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

in good Cloth vs. Disposable

The Great Diaper Debate

January 2012 • Issue 77

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Rochester–Genesee Valley Healthcare Newspaper

Your MEDICAL RECORDS More than 500,000 people in an 11-county area have agreed to share their records electronically. And the Rochester General Hospital just concluded a $65-million project to convert its patients’ medical records into electronic ones. Is this the wave of the future? How will this affect you? Story on page 18

MAMMOGRAMS Should you test at 40 or wait until you turn 50?

Making a Difference in the Lives of Local Children Vestal surgeon discusses innovative endoscopic spine surgery

Hillside Family of Agencies Chief Operating Officer Clyde Comstock has devoted most of his life to helping children

Gates blood donor celebrates 100th platelet donation Blood donor Stephen Kingsley shown with son James, also a donor January 2012 •

Finding the Right Fitness Facility in 2012

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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

Health Groups Target Unecessary ER Visits More than 700,000 trips to ERs in Upstate New York may be unnecessary, according to study

ocal health care groups launched a campaign last month tackling potentially avoidable emergency rooms visits after an analysis shows that Upstate New Yorkers make more than 700,000 ER trips annually for minor medical problems such as sore throats and earaches. “For the second year in a row, our detailed analysis of ER visits in which patients don’t stay overnight found that two out of five visits are potentially avoidable,” said Jamie Kerr, vice president and chief medical officer, utilization management, Excellus BlueCross BlueShield. “True emergencies belong in the ER,” Kerr added. “But most sore throats and earaches, for example, should be seen by your primary care doctor. Your doctor will likely see you more quickly and your copay for a doctor visit will be less.” As a result, the Monroe County Medical Society (MCMS), Finger Lakes Health Systems Agency (FLHSA) and Excellus BCBS have launched a public service campaign in the Rochester region. The campaign features television and radio advertisements urging people to first call their physician for non-urgent issues. The campaign is modeled after a similar campaign by the Baptist Memorial Health Care hospital system based in Memphis, Tenn. The Medical Societies of Herkimer and Oneida counties teamed with Excellus BCBS to launch a similar campaign in the Utica region. “The quality of health care is greatly improved when doctors and patients work together as partners,” said Joseph DiPoala Jr., a primary care physician in Irondequoit and member of the MCMS Quality Collaborative. “Patients should call their primary care doctor first when deciding the best place to receive care for medical problems.” “The goal of effective health care policy is providing to patients the highest quality of care at the lowest possible cost in the most appropriate environment,” said Paul A. Hamlin, president, Medical Society of the State of New York. “Educating the public to use the emergency room only when necessary and appropriate is absolutely consistent with this laudable goal”

Rochester–GV Healthcare Newspaper

from diagnosis to treatment.

Finger Lakes Hematology & Oncology Drs. Stephen Ignaczak & Bruce Yirinec 6 Ambulance Drive, Clifton Springs, NY 14432 315-462-1472 • www.ﬂhocancercare.com

The report

The Excellus BCBS analysis that was also released in December — The Facts About Potentially Avoidable ER Visits in Upstate New York — took a New York University formula used to classify ER visits and applied it to hospital data collected by the New York State Department of Health to determine the number of ER visits that were potentially avoidable.

According to the report:

• One out of four ER visits in 2009 in which patients were treated and released on the same day was for a medical issue, such as a back problem, that didn’t need care within 12 hours. • Another 19 percent of visits were for medical conditions that needed treatment soon — such as ear infections — but could have been treated in a primary care setting. • A significant amount of health care dollars could be saved in Upstate New York if patients went to the physician’s office instead of the ER for minor problems. Potential annual savings for commercially insured patients range from $8.1 million to $10.7 million if 5 percent of patients currently going to an ER for minor problems instead went to a physician’s office and from $40.5 million to $53.5 million if 25 percent of patients currently going to an ER for minor problems instead went to a physician’s office.

The analysis

“Many of the figures in the analysis are conservative,” Kerr added. “The number of potentially avoidable ER visits in Upstate New York is likely larger, because the report did not include visits the NYU formula deemed ‘unclassifiable,’ such as injuries.” The report also looked at health insurer payments for care rendered to commercially insured patients to see how much would be saved if these patients went to a physician’s office instead of the ER for minor medical issues. More health care dollars would likely be saved if the analysis also looked at the uninsured and those who have Medicare and Medicaid. To view the report, go to excellusbcbs. com/factsheets.

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Macular Degeneration Dr. George Kornfeld uses miniaturized binoculars or telescopes to help those with vision loss keep reading, writing driving and maintaining independence.

By Elana Lombardi Freelance Writer Just because you have macular degeneration or other eye diseases like diabetic retinopathy doesn’t mean you must give up driving. “People don’t know that there are doctors who are very experienced in low vision care.”Dr.George Kornfeld, a low vision optometrist. Low Vision patient, Bonnie Demuth, with Bioptic Telescopes

In Good Health is published 12 times a year by Local News, Inc. © 2012 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone:(585) 421-8109 • E-mail: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto Associate Editor: Lou Sorendo Writers and Contributing Writers: Eva Briggs (M.D.), Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, Ernst Lamothe Jr., Amy Cavalier, Beth Emley, Sheila Livadas Advertising: Marsha K. Preston, Donna Kimbrell Layout & Design: Chris Crocker Ofﬁcer Manager: Laura Beckwith No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

January 2012 •

Bonnie was helped with two pairs of glasses: Special $475 prismatic glasses let her read the newspaper and bioptic telescopes helped her distance vision.

“My new telescopic glasses make it much easier to read signs at a distance.” Says Bonnie, “Definitely worth the $1950 cost. I don’t know why I waited to do this. I should have come sooner.” Low vision devices are not always expensive. Some reading glasses cost as little as $450 and some magnifiers under $100. Every case is different because people have different levels of vision and different desires. “Our job is to figure out everything and anything possible to keep a person functioning visually.” Says Dr. Kornfeld. Dr. Kornfeld sees patients in his five offices throughout upstate New York including Rochester. For more information and a FREE telephone consultation call:

585-271-7320 Toll-free 1-866-446-2050

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

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Specializing in individual and couples, depression, loss and grief counseling,family and parenting issues, aging and caretaking and substance abuse counseling.

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Jan. 15

Vegetarian group to discuss organic veggies

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The public is invited to attend the January meeting of the Rochester Area Vegetarian Society and meet local organic farmers who offer farm shares. Titled “Where do I get my organic veggies?” the program will feature a panel of organic farmers who offer community-supported agriculture. The Jan. 15 event will start with a vegan share-adish dinner at 5:30 at Brighton Town Park Lodge, 777 Westfall Road. The program will include a slide show and Q&A period with informational and registration materials. Free to RAVS members. For dinner, $3 fee for nonmembers in addition to bringing vegan food to share; fee is waived if you join at the meeting. You may attend either the dinner or the lecture, or both, and there is no need to reserve for either.

Jan 21

contains no animal products. They will have learned how to eat out at restaurants and at the homes of friends and family. They will be able to explain how eating this diet benefits their health, the future of the planet, the welfare of animals, and our nation’s prosperity and security. The course will be given on successive Mondays from 7 – 9 p.m. beginning Jan. 23 through Feb. 27. The Monday prior to the first session (Jan. 16), there will be a showing of the documentary “Forks Over Knives.” The cost for the entire sixweek course (including all materials) is $60 for JCC members and $75 for nonmembers. Any profit will be donated to the Rochester Area Vegetarian Society. The cost of the showing of Forks Over Knives is $8 for JCC members and $10 for non-members. To register for the course or movie, call 461-2000 or visit the JCC website (jccrochester.org), click on “Registration,” and search for “Adult One-Time Programs.”

Jan. 24

Fibromyalgia group to hold Couples relationship expert meeting to offer a “Passion Retreat” Don Boice, a counselor specializing in gender communications and couples counseling, will offer a full-day “Passion Retreat” for couples from 9 a.m. to 5 p.m., Saturday, Jan. 21, just in time for Valentine’s Day. Designed to help people get the spark back in their lives, participants will learn to ask for the support and love they want from their partners. Space is limited and registration is required by calling 802-1273. Cost is $150 per couple. The workshop will take place at Boice Counseling’s new office, 572 Titus Ave. in Irondequoit. Participants will start the day in a group and then each couple will go to their own space to review what was discussed. Participants will come back together periodically for debriefing and more learning, sharing only the information they feel comfortable sharing. Since 2007, Boice Counseling has served individuals, couples and organizations interested in learning practical ways to manage conflict, anger, depression, anxiety and other issues. For more information, visit www. boicecounseling.com.

Jan 23

Six-week program on plantbase diet at JCC JCC of Rochester will present “A Plant-Based Diet — Eating for Happiness and Health,” a six-week program to be presented by Dr. Ted D. Barnett (primary instructor) with wife Carol H. Barnett assisting. The Barnetts are co-coordinators of the Rochester Area Vegetarian Society (RAVS). Participants will learn the rationale behind eating a low-fat, whole-foods plant-based diet. By the end of the course, participants will be comfortable feeding themselves and their families a healthy diet that

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

The New Fibromyalgia Support Group is inviting the public to learn about alternative arts therapy that can help reduce and help with stress and pain caused by fibromyalgia. Titled “Creative Arts for Stress / Roundtable Chat,” the group will host an art therapist who will focus on a specific therapy outlet such as music, drawing, or other interesting practices. The meeting will take pace from 6:30 – 8:30 p.m. at Westside YMCA, 920 Elmgrove Road, Gates. The evening is designed for people with fibromyalgia, their families, friends, and anyone interested in learn more about this disorder. For more information, call Jackie at 585-752-1562 or email her at Jacolyn_fibrosupport@hotmail.com. More information can also be found at www. newfibrosupport.com.

Feb. 11

Mental Health Association organizes its ‘Skyway Open’ The Mental Health Association of Rochester is organizing its Skyway Open, an event that is expected to draw more than 500 area golfers to play 18 holes of miniature golf throughout the Eastview Mall in Victor mall — ending at the 19th hole and a high end silent auction. The silent auction will feature trips, hotel packages, wine tours, dinners at fine restaurants, artwork, evenings at GEVA, the RPO, Garth Fagan Dance & Downstairs Cabaret, weekend packages on both Canandaigua Lake and Keuka Lake and many more items. There will be a raffle for high tech items such as an iPod and X Box 360. The event takes place begining at 9:30 a.m. and will end at 5p.m. Feb. 11. The event will raise funds for the Mental Health Association and its services. For more information, call 325-3145, ext. 111.

A War Inside: Saving Veterans from Suicide

n estimated 18 American military veterans take their own lives every day — thousands each year — and those numbers are steadily increasing. Even after weathering the stresses of military life and the terrors of combat, these soldiers find themselves overwhelmed by the transition back into civilian life. Many have already survived one suicide attempt, but never received the extra help and support they needed, with tragic results. A team of researchers from the University of Pennsylvania and colleagues discovered that veterans who have attempted suicide not only have an elevated risk of further suicide attempts, but face mortality risks from all causes at a rate three times greater than the general population. Their research was published in “Biomed Central Public Health.” Therese S. Richmond, an associate professor at Penn Nursing, was part of a team involved in the study, which was the largest follow-up of suicide attempters in any group in the United States, and is unique even among the relatively few studies on veteran suicide. “Veterans who have attempted suicide face elevated risks of all-cause mortality with suicide being prominent. This represents an important population for prevention activities,” explains co-investigator Richmond. “We looked at suicide among veterans who had already attempted suicide one time,” notes study author Douglas J. Wiebe, assistant professor of epidemiology. The findings, he says, “should have us very concerned about current veterans in the more contemporary era.” Joseph Conigliaro of the New York University School of Medicine conducted a study of military veterans who received inpatient treatment at a Department of Veterans Affairs (VA) medical center for a suicide attempt between 1993 and 1998. Using additional data from the VA, as well as the National Center of Health Statistics, these veterans were followed for incidence, rate, and cause of mortality through the end of 2002. The study strongly urges the increased need for rigorous efforts to identify and support at-risk veterans, especially those who have previously attempted suicide, say the authors.

Local Hospitals Join Forces to Combat Bacteria Initiative follows the deaths of three patients at United Memorial Medical Center in Batavia last year By Sheila Livadas

our Rochester-area hospitals and can strike healthy people who are a health insurer have launched not taking antibiotics or hospitalthe Rochester Patient Safety Colized. laborative to fight a potentially deadly The launch of the Rochester germ known as Clostridium difficile. Patient Safety Collaborative Deadly Health care professionals aim to lower followwed the deaths of three pathe infection rate by 30 percent in three tients at United Memorial Medical Cenyears. ter in Batavia who had been diagnosed “I think it’s tremenwith C. diff earlier this dously exciting that year. Prevalence of the as a community we’re bacteria in the Rochester coming together because area is roughly 1.5 perit really is all about cent, experts say. patient safety,” says Mild to moderate Linda Greene, director of C. diff causes watery infection prevention at diarrhea for two or more Rochester General Hospidays and abdominal tal and a member of the cramping. Severe infeccollaborative’s steering tion can entail diarrhea committee. a dozen or more times Clostridium difficile, a day, intense abdomialso known as C. diff or nal pain, dehydration, C. difficile, wipes out nausea, fever, blood or beneficial microbes in the pus in the stool, loss of colon and can cause variappetite, weight loss and ous symptoms, including colitis. watery diarrhea, abdomiSome people with C. nal pain and life-threatdiff carry the infection Ann Marie Pettis, director ening colon inflammabut remain healthy. of the infection prevention tion. C. diff often targets The local collabprogram at the University of orative, comprised of older adults in hospitals or in long-term care Rochester Medical Center, representatives from facilities. Rochester General says a local collaborative Antibiotics play a Hospital, Strong Hospiis making important strides key role in C. diff betal, Highland Hospital, to ﬁght a bacteria called cause they can disrupt Unity Health System Clostridium difﬁcile. the balance of good gut and Excellus BlueCross flora and bad. BlueShield, is attacking Given its persistence, the infection C. diff on various fronts. typically lengthens patients’ hospiBesides standardizing patient-room tal stays and ratchets up care costs. cleaning protocols, it is focusing on Experts say those afflicted with C. diff staff compliance for hand hygiene and have a 20 percent chance for recurrent patient-isolation procedures. The group infection. also is evaluating whether ultra-violet According to the Mayo Clinic in light would help decontaminate rooms Rochester, Minn., C. diff has become and whether tempering antibiotic more common, more virulent and more prescribing would hem in the infection difficult to treat nationwide. The illness rate.

Ann Marie Pettis, director of the infection prevention program at the University of Rochester Medical Center and a member of the collaborative’s steering committee, expects to see a reduction in the number of C. diff cases in six months to a year after local hospitals’ efforts get up to speed. Health care professionals rely on stool tests to diagnose C. diff., and local hospitals are leading the charge on adopting the most sensitive detection tools available, Pettis says. Employees hospitalwide, from physicians and nurses to housekeepers and administrators, have a role to play in controlling C. diff, Pettis adds. “You’ve got to have eyeballs on the process to make sure [compliance] is happening on a consistent, reliable basis,” she says. Hospital-acquired infections often act “like the perfect storm. The [factors] all come together to put the patient at risk,” Pettis says. Greene of Rochester General agrees that awareness and teamwork have energized the collaborative’s efforts. “You have a whole host of people who really have to come together and work as a team to decrease it,” Greene says. The health care industry has begun shifting away from its once-rigid and isolating approach to patient safety, Greene says. That means “we will have a greater opportunity to perhaps really decrease and potentially, someday eliminate this severe infection,” she says.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Meet

Your Doctor Dr. Matthew Bennett Surgeon discusses innovative endoscopic spine surgery Q: What is endoscopic spine surgery? A: Endoscopic spine surgery is a minimally invasive surgical procedure that allows you to get relief from pinched nerves in the spine. When a spinal nerve gets pinched, the burning stabbing pain can be very debilitating. This procedure allows a tube the size of a pencil to be inserted into the spine through an incision the size of a fingernail. With some minimally invasive surgery the incision size is really just a gimmick and what happens under the skin is really not too minimal. However, with this technique, the muscles are not cut or torn. They are literally pushed aside to allow this small tube to enter the spine. From there we use a “high-def” camera to see into the spine and “un-pinch” the nerve under direct view. It’s really amazing to watch a distorted pinched nerve fall back into a natural position — some patients will immediately feel relief. Q: How is it better than traditional spine surgery? A: Those of us who are good at using the scope to treat spinal problems have recognized several advantages. First of all, endoscopic spine surgery has been very effective at relieving pain. Some patients will leave the hospital several hours after the procedure with a complete relief from their pain. The most striking example was a patient of mine who had literally been in bed for two months because of the severity of his leg pain. By 5 pm the night of surgery, he was out walking his two dogs – it was really amazing. Secondly, there is very little structural damage or “collateral damage” from the spinal surgery. Realistically, most patients with pinched nerves require only a few millimeters of decompression to obtain pain relief. With traditional spine surgery, important stabilizing spinal muscles are cut or stretched. Bone and ligament are then cut away, leaving an area of exposed nerve tissue that is at risk to develop scar tissue. That nerve sack is then pulled to the side and the few millimeters of disc material or bone spurs can then be removed. The endoscopic technique bypasses all of the above — we take advantage of an opening that already exists in the side of the spine called the neuroforamen. Very often I’ll enlarge that opening by a few millimeters to make even more room for the nerve and then remove the ruptured disc or bone spurs without taking the natural structure of the spine apart. We have seen very little development of scar tissue. With traditional spine surgery, a technically wonderful operation can be performed only to develop scar tissue and the return of pain as the nerve gets tethered back down inside the spine. This isn’t the fault of Page 6

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the spine surgeon — unfortunately it’s the body’s own response to the trauma. Patients can usually maintain their range of motion after endoscopic spine surgery. Muscles are not being disconnected, screws and rods are not being placed, and incisions are small enough that healing is usually not a factor. Patients like being able to return to an active lifestyle quickly. These days, many people want to return to work as quickly as possible. People just can’t afford to stay out of work. Q: Do you still do traditional spine surgery? A: I try to customize the operation for the patient. So yes, I still perform traditional spine surgery when I think it matches the patient’s needs better. I think that it’s important not to pigeonhole every problem into something that can be treated with one procedure. Some clinics around the country have done just that — they’ve turned more into a marketing machine — spending millions of dollars a year to promote their own “customized” procedure. I put my patients needs first. Q: Who is a candidate for endoscopic spine surgery? A: People who have leg pain from a ruptured or herniated disc, or bone spurs may be a candidate. It really needs to be decided on a person-byperson basis. But there are certain types of disc herniations that in my experience are almost always better served with an endoscopic approach — neuroforaminal or far-lateral disc herniations, contained disc herniations, and many extruded or sequestered disc herniationss. Q: Are there any patients who are not candidates for traditional spine surgery that can benefit from endoscopic spine surgery? A: There are definitely patients who present with what I call the “Princess and the Pea phenomenon.” These patients have pain and real

structural problem in the spine. However, the structural problems in the spine may be quite small — for instance, just a small disc bulge. For these patients, the risks of traditional open spine surgery just don’t make sense and many of these patients are told to live with their pain. Some of these patients can potentially be helped with this lesser invasive surgery. Some people cannot tolerate or survive a general anesthesia. People treated with this endoscopic technique do not need to undergo a full general anesthesia. They don’t need to be put to sleep and they don’t need a breathing tube. There are many patients who really need a spinal procedure but are not healthy enough to tolerate a major anesthesia — these patients can now get the relief they need. Q: What are the risks? A: Any operation or procedure has risks. This one is no different. Anesthesia has risks and your medical doctor can help to stratify this risk — but the amount of anesthesia is so much less than with traditional spine surgery. This is often done under a twilight anesthesia. Bleeding and infection risks are small. In fact, we have seen very few infections with this approach, probably because blood flow to the spine is not interfered with and the fact that the procedure is done under continuous antibiotic bath irrigation. The risk of nerve irritation is low because the patient is able to tell us right away if the nerve is becoming irritated by the procedure. Some patients may require a more invasive traditional open surgical approach. But it is rare that any bridges are burnt with this less destructive approach. Certain risks are inherent with any spine operation — the disc herniation can recur, the disc can become degenerative over time, or the spine can become unstable. So far, we have seen fewer complications with endoscopic spine surgery than with open spine surgery, but that really needs to be proven with solid scientific data. Q: Is anyone working on clarifying the results with solid scientific data? A: Our combined international efforts have already provided quite a bit of solid science. I am excited to be one of 5 sites around the US that is studying exactly how patients do over time. We want clarify outcomes, try to determine who exactly are the best candidates, and document any real downsides to the procedure. We basically want to improve spine treatment, and we want to do it the right way.

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

Q: Is special training required? A: I’m a board certified orthopedic surgeon. I did my residency training at Upstate Medical University in Syracuse — where the spinal training is really top notch. Then, I did a specialized spinal fellowship at the Texas Back Institute outside of Dallas — another world famous institution. I’ve spent a lot of time learning endoscopic spine surgery. I’ve learned from very accomplished surgeons here in the US as well as international surgeons. I’ve been to Germany where the current procedure was invented and spent time learning directly from the German surgeons. I’ve been very fortunate in that regard. The international community of endoscopic spine surgeons is still relatively small. We routinely meet at select user meetings as well as at societies such as SMISS (Society for Minimally Invasive Spine Surgery). I’ve been a teaching instructor for other surgeons for several years now. Q: Why did you dedicate the time to learn this technique? A: As spine surgeons, we see patients in the office who have problems that vary in intensity and severity. It seemed to me that we really didn’t have enough options to successfully match our patients’ needs to our operative procedures. I want to put my patients’ needs first, so I will usually be sure that the patient doesn’t have a problem that can be treated non-operatively first. Physical therapy, chiropractic care, medications, and injections may be enough to treat the majority of patients. When these options fail, a traditional open surgery like a laminectomy or a microdiscectomy used to be the next step. If the problem was significant enough a fusion connecting the bones of the spine together may be needed. In many cases I wished that I had something different to offer — something with less risks. That’s what was so alluring about the endoscopic option. The spine is such a wonderful structure when everything functions normally. Unfortunately, the spine is also a complicated and linked structure. When one thing goes wrong other areas of the spine can be effected. Traditional spine surgeries can magnify this domino effect, and in some cases we believe that screws, rods, and cages can even accelerate the degenerative cascade. Can endoscopic spine surgery help to avoid fusion surgeries? Well that’s exactly what we are trying to understand and I am honored to work with professional organizations like the Society for Minimally Invasive Spine Surgery who are trying to understand these important questions. If we look at many common surgical procedures patients have done much better with lesser invasive options. People have been able to move quicker, return to life quicker, and avoid a lot of collateral damage. For instance, before laparoscopy a gall bladder surgery used to be very traumatic and challenging for patients to recover from. The same is true for knee surgery. Now, with the laparoscope or arthroscope these procedures have become common. We are seeing urologists able to take out prostate cancer with a robotic scope. In each of these cases, surgery has evolved. I believe that spine surgery is evolving too — and endoscopic spine surgery is going to be part of that process. Bennett can be reached at 100 Plaza Drive; Vestal, NY 13850 (Binghamton area). For more information, visit www.tierorthopedics.com or call 607-798-9356

Gates blood donor celebrates 100th platelet donation Blood donor Stephen Kingsley recently honored at the American Red Cross’ West Henrietta Blood Donation Center By Beth Emley

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hose who donate blood — or blood products such as plasma and platelets — may say it makes them feel good to know they are helping others. But the act of donating is more than just a “feel good” experience for Stephen Kingsley, who gets emotional every time he talks about being a donor. Kingsley, 60, of Gates, a clinical engineering technician who works in the dialysis unit at Rochester General Hospital, has been donating platelets and plasma for 25 years. Platelets, or thrombocytes, are small, colorless cell fragments in the blood whose main function is to interact with clotting proteins to stop or prevent bleeding. Plasma is a fluid, composed of about 92 percent water, 7 percent vital proteins such as albumin, gamma globulin, anti-hemophilic factor, and other clotting factors, and 1 percent mineral salts, sugars, fats, hormones and vitamins. Earlier this year, Kingsley reached his 100th platelet donation and was honored by his son, James Kingsley, also a platelet donor, along with family and friends, at a birthday/donor event party in his honor at the American Red Cross’ West Henrietta Blood Donation Center, where he donates. In an interview, Kingsley recalled how he got started as a donor and had to pause a few times because he got choked up talking about how he feels about give platelets. “I love talking about what it means to me,” Kingsley said. “Every time I talk, I choke up about it. I love to talk and encourage other people. I can’t encourage them enough.” Stephen Kingsley said his interest in donating began about 25 years ago. At that time, Kingsley donated whole blood a few times. But later he learned that since he had AB-negative blood, it would be more beneficial to donate platelets and plasma. AB-negative is to platelets as Onegative is to whole blood. As O-negative is universal, and anyone can receive a donor’s whole blood, AB-negative has universally acceptable platelets that can be received by anyone. Unlike whole blood, which can only be donated about every four weeks, Kingsley is able to donate platelets about every two weeks and he often does. Sometimes he donates platelets and plasma (which on its own can be donated once every four weeks) at the same time. The process of donating platelets is different than for donating whole blood, Kingsley said. He said the technician will poke both arms, extract the blood and then run it through a machine to separate out the platelets. The blood can be returned to the body. The process takes two to two and a half hours, he said. “It doesn’t tax your body the way donating blood does,” Kingsley said.

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Blood donor Stephen Kingsley shown with son James, also a donor. “When they take the platelets out, they return the same volume” of blood back to the body. The process of donating platelets really is a “rush” for Kingsley. “For me, my body goes into regeneration like the best coffee latte with an extra shot,” he said. “It’s like I have three projects and I want to start them all at once. It’s an excellent thing for me.” Kingsley said there are some donors who can “relate to the healthy part but not the energy part” of donating platelets. “When I don’t do it, I feel logy,” he said. While he doesn’t report the same kind of physical rush as his father from donating platelets, 34-year-old son James Kingsley, of Greece, a quality control technician at the Red Cross in Henrietta, said he just feels good about giving platelets because “it’s the right thing to do.” James, who has been giving plasma and platelets for over four years, said his dad stressed the importance of generosity. “My dad’s always raised us to be giving people,” he said. “That’s why we wanted to do that party. It feels good for me on the inside to give.” Donations made at the Red Cross can go to numerous hospitals or medical facilities within the state and across the county. But Stephen Kingsley said there is one he feels especially good about. A few years ago, Kingsley said he

had a lull in his giving when he learned of the need at Albany Medical Children’s Hospital. Platelets were needed for children who have cancer. Babies who have cancer and need platelets benefit from another characteristic of Kinglsey’s blood — he is CMV negative. CMV” stands for cytomegalovirus. CMV is a relative of the lesser herpes virus that most adults have been exposed to early in their lives. His has none of the antibodies that could adversely affect the child’s already compromised system. Kingsley said he plans to keep on donating platelets and plasma well beyond the milestone of his 100th time. “I hope I don’t have to quit. I enjoy the people as much as the giving,” he said. “I request one needle be placed in the lower arm rather than the normal inside elbow area, so I can use that arm to turn pages, I read and visit during the process, rather than watch a movie. I might as well enjoy it — read and talk with people. They have good coffee and cookies too,” he said, with a laugh. Deb Drexler, marketing program manager for the Henrietta chapter of the American Red Cross, said the organization appreciates donors like the Kingsleys and is always encouraging people in the community to give. To give, go to the website at redcrossblood.org/nypaph/pass-it-on for new platelet donor recruitment tips, email template, platelet donation, frequently-asked questions, and to download the online donor and referral information form.

January 2012 •

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Page 7

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

New to Living Alone? What Not to Do

ave you seen the popular TV show called What Not to Wear? Fashion experts Stacy London and Clinton Kelly transform fashionchallenged women into stylish personalities. Watching the show is one of my guilty pleasures. I just love seeing the participants learn and grow during the weeklong makeover, which often results in renewed self-confidence and empowerment. In addition to receiving plenty of fashion and makeup “do’s,” the participants are cautioned against fashion “don’ts” and advised what not to wear. This highly instructive, sometimes painful, yet very funny part of the show (when participants’ existing wardrobes are literally thrown out) is what inspired this column. I’ve shared lots of “do’s” in the past to help people live alone with more success. Here are a few “don’ts” — some lighthearted — that may also help you on your journey toward contentment:

Don’t isolate. Get up, get dressed, get out of the house or get on the phone. We humans are social animals; we’re meant to be with others. Don’t go on a shopping spree to fill an emotional void. Your savings account will thank you. Don’t make ice cream your main course for dinner. Well . . . maybe on occasion. But as a general rule? No. Create a nice place setting, fill your plate with something healthy, light a candle, and enjoy some well-deserved time to yourself. Don’t label yourself a loser just because you are spending Saturday night alone. It’s not the end of the world. It doesn’t define you. Rent a DVD and call it a night. But, if the prospect of a weekend night alone is too difficult, reach out to a friend today and make

KIDS Corner Kids and Cholesterol: What You Need to Know

ecently, the U.S. Department of Health & Human Services shocked parents around the country when they issued new guidelines regarding children and cholesterol. Their recommendations, joined by those of The National Heart, Lung and Blood Institute, outline guidelines that suggest all children between the ages of 9 and 11 should have their cholesterol levels checked. The move, which came about because children today are being seen with abnormal cholesterol levels and even the beginning stages of artherosclerosis, has left many parents seeking answers to their questions. “It is a big change, because formerly the recommendation was only for those who had a family history of high cholesterol,” explains Pamela McCullough, a pediatric nurse practitioner and the director of the nursing Page 8

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program at Stratford University’s Woodbridge campus in Virginia. “This should be seen by many parents as a sign of our times and what is going on with the lifestyles we are raising our children to lead. It is also a great time for families to learn all they can, and to make changes in order to live a healthy lifestyle.” The two most important things that parents need to know in order to address this issue are 1) to learn all they can about cholesterol, and 2) to make healthy lifestyle changes. Cholesterol is a waxy substance that is produced in the body’s liver. While the substance is important to cell function, having too much of it can lead to a narrowing of the arteries, as it builds up inside the body. In addition to the cholesterol our body makes, we end up getting more of it through our diet and lifestyle choices.

plans for next Saturday. Don’t put too much stock in that Dreamcatcher. If bad dreams keep you up at night, try meditation, journaling or aromatherapy. If they don’t do the trick, there’s always warm milk or a good, boring book. Don’t avoid dancing lessons because you don’t have a partner. Good teachers know how to incorporate singles into their classes by making introductions or by partnering with single members to demonstrate steps. Lucky you! Don’t jump into someone’s arms out of loneliness. Feelings of desperation can make you easy prey for a “suitor” with dubious intentions. It’s a risky place to be. Getting good at living alone will improve your chances of meeting someone who values and appreciates your strengths, not your weaknesses. Don’t get behind the wheel after a night of drowning your sorrows with friends. Self explanatory. Don’t be afraid to travel alone. Some of my best trips have been taken with my favorite traveling companion: myself. I create my own itinerary, go at my own pace, and meet all kinds of interesting people along the way. Don’t neglect your car’s needs. Get

The first thing families will want to do is focus on eating a healthy diet. This will help reverse and prevent obesity, which should also lead to a reduction in cholesterol levels. Dietary cholesterol is found in animal-based foods, such as meat, seafood, eggs, and dairy products. Focusing the family diet on healthy meals that include minimal amounts of animal products is ideal. The goal is to eat a lot of fruits, vegetables, whole grains, and low-cholesterol sources of protein (e.g., beans, tofu, nuts, lentils, etc.). Additionally, families are advised to increase their child’s activity level. Today, children often spend more time engaged in sedentary forms of electronic entertainment than they do in physical activity. Parents should aim for their children to get at least one hour of physical activity per day, which includes such things as running, brisk walking, playing sports, bike riding, etc. “This is a serious issue for parents to be aware of, because high cholesterol problems in a child today can lead to

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

that oil changed, fill those tires, check out that funky engine sound. Similarly, don’t neglect your body’s needs. You’re no good to anyone, especially yourself, if your health suffers. Make that appointment, fill that prescription, and get that screening. Don’t decline an invitation because it means walking in (and walking out) alone. You can do it. Make a beeline for the fondue and before you know it you’ll be engaged in conversation. Go and have fun! Don’t act your age. You’re free and on your own. What better time to spread your wings, be silly, and otherwise express yourself. Don’t take these “don’ts” too seriously. You’re in the best position to decide what to do or not to do — no shoulds, musts, or other people’s agenda. That’s one of the glorious benefits of living alone! Don’t I know it! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment Workshops for women held throughout the year in Mendon, New York. For information about her upcoming workshops or to invite Gwenn to speak, you can call her at 585-624-7887; email her at gvoelckers@rochester.rr.com.

major problems as an adult,” adds McCullough. “The sooner parents help their children to be in control by living a healthy lifestyle, the better off they will be. Once you focus on making these healthy lifestyle choices, the rest usually falls into place.”

Pediatrician Offers Advice on Safer Social Networking Smart phones, tablets, notebooks, and multi-tasking MP3 players — how can these gadgets affect your children

iven the abundance of smart phones, tablets, notebooks, and multi-tasking MP3 players the most popular gift this season may be increased access to social networks. “There doesn’t seem to be a handheld device out there that doesn’t provide the ability to text or otherwise connect to a social network and many of these are the ‘hot’ gifts requested by children ranging from ‘tweens’ to teens,” says Mark Cohen, board-certified pediatrician and internist with Lifetime Health Medical Group. “If I could offer one piece of advice to parents about social networking, it would be to proceed with caution.” While kids may navigate the online jungle easily, Cohen including some of the most popular sites like Facebook and Twitter, they don’t always do so safely, says Cohen. “Even when kids are emotionally and mentally mature enough to be texting and using social networking sites, they may not think about the risks of certain behaviors.” Among the most publicized negative outcomes is cyber bullying, when a child is victimized in front of a sprawling network of his or her peers. However, there are risks presented even when a child has positive relationships with peers online. Many young users frequently log in to the sites for

fear they’ll be behind their peers in getting information posted there. “This can lead to negative performance in school, a lack of sleep and even narcissistic behavior,” says Cohen. “The Internet eliminates many of the social barriers that exist in real life, so kids feel they have the freedom to do or say things they wouldn’t normally do, even things that are inconsistent with their personalities.” Cohen advises families to also be aware of the practice of data mining that has become popular with employers, colleges and universities, and even insurance companies. Some organizations are creating “shadow resumes” by downloading content kids have posted online, he says. Risqué photos, photos showing illegal behavior such as underage drinking or substance abuse, or even derogatory comments made to others can mean the difference between a young adult being accepted into their college of choice or getting their first professional job. Cohen offers some advice for parents to help kids have safe interactions online: • Familiarize yourself with the sites your kids use. Create your own account, scout around, and add your child to your network. • Use parental controls to monitor

your children’s online activity, especially for younger children. A wide variety of software is available to do this. • Discourage handheld Internet access. “When you really ponder this issue, there are few legitimate reasons for a child or teenager to have a phone with Internet access enabled,” says Cohen. • Don’t overlook other forms of social networking your child participates in, like sending and receiving texts or other electronic messages — which now can be done through handheld games and MP3 players in addition to smart phones and portable computers. • Keep the family computer in a central location in your home. Do not allow your child to have a computer or webcam in his or her room. • Talk to your children about putting personal information online. Discuss the risks of specific types of information, such as phone numbers, addresses, immediate location/status updates and even what school they attend. • Make sure your children understand the possible negative impact of posting risky content online. Get kids thinking about the long-term implications for their education and future career.

• Limit computer time. Instead, encourage face-to-face interaction with friends and family. • Lead by example. If you frequently check your text messages and social network profiles, your child will copy that behavior. “The bottom line is that parents should be involved in their children’s online activity, with more involvement for younger children,” says Cohen. “And no matter what age, kids need to understand safe behaviors for the websites they are using.”

Finding the Right Fitness Facility in 2012

any holiday party goers will likely start 2012 searching for the perfect fitness facility to shed the holiday weight gain and fulfill a New Year’s resolution. Finding the right fitness facility can be a tricky task if you’re looking for more than just the lowest-cost option. “You need to assess your fitness goals before selecting the best gym for you,” said Janette Westman, health and wellness consultant, Excellus BlueCross BlueShield. “Do you want a basic gym with treadmills for a daily run or walk, for example, or do you prefer a gym with varied classes or state-ofthe art equipment to keep you motivated?” Westman, a former personal trainer, offers the following tips for finding the right fitness facility: • Location: People often stop exercising because they lack the time. If you exercise after work, select a gym close to your employer. Weekend warriors in the battle against the bulge may want a gym close to home. • Hours of operation: The gym should be open when you plan to exercise. Early birds, for example, may need a gym with early hours to allow for the 5 a.m. swim

before work. • Cost: Ask if the gym will waive the enrollment fee so that you’re only responsible for the monthly dues. • Free trial pass: Test the gym during the times you’ll likely exercise. Is the gym too crowded? Are the classes, equipment and atmosphere right for you? Are showers and changing facilities up to par? • Equipment quality: Check if the cardio and weight machines are clean and in good condition. • Staff: Are staff members qualified with the right certifications? You may want a gym with fitness trainers and dietitians to help you get healthier. • Classes: Ask if classes such as spinning and yoga cost extra. If you’re solely interested in classes, a studio instead of a fitness facility may be a better option for you. “Once you secure a gym membership, keep your fitness goals S.M.A.R.T — specific, measurable, attainable, realistic and timely — and remember to have fun!” Westman added. “You’re more likely to continue exercising if you stick to activities you enjoy.”

January 2012 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

My Turn

By Eva Briggs

Five Common Reasons Your Doctor May Misdiagnose You

y oldest daughter is a philosopher. As I write this, she probably is sitting on a rock in a remote corner of the world, wearing a toga, doing what philosophers do: trying to solve the world’s enigmas through logic. Seriously, when she was a teenager, her arguments with parents were not the typical teenage drama. Instead, she would listen quietly when my husband or I explained our position, and then she’d carefully point out which fallacy we’d made in our reasoning. For example, the straw man, ad hominem, no true Scotsman, ad ignorantium, and more! Because my daughter taught me all the various ways thinking can run amok, I read with interest a recent article titled “Flaws in Clinical Reasoning: A Common Cause of Diagnostic Error” (“American Family Physician,” November 2011 issue). The authors described five common flaws in clinical reasoning doctors make, estimating that diagnostic errors occur 5 –10 percent of the time in emergency room visits. Below I’ll try to describe these types of errors, and show examples.

Anchoring means sticking with a diagnosis. Suppose a lamp won’t turn on. You decide to change

the bulb. It still won’t turn on, so you replace that with another bulb. That’s anchoring: you decided that the bulb is bad even when a replacement bulb didn’t solve the problem. A common medical example occurs when a patient has a cough, and is repeatedly treated with a changing spectrum of antibiotics for a diagnosis of sinusitis. By failing to consider new or different diagnoses, the physician might miss other causes for the persistent cough: allergies, asthma, reflux, tuberculosis.

notice several insects on the plant, and conclude that they are killing it. Even though there might be other causes, you blame the insects because they are so obviously visible. Doctors can make the same type of error. Suppose a patient with back pain thinks he has a urine infection. The physician may conclude that the patient has a urine infection because the urine dipstick is positive for white blood cells, even when other evidence fails to fit the diagnosis.

Availability refers to whatever comes most easily to mind. You come home and find a broken window. So you assume someone was trying to break into to your house. That could be the case, but there are other possibilities: a stray baseball, a punch from an angry teenager, a collision from a misguided bird. For a medical example, consider an itchy rash around a patient’s waist that appears to be scabies. But there are other possibilities that must be considered: hives or contact dermatitis from nickel in a jeans snap, and more.

Framing is assembling elements that support a diagnosis. This is a type of decision-making biased by subtle cues and irrelevant information. You are driving your car, and as you pass through deep puddle the “check engine” light turns on. So you begin looking for problems that are caused by moisture, like a bad spark plug wire. But the puddle might have been pure coincidence, and the true problem may have no relationship to wetness. Medical examples include assuming that a patient with a fever has malaria because he just returned from Africa, or that an opioid addicted patient’s abdominal pain is due to narcotic withdrawal. In both cases it’s important to look for other causes so as not to miss serious alternative diagnoses. The first

Confirmation means assigning preferences to findings that confirm a diagnosis. Imagine that a plant in your garden is dying. You

s e t e b ia

reater Rochester Health Foundation has awarded $471,596 to the diabetes prevention program (DPP), a community health initiative of the University of Rochester Medical Center (URMC) that is administered through its Center for Community Health. This three-year grant builds on one of the foundation’s major areas of focus: prevention. The DPP will expand its existing lifestyle intervention program to 11 primary care settings with a goal to reduce the incidence of diabetes in the targeted patient populations by more than half. It is estimated that 20 percent of

patient could have pneumonia, and the second could have appendicitis. Not to mention a myriad of other possibilities.

Premature closure refers to failure to seek additional information after reaching a diagnostic conclusion. Perhaps your car is leaking oil. Upon discovering that the plug is loose, you fail to notice a second cause like a leaking valve cover gasket. The same thing happens in medicine. For example, a doctor detects a broken bone in the foot and then fails to notice a second broken bone next to the first one. With so many ways for diagnostic error to occur, how can the risk be minimized? Evidence suggests that teaching residents (and perhaps by extension other medical professionals) about the types of erroneous reasoning may help. After all, thanks to my daughter’s tutelage, I am less likely to commit the types of fallacious reasoning she explained to me. Diagnostic checklists also appear to reduce the risk of error.

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

Prevention Program Introduced to Physician Practices

African Americans living in the City of Rochester have diabetes, and medical experts say it is likely that one in three city residents has pre-diabetes and is at risk of developing diabetes. The DPP has been highly successful and cost-effective in studies, but has not been broadly implemented in clinical practices. Over the course of the grant, the program will be implemented in 11 primary care settings, starting with Anthony L. Jordon Health Center, Culver Medical Group, East Ridge Family Medicine, Westside Health Services, Rochester General Medical Associates, and Unity Health System. The program involves 22 weeks of intensive intervention in group and individual meetings with nutritionists

and physical activity counselors, which allow individuals to attempt behavior change in a supportive environment over a period of time. “We are eager to work with primary care practices to enhance their capacity for prevention,” said Nancy M. Bennett, director of the URMC Center for Community Health. “By providing resources and training for practice personnel, we hope to create a sustainable model of intervention for patients at risk for diabetes. The DPP’s goals — a 7 percent loss of body weight and an increase of physical activity to 150 minutes per week — are attainable for most patients. We are very grateful for GRHF’s support in developing this program.”

“Over the grant’s three years, it is expected that more than 1,000 high-risk individuals will be enrolled in the program through these urban physician practices, resulting in $1 million in potential health care savings each year,” said John Urban, president and CEO of Greater Rochester Health Foundation. “There are many serious conditions associated with diabetes, including heart disease, stroke, blindness and kidney failure, susceptibility to infection and vascular disease that can result in amputations. Being able to prevent diabetes and these complications is a significant contribution to improving the health of the community because this disease impacts so many individuals, their families and employers.

More students wanted to help find cure for Type 1 diabetes

anted: Elementary and middle school students willing to help their fellow students fight a potentially disabling disease. A $10,000 grant from Excellus BlueCross BlueShield will allow the Juvenile Diabetes Research Foundation (JDRF) Rochester chapter to expand its Kids Walk to Cure Diabetes program. Students in the program learn about the different types of diabetes and the importance of exercising and Page 10

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eating healthy. Students spend the next two weeks raising money for research on Type 1 diabetes, which is a condition diagnosed in 13,000 U.S. children annually in which one must take insulin to stay alive. The fundraising ends with a walk at the school. “The program refutes student misperceptions that diabetes is contagious or that Type 1 is preventable,” said Mary Anne Fox, executive director, JDRF Rochester chapter. “Students

become more accepting of others who have diabetes and they love the chance to take action by raising money to find a cure.” Thanks to the Excellus BCBS grant, up to 15 more local schools and daycares in the eight-county Rochester area will be able to participate in the free program. The eight-county area includes Monroe, Ontario, Wayne, Yates, Chemung, Steuben, Livingston and Schuyler counties.

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

About 4,000 local elementary and middle school students have raised about $45,000 since 2009. Most recently, The Ellis B. Hyde Elementary School in Dansville, Livingston County, raised almost $3,000. If you know of a school or daycare willing to participate in the program, call JDRF at 585-546-1390.

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adies, does it seem like you struggle to lose weight but the pounds easily melt off your husband? It’s not your imagination. There’s science behind the notion. “The reason men can maintain weight easier than women is because men have more lean muscle mass naturally,” said Jennifer Glen, dietitian with University of Rochester Medical Center. “It’s metabolic so they burn more calories at rest.” Unfair? You bet! But you can fight back against your body’s low muscle mass and build it up to torch calories. “Exercise regularly to build lean muscle mass and burn calories and for general health,” Glen said. Many women eschew weights, fearing they will end up looking too bulky; however, women are not capable of looking Glen muscle-bound unless they spend several hours a day lifting. Don’t let the number on the scale fool you. Since muscle weighs more than fat, you may actually gain weight once you start lifting weights or performing resistance movements. “If your clothes are fitting better and you feel good, that’s key,” said Chris Sutton, personal trainer and owner of Wergo, Inc Personal Training in Rochester. Focusing on the number on the scale alone causes women to “set themselves up for failure,” Sutton added. Hormonal fluctuations throughout your lifetime can also help you gradually pack on pounds. Many women still carry “baby weight” gain through having children who are now school-aged Sutton and older. Although gaining weight is a normal part of a healthy pregnancy, gaining too much makes it harder to lose the weight postpartum, especially for moms who do not breastfeed since lactation burns a few hundred calories per day. Other hormonal times can include during menstruation, peri- and postmenopause and while using some kinds of contraceptives, none of which are factors in men’s lives. “For women on hormonal birth control method, weight gain is a side effect,” said Janelle Kauffman, physician assistant with Geneva Family Planning Center. “It’s greater for some than others. With any hormonal influ-

Secure • 24/7 access • Strictly Conﬁdential • Payment for Research Interviews ence, women tend to gain weight if they’re not monitoring it carefully.” Talk with your OB-GYN if you find your weight creeping up on you. You may be able to switch contraceptives or plan ways to keep your weight under control. Lifestyle issues can also play a role for women regarding weight loss. In many families, traditional roles still persist despite both spouses working. Women who find themselves doing the lion’s share of the childcare, housework, laundry, grocery shopping, and cooking may have little time to take care of themselves by working out and eating right. Add to that a full-time job and time for regular exercise and careful meal planning evaporates. “Plan meals out ahead of time so both partners are taking part,” Glen said. Cooking ahead on weekends may also help incorporate more healthful meals into the week. “Read labels to make sure you know what you’re eating and that you’re following a reasonably low calorie diet, one that’s low in saturated fat and no trans-fats,” Glen said. “If you make small changes, they’ll stick. “If you say ‘I’ll eat 800 calories a day and exercise for an hour every day,’ you’ll soon quit.” Instead, she urges Kauffman clients to try small goals, such as skipping the cream and sugar in coffee or not buttering their toast. “Every week, add another change,” she said. “My main goal is the physical activity. It’s almost impossible to lose weight without it.” Carve out time to exercise by instituting an hour of “Daddy time” or swapping babysitting with a friend a few times per week so you can get out to the gym or exercise at home undisturbed. Ideally, work out first thing in the morning. Perhaps before everyone gets up, you could follow an exercise video or jog for half an hour. “If you wait to do it at night you probably won’t fit it in,” Glen said. But if evenings work better for you, plan it and do it. Or consider power walking with baby in the stroller, playing actively with the children in the yard or hiking around the neighborhood. “One pound at a time, one day at a time,” Glen said. “Don’t look at the entire goal. There will be setbacks but don’t let it take you all the way back to regaining the weight. Keep plugging along.” January 2012 •

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Page 11

Women’s issues Study Reveals Who Gets Late-Term Abortions By Stephanie Pappas

ounger women, blacks and women with a high number of recent life disruptions are more likely than their counterparts to get secondtrimester abortions, a new study finds. The research focuses on a relatively small group of American women, those who end pregnancies after the first trimester, which lasts 12 weeks. As of 2006, 88 percent of abortions occurred before the end of the first trimester, making second-trimester abortions relatively rare. These later abortions, however, are more expensive, more difficult to come by, and carry more medical risk than earlier procedures, according to the Guttmacher Institute, a reproductive health research organization. There is no medical definition for when an abortion becomes “late term,” though many sources place the line at after the 20th week of gestation. According to Planned Parenthood, medical risks from abortion such as an incomplete abortion, infection, or injury to the cervix or other organs increase the longer a pregnancy continues. Until 20 weeks gestation, the risk of death to the mother from childbirth is 11 times greater than the risk of death from an abortion. But after 20 weeks, the risk from abortion and childbirth are about the same. The Centers for Disease Control and Prevention (CDC) keeps some data on second-trimester abortions, but the only demographic information available from those records is age and race.

According to the CDC, teens, black women and Hispanic women are more likely than older adults or other races to get second-trimester abortions — but that data is limited. For example, it doesn’t include California, site of 18 percent of all abortions in the U.S.

Second-trimester abortions

To get more comprehensive information, Guttmacher Institute researchers surveyed 9,493 abortion patients at 95 hospitals and clinics across the country in 2008, weighting the data to create a nationally representative sample of abortion patients. They queried the women on demographic factors like race, poverty, education and marital status, as well as asking them about domestic violence, health insurance, and recent disruptive life events, including unemployment, serious medical problems and death or illness among friends and family. They then focused on women who had abortions after 13 weeks. Within that group, they compared women who had 13-to-15-week abortions with those who had abortions after 16 weeks. “We kept seeing all these discussions of second-trimester abortions and attempts to limit abortions by trimester,” said Guttmacher senior research associate Rachel Jones. “It dawned on us that we didn’t know anything about this population.” Of all women surveyed, 10.3 percent had abortions after the first trimester. These women were more likely

to be young, black, less educated and living in poverty than women who had earlier abortions. They were also more likely to have experienced violence at the hands of the man who got them pregnant and to have dealt with at least three serious life events in the last year. Compared with the 10.3 percent overall number, 14 percent of patients under age 18 had second-trimester abortions, as did 13.8 percent of adolescents ages 18 to 19. Among all ages, 13.4 percent of black abortion patients had second-trimester procedures, compared with 8.5 percent of white abortion patients and 9.9 percent of Hispanic abortion patients. Of abortion patients without highschool diplomas, 13.1 percent had second-trimester abortions, a proportion that decreased with education. Of college-graduate abortion patients, only 5.8 percent had late abortions. A lack of education may mean that patients are less health-literate, and thus less likely

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

to figure out how to access an abortion until later in pregnancy, the researchers wrote in their report released today (Dec. 16) and to be published in an upcoming issue of the journal Contraception. Living under the poverty line also increased the chances of a later-term abortion, with 12.6 percent of abortion patients living in poverty getting second-trimester procedures. The rate of second-trimester abortions dropped to 7.7 percent among women earning at least twice as much as poverty levels. Stephanie Pappas is a writer with LiveScience.com

SmartBites

with so many foods, is moderation. By Anne Palumbo

The skinny on healthy eating

The Perks of Drinking Coffee

t the beginning of every new year, I used to contemplate my coffee consumption, vowing to drink less. It’s not that I drink that much — about three to four cups each morning — it’s just that I drink it more regularly than any other beverage. But all that mulling came to a screeching halt when, after some serious investigation, I got to know the upside of my beloved joe. According to a growing body of research, coffee drinkers, compared to nondrinkers, are less likely to have type 2 diabetes, Parkinson’s disease, and dementia, including Alzheimer’s disease. What’s more, researchers have found strong evidence that coffee may reduce the risk of heart disease, strokes, and certain cancers. Frank Hu, nutrition, medical doctor and epidemiology professor at the Harvard School of Public Health, recently stated that “all of the studies have shown that high coffee consumption is associated with decreased risk of liver cirrhosis and liver cancer.” Although researchers have not been able to pinpoint exactly how coffee works its magic, they have identified compounds in coffee that may contribute to the aforementioned health benefits.

For starters, coffee teems with antioxidants, those beneficial free-radical-gobbling compounds most often associated with beans, fruits, and vegetables. While coffee’s antioxidant levels are indeed lower than most acknowledged sources, it’s the top source of antioxidants in the U.S. diet, according to Joe A. Vinson, a professor at the University of Scranton, because we drink so much of it. Coffee also contains minerals such as magnesium and chromium, which help the body use insulin, a hormone that lowers the level of glucose in the blood. Since, with Type 2 diabetes, the body loses its ability to use insulin and regulate blood sugar effectively, it’s no wonder that coffee has been linked to keeping this disease at bay. On the downside, heavy coffee consumption — 5 to 7 cups a day — can cause problems such as restlessness, anxiety, irritability, heartburn, and sleeplessness. The key here, as

Helpful tips

Exposure to air is coffee’s worst enemy, followed by heat and sunlight. That said, you’ll want to store your coffee in an airtight container and place it in a cool, dark place. Large quantities may be frozen, but do divvy up the amount into weekly portions, as once you remove it from the freezer, it should never go back in. Looking to lower your caffeine intake? Choose dark roasted coffees, as the longer a bean is roasted the less caffeine it contains.

sauté another minute. Mix in chili powder, cumin, cayenne and oregano. Cook 1 minute. Add tomatoes, honey, coffee, drained beans, red pepper and remaining chicken broth. Bring to simmer, then reduce heat to low, and cook for 20 minutes, uncovered, stirring occasionally. Stir in more broth if mixture seems too thick. Add salt and pepper, to taste. Optional: Top with chopped green onions, low-fat sour cream, or shredded low-fat cheddar cheese. Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Easy Bean-and-Coffee Chili 1 tablespoon olive oil 2 tablespoons chicken broth 1 large onion, chopped 3 garlic cloves, minced 1 tablespoon chili powder 2 teaspoons ground cumin ¼ teaspoon cayenne pepper (optional) 2 teaspoons dried oregano 1 28-ounce can diced tomatoes, undrained (recommend: fire roasted) 1 tablespoon honey ½ cup strong coffee 1 15-ounce can black beans, drained, rinsed 1 15-ounce kidney beans, drained, rinsed 1 roasted red pepper (from jar), chopped ½ cup chicken stock Salt and pepper, to taste Heat olive oil and 2 tablespoons chicken broth in a large pot over medium heat. Add onions and sauté until tender, about 8 minutes. Add garlic and

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Confused About Mammograms? Should you start at 40 or 50? By Deborah Jeanne Sergeant

ost women know that mammography can be a life-saving screening for breast cancer. But confusion as to when to begin mammograms and their frequency arose in 2009 when the U.S. Preventive Task Force — an independent panel of health care experts that evaluates the latest scientific evidence on clinical preventive services — recommended women asking their physicians about delaying screening until age 50. For many women, this implied that the golden rule of “start annual screenings at 40” didn’t apply anymore. The purpose behind the task force’s recommendation was to save medical dollars for what its members perceive as unneeded tests. Nearly one in eight American women will have breast cancer at some point in her life, meaning that seven in eight will receive negative mammograms their entire lives. Dr. Baktash Bootorabi of Clifton Springs’ Interventional Radiology and Vascular Radiology Department, said that the task force’s view is not shared with all the other health care organizations and physicians. “This is not the policy of American College of Radiology and American Cancer Society,” he said. The latter two organizations recommend mammograms for most women starting at age 40 and yearly thereafter. Some women are the exception and should start sooner. The National Cancer Institute states that women with certain gene mutations (BRCA- 1 and BRCA-2) have 60 percent chance of developing breast cancer in their life time vs. the general population’s 12 percent chance. “Breast screening in such high risk individuals is recommended at earlier age of 30 with such modalities as MRI,” Bootorabi said. Beginning screening before 40 should be discussed with one’s health care provider, especially for women who have: • Family history of breast cancer with a first-degree relative such as mother, sister, or aunt. • Previous breast cancer. • Giving birth to the first child after age 30 or never having a child. • Menstruation before age 12. • Late menopause beyond the age of 55. • Combination hormone therapy with estrogen and progesterone. • Increased risk associated with obesity, alcohol (more than one drink a day), oral contraceptives. • Increased risk associated with prior radiation therapy to the chest such as for Hodgkin’s lymphoma. • Caucasians have slightly higher risk for developing breast cancer. Nancy Gadziala, a radiologist with Borg & Ide Imaging in the Rochester area, believes that the task force “caused confusion among physicians and patients,” she said. “It’s hard to know who is at greatest risk for developing breast cancer when a lot of women who develop

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

it have no family history and those women would be then considered lowrisk,” Gadziala said. “In younger women in particular, these cancers can be more fast-growing and aggressive,” Gadziala added. “We may not pick up tumors as early as we might with mammograms.” Avice O’Connell, a physician who teaches clinical imaging science at the University of Rochester Medical Center, said, “Again and again, the numbers have shown the mortality of breast cancer has gone down 30 percent since we started using regular mammography.” Some may argue that 20 years ago, treatment methods were not as effective as they are now, however, O’Connell views early detection and improving treatment methods as two sides of the same coin. Both are needed to effectively fight cancer. The same task force recommended that women should not continue mammography after 70; however, O’Connell disagrees with that notion since many women live vibrant, active lives for at least another decade beyond 70. A simple lumpectomy prompted by a positive finding on a mammogram could easily extend a 70-year-old’s life. Mary Ann Walton, diagnostic imaging supervisor with Finger Lakes Health, suggests that women should continue receiving mammograms annually “for as long as a woman is in good health.” For a screening mammogram, patients typically fill out a breast history sheet, which asks about age at first menstrual period, child bearing and age of first pregnancy, hormone therapy, breast surgery history and family history of breast cancer. “The woman is then taken into the mammography room and asked to disrobe from the waist up,” Walton said. “She puts on a patient gown. I usually tell a patient that I am going to take two X-rays of each breast, one top to bottom and one side to side. Then I demonstrate and explain how the woman puts her bare breast on the machine and the plastic compression device comes down onto her breast. “I usually say that it gets very tight and it feels like someone is pulling on your breast but there should be no pain. I also tell them that if it hurts I want to know. “During each exam I try to tell the patient that we are a team and we will work together to try to get her the best exam possible.”

Women’s issues Cloth vs. Disposable

The Great Diaper Debate

By Amy Cavalier

away moisture so they can keep a bahe prospects of a new baby can Holt said she was spending $100 a handling of “solid waste” as Holt calls bies’ skin a bit drier, and cloth diapers be overwhelming. New parents month on disposable diapers for two it, are usually the two biggest deterneed to be changed more often. are bombarded with decisions, kids. She started off with cloth diapers rents for parents debating cloth vs. “If a baby has a diaper rash, somefrom whether to breastfeed or use by investing $100 and buying a few disposable diapers. times I recommend for a short period formula, to whether to immunize or more each month. When she decided to “People are worried about it being of time until the rash clears up —parnot to immunize. When it comes to go cloth, Holt says, there wasn’t a lot of disgusting, but you can’t avoid the ticularly if it’s a yeast infection —that deciding on which diapers to use, it’s resources to help her get started. poop with the baby,” she says. “It’s they switch to disposable diapers just no wonder about 95 percent of parents “I saw this as something that was going to get on you at some point, no in the United States choose disposable, until that’s cleared up or do as much needed in Rochester to educate families matter what diaper you use.” according to Richer Investment Diaper diaper-free time as possible.” on what’s available,” Holt says. “There The other concern is the additional On the other hand, Queenan says, Consulting Service. are so many options in cloth diapers laundry. While disposable diapers are easier she’s seen many babies’ skin do better these days.” “I thought that too…,” Holt says. with cloth diapers because they don’t to use than cloth, the cost adds up. AcLuvaboos offers a trial pack where “I imagined scrubbing, pins and nasty have any of the chemicals or the elastic cording to a detailed price breakdown parents can pick out as many cloth dia- plastic pants.” binding found in disposables. by Diaper Decisions, it costs about pers as they want, and for an extra $15 Holt says cloth diapering for Whether it’s for cost savings, $2,500 to use disposable diapers from fee, they can return everything within multiple children added about two to infant to toddler age vs. anywhere from environmental or health reasons, two weeks for store credit if they dethree extra loads of laundry a week. the number of families in Rochester $380 to $1,400 for cloth, including the cide they don’t like them. The package But between cloth diapering and breast choosing cloth diapers is on the rise, cost of washing them at home. includes detergent, diaper rash cream feeding, she says, she didn’t have to Cost and convenience are just a few as evidenced by the continued success and cloth wipes. Holt also offers a gift worry about running to the store as of Luvaboos, a specialty parenting and of the factors involved in the debate registry for cloth diapers and a class on much for formula or disposables. cloth diapering store, and the recent between cloth and disposable diapers. Diapering 101. “It’s very overwhelming being opening of family-owned Sweet Pea Emily Queenan, a physicians with “You can adjust the absorbency a new parent,” says Holt. “There are Cloth Diaper Delivery Service on East Queenan Family Medicine and Maif you have leaking issues,” she says. so many things coming at you. You Main Street in Rochester. ternity Care, says the decision should “They fit each baby differently based don’t have to feel bad if you don’t use “We are seeing an increase, that’s be based on each individual family’s on the different styles.” cloth diapers. It’s such a minor thing, for sure,” says Mary Anne Lockwood needs and values. Cloth diapers can vary in cost from but there is that feeling of divide, and of Sweet Pea. “My primary $2 up to $17 a piece. There are a variety I think it comes from the insecurity Heather Holt and her husband Tothought is to mainof styles, Holt says, including diapers that we all want to do the best for our pher launched Luvaboos in their home tain an open mind, that require covers, all-in-one diababy.” over three years ago. They relocated without too much pers, pocket diapers with a removable moral judgment one to 683 Winton Road two years ago. inserts, diapers that go on and off with The Holts switched from disposable to way or the other,” Velcro straps, or ones that have built cloth diapers with the second of their says Queenan. in snaps to adjust as the baby grows. three children. “There are some Instead of pins, cloth diapers can be “I had always pictured old fashfamilies that pride secured with Snappy Diaper Fasteners themselves on using ioned diapers so I was just blown away which work like ACE bandage clips. For more information about diawhen I saw what was out there and cloth diapers and There’s even a high powered sprayer pers, visit the following websites: Queenan look down on some- tried it,” Holt says. “It’s pretty much you can attach to your toilet to rinse • Real Diaper Association – www. just like disposables. You just wash one who uses disposable…I think life the diapers. them instead of throwing them away.” realdiaperassociation.org/ with a newborn is hard enough. Don’t The upfront investment and the kill yourself over the diaper decision.” • The Diaper Debate Although cloth diapers save money – abcnews.go.com/Technology/ in the long-run, Queenan says, some story?id=789465&page=1 families can’t afford the upfront cost. • The New Parents Guide – www. On the plus side, used cloth diapers can be resold or be used over multiple thenewparentsguide.com/diapers. babies. htm Some families will alternate between using disposable and cloth depending on the situation, for example on a long car trip or at day care, since some centers won’t accept cloth diapers. “Be flexible and maintain an open mind because it’s hard to judge what’s best for you until you’re using it,” Queenan says. For some, the decision is environmental. It’s estimated that about 50 million diapers land in U.S. landfills every day. That amounts to about 18 billion diapers a year, according to the Environmental Protection Agency. For some families, using disposable diapers “is a compromise we make, knowing we are creating more waste,” says Queenan. She points out that there are chlorine-free disposable diapers available and some brands of diapers are more biodegradable than others. Another factor in the diaper debate is babies’ health. Although she’s not an Heather Holt with her youngest of three children Ariella at Luvaboos parenting and cloth diaper shop, located at 683 North Winton expert, Queenan says in her experience, in Rochester. She and her husband Topher also have two other children, Braeden and Landon. The couple launched Luvaboos in their disposables tend to be better at wicking home over three years ago.

Diaper Resources

January 2012 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Women’s issues Moms Weigh in on the Diaper Dilemma Four Rochester area mothers share their reasons for choosing disposable vs. cloth By Amy Cavalier

aggie Spallina would have liked to use cloth diapers when her daughter Adeline was born six years ago. At 19, she had returned to Rochester from the west coast. “I had no intention of laying down roots,” she says. “I was supposed to be working and head back out when I found out I was pregnant. I realized I had nine months to assemble a life that was appropriate to welcome a new human being into it.” So Maggie says she “prioritized.” When it came to diapers, she says she realized cloth was better for the environment but disposables were more suited to her lifestyle. When Adeline was 6 weeks old, Maggie went back to working two jobs. “There was no way I could have done cloth diapers, especially not having a washing machine, let alone affording them, and I think back now, why did I feel so guilty?” she recalls. “Every time I saw a mother using cloth diapers, I felt so bad.” To reduce her carbon footprint, Maggie says, she avoided wrapping the waste and baby wipes in the diaper. She says cloth diapering may be easier in situations where one parent can stay at home or work from home. “It’s kind of a privilege to be able to use cloth diapers,” she says. “It’s a time, energy and money privilege and I think that’s unfortunate…Everyone wants to do what’s best for their child and the environment, but sometimes cloth diapers are just not practical.” When Allison Diedreck and her husband Rudy found out they were expecting their son Caleb over two years ago, they sat down to weigh the pluses and minuses of cloth vs. disposable diapers. “Rudy wanted to do cloth diapers because he’s very environmental,” she says. “And I did not want to at all. There’s something about changing a diaper that you just don’t want to keep it around.” Since it was Allison staying home with the children, doing most of the diaper changes and laundry, the Diedrecks settled on using disposables. Although Allison says there are a lot more options out there in terms of cloth diapering than there were just two years ago, the family has continued using disposables with the recent birth of their daughter Claire. “We are very active family,” she said. “On the weekends, you’ll never find us here. We’re just out so much and then what do you do with the [soiled] cloth diapers when you’re two hours away? Keep them in a bag? If we Page 16

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were more homebodies and we didn’t leave as much, I could understand.” When Stacy and Gabe Siftar learned they were expecting their first child over three years ago, they researched cloth diapers online, and talked to other families who had used them. “It’s something we feel strongly about, saving the environment,” she says. “It just seemed like the natural thing to do. The more we talked about it and the more we learned about it, it just seemed no more difficult than regular diapers, especially now. They’re so different.” The Siftars settled on cloth diapers by Bum Genius because there was no

stuffing or pins involved, and inserts can be added for heavy-wetters. “A lot of people, when you tell them you use cloth diapers, they get scared and say, ‘I don’t know how to do that’, but when you show it to them, it’s easy,” she says. Stacy says they dispose of the solid waste in the toilet and keep the dirty diapers in a waterproof bag until they are ready to be washed. The only downfall, she says, is certain diaper creams can make cloth diapers less absorbent. When the family goes on vacation, Stacy says, packing cloth diapers does take up more room and requires access to laundry. “Obviously no one wants to go to

Sara and Derek Lynch knew early on in Sara’s pregnancy that they would use cloth diapers. “My mom did it with both me and my brother, so why wouldn’t I do it?” she says. The couple is shown with their newly born baby, Cassidy.

Allison and Rudy Diedreck with their children Caleb and Claire. After some consideration, the couple settled for disposable diapers. “Rudy wanted to do cloth diapers because he’s very environmental,” she says. “And I did not want to at all. There’s something about changing a diaper that you just don’t want to keep it around.”

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

the laundromat on their vacation, but if that’s what you decide to do, that’s what you have to do,” she says. Although cloth diapers are less expensive in the long run, Stacy says she understands the upfront cost is not feasible for some parents. For Rollin, she estimates spending about $15 per diaper and purchasing about 60 diapers. The real cost savings will be realized with Gabe and Stacy’s second son, Asa, who was born October. “The new baby will reuse the diapers I already have so there’s no additional cost to have a second baby in diapers,” she says. “I know one person being in cloth diapers isn’t going to make that big a difference but it makes me feel better.” Sara and Derek knew early on in Sara’s pregnancy that they would use cloth diapers. “My mom did it with both me and my brother, so why wouldn’t I do it?” she says. The couple felt that cloth diapers would be safer for their daughter Cassidy’s skin and better for the environment. “I cannot fathom that much garbage,” Sara says. “We literally put out a half a bag a week. We recycle everything…and we compost.” While the initial investment is more with cloth diapers, the overall cost savings is significant, Sara says. “Right now we feel like we’re spending a lot of money on diapers, but in the end we’re not going to be running out to the store buying diapers,” she says. “It won’t be a yearly, monthly, weekly cost for us, and if I get real crafty, I could make them on my own.”

Maggie Spallina with her daughter Adeline, 6. The mother said she would have liked to use cloth diapers when her daughter Adeline was born but disposables were more suited to her lifestyle.

When Gabe and Stacy Siftar learned they were expecting their ﬁrst child over three years ago, they researched cloth diapers online, and talked to other families who had used them. They settled for cloth diapers. “It’s something we feel strongly about, saving the environment,” she says. The couple is shown with their sons Rollin and Asa.

Profile

Clyde Comstock: Helping Make a Difference in the Lives of Local Children Hillside Family of Agencies’ chief operating officer has devoted most of his life to helping children By Ernst Lamothe

ith a love of languages, Clyde Comstock figured he knew at a young age what path life would take him. He would graduate from a prestigious liberal arts school, probably majoring in French, and spend his life teaching others the lure of learning a foreign language. Maybe after a decade or less of teaching, he would move up the professional track and one day become superintendent of a medium-sized school district. Well, life has a way of making other plans for you when you’re busy figuring out ways to conjugate French verbs. Comstock, the chief operating officer for Hillside Family of Agencies, recently received the Career Achievement Award by United Way of Greater Rochester and the Rochester Business Journal. He is responsible for overall operations of affiliates Crestwood Children’s Center, Hillside Children’s Center, Hillside Work-Scholarship Connection, and Snell Farm Children’s Center. “Getting the award was unexpected because the success we have here is never dependent on one person,” says Comstock, 63, of Irondequoit. “It’s difficult being singled out since we’re able to help so many people at Hillside because of team members who work hard to help children and young adults reach their potential.” When Comstock was forging his own life as a young adult, he expected to be involved in the lives of young kids but never envisioned making the holistic difference in the lives of the youth that he does today. A youthful Midwestern Democrat born from two conservative Republican parents, Comstock grew up pretty well in suburban Cleveland. He attended Hawken School, an independent college prep school with a graduating class of 55 kids. Looking to expand his horizons after high school, he enrolled at Hamilton College, a small private, four-year liberal arts institution in Clinton, near Utica, which in Comstock’s time was a male-only university. “My dad seriously told me that he would pay for any college I went to as long as it was 100 miles away,” says Comstock. “I still laugh at that one today.” The liberal arts school, which is the third oldest college is the state, is well known for economics and psychology majors. The latter intrigued him and he began volunteering during his undergraduate years at the House of the Good Shepard in Utica, about

nine miles away from Hamilton College. The organization, which sits on a 27-acre campus, is a comprehensive human service agency providing help to more than 600 children, including ages from infant to 21. They help families who struggle with serious emotional, social and behavioral problems. When he began volunteering at Good Shepherd, he was unclear about his role. “They told me my job would be a social worker, and at the time, I didn’t even know what that was,” says Comstock. “Then they explained to me that I talk to kids about their problems and help them make good decisions.” In between reading his case load and sitting one-on-one with young students discussing the poor hand life dealt them and the poor decisions they made to worsen that hand, something stirred within him that changed the course of his course work. “I kept seeing kids who needed a lot more in life than learning French at a private school,” says Comstock. “I saw kids that were struggling with mental health and I saw an opportunity to truly do something meaningful with my life. I saw what I was doing would really make a difference.” He ditched his plans to study French at the La Sorbonne, an elite school in Paris with an international reputation placing it among Europe’s most prestigious universities. Deciding instead to complete his undergraduate studies and then finish his master’s program in social work at Boston University. “When you walked on campus, you would see big beautiful, brick buildings for law and medical students. Then there was this small old stone house in the middle of campus and that was the School for Social Work,” says Comstock. “But my dad always told me never do a job for the money. Do a job that you really like doing and you can provide for yourself and you will be happy.” He then went back to the organization that spurred his interest becoming a social and child care worker, camp director and then eventually interim executive director at the House of the Good Shepherd from 1971–1980. He then became executive director of the Children’s Home of Kingston in 1980. Familiar with the Rochester area after going to college in Upstate New York, he began working at Hillside in 1984, an agency that helps children, from early teens to early 20s, with serious emotional, social and behavioral

problems. Today, as chief operating officer he is responsible for managing a $140 million budget, aiding more than 12,000 kids per year. “Clyde is someone who has deep seeded values that have helped guide Hillside for the past quarter of a century,” said Dennis Richardson, president and CEO of Hillside. “He’s someone who you can not only count on but trust fully and that is something that you can’t say about many people nowadays. Families that deal with Clyde have confidence that when he tells you something he will follow through.” In the past two years the organization turned its focus to creating a village atmosphere for children. Dovetailing a popular California program, the agency staff searches for the relatives of Hillside children who are willing to take an interest in the child’s development. Sometimes only an aunt or uncle will step up, while other instances features a web of extended family members, some who never knew the child existed. “We figured out that you are going to have to create a host of family support to help make these kids accountable if you really want to do some good,” says Comstock. “There has to be a network of people who are going to care about you for the rest of your life.” Richardson said it was Comstock that has pushed parents to have more of a voice and students to realize their goals.

January 2012 •

“He wants to make sure that as an organization, we are always thinking about the family and we are always paying attention to what the youth want and need,” added Richardson. Surrounding the interior and exterior of Comstock’s office are pictures that offer a snap shot at the important aspects of his life. There are up close, enlarged portraits of happy Hillside families. There are roaring waterfalls from Letchworth State Park and birds of prey from trips he’s taken to Hawaii, Seattle and Montezuma National Wildlife Refuge. There’s the background of Durand Eastman Beach, where he often ran five miles, five days a week either for exercise or to train for the Corporate Challenge before two back surgeries and a knee problem sidelined him to only riding his bike down that path. There’s a picture of his 4-year-old, 40-pound beige and white dog named Collie running through the snow. And you can’t forget one of the pictures closest to his desk: his wife of 26 years, Karen, whom he met at a selfdescribed “hippy new age” workshop in Kingston that taught people how to develop their sense of intuition. “All I know is that my intuition told me she was cute and that was all I needed to make the first move,” says Comstock. They later married August 24, 1985. “My mom would joke that it is just as easy to fall in love with a rich girl as it is a poor one. Well I didn’t fall in love with a rich girl but I feel in love with the love of my life” says Comstock.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Accessing Your Medical Records — Electronically Rochester General is the latest hospital in the area converting patients’ medical records into electronic records. More than 500,000 people have agreed to share their records By Ernst Lemothe

patient’s medical records today are stuck in files scattered across various doctors’ offices, specialists and clinics from hospital visits. But the day is coming soon when — with a patient’s consent — all their medical information can be shared throughout hospital departments locally. Rochester General Hospital is the latest to get on board, having spent $65 million on its new electronic system. Strong Memorial Hospital earlier last year converted to a paperless health organization and Clinton Spring Hospital and Clinic as well is also moving its files online. “It’s one patient, one record, one system,” said David Krusch, physician and chief medical information for the University of Rochester Medical Center. “We have already had a situation where we had a patient from Strong who was at Rochester General Hospital and we were able to transmit their information. By January [2012], they will be able to send information to us.” Care Connect, the new name for the electronic medical records system for Rochester General Health aims to convert the entire organization from a combination of paper and computer-based patient records to a single integrated electronic system. Patients entering Rochester General and Strong Memorial hospitals will now see doctors, nurses and staff with desktop computers, iPads and lap tops as they insert medical information that previously was filled out by charts. Designed and built with the help of Wisconsin-based Epic Systems, the electronic system has already been used at a number of top academic medical centers like Cleveland Clinic, New York University Langone Medical Center and Mount Sinai. The process

for Rochester General was more than a year in the making. Calling the move the best chance for the medical profession to provide effective and efficient patient care, officials believe this new technological step was evitable. “Before a doctor from any department would ask to see someone’s records and they had to wait for the information to be faxed from a chart. And sometimes we wouldn’t get all the information we needed so we have to call for more information and wait for another fax,” said Robert Biernbaum, chief medical information officer for Rochester General Health System. “Now for each patient, there is only one medical record no matter what department they go into in the hospital.” Biernbaum estimated that about 75 percent of Monroe County residents go either to Rochester General or the University of Rochester Medical Center, which encompasses Strong Memorial Hospital. Richard Gangemi, senior vice president for academic and medical affairs for Rochester General Health System, believes electronic record keeping is the wave of the future for other big hospitals in Upstate New York and nationwide. However not for everyone. “Larger organizations like ours can afford to invest in this because to be honest this is expensive,” said Gangemi, who has 30 years in the medical profession. “A doctor with a small private practice would have difficultly implementing something like this.” The hospital systems are linked to the Greater Rochester Regional Health Information Organization, a secure health information exchange. Patients must give permission to have their test and radiology results, lab reports, medication history and insurance eligibility

Rochester General Health Care Connect staff in command center answering team member questions about the new electronic medical record system Page 18

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Dr. Robert Biernbaum, chief information ofﬁcer at Rochester General Hospital (left) at his post in the command center receiving a status update. shared electronically with providers who are part of the organization. Officials say the process creates fewer risks, fewer repeated tests, better emergency care and greater convenience. “A lot of times patients would walk into my office and be frustrated because they were asked the same questions over and over each time they came to visit. And when they came back later that year or for emergency reasons, they would have to answer the same questions again and they were tired of it,” Biernbaum said. About 4,000 doctors and other health care providers have been using the regional health information organization, and nearly 500,000 people in an 11-county area have given permission for their doctors to share their medical information. In an effort to quell patients concern about confidentiality, the data in the computerized-system is encrypted and password protected. Access to a patient’s information is strictly limited to those who are authorized. “There are patients that are going to have concerns and be a little nervous anytime you put their information on a computer,” said Biernbaum. “We just have to explain to them that we have significant firewalls in place.” The Care Connect system backs up data to prevent the loss of patient information in case of computer malfunction. The computer system also serves as an electronic physician where it alerts officials if a new prescribed medication might interact badly with the patients’ current medication. “Anyone who tells you a system is 100 percent foolproof is lying to you,” said Gangemi. “There are risks anytime you put something online but because the information is encrypted that makes everything that much more protected. Plus it’s easier for someone to break into a doctor’s office and steal your paper files from cabinets than it is to get your information on this system.” Last year, Strong Memorial Hospital launched its own $78 million in pa-

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

tient computerized version of a medical chart using the same system at Rochester General Hospital. The electronic system went live in Highland Hospital last summer and is expected to go to University of Rochester Medical Center outpatient services on May 2012. “For some reason healthcare has lagged behind other industries when it comes to technology,” said Dawn DePerrior, project director for the University of Rochester Medical Center. “The good news is that even though we are playing catch up, we are catching up fast.” DePerrior said the future is doing more preventive work. Strong officials said creating by coalescing data into a single system, all critical information pertaining to any given patient is at the fingertips of a doctor’s entire care team. The initial rollout included impatient units, emergency department, OB-GYN, pharmacy and outpatient oncology at Strong and Highland. In the next three to five years, cardiology, transplant, anesthesia and radiology could be converted to the electronic records. More than 8,000 clinical staff were trained in the technology. In addition, the last component to the system is something that doctors said patients have been clamoring to see for years. MyCare allows patients to view their most up-to-date personal medical records anywhere and anytime they need. Instead of wondering what information a doctor is placing inside his or her beige, manila folder, patients can view their medical history, latest lab results, prescription refills and make a doctor’s appointment, which can be accessed with a user name and password through the Rochester General Hospital website. “Going to the doctor’s office can be stressful but when the patient has all this information easily available to them, it puts them at ease,” said Gangemi. “With this feature along with the electronic medical records, I have never met a doctor who would rather go back to dealing with all that paper.”

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How to Find and Research Doctors Who Accept Medicare Dear Savvy Senior, What resources are available to help seniors locate and research Medicare doctors? My husband and I are approaching age 65 and need to find a new internist or primary care doctor who accepts Medicare. Our current doctor is not enrolled with Medicare and will not continue seeing us as Medicare patients. Looking For Care Dear Looking, Depending on where you live, finding a new primary care doctor or specialist that accepts Medicare patients can be challenging. Because of low reimbursement rates and greater paperwork hassles, many doctors today have opted out of Medicare or they’re not accepting new patients with Medicare coverage. With that said, Medicare is now offering a service that makes finding Medicare-approved doctors a little easier. And, there are a number of good resources available today that can help you check up on prospective doctors for free. Here’s what you should know. Medicare Doctors

The government’s new online “Physician Compare” tool is one of the easiest ways to locate doctors in your area that accept traditional Medicare. Just go to www.medicare.gov/find-adoctor where you can do a search by physician’s name, medical specialty or by geographic location. Or, if you don’t have Internet access, you can also get this information by calling 800-6334227. Keep in mind, though, that locating a Medicare-approved doctor doesn’t guarantee you’ll be accepted as a patient. Many doctors limit the number of Medicare patients they accept while others have a full patient roster don’t accept any new patients. You’ll need to call the individual doctor’s office to find out. Another option you may want to consider is to join a Medicare Advantage plan. These are government approved, private health plans (usually HMOs and PPOs) sold by insurance companies that you can choose in place of original Medicare. These plans may have more doctors available than original Medicare does. See www.medicare. gov/find-a-plan to research this option.

Doctor’s Check Up

After you’ve found a few Medicare-approved doctors that are ac-

cepting new patients, there are plenty of resources available today that can help you research them. Some of the best include HealthGrades, Vitals and RateMDs. These are free doctor-rating websites that provide important background information as well as consumer comments and ratings from past patients. Here’s a breakdown of what each site offers: • Healthgrades.com provides indepth profiles on around 750,000 U.S. physicians including their education and training, hospital affiliations, board certification, awards and recognitions, professional misconduct, disciplinary action and malpractice records. It also offers a 5-star ratings scale from past patients on a number of issues like communication and listening skills, wait time, time spent with the patient, office friendliness and more. • Vitals.com provides some basic background information on around 720,000 U.S. doctors along with unedited comments from past patients and ratings on things like promptness, bedside manner, accurate diagnosis and more. • Ratemds.com primarily offers ratings and anonymous comments from past patients. It’s a good idea to check out all three doctor-rating sites so you can get a bigger sampling and a better feel of how previous patients are rating a particular doctor.

Fee-Based Help

Another good resource to help you gather information is at angieslist. com (888-888-5478). This is a fee-based membership service that also offers doctors ratings and reviews from other members in your area for $7.60 for one month or $25 for the year. Or, consider purchasing a copy of the “Consumers’ Guide to Top Doctors.” Created by Consumers’ Checkbook, a nonprofit consumer organization, this book will help you find top-rated doctors that have been recommended by other doctors. Their database lists 24,000 physicians, in 35 different fields of specialty, in 50 metro areas. The cost for this guide is $25 plus shipping and handling (call 800-2137283 to order a copy), or you can view the information online at checkbook. org/doctors for $25. 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. January 2012 •

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Page 19

90-and-Older Population Triples in 3 Decades

The Social Ask Security Ofﬁce

Among the 90-and-older population, women outnumber men by a ratio of nearly three to one

he nation’s 90-and-older population nearly tripled over the past three decades, reaching 1.9 million in 2010, according to a report released in November by the U.S. Census Bureau and supported by the National Institute on Aging. Over the next four decades, this population is projected to more than quadruple. Because of increases in life expectancy at older ages, people 90 and older now comprise 4.7 percent of the older population (age 65 and older), as compared with only 2.8 percent in 1980. By 2050, this share is likely to reach 10 percent. The majority of people 90 and older report having one or more disabilities, living alone or in a nursing home and graduating from high school. People in this age group also are more likely to be women and to have higher widowhood, poverty and disability rates than people just under this age cutoff. These findings come from “90+ in the United States: 2006-2008,” which presents an overview of this age group and a comparative analysis of selected demographic and socio-economic differences between people 90 and older and their younger counterparts within the older population. Statistics for the report, which go down to the state level, come from the 2006-2008 Ameri-

can Community Survey three-year estimates and 2008 one-year estimates, as well as census and projections data. “Traditionally, the cutoff age for what is considered the ‘oldest old’ has been age 85,” said Census Bureau demographer Wan He, “but increasingly people are living longer and the older population itself is getting older. Given its rapid growth, the 90-and-older population merits a closer look. While nearly all people in their 90s who lived in a nursing home had a disability (98.2 percent), the vast majority (80.8 percent) of those who did not live in a nursing home also had one or more disabilities. Difficulty doing errands alone and performing general mobility-related activities of walking or climbing stairs were the most common types, which indicates that many who live in households may need assistance with everyday activities. The proportion of people age 90 to 94 having disabilities is more than 13 percentage points higher than that of 85- to 89-year-olds. Among the 90-and-older population, women outnumber men by a ratio of nearly three to one. There were 38 men for every 100 women ages 90 to 94, with the ratio dropping to 26 for ages 95 to 99 and 24 for those 100 and older.

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Column provided by the local Social Security Office

All About Retirement

ocial Security is as American as baseball and apple pie. Not everyone likes apples or baseball games, but almost every American who reaches retirement age will receive Social Security retirement benefits. In fact, 96 percent of Americans are covered by Social Security. If you’re ready to retire in the near future, this article is for you. We’d like to share with you a few important items about Social Security retirement benefits and how to apply for them. When you work and pay Social Security taxes, you earn “credits” toward Social Security benefits. If you were born in 1929 or later, you need 40 credits (10 years of work) to qualify for retirement benefits. To qualify for retirement benefits, 10 years is the minimum. However, the amount of your benefit is determined by how long you work and how much you earn. Higher lifetime earnings result in higher benefits. If there were some years when you did not work or had low earnings, your benefit amount may be lower than if you had worked steadily or earned more. Also, your age when you retire makes a difference in your benefit amount. The full retirement age (the age at which full retirement benefits are payable) has been gradually rising from age 65 to age 67. You can retire as early as age 62, but if benefits start before you reach your full retirement age, your monthly payment is reduced. Find out what your full retirement age is by referring to the convenient chart in our publication, Retirement Benefits, at www.socialsecurity.gov/ pubs/10035.html. It’s in the second section. Just as you can choose an early retirement and get a reduced payment,

Q&A

Q: I prefer reading by audio book. Does Social Security have audio publications? A: Yes, we do. You can find them at www.socialsecurity.gov/pubs. Some of the publications available include What You Can Do Online, How Social Security Can Help You When A Family Member Dies, Apply Online For Social Security Benefits, and Your Social Security Card And Number. You can listen now at www.socialsecurity.gov/pubs. Q: I am receiving Social Security retirement benefits and I recently went back to work. Do I have to pay Social Security (FICA) taxes on my income? A: Yes. By law, your employer must withhold FICA taxes from your paycheck. Although you are retired, you do receive credit for those new earnings. Each year Social Security automatically credits the new earnings and, if your new earnings are higher than in

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

you also can choose to keep working beyond your full retirement age to take advantage of a larger payment. Your benefit will increase automatically by a certain percentage from the time you reach your full retirement age until you start receiving your benefits or until you reach age 70. The decision of when to retire is an individual one and depends on a number of personal factors. To help you weigh the factors, we suggest you read our online fact sheet, When To Start Receiving Retirement Benefits, available at www.socialsecurity.gov/pubs/10147. html. You may want to consider your options by using our Retirement Estimator to get instant, personalized estimates of future benefits. You can plug in different retirement ages and scenarios to help you make a more informed retirement decision. Try it out at www. socialsecurity.gov/estimator. When you decide to retire, the easiest and most convenient way to do it is right from the comfort of your home or office computer. Go to www.socialsecurity.gov where you can apply for retirement benefits in as little as 15 minutes. In most cases, there are no forms to sign or documents to send; once you submit your electronic application, that’s it! In addition to using our award-winning website, you can call us toll-free at 1-800-772-1213 (TTY, 1-800-325-0778) or visit the Social Security office nearest you. Either way you choose to apply, be sure to have your bank account information handy so we can set up your payments to be deposited directly into your account. To learn more, please read our publication, Retirement Benefits, at www. socialsecurity.gov/pubs/10035.html.

any earlier year used to calculate your current benefit, your monthly benefit could increase. For more information, visit www.socialsecurity.gov or call us at 1-800-772-1213 (TTY 1-800-325-0778). Q: How are my retirement benefits calculated? A: Your Social Security benefits are based on earnings averaged over your lifetime. Your actual earnings are first adjusted or “indexed” to account for changes in average wages since the year the earnings were received. Then we calculate your average monthly indexed earnings during the 35 years in which you earned the most. We apply a formula to these earnings and arrive at your basic benefit. This is the amount you would receive at your full retirement age. You may be able to estimate your benefit by using our Retirement Estimator which offers estimates based on your Social Security earnings. You can find the Retirement Estimator at www.socialsecurity.gov/estimator.

H ealth News Nancy Camp appointed nurse manager at Hillside Hillside Family of Agencies announced that Rochester resident Nancy Camp has been appointed as community health nurse manager. She will be responsible for promoting the health of all youth under the care of Hillside Family of Agencies and its affiliates by offering expertise in the areas of infectious control and community health issues. In her new position she will provide consultation and collaboration with Hillside Family of Agencies’ nursing and medical teams as well as other Hillside Family of Agency departments. Camp Camp will continue to supervise the regionally-based therapeutic foster care nursing teams across Hillside Children’s Center and will remain a member of Hillside Family of Agencies nursing management team. Camp has 15 years of nursing experience, both in hospital and community-based settings. She has worked for Visiting Nurse Service in hospice and palliative care and worked the HIV, HEP C and chemical dependency clinic at Anthony L. Jordan Health Center. Camp has been employed by Hillside Family of Agencies for more than 11 years and has worked in numerous nursing care and leadership positions.

Cherry Ridge Expands its Enhanced Living Cherry Ridge, part of St. Ann’s Community in Webster, has been approved by the Department of Health to increase its number of enhanced assisted living units from six to 15 apartments within The Glen (Cherry Ridge’s assisted living). Cherry Ridge is one of only a few communities in the Rochester area that can offer this level of care. “This level of care allows seniors to age in place. If they come into Cherry Ridge’s assisted living program and then develop needs that fall under enhanced guidelines, we can provide those services,” said Michael Seelig, Cherry Ridge’s vice president of housing/administrator. “They don’t need to move out of Cherry Ridge or even to a different apartment. We can manage their needs right where they are. If we didn’t have enhanced living, residents whose needs increased would have to transition to home care or skilled nursing. Seelig said that Cherry Ridge began providing the new level of care in January last year and quickly realized they needed to increase the number of units. The enhanced assisted living services include all assisted living services provided with the addition of physical assistance of another person for: transferring, walking, climbing or descending stairs, managing medical equipment or managing incontinence. Cherry Ridge began to offer enhanced living in January 2011. Traditional as-

sisted living will continue to be offered. Seelig said that once the construction of Cherry Ridge’s skilled nursing center is complete in 2012, Cherry Ridge will be one of only a few senior living communities in Western New York to offer a full continuum of services on one campus. “At that time, Cherry Ridge will provide independent living, assisted living, enhanced living, memory care, transitional care and skilled nursing. Having all these care levels on one campus provides great benefits to residents. They are able to remain on the same campus as their needs change, and if a spouse needs a higher level of care, the two can still be near one another.”

VA Nurses Recognized with Best Practice Award

Gajendra named clinical chief at Eastman Dental Sangeeta Gajendra of Penfield, has been named clinical chief of community dentistry for Eastman Dental, part of the Eastman Institute for Oral Health at the University of Rochester Medical Center. In this role, she has responsibility for all clinical, human resources and financial oversight of Eastman Dental’s outreach sites, including the SMILEmobile program, which provides care to thousands of children at 16 city schools throughout the year. She speaks frequently at dental association meetings about her published research, including oral Gajendra effects of smoking, oral health in patients with AIDS, the oral health status of children in foster care, and other dental public health related topics. Gajendra won the Basil G. Bibby Award for Outstanding Scientific Merit from the Rochester Section of the American Association of Dental Research and a Certificate of Award for Outstanding Contributions in Genetics, Newborn Screening, SIDS and Oral Health from the Illinois Department of Public Health. Gajendra completed her dental degree at the A.B. Shetty Memorial Institute of Dental Sciences in India, her master’s of public health degree from University of Illinois at Springfield in 2001 and the requirements for the dental public health residency in the New York State Department of Health in Albany in 2002. In 2005, she graduated from the international postdoctoral program in general dentistry at Eastman Dental and was appointed assistant professor in community dentistry and oral disease prevention. She is board certified in dental public health, and expects to earn a Master of Science degree in medical management at the Simon School of Business at the University of Rochester next year. Eastman Institute for Oral Health is a world leader in research and post-doctoral education in general and pediatric dentistry, orthodontics, periodontics, prosthodontics and oral

Canandaigua VA Medical Center nurses Patricia Lind and Nina Mottern. They were recognized recently for the mobile adult day care program sponsored by the VA. Nina Mottern and Patricia Lind recently received the 2011 New York Organization of Nurse Executives Best Practice Award for the Canandaigua VA Medical Center’s mobile adult day care program. This program was recognized for its innovation and veteran-centric interventions to help veterans remain living in their homes and communities, forestalling institutionalization. To date, more than 60 veterans are part of the programs located in American surgery. Patients are seen at many sites throughout the Rochester community.

St. Ann’s Community appointment St. Ann’s Community recently appointed Dennis P. Kant of Webster as its new senior vice president and chief financial officer. Kant will oversee the finances of the $76 million organization and serve on the executive leadership team. Kant has 30 years of financial experience in the health care industry. He previously worked as chief financial officer for Universal Health Care Group, Inc. in Saint Petersburg, Fla., and was employed for several years at MVP Health Care, Inc. Kant in Schenectady and Preferred Care, Inc. in Rochester. He is a certified public accountant and received his Bachelor of Science degree in accounting from Valparaiso University in Valparaiso, Ind. “I am thrilled to have Dennis as our new CFO and valuable member of

January 2012 •

Legion Posts in Greece, Webster, Penn Yan and Waterloo. The nurses said veterans and their families are enthusiastic supporters of the mobile adult day care program, which provides recreation, community-focused activities and linkages to VA services. For more information about the program, contact Nina Mottern at 585-393-7514 or email Nina. Mottern@va.gov.

our senior leadership team,” said Betty Mullin-DiProsa, president and CEO of St. Ann’s Community. “He has a strong depth of financial and accounting expertise, and has already demonstrated a sense of organization and partnership with members of the senior leadership team, the board and operations, which will help ensure the success of our organization.”

Hillside receives $76,610 grant for telehealth services Hillside Family of Agencies announced it has received a rural business enterprise grant for $76,610 from the U.S. Department of Agriculture. The grant will be used to improve telehealth options for schools and outpatient clinics across Hillside Family of Agencies affiliates in the Finger Lakes, Central New York and the Southern Tier including Cayuga, Seneca, Yates, Allegany and Steuben counties. Sen. Charles E. Schumer helped Hillside Family of Agencies secure the funding. “For nearly 175 years Hillside Family of Agencies has been a service leader in the community, helping youth and their families reach their full potential and this grant will allow our organization to continue offering cut-

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 21

H ealth News ting-edge, advanced technology,” said Dennis Richardson, president and CEO of Hillside Family of Agencies. “We are grateful to Sen. Schumer and the USDA for their support and look forward to bringing patients in rural communities innovative heath services, as it is essential for all youth and families in our region.” The funding will use virtual technology to provide access to medical specialists based in Rochester, helping to keep the rural communities that Hillside Family of Agencies serves on the leading edge of quality health care. “Efficiently supporting our rural youth with access to quality health services is pivotal for our community and our economy,” said Sen. Schumer. “Funding for rural health will help enhance quality of life in Cayuga, Seneca, Yates, Allegany and Steuben counties and lead the way to economic development.” Funding will help the nonprofit broaden telehealth services that it currently provides with existing video teleconferencing at Hillside Fam-

ily of Agencies affiliates: Snell Farm Children’s Center in Bath and Hillside Children’s Center in Varick. The grant will also allow the nonprofit to extend telehealth service locations to two additional outpatient clinics at Crestwood Children’s Center in Penn Yan and Hillside Children’s Center in Cuba. Both locations will focus on telediagnosis, telemedication management and telemonitoring. The project is designed to expand the care capacity of Hillside Family of Agencies’ psychiatrists, pediatricians and nurse practitioners using new diagnostic software, computer equipment and peripheral devices, such as digital otoscopes, telephonic stethoscopes, and skin cameras. The grant is part of the USDA Rural Development annual budget. USDA Rural Development’s mission is to increase economic opportunity and improve the quality of life for rural residents. Rural Development fosters growth in homeownership, finances business development, and supports the creation of necessary community and technology infrastructure.

What They Want You to Know:

Registered Dietitians By Deborah Jeanne Sergeant

he American Dietetic Association states that “registered dietitians have completed academic and experience requirements established by the Commission on Dietetic Registration, ADA’s credentialing agency, including a minimum of a bachelor’s degree from an accredited college or university and an accredited pre-professional experience program. RDs must successfully complete a rigorous professional level exam and must maintain ongoing continuing education to maintain their credential. Some RDs hold advanced degrees and additional certifications in specialized areas of practice.” The site also states that the services registered dietitians provide include “reliable, objective nutrition information, separate facts from fads and translate the latest scientific findings into easy-to-understand nutrition information.” • “When it comes to healthy eating, people have black-and-white thinking. There are no ‘bad’ foods you can’t incorporate into a healthful diet. Ninety percent should be healthful Page 22

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ones and 10 percent are ‘fun foods.’ • “People go on crazy, wild diets or a health kick for a month but there’s no room to incorporate any kind of a treat and then they go off. People go on a diet or else are overeating. Moderation is what our dietitians try to teach people. • “When people come to see a dietitian, they think we’ll be the enemy and we’ll take away all their favorite foods. We’re human, too. We like cake as much as you. We’ll help you incorporate foods you like and be healthy too. I try to never judge the clients who come in. I understand how hard it is to make healthful choices. It’s not all about ‘yes’ or ‘no’ lists but balancing out your life. • “We tend to find with weight management clients that exercise is a prescription for health that isn’t optional. A lot of people try to avoid it but it’s an important piece of anyone’s health not just to lose weight. There’s a disconnect between what exercise does. It’s not just to lose weight but to stay healthy. • “In terms of aging well, we tend to look at how long people live but

Law to Create Missing Vulnerable Adult Alert System The new system provides for the rapid public dissemination of information regarding adults with dementia, Alzheimer’s, or other cognitive impairments who go missing

ov. Andrew M. Cuomo recently signed a law to create a statewide alert system for missing vulnerable adults, similar to the nationwide Amber Alert program, which will help authorities locate cognitively impaired persons who go missing. The new law is in response to a number of instances where cognitively impaired individuals have wandered away from home and gone missing for an extended period of time, often placing themselves and others at risk. The new system provides for the

rapid public dissemination of information regarding adults with dementia, Alzheimer’s, or other cognitive impairments who go missing. Under the new law, the same Amber Alert mechanisms used to find missing children will be activated for missing vulnerable adults, including the printing and distribution of photographs and posters, a toll-free 24 hour hotline, a curriculum for training law enforcement personnel, and assistance for returning missing vulnerable adults who are located out of state.

exercise helps determine how well we age and how long we live. It’s the fountain of youth if there is one. • “We work with the weight management and address diet, exercise and other components of weight management. There are a lot of reasons why people overeat such as a busy schedule, emotional attachment to food and lack of education. It’s not just that people come in and get a list of what not to eat.”

diet. Moderation is key, not deprivation.”

Bridget Bigelow, registered dietitian with the Endocrine-Diabetes Care & Resource Center, affiliated with Rochester General Hospital • “If you have been diagnosed with diabetes, please be assertive about taking care of yourself. Don’t wait for your blood sugars to get out of control as too many people do. If your doctor says your blood sugar is running a bit high, then make an appointment to see a certified diabetes educator right away. • “A few small changes in your diet might be all you need to keep that blood sugar under control and avoid, or delay, further complications. • “I see too many patients who were diagnosed with diabetes years ago but never take the time to learn how to control their blood sugar until they have serious problems. With just a few diet and lifestyle changes a diabetic can at least delay, and often, avoid serious complications. • “Also, everyone should think of exercise as medicine for your body. It is not just for preventing weight gain. It will help you feel stronger, sleep better, improve your brain power, strengthen your heart, lungs, bones and lower blood pressure and blood sugar. Amy L. Stacy, registered dietitian with Lakeside Wellness Program, Lakeside Health System • “In January, 2012 the world’s largest organization of food and nutrition professionals will become the Academy of Nutrition and Dietetics. Visit us at www.eatright.org for nutrition advice from the experts. • “Every food has its place in your

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

Caitlin Sexton, registered dietitian and clinical nutrition manager at Clifton Springs Hospital • “We are nutritional professionals. We have completed a bachelor’s or master’s degree from an accredited educational program, [spent] 1,200 hours of supervised practice and passed a national exam to become a registered dietitian. We have continuing education requirements to maintain registration and keep us current with best practice. • “We are trained and qualified individuals who work in a myriad of jobs: weight management, sports nutrition, diabetes management, kidney disease, stroke rehabilitation, cardiac rehab, cancer, pediatrics, gastroenterology, and eating disorders to name of few. We work in hospitals, long-term care centers, public health clinics, schools, rehabilitation centers, visiting nurse services, restaurants, grocery stores, spas, and fitness centers. Many dietitians see patients in private practice or doctor’s offices. • “We also work in research, magazines/newspapers, universities, professional sports teams and in work site wellness programs. • “Always look for the ‘RD’ credentials when seeking sound nutritional advice.” Sarah M. Eighmey, registered dietitian and clinical dietitian with Geneva General Hospital Deborah Jeanne Sergeant is a writer with In Good Health. “What Your Doctor Wants You to Know” is an ongoing column that appears monthly to give our area’s healthcare professionals an opportunity to share how patients can improve their care by helping their providers and by helping themselves.

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