in good A New Voice for the Deaf Antony McLetchie is the new superintendent and chief executive officer of the Rochester School for the Deaf
June 2015 • Issue 118
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What Works?
11 weight-loss programs after one year: Which one works?
Brockport Nurse Publishing Book URMC nurse launching fourth in a series of easy-to-read books on medical issues. She tackles diabetes this time
“It’s important for the public and doctors to know which programs help people to lose weight, but also which ones help to keep it off,” say experts at Johns Hopkins University School of Medicine.
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Turning 35? Time to Start the Conversation About Prostate Cancer
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Crossroads Compass of Care
Meet Russ Willemsen, leader of a nonprofit that helps people in need in the Finger Lakes
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Big Reasons to Eat More Black Beans
Meet Your Doctor
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Highland physician, Roan Glocker, talks about vascular surgery and how it is saving lives June 2015 •
Sports Drink or Water? What to do to recover from working out
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Noah and Emma:
Most Popular Baby Names E mma and Noah are America’s most popular baby names for 2014, according to figures from the Social Security. Emma returns to the top spot she held in 2008 and hangs out in first place with Noah. There are a few new names in the top 10 in 2015 — James (a former No. 1 from the ‘40s and ‘50s) on the blue side and Charlotte on the pink side, her first time ever in the top 10. Makes you wonder if the Duke & Dutchess of
Cambridge got a sneak peak at the list, since naming their baby girl Her Royal Highness Princess Charlotte (which lands at No. 10) Elizabeth (which fell from the top 10 to No. 14) Diana (No. 297) of Cambridge. Each year, the list reveals the effect of pop-culture on naming trends. This year’s winners for biggest jump in popularity in the Top 1,000 are Aranza and Bode. Aranza jumped an amazing 3,625 spots on the girls’ side to number 607, from number 4,232 in 2013. The Latin soap opera “Siempre Mi Amore” was aired on Univision from 2013 to 2015. The show featured a
young lead character named Aranza, and obviously had its effect on naming trends last year. Bode raced ahead 645 spots, from number 1,428 in 2013 to number 783 in 2014. This might have had something to do with the Winter Olympics in early 2014, where Bode Miller continued his outstanding alpine skiing career by collecting his sixth Olympic medal. Not only is he the most successful male American alpine skier of all time, he is considered by many to be an American hero. The second fastest riser for boys was Axl, a nod to both rock legend Axl Rose of Guns N’ Roses and Axl Jack Duhamel, son of Stacy Ann “Fergie” Ferguson and Josh Duhamel. For girls, Montserrat, the lead character in a very popular Latin soap opera, was number two, joined by another Monserrat (spelled just one letter differently) at number three. For all the top baby names of 2014, go to Social Security’s website, www. socialsecurity.gov.
Here are the top 10 boys and girls names for 2014: BOYS GIRLS 1 Noah Emma 2 Liam Olivia 3 Mason Sophia 4 Jacob Isabella 5 William Ava 6 Ethan Mia 7 Michael Emily 8 Alexander Abigail 9 James Madison 10 Daniel Charlotte
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11 Weight-Loss Programs After 1 Year: Which Work?
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mong commercial weight-loss programs, Weight Watchers and Jenny Craig show the strongest evidence that they can help dieters keep weight off for at least 12 months, a new study suggests. Researchers found that after one year, Jenny Craig participants lost an average of 4.9 percent more weight, and people enrolled in Weight Watchers lost an average of 2.6 percent more weight than people who either dieted on their own, were given printed advice about weight loss or received a few sessions of health education and behavioral counseling. The study showed that for the majority of commercial weight-loss programs out there, researchers don’t know whether they work, said lead author, physician Kimberly Gudzune, an assistant professor of medicine at The Johns Hopkins University School of Medicine in Baltimore. “It’s important for the public and doctors to know which programs help people to lose weight, but also which ones help to keep it off,” Gudzune said.
Weight-loss success
In this review study, the researchers looked for published studies on weight-loss programs that were rigorous, long-term randomized controlled trials, which are considered the highest-quality data to evaluate whether a program works. The researchers included only studies that were at least 12 weeks long
and were based on comprehensive weight-loss programs, meaning the programs emphasized nutrition and also offered behavioral counseling or social support, although they may or may not have focused on physical activity. Only 39 studies of 11 weight-loss programs met the researchers’ criteria to be included in the review. The 11 programs evaluated included Weight Watchers, Jenny Craig, Nutrisystem, Health Management Resources (HMR), Medifast, Optifast, Atkins, Slimfast and three Internet-based offerings (The Biggest Loser Club, eDiets and Lose It!). Other programs that were not included had not done rigorous studies, the researchers said. “I had hoped more programs had done more rigorous long-term trials in the 10 years since the last review study on this topic had been done,” Gudzune said. Among the 11 programs, only the people who participated in Jenny Craig or Weight Watchers achieved significant weight loss that was sustained for at least 12 months, Gudzune told Live Science. The findings, which were published April 6 in the journal Annals of Internal Medicine, also revealed a few other programs with promising results early on, such as at three or six months, but they lacked research on whether the weight loss was sustained after one year on the program.
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
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
Excellus Wants to Give You $2.66 Million
M
ore than 13,600 individuals and companies in New York state have forgotten more than $2.66 million in checks issued by Excellus Health Plan, including by its d.b.a., Excellus BlueCross BlueShield (BCBS). This isn’t money left in their pockets, but is in the form of unclaimed checks issued in 2011 to members and providers. A complete list of names of people and companies with checks to claim is available on the company’s website at excellusbcbs.com/forgottenfunds. Every year, the state requires insurers like Excellus BCBS to make a list of unclaimed checks that are at least three years old. The names are then placed in advertisements in local papers in an attempt to find the people who have money to claim. If the property is not claimed by the end of August, the money is then turned over to the Comptroller of the State of New York. “This is money that was paid for claims or refunded premiums. If the money remains unclaimed it will go to
the state,” said Christopher C. Booth, president and chief executive officer. “It rightfully belongs to our members or providers and we want to make sure they have one more chance to claim it before it goes to the state.” Most of the funds that have yet to be redeemed were allocated to Excellus BCBS members and providers. Checks may not have been cashed for a number of reasons. The member may have moved and not left a forwarding address, a member may have died, or the member simply forgot about the money. To claim a check prior to Aug. 31, email www.excellusbcbs.com/ wps/portal/xl/our/contact/ or call the phone number on your member identification card. If you are no longer a health plan member, or if you are calling on behalf of the estate of a family member, call Excellus BlueCross BlueShield: 1-877-757-3850. Please note that checks will not be mailed to claimants until after Aug. 31.
Preventing early childhood vision problems
T
he Association for the Blind and Visually Impaired (ABVI) has received a $2,500 grant from Excellus BlueCross BlueShield to support its early vision screening program. The program helps identify children aged 6 months to 5 years old who may have potential blinding disorders. “Vision loss in preschool-aged children threatens their ability to learn how to read and develop to their full potential,” said Kimberly Lawrence, coordinator for vision wellness and preventive services at ABVI. “Parents and teachers of children struggling in school may pinpoint them as having a learning disability when they’re actually having problems seeing.” The early vision screening program is often more effective than a screening performed in a doctor’s office because it requires minimal response from the child, said Lawrence. Unlike traditional screening methods such as reading off an alphabet chart or picture cards, the program uses a machine to photograph a child’s eyes. Almost 2,000 children
were screened last year. On average, 20 percent of children do not pass the screening. When this happens, ABVI gives parents a list of local eye doctors who see children under the age of five and recommends they schedule an appointment. This program has helped identify eyes turning in or out, cataracts, tumors and the simple need for glasses. “We’re helping to improve the quality of life in our youngest community members,” said Robert Thompson, vice president, community health engagement, Excellus BCBS. “ABVI’s early vision screening program gives children an opportunity to see more clearly and succeed in their earliest developmental years.” The Association for the Blind and Visually Impaired early vision screening program is a free service and is provided at local child care centers, preschools and community centers. For more information about the program, child care centers and families can call 585-697-5738.
Serving Monroe and Ontario Counties in good A monthly newspaper published by
Health Rochester–GV Healthcare Newspaper
Local News, Inc. Distribution: 30,000 copies. To request home delivery ($15 per year), call 585-421-8109.
In Good Health is published 12 times a year by Local News, Inc. © 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
Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Ernst Lamothe Jr., Chris Motola, George W. Chapman, Kristina Gabalski, Jennifer Faringer, Mike Costanza, John Addyman • Advertising: Donna Kimbrell, Marsha Preston • Layout & Design: Chris Crocker • Officer Manager: Alice Davis No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
June 2015 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Members of Fairport Nonprofit Traveling to Bolivia
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eaders of the Fairport-based AAVia Foundation for the Health of Bolivian Children traveled to Bolivia May 27 to work with their partners and document their successes. They will remain in the South American country until to June 10. Bolivia, high in the Andes Mountains of South America, is one of the poorest nations in the western hemisphere. The Bolivian organizations work with the AAVia Foundation to receive funding and medical supplies necessary to improve children’s health. The Pucarani Nursing School, located in a rural province outside of the capital city of La Paz, is one of these partners. The school has created a year-long hand-washing initiative, which teaches the importance of hand hygiene to over 500 students in elementary schools around the province. “Improving hand hygiene is one of the easiest ways to prevent infections,” says Timothy Malia, medical director and co-founder of the AAVia Foundation. “The goal is that by teaching kids these habits, their communities will become healthier too.” Another partner of the AAVia Foundation is Hospital Juan XXIII, a hospital located in a poor section of the city of La Paz. The AAVia Foundation is providing needed medical equipment for the hospital’s neonatal unit. AAVia Foundation team members will be blogging and posting on social media platforms throughout the trip. “Our trip is to document the work our partners are doing,” says Mackenzie Malia, the president and co-founder of the nonprofit. “We’ll bring Bolivia back to our friends and partners in America.” Information about the AAVia Foundation can be found at www.AAViaFoundation.org, which includes a blog feed, as well as on their Facebook page, where they will post updates about the trip and their work.
CALENDAR of
HEALTH EVENTS
June 2
June 20
Audiologists to present seminar at HLAA
Workshop to discuss ways to cure allergies
People with hearing loss are invited to take part in the two meetings Hearing Loss Association, Rochester chapter, is sponsoring on June 2 at St. Paul’s Episcopal Church, East Avenue at Westminster Road, across from George Eastman House. The daytime program “Ask the Audiologist” begins at noon. “Bluetooth Technology and Hearing Aids” starts at 8 p.m. The informative “Ask the Audiologist” presentation is completely impromptu and unrehearsed. Participants are asked to bring the questions about hering aids, deafness and new hearing technology to a panel of audiologists. Audiologists who will field the questions are Peter Hart, with Hart Hearing Centers; Christy Monczynski Hopson, director of clinical services, audiology department, University of Rochester Medical Center; and John Salisbury, Clifton Springs Hearing Center. “Bluetooth Technology and Hearing Aids” with audiologit Kristen Nolan, begins at 8 p.m. She will explore different bluetooth options for those wearing aids in addition to bluetooth assistive devices. Nolan is a clinical audiologist with Sounds for Life. She has over 15 years of experience as an audiologist in the Rochester area. The 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.
Deb Pecora of Health in Harmony will present the workshop “Cure Your Own Allergies” from 9 a.m. – 2 p.m. June 20 at Lori’s Natural Foods, 900 Jefferson Road in Rochester. The class will include information on the nature of allergy and tolerance, training in muscle testing for allergy or tolerance as well as the allergy-tolerance tapping procedure to balance the energy system in the presence of the allergen. Manual provided. For more information and to register for this class, call 585-443-0585. Students can bring their own lunch or purchase food at Lori’s.
June 6
Friendly Home hosts a USO-inspired event Friendly Home will host a USO-inspired event, the Boogie Woogie Bugle Bash, featuring Whiskey 7, a restored troop carrier that participated in the D-Day invasion and other WWII planes on the 71st anniversary of D-Day. The event will take place from 6 – 10 p.m., Saturday, June 6, at JetSmart Aviation Hangar, located at 1205 Scottsville Road, Rochester. Cadets will be in early 1940s uniform while Gap Mangione and the USO-inspired performers of New Orleans, the Victory Belles, provide live entertainment throughout the evening. The evening’s emcee is Rochester’s Rich Funke. All proceeds will benefit Friendly Home. Tickets are $150 per person. For more information and to purchase tickets, visit friendlyhome. org.
June 21
Vegan group to sponsor meeting, potluck dinner The Rochester Area Vegan Society will hold a meeting that will address vegan cooking. Titled “Fresh, Fast, and Frugal: Cooking and Meal Planning Tips from a Panel of Experienced Vegan Cooks.” The meeting will address several issue revolving vegan cooking. A question and answer period will follow. The event will be held from 5:30 – 7 p.m., Sunday, June 21, at the Brighton Town Park Lodge, 777 Westfall Road. Participants are invited to a vegan potluck dinner. No animal products (no meat, poultry, fish, eggs, dairy products or honey) are served. Participants are asked to bring a dish with enough to serve a crowd, and a serving utensil. Call 234-8750 for help or email rochesterveg@gmail.com. Dinner is free to members and $3 for guest and non members.
June 23
Fibromyalgia group holds meeting in Rochester The public is invited to attend a support group meeting sponsored by the New Fibromyalgia Support Group from 6 – 8:30 p.m. Tuesday, June 23, at Westside Family YMCA, 920 Elmgrove Road in Rochester. Sandra Fischer Kierecki, a qualified therapeutic touch practitioner and teacher, will discuss the healing properties that energy has upon our health. Kierecki is also a certified midwife and registered nurse. Classes are small and participants are urged to register three days ahead by emailing fibro123.wellness.programs@gmail.com or calling 752-1562. The New Fibromyalgia Support
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
Group meets at 6 p.m. every fourth Tuesday of the month, always at Westside YMCA. For more information, visit www.newfibrosupport.com.
July 8 – 10
Free bereavement camp for children Children aged 7 through 15 who are adjusting to the death of a loved one are invited to a free day camp this summer. Camp Heartstrings / Camp Dreams will run from 1 – 5:30 p.m. July 8 through July 10 on the campus of Nazareth College. Professionally trained bereavement social workers, interns and volunteers will work with the children to promote understanding, acceptance, hope and healing through a comprehensive program of activities such as crafts, yoga, music, pet therapy, games and summer fun. Through this program, children will develop coping skills for handling and expressing grief, feel safe while expressing their grief, and realize other children struggle with the same emotions. There is no charge to attend, but space is limited. For more information, visit www.VNSnet.com and click on “Bereavement” under the “Hospice Care” tab or call Michele Allman at 585-787-2233, ext. 8241. Camp Heartstrings / Camp Dreams is presented by Visiting Nurse Hospice, Dreams from Drake, Pittsford Youth Services and Nazareth College.
July 25-30
Deaf and hard-of-hearing camp at RIT Deaf and hard-of-hearing girls and boys who are interested in science, technology, engineering and math and entering 7th, 8th or 9th grades in September are encouraged to attend “TechGirlz” or “TechBoyz” summer camps at Rochester Institute of Technology’s National Technical Institute for the Deaf, July 25‑30. TechBoyz and TechGirlz camps are designed to help students learn about and consider careers in science and technology. Through hands-on activities, campers will explore chemistry, computers, engineering and science; learn to build their own computer; and command a simulated mission to Mars. They also will meet other students with similar interests and participate in social activities. Camp classes—held in English and in sign language—are certified by the New York State Department of Health and incorporate National Science Education standards. The cost for the week-long camp is $700 and includes tuition, housing in a campus residence hall, and meals and snacks. Limited scholarships are available based on financial need. Parents are invited to opening and closing activities. For more information or an application, go to www.rit.edu/NTID/TechGirlzNR or www.rit.edu/NTID/TechBoyzNR, or call 585-475-7695 (voice), 585-286-4555 (videophone) or email TechGirls@ntid.rit.edu or TechBoyz@ ntid.rit.edu.
Reach thousands of health consumers, providers. 35,000 copies distributed evey month.
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Water or Sports Drink? What to do to recover from working out By Deborah Jeanne Sergeant
D
o you need a post-workout snack or drink? That depends on how strenuously you workout. If you stroll the mall for an hour, you’re probably fine with just drinking water during and afterwards. You’ve probably not depleted your resources enough to warrant a post-workout snack or shake. Aside from other health conditions, snacking at this point would undo the calorie-burning benefit of the walk. Unless you’re training for a marathon or other serious training, “a protein shake after just adds calories and likely extra weight down the road,” said Daniel Day, primary care and sports medicine physician with Rochester Regional Health System. However, if you work out several days per week with strenuous cardio training and resistance exercise, Day recommends a small snack beforehand. Your next meal post-workout should
include “carbohydrates, protein, vegetables and healthful fats. “I get a lot of questions about sports drinks, protein powder, creatine, and supplements,” Day said. “At the end of the day, most people are looking to stay healthy and fit. If you have a good sweat for more than an hour, you may need a sports drink but most people need just water.” If you regularly work out hard and you don’t have a snack before a workout, you may need one afterwards. Include carbohydrates, protein and a healthful source of fat. This could include apple slices spread with one tablespoon of peanut butter; a small handful of almonds and a banana; one scrambled egg with one slice of toast and jelly; or one-half cup trail mix with nuts and dried fruit. Day said that there’s no supplement or post-workout diet that causes dramatically improved muscle building or athletic performance.
“Live a healthy lifestyle with good sleep hygiene, stay active and work out throughout the week, eat a well-balanced, healthful diet,” Day said. “Cut out things like smoking and lots of caffeine consumption.” Rachel Reeves, clinical dietitian in food and nutrition at UR Medicine’s Strong Memorial Hospital, stresses adequate fluid intake for post-workout recovery. Reeves works with UR Medicine Sports Medicine patients. “It is critical to recovery,” Reeves said. “Just a 2 percent fluid loss can affect performance. Drinking eight
ounces or more of water after a workout can help replace what was lost through sweat. It is also important to be well hydrated before, and to drink during a work out.”
Healthcare in a Minute By George W. Chapman
Hospital report card Medicare has developed a five-star hospital ranking system. The number of stars a hospital earns is based on how it did according to an 80-question survey of patients who received care, inpatient or outpatient, within the last six months. The survey covers 3,500 Medicare certified hospitals. Hospitals are graded on pertinent issues like how they were treated by business and clinical staff, communication with physicians and other caregivers, medication administration and instructions, and overall care received. The survey does not inquire about the non-clinical amenities or lures that have little to no relevance on the quality of care received such as valet parking, executive chefs and free cable TV. So far, only 7 percent of hospitals have received five stars. Forty percent of hospitals garnered three stars. Fortunately, only 3 percent of hospitals received just one star. Thirty percent of a hospital’s Medicare reimbursement is based on this survey. Hospital ratings are updated quarterly. While critics argue that no survey can accurately reflect the quality of care received, advocates argue that, nevertheless, hospitals need to understand that the consumer is always right.
Individual insurance mandate Fifteen million Americans had an individual policy last year, a 46 percent increase over 2013, according to the Kaiser Family Foundation. The report does not give the breakdown between policies purchased on the exchange or directly from carriers. Fifty percent of the increase last year came from
California, Florida, Texas and Georgia, which coincidentally are some of the states with the highest uninsured rates. More individuals would have purchased insurance if the penalty for not having insurance was more onerous. It’s still far cheaper to pay the penalty vs. buy insurance. The individual mandate penalty for not having insurance in 2014 was only $95. It increased to $325 this year, which still a bargain compared to buying insurance, even if one qualifies for a discount based on income.
Wellness Incentives The ACA affords employers the opportunity to offer financial wellness incentives to their employees. Participation in wellness programs (like weight loss and smoking cessation) must be voluntary. Participation cannot be mandatory. Participating employees (family members are ineligible) can receive as much as a 30 percent discount on their individual premium. US Surgeon General Vivek Murthy called for a prevention-based society in a recent Washington Post story. He suggested that all institutions — including government, private employers, schools, churches, providers, etc — need to emphasize wellness and physical activity. Healthiness must become part of our culture.
ACO growth slows While the growth rate slowed last year, there are now about 600 accountable care organizations (ACO), putting 70 percent of us in a market served by one of them. 5.6 million Americans, or 11 percent, receive care from an ACO. The majority of ACOs are still Medi-
care sponsored. Commercial ACOs are slower to develop.
Transformative technology
Though long overdue, healthcare innovation and technology has exploded onto the scene in just the past few years. Mahek Shaw, MD, the founder of Symplexi, says consumers will benefit from three technological advances in particular. First, cloud-based electronic records are proving to be more accessible, agile, adaptable and flexible for both consumers and providers. Epic and Cerner currently dominate the client-server based electronic record systems. Shaw predicts that within five years they will be outmoded. Second, patient centric devices like TEDMED, Jawbone, Fitbit and SXSW will transmit your data directly to your provider, allowing the doctor-patient relationship to be more of a partnership. Third, big data analytics will progress from improving operations and lowering costs to actually improving the care of the population being served by the provider organization. All of this cannot come quickly enough as both consumers and physicians are frustrated with the amount of paperwork and red tape involved in receiving and delivering care.
Impact of hospital closures According to a study published in Health Affairs, hospital closures do not significantly impact hospitalizations or mortality rates of the local residents. The Harvard researchers looked at 195 closures between 2003 and 2011 using Medicare data. Closed facilities tended to be for profit, in the South and urban. According to the study, the impact of most of the closures was negligent be-
June 2015 •
cause in most urban/suburban markets there is more than an adequate inventory of beds as opposed to rural/isolated areas. Most of the NYS hospitals in danger of closing are within 30 minutes of another facility.
Opposition to ObamaCare losing steam There have been over 50 attempts to repeal the Affordable Care Act. For several reasons, opposition has become less vociferous in Congress. First, 16 million people would lose their insurance. Second, the early glitches in enrollment have been fixed. Third, employer-sponsored plans remain strong with 93 percent of full time workers eligible for employer-sponsored coverage and 70 percent choosing to participate which is unchanged since 2013. Fourth, insurance premiums have increased an average of only 6 percent since 2013. Fifth, younger people are enrolling. 3.4 million are young adults under 26 elected to stay on their parent’s plan. Sixth, dire predictions of providers being overwhelmed with an influx of newly insured sick patients has not happened. Finally, the public is better educated and the fear of the unknown dissipates. 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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Meet
Your Doctor
By Chris Motola
Roan Glocker, M.D Highland doctor talks about vascular surgery and how it is saving lives
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Q: Tell me about your specialty and teaching duties. A: Vascular surgery encompasses care for patients who have problems with artery, vein and lymphatic disease. We see everything from hardening of the arteries to aneurism disease, where the arteries are bigger than they should be. Then on the venous side, we see patients for blood clots or DVT (deep vein thrombosis). Myself and my partners are all clinically active taking care of patients, but we also have a teaching responsibility with our residents. We have a vascular surgery residency program. So they come to us after graduating in medical school, we work with them for five or six years and then, at the end of that, they’re licensed to practice vascular surgery just like we are. We also do some teaching for the medical students of the University of Rochester. Q: Is your typical patient experiencing heart issues? A: We do have a lot of patients with heart trouble. It’s still the No. 1 killer in America. Peripheral vascular disease is kind of an extension of that, so it’s a similar patient population. We, ourselves, do not do heart disease. So we’re treating all vascular disease outside of the heart itself. Our typical patient is probably someone who has leg pain or wounds due to inadequate blood flow. Aneurism patients are often asymptomatic and picked up on incidentally from an unrelated exam, like a CAT a scan. We also see a lot of cerebrovascular disease, so patients who have had strokes due to the hardening of the arteries that lead to the back of the brain.
stenting of the legs. And if that doesn’t work, then we’ll perform a bypass surgery, where we’ll reroute the blood flow around the blockage and to the tissues that need it. Q: What are the major risk factors in developing peripheral vascular disease? A: The biggest modifiable risk factor is smoking. We also see a lot of patients with diabetes. It really affects the peripheral vasculature in an adverse way. Then there’s high blood pressure, high cholesterol, those kinds of things. Family history to a smaller extent, but particularly with regard to aneurisms. If you have a family history of aneurisms, you should be screened at a younger age. Q: As a surgeon, how often are you in contact with patients? Do you get to develop a relationship with them? A: Sometimes people get sent to us with the idea that they have arterial disease when they do not, but for patients with arterial disease, it’s a systemic process that occurs all over the body. And while risk factor modification can affect the progress of the disease, we don’t yet have a cure or anything that makes the disease regress. Once they have arterial — or vascular or aneurism disease
Q: What are some of the symptoms that a part of the body is not getting enough blood? A: The legs are the most common. It can include pain or limping after walking a certain distance. The next level up is pain all the time, even when resting. It’s similar to a heart attack, only the muscle affected is in your leg, rather than your heart. And the worstcase scenario is when patients don’t have enough blood flow to maintain their tissue integrity. They may spontaneously develop wounds on their extremities or be unable to heal a superficial wound they receive from something as minor as wearing new shoes. Our goal is to improve their peripheral blood flow either with peripheral interventions like angioplasty or
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
— then they’re usually our patient for life. We’ll see them on an annual basis. We practice a lot of medicine, not just surgery, which is something I really like about the specialty. There’s significant component that includes a lot of patient education and getting the patients to understand what the disease is all about. And every patient we operate on, we’ll see on at least a yearly basis to monitor the intervention and see how it’s doing down the road. Q: How good are the outcomes, typically, for this kind of surgery? A: Well, it depends what the disease process is and what type of patient it is occurring in. In general the outcomes are very good. We’ve made big strides, especially recently. So taking cerebrovascular disease for example — our outcomes for stroke prevention with surgery are excellent. If you have a patient who has had a stroke-related to carotid artery disease, their risk of having another stroke within two years is about 26 percent. With surgery, we can drop that down to around 10 percent. In terms of vascular aneurism repair, what used to only be able to done with an open surgery that took a week to 10 days to recover from, we can now do with two small incisions near the groin. Those patients can usually go home the day after surgery. Q: As far as education goes, how do you get your patients to really understand what’s going on with their bodies and what, if anything, they can do about it? A: It’s certainly a struggle, particularly smoking cessation, as well as adequate diabetes control. But when someone’s faced with needing a major operation or even amputation if they don’t get it under control, it can be a major wake-up call. Q: What about your specialty appealed most to you? A: I really like that it gives me the opportunity to operate all over the body. Everything from the neck to the abdomen, to the extremities. Most are specialized in one organ system or another. I think the technology that we’re using and have access to is really neat. We do all aspects our field, everything from diagnoses, to surgeries, to interventions, to follow-ups. A lot of the other fields surgeons will only do surgery. Q: How does being a younger doctor affect your relationship with your patients? A: Only once or twice has someone said they thought I was too young to take care of them. Most people, if you spend the time to listen to their concerns, are happy to have someone take care of them, regardless of your age. I’m relatively young, but seven years [in practice] is a pretty long time.
Lifelines Name: Roan Glocker, M.D., M.P.H. Position: Assistant professor of vascular surgery at Highland Hospital Hometown: Rochester Education: Tulane (undergrad), Dartmouth (graduate), SUNY Upstate Medical University (M.D.) Affiliations: UR Medicine hospitals and facilities Organizations: Society of Vascular Surgery Family: Married to Miranda Harris-Glocker, M.D., three children Hobbies: Baltimore Orioles and Buffalo Bills fan, travel, outdoor activities
Brockport Nurse Publishing New Book — on Diabetes URMC nurse launching “Diabetes, Easy Does It! A Simplified Guide to Managing Diabetes,” fourth in a series of easy-to-read books on medical issues By Kristina Gabalski
D
o you know where your appendix is? How about your spleen or gallbladder? Why is your infant pulling his ear? What can you do to help your aging parents continue to live full, independent lives? Do you have to change your entire diet if you’ve been diagnosed with diabetes? All of these questions and more, along with concise, easy-to-understand answers, are part of a series of books written by Kathleen Fink, a New York state-certified emergency nurse at University of Rochester Medical Center / Strong West’s emergency department in Brockport. Fink began publishing her series of full-color, illustrated paperbacks in 2010 after experiencing first-hand the public’s lack of basic medical knowledge while she worked as an emergency department nurse. “Until they’ve faced a particular ailment or injury, they don’t know a lot about the body or how it works,” Fink explains. The series of medical guides is directed especially toward non-medical people who can use them as an easy reference when medical issues arise. “The main purpose is to get information out there,” she says.
Kathleen Fink is a New York statecertified emergency nurse at University of Rochester Medical Center / Strong West’s Emergency Department in Brockport. She began publishing her series of fullcolor, illustrated paperbacks in 2010 after experiencing first-hand the public’s lack of basic medical knowledge. She is now publishing her fourth book, “Diabetes, Easy Does It! A Simplified Guide to Managing Diabetes.”
“It’s My Baby! What Do I Do? A Dozen Solutions to Baby Emergencies,” was Fink’s first book published in 2010. It features information and illustrations regarding common infant health issues such as fever, head lacerations and vomiting. The book helps parents assess whether or not a situation calls for a visit to the ED or if it can be handled at home. “It’s My Baby!” is also available in a Spanish edition that has been used in outreach programs by local agencies and SUNY campuses that assist migrant groups. “The Golden Years: Keeping up the Fight, Helping Seniors Maintain Well-Being,” Fink’s second book, was published in 2011 and covers various topics of concern to mature adults as they age, including housing options, emergency preparedness, diet regimes and general health and fitness considerations. The book can be used as a resource for the elderly and their adult children/caregivers.
Learning body parts
In 2014, Fink published, “Where’s My Appendix? A Simplified Guide to the Human Body and Common Medical Disorders.” This third book in the series helps anyone to understand the various body systems and what happens when things go wrong. Included are detailed color illustrations by Fink as well as X-ray images depicting, among other things, what pneumonia and a stroke look like. Fink notes medical terminology is often a barrier for patients. “Medical lingo can differ from common terms,” she says. “A fracture is a break, an abrasion is a scrape, and a mass is a lump. It can be confusing to the general public.” She notes that “Where’s My Appendix?” can also serve as a helpful learning tool for students and emergency medical technicians. Her latest endeavor, “Diabetes, Easy Does It! A Simplified Guide to Managing Diabetes,” is due out in the summer and Fink predicts it may be her most popular book. “More and more people are diagnosed with the disease,” she says. Included is a description of diabetes, a discussion of diet, how diabetes affects body organs and chemistry and medications prescribed for diabetes management. Books range in price from $11.99$13.99 (plus tax) and are available at the Liftbridge Book Shop in Brockport and via Fink’s website: www.simplyhealth.biz. Evenhouse Printing, LLC, in Hamburg publishes the books and volume discounts are available. Fink says she plans to turn the books into e-books through Kindle Direct Publishing. June 2015 •
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RSD is a private, caring school where deaf and hard of hearing children, newborn to age 21, thrive. Education programs are provided at no cost to families. Skilled RSD professionals provide students with direct access to communication in a rich and vibrant bilingual - American Sign Language and English - environment. Students at RSD also receive individual attention, as they learn and grow together in safe and inclusive surroundings.
Infant, Early Childhood, K-12 School and Sign Language Learning Programs Call: 585-544-1240 u Visit: www.RSDeaf.org u E-mail: info@RSDeaf.org 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
There’s no place like home: Make it your own!
W
hen Dorothy in the “Wizard of Oz” closed her eyes, clicked her heels and said wistfully, “There’s no place like home,” she was hoping to be transported back to that place of security, warmth, and love . . . and into the arms of her adoring Auntie Em. Ahhh, the comforts of home. Creating a soothing and safe haven for myself after my divorce was an essential part of starting my life over as a woman on her own. Intuitively, I knew I needed to walk through my new front door and into my very own “warm hug,” a place where I would be embraced and inspired by all things familiar and friendly. So I set out to create a retreat — a personal sanctuary where I could feel safe and sound. It was what I needed at the time. Since then, I’m delighted to share that my home has evolved into much more than just a nurturing place. My living space became a pallet of personal expression where I gained a true appreciation for the value of having a “room of one’s own.” With yourself as your sole guide and decorator, your kitchen, living room and bedroom can become portraits of your values, your loves and
your life. Making a home your own becomes an adventure in autonomy and a chance to explore and express — perhaps for the first time in your life — your own tastes unleashed, without compromise. It can be liberating. Energizing. Even healing. One of the first things I did when I bought my own home (after I tore out the grass green shag carpet!) was to frame and display photographs of my family and friends. I wanted to see their faces when I entered a room and to be reminded of good times and the love that surrounds me. This was just the beginning of a series of decisions that made living alone in my own space not just pleasant, but lovelier and more wondrous than I could have imagined. Paying attention to your surroundings can have an immediate and lasting impact on how you feel about yourself and about living alone. What better time than now to put out the welcome mat and make your home
your own. Here are some tips: Follow your heart. You’re on your own now. There’s no one around to second guess your decisions or rain on your preferences. You are free to express yourself in the colors you choose, the fabrics, the art and the accessories. Don’t know where to start? Look at your wardrobe. There, you’ll find a reliable reference for your style and tastes in color. Banish the negative. If something makes you feel bad when you look at it, either get rid of it or repair it. Ratty dishtowels, old lampshades, faded curtains: Their very existence in your home can dampen your mood and erode your self-esteem. Don’t underestimate the negative power of unsightly or outdated objects. Exhibit the positive. On the other hand, surround yourself with images and objects that lift your spirit and reinforce who you are or want to become. Photos of loved ones work for me. So do fresh flowers and original pieces of
art I collect on my travels. I believe in the symbolic nature of objects and find inspiration in what fills my home. Reduce the clutter. Closets or drawers crammed with useless stuff, dark corners, cramped spaces — all of these contribute to negative energy, according to the tenets of Feng Shui, the ancient Chinese practice of organizing space to achieve harmony and balance. I’m a true believer in this concept, and it’s made a positive difference in my life. A good book on the subject is “Clear Your Clutter with Feng Shui” by Karen Kingston. Check it out. Decorate with your senses. Is the hollow sound of loneliness bouncing off your walls? Is there a musty smell wafting up from the basement? Are your cabinets sticky? When I started paying attention to more than just visual aesthetics, my home became even friendlier territory. Transform your solitary space by creating a beautiful atmosphere filled with lovely music, pleasing aromas, and clean surfaces. Your home can become an oasis of independence and autonomy — a place that’s unconditionally yours, absent of compromise. Claim it. Fill it with who you are. Because once you make your personal space your own . . . there’s no place like home! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, NY. For information about her upcoming workshops or to invite Gwenn to speak, call 585-624-7887 or email: gvoelckers@rochester.rr.com.
A Pregnant Woman Never Drinks Alone
If you're pregnant, don't drink. If you drink, don't get pregnant.
Fetal Alcohol Spectrum Disorder is the leading known cause of preventable developmental disabilities.
DEPAUL Page 10
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
National Council on Alcoholism and Drug Dependence — Rochester Area (585) 719-3480 • www.ncadd-ra.org
SmartBites
By Anne Palumbo
The skinny on healthy eating
Big Reasons to Eat More Black Beans
S
o many beans, so little time: it’s the feeling that washes over me whenever I’m in the canned-goods aisle of the grocery store. And while I’m crazy about all beans, my heart belongs to the black bean. There’s just something about the taste and texture of this versatile little bean that bowls me over. Despite its small size, black beans are nutritional powerhouses. In fact, America’s top heart hospital, the Cleveland Clinic, cited this bean first in its best four legumes for boosting heart health. I’m keen on this bean because it’s particularly high in nutrients I care about — protein, fiber and antioxidants — and admirably low in substances I want to avoid — saturated fat, cholesterol and sodium. Black beans are an excellent protein source, with one cup providing 15 grams or about 30 percent of our daily needs. Although it’s not a “complete” protein (meaning it does not have all nine essential amino acids), black beans can easily be paired with a grain, such as rice, to equal one. A workhorse nutrient, proteins function as building blocks for bones, muscles, cartilage,
diseases. Black beans teem with folate, arguably one of the most important B vitamins for reducing risk of cardiovascular disease. We’re talking nearly twothirds of our daily needs in one cup! Hearts love folate because it effectively lowers levels of homocysteine, an amino acid in the blood that can lead to dangerous blood clots, hardening of the arteries, and heart disease. As for carbs, yes, black beans do have carbs, but they’re the goods ones — the complex carbs that provide a steady stream of energy because they take longer to digest. And as for calories, black beans rock with only 220 calories per cup. Swimsuit season, here we come!
Helpful tips
skin, blood, enzymes and hormones. Looking to add more fiber to your diet? One cup of black beans has a whopping 15 grams or about 60 percent of our daily needs (a little less for men). Since black beans contain both soluble and insoluble fiber, we’re looking at a mighty bean that not only improves digestive-tract functioning and prevents constipation, but one that also lowers cholesterol and blood-glucose levels. Thanks to its rich black coat, black beans are antioxidant superstars, boasting more antioxidant activity than any of its bean brethren and providing levels that rival those found in apples, grapes and cranberries. Antioxidants neutralize damaging free radicals and may help lower the risk of heart disease, cancer, and other age-related
In general, canned beans have the same amount of nutrients as dried, but are usually higher in sodium. Look for canned beans with no added salt; some organic brands have less. Thoroughly drain and rinse canned beans before using. Cooked beans, whether prepared from the dried state or retrieved from a can, can be covered and chilled for up to five days.
Health Tex-Mex Black Bean Burgers
By Jennifer Faringer
A
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.
1 cup cooked white long-grain or brown rice 2 15-ounce cans black beans, drained and rinsed 2 garlic cloves 1 medium shallot, chopped 1 red or green jalapeno (optional) 1 tablespoon prepared barbecue sauce
Expert: No amount of alcohol consumption can be considered safe at any time during pregnancy
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How to Seek Help
For more information on fetal alcohol spectrum disorder, the FASD Parent group or to schedule a community presentation on FASD, contact Jennifer Faringer, director of DePaul’s National Council on Alcoholism and Drug Dependence-Rochester Area at 585-719-3480 or visit our website at www.ncadd-ra.org. Jennifer Faringer is the director of DePaul’s NCADD-RA (National Council on Alcoholism and Drug Dependence-Rochester Area). She hold a master’s degree in education and is a credentialed prevention professional, with a gambling specialty (CPPg).
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the Snyders said. “When others stare at you and your child with disbelief in his antics, you learn to ignore,” the couple adds. “When family members and others give you advice on parenting you smile and pretend to heed their expertise. We adore our son and pray he has many opportunities in his future. We would never trade a day in our lives with Aleks, but so wish we all didn’t have the tremendous hurdles to overcome.”
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tion by the U.S. Surgeon General. As the effects of prenatal alcohol exposure occur on a continuum, we refer to this continuum as fetal alcohol spectrum disorder (FASD). The more a woman drinks during pregnancy, the greater the risk of effects and the greater the potential range and severity. While heavy drinking is linked to the most serious risk, moderate consumption can also be harmful. Occasional drinking has also been linked to more subtle effects such as learning and behavior problems like attention and hyperactivity disorders, and problems with judgment and understanding cause and effect. NCADD-RA hosts a FASD Parent Networking and Support group meeting. Participants Eileen and Mike Snyder adopted their son Aleksandr from Russia when he was 10 months old. He was born with fetal alcohol syndrome (FAS) and is now 17 years old. They say the journey between then and now has been a roller-coaster ride. “Having a child with FAS is not for the faint of heart,” said the Snyders. “Being told that he had not been exposed to alcohol prenatally, only to find out differently, was difficult for us.” Having the proper supports in place and being a strong advocate has helped make everyday life possible when dealing with a child with FAS,
Preparation
Cook rice according to package directions (1/3 cup should equal 1 cup cooked rice) and let cool. Set aside 1/2 cup beans. In food processor, pulse garlic, shallot and jalapeño until minced. Add barbecue sauce, chili powder, cumin, and remaining beans to mixture and pulse until a chunky purée forms. Transfer purée to a large bowl and mix in egg white, rice, and reserved beans; season with salt and pepper. Form mixture into 6 patties about 1/2inch thick; cover and chill 1 hour (this helps bind patties so they stay intact while cooking). Heat 1 tablespoon oil in a large nonstick skillet over medium heat. Working in two batches and adding remaining 1 tablespoon oil between batches, cook patties until browned and crisp, about 5 minutes per side. Serve on buns with desired toppings. We had ours with cheese and salsa — yum!
Adapted from Bon Appetit Serves 6
Fetal Alcohol Spectrum Disorder is Preventable
mother’s alcohol use is the leading known cause of preventable developmental and cognitive disabilities. Children exposed to alcohol in utero are at risk for growth deficiencies, facial abnormalities, central nervous impairment, behavioral disorders and impaired intellectual development. Consuming alcohol during pregnancy also increases the risk of miscarriage, low birth weight and stillbirth. In 2005, the United States Surgeon General issued an advisory on alcohol use in pregnancy, which stated that no amount of alcohol consumption can be considered safe at any time during pregnancy and that the cognitive deficits and behavioral problems resulting from prenatal exposure to alcohol are life-long. If women avoid alcohol entirely while pregnant or trying to conceive, alcohol-related birth defects are 100 percent preventable. Alcohol consumption has the potential to cause damage to the baby in the earliest weeks of pregnancy, even before a woman knows she is pregnant. The long-standing position of American College of Obstetricians and Gynecologists (ACOG) is that no amount of alcohol consumption can be considered safe during pregnancy, which reaffirms earlier recommenda-
1 teaspoon chili powder 1/2 teaspoon ground cumin 1 large egg white Kosher salt, coarse black pepper 2 tablespoons vegetable oil, divided 6 hamburger buns Favorite burger toppings
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 11
A Voice for the Deaf Rochester School for the Deaf has new leader By Ernst Lamothe Jr.
classrooms, a $5 million mass notification system on campus and implementation of an ASL-based website for the schools,” said McLetchie. He views some similarities and differences in the deaf communities in Rochester and Canada.
Challenges north of border
A
ntony McLetchie was looking for a new challenge. He found it across the border. McLetchie, 45, was welcomed recently as the seventh superintendent and chief executive officer of the Rochester School for the Deaf, 1545 St. Paul St., Rochester. The school was established in 1876. He replaces Harold Mowl, 67, who led the school since 1990. Mowl will remain in an advisory role until June 30 to ensure a smooth transition. McLetchie, a Canadian-born man who is deaf, previously worked as principal at Ernest C. Drury Secondary School for the Deaf and Robarts School for the Deaf, both in Canada. “The close proximity to Ontario, Canada, and the deaf community in Rochester attracted me to apply for this position,” said McLetchie. McLetchie holds a bachelor’s degree in history and deaf studies and a master’s degree in deaf education. Rochester School for the Deaf provides deaf infant and pre-K education programs and services to about 120 deaf and hard-of-hearing children, newborn to age 21. The school’s service area covers school districts from nearby Batavia to the east, west to near Syracuse and south to the Pennsylvania state line. The school is private and supported by New York state. Deaf and hard-of-hearing children attend RSD at no cost to their families. With Rochester School of the Deaf having a long tradition of success, McLetchie has high hopes of extending that trend. “I am hoping to continue this great tradition and ensure our school continues to provide a top-notch education to our students and prepare them well for the rapidly changing society once they graduate from here,” he said. “Also, I
Antony McLetchie, 45, has recently become the seventh superintendent and chief executive officer of the Rochester School for the Deaf. He moved from Toronto in Canada to take the position. want to continue to develop a sense of support and pride with all stakeholders who support the school throughout the years.” Working as a teacher of the deaf also added another layer to his educational and administrative career. He learned much from his successful stints at Ernest C. Drury Secondary School for the Deaf and Robarts School for the Deaf. “I was fortunate to be given the opportunity to participate in and lead several major projects, such as the implementation of American Sign Language as an academic language in
“I was born in Halifax, Nova Scotia. The deaf community universally is still a strong, close-knit community, but in Canada there are challenges we are facing,” said McLetchie. “There is a higher percentage of deaf people being underemployed or unemployed, which is also a fact in the United States. They have limited access to services in Canada, such as interpreting services in some remote areas, and the fact that Canada has no video relay services, which are common in the United States.” Board members said McLetchie has a strong background in deaf education along with being an experienced teacher and administrator. “It is exciting to have an educator of Mr. McLetchie’s caliber join our team,” said RSD Board of Directors President Dr. Michael Doughty. “He is passionate about deaf and hard-ofhearing children and young adults and their education, and he brings to Rochester a wealth of experience in building a strong school culture, a well-supported teaching staff and an
CEO McLetchie with Harold Mowl, 67, who led the school since 1990. Mowl will remain in an advisory role until June 30 to ensure a smooth transition.
effective curriculum. “It was obvious that Antony has extensive educational leadership, excellent interpersonal and communication skills, and is a strong leader.” Mowl looks forward to starting a leisurely life with his wife, Mary, and spending more time with his daughter and son-in-law who live in Connecticut. He decided it was the right time to retire. “I still have good health and plenty of energy. Instead of continuing to work at my age, I simply decided that I should begin to enjoy life in new ways,” said Mowl. “I am sure we will find plenty of things to do, but I want to begin my retirement by just waking up in the morning and then deciding what I would like to do for the day.” There are many things he will look fondly back on from his more than three decades as the leader of the Rochester School for the Deaf, such as the board of directors, faculty and staff who worked to provide children with a strong curriculum and modern facility. He will also miss the interaction with students who are currently there and who have graduated. “I am always proud to see our graduates move on to new things in life,” he said. “I continue to be proud of our students and their desire to succeed in life as deaf persons. I am proud that our school continues to instill in our students a love for learning.” His students will miss him. “First, we must give heartfelt thanks to Dr. Mowl for his years of dedication and commitment to RSD,” says Brianna Di Giovanni, a high school junior and president of the Junior National Association of the Deaf RSD Chapter. “We are indeed fortunate to have him as our leader. His will be very large shoes for Mr. McLetchie to fill, and we are confident he can. And administrators will miss him as well.” “Our entire community is truly grateful for the dedication and leadership of superintendent Mowl over the past 20-plus years,” added Doughty. “He is leaving us well prepared for the future with a strong fiscal plan, a collaborative learning culture and a record of strong student performance.”
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
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Local community health center expands beyond its 30-year history of HIV/ AIDS care to deliver primary care services for all Q. What is the nature of your organization? A. With a 30-year history of providing HIV/ AIDS care, Trillium Health is a community health center where individuals receive the highest quality, barrier-free care, delivered with warmth and compassion by our committed staff. Trillium Health provides its primary care and wrap-around services all under one roof: • Primary medical care • LGBT specialty health care • HIV/AIDS care and prevention • On-site pharmacy and lab services • Behavioral health counseling and support groups • Care management and supportive services • Insurance, transportation, and housing assistance • HIV, STD and Hepatitis C testing • Narcotics overdose prevention training Q. Can you tell us more about your history and how you came to be? A. Trillium Health has been providing comprehensive and compassionate primary care since the early ‘80s. While staying true to our pioneering HIV/AIDS treatment and prevention services, we
have expanded our focus to include all individuals desiring our alternative approach to health care. Everyone is welcome, regardless of circumstance. As we grow and expand as a community health center, we seek to improve the overall health not only of each individual we serve, but also of the Family Nurse Practitioner Kristen Smith huddles with care greater community. managers before patients arrive. Q. What would others find different about you that would be helpful to know? region, we are following the practices of a comA. Trillium Health combines primary medical munity health model that eliminates barriers for care, care management and supportive services — everyone seeking a quality health care experience. all managed through a collaborative team effort Second, we are actively engaged in New York that provides a seamless experience for those we state’s End the Epidemic by 2020 (EtE2020) initiaserve. We add a unique element to the way we tive through expansion of testing to diagnose those deliver care, meeting individuals where they are with HIV, linking and retaining them in treatment, through community outreach and education. This and providing access to prevention for those who comprehensive, coordinated system helps to retain are most at risk. individuals in care, optimizes health outcomes, avoids unnecessary hospital visits, decreases We continue to build on our founding princihealth care costs, and fosters healthier communiples of courage, hope, and innovation: ties. • Courage to break down barriers to care • Hope for a healthier tomorrow for those we Q. What are your aspirations for the future? serve and for our community A. First, in seeking to improve the overall • Innovation that continues to keep us on the health of the population living in our nine-county leading edge of advances in health care delivery
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 13
Men’sHealth Prostate Cancer
Turning 35 Means Guys Should Start a Conversation About Prostate Screenings By Deborah Jeanne Sergeant
S
ince about six year ago, the American Cancer Society shifted its position on routine annual prostate cancer screenings. Now, the position is, “talk to your doctor.” “We advise men to talk with their doctor about the importance of prostate screening and understand the benefits and limitations of a prostate cancer screening,” said Jason Warschal, health systems manager for hospitals in Northern, Southern and Central New York. He said that the shift stems from concern about the limitations and liabilities surrounding prostate screening. “We want to be sure that with what tests are currently available, they really are able to decipher whether a man Warchal has prostate cancer or not and finding if it is a more aggressive cancer or not.” Currently, the prostate-specific antigen and digital rectal exam don’t identify cancer. A biopsy follow-up may or may not be able to confirm cancer. Darryl Mitteldorf, a licensed clinical social worker and chairman of the New York State Prostate Cancer
Coalition in New York City, also wants more men to discuss prostate screening, rather than requesting routine screening, and to start the conversation in their mid-30s. “Men who are younger can have prostate cancer,” Mitteldorf said. “People base it on a decade, but it could be earlier.” Typically, men are told that they should receive an initial prostate exam at age 50 or at 45 if they have risk factors such as being African-American or from a family with a close relative with prostate cancer. But Mitteldorf wants men to start the conversation at age 35. “The age 50 is a made-up number,” he said. “Starting the conversation at age 35 captures the men who would benefit from PSA testing earlier. It’s a simple message.” He feels like the multiple starting ages makes the matter “convoluted.” He also thinks that starting the conversation earlier can encourage men to actually follow through. Many men delay and avoid prostate screening for several reasons. “The biopsy itself can have a very slight risk of impotence or hospitalization, but it’s only like 3 percent,” Mitteldorf said. Should the biopsy identify cancer, men must decide if they want to have surgery to remove the prostate, radiation to destroy the cancer cells, or, if the cancer is slow-growing, take the active surveillance approach. “The treatments can cause im-
potence and incontinence and can’t guarantee to cure them of cancer,” Mitteldorf said. Some men feel uncomfortable with the invasive nature of the digital rectal exam, but beyond that aversion, practical barriers such as taking time off from work can make it difficult for men to receive a prostate exam. Despite the chances of these issues and side effects, Mitteldorf believes that taking a case-by-case approach to weigh risk factors offers men the best chances of early detection and, should they have prostate cancer, a long and healthy life. Patrick Fisher, Rochester chapter leader of Us Too, wants more men to get the message to start screening for prostate cancer sooner, including military men exposed to Agent Orange in the Vietnam era. “They’re developing a more aggressive prostate cancer,” Fisher said. “Men taking testosterone supplement or apply gels” are also at higher risk.” Since prostate cancer may or may not present symptoms, Fisher encourages more men to get screened. Men should take heart that most prostate cancers aren’t aggressive and require only surveillance. Recent advances are helping to identify more aggressive cancers. A urine test can find genetic markers that identify these cancers to give men the facts they need to make a more informed decision on the treatment options. “It could indicate the biopsy
All About Prostate Cancer According to the American Cancer Society: • Prostate cancer is the 2nd leading cancer diagnosed among men, behind skin cancer. • About 220,800 cases are diagnosed per year. • Of those, about 27,540 die from prostate cancer, or one out of 38. • Six out of 10 cases occur in men 65 years older or older. • The average age at time of diagnosis is 66. • Prostate cancer is rare before age 40. • 2.9 million men are living with prostate cancer in the United States. • The five-year survival rate is 100 percent. • The 10-year survival rate is 99 percent. • The 15-year survival rate is 94 percent.
missed the cancer,” Fisher said. “Biopsy is only taking a snapshot in time. It’s like sticking pins into a pin cushion. You don’t know if you’re hitting where the cancer could be.” Ultrasound-guided biopsy can help make the procedure more accurate. Men with elevated PSA must continue to monitor the number for the rest of their lives because even if their prostate cancer has been treated successfully, any missed cells can spread to other areas of the body. “Men have go to become their own best health advocate,” Fisher said. “Men who have had a history of prostate cancer owe it to their brothers and sons to have that conversation. It’s only beneficial to talk about it.”
FDA Ready to Lift Ban on Blood Donations by Gay Men Studies from other countries show such donations wouldn’t compromise blood supply, health officials say
G
ay and bisexual men who have abstained from sex for one year would be allowed to donate blood in the United States, under a new federal policy unveiled Tuesday. The U.S. Food and Drug Administration announced its intentions in a draft guidance that was first proposed in December. The agency said it would collect public comments on the proposal for 60 days before issuing final rules. Implementing the “one year deferral” clause for gay or bisexual men would reverse a three-decade-old ban on donations from this group that traces back to the start of the AIDS epidemic. The FDA said it was changing its policy based on data from other
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countries that show allowing such donations would not increase the risk of HIV-tainted blood entering America’s blood supply. Physician Peter Marks, deputy director of the FDA’s Center for Biologics Evaluation and Research, noted in December that some of the most compelling data for the change came from Australia, which in 2000 implemented a one-year deferral on blood donations from sexually active gay men. “These studies documented no adverse effects on the safety of the blood supply with a one-year deferral,” Marks said. Marks estimated that about half of the people now barred from donating blood under the current policy would
be able to donate under the new policy. The change will better align the FDA’s donation policy for gay and bisexual men with its policies regarding other people potentially exposed to HIV, the virus that causes AIDS, officials said. However, sexually active gay men in a monogamous relationship would
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
not be allowed to donate blood under the new policy.
Men’sHealth Untreated Low Testosterone Can Cause Serious Problems By Deborah Jeanne Sergeant
M
en, if you’re experiencing a gradual loss of libido, energy, lean muscle mass, and ambition, you may have low testosterone, a hormone imbalance. In addition to these undesirable symptoms, low testosterone can contribute to other life-changing health issues. “Men come in with profound symptoms of depression, loss of good mood, major life stress, unable to concentrate or to spend time with their family,” said Jason Donovan, physician assistant at Vitalize Medical. “They want to come home from work and just flop down on the couch. They have no energy or interest in life like they used to. “This can lead to hypertension, obesity, and not eating right. We see this all the time.” Vitalize, operated by urologist Ralph Madeb, serves clients in Rochester, Syracuse and Buffalo. Low testosterone can negatively affect diabetics. “Low testosterone leads to insulin resistance,” Donovan said. “All diabetics should have normal testosterone. It
will help their diabetes.” Donovan said that even as recently as five years ago, “a man didn’t have a clue as to what was happening and didn’t bring it up at all,” he said. Part of the reason they didn’t seek help for the group of seemingly unrelated symptoms is that “men don’t like to admit they have problems,” Donovan said. “Men try to keep sexual dysfunction to themselves.” The aging baby boomers and advertising for the testosterone replacement prescriptions that could help them has resulted in more conversation about low testosterone and how men can address the issue. Oftentimes, men use the advertisements as a starting point to discuss their low libido and energy issues with their urologist or primary. Physicians typically complete a physical and blood test to help diagnose low testosterone and other hormone imbalances in patients. A thorough physical and medical history evaluation is necessary to help uncover any possible contraindications and risks involved with testosterone
replacement therapy. For example, testosterone replacement isn’t recommended for men with prostate cancer. “Testosterone is understood to be feeding prostate cancers,” said Patrick Fisher, Rochester chapter leader of Us Too, a prostate cancer education and advocacy organization. “So a man taking testosterone, but isn’t screened for prostate cancer, is endangering his health. It doesn’t cause prostate cancer, it but it worsens it if it’s already present.” The therapy may also worsen benign enlarged prostate, sleep apnea, and risk of blood clots. Men with other risk factors for these health issues should discuss their concerns with their doctors before undertaking testosterone replacement therapy. Donovan added that some debate whether or not testosterone replacement increases a man’s risk for cardiovascular events. Some people worry about undue aggression from testosterone replacement therapy; however, when taken therapeutically, testosterone doesn’t
cause this symptom. “Instead, people say they have a bad attitude when they don’t have the right level of testosterone,” Donovan said. Testosterone replacement may be administered through injections, patches or cream. Minor side effects could include patch or injection site irritation, and acne.
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Social Security Supports National Cancer Survivors Day
n 2015, more than a million people will be diagnosed with cancer. This alarming statistic affects people and families all over the world. On June 7 we observe National Cancer Survivors Day in the United States. In support of this day, Social Security encourages checkups, early detection, and awareness, while honoring the survivors who have gone through this battle and defeated the disease. Social Security stands strong in our support of the fight against cancer. We offer services to patients suffering from this disease through our disability program and our compassionate allowances program. Compassionate allowances are cases with medical conditions so severe they obviously meet Social Security’s disability standards, allowing us to quickly process the cases with minimal medical information. There is no special application or
Q&A
Q: What is the maximum Social Security retirement benefit? A: The maximum benefit depends on the age you retire. For example, if you retire at full retirement age in 2015, your maximum monthly benefit would be $2,663. However, if you retire at age 62 in 2015, your maximum monthly benefit would be only $2,025. If you retire at age 70 in 2015, your maximum monthly benefit would be $3,501. To get a better idea of what your benefit might be, visit our online Retirement Estimator at www.socialsecurity.gov/ retire/estimator.html. Q: Can I refuse to give my Social Security number to a private business? A: Yes, you can refuse to disclose your Social Security number, and you should be careful about giving out your number. But, be aware, the person requesting your number can refuse services if you don’t give it. Businesses, banks, schools, private agencies, etc., are free to request someone’s number and use it for any purpose that doesn’t violate a federal or state law. To learn more about your Social Security visit www.socialsecurity.gov/ssnumber. Q: How can I check the status of a pending application for retirement benefits? A: If you applied for retirement or disability benefits online, you can check the status of your application at www.socialsecurity.gov by selecting “Benefits” and “Check Application Status” under “Apply.” You will need to enter your Social Security number and the confirmation code you received when you filed online.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
form you need to submit for compassionate allowances. Simply apply for disability benefits using the standard Social Security or Supplemental Security Income (SSI) application. Once we identify you as having a compassionate allowances condition, we’ll expedite your disability application. Social Security establishes compassionate allowances conditions using information received at public outreach hearings, from the Social Security and disability determination services communities, from medical and scientific experts, and based on our research. For more information about compassionate allowances, or to view the conditions currently listed, visit www.socialsecurity.gov/compassionateallowances. If you think you qualify for disability benefits based on a compassionate allowances condition, please visit www.socialsecurity.gov to apply for benefits.
Your application status will show: • The date we received your application; • Any requests for additional documents; • The address of the office processing your application; and • If a decision has been made. Q: How do I appeal a decision on my application for disability benefits? A: When we make a decision on your application, we’ll send you a letter explaining our decision. If you don’t agree with our decision, you can ask us to look at your case again, or appeal it. You must appeal within 60 days from the date you get our decision letter. You can: • File a disability appeal online with our new, improved process and electronically provide documents to support your request, even if you live outside of the United States; or • Visit your local Social Security office. For more information, call us at 1-800-772-1213 (TTY 1-800-325-0778), Monday through Friday from 7 a.m. to 7 p.m. To learn more about Social Security’s disability programs, visit our website at www.socialsecurity.gov/ disability. Q: How can I become a representative payee? A: If you know someone who receives Social Security or Supplemental Security Income (SSI), and who needs assistance managing his or her payments, contact your local Social Security office about becoming his or her representative payee. Go to www. socialsecurity.gov/payee for more information.
By Jim Miller
How to Recognize Stroke Symptoms and What to Do Dear Savvy Senior, What are the symptoms of a stroke? My 66-year-old aunt had a stroke a few months ago and neither she nor my uncle had a clue it was happening. Concerned Relative Dear Concerned, Unfortunately, most Americans don’t know the signs of a stroke, but they need to. Stroke is the fifth leading cause of death in the United States and the No. 1 cause of disability. Being able to recognize a stroke and getting to the hospital quickly can make a huge difference in reducing its potentially devastating effects. Here are some tips that help you recognize a stroke, and what you should do if it happens to you or your loved one. Types of Stroke
According to the Centers for Disease Control and Prevention, every year more than 795,000 people in the United States have a stroke — three-quarters of which are over the age of 65. A stroke occurs when a blood vessel that carries blood to the brain is suddenly blocked by a clot (ischemic stroke), or burst (hemorrhagic stroke), causing parts of the brain to become damaged or die. About 87 percent of all strokes are ischemic. Depending on the severity of the brain damage, strokes can cause mild to severe disabilities including paralysis, loss of speech, vision and memory, along with other health and emotional issues, and death.
Stroke Signs
Because stroke injures the brain, the person having a stroke may not realize it. Stroke victims have the best chance if someone around them recognizes the symptoms and acts quickly. The five most common symptoms include: • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body. • Sudden confusion, trouble speaking or understanding. • Sudden trouble seeing in one or both eyes. • Sudden trouble walking, dizziness, loss of balance or coordination.
• Sudden, severe headache with no known cause. The easiest way to identify a stroke is to use the F.A.S.T. test to identify the symptoms. • F (Face): Ask the person to smile. Does one side of the face droop? • A (Arm): Ask the person to raise both arms. Does one arm drift downward? • S (Speech): Ask the person to say a simple sentence. Is their speech slurred? • T (Time): If you observe any of these signs of stroke, call 911. To help you remember the signs, the American Stroke Association has a free “Spot a Stroke FAST” app (see strokeassociation.org) that you can download on your smartphone or mobile device. Or, visit the National Stroke Association at stroke.org and print their “Act FAST” wallet card to keep as a reminder.
SHE DOESN’T HAVE ALZHEIMER’S. BUT IT’S CRUSHING HER. Being a caregiver is one of the toughest roles on the planet and many caregivers will reach their breaking point without ever asking for help. The good news is, you can provide hope. If you
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Act Quickly
Remember that stroke is a medical emergency and every minute counts. Even if you’re not sure a stroke is happening, call 911 anyway. The longer blood flow is cut off to the brain, the greater the damage. Immediate treatment can save a person’s life and improve their chances for a successful recovery. Ischemic strokes are treated with a drug called t-PA that dissolves the blood clots that block the blood flow to the brain. The window of opportunity to start treating a stroke is three hours. But to be evaluated and receive treatment, patients need to get to the hospital within 60 minutes. If you have a choice, wait for the paramedics rather than driving the patient yourself. Patients who are transported by EMS are evaluated and treated much quicker than people who are driven in. And, of course, don’t drive if you are the one having a stroke. It’s also very important that you call 911 even if symptoms go away. When symptoms of stroke disappear on their own after a few minutes, a “mini-stroke” or transient ischemic attack (TIA) may have occurred which is a warning that a major stroke may be coming. That’s why mini-strokes need to be treated like emergences too. 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. June 2015 •
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Dancing the Night White
The Rochester White Party promises to be a lively evening of food, drinks and mingling. All proceeds benefit the patients and clients of Trillium Health, a local healthcare agency focused on treating those afflicted with HIV and AIDS.
Putting an End to the HIV/AIDS Epidemic By Jessica Gaspar
D
o you know someone affected by HIV or AIDS? Diane Chevron does. In fact, she knows quite a few. As a young budding actress in the ‘70s and ‘80s, Chevron, who is now a Rochester theatre legend, learned a lesson on the fatality of a largely unknown and curious disease later identified as the human immunodeficiency virus (HIV), later found to be the virus that causes AIDS. When HIV and AIDS were still new with lots of questions and very little understanding, Chevron watched many of her friends fall victim to the
virus. “My friends were dying. They were dropping off like flies,” she recalled, remembering having to attend several funerals of friends and acquaintances taken too soon by HIV/AIDS — sometimes three a month. Chevron and her remaining friends wanted to do something — you could almost say they had to do something. After all, they didn’t have any tears left, as Chevron put it. Over the years, their myriad efforts have included finding transportation for HIV and AIDS patients so they can go to doctor appointments to just
What: The Rochester White Party When: 7 p.m. Saturday, June 13 Where: Century Club of Rochester, 566 East Ave. Cost: $100 per person More Info: Contact Karly Marshall at (585) 210-4254 or visit www.rochesterswhiteparty.com.
Local actress Diane Chevron and Dr. William Valenti enjoy the 2013 Rochester White Party. The two are looking to help eradicate HIV and AIDS. Valenti is a physician who specializes in infectious diseases, particularly HIV and AIDS. Chevron is a local theatre legend and HIV/ AIDS activist who has lost many friends to the disease.
Lisa Cove and physician William Valenti, both White Party organizers and chairpersons, stand with the 2013 White Party planning committee. The 2012 and 2013 parties raised a combined amount of $150,000 to help support programs and services for HIV/AIDS patients in the Rochester area. Page 18
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Attending Rochester White Party
being a shoulder to cry on or a support person. “I don’t think the general public should become complacent about HIV and AIDS as a has-been disease,” she said. The shock factor remains in the numbers. According to figures released by Trillium Health this past winter, in 2014 alone there were about 3,000 new HIV cases diagnosed in New York state. While that number is much smaller than the 14,000 cases diagnosed in 1993, the disease is far from being eradicated. NBA star Magic Johnson was diagnosed with HIV in 1991 and was likely the first face of the disease for many Americans. Then the general public first got a bird’s eye view into the life of an AIDS patient when Tom Hanks played Andrew Beckett in the 1993 blockbuster movie “Philadelphia.” Since then, much research has been put into eradicating the virus, which was once considered a death sentence. While Beckett died, Johnson is still alive and well. He reportedly no longer tests positive for the disease, but still takes a daily combination of drugs as part of his treatment. If you ask doctors and researchers involved in HIV and AIDS care, there is still much work to be done. And, it starts with awareness. “The onus is on people like me,” Chevron said. “We need to tell them why it’s so important. You have to educate them with facts and statistics.” That’s what local Rochesterians hope to spark with the emergence of the Rochester White Party. Rochester’s inaugural White Party took place in 2012 with a follow-up party in 2013 and was the brainchild of
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
Lisa Cove, the party chairwoman. Among the LGBT (lesbian, gay, bisexual, and transgendered) community, the White Party is the name of circuit parties held annually in many cities in the United States and Canada. Partygoers usually wear all white, hence the name. According to William Valenti, co-founder of Trillium Health who currently serves as staff physician and senior vice president of organizational advancement, the two events raised a combined amount of about $150,000 which was used toward new program start-up and helped provide services to people with HIV/AIDS. Valenti recently served on Gov. Andrew Cuomo’s task force for the recent initiative titled “Ending the HIV Epidemic by 2020,” or EtE 2020 for short. This program’s focus is to bring the number of new HIV cases in New York state down from about 3,500 per year to 750 per year by 2020, according to Valenti. About 80 new HIV cases were reported in Monroe County last year, but Valenti cautions those numbers may not be an accurate reflection of folks living with the virus. “The number of people acquiring HIV may be higher — we only know the number of people being reported through various testing programs,” he added. Valenti said the two largest demographics at risk for contracting HIV are men who have sex with men, particularly young, black men, and heterosexual women. The EtE 2020 program will be unveiled at the White Party this year. Valenti said the focus of EtE is threefold. Those efforts are first to increase HIV testing efforts to identify those with the virus who don’t know it and link them to care within Trillium Health. Secondly, it will retain patients in Trillium’s care and treat them with modern-era HIV drugs (a.k.a. pharmaceutical cocktails) that will prevent spread of the virus to others. Thirdly, it will identify high-risk people who are currently HIV-negative and put them on another drug to prevent them from acquiring HIV. This program has been labeled PrEP for PreExposure Prevention that will involve taking one pill once a day to prevent HIV. “The drug is effective, but expensive,” Valenti added. He is hopeful the initiatives unveiled through PrEP and EtE 2020 will save lives in the long run. Trillium is partnering with the New York State Department of Health to launch EtE 2020. “To date, we have more people enrolled in PrEP that any other program in New York state, including New York City,” he said.
H ealth News Highland Hospital honors physician Melissa Schiff
Brockport. In his new role, Klinetob oversees both the M.M. Ewing Continuing Care Center and The Brighter Day medical adult day program. Located adjacent to Thompson Hospital at 350 Parrish St. in Canandaigua, M.M. Ewing has a total of 188 beds and offers long-term care, dementia care and post-hospital care. Located at 30 Fort Hill Ave. in Canandaigua, The Brighter Day is open Mondays through Fridays, providing personal care, social opportunities and meals to individuals who live alone or with caregivers but need medical supervision during the day.
Physician Melissa Schiff recently received Highland Hospital’s Distinguished Physician Award for 2014. Schiff, chief of nephrology at Highland Hospital, professor of clinical medicine at University of Rochester Medical Center and medical director at Clinton Crossings Dialysis Unit, has served Highland for more than 30 years. Colleagues described her as a caring physician and educator who is “the gold standard” in delivering patient-centered and compassionate care. “It is wonderful to be honored, especially by your peers,” said Schiff who accepted the Schiff award from physician David Stornelli, president of the medical staff at Highland Hospital. Schiff’s career began at Highland in 1983 when Thomas Talley, founder of the nephrology program at Highland Hospital, recruited her. Six years later she became medical director the University of Rochester’s first off site dialysis unit, now located at Clinton Crossings, and, in 1995, she became chief of nephrology at Highland. Schiff received her bachelor’s degree and her doctor of medicine degree from Boston University School of Medicine. She completed her internship and residency at SUNY Upstate Medical Center and a fellowship at Boston University Hospital. A resident of Brighton, Schiff is married to physician Steve Sulkes. They are the parents of two sons, Zeke and Gabe.
Physician Sandra Boehlert recently opened her new practice of internal medicine at 780 Blossom Road in Rochester. The practice, Blossom Road Medicine, shares the building with physician Ernest Anderson. Boehlert is a tier 1 on the AHP URMC’s AccountBoehlert able Health Partners and previously started the outpatient center for Medina Hospital in Albion. She held residencies at URMC and Westchester Hospital. She earned her medical degree at New York Medical College and completed two years of OB-GYN residency at URMC before completing her medicine residency at New York Medical College Westchester Hospital. She is board certified in internal medicine and speaks fluent Spanish.
Klinetob named VP of longterm care at Thompson
St. Ann’s Chapel Oaks has new director
Terence Klinetob of Brockport recently became vice president of longterm care for UR Medicine’s Thompson Health. As a licensed nursing home administrator with a doctorate in physical therapy, Klinetob brings more than 20 years of experience in both the long-term care arena and in the physical therapy/ rehabilitation services field. Most recently the administrator at Hill Haven Nursing and Rehabilitation in Rochester, Klinetob previously Klinetob served for several years as senior vice president of longterm care and director of rehabilitation services at Lakeside Health System in
Rebecca Ahrns-Walker has 20 years of experience working in senior living communities, 18 of which were at Chapel Oaks. She recently became the facilit’s new director. Ahrns-Walker previously held the position of resident services and facilities manager for 14 Ahrns-Walker years. She started at St. Ann’s as activities coordinator. She holds a bachelor’s degree from SUNY Brockport in recreation management and an associate’s degree in hospitality management. She is CASP certified (Certified Aging Services Professional) and CPRP certified (Certified Park and Recreation Professional).
Rochester Regional Health Library Receives Award
Physician opens Blossom Road Medicine
www.gvhealthnews.com
The Werner Medical Library / Rochester Regional Health at Rochester General Hospital has been named Academic/Special Library of the Year by the Rochester Regional Library Council. “The library and staff had a wide variety of recommendations and some were extensive,” said one of the judges. “Busy doctors and nurses took the time to nominate. Some were very detailed on the service they received; you could clearly see a wave of a lot of great service. But the most impressive thing was that the nominations really focused on the human impact of the service provided. There was a strong emphasis on the human component.” The Werner Medical Library
eHealth Technologies gets “Healthiest Companies in America” award Rochester-based eHealth Technologies recently received national recognition as one of the “Healthiest Companies in America” by Interactive Health, the country’s leading provider of health management solutions. eHealth Technologies was one of 158 honorees recognized for implementing life-changing preventive programs in the workplace. The “Healthiest Companies in America” award is given to organizations that have helped transform the lives of employees by offering programs combining thorough health evaluations with fast, personalized results. The company provides ample opportunities for employees to engage in wellness programs. Two initiatives have proven to be popular with employees: biometric wellness screenings and weight management programs. The company experienced a 44 percent YOY increase in employees who took advantage of the wellness screening. Over 60 percent of the first screening participants experienced an improvement or stayed the same. Employees also have access to an onsite fitness facility and healthy menu options during corporate sponsored events. “Our employees’ health is a top
June 2015 •
provides access to evidence-based literature, books, databases and patient education, and houses a collection of leisure reading materials for patients and staff. Located on the first floor of RGH, the library features comfortable seating, computers, and meeting rooms for individual and group work. The library’s liaison program partners health sciences librarians with individual departments to help team members locate, use and organize information. Known for its quick and efficient service, library staff will conduct literature searches and provide copies of articles upon request. To learn more, visit the library on the web at wernerlibrary.org
priority for us,” said Ken Rosenfeld, eHealth Technologies’ CEO. “We strive to be a leader in healthy outcomes for our employees and the customers we serve. This award serves as reinforcement that our wellness efforts make a difference in transforming people’s lives. As a first time recipient, we are proud to be amongst the elite group that have achieved this status and, most importantly, we are proud of our employees for making a personal commitment to be healthy.”
New hearing protection products locally available Sounds For Life, a Pittsford-based holistic hearing healthcare and hearing aid practice, has introduced a brand new all-digital line of hearing protection products designed especially for the hunters/shooters, military and police as well as anyone who works with loud machinery or in an industrial setting. Whether in the woods, at the range or on a factory floor, hearing is critical to performance and safety. The challenge is to maintain hearing capability at a high level while simultaneously protecting precious hearing from sudden or continuous loud noise. The new SoundGear system from Starkey Hearing Technologies was designed specifically for these challenging situations.
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H ealth News “SoundGear uses seamless sound-activated compression to trigger instant, automatic suppression of dangerous noise levels,” explains Sounds For Life founder Ramona Stein, an audiologist. “This is the leading edge in electronic hearing protection, enabling users to be protected yet still hear voices and sounds in their environment”. Hunters, shooters, motorcyclists, motor racers, and many workers in industrial settings can finally have the safety, convenience and peace of mind that has never before been possible. For more information, call 585-2485212 or send an email to sperkins493@ gmail.com
Unity Hospital receives award for stroke care Rochester Regional Health’s Unity Hospital in Greece has received the American Heart Association / American Stroke Association’s Get With The Guidelines-Stroke Gold Plus Achievement Award with Target: Stroke Honor Roll Elite Plus. The award recognizes the hospital’s commitment and success ensuring that stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. To receive the Gold Plus Quality Achievement Award, hospitals must achieve 85 percent or higher adherence to all Get With The Guidelines-Stroke achievement indicators for two or more consecutive 12-month periods and achieved 75 percent or higher compliance with five of eight quality measures. Unity Hospital earned the Target: Stroke Honor Roll Elite Plus, by meeting quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator (TPA) the drug used to significantly reduce the effects of stroke and lessen the chance of permanent disability. “With a stroke, time lost is brain lost. This award demonstrates our commitment to ensuring patients receive care based on nationally respected clinical guidelines,” said physician Chris Burke, medical director of the Stroke Center at Unity Hospital.
Spreading the News
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In Good Health
Rochester’s Healthcare Newspaper Page 20
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Magicians with a Mission Magicians travel the country to teach occupational therapists and other professionals how to use magic to treat their clients By Mike Costanza
I
llusionist Kevin Spencer gave local occupational therapists and other professionals a touch of wizardry last March. Spencer, co-founder and executive director of the nonprofit Healing of Magic, came to Nazareth College to demonstrate the use of magic tricks to help those who have disabilities or special needs. About 40 occupational therapists and other professionals attended the afternoon workshop. Kevin and his wife, Cindy, came up with the idea of using magic tricks in therapy by accident — literally. They were on a break from touring with their magic show back in 1988, when Kevin suffered a serious auto accident near their Virginia home. A tractor-trailer struck his car from behind. “My seat broke in half, and I came out of my seat through the back window of the vehicle,” Kevin explains. “I woke up in neurological intensive care with a brain injury and a spinal cord With just a flick of his hand, Spencer brings a look of wonder to the face of a young hospital patient. injury.” As part of his treatment, The illusionist and his wife travel the country to teach occupational therapists and other professionals how to use magic to treat their clients. He particularly enjoys demonstrating his techniques with kids Kevin underwent eight difficult months of repetitive who are ill or in need of therapy. physical therapy. “It can be a frustrating process, but Those who perform the paperclip program, there’s an academic compomostly it was just a really boring proare supposed to catch the paperclips in nent that goes with it that’s related to cess,” he says. “Just finding the motiva- flight. Through learning and practicing math, science or language arts.” tion to do something that doesn’t seem the trick, clients can develop their conAt Nazareth, Kevin’s demonstralike it’s doing much for you can be a centration and memory skills, acquire tion of magic therapy seemed to be a challenge.” an understanding of position concepts big hit. After enjoying the presentation Once Kevin was out of therapy, such as up-down and left-right, and de- — and doing the tricks — occupational the couple worked with occupational velop greater manual dexterity. Success therapist Annie O’Reilly looked fortherapists and other professionals to can also encourage a client to continue ward to putting the knowledge she’d develop a program that used magic for in therapy. gained to work with her clients. rehabilitative purposes. “To learn to do something that “It’s an enjoyable way to obtain “What kinds of magic tricks could perhaps the normal able-bodied person goals,” says O’Reilly, who works at be used to accomplish the same goals can’t do, that can be a tremendous Holy Childhood, an agency that serves that you’re working on in traditional boost to their self-esteem,” Kevin the intellectually and developmentally forms of therapy — that would require explains. “That becomes the basis for disabled. all of the same movements and all of them to actually do the therapy.” D.J. Tuttle, who came to the workthe same cognitive processes?” Kevin Finally, clients gain the pleasure shop as O’Reilly’s student — he is in says. — and benefits — of performing their the University of Buffalo’s graduate ocThe Spencers selected about 50 ba- trick for others. cupational therapy program — agreed sic magic tricks to use for those purpos“Once you learn a trick, you with that view. es, and all of which could be performed automatically want to show that to “It’s another way to have a meanwith basic props — paperclips, string, someone,” Kevin says. “That builds ingful activity to do with individuals,” rope and the like. those communications skills, social Tuttle asserts. “It’s repetitive, with a While performing their magic confidence, self confidence…the things purpose.” show on the road, they began using that you really suffer with after you’ve Alex Halligan, a senior in Nazatheir off hours to teach those stunts to had a debilitating illness or a disability reth’s occupational therapy program, therapists and other professionals who or an accident.” called the magic tricks “kind of a fun work with individuals who have disThrough the years, the Spencers way to get people into their therapy.” abilities. Once they’d learned the tricks, have devoted more and more of their The Spencers are not the only illuthe therapists could teach them to their energy to the propagation of magic sionists to make use of magic therapy clients. therapy. In 2009, they created a second — Kevin says that it is used in more The couple formed Healing of nonprofit that took their work in a new than 200 facilities in 30 countries. At the Magic in 1989 to foster those aims. direction. Though Hocus Focus, Inc. same time, the success of their efforts Kevin uses one of his favorite encompasses Healing of Magic, the has led the couple to cease doing regustunts to illustrate how magic therapy new organization is dedicated to teachlar magic shows, and focus completely works. The “paperclip” uses two paing those who work with kids who upon using their arts to help others. perclips and a dollar bill as props. have special needs how to use magic to “When you’re an artist, and you “By putting the paperclips on help their charges. find that what you do to entertain peothe dollar bill in a certain way, when “We train teachers on arts-integratple has the ability to kind of impact the you pull the dollar bill, the paperclips ed interventions for kids with special quality of their lives, it really changes fly into the air and link together,” he needs,” Kevin explains. “For every you,” he asserts. explains. magic trick that’s in the Hocus Focus
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
The Difference between ‘Use-By’ ‘Sell-By’ and ‘Best-By’ Dates will necessarily make you sick if eaten after the use-by date. However after the use-by date, product quality is likely to go down much faster and safety could be lessened.
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onfusion over date labeling leads to billions of pounds of food waste every year. Bob Brackett, director of the Institute for Food Safety and Health at the Illinois Institute of Technology, explains the difference between “use-by,” “sell-by,” and “bestby” dates.
Use-By
This label is aimed at consumers as a directive of the date by which the product should be eaten; mostly because of quality, not because the item
This label is aimed retailers, and it informs them of the date by which the product should be sold or removed from shelf life. This does not mean that the product is unsafe to consume after the date. Typically onethird of a product’s shelf-life remains after the sell-by date for the consumer to use at home.
Best-By
This is a suggestion to the consumer on which date the product should be consumed to assure for ideal quality. Brackett also points out that smell and taste are not good indicators of whether or not a food is safe to eat.
Region Gets $565 Million to Transform Medicaid Healthcare Delivery
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ew York State Department of Health announced last month that the Finger Lakes Performing Provider System (FLPPS) is eligible to earn up to $565,448,177 over five years to transform the way healthcare is delivered to more than 300,000 Medicaid beneficiaries in the Finger Lakes region. The Finger Lakes Performing Provider System, headquartered in Rochester, is one of 25 performing provider systems in New York state. FLPPS is comprised of 28 hospitals, 3,000 healthcare providers and more than 600 healthcare and community-based organizations in a 13-county region. “With the many changes in health care, we recognized the importance of regional collaboration to support this important transformation,” says Kathy Parrinello, chief operating officer, Strong Hospital and FLPPS board chairwoman. “Our region shares a history of healthcare innovation and we look forward to our collective success in developing this integrated network.” The $565 million, allocated by the Centers for Medicare and Medicaid Services (CMS) and dispersed by New York State Department of Health, is a maximum possible award, which can be earned primarily by achieving performance metrics within the delivery system reform incentive payment (DSRIP) program. DSRIP is part of a Medicaid reform model which, in NYS, has a goal of improving clinical outcomes and reducing avoidable ED use
and hospitalizations by 25 percent over five years. Following a comprehensive community needs assessment, FLPPS chose 11 DSRIP projects to focus their work. Each project addresses a current shortfall in the healthcare system such as the role of behavioral health in primary care and skilled nursing facilities, triage practices in emergency department, patient care transitions, chronic disease management and integrating healthcare services across multiple care settings. “It is too hard for patents with complex health conditions and limited resources to maintain their health using the current system,” says physician Bridgette Wiefling, chief quality clinical innovations officer, Rochester Regional Health System and FLPPS board vice-chairman. “Our existing system reflect silos that focus on individual aspects of healthcare delivery. Our region is building an Integrated delivery system that will break down those silos and make it easier for patients to navigate and more useful for providers who are sharing information, identifying resources and ultimately developing treatment plans that can be successful.” The five-year implementation period began April 1. For more information about this award, DSRIP or the Finger Lakes Performing Provider System, contact Meredith Rutherford, FLPPS communications director at 585-455-0414, or at Meredith_Rutherford@dsripfingerlakes. org. June 2015 •
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 21
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Popcorn — along with refrigerated juices, smoothies, yogurt, nutrition bars, trail mixes and specialty nut butters — is among the fastest growing healthy snacks, according to the Institute of Food Technologists.
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he April 2015 issue of Food Technology magazine, published by the Institute of Food Technologists (IFT), features Contributing Editor A. Elizabeth Sloan’s insights on the top food trends for 2015. Sloan gathers data from a multitude of industry resources to come up with the following trends. 1. Fresh and Refrigerated Foods: Nearly nine in 10 adults feel that fresh foods are healthier, 80 percent feel that they are tastier, and 78 percent of consumers are making a strong effort to eat more fresh vs processed foods. Shoppers are buying more fresh ingredients, up 10 percent vs. just three years ago. 2. Eating for a Specific Lifestyle: Dramatic changes in lifestyle, eating patterns, and demographics are creating new rules for marketing and packaging and are motivating new food product purchases. Nearly half of all eating occasions are alone and the family meal continues to erode; only 27 percent of family meals include children. 3. Reasonable Snacking: The average number of in-between-meal snacks has grown from two per person per day in 2010 to almost three in 2014, and consumers are snacking throughout the whole day. Refrigerated juices, smoothies, yogurt, nutrition bars, trail mixes, specialty nut butters and popcorn were among the fastest growing healthy snacks in 2013. 4. Discovering New Cuisines: More sophisticated food experiences characterized by unique flavors and culinary narratives is another trend on the rise. Gourmet products such as oils, cheeses, and baked goods are purchased by more than 40 percent. Pickling, fermenting, fire-roasting, and smoking are all hot food preparation trends for 2015 as well as global flavors like harissa, aji, gochujang, yuzu, togarashi, peri peri, and za’atar. 5. Exclusion Diets: Consumers are continuing to experiment with alternative eating styles. In 2014 one-third of adults tried a specialty regiment like gluten-free, lactose-free, raw/living foods, dairy-free or a juice cleanse. Three-quarters of U.S. households prepare meat alternatives for dinner
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
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with eggs being the most popular meat alternative. Food restrictions, intolerances, or allergies have a good deal of influence on food choices for one in 10 shoppers and 17 percent are somewhat influenced. 6. Breakfast: Most people are eating breakfast five times a week. Having more energy and mental focus, helping maintain weight and feeling full until lunchtime are all things that motivate non-breakfast eaters to dig into breakfast. Ethnic flavors for breakfast are trending as well such as chipotle, manchego, chutney, Cotija, and chimichurri. 7. Rethinking Natural: In 2014, 29 percent of consumers bought more local foods and beverages, 28 percent bought more organic products, 25 percent more natural foods, and 23 percent more non-GMO offerings. 8. Whole Food Nutrition: In 2014, fiber/ whole grain were the most sought after food ingredients. Non-wheat flours (peanut, millet, barley, and rice) were among the hot culinary ingredients in 2015, followed by ethnic flours like fufu, teff and cassava. More than one third of the best-selling new foods/ beverages in 2013 carried a real fruit or fruit health benefits claim, and 14 percent of the best-sellers touted a vegetable health benefit. 9. ‘Cook-Less’ Meals: More than a quarter of consumers say they are preparing more meals in less than 20 minutes than they did five years ago. One-pot meals were up 29 percent, and meals using marinated meats and poultry were up 21 percent. Packaged meals and kits, oven baking, and take-and-bake products are all popular among consumers. 10. Diet Watching: Over half of adults are watching their diets; 66 percent for general health reasons, 55 percent to lose weight, 40 percent to limit fat, sugar, sodium, 38 percent to prevent future medical issues, 37 percent to maintain weight, 22 percent to treat a current medical condition, and 10 percent for a real or perceived food allergy or intolerance.
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lot of hard work, practice and dedication can help you sculpt a well-muscled body, but anabolic steroids will get you there a lot faster. What will it cost you, though? To help sort speculation from fact about the side effects, Clarkson University assistant professor of physical therapy and physician assistant studies Ali Boolani and two of his students have just published an opinion paper in Medical Research Archives. The short side of the long story of their research-based conclusion is: Don’t use steroids. “It’s a hot topic, but we can’t do clinically based steroid research. It’s illegal and unethical,” says Boolani. “We started this project last summer to
explore what’s known on side effects, and my students spent hundreds of hours each sifting through current information.” The allure of a bigger, stronger, faster body is as enticing as the huge paychecks professional athletes can command, but the use of anabolic-androgenic steroids (synthetic testosterone) also creates some powerful and contradictory conditions, according to Boolani and students Britni R. Keitz and Holly S. Bronson. Side effects include: acne, increased body hair, aggressive behavior, fluid retention, elevated blood pressure, sleeplessness, increased irritability, feelings of low libido, increased sex drive, increased appetite, sweating, increased feeling of well-being, depressive mood states, loss of head hair, and gynaecomastia (enlarged breast tissue in men). “I found a lot more new research, so I added it and tried to get two sides of the issue but there’s a lot of inconsistent data. Much of the information on steroid use is from questionnaires,” Keitz says. “I found it amazing, though, what psychological changes the studies report — depression and homicidal feelings.” Bronson adds, “It’s sad to risk your health to get ahead. This research can help open people’s eyes to the negative effects of steroids so they can make an informed decision before they take anything.” The paper, “The Effects of Anabolic Androgenic Steroids on Performance and its Adverse Side Effects in Athletes” is published in Issue 1, 2015, of Medical Research Archives.
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Check In Good Health online at GVhealthnews.com June 2015 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 23
How Can a Few Make a Difference?
Ask Crossroads Compass of Care Volunteers Nonprofit affects the lives of at least 700 people in the region By John Addyman
U
nless you count yourself a member of the Finger Lakes working poor, wondering how you’re going to feed your family on what you make each week, you’ve probably never heard of them. If you haven’t been forced from a burning house with nothing but the shirt on your back, wondering what comes next in your life that has just been destroyed, you probably don’t know they exist. To a single mom who has reached a point of desperation trying to keep a job, feed a growing brood and keep a roof over their heads, they’re lifesavers in word and deed. For a woman who has been struck senseless by a man she promised to love forever, they are not only shelter, but promise a road to a life’s reconstruction. And for third world scholars-tobe, whose schools cannot afford the texts they need to populate a library and classrooms, they are a godsend, a leg up from the deepest poverty and despair. Beyond all that, they are local, and they are, for the most part, of a certain age past 55. Crossroads Compass of Care, a faith-based charitable organization born in the Flint Creek Church of God in Stanley, affects the lives of some 700 people in Wayne, Seneca, Yates, Ontario and Monroe counties. The group, which numbers about two dozen volunteers, is led by Russ Willemsen, who is the 35-year pastor of the Flint Creek church, and a board of directors from the area that is focused on expanding what Willemsen had been accomplishing through a singular ministry. Crossroads Compass has five care components — a mobile food pantry, Beacon of Hope; Through the Fire services to fire and natural disaster victims, including a supply of gently used furniture and housewares; services to single mothers on the verge of homelessness for their families — Naomi’s Harvest; a domestic abuse shelter and services, Serenity’s Promise; and Books To The Nations, which has collected, cataloged and provided texts and books to Nigeria and South African schools. Each Wednesday, Willemsen makes the rounds with food. He collects from generous donors at Wegmans, Tops and BJs in Canandaigua, and meets needy people in a parking lot at Colt and Genesee streets in Geneva at 11 a.m. Many mornings, whatever the weather, he may have more than 75 people waiting for him. The Crossroads truck then makes special deliveries, visiting some of the larger employers in the area, taking food to employees who are earn the minimum wage and are struggling to make ends meet — the working poor. “They come and get whatever we have that day,” Willemsen said. “I make some other stops to reach out to the working poor, the people who are out there working every day. I’ll also drop off some food to single mothers.” He’ll make another run on Saturday and if the donors are especially Page 24
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Lorraine VanCamp of Phelps helps sort donated food for delivery to the poor and working poor in the Geneva and Canandaigua areas. outreach — getting gently used furniture to burned-out families,” he said.
The beginnings
Russ Willemsen, leader of the Crossroads Compass of Care, a small nonprofit organization that helps people in need in several Finger Lakes counties, including Monroe and Ontario. generous and he has food left over, he’ll make a trip into the countryside to contact Mennonite families in need. Willemsen has a couple of small storage areas stocked with furniture, bedding, appliances and household items — “nothing with stains,” he stressed. When the need arises, the inventory is distributed among those who need it. “One night there was a terrible fire in Gorham, on East Lake Road. I called the lady and asked if there was anything we could do,” Willemsen said. “She was homeless — the family got out of the house with just the shirts on their backs. I asked her, ‘Have any churches responded to your crisis?’ “’No,’ she said. “That was the beginning of our
The program started in Willemsen’s Stanley church in 1995 with what he called “The Raven’s Food Pantry,” noting that ravens and food are mentioned in the Bible in Kings, Job and Luke. Trying to reach the people who needed help, Willemsen was frustrated when folks couldn’t connect the image of the raven and his food pantry. “It was so hard to put a graphic to the raven,” he said. Then he had an epiphany looking at a picture of a lighthouse with a beacon shining from it and “Beacon of Hope” was born. “In the beginning, we didn’t know what we were doing. We had never had a food pantry in our church.” By 2007, the minister’s outreaches were taxing the ability of his church to support them through the Sunday collection plate. “By this time we were also helping single moms. I called our [church] corporate attorney in Tennessee. He said we needed to spin this off and create a 501 (3) (c) and we started that paperwork, for Crossroads Compass of Care. We wrote bylaws, and went to the community to get a board of directors.” Pat Owen, the secretary of the board of directors, put the organization’s outreach clearly: “We’re a nonprofit serving 700-800 people in the Finger Lakes area. Everyone on the board of directors [except for treasurer Gordon Lahr] is over 55. We deliver food in a dilapidated truck. We pick up, store and haul furniture to victims of domestic violence, fires, and to homeless vets. We coach people with problems. We collect books for nations that need them.” Kim Tinder, the president of the board of directors, notes that everything Crossroads accomplished in 2014
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • June 2015
was on a budget of $8,000, an incredible bang for the buck. “We increased our budget to $13,000 for 2015 and my goal is to almost double that by 2016… for such a small group of volunteers, we reach a significant number of people who need us. “We would just love for people to know more about us. If they have furniture or things they want to donate, or have time they can donate as volunteers, or money, or if they know people in need — we want to know.” “Every year our budget goes up and we’re able to do more,” said Willemsen. “We don’t even know where the money comes from.” The two most immediate needs are a new truck — Willemsen uses a pick-up truck to haul furniture and the underpinnings are so rusty, he worries about the cab separating. And Crossroads needs a warehouse big enough to store furniture. “We’re fundraising and trying to write grants to get a new vehicle so Russ can deliver food and furniture in the five-county area we operate in,” Tinder said. Long-term, we’d like to provide emergency housing — for someone who has been in a fire, domestic abuse, teenage pregnancies — we’re not necessarily looking for a building, but it could be that. We have to be creative. We need to provide abused women with a safe place to stay. “I totally understand the poverty of the Finger Lakes region,” Tinder said. “There are a lot of working poor. It’s gotten worse for them rather than better over the last several decades. We’re trying to care for people regardless of their situation, regardless of who they are or where they came from and the situation they’re in.” She and Willemsen noted that although Crossroads itself can only do so much, it is partnering with many other agencies to get people information and assistance. Board Vice President Bob Nantais, a retired minister and former director of the LaTourneau Christian Conference Center on Canandaigua Lake, has watched Willemsen drive so much of the Crossroads outreach. “His heart is bigger than the sky,” Nantais said. “He just keeps giving and giving. He is a guy who knows what sacrifice is about. He puts so many people first. He has a servant’s heart and a teachable spirit.” Nantais hopes people will see the value of Crossroads of Care. “Many hear about what’s going on in their communities, what other people are doing. Most know someone who is hurting and in need. We hope they say, ‘There’s a place where you can get help and people who will reach out to help you: Crossroads Compass of Care.”
Want to Help?
Crossroads Compass of Care is now raising funds to buy a newer truck to deliver food and furniture to the needy and arrange for a warehouse big enough to store furniture. To contact the organization, call 585-526-5600, visit www.crossroadscompassofcare.org or send an email to Pastor Russ Willemsen atatriaw@frontiernet.net.