Gv igh 97 sept13 by In Good Health: Rochester's Healthcare Newspaper

in good George W. Bush’s Heart Problems A healthy and fit former President Bush finds himself with heart problems. What does it say for the rest of us? How at risk are we?

“30 things I’ve learned about living alone”

September 2013 • Issue 97

Rochester–Genesee Valley Healthcare Newspaper

$152,000 Beatriz FolchTorres, a first-year resident student at the University of Rochester Medical Center, said she will leave school with more than $200,000 in loans.

That’s the average loan of medical students at University of Rochester when they leave school. Too high? It’s actually lower than the average

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New School Season Means New Injury Season

Toenail Fungus With lesser known treatment, expect healthy nails in 12 – 15 months, says Rochester foot reflexologist

Participating in school sports offers students unique opportunities to develop lifelong fitness habits, learn teamwork skills and build lasting friendships; however, sports can also expose children to environments and activities where serious injury is possible.

Men’s Low Libido

Do they have to live with it or is there treatment?

ANTIBIOTICS

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How safe are they?

Juvenile Arthritis Meet Your Doctor Physician Bridgette Ann Wiefling talks about her experience in patient care

priceless

Lizzy Parrone, a 3-year-old who lives with her family in East Rochester, suffers from juvenile arthritis. “At first the doctors thought she had an infection in her knee, but when we saw an orthopedic specialist, that’s when we received the shocking news,” says her mother, Natasha.

Vintage Raider Rochester Rochester MS victim victim MS takes to to his his takes bike to to raise raise bike funds funds

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

September 2013 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Daily Money Management

CALENDAR of

by Jacquelyn M. Bell CPA

omething we all should do is consolidate our personal financial and medical information. It is prudent to be proactive and have this information readily available when needed. Compile a list of all of your bank and investment accounts, insurance policies and professional contacts – attorneys, financial advisors, doctors, insurance agents, etc. Keep a current list of your medications. Document the names of your Power of Attorney and Health Care Proxy and note where all your important legal documents are stored. Let a trusted person know where to find this information. Tell this person where the key to your safe deposit box is. A Daily Money Manager (DMM) can help with this process. We ensure our clients’ personal financial lives are under control, and this gives our clients great peace of mind. All DMM’s adhere to high ethical standards and commit to providing the best possible service to their clients. For more information, please visit www.aadmm. com or call Jacquelyn M. Bell CPA, PLLC, at (585) 229-4477.

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for a FREE telephone consultation call:

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HEALTH EVENTS

Sept. 7

Free health screenings At Women’s Health Fair The City of Rochester, URMC, Chase Bank and Monroe Wheelchair are sponsoring the 5th Annual Women’s Health Fair at the Market, which will take place from 9 a.m. to 1 p.m. Saturday, Sept 7 at the Rochester Public Market. The fair will offer a variety of free health screenings to adult women from ages 18 to 80, including tests for asthma, AIDS/HIV, osteoporosis, breast cancer, heart disease, stroke risk, dental problems, diabetes, glaucoma, kidney disease, lead poisoning, mental health issues and skin cancer. Information booths will be available. Help for smoking cessation and also for insurance enrollment will be offered for those in need. Physicians and mid-level care providers will be on site throughout the event for screenings and to answer questions. For more information, contact physician James R. Woods Jr. at 585-275-5201.

Sept. 10

National director of hearing loss group in Rochester Anna Gilmore Hall, the new executive director of Hearing Loss Association of America, will be a guest speaker during a program hosted by HLAA/ Rochester. She will meet members of the local chapter and other attendants during the meetings the organization holds at 11 a.m. and 7 p.m. Sept. 10 in the vestry room of St. Paul’s Episcopal Church, East Avenue at Westminister Road. Gilmore Hall, who assumed the executive directorship July 8, will comment on her vision for the future of the nation’s foremost membership and advocacy organization for people with hearing loss, based in Bethesda Md. “Having met Anna Gilmore Hall at the convention, I’m delighted to welcome her to Rochester and look forward to our chapter working with the national association and Anna to further our goals,” said chapter president, the physician Elise dePapp. A New Englander, Anna Gilmore Hall is a graduate of Eastern Maine Medical Center School of Nursing with a diploma in nursing; she also holds a Master of Science degree from University of Maine and Capella University. She has earned a certification in Association Management from the American Society of Association Executives. With more than 20 years of managing nonprofit organizations, before joining HLAA she was the executive director of Practice Greenhealth, the nation’s leading membership organization for institutions in the health care community that commit to sustainable eco-friendly practices. From 2004-08 she was co-executive director of Health Care Without Harm, an international

campaign for environmentally responsible health care. For more information visit www. hlaa-rochester-ny.org or call 585-2667890.

Sept. 10

FARNY to host discussion fatigue and stress “Adrenal Fatigue and Stress” is the topic of a discussion sponsored by the Fibromyalgia Association of Rochester New York (FARNY), which serves people in Monroe, Wayne, Ontario, Livingston, Genesee, Wyoming and Orleans counties. The support group meeting will take place from 7 – 8:30 p.m., Sept. 10, at the Greece Town Hall Meeting Center, 1 Vince Tofany Blvd. in Rochester. Speaker will be physician Pam Grover of Quality of Life Medicine of Rochester. Grover has treated many patients with fibromyalgia and has a degree in sports medicine from the medical school at SUNY Buffalo. She also taught medical students and family medicine residents at the University of South Florida. For more information, visit www.farny. org or call Mary Ann Nardone Bello at 585-225-7515.

Sept. 11

Unity offers class: ‘Jump Start your Diet this Fall’ Learn how to cook with beans, lentils, legumes and soy and be amazed by the health benefits. A program presented by Unity Diabetes & Endocrinology Services will teach participants how do adopt a low fat plant-based approach to manage diseases such as diabetes, high cholesterol, hypertension and promotes weight loss. It will feature live cooking demonstrations, sampling and recipes. Titled “Seeds of Change” the program will meet for two-hour sessions over the course of four weeks. It will take place from 6 – 8 p.m. on Sept. 11, 18, 25 and Oct. 2. The class is taught by registered dietitians and certified diabetes educators at Unity Diabetes & Endocrinology Services, 2655 Ridgeway Avenue, suite 220 in Rochester. The cost if $120, payable to Unity Health System.

Sept. 22

Lori’s Natural Food holds ‘Taste of Lori’ Lori’s Natural Foods Center will celebrate its 32nd anniversary with a special Taste of Lori’s event, which will take place from 6:30 – 8:30 p.m., Sunday, Sept. 22. Attendants will have the opportunity to taste several of the food available at the center, located at 900 Jefferson Road in Rochester. Many great prizes will be given away. Also as part of the celebration, Lori is planning

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

other events all month long. They will include giveaways, prizes and sale at 25 percent. It will also have a ‘createa-logo’ contest and a popular Dancing Banana event. For more information, call 585-424-2323 or visit www.lorisnatural.com.

Sept. 24

Chiropractor to discuss ﬁbromyalgia treatment Chiropractor Emma Summers will discuss the benefits of chiropractic treatments and how they can help enhance the daily life of people who suffer from fibromyalgia. The meeting, organized by New Fibromyalgia Support Group, will take place from 6:15 – 8:30 p.m. at Westside YMCA, 920 Elmgrove Road in Gates. She is expected to explain the various kinds of treatments available for the different kinds of disorders for chronic pain, including soft tissue disorders for fibromyalgia patients. Program is open to the public but registration is needed. Contact Brenda Lind at Rochester YMCA, 585341-3290 or brendal@rochesterymca. org for more information.

Oct. 8, 15, and 22

Workshop: ‘Survive and Thrive on Your Own’ Do you live alone? Is it a challenge for you? “Living Alone: How to Survive and Thrive on Your Own,” is a three-part workshop offered for women who want to gain the know-how to forge a meaningful and enriching life on their own. You’ll discover how to think differently about living alone and learn practical strategies to overcome loneliness and other emotional pitfalls, rediscover your true self, and socialize in a couples’ world. The workshop takes place from 7– 9 pm at House Content Bed & Breakfast in Mendon on three consecutive Tuesdays: Oct. 8, 15, and 22.The workshop fee of $125 includes a Living Alone manual, empowerment exercises, and lots of helpful resources. To register, contact Gwenn Voelckers at 585-624-7887 or email gvoelckers@rochester.rr.com

Oct. 20

MS group sponsors ‘Monster Scramble’ The National Multiple Sclerosis Society Upstate New York Chapter is launching a unique run/walk series in October across the state called, “Monster Scramble,” a chip-timed, Halloween-themed race that will have the runners in costume, as well as costumed volunteers on the course. (The event name, Monster Scramble, is a play on the phrase, “The Monster,” which is how some people refer to MS.) Each Monster Scramble site — Lake George, Rochester, Buffalo and Syracuse — will feature a 5K and 10K race and, if running isn’t your speed, a onemile family oriented trick-or-treating stroll that will take place after the race. In Rochester, the event will take place at 10 a.m., Oct. 20, starting at Mount Hope Cemetery, 1133 Mount Hope Ave. in Rochester. For more information, contact Susan Ashline, at 585-271-0805 (ext. 70344), or thru her email, Susan. Ashline@nmss.org.

ANTIBIOTICS

Doctors most often choose strongest types of drugs but more than onequarter of such prescriptions are unwarranted, study finds

hen U.S. physicians prescribe antibiotics, more than 60 percent of the time they choose some of the strongest types of antibiotics, referred to as “broad spectrum,” which are capable of killing multiple kinds of bacteria, University of Utah researchers show in a new study. Unfortunately, in more than 25 percent of cases studied, such prescriptions are useless because the infection stems from a virus, which cannot be treated with antibiotics. This overuse of antibiotics has a number of downsides, including that these types of drugs kill more of the “good” bacteria found in our bodies — which may lead to more side effects — and also contribute to the growth of antibiotic-resistant bacteria, according to Adam L. Hersh, an infectious disease expert, assistant professor of pediatrics at the University of Utah School of Medicine and senior author on a study published July 29 in the Journal of Antimicrobial Chemotherapy. Discerning whether an infection is viral or bacterial can be tricky, according to Hersh, which probably accounts for much of the overuse of antibiotics. “It seems that the natural bias, when there is uncertainty about an infection’s cause, is to err on the side of prescribing antibiotics,” he says. “Our study found that the majority of prescriptions are for antibiotics that kill a wider range of bacteria, and that they are most likely to be given when they’re not needed, such as in cases of viral

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infections.” The types of illnesses where doctors seem to choose stronger antibiotics include respiratory problems, skin infections and urinary tract infections, which in many cases would be better treated by other antibiotics that are less likely to cause resistance. Antibiotic overuse among children and adults is a serious problem and a threat to everyone’s health, according to Hersh, Andrew T. Pavia, also an infectious disease expert and a medical epidemiologist at the U.S. Centers for Disease Control and Prevention “The biggest problem with using antibiotics when they’re not needed is the development of antibiotic resistance, which is when bacteria survive by outsmarting the antibiotic,” she says. “Common infections become difficult to treat, and when you really need an antibiotic, it may not work.” He urges patients to play a larger role by asking their doctor two questions: Do I really need this antibiotic? And, is this antibiotic the best choice for my infection? “Both doctors and patients have a role in ensuring the effectiveness of antibiotics is preserved by using them only when needed,” Hersh says.

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

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

In Good Health is published 12 times a year by Local News, Inc. © 2013 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo • Writers and Contributing Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Jessica Spies, Joel Swartz • Advertising: Donna Kimbrell, Amber Dwyer Layout & Design: Chris Crocker Ofﬁcer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

September 2013 •

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585-340-8926 University of Rochester Translational Pain Research IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor

By Lou Sorendo

Bridgette Ann Wiefling How a trip to Bolivia and Honduras and being the CEO of Anthony L. Jordan Community Health Center have shaped a doctor’s view of patient care

ridgette Ann Wiefling is the interim senior vice president and executive medical director of the Rochester General Medical Group. She is also the vice president for clinical innovation for the Rochester General Health System. Q.: What motivated you to choose internal medicine and pediatrics? A.: I really enjoyed all aspects of my medical education and actually found it extremely difficult to choose which specialty I was going to go into. Internal medicine and pediatrics was a relatively new specialty when I chose it. It featured the broadest education that I could get and had enough detail into the body system to really satisfy my desire to have a comprehensive approach to patients and be able to serve a very broad population. Internal medicine and pediatrics are two different programs. I am an internal medicine physician and a pediatrician. They are two completely separate lines of business. Q.: Why did you choose the Rochester area to practice in? What do you enjoy about the region? A.: One of my criteria for where I chose my residency—besides wanting to be in a residency program with a great reputation—was to be on the water because I sail. I also wanted to be where I could have an urban life as well because I really enjoy the inner city practice of medicine.

that helped to reshape the infrastructure of that system so that it would not just deliver care, but actually deliver an experience and address a need beyond the individual patient-to-patient level. Q.: You served as part of a medical/ surgical outreach team in Bolivia and Honduras. What motivated you to get involved with the team and how did you benefit from it on a personal and professional level? A.: One of my great interests is studying and understanding how medical systems work, both from a policy, economics and social influence perspective. Having the opportunity to participate in medical outreach into areas that are more resource poor or require more intense resources gave me the opportunity to really delve into another area of health systems. It helped me to understand how their social structure, economic situation and health system af-

fects their population. Personally, I love medicine and I feel that my medical education was a gift. I really wanted to use it to help those who might not have another opportunity to get that help. If I can give a little for someone else to get a lot, that would be awesome. Q.: What are some of the common illnesses/conditions you are encountering at RGH? Do you see patients of all ages? A.: In my position, I’m overseeing the medical group that takes care of adult primary care, pediatric primary care as well as specialty care. There are multiple specialties that I oversee. I’m seeing a broad range of the population, and we are seeing the standard conditions such as diabetes, hypertension and obesity. We are also seeing a lot of anxiety and depression, and I feel that economics has weighed heavily on our community. There is also an increasing amount of pressure we are seeing on our patients—including pediatric patients— due to the Internet and different social pressures that have been added through technology. Q.: What do you find to be the most gratifying aspect of practicing medicine? How about the most challenging? A.: The most gratifying aspect of medicine for me is being able to help people navigate through complex systems, not just the complexity of the infrastructure of our health system but also the complexity of health itself. There is nothing more satisfying then when I can help a person understand an illness they are facing and its impact on the body in a way that allows them to be engaged and be an active participant in making decisions for themselves around treatment plans. I think the rapidness around which we are seeing change occur in the way healthcare is being delivered because of regulatory pressure is probably right now the most challeng-

Q.: How did your experience as CEO of the Anthony L. Jordan Community Health Center help shape you as a healthcare professional? A.: Being at the Anthony L. Jordan Community Health Center taught me a lot both as a physician and administrator. What I came to understand is how critically important the environment, social influence and economics all come together to really impact a community’s health. What the definition of health is in one community may not be the same as the definition of health in another community. Q.: What were some of your foremost accomplishments at the health center? A.: My big accomplishment was that I was able to build a great team Page 6

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

ing aspect of practicing medicine. It has become extremely difficult for both independent as well as employed primary care physicians to cope with an ever-increasing demand involving paperwork, adoption of electronic medical records and changes in billing regulations. I think that is the biggest hurdle we are facing and it is pushing early retirements and reducing the number of medical students interested in primary care. I actually see it as a substantial threat to primary care in the future. We really have to work hard on addressing that as a nation. Q.: What do you see as the most threatening problem affecting the health of Americans today? A.: Obviously right now, the hot topic is obesity. It is felt by many to be the etiology of subsequent other illnesses like diabetes and hypertension. I think that is probably our greatest threat and there are significant societal pressures to fight against in order to help reduce the impact of obesity. We are a fast food society and there’s lots of marketing to promote foods that go against a healthier diet. That is hard to fight against, similar to the smoking battle when we are up against the marketing forces of the tobacco industry. That is a problem that is helping to contribute toward obesity. With technology, we have also developed a more sedentary lifestyle that we are also combating. However, I definitely see incredible signs of help on the horizon. We are seeing more opportunities at restaurants and other food outlets to choose healthier foods. Wegmans has had a great impact on the community and that’s exciting. Rochester General Health System just opened up a wellness center for its employees, and RIT did as well. That’s really important and a great sign that employers are recognizing the importance of helping their employees be healthy. Q. You are the vice president for clinical innovation at Rochester General Hospital. What exactly is that and what is your role in the program? A.: That portion of my work involves building the components that will allow our integrated delivery network to really expand and capitalize on population health management. It’s not just about technology but also how we perform the transition of care, what our philosophy is around the patient handoff, and how we structure our episodes of care from a utilization management perspective so that we are the most effective and the most efficient and can really deliver on good patient outcomes. I administer the program along with an entire cross-discipline, enterprise-wide committee.

Lifelines: Birthplace: Pittsburgh, Pa. Current residence: Rochester Education: Internal medicine and pediatric residency, University of Rochester, Strong Memorial Hospital and Golisano Children’s Hospital, Rochester; medical degree, University of Wisconsin College of Medicine, Madison, Wis.; Bachelor of Science degree in biology, Slippery Rock University, Slippery Rock, Pa. Personal: Married with three stepchildren Hobbies: Sailing

The Cure for Toenail Fungus

With lesser known treatment, expect healthy nails in 12 to 15 months, says Rochester foot reflexologist By Joel Swartz

nychomycosis (on·y·cho·my·co·sis) is the technical term for a toenail fungus infection that affects millions of people in this country. It is caused by fungus spores that find their way under one or more toenails. This can happen when there is damage to a toenail or when a separation between a toenail and its nail bed creates a way for fungus spores to enter. Unfortunately, the environment under a toenail is a perfect place for this fungus to grow; it is dark, moist and warm. Once there, the spores grow into an infection that is often very difficult to remove. I have been a foot reflexologist for more than 25 years, and during that time I have had many occasions to observe and talk with clients about the struggle they have had with trying to eliminate their toenail fungus infections. Over the past few years I have studied various approaches to the removal of this fungus. Many people try over-the-counter products, home remedies or visit a podiatrist, who may prescribe topical or systemic medications. Prescribed medications have a 30 to 50 percent chance of working. The other approaches are mostly ineffective. But there is another avenue that is less known but more effective: It is the avenue of light. Yes, light is the way to bring fungus nails back to healthy nails once again.

This approach involves three specific wavelengths of LED light—the first two are near infrared (NIR) and the third is blue light. Together, a timed dose of these LED lights stimulates the fungus cells to work overtime, which generates excessive amounts of oxygen. Too much oxygen has a toxic effect on the fungus, which causes its life force to cease. While these LED lights are toxic to fungus organisms—which are classified as plants—they are not dangerous to any human cells. Most importantly, there are no side effects or heat felt from these LED lights. Each session I conduct is about 30 minutes and takes place in your home. For a mild to moderate infection two sessions are enough. For those with thickened nails, a third session may be required. Following these sessions, your toenails will look just as they did before the light dose was applied to them. Toenails grow very slowly, about one millimeter a month. With this in mind, you should begin to notice healthy nail growth in about four to six months and fully grown out healthy nails in 12 to 15 months. During the session I will discuss how you can avoid re-infecting yourself in order to keep your toenails fungus free. For any questions please contact Joel Swartz at 546-6712 or email him at ejswartz@frontiernet.net.

Epilepsy Foundation and PRALID Merge to Become Epilepsy-Pralid, Inc.

common mission of helping people with epilepsy and brain injuries was the impetus for a recent merger between the Epilepsy Foundation of Rochester-SyracuseBinghamton and People Rebuilding And Living In Dignity (PRALID). The resulting entity is now known as Epilepsy-Pralid Inc., (EPI). The nonprofits were drawn together in the interest of enhanced services and cost savings. The result is that EPI will be able to provide an expanded variety of innovative, tailored services to individuals and families with unique social, development, and behavioral needs. “This was a natural step for both organizations,” said Jeff Sinsebox, President, EPI who formerly served as PRALID president. “The organizations realized that together they would be stronger, more fiscally sound, better able to serve those who turn to us for assistance and uniquely poised for future growth opportunities.” The merger will result in administrative efficiencies and cost savings. As a united entity EPI will be better prepared to mitigate anticipated reim-

bursement changes under managed care as well as New York state policy reimbursement structure changes which could affect availability of services to individuals. As both agencies are government funded, a greater portion of taxpayer money will be spent on services because of a consolidation of administrative expenses. Funds from United Way of Greater Rochester’s Synergy Fund helped make the merger possible. “United Way supports organizations that are exploring collaboration to help sharpen their focus and keep up with the changing priorities of our community,” said Patricia Leo, director of community investment at United Way. “Our investment in this affiliation provided technical assistance through the New York Council of Nonprofits, Inc. and will enhance the overall operations of the organizations.” This is the first local Medicaid/ Medicaid organization merger funded by United Way’s Synergy grant. The Disability Resource Connections program provided by the Epilepsy Foundation will also continue to be supported by United Way’s Community Fund. September 2013 •

Do you live alone? Living alone can be a challenge, especially for women in mid-life who are divorced or widowed. But it can also be the start of a rich and meaningful chapter in your life. Need a jump start?

Living Alone: How to Survive and Thrive on Your Own Tuesdays, October 8, 15 and 22 7:00 pm - 9:00 pm House Content B&B, Mendon, NY

In the workshop led by Gwenn Voelckers — a woman who’s “been there” — you’ll learn practical strategies to overcome loneliness and other emotional pitfalls, rediscover your true self, and socialize in a couples’ world. $125 fee includes empowerment exercises and many helpful resources. For more information, call (585) 624-7887 or email gvoelckers@rochester.rr.com

When you text a driver, you increase their risk of an accident by

TWENTY-

THREE TIMES

Visit URthatDistracting.org to see how you can help end distracted driving.

*SOURCE: DISTRACTION.GOV

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

30 Things I’ve Learned About Living Alone

have been living alone for almost 30 years now. Thirty years! One might think I’ve become stuck in my ways, but — honestly — just the opposite has happened. Being on my own has given me the freedom to live unencumbered, to change, to grow, and to embrace lifelong learning. The only thing I’m stuck on is living life to the fullest! And apparently, I’m not alone. According to recent census data, singles make up almost 30 percent of US households. That suggests to me that more and more women and men — whether divorced, widowed, or never married — may be finding contentment on their own.

Below are 30 things I’ve learned about living alone: 1 — Living alone doesn’t mean being alone. In fact, it may offer more opportunities to pursue friendships, date, and spend time with family members. 2 — Rediscovering your “true self” and identifying those things that bring meaning and joy into your life can turn living alone into an adventure. 3 — Loneliness is not a “state of being” reserved for single people. Were you ever lonely while you were married? 4 — Accepting party invitations, even if it’s a party with mostly couples, is worth doing. It gets you out of the house. Couples often separate into groups of women and men anyway, so singles blend right in. 5 — Figuring out how to replace

the flapper value in your toilet, all by yourself, can be very rewarding! 6 — The stereotyped image of singles as desperate and miserable is exaggerated and just plain untrue. Recent studies on the subject bear this out. 7 — Pursuing a new career or college degree in midlife can be liberating and fun. 8 — Doing a “random act of kindness” is a great antidote when you’re feeling sorry for yourself. 9 — Friends matter. Reach out. Nurture your friendships. Honor your commitments. 10 — Accepting a dinner invitation does not obligate you to anything. Take your time. Get to know the person you’re dating before you embrace romance — literally. 11 — Paying your own fair share on a date can feel very empowering. 12 —Children are priorities, even in the face of a hot and heavy romance. 13 — Letting go of the idea that you need to be married to feel happy and fulfilled is essential. That outlook will only keep you mired in self-pity. 14 — Living alone can release your inner Martha Stewart. Do you have a craft project secretly lurking inside you? Set it free! 15 — Treating yourself well builds esteem. Prepare and eat decent meals at home. Get enough sleep. Exercise. You’re worth it. 16 — Getting out of your com-

KIDS Corner Most Adults Support Banning Smoking When Kids Are in the Car

new poll shows 82 percent of adults support banning smoking in cars when children under 13 are riding in the vehicle. According to the latest University of Michigan Mott Children’s Hospital National Poll on Children’s Health, support is strong for prohibiting drivers and passengers from smoking when kids are in the car. However, only seven states nationwide have laws banning the practice. The poll also showed that 87 percent of adults would support a ban on smoking in businesses where children are allowed. Seventy-five percent expressed support for banning smoking in homes where children have asthma or another lung disease. Page 8

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“Smoke is a real health hazard for kids whose lungs are still developing, and especially for kids who have illnesses like asthma where the lungs are particularly fragile and flare up when exposed to secondhand smoke,” says Matthew M. Davis, director of the C.S. Mott Children’s Hospital National Poll on Children’s Health. Even among current smokers in the poll, more than one half supported bans that would protect children from secondhand smoke. For example, 60 percent of current smokers said they’d strongly support or support a ban on smoking in cars with children under 13 years old present, compared with 84 percent of former smokers and 87 percent of never-smokers.

fort zone is worth the discomfort. Try something new — dance lessons, computer lessons, jewelry making, a class in public speaking. It’s a great way to have fun and meet people. 17 — Still in your PJ’s at noon? No one has to know. 18 — Isolating on holiday, birthdays, Sundays, etc. is for the birds. Solitary confinement is punishment for criminals, not single people. Make plans. 19 — Traveling solo is an adventure in self-discovery. Whether it’s Paris or Peoria, striking out on your own will expand your world and build self-confidence. 20 — Comb your hair. Lose the sweat pants. Put a smile on your face. It’s important to create your own positive feedback. Looking good will draw people (and compliments) to you. 21 — Self-confidence and humor are powerful aphrodisiacs. Neediness and desperation are real turn-offs. 22 — It’s all yours — the good, the bad, the chores, the bills. Living alone, like being married, is not Shangri-La. It’s real life. 23 — There’s no shame in asking for help. It’s not a show of weakness. On the contrary. 24 — Doing something alone means you enjoy life and your own company; it does not mean you are a loser. 25 — Expanding your definition of

love beyond “romantic love” will stand you in good stead. Embrace “passionate friendships” — those relationships in which you can be yourself and feel completely comfortable. 26 — Hanging out with negative people is a real downer. Put yourself with people who make you feel good about yourself and about life. 27 — Time alone can make you philosophical: If I vacuum in the nude and no one is here to see it, did it really happen? 28 — Your dream house can be yours. Whether it’s a shoebox-sized apartment or cottage in the county, you can — at long last! — make your home your own. 29 — Mac ‘n cheese may be just what the doctor ordered. There’s no harm in occasionally indulging in your favorite comfort food and tearjerker movie if it soothes your soul. “The Way We Were” is my three-hankie movie of choice. 30 — Living alone and loving it takes practice. Know that there is always someone you can call or something you can do to improve your situation. A little prayer doesn’t hurt either. Those of us who have learned to enjoy living along are not spending our time bemoaning our fate. We have overcome adversity and we are the stronger for it. We have taken our lives into our own hands and have embraced the choices and possibilities that living alone has to offer. Here’s to the next thirty years! 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 October workshop schedule, turn to the Calendar of Events in this issue, call (585) 624-788,7 or e-mail Gwenn at gvoelckers@rochester.rr.com.

Why Kids Should Not be Allowed on Trampoline Pediatric orthopedic surgeon says trampolines not worth injury risk

ess than two weeks after getting a new trampoline, 12-year-old Abbey Creamean broke her ankle when she landed awkwardly. She wore a cast up to her midthigh. She had to cancel a dance recital, quit her softball team and give up swimming. Abbey is among the more than 100 young patients that physician Terri Cappello of Loyola University Medical Center has treated during her 15 years as a pediatric orthopedic surgeon. “A trampoline puts a child at risk for serious injuries,” Cappello said. “Kids sustain broken arms, legs and even break their necks which can lead to paralysis. Just as you would not let your child jump into a shallow swimming pool, you should not let them jump on a trampoline.” Cappello agrees with a policy statement from the American Academy of Pediatrics (AAP) that says safety measures such as enclosure nets and padding have not substantially reduced the risk. “Therefore, the home use of

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

trampolines is strongly discouraged,” the Academy statement said. The AAP estimated that in 2009, there were nearly 98,000 trampolinerelated injuries in the United States. And injuries peak during the summer months. Cappello said trampolines might be worth the risk only when used for training purposes by gymnasts and divers, under careful supervision.

Former President Bush’s Heart Trouble If someone like former President George Bush — who doesn’t smoke or drink, who exercises regularly and is very fit — has to have a heart surgery to open a blocked artery, what should the rest of us expect when it comes to heart problems? By Ernst Lamothe Jr.

e didn’t drink alcohol for the past 27 years. He didn’t smoke or do drugs. People who met him said they were instantly impressed with his physique. His broad shoulders often gave away that he must work out regularly. He even biked 100-K this past May as he does every year as part of an event honoring U.S. service men. He also just went in for heart surgery in August after doctors discovered a blocked artery. Seemingly doing everything right, former President George W. Bush, 67, became one of a million people each year to have the procedure, according to the National Institute of Health. To an outside observer, it’s puzzling how someone who was so active and fit could have a heart problem. While there may not be a myriad of answers to why he had the conditions, there have been questions as to why his physician decided on the particular treatment. Physician Christopher Cove, assistant director of the Cardiac Catheterization Laboratories at the University of Rochester Medical Center, said the former president’s active life could be the reason why it was only minor surgery. “Clearly he was a healthy person who exercised and took care of himself,” said Cove. “He was one of those people who would have been a low candidate for coronary disease. If he hasn’t been healthy, he would have been in far worse shape than the was.” Bush found out about the blockage through an annual physical exam and stress test in Dallas and was treated at Texas Health Presbyterian Hospital. He had a blockage in a crucial artery that supplies the heart with blood. Doctors placed a stent to open the artery so blood could go through. Stents are used to treat narrow or weak arteries in a procedure called angioplasty. The doctor makes a small opening in a blood vessel in your groin upper thigh, arm or neck. Through this opening,

the doctor threads a thin, flexible tube called a catheter. The catheter will have a deflated balloon at its tip and the stent is placed around the deflated balloon. At the Cardiac Catheterization Laboratories in Rochester, Cove performs diagnostic and interventional procedures including complex coronary interventions, and primary angioplasty for acute infarcts. He is familiar with the procedure Bush went through and some physicians in the medical community viewed putting in a stent as questionable. “Because he was asymptomatic, the procedure is not consistent with the recommendation by the American Heart Association and other medical organizations,” said Cove. “If he had chest pains or a heart attack it would make sense, but we don’t know what the benefit is for someone who didn’t have symptoms. There has been a lot of uproar, but there is also no clear-cut guideline on how to treat asymptomatic patients.” He said likely Bush talked with his physician, received all the options and they opted for this one. Cove also said a minor blockage is rather common for older citizens. “Just because you have a blockage doesn’t mean it needs to be fixed,” he said. “What you have to do is calculate the risk of treatment with the risk of the condition.” Robert Carhart, associate professor of medicine and cardiologist at Upstate University Hospital in Syracuse, said even healthy people can have a blockage. And it’s especially the case as individuals get older. “Over time, the arteries become stiffer as part of the natural aging process. That’s when some blockage can occur,” said Carhart. “Plus there are factors like family history, cholesterol and other issues that play a role in your condition.” Doctors caution individuals not to get too comfortable even if you just had

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the same procedure as Bush. “It doesn’t mean that you can go back to smoking or living an unhealthy life,” said Carhart. “Stents are important for treating a condition but they are not going to prevent you from having a heart attack if you don’t focus on living a healthy life. But it was good that President Bush got a stress test as part of his annual exam.” Cove said he has seen fewer patients receive angioplasties because of a nationwide push and education to maintain healthy lives. Whether it’s the targeted campaign against smoking that have lowered the overall rate, information on obesity or more people running, biking and swimming, there has been a concerted effort to educate the public on their health. More than ever today, every food item at the grocery store or sometimes in restaurants contains nutritional information. Even places like McDonalds put the overall calories in every food and beverage next to the item either on

its digital wall or the information box close to the registers. “People are eating healthier and taking medication that lowers their cholesterol,” he said. “People understand the problems that risky behavior like smoking, heavy drinking or eating the wrong foods can do to your body. Over the last 10 to 15 years, we have seen the trend of healthy living.” Cove added that 30 minutes of cardio exercise three to four times a week that raises your heart rate makes a world of difference to maintaining a healthy heart. Even though statistics are showing improvements in heart care, it really boils down to maintaining a healthy life and paying attention to symptoms.” “If anything we are seeing the number of people dying of heart disease decreasing,” added Carhart. “But it doesn’t mean we have eliminated it. We are treating people on the front end, but they are just living longer managing their chronic pain.”

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Men’sHealth

Men’s Low Libido Do men have to live with it or is there treatment? By Deborah Jeanne Sergeant

ike many men’s health problems, low libido isn’t one guys like talking about or asking their doctor about. But it is one problem that in most cases can be resolved. “It’s not something you have to accept,” said John Valvo, urologist with Center for Urology in Rochester. “You have to be honest with your practitioner and explore all aspects in your life to improve it. The sexual part of our life can be a very high quality part of our life. We can have a better self image and better relationship.” Low sex drive presents patients and their physicians with a complex medical Valvo problem involving biological, psychological and emotional factors, along with the needs of the patient’s wife. Typically, a doctor asks his patient about unrelated health issues, medication and stress, all of which can affect libido. Diabetes, obesity, and blood pressure problems can all make sexual performance more difficult. Some drugs such as anti-depressants and blood pressure medication can affect libido. Louis Eichel, urologist at Center for Urology and chief of urology at Rochester General Hospital, said that a man’s emotional state can affect his libido. He asks his patients about any stressors in their lives such as a job loss or relationship problems. “I ask about how he’s doing with

his sexual partner, like attraction and why not he’s attracted, if that is the case,” Eichel said. “It goes beyond themselves. Some people may be bored. If it’s not some sort of physiological issue, it could be something else. You have to look into the relationship.” Men who have sporadic erectile dysfunction may fear poor response so much that they create a cycle of selffulfilling prophecy. Sometimes, Eichel refers patients to a therapist to help work on emotional and relationship problems. In older men and, rarely, in younger ones, low testosterone levels can make interest in sex wane. Ralph Madeb, a physician affiliated with Vitalize Medical Center in Rochester, said that andropause, known as “male menopause,” can affect sex drive since testosterone Eichel levels plummet at this stage of life, along with other factors related to intimacy such as mood, and self image. “Their energy level and concentrating ability is a problem, too,” Madeb said. “They may have weight gain, increasing the fat deposition in the gut and legs, and decreasing the muscle content. These are signs of low testosterone.” Many men do not realize what’s going on because the signs can be either mistaken for something else, since men don’t experience obvious, abrupt

symptoms like women, or glumly accepted as part of old age. “It’s a gradual encroachment,” Madeb said. “Their mood will shift. All they want to do is sleep on the couch. He can get an erection fine but he’s so tired.” Increased fat on a Madeb man’s body does more than ding his self image. Madeb said it can directly affect libido. “The silent killer of libido in men is excess weight,” Madeb said. “It inactivates testosterone and makes it much harder to make other natural chemicals

in the body to work. It’s a very important concept for men to learn.” He has treated patients with low sex drive and low energy levels who had expected Madeb to prescribe testosterone; however, losing weight has proven to alliviate their symptoms instead. His office offers a medicallymonitored exercise, nutrition and supplement program that helps patients shed pounds quickly and more safely. For men with low testosterone, Madeb may prescribe hormone replacement therapy, which he said is 100 percent effective with few unwanted side effects, including restlessness and benign prostate enlargement. Patients’ blood tests are carefully monitored to help them maintain a healthy testosterone level.

September is National Prostate Cancer Awareness Month Be a Man. Have Your Prostate Checked By Patrick Fisher

s a survivor of prostate cancer and a Vietnam veteran I encourage every man to discuss prostate health with a medical provider. If your primary care provider does not address your concerns to be tested for prostate cancer, seek a second opinion. When researching information use reliable Internet websites that reflect current knowledge and trends. While a rising PSA may not necessarily indicate prostate cancer, it is a true medical concern. Here are a few items to consider: • Prostate cancer may be curable but only if detected early. • In the U.S., prostate cancer will affect one in six men in their lifetime. However, not all prostate cancers require aggressive treatment. • Men have a 35 percent greater Page 10

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chance of being diagnosed with prostate cancer than women have of being diagnosed with breast cancer. • Vietnam veterans, men over age 50, men with a family history of prostate cancer, African American men, and men who apply or take testosterone supplements may be at greater risk. • Some men with prostate cancer have no symptoms; some even have a normal PSA. • Once a man develops symptoms, it may be too late for cure but treat-

ments exist that allow them to live a long and productive life. • Side effects from treatment or surgery may vary from one individual to the next, but new research has resulted in multiple options. • Everyone born male needs to pay attention to their prostate health. Survivors of prostate cancer and those who love them may benefit by attending meetings with a local prostate cancer support group. In Rochester, contact the following organizations for support information: • Gilda’s Club: Phone 585-423-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

9700; • Wilmot Cancer Center at Strong Memorial Hospital: Phone 585-2755823; • Lipson Cancer Center at Rochester General Hospital: Phone 585- 9224020; • Cancer Care Center at Unity Health: Phone 585-368-359. Patrick Fisher is Us TOO Rochester leader. Us TOO Rochester NY is a nonproﬁt support group dedicated solely to men surviving prostate cancer. The group meets from 7 – 9 p.m. on the second Thursday of each month at the Greater Rochester Jewish Community Center, 1200 Edgewood Ave. in Rochester. For more information, call 585-787-4011 or email ustoorochesterny@gmail.com.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

Reading, Writing, ‘Rithmatic, Running and Radishes? Local school districts embark on new efforts to reduce obesity By Deborah Jeanne Sergeant

f course the “Three R’s” comprise the pillars of any school’s curriculum; however, to successfully combat the obesity epidemic in America, health education initiatives need to ramp up. And area schools are doing just that. Rochester City School District’s David A. Brown, director of Food Services, believes that introducing young children and their parents to healthful dining can help cultivate improved lifelong eating habits. “We had a community taste test a month ago,” Brown said in August. “We’ve started serving homemade healthy lunches. We’re looking to provide students with healthful options like wheat bread as much as possible.” The school district’s move away from processed foods included hiring a nutritionist, buying more fresh ingredients and remodeling cafeteria kitchens to accommodate made-from-scratch cooking. But Brown also believes that instilling healthful eating starts at home. “We’re also trying to get parents involved and that’s why we had the taste test,” Brown said. The cafeterias will feature more visuals to help students understand the differences among “green light” foods

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(the most healthful), “yellow light foods” (those with some merit, but not tops in nutrition) and “red light foods” (foods that should be eaten sparingly). Carlos Cotto, executive director of health education, physical education and athletics for Rochester City Schools, said that the district provides “comprehensive curriculum for both PE and health education, and providing opportunities to integrate health into the classroom.” Some classes are raising a few edibles at school, such as 4th graders growing a harvest of cilantro, instead of only reading about plant lifecycles. Interspersing movement throughout the day, instead of just during required physical education classes, keeps students active. For example, calisthenics during daily announcements, and Math Movements, an actionbased learning method, help students squeeze more activity into the day. Cotto hopes that introducing new activities such as orienteering and geocaching will instill in children lifelong enjoyment of physical recreation, since not every student plays sports. And those who do may not be able to continue to do so after graduating. At Rush-Henrietta Central School District, activities such as March Nutri-

School ofﬁcials hope that inviting parents to taste test the Rochester City School District’s revamped menu will encourage families to eat better at home, too.

tion Madness help students try new produce. “Veggies and fruits compete against each other by the elementary kids tasting them,” said Travis Anderson, representing the school. “They really like it and look forward to it every year, parents come in to volunteer to cut up fruits and vegetables and we email weekly updates on how kiwi is doing versus tomato. It’s all done in a NCAA bracket.” When the winning produce has been declared, the school offers a display of the top fruit and vegetable and

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

distributes information on why and how to include the produce in one’s diet. The Winslow Elementary School and Crane Elementary School in the Rush-Henrietta district formed 5k clubs last year. Forty students trained throughout April and May to run in the Lilac 5k in Highland Park. “Some teachers got together to help them train and hopefully form some lifelong habits,” Anderson said. Like Rochester schools, the RushHenrietta district has used movement in the classroom both to aid memoriza-

Cotto

tion and offer more opportunities to stay active throughout the day. “It’s not something everyone is required to do, but it’s a tool they have to work into their day,” Anderson said. To help your children eat right during the school year, provide health-

ful options at home, such as a wholegrain, low sugar cereal, skim milk and piece of fruit for breakfast. Stock up on healthful after-school snacks, like low-fat string cheese, whole fruits, baby carrots, and whole grain crackers. Prepare balanced meals for dinner and eat together as a family, not in front of screens. Get active as a family for everyone’s health. Playing active games, taking family walks or joining a fitness center can provide each family member with ways to stay fit.

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Does Your Child’s Back-to-School List Include an Allergy Action Plan?

ackpacks. Crayons. Glue Sticks. EpiPen? For more and more school-age children, emergency epinephrine autoinjectors such as the EpiPen or Auvi-Q are becoming a necessity for completing the back-toschool supply list. In fact, allergic conditions are one of the most common medical conditions affecting children in the U.S. “Accidental exposure to allergens at school is a major concern for kids with severe allergies since an exposure could be fatal,” said Joyce Rabbat, pediatric allergist at Loyola University Health System in Chicago. Food allergies are the most concerning for school-age children since allergens can be hidden in food or utensils and pots and pans could be contaminated without the child’s knowledge. Rabbat said that parents of children with food allergies should ensure an allergy action plan is in place for the child at his or her school. “In the event of an accidental ex-

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posure, the plan helps school personnel manage the reaction in a prompt and effective way,” Rabbat said. Rabbat says a parent should make sure the school reviews the child’s health records that they provide from the physician. She also suggests asking what the school does to prevent accidental exposure and how staff is trained to handle an emergency situation. If the child is older and knows who to self-administer medications Rabbat suggests talking to the school about allowing the child to carry the medication with them. If that is not allowed at the school make sure the following medications are available: • Epinephrine autoinjectors • Antihistamines • Albuterol rescue inhalers Also make sure a staff member who is properly trained on how to administer medication is available at all times and that your child is familiar with this person.

If you suffer from mild hypertension (high blood pressure), you may qualify to participate in a study. • If you blood pressure is between 140-160 (systolic or “top number”) • Between 18-80 years old • Male or Female • Not currently pregnant or trying to become pregnant An initial medical evaluation is required to determine if it is safe for you to use the study drug carvedilol. The study drug carvedilol is FDA approved and currently used for the treatment of high blood pressure.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

SmartBites

The skinny on healthy eating

Befriend the Fantastic Fig

ong before I gave a fig about a fig, I had a crush on this scrumptious little fruit. Sandwiched into my favorite childhood cookie — the immortal Fig Newton — it found its way into my lunchbox on a regular basis. Today, I’m fond of figs for something else: their standout nutritional value. Since heart disease is the leading killer of men and women, let’s first look at the different ways figs do a heart good. Figs rock on the roughage front, providing decent amounts of both soluble and insoluble fiber. Current research shows that fiber may lower both blood pressure and bad cholesterol, as well as reduce the inflammation now attributed to cardiovascular disease. Pop just four dried figs in your mouth and you will have consumed around 20 percent of your daily fiber needs. Figs also pack a respectable potassium punch, with four figs delivering just a tad less than one small banana. A powerhouse mineral, potassium benefits the heart in several ways: it promotes normal heartbeats; it controls blood pressure; and it may lower cho-

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By Anne Palumbo

lesterol. Like most fruits, figs are full of antioxidants, important compounds that mop up damaging free radicals. Over time, repeated free radical attacks can lead to a host of chronic diseases, including heart disease, cancer, and Alzheimer’s, which is why eating antioxidant-rich foods is always a good thing. But unique among fruits, figs contain calcium, an essential mineral that helps form and maintain healthy bones and teeth. With the threat of osteoporosis looming in my future, I may have to up my figgy consumption. Although figs are low in sodium, cholesterol and fat, they are somewhat high in calories and sugars (between 25 to 30 calories per fig). As with other foods that are calorically dense but nutritionally rich, moderation is the key.

If buying fresh, figs should be soft but not mushy. Seek out slightly wrinkled skin with no bruising. Small cracks are okay (as long as they are not weeping or leaking). Plan on eating figs within a day or two of purchase. They keep (and taste) best at room temperature, but may last a little longer when stored in the refrigerator. Dried figs should be plump and soft; squeeze the packet to make sure.

Oatmeal Fig Bars 1 cup chopped dried figs, stems removed ½ cup water 1 tablespoon lemon juice 1 ½ cups rolled oats ½ cup unbleached all-purpose flour ½ cup whole wheat flour ¾ cup packed brown sugar ½ teaspoon baking soda ½ teaspoon salt 1 teaspoon cinnamon ½ cup toasted chopped walnuts 6 tablespoons butter, melted (I used “I can’t believe it’s not Butter!” stick) 1 egg white 1 teaspoon vanilla Preheat oven to 350 degrees. Prep 8 x 8” baking pan with canola oil or cooking spray. Put figs, water and lemon juice into small pan and bring to a boil. Cover; reduce heat and simmer until figs start to break down (about 5 minutes). Let cool for 5 minutes and then process in food processor until smooth. Set aside.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

In a large bowl, whisk together oats, flours, sugar, baking soda, salt and cinnamon. Mix in nuts. Melt butter, let cool a minute, then whisk in egg white and vanilla. Add butter mixture to oat mixture and stir until combined (use hands for best mixing). Lightly coat hands with flour and then press half of the oat mixture into the prepared pan. Next, spread with the fig mixture. Recoat hands with flour if necessary and then pat remaining oat mixture over fig mixture. Bake for 25 minutes; cool on wire rack. Fun Fact: Figs Newtons are named after Newton, Massachusetts. 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.

School Sports: Hundreds of Thousands Suffer Concussions Annually Sport season in school means possible serious injuries. See what the experts say about preventing them By Deborah Jeanne Sergeant

articipating in school sports offers students unique opportunities to develop lifelong fitness habits, learn teamwork skills and build lasting friendships; however, sports can also expose children to environments and activities where serious injury is possible. “It depends upon the age of the child,” said physician Elizabeth Murray, who works in the pediatric emergency room at Strong Hospital. “We see a lot of injured arms and hands from falls and concussion and concern for concussion.” Though a minor injury can sideline a player for a while, concussions Murray can cause lifelong problems for athletes or even death. Physician Christopher Brown specializes in sports medicine and orthopedic surgery with Finger Lakes Bone and Joint Center, affiliated with Rochester General Hospital and Newark-Wayne Community Hospital. He said that high school sports account for between 136,000 and 300,000 concussions annually. The range is so wide because many athletes, parents and coaches do not know the signs of concussion. “We still have 47 percent of concussions unrecognized,” Brown said. “In schools that have athletic

trainers, the number is higher because the trainers recognize [concussions] better.” Loss of consciousness is only one sign of concussion and athletes may have suffered a concussion even if they remain conscious. Other immediate symptoms can include headache, disorientation, no memory of the injury, dizziness, nausea, slurred speech, ears ringing and unwarranted fatigue. Athletes who appear fine but actually suffer a concussion can become seriously injured or even die from second impact syndrome, which describes a phenomenon where the next head injury causes greater damage to the brain. “Our brain, like any other part, needs time to recuperate after injury,” Brown said. A return-to-play protocol can include removal from play, supervision for a few hours, evaluation by a medical professional, and a return-toplay progression upon approval of a doctor. Gradually returning to play for about 10 days while monitoring for symptoms can help ensure the brain has healed. Schools on a budget can rest easy about used gear. Brown said that research shows that if it fits well and according to manufacturer directions it offers just as much protection. Of course, no protective gear will guarantee students will remain injuryfree. Rob Anderson, a physician with Finger Lakes Health, said that

contact sports carry higher risk than others. However, learning proper playing techniques, receiving a pre-participation concussion exam, and wearing gear properly can help mitigate the risk of long-term problems. “A helmet cannot prevent the rotational head motion that causes many concussions, so they should not be viewed as perfect protection,” Anderson said. In general, for other types of injuries, athletes need medical attention if they experience extreme pain, continued pain and swelling after three days, physical deformity, or anything that limits their ability to walk. At Canandaigua Central School District, Jim Simmons Director of Athletics, said that the district’s coaches are trained in first aid for coaches, which he described as “an extensive, detailed course that they have to update every three years per the state [regulations] and they are trained in CPR and automated external defibrillator.” The district contracts with Thompson Health to provide medical services at the school for minor issues and to cover contact sports games. Like most schools, Canandaigua student athletes must complete a physical annually. Each student’s health sheet becomes part of the team medical kit to help medical personnel in case of an injury or illness while playing, both at home and on the road. The school’s coaches take injuries such as concussions seriously and

complete a course in concussion recognition and management. Any student who is thought to have a concussion is immediately removed from play and must submit to the school’s return to play policy before rejoining the activity. The school’s concussion management team meets several times a year to talk about the latest information available. The coaches also keep abreast with important topics such as heat injury, ACL knee injuries and other potential health and safety issues. Though it’s important for coaches to stay current on safety, parents’ role in sports safety is important, too. “Make sure that whatever the child participates in, the school should recognize it as a sport, such as cheerleading, which has acrobatics, gymnastics and there’s a tremendous risk for injury,” said physician Elizabeth Murray of the pediatric emergency room at Strong Hospital. If an activity isn’t recognized as a sport, students may not have access to trainers who can help them condition and use equipment right. Though referees and coaches shouldn’t let children play if they don’t have proper equipment or are using the right techniques, students may anyway if no one notices. “You need to watch them, too,” Murray cautioned. “And make sure your child is playing only with children his own size if there’s possibility of contact.”

Packing a Fun, Healthy Lunch for Your Child

ne of parents many concerns now that their kids are back to school is about the daily ritual of packing their kids a healthy lunch. “The goal is to send the kids off to school with a lunch they may actually eat, rather than swap for something less healthy, or worse yet, toss,” said Patricia Salzer, a registered dietitian and health and wellness consultant for Excellus BlueCross BlueShield. Salzer offers three simple tips for parents: Focus on health, taste and safety.

What’s Healthy

• Fresh Fruit: “It’s nature’s fast food,” Salzer said. Dried fruit such as raisins is OK too. • Vegetables: Baby carrots and cucumbers • Protein: Peanut butter, hard boiled eggs and lean deli meats • Grains: Whole wheat bread or crackers, tortillas and pita bread • Dairy: Fat-free milk, low fat cheese sticks and low-sugar yogurt “Parents can use a knife or cookie cutter to turn sandwiches and veg-

etables like cucumbers into fun shapes, making these nutritious foods more desirable to their children,” Salzer said.

What’s Tasty

• Add healthy foods into items that kids already love. Use apples or bananas when making muffins. Pack slices of pizza topped with vegetables into your child’s lunch. Slip diced apples into that chicken salad sandwich. • Create healthy trail mix. Mix dry whole wheat cereal with raisins, nuts (if there are no allergy or choking problems), pretzels or even a few chocolate

chips.

Be Safe

• Place an ice pack in your child’s lunch bag, or keep the lunch in the cooler to keep the food at a safe temperature. Don’t forget to remind your kids to wash their hands before eating! “Parents also should ask their child what healthy foods they would like in their lunch,” Salzer added. “The more involved kids are in the lunch planning and grocery shopping, the more likely they are to eat the foods they helped select.”

Experts: Continue Protecting Your Skin

ummer is coming to an end, but the risk for skin cancer is still present. Medical professionals suggest wearing a sunscreen of SPF 15 or higher every day and covering exposed skin, even in the fall months. Skin cancer prevention is becoming increasingly important; rates of melanoma, the deadliest form of skin cancer, have increased by 800 percent among young women and 400 percent among young men in the U.S. in the last 40 years, according to the Skin Cancer Foundation.

“Skin cancer doesn’t only affect older people,” said physician Frank Dubeck, vice president and chief medical officer, medical policy, Excellus BlueCross BlueShield. ”Teenagers and young adults are at risk and need to take prevention seriously.” One or more blistering sunburns in childhood or adolescence more than doubles a person’s chance of developing melanoma later in life. Yet half of young adults said they’ve been sunburned in the last year, according to the Centers for Disease Control and September 2013 •

Prevention. Less than 15 percent of high school students use a sunscreen of SPF 15 or higher when they’re outside for more than an hour on a sunny day, according to the Skin Cancer Foundation. Take action to prevent sunburns and skin cancer by doing more than the minimum; simply applying sunscreen on summer beach or pool days is not enough. Skin needs to be protected during fall, winter and spring months as well. The Skin Cancer Foundation rec-

ommends: • Using a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher when you’ll be outside for a long period of time. • Applying sunscreen 30 minutes before going outside. • Reapplying sunscreen after two hours of sun exposure, swimming or sweating. • Wearing UVA/UVB protective sunglasses and protecting your face with wide-brimmed hats. • Seeking shade, especially midday.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

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he National Association of School Nurses states that school nurses play “a critical role in improving public health and in ensuring students’ academic success” by the health services they provide on school campuses.

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• “Nurses are busy from the minute they walk in until the minute they leave. • “We’ll use every opportunity to give students information as to how to care for themselves as it relates to why they come in. • “Parents ask about students with allergies if it’s a peanut-free school and can we accommodate their children. We don’t, as far as I know, have peanut-free schools. You walk a fine line in trying to keep the classroom reasonably accommodating. • “Children have to be immunized unless they have a religious or medical exemption. A lot of parents ask if 4-year-old kids can come to school and wait until they’re 5 years old for immunization. Some doctors will say they can wait until they’re 5 but they must be immunized before coming to school. • “Whether a child is injured or ill during school, the parents’ health insurance on them applies first. • “We keep the buildings and grounds according to New York state standards. The staff is as concerned about student safety above anything else. We have not had issues about safety in the past several years. • “Our job isn’t too exotic, but we get a lot of kids in with basic self concerns like cutting a finger and we take care of them as we need to. We go through a lot of Band-Aids and ice packs.” Althea Mix-Bryan, nurse coordinator for Webster Central School District • “Our nurses are very good at linking parents to community agencies and resources. We make many referrals in our urban population. Parents may not have insurance or may not be able to physically get there. • “We have a lot of dental programs in our district. We have the Smilemobile. There are school-based and school-linked health centers. We help get students enrolled and see that they

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

get there when they need to. We can help with linking families to appropriate mental health. We can help them get enrolled in healthcare insurance. • “A lot of nurses see kids that need a pick-me-up. The school day is getting longer and the educational plans are getting more stringent. They like to see someone who pats them on the back and gives them care they need. • “Parents should know that the nurse is there as a resource if they ever question as to whether they should send a child to school. A lot of times, they keep them home for things they don’t need to keep them home. Colds are normal. It doesn’t necessarily means the student should be home, but look out for the symptoms that could mean flu. • “Make sure your child gets his physical when he’s supposed to and the school nurse is in the loop about medical conditions. We need to know ahead of time to prevent emergencies.” Erin Graupmann, coordinator of school nurses, Rochester City School District

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.

Average Loan Debt of a Med Student at UofR: $152,000

“It is extremely daunting to see that number, and to know that it will continue to accumulate interest throughout the years,” says a student By Ernst Lamothe Jr.

t can be scary being in debt to anyone, let alone the federal government. Or being in debt to a large company that has no sympathy for your situation. It can feel a little like owing money to the mob. Typically a University of Rochester medical student will walk out of college with an average of $152,000 in student loans—some upwards of $200,000. That figure is not only rising, but it’s a intimidating and sometimes paralyzing feeling for a 21-year-old even if they will make six figures a decade from now. Beatriz Folch-Torres, a first-year resident student in the obstetrics and gynecology department at the University of Rochester Medical Center, decided to become a physician because of many factors, including doing volunteer work with autistic children and teaching ballet to the disabled. She was ultimately drawn into the medical profession by her commitment to serve others in need, especially the underserved. But when she is finished with her residency, she’ll also be saddled with more than $200,000 in loans from medical school, which would have been worse if she had carried any undergraduate debt. “It is extremely daunting to see that number, and to know that it will continue to accumulate interest throughout the years,” said Folch-Torres. “It will take many years to pay back my loans.” At the university’s professional schools, the tuition rates for 2012-13 were $44,700 for the school of medicine and dentistry, a 3.7 percent increase and $37,018 for the school of nursing, a 4 percent increase. Room and board is an additional $12,618, plus students typically pay close to $1,300 in books for their education. The college has resources that help offset debt such as endowments for students who need financial assistance. During the past school year, the University of Rochester increased its commitment to student financial aid by 5.7 percent to $85 million. With interest from loans growing quicker than a physician’s income, the strain to catch up can feel unimaginable. Every spring B J Revill, director of financial aid at the University of Rochester Medical Center, meets with fourth-year medical students before they go onto their residency programs. He talks with them sometimes at length about their financial options, while also spelling out their entire debt. “Just in case they are not tracking their own loans, it’s important for them to know the reality of their situation,” said Revill. The median debt for a private medical school graduate climbed to nearly $180,000, more than a five-fold increase in the past two decades, according to the American Association of Medical Colleges. But there are options. Under certain circumstances, you

can receive a forbearance that allows you to temporarily postpone or reduce your federal student loan payment. For medical students, they can delay that payment until after their residency. Depending if you have a Perkins, Stafford or direct subsidized loans, the federal government may pay the interest on the loan during the deferment period. If students are in a deferment program where the interest does accrue, the nearly $180,000 median debt of a private medical school graduate will have grown to almost $242,000. The vast majority of students that Revill speaks with take another option — the loan forgiveness program. Physicians are eligible for a loan forgiveness program through the College Cost Reduction and Access Act after 10 years of paying back the loan, while practicing in a public service position. Those positions include nonprofit organizations, faculty in high-needs areas as determined by the secretary of education, and service at private organizations B J Revill providing public health or emergency management services. “Basically anything that is not private practice counts,” said Revill, who is also the resident debt adviser. At first, it was a program typically geared for teachers and social workers who had high loans because of masters and doctorate programs, but wouldn’t be making anywhere near six figures as a starting salary. Yet Revill said with tuition nationwide increasing, the program made sense for other professions. Medical students must work in the public sector for 120 months, while working at least 30 hours a week. It does not have to be consecutive months, but the student must consistently repay their loans depending on their salaries. That can be anywhere from $200 to $350 a month. “And after those 120 months are done, they no longer have to pay their loans. That can be sometimes hundreds of thousands in savings,” said Revill. “It’s a huge opportunity and students like the freedom of not having to sign any contact up front at graduation and you can even begin paying while you are doing your residency. They just have to be serious about paying their loans each month.” He also brings a debt specialist from the American Association of Medical Colleges each year to give a presentation to the students. “It is very helpful to have a financial adviser who can help you decide what is the best repayment plan for you based on the type and amount of your loans,” said Folch-Torres, who appreciated the wisdom bestowed by Revill. “You have people with a lot of different situations like those with

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www.retb.org 1.800.568.4321 Rochester Eye & Tissue Bank Our Practice Welcomes New Patients. Beatriz Folch-Torres of UofR says she will leave medical school with more than $200,000 in debt. undergraduate and graduate loans, people with just graduate loans, people who are married or have a kid versus people who are single.” To aid students, the University of Rochester has built a scholarship base and coordinated with the Alumni Association to give back so current students can pursue their dreams of helping others. Officials at UofR recognize there is an enormous debt carried by the vast majority of students. Typically, around 80 percent of UofR medical students became borrowers to attend medical school. Another thought is what happens if the young doctors have medical issues of their own, adding to their already burdensome debt. More than 73 million working-age adults have accrued medical debt, according to the Commonwealth Fund. In April, House of Representative Maxine Waters D-California introduced H.R. Bill 1767 that would exclude medical debt that are in collections from consumer credit reports. Called the Medical Debt Responsibility Act of 2013, the bill tries to even out the playing field when someone has an unexpected and sudden medical condition. Because medical debt can cause significant damage to credit scores for years to come, young medical profession may be denied credit or pay higher interest rates when buying a home or obtaining a credit card. Whether this because law or colleges start offering more scholarships, loans will always permeate the fabric of higher education. Those who have to pay have simple suggestions to others that will come after them. “Seek the advice of professional financial aid advisers,” said Folch-Torres. “It can only help you.”

September 2013 •

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

STUDY: Vegetarian Diets Associated with Lower Risk of Death

egetarian diets are associated with reduced death rates in a study of more than 70,000 Seventh-day Adventists with more favorable results for men than women, according to a report published Online First by JAMA Internal Medicine, a JAMA Network publication. The possible relationship between diet and mortality is an important area of study. Vegetarian diets have been associated with reductions in risk for several chronic diseases, including hypertension, metabolic syndrome, diabetes mellitus and ischemic heart disease (IHD), according to the study background. Physician Michael J. Orlich of Loma Linda University in California, and colleagues examined all-cause and cause-specific mortality in a group of 73,308 men and women Seventh-day Adventists. Researchers assessed dietary patients using a questionnaire that categorized study participants into five groups: nonvegetarian, semi-vegetarian, pesco-vegetarian (includes seafood), lacto-ovo-vegetarian (includes dairy and egg products) and vegan (excludes all animal products). The study notes that vegetarian groups tended to be older, more highly educated and more likely to be married, to drink less alcohol, to smoke less, to exercise more and to be thinner. “Some evidence suggests vegetarian dietary patterns may be associated with reduced mortality, but the relationship is not well established,” the study notes. There were 2,570 deaths among the study participants during a mean (average) followup time of almost six years. The overall mortality rate was six deaths per 1,000 person years. The adjusted hazard ratio (HR) for allcause mortality in all vegetarians combined vs. nonvegetarians was 0.88, or 12 percent lower, according to the study results. The association also appears to be better for men with significant reduction in cardiovascular disease mortality and IHD death in vegetarians vs. nonvegetarians. In women, there were no significant reductions in these categories of mortality, the results indicate. “These results demonstrate an overall association of vegetarian dietary patterns with lower mortality compared with the nonvegetarian dietary pattern. They also demonstrate some associations with lower mortality of the pescovegetarian, vegan and lactoovo-vegetarian diets specifically compared with the nonvegetarian diet,” the authors conclude. Page 18

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Vintage Raider Rochester MS victim takes to his bike to raise funds By Jessica Spies “I never thought that it would happen,” he said. Andolina initially signed up for the ride after his friend, Dennis Gugliandro, was diagnosed with MS in the early ‘90s. Instead of just showing support for his friend, Andolina “felt I had to do something more. That I can actually help. I can raise more money than I can give,” he said. MS is a potentially debilitating disease that affects the central nervous system. According to the MS Society, more than 2,700 people in the greater Rochester area are affected with MS, with 2.1 million people worldwide having a MS diagnosis.

‘Personal disease’

o say that 60-year-old Jim Andolina is a “professional on the move” is an understatement. Andolina, of Hilton, works as a sales manager for Röchling Advent Tool & Mold, a Rochester-based plastics injection molding manufacturing company, volunteers with the National Multiple Sclerosis Society and makes time to exercise every morning. Andolina was recently awarded the National MS Society Upstate New York Chapter’s 2013 Professional on the Move award. This year will mark the 19th year that Andolina will ride in Bike MS, a cycling fundraising event for the society. “This is the chapter’s way of saying ‘thank you’ to someone who has really gone the extra mile to help make one of our biggest fundraisers a success,” said Stephanie Kunes-Mincer, president and CEO of the Upstate New York Chapter. “Jim is a great example of the passionate volunteers and fundraisers we have in our 50-county chapter area who are working tirelessly to raise funds to find new treatments and a cure for MS.” Andolina was nominated for the award by his daughter and surprised to hear that he was recipient of the award.

“It’s a very personal disease. It affects everyone differently and symptoms vary for the individual,” said Andolina’s wife Jeanne. Only three years ago, in December 2009, Andolina suffered a heart attack. “Before I came out of the hospital, I said, ‘I’m going to be riding in August.’ And I did.” Andolina couldn’t miss the ride that he had participated in for the past 15 years. “In August of 2010, I found myself at Bike MS Finger Lakes Challenge surrounded by friends, family, and all the selfless people that make this event special,” he said. Andolina said he was able to recover so quickly from the heart attack because he was so active before. Andolina has made physical fitness a priority throughout his life. “Everyone gets 24 hours in a day,” he said. “You have to make it a priority.” Andolina sometimes works extended and weekend hours at his job but, “I own the morning,” he said. And he’s not exaggerating. “He gets out of bed every day at 4:30 in the morning. He inspires me,” Jeanne, his wife of 11 years, said. Andolina typically rides 30 to 40 miles in a weekend and he has a higher goal in mind. “He’s bound and determined to do a century,” Jeanne said. A century is a bicycle ride of 100 miles or more within 12 hours. Andolina enjoys riding not just for physical fitness but also because of the experience. “You see things different on a bike,” he said. Jeanne agreed, adding that in such a fast-paced world, you can experience things at a “slower pace.” Jim and Jeanne had originally dated in high school and when they reunited later in life, the first question Jim asked Jeanne was: “Do you ride?”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

How to get involved For more information, on Bike MS or the National Multiple Sclerosis Society, visit www. nationalmssociety.org. Jeanne had only biked casually but was willing to cycle more. Now not only does Jeanne cycle, but so do their children and grandchildren. “He got us all hooked,” she said.

Family affair

Jim and Jeanne’s children, grandchildren and friends join them to ride in Bike MS—that’s three generations of Andolinas who ride together. “At one point, he had everyone riding in the family,” Jeanne said. Jim and Jeanne have five children and five grandchildren. “Jim keeps us fit,” Jeanne said, adding that family time spent together often includes physical activity not limited to bike rides. Jim recruited his son and friends to form what would be his team of 19 years—the “Vintage Raiders,” in 2002. The ride, which loops through Keuka College, is almost 100 miles over a weekend. Jim and his team will typically cycle 60 miles the first day and 30 on the second. Cycling nearly 100 miles in a weekend presents a challenge. But when Jeanne needs motivation, she thinks of why she rides. “You struggle up hills. Anyone with MS would love to struggle up that hill. That keeps me going,” she said. Jim and his team’s goal this year is to raise $10,000. The amount his team has raised in past years varies and has ranged from $6,000 to $13,000. The Vintage Raiders have been among the chapter’s top three Bike MS fundraising teams for several years. Jim says his team uses grassroots efforts to raise the money. “My granddaughter goes door to door,” he said. “It’s $5 here and there.” Jeanne said they rely on “word of mouth,” but Jim is “so dynamic in sales” that they are able to reach their goal every year. Even though Jim hopes there won’t be MS in 20 more years, he does hope to keep riding and support a charity important to him in the meantime.

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Music Therapy for Alzheimer’s Patients Dear Savvy Senior, What can you tell me about music therapy for Alzheimer’s patients? I’m helping my dad take care of my 80-year-old mother who has mid-stage Alzheimer’s disease and thought it might be something worth trying. How do we proceed? Unmusical Mary Dear Mary, Music has amazing power, especially for people with Alzheimer’s disease. Studies have shown that listening to familiar music can significantly improve mood and alertness, reduce agitation, and can help with a number of behavioral issues that are common in the middle stages of the disease. Even in the late stages of Alzheimer’s a person may be able to tap a beat or sing lyrics to a song from childhood. Sitting and listening to music together can also provide a way for you and your dad to connect and bond with your mom, even after she stops recognizing your names and faces. Here are a few tips to help you create a music therapy program for your mom. Create a Playlist Your first step is to identify the music that’s familiar and enjoyable to your mom. Does she like jazz, classical or Frank Sinatra? What songs make her want to get up and dance? Then go back to the era when she was a teenager through their early 20s. Research shows that music during this time period seems to get the best response and triggers the most memories. If you need some help creating a playlist, the Institute for Music and Neurologic Function provides a suggested list of top songs by era and genre on its website at musictherapy. imnf.org — click on “Outpatient Services,” then on “Top 10’s For Memory.” The website pandora.com will also tailor a radio station to match your

mom’s musical taste when you select an artist, song or genre. And musicandmemory.org offers a free guide to creating a personalized playlist. You can also get help from a music therapist. The American Music Therapy Association offers a national directory of more than 6,000 therapists at musictherapy.org to help you find someone in your area. To keep things fresh, it’s best to create a diverse playlist of numerous artists, with no more than five to 10 songs per artist. It’s also important to keep tweaking their playlist. Every week or so, ask your mom which songs she likes and which ones are just so-so. Remove the so-so ones, and build on the successful ones so you end up with 100 or 200 songs that all resonate.

Music Delivery There are a number of ways you can deliver your mom’s favorite music: a digital listening device, CD player, a computer or tablet, or even an old record player. If you don’t have any music and are on a tight budget, check with your local public library. It may have CD selections you can check out. Digital listening devices like an iPod or MP3 player are the most convenient and widely used options among music therapists for delivering music, because they’re easy to add and remove songs from. The $49 Apple iPod Shuffle (apple. com/ipod-shuffle), and $40 SanDisk Sansa Clip MP3 Player (sandisk.com) that require headphones, and the $60 Peabod SweetPea3 MP3 Player (sweetpeatoyco.com) which has an external speaker, are three excellent devices that are extremely simple to use and very affordable. Another option to consider for listening to music together is through an Internet radio service like spotify.com and rhapsody.com. These services will let you create a customized playlist (for free or a small monthly subscription fee) that your mom and you can listen to via computer, mobile device, home entertainment system, or a home Internet radio like the $180 Logitech UE Smart Radio (ue.logitech.com), which is a great alternative that’s simple to use and compatible with most online radio services.

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. September 2013 •

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Page 19

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

Get Your Benefit Verification Letter Online

o you need a letter from Social Security verifying your benefits? The fastest, easiest, most convenient way to get a benefit verification letter these days is to go online to www.socialsecurity.gov. You may need a benefit verification letter for a number of reasons. Perhaps you need proof of income for a loan or to verify your monthly income for housing, or state or local benefits. You may need proof of your current Medicare health insurance status. In some cases, a person may need proof of retirement status, disability status, or age. For any of these situations, a benefit verification letter will provide the proof you need. Sometimes a benefit verification letter is called a budget letter, benefits letter, proof of income letter, or proof of award letter. Don’t let the different titles confuse you; they are all the same thing: a benefit verification letter. Whatever the reason you need your benefit verification letter, you can get yours immediately online for free. To get your benefit verification letter, simply visit us online at www.socialsecurity.gov/myaccount and set up a my

Q&A Q: Are Social Security numbers reassigned after a person dies? A: No. We do not reassign Social Security numbers. In all, we have assigned more than 460 million Social Security numbers. Each year we assign about 5.5 million new numbers. There are over one billion combinations of the nine-digit Social Security number. As a result, the current system has enough new numbers to last for several more generations. Q: Can I apply online for retirement benefits? A: Yes. In fact, almost half of all individuals apply for retirement benefits online. Join the millions of Americans who have saved a trip to a Social Security office and applied the quickest and easiest way—online. In as little as 15 minutes you can submit your application electronically. In most cases, once you’ve submitted your application, you’re done and there are no forms to sign or documents to send in. If we do need more information to process your application, a representative will contact you. For more information about applying online, visit our website at www.socialsecurity.gov or call us tollfree at 1-800-772-1213 (TTY 1-800-3250778). Q: If both my spouse and I are entitled to Social Security benefits based on our Page 20

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Social Security account. To create an account, you must provide some personal information about yourself and give us answers to some questions that only you are likely to know. They are the same types of questions you would encounter if you were trying to open an online account at a financial institution or obtain your credit report. Next, you create a unique username and password that you will use to access your online account. This process protects you and keeps your personal Social Security information private. Once you’ve established your account, it will be simple for you to come back and transact business with Social Security in the future. For example, in addition to getting another benefit verification letter in the next year or two, you can check your benefit and payment information as well as your earnings record. You also can change your address, phone number, and direct deposit information. So remember: there’s no need to fight traffic and visit a busy government office in order to obtain proof of your benefits. Simply visit www.socialsecurity.gov/myaccount and establish a my Social Security account so you can obtain your benefit verification letter online in a matter of minutes.

own work records, is there any reduction in our payments because we are married? A: No. We independently calculate each person’s Social Security benefit amount. Each spouse receives a monthly benefit amount based on his or her own earnings. Couples are not penalized simply because they are married. If one member of the couple earned low wages or did not earn enough Social Security credits to be eligible for retirement benefits, he or she may be eligible to receive benefits as a spouse. Q: If I go back to work, will I automatically lose my Social Security disability benefits? A: No, Social Security has several work incentive programs to help people who want to work. You may be able to receive monthly benefits and continue your health care coverage during a trial work period. For information about Social Security’s work incentives and how they can help you return to work, you should: • Visit our special work site at www. socialsecurity.gov/work; • See the Red Book on work incentives at www.socialsecurity.gov/redbook; or • Check out our publications at www. socialsecurity.gov/pubs and type “work” in the search box. For more information, visit our website at www.socialsecurity.gov or call us toll-free at 1-800-772-1213 (TTY 1-800325-0778).

H ealth News NYC chosen as “Great Colleges to Work For” For the fifth straight year New York Chiropractic College earned a position on the Chronicle of Higher Education’s “Great Colleges to Work For” list and, additionally, made its coveted “Honor Roll” (for the fourth consecutive time). What’s more, only four health-professions colleges were recognized within the small colleges category, and NYCC was the sole chiropractic college. A total of 300 institutions participated this year and 44,688 surveys were completed by administrators, faculty members, and professional support staff members. Of the 300 participants, only 42 colleges earned scores to qualify them for the “Honor Roll.” NYCC was rated highly in all applicable categories, including: professional/career development programs, teaching environment, compensation & benefits, facilities, workspace & security, work/life balance, confidence in senior leadership, and respect and appreciation.

Thompson Guild Scholarships Awarded The Thompson Guild presented two recent high school graduates each with a $2,000 scholarship at the Guild’s recent Annual Dinner. Benjamin Pulver of Naples Central School is attending the Worcester Polytechnic Institute in Massachusetts for biomedical engineering and received the Phyllis Ehmann Memorial Scholarship. Kristy Walker of Honeoye FallsLima received the Theresa Tremblay Memorial Scholarship and is attending Hartwick College in Oneonta with the goal of becoming a nurse practitioner. The two, $2,000 scholarships are awarded annually to students who are registered in a health-related field. Recipients must complete their first semester with the intent to continue in a health-related field their second semester.

New radiation oncology doc joins Highland Hospital Highland Hospital welcomes physician Kevin Bylund to the Radiation Oncology Department where he will care for patients undergoing radiation cancer treatments. Bylund recently completed his residency in radiation oncology at the University of Rochester Medical Center. He completed a preliminary year of residency training in internal medicine at Saint Louis University in 2009. Prior to residency, Bylund

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

Bylund participated in the Doris Duke Clinical Research Fellowship Program at the University of Iowa. He earned a Radiological Society of North America Resident/Fellow Research Award in 2008 and again in 2012. He is a member of the American Society for Radiation Oncology, Radiological Society of North American and American Brachytherapy Society. Bylund lives in Henrietta.

Thompson offers inpatient dialysis, nephrology Thompson Hospital will begin offering dialysis services to its inpatients, as well as referral-based nephrology consultations for both inpatients and outpatients dealing with kidney disease. The new services, a result of Thompson’s 2012 affiliation with the University of Rochester Medical Center, started Aug. 4. They are overseen by physician David Bushinsky, chief of nephrology at URMC. The offering of inpatient dialysis is expected to initially benefit approximately 60 Thompson patients per year, with the potential for many more. Thompson Health Executive Vice President/COO Kurt Koczent explains these are patients hospitalized for other conditions who need dialysis — a blood-cleansing treatment for kidney failure — on a regular basis. Previously, these patients would have had to travel to Rochester in order to receive treatments during their hospitalizations. “If there is ever a time when you want to be close to friends and family, it’s when you’re hospitalized,” Koczent says. “There is a growing need for dialysis, and our inpatients deserve to be able to receive these services close to home.”

RGHS signs partnership with Mayo Medical Lab Rochester General Health System (RGHS) has entered into an expanded relationship with the Mayo Medical Laboratory (MML), a division of Mayo Clinic. This new, primary partnership will give RGHS both access to the Mayo Clinic’s extensive menu of reference laboratory tests and clinical expertise and access to innovative tools and resources. This new partnership will support initiatives being developed by the RGHS department of pathology and laboratory medicine and RGHS ambulatory care laboratories services to optimize lab test utilization for patients, physicians and other healthcare providers. “Many healthcare decisions are influenced by lab test results, and laboratory testing costs patients and insurers billions of dollars each year”, said physician Dawn Riedy, RGHS

H ealth News chief of pathology. “These tools and initiatives will help us guide ordering providers to choose the most appropriate tests for their patients. There are thousands of testing options, with new tests beginning developed every day, and it’s difficult for healthcare providers to always know exactly which tests will give them the information they need to most effectively care for their patients. Our goal is the right test, for the right patient, at the right time. This is important to both proactively manage healthcare costs and ensure consistently highest quality care.” RGHS Laboratories perform millions of lab tests each year on-site at Rochester General and Newark Wayne hospitals. Like all local laboratories, RGHS collaborates with a reference laboratory for tests, which are rarely ordered or highly specialized in nature. Mayo Medical Laboratories will now serve as the RGHS primary reference laboratory, which also means Mayo Clinic physicians and scientists in every specialty laboratory will be available for consultation regarding test selection, methodologies and result interpretation.

Health Foundation funds program to reduce falls Greater Rochester Health Foundation (Health Foundation) has awarded Lifespan of Greater Rochester, Inc. up to $595,000 for a three-year program to reduce falls in adults 65 and older. The goal of the program is to reduce falls in patients served by the University of Rochester Center for Primary Care Network by 10 percent. Major program components include A Matter of Balance, home modifications, home visits by a clinical care manager and connections to community-based providers. Falls are a major concern for older adults. Each year one in three adults age 65 and older falls, approximately 34,500 adult residents in Monroe County. Of people who fall, 30 percent require medical attention and 10 to 15 percent of people require hospitalization. “Lifespan pilot tested a multimodal, multi-disciplinary fall prevention program in 2009 and 2010 in which participants showed significant improvements in strength and balance and a reduction in falls. Lifespan has incorporated their learnings into the comprehensive program funded by the Health Foundation,” says John Urban, president and CEO of the Health Foundation. “Older adults, their families and health care providers are concerned about the high rates of falls in older adults. Research has shown that even a small amount of exercise can improve a person’s strength and balance. A Matter of Balance, coupled with home modifications and support from care managers, is expected to result in cost savings for the overall community and improved quality of life for older adults and their families.” says Essie Calhoun McDavid, board chairman of the Health Foundation.

Report: Highland Hospital among best in WNY

Highland chief of medicine receives prestigious appointment

Highland Hospital has been listed by U.S. News and World Report as one of the best hospitals in Western New York for 2013-14. The regional rankings also recognized Highland for the high quality of its services in six specialty areas, including ear, nose and throat; gastroenterology and GI surgery; geriatrics; gynecology; orthopedics; and pulmonology. The annual U.S. News Best Hospitals rankings recognize hospitals that excel in treating the most challenging cases. The publisher evaluates hospitals in 16 adult specialties. In most specialties, it ranks the nation’s top 50 hospitals and recognizes other high-performing regional hospitals that provide care close to the level of their nationally ranked peers. The University of Rochester Medical Center (URMC), of which Highland is an affiliate, received a “Best Hospital” recognition. URMC has six programs — a record number of specialties — ranked among the very best in the nation by US News. Fewer than 50 hospitals in the nation had six or more programs on the lists. Only about 15 percent of hospitals are recognized for their high performance as among their region’s best, and just 3 percent of all hospitals earn a national ranking in any specialty. U.S. News uses a combination of measures, including survival rates, patient safety scores, volume and reputation, to select the top hospitals and services.

level,” Ahmed said. Highland Hospital Chief of “Dr. McCann was selected by Medicine Robert M. McCann has been named a fellow to the Royal his international peers to become a College of Physicians of Edinburgh Fellow of the Royal College based (RCPE). Fellowship is the highest on his exemplary reputation as a level of membership of the organiphysician along with his high level zation, which has supported and of accomplishment as Chief of Medirepresented physicians for cine at Highland Hospital,” nearly 350 years. said Hall. The physician accepted As a fellow, McCann the honor at a ceremony in will serve as an international Edinburgh, Scotland in July. examiner for the member“To be recognized among ship test in Edinburgh and so many accomplished physibe involved in the RCP’s cians from around the world advisory board. is truly an honor,” said Dr. McCann has served as McCann. Highland Chief of Medicine To become a “fellow,” since 1999. Among other doctors must distinguish accomplishments, he helped themselves in the practices develop the Hospital Elder McCann of medicine, medical science Life Program to prevent deor medical literature, and they must lirium in older hospitalized patients; have made a significant contributhe Acute Care for Elders Unit; tion in one or more of these areas. outpatient practices in geriatrics; Another fellow must nominate the and the Geriatric Fracture Center at physician in order to be elected by Highland. council. Since 2011, McCann has served Physicians Bilal Ahmed, associas a principle investigator for a ate chief of medicine, and William national geriatrics training project Hall, director of the Center for funded by a $1 million Donald W. Healthy Aging at Highland, nomiReynolds Foundation grant. The nated McCann for this distinction. four-year grant is allowing geriatricians at Highland to teach and Both are fellows. collaborate with hospitalists and “This fellowship recognizes Dr. McCann’s excellent leadership skills physicians across several specialand the significant contributions he ties, including orthopedics, physical has made in improving health care medicine and rehabilitation, emerfor the elderly at a local and national gency medicine and neurology.

Katherine Streeter selected for national program LeadingAge has selected Katherine Streeter, assistant director of nutrition services from St. Ann’s Community, as a member of its 2014 Leadership Academy program. Streeter has been with St. Ann’s for five years. The Leadership Academy is a yearlong leadership program designed to strengthen nonprofit leadership in aging services. The program provides a challenging and engaging learning environment that enhances the leadership capacity of aging-services professionals so they are better equipped to serve our field. Fellows will meet throughout the year to explore diverse perspectives from aging services leaders, learn from innovative care Streeter and service models, enhance their leadership skills and core competencies, and advance person-centered programming in aging services. To expand the world of possibilities for aging, LeadingAge members and affiliates touch the lives of four million individuals, families, employees and volunteers every day. The LeadingAge community includes 6,000 nonprofit organizations in the United States, 39 state partners, hundreds of businesses,

research partners, consumer organizations, foundations and a broad global network of aging services organizations that reach over 30 countries.

of North American and Alpha Omega Alpha Medical Society. Originally from Canastota, Kadura lives in Rochester.

Highland Hospital announces new hospitalist

MVP standard plans approved in Vermont

Physician Sullafa Kadura has joined the hospitalist program at Highland Hospital. As a hospitalist, Kadura specializes in the care of acutely ill hospitalized patients. Kadura recently completed her residency in internal medicine at the University of Rochester Medical Center. She spent a portion of her residency seeing patients at Highland. Kadura earned her medical degree from Universidad Central del Caribe in Bayamón, Puerto Rico. She graduated cum laude with her bachelor’s degree in biology and Spanish language, literature and culture from Syracuse University. She is a member of the American College of Physicians, National Arab American Medical Association, Islamic Medical Association Kadura

MVP Health Care (MVP) announced that Vermont has approved its state-prescribed standard plans as well as designated non-standard plan choices that will be offered on the Vermont Health Connect Exchange this October. The state of Vermont, in accordance with provisions in the Affordable Care Act (ACA), selected a benchmark plan from which all standard plan designs must be derived. As a result, the MVP standard plans must meet or exceed the health benefits contained within the benchmark plan. MVP says its non-standard plans contain unique features that enhance the value of the benchmark benefits offered in the standard plan designs such as lowering the enrollee cost sharing for the most common health care needs. “At MVP Health Care, we understand the importance of value and choice when it comes to selecting the best health insurance coverage op-

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H ealth News tions,” said David Crosby, executive vice president of MVP Health Care Commercial Business. “More importantly, we understand that our enrollees’ health and well-being are vital to living a healthy, happy lifestyle. With that in mind, our product development team has worked hard to provide Vermonters with benefit-rich, high-quality plan designs that allow enrollees to select the plan that best meets their needs.”

RHIO receive award to improve lab test reporting Greater Rochester Health Foundation (Health Foundation) awarded the Rochester Regional Health Information Organization (Rochester RHIO) $599,108 to fund a three-year project as part of the health foundation’s strategic focus on health care delivery. The project will help the health care system in a 13-county area convert to a standardized set of codes for laboratory results. Once completed, medical professionals will be able to more fully evaluate a patient’s lab results regardless of where the tests were performed. Currently, the 19 independent labs and

hospitals system labs in the area use different codes, making it challenging and time consuming for physicians to effectively use lab results. The grant will enable the RHIO to be more effective in exchanging timely clinical data with Anthony physicians and other medical professionals and to accurately analyze information from different health care providers. “While patients don’t see the back room operations of such clinical improvement, they will be better served because a physician will be able to more readily evaluate lab results regardless of location so that patients may avoid the inconvenience and cost of duplicative tests. This will have a significant impact on the quality of clinical care in the community,” said physician Louis Papa, chairman of the Health Foundation’s program committee. Said Ted Kremer, executive director of the Rochester RHIO: “Creating a more intelligent and patient centric healthcare system really requires us to be speaking the same language, as such

RGHS Opens Dialysis Center In Penﬁeld

Rochester General Health System (RGHS) has recently opened the Bay Creek Dialysis Center in Penfield. The center houses 21 new dialysis stations, equipped with heated chairs, personal televisions and WiFi, and brings to 69 the total number of outpatient dialysis stations operated by RGHS. “RGHS has been a leader in providing outpatient dialysis,” said physician John Hix, medical director at Bay Creek. “Delivering superior patient care in an ambulatory setting, close to where our patients Page 22

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live, has been a top priority.” Services provided at the new Bay Creek Dialysis Center include in-center hemodialysis, training and support for home hemodialysis and home peritoneal dialysis. All services are provided by boardcertified nephrologists and a highly skill team. The Bay Creek Dialysis Center is located at 2010 Empire Blvd. in Penfield. For more information, contact the Bay Creek Dialysis Center at 585-922-0580.

this effort will help support many of the care transformation and improvement efforts around our region. We are really excited and pleased to see the level of community support for this project already and the opportunities before us.”

Unity Welcomes Physician Paul A. Patrick Physician Paul A. Patrick, a Rochester resident, has recently joined Unity Health System. Patrick will join the hospital’s emergency center. He earned his Doctor of Medicine degree from the University of Rochester School of Medicine and Dentistry. He completed his residency in emergency medicine at Strong Memorial Hospital. Patrick is a member Patrick of the American College of Emergency Physicians.

New head at biochemistry and biophysics at URMC Jeffrey J. Hayes has been selected as chairman of the department of biochemistry and biophysics at the University of Rochester Medical Center. A faculty member for nearly two decades and the recently installed Shohei Koide Professor in Biochemistry and Biophysics, Hayes takes the reins after serving as interim chairman since early 2012. An accomplished and highly-respected scientist, Hayes’ research focuses on chromatin, the combination of DNA and proteins that comprise the nucleus of a cell. His lab works to understand how the DNA within chromatin is accessed for replication and repair and used in gene expression — the conversion of genetic information into proteins that make up the body and perform most life functions. “Jeff is skilled at bringing people together for the common good and understands what it takes to create an environment that is conducive to great scientific research and education,” said Lynne E. Maquat, director of the Center for RNA Biology and the J. Lowell Orbison Distinguished Professor of Biochemistry and Biophysics. “He is organized, transparent and fair by nature and we are fortunate that he has agreed to take the helm.” As chairman, Hayes plans to grow the department’s recognized areas of excellence, including RNA biology — the study of ribonucleic acid (RNA) and its roles in the regulation and expression of genes and computational biology — the use of computational methods to study the behavior of molecules and learn new things about the structure and function of biological systems. He also plans to improve the physical look of the department, updating the overall space and equipment to help recruit new faculty members and students.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013

URMC and Interlakes Oncology Plan Merger The University of Rochester Medical Center (URMC) and Interlake’s Oncology and Hematology announced in August that they have entered into formal discussions to further collaborations between the two organizations. Representatives from the URMC and Interlake’s have been meeting for the last several weeks to discuss how to further expand the organizations’ existing collaboration, which currently includes co-located oncology services at the Sands Cancer Center at Thompson Health, as well as the ability for Interlake’s patients to participate in URMC-lead clinical trials. “Interlake’s has an excellent reputation for providing compassionate and accessible cancer care from their highly-regarded oncologists and staff for more than 15 years, with a very well-established network of locations,” said URMC CEO Bradford C. Berk. “We know firsthand of the superior care they provide thanks to years of interactions between our staffs and patients. An enhanced collaboration would help both organizations deliver more complete, higher quality cancer care to patients in Monroe and Ontario counties by leveraging the strengths and networks of both organizations.” An expanded collaboration would provide URMC patients with greater access to medical oncology services through Interlakes’ established network of locations, while enhancing accessibility to URMC’s robust cancer research, clinical trials and expertise for Interlakes patients. A state-of-theart electronic medical records system would allow patients to move more easily through the network to ensure they are receiving specialized cancer care, while maintaining continuity of care. Physician Alexander Solky, president of Interlakes Oncology and Hematology, said: “Our mission is to ensure that our patients receive the best and most advanced care in the area from highly experienced doctors and nurses. An expanded collaboration with URMC will provide additional support to our current oncologists and nurses to help us to fulfill this promise. Our patients will continue to receive the same exceptional cancer care from our staff, but would have access to top-flight technology, cancer research, facilities and enhanced clinical trials available through the URMC.” Officials from the URMC and Interlakes estimate that a formal agreement could be finalized by the end of 2013. Both organizations are involved in a process of due diligence and the proposed arrangement would be subject to regulatory approval.

ARTHRITIS

Not Simply the Disease of Senior Citizens By Ernst Lamothe Jr.

izzy Parrone had just gotten up from her nap as toddlers do throughout the day. But when she woke up, her mother, Natasha, realized that her daughter couldn’t stand and put any weight on her right leg. That leg was also warm to the touch. “I thought she had fallen and hit her leg because the knee was swelling. After a few more times when her knee did the same thing, I took her to the doctor for a lot of testing,” said Parrone, of East Rochester. “At first the doctors thought she had an infection in her knee, but when we saw an orthopedic specialist that’s when we received the shocking news.” Lizzy was diagnosed with juvenile rheumatoid arthritis. Nearly 50 million Americans suffer through various forms of arthritis. Striking one of every five adults and one out of every 300,000 children, the ailment has become the leading cause of disability in the United States, according to the National Institute of Health. But just because it is a recognizable condition doesn’t mean people truly understand arthritis. The Arthritis Foundation’s efforts

prevention and quality of life. “Arthritis is not something that people take seriously,” said Melinda Merante, regional director of the Arthritis Foundation in Rochester. “When someone hears they have cancer or heart disease, they fully understand the toll it will take and do everything they can to fight it. But people need to understand that arthritis can be quite debilitating in its own right to your daily quality of life.” By 2030, an estimated 67 million Americans will have arthritis, unless the trend is reversed. The foundation has worked to provide $20 million in grants to more than 300 researchers to help find a cure, prevention programs or better treatment for arthritis during the past half century. While there are many forms of arthritis, the three most common are osteoarthritis, rheumatoid and juvenile arthritis. Osteoarthritis, which is the most widespread form, is a progressively degenerative joint disease. Rheumatoid is the inflammation of the membranes lining the joints, which causes pain and stiffness, while juvenile arthritis is the autoimmune and inflammatory conditions that can develop in children ages 16 and younger.

A family battles with juvenile arthritis

Lizzy Parrone ’s condition has affected the whole family, but her mother Natasha says the family has remained calm and sought care from their local medical doctor. “The Internet can be a scary thing and you would rather have professional medical advice than drive yourself crazy reading page after page of a website,” the mother says. Pictured are Matthew (Dad), Natasha (Mom), and children Lizzy, Andrea and Ben, and the family dog, Duke. center on a three-fold mission: research,

After the shock wore off, Parrone was simply happy to hear that something could be done for her daughter. Over the years, Lizzy, who is now 3, had joint problems on her right and left knees, right and left wrists, pinkie and eyes. She had to teach herself how to write with both hands because of the joint issues. Lizzy began taking oral medication once a day as well as receiving two weekly injections in her knee. “The advice I would give to parents is that if you are calm, your child will be calm. It was hard at first because as a baby they can’t verbally tell you what is hurting but we eventually figured out the times when she would be in pain because of her arthritis,” said Parrone. “But overall she is doing well. The rain and cold weather still makes her joints feel stiff, but she is able to do anything that other 3 year olds can do.” And while the Internet might help some, Parrone stayed away from it. “Whenever we had a question we would just ask her doctors,” she said. “The Internet can be a scary thing and you would rather have professional medical advice

Lizzy Parrone, a 3-year-old who lives with her family in East Rochester, suffers from juvenile arthritis. “At ﬁrst the doctors thought she had an infection in her knee, but when we saw an orthopedic specialist that’s when we received the shocking news,” says her mother, Natasha. than drive yourself crazy reading page after page of a website.” Understanding the key role that keeping in shape has in the battle, the Arthritis Foundation organizes water- and land-based exercises, Tai Chi classes, support groups, instructional videotapes and public forums. Every one pound of weight loss takes four pounds of pressure off each knee, according to the U.S. Department of Health and Human Services. “Extra weight can put enormous strain on your joints,” said Merante of the Arthritis Foundation in Rochester. “Exercising regularly can keep the joints fluid and it minimizes some of the issues you will have in your life. These programs like Tai Chi and our other exercise programs are proven remedies.” Janet S. Sarbou had a degenerative back disorder. First, her worn disks allowed her vertebrae to slip forward and over the years narrowed her spinal canal. Then in 2006 and 2009, she had neck and back surgeries. Her surgeon recommended taking water walking classes that the foundation sponsors and she has seen the difference. “I have a body that is full of arthritis,” said Sarbou, of Irondequoit. “Because of these classes they have made it easier for me to adjust to my physical limitations. I would not be walking and as active if I had not attended these classes.” Along with exercising, the other partner in crime of healthy living still remains eating right. That includes balanced meals, proteins, fruits and vegetables. In addition, with the body working as a team with itself, that means when one part is ailing it can in-

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By 2030, an estimated 67 million Americans will have arthritis. “Arthritis is not something that people take seriously…. But it can be quite debilitating.” Melinda Merante, regional director of the Arthritis Foundation in Rochester. fluence the rest. Arthritis has been tied to diabetes and affecting organs such as the heart. “If you don’t take your health seriously, arthritis is something that can seriously impact your life,” said Merante. “Eating right can really have a lasting effect on your life and help to prevent arthritis.” The foundation members have worked hard on dispelling common myths surrounding arthritis. First, arthritis is not simply the disease of senior citizens. Two-thirds of people with arthritis are under the age of 65. “People tend to only associate arthritis with older age groups. Because of that people don’t think to do anything preventative,” said Merante. “This is something that can hit any age group from young kids and teenagers to people in their thirties and senior citizens.” Officials have traveled to local festivals, health fairs and given corporate presentations about the issue. They also have connected with rheumatologists to work together and spread the information throughout the community.

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Take Your VA Health Care Wherever You Go With My HealtheVet you can: View records from doctor visits and hospital stays Request and view appointments online Refill VA prescriptions online Send secure messages to your doctor and health care team Share information with all your health care providers See results from tests and procedures

Ask about it today!

For questions on how to register contact the local My HealtheVet Resource room at 585-393-8203 or the national My HealtheVet Help Desk at 1-877-327-0022

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2013