he can appreciate their consistency season after season, their teamwork despite unforeseen circumstances and their drive to achieve perfection in every aspect of the game on every play. That’s the way Kirshner runs the Rochester Heart Institute and his staff as chief of cardiothoracic surgery at Rochester General Hospital. It’s one of the reasons RGH is considered near the top of cardiovascular hospitals. After graduating from Temple University Medical School in Pennsylvania, he performed his internship and vascular, cardiothoracic and general residency at University of Rochester Medical Center and joined the staff in 1988. Understanding health care and surgery is not an individual sport was a lesson he and many young doctors sometimes struggle to accept. Even though Kirshner, 59, prefers not to give advice — saying every person needs to learn life experiences on their own — he does admit to having a “go it alone” mentality in his early years in the profession. While it took a little time for him to appreciate the team-mentality, today he embraces it as a necessity for success. “There’s a lot of people involved in making sure a patient is doing well,” he said. “It’s not just the surgeon operating for hours on someone’s heart that should get all the credit. It starts with preoperative evaluations, then the nurses taking care of big and minor details, everyone in the operating room and then post-ops once surgery is over.” Coming from a family of eight, he knew early about the strengths of working together. What he didn’t know was that his family would gravitate to the same profession. Two of his younger brothers, Drew and Merrick, emulated his path and became thoracic surgeons in Arizona and Montana. In total, six of Kirshner’s seven siblings are physicians, a rare feat in one family. “I went out for wrestling and later on so did my two brothers. When I was growing up, everyone knew I wanted to be a heart surgeon and now they are heart surgeon so we all know who followed who,” joked Kirshner. When Kirshner lead the charge of the Rochester Heart Institute inside the Rochester General Hospital, he expected nothing less than the best. In 2010, it was rated the second best place

in the nation for major cardiac surgery and the best hospital in New York state for overall cardiac care. “If you are going to do something you better strive and believe you are going to be the best in the world or it’s not worth doing it,” said Kirshner. “We’re all going to fail at something but you come back tomorrow and figure out how to do it better.” Although he preaches team-concept, he never forces people to be someone they are not. Sometimes that has resulted in employees not working out on his team or others who at first may not have seemed like a good fit for the team finding their niche within the Rochester Heart Institute. He said he doesn’t know any good team that came together without a combination of solid leadership and the notion of not elevating any one member above the team’s mission. The best quarterbacks know that great plays don’t happen by themselves. “We give people an opportunity to shine here,” said Kirshner. “I ask people to be exactly who they are. There are extroverted people on this team and others who started just sitting in the corner and never speaking who ended up being valuable to the team.” While he deflects the majority of attention from himself, others on his staff believe the spotlight deservingly should be put back on him. “Dr. Kirshner won’t say this about himself, but the Rochester Heart Institute is successful in part because of the way he leads,” said Amy Craib, vice president of the heart institute. Kirshner has a unique approach to making sure his team stays on task and that involves not setting any specific goal other than striving to be perfect; an intimidating and overwhelming achievement on its own. His personality allows him to be cerebral enough to look at short and long term tasks without zeroing in on a mile marker. “Each day I wake up and see what the challenges are and what problems needs to be addressed,” he said. While every surgery — whether it’s emergency or elective — has risks, open heart surgery seems to have a lasting effect, said Craib. She’s seen strong military men whose lives hung in the battlefield minute by minute become humbled and change their steely demeanors after surgery. “People have a different feeling when you operate on their heart,” said Craib. Kirshner agrees. “There is some-

thing about cracking someone’s chest open and working on their heart that makes people look at their mortality,” he added. He never views any surgery as routine. But when common cases come into the operating room, he treats them like emergency cases and wants to be meticulous at all times. “Some people believe in the terms of small or big problems but I don’t,” he said. “Small problems turn into the big problems of tomorrow. They don’t go away.” With February being American Heart Awareness Month, Kirshner’s profession takes on an added spotlight. Every year about 785,000 Americans have a first heart attack. Another 470,000 who have already had one or more heart attacks have another attack, according to the Centers for Disease Control and Prevention. Hospital officials don’t believe education is the issue. They see a lack of personal patient responsibility as the reason heart disease remains the leading cause of

February 2012 •

death in the United States. “At this point, everybody already knows what they need to know about exercising, eliminating smoking from your life, and everything else that goes into taking care of yourself,” said Kirshner. “People need to stop talking about it and start doing it.” When it comes to retirement, he lets other family and friends talk about that and chooses to focus his energy on his new passion, which is learning how to become a racecar driver in his spare time. He’s practiced at Watkins Glen, and when you look at it, there are several similarities to his current job as chief of cardiothoracic surgery. Both are very technical, have immediate rewards, demand precision and requires an experienced team to survive a life and death situation. “I don’t give retirement a moment’s thought. I’ll just see what happens when the times comes. I hope to do this for years to come,” added Kirshner.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

What They Want You to Know:

Cardiologists

By Deborah Jeanne Sergeant

he American College of Cardiologists defines a cardiologist as “a doctor with special training and skill in finding, treating and preventing diseases of the heart and blood vessels.” The ACC describes cardiologists’ training as completing “a minimum of 10 years of clinical and educational preparation [and they] must pass a rigorous two-day exam given by the American Board of Internal Medicine. This exam tests not only their knowledge and judgment, but also their ability to provide superior care.” • “Know your numbers — cholesterol and blood pressure — and family history. • “Do whatever you can to reduce your risk factors for heart disease, like keeping under control diabetes, blood pressure and cholesterol. Cardiovascular disease is 80 to 90 percent preventable.” Seth M Jacobson, cardiologist with Rochester General Hospital

• “I think patients need to be forthright with each of their physicians because in being honest, that will potentially allow the physician to further try to determine what the cause of their symptom or complaint is. In the absence of full disclosure, I will not be able to take good care of the patient. There could be something I’m unaware of that could have a bad reaction with the treatment I propose. Dr. Eugene Storozynsky, assistant professor of Medicine and Cardiology with the University of Rochester Medical Center • “The main thing I find myself talking to patients about frequently is lifestyle choices they can do that increase their cardio health. Dietary sodium intake is one. Most don’t take into account the amount of sodium in foods, especially in canned soup, processed foods, deli meat, pickles and condiments. These are a few examples of foods with high sodium that affect hypertension. One of the things people can do is try to avoid foods that have

sodium. We recommend people to read labels. They shouldn’t have more than 1,500 to 2,000 milligrams of sodium a day. It can help people to reduce blood pressure and increase cardiovascular health. • “We recommend daily exercise, 30 minutes per day at a rate that causes them to break a sweat and get the heart rate up. It could be a brisk walk — not just a stroll, but at a faster pace, biking, using an elliptical machine or aquatic sports, which are especially good for people with orthopedic problems and joint pain. Exercise is something that will help improve blood pressure, cholesterol profile and give more energy help you feel good.” Gregory Singer, cardiologist with Rochester General Hospital • “If you’re a new patient, bring the following: list of all the doctors you see on a regular basis so we can send them a report from your visit with us, list of all medications taken so we can make sure anything we prescribe won’t interact with what you’re already taking, and list of all heart-related tests or procedures you have had done in the last five years. • “If you’re an existing patient of ours, [bring a] list of all medications taken. We don’t have any way of knowing if one of your doctors changed some of the medicines or doses you are currently taking. But we need to know them all so we make sure the combination of all your medications is safe for your heart. If you have a prescription for something but don’t actually take it, let us know. It’s important. • “Two weeks before the visit to our office, start a list of questions you want to ask us. Do you have a question about a particular medication you’re taking? Did you read something in the paper that worries you about your heart? Did your sister or brother recently have a heart attack or stroke? • “Have you started seeing a new doctor and has that person diagnosed you with a new problem? We need to

RA and Heart Disease Linked If you have rheumatoid arthritis, beware of heart problems By Deborah Jeanne Sergeant

or years, people with rheumatoid arthritis (RA) have been identified as at twice the risk for cardiovascular disease as the general population. “With RA patients, we try to screen them early for the risk of heart disease and often get a cardiologist involved,” said Allen Anandarajah, director of the Early Arthritis Clinic at the University of Rochester Medical Center. “Traditionally, heart disease has been ignored in women and RA is more prevalent among women and strikes younger women. Onset is usually 40.” Many of the medications used to treat RA, an oftentimes aggressive autoimmune disease, have numerous side effects. Experts had blamed the medication; however, more recently, physicians believe that the risk could be related to the inflammation RA brings, and not entirely because of the drugs used to treat RA. In fact, some RA drugs may help mitigate the risk for heart disease, such as methotrexate. “Methotrexate is shown to decrease risk of heart disease,” Anandarajah Page 18

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said. “These are preliminary studies. Good control of inflammation with methotrexate or other therapies help decrease risk for heart disease.” The relationship between RA and elevated risk of heart disease could also stem from other factors related to RA. The autoimmune disease causes swelling in the joints and fatigue among its symptoms. Mark Rosenzweig cardiologist with Finger Lakes Cardiology Associates, associated with the University of Rochester Medical Center, said that the most common type of cardiovascular disease associated with RA causes inflammation of the coating around the heart. “It can lead to shortness of breath and low cardiac output and swelling,” Rosenzweig said. “It’s only relatively lately that doctors have recognized that patients with RA are more likely to develop coronary artery disease and coronary heart disease. “It appears that RA seems to have an independent risk factor,” Rosenzweig said. “We believe that the higher

that your inflammation level is with RA that the higher risk you are at developing other kinds of things outside of the joints. “People with RA have a higher prevalence of high blood pressure and cholesterol abnormalities,” Rosenzweig added. Some people with untreated RA are more sedentary because of the stiffness and swelling around the joints and fatigue caused by the disease. Sedentary lifestyle contributes to heart disease. A diagnosis of RA doesn’t guarantee you will have heart problems. Cardiologist Eugene Storozynsky at the University of Rochester Medical Center said that although “inflammation seems to play a role for either the development or the propagation of heart disease, it’s not like every single person who has an inflammatory condition develops heart disease.” Other underlying predispositions to developing heart conditions — family history and lifestyle choices — make a big difference.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

know that. It helps us decide how to best treat you. • “Have you had any heart-related tests or procedures, or any hospitalizations, since your last visit? • “Has your family seen something they want you to discuss with us? • “Have you had any major changes to your diet or your physical activities?” Robert Rosenblatt, cardiologist with Clifton Springs Hospital • “People know to measure weight, blood pressure and cholesterol, but they need to know how to do CPR. The rules have changed. Oftentimes, passersby let someone die because they don’t want to do mouth-to-mouth. All you have to do is the CPR part, not the breathing part. Though it’s nice to have taken a class, you can do it without if you see someone having a cardiac emergency. It works as well or better than with breathing.” Thomas Stuver, cardiologist with Rochester General Hospital • “We see patients as needed for ongoing problems. Some we see frequently and some we don’t see that frequently. They need to follow through with what they’re supposed to do as they’re growing and aging.” Daniel Miga, cardiologist with University of Rochester Medical Center

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.

“These inflammatory conditions are an independent or additional risk factor for developing heart disease,” Storozynsky said. If you have RA, controlling it is one key to reducing the risk of heart disease and the other problems it causes. Ideally, treat RA as early and as effectively as possible. Don’t skip doses or keep silent if a particular drug is not working to control inflammation. Numerous RA drugs are available and what works for one person may not work as well for another. Keep regular appointments with your rheumatologist and primary care physician. Follow doctor’s orders. Lower your other heart disease risk factors. Don’t smoke and avoid secondhand smoke. Tobacco use is implicated as a factor in heart disease. Engage in regular exercise. View it as a vital part of your wellness such as eating well and visiting the doctor. Exercise can promote joint range of motion, weight management and cardiovascular fitness. Aim for at least 30 minutes of aerobic exercise daily as a minimum. Try brisk walking, using an elliptical machine or taking a fitness class you enjoy. Aquatic exercise can be easier on days when joints are achy. But don’t neglect weight-bearing exercise. Its bone-building ability is especially important since some RA drugs inhibit the body’s absorption of calcium.

Stress contributes to heart disease Work, relationships, illness, disappointments even positive changes cause stress, which can impact cardiovascular disease, say local cardiologists By Deborah Jeanne Sergeant

veryone knows that stress can impact one’s emotional state. But unmanaged stress can also damage heart health. Someone stressing over a failed relationship could have a physically “broken heart.” M. Saleem Ismail, a psychiatrist in private practice with Psychiatry and Alzheimer’s Care of Rochester and with Rochester General Hospital, said that some experts recommend that cardiac patients should be evaluated a few months after their cardiac events and monitored by their families for their stress level. If their stress level becomes too high, it can exacerbate their heart problems. Dr. Eugene Storozynsky at the University of Rochester Medical center, said, “There seems to be a relationship between stress and heart disease. Recent stressful situations like the loss of a family member or loved one can lead to stress-induced cardiomyopathy.” Cardiomyopathy hampers the heart’s ability to supply the body with blood because it weakens and enlarges the heart. Cardiologists aren’t entirely certain how stress impacts heart health since it’s hard to single it out as a factor in cardiac disease and difficult to measure stress levels scientifically to study its effect. “It’s under recognized in the medical community,” said Seth M. Jacobson, cardiologist with Rochester General Hospital. Jacobson believes that stress is “a huge impact on cardiovascular disease. We don’t pretend to understand the entire impact of stress on illness. Stress is the No. 1 most common trigger for heart attack, followed by physical activity. “We have a hard time understanding why and how people have heart attacks. We don’t know why people would have a heart attack at one time and why at another time they won’t.” Of course, everyone experiences stress of some sort. Work, relationships, illness and disappointments cause stress. Even positive changes such as a promotion can be stressful. “Even in sports, when a Super Bowl or World Cup game is played, there are higher numbers of heart attacks when the team loses that someone’s rooting for than if the team wins,” Jacobson said. It’s impossible to eliminate all stress from life, and considering the positive sources of stress, such as holidays, entertaining and vacations, doing so would be undesirable. The difference between someone whose stress causes physical problems and one whose stress doesn’t seems to be how much stress they experience and how they deal it. Just as negative emotional responses to stress harm the heart, “positive

emotions can contribute to healthy heart and healthy blood vessels and heart rate and help people to deal with things,” Jacobson said. Jacobson has observed pet therapy animals relieve stress on the cardiac floors, for example. “The amazing response from staff and patients is positive and enjoyable,” he said. “It’s a form of stress relief to focus on the dog and pet it. It brings them joy. The most important thing is to recognize if stress is affecting you. You need to be able to find support in their life if it’s a loved one or family member to support you if you’re stressed,” Jacobson added. Ismail agreed. “Talk about why you’re stressed,” he said. “People could benefit from counseling to learn how to see things

better. How you see things, like if you see the glass as half full, makes a difference.” Regularly engaging in exercise, getting outdoors, engaging in a satisfying hobby or recreational activity, and occasional massage therapy helps relieve stress. Get up a little early to work out before your day becomes too busy. Or slip in mini workouts throughout the day. Take a walk midday or after work. The change of pace and fresh air will help you minimize the day’s stress. If you can’t remember the last time you’ve done something you enjoy just for fun, it’s time to pick up on old hobbies, tweak favorites or try new ones. Pull out that box of hobby items you’ve kept in storage to see if you still enjoy them. If you loved to sled as a kid, perhaps you’d like snowshoeing as an

adult. Or if you’ve always wanted to try martial arts, dance or cabinet making why not take a short-term class to see if you like it before making a commitment? Many people find massage therapy melts away their tension. If you can’t afford a professional, just lying still in a quiet, dimly lit room for a few minutes or exchanging foot rubs with your spouse may help. When sudden stressors strike such as the unexpected death of a loved one, “don’t turn to things like alcohol and drugs to drown yourself out of reality,” U of R’s Storozynsky said. “Surround yourself with positive thinking people who are a positive influence so you can talk about your grief. That will help you get through that unexpected time better.”

Surviving Heart Attack Season

hile we may be accustomed to battling frigid temperatures and the inevitable snow storms that arrive every winter, many of us are unaware of the dangers these pose to our hearts. “When the temperature outside drops, our blood vessels narrow to prevent our bodies from losing heat. This is a natural response that can also put people with heart conditions and those involved in strenuous exercise at greater risk of having a heart attack,” says Dr. Holly Andersen, director of education and outreach at the Ronald O. Perelman Heart Institute of NewYork-Presbyterian Hospital/Weill Cornell Medical Center. Shoveling snow is one of the February 2012 •

most strenuous and dangerous winter exercise activities. It can raise blood pressure, and coupled with the effects of colder temperatures, shoveling can increase heart attack risk drastically. Andersen offers the following tips for safe shoveling and maintaining a healthy heart this winter: • Warm up. Warm up with stretching and light activity before shoveling, exercising, or beginning more strenuous physical activities. • Bundle up. When going out to shovel, always wear a scarf over your mouth and nose to warm the air before you breathe in, and dress in layers. Layering clothes underneath a windproof and waterproof outer shell

helps maintain body heat. • Push the shovel. It is less strenuous to push the snow rather than lifting it, and this reduces the risk of overexerting yourself. • Take breaks. You should take frequent breaks while shoveling to give your muscles, especially your heart muscle, a chance to relax. You may also consider sharing the work with a friend to make the workload lighter and ensure that you are not alone in the event of an emergency. • Consult a doctor. If you are over the age of 50, overweight, out of shape or have suffered a heart attack, you should consult a doctor before shoveling snow or starting any exercise routine.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 19

Do You Know Your Dosha? By Krista Ingerick

Does your child suffer from

ASTHMA?

Common childhood asthma signs and symptoms include: � Coughing � Wheezing � Shortness of breath � Chest congestion or tightness � Chest pain, particularly in younger children The triggers for asthma are all around us-colds, pets, pollen, pollution, and even the weather. If your child continues to have asthma symptoms even while taking asthma medication, you may want to consider volunteering for a clinical research study. This study is evaluating the safety, tolerability and effectiveness of an investigational drug for childhood allergy symptoms. As a qualiﬁed participant, your child will receive all study related care and study medication at no cost. Your child’s asthma condition will be closely monitored during the study by an experienced study team. There are important things you should know about potential beneﬁts and risks that the study doctor will explain to you.

Your child may qualify for this study if he or she: • is 5 to 11 years of age (inclusive) • has had asthma symptoms for 6 months or more • has been taking inhaled asthma medication for at least 12 weeks

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AAIR Research Center at (585) 442-1980 or research@aair.info 300 Meridian Centre, Suite 305 Rochester, NY 14618

www.aairresearch.com Page 20

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yurveda is a 5000-year old science of health and longevity that forms the core of traditional medicine practiced widely in India, Tibet, Indonesia and other regions of Southeast Asia. Ayurveda, which translates as “science of life,” has become recognized today for its wonderful dietary, herbal, lifestyle and exercise therapeutics. The main focus is on biopurification and rejuvenation of the body and health, with individualized treatments to balance each person’s particular “dosha,” or body-mind constitutional type. A person’s constitution is made up of three doshas: “vata,” “pitta,” and “kapha.” There is usually one dominant dosha (sometimes two are equally dominant), which defines the constitution you are born with, or the “prakruti.” Since the doshas are always active in the body, each dosha can become imbalanced, both in excess or deficiency, which can manifest various symptoms. The term “vikruti” is used to describe current dosha activity. Assessment of vikruti helps a therapist determine the best treatment on a particular visit. Ayurveda is by no means a onesize-fits-all approach, but allows for an individual assessment of your needs. Self-discovery and awareness of your own dosha can give you insights about what foods you should eat, what type of skin care products to use, ideal settings for work, play and relaxation, what are the best lifestyle choices, and much more. Ayurveda teaches that keeping the doshas in balance helps to maintain a healthy body, mind, and spirit. One should not consider his or her dosha a “badge” The doshas affect our physical being by impacting how our nervous system and energetic systems communicate with the organs and the brain. Knowing how the doshas manifest in your own body can give you a “best guess” about what may help you. Ayurveda provides guidance about what things you can do to calm those factors that aggravate a particular dosha, as well as provides insights about what things will support and nourish. Here are some general characteristics about the doshas: • Vata: Vata governs all movement: voluntary and involuntary physical movements as well as movements of mind and thoughts. Imbalance in Vata can cause a fidgety mind and body and is associated with insomnia. Vata-types are “like the wind”…they can’t sit still and jump from topic to topic quickly, they may worry or become prone to mood swings, are often cold, tend to be slim and fine boned, and have a variable hunger but can get cranky or anxious if they forget to eat. • Pitta: Pitta is associated with heat and keenness of mind. Pitta-types tend to overheat easily and tend toward redness in skin when irritated. They like the best of the best, are very intel-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

lectual, prefer details about new topics, and are very results-oriented. Pittatypes tend to be of medium build and strong-boned, and can become irritable or prone to angry outbursts when stressed. • Kapha: Kapha’s unique quality is density; they tend to have dense tissue and are heavy boned and curvy. They gain weight easily, are slow to lose weight and NEED movement and activity to lose. Kapha personalities are quiet, careful, deep thinkers, and can be prone to depression. They are intrigued by tradition, are slow to change habits. They benefit from routine but also from excitement, challenge and getting out more. The combination of lifestyle, healing modalities, and unique bodywork treatments of Ayurveda make it today’s most sought after form of traditional medicine for people looking to reduce stress, heal, and experience rejuvenation by seeking to balance the doshas. Through the use of dosha-specific dietary recommendations, you can keep your doshas balanced to maintain health of body, mind and spirit, and improve your longevity. Krista Ingerick, a licensed massage therapists, is the operations manager at The Springs Integrative Medicine Center & Spa Clifton Springs Hospital & Clinic. The spa recently launched “Spayurveda” treatments, following a one-on-one training from Robert and Melanie Sachs of Diamond Way Ayurveda. The term Spayurveda reﬂects the integration of both “spa” and “ayurveda.” For more information on The Springs and a complete list of ayurvedic therapies, visit www.thespringsofclifton.com.

New Trend?

SUNY Brockport has recently become the first college campus to ban smoking on and around its premises. A new group is pushing for other campuses to follow suit By Ernst Lamothe

atherine Tarantine, a junior at the University of Rochester, is tired of walking past residence halls and university buildings and being engulfed by the smell of nicotine and the waft of smoke. She’s disgusted walking along the river and seeing old cigarette butts on the ground or floating downstream. “People say they have a right to smoke but there is nothing on the cigarette box that gives you permission to smoke at this university or gives you permission to smoke at any certain place,” said Tarantine, 20, an epidemiology major and member of the UR Smoke Free Initiative. “Just like you used to be able to smoke indoors, now you can’t. We are not infringing on anyone’s right.” She said students have a right to breathe better, yet other campuses have been slow to fully make that a reality. However, one campus has. Starting this school year, smoking is prohibited on the SUNY Brockport properties, both indoors and outdoors. This includes covered and uncovered walkways, breezeways, outdoor dining areas, bus stop shelters, loading docks, building entrances, and exterior stairways and landings, and in all vehicles owned and leased by the college. The sale of tobacco products on campus is prohibited as well. An estimated 46 million people in the United States or 20.6 percent of all adults over 18 smoke cigarettes, according to the National Institute of

Health. The habit is more common among men (23.5 percent) than woman (17.9 percent.) Cigarette smoking causes 87 percent of lung cancer deaths nationwide. It also is responsible for other health problems, including lung, heart and blood vessel diseases, strokes and cataracts. Women who smoke have a greater chance of certain pregnancy problems or having a baby die from sudden infant death syndrome. All this information was startling enough for Brockport officials to get on top of health risks resulting from second-hand smoke exposure, which is one of the leading causes of preventable U.S. deaths.

Trend on college campuses

With exposure to secondhand smoke a reality, tobacco and smokefree campuses are slowly becoming the trend with 550 colleges nationwide adopting the policy. “We are known for many healthrelated majors here at Brockport and because we promote health within our academics, changing our policy was a good fit for us,” said Karen Logsdon, assistant to the vice president for enrollment management and student affairs. “We did a highly publicized campaign last year to students, but with any new change there are some people who are a little slower to comply. We are using positive peer pressure to change that.” For instance, the school has coordinated a group of trained student volun-

teers who will make presentations and help educate their classmates about the policy in a respectful way. Campus officials said the policy shift was not to target smokers. “Second-hand smoke is a real problem that we couldn’t ignore,” added Logsdon. Logsdon, who recently gave a presentation at the U of R hosted by the New York State Colleges TobaccoFree Initiative Conference, said several local schools attended, including U of R, Rochester Institute of Technology, St. John Fisher and Nazareth colleges. She said smoke-free campuses are also starting to be common practices at hospitals and private businesses. But none of the major schools that attended the conference have pledged to change their policy. One group would like to change that. A student-led, grassroots initiative at U of R began recently to examine smoking and second-hand exposure on campus. Students said they were frustrated by ineffective current policies. Their mission is to create a smoke-free campus, which they believe will decrease litter on campus from cigarette butts and emphasize the desire for a healthy community. The organization wants a new policy in place within the next three years.

Student: Time to step up

Catherine Taratine, 20, a junior at the University of Rochester, is a member of the UR Smoke Free Initiative. The group ﬁghts for a smoking ban on local collge campuses.

Tarantine, who hopes U of R one day goes smoke free, wants her campus to go one step more than most. “We need to go a step further because if you prohibit smoking then people might decide to start doing dip and chewing tobacco,” she said. “I understand that this is a tricky argument since smoking is something that hurts others through second-hand smoke, but chewing tobacco only hurts the person who is doing it.” Brockport health officials think their new policy needs a two-prong approach. One they already did by making a smoke-free environment, but the other is out of their control. They believe more educational programs need to take place in high schools. Close to 80 percent of adult smokers began before age 18, according to the Campaign for Tobacco-Free Kids. New York budgeted $47 million in 2011-12 for tobacco-prevention initiatives, said a spokesperson for the state budget office, down $17 million from last year. Three years ago, the state spent upwards of $80 million annually on programs.

February 2012 •

The New York state Department of Health Tobacco Control Program helps run Reality Check, a statewide initiative empowering youth to participate in reducing tobacco use among peers, removing tobacco advertising from magazines delivered to schools and removing tobacco use from movies rated G, PG and PG-13. Several years ago, the Reality Check program existed at several Monroe County schools such as WheatlandChili, all four Greece high schools and both Pittsford high schools. But when funding dried up, so did the programs, except for Pittsford. Through fundraising efforts, the schools kept the club alive. Schools do cover anti-tobacco efforts in health class, but few teen-organized groups exist. Other health experts disagree that the lack of state funding is having any effect. Cigarette use by high school students declined from 27.1 percent in 2000 to 12.6 percent last year, they said.

Downward swing noted

“The numbers are going down and there is nothing that says teen smoking is going to go up again,” said Jeffrey Hammond, spokesman for the state Department of Health. “We’ve made a comprehensive effort and policy-driven approach to prevent people from smoking and motivate others to stop.” With one of every five deaths in the U.S. connected with smoking, it continues to be one of the leading causes of preventable death in the U.S., taking the lives of 443,000 people each year, according to the Centers for Disease Control and Prevention. The Department of Health and Human Services website provides links to various cessation programs, including text-message counseling and tools to prevent kids from smoking. New, graphic warning labels issued by the Federal Drug Administration will eventually be required on some cigarette packs sold in the U.S. showing shocking images of cancer and lung disease. “If you are a smoker, you need to quit. If you are someone who hasn’t started, you need to keep it that way, and if you are someone who doesn’t smoke but you are around a lot of people who do, you have to find ways to limit your second-hand smoke,” said John Ricci, senior public health educator at the Monroe County Department of Public Health. “Some people think we won the battle on smoking but it would be a mistake to conclude that because a high number of people are still doing it.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Depression Among Seniors Local officials say problem is more prevalent than what figures show By Deborah Jeanne Sergeant

epression is just as common, if not more, among older adults as younger ones. Although statistically incidences of depression are higher among young adults, the figures may be misleading. “I definitely think it’s underreported,” said Corinda Crossdale, director of the Monroe County Office for the Aging. “The estimate might be lower than what we think as far as incidences of depression with older adults.” Because statistics like these are usually gathered by surveys Crossdale of mental health care providers, the numbers may be skewed if seniors don’t treat their depression. “The older generation has a greater stigma that depression is a sign of weakness,” said M. Saleem Ismail, psychiatrist in private practice with Psychiatry and Alzheimer’s Care of Rochester and with Rochester General Hospital. “Younger folks will come in and say, ‘I’m depressed.’ Retirees may not have the same health coverage they had while they were working so mental health care may be an out-of-pocket expense. Although seniors may have reasons for not seeking treatment, it’s vital they do so, according to Crossdale. Seniors are just as prone as younger people to attempt suicide and that research shows the number of mental health issues among New York seniors is expected to rise from 540,000 cases to 780,000 in the next quarter century. “Depression is most prevalent mental health disorder for that population,” Crossdale said. Many people believe depression is a natural part of growing older and thus do not urge a friend or relative to seek help. Crossdale disagrees, saying, “It does not just come along with aging. Older adults who don’t receive treatment become sicker, more instances of illness and their illnesses are more severe in nature.” The signs of depression include Page 22

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change in appetite and sleep habits; decreased interest in socialization and previously enjoyed hobbies and lasting sadness. “It may manifest as medical problems, physical pain, and isolation,” Ismail said. It can be hard to tell if a senior is depressed. Medical problems and pain may also be some of the causes of depression in older adults. Physical issues such as diminished vision, hearing and mobility can contribute to isolation. “Health issues Jacobsen such as stroke, Parkinson’s disease, coronary artery disease, Alzheimer’s disease all have a high prevalence of depression and these are all ‘old age’ illnesses,” Ismail said. While it’s difficult to remove many of the causes of depression for older people, friends and family can offer support and companionship. Tina Weller, director at Ashton Place, urges families and friends to stay more connected to seniors. “Check in on them,” she said. “I have found that people who are adults want their own time and independence but want to know people care about them. “Take them to church on Sunday and do something with [them] that gets them up and out of the house. Being around people and staying social and active are all very important things to help people avoid depression.” If you see signs of depression, refer them to a mental health professional

or contact your local agency on aging, ElderSource or New York Connects. Many of the Silent Generation may resist a direct suggestion for mental health care. Instead, say, “It seems like you’ve been feeling down lately and I’m concerned about you. Do you think it would be helpful if you spoke with someone about this?” Recommend that they ask their primary care doctor for suggestions since many of the symptoms of depression manifest physically. But the symptoms that appear to be depression could be the sign of another illness. “Some people present as depression but it could be the start of Alzheimer’s disease,” Ismail said. “If they’re not as involved in talking about sports or doing crossword puzzles as they used to, they could be avoiding it because they have difficulty in comprehending the game or having problems being in a crowd because they can’t come up with words.” They may purposefully isolate themselves if hearing loss makes conversation difficult. Or the senior could have depression along with a different health issue. Depression can also exacerbate other unrelated health problems, so it’s important to treat depression for that reason, too. “If someone has a heart problem and depression, they will have another heart problem in six to 12 months if their depression isn’t treated,” Ismail said. “It’s very important because there’s a stress/cardiac relationship. Depression becomes more severe if you have pain.” Linking the impact of mental health with physical health may convince some seniors to visit their primary care doctor to talk about how they’re feeling. “We aren’t the experts in this but

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

it’s important for all physicians to recognize depression in patients,” said Seth M. Jacobson, a Rochester General Hospital cardiologist. Depression “can raise the heart rate, blood pressure, and increase likelihood of blood vessel constriction, blood clotting and inflammation,” Jacobson added. “It impacts adverse or risky behaviors where people may smoke more, drink more, not exercise as much or not take their medication as much.” Solo seniors who are depressed may quit exercising, eat poorly and not get enough fluids. “We see that if we don’t keep seniors active, they just generally decline,” Weller, the director at Ashton Place, said. “They don’t have the will and reason to get up and go to a meal. They become weak because they’re not eating properly. They’re not getting their exercise. Physically, it’s a downward spiral.” Offer to drive or accompany the senior to the visit if that would help. The Monroe County Office for the Aging makes home visits to homebound seniors. If your senior parent shows signs of depression, you may also contact the senior’s primary care doctor before a visit to request a depression screening. It’s better to seek professional help for depression. “I wouldn’t encourage a family member to provide mental health services,” Crossdale said. “Even if someone had a recent loss like a spouse there will be sadness but it shouldn’t prevent another family member or friend to make that referral to a mental health professional. Let a clinical specialist make that distinction [between sadness and depression]. It can be dangerous to treat yourself.”

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How to Get Your Affairs in Order Dear Savvy Senior I would like to get my personal and financial information organized so my kids will know what’s going on when I die. Any tips would be appreciated. Overwhelmed Senior Dear Overwhelmed, Organizing your important papers and personal information is a smart move and a great gift to your loved ones. Here are some tips to help you get started. Get Organized

The first step in getting your affairs in order is to gather up all your important personal, financial and legal information so you can arrange it in a format that will benefit you now, and your loved ones later. Then you’ll need to sit down and create various lists of important information and instructions of how you want certain things handled when you die or if you become incapacitated. Here’s a checklist of areas you need to focus on.

Personal Information

• Contacts: Make a master list of names and phone numbers of close friends, family, clergy, doctors, and professional advisers such as your lawyer, accountant, broker and insurance agent. • Personal documents: Include such items as your birth certificate, Social Security card, marriage license, military discharge papers, etc. • Secured places: List all the places you keep under lock and key or protected by password, such as safe deposit boxes, safe combination, security alarms, etc. • Service providers: Provide contact information of the companies or people who provide you regular services such as utility companies, lawn service, etc. • Pets: If you have a pet, give instructions for the care of the animal. • End of life: Indicate your wishes for organ, tissue or body donation including documentation (see donatelife. net), and write out your funeral instructions. If you’ve made pre-arrangements with a funeral home include a copy of agreement, their contact information and whether you’ve prepaid or not.

Legal Documents

•Will: Include the original copy of your will and other estate planning documents you’ve made. • Power of attorney: This names someone you trust to handle money

matters if you’re incapacitated. If you don’t have a will or power of attorney, do-it-yourself resources like legalzoom. com can help you create them for a few dollars. • Advance directives: These documents — a living will and medical power of attorney — spell out your wishes regarding your end-of-life medical treatment when you can no longer make decisions for yourself. For free advanced directive forms visit caringinfo.org or call 800-658-8898.

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Financial Records

• Income and debt: Make a list of all income sources such as pensions, Social Security, IRAs, 401Ks, interest, investments, etc. And do the same for any debt you may have — mortgage, credit cards, medical bills, car payment. • Financial accounts: List all bank and brokerage accounts (checking, savings, stocks, bonds, mutual funds, IRAs, etc.) and their contact information. And keep current statements from each institution in your files. • Company benefits: List any retirement plans, pensions or benefits from your current or former employer including the contact information of the benefits administrator. • Insurance: List the insurance policies you have (life, long-term care, home, auto, Medicare, Medigap, prescription drug, etc.) including the policy numbers, insurance agents and phone numbers. • Credit cards: List all credit and charge cards, including the card numbers and contact information. • Property: List real estate, vehicles and other properties you own, rent or lease and include documents such as deeds, titles, and loan or lease agreements. • Taxes: Keep copies of tax returns for seven years and the contact information of your tax preparer. Keep all your organized information and files together in one convenient location — ideally in a fireproof filing cabinet or safe in your home. Also be sure to review and update it every year, and don’t forget to tell your loved ones where they can find it. Savvy tips: To help you get organized, Nolo (nolo.com, 800-728-3555) offers a great resource book called “Get It Together” for $18.50. You can also purchase helpful guides at organizemyaffairs.com.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. February 2012 •

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Upstate Has Relatively The Social High Job-Based Health Insurance Coverage and Security Ofﬁce Below-Average Uninsured Rates Be In The Know Before You Go

Ask

Column provided by the local Social Security Office

e’re in the dead of winter. In many areas of the country, that means that we could be in for some rough weather. When severe weather strikes, parents of young children are well aware that they need to check for school closings as they prepare for the day. But sometimes inclement weather can be severe enough to close down government buildings and offices as well — including Social Security. If the weather outside is frightful, you should check our website before making a trip to your Social Security office. The place to go to find out about emergency office closings is www. socialsecurity.gov/emergency. Social Security’s office closings and emergency page provides information on specific offices that are closed due to weather and emergencies, as well as reminders about upcoming federal holidays during which government offices are closed. The website also offers a link to a comprehensive list of federal holidays throughout the year. To the right side of the page, you’ll find helpful resources from other

government agencies, such as the Federal Emergency Management Agency (FEMA) and the National Weather Service. They can help you to prepare for weather emergencies before they happen. We also provide information about alternatives to visiting an office, helpful even when offices are open. For example, many of our most popular services are available online at www. socialsecurity.gov. Find out what types of benefits you may be eligible for by using our benefits eligibility screening tool and then apply online. If you are already getting benefits, you can use our website to sign up for direct deposit so that your payments won’t be interrupted during weather emergencies. You can learn about these and other services available on our secure website by visiting our Online Services page at www.socialsecurity.gov/onlineservices. If you’d like to be alerted to office closings, that’s easy to do. Just visit www.socialsecurity.gov/emergency and subscribe to the page by selecting the “Get email updates” link next to the red envelope. Then you’ll get an email alert any time there is a change, such as an office closing.

Q: We adopted a baby girl overseas and brought her home with us to the United States. We need to get a Social Security number for her. What do we do? A: In general, to apply for a Social Security number for your child you must: Complete an Application for a Social Security Card (Form SS-5) for your child, which you can find online at www.socialsecurity.gov; show us documents proving your child’s: U.S. citizenship or immigration status; adoption; age; and identity. Also, show us a document proving your identity show us evidence that establishes your relationship to the child if your name is not listed as the parent on the child’s evidence of age. The adoption decree or the amended U.S. birth certificate will suffice. You can take your application and original documents to your local Social Security office, or you can mail them to us. All documents must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies of documents. If you do not yet have proof of your child’s citizenship, we can assign a number based on documentation issued by the Department of Homeland Security upon the child’s arrival in the United States. When you do receive documentation of your child’s citizenship, you can bring it to us, and we will update your child’s record. We will mail your child’s number and card as soon as we have verified your documents with the issuing offices.

Q: How long do I need to work to become eligible for retirement benefits? A: Everyone born in 1929 or later needs 40 Social Security credits to be eligible for retirement benefits. You can earn up to four credits per year, so you will need at least 10 years to become eligible for retirement benefits. During your working years, earnings covered by Social Security are posted to your Social Security record. You earn credits based on those earnings. If you become disabled or die before age 62, the number of credits needed depends on your age at the time you die or become disabled. Learn more at www.socialsecurity.gov.

Q&A

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Q: My grandfather, who is receiving Supplemental Security Income (SSI), will be coming to live with me. Does he have to report the move to Social Security? A: Yes. An SSI beneficiary must report any change in living arrangements within 10 days after the month the change occurs. If the change is not reported, your grandfather could receive an incorrect payment and have to pay it back, or he may not receive all the money due. Just as importantly, your grandfather needs to report the new address to Social Security to receive mail from us. You can report the change by mail or in person at any Social Security office or call Social Security’s toll-free number at 1-800772-1213 (TTY: 1-800-325-0778). You can get more information by reading the booklet “Understanding SSI,” at www. socialsecurity.gov/ssi.

pstate New York’s uninsured rate is 5 percentage points lower than the national average, thanks in part to higher levels of employment-based health insurance coverage in the region, according to a census data analysis issued recently by Excellus BlueCross BlueShield. With a population of more than 6 million residents, Upstate New York has more residents than 34 U.S. states and the District of Columbia, and it’s among the 10 most favorable places to live when it comes to health insurance coverage. Upstate New York’s three-year average (2008 through 2010) uninsured rate is 11.1 percent, lower than the New York state average of 14.6 percent and national average of 16.1. Comparing these numbers to Excellus BlueCross BlueShield’s previous (2003) research on the uninsured in Upstate New York shows that the uninsured rate has grown by almost 2 percentage points over the past decade. Upstate New York’s relatively favorable health insurance coverage rate goes hand-in-hand with the comparatively large share of residents who have job-based health benefits. From 2008 through 2010, the employer-based coverage rate was 62.4 percent in Upstate New York and about 56 percent statewide and across the U.S. “It’s encouraging to see that even though Upstate New York’s uninsured rate has gone up over the past 10 years, the region still has such a high percentage of people who access health insurance through the workplace,” said Jim Reed, senior vice president, marketing and sales, Excellus BlueCross BlueShield. “Upstate New York’s low uninsured numbers no doubt are related to the broader reach of employerbased coverage here, compared to the state and the rest of the country.” “The Facts About Employer-Based Health Coverage And Uninsured Rates In Upstate New York “ also highlights the uninsured and employment-based health insurance rates in Upstate New York’s four largest urban areas (Albany, Buffalo, Rochester and Syracuse). Combined, these four urban centers are home to about two-thirds of the total Upstate New York population. Just 9 percent of these residents are uninsured, and 62.7 percent have employer-sponsored health coverage. The uninsured rate is 6.3 percent in Rochester, 13.1 percent in Albany, 11.6 percent in Syracuse and 10.0 percent in Buffalo. The job-based coverage rate in these areas ranges from 61.4 percent in Syracuse to 67.4 percent in Albany. By comparison, the combination of smaller metropolitan and nonurban communities that comprise the balance of Upstate New York have a higher uninsured rate (13.0 percent) and a slightly lower job-based coverage rate (62.1 percent).

What explains Upstate New York’s lower uninsured rate? Lower health care costs in Upstate

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

Lower health care costs in Upstate New York may explain why the region has higher levels of employment-based health insurance coverage and a lower-than-average uninsured rate. New York may explain why the region has higher levels of employment-based health insurance coverage and a lowerthan-average uninsured rate. Excellus BlueCross BlueShield’s analysis of uninsured rates presents data from The Dartmouth Atlas of Health Care suggesting that health care costs less in Upstate New York than it does statewide and nationally. Data from this nationally known source of health care cost variations reveal that Medicare spending (an indicator of costs) in Upstate New York has been consistently lower than corresponding statewide and national figures. “National research has linked the growing uninsured rate to rising health care costs, which drive health insurance premium increases,” noted Reed. “Higher premiums are passed on to the employers that provide health insurance benefits. Employers are faced with difficult decisions about shifting higher costs to employees or taking other measures, such as reducing benefits or limiting eligibility, that end up restricting employee access to affordable coverage.” According to The Dartmouth Atlas of Health Care, Medicare spending in 2008 was $7,193 per Upstate New York recipient, 30 percent less than the statewide figure ($10,267) and 20 percent less than the national figure ($9,021). Per-enrollee spending was $7,927 in Buffalo, $7,534 in Syracuse, $7,279 in Albany and $7,037 in Rochester (where uninsured rates are the lowest among the four largest upstate New York metropolitan areas). “Upstate New Yorkers are fortunate to live in a region where the average cost of health care has stayed below statewide and national averages,” Reed concluded. “Lower health care costs lead to the lower premiums that make health insurance coverage affordable, extending job-based coverage and keeping uninsured rates in check.” Excellus BlueCross BlueShield’s full library of reports and fact sheets is available on the Web at excellusbcbs. com/factsheets.

H ealth News Urgent Care by Lifetime Health earns certiﬁcation Urgent Care by Lifetime Health, which provides same day care for urgent injuries and illnesses, has received certification by the Urgent Care Association of America (UCAOA). The certification places Lifetime Health’s urgent care facilities among only a select few in the country to have met all of the UCAOA’s nationally-standardized criteria. Lifetime Health earned certification for all of its Rochester locations — in the Folsom Health Center, Greece Health Center and Wilson Health Center — as well as three of its Buffalo sites. Urgent Care by Lifetime Health is the longest standing urgent care provider in the Rochester and Buffalo regions, serving patients in urgent care settings in Rochester for more than 20 years and Buffalo for nearly 30. UCAOA publicly noted Lifetime Health’s Certified Urgent Care (CUC) designation in the January issue of Journal of Urgent Care Medicine. To be awarded the CUC designation, urgent care centers must meet strict criteria, including accepting walkin patients of all ages for a wide variety of illness, injury and disease during all hours of operation; maintaining minimum hours of operation seven days a week; having a licensed physician as medical director responsible for overall quality; and performing ethically.

senior vice president of medical and academic affairs and chief medical officer at Rochester General Health System. “Anyone who has worked with her can attest to the combination of skill, dedication and enthusiasm that makes her a natural choice for this new role.” Riedy Riedy attended medical school and completed her residency at the University of Rochester School of Medicine and Dentistry, and completed a fellowship in surgical pathology and cytopathology at the University of Virginia. Prior to serving as director of the department of pathology at Rochester General, she headed the department of cytology at RGH. She has also practiced at the former Genesee Hospital and served for two years as the director of pathology at Penn State University Hershey Medical Center. Riedy currently serves as an elected member of the medical and dental staff at Rochester General Hospital and on the executive committee of the RGH Breast Center. She has a strong interest in patient advocacy and is a champion of the interdisciplinary approach to patient care at Rochester General Health System. Riedy is a resident of Brighton.

Rochester General Hospital Clifton Springs nurse earns announces new physicians diabetes certiﬁcation Several physicians have recently The National Certification Board for Diabetes Educators recently granted Clifton Springs Hospital nurse Charlotte Tack, the designation of certified diabetes educator (CDE). This CDE credential is granted to health care professionals who have demonstrated distinct and specialized knowledge in diabetes self-management education. Tack has worked for Clifton Springs Hospital for eight years and Tack with the Clifton Springs Hospital Regional Diabetes Health Center for one year. The diabetes health center has a nationally recognized diabetes outpatient education program administered by nurses and a dietitian who are all certified diabetes educators. Additionally, the center provides inpatient diabetes education and case management.

Riedy appointed chief of pathology at RGHS Rochester General Health System announced the appointment of Dawn Riedy as chief of pathology and laboratory medicine. “Since 2009 Dr. Riedy has served with distinction as the director of pathology,” said Richard Gangemi,

joined Rochester General Health System recently. They are: • Thuc Doan Huynh, who specializes in family medicine and is practicing at the Gananda Family Practice in Macedon. She attended Medical University of the Americas, Charleston, Nevis, West Indies, and completed her residency at Rapid City Regional Hospital, Huynh Rapid City, S. D. She lives in Macedon. • Maria Kilari, who specializes in internal medicine and is practicing at Northridge Medical Group in Rochester. Kilari attended Ziauddin Medical University, Karachi, Pakistan and completed her residency at New York Methodist Hospital, Kilari Brooklyn, She is board certified in internal medicine and lives in the town of Brighton. • Jae Hyun Shin, who specializes in internal medicine and has joined the hospital’s outpatient medical department. Shin attended Seoul National University College of Shin Medicine in South Ko-

rea and completed his residency at Rochester General Hospital. He lives in Webster. • Stephanie Mann, who specializes in maternal fetal medicine and obstetrics and gynecology. She attended George Washington University School of Mann Medicine and completed her residency at SUNY Stony Brook in New York. She completed a maternal fetal medicine fellowship at Harbor-UCLA Medical Center, Torrance, Calif. Mann is board certified in obstetrics and gynecology and maternal fetal medicine. She is a member of the AmeriMichalko can College of Obstetricians & Gynecologists; American Institute of Ultrasound in Medicine; International Society of Ultrasound in Obstetrics and Gynecology and Society of Maternal Fetal Medicine. • Karl Michalko, who specializes in orthopaedic surgery limited to the treatment of the upper extremity including the shoulder. Michalko attended the University of Rochester School of Medicine and also completed an orthopaedic surgery residency there. In addition, he completed a residency in plastic and reconstructive surgery at the University of Wisconsin and a hand fellowship at Brown University/Rhode Island Hospital. He is board certified by both the American Board of Plastic Surgery and the American Board of Orthopaedic Surgery. Michalko resides in Pittsford.

At Home With Wellness opens ofﬁce in Mendon Home With Wellness, LLC has recently opened a new practice in Mendon. It offers digestive health and wellness consulting to clients in the greater Rochester area. At Home With Wellness will have the primary focus of working with clients to implement a dietary protocol that works to help balance the gut/digestive system and in turn bring psychological balance. Additionally, this protocol has had success in assisting clients with various autoimmune disorders. Laura Villanti, founder and managing principal of At Home With Wellness, is certified as both a GAPS (Gut and Psychology Syndrome) practitioner and a healing food specialist. She is also co-leader of the Rochester chapter of the Weston A. Price Foundation, an international nonprofit nutritional foundation that disseminates the research of nutrition pioneer Weston Price, whose studies of isolated peoples established the parameters of human health and determined the optimum characteristics of human diets. Villanti received her certification as a GAPS practitioner and follows the methodology of Natasha CampbellMcBride, a physician with advanced

February 2012 •

degrees in neurology and nutrition who practices in Cambridge, England. For more information on At Home With Wellness, visit their website at www.athomewithwellness.com

Hillside meets its holiday gift-giving goal Again this year, Hillside Family of Agencies met its holiday gift-giving goal. Hillside Family of Agencies announced that its annual Hillside Special Santas program was able to provide gifts to all clients in need. The program benefited 3,150 youth and 1,350 families served by Hillside Family of Agencies Rochester-region affiliates: Crestwood Children’s Center, Hillside Children’s Center and Hillside WorkScholarship Connection. Overall, Hillside Special Santas provided gifts to 4,200 youth and 2,000 families across New York state. Many children and families served by Hillside Family of Agencies do not have the resources for gifts during the holidays. The goal of Hillside Special Santas is to provide youth and families with three gifts in addition to a modest grocery card to help make ends meet. “Hillside youth, families and staff are fortunate to have the continuous support of the Greater Rochester community, especially during the holiday season. Hillside Special Santas was able to provide gifts for all our youth and families, who might not otherwise have received presents this holiday season,” said Heather VanDyne, Hillside Special Santas manager. “The youth and families receiving gifts were touched to know that our community partners and volunteers are thinking of them during the holidays.”

MVP Health Care earns highest NCQA accreditation The National Committee for Quality Assurance (NCQA) has awarded “Excellent Accreditation,” its highest accreditation status, to the MVP Health Care commercial and Medicare HMO and point-of-service plans (POS) plans. NCQA is an independent nonprofit organization dedicated to measuring the quality of America’s health care. NCQA accreditation is a nationally recognized evaluation that purchasers, regulators and consumers can use to assess managed care plans. NCQA’s accreditation surveys include rigorous on-site and off-site evaluations of more 60 standards and selected Health Employer Data Information Set (HEDIS) performance measures. A team of physicians and managed care experts conducts accreditation surveys. A national oversight committee of physicians analyzes the team’s findings and assigns an accreditation level based on the performance level of each plan. “Excellent accreditation from NCQA is important to MVP because it sends a clear message to our members, employers and participating providers — MVP delivers high-quality care and service. It also ensures that MVP

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H ealth News Rochester Scientist Leads National Fight Against Lead When the U.S. Centers for Disease Control and Prevention needed a scientist to lead the panel charged with making recommendations regarding hazardous levels of lead in children, they turned to one of Rochester’s own. Deborah Cory-Slechta, professor of Cory-Slechta environmental medicine and an internationally recognized authority on the hazards of lead, was co-chairman of the CDC panel that in January recommended slashing the level of lead that should be considered as the point for intervention by physicians and public health authorities. The main message of the recommended guidelines put forth by Cory-Slechta and colleagues, however, isn’t about the precise levels of lead in the blood that should be considered “safe” or “unsafe.” Rather, she states unequivocally, “With lead, there is no safe level. It’s that simple.” But as patients, physicians and public health agencies across the

has programs in place for continuous quality improvement,” said David W. Oliker, MVP president and CEO. “The NCQA accreditation process is recognized as the gold standard by employers and consumers,’ said Allen Hinkle, MVP executive vice president of medical affairs and chief medical officer. “Our excellent accreditation status confirms that MVP works closely with our participating providers to ensure consistent, high quality patient care to our members. We sincerely appreciate the dedication and support of our participating providers,” he said.

Healthcare Trustees of New York State elects ofﬁcers The Board of Governors of Healthcare Trustees of New York State (HTNYS) elected its 2012 chairman and officers. • John Lane, a trustee at WinthropSouth Nassau University Health System in Melville, was elected chairman of the HTNYS board, effective Jan. 1. The board also elected the following officers to serve one-year terms: • Vice chairman: Dr. S. Jan Eberhard, chairwoman of the board, Arnot Ogden Medical Center, Elmira; • Secretary/treasurer: Sharon Norton Remmer, Brookhaven Memorial Hospital Medical Center, Patchogue; and • Immediate past chairman—Sarah J. Schermerhorn, Ellis Hospital, Schenectady. Page 26

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nation clamor for guidance about how best to approach the pervasive problem, it’s clear that guidelines are needed. So while the panel states clearly that any measurable amount of lead damages the body, it made the decision to put the “action point” at 5 milligrams of lead per deciliter of blood — just half the number that has been in place since 1991. While estimates vary in the number of children who need to have their lead levels lowered immediately, estimates under the current rule put that number at approximately 250,000. The new measure, if adopted by CDC, would nearly double that number, to 450,000. “While no level is safe, we do need a number that people can cite to help give them direction about when action is needed,” said Cory-Slechta. “For instance, with current level, many pediatricians would tell families whose children who had some lead but whose level was below 10 that their children were fine. But, there really is no safe level. Reducing the action level is one way of increasing the number of children who will be protected more forcefully.”

Other trustees serving on the HTNYS Board of Governors in 2012 are: Eric R. Allyn, Auburn Memorial Hospital, Auburn; Neboysha R. Brashich, Eastern Long Island Hospital, Greenport; Daniel E. Clark, Alice Hyde Medical Center, Malone; John J. Daly, St. Mary’s Hospital, Amsterdam; Arthur Dawson, Ph.D., New York Hospital Queens, Flushing; Judith J. Foster, Samaritan Medical Center, Watertown; Peter J. Hamilton, O’Connor Hospital, Delhi; Richard H. Hawks, Jr., Thompson Health, Canandaigua; Susan R. Holliday, Strong Memorial Hospital, Rochester; Howard T. Howlett, Jr., Southern Tier Health Care System, Olean; Brenda J. Ireland, WCA Healthcare System, Jamestown; F.J. McCarthy, North Shore-Long Island Jewish Health System, Great Neck; Ronald B. Milch, MJHS, Brooklyn; George V.C. Muscato, Esq., Eastern Niagara Hospital, Lockport; John W. Neubauer, Putnam Hospital Center, Carmel; David Prince, Olean General Hospital, Olean; John B. Robinson, Albany Medical Center, Albany; and Calvin Simons, M.D, F.A.C.P., The Brooklyn Hospital, Brooklyn Healthcare Trustees of New York State is a nonprofit membership organization dedicated to strengthening the governance of New York’s non-profit and public health care facilities. HTNYS is governed by a Board of 25 trustees from health care facilities across the state and is an affiliate of the Healthcare Association of New York State.

Rochester Heart Institute ranked No. 1 in NYS Rochester General Hospital, the flagship affiliate of Rochester General Health System, has once again received some of the highest state and national rankings for cardiac care as well as overall hospital and surgical care — including being named the leader in New York state for “Major Cardiac Surgery and Cardiac Care” — according to the latest report from CareChex®, a division of The Delta Group. The CareChex 2012 study provides hospital rankings in the categories of medical care and patient safety, with awards based on an institution’s cumulative performance across the most recent three years of public data. In compiling its rankings, CareChex® incorporates six evidence-based peer-reviewed methodologies which address key components of inpatient care quality. These methods encompass quality measures including mortality rates, complication rates, patient satisfaction measures, inpatient quality indicators including core measures, and patient safety indicators. In the study, Rochester General Hospital received among the highest rankings in categories including “Major Cardiac Surgery” (No. 1 in New York state, No. 3 in the United States), “Cardiac Care” (No. 1 in New York state), “Overall Surgical Care” (No. 3 in New York tate) and “Overall Hospital Care” (No. 3 in New York state). RGH led the greater Rochester region in all of these categories. A complete analysis of hospital performance data is available at www. carechex.com.

Victor doctor joins Clifton Springs Hospital Clifton Springs Hospital & Clinic announced that Dr. Gerald J. Conezio of Victor has joined Health First Family Medicine at Clifton Springs Hospital. Conezio is the founder of Victor Health Associates, which specializes in internal medicine and pediatrics. He is a member of the American College of Physicians. Conezio earned his medical degree from SUNY Upstate in Syracuse in 1974 and Conezio completed his residency in internal medicine at Genesee Hospital in Rochester. He has been an attending physician at Clifton Springs Hospital & Clinic since 1996. Conezio will be joining Dr. Azfar Ahmed in the Health First Family Medicine practice, which also includes nurse practitioners Cathy Olschewske and Rena Reed and Brenda Suhr, a physician assistant.

Finger Lakes Health receives pharmacy award Leza Hassett, director of pharmacy at Finger Lakes Health, based in Ge-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012

neva, has recently honored by Comprehensive Pharmacy Services (CPS), Memphis, Tenn. Hassett was one of seven people that received the prestigious Edward G. Hirschman Award for 2011. The presentations were made during a senior management conference held in conjunction with the American Society of Health-System Pharmacists (ASHP) mid-year trade show in New Orleans. The “Site of the Year” award is presented to the director of pharmacy at the site with an operations audit score of at least 85 percent; outstanding financial performance by meeting or exceeding budget; superior scores on The Joint Commission survey, as well as clinical success and maintaining good relationships with hospital administration. According to a news release, Hassett has moved the Finger Lakes Health pharmacy services into the new frontier by implementing multiple technologies, changing the staffing model and empowering her staff to become part of the new model. She led the Computerized Physician Order Entry (CPOE) and bar-coding processes. Further, she has identified and implemented programs that expand services and generate revenue.

URMC lung research awarded $4.7M The University of Rochester Medical Center has been awarded $4.7 million from the federal government, with several options for additional funding, to establish a center to study the germs that cause lung disease. The agreement with the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, took effect in December. The agreement, renewable on a year-by-year basis, could last potentially for seven years. If the agreement lasts the full seven years, contract funding may be at least $35 million, and support could reach as much as $50 million, if NIAID exercises all its options. university officials expect the contract to create or retain a total of approximately 250 jobs at the University — a mix of laboratory technicians, study coordinators, nurses, information analysts, scientists, and others. The center is being established by NIH to help protect citizens against bacteria and viruses that take aim at the respiratory system. These cause pneumonia and flu, as well as a host of other infections caused by lesserknown but still-deadly microbes such as coronaviruses, metapneumoviruses, parainfluenza viruses, and respiratory syncytial virus (RSV), as well as a host of bacteria. The creation of the center places the university at the vanguard of the health of the nation’s citizens. The new center, known as the Respiratory Pathogens Research Center, effectively puts university scientists “on call” in the realm of respiratory infections. In times of national need, center personnel are available at the request of Federal officials to take on urgent projects to inform public health needs.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2012