In Good Health by In Good Health: Rochester's Healthcare Newspaper

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November 2012 • Issue 87

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Rochester–Genesee Valley Healthcare Newspaper

Meatless Monday

Best Website We analyzed websites of all hospitals in the region. What’s the best one? Go to page 9

‘Meatless Monday’ movement gaining ground in the Rochester area. P. 16

The Flu & Seniors If you’re one of the unlucky seniors who catches the flu, your risk for complications is greater than that of a younger person

NPs On the Rise The Rochester area is well equipped with its arsenal of nurse practitioners but experts say the number of NPs will continue to increase

Facing Thanksgiving Alone? Find tips on how to make a memorable Thanksgiving, even if you’re alone

Golden Years. Special Edition

Rochester Welcomes

Trader Joe’s

The new grocery store is interesting, affordable, unconventional, and just plain fun

he mobscene you will find in the parking lot of the new Trader Joe’s in Pittsford Plaza is well worth it. I will admit I have been waiting for this store to move in long before its opening was even announced, as my years of experience in several of the Boston-area locations were more than satisfactory. November 2012 •

For kids, battling epilepsy not an easy task Life can change in an instant. A few years ago, Chili residents Tim and Christine Emerson were playing with their 4-year-old daughter, Julia. All of a sudden their energetic, full of vigor child started having seizures caused by the fever from a viral illness. Story on page 9

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 1

t’s funny to watch what so much choice does to our residents. Even the most particular grandpa will love choosing between three meals a day or just one. Between full-time transportation or twice-a-week shopping. When you have choices, like you get at The Villages, you have control. You determine what you pay, what services you want, how you save. So if you’re notoriously picky, consider all your choices here. It’s a wonderful life at The Villages.

VillagesSeniorLiving.org

(585) 723-7442 Live it up.

HELP REDUCE ER CROWDING. FOR COLD AND FLU SYMPTOMS, SEE YOUR DOCTOR. A recent study found that each year there are hundreds of thousands of emergency room visits in upstate New York that could be avoided. Minor conditions like cold and ﬂu symptoms, congestion, back pain, earaches and sports injuries are best treated by your doctor. If your doctor isn’t available, consider visiting an urgent care facility. And do your part to relieve ER crowding.

Sponsored by the Monroe County Medical Society, Finger Lakes Health Systems Agency, and Excellus BlueCross BlueShield. A nonproﬁt independent licensee of the BlueCross BlueShield Association

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

Abortion Rates Plummet with Free Birth Control

roviding birth control to women at no cost substantially reduced unplanned pregnancies and cut abortion rates by 62 percent to 78 percent over the national rate, a new study shows. The research, by investigators at Washington University School of Medicine in St. Louis, appears online Oct. 4 in Obstetrics & Gynecology. Among a range of birth control methods offered in the study, most women chose long-acting methods like intrauterine devices (IUDs) or implants, which have lower failure rates than commonly used birth control pills. In the United States, IUDs and implants have high up-front costs that sometimes aren’t covered by health insurance, making these methods unaffordable for many women. “The impact of providing no-cost birth control was far greater than we expected in terms of unintended pregnancies,” says lead author and gynecologist Jeff Peipert. “We think improving access to birth control, particularly IUDs and implants, coupled with education on the most effective methods has the potential to significantly decrease the number of unintended pregnancies and abortions in this country.” Unintended pregnancies are a major problem in the United States. Each year, about 50 percent of all U.S. pregnancies are unplanned, far higher than in other developed countries. About half of these pregnancies result from women not using contraception and half from incorrect or irregular use. The Contraceptive Choice Project enrolled 9,256 women and adolescents in the St. Louis area between 2007 and 2011. Participants were 14-45 years of age, at risk for unintended pregnancy, and willing to start a new contraceptive method. Participants had their choice of

birth control methods, ranging from long-acting forms like IUDs and implants to shorter-acting methods such as birth control pills, patches and rings. The women were counseled about the different methods, including their effectiveness, risks and benefits. The extremely low failure rate (less than 1 percent) of IUDs and implants over that of shorter-acting forms (8 percent to 10 percent) was emphasized. In all, about 75 percent of women in the study chose IUDs or implants. From 2008 to 2010, annual abortion rates among study participants ranged from 4.4 to 7.5 per 1,000 women. This is a substantial drop (62 percent to 78 percent) over the national rate of 19.6 abortions per 1,000 women in 2008, the latest year for which figures are available. The lower abortion rates among Choice participants also is considerably less than the rates in St. Louis city and county, which ranged from 13.4 to 17 per 1,000 women, for the same years. Among girls ages 15-19 who had access to free birth control provided in the study, the annual birth rate was 6.3 per 1,000, far below the U.S. rate of 34.3 per 1,000 for girls the same age. While birth control pills are the most commonly used contraceptive in the United Sates, their effectiveness hinges on women remembering to take a pill every day and having easy access to refills. In contrast, IUDs and implants are inserted by health-care providers and are effective for five to 10 years and three years, respectively. Despite their superior effectiveness over short-term methods, only a small percentage of U.S. women using contraception choose these methods. Many can’t afford the cost of IUDs and implants, which can cost more than $800 and may not be covered by insurance.

Study: Stroke Becoming More Common in Young People

ew research reveals that stroke may be affecting people at a younger age. The study is published in the Oct. 10 online issue of “Neurology,” the medical journal of the American Academy of Neurology. “The reasons for this trend could be a rise in risk factors such as diabetes, obesity and high cholesterol,” said study author and physician Brett Kissela with the University of Cincinnati College of Medicine in Ohio and a fellow of the American Academy of Neurology. “Other factors, such as improved diagnosis through the increased use of MRI imaging may also be contributing. Regardless, the rising trend found in our study is of great concern for public health because strokes in younger people translate to greater lifetime disability.” For the study, researchers looked at occurrences of strokes in people between the ages 20 and 54 in the Greater Cincinnati/Northern Kentucky area during three separate, one yearlong periods between July of 1993 and June of 1994, and the calendar years of 1999 and 2005. Only first ever strokes were included in the analysis.

The study found that the average age of people who experienced stroke fell from 71 years in 1993 and 1994 to 69 years in 2005. In addition, the study found that strokes among people under 55 made up a greater percentage of all strokes over time, growing from about 13 percent in 1993-94 to 19 percent in 2005. The stroke rate in young people increased in both African-Americans and Caucasians, from 83 strokes per 100,000 people in 1993-94 in AfricanAmericans to 128 per 100,000 in 2005 and in Caucasians from 26 strokes per 100,000 people in 1993-94 to 48 per 100,000 in 2005. “The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise,” said Kissela. “However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease.” The study was supported by the National Institutes of Health. To learn more about stroke, visit http://www. aan.com/patients. November 2012 •

Practitioner Needed Busy Chiropractic/Acupuncture ofﬁce is currently seeking an additional Practitioner to join it’s staff. Modern facility on East side of Rochester. Practice has current patient base of 4000 active patients. Space is available on a monthly rental basis. See us, and contact us at our website www.drsadlon.com

UPSTATE MAKES A DIFFERENCE! Upstate is an academic medical university built around patient care, education and research. It is the only one of its kind in Central New York. As a place dedicated to serving the community it is a great place to start or continue your career. Upstate Medical University/Upstate University Hospital is an AA/EEO/ ADA employer engaging excellence through diversity. Smoke-free campus since 2005

To learn more about career opportunities at Upstate and apply on-line www.upstate.edu/jobs

Colleges of: Medicine, Nursing, Health Professions and Graduate Studies Upstate University Hospital - Downtown and Community campuses Upstate Golisano Children’s Hospital I www.upstate.edu/jobs IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Insurance assistance for Kodak retirees Eastman Kodak Co. retirees who are 65 and older and facing the possible loss of their company-provided health insurance can attend a free and exclusive Medicare plans seminar to learn more about their coverage options. Excellus BlueCross BlueShield is offering two dozen free Medicare plan seminars for retirees in several locations. Excellus BCBS representatives will help retirees understand their options, such as Medicare Advantage and Medicare Supplement Plans. Here are some of the upcoming Medicare plan seminars for Kodak retirees who are Medicare eligible: • Tuesday, Oct. 30 at 10 a.m. at the American Legion, 454 North Main St., Canandaigua; • Friday, Nov. 2 at 10 a.m. and 12 p.m. at the Burgundy Basin Inn, 1361 Marsh Road, Pittsford; • Tuesday, Nov. 6 at 2 p.m. and 4 p.m. at The Strong National Museum of Play, One Manhattan Square Drive, Rochester For other meeting and to register, visit To register for a Medicare seminar, visit brand.excellusbcbs.com/medicare/ retirees or call toll-free (888) 834-1408 (TTY/TDD users call (800) 421-1220) from 8 a.m. – 8 p.m., seven days a week.

Nov. 5

Diabetes Health Fair in Clifton Springs The Regional Diabetes Health Center at Clifton Springs Hospital will host its Seventh Annual Diabetes Health Fair on Monday, Nov. 5, at Clifton Springs Hospital. The event begins at 1 p.m. with free educational sessions in The Rotary Room titled “Holiday eating…it’s easy as pie!” The event will bring vendor booths and will include information on glucose meters, medications, insulin pumps, nutrition and more. Free door prizes will be given throughout the event. At 5:30 p.m., keynote speaker endocrinologist Shahana Arshad will present her annual diabetes update. A free light dinner will be available after 4 p.m. Call 315-462-0220 for dinner reservations. Reservations are not required for the breakout sessions or to view the exhibits. Exhibits will be open until 5:30 p.m.

Nov. 6

Hearing loss group holds seminars The Rochester chapter of Hearing Loss Association of America (HLAA) will sponsor two seminars Nov. 6. They are both to be held at St. Paul’s Church, East Avenue and Westminster Road. Page 4

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

Flu shots for veterans at Canandaigua VA Every Tuesday through Nov. 13 the Canandaigua VA Medical Center will provide flu shots to veterans. Flu shots will be available by appointment from 9 – 11 a.m. and from 1 – 3 p.m. Veterans are asked to call 585-393-7401, then select the number for their provider to schedule an appointment. The flu shot clinic is located on the fourth floor of building No. 1. For more information, contact Lori Zona, supervisory program specialist at 585-393-7269 or email Lori. Zona@va.gov. The Canandaigua VA Medical Center is located at 400 Fort Hill Ave. in Canandaigua. • At the 11 a.m. seminar participants will hear James DeCaro, professor and dean emeritus at National Technical Institute for the Deaf at Rochester Institute of Technology, to discuss ways to guide the future of HLAA. • At the 8 p.m. seminar physician Steven Barnett, medical director of Strong Connections, the University of Rochester’s telehealth sign language interpreter program — along with HLAA members Mary Chizuk and Don Bataille — will discuss a request to partner with National Center for Deaf Health Research for the next phase of the Prevention Research Center funded by the Center for Disease Control and Health Promotion. For more information visit www. hlaa-rochester-ny.org or call 585 266 7890.

Nov. 11

Rochester practice to offer free acupuncture Rochester Community Acupuncture, a local practice that makes acupuncture accessible to people of all means and backgrounds by providing affordable health treatments, is giving free 30-minute general wellness treatments to new patients. The event will take place from 9 a.m. – 2 p.m., Sunday Nov. 11, at 302 N. Goodman street, suite 403 in Village Gate. Practitioners say this is an opportunity to try acupuncture and experience the positive effects for any number of health concerns. For appointments, call 585-287-5183, or just walk in. Visit: www.rochestercommuni tyacupuncture.com.

Nov. 13

Fibromyalgia group holds meeting in Rochester The Fibromyalgia Association of Rochester New York, a nonprofit Continued on page 26

U.S. Sees a Run on New Knees Since 1990s Over $9 billion spent annually on the operation, researchers say

he number of Americans getting knee replacement operations has jumped more than 100 percent over the past two decades, keeping many more older adults active and independent, a new study finds. At about $15,000 an operation, however, the costs to Medicare and other insurers have also ballooned. But experts analyzing fees associated with the procedures say that added productivity and mobility may offset the initial outlay. Knee replacement is cost-effective, said Matthew Hepinstall, an orthopedic surgeon at Lenox Hill Hospital in New York City. “This is a surgery that can actually pay for itself in the increased productivity of the person who goes from disability to return to work,” said Hepinstall, who was not involved in the study. There are also savings in disability payments and the costs of ongoing care, he said. According to background information in the study published in the Sept. 26 issue of the Journal of the American Medical Association, roughly 600,000 knee replacements are done each year in the United States. The total cost of all these knees is $9 billion, the researchers noted. Among Medicare beneficiaries — patients 65 and older participating in the government’s health insurance program — first-time knee replacements jumped 162 percent between 1991 and 2010, the study found. Revisions (replacement of an artificial knee) increased about 106 percent in that time period. Lead researcher Peter Cram, an associate professor of medicine at the University of Iowa Carver College of Medicine in Iowa City, credits the burgeoning baby boom generation and better success rates with the procedure’s popularity. “We are doing more procedures as the population ages,” Cram said. In addition, a higher proportion of that aging population wants the surgery, he

said. With many years of practice, the operation is very safe and the rate of complications remains low, Cram added. For people with severe knee damage, a knee replacement can relieve pain and restore movement. To examine the effects of knee replacements on health costs, Cram’s team collected data on almost 3.6 million Medicare patients who had a knee replacement or a revision of an initial knee replacement in the previous 20 years. The investigators found initial knee replacements rose 76 percent and revisions increased 99 percent. While success rates were consistent over the period, the number of hospital readmissions within 30 days inched up from 4.2 percent to 5 percent in initial knee replacement patients and from about 6 percent to almost 9 percent among revision patients. That rise in readmissions is largely related to shorter initial hospital stays today, Cram said. After an initial knee replacement, patients now leave the hospital in 3.5 days vs. 7.9 days in the mid-1990s, the study found. Wound infections were one reason for readmissions, but the authors weren’t certain of the cause. Cram said knee replacements last 15 to 20 years, which means many patients may live long enough to need a second operation. However, the newer implants may last longer than the earlier models, he said. “Implants we are implanting today are different than the one we used 10 to 15 years ago,” Cram said. “Hopefully, they’re newer and better, but we don’t really know that.” Recovery from a knee replacement takes about three months and requires patients to undergo physical therapy. Results depend on the surgery itself and the patient’s willingness to work on moving the knee, said Hepinstall. The study also found that more obese and diabetic patients get new knees nowadays, and more patients are getting outpatient rehabilitation than two decades ago.

Arł The

HEARING CENTERS

of Hearing

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

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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., Deborah Graf, Suzanne Ellis, Chuck DiNatale 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.

November 2012 •

Hearing care is an art … become one of our masterpieces. www.HartHearing.com Irondequoit 585-266-4130

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Holiday Family Discussions by Jacquelyn M. Bell CPA

hen the family is together this holiday season, take the time to discuss your financial situation and your plans and wishes for the future with trusted family members. Be sure that someone knows where your important documents are – will, living will, health care proxy, power of attorney, etc. – where your safe deposit box is (and the key !), and who to contact if something should happen – your attorney, financial advisor, tax accountant, health insurance company, etc. Think about where YOU would like to live when you get older. Make sure that people around you KNOW your wishes. If you need help organizing your financial situation, consider hiring a Daily Money Manager – someone who is experienced in bills, budgets, and recordkeeping. For help with these issues, visit www.jmbellcpa.com or call me at (585) 229-4477. Page 6

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Your Doctor

By Chris Motola

Dr. Erik P. Peterson ER chief at Lakeside: “We’re already excellent, but we’d like to be even better” Q: Emergency departments seem like they’re getting busier all the time. What goes on on the administrative side? A: Yeah, we are. I work 50 percent clinical, 50 percent in an administrative role. In the clinical role I’m seeing patients, that’s the easy part. Administratively I develop policies for the department, recruitment, coordinating schedules, meeting with liaisons from different departments of the hospital. Coordinating things between different emergency medicine agencies that bring us patients. Q: What are the most common complaints you treat in Lakeside’s ED? A: Probably chest pains, shortness of breath and abdominal pain are the three most common complaints. Q: What kinds of training does an emergency medicine physician need? A: Emergency medicine is a three-year residency after medical school. There’s board certification after that. It’s a relatively new specialty. It only became its own specialty with its own specialty board in the last few decades. Before that emergency medicine was pretty luck-of-the-draw between hospitals and how they organized their emergency departments. Usually physicians would staff it on a rotating basis. Now it’s fairly standardized throughout the country. Most EDs are staffed by residency-trained, boardcertified physicians, but there aren’t enough to fully staff every one in the country. So smaller community hospitals like Lakeside have a mix of board certified in emergency medicine

and other providers. In New York state, to work in the ED, you have to be board certified in emergency medicine, family medicine, internal medicine or general surgery. Also, if you have 5,000 hours of experience in emergency medicine, you qualify to work in the emergency room without board certification. At Lakeside, we have a mix. We have five full-time doctors. I, myself, am actually boarded in family medicine. We have one ER-boarded doctor. Another family medicine-boarded doctor. We have a internal medicine boarded doctor and a doctor who has just been around forever and has a ton of experience. Q: How would you sell a career in emergency medicine to medical students? A: If they like to multitask, it’s a great specialty. You can’t just see one patient and move on. You need to be able to see multiple patients, with a wide variety of complaints at the same time in addition to talking on the phone with doctors and administrators. If you like to do a little bit of everything, it’s perfect. If

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

you like to see instant gratification, you can often see immediate results in the ED. You need to be able to work under pressure. It does have some lousy hours, but it’s shift work. When your shift is over, you go home and you’re not usually on call. So, yeah, we’re open 24/7, holidays and weekends, but you can plan your family life around it. Q: Why are emergency rooms under so much pressure these days? A: I think we might be victims of our own success. Patients can come to us and get a lot done at one time. Also, without getting too far into legal elements of it, we do practice a lot of defensive medicine. Patients will get a lot of blood work, X-ray and testing and we need to get those results right away. The same tests might take a couple weeks to get back if they’re ordered by primary care. We need to rule out the life-threatening emergencies first where primary care can look for the most likely causes. Also, primary care offices are getting busier, so patients may be seeing the emergency department as an alternative. Q: What kinds of initiatives have you brought to Lakeside’s emergency department? A: We have a new charting system we’re introducing to the ED. Right now it’s a mix of paper and electronic, but we’re moving to all electronic, which will help communication between the ED and primary care doctors. We are a New York state-designated stroke center, so we have the capability of administering prophylactics in a timely manner, if the patients come in quickly enough. That’s always a problem, the patient realizing that they’re having a stroke in time. We’ve implemented bedside registration as much as possible. We are currently looking at becoming certified as a chest pain center to try to improve our care of patients with chest pains and heart attacks. We’re already excellent, but we’d like to be even better. Q: Does your training as a D.O. influence your perspective on emergency medicine? A: It doesn’t really influence what I do all that much. If I were in primary care, it might have more of an impact. It’s hard to bring that into emergency medicine. I try to bring in family members into the room and be there when I actually see the patient. I think any good ER doctor will do that, but I might be a little more conscious of that because of my training. But there’s not really much of difference between a D.O. and an M.D. in the emergency room.

Lifelines: Name: Erik P. Peterson, D.O. Hometown: Hamburg, NY Position: Medical director of emergency medicine at Lakeside Health System Education: University of Rochester (undergrad), New York College of Osteopathic Medicine(medical) Afﬁliations: Lakeside Health System, medical director of emergency medicine; Unity Health, privileges Organizations: American College of Emergency Physicians; American Academy of Family Physicians Family: Married, three daughters Hobbies: Golf, ﬁshing, travel

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Shoppers leave Trader Joe’s in Pittsford with a full cart. This new and unique, earthfriendly and community-conscious grocery store offers affordable, all-natural foods and ﬂavors from around the world.

Welcome Trader Joe’s, Culinary Genius, Naturally The Rochester grocery store is interesting, affordable, unconventional, and just plain fun By Deborah Graf

he mob-scene you will find in the parking lot of the new Trader Joe’s in Pittsford Plaza is well worth it. I will admit I have been waiting for this store to move in long before its opening was even announced, as my years of experience in several of the Boston-area locations were more than satisfactory. In fact, Trader Joe’s fed my family of five with delicious meals each week on our slim budget. From the minute you walk into this innovative, natural food emporium complete with island-esque décor, cedar-plank walls, and giant chalkboards highlighting interesting products, you will emerge into the captivating scene. Crew members donned in Hawaiian shirts are jolly, offering a helping hand, tips or directions on where you might find what want. You will hear the hum of the crowd, the laughs of the staff, and the ship bell ring—once for additional registers, twice for customer service, and three times for a manager. No need to worry, it’s all part of the atmosphere. This is not your typical grocery store. What you will find here that no other store of its kind offers, are healthy, affordable and interesting items that you may not even know you needed. And when you find them, you’re hooked. Trader Joe’s sells food flavors from around the world, and nearly everything to stock the pantry, refrigerator and even bathroom. From bakery items, doughs, cheeses, appetizers, snacks, sauces, soups, meats, and seafood, to fresh cut flowers, pet foods, vitamins, herbal and organic remedies and toiletries, there isn’t much you won’t want to buy... or try. While shopping you may get a whiff, or better yet a taste, of what they are serving as samples. This natural-foods store makes it almost too easy to shop. Fresh or frozen, jarred or bagged, raw or prepared, packaged conveniently,

arranged neatly, and easily accessible, it’s not hard to understand what you’re buying. Rest assured that even without reading labels, you will know you are getting no artificial flavors, colors or preservatives, no genetically modified ingredients, no MSG, or any added trans fats. Trader Joe’s is perfect one-stop shopping for just about everyone. Gluten-free, vegan, vegetarian, fatfree, kosher, low-sodium, it’s all there. Check out the “handy product lists” already made up online to see product offerings to meet your personal needs. Or read the Fearless Flier, the newspaper-type booklet featuring seasonal products and interesting items. Interjected with humor and a few cartoon drawings, this flier is actually fun to read. This month some of the hot products include everything pumpkin, from ice cream and yogurt to coffee, pumpkin cream cheese and honey roasted pumpkin ravioli, and yes, pumpkin-flavored dog treats. Even if you miss something in the flyer, it’s hard to miss items in the store — it’s spacious and simple, not overdone. Many of the products are under the Trader Joe’s label, and are sourced locally as much as possible. While the stock rotates, you are never at a loss for anything, and if it’s not there, ask a crew member how you might locate it. The Pittsford location sells beer, but others outside of New York even sell wine. Charles Shaw wines, or “Twobuck Chuck” as they are famously named, still sell for $2 per bottle. I have never been let down by Trader Joe’s in any location, and the new Rochester-area store is a muchneeded, refreshing change. It’s interesting, unconventional, and just plain fun. Not to mention, affordable. But that’s the whole concept behind Trader Joe’s famous philosophy — healthy, delicious, affordable, and friendly. Welcome to the neighborhood. November 2012 •

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DR. KATRINA HALLAHAN Dr. Katrina Hallahan graduated from Syracuse University in 2006 with a B.S. In Biology. She attended medical school at the Ohio College of Podiatric Medicine and graduated in 2009 with her Doctor of Podiatric Medicine degree. Dr. Hallahan then completed a three year podiatric surgical residency at Beth Israel Deaconess Medical Center affiliated with Harvard Medical School in Boston, Massachusetts. She has recently joined the Westside Podiatry Group as an associate. Dr. Hallahan is board qualified in forefoot and rearfoot surgery by the American Board of Podiatric Surgery and is a member of the American College of Foot and Ankle Surgery and is also an active member of the American Katrina J. Hallahan, D.P.M Podiatric Medical Association. Podiatric interests of Dr. Hallahan include but are not limited to: forefoot surgery, complex reconstruction for post-traumatic and degenerative conditions of the forefoot and rearfoot, flatfoot deformities, diabetic limb salvage, foreign bodies in the foot, heel pain, and tendon and ligament reconstruction.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Are You Facing Thanksgiving Alone?

f you are facing Thanksgiving alone for the first time, you may be anticipating a lonely and depressing fourth Thursday of November. But it doesn’t have to be so. Whether you’re divorced, widowed or just can’t make it home for Thanksgiving, this family-centered holiday can be an opportunity for personal growth and expression. Below are some tips and creative ways to manage and embrace what can be a challenging day in the life of those alone this time of year: Be thankful. And why not start with yourself? Consider making a list of all the things you are thankful for this year: Your health? Your children? Those good friends who have stood by you through thick and thin? A career or volunteer job you love? A beloved pet. Or perhaps even this opportunity in your life to learn and grow? Take the long view. While you may be alone this year, it doesn’t mean you’ll be dining solo on leftover stuffing the rest of your life. This one day doesn’t dictate your destiny. Who knows what the future holds? Over the next year, you may meet someone special or achieve a measure of inner peace and confidence that enables you to really enjoy a holiday on your own. Do good. Helping others this time of year can take your mind off being alone and give you something worthwhile to do. Shelters and food kitchens often

welcome volunteers, but — truth is — many of these agencies fill up fast with regular volunteers. You may need to plan ahead and be creative. As an alternative, many local YMCAs host “Turkey Trots” and need volunteers to register and cheer on runners of all ages. Instead of serving stuffing at the shelter, you could be serving up smiles at the finish line! Throw your own little holiday dinner for fellow strays and disconnected persons. Have some fun! It doesn’t have to be elaborate or even planned far in advance. Sometimes last-minute dinner invitations can turn into the best, most memorable get-togethers. Chances are you know others who may be alone this Thanksgiving. Extend a warm invitation and ask people to bring a holiday side to pass. This gives everyone a chance to make a meaningful (and delicious!) contribution. Beware of “euphoric recall.” When you’re feeling lonely, it’s easy to glorify the past. Did last year’s Thanksgiving live up to the Norman Rockwell ideal? Or did all the

Gregory G. Carnevale, M.D., L.L.C. www.drcarnevaleent.com

bickering, bad blood, and woozy, overstuffed relatives make you want to run for the hills? Maybe, just maybe, being with your own good company is a blessing. Rent a movie and indulge in a tasty guilty pleasure. Oh, why not? Rent a favorite “feel good” film and make a night of it. You might check out “Tootsie” or “On Golden Pond,” two of my favorite oldies, which never fail to warm my heart. Or find a new movie you haven’t seen and enjoy the novelty of seeing something for the first time. Top it off with a favorite treat. I love pumpkin pie ice cream this time of year! Pick up the phone. I’ve adapted one of Abe Lincoln’s famous lines for my own purposes: Most folks are as lonely as they make up their minds to be. The difference between isolation and engagement can be as simple as dialing a seven-digit phone number. My experience happily tells me that most folks welcome a call on Thanksgiving. An invitation to go for a walk or see a matinee while the turkey is in the oven is often seen as a nice diversion and chance to get out of the house. Others just love opening

their homes, inviting friends in, and expanding the celebration. It can be a beautiful thing for everyone. Nurture yourself. On your own, Thanksgiving can be a great day to do whatever you enjoy doing. Treat yourself to well-deserved time to yourself to read, luxuriate in a warm bath, nap or take a nice walk to enjoy nature. Pamper yourself for at least 30 minutes and take a mini-vacation from your worries, doubts and fears. Write thank-you notes. Now here’s an idea that’s so obvious it often gets overlooked on Thanksgiving. “Build bridges the rest of the year, and cross them during the holidays,” said Craig Ellison, author of “Saying Goodbye to Loneliness and Finding Intimacy.” If you can’t be with friends or family this holiday, pick up a pen and thank them for their support and friendship. Who wouldn’t love to receive a card on the day after Thanksgiving that begins, “I’m sitting here on Thanksgiving morning thinking of you. On this day of thanks, I can’t help but be thankful for our (fill in the blank).” In preparation for this king gesture, purchase cards and stamps in advance. So there you have it: Survival tips for a single-serving Turkey Day. The good news? It will be Friday before you know it and you can be thankful you got out of bed, rose to the occasion, and enjoyed your Thanksgiving. Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops or to invite Gwenn to speak to your group, call 585-624-7887 or email: gvoelckers@rochester.rr.com.

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

For kids, battling epilepsy not an easy task

her condition. The side effects caused hair loss, weight gain and personality changes. “The medicine took a normal, young healthy girl and turned her into something we had never seen,” said Emerson. “She couldn’t do the normal activities she was able to do before and she was in a kind of drunken stupor throughout the day. She would sometimes want to go off with strangers and had an affinity for jumping off high surfaces. She just wouldn’t restrain any of her actions.” The family went to Johns Hopkins Medicine in Maryland and hospitals in Boston looking for a remedy. Most days they were afraid to leave their house because they didn’t know how Julia would react in the outside world. With their situation turning dire,

they turned to a previously unheard eating regimen the Emersions believed saved their young daughter’s life. The ketogenic diet, which doctors usually prescribe for two years, consists of 80 percent fat from foods such as ground nuts, eggs, butter, creams, olive oil, pork and specific vegetables. The remaining 20 percent comes from carbohydrates and some protein. The diet forces a child’s body to burn fat around the clock by keeping carbohydrate low and making fat products the primary food. For decades, doctors have known reducing the number of carbohydrates a child eats decreases seizures. Researchers at Johns Hopkins University studied 150 children with epilepsy. After a year on the ketogenic diet, half the children had 50 percent fewer seizures. One fourth of the children reduced their seizures by 90 percent. After a few years on the diet, many of these children no longer needed medications at all. If a child progresses, a time may come when they no longer need to take their antiseizure medicine. Then it’s time for the child to slowly start a normal diet. Emerson said the diet’s benefits were numerous and immediate. Julia became more alert, energetic, could concentrate at school, and all with less seizures. “She’s 95 percent better than she has ever been since she began having

seizures,” said Emerson, who spends 25 hours a week making specific food for Julia. “She is almost off her medicine.” As with anything there are possible side effects, many times for adults. The ketogenic diet has produced symptoms like dehydration, constipation and, sometimes, complications from kidney stones or gall stones. Adult women on the diet may have menstrual irregularities and decreased bone density. And because the diet lacks essential vitamins many times supplements are needed. Similar to the Emersons’ story, Jessica Majors’ son, Jaden Wright, wasn’t born with epilepsy. Then he developed a sickness at 6 months and soon became diagnosed. At 6 years of age, he still struggles with the condition, averaging seizures two to three times a week. There are times when he will go months without them, but they always return no matter what medicine or diet he tries. He either loses significant weight or the medication makes him sicker. Every year, they hope something changes between his monthly doctor’s appointment and his twice-a-year brain scans. “I’m a single mother and it’s been hard seeing Jaden battle every day,” said Majors, of Rochester. “At least he has gotten to the point now where he can feel a seizure coming and that way he gives me warning so I can take care of him.” She’s had to learn tips along the way like not rubbing Jaden’s head during a seizure because instead of calming him down it exacerbates the condition. Majors had to leave several jobs because of the time it takes to care for her bright, energetic boy with glasses. Because Jaden’s seizures can happen anytime, her house is extra-childproof with open space. “There have been times when he has fallen off the couch, a chair or down the middle of stairs,” said Majors, who placed her son in first grade at School No. 1 on Hillside Avenue because they have full time nurses. There is still work to be done. The mortality rate among people with epilepsy is two to three times higher— and the risk of sudden death is 24 times greater—than that of the general population. This year an estimated 25,000 to 50,000 will die of seizures, according to the Epilepsy Foundation. “This is a chronic life-altering condition where you don’t know from one day to the next what is going to happen,” said Emerson. “It’s a struggle, but we are so happy that almost two years later our daughter is on her way to recovery.”

Epilepsy Foundation of RochesterSyracuse-Binghamton has helped the community for 36 years. It began with a group of parents forming a bond and setting up an epilepsy support group in 1976 to educate others, find a cure and overcome challenges created by the condition. One year later, that group was incorporated as the organization that today serves about 8,000 people each year. “Our programs and services are critical complements to medical treatment that improve quality of life by connecting individuals to the services they need,” said Korba, communication director for the Epilepsy Foundation. The organization provides epilepsy education, seizure first aid training, support groups and

counseling, employment services, service coordination and other Medicaid waiver services, traumatic brain injury services and residential services. It serves 22 counties in New York state, including Monroe, Wayne, Ontario, Wyoming, Livingston and Yates. Korba said removing the stigma associated with the condition is at the forefront of their minds, along with providing fast response and highquality services so people can reach their potential. “Seizures can be frightening and confusing, especially to someone who has never seen a seizure before,” said Korba “We want people to know that epilepsy and seizures are something to take seriously, but not something

to be frightened of. When someone is having a seizure, don’t try to restrain them, but do try to guide the person to a safe place or remove potential hazards from the environment.” The organization offers several family service programs, including counseling for the emotional upheaval frequently accompanied with an epilepsy diagnosis. Because of traumatic brain injury, the foundation has a new initiative to educate service men and women returning from Operation Enduring Freedom and Operation Iraqi Freedom. Between 48,000 and 169,000 soldiers serving in Iraq and Afghanistan are expected to develop post-traumatic epilepsy. For more information, visit www. epilepsyuny.org.

By Ernst Lamothe Jr.

ife can change in an instant. A few years ago, Chili residents Tim and Christine Emerson were playing with their 4-year-old daughter, Julia, which was a normal occurrence. What happened next wasn’t. All of a sudden their energetic, full of vigor child began shaking uncontrollably for 20 minutes, due to a high fever from a virus. “We were just so scared and we rushed her into the emergency room. We didn’t know what to think until the doctor diagnosed her,” said Christine Emerson, who is also a pediatric nurse practitioner at RushHenrietta Central School District. “It felt like a wrecking ball was going through our lives because until that day, she was otherwise a healthy person. We were told your daughter has bad seizures, and if medicine doesn’t work you are in big trouble.” Epilepsy is a medical condition that produces seizures affecting mental and physical functions. When seizure attacks happen more than once, the person is diagnosed with epilepsy. The fourth most common neurological disorder in the U.S. after migraine, stroke and Alzheimer’s disease, more than 2.2 million Americans are affected by epilepsy, according to the Centers for Disease Control and Prevention. Its prevalence is greater than autism, cerebral palsy, multiple sclerosis and Parkinson’s disease combined, effecting 65 million people worldwide. The number of elderly epilepsy cases are climbing as the baby boom generation reaches retirement age with 570,000 adults aged 65 years or older have the condition. But even though it remains common among suffers and medical officials, most people don’t understand the chronic medical condition, even though one in three adults know someone with the disorder. “If you have a premature infant or a kid who has cancer, you get all kinds of outpouring because people can visibly see that the child needs help,” said Emerson. “But when your child has epilepsy, they look normal until the seizures come. And when the seizures come and people see it, it can be hard to watch and sometimes it turns away people. It can be a very lonely journey.” In their case, the road to recovery was a winding road. At first the medicine doctors gave Julia worsened

Epilepsy: One of the most under-supported medical condition

arah Korba is surrounded by staggering numbers. One in 26 Americans will develop a form of epilepsy in his or her lifetime, while epilepsy still remains one of the most under-supported medical conditions in the nation. About 300,000 U.S. children under the age of 14 have epilepsy. One-third of the more than two million Americans living with epilepsy have no seizure control. Some will only be affected for a short amount of time. Others will have to live through it for a lifetime. Looking to serve both groups, the

The parents of Julia Emerson found out she had epilepsy when she was 4 years old. After years of different treatments and medicines Julia now is able to live a normal life thanks in part to a special diet.

“This is a chronic lifealtering condition where you don’t know from one day to the next what is going to happen,” says a mother of an epileptic child

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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My Turn

By Eva Briggs

Got Genital Herpes? No Need to Hit the Panic Button Medicines don’t cure the disease, but control the symptoms.

ometimes patients burst into tears about their medical problems. Often it’s because their diagnosis is life threatening or life altering, even if only temporarily. (Think the triathlete with a broken ankle.) Other times people cry because although the disease is common and controllable, our society stigmatizes the problem. An example is genital herpes. Studies using blood tests to search for antibodies to the causative virus estimate that in the U.S., about 16 percent of people carry HSV-2 (herpes simplex virus type 2). Because herpes virus infection doesn’t always cause an obvious breakout, as many as 88 percent of people who test positive aren’t aware that they are infected. The herpes virus comes in two closely-related strains, or serotypes. The first, herpes virus type 1 (HSV1), usually causes cold sores on the lips and face. HSV-2 typically affects the genital area. But there is a lot of overlap, and either serotype can cause disease in either area. Transmission of genital herpes occurs by direct skin contact. Herpes lesions are the most likely to spread the disease. However sometimes herpes lesions are mild and are

mistaken by patients for something else: insect bites, razor burn, and other skin irritations. Sometimes normal-appearing skin sheds the virus. Lesions often occur in areas not covered by condoms. Condom use still reduces transmission of herpes but it doesn’t completely prevent infection. Three typical patterns of genital herpes occur. Primary infections happen when someone who has never had herpes develops a first episode. Primary infections are the most severe, and the most likely to bring a patient to the doctor. Painful blisters and sores in the genital area may be accompanied by fever, swollen glands, and malaise. Urine may burn as it passes over blisters, fooling people into believing they have a infection. Non-primary infection is first episode of genital herpes in person with a prior herpes infection affecting a different area, such as genital herpes in someone who has had lip cold sores. It’s usually less severe than a primary infection, but may still cause systemic symptoms like fever, and swollen glands. Recurrent herpes occurs because once acquired, herpes virus remains dormant in the body, and can reactivate

intermittently. Recurrent episodes are usually milder, with fewer lesions, and few systemic symptoms. The incubation period — the time between exposure to the virus and infection — is short, usually two to 12 days. But here’s the rub: the initial infection doesn’t always produce symptoms, or symptoms severe enough to be recognized. In fact, the first recognized outbreak of herpes might occur several years after someone acquires the virus. So a patient with more than one sexual partner can’t always figure out the source. That seems to be where people run into psychological trouble. Unfortunately people feel an unwarranted shame and/or anger, and a need to blame someone. But remember, herpes is a virus, and like the cold virus, it is an equal opportunity infection: it doesn’t care whether you are young or old, dirty or clean. Blame and anger won’t undo the disease, but will compound suffering and distress. The good news: there are antiviral medicines to treat herpes. These medicines don’t cure the disease, but control the symptoms. Zovirax (acyclovir) and Valtrex (Valcyclovir) started as soon as

the infection is recognized shorten its duration and severity. Some people get a prodrome of tingling or pain before the rash appears, and can start the medicine then. Many people with herpes get recurrent episodes. At first the episodes may be frequent, several times per year. Overt ime they often become less frequent and less severe. Patients with frequent or severe recurrences can take antiviral medicines regularly to prevent outbreaks. A very small percentage of patients with herpes develop serious illness, such as meningitis. Patients who are immunosuppressed, such as those with HIV infection, can also become very ill. And newborn infants infected during the birth process can become very sick with herpes. So it’s important for a pregnant woman who has had herpes to discuss this with her obstetrician. But for most people, there’s no need to hit the panic button. The diagnosis does not mean that you or your partner are bad people. And there are medicines that help.

Eva Briggs is a medical doctor who works at various urgent care centers in the Syracuse area.

Uptick in Cinematic Smoking More onscreen tobacco use in movies aimed at young viewers — “The Help,” “Midnight in Paris,” and “Hugo” some of the movies that showed the most smoking

From “Midnight in Paris”

op box office films last year showed more onscreen smoking than the prior year, reversing five years of steady progress in reducing tobacco imagery in movies, according to a new University of California at San Francisco (UCSF) study. Moreover, many of the topgrossing films of 2011 with significant amounts of smoking targeted a young Page 10

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audience, among them the PG-rated cartoon Rango and X-Men: First Class.” The more smoking young people see in movies, the more likely they are to start smoking, the U.S. Surgeon General has reported. “Hollywood has still not fixed this problem,” said lead author Stanton A. Glantz, a professor of medicine at UCSF and director of the Center for Tobacco Control Research and Education. “The result of the increase in onscreen smoking in youth-rated films will be more kids starting to smoke and developing tobacco-induced

disease.” Altogether, the 134 top-grossing films of 2011 depicted nearly 1,900 tobacco “incidents,” the analysis found. An incident is defined as one use or implied use (such as a lit cigarette) of a tobacco product by an actor. Total tobacco incidents per movie rose seven percent from 2010 to 2011. Among movies rated G, PG or PG-13,

smoking incidents per movie soared by 36 percent. The data was obtained by counting tobacco incidents in movies whose box office sales ranked in the top 10 for at least a week. Some of the films that showed the most smoking were “period” movies, such as “The Help,” “Midnight in Paris,” and “Hugo,” which depicted an era when smoking was more common than it is today. But others were fantasy films, including “Cowboys & Aliens,” “Green Hornet” and “The Twilight Saga: Breaking Dawn — Part 1,” which were aimed squarely at the youth market, noted Glantz. “Movies continue to deliver billions of smoking images to adolescents,” the authors reported. In stark contrast to prior years, the three major film companies that have adopted policies designed to discourage smoking in their movies depicted just as many tobacco incidents per youth-rated movie as companies that lack tobacco use policies. Those three studios with tobacco reduction policies are: Time Warner (established policy in 2005), Comcast (2007) and Disney (2004). The three

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

companies with no such policies: Viacom, News Corp. and Sony. The study authors, noting that about two-thirds of subsidies for top-grossing movies are earmarked for productions with smoking, recommended that health departments work with policy makers to correlate movie subsidies with public health interests in reducing smoking. “These results underscore a need for an industry-wide policy to keep smoking out of films marketed to youth,” Glantz said. “An R rating for movies with smoking would give film producers an incentive to keep smoking out of movies aimed at young viewers. The exception would be when the movie clearly reflects the dangers and consequences of tobacco use, or represents the smoking of a real historical figure.” Tobacco, the leading cause of preventable and premature death, kills an estimated 443,000 Americans annually, according to the United States Department of Health and Human Services. Every day in the U.S., an estimated 3,800 young people smoke a cigarette for the first time, the agency reported earlier this year.

Strong Has Best Website Among Area’s Hospitals By Suzanne M. Ellis

e received a press release this summer from the folks at Rochester General Hospital about the launch of their newly redesigned website. In the release, Wendy Maxwell, webmaster for the Rochester General Health System, said, “We had one goal in mind as we began the redesign process, to make absolutely certain the user experience would be uncomplicated and helpful.” We decided to test that claim and also launch something of our own: an informal, unscientific survey whereby we would compare the websites of Rochester General and five randomly selected Rochester/Finger Lakes-area hospitals. Our primary objective was to determine how user-friendly the websites are and whether some relatively simple information was easy to obtain. We considered lots of criteria and narrowed it down to two checkpoints: 1. Is the hospital’s website easily accessible and user-friendly, especially for someone who isn’t familiar with the area and isn’t terribly computer savvy? 2. Is the information we’re seeking easy to obtain or is it akin to running on a hamster wheel, working hard but getting nowhere fast? For the purpose of this article, we did a Google search for each of the hospitals — in some cases using only a portion of its name or deliberately misspelling its name — and once we got to the hospital’s home page, we attempted to quickly determine what the visiting hours were for patients in the intensive care and maternity units. Using that criteria as the basis for our “investigation,” we took a look at the websites for these six hospitals in our coverage area: Clifton Springs Hospital & Clinic, Geneva General Hospital, Lakeside Hospital, Rochester General Hospital, Strong Memorial Hospital/University of Rochester Medical Center and Thompson Hospital.

Clifton Springs Hospital & Clinic

Recognizing that the spelling skills of some people might occasionally be lacking, we searched for “Clifftan Springs Hospital.” We were immediately asked if we meant “Clifton Springs Hospital” and even if someone didn’t know how to respond, it didn’t matter because the hospital’s primary link was directly below that query. The home page links were varied and plentiful, but there was no obvious route to anything that would help us find visiting hours. We tried “Forms & FAQ,” and that got us nowhere. Back on the home page, we took another look at the 20-plus links. Thinking “Services & Locations” might help us, we discovered that it wasn’t a clickable link. Underneath that nonclickable heading, we linked to both “Emergency Care” and “Gynecology and Obstetrics” but neither provided us with visiting-hour information. With no search box (except one for “doctor and specialty”) the only option left was

to call the hospital. We finally spotted their phone number, at the very bottom of the page, in small letters. Our search rating: C-

Geneva General Hospital

The top result in a search for “Geneva Hospital” was a website for Finger Lakes Health. We spent five minutes or so searching that site, eventually learning that the hospital is part of the Finger Lakes Health system. That bit of information, helpful as it might have been to others, didn’t help us find what we were looking for. We returned to the Google search results and clicked on the next link: Geneva General Hospital. Much to our surprise, we were taken back to the Finger Lakes Health website, but this time to a page focusing on the hospital. That fact wasn’t clear, however, when the page appeared on our screen. We had to read the narrative, about two thirds of the way down the page, to find that out. (Remember, we are playing the role of someone who knows nothing about these hospitals and simply wants to visit a patient, so by now we’re getting pretty frustrated.) There, we saw only one link that looked promising: “Patient & Visitor Guide.” We clicked on that and a ponderous PDF file opened. We scrolled down, visually scanning as we went, until we found an index. The section “For Visitors,” it said, started on Page 9. More scrolling, and we finally found what we were looking for. Our search rating: C+

Lakeside Memorial Hospital

We searched for “Lakeside Hospital,” and the first link took us to the home page for Lakeside Health System. There was a reference to a community hospital and a Brockport address at the very bottom of the screen, so we figured we must be in the right place. There was also a prominent link for “Patients/Visitors” and we were optimistic we’d have our information on hospital visiting hours in no time. That link, however, had only two items in its dropdown menu: “Registration” and “Directions & Building Map.” The only helpful information in either of those was a phone number for the hospital so we continued our search. Back to the home page again, where we first clicked on “Emergency,” thinking there might be visiting hours listed there. Nothing about visiting hours and no helpful links, but there was a phone number for that department. Back to the home page, where we clicked on “OB/ GYN.” Nothing about visiting hours and no helpful links, but there was a phone number for that department. More clicking on “Clinical Services,” “News/Events” (we were getting desperate) and various other links we found on those pages, and still nothing. The only option left was to pick up the phone and contact those departments directly. Our search rating: C-

We rated websites of six hospitals in the Rochester – Finger Lakes area

Rochester General Hospital

This is the website that started it all, promoted in that press release we mentioned earlier with adjectives like “robust,” “interactive” and “easyto-use.” We began with a search for “rochester general ny hospital” and the top result was a link to the Rochester General Health System. (what’s with all the “health systems” around here?) Unless you happen to time it just right as the photos are rotating, the only place you see the word “hospital” are “Newark-Wayne Community Hospital” and “Rochester General Hospital Foundation,” both at the very bottom. We decided to stay on this page because other top Google results didn’t look too promising. We clicked on “Locations” and it was there we were able to confirm we were in the right place because there was a link to Rochester General Hospital. That led us to a link for “Patients and Visitors” which led us to a link for “Family & Visitors Information and Services.” That fourth link took us to a link for “Visiting Hours” which we clicked and finally found the information we needed. The good news regarding this website is that we went back to the home page and typed “visiting hours” in the search box and were taken immediately to where we needed to go. For the purpose of this article, our only real gripe is that there’s no direct link to the hospital — or even an obvious mention of it — on the home page. Our search rating: A-

Strong Memorial / University of Rochester Medical Center

We started the search for the website of our region’s largest hospital with the words, “Strong Hospital” and provided no additional geographical information. Even so, Googles’ top result was exactly the facility we were looking for. The hospital’s home page was crisp, clean and uncluttered. For that reason, we immediately saw the link for “Visiting Information” which took us to a second page where we found basic information for visitors. Another obvious link — for “Hours and Policies” — and we were taken to a third page where we found everything we needed to know about visiting patients in the intensive care and maternity units. No confusion, no useless links, no frustration. The third page had links to pretty much everything a visitor might need to

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know, including dining and food options, gift shop hours and inventory, banking and mail, the Barnes & Noble bookstore on the ground floor and rules for family waiting rooms. From our initial search for Strong Hospital to the moment we had the exact information we needed took less than 30 seconds. Our search rating: A+

Thompson Health

Our next search — for “Thompson Hospital” — delivered yet another link to a “health system.” The difference here, though, is that “Thompson Hospital” was clearly visible in that search result so we didn’t have to wonder if the hospital was part of that system. We were pleased to see a search bar prominently displayed on the home page so we typed in “visiting hours.” That resulted in a message, “Your search for visiting hours did not generate any results. Try another search.” So we did as we were told, this time typing “hospital visiting hours” in the box. We received the same message a second time. We then clicked on the “Visitors” tab and from there, the “General Info and Hours” tab in the dropdown menu. We found general information about visiting hours in the maternity/birthing unit, including the suggestion to “call the unit” beforehand just to be certain we’d be allowed to visit. But no telephone number was provided there or in the link to the Birthing Center. We tried a number of other links and dropdown menus but were unable to find anything about visiting hours in the emergency/critical care unit of the hospital. Our search rating: C+ Keeping in mind the simple goal of this informal, unscientific survey, the only hospital that knocked our socks off — the one that provided us with all the information we needed in less than 30 seconds — was Strong Memorial. In closing, we might offer a suggestion to the webmasters who are responsible for site content: In the future, you may want to focus a little less on fancy marketing and a little more on the average consumer looking for basic information in a timely fashion.

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Nurse Practitioners on Rise in NYS Rochester General NP talks about rising influence of healthcare pros By Lou Sorendo Call it a woman’s intuition. Or in this case, a nurse practitioner’s intuition. For Rochester native Vincenzina Sciortino, working on the front lines of healthcare has helped prepare her to be an NP. Her years of experience in the surgical ICU and trauma ICU on the West Coast has proven invaluable, she said, as well as her time spent in the cardiac ICU at Rochester General Hospital. “I think probably my greatest skill is intuition and going with my gut feeling that something is really wrong,” she said. “I like to see my job as a puzzle and I really enjoy trying to link the dots and try to see what’s going on. “I have a really good gut that something is going on and this is the direction it’s taking.” Her intuitiveness has saved lives. Several years ago, a young man went to the RGH emergency room with abdominal pain. He had a chronic condition and the staff was attributing his pain to that. Sciortino received a call from the patient’s father requesting that she “eyeball” him as he was being discharged. “Not to slam the ER physician, but it looked like a duck, walked like a duck and talked like a duck,” she said. “They were going with that diagnosis.” “In talking with the young man, the presentation of his illness was different,” she said. “It goes back to intuition. I just had a gut feeling that something different was wrong with this young man,” she said. “I listened to the patient who told me something different than what I had experienced before even though the symptoms were the exact same symptoms,” she said. Thankfully for the young man and family, he wasn’t discharged and it was determined he has sub-acute appendicitis. He was then wheeled to the ER where he had his appendix removed. “They were sending this kid home and he was really quite sick,” she said. It is this level of expertise which is helping to make NPs a well-known commodity on all levels of healthcare throughout New York state.

Trending upward

The Rochester / Genesee Valley area is well equipped with its arsenal of NPs. As of mid-August, Monroe County featured 1,032 NPs, followed by Ontario (143), Wayne (70) and Genesee (64) counties. According to Tom Nicotera, director of membership and public affairs for the New York State Nurse Practitioners Association, these numbers have been increasing and are expected to escalate. Just taking a look at the number of licenses issued by the New York State Education Department shows the upward trend of NPs on the statewide healthcare scene. • 2007—831 • 2008—946 • 2009—917 • 2010—1,102 • 2011—1,163 “There has been a fairly consistent Page 12

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increase,” and projections call for more of the same, Nicotera said. “We haven’t seen anything that will indicate it will do anything else.” Nicotera said employment opportunities for NPs are continuing to grow. “It is a progression for registered nurses wanting to do more,” he noted. He said those factors combined with the impending Patient Protection and Affordable Care Act will result in more increases of NPs. “There will be a lot more people coming into the system. The need is going to grow in general for healthcare providers,” he added. “Nurses as a group are a helping profession,” Nicotera said. “Nurses have the desire to help patients and work with them. They come from a different frame of reference when it comes to patients.” Use of the title NP in New York requires a certificate issued by the New York State Education Department. To receive a certificate to practice as an NP in New York state, one must have a registered New York state license as a registered professional nurse and meet education requirements.

Holistic approach

Sciortino said the prevalence of NPs has been sparked by a physician shortage. “Patients have spoken and said they enjoy the nurse practitioner experience. We are able to spend more time with patients,” she said. “Most NPs are taught that a patient is not just a patient. The whole family is your patient. We deal a lot with family issues that affect the patient’s problem. I have learned over the years that if you don’t get the family to buy in, your outcome is not going to be the same,” she added. “I met some amazing families that have gone through horrendous situations and they have shown incredible grace through the whole process,” she said. Sciortino said another valuable skill set for an NP is critical care thinking. “You need to be able to identify a problem and figure out either how did I get to that problem or how do I get out of that problem,” she said. When a patient presents with a diagnosis, the NP must know how to manage it; when the patient presents with symptoms, the NP must be able to come up with the diagnosis, Sciortino said. Sciortino is also a clinical adjunct faculty member at SUNY Brockport’s RN program. She is a clinical instructor for critical care. “I really enjoy giving back and just pushing students to think outside the box,” she said. “Not all patients come with recipe cards.” “I really enjoy teaching. It’s my way of giving back to the profession,” she said.

Award-winning approach

Several years ago, Sciortino won the prestigious Patricia M. Lewis award. RGH medical and dental staff created this award of clinical excellence to be presented to an adjunct staff member annually.

“Patients are living longer and they are sicker. If we can prevent problems before they start, that is great,” she said. Sciortino said NPs are trying to break the cycle of patients using emergency rooms as private doctors. “I think NPs fill the void. We don’t have enough physicians, especially in primary care,” she said. “NPs can pick up that role and they do so very well.” Less than 5 percent of all graduating MDs are planning a future in family practice. Meanwhile, educational programs are graduating NPs at a rate of 3-to-1 to MDs. “Nurse practitioners in the private sector—in clinics and offices—can really impact society in terms of preventing complications with [diseases] such as diabetes or putting young people on asthma protocols. We are trying to keep patients out of the hospital,” she said. Prior to the explosion of NPs, they were mostly found in primary care clinics, internists’ offices, and in the area of pediatrics and obstetrics/gynecology. Now, there is substantial groups of NPs working in the acute care setting, whether it be managing entire units, working in emergency rooms, urgent care centers, operating rooms, or attending to cardiothoracic, general and plastic surgery. “NPs are in every discipline at Rochester General and are also utilized as surgical hospitalists, meaning you are the person on for surgery for

Vincenzina Sciortino, a nurse practitioner with Rochester General Hospital. the whole hospital. I think they have evolved and moved into the acute care setting,” she said. When comparing wages of NPs versus MDs, one will note that an NP is likely to receive slightly more than one-third of an MD’s wage. An NP in family practice earns approximately $85,000 a year. State law requires an NP to have a collaborating physician. This collaborating MD is responsible to review records of the NP every three months. MDs charge NPs in private practice for this required stipulation of their license.

Nurse Practitioners Play Key Role in the Care of Patients By Heather Cook-Smith

hroughout the month of November, nurse practitioners (NPs) from across New York state and in Rochester will celebrate their contributions to the healthcare industry and the role they will play in the new age of health reform. National Nurse Practitioner Week is November 11 – 17. In New York, there are more than 15,000 licensed nurse practitioners. Nurse practitioners are advanced practice nurses who function as mainstream healthcare providers in various primary care and specialty roles. The combination of nursing experience and advanced study makes NPs uniquely qualified to provide high quality, nurturing, and individualized care. NPs diagnose and treat illness, monitor and manage chronic conditions, order and interpret diagnostic tests, and prescribe medications. In New York state, NPs typically work in practices or settings similar to physicians and are committed to providing quality care as valuable members of a collegial healthcare community.

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

NPs must maintain their certification on an ongoing basis. NPs are required to be registered nurses (RNs). They must have a master’s degree before sitting for the national certification exam. Presently, there are over 148,000 nurse practitioners nationwide certified in various specialty areas, including acute care, adult health, family health, gerontology, holistic nursing, neonatology, obstetrics/ gynecology, oncology, palliative care, pediatrics, perinatology, psychiatry, and school health. Use this occasion to celebrate the vital role that NPs play in bringing high quality, costeffective, comprehensive, patientcentered healthcare to all populations of the United States. Heather Cook-Smith, on behalf of the Nurse Practitioner Association of Greater Rochester. CookSmith is a mid-level provider manager at Unity Geriatric Associates.

Healthful Thanksgiving Emphasizing more vegetable side dishes can help increase the nutritional value of Thanksgiving dinner By Deborah Jeanne Sergeant

hanksgiving dinner doesn’t have to be a dietary disaster. Amid the sugar- and fat-laden fare, a traditional Thanksgiving dinner does offer some really nutritious foods. So have a small sample of the less-thannutritious dishes and enjoy a serving of the wholesome bounty Thanksgiving offers. Bridget Bigelow, registered dietitian with Rochester General Hospital, said that turkey is pretty good for us. “It is a good choice because it’s high in B vitamins and protein,” she said. She also likes the orange vegetables traditionally served such as squash, sweet potatoes and pumpkin. “They’re high in fiber, vitamin C, and carotenoids,” Bigelow said. “These occur in the yellow and orange pigments and they may prevent cancers.” Go easy on the sugar-topped sweet Sexton potato casserole, buttertopped squash and pumpkin pie, or try alternatives that lower the sugar and fat. For example, roasting sweet potatoes and topping with a drizzle of maple syrup and a sprinkle of chopped nuts makes the dish special but more healthful than one swimming in brown sugar, butter and marshmallows. Cranberries are also nutritional superstars packed with antioxidants, but again, “instead of cranberry jelly that’s full of sugar, make some with oranges in it to make it more a traditional sauce,” Bigelow said. The starches of the Thanksgiving meal — potatoes and stuffing — seem to take a beating when it comes to

their nutritional information; however, instead of white bread stuffing and peeled potatoes, stick with whole wheat bread and don’t peel the spuds (bonus: you’ll save time and add flavor). “There’s selenium, iron and copper and B vitamins,” Bigelow said. “Even white potatoes, which have a bad reputation, have lots of potassium.” Emphasizing more vegetable side dishes can also help increase the nutritional value of Thanksgiving dinner. While green bean casserole in a rich sauce and topped with fried onions isn’t a nutritional powerhouse, a few bites are fine. But adding more healthful vegetable dishes can help. Joy Valvano, registered dietitian with Unity Diabetes Center, recommends “eating a rainbow: get red, orange, green vegetables in there.” Beyond the orange vegetables, serving a green tossed salad can add vitamin C, fiber, ion and folate. Add a tomato to the mixed greens for more vitamin C and lypocene, “a great antioxidant which cuts cancer risk,” Valvano said. “All the colors do something different.” Use greens such as kale, endive, and Romaine, which contain more nutrients than iceberg lettuce. How you prepare the vegetable makes a difference, too. “Definitely try to do the whole forms of vegetables,” Valvano said. “For mashed potatoes, scrub them well and mash with the skins, for example. Roast the squash. By doing less processed versions and using fresh or frozen, which are generally picked and

immediately blanched and frozen, they maintain a lot of vitamin content.” How you serve the meal can help with portion control and help you focus on vegetables, too. Serving a vegetable-based soup or pumpkin soup first not only helps control your appetite, but it can also increase your vegetable intake. “Making Thanksgiving healthful is easy when you focus on increasing the veggies,” said Caitlin Sexton, registered dietitian and clinical nutrition manager with Clifton Springs Hospital. “The USDA recommends making half of your plate fruits and vegetables, and Thanksgiving doesn’t have to be an exception.”

Burning the Extra calories

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gobble better. fewer calories. smaller portions. healthier you. Clifton Springs Hospital & Clinic offers outpatient nutritional counseling, diabetes education, and $5 weight-loss classes. Call 315.462.0257 or 315.462.0220 for more information. Go to CliftonSpringsHospital.org for some healthy Thanksgiving recipes.

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SmartBites

By Anne Palumbo

The skinny on healthy eating

Enlightening News About Onions

or years, I avoided onions. They made me cry; they gave me bad breath; they upset my stomach. But, these days, onions are a pantry staple, thanks to a few lifestyle changes. In a nutshell: I chill onions right before cutting to reduce tears; I eat parsley afterwards to curb bad breath; and I only eat cooked onions. I reach for this vegetable on a regular basis because, like other sulfurrich alliums (garlic, leeks, shallots), onions are loaded with health benefits. To begin, onions show big promise in fighting cancer. Although scientists are still learning how onions may thwart this disease, researchers at Cornell University have found that members of the onion family with the strongest flavor — particularly New York Bold and Western Yellow — are the best varieties for inhibiting the

½ teaspoon red pepper flakes (optional) 1/3 box whole-grain spaghetti 14.5-ounce can petite-diced tomatoes 1 cup 2 percent milk Salt and pepper to taste Shredded Parmesan cheese

combines with vitamin C and other compounds to inhibit enzymes that generate inflammation. Plagued by gastritis or stomach ulcers? You might want to stock up on onions. Because onions may inhibit the growth of H. pylori, an ulcer-forming microorganism, some medical centers recommend that people with gastritis add onions to their diet. Like many vegetables, onions are low in calories (about 60 per cup), have no fat or cholesterol, and have next to no sodium. What’s more, they’re a decent source of both fiber and vitamin C, and even provide a little protein.

Slice off the ends of the onions. Cut each onion in half lengthwise and remove the peel. Slice each half lengthwise into strips. Bring a large pot of water to boil. While the water heats, warm the olive oil in a large skillet. Add the onions, fennel seeds, and hot pepper flakes (if using) and sauté over medium heat, stirring occasionally to prevent sticking, for about 10 minutes. Add the spaghetti to the boiling water, stir, and cover. Set timer for 5 minutes. Meanwhile, add the milk and tomatoes to the onions. Cover and gently simmer. When the spaghetti has cooked exactly 5 minutes, drain and add immediately to the onion mixture. Simmer the spaghetti in the sauce for about 5 minutes, stirring constantly, until the pasta is done and the sauce thickens. Add salt and pepper to taste, top with shredded cheese, and serve.

Helpful tips

growth of liver and colon cancer cells. Next, onions may promote longevity. Loaded with flavonoids — beneficial antioxidants that mop up cell-damaging free radicals — onions may prevent or slow down diseases related to aging, such as heart disease, dementia, cataracts and cancer. Make that two bowls of French onion soup, please! Another good reason to befriend this bulb: Onions may deter inflammation. Several studies have shown that quercetin, a particularly powerful flavonoid found in onions,

Having A Hard Day’s Night?

Choose firm, dry onions that have no sprouts or moldy spots. Store onions in a well-ventilated, dark place, away from potatoes (which will cause them to spoil more quickly). Do not store onions in plastic. With proper storage, whole dry onions can last about a month. Cut onions can be stored in the refrigerator in a sealed container for up to seven days.

Spaghetti with Creamy Onion Sauce

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.

Adapted from Moosewood Restaurant Low-Fat Favorites Cookbook 3 large yellow onions 2 teaspoons olive oil 2 teaspoons fennel seeds

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Can Eating Tomatoes Lower the Risk of Stroke?

ating tomatoes and tomato-based foods is associated with a lower risk of stroke, according to new research published in the Oct. 9 print issue of Neurology, the medical journal of the American Academy of Neurology. Tomatoes are high in the antioxidant lycopene. The study found that people with the highest amounts of lycopene in their blood were 55 percent less likely to have a stroke than people with the lowest amounts of lycopene in their blood. The study involved 1,031 men in Finland between the ages of 46 and 65. The level of lycopene in their blood was tested at the start of the study and they were followed for an average of 12 years. During that time, 67 men had a stroke. Among the men with the lowest levels of lycopene, 25 of 258 men had a stroke. Among those with the highest levels of lycopene, 11 of 259 men had

a stroke. When researchers looked at just strokes due to blood clots, the results were even stronger. Those with the highest levels of lycopene were 59 percent less likely to have a stroke than those with the lowest levels. “This study adds to the evidence that a diet high in fruits and vegetables is associated with a lower risk of stroke,” said study author Jouni Karppi of the University of Eastern Finland in Kuopio. “The results support the recommendation that people get more than five servings of fruits and vegetables a day, which would likely lead to a major reduction in the number of strokes worldwide, according to previous research.” The study also looked at blood levels of the antioxidants alphacarotene, beta-carotene, alpha-tocopherol and retinol, but found no association between the blood levels and risk of stroke. To learn more about stroke, visit www.aan. com/patients.

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’ y a d n o M s s e l t a e ‘M t n e m e v o M Gaining Ground By Deborah Jeanne Sergeant

few restaurants and food service departments at area hospitals and schools have introduced Meatless Mondays to encourage eating more plant-based foods and reduce red meat consumption. One of the local organizations that recently adopted the program is the University of Rochester. It launched the Meatless Monday in the spring. “Our main goals for Meatless Mondays are to create an environmentally-aware community at the University of Rochester, decrease energy use, and promote a healthy diet,” said Rachel Goldstein, a student who plans to graduate in 2013. Goldstein is a member of dining service’s Team Green, a group of student interns that focuses on environmental sustainability and dining. Since 2009, the Team Green’s

“Flexitarian” dinners have offered students non-meat items once a month. Meatless Mondays takes it a step further with a weekly meatless emphasis. Goldstein calls the meat replacements “less energy-intensive sources of protein. Meat production also uses significantly more water than plant production and generates approximately one-fifth of man-made green house gas emissions according to research. “Reducing meat consumption is beneficial to both a person’s health and the environment,” Goldstein said. “For example, reducing the risk of heart disease, diabetes, and cancer, University Health Services stepped on board to help spread the message and they continue to partner with Team

Green today.” Signs have helped promote Meatless Mondays, along with themes such as “Comfort Food.” Sarah M. Eighmey, clinical dietitian with Geneva General Hospital, thinks that reducing red meat intake is important. “We look at red meat as a risk factor in cancer and heart disease,” she said. “Any reduction that you make in red meat consumption may reduce your risk of disease and it may also lead to healthier lifestyle changes that continue to reduce your risk such as eating more fruits, vegetables and whole grains as well as exercising, cutting back on tobacco and alcohol use.” Geneva General Hospital participates in Meatless Mondays in the facility’s cafeteria to encourage employees to make healthier choices. “We’re hoping that it continues as they go home to feed their families,” Eighmey said. Though a good way to boost fruit and vegetable and whole grain intake, Meatless Monday may lead some consumers to believe that meat is unhealthful in any form or amount. While it’s widely known that certain meats — salami, bacon, and

pepperoni, to name a few — are not good for us, area dietitians stress that all meat isn’t bad. “Look at the ingredients,” said Beth Smythe, registered dietitian for the New York State Dietetic Association in Rochester. “The less processed it is, the better it will be. Look at the cut.” She added that many people assume that a turkey burger is automatically lower in saturated fat than ground beef, but if it contains dark meat, skin and other fatty portions of the bird, lean ground sirloin may be much lower in cholesterol. Beef offers 29 lean cuts. Just ask your store’s butcher or a meat shop for help in identifying them. Bison and venison is often much leaner than many cuts of beef. With other cuts of red meat, look for visible fat as a clue. “If it doesn’t have a lot of marbling and you trim off the white edge, you reduce the saturated fat which clogs arteries,” Smythe said. “Anything from the loin or round is healthiest.” The size of the portion of meat also makes a big difference. Many restaurants serve very large slabs of red meat that measure many times the size dietitians such as Smythe recommend. “Beef can be part of Smythe a nutritious diet,” she said. “A 3-oz. portion is 150 calories. It’s very reasonable. Beef gets a bad rap, but it can be part of a healthy diet. “We need at least 5.5 oz. of any protein foods daily. The recommendation within that is 1.8 oz. of meat. Research lately shows we’re getting 5.1 oz. of protein a day and any type of meat is 1.7.” Red meat is rich in iron, which some women of childbearing years lack, but other foods contain iron, too. Although some people could stand to reduce their meat intake,

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

especially processed meat, eliminating or drastically reducing meat intake “doesn’t mean you’re healthier,” Smythe said. “A lot of people who choose vegetarianism gain more weight because the types of foods they’re eating.” For example, replacing lean meat with the same volume of whole-fat cheese will add many more calories to the diet. “Cheese is a good food in moderation,” Smythe said, “but if your diet is predominately cheese for protein, could you potentially take in more calories than you can burn? You need a variety of nutrients to be in good health. It’s easy for people to villain-ize certain foods.”

Why Meatless Monday? From www.meatlessmonday.com: “Meatless Monday is a nonprofit initiative of The Monday Campaigns, in association with the Johns Hopkins’ Bloomberg School of Public Health. We provide the information and recipes you need to start each week with healthy, environmentally friendly meat-free alternatives. Our goal is to help you reduce your meat consumption by 15 percent in order to improve your personal health and the health of the planet. “Presidents Wilson, Truman and Roosevelt galvanized the nation with voluntary meatless days during both world wars. Our intention is to revitalize this American tradition. We’re spearheading a broad-based, grassroots movement that spans all borders and demographic groups. By cutting out meat once a week, we can improve our health, reduce our carbon footprint and lead the world in the race to reduce climate change.”

Health Benefits

• Limit Cancer Risk: Hundreds of studies suggest that diets high in fruits and vegetables may reduce cancer risk. Both red and processed meat consumption are associated with colon cancer. • Reduce Heart Disease: Recent data from a Harvard University study found that replacing saturated fatrich foods (for example, meat and full fat dairy) with foods that are rich in polyunsaturated fat (for example, vegetable oils, nuts and seeds) reduces the risk of heart disease by 19 percent • Fight Diabetes: Research suggests that higher consumption of red and processed meat increase the risk of type 2 diabetes. • Curb Obesity: People on low-meat or vegetarian diets have significantly lower body weights and body mass indices. A recent study from Imperial College London also found that reducing overall meat consumption can prevent long-term weight gain. • Live Longer: Red and processed meat consumption is associated with increases in total mortality, cancer mortality and cardiovascular disease mortality. • Improve Your Diet. Consuming beans or peas results in higher intakes of fiber, protein, folate, zinc, iron and magnesium with lower intakes of saturated fat and total fat. Source: www.meatlessmonday.com

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lanned Parenthood of the Rochester and Syracuse Region (PPRSR) has been awarded up to $465,133 by Greater Rochester Health Foundation (GRHF) to implement an electronic practice management/ electronic health records (EHR) network. The system will enable PPRSR to improve the quality of patient care by providing reliable real-time access to health information at six Planned Parenthood affiliates in Upstate New York. “The ability to track a patient through medical records is a key part of delivering high-quality health care. Being able to thoroughly review a patient’s medical history allows us to better understand her or his reproductive health needs. Through the confidential electronic health records system, we will have an easily accessible overview of a patient’s history that includes results from preventive cancer screenings and tests for sexually transmitted infections or pregnancy. We will also know when to expect lab results from tests, such as Pap smears, that will allow us to promptly share the results with the patient and assist her or him in accessing additional care,” says James Stewart, president and CEO of PPRSR. The three-year grant will help PPRSR purchase the necessary infrastructure to allow each affiliate to participate as well as provide funds to prepare and train health center staff in the electronic practice management electronic health records systems. Adoption of electronic health records has been identified by the New York State Department of Health as a priority. “An EHR system not only improves operational efficiency, but allows a practice to link coding and billing which will enable PPRSR to maximize revenue and improve cash flow by expediting payment from third party payers. In addition, the streamlining of appointment scheduling will enable PRRSR to increase its capacity to serve its female and male patients,” said John Urban, president and CEO of Greater Rochester Health Foundation. “In reviewing the proposal for funding, we recognized the need for affiliates to be able to track and serve a young, mobile patient population. PPRSR patients are very loyal but cannot always seek treatment from the same health center. The system allows for quick transfer of medical records and all affiliate practitioners will have real-time access to complete patient health information when it is needed,” says Louis Papa, a physician who chairs the GRHF’s board program committee.

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Grandparents as Caregivers The U.S. Census recently released a series of facts about grandparents in celebration of Grandparents Day, which took place Sept. 9 Here are a few things the report shows: 580,000 The number of grandparents responsible for grandchildren under 18 and whose income was below the poverty level in the past 12 months compared with the 2.2 million grandparent caregivers whose income was at or above the poverty level. $45,000 Median income for families with grandparent householders responsible for grandchildren under 18. Among these families, where a parent of the grandchildren was not present, the median income was $33,000. 1.9 million The number of married (including separated) grandparents responsible for caring for their grandchildren. 1.7 million The number of grandparents responsible for grandchildren who were in the labor force, out of the total 2.7 million who were responsible for grandchildren. 670,000 The number of grandparents who had a disability and were responsible for their grandchildren. 1.9 million The estimate of grandparents responsible for their grandchildren who were living in owner-occupied housing, compared with 840,000 that were living in renter-occupied housing. 490,000 The number of foreign-born grandparents responsible for their own grandchildren younger than 18. This contrasts with 2.2 million native-born grandparent caregivers. 2.1 million The number of grandparents responsible for their grandchildren, who speak only English. Another 270,000 speak another language, but speak English “very well”; 390,000 speak another language and speak English less than “very well.” 5.4 million The number of children under 18 living with a grandparent householder in 2010. 10% Percentage of children in the U.S. living with a grandparent in 2010, totaling 7.5 million. 3.2 million The number of children living with both grandmother and grandfather in 2010.

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Golden Years

Hospice at Home or Not? When you need help, hospice professionals deliver care to patients at home, nursing home, hospitals or at comfort care homes By Deborah Jeanne Sergeant

f you or a loved one is faced with an incurable health condition and imminent end of life, hospice care can help make the transition easier and more comfortable for everyone. Kimberly Sisco, director of social work and admissions coordinator at Lakeside Health System, likes to describe the hospice care that Lifetime Care provides at Lakeside as “another layer of benefits to patients.” Patients and families may choose hospice care as part of the care they receive as inpatients at a facility such as Lakeside or at any of the 11 inpatient hospice residences in New York, which becomes the patient’s home-away-from-home. Or, one may receive hospice care in his home. McMahon The levels of care are respite care to “fill in” for the normal caregivers temporarily (such as when the patient’s caregiver is traveling), general care for acute symptoms, routine care to supplement and enhance the daily care given or continuous Wellman care. Hospice care could include a nurse who focuses on pain management, aides who offer companionship, music therapists, clergy members who give spiritual guidance and others. “The benefits are all a la carte,” Sisco said. “It gives the family a bit of a respite. During the meeting when someone signs onto hospice, we ask the time they typically visit so the family has a span of time that even though they can’t be there, the resident will have one-on-one attention. “Many families near end of life feel pressured to be here so their loved one is not left alone,” Sisco said. Staying for weeks or months by a patient’s bedside isn’t possible for most families, so hospice can offer the comfort of another person’s presence. Hospice care also assures the family that their loved one is as comfortable as

possible to increase the quality of their lives. Hospice providers such as Visiting Nurse Service in Rochester offer a 24hour on-call number so when a patient enrolls, he or the family can reach a nurse anytime they need extra help, which can prevent unnecessary and expensive emergency room visits. “It gives extra assurance to the family, too,” said Jill L. Wellman, senior social worker at Visiting Nurse Service. Choosing to receive hospice care at a facility “gives the family the ability to focus on those important visits instead of being the primary caregiver,” Sisco said. “It taxes families a lot less when their loved one is in a facility and nursing in hospice can provide their loved one’s needs.” Some people prefer non-family members to take care of their personal needs instead of having a son or daughter help them bathe or use the bathroom. But many people prefer their own homes to living in a hospital or nursing home. They want to be surrounded by their belongings and feel more secure

in a familiar place. Many factors can help patients and families decide if at-home care will work, such as the number of willing caregivers. “When you talk about institutional hospice, a majority of our patients are at advanced age,” said Terry Klinetob, senior vice president of long term care and director of rehabilitation services with Lakeside Health System. “Athome hospice, you see more prevalence among those who are younger.” Planning ahead can make all the difference in whether or not a patient’s wishes are honored. These can be difficult conversations, but necessary to make sure that the patient and family receive the care they want. “Advanced care planning should take place early, not during a crisis so the patient can make known what they want,” said Kathy A. McMahon, president and CEO of Hospice and Palliative Care Association. “People need to fill out an advanced directive and a health care proxy so someone can make decisions for them if they lose decision-making capacity.”

Misconceptions about hospice Many people hold misconceptions about hospice care. Experts in the area share a few of those misconceptions • Choosing hospice means that you are giving up hope. “I hear [that] a lot...[Hospice is] reframing hope to quality of life with the time you have left.” • Hospice is just for the last few days you have left. “Hospice is intended to be a six-month benefit. It can be longer. The median length of stay for hospice in New York state is 17 to 19 days. It’s very low. I would like people to take full advantage of this benefit.” • Hospice is for elderly people with cancer. “That’s not true. Hospice is for everybody with a terminal diagnosis of six months or less if the disease runs its normal course.” Kathy A. McMahon, president and CEO of Hospice and Palliative Care Association. • Hospice is a place you go to receive care. “We can deliver care to a home, nursing home, hospital in-patient or a comfort care home.” • I couldn’t afford it. “Everyone with Medicare has a hospice rider and a majority of commercial insurance has hospice coverage.” • Once I sign up for hospice, I can’t change my mind. “They’re not locked into anything. It’s perfectly fine go back to their previous situation.” Jill L. Wellman, senior social worker at Visiting Nurse Service in Rochester.

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

Golden Years Seniors Should Vaccinate to Avoid Flu If you’re one of the unlucky seniors who catches the flu, your risk for complications is greater than that of a younger person By Deborah Jeanne Sergeant

f you’re 50 and older, you have a good reason to obtain an influenza vaccination this flu season. Other reasons can include living in a longterm care facility or nursing home, or if you come in contact with children, pregnant women or someone with a compromised immune system or chronic medical condition such as asthma, COPD, heart disease or diabetes. “Anyone who comes in contact with a high risk group should get vaccinated, not only to protect themselves, but also to help avoid the spread of the disease to the more vulnerable,” said Robin Knab, infection prevention coordinator at Lakeside Health System. Knab referenced a study of healthcare workers who claimed they never get sick with the flu, but testing revealed the opposite. “Even those with sub-clinical symptoms can spread the virus to

Read the Savvy Senior column (page 23) for different options for flu vaccine others,” Knab said. “You may survive the illness, but your loved one, your friend, the person in line next to you at Wegmans may not. Stop the spread.” Susan Hoynowski, pharmacist and immunization coordinator for Wegmans’ Rochester region stores, said that she hears the “I-never-get-sick” excuse all the time. “I tell them once you get the flu, you’ll always get it,” she said. “People forget the epidemics that used to happen where hundreds of people died before we had flu vaccines. It’s like herd immunity. They are weakening the Hay herd immunity by not getting their flu shot.” Herd immunity refers to the relative safety of an unvaccinated person who comes in contact only with those who are vaccinated; however, if too many people do this, the risk of an outbreak rises. If you’re one of the unlucky seniors who catches the flu, your risks for complications is greater than that of a younger person. This is because older people “tend to have more chronic

illness than the younger population,” Hoynowski, the Wegmans pharmacist, said. “When they get the flu, they get it more severely. It causes much more dehydration and that is a greater concern because they get dehydrated faster. They have higher rate of death than the young population among flu patients.” Christine Hay, a specialist in infectious diseases at University of Rochester Medical Center, agrees that the older population is at higher risk for complications as contracting influenza can make seniors Wegmans employee Stanley Adams from Rochester receives a ﬂu vaccination from Susan Hoynowski, more susceptible to pharmacist and immunization coordinator for Wegmans’ Rochester region stores. other illnesses. “Bacterial pneumonia can be fatal in some cases,” concerns. The inhaled version of the Hay said. “Viral pneumonia can If affordability is holding you vaccination is available for people 2 develop from the flu virus itself. If they through 49. back, ask your county’s public health have other underlying disease they can department for a list of sliding scale There’s also a higher dose flu get much worse.” clinics in your area. Medicare and most vaccine that may provide better Some people feel that vaccination health insurance plans cover flu shots. protection, but it causes more pain, is futile because they have, in the The quality of the vaccine is the same redness and swelling at the injection past, caught the flu after vaccination. regardless of where you go. site than the lower dose. However, Hay said that vaccination “There are only a couple FDAIt’s important to talk over the can lessen the impact of the flu should approved manufacturers in country options with your health care provider you still become sick. and they’re all fine,” Hay said. in relationship to your other health Other people claim they have become sick because of the flu shot. They received a vaccination and a few days later became sick. But it takes at least two weeks for a vaccination to become fully effective. It’s likely that the person was exposed during this window of opportunity. “It’s physically impossible to get the flu from the flu shot,” Hay said. aying that many of Monroe Coun- proposed cuts on both Medicare and “We use a dead virus.” ty’s senior adults are unable to get Medicaid anticipated by both parties, As a natural immune response, themselves to the polls because of older Americans need to step up to the the body builds up antibodies to the transportation issues, Home Helpers, a plate now more than ever in order to “invader” and thus the individual can non-medical companion care company, ensure their vote is cast.” fight off flu germs when they come. is offering free transportation to elec“There are some major issues in Hay recommends vaccinating in tion polling places Nov. 6. The offer is our community that could be affected early to mid-fall, but anytime is better valid for Monroe County senior adults, by this year’s election.” added Kostiw. than not at all. “It’s critical that seniors get to the polls For needle phobics, the intradermal age 65 and older. “The upcoming presidential elecin order to cast the votes that could shot with the smaller, thinner needle tion is especially important for seniors ultimately result in better services and may offer less pain. This vaccination this year because of a number of issues programs for them,” Kostiw continued. goes into the skin, not the muscle, that could have an impact on them one For more information or reservawhich some find easier to handle. way or the other,” said Debra Kostiw, tion, call 585-334-0999. People 18 through 64 may receive this president of Home Helpers. “With shot.

Home Helpers offering free rides to the polls for seniors

November 2012 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Golden Years Make your home safer for your grandkids For grandparents, holiday is a time to put knives, scissors, cleaning supplies, chemicals and medication out of kids’ reach By Deborah Jeanne Sergeant

ew grandchild on the way or visiting during the holidays? Now’s the time to make your home safer. Even if you reared your children in your current home, a lot has changed since then, both in the function of your home and in new child safety guidelines. The youngest grandparents must admit it’s been a few years since a little one was in the house. It’s easy to forget how quickly they grow and that curious, mobile babies get into everything. Holiday festivities can both present more hazards for children and create more diversions for caregivers. “We see a lot of toddlers getting Brayer injuries when visiting grandparents or at holiday parties where their parents are otherwise distracted,” said Anne Brayer, codirector of the Injury Free Coalition for Kids and pediatrician for emergency medicine at the University of Rochester Medical Center. Since it’s next to impossible and likely not desirable to eliminate every possible threat, “make sure children are never without an adult,” Brayer said. “Cousins or other grade school-aged children may not recognize potentially hazardous situations and often get

carried away amusing one another, without making safety for infants a priority.” It can be hard to get back into the mindset of taking care of a baby or toddler if you’ve been out of the baby game for a while. Theresa Schoell, child life specialist at Rochester General Hospital, tells parents of tots that new grandparents’ “brains were constantly focused on ‘What are the hazards?’ when we were little, but for grandparents who don’t watch them daily, they’re excited about baking cookies or doing fun things, not putting things away.” Some rooms, however, are especially prone to hazards: kitchens, bathrooms and utility rooms. And some basic safety precautions can help make watching small grandchildren easier. Although most grandparents put knives, scissors, cleaning supplies, chemicals and medication out of kids’ reach, “purses are common places for children to reach medication,” Schoell said. Stow vitamins and supplements, too. To discover other hazards, get down on a child’s level (or have your adult children do so) in the rooms where the children will play and sleep. Look for anything sharp, breakable, small enough to fit through a toilet paper tube (these are choking hazards), or long strings, which present strangulation or circulatory hazards.

Unless secured against the wall, bookcases can topple over on children, as can small tables. The latter are especially hazardous if topped by large, heavy objects. Extension cords or dangling cords can also allow children to topple small appliances. Baby furniture has undergone major changes since your children were small. Mark Simon, owner of Simon’s Baby Furniture in Rochester, said that the biggest safety issue is “grandparents using older products that are no longer safe like drop-side cribs, cribs in general that are seven to 10 years old or older, because they likely don’t meet today’s standards.” An older crib might have an older mattress that is too soft, for example, or that has dust mites or allergenic materials in it. If your grandchild won’t sleep much at your house, you can likely get by with buying a new portable crib. These start at around $70 and have their own fitted sheets, too. But don’t put in toys or crib bumpers in any crib to reduce suffocation risks. Babies need only a properly-fitting sheet. Footed sleep suits keep babies warm; they don’t need blankets. “A lot of people use pressuremounted gates at the top of the stairs, which isn’t the right thing,” Simon said. “They should be screwed into the wall and anchored. We haven’t carried baby walkers for years. I don’t know of anyone who would have them.”

Baby walkers have been shown hazardous because they tip over easily. Don’t assume your other baby gear or toys meet today’s standards, even if your adult children used them as tots. Act graciously if your children shun your cherished heirloom toys. It’s nothing personal; they’re probably just following their pediatrician’s suggestions for the baby’s safety. Many toys of yesteryear used leadbased paint, small parts, and breakable materials. Even plastic toys of 10 or 15 years ago may have worn to the point where parts can snap off. Ask your children if the gear and toys you have are OK. Some toys would make better display items (such as a porcelain doll), but remember that many small children will not understand why they have been given a “toy” they cannot play with. Especially if your grandchildren are staying in your care overnight, review and abide by the rules your children lay down. Some are important safety rules such as laying babies on their backs for sleep, which reduces the risk of sudden infant death syndrome. Though you may be an expert in childcare, your children are the experts about your grandchildren. “Toddlers are learning their own bodies and preschoolers want to master their environment,” Schoell said. “They don’t want to be told no because they want the control. Planning ahead can make a more pleasant visit.”

November is National Alzheimer’s Awareness Month

Know Your Risk Factors to Help Prevent Dementia

esearch shows that managing and treating vascular disease risk factors are not only beneficial to preventing heart disease and stroke, but also common forms of dementia. Physician Gustavo C. Roman, director of the Nantz National Alzheimer Center at the Methodist Neurological Institute in Houston, summed up decades of dementiarelated research in a review paper in Alzheimer’s Disease and Associated Disorders. Roman said although more definitive research is needed, focusing on the following risk factors can go a long way to helping reduce the risk of vascular dementia and mixed dementia (the combination of vascular dementia and Alzheimer’s disease). By 2050, 11 to 16 million Americans will suffer some form of dementia. Page 20

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Hypertension

Controlling blood pressure reduces the risk of stroke and heart disease. Studies are also beginning to show that hypertension increases the likelihood that people with mild cognitive impairment will eventually have dementia later in life.

Hyperlipidemia

Epidemiological studies show that in addition to cardiovascular disease, high blood pressure and diabetes, high blood cholesterol is an important risk factor for dementia, including Alzheimer’s.

Smoking

Not only is smoking associated with increased risk of lung cancer, cardiovascular disease and emphysema, but it also adversely

affects blood flow to the brain which can lead to cognitive decline and dementia.

Diabetes

Studies have already linked the obesity epidemic to increased risk of high blood pressure, metabolic syndrome, cardiovascular disease, stroke, renal failure, peripheral vascular disease, obstructive sleep apnea, and type 2 diabetes mellitus. In fact, people with this form of insulin resistant diabetes are twoto-three times more likely to face an Alzheimer’s diagnosis, in part because of vascular complications.

Diet and Exercise

An overall healthy lifestyle decreases risk of dementia as people age, particularly vascular dementia. Here, the focuses on a low body mass

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

index (25 or lower), healthy diet (based on dairy, meat, fish, fruits, vegetables, cereals, low alcohol, and the ratio of monounsaturated to saturated fat), and aerobic exercise.

Hyperhomocysteinemia

Homocysteine is an amino acid in the blood, and high blood levels are linked to an increased risk of developing Alzheimer disease. People who already exhibit signs of dementia and test positive for high levels of homocysteine are more likely to respond well to large doses of B vitamins. Research has proven that taking large doses of B-complex vitamins can reduce the rate of brain shrinkage by half in elderly people with memory problems and slow the progression of dementia.

Golden Years Clouded Vision How cataracts develop and are treated By Chuck Di Natale

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ike many who develop cataracts, my first awareness of the condition occurred while driving at night. The first sign was the way the headlights of the other vehicles took on a brighter, “starburst” appearance. More disturbing was the fact that my night vision was suddenly greatly diminished. Fortunately, my wife was with me the twilight evening that we barely missed a jaywalker crossing the street; it was only her warning that prevented me from hitting the woman who appeared — to my eyes — out of nowhere. Cataracts are a condition in which the natural lens of the eye becomes less transparent. This results in clouded vision, as if the eye’s natural lens was scratched or hazy. Other symptoms of cataracts can include trouble seeing distant images such as highway signs; the inability to perform close work without more light; tired eyes while reading; trouble seeing in dimly lit rooms; poor night vision; glare; “ghost images” such as multiple images of the same thing; and faded or washed out colors. More than 20 million Americans suffer from cataracts annually. Although the exact cause of cataracts is not yet known precisely, there are a variety of risk factors that can contribute. Age is often one of the greatest contributing factors. “Cataracts are the most common cause of blurred vision in people over age 50,” write physicians David F. Chang and Howard Gimbel in their book ‘Cataracts: A Patient’s Guide To Treatment.” Other contributing factors can be family history, medical disorders, race, nearsightedness, steroid use, eye diseases and eye injuries. In my case, according to physician Cary A. Kazdan of Kazdan and Associates, Penfield, prolonged use of the steroid prednisone during my treatment for cancer is the most probable cause for the growth of cataracts in both of my eyes. Early in its course, the cataract may not cause any visual problems, but progressively, vision becomes more clouded. As the eye’s lens becomes cloudier, it can eventually become completely opaque and obscure all useful vision. Since cataracts develop in stages, it can take years before the eyes’ lenses become fully clouded. At that point, the entire lens can turn white and the eyes themselves are functionally blind. “Other than lens clouding,” write Chang and Gimbel, “cataracts do not damage or harm your eyes....If you’re having no trouble with normal activities and you’re satisfied with your eyesight, there’s no pressing need to have a cataract removed.” However, with progressive cataract growth, and especially when the cataract matures fully to where

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it causes blindness, the only option available becomes surgery. This involves removal of the natural lens from the eye and its replacement with an artificial plastic lens. To understand cataract surgery we must examine the anatomy of the eye itself. Like a camera, there are basically three parts to the eye: the pupil, which is like a camera’s lens; the lens, which focuses light in the eye similarly to the aperture of a camera; and the retina on the back of the eyeball which performs the same kind of function as a camera’s film. The healthy eye lens is a flexible bag of clear protein that changes shape — flattening or thickening, for example — to bring objects into focus relative to their distance. Common vision problems such as nearsightedness or farsightedness occur when the lens focuses light in the wrong part of the eye. This can happen due to eye disease, eye injury or congenital defect. As we age, though, usually by our mid-40s, the lens loses its ability to flatten, thicken or otherwise focus light. When this happens to produce cataracts, surgery can become necessary. As might be expected, when surgery is involved in something as vital as sight, a good deal of preparatory examination is performed by the ophthalmologist who will perform the surgery. Cataract surgery is not only one of the most common operations performed in the United States today, but is also one of the most successful. Once cataracts form, there is no medication available today that will eliminate them. Instead, an eye surgeon removes the cataract-ridden natural lens and replaces it with a new artificial lens called an intraocular implant. The implanted lens then restores vision and the cataract never returns. One of the most important precataract surgery examinations an ophthalmologist performs determines the focal power of the artificial lens he or she will implant. Unlike eyeglass or contact lenses, the focal strength

of an intraocular implant cannot be determined experimentally. “Since the intraocular implant is placed inside the eyeball after the natural lens has been removed, there is no way to preview different … powers in advance,” write Chang and Gimbel. Instead, the ophthalmologist employs a computer program that estimates the appropriate focal power of the artificial lens prior to surgical implant. The program painlessly calculates the eyeball’s dimensions, determining, for example, the amount of curvature in the cornea to measure the cornea’s optical power. Cataract surgery can take two forms, either as a small incision or a large incision. Small-incision surgery is the more common technique. Only a small incision of about 1/8th of an inch is required with this operation. Once the incision is made and the cataract-ridden lens is removed using ultrasound waves, the pieces of clouded lens are vacuumed out and the intraocular implant is inserted. Sutures are usually not required. With the large-incision surgical procedure, an incision of up to 1/2inch in length is made. As many as nine sutures may be required. Since this procedure weakens the wall of the eye because of the size of the incision, patients may have to limit their physical activity for as long as a month to avoid straining the large incision. Normally, cataracts occur in both eyes and ophthalmologists prefer to operate on one eye at a time. Assuming there are no undue complications, according to Kenneth J. Lindahl of the Rochester Eye & Laser Center, the cataract surgery patient can return to work as soon as the next day, following an examination by the eye surgeon. Like any surgery or medical condition, expert counsel should always be sought before a decision is made. However, today, while the incidence of cataracts may seem to be on the increase because so many of us are living longer, so is the ability to restore and improve sight through proper medical care.

November 2012 •

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and recommendations from the American Academy of Allergy, Asthma and Immunology and other leading medical organizations.” Eduardo E. Arreaza, a physician with Rochester General Allergy.

What They Want You to Know: Allergists/Immunologists By Deborah Jeanne Sergeant

he American Academy of Allergy, Asthma and Immunology defines allergist/immunologists and related professionals as having “advanced training and experience dedicated to allergy, asthma, immune deficiencies and other immunologic diseases.” This is additional training beyond what they received to become medical doctors. • “Since the incidence and severity of allergic diseases in the USA and many industrialized countries have been increasing over the past two to three decades, the allergist has played an increasingly important role in the care of many patients. • “Allergies and asthma are an important cause of morbidity, and asthma causes about 4,500 fatalities a year in the US, many of them preventable with proper care. • “Patients who see an allergist should be prepared to describe not only their specific symptoms, but also the impact those symptoms may be

having on their daily activities, work, school performance, sleep and quality of life. Additionally, the allergist will obtain a detailed history of the patient’s environment, both at home and at work or school, and determine, with the aid of diagnostic tools such as skin testing, lab tests, pulmonary function tests and others, the impact that those environmental conditions may be having on the patient, and will then determine the best possible therapeutic approach. • “In my opinion, one of the most common misconceptions many patients — and even other physicians — have about allergists is that they ‘just put patients on shots.’ Immunotherapy or allergy shots, is just one of the many therapeutic options available to allergists to treat certain allergic disorders, such as asthma, allergic rhinitis/sinusitis and insect venom allergy, in selected patients. In my own practice, only a relatively small portion of my patients receive allergy injections, closely following guidelines

• “Not every symptom is an allergic reaction. There are side effects from taking medication that have nothing to do with the immune system. • “People oftentimes underestimate the effect of allergies on day-to-day living and their wellbeing. Data suggest that they have lower productivity at work and impaired sleep living with untreated allergies. • “It’s helpful when people have a problem with medication that they make a timeframe for when they first started having the problem and what medication they’re taking and what seems to trigger the reaction. That helps us figure out what’s going on.” Anatole Kleiner, a physician with Allergy Asthma and Immunology of Rochester. • “I think we’re more attuned to what fits the patients’ lifestyle than we used to be. • “We’re trying to work with patients with cost control. Sometimes, it’s frustrating for both the patient and myself. We model our approach to an appropriate number of visits, and home care instruction and informational handouts help. • “It’s nice to see that a lot of the medicines we’ve used are now over the counter, so there are generics and are easier to access. We see more of the severe cases of allergies now since most patients who can treat mild allergies do so with OTC medication. • “People always ask if it’s a ‘good season’ or ‘bad season’ for allergies, but it’s so individualized it’s hard to say. Their seasonal allergens dictate their symptoms and some people react

differently. It’s quality of life and affects your sense of well being and things like sleep so I address all those in our practice. • “People ask if they have to be on shots the rest of their lives, but we follow the three to six weeks’ window. • “Our bodies become less reactive as we age. We can develop new allergies. Genetically, there’s some type of risk factor to develop further allergies later in life. • “Food allergies are an interesting study these days. there’s a greater need to address these in children. That’s where people are finding there is some degree of outgrowing allergies because their bodies become accustomed to what previously caused a reaction. There are some that cause lifethreatening reactions such as peanuts or shellfish. • “I think it’s a misconception is that when you treat yourself with OTC or prescription medication that you’re curing the allergies. You’re really just treating the symptoms. The only way to treat the allergies is immunotherapy. It’s a commitment for the patient and caregiver but it’s the only long-term solution.” Gregory Carnevale, a physician with Finger Lakes Allergy Clinic in Geneva and Penn Yan.

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.

Ask The Social Security Ofﬁce Column provided by the local Social Security Office

Social Security Helps Veterans (and Active Duty Military) Every Day

ov. 11 is more than just a national holiday — Veterans Day is a time to honor the men and women who risk their lives to protect our freedom. We at Social Security ask you to join us in saluting the men and women of the armed forces. Be sure to say “thank you” to a veteran on this important day. For those who return home with injuries, it will be our turn to help them. If you know any wounded veterans, please let them know about Social Security’s Wounded Warriors website. You can find it at www. socialsecurity.gov/woundedwarriors. The Wounded Warriors website answers a number of commonly asked questions and shares other useful information about disability benefits, including how veterans can receive expedited processing of disability claims. It is important to note that benefits available through Social Security are different than those from the Department of Veterans Affairs and require a separate application. Page 22

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The expedited process is used for military service members who become disabled while on active military service on or after Oct. 1, 2001, regardless of where the disability occurs. Even active duty military who continue to receive pay while in a hospital or on medical leave should consider applying for disability benefits if they are unable to work due to a disabling condition. Active duty status and receipt of military pay does not necessarily prevent payment of Social Security disability benefits. Receipt of military payments should never stop someone from applying for disability benefits from Social Security. A person cannot receive Social Security disability benefits while engaging in substantial work for pay or profit. However, the work activity is the controlling factor and not the amount of pay the person receives or military duty status. Learn more by visiting www. socialsecurity.gov/woundedwarriors.

We at Social Security thank all veterans and members of the armed services for all that they do — not only on Veterans Day, but every day of the year.

Q&A

Q: I applied for a Social Security card for my baby at the hospital, but the card came back with a misspelled name. What should I do? A: Find at least two original documents proving your child’s U.S. citizenship and identity, as well as one proof of your identity as the parent. Then go to your local Social Security office or card center to ask for a corrected card. The documents you show us must be either originals or copies certified by the issuing agency. We cannot accept

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

photocopies or notarized copies of documents. To find out more, visit www.socialsecurity.gov/ssnumber. Q: What is Supplemental Security Income (SSI)? A: SSI provides monthly income to people 65 or older, blind or disabled, who also have limited income and financial resources. To be eligible, an individual also must be a U.S. citizen and resident of the United States or a noncitizen lawfully admitted for permanent residence. There are, however, some noncitizens granted a special immigration status who are eligible. To get SSI, an individual’s financial resources (savings and assets) cannot be more than $2,000 ($3,000, if married). For more information, read our publications, Supplemental Security Income or Understanding Supplemental Security Income. Both are available at www.socialsecurity. gov/pubs.

By Jim Miller

Vaccination Options for Seniors This Flu Season Dear Savvy Senior, Are there any new or different types of vaccines being recommended to seniors this flu season? Health Conscious Carol Dear Carol, There are actually several different types of flu shots available to seniors this year, along with a new FDAapproved shot for pneumonia. Here are your options. Flu Shots

Just as they do every year, the CDC strongly recommends a seasonal flu shot to almost everyone, but it’s especially important for seniors who are more vulnerable. The flu puts more than 200,000 people in the hospital each year and kills around 24,000 — 90 percent of whom are seniors. This year, all seniors 65 and older have two flu vaccine options from which to choose. A traditional flu shot or a shot of Fluzone High-Dose. The high-dose vaccine contains four times the amount of antigen (the part of the vaccine that prompts the body to make antibody) as a regular flu shot does, which creates a stronger immune response for better protection. And if you’re under age 65, your two options are a regular flu shot or a shot of Fluzone Intradermal. The intradermal vaccine uses a shorter, thinner needle to inject the vaccine just under the skin, rather than deeper in the muscle like standard flu shots. If you’re squeamish about needles, this is a nice option. You also need to be aware that if you’re allergic to chicken eggs or if you have had a severe reaction to a flu vaccine in the past you should not get vaccinated without consulting your doctor first.

To locate a vaccination site that offers regular, high-dose and intradermal flu shots, ask your doctor or pharmacist, or check the online flu-shot locator at flu.gov. Most chains like CVS, Walgreens, Safeway, Kmart, Walmart and Rite Aid offer all types of shots. You’ll also be happy to know that if you’re a Medicare beneficiary, Part B will cover 100 percent of the costs of any flu shot. But if you’re not covered, you can expect to pay around $25 to $35 for a regular or intradermal flu shot, or $50 to $60 for a shot of the high-dose.

Pneumonia Vaccine

The other important vaccination the CDC recommends to seniors — especially this time of year — is the pneumococcal vaccine for pneumonia and meningitis. Pneumococcal diseases hospitalize around 300,000 U.S. seniors each year, and kills around 5,000. The CDC currently recommends all seniors 65 or older get a one-time only shot of the vaccine Pneumovax, as well as those under 65 who smoke or have chronic health conditions like asthma, lung and heart disease, diabetes, or a weakened immune system. Pneumovax, which protects against 23 strains of the pneumococcal disease, is also covered 100 percent under Medicare Part B, and you can get it on the same day you get your flu shot. If you’re not covered by insurance, this vaccine costs around $45 to $85 at retail clinics. You also need to know that this year, there’s an alternative pneumococcal vaccine available to people age 50 and older called Prevnar 13. This vaccine, which has been available to children for several years, may provide seniors longer lasting and better protection against pneumonia than Pneumovax. Talk to your doctor to determine which pneumonia vaccine is best for you. Prevnar 13 is also covered by most insurers including Medicare Part B, but if you aren’t covered the shot runs between $100 and $150.

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. November 2012 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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H ealth News Unity now has adviser for care management Physician Joanne Hessney has been appointed Unity Hospital’s adviser for care management. This new position was created as a critical part of clinical care redesign to ensure high quality care is provided to all patients. Hessney is responsible for engaging physicians and reviewing best practices to achieve resource management and quality goals. She will collaborate with system and physician leadership, medical staff, all clinical care services, resource management, care management/social work, discharge Hessney planning, and utilization management to reach goals of reducing length of hospital stay, ensuring patients are in the appropriate level of care, maintaining compliance with established order sets and clinical protocols, and monitoring the appropriate use of diagnostic and therapeutic modalities. Hessney joined Unity in 1990. She has served as president of the medical staff, director of critical care medicine, and acting chief of anesthesiology. Her most recent position was the director of the intermediate care unit and secretary/treasurer of the medical staff. The Victor resident has been active in medical education of Unity residents as is part of Rochester Institute of Technology’s adjunct clinical faculty for its physician assistant program.

Ashton Place Senior Living appoints assistant director Ashton Place Senior Living Community announced the appointment of Kevin Christiano as assistant director. Christiano is a recent graduate of The University of Colorado at Boulder having earned a degree in finance. He also completed an administrative internship at Aaron Christiano Manor Rehabilitation and Continuing Care Center, located in Penfield. In his role as assistant director, Christiano will oversee the operation of three senior living options: active, independent and assisted living at the Ashton Place campus located in the village of Clifton Springs.

Brain injury agency opens site in Brockport The Hickok Center for Brain Injury, a place where people with brain injuries can go to redevelop the skills they have lost, has opened a new satellite site at 36 Erie St., Brockport. Page 24

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The new site is an extension of the agency’s main site in Rochester and offers service coordination, a structured day program, independent living skills training, community integration counseling, and supported employment services to adults who have sustained a brain injury. In addition to the new office in Brockport, The Hickok Center for Brain Injury has centers in Rochester and Newark.

Wilmot Center doctor to head international group Alok Khorana, vice chief of the hematology/oncology division at the HYPERLINK “http://www.urmc. rochester.edu/cancer-center/”James P. Wilmot Cancer Center, has been appointed chairman of the hemostasis and malignancy subcommittee of the International Society of Thrombosis and Haemostasis (ISTH). The appointment signifies Khorana’s growing reputation as a global authority on thrombosis and other blood disorders. Founded in 1969, ISTH, with more than 3,000 members, is the leading worldwide organization dedicated to the advancement Khorana of understanding, prevention, diagnosis and treatment of thrombotic and bleeding disorders. Its mission remains the advancement of education and stimulation of research into thrombosis and hemostasis through meetings, peer-reviewed publications and expert committees on practical issues related to research methods and standards. In his new, leadership role, Khorana will be responsible for the subcommittee’s 2013 program of work, primarily the 2013 scientific subcommittee meeting, which will take place in conjunction with the 24th ISTH congress in June in Amsterdam. Khorana is tasked with proposing educational topics and speakers for the session. Khorana, who is also an associate professor of hematology/oncology in the department of medicine, has been at the cancer center since coming to the University of Rochester Medical Center as a fellow in hematology/oncology in 1999. He is a resident of Pittsford.

RGHS has new VP for clinical innovation Physician Bridgette Wiefling has been appointed to the Rochester General Health System’s newly created position of system vice president for clinical innovation Wiefling presently serves as the president and chief executive officer of the Anthony Jordan Community Health Center where she has served since 2006. According to a news release, Wiefling is a highly respected member of the Rochester medical community and has been recognized for the strong

Rob Mayo Named RGHS’s Chief Medical Ofﬁcer Physician Rob Mayo has recently been appointed to chief medical officer of Rochester General Health System. He will replace outgoing CMO Richard Gangemi when he retires from his long-held position in December. Mayo, who joined RGHS in 2002, has served in a variety of leadership positions, including president of the medical and dental staff of Rochester General Hospital. In 2004 he was selected by more than 800 RGH nurses as the health system’s first physician of the year based on his unmatched ability to balance genuine compassion with clinical expertise. Since 2009 he has served as vice president and patient safety officer for the Institute of Patient Safety and Clinical Excellence. He has held numerous faculty positions at the University of Rochester School of Medicine and Dentistry. “Dr. Mayo possesses that rare combination of sharp intellect,

and innovative leadership she has provided to Jordan and Westside, two important federally qualified community health centers. “We are very pleased that Dr. Wiefling has agreed to join us as system vice president for clinical innovation, “ said Mark C. Clement, president and CEO of Rochester General Health System. “As we prepare for significant changes in the delivery and payment of healthcare services, Dr. Wiefling will work collaboratively across our system to develop an integrated plan to foster efficiency of services while providing the highest patient care possible. It is this innovative approach that is shaping RGHS to become the model healthcare system for the future.” Wiefling completed her medical school education at the University of Wisconsin College of Medicine and her internal medicine and pediatrics residency at Strong Memorial Hospital and the Golisano Children’s Hospital at the University of Rochester Medical Center in 2005.

Scott Schwabe promoted at Unity Health Unity Health System recently announced the promotion of Scott Schwabe to vice president of cardiovascular services. Schwabe will also serve in a dyad leadership role alongside physician James Haley to provide administrative functions for areas such as medical education and teaching, medical staff development, and patient experience modeling at

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

skill, heart, and humility that not only make him an exceptional physician, but also a highly-respected and admired colleague, leader, educator, and role model,” said Mark Clement, RGHS president and CEO. “This selection showcases the ability of our system to nurture and grow world-class healthcare leaders that can emerge as top candidates among national contenders. The medical direction of our health system couldn’t be in better hands.” Mayo earned his medical degree and completed a fellowship at the University of Michigan, and completed his internship and residency at St. Joseph Mercy Health System in Michigan. He is board certified in internal medicine and specializes in nephrology, and will continue to practice on a part time basis as he takes on this new leadership role. He and his family live in Victor.

Unity Hospital. Schwabe has been with Unity for 16 years, most recently serving as senior director of the department of medicine. His former position was vice president of planning and program development at Myers Schwabe Community Hospital, in Sodus. He holds an MBA from St. John Fisher College and lives in Webster.

Thompson’s Prunoske Among Forty Under 40 Thompson Health’s chief financial officer and senior vice president of finance is one of the Rochester Business Journal’s “Forty Under 40” honorees this year. Chosen for both professional and civic achievements, Mark Prunoske was honored Oct. 29 during a luncheon held at the Hyatt Regency Rochester. Prunoske, 39, is a graduate of Mansfield University and the University of Rochester’s William E. Simon Graduate School of Business Administration who first joined Thompson Health in 1997 as a financial analyst. The Canandaigua resident was later promoted to director of finance and from 2008 to 2010 served as VP of finance. He was named to his current position in 2010. In addition to overseeing nearly

H ealth News 100 employees in 10 departments of Thompson Health, a multi-corporation community health system in Canandaigua, Prunoske implemented one of the few true cost-accounting systems within a New York healthcare Prunoske system, closed on a $29.7 million bond deal to finance Thompson’s current expansion/ renovation project, and secured $15 million in financing for its 132apartment senior communities complex. Prunoske’s community involvement includes service through the Canandaigua Salvation Army and the Rotary Club of Canandaigua.

Beth Whitbeck named employee of distinction LeadingAge New York, the professional association representing nonprofit providers of long-term care in the state, has named Beth Whitbeck of Newark, activities director at Clifton Springs Hospital Nursing Home the “Long-term Care Employee of Distinction 2012” for the Rochester Region.

The director of LeadingAge, Elliott Frost, presented the award to Whitbeck at a ceremony attended by more than 50 nursing home residents, family members, and staff on Oct. 11. Frost said that the nominating documentation spoke Whitbeck of Whitbeck’s 27 years of service to Clifton Springs Hospital Nursing Home and described her as an “advocate, compassionate, insightful, sensitive, caring and concerned about residents.” Frost presented Whitbeck with a certificate of recognition and a copy of the New York State Legislative resolution honoring the 16 statewide recipients of the award. Whitbeck was nominated by James Marotta, director, vice president of long term care, Clifton Springs Hospital Nursing Home; Doug Porschet, nurse manager, special care unit; and nursing home resident Ruth Bartleson and her family. LeadingAge New York, formerly the New York Association of Homes & Services for the Aging, represents nonprofit, mission-driven and public continuing care providers, including nursing homes, senior housing, adult care facilities, continuing care retirement communities, assisted living and community service providers.

RGHS Dedicates Jack A. & Norma Erdle Medical Building

Rochester General Health System (RGHS) has dedicated one of the buildings on the newlyacquired Linden Oaks Medical Campus to recognize one of the largest gifts of its upcoming campaign. The building, located at 20 Hagen Drive in Penfield, has been named “The Jack A. & Norma Erdle Medical Building.” “I feel honored that Jack and Norma have included Rochester General Health System as one of the organizations they trust,” said Mark Clement, president and CEO of Rochester General Health System. “Because of their trust, and the trust of our other generous friends, our health system is poised to do great things for our community.” The gift will support Rochester

Hillside unveils $22M renovated Monroe Avenue campus

Thompson Health names executive VP/COO

Hillside Family of Agencies recently unveiled the newly renovated Hillside Children’s Center Monroe Avenue campus. The campus has undergone a 13year $22 million renovation project. It serves 115 youth in residential care. The renovations come at a time when Hillside Family of Agencies is marking its 175th anniversary as one of the largest oldest youth and family non-profit human services organizations in the United States. Since 1837 the organization has grown and changed to accommodate the needs of additional children, including those with more difficult emotional, social and behavioral needs.

“When we began the campus renovations 13 years ago, we wanted to ensure that the integrity and beauty of the one hundred and seven year-old campus historically remained intact,” said president and CEO Dennis Richardson. “The revitalized campus has already created such a renewed sense of growth and prosperity for our youth living here and has allowed us to continue to provide the very best quality care.” Financial support for the new buildings, upgrades and renovations was raised from private donors and funders and through numerous campaigns over more than a decade.

A former Thompson Health vice president is returning to the health system to serve as its executive vice president and chief operating officer. Kurt M. Koczent of Geneva began his new role in October. Most recently, Koczent was the chief administrative officer for Finger Lakes Health Medical, PC, where he had served since 2009. Previously, he was Thompson’s vice president of outpatient and diagnostic services and its director of practice management. Koczent is a registered nurse who served 10 years with the U.S. Army Reserve and was honorably discharged at the rank of captain. He holds a Bachelor’s of Science in nursing from Roberts Wesleyan College, a Master of Science in health administration from Roberts Wesleyan and a position of adjunct professor in the nursing program at Keuka College. In his most recent position, Koczent constructed a physician corporation that will serve more than 100,000 patient visits annually. The corporation is certified by the National Committee for Quality Assurance as a PatientCentered Medical Home, a model that Thompson Health is pursuing in each

November 2012 •

General Health System’s upcoming campaign, which will address a broad range of healthcare needs throughout the region, including improvements to the campus and surrounding property where the Jack A. & Norma Erdle Medical Building resides. “This campus will be the setting for one of the most significant clinical expansions in our history,” Clement said. “By creating a comprehensive facility and network that acts as a ‘hospital without beds,’ we are becoming a destination healthcare provider for a full range of critical services. The result will be RGHS making healthcare more accessible, advanced, safe and cost effective than ever before.”

of its five family practices. In his new role as Thompson Health’s executive vice president and COO, Koczent will replace Michael F. Stapleton, Jr. Stapleton served as the health system’s executive vice president and COO prior to being named president and CEO earlier this year. Koczent will focus on strengthening Thompson’s primary care base and expanding its reach into its primary and secondary markets. In addition, he will be instrumental in championing numerous service excellence and quality initiatives throughout Thompson Health.

Thompson nurses recognized for excellence A total of 10 Thompson Health nurses were recognized Sept. 21 at the March of Dimes Foundation’s second annual Nurse of the Year Awards Gala, held at the Radisson Hotel in Rochester. In addition to raising funds and awareness for the nonprofit organization, the awards showcase the achievements and excellence of the region’s nurses. Eight of Thompson’s nurses were acknowledged as finalists, and two more were nominated, in the following

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 25

H ealth News categories: Jane Hallstead, education/ research/nurse author; Jessica Falk, emergency; Lauren Baker, geriatrics / long term care / rehab; Amber Fulmer, medical / surgical; Jenny Riordan, medical / surgical; Whitney Barrett, rising star; Alice Taylor, rising star; Cristine Crawford, women’s health; Vicki Erway (nominated); and Kathleen Palowitch (nominated).

Artemis Health welcomes new physician Physician Josephine Ellis has joined Artemis Health, a Lifetime Health Medical Group practice. She began welcoming new patients in October as part of the practice’s team of women physicians providing health care for women.

“We are very excited to add an additional physician,” says Diane Ahlman, a boardcertified internist who practices at Artemis Health. “Dr. Ellis is an experienced physician who shares our commitment to providing Ellis comprehensive and compassionate care.” Ellis completed her residency in family practice at the Olean General Hospital in Olean. She earned her medical degree from The Chennai Medical College in Chennai, India. She is board certified in family medicine, and is a member of the American Academy of Family Physicians as well as the Medical Society of the State of New York.

Some of our patients have described walking into Finger Lakes Radiation Oncology Center like walking into their own family’s home. It’s true, the atmosphere here is unique. Every day we strive to create a warm, compassionate and friendly atmosphere to help guide you through your cancer journey.

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Dr. Carnevale’s moves to a new ofﬁce in Geneva Gregory G. Carnevale, a board certified ear, nose, throat, allergy and sleep medicine physician, has recently moved his medical practice from 784 Pre-Emption Road in Geneva to the Carnevale Medical Arts Building, located at 64 Elizabeth Blackwell St., also in Geneva. According to a new release, his new office is larger, more efficient, easy to get to and is handicapped accessible with plenty of parking. Carnevale’s office provides a broad Carnevale range of medical and

HEALTH EVENTS

Continued from page 4 that serves people in Monroe, Wayne, Ontario, Livingston, Genesee, Wyoming and Orleans counties, will sponsor a support group meeting from 7 – 8 p.m. Nov. 13 at Pieters Family Life Center, 1025 Commons Way in Rochester. The event will feature Barb Cacia, wellness coordinator for Pieters Family Life Center, who will discuss “Living Better With Fibromyalgia.” The meeting is free of charge and is open to the public. The Fibromyalgia Association of Rochester New York was formed in spring 1993 to educate and inform others about fibromyalgia syndrome as well as to serve as a support system. For more information, call Mary Ann Nardone-Bello at 585-509-0703 or visit www.farny.org.

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surgical services. He specializes in general ear, nose, and throat diseases, sinus problems, respiratory allergies, thyroid and parathyroid disorders, head and neck cancer, skin cancers of the head and neck, snoring and sleep apnea, food allergies, asthma, dizziness, hearing loss, and voice, speech and swallowing problems and treats patients of all ages, from infants to the elderly. Carnevale has been in practice since 2001.

Nov. 15

The Labyrinth Society holds event in Rochester The Labyrinth Society of Rochester is sponsoring its Community Labyrinth Walk from 7–9 p.m., Thursday, Nov. 15, 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. A 15-minute orientation from 7-7:15 p.m. will be available. For more details, contact Kay Whipple: 585-3923601.

Nov. 18

Pancreatic Cancer Association sponsors walk Pancreatic Cancer Association of Western New York is holding its Third Annual Pancreatic 5K Walk at 12 p.m. Nov. 18 at RIT Gordon Field

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House. The walk starts 1:30 p.m. There will be a 50/50 raffle, silent auction, door prizes and entertainment for both kids and adults. All the proceeds will benefit University of Rochester Wilmot Cancer Center pancreatic cancer research. Participation fee for adults is $25; for students (13 to 31) is $15; children between 4 and 12 pay $5. There is no fee for those 3 years old and younger. For more information, call 585-225-8046 or visit www.pcawny.org.

Dec. 1

Arthritis Foundation ‘Jingle Bell Run/Walk’ Get in the spirit the holiday season at the Arthritis Foundation’s Jingle Bell Run/Walk for Arthritis. Thousands of runners and walkers are expected to hit the nation’s pavement, pathways and parks to fight the nation’s leading cause of disability. In Rochester the event will take place at 8:30 a.m. Dec. 1 at Monroe Community College, 1000 E. Henrietta Road, and will include a candy cane fun run and a certified 5K course. Organizers say Jingle Bell Run/ Walk is a fun and festive way to kick off your holidays by helping others. Wear a holiday-themed costume, tie

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

jingle bells to your shoelaces. Run or walk with your team members and celebrate the season by giving. For more information, call the Arthritis Foundation — Upstate New York Chapter at 585-264-1480.

Dec. 9

Annual tree of lights in Clifton Springs The Clifton Springs Hospital & Clinic Auxiliary will host its 27th annual Tree of Lights Ceremony at 5 p.m. Dec. 9, in the main lobby of the hospital, 2 Coulter Road, Clifton Springs. All are invited to join us for this special holiday event. For a taxdeductible donation of $5 or more, community members may have a star placed on the tree located in the main lobby in memory of a loved one or in honor of someone close. Names will be read aloud during the Tree of Lights Ceremony. Donations will benefit the Auxiliary and be used for various projects throughout the hospital. To contribute to the Tree of Lights, stop by the information desk in the main lobby, call Clifton Springs Hospital at 315-4620120, or visit CliftonSpringsHospital. org.

Experts: U.S. Risks Losing Out to Asia in Medical Research

edical research saves lives, suffering and dollars – while also creating jobs and economic activity. The United States has long led the world, with hundreds of thousands of jobs and marketable discoveries generated by government research funding every year. Top students from around the world come here for training — and often stay to help fuel medical innovation. Now, warns a team of researchers in the New England Journal of Medicine, the U.S. risks losing out to Asia as the hub of medical discovery. The result, they caution, could be a “brain drain” of top young researchers, and the loss of untold discoveries and economic activity. The authors are

two physician researchers from the University of Michigan Medical School and VA Ann Arbor Healthcare System, and an American researcher who left the U.S. for better job prospects in Singapore. They compiled data on five Asian countries — China, India, Singapore, South Korea and Taiwan — that are all boosting their government support for medical research right now. All five have a long-term plan for increased support for such research, as part of efforts to boost their national economies and world standing. By contrast, American medical scientists and physician researchers face almost certain cuts to federal research funding.

At best, the authors say, funding for the National Institutes of Health — which supports most U.S. medical research — will fail to keep pace with inflation next year. At worst, if the federal budget falls off the ‘fiscal cliff’ of automatic cuts, American medical research spending will fall by 8 percent, with thousands of researchers cut off from funding. One estimate says this could cost the U.S. $4.5 billion in economic activity. There are also proposals to cut entire health research agencies. By contrast, China has increased spending on medical research by 67 percent, South Korea by 24 percent, India by 15 percent, Singapore by 12.5 percent and Taiwan by 4 percent in the

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most recent year for which data was available. “In recent years, NIH funding has not kept pace with growth in biomedical innovation, making it harder for scientists to win grants,” says first author Gordon Sun, an otolaryngologist and health researcher who is currently a 2011-2013 Robert Wood Johnson Foundation Clinical Scholar at University of Michigan, supported by the U.S. Department of Veterans Affairs. “Meanwhile, these five Asian countries have pledged long-term increases in funding.” He notes that the number of clinical trials of new medical ideas in the U.S. has fallen, while the number in countries like China has grown.

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• Writing your life story can be easier than you think • Should you ditch your land line? • The weather is perfect to stay at a bed and breakfast • Elizabeth Osta: a journey like no other •Curt Smith talks about his job as speech writer for presidents Reagan and Bush I • Peter Parts builds lucrative international ﬁrm • Don Stevens starting his 27th year as Amerks announcer • More boomers taking the entrepreneurial route • Recorders: deceptively simple music-makers • Town of Rush supervisor talks about his decision to retire

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Valet Parking Attendants Beating the Odds If you use valet parking at the airport or civic center chances are those parking your car are hard of hearing or deaf By Ernst Lamothe Jr.

hen Frank D’Ettorre retired from Kodak in 1992, he set his sites on enjoying the simple things in life. He was going to spend his days fishing and traveling. But after a decade of living the good life, there wasn’t enough leisure to keep him busy. Determined to still be a productive working man, D’Ettorre decided to start looking for part time jobs at the age of 63. He knew that would be a difficult task, yet he also knew his biggest barrier would have nothing to do with his age. Born hard of hearing, D’Ettorre attended the Rochester School for the Deaf and has worn a hearing aid all his life. “I can’t live without hearing aids because if I don’t have it, I’m lost,” said D’Ettorre, 70, of Gates. Knowing there weren’t many options for him, he applied to work in February 2005 at MAPCO Parking, a full service parking organization that handles lots at the Greater Rochester International Airport and the downtown Civic Center. What he didn’t know then was that he wouldn’t even be the first of many deaf or hard of hearing employed by MAPCO owners Rick and Les Goldstein. They provide the deaf and hard of hearing employees with Blackberry phones to communicate the tasks for the day instead of having to read lips. “We just look for good employees who are hard working and can do the job no matter who they are,” said Rick Goldstein, CEO and president, the third generation of the family-owned

business. “We don’t think of people as hearing impaired because that shouldn’t be a factor. We just think of them as part of our family and we ask can they do the job?” Five years ago, the company introduced a valet parking service at the Greater Rochester International Airport. D’Ettorre became one of the first members of the new program and remains there today. Ron Smithski is another employee at MAPCO. He was born deaf and has two grown-up deaf daughters. “I work for Rick most of the time and I really want to thank him for hiring a few deaf people and show we can do the job,” said Smithski, 68, of Chili, who started work two months after D’Ettoree and is in his seventh year. Sam Sirianni, 60, of Rochester, born deaf, was working at Frontier Field during the baseball season years ago. After the season was over, he was told about an opportunity at the airport. He has worked there and at the downtown Civic Center. Thriving in his position, he said more employers need to open their hearts, listen to their employees and create an environment that includes everyone. D’Ettorre wears a hearing aid to hear when clients walk in needing valet services and discusses when they will pick up their cars. Comfortable in many environments, D’Ettorre often has casual conversations with the customers about the weather, their families and what kind of adventures they are looking forward to on their

Here Frank Dettorre and Ronald Smithski are on break communicating with their hands. Page 28

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Frank Dettorre of Gates hasn’t left his hard of hearing condition prevent him from holding regular jobs. He works for MAPCO Parking, a full service parking organization that handles lots at the Greater Rochester International Airport and the downtown Civic Center. Like him, the company employs other people with hearing problems. subsequent flights. Diligent as he’s always been since his days at Kodak, D’Ettorre, who was nominated last year for employee of the year, eventually got promoted as the lead trainer and supervisor over new valets. He realizes that few business owners can see through a person’s disability. “I’m hard of hearing, but that doesn’t make me handicapped to Rick,” said D’Ettorre. “They just care about everyone who works for them and they don’t discriminate no matter who you are. All we ask for is a chance to be great employees.”

Goldstein, whose 150-employee company has been in the area since the end of the Great Depression, said most customers don’t even realize the company has several hearing-impaired employees because the job gets done correctly. “They are a terrific group of guys that make our team better who are willing and capable of doing everything we asked them to do,” said Goldstein. “You don’t have to see if they are doing their tasks the right way because they are professionals. And with the Blackberry phones, technology has removed any barriers.”

MAPCO Parking provide the deaf and hard of hearing employees with Blackberry phones to communicate the tasks for the day instead of having to read lips.

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