Gv igh no114 feb15 by In Good Health: Rochester's Healthcare Newspaper

in good REFUGEES

The new Center for Refugee Health in Rochester already has a patient list of about 2,500. Officials expect around 5,000 in a few years.

February 2015 • Issue 114

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Rochester–Genesee Valley Healthcare Newspaper

HOW HIGH RESOLUTIONS IS YOUR Why we keep making them year after year? Experts explain BLOOD how we to make resolutions that we can achieve PRESSURE? Also: What your doctor

Bev Shank of Brighton was able to leave the transplant waiting list and restart her life thanks to the gift of a new organ. “December 14, 2005, was an important day in my life — it was my new beginning,” she said.

Local experts discuss ways to you to do in 2015 bring it down wants Page 14

Read more about a campaign to increase organ donors inside

Teen Driving

Chicken Soup and Other Wives’ Tales There are plenty of wives’ tales for preventing and fighting colds and flu. Which are true?

Alternative Treatments for Psoriasis

Study: Half of teen, young adult car crash deaths involve pot or alcohol.

Local experts weigh in Page 11 See Smart Bites on page 13

Move Over, Chicken: It’s Pork Time!

Winter Warriors Part of a group of about 180 people who participate in this year’s winter warrior program through Fleet Feet Sports. The program helps fitness enthusiasts enjoy the outdoors even when it’s snowing and cold.

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Valentine’s Day: Love the One Who Matters Most: YOU!

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Weight Loss: 5 Mistakes You Should Avoid

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

START TODAY AND LOSE 20 TO 45+ LBS IN 40 DAYS, NATURALLY.

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February 2015 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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eople whose blood type is A, B or AB have an increased risk of heart disease and shorter life spans than people who have type O blood, according to a new study. But that doesn’t mean people with blood types other than O should be overly concerned, because heart disease risk and life span are influenced by multiple factors, including exercise and overall health, experts said. In the study, researchers followed about 50,000 middle-age and elderly people in northeastern Iran for an average of seven years. They found that people with non-O blood types were 9 percent more likely to die during the study for any health-related reason, and 15 percent more likely to die from cardiovascular disease, compared with people with blood type O. “It was very interesting to me to find out that people with certain blood groups — non-O blood groups — have a higher risk of dying of certain diseases,” said the study’s lead investigator,

ith the new year comes a new practice at UR Medicine’s F.F. Thompson Hospital in Canandaigua: Each time a new baby is welcomed in the hospital’s birthing center, a short, quiet segment of “Brahms’ Lullaby” will play on the overhead paging system throughout the hospital. “It is our intent that this will be a reminder, in the midst of our daily stressful lives, of the hope and joy that each new life brings,” says Director of Obstetrics Deborah Jones. “Those of us who are privileged to be part of the miracle that is childbirth are pleased to share it with other Thompson associates, patients and families.”

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

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Arash Etemadi, an epidemiologist at the U.S. National Institutes of Health. The researchers also examined whether people’s blood type may be linked with their risk of gastric cancer, which has a relatively high incidence rate among the people living in northeastern Iran. They found that people with non-O blood types had a 55 percent increased risk of gastric cancer compared with people with type O blood, according to the study, published online Jan. 14 in the journal BMC Medicine. The association between blood type and people’s disease risk and life span held even when the researchers accounted for other factors, including age, sex, smoking, socioeconomic status and ethnicity.

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Hospital Infection Rates Falling, But More Improvement Needed: CDC About 1 in every 25 U.S. patients develops an infection while in the hospital, agency says

ates of many types of hospital-acquired infections are on the decline, but more work is needed to protect patients, according to a U.S. Centers for Disease Control and Prevention report. “Hospitals have made real progress to reduce some types of health care-associated infections — it can be done,” CDC Director Tom Frieden said. The study used national data to track outcomes at more than 14,500 health care centers across the United States. The researchers found a 46 percent drop in “central line-associated” bloodstream infections between 2008 and 2013. This type of infection occurs when a tube placed in a large vein is either not put in correctly or not kept clean, the CDC explained. During that same time, there was a 19 percent decrease in surgical site infections among patients who underwent the 10 types of surgery tracked in the report. These infections occur when germs get into the surgical wound site. Between 2011 and 2013, there was an 8 percent drop in multidrug-resis-

tant Staphylococcus aureus (MRSA) infections, and a 10 percent fall in C. difficile infections. Both of these infections have prompted concern because some strains have grown resistant to many antibiotics. Catheter-associated urinary tract infections rose 6 percent since 2009, but initial data from 2014 suggests that these infections have also started to decrease, according to the annual CDC report. The CDC also noted that on any given day, about one in 25 hospital patients in the United States has at least one infection acquired while in the hospital, which highlights the need for continued efforts to improve infection control in U.S. hospitals. According to Frieden, “the key is for every hospital to have rigorous infection-control programs to protect patients and health care workers, and for health care facilities and others to work together to reduce the many types of infections that haven’t decreased enough.”

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U.S. Painkiller Abuse ‘Epidemic’ May Be Declining

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he U.S. “epidemic” of prescription-painkiller abuse may be starting to reverse course, a new study suggests. Experts said the findings, published Jan. 15 in the New England Journal of Medicine, are welcome news. The decline suggests that recent laws and prescribing guidelines aimed at preventing painkiller abuse are working to some degree. But researchers also found a disturbing trend: Heroin abuse and overdoses are on the rise, and that may be one reason prescription-drug abuse is down. “Some people are switching from painkillers to heroin,” said Adam Bisaga, an addiction psychiatrist at the New York State Psychiatric Institute in

New York City. While the dip in painkiller abuse is good news, more “global efforts” — including better access to addiction treatment— are needed, said Bisaga, who was not involved in the study. “You can’t get rid of addiction just by decreasing the supply of painkillers,” he said. Prescription narcotic painkillers include drugs such as OxyContin, Percocet and Vicodin. In the 1990s, U.S. doctors started prescribing the medications much more often, because of concerns that patients with severe pain were not being adequately helped. U.S. sales of narcotic painkillers rose 300 percent between 1999 and 2008, according to the U.S. Centers for Disease Control and Prevention.

Serving Monroe and Ontario Counties in good A monthly newspaper published by

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

In Good Health is published 12 times a year by Local News, Inc. © 2015 by Local News, Inc. All rights reserved. 106 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

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February 2015 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

All Month

Vegan group sponsors course on healthy eating Rochester Area Vegan Society will sponsor a seminar titled “A PlantBased Diet: Eating for Happiness and Health.” This six-week course will be given for the seventh time. More than 275 local residents have taken this course, including doctors, nurses and dietitians, organizers say. The course will be conducted by physician Ted D. Barnett. It started Jan. 20 and will continue until Feb. 24. It takes places from 6 - 8:15 p.m. at the Unity Hospital Education Center. Cost is $125 with some discounts available. Continuing medical education (CME) credits, and certification for other health care professionals, available at additional cost. According to organizers, the course will provide the rationale for a wholefood, plant-based diet and its benefits for human health and all life on the planet, with up-to-date references to medical and scientific studies. Recipes and food samples at each class. Visit rochesterveg.org for more information and to register.

Feb. 1

MS Cycle for a Cure held in Webster The local chapter of the National Multiple Sclerosis Society is holding its MS Cycle for a Cure — A Ride for Research event from 10:30 a.m. – 1 p.m., Feb. 1, starting at Gold’s Gym Webster, 855 Publishers Pkwy in Webster. The vent’s goal is to raise money to find a cure for multiple sclerosis and to support those individuals and their families living with MS until a cure is found.” The event is comprised of two rides — each session is 45 minutes long. Each team must have a rider on the bike at all times. Individuals may ride more than one session. Individuals must commit to raising a minimum of $250 per each session they are on the bike. Registration is $25 per participant. For more information, please contact MS Hope for a Cure at info@ mshopeforacure.org or at 212-476-0483

Feb. 3

Seminar: How technology enhances hearing aids Assistive devices and new technology can enhance communication with hearing aids, cochlear implants and smart phones for people with hearing loss. Technology is the subject of Hearing Loss Association of America, Rochester chapter’s Feb. 3 meetings at St. Paul’s Church, East Avenue and Westminster Road across from George Eastman House. At noon, registered architect Donald Bataille advises on “Making the Page 6

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Most of Your Hearing Aids.” He will review the pros and cons of different assistive listening systems such as personal hearing and streaming devices, iPad and iPhone applications and other wired and wireless systems. Participants can try out and compare different technologies. Bataille’s firm, Hearing Loops Unlimited, designs and installs hearing loop systems. “Keep in Touch with Internet Technology” is the 8 p.m. meeting topic. Carmen Coleman and physician Elise dePapp will cover the benefits of social media for people with hearing loss. dePapp will introduce “Innocaption,” a new application for smart phone captioning. Hearing Loss Association is a nationwide organization dedicated to advocacy, education and support for people with hearing loss. For more information visit www.hlaa-rochester-ny. org or telephone 585-266-7890.

Feb. 10

Fibromyalgia Association holds open meeting The Fibromyalgia Association of Rochester New York will hold a support group meeting for anyone interested in fibromyalgia. Participants are encouraged to bring their thoughts, questions, and suggestions for speakers. The event will take place from 7 – 8:30 p.m., Feb. 10 at Greece Town Hall Meeting Center, 1 Vince Tofany Blvd., Rochester. It’s free and open to the public. For more information, visit www.farny.org or email publicity@ farny.org. The Fibromyalgia Association of Rochester New York was formed in spring 1993 to educate and inform others about fibromyalgia syndrome as

well as to serve as a support system.

Tea expert to speak at The Labyrinth Society holds fibromyalgia meeting event in Rochester The owner of Happy Earth Tea, Feb. 12

The Labyrinth Society of Rochester is sponsoring its Community Labyrinth Walk from 7–9 p.m., Thursday, Feb. 12, at the First Unitarian Church of Rochester, 220 So. Winton Road in Rochester. The event is free but organizers will accept donations. Organizers say it will provide free energy work, chair massage and music. They say participants will experience the transformational power of the labyrinth combined with the restorative energies of reiki and chair massage. The event is free, however, donations are appreciated to help cover expenses. A 15-minute orientation from 7-7:15 p.m. will be available. The event will also be held at the same time and location in the following dates: March 23, April 28 and May 27. For more details, contact Kay Whipple at 585-392-3601.

Feb. 21

Finger Lakes CC offers ballroom dance class Finger Lakes Community College will offer a six-week ballroom dance class on Saturdays, starting Feb. 21, at the main campus in Canandaigua.. Participants will learn the foxtrot, rumba, swing and waltz in sessions that run Feb. 21 to March 28, from noon to 12:55 p.m. in the George M. Ewing Sr. Atrium at the main campus, 3325 Marvin Sands Drive. The cost is $84 per person. The instructor is Michelle Madore, the 2002 Professional World Exhibition Ballroom Dance Champion. She has a master’s degree in fine arts in dance and choreography and a bachelor’s degree in kinesiology. For more information go to www.RochesterDanceSport. com. To register, contact Charlene Fairman in the FLCC Community Affairs Office at 585-785-1660 or pdce@flcc. edu.

Excellus Makes $85,000 in Grants Available to Nonprofits

onprofit organizations can apply for Excellus BlueCross BlueShield Community Health Awards that add up to a total of $85,000 to help fund health and wellness programs in upstate New York. Nonprofit, 501(c)(3) organizations in Excellus BCBS’s 31-county Upstate New York region are invited to apply for an award of up to $4,000 each. The award can be used for programs that have clear goals to improve the health or health care of a specific population. Programs that improve the health status of the community, reduce the incidence of specific diseases, promote health education and overall wellness will be considered. “The company’s Community Health Awards demonstrate a corporate commitment to support local organizations that share our mission as a nonprofit health plan,” said Bob Thompson, vice president, community health engagement, Excellus BCBS. “These awards complement our existing grants and sponsorships with agen-

Feb. 24

cies that work to enhance quality of life, including health status, in Upstate New York.” The deadline to submit an application to be considered for an Excellus BCBS Community Health Award is Feb. 9. Applications and additional information are available online or by emailing Community.Health.Awards. ROC@Excellus.com. Organizations in Monroe, Wayne, Ontario, Livingston, Seneca or Yates County are asked to email the complete application to Community.Health.Awards.ROC@Excellus. com. Applications received after Feb. 9 will not be considered. Awards will be announced in March 2015. Excellus BCBS’s 31-county region includes: Broome, Cayuga, Chemung, Chenango, Clinton, Cortland, Delaware, Essex, Franklin, Fulton, Hamilton, Herkimer, Jefferson, Lewis, Livingston, Madison, Monroe, Montgomery, Oneida, Onondaga, Ontario, Otsego, Oswego, Schuyler, Seneca, Steuben, St. Lawrence, Tioga, Tompkins, Wayne and Yates counties.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

Niraj Lama, will be the guest speaker at the support group meeting organized by the New Fibromyalgia Support Group of Rochester. Happy Earth Tea is a specialty store selling a variety of herbal and medicinal teas in Rochester. The event will offer a sample of organic, handcrafted teas from around the world. It will take place from 6 – 8:30 p.m. Feb. 24 at the New Fibromyalgia Support Group, 920 Elmgrove Road, Rochester. $5 per person. For more information, call 585-752-1562 or visit www.newfibrosupport.com.

Feb. 25, March 25

RRHS offers free health talks to Community Rochester Regional Health System has partnered with Total Sports Experience to offer free monthly health talks for the community. • 7 .p.m., Wednesday, Feb. 25 at Total Sports Experience, 80 Elmgrove Road, Gates. Speaker: Kathy Ross, a registered nurse from the cardiac rehabilitation program at Unity Hospital, will talk about the importance of ‘knowing your numbers’ and your risk factors for heart disease. She will also provide tips on how to live a healthier lifestyle through diet and daily exercise. • 7 .p.m., Wednesday, March 25 at Total Sports Experience, 435 W. Commercial St., East Rochester. Speaker: Physician Daniel Day, who specializes in sports medicine, from the Rochester General Sports Medicine Institute, will talk about sports injuries and provide helpful tips and an interactive presentation. Cost to attend the seminar is free. To register, visit totalsports-experience. com or call 585-458-4263 to register.

March 13-14

Gay Alliance holds SpeakOUT training Rochester’s Gay Alliance is sponsoring an educational workshop titled “SpeakOUT — Successful LGBTQ Education.” The event will take place from 8:30 a.m. – 5 p.m. Friday, March 13, and from 6 a.m. – 9 p.m. Saturday, March 14, at Ashbury United Methodist Church, 1050 East Ave., Rochester. According to organizers, SpeakOUT training participants become more confident and articulate while talking with others about LGBTQ issues. They say it’s a great experience for someone new to LGBTQ issues or someone who has lived or worked with the issues for years. This training is also designed for teachers, counselors, social workers, dignity act coordinators, GSA advisers, parents, anyone who wants to make a difference. The class is open and appropriate to everyone; all ages, all identities, all experiences and will prepare participants to respectfully and successfully advocate for and address challenges to full LGBTQ inclusion. $75 registration includes lunch. ASL interpreting services available. For more information, visit www. gayalliance.org/speakout.html or email education@gayalliance.org.

Caring for the Refugee Population The new Center for Refugee Health in Rochester already has a patient list of of about 2,500. Officials expect that number to increase to around 5,000 in the next few years By Ernst Lamothe Jr.

oving can generally be a scary and challenging situation. Now, just image yourself moving to a different country where you don’t know anybody. There are constant adjustments and learning curves, including language and cultural environment. And when it comes to finding good health care, that offers another obstacle in itself. Seeing the challenge, Rochester Regional Health System has recently looked to fill that need. The health system and its Office of Community Medicine have opened the Center for Refugee Health in Rochester. The healthcare facility’s primary goal is serving the medical needs of newly-arriving refugees. “We have learned over time that it is difficult for refugees to find health care providers as they are looking for work. We came to the conclusion that we needed to have a dedicated staff who can work with refugees as they learn to navigate the system,” said James Sutton director of the Office of Community Health, which is part of Rochester Sutton Regional Health System. Each year, about 800 refugees settle in Rochester. They represent about 16 percent of all refugees who come to New York. The United Nations describes refugees as someone who flees a country in search of safety as in times of war, political oppression or religious persecution and applies for admission to a different country while overseas. Most refugees get on Medicaid when they first enter the country before they can find full-time employment. When it comes to health, it is an issue that affects everyone’s lives. If someone doesn’t address the issues, bad things occur. “People will end up taking unnecessary emergency room visits when they come here because they won’t know what to do and how to navigate the system for their health. If there is no guidance being done when they arrive in Rochester, then they are at a disadvantage,” added Sutton. Once settled, they are given an opportunity to apply for US citizenship. Sutton said about 10 percent of the population in the city of Rochester includes previously resettled refugees. Rochester Regional Health System began the journey of providing health assistant to this population in 2009. “It is not reasonable for all these newly arrived refugees to automatically integrate into our health system,” said Sutton. “There are so many barriers, especially in the first year, to establish and find a primary care physician.” The new eight-room center at 222 Alexander St., which has been accepting patients since last fall, is staffed with handpicked medical personnel

with specific training in refugee care. It opened with a patient list of about 2,500, and Sutton hopes to increase that to around 5,000 in the next few years. A center specifically for refugees will be prepared to spend the time and resources needed for the best refugee care. The Catholic Family Center works with the new refugee health center to make appointments within a week of a refugee’s arrival, and will transport refugees for medical appointments for up to 90 days under federal funding. Sutton said with any endeavor this big it did take some time for people to buy into the sustainability of a center and the need for highly specialized personnel. The model involves a great deal of collaboration when refugees first come and are seeking employment and work A patient being examined by a physician. Each year, about 800 refugees settle in Rochester. They with many different represent about 16 percent of all refugees who come to New York. The center has a patient list of 2,500 agencies within the first people. It’s located at 222 Alexander St. six months. “Our goal is to dedicated exclusively to the care of as well as the Finger Lakes region. provide newly arrived refugees with refugees, we will have the opportunity The system includes three full service highly specialized, culturally appropri- to further our on-going efforts to create acute-care hospitals and comprehenate care that will better prepare them to evidence-based treatment protocols sive ambulatory services; leading cardinavigate the complex Western healththat can be shared worldwide.” ac, orthopedic, neuroscience, oncology, care system the rest of their lives,” Rochester Regional Health Syssurgery, women’s health and medicine added Sutton. “With our new center, tem serves the greater Rochester area, programs.

Physical Therapy: Answers for Pregnancyrelated Pain and Dysfunction By Wendy M. Featherstone and Jennifer Morin

ack pain. Pelvic pain. Sciatica. Painful sex. Incontinence. These are a few of the complaints related to what is otherwise a healthy pregnancy. Many times women are made to feel as if these complaints are normal. Pregnant women often feel that there is nothing to be done but suffer through the nine months and possibly into the time following the birth. The good news is that women don’t have to live with it. While common, these conditions are not normal. Contributing factors may be hormonal changes affecting the stability of ligaments, changes in center of gravity altering posture and alignment, and/or compromise of the core musculature related to childbirth. Sciatica can be the result of nerve compression related to poor alignment or muscle tension. Physical therapy treatment offers relief of common pain complaints

during and after pregnancy. A complete evaluation, including assessment of posture, alignment and muscle balance is key in identifying factors contributing to pain. Treatment is individualized depending upon the specific complaints, but generally includes postural exercises, core strengthening, direct treatment of affected muscles, advice on lifting, bending, and repetitive activities, and possible use of external supports. Incontinence and painful sex are generally related to problems with the pelvic floor muscles. The pelvic floor is the group of muscles spanning the space between the pubic bone and tailbone, surrounding the urethra, vagina and rectum. Many people are unaware that these muscles are part of the core, and require rehabilitation following pregnancy and childbirth due to the innate stresses imposed by these processes. Physical therapists are uniquely

February 2015 •

qualified to address problems related to muscular pain and dysfunction. Some therapists specialize in problems related to pregnancy, childbirth and the pelvic floor. They are aware of the necessary precautions in treating pregnant women, and have specialized training in treatment of the pelvic floor. Some form of biofeedback is often employed because it is difficult for most people to identify the correct method to exercise the pelvic floor. Physical therapy provides relief for these common complaints related to pregnancy and delivery. Therapists across the country who specialize in pregnancy-related pain can be found at www.womenshealthapta.org. Wendy M. Featherstone, PT, DPT and Jennifer Morin, PT, ACT, OCS specialize in treatment of female and male pelvic health at Specialty Physical Therapy in Rochester.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 7

Radon’s Link to Lung Cancer

ach year, radon kills more people than home fires, drowning, falls or drunk driving. It takes some 21,000 lives annually, and is the No. 1 cause of lung cancer in nonsmokers. Even though there are plenty of ways to decrease exposure to the radioactive element that results from the decay of uranium, many people aren’t aware of their risk or options. Because radon is naturally present in soil, rock and water, everyone is exposed to at least low levels of it in the air we breathe. Some areas have soil with higher concentrations than others. When radon is released into enclosed structures — such as modern homes with higher energy efficiency and less ventilation — the levels can become dangerous. “The degree of radioactivity causes DNA damage and cancer,” says physician Jennifer Toth, director of interventional pulmonology at Penn State Hershey. “It is a colorless, odorless, intangible thing that creates a cumulative effect.” When inhaled at high levels or for extended periods of time, the radioactive particles can damage the cells that line the lungs. Decades typically pass between exposure and when health problems surface. “If you are living in a basement where the radon level is 20 for five years, you have the same risk as someone who has lived in a home with a radon level of 10 for twice as long,” Toth says. “Children also tend to have higher exposure to it because of their lung structure and their higher respiratory rate.” Physician Michael Reed, chief of the division of thoracic surgery at Penn State Hershey, says the general public tends to underestimate the risk — or believe that only smokers need worry about it. “Everyone should have their home checked,” he says. “If the levels are high, move forward with some sort of abatement process.” Although smokers who are exposed to radon have 10 to 20 times the risk of nonsmokers of developing lung cancer, anyone can suffer the effects of high radon levels. Many homes are tested for radon before they are bought and sold, but if you don’t know the radon level where you live, you can purchase a test kit or hire a certified professional to assess the risk and offer suggestions to decrease the levels. “Current technology can easily decrease the concentration of radon in the air and lower the risk,” Reed says. “It’s easy, but it’s merely awareness.” For more information about radon, visit www.epa.gov/radon.

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Meet

Your Doctor

By Chris Motola

Catalina Vial, M.D. New OB-GYN doctor in Brockport fluent in Spanish. She talks about cultural differences in treating Hispanics and non-Hispanic patients Q: Do you perform surgeries as well as primary care? A: I do operate. I perform both obstetrical and GYN procedures. Q: Describe your typical patient. A: I have the full spectrum of patients. I see very young girls, adolescents, but then I also see women all the way through childbearing years and into the menopausal years. Q: Do you have different strategies for interacting with patients at so many different life stages? A: In the initial conversations with patients, I try to get a sense of what their interests are and then try to bring those interests up when it’s appropriate. With a younger person I might ask what they’re up to at school, what kinds of sports they engage in, just try to find areas of interest that I can use to pull them into a conversation and create a level of comfort that helps both of us interact in a way that’s beneficial to their health care. Q: As a bilingual physician, you’re able to converse with Spanish-speakers in Spanish. Are there cultural differences in addition to language that you need to consider? A: For the most part, it’s just a language issue, but with some of the older ladies, there is a little bit of a cultural difference. They may have had a more conservative upbringing, but for the most part it’s just language.

community? Or is it more just a matter of it being a tool in your personal practice? A: Well, particularly with the office at Brockport they want to reach out to the community because of the strong Hispanic community here and let them know that there is a Spanish-speaking physician available to them at the office. So they’re trying to highlight that to the community. Q: Do you find the Internet has helped your patients become better educated before they even come to see you? A: A lot of them are increasingly well-educated. They do a lot of online research, so they come in with very intelligent and pertinent questions that they want addressed. I think it’s mostly a matter of stressing the importance of routine health care: mammography, colonoscopy, the benefits of health weight management, healthy diet and exercise.

Q: You were born in Chile, but you grew up here. Was it difficult to retain your Spanish? A: We came to the States when I was 4, but my parents spoke Spanish to us in the home, so we were really able to retain the language. And then as I got into medicine and began to encounter more Spanish-speaking patients, I was able to keep practicing it. The more you’re able to practice, obviously, the better you’re able to maintain it. Q: Are you part of a broader outreach to the local Hispanic

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

Q: Is the information generally of a decent quality? A: There’s a little bit of everything. Some of it is certainly better than others. What the volume of stuff does do is help foster those pertinent questions that we can than tease out at our appointment. Admittedly, it can be a mixed bag. Q: Are your patients having children at an older age on average? A: A lot of women are waiting until they’re a bit older and have been able to establish themselves in a career before they necessarily are ready to start a family. Q: What are the implications of that on an OB-GYN practice? A: As women wait longer to start a family, we do see more instances of difficulty conceiving to begin with. And, statistically, women who get pregnant later in life are more likely to have medical complications due to things like diabetes or high-blood pressure complicating pregnancy. Toxemia, which is a hypertensive disorder unique to pregnancy, shows higher incidences in women who are a little bit older, particularly with their first baby. Q: Now that the HPV vaccine has been out for a while, what affect has it had on your patients? A: As far as the vaccine itself, the side effects have been fairly few and far between. I think we’re still not quite to a point where we’re seeing fully all the benefits of the vaccine. I do see a lot of young women who have received the vaccine and the anticipation is that we’re going to see a lot fewer atypical pap smears. We’re just now reaching the age group where that’s going to become more clear. Q: With all of the recent changes to the health care system, do you find that you’re performing more generalized primary care for women than you might have in the past? A: I think there’s a certain element of truth to that. We’re in a specialty that does have a certain amount of crossover with a primary care generalist. So a lot of times patients will see us for primary care concerns. I think you’re right that, with the way health care is evolving, patients are sometimes looking for one-stop shopping. In general terms, I think that we do try and make sure we remain educated in managing more general health concerns to make women’s health as comprehensive as we can. I think it serves patients well.

A: We’re seeing, across the country, a fairly significant rate of C-sections. The reasons range from big babies to medical complications, repeating C-sections for patients who may have had one previously.

Lifelines Practice: Unity OB-GYN at Brockport Hometown: Camden, Me. Education: University of Vermont College of Medicine Affiliations: Rochester Regional Health System Organizations: American College of OBGYN Family: Married, two daughters Hobbies: Travel, cooking Favorite Thing To Cook: Smoking and grilling on Big Green Egg

Winter Warriors Finding peace wearing a pair of running shoes By Jessica Gaspar

he’s a runner. Left foot up. Right foot down. Breathe in. Breathe out. She might not be the fastest, but that’s not her concern. She’s happy — some would even say content — as she travels down her chosen route. Tina Pellegrin has been running for about five years now. In that time, the Greece resident has run in six marathons, two ultra-marathons and a fair share of half-marathons in many states, including Pennsylvania, Missouri and Virginia. Her best time so far was a little more than six hours. “I’m just at peace running for hours and hours. People think I’m nuts,” Pellegrin said. “How could running for six hours be relaxing? It just is.” Pellegrin is one of about 180 people who are participating in this year’s winter warrior program through Fleet Feet Sports, a nationwide sporting goods store with two locations in the Rochester area. The program helps fitness enthusiasts enjoy the outdoors even when it’s snowing and cold, according to Katie Niebuhr, training coordinator for

Fleet Feet. On a recent Friday night in mid-December, about 30 people attended a “happy hour” running session at the Greece location. Pellegrin was there. Pellegrin has been a winter warrior for four years now. Prior to becoming involved with Fleet Feet, she mainly ran on a treadmill. “Thanks to Fleet Feet and this program, I can no longer run indoors,” she said. The last two years, Pellegrin was crowned one of the winter warrior winners. The program works this way: you sign up in December and accrue points by participating in exercise and running sessions, which could be anything from running to snowshoeing to a snow trail race. The more points accumulated will go toward a prize at the end of the program, which ends in March. Whoever garners the most points is dubbed the winner. There is usually one woman and one man. But, the overall goal isn’t to declare a winner, Niebuhr said, it’s the satisfaction in participating in healthy activity.

Tina Pellegrin (left) has been running for about five years. She is part of a group of about 180 people who participates in in this year’s winter warrior program through Fleet Feet Sports. The program helps fitness enthusiasts enjoy the outdoors even when it’s snowing. “It’s just to encourage people to come out and enjoy the Rochester win-

ter,” she said. “It’s meant to be social and fun.”

Healthcare in a Minute By George W. Chapman

The changing ACA landscape Many factors impacting execution of Affordable Care Act

ffordable Care Act-ObamaCare. Now that the GOP controls both houses in Congress, it is further emboldened to repeal at least some aspects of the ACA. There have been over 50 attempts to repeal so far. Realizing President Obama will clearly continue to veto any repeal of the entire law, the GOP plans to hack away at parts of the law like the employer mandate and the medical device tax. The GOP is also hoping the U.S. Supreme Court will declare federal subsidies unconstitutional. The states would then have to step up and pay 100 percent for ObamaCare, which many believe would be its undoing. In the meantime, early signs indicate that enrollment will hit more than 9 million. That includes 6.7 million returning enrollees. Small businesses under 50 employees do not have to offer health insurance. Consequently, many are dropping employer-sponsored insurance and are encouraging their employees to shop for care on the exchanges, many of which would qualify for a subsidized/ cheaper premium. While some larger employers like Sears and Walgreens have opted for private health exchanges, most large employers are taking a wait-and-see approach and continue to provide employer-sponsored insurance.

About 3 percent of all large employers opt to send their employees to an exchange for their insurance. The House just passed a bill raising the definition of “full time” from the current 30 hours to 40 hours. Most likely this bill, even if passed by the Senate, would be vetoed. Many predict the tactic will backfire as more people would be dropped by their employer and seek government-provided insurance which would increase the deficit. The Congressional Budget Office estimates if the full-time definition was raised to 40 hours, 1 million people would lose their employer insurance by having their hours cut to just below 40. They would end up on taxpayer-supported healthcare, increasing the deficit by $46 billion over the next 10 years. Medical debt. According to the Consumer Financial Bureau, 43 million of us have unpaid medical debts averaging $1,766. Fifty-two percent of the debt referred to collection agencies is healthcare-related. Healthcare-related debt is one of the major causes of personal bankruptcy. Some nonprofit hospitals are suing patients or garnisheeing their wages via a for-profit subsidiary. Nonprofit hospitals are tax-exempt primarily

because of their charitable mission. Smoking costs. According to the Centers for Disease Control, 480,000 of us die from illnesses caused by smoking every year. About 18 percent of Americans still smoke, which is actually a historic low. The CDC has calculated that 9 percent of all healthcare expenses (about $170 billion annually) are the result of smoking. Many advocate higher premiums for smokers. Medically uninsured rate down. According to Gallup, the percentage of Americans without health insurance is 12.9 percent. It was 17.1 percent a year ago. This is due to a combination of the ACA (Medicaid expansion and commercial coverage through private exchanges) and an improving economy. Massachusetts remains the only state that mandates individual coverage. Only 1.5 percent of that state’s residents are uninsured. The Obama administration is said to be amenable to considering conditions on Medicaid enrollment like job requirements, plan premiums or wellness screenings. Premiums. The Commonwealth Fund reported health insurance premiums have increased 73 percent over the last 10 years. The national average for a

February 2015 •

family policy is now over $16,000. That’s $1,333 a month, which for most Americans, is a healthy mortgage payment. Out-of-pocket expenses — premium contribution, deductibles, coinsurance — now account for almost 10 percent of median household income. Ten years ago it was just over 5 percent. Telemedicine at school. More studies are beginning to show the effectiveness of telemedicine. Consequently, insurers are gradually acknowledging the effectiveness, clinically and financially, by paying for telemedicine services when provided. While consumer demand remains far ahead of what most providers are willing to offer right now, forward-thinking health systems are forging ahead with innovative programs. The world- renowned Mayo Clinic has recently struck a telemedicine deal with the Austin Public Schools of Minnesota. Instead of taking children out of the classroom and working parents out of their offices, the two partners are developing telemedicine protocols for quick and effective consults for common, low-level complaints such as coughs, colds, respiratory infections and minor skin conditions through videoconferencing. GEORGE W. CHAPMAN is a health consultant who operates GW Chapman Consulting in Upstate New York. To reach him, email gwc@gwchapmanconsulting.com.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Valentine’s Day: Love the One Who Matters Most: YOU!

s I’ve shared with you in the past, my divorce and reluctant return to singlehood was a real blow to my self-esteem and identity. My confidence took a nosedive, and I struggled with self-doubt and feelings of worthlessness for too long. When I finally “came to,” I realized I needed to shift my thinking before I could move on with my life. After all, I concluded, if I didn’t feel I deserved a good life or love, why should the universe feel any differently? I knew I needed to hold myself in higher regard if I were going to create a better life, make new friends, and perhaps fall in love again. A change of heart was definitely in order. But where to begin? How was I going to rebuild my sense of self-worth in the face of all my negative thinking? How was I going to love myself again amidst all this rubble? It happened one small step at a time. Slowly, steadily and with intention, I decided to focus on my positive features instead of my faults. I decided to be kinder and gentler to myself and to be more deliberate in my thoughts and actions. It took some time, but eventually

I began to like, and ultimately love myself again. My confidence and happiness returned and life got better. Much better. If you are struggling to love yourself, as I did after my divorce, you may find the tips below helpful. These are the things I did to reclaim and rekindle my love for myself: I stopped beating myself up. I was taking ownership for any and everything that went wrong in my world: I didn’t do that right, I could have done this better, I should have said that, if only I’d chosen this . . . and on and on. It was never-ending. It was doing me no good. So I put a stop to it. When I started going down that useless thought path, I would deliberately shift my thinking to something more constructive. Constantly finding fault with myself was a hard habit to break, but with practice I was giving myself more pats on the back than punches in the stomach.

KIDS Corner

I became grounded spiritually. This means different things to different people. For me, it meant two things: searching for a deeper sense of self and nurturing a stronger connection with something bigger than myself. Greater inner peace and security emerged, and the feelings were both liberating and profound. I found myself becoming less fearful and less self-centered, which unlocked my heart. I became a more compassionate and loving person, not only toward others, but importantly, toward myself. I learned to forgive myself. People say it all the time: “Give yourself a break; we all make mistakes.” So why did I think that applied to everyone but me? Why was I choosing to obsess over my misdeeds, and to live with so much angst and apprehension. Sound familiar? I needed help to make progress here. I talked with a therapist about my past missteps and learned how to trust in my own goodness. When that began to happen, my

substance, usually alcohol. For Keyes and her colleagues pulled data on 16- to 25-year-olds from the Fatality Analysis Reporting System (FARS), a federal database of fatal crashes. They focused on California, Connecticut, Hawaii, Illinois, New Hampshire, New Jersey, Rhode Island, Washington and West Virginia, because each of these states tests at least 85 percent of its fatal car crash victims for

Half of Teen, Young Adult Car Crash Deaths Involve Pot or Alcohol

alf of the teen and young adult drivers who die in car crashes are under the influence of either pot, alcohol or both, suggests a new study done in states where toxicology screening for accident victims is routine. What’s more, the increasing legalization and availability of marijuana does not seem likely to push alcohol use aside, the researchers said. The crash victims in the study who were over age 21 (and of legal drinking age) were more likely than younger victims to have used both marijuana and alcohol prior to their crash. “Given the rapid changes currently underway in marijuana availability and permissibility in the U.S., understanding the effects of drug control policies on substance use behavior and adverse Page 10

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health outcomes, such as fatal motor vehicle crashes, has never been more important,” study researcher Katherine Keyes, of Columbia University’s Mailman School of Public Health, said in a statement.

Under the Influence

Car crashes are the leading cause of death of 18- to 25-year-olds in the U.S., and driving under the influence is a major cause of accidents. Not every state conducts routine toxicology tests on car crash victims right after the accident, but those that do have come up with alarming results. For example, a 2012 study in the journal Addiction found that 57.3 percent of the drivers in this age group who died were on some kind of mind-altering

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

world opened up and I could again see possibilities. I created my own positive feedback. My “self love” project needed all the reinforcement it could get. I started to dress and behave in ways that invited healthy, positive attention — attention that boosted my ego and helped me feel good about myself. I spruced up my wardrobe, put a smile on my face (even when I didn’t feel like it), looked people in the eye, and listened more intently. When I took these deliberate steps, the universe returned the favor and I got what I needed — affirmation, engagement with others and a compliment or two along the way. I learned to love and accept myself. At the end of the day, when I look at my reflection in the mirror, I now see someone I love. Not a perfect person, but someone I’ve grown to admire and accept, flaws and all. Is my work done? Not by a long shot. I am a work in progress and, like my garden, I need constant tending to grow, change and become more bountiful. Nurturing and loving myself has been the key to living a fulfilling life on my own. What do you see when you look in the mirror? If you don’t adore the person staring back at you, ask yourself “What can I do today to demonstrate my love?” Then do it. And do it again tomorrow. And the next day. And the next . . . 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, call 585-6247887 or email: gvoelckers@rochester.rr.com.

drugs and alcohol within an hour of the accident. The researchers found that half (50.3 percent) of the young drivers who died were drunk or high at the time of their fatal crashes, the researchers found. In total, 36.8 percent tested positive for alcohol alone, while 5.9 percent tested positive for marijuana alone and 7.6 percent had been using both.

Complementary Medicine Alternative Treatments for Psoriasis By Deborah Jeanne Sergeant

bout 3 percent of the world’s population has psoriasis. That’s a pretty small percent. But if you’re among them, the itching, pain and redness typifying many psoriasis flare-ups can affect many aspects of life. Though the condition isn’t contagious, friends and family may fear “catching” it if they mistake it for other skin problems. Psoriasis often presents white, flaky skin and it can cause skin to crack open, inviting infection. Medication may provide relief for psoriasis, but it does not completely work for some patients. Fortunately, they have more options, such as alternative health treatments and lifestyle modification. “With higher co-pays and medicine that is expensive, we may see a surge of alternative health treatments for psoriasis,” said Francisco Tausk, a physician who teaches dermatology and psychiatry at University of Rochester Medical Center. Tausk specializes in the treatment of psoriasis and heads the Center for Integrated Dermatology, which specializes in treatments for skin diseases that involve both the body and the mind. He’s also part of the multidisciplinary care offered by UR Medicine’s Psoriasis Center. “Some methods patients use that haven’t had much scientific backing,” Tausk said. He said that no pharmaceutical company would fund a trial study on a remedy that could not be patented. But patients provide anecdotal evidence that alternative methods help. When alternative methods help, patients and doctors may not know why they worked. For example, many patients experience relief while on vacation. But it’s not clear if their psoriasis clears because of sun exposure, salt water, lower stress, higher or lower humidity, different foods or a combination of some or all of these factors. “There have been studies on mindfulness meditation with photo therapy and they cleared in half the time,” Tausk said, “But they were small studies. It’s difficult to say how effective these are.”

All About Psoriasis There are five types of psoriasis. The most common form, plaque psoriasis, appears as raised, red patches covered with a silvery white buildup of dead skin cells. Psoriasis can occur on any part of the body and is associated with other serious health conditions, such as diabetes, heart disease and depression.

Symptoms and Diagnosis

Psoriasis is an autoimmune disease that causes raised, red, scaly patches to appear on the skin.

Types of Psoriasis

Psoriasis appears in a variety of forms with distinct characteristics. Typically, an individual has only one type of psoriasis at a time.

Tausk added that individuals respond to alternative health methods differently just as they do to medicine. What works for one may not work for another. At Helendale Dermatology & Medical, physician Elizabeth A. Arthur’s patients often report that taking an Omega-3 supplement helps. “And we make sure their vitamin D supplements are good,” Arthur said. “Patients who are obese or who smoke have worse psoriasis. I encourage them to do a smoking cessation program and we talk about obesity. We are what we eat.” Some people seek tanning beds for relief; however as a dermatologist, Arthur cannot recommend tanning because it increases the risk for skin cancer. She does recommend a narrow band, UVB light, which is not like a broad-spectrum light found in tanning beds. Tausk “It is like a laser head,” she said. “We expose just the psoriasis area to it.” Christine Brogan Huber, wellness consultant at Lori’s Natural Foods Center in Rochester, said that doctors often send their clients with psoriasis to her store for probiotic supplements and healthful foods. “That’s general purpose because people with immune issues benefit from gut support nutritional programs and probiotics,” Brogan Huber said. “Gut health is really, really important.” She said that cultured foods such as plain yogurt and kefir help support a healthy gut, which, in turn, may help reduce flare-ups from psoriasis. Safety should be the patient’s top concern when considering alternative treatments. “It’s best to get clearance from your doctor first,” Tausk said. “Some fads have no reason why they should work.”

It’s also important to keep doctor appointments, take any medicine that’s prescribed, and ask about different medication available. New medication may be more effective.

As for lifestyle modification, “the logical thing to do is to pay attention to is to eat healthy (leaning vegan), get exercise, and lose weight,” Tausk said. “Practice stress control.”

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The emergency The emergency department department staff at staff Clifton at Clifton Springs Springs Hospital Hospital focuses focuses on on Psoriasis can show up anyComprehensive Psychiatric Emergency Program where—on the eyelids, ears,compassion mouth compassion and the andattention the attention to personalized to personalized care. care. We are Weproud are proud to offer to offer excellent excel and lips, skin folds, hands and feet, customer service, service, experienced experienced nursing nursing care and careminimal and minimal wait wait times.times. and nails. The skin at each of these customer sites is different and requires different treatments.

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Severity

Psoriasis can be mild, moderate or severe. Your treatment options may depend on the severity of your psoriasis.

Triggers

Researchers believe that for a person to develop psoriasis, the In anIn emergency, an emergency, call 9-1-1. call 9-1-1. Request Request Clifton Clifton Springs Springs Hospital Hospital as your as your destination. destination individual must have a combination of the genes that cause psoriasis and be exposed to specific external CliftonSpringsHospital.org CliftonSpringsHospital.org | clifton | clifton cares.cares. factors known as “triggers.”

In an emergency, call 9-1-1. Request Clifton Springs Hospital as your destination.

From the National Psoriasis Association (www.psoriasis.org): February 2015 •

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Complementary Medicine

Mangosteen: Tropical Fruit Offers Many Benefits By Deborah Jeanne Sergeant

angosteen represents a tropical super fruit, packed with numerous healthful properties. Sectioned like an orange, sized like a tangerine, and covered with a purple rind, the tangy, sweet fruit contains almond-sized seeds. Mangosteen primarily grows in Southeast Asia. In recent years, growers have begun growing mangosteen trees in Columbia, Puerto Rico and

Deutschbein

India. Mangosteen trees thrive in climates where the temperature stays above 75 degrees Fahrenheit year round and the relative humidity stays around 80 percent. Prolonged freezing temperatures have been known to kill even mature, well-established trees, making the United States inhospitable to mangosteen cultivation. Despite its healthfulness and exotic flavor, don’t count on finding it at your local grocery store. It’s a fruit that’s next to impossible to export from where it’s grown because it easily bruises and spoils while shipping. Its delicate nature doesn’t mean you’ll never enjoy mangosteen’s health benefits. Some specialty markets in larger cities carry it. Check Asian markets when you’re traveling and you could find mangosteens for sale. Locally, health foods stores and the natural health aisles of mainstream stores sell products containing magosteen, including canned mangosteen, though the fruit’s flavor is compromised through the canning process. Mangosteen juice also offers the nutrients and taste of the tropical treat. Cindy Fiege, certified herbalist and owner of Harmony Health Store, LLC in Rochester, said that mangosteen is often used by manufacturers as an

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ingredient in anti-oxidant supplements. “It has anti-inflammatory properties and anti-oxidants to protect against free radical damage,” she said. “People that I know who drink it do so for so many reasons. They say it gives you energy and it helps with allergies and infections. They say it improves mood and gives you energy.” Gregg Deutschbein, wellness department supervisor at Lori’s Natural Foods Center in Rochester, added cardiovascular support to the list. “A lot of people take it for lowering blood pressure or cholesterol,” he said. “Some take it for intestinal health, skin health — like acne or eczema — or to lower blood sugar. Others say it supports brain and nerve health.” Lori’s sells whole fruit mangosteen juice, which includes the skin, market-

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ed as a dietary supplement. Deutschbein said it tastes like strawberry, kiwi and plum. While it sounds like mangosteen is a panacea, Deutschbein said that people should not consider it a cure-all, “even for any one thing. Integrate it into a healthful diet, one ounce, one to two times per day. “Eating right pays huge dividends. Over the course of time, it makes a huge impact in health. It’s like letting the food be your medicine to maintain health.” Eating more of any type of whole fruit or vegetable helps add more nutrients to your diet, whether it’s a “super fruit” or just a “regular” one. Consult with your doctor before making any changes to your diet. Mangosteen has not been approved by the FDA to treat or prevent any health conditions.

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here are plenty of wives’ tales for preventing and fighting colds and flu. Which are true and which aren’t?

Chicken Soup

Plenty of moms have made chicken soup to help fight off a cold’s effects and, it turns out, mom knows best. “Chicken soup works!” says physician Roy Buchinsky, director of wellness at University Hospitals (UH) Case Medical Center. “It works as an anti-inflammatory, it boosts the immune system, and can help with nasal congestion.” Chicken soup works: TRUE!

Feed a Cold, Starve a Fever

“You should eat whether you have a fever or a cold,” says Buchinsky. “Eating enhances your immunity to fight off infections.” Buchinsky says

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

before modern medicine, people believed colds thrived when your body temperature was low and therefore your immunity was low so eating was recommended to increase a body’s internal thermostat and raise immunity. That part of the equation has merit. People also believed by not eating, you could lower the body’s temperature to lower a fever. That part of the equation is incorrect. Buchinsky says eating healthy helps regardless of whether you have a cold or a fever. FALSE!

Vitamin C

“Studies have shown there is no benefit of vitamin C in the normal population in preventing colds,” says Buchinsky. It might help, however, with the elderly, the immune-suppressed, and for people with poor diets. MOSTLY FALSE!

SmartBites

By Anne Palumbo

The skinny on healthy eating

Helpful tips

Move Over, Chicken: It’s Pork Time!

Select lean cuts of pork — tenderloin, loin chops, and boneless loin roast—if you’re looking for healthy pork options. Bacon, pork cutlets, spareribs and shoulder roast are all higher in saturated fat and calories. Just a few years ago, the USDA lowered its safe cooking temperature of pork to 145 degrees, from the longtime standard of 160 (trichinosis, a type of parasite sometimes found in undercooked meat, can’t survive above 145 degrees). The easiest way to tell when pork is done is to use a meat thermometer.

ver since the medical community revealed links between heart attacks and foods high in saturated fat — such as red meat — I have made a concerted effort to consume less of this particular protein, especially the fattier cuts. In its place, I initially substituted beans, fish and the only white meat I could think of: chicken. But then, recalling a brilliant ad campaign that positioned pork as “the other white meat,” I looked into pork, the leaner cuts touted in the ads. I am now a bona fide pork-a-holic. Although technically a red meat, pork (select cuts) has many of the health advantages of lean, white meat: it’s low in fat and calories, it’s super high in protein, and it’s chockfull of B vitamins. On the fat and calorie front, an average 3-ounce serving of pork loin has only 3 grams of total fat, 1 gram of saturated fat, and 122 calories, which is on par with a similar serving of skinless chicken breast. A 3-ounce rib eye steak, on the other hand, has 18 grams of total fat, 9 grams of saturated fat and 230 calories. According to the American Heart Association, the average adult should

thiamine (helps convert food to energy), niacin (good for nerves, digestion and skin), vitamin B12 (essential for red blood cell production and overall energy) and selenium (a powerful antioxidant).

not consume more than about 15 grams of saturated fat a day. As many know, foods that are high in saturated fats raise our total blood cholesterol and unhealthy LDL cholesterol levels — levels that, over time, contribute to clogged arteries and an increased risk of heart disease or stroke. On the protein front, pork is a prodigious source, serving up around 22 grams per 3-ounce serving. A nutrient we need to build up, keep up and replace tissues in our body, protein also makes up the enzymes that power many chemical reactions and the hemoglobin that carries oxygen in our blood. Put another way: We’d be limp noodles without this mighty nutrient. In addition to all that good protein, pork is also an excellent source of

Pork Tenderloin Studded with Rosemary and Garlic Adapted from “Cooking Light” Serves 4 2 tablespoons finely chopped fresh rosemary (or, 2 teaspoons dried, crushed) 4 garlic cloves, minced 1 (1-pound) pork tenderloin, trimmed 1/2 teaspoon salt 1/4 teaspoon black pepper Canola oil Preheat oven to 475°. Combine

the rosemary and garlic. Make several 1/2-inch-deep slits in pork; place about half of rosemary mixture in slits. Rub pork with remaining rosemary mixture; sprinkle with salt and pepper. Place pork on a rimmed baking sheet lightly coated with canola oil. Insert a meat thermometer into thickest portion of pork. Bake at 475° for 20 minutes or until the thermometer registers 145° (slightly pink) or desired degree of doneness. Let stand 5 minutes, and cut into 1/2-inch-thick slices. Note: If using fresh rosemary, strip leaves by running your fingertips along the stem in the opposite direction from which the leaves grow. 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.

What if you could choose?

5 Days or 45 Days

hoacny.com February 2015 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

Controlling Blood Pressure By Deborah Jeanne Sergeant

bout 78 million U.S. adults have high blood pressure, also known as hypertension, according to the American Heart Association. Many of them don’t realize they have hypertension until it’s detected during a medical exam or until they experience a health crisis. Of those with high blood pressure, about half do not follow their doctor’s orders regarding medication and lifestyle changes. In Good Health interviewed several experts who presented suggestions to keep blood pressure in check. • “Stress can raise blood pressure. Stress hormones increase blood pressure. They constrict blood vessels, making the blood pressure go up. Chronic stress that happens again and again causes damage that can be hard to reverse. Get rid of these: anger, worry, fear and stress. They’re like poison. • “Twenty-four hours a day, seven days a week, stay in an environment you love. • “Use breathing techniques. Breathe into the nose as deep as you can and out of your mouth. You relax the whole body. Doing it 15 to 20 times helps. If you’re stressed, have a three- to five-minute walk to melt away stress.” Az Tahir, MD, practicing internal and holistic medicine in Rochester. • “Decrease salt intake. Salt is hidden in so many foods. Avoid garlic

Why Bother Keeping Your Blood Pressure Low? Why is controlling blood pressure important? Physician Az Tahir, who practices internal and holistic medicine in Rochester, said that blood pressure is important to control because if the pressure in blood vessels becomes too high, they can rupture and hemorrhage in the brain, the heart, or kidneys. “Normal blood pressure keeps the normal flow of circulation to every part of your body and, eventually, every cell of the body. If it’s down, it changes circulation and that’s what gets oxygen to the cells which we need for survival.” salt, seasoned salt, ketchup, mustard, hot foods, canned soups, salami, bacon, sausage, ham: almost any processed food will have salt in it. There are many, many ways to cut back. A natural diet will help. • “Weight loss is a big thing. It’s hard to achieve but losing 5 to 10 percent of your weight will help tremendously. • “Take your blood pressure medication. Nationally, only 60 percent of prescriptions ever written are ever filled and of those, only half are taken.” William Bayer, MD, family medical physician with Jefferson Family Medicine in Rochester. • “Regular aerobic exercise can help manage blood pressure by opening peripheral blood vessels. It works on different levels. Smaller bouts of exercise more often is more effective for lowering blood pressure throughout the day than one session. Break up a 30-minute cardiovascular workout into

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three, 10-minute sessions a day. Work out at least five days a week. To lose weight, you’ll need more exercise, 300 minutes a week. • “Go by the talk test as a general guideline as to how strenuously you should exercise. Walk a pace like you’re late for the bus. You should not be able to sing. Measuring the pulse can be hard. Walk with purpose or do the stairs. Christine Stanford, exercise physiologist and owner of Strength In Wellness in Rochester. • “The long term effect is that exercise helps to strengthen your blood vessels. They become more flexible, pliable. They can respond and react to your blood pressure a lot easier. The lower your elasticity, the more pressure that’s put on your blood vessels. If you have hard blood vessels, it’s more effort for your heart. • “I work with many clients with high blood pressure. During a screening, if they are on blood pressure medication, it’s generally best to refer to the American Heart Association manual. I want to watch their intensity. I limit the duration. If they’re doing calisthenics, I might have them change it every 30 seconds so they have a 10 second recovery before the next set. That helps them keep it from being too strenuous. • “Some foods have been shown to reduce blood pressure, like legumes.

Fruits and vegetables that are high in vitamins K and C help, too.” Michael Knapp, certified personal trainer and owner of At Your Home Personal Training in Rochester. • “I turned 72 this past May. We have high blood pressure in our family. I’m a Type A-personality and I’ve learned to relax. I also have a beta blocker so it doesn’t allow the heart to beat maximally. I don’t let things bother me as much. • “I do a lot of strength training which helps. I do cardio training as well, working within the target heart rate zone. Or you can go by the old-fashioned talk test: if you can’t talk or whistle. • “I’m a firm believer in heart rate monitors. You can correlate the heart rate as to what you’re doing while wearing it. • “A lot of people turn to interval training and cardiologists are finding that’s highly successful with patients. Exercise is medicine. There’s no doubt about it.” Phil D’Angelo, fitness specialist, personal trainer, and post-rehab conditioning specialist with Penfield Sport & Fitness and Star Physical Therapy in Perinton

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

Untangling the New Daily Aspirin Study: Many Don’t Really Need It

f you’re taking aspirin to prevent heart attack and stroke, there’s a chance you may not need to be popping the little white pills after all. Researchers at Baylor College of Medicine and several other health institutions studied records of 69,000 people taking daily aspirin for primary prevention of heart attack and stroke. They concluded that more than one in 10 of them didn’t need to be taking the over-the-counter drug because their risk of developing heart disease was too low to warrant a daily aspirin regimen, according to the study published in January in the Journal of the American College of Cardiology. Aspirin risks can include stroke caused by burst blood vessels and gastrointestinal bleeding, both of which can be fatal, cardiologists say. But the researchers in this study did not look at aspirin-related complications — such as gastrointestinal bleeding or ischemia — in people taking it inappropriately. “People have a tendency to think

that aspirin is a benign drug, which it is not,” said Daniel Simon, chief of cardiovascular medicine at UH Case Medical Center in Cleveland, Ohio. People should take daily aspirin for heart disease prevention only if they have a more than 6 percent risk of developing heart disease over the next 10 years, according to the American Heart Association. This new study deemed anyone taking daily aspirin with a lower risk to be using the drug “inappropriately.” Simon said people can use online tools, such as the Framingham Risk Score, to determine their risk, or ask their doctors. Questions generally include age, gender, smoking status and family history. The Journal of the American College of Cardiology study did not include people who had already had a heart attack, stroke or anything else that would warrant aspirin for prevention of a second cardiovascular problem. They also did have information on specific aspirin doses.

St. Ann’s Community is proud to introduce HeartMatters, a new evidence based program that was developed in collaboration with Cardiologists and Cardiothoracic surgeons including Rochester General Hospital Chief of Cardiology, Gerald Gacioch, M.D. and St. Ann’s Chief Medical Officer, Diane Kane, M.D. HeartMatters provides the region’s best program for patients with cardiac conditions such as heart failure, myocardial infarction and post cardiac surgery (i.e., CABG, valve replacement). We recognize the uniqueness of each individual and will work with you to develop a plan of care that will improve your quality of life and reduce the likelihood of readmission back to the hospital. You and your family will receive the knowledge necessary to better manage your condition after returning home. For more information or to learn how to preplan a rehab stay, please call 585.697.6311 or visit stannscommunity.com. The HeartMatters cardiac rehab program is available at: St. Ann’s Community, Irondequoit and St. Ann’s Care Center, Cherry Ridge Campus in Webster.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 15

Exercise Helps Prevent Heart Trouble By Deborah Jeanne Sergeant

f heart conditions run in your family, exercise could help prevent problems for your ticker. Of course, it’s no guarantee that working out excludes you from heart disease. Diet and stress also play roles, along with genetic predisposition; however, considering the reduced risk of heart disease and the multiple other benefits of exercise, it’s worth pursuing. Christopher Cove, cardiologist with University of Rochester Medical Center, recommends that if you’re interested in beginning exercising, you should “start with a check-up to make sure you’re healthy.” Once your physician gives you a green light, plan to exercise regularly. “The weekend warrior who exercises one or two times a month doesn’t do himself Cove a favor and may be in danger,” Cove said. “They may be at risk.” Your heart, lungs, joints, and con-

nective tissues won’t be conditioned for that kind of strain. Occasional workouts put you at risk for injuries that can sideline you for long stretches. Cove said that regular aerobic exercise — at least four days a week — is what helps reduce your risk of heart problems. Many people don’t understand how strenuously they must exercise to benefit their hearts. The concept of “target heart rate” can give you a solid reference point. Subtract your age from 220. Eight percent of that number equals the target heart rate. A 60-year-old’s target heart rate figures as follows: 220-60=160. 80 percent of 160=120. Therefore, a 60-year-old’s target heart rate is 120 beats per minute while exercising. He should maintain that rate for 20 minutes during each exercise session. As a general rule, the exercise should be strenuous enough to make talking, but not breathing, difficult. Naturally, people who have not exercised regularly will need to gradually increase their fitness level by working out a little longer and a little more intensely each day. Michael Knapp, certified personal trainer, operates At Your Home Personal Training in Rochester. He teaches FIT

for a health heart: Frequency, Intensity and Time. Frequency refers to how often one exercise, intensity is how hard the exercise is in relation to the maximum heart rate, and time is about how long the person exercises. “Moderate to vigorous exercise includes brisk walking, swimming, biking or an exercise class,” he said. “You may need to build up to that time goal.” Susan Siebert, certified personal trainer and owner of Physical Forum, LLC in Rochester, said that brisk walking easily help you start on your goal to maintain a healthy heart. But don’t mosey. “You should move with a purpose,” she said. “Instead of just ambling down the road, set a time goal. Shave off more time the next time.” As you improve in your fitness level, choose a physical activity you like, such as ballroom dancing, martial arts, hiking or anything else that involves sustained movement. “I tell people if they like some-

thing, do it,” Siebert said. “If they move around more, they’ll want to do it.” Although activity such as housework and yard work can count towards a weekly activity total, interruptions and lags in intensity can mean less work for the heart. “If they really want to get into an exercise program, make an appointment with a personal trainer and get the basic education,” Siebert said. “People can get frustrated if they don’t know how to do anything to exercise.”

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1. Vandenplas Y, Brunser O, Szajewska H (2009) Saccharomyces boulardii in childhood. Eur J Pediatr 168: 253-265. 2. Klein SM, Elmer GW, McFarland LV, Surawicz CM, Levy RH (1993) Recovery and elimination of the biotherapeutic agent, Saccharomyces boulardii, in healthy human volunteers. Pharm Res 10: 1615-1619. 3. Martins FS, Silva AA, Vieira AT, Barbosa FH, Arantes RM, et al. (2009) Comparative study of Bifidobacterium animalis, Escherichia coli, Lactobacillus casei and Saccharomyces boulardii probiotic properties. Arch Microbiol 191: 623-630. 4. Swidsinski A, Loening-Baucke V, Verstraelen H, Osowska S, Doerffel Y (2008) Biostructure of fecal microbiota in healthy subjects and patients with chronic idiopathic diarrhea. Gastroenterology 135(2): 568-579.

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The World Health Organization defines probiotics as “live microorganisms which, when administered in adequate amounts, confer health benefits to the host.”†4 These microorganisms include specific strains of bacteria or yeast cells.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

44 Million People Still Smoke in the U.S. Despite successful CDC campaign urging people to quit, 44 million people still addicted to cigarette smoking By Ernst Lamothe Jr

he power of watching someone else make a mistake can be powerful. When you sit at home and see a commercial of a woman talking from a voice box through a hole in her throat as she covers it up with a scarf before going out, it affects you. Or you see someone describing losing his foot, fingers and other body parts to Buerger’s disease, a disorder linked to smoking. Well, seeing is believing, when you see others go down a road you want to avoid. Officials at the Centers for Disease Control and Prevention say their marketing efforts to get people to kick the smoking habit are paying off. The first federally funded national mass media anti-smoking campaign — Tips From Former Smokers — launched in 2012, cost roughly $48 million. The 12-week campaign was responsible for an estimated 100,000 smokers quitting permanently. It also motivated more than 1.6 million to at least attempt to quit. In addition, smoking has decreased 4 percent each year for the past few years. “The campaign has worked because people can relate to those in the commercials talking about their everyday expeHyland riences and how smoking affects their day-to-day lives,” said physician Andrew Hyland, chairman of the department of health behavior at Roswell Park Cancer Institute. “We all know that smoking is bad for you and it can cause cancer, but there has never really been a campaign from people who are former smokers talking about how smoking really made them feel. The personal stories really resonated with people.” Even with the Tips from Former Smokers campaign and the fact that

smoking overall is going down, there is still more than 44 million people smoking, said Hyland. Whenever people decide to curb their smoking, there are always new products that arrive. Over the last few years, that product has been the e-cigarette, which is a battery-powered vaporizer that has a similar feel to tobacco smoking. Electronic cigarettes do not contain tobacco, although they do use nicotine from tobacco plants. “The problem is that e-cigarettes are so new that it is difficult to find strong evidence on potential benefits,” said Hyland. “It could be a benefit if someone is using it as a transition away from smoking. But the problem is that people could be using it as a crutch and keep using the e-cigarettes.” Cigarette smoking is the leading preventable cause of disease and death in the United States, killing about 480,000 Americans each year. For every person who dies this year, there are more than 30 Americans who continue to live with a smoking-related disease, according to the CDC. “There is no part of the body and no organ that is unharmed by tobacco and cigarette smoking,” added Hyland. “When you have something that has a number of carcinogens and carbon monoxide along with an addictive substance that keeps you coming back for more, that is dangerous combination to put in your body. There are no health advantages in life that you get from smoking.” The Tips from Former Smokers, campaign spent $480 per smoker who quit and $393 per year of life saved. A commonly accepted threshold for cost-effectiveness of a public health intervention is $50,000 per year of life saved. The results of the study were published this month in the American Journal of Preventive Medicine. “There was a lot of money funded for this national campaign. You have to spend that money to get the campaign in front of the largest amount of people so the message comes through,”

Smoke-free Homes By Cassie Gratton

smoke-free home is a step toward protecting your heart health. Secondhand smoke contains more than 4,000 chemical compounds. According to the Surgeon General, there is no safe level of exposure to secondhand smoke. Even brief exposure to secondhand smoke has immediate negative effects on the cardiovascular system and interferes with the normal functioning of the heart, blood and vascular systems in ways that increase the risk of a heart attack. Exposure to secondhand smoke at home or work increases a nonsmoker’s

risk of developing heart disease by 2530 percent. Do you live in a smoke-free home? According to the 2014 Community Tobacco Survey of Adults Residents of Monroe County, conducted by the Smoking and Health Action Coalition of Monroe County, 53 percent of Monroe County adults who currently live in multi-unit dwellings (apartment buildings) support a policy that prohibits indoor smoking everywhere inside a residential building, including living areas. The Rochester Housing Authority (RHA) adopted a policy that made all

said Hyland. “When you combined that with media stories addressing this number one cause of preventable death in the U.S., that is how real change happens.” Health officials said people are dealing with chronic obstructive pulmonary disease and emphysema, which destroys the lungs over time. There are so many destructive things that people continue to do to themselves including smoking and things that lead to diabetes. Smokers can get help quitting by calling 1-800-QUIT-NOW. The quitline provides free counseling and information about the smoking cessation program, which is approved by the U.S. Food and Drug Administration (FDA). Helpful tips on how to quit are also available on the website at www. smokefree.gov. “There is no question the Tips campaign is a ‘best buy’ for public health because it saves lives and saves money,” said CDC Director Tom Frieden, in a news release. “Smoking-related disease costs this nation more than $289 billion a year. The campaign is one of the most cost-effective of all health interventions.”

RHA properties smoke free. Smoke-free housing helps eliminate secondhand smoke, improves indoor air quality, and helps protect all residents. For more information about smoke-free housing, call the Smoking and Health Action Coalition at 585666-1399 or visit the website smokefreemonroe.com.

February 2015 •

Cassie Gratton is the director of Smoking and Health Action Coalition (SHAC), program of the American Lung Association of the Northeast. She wrote this column to mark American Health Month, which falls in February.

Excellus report shows Upstate adults are more likely to smoke than adults in the rest of the state and nation

igarette smoking among Upstate New Yorkers has steadily declined since 2004, but smoking rates in Upstate New York continue to be higher than state and national averages, according to a new Excellus BlueCross BlueShield report. Issued during the 50th anniversary year of the first Surgeon General’s report linking smoking to lung cancer, the Excellus BCBS report, released in December, found that while 20.9 percent of Upstate New York adults smoke, the smoking rate among all New York state adults is significantly lower (16.2 percent), and the smoking rate among U.S. adults is also lower (18.1 percent). In the Finger Lakes region, 18.1 percent of the adult population smokes, which is the same as the nationwide average. Among adult males in the region, 20.2 percent smoke. Among adult females in the region, 17.3 percent smoke. The data also shows that over the past decade, the rate of adult smokers in Upstate New York has declined 5.4 points, while the rate of adult smokers in New York state declined 4.9 points, and the rate of adult smokers in the U.S. declined 3.7 points. Kerr expressed concern that more people haven’t quit. “A significant amount of money has been spent over the past five decades to educate the public about the dangers of smoking, New York state passed legislation restricting where people can smoke, and the state’s taxes on cigarettes are among the highest in the country,” said physician Jamie Kerr, Excellus BCBS vice president and chief medical officer for utilization management. “Despite all that, about 24,000 New Yorkers die each year from diseases caused by smoking cigarettes, and another 3,000 lives are claimed by exposure to secondhand smoke.” Excellus BCBS’s “The Facts About Cigarette Smoking Among Upstate New York Adults” reports that smoking costs New York state more than $15.6 billion (2014 dollars) each year in direct medical costs and economic productivity losses. “Imagine the initiatives that could be funded in our state by re-directing $15.6 billion to purposes other than those related to tobacco use,” said Kerr. Smoking among New York state adults varies by socio-economic demographic: One in five adults aged 25 to 34 (21.0 percent) smokes. Adults who haven’t earned a high school diploma or GED are more than three times as likely to smoke (24.0 percent) than college graduates (7.3 percent). Adults with incomes below $15,000 are more than twice as likely to smoke (25.2 percent) than those with incomes of $50,000 or more (11.7 percent). “Our intent in writing this report was to document 50 years of progress in reducing the impact of cigarette smoking on public health and health care spending, but instead we found a 50-year mix of success and failure,” said Kerr. “Our hope is that those people who have resolved to quit smoking in 2015 will take advantage of available support materials.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

Jewish Senior Life launches ‘Music & Memory’ program

The Social Ask Security Office

Program brings personalized level of music therapy into the lives of the elderly, improving quality of life

ewish Senior Life (JSL) has launched a new evidence-based program called Music & Memory. As the first certified care community in the Rochester area, Jewish Senior Life’s team of professional caregivers will utilize best practices for providing a personalized playlist delivered on iPods and other digital devices for residents with Alzheimer’s, dementia and other cognitive and physical challenges to reconnect with the world through music-triggered memories. Music helps connect brains to certain events in one’s life. According to the Alzheimer’s Association of America, music, if used appropriately, has the power to shift mood, manage stress-induced agitation, stimulate positive interactions, facilitate cognitive function and coordinate motor movements. “Personalized play lists provides a wonderful tool for some of our residents who are unable to verbally express themselves due to their diminish-

ing abilities,” said Michael King, chief operating officer/administrator for Jewish Senior Life. “When the Music & Memory program was first introduced to the organization, we recognized the value in providing this service to our residents. Jewish Senior Life is committed to the success of the program by establishing ‘memory coaches’ to help identify residents who would directly benefit from the program.” The personalized music developed through the Music & Memory program can tap into emotions and special events unique to an individual that otherwise may have been lost. Music enriches the lives of residents by helping to ease incidents of depression, anxiety and challenging behaviors. “The residents of Jewish Senior Life have seen remarkable success by the thought behind the Music & Memory program,” said Susan Price, person-center care manager for Jewish Senior Life.

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By Deborah Banikowski

Wear Your Heart On Your Sleeve

ebruary is the month when we celebrate love and friendship. The Centers for Disease Control (CDC) has also declared February as American Heart Month to bring awareness to the leading cause of death for both women and men in the United States: heart disease. We encourage you to wear red all month to promote cardiovascular disease prevention. Just as the heart is vital to our emotional and physical well-being, Social Security disability benefits are often a vital lifeline for people who are unable to work due to severe disabilities — whether heart-related or not. There are numerous ways to protect our hearts, including eating well, exercising and not smoking. We get checkups and make sure to keep our cholesterol down. However, sometimes these measures aren’t enough. In fact, disability will affect one in four of today’s 20 year-olds before reaching retirement age. The Social Security disability program excels in providing financial help to people when they need it most — help they earned by paying Social Security taxes on their earnings or as dependents of someone who paid Social Security taxes. Social Security pays benefits to covered people who can’t work and

Q&A

Q: I heard that Social Security benefits increased at the beginning of the year. What is the average Social Security retirement payment that a person receives each month? A: You are right — Social Security benefits increased this year. In 2015, nearly 64 million Americans who receive Social Security or Supplemental Security Income (SSI) began receiving a cost-of-living adjustment (COLA) increase of 1.7 percent to their monthly benefit payments. The average monthly Social Security benefit for a retired worker in 2015 is $1,328 (up from $1,306 in 2014). The average monthly Social Security benefit for a disabled worker in 2015 is $1,165 (up from $1,146 in 2014). As a reminder, eligibility for retirement benefits still requires 40 credits (usually about 10 years of work). The Social Security Act details how the COLA is calculated. You can read more about the COLA at www. socialsecurity.gov/cola. Q: I recently got married. How can I update my insurance under the Affordable Care Act? A: You can do so before the Affordable Care Act open enrollment period ends Feb. 15. You and your spouse

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

whose medical condition meets the strict definition of disability under the Social Security Act. A person is considered disabled under this definition if he or she cannot work due to a severe medical condition that has lasted or is expected to last at least one year or result in death. The person’s medical condition must prevent him or her from doing work that he or she did in the past, and it must prevent the person from adjusting to other work based on their age, education and experience. You can find all the information you need about eligibility and benefits available to you by reading our publication, Disability Benefits, available at www.socialsecurity.gov/pubs. If you are disabled, and think you are eligible to receive disability benefits, you will need to complete an application for Social Security benefits. It’s easy to apply online at www. socialsecurity.gov/disability. We also invite you to visit our Faces and Facts of Disability website to watch and read stories about people who have truly benefited from Social Security’s disability program and to get the facts about this very important program. Helping people is at the heart of what we do. You can learn more at www.socialsecurity.gov/disabilityfacts. During American Heart Month, go ahead and wear your heart on your sleeve. Go red, and go to www.socialsecurity.gov/disabilityfacts.

can shop for a new healthcare plan any time before Feb. 15. Be sure to update your information, including your new name, address or anything that might have changed. Healthcare.gov is your hub for everything involving affordable healthcare. To start shopping for a plan that best suits you, visit the website at www.healthcare.gov. Q: My child lost his Social Security card. How can I get a replacement? A: You can replace your child’s Social Security card at no cost to you if it is lost or stolen. You are limited to three replacement cards in a year and 10 during a lifetime. Legal name changes and other exceptions don’t count toward these limits. Also, you may not be affected by these limits if you can prove you need the card to prevent a significant hardship. The documents you will need to provide will differ depending on whether your child is a citizen of the United States or foreign-born citizen. To get a new card, you will need to provide original documents that prove citizenship. No photocopies or digital replications are accepted. You will have to provide proof of your identity as well using a U.S. driver’s license, a state-issued non-driver identification card, or a U.S. passport.

to 100 days of skilled nursing or rehabilitation care immediately following a three-day inpatient hospital stay. Personal care: The cost of hiring help for bathing, toileting and dressing are not covered unless you are homebound and are also receiving skilled nursing care. Housekeeping services, such as shopping, meal preparation and cleaning, are not covered either unless you are receiving hospice care. By Jim Miller

What Medicare Doesn’t Cover Dear Savvy Senior, I’m about to sign up for Medicare Part A and B and would like to find out what they don’t cover so I can avoid any unexpected costs down the road. Almost 65 Dear Almost, While Medicare covers a wide array of health care services, it certainly doesn’t cover everything. If you need or want certain services that aren’t covered, you’ll have to pay for them yourself unless you have other insurance or you’re

in a Medicare Advantage health plan, which may cover some of these services. Here’s a rundown of what original Medicare generally does not cover. Alternative medicine: This includes acupuncture or chiropractic services (except to fix subluxation of the spine), and other types of alternative or complementary care. Cosmetic surgery: Elective cosmetic procedures are not covered, however, certain surgeries may be if necessary to fix a malformation. For example, breast prostheses are covered if you had a mastectomy due to breast cancer. Long-term care: This includes nursing home care, the costs of assisted living facilities and adult day care. Medicare does, however, help pay up

Dental and vision care: Routine dental and vision care: Medicare will not cover routine dental checkups, cleanings, fillings or dentures. Nor do they cover routine vision care like eye exams, eye refractions, contact lenses or eyeglasses — except when following cataract surgery. Hearing: Routine hearing exams and hearing aids are not covered either, although some hearing implants to treat a severe hearing loss may be covered. Foot care: Medicare does not cover most routine foot care, like the cutting or removing of corns and calluses, nor does it pay for most orthopedic shoes or other foot supports (orthotics). Medicare will, however, cover foot injuries or diseases like hammertoes, bunion deformities and heel spurs, along with foot exams and treatments if you have diabetes-related nerve damage. Non-emergency services: Medicare does not pay for copies of X-rays or most non-emergency transportation including ambulette services. Overseas coverage: In most cases, health care you receive outside of the United States is not covered.

The best way to find out if Medicare covers what you need is to talk to your doctor or other health care provider. Or visit medicare.gov/coverage and type in your test, item or service, to get a breakdown of what is and isn’t covered. Also keep in mind that even if Medicare covers a service or item, they don’t usually pay 100 percent of the cost. Unless you have supplemental insurance, you’ll have to pay monthly premiums as well as annual deductibles and copayments. Most preventive services, however, are covered by original Medicare with no copays or deductibles. For more information on what original Medicare does and doesn’t cover, see the “Medicare and You” 2015 booklet that you should receive in the mail a few months before you turn 65, or you can see it online at medicare. gov/pubs/pdf/10050.pdf. You can also get help over the phone by calling Medicare at 800633-4227, or contact your State Health Insurance Assistance Program (SHIP), who provides free one-on-one Medicare counseling in person or over the phone. To find a local SHIP counselor visit shiptalk.org, or call the eldercare locator at 800-677-1116. If you enroll in a Medicare Advantage plan, you’ll need to contact your plan administrator for details. 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.

Getting Around When You No Longer Drive By Jim Miller

lternative transportation services vary widely by community, so what’s available to your mom will depend on where she lives. Here’s what you should know.

Transportation Options

For starters it’s important to know that while most urban areas offer seniors a variety of transportation services, the options may be few to none for those living in the suburbs, small towns and rural areas. Alternative transportation is an essential link in helping seniors who no longer drive get to their doctor’s appointments, stores, social activities and more. Depending on where your mom lives, here’s a rundown of possible solutions that can help her get around, along with some resources to help you locate them. Family and friends: This is by far the most often used and favorite option among seniors. So make a list of all possible candidates your mom can call on, along with their availability and contact information. Local transportation programs: These are usually sponsored by nonprofit organizations that serve seniors. These

services may charge a nominal fee or accept donations and often operate with the help of volunteer drivers. Also check out the Independent Transportation Network (itnamerica. org), which is a national nonprofit that has 27 affiliate transportation programs in 23 states. With this program, seniors pay membership dues and fees based on mileage. And, most programs will let your mom donate her car in return for credits toward future rides. Demand response services: Often referred to as “dial-a-ride” or “elderly and disabled transportation service,” these are typically government-funded programs that provide door-to-door transportation services by appointment and usually charge a small fee or donation on a per ride basis. Many use vans and offer accessible services for riders with special needs. Taxi or car service: These private services offer flexible scheduling but can be expensive. However, they’re cheaper than owning a car. Some taxi/car services may be willing to set up accounts that allow other family members to pay for services and some may offer senior discounts. Be sure to ask.

Another option to look into is ride-sharing services, which connects people with cars, with people who need rides. Uber (uber.com), Lyft (lyft. com) and Sidecar (side.cr) are three of the largest companies offering services in dozens of cities across the U.S. Private program services: Some hospitals, health clinics, senior centers, adult day centers, malls or other businesses may offer transportation for program participants or customers. And some nonmedical home-care agencies that bill themselves as providing companionship and running errands or doing chores may also provide transportation. Mass transit: Public transportation (buses, trains, subways, etc.) where available, can also be an affordable option and may offer senior reduced rates. Hire someone: If your mom lives in an area where there are limited or no transportation services available, another option to consider is to pay someone in the community to drive her. Consider hiring a neighbor, retiree, high school or college student who has

February 2015 •

a flexible schedule and wouldn’t mind making a few extra bucks.

Where to Look

To find out what transportation services are available in your mom’s community, contact the Rides in Sight national toll-free call center at 855-6074337 (or see ridesinsight.org), and the Eldercare Locator (800-677-1116), which will direct you to her area agency on aging for assistance. Also contact local senior centers, places of worship and retirement communities for other possible options. And check with her state department of transportation at www.fhwa.dot. gov/webstate.htm, and the American Public Transportation Association at publictransportation.org.

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H ealth News New chief communications officer appointed at RRHS Susan M. Alcorn will join Rochester Regional Health System as senior vice president and chief communications officer. She will begin her new role in early February. Alcorn comes to Rochester Regional from Jarrard Phillips Cate & Hancock, a communications firm that specializes in the high-stakes communication challenges facing hospitals and health systems. Previously, she was chief communications officer at Geisinger Health System, Danville, Alcorn Pa., where she helped position the system as a nationally recognized model for healthcare delivery and financing. She is co-author of the books, “Healthcare Mergers, Acquisitions, and Partnerships: An Insider’s Guide to Communication,” and “Healthcare Communications in a Brave New World.” “Susan is an ideal addition to our team during this transformative time in Rochester Regional’s history,” said physician Eric Bieber, president

and CEO of Rochester Regional. “This appointment reflects our deep commitment to enhancing and creating strong and trusting relationships across our organization and with our community.”

Evarts Joint Center at Highland has new director Physician Christopher Drinkwater has been appointed director of the Evarts Joint Center at Highland Hospital and chief of UR Medicine’s division of adult reconstructive surgery. Part of UR Medicine’s department of orthopedics and rehabilitation, the Evarts Joint Center is the most comprehensive joint replacement program in Upstate New York, with fellowship-trained specialists offering joint replacement of the hip, knee, shoulder, elbow and hand. Drinkwater, Drinkwater who is an associate clinical professor of orthopedics at the University of Rochester School of Medicine and Dentistry, has been an attending orthopedic surgeon at Highland Hospital since 2005. He is board-certified in orthopedic surgery

NYCC Has Significant Impact on Finger Lakes Economy: Study With total payroll exceeding $26 billion for 394,400 direct, indirect and induced jobs, New York’s independent colleges and universities (private, nonprofit) are a major source of jobs in all regions of New York state, according to a new economic analysis by the Center for Governmental Research (CGR) released in January by the Commission on Independent Colleges and Universities (CICU). New York Chiropractic College’s (NYCC) economic impact on the Finger Lakes Region is significant. In 2013, the college employed 330 people. Including spillover employment, this brings the total of those employed as a result of the college’s activities to 690. Considering all factors, the CGR puts NYCC’s economic impact at $67.6 million New York’s independent colleges and universities continue to be a major contributor to the New York state economy, according to the study. This is particularly significant in the current hyper-competitive higher education economy. “These schools have maintained enrollment in the face of declining numbers of high school grads and boost total research spending by 17 percent despite reductions in federal research investment,” said CDR’s chief research officer, Kent Gardner, who Page 20

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led the study. “New York state continues to depend on its higher education institutions to educate our next generation of leaders, as well as contribute to our future economic growth,” said CICU President Laura L. Anglin. “Playing the role of anchor tenants with communities around the state, the independent sector educates hundreds of thousands of students while also providing jobs and significant fiscal impact for the communities where they are located. Throughout the state, our campuses are significant contributors to both economy and community.” “While our focus is on education, we are particularly proud of our ongoing contribution to the Finger Lakes region, which has been our home since 1991,” said NYCC President Frank J. Nicchi. “The decision to move from Long Island to Seneca Falls was a good one for the college and we are gratified that our presence in the community that has become our home provides strong support for the local economy.” New York Chiropractic College delivers an exceptional, leading-edge chiropractic education offering an integrated curriculum that combines a unique balance of art, science and philosophy.

and fellowship-trained in joint replacement and arthroscopic surgery. He performs more than 400 total joint replacements for patients with hip and knee arthritis at Evarts each year. Drinkwater specializes in modern joint replacement techniques including direct anterior hip replacement, hip resurfacing, and partial and total knee replacement. Drinkwater earned his medical degree at Australia University of New South Wales and completed his residency in orthopedic surgery in Sydney, Australia. He and his family live in Pittsford.

Schweizer named Meals On Wheels new director Visiting Nurse Service of Rochester, part of UR Medicine’s home care agency, recently appointed Margaret K. Schweizer as director of its Meals On Wheels program. Schweizer will oversee the Monroe County program, which delivers approximately 250,000 meals each year to vulnerable seniors and utilizes a workforce of 2,500 volunteers, one of the largest volunteer groups in the Rochester community. “I am very pleased to announce that Margaret, formerly the assistant director, accepted the position of Meals On Schweizer Wheels director,” said William Belecz, chief information officer and VP of operations and business analysis at Visiting Nurse Service. “She has been performing as the interim director and the program has not missed a beat. In fact, Margaret has done what she always has — tackled the daily challenges in a calm and effective manner, supported the staff and volunteers, and above all put our meal recipients first.” Schweizer has worked for Visiting Nurse Service for seven years. As a certified dietitian-nutritionist, she started as the Meals On Wheels nutrition manager. Schweizer received her associate’s degree in business from Lakeland Community College and her bachelor’s degree in applied science from Youngstown State University. In 2011, she received her ServSafe Certification. She also serves as a current board member of the Cornell Cooperative Extension of Monroe County.

VNS in top 500 of home care agencies nationwide Visiting Nurse Service of Rochester and Finger Lakes Visiting Nurse Service announced it was named to the top 500 of the 2014 HomeCare Elite, a recognition of the top-performing home health agencies in the United States. Now in its ninth year, the HomeCare Elite identifies the top 25

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

percent of agencies and highlights the top 100 and top 500 agencies overall. Out of 9,994 agencies considered, 2,501 are elite. Winners are ranked by an analysis of publicly available performance measures in quality outcomes, best practice (process measure) implementation, patient experience (Home Health CAHPS), quality improvement and consistency, and financial performance. In order to be considered, an agency must be Medicare-certified and have data for at least one outcome in Home Health Compare. “The 2014 HomeCare Elite winners demonstrate a commitment to providing high quality care in their home health communities and we recognize them for their remarkable achievements,” said Mary Oakes, senior vice president of post-acute at National Research. “We congratulate UR Medicine’s home care agency, Visiting Nurse Service and Finger Lakes Visiting Nurse Service, on being among the top 500 home care agencies in the country.” The award is sponsored by OCS HomeCare by National Research Corporation, the leading products for home health metrics and analytics, and DecisionHealth, publisher of the most respected independent newsletter in the home care profession, Home Health Line. Denise Burgen, Visiting Nurse Service’s and Finger Lakes Visiting Nurse Service’s Chief Clinical Officer, credits employees’ dedication and compassion with the agency’s ability to achieve recognition as one of the HomeCare Elite. “Our staff truly cares about patients and their families. They go the extra mile to make those in our care safe at home. Our staff don’t just see it as a job; it’s their passion,” she said.

Highland chief doctor earns national recognition Physician Robert McCann has been selected as one of 55 U.S. physicians to receive mastership recognition from the American College of Physicians for 2014-2015. ACP is a national organization of more than 100,000 board-certified internists. Masters are selected for making significant contributions to the field of medicine and demonstrating high achievement in research, education, health care initiatives, volunteerism or administrative positions. McCann, a resident of Pittsford, is chief of medicine at Highland Hospital and a professor McCann of medicine at the University of Rochester. He is CEO of Accountable Health Partners, a clinically integrated network that includes independent community practitioners from around the region, as well as physicians from the University of Rochester Medical Faculty Group (URMFG). McCann is board-certified in

H ealth News geriatrics, hospice and palliative care, and internal medicine. He earned his medical degree and completed his internship at SUNY Upstate Medical Center in Syracuse. McCann completed his residency at Rochester General Hospital and began practicing there in 1987; among his achievements, he established a social and medical day

care program for older adults known as PACE that has since been replicated nationwide. Since joining Highland Hospital in 1999, McCann has led the development of the hospital’s nationally recognized geriatric medicine program, which has the largest number of geriatric medicine specialists in Upstate New York.

East House, MHA get funding for respite program East House and the Mental Health Association (MHA) of Rochester were awarded $500,000 from the Monroe County Office of Mental Health to

American Diabetes Association Awards Tour de Cure Rider with Night on the Town

Malehorn

The American Diabetes Association recently announced Rich Malehorn as the winner of the Night on the Town giveaway presented by East Avenue Inn & Suites. The winner was randomly selected from a pool of individuals who have raised over $200 for the 2015 Sage Rutty Tour de Cure. Prize details include a dinner for two at City Grill and one premium night stay at East Avenue Inn & Suites. The Sage Rutty Tour de Cure is the region’s

largest cycling event and the fifth largest in the nation. The event is scheduled for Saturday, June 13 and benefits diabetes education and research. By the end of 2014, the Sage Rutty Tour de Cure will have raised $1 million through the support of individuals and the business community. For more information, sponsorship opportunities, or to register for the 2015 Sage Rutty Tour de Cure, visit www.diabetes. org/RochesterTour or call 585.458.3040 x 3473.

establish a peer respite program in the spring of 2015. The first of its kind in the greater Rochester area, the peer respite program provides short-term care to individuals in crisis as an alternative to emergency room visits or inpatient care. “With fewer beds available at the Rochester Psychiatric Center and emergency rooms already experiencing overcrowding, programs such as this will become more important in our community,” said Greg Soehner, president and CEO of East House. “A manager will oversee the program, but the rest of the staff will be peers — individuals who have progressed in their own recovery and are willing to self-identify as peers and assist others. We are excited to offer this alternative.” The program will feature an eightbed respite facility, slated to open in April and located at 269 Alexander St. in Rochester and will serve individuals from six counties. “As the state transitions away from inpatient care, we will see more programs like this one,” said Pat Woods, executive director of the Mental Health Association. “Peers have played an important role at the MHA for many years. Peer respite is a promising model of care, and we look forward to utilizing our expertise in this area to establish this service in our community. ”

IT’S ONLY SUPER IF YOU TAKE IT. According to the National Institutes of Health, up to 20 percent of patients fail to fill new prescriptions, and 50 percent of people with chronic health conditions discontinue their medication within six months. If you have a chronic condition like high blood pressure, diabetes or high cholesterol, taking your prescriptions as directed is essential to healthy living. So remember: If you’re not taking your prescriptions as directed, you’re taking a chance. To learn more, visit ExcellusBCBS.com/ TakeAsDirected.

#TakeAsDirected A nonprofit independent licensee of the Blue Cross Blue Shield Association

February 2015 •

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PassLifeOn.org Ad Council, local health groups launch campaign to increase organ donors

he Ad Council of Rochester and the Finger Lakes Donor Recovery Network, along with local health groups, recently launched a new campaign to decrease the number of individuals who die or whose health deteriorates because they’re waiting for an organ transplant. The new mass media campaign uses emotional messages to compel individuals to go to a new website — PassLifeOn.org — and join the New

York State Donate Life Registry. Only about one in three adults in the Finger Lakes region have signed up for the registry, according to a recent report by Excellus BlueCross BlueShield. Yet polls show that the majority of New Yorkers are in favor of organ donation. “Support for donation exists — we know that — but there is often a disconnect between that support and taking action,” says Rob Kochik, executive director of the Finger Lakes Donor

Recovery Network, which coordinates organ donations at 37 hospitals in the Finger Lakes, Central and Upstate regions. “Our hope is that this important message and these beautiful ads will remind each of us that by enrolling in the Donate Life Registry we can make a significant difference and literally save the lives of our friends, neighbors and family members.” The need for lifesaving organs in New York state is among the highest in the country. More than 10,000 New Yorkers are waiting for an organ or tissue transplant. Yet the rate in which New York state adults sign up for the registry is among the lowest in the U.S. To tackle this major health improvement opportunity, the Ad Council and the Finger Lakes Donor Recovery Network teamed with several local health organizations, Bev Shank of Brighton is one local resident who was including the University of able to leave the transplant waiting list and restart Rochester Medical Center, her life thanks to the gift of a new organ. “December Rochester Regional Health 14, 2005, was an important day in my life — it was System, Rochester Eye and my new beginning,” she said. “Having the transplant Tissue Bank, National Kidney allowed me to see my son graduate and become a Foundation, Excellus BCBS and the Transplant Awarewonderful young man and my daughter advance in ness Organization of Greater her career and meet someone special.” Rochester. “Whenever we tackle an issue as Cool, and we’ve developed a strategy complex and important as this one, we and creative materials that we expect know it will take the work of many will help us drive action, in the form of partners to achieve the impact we’re joining the organ donor registry.” after,” said Todd Butler, Ad Council Rochester advertising agency president and CEO. “We’ve worked Brand Cool donated time to develfor a year with these health organizaop the campaign’s advertising and tions, marketing volunteers and Brand PassLifeOn.org website. The advertising features beautiful scenes and actions that coincide with a heartfelt address about “The Greatest Person Never Known,” which is what an organ donor is to someone waiting for a transplant. “Humans have intrinsic motivations, such as wanting to see their actions contribute to a larger good. We chose to use this emotional dimension to inspire people to take a simple action that can have life-changing consequences,” said Sue Kochan, Brand Cool’s CEO. “Other states have a higher percentage of their population on the registry, so it’s safe to believe the CareGivers, a licensed home care majority of New Yorkers want to be on agency is looking for HHAs, PCAs, the registry, but just need prompts to complete the easy task.” and CNAs for private duty cases. About half of American adults (48 percent) are registered organ and tissue 2-8 hour shifts are available with donors, but only 22 percent of New immediate openings for weekends and York state adults are on the registry, overnights. according to the Excellus BCBS report. New York’s registration rate is lower Cases available in Monroe, Ontario and 48 states and the District of CoEastern Wayne counties. Transportation than lumbia. But New York adults represent a must. Starting rate $10.50/hour and 10 percent of all Americans waiting for benefits available including time and a donation. Bev Shank of Brighton is one local a half for major holidays. resident who was able to leave the transplant waiting list and restart her PCA Training for qualified applicants life thanks to the gift of a new organ. nd th “December 14, 2005, was an important day in my life — it was my new beginning,” she said. “Having the transplant allowed me to see my son graduate and become a wonderful Call today for an appointment to apply young man and my daughter advance in her career and meet someone special. Now I am thankful for each day, I make every day count, take care of myself and give back with my time.” Thirty Rochester-area media partwww.caregivershomecare.com ners will contribute free space and time for the campaign.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015

Weight Loss: 5 Mistakes You Should Avoid Bad strategy No. 1: I’ll lose weight at the gym. Working out is good for your health and can help to maintain your weight. But exercise alone is not very effective in shedding pounds. To lose weight, you will need to eat fewer calories. Bad Strategy No. 2: I’ll have to dramatically change my diet. A radical change is not necessary. A more effective strategy is to simply cut back a few hundred calories a day. When going to a restaurant, for example, eat an apple before dinner to dull your appetite, then skip the bread before the main dish arrives. Eat smaller portions and ask for a to-go container. Bad Strategy No. 3: Weight-loss supplements will make it easier. Supplements burn more muscle than fat. And when you stop taking

them, you will gain back more fat than muscle, making you worse off than if you had never taken them in the first place. Bad Strategy No. 4: I want to be like the Biggest Loser and shed pounds quickly. A more realistic — and healthy — strategy is to try to lose 1 to 2 pounds per week. If you cut back 500 calories a day (such as a bagel and cream cheese), you will lose a pound a week. If you cut back just 250 calories a day (one candy bar) you will lose 2 pounds a month. This will provide the slow-andsteady type of weight loss that will be long-lasting. Bad Strategy No. 5: I give up. I’ll never get down to a normal weight, so why even try? Do not despair if you do not get down to a trim, normal weight (defined as a body mass index of between 18.5 and 24.9). If you are overweight or obese, losing 10 percent of your body weight will improve your appearance

and have significant health benefits, such as lower blood pressure and a reduced risk of diabetes. Even losing as little as 5 pounds will be good for your

joints.

Source: Physician Aaron Michelfelder, Loyola University Health System.

Imagine the Difference You Could Make in Our Community! Rochester Regional Health System, newly-formed from Rochester General and Unity health systems, provides an array of Home Care Services to Monroe County residents through ElderONE and Rochester Regional Home Care. ElderONE, a Program of All-Inclusive Care for the Elderly (PACE), offers frail seniors an alternative to nursing home placement by providing comprehensive care and support services that include in-home care, adult day centers, rehabilitation and transportation. Rochester Regional Home Care follows the same mission, but with a focus on short- and long-term, in-home care for a more acute patient population.

Our dedicated and passionate team members have the freedom to provide exceptional care autonomously with schedule flexibility to support their caseload and personal work/life balance. We offer competitive starting salaries, based on experience, and great benefits. Consistent assignments help our team members become familiar with participants over time – enabling them to quickly notice and respond to, even subtle, medical, functional and psycho-social changes. This proactive care and attention results in peace of mind for providers, participants and their families.

February 2015 •

Join Our Home Care Team Today Opportunities with Rochester Regional Home Care • • • • • •

Community Health Nurse Home Care Coordinator (RN) Physical Therapist Home Health Aide (HHA) Home Health Aide Trainee Home Care Customer Service Rep

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • February 2015