in good Meet Your Doctor URMC transplant surgeon Sunil Prasad talks about the ‘pretty intense four hours’ his team goes through to proceed with each heart transplantation
Sugary Drinks
December 2016 • Issue 136
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Holiday Blues or Depression? Why do many people feel sad during the ‘happiest season of all’? Is it just holiday blues or depression? Experts weigh in and suggest ways to stay positive page 12
Daily can of soda boosts odds for prediabetes, new study finds
Walking in Winter
More than three million patients worldwide have experienced robotic-assisted surgery since its introduction in 2000. It continues to evolve as a surgical tool, offering both surgeons and patients more advantages compared with open surgery and even to standard laparoscopic surgery.
Organizations unveil newly designated walking paths in Rochester area to encourage residents to move more
Weight Gain & the Holidays Forget about losing weight this time of the year. The main challenge, experts say, is not to gain too much
3,000,000+
page 11
SPANKING Fewer parents are spanking their kids. More are relying on timeouts to discipline children, study shows
page 10
GMO Labeling
Law to allow labeling GMO food doesn’t please critics or supporters page 9
Getting Some Walking in Winter U.S. Heart Disease Rates Fell 20 Percent Since 1980s
Researchers chalk it up to better meds, prevention efforts
N
ew research shows that cases of heart disease have dropped 20 percent in the United States in the last four decades. Experts credit the trend to better detection and prevention of risk factors that endanger heart health. “That means all the efforts are paying off,” said senior researcher Michael Pencina. He is director of biostatistics for the Duke Clinical Research Institute at Duke University, in Durham, N.C. However, most major heart risk factors — bad cholesterol, high blood pressure and smoking — remain strong contributors to heart disease, showing that more can be done to protect patients, Pencina added. “Coronary disease was the size of a large pizza, but now it’s a medium
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pizza,” Pencina said. “But in terms of slices, what portion of the pizza you can attribute to the risk factors, it’s about the same,” he explained. “There is definitely room for further improvement. We can get maybe to the smaller personal pizza size, to keep to the analogy,” he continued. “Because risk factors still matter, intervening in these risk factors should drive further reductions.” About 610,000 people die of heart disease in the United States every year — about one in every four deaths, according to the U.S. Centers for Disease Control and Prevention. The study was published Nov. 15 in the Journal of the American Medical Association.
Organizations unveil newly designated walking paths to encourage residents to move more
T
he weather is getting cooler and the leaves have fallen. While it can be hard to say goodbye to the warmer days, now is the perfect time to get out and go for a walk. There are 30 official American Heart Association designated walking paths in Monroe County. Many of the paths are sponsored by Excellus BlueCross BlueShield. Residents are encouraged to use these AHAdesignated paths to walk for 30 minutes a day. “When people want to get healthy, they often try dramatic changes,” said Janette Westman, workplace wellness consultant at Excellus BCBS. “But it’s the small changes, like making a goal to walk more every day, that lead to longerlasting benefits.” The establishment of the walking paths is the AHA’s national initiative that champions walking because it has the lowest dropout rate of any
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
physical activity. Some of the Monroe County walking paths can be found at: • Chili’s Union Park • Fairport Public Library • Johanna Perrin Middle School in Fairport • Around the perimeter of the Ogden Farmers Library. • Webster Park • Mendon Ponds Park, including Quaker Pond Trail Loop and Nature Trail Birdsong & Swamp Trail. • Ellison Park, including Indian Landing Trail and Overlook Trail. “Walking for as little as 30 minutes a day will improve circulation, lower cholesterol and blood pressure, and promote weight loss,” Jason Stulb, senior corporate relations director, Rochester American Heart Association said. “Walking with others helps set and keep your goals, you have someone to celebrate accomplishments with and it is free to walk!”
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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CALENDAR of
HEALTH EVENTS
Every Thursday
Weight loss group holds meetings in December The public is invited to participate in TOPS weight-loss support group, which takes place every Thursday evening at the Concord Lutheran Church, 485 Holmes Road in Greece. TOPS stands for Take Off
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Pounds Sensibly. It’s part of TOPS Club Inc., a group that helps residents organize meetings nationawide and in Canada. Members of the group work together in a friendly and respectful manner with the goal of losing weight. For more information, contact Mary Ann Nardone-Bello through email (marealms@gmail.com) or phone (585-225-7515). Those interested can also check the group’s website at www.tops.org.
Dec. 1
Elizabeth Wende Breast Care hosts bazaar Elizabeth Wende Breast Care hosts Breast Friends Holiday Bazaar for women new to EWBC. Guests will have the opportunity to have a mammogram with results while enjoying an evening of mocktails, hors d’oeuvres and holiday shopping from specialty vendors. Bringing a breast friend is encouraged. Vendors include The Brighton, Pampered Chef, Tastefully Simple,
Lularoe, Initials Inc., Matilda Jane, Young Living Essential Oils, and Breathe Yoga & Juice Bar, which will offer meditation sessions. The event will take place 5 to 9 p.m., Thursday, Dec. 1, at Elizabeth Wende Breast Care — Brighton location, 170 Sawgrass Drive, Rochester. RSVP is required. For more information on Breast Friends Holiday Bazaar and to register, call 585-4422190 or ewbc.com/news.
Jan. 24
Fibromyalgia group: How to start the new year right The New Fibromyalgia Support Group will start the New Year off showing people suffering from fibromyalgia how to make small strides and improve their health one step at a time. The workshop — titled “Five Simple Ways to Start the New Year Right” — will focus on modalities such as exercise, diet and stress reduction as tools to work through pain reduction, and overall health improvement. The event will take place from 6 to 8:30 p.m., Jan . 24, at Westside YMCA, 920 Elmgrove Road, Gates branch. The meeting is free and open to the public. No need to be a YMCA member to participate. Classes are small and registration is needed. Register with a voicemail by calling 585-752-1562. Speak slowly and clearly. Leave your name and details.
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Daily Can of Soda Boosts Odds for Prediabetes, Study Finds Diet sodas do not appear to pose the same danger, researcher says
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rinking a can of sugary soda every day can dramatically heighten a person’s risk of developing prediabetes, a “warning sign” condition that precedes fullblown Type 2 diabetes, a new study reports. A person who drinks a daily can of sugar-sweetened beverage has a 46 percent increased risk of developing prediabetes, said senior researcher Nicola McKeown, a scientist with the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston. However, a can of diet soda every day does not boost prediabetes risk, the researchers found. The results show how regular sugar intake can batter a person’s body on a cellular level, McKeown said. Cells require the hormone insulin to break down sugar into energy, she said. But too much sugar in the diet can overexpose the cells to insulin. “This constant spike in blood
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
glucose over time leads to the cells not becoming able to properly respond, and that’s the beginning of insulin resistance,” McKeown said. Once insulin resistance starts, blood sugar levels rise to levels that are damaging to every major system in the body. Prediabetes is an important landmark on the way to Type 2 diabetes, McKeown said. It means a person has elevated blood sugar — a sign of increasing insulin resistance — but has not entered full-blown Type 2 diabetes. Prediabetes is reversible if a person cuts back on sugar. Sugar-sweetened beverages are the leading source of added sugar in the American diet, the authors said in background notes. These results show cutting back on sugary drinks is “a modifiable dietary factor that could have an impact on that progression from prediabetes to diabetes,” McKeown said.
Call 585-670-0020 or go online to schedule at riddlewellness.com
“After suffering a major injury and 8 1/2 months of physical therapy, cortisone shots, and even surgery I was worse off and in more pain than ever. My insurance company had even cut me off. Within 20 minutes of walking through the door of an ARP clinic I was swinging the club full speed with no pain.” - Chris Loughney Pro Golfer
December 2016 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Meet
Your Doctor
By Chris Motola
Sunil M. Prasad, M.D URMC transplant surgeon and his team celebrate 200th heart transplant. He talks about the ‘pretty intense four hours’ his team goes through to proceed with each transplantation Q: Give us an overview of your specialty. A: I’m an adult heart surgeon. My specialty in that field is treatment of advanced heart failure. In that field, there are a lot of ways to treat that, including transplantation. I’m the surgical director of heart transplant for Strong. Q: Are we talking about full heart transplants or valve replacements? A: We have different modalities to fix weak hearts. For people who, say, might just get a little out of breath walking around, we usually treat them with oral medication. If you’re getting really winded walking out to your dog and actually have to stop to catch your breath, then you might be on your way to advanced heart failure. The engine is sputtering. So that’s when we start looking at advanced therapies. So we have ways to helping the left or right side of the heart, pumps called LVADs. You can think of them like putting a turbo-charger on your car. And then transplants are the ultimate option, where we literally remove the heart 100 percent and put in a donor heart. That’s a complete replacement.
Q: What options are there when we’re talking about full transplants? A: We’re the only heart transplant center in Upstate New York. The only other place in the state where you can get a transplant is New York City, five hours away. So we cover an enormous area. These patients come to Strong Memorial Hospital for an evaluation. They go through a very thorough process that confirms they’re both sick enough to need a transplant and that they’ll do well if they get one. We need to make sure they’re not smoking, not doing drugs. So they have to qualify since it’s a privilege to get a heart, and you need to show that you can take care of it. There are about 5,000 patients on the heart transplant list and we get only about 2,000 hearts a year. So the chance of getting a transplant in the U.S. is less than 50 percent. It’s a donor problem. We then discuss the pros and cons on a committee, and review contraindications, which we’re required to do by law. If the patient is a good candidate, they then go on a heart transplant list, which is kept
by one organization, the United Network of Organ Sharing. It’s kept in a central computer that uses an algorithm to find the best match. Q: What happens when you get a match? A: Once the computer hits that match, you get a phone call letting you know a heart is available. So, let’s say the heart is in Kentucky. What happens at that point is that we’ll get information on the donor, then make a clinical decision about whether it’s a good match for a patient. Then we’ll send our team to Kentucky to have a look at the heart. If they like what they see, we’ll cut out the patient’s heart. When we do that, we have about four hours to put the new heart in and put the patient back together. It’s a pretty intense four hours. So that’s the process. Q: I understand the body’s immune system is probably one of the biggest obstacles to successful transplants, and a lot of the immuno-suppressing drugs that help also leave patients open to infections and cancers. Are the drugs getting any better? A: The kryptonite for organ transplants is that you are putting in a foreign object, and your body reacts to that object. The medicines have improved a bit over the last few years. We’re now better at directly suppressing the immune response to the organ rather than suppressing everything. So the incidences of cancer are going down, but they’ve not been eliminated. The median heart transplant survival rate is over a decade now, and that includes taking cancer and things like that into account. We don’t usually use steroids past the first year now — steroids are the global suppressants. So our medicines are more like a sniper rifle now, so we’re headed in the right direction, but there’s still room for improvement. Q: Considering the long-term survival rate, are you likely to need multiple heart transplants? A: If you get a heart transplant when you’re 30, you’re probably going to need another one by 40 to 45. A lot of transplants are living over 20 years now, but it’s less common than 10 years. So, young patients that need transplants might have severe viral myocarditis or women have post-partum cardiomyopathy when they’re having a child, and the child’s immune system attacks their heart, those patients will need multiple transplants. Q: Why don’t the hearts last? A: It’s the immune response. It’s also why we’re so serious about screening for smoking. The immuno-suppressing drugs, just by their very nature, increase the development of atheroschlerotic disease. It’s also why we use hearts from young donors. If you took a heart from a 50 year old, within a year that heart would look like an 80-year-old heart. We can still use other organs from 50-year-old do-
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
nors, but not hearts. We’ll often need to put stents into the transplants to keep them going about five years in. You may have a patient who is only 26, but the heart is aging rapidly. Q: You’re working on trying to improve New York’s donor pipeline, I understand. A: We are in a donor-negative situation. So we have a lot of patients who need transplants, but not enough hearts, so we end up relying on LVADs [left ventricular assist devices]. Strong did its first heart transplant in February 2001. We did our 204th a couple days ago. It requires a large team and a very coordinated approach, but the mainstay is the generosity of the organ donors. You can have a great football team, but there won’t be a game without a football. In the great tragedy of death, you can save three, four, five, six people. That’s what’s so amazing about it. Unfortunately, New York has the poorest participation. We’re dead last in terms of the percentage of citizens who are organ donors. About 25 percent of New Yorkers who would be eligible donors are donors. The national average is 52 percent. Currently you have to be 18 to be a donor, but that will be changing in February 2017. Q: Is it a policy problem? Or are New Yorkers really just that stingy? A: I’ve only been here six months, but I understand it’s a bit of a process here. And having to be 18 years old means you’re probably not doing it when you sign up for your driver’s permit. It’s a bit onerous. You can check the box on your license, but you still have to print out a form and send it in. You can only get 90 percent of the way online. Q: Where can people sign up to be donors? A: People can join the state’s organ donor registry online at passlifeon. org or by registering in person at the Department of Health, Department of Motor Vehicles, or Board of Elections.
Lifelines Name: Sunil M. Prasad, M.D. Position: Chief of the division of cardiac surgery at Strong Memorial Hospital Hometown: Chicago, Ill. Education: University of Illinois Medical School (medical); Michigan State (undergrad); Duke University (graduate) Affiliations: University of Rochester Medical Center system Career: Prior to joining UR Medicine in the summer of 2016, he served as assistant professor of surgery in the division of cardiothoracic surgery at the University of Illinois and Washington University School of Medicine. Most recently, he held the position of cardiothoracic surgeon at Mercy Springfield Hospital. He serves as council on cardiothoracic and vascular surgery of the American Heart Association, and is a member of the American Medical Association, the American College of Surgeons and the Society of Thoracic Surgeons. Organizations: Society of Thoracic Surgeons, United Network of Organ Sharing Family: Married; two children Hobbies: Modifying cars
Texting Can Be a Real Pain Pain in the hand and neck might be associated with excessive texting, say experts By Deborah Jeanne Sergeant
I
f your child complains of hand and neck pain, keep a closer eye on his texting and tablet habit. It might be the culprit. Beth Orlowski, pediatrician at Sodus Pediatrics, said she has seen teens with these symptoms because “they’re hunching over to see the little screen. It’s becoming a problem because they’re all looking down. Some have to wear a wrist brace at night.” Sitting up straight and keeping the device at a comfortable level can help prevent injury, but she added that teens should not spend more than two to three hours daily doing
things on a screen. Overuse injuries can happen at any age. Shawn Belles, licensed massage therapist at Pace Family Chiropractic in Rochester, explained that injury can occur as the muscles tighten and contract when a person is looking down. Belles said that some people may experience nerve compression in the neck from using smartphones and find relief in massage therapy. “I start up at the neck and follow the nerve pathways to the chest and arm to find where the compression is,” Belles said. “When I have a client on the table, I may find spots restrict-
ed by the muscle.” For some clients, just two to three appointments can provide complete, lasting relief — until they overuse their equipment again. “A good self care routine can get you right out of those symptoms,” Belles said. “Some people will be on their devices all day long. I’d say maybe restrict use. Get out and be more active. Some have to use them, so they should especially implement the self care plan. You don’t have to do crazy gym hours, but a stretching routine can help.” Physician Matthew Tomaino, shoulder, hand and elbow specialist and founder of Tomaino Orthopaedic Care for Shoulder, Hand, and Elbow, LLC in Rochester, said that “tingling in the thumbs and numbness in the hands while driving or on the phone are frequent symptoms in carpal tunnel syndrome to seek medical care.” He said he hasn’t seen people succumbing to carpal tunnel syndrome from texting, but overuse can cause conditions such as tendinitis. “If you’re 40 plus and feeling pain while texting, you’re probably developing arthritis or something else,” Tomiano said. In New York state, patients may self-refer to a hand therapist without seeing a primary care provider. Phys-
ical therapy, combined with home care, can offer relief for many people, according to sources interviewed for this story. “Give it a little bit of a break,” Tomaino said. “If symptoms don’t get better, there may be an overuse element. Advil or Aleve can diminish inflammation as well. Those are the basic first starting points. If you’re waking up at night, pick up a wrist splint at the drug store. If that won’t help, get a formal evaluation.”
Healthcare in a Minute By George W. Chapman
2015 cost of employersponsored care
The annual Milliman Medical Index is regarded as one of the most reliable sources of actuarial, analytical and financial research for employer sponsored health insurance. Here are some of their key findings for 2015. The average cost to insure a typical family of four was $24,671. This is three times the cost in 2001. The cost of care rose 6.3 percent in 2015 due largely to unrestrained/unregulated increases in drug costs, which increased almost 14 percent from 2014. Since 2001, drug prices have increased at an average annual rate of 9.4 percent — exceeding the 7.7 percent average increase for all other services. While employers still pay the lion’s share of the premium, (58 percent) an employee’s out-of-pocket cost has increased 43 percent over the last five years while employer costs increased 32 percent. Of the $24,671 cost for a family, the typical employee paid about $10,400 (42 percent). That includes about $6,400 in payroll deductions ($533 a month) and about $4,000 in out-of-pocket expenses for deductibles and copays.
2015 components of employer-sponsored care
Physicians and other professionals accounted for 31 percent of all costs, followed by hospitals also at 31 percent, outpatient services at 19 percent, drugs at 16 percent and “other” at 4 percent. Other includes mostly durable medical equipment, supplies, ambulance and home care. Again, drug costs increase almost 14 percent last year and almost all of this increase was due to price increases vs. increases in utilization. Physician costs increased only 3.6 percent. Hospital costs increased 5.4 percent. Most notable stat: over the
last five years, hospital utilization has increased only 0.5 percent.
ACA exchange costs
The exchanges continue to be the most misunderstood component of the Affordable Care Act, better known as “ObamaCare.” The exchanges were established to provide individuals under 65, who don’t receive insurance through an employer or Medicare, the ability to purchase an individual commercial plan. Recently, the purported average 25 percent increase in exchange premiums has brought “ObamaCare” under more scrutiny. Here are some facts and some perspective. 20-plus million people are currently covered by “ObamaCare.” Of the 20-plus million, about 7 million are covered by expanded Medicaid. Consequently, they do not pay any premiums and are not impacted by the 25 percent premium increases. That leaves about 13 million people, not covered by expanded Medicaid, who do pay for their insurance and are the ones impacted by the 25 percent increase. The average insurance premium offered on the exchanges has increased 2 percent in 2015 and 7 percent in 2016. If you factor in the anticipated 25 percent increase for 2017, that is a three-year average of 11 percent. The federal government does not set the premiums. Commercial carriers like BCBS, Aetna, Humana, United, Cigna, etc. set their own premiums. The 25 percent increase is due to two factors: the rates were way too low to begin with and the insurers grossly underestimated the health status (sicker) of their new members. Consequently, rates had to go up in 2017 if insurers were to survive. The national average premium for a standard “silver” or basic employer type plan in 2016 on the exchange December 2016 •
was about $400 a month or $4,800 a year compared to about $6,000 a year or a typical employer-sponsored plan. A 25 percent premium increase will result in a premium of $500 a month or $6,000 a year which is just where the average employer plan is. In 2009, eight years ago, the Congressional Budget Office predicted a 2017 silver plan premium of about $5,500. Close. Why was the CBO so much better at estimating premiums than the huge commercial carriers? Most, 83 percent, of the 13 million people who are effected by the 25 percent increase qualify, based on their income, for a subsidized discount. The subsidized amount is paid to the commercial carrier. The average premium actually paid by the 13 million people this year is $113 a month or $1,356 a year. With discounts still available in 2017, and all other things being equal, the average net premium actually paid, factoring in the 25 percent increase, will be around $141 a month. That is a net increase of $28 a month.
ACA exchange carriers
Several commercial plans are pulling out or threatening to pull out of the exchanges because of losses. (Again, they miscalculated their own rates.) Many are pulling out for other reasons. First, it is far easier to sell and administer group or employer-based insurance because of clear economies of scale. Individual policies are administratively more expensive and time consuming. Second, there are no sales commissions for their agents on insurance purchased on the exchange. Third, with hundreds of carriers (local and national) fighting over 13 million people, many may not think the effort is worth it. Many insurers came into the exchanges with artificially and unsustainable low premiums in order to attract more business. Some
have gone out of business as a result. Fourth, all for-profit carriers have stock holders to please. United is a perfect example. They are pulling out of the exchanges claiming losses of $720 million, which is a lot on face value but relatively insignificant when put into perspective. United reported an overall a profit of $11 billion on revenues of $157 billion, so the exchange is a small portion of their business. CEO Stephen Hemsley earned $66 million in 2014, but that is way down from $102 million in 2010. Many states claim they will be down to one or two carriers next year. The potentially bad news is less competition. But the potentially good news is one or two healthy carriers with enough members to absorb risk. The more insured lives a carrier has, the more apt it is to survive. Finally, our president-elect has promised to repeal and replace “Obamacare.” He should first get an understanding of what that is and how it works. At a pre-election rally he called the ACA a “disaster.” adding all his employees are negatively impacted, especially by the 25 percent increase. Shortly thereafter, one of the directors of all Trump properties corrected his boss and confirmed all employees are covered by normal employersponsored insurance. George W. Chapman is a healthcare consultant who works with hospitals and medical groups. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@ gwchapmanconsulting.com.
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Better Cultural Knowledge = Better Health Outcomes
Health organizations are slowly learning the importance of ‘cultural competence’ By Ernst Lamothe Jr.
H
ow you talk to someone matters. It’s especially essential in the medical field where patients’ interaction with doctors and other healthcare officials can lend itself to a lifelong wonderful relationship or a never-ending cycle of distrust. Health organizations are slowly learning the importance of cultural competence. Culture is often described as the combination of a body of knowledge, a body of belief and a body of behavior. It involves a number of elements, including personal identification, language, thoughts, communications, actions, customs, beliefs, values and institutions that are often specific to ethnic, racial, religious, geographic or social groups, Reid-Rose according to the National Institute for Health. For the provider of health information or healthcare, these elements influence beliefs and belief systems surrounding health, healing, wellness, illness, disease and delivery of health services. Cultural competence means having respect, knowledge and effectively responding to individual needs.
“It is essential for any hospital personnel to realize and understand the nuances within a culture,” said Lenora Reid-Rose, director of cultural competence at the Coordinated Care Services Inc. in Rochester. “An easy example is if a doctor is asking a Hispanic person if they use salt when they cook. The patient might say no, but health officials need to understand that a popular seasoning within their culture is adobo, which has a high amount of salt. But the community may think of salt as just regular salt instead of seasoning.” Reid-Rose believes the reason why knowing a patient’s cultural background and possible tendencies is because it becomes pivotal in transforming healthcare. It provides a positive impact for patient care and communication with providers and provide services that are more respectful and responsive to people. Lack of that communication can have dire consequences. “In those doctor offices is where true achievement in healthcare can occur,” said Jonique Freeman, program associate for cultural and linguistic competence in Coordinated Care Services Inc. “We have to find a way to avoid the disconnect in conversation where patients don’t feel like they are talking to someone who understands and cares about their concerns. Patients should feel like they are being treated like a person or they won’t come back and that
could mean serious health problems later in life.” With healthcare, there are many social determinant factors that affect access to care such as unemployment, poverty or fear of the medical profession. Making the matter worse, even when patients are able to navigate through the obstacles and see their physician, their initial interaction could turn them off. The importance of cultural information has many benefits including improving the therapeutic encounter for the patient, trust building and enhancing the likelihood of greater engagement and appropriate retention in care. Reid-Rose said the concept of cultural respect has a positive effect on patient care delivery by enabling providers to deliver services that are respectful of and responsive to the health beliefs, practices and cultural and linguistic needs of diverse patients. The work also has to be done from the patient itself. “I can use myself as an example. The things I know and the things I do are very different sometimes when it comes to healthcare,” said
Reid-Rose. “It is very hard to make changes as an individual if we don’t ask ourselves who we are and what are our tendencies. You have to be responsible for your own cultural knowledge and find out what ways can I improve my own knowledge.” While change is something that Shelton everyone wants, officials do caution having a realistic timeline. It will involve having community forums and truly listening to different options and seeing what might be successful. “When you talk about transformative, revolutionary change, that often doesn’t take a day or a month,” added Freeman. “We have to face the fact that it has to be a consistent message we are putting out there for any real impact to happen.” In the end, every medical official and institution is looking for one thing; better health outcomes. “There are so many factors that make us unique from where we live to where we work and how we interact with each other,” said Nancy Sung Shelton, program associate for the Coordinated Care Services Inc. “One of the ways that we can achieve success is understanding each other. As we engage with patients from different cultural backgrounds, we have to understand how their culture plays a role in the service we provide for them. How we do with that interaction might save their lives.”
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 • December 2016
GMO Labeling Law to allow labeling GMO food doesn’t please critics or supporters By Deborah Jeanne Sergeant
I
n August, President Obama signed into law a requirement for labeling designating foods containing genetically engineered ingredients, often referred to as genetically modified organisms (GMOs). But it seems that the measure doesn’t please either those who support or denounce the use of GMOs. Cindy Fiege, certified herbalist and owner of Harmony Health Store, LLC in Spencerport, believes the labeling is inadequate since the labels aren’t as forthcoming as she wants. Food packers and manufacturers need only include wording about the GMO ingredients, a QR code or a toll-free phone number to access more facts. In the latter two labeling types, consumers must seek the information themselves. “It’s sad that people in our country are unaware of the potential health risks of eating GMOs,” Fiege said. “She claims that evidence proves that GMO foods are not safe for human consumption.” Among other loopholes, foods that are processed from genetically modified crops and contain only traces of genetically modified material may bypass the labeling. A part of the American diet since 1996, genetically modified foods are from plants that have been grown from seeds with altered DNA. The changes help plants resist pests, promote positive traits (such as non-browning apples), and resist herbicides used around crops. With only about 20 years of research on the effects of consuming these foods, Fiege is not convinced of their safety. “Serious health risks are associated with GMOs,” said Fiege. “Health risks are infertility, immune problems, accelerated aging, faulty insulin regulation, and changes in major organs and the gastrointestinal system. It’s a no-brainer why gastroenterology practices have boomed in 20 years.” Steve Ammerman, representative of New York Farm Bureau in Albany, contests this viewpoint. “There have been more than 2,000 studies that have shown there’s no greater risk to human health to crops grown with genetic engineering than those traditionally bred,” he said. “The National Academies of Science has released a study. It was a very wide reaching analysis of the information and it supported what an overwhelming number of scientists believe. It spoke a lot to the safety of GMO crops.” Available at https://nas-sites. org/ge-crops, the study stated that only about 12 percent of the world’s farmland is planted to genetically engineered crops. Few crops are predominately available — and widely planted — as genetically engineered. They include soybeans, cotton, corn and canola. Sugar beets, summer squash, and papaya aren’t as widespread. A few other crops, such as non-browning apples and potatoes, are still pretty rare as genetically modified types.
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Ammerman said that labeling foods as containing or not containing genetically engineered ingredients can lead consumer to think that “GMO” means “unsafe.” “That’s been a concern of agriculture for quite some time,” Ammerman said. “A mandatory GMO label is seen as a skull and crossbones. There has been a lot of misinformation. There has been fear bred in consumers.” He added that some foods that have never been available as genetically engineered are now being billed as “GMO-free” which he believes is misleading. “It’s marketing and trying to take advantage of the trend of the moment and some consumer bias one way or another,” Ammerman said. “It’s like ‘fat-free’ or ‘natural’ or ‘gluten-free.’” Some people fear that genetically modifying crops to resist herbicide can lead to additional pesticide use to rid fields of weeds. But Ammerman said that Round-Up, a commonly used herbicide, “is one of the most mild herbicides. You can buy it at Wal-Mart and put it on your driveway.” But as for over-using herbicide or engaging in off-label use, Ammerman said that’s unlikely since farmers try to reduce their overhead as much as possible and herbicide costs them money. A statement on Farm Bureau’s webpage about GMOs reads, “Technology allows farmers to produce more food, using less land and few chemicals, while conserving soil, water, and on-farm energy.” But farmers can choose nonGMO seeds if they wish. “Farmers have a choice,” Ammerman said. “Most corn grown is GMO, but there is non-GMO corn available that you can plant for organic or conventional use.” He views genetically engineered seeds as helping farmers cope with environmental fluctuations and challenges of areas stricken with drought or other problems. “A GMO seed has an average of 13 years of testing before it goes into the market,” Ammerman said. “There’s more testing on seeds than pharmaceuticals.” December 2016 •
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
A Dozen Don’ts for December and Beyond
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’ve shared lots of dos in the past to help people live alone with more success. Here are a few don’ts — some lighthearted — that may also help you on your journey toward contentment as you approach the New Year: n Don’t become a hermit. Get up, get dressed, lose the PJs or sweat pants, and get out of the house (or get on the phone). We humans are social animals; we’re meant to be with others. Solitary confinement is for criminals, not for people who live alone. Stay connected! n Don’t go on a shopping spree to fill an emotional void. Your savings account will thank you. n Don’t make Fruit Loops your main course for dinner. Well ... maybe on occasion. But as a general rule? No. Create a nice
place setting, fill your plate with something healthy, light a candle, pour yourself a glass of wine or cranberry juice, and enjoy some well-deserved time to yourself. A favorite magazine, book, or crossword puzzle can make for a nice dining companion. Bon appetite! n Don’t label yourself a loser just because you are spending a Saturday night alone. It’s not the end of the world. It doesn’t define you. Stream a Netflix movie or clear some clutter and call it a night. If the prospect of a Friday or Saturday night alone is too difficult, reach out to a friend today and make plans for next weekend. n Don’t put too much stock in that Dreamcatcher. If you find yourself wide awake in the middle of night fighting demons, you
KIDS Corner Fewer Parents Are Spanking Their Kids
might try meditation, journaling or aromatherapy. I fill my diffuser with lavender oil and do some deep breathing while I repeat the phrase, “Sleep is healing.” If that doesn’t do the trick, I get up and prepare myself some warm milk or herbal tea. I return to bed with fingers crossed and eyes closed. If all else fails, consider sleep aids. n Don’t avoid dancing lessons because you don’t have a partner. Good teachers know how to incorporate singles into their classes by making introductions or by partnering with single members to demonstrate steps. Lucky you! n Don’t jump into someone’s arms out of loneliness. Feelings of desperation can make you easy prey for a “suitor” with dubious intentions. It’s a risky place to be. Getting good at living alone will build your self-esteem and improve your chances of meeting someone who appreciates your strengths, not your weaknesses. n Don’t get behind the wheel after a night of drowning your sorrows with friends. No explanation needed. Drink and drive responsibly. n Don’t be afraid to travel alone. Some of my best trips have been taken with my favorite traveling companion: myself. I create my own itinerary, go at my own pace, and meet all kinds of interesting people along the way. Even a small jaunt can boost your confidence. On your own, you’ll discover your own resourcefulness, ability to solve
problems, and capacity to spend some time alone. It can be an enlightening adventure in self-discovery. I highly recommend it. n Don’t decline an invitation because it means walking in (and walking out) alone. You can do it. Make a beeline for the host to say “hello” and ask for an introduction to someone, if you are surrounded by strangers. Or get in line at the refreshment station. You’ll be engaged in conversation before you know it. Be yourself, be sincere, and be curious about others. Go and have fun! n Don’t act your age. You are free, unencumbered and on your own. What better time to spread your wings, be silly and otherwise express your glorious, awesome self. Put yourself with people who make you laugh. For me, that’s my sister Anne. So keep your sense humor. After all, life can be funny. n Don’t take these don’ts too seriously. You are in the best position to decide what to do or not to do — no shoulds, musts, or other people’s agendas. That’s one of the best benefits of living alone. Don’t I know it!
psychology at Georgetown University in Washington, D.C. “At all income and education levels, parents’ attitudes toward physical punishment have changed over the last 20 years and, very likely, their behavior with their children,” she said. For the study, Ryan and her colleagues reviewed four national studies of kindergarten-age children — about 5 years old. The studies were conducted between 1988 and 2011. Although a cultural shift away from physical discipline has occurred, some parents still believe spanking and hitting is the best way to control unwanted behavior, the findings showed.
More low-income parents than high-income parents still believe in hitting children to discipline them. Yet poorer parents, like richer parents, are increasingly using timeouts, the study authors noted. Nearly one-third of mothers with the lowest incomes still spanked or hit kindergarten-age children. Almost 25 percent reported using physical punishment in the last week, the researchers said. Parents with the highest incomes are less likely to endorse or report using physical discipline than those at the bottom of the income scale, the study found. The report was published online Nov. 14 in the journal Pediatrics.
More are relying on timeouts to discipline children, study shows
S
panking and hitting children to discipline them has been on the decline among U.S. parents — rich and poor alike — since 1988, a new study finds. According to the researchers, the number of mothers with an average income level who considered physical discipline acceptable decreased from 46 percent to 21 percent over two decades. Page 10
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At the same time, mothers who felt timeouts were a better type of discipline rose from 51 percent to 71 percent, the investigators found. “Parents seem to be using more reasoning and nonphysical discipline strategies with children, which is in line with what the American Academy of Pediatrics recommended in 1998,” said lead researcher Rebecca Ryan. She’s an associate professor of
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, New York. For information about her workshops or to invite her to speak, call 585-624-7887, or email gvoelckers@rochester.rr.com.
3,000,000+
That’s the number of robotic-assisted surgeries performed worldwide By Deborah Jeanne Sergeant
M
ore than three million patients worldwide have experienced robotic-assisted surgery since its introduction in 2000. It continues to evolve as a surgical tool, offering both surgeons and patients more advantages compared with open surgery and even standard laparoscopic surgery. So far, the FDA has approved only the da Vinci System as a robotic-assisted surgery tool. It is used for surgery related to cardiac, colorectal, gynecologic, head and neck, thoracic and urologic issues. It may also be used for general surgery. John Valvo, chief of robotic surgery with Rochester Regional Health, said the benefits of robotic surgery “haven’t changed much” and include precise control, easier access to surgical sites, faster recovery time and smaller incisions. “The 3-D, high definition is better than what you can see with the naked eye,” Valvo added. “That’s a major advance over laparoscopic surgery. It allows the surgeon to immerse himself in the surgery visually.” A recent development involves better visual detection of malignant tissue during surgery. By injecting immunofluorescent dye during surgery, “it gives some important ref-
“It’s very interesting to watch and be part of this evolution. Initially, it was on the cutting edge and now it’s mainstream and one of the single most technological advances in medicine. It’s here to stay.”
John Valvo, chief of robotic surgery with Rochester Regional Health. John Valvo,M.D. erences to the surgeon when they’re doing a surgery, particularly when taking part of an organ out,” Valvo said. Newer systems are going smaller to help increase their affordability. That should help out-patient surgical centers to upgrade to robotic-assisted surgery, which fits well with their model of sending patients home the same day. Current models cost about $2 million and require hundreds of thousands of dollars in annual
Misconceptions About Robotic-assisted Surgeries • Robotic assisted surgery involves lasers. "Robotic-assisted surgery is another tool with which to perform laparoscopic surgery. It has nothing to do with lasers." • The surgeon won't know what's going on because he
won't be next to the patient. "Some people feel awkward having a machine by them and not their surgeon. That fear is relieved somewhat when we have a discussion on it. There are many failsafes built in." December 2016 •
upkeep. “It’s very interesting to watch and be part of this evolution,” Valvo said. “Initially, it was on the cutting edge and now it’s mainstream and one of the single most technological advances in medicine. It’s here to stay.” Most surgeons tend to use robotic-assisted surgery for issues involving fixed organs. Intestinal surgeons haven’t used it as widely because it’s challenging working in such a large area of the body and with organs that aren’t as fixed.
• The robot takes over and can do what it wants. "The robot can't do anything without being controlled by the surgeon. It's just a tool to do things we've done for decades." Source: Brian Watkins, surgeon with Genesee Surgical Associates in Rochester.
“The setup of the robot is more difficult because it’s not originally designed for multi-quadrant surgery,” said Stephen Raugh, surgeon with Rochester Colon & Rectal Surgeons P.C., based in Rochester. But as the newer models come out, Raugh sees more usefulness for surgeons working in the abdomen. “One of the techniques in intestinal surgery is stapling,” he said. “The robot has greatly improved our ability to use stapling techniques in minimally invasive surgery.” It also helps for operations such as removing rectal cancer, when the surgeon must operate low in the pelvis. Since access from the outside is restricted because of the bony pelvis, accessing through the anal area or abdomen are the only choices. “Seeing into the deep pelvis from the deep abdomen is remarkably difficult, particularly the closer to the anus that the cancer is,” Raugh said. “Hence, colostomies were required way more often. One of the best advances is the ability to see and function or operate deep in the pelvis which improves the effectiveness of the cancer surgery.” Surgeons can also operate more easily on obese patients since they don’t have to reach through an incision and deeper layers of tissue. One of the drawbacks to robotic-assisted surgery is that it can take longer because of the diminutive size of the equipment. Raugh compared it to using manicure scissors instead of kitchen shears. It just takes more cuts to achieve the same results. He added that several companies are close to FDA approval of robotic systems. “When that happens, the pace of improvement and adoption of robotic surgery will quicken because competition does just that,” Raugh said. “I look forward to the competition because of the number of new advances will increase more rapidly and those advances will hold many benefits for patients.”
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Holidays
Holiday Blues or Depression?
Why the ’happiest season of all’ brings sadness and depression. Experts weigh in
By Deborah Jeanne Sergeant
I
nstead of Joy to the World, some people feel sad, lonesome and overwhelmed during the holiday season. It may seem strange to those not experiencing those feelings, but for some, the season elicits symptoms that mimic depression or actually trigger depression. Ese Moynihan-Ejaife, licensed mental health counselor and owner of Moynihan Counseling Services in Rochester, said that a few key factors differentiate holiday blues from clinical depression. “Holiday blues often are a little more temporary,” she said. “It characteristically sets in when we start preparing for Thanksgiving and passes a little after New Year’s.” Clinical depression typically lasts longer and is typified by deeper, more profound sadness accompanied by five or more of the following symptoms: sadness, crying, changes in sleep patterns, lack of concentration, anxiety, increased or decreased appetite, feelings of guilt and worthlessness, lower energy levels, and lower motivation.
Some people experiencing depression contemplate self-harm. Feeling sad during the holidays seems incongruent with the “happiest season of all,” but for some people, reality falls short of their expectations. “There’s a certain level of pressure that comes with holidays,” Moynihan-Ejaife said. “That may mean following traditions, getting together with people. There may be financial pressure we may or may not be able to meet. The holiday may have a very specific structure that can be frightening to have to fill every single year.” If the family always gathered at mom and dad’s to celebrate, but dad passed away and now mom lives in a condo, it can be hard to adjust to the new normal. Or perhaps the entire family is intact but has never gotten along well. Those Hallmark-perfect memories never happen. Moynihan-Ejaife recommends clients to identify their source of stress and develop healthy means of addressing them. Avoidance, turning
to alcohol or overspending represent unhealthy coping mechanisms. Healthy coping “might mean reaching out for support, setting boundaries for people who might be toxic or unhealthy in their lives, letting go of some expectations that can’t truly be met, and learning how to engage in self-care,” Moynihan-Ejaife said. “Do what you need to do to know you’re OK and healthy and well. Sometimes, it’s letting go of some traditions that take too much energy or aren’t realistic anymore.” For example, attending a family celebration filled with put-downs and verbal arrows can cause plenty of stress. Briefly making an appearance can help keep the tradition without enduring hours of emotional pain. It’s important to note that in the North, seasonal affective disorder (SAD) influences how some feel. Lack of sunlight can trigger the mood disorder since the body does not receive sufficient natural sunlight. “Our brains translate this low level of light intake into feelings of sadness, difficulty concentrating and feeling generally Rudd mopey,” said Amanda J. Rudd, licensed clinical social worker in private practice in Rochester. “Combine an already altered mood by weather and season, add in obligation, stress, and frustration, and bam- holiday blues.” Of course, some people may
experience depression during the holidays, even if they don’t feel grief from loss or being overwhelmed. “A lot of clients describe these feelings of hopelessness, despair and a lack of motivation despite life being generally good for them,” Rudd said. “The holiday blues are often tied to circumstances, or probably more often, traumatic memories revolving around holiday gatherings and/or family situations.” Although depression is a medical condition usually treated by medication and talk therapy, neither depression or holiday blues should be ignored. “If you aren’t sure about which you are experiencing, go see your primary care provider, or take a self-rated quiz, like the Beck Depression Inventory (www.hr.ucdavis. edu/asap/pdf_files/Beck_Depression_Inventory.pdf) to help clarify what you are feeling, how long it’s been going on and what to do next,” Rudd said. Rudd encourages people seeking treatment for depression to find a therapist with whom they feel comfortable. Kathryn S. Castle, Ph.D, and licensed mental health counselor practicing in Rochester, encourages people to take part in self-care activities in addition to healthy coping skills to prevent holiday blues and depression. “Self care is really, really important,” Castle said. “Get involved in a mindfulness activity, which can help you focus on one thing in the moment. It could be petting your dog or cat while noticing everything about the animal.”
ing bodyweight movements at home “is very effective at increasing your heart rate to burn some calories off.” These include movements such as air squats, burpees, and sit-ups. Callisthenic movements like these are portable for anyone traveling during the holidays, too. To prepare for a party or holiday meal, he advises engaging in an extra workout that week and stick with healthful choices when possible. Heather Carrera, certified nutrition specialist at the practice of physician Lesley James, board-certified family physician in Rochester, would agree. She said that poor food choices, along with overeating, contribute tremendously to holiday weight gain. Eating a light meal that includes healthful fat, fiber and protein before leaving home can help you avoid arriving famished and making poor food choices. “If you choose to indulge at a party or family get-together, always pair a high glycemic food with protein, fat or fiber,” Carrera said. “These will all slow the absorption of
the sugars, lessening the impact they have on your blood sugar, and will lower the overall glycemic index of the meal. She listed deviled eggs, a veggie platter with hummus, a turkey slice from an antipasta tray, mixed nuts, or some olives as good choices. If it’s a casual gathering, bring your own platter of cut-up veggies or fruit, or shrimp and cocktail sauce. Go easy on alcohol, as its high caloric content and ability to impair your judgment can spell disaster for your healthful eating plan. Carrera recommended dry wines or using seltzer water and lime as a mixer. With parties to plan, attend, gifts, decorations and events, it’s easy to get so busy that grabbing fast food sounds like an easy solution for meals. But Carrera advises clients to carry healthful snacks with them in the car or bag to tide them over, such as a 100-calorie bag of nuts, seeds, fresh fruit, and a water bottle. The snack should help you stay fueled up until you can eat a healthful meal.
Avoid Holiday Weight Gain — If You Can By Deborah Jeanne Sergeant
T
he Jolly Old Elf may be part of your celebration, but you don’t want to end up looking like him after New Year’s. Many people find it hard to keep weight off during the last month of the year for different reasons. Physician Michael J. Gavin, UR Medicine Primary Care Towpath Medical Group, said that “decreased exercise, shorter days, longer nights, cold weather, and changes in sleep Gavin habits” are part of the reason people gain weight during the season. “[But] the most influential contributor is the holidays themselves. Or more specifically, pies, large quantities of meats, carbohydrates, several different forms of potatoes, overeating, and my personal favorite: cut-out cookies.” Page 12
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He also views stress and lack of sleep as contributors since these increase the body’s cortisol levels. This hormone signals the body to latch onto calories and store them as fat. Busy schedules also limit many people’s ability to exercise as they normally would. “Make time for it in your week,” Gavin said. “I tell my patients to schedule it in their calendar and to set reminders for it, like it’s a meeting for yourself that you can’t miss.” Brian Lelli, head coach and owner of Forge Fitness in Rochester, said that planning ahead makes a big difference in staying on-focus with weight control during the holidays. “Once we have some tangible goals set for our people, we have them write them down on our big chalkboard as well as tell multiple people in their lives,” Lelli said. “This additional accountability is a great motivator when we have thoughts of skipping the gym for one reason or another.” He advises clients that when the day doesn’t go as planned, perform-
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
Holidays Toy-buying Season. But How Safe Are These Toys? Experts say consumers have to be careful with what types of toys they buy for children
By Deborah Jeanne Sergeant
A
re children on your gift list? Keep them safe by purchasing appropriate gifts. Beth Orlowski, pediatrician with Sodus Pediatrics, advises buyers to look at gift packaging to ensure the child can safely play with it. “A 2 1/2-year-old should not get a toy rated for 3,” Orlowski said. “An issue I’ve run into is with parents that have multiple-aged siblings. It’s important to make sure the older child picks up the toys. They should keep the toys in a room the baby can’t get into.” Children’s developmental stages can vary. Some children may not be mature enough to play with toys that
are rated for their age. For example, a 3-year-old who still frequently places toys in his mouth may need to wait on a toy rated for his chronological age. Not all toys bear age safety ratings. Some toys sold from a bulk bin lack packaging. You can look up used toys online for recall information (www.cspc.gov); however, vintage and handmade toys lack this information. Orlowski said that as a general rule, any toys or parts of toys smaller than a fist present a choking hazard. Look for removable parts or parts that may be broken off. U.S.-made toys made more recently than the
SmartBites
The skinny on healthy eating
Flour Power: What’s Good, What’s Not
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s flour good for you? Now that the holidays are here — a time deliciously devoted to baking and consuming products made of flour — we wanted to shine a light on this popular grain. Let’s begin with our considerable consumption. According to some studies, the average American consumes between 400 to 500 cups of flour a year, which translates into about 1¼ cups (or 10 ounces) a day. “Six ounces of grains” is what the USDA recommends that we consume each day for all grains, not just flour, with an added recommendation that half of those 6 ounces be whole grains. So, 10 ounces from flour alone is both sobering and noteworthy. Because, like many, I get a good dose of my daily grains from flour — from bread (two slices equal 2 ounces) to pasta (one cup equals 2 ounces) — I made a conscious decision years ago to stop eating foods made with refined white flour in favor of those made with the more nutritious whole wheat flour. It’s mostly what I bake with, too. That’s not to say that white flour, which has been stripped of its bran and germ, has no merits. Much like whole wheat flour, a quarter cup of enriched white flour provides about 100 calories, 3 grams of protein and a slew of B vitamins and some minerals. Some enriched white flours, in fact,
1970s won’t contain lead; however, those made before and overseas may still have lead which is harmful to children’s development. The Consumer Product Safety Commission has worked to tighten inspection of imported toys, but if you purchase them directly on the Internet, you can’t know if the toys contain lead or not. Orlowski warns buyers to pay special attention to toys purchased on Amazon.com or eBay.com, as some are used and may not include the packaging or be up-to-date with current safety standards. Some manufacturers post their safety data online, so if you want to save money buying a used toy, research the company’s available information. Many people enjoy shopping at craft fairs for handmade toys. Especially with these items, look for buttons and other fasteners on teddy bears and doll clothing. Embroidered eyes are safer than button eyes, for example. With electronic toys, “button batteries are a major concern,” Orlowski said. “They’re easily accessible to get out. The battery acid is very dangerous. It’s considered a surgical emergency if the child may have swallowed it. They are surgical emergencies. It’s not like a coin where you can see if it passed. Magnets are
another risk. If you swallow multiple magnets and they get caught in the intestines and perforate the bowel.” Malachi Fisher, coalition leader for Safe Kids Western New York region, also warns that buyers should consider strangulation and circulation hazards such as pull strings that could wrap around a neck or digits. Plastic tubing used for pulling toys provides greater safety. Carefully inspect larger toys such as a playhouse for sharp edges and corners. Don’t modify the assembly information as that may compromise the toy’s safety. “If you’re buying online, took at reviews,” Fisher said. “They should have consistent reviews. Follow up on those.” Skip gifts that are too fragile for children to play with. The glass angel ornament may thrill your little girl, but will she resist playing with it? If someone gives your child a toy you don’t feel is safe, you can put the toy away until he is mature enough for it. With all the hubbub of opening gifts, he likely won’t notice one toy is “missing” anyway. If you’re in doubt, give that grandchild, niece or nephew a gift card to a toy store so the parents can help guide the gift choice.
and Japan have banned the use of these chemicals, but the US has not. Food in California that contains potassium bromate, however, must bear a warning label. Although the research is still out on the potential health risks of consuming these chemicals, numerous US flour companies no longer use them. So, is wheat flour good for you? Yes; although some kinds are better than others. Whole wheat is more nutritious than white; enriched white is better than non-enriched white; and any flour that has not been bleached or bromated is better than the alternative.
fine
Helpful tips
have more iron and certain B vitamins (such as folic acid) than their whole wheat cousins. What refined white flour doesn’t have, however, is fiber — the nutrient that keeps us regular, helps with weight control, stabilizes blood sugars and assists with the removal of bad cholesterol. Most whole wheat flours provide about 3 grams of fiber per quarter cup. Health-promoting phytochemicals and antioxidants such as vitamin E are also removed in the making of white flour. Studies have shown that both may help to protect against cancer, cardiovascular disease and Type 2 diabetes. Again, whole wheat flour boasts many of these beneficial compounds. Lastly, many flour companies add benzoyl peroxide or chlorine dioxide to chemically whiten (bleach) their flours. Some add potassium bromate to chemically strengthen their flours. Several European countries, Canada December 2016 •
To prolong shelf life, transfer flour from its paper bag to an airtight plastic or glass container. Store refined flour in a cool, dry place. Store whole wheat flour in the fridge or freezer. Flour that has gone rancid smells sour. Bakers’ hints for baking with whole wheat flour: Make sure flour is fresh; add two teaspoons of liquid (water, milk, orange juice) per cup of whole wheat flour (to combat dryness); substitute some of the whole wheat flour in a recipe with all-purpose flour (for a lighter texture); and use “white whole wheat flour, “ which is simply whole grain flour that has been milled from white wheat (for a lighter color and milder taste).
Chocolate-Nut Thumbprints Adapted from America’s Test Kitchen; Makes two dozen cookies 8 tablespoons (1 stick) unsalted butter, softened ½ cup sugar ¼ teaspoon salt ¼ teaspoon cinnamon 1 egg yolk 1 teaspoon vanilla extract 1 tablespoon milk ½ cup pecans, toasted and ground
1 cup white whole wheat flour* ¼ cup all-purpose flour ½ cup semisweet chocolate chips ¼ cup heavy cream or milk 1 tablespoon corn syrup
Heat oven to 350 degrees. Line baking sheets with parchment paper. With electric mixer on medium speed, beat together butter, sugar, salt and cinnamon until smooth. Add yolk, vanilla, milk and nuts and beat until well blended. With mixer on low speed, beat in flour just until dough forms a cohesive mass. Roll dough into 1-inch-thick balls and place 1 inch apart on prepared sheets. Bake for 10 minutes, remove from oven, and press indent into each cookie using thumb or bottom of rounded ½-teaspoon measure. Return to oven and bake 7 minutes more. Remove to a wire rack to cool. In a small saucepan over medium-low heat, combine chocolate chips, cream or milk, and corn syrup, stirring constantly until smooth. Cool 20 minutes. Fill the thumbprints with the chocolate mixture; let sit for another 30 minutes. *New to cooking with whole wheat flour? You may want to start with a ratio of ¾ cup whole wheat flour and ½ cup all-purpose flour for this recipe. 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.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Sour on Sweets Pediatrician uses personal experience to help patients look at sugar differently By Ernst Lamothe Jr.
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n every way possible, Jeff Eisenberg was an addict. His white, granular drug of choice is often overlooked, but causes one of our greatest health concerns this century. Eisenberg, a pediatrician by training, knew for his own sake he had to quit his habit as soon as possible and leave the massive amounts of sugar he was putting into his body out of his diet. “I was a healthy person who worked out regularly. If you saw me nobody would have thought that I was constantly having sugar,” said Eisenberg, 58, of Pittsford. “But it was finding its way through every level of my life. Even after working out, I would down two Gatorades, which is packed with sugar. I probably wasted my entire workout.” Eisenberg had a series of sugary snacks that eventually led to his health conditions — processed Pop-Tarts, cakes, cookies, chocolate-covered almonds and Eisenberg ice cream. He would eat healthy, nutritious meals around those snacks, figuring that exercising would counteract his addiction. He biked, golfed and was a cross-training enthusiast, but then high blood pressure snuck up on him after receiving his lab work. It was predictably followed by high cholesterol and having to take daily medication.
emy of Pediatrics. He was voted one of the top 100 pediatricians in Rochester, and was voted one of the top 100 pediatricians in the nation. His specialty interests include the evaluation and management of attention deficit disorder and anxiety. But dealing with his addiction led him to want to share the information and the ills of sugar with a broader population, so he wrote a book. “Sugar is all around us. Do you know there are 156 different names for sugar? So even though the public is aware of the term high-fructose sugar, that doesn’t mean that a company just isn’t using another kind of sugar that is just as bad,” said Eisenberg. “You walk through a grocery store and you would be astonished at the percentage of food that has a high level of sugar.”
Not sugar coated
“This is not the way I wanted to live my life,” said Eisenberg. “I needed to make a change and I needed to make it now.” Slowly, he decided to concentrate limiting his sugar tremendously. This personal decision also allowed him to speak to patients in a first-hand way. “I tell them that you can exercise and eat right, but if you ignore the amount of sugar you are putting into your body, then bad things will happen.” Eisenberg added. “And I am not talking to them as someone who is lecturing. I talk to them as someone who is still dealing with the addiction and battles it everyday. I’m not someone who can just have a bite of a candy bar. I want two candy bars.” During his 30-year tenure in primary care, Eisenberg has been a member of his local medical society and a fellow of the American Acad-
“Suckered,” written last year, tracks the stealthy infiltration of one of America’s greatest threats, a silent killer 10,000 years in the making — sugar. The book is the result of over a year of dedicated and diligent research work and consultations to discover the deadly truth about how sugar works in our bodies. Eisenberg said sugar’s role in transforming societies and defining national boundaries is explored and reveals the shocking truth of how sugar has come to saturate our diets. While not all bad, he believes the addictive toxin has wreaked havoc on our biological systems, from diabetes to cancer, heart disease to dementia, hypertension to obesity. With a plan for the future to empower personal and nationwide change, he hopes “Suckered” provides insight into combating the nation’s biggest addiction. “Sugar tricks the brain into thinking you are still hungry so you go to the fridge or cupboard to look for something and your first thought isn’t to find something healthy. And the more sugar you eat, the hungrier
‘Easing the transition of a loved one and sharing the moment of passing are among the finest gifts we can hope to give and receive in this life.’ you might be,” said Eisenberg. “I think some people are judgmental and think if someone is overweight it is only because they don’t have will power. But so much more goes into it.” By tracing the history of sugar, Eisenberg said it becomes clear how we’ve all been so blind to the stronghold it has gradually placed upon us. The book dives deep into sugar-sweetened soft drinks. It details that for every soda consumed, the odds of developing obesity increase by 60 percent and it averages 7.1 percent of total daily calorie consumption. “People have read the book and they say it has changed their lives,” said Eisenberg. “It’s because I am not selling a trick or something amazing. I am just helping people connect the dots and show them a way out of the trouble they might be in. The first step is just educating people on the issue and teaching them information they never knew before.” As he continued to do his research, what made him even angrier was the fact that businesses were targeting kids when it came to sugar. He said they would package cartoon characters, bright colors and celebrities to pitch unhealthy sugar-coded processed obesity. He hopes the federal government works on putting warnings on foods with high sugar. “This is how the problem starts when they are young and spreads,” said Eisenberg. “There is even sugar in baby food in quantities that are unnecessary. People make it seem like you should only look at the fat content in the nutrition facts, but sugar is the real killer.”
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
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Get Ready for Flu Season Flumist inhaled flu vaccine is out this year, but there are other types, especially for seniors, expected to be more effective By Deborah Jeanne Sergeant
A
re you ready for flu season? February usually represents the month with more cases of influenza than any other, according to the Centers for Disease Control. You still have time to get ready. A few factors have changed since last year. Flumist inhaled flu vaccine, though popular with children and anyone who hates needles, won’t be offered this year. “Upon reviewing the data for the last three years for the use of Flumist, it wasn’t effective for the past three years,” said physician Nancy Bennett, director of the URMC Center for Community Health. “We’re suspending the Bennett use pending additional data. Flumist is a wonderful technology we’d like to see used.” Other major topics have been vaccines in those over the age of 65. Two new formulations may prove to offer better protection. “Both have been studied in older people to see if they’d be more effective,” said Bennett, who is also co-director of the URMC Clinical & Translational Science Institute, and chairwoman of the Centers for Disease Control’s advisory committee on immunization practices. “The hope is that they will elicit more immunity than the standard vaccine. We’ve noted for years it’s not as effective in older people as younger. “The goal has been finding new technology that make it more effective for older people. Older people have less strong immune response to vaccine. They’re at much higher risk for complications from influenza, so it’s especially important that they get vaccine and that it’s effective in them.” Physician Luis Postigo, owner of Senior Medical Care in Webster, said the high dose vaccine is more expensive than standard flu vaccine. Referring specifically to Fluzone High-Dose, manufactured by Sanofi Pasteur Inc., he said it “seems it produces a stronger immune response but what is not clear is if this stronger response leads to a increased protection.” The vaccine costs more than standard flu vaccine. “Since the Centers for Disease Control and Prevention and its advisory committee on immunization practices have not expressed a preference for any [special] flu vaccine
for people above 65 for the season 2016-2017, I do not recommend it for this season,” Postigo said. While most people recognize that influenza vaccine is important for children and the elderly, Bennett said everyone should receive vaccine to avoid infecting these populations, who can become critically ill because of their lower immunity. “If we don’t get vaccinated, we can transmit the flu to people less able to fight it,” Bennett said. “It’s very important for everyone to get vaccinated. Flu makes you very, very sick. It’s not a cold. It’s much more severe.” Cindy Fiege, certified herbalist and owner of Harmony Health Store, LLC in Spencerport, said that keeping the immune system strong helps prevent getting the flu. “I do not believe in a ‘flu season,’” Fiege said. “Fall/winter is a time when our bodies just get overloaded and our immune system is weak.” She recommends high-quality supplements, including vitamins C and D-3. “The best way to keep your immune strong is to have eight hours of undisturbed sleep per night, eat a healthy diet with plenty of green leafy vegetable, drink plenty of water, avoid sugar, and exercise daily,” Fiege said. “A simple 20 minute brisk walk does wonders for the body.” Lou Papa, UR medicine primary care physician, strongly recommends vaccination and occasionally must reassure patients that flu vaccine is safe. “The amount of mercury in there is infinitesimal,” Papa said. “It’s nothing compared to the mercury you get from the food you eat. Most vaccines now are preservative-free so there’s none even in them. The autism connection has been clearly disproven.” He said that the danger from contracting influenza is much greater than the extremely low danger of even a mild reaction from the vaccine. Papa said that beyond vaccination, avoiding people who have the flu is the best way to avoid the flu. But since people can spread the flu before they know they’re infected, frequent hand washing can help curtail flu. “If you have the flu or suspect it, don’t practice presentee-ism,” Papa said, referring to employees going to work while sick. “You’ll infect more people. Use the upper part of your arm to cover sneezes, not your hands.”
December 2016 •
18 CONVENIENT LOCATIONS IN MONROE AND LIVINGSTON COUNTIES
Close to Where You Work or Live
Early Morning and Late Evening Hours for Your Convenience LATTIMORE PHYSICAL THERAPY NETWORK AVON PHYSICAL THERAPY 490 Collins Street Avon, NY 14414 Phone: 226-2480 Fax: 226-2494 Co-Clinical director: Jon Gerenski, DPT Co-Clinical director: Leslie Summers, PTA Owner: Mario Melidona, PT DANSVILLE PHYSICAL THERAPY 40 Village Plaza Dansville, NY 14437 Phone: 335-2456 Fax: 335-3494 Owner: Matt Marino, MS, PT
LATTIMORE OF IRONDEQUOIT PT 1299 Portland Ave Suite 10 Rochester, NY 14621 Phone: 286-9200 Fax: 286-9203 Clinical Director: Lindsey Yu, DPT, LMT LATTIMORE PHYSICAL THERAPY AND SPORTS REHABILITATION 1655 Elmwood Ave Suite 130 Rochester, NY 14620 Phone: 442-9110 Fax: 442-9049 Clinical Director: Erin Tobin, PT, DPT
LATTIMORE OF FAIRPORT PT 59 Perinton Hills Shopping Ctr Fairport, NY 14450 Phone: 385-0444 Fax: 385-0442 Clinical Director: Matthew Stoutenburg, MS, PT, CSCS
LATTIMORE PHYSICAL THERAPY (Land and/or pool based therapy) 383 White Spruce Blvd Rochester, NY 14623 Phone: 442-6067 Fax: 442-6073 Clinical Director / Owner: Andrew Chatt, DPT, OCS Owner: Cynthia Shuman, MS, PT, ATC
LATTIMORE OF GATES-CHILI PT 5 Fisher Road Rochester, NY 14624 Phone: 247-0270 Fax: 247-0294 Clinical Director: Jeff McGiven, PT
NORTH GREECE PHYSICAL THERAPY 515 Long Pond Road Rochester, NY 14612 Phone: 227-2310 Fax: 227-2312 Owner: Tim Anne, MS, PT, MLD-CDT
LATTIMORE OF GENESEO PT 4577 Morgan View Road Geneseo, NY 14454 Phone: 243-9150 Fax: 243-4814 Clinical Director: Johanna Kaufman, DPT
PIANO WORKS PHYSICAL THERAPY 349 W. Commercial St. Ste. 1275 East Rochester, NY 14445 Owner: Leah Gerenski, DPT, OCS
LATTIMORE OF GRPT 2000 Empire Blvd. Building 2 Webster, NY 14580 Phone: 671-1030 Fax: 671-1991 Clinical Director: Melissa Graham, DPT, OCS
PITTSFORD MENDON PT 20 Assembly Dr. Suite 101 PO Box 212 Mendon, NY 14506 Phone: 582-1330 Fax: 582-2537 Clinical Director: Dustin Maracle, PT, DPT, MS, SCS, COMT,CSCS
LATTIMORE OF GREATER PITTSFORD PT 40 State Street Pittsford, NY 14534 Phone: 387-7180 Fax: 387-7182 Clinical Director: Adam Ellis, DPT
RUSH HENRIETTA PT 60 Finn Road Suite C Henrietta, NY 14467 Phone: 444-0040 Fax: 444-0052 Clinical Director: Karen Shufelt, DPT, CHT
HILTON PHYSICAL THERAPY 1026 Hilton Parma Corners Rd. Suite 1, PO Box 131 Hilton, NY 14468 Owner: Matt Landon, DPT HONEOYE FALLS LIMA PT 58 North Main Street Suite 200 Honeoye Falls, NY 14472 Owner: David Monsees, MS, PT
LATTIMORE OF SPENCERPORT PT 37 N. Union Street Spencerport, NY 14559 (585)349-2860 Fax (585)349-2995 Clinical Director: Russell Manalastas, DPT, SCS, COMT, CSCS LATTIMORE OF WEBSTER PT 1130 Crosspointe Lane, Suite 6 Webster, NY 14580 Phone: 347-4990 Fax: 347-4993 Owner: Adam Frank, MS, PT
www.lattimorept.com IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 15
Paula Busch and Sue Kummer both were instrumental in creating and developing TIG — Consortium of Trauma, Illness and Grief in Schools. Both retired over the summer. Busch from Webster Schroeder High School, Kummer from Penfield Central School District. They are still active in the TIG group.
Dealing with Trauma, Grief in Schools Group works with 100 school officials on how to aid students and faculty in the event of a major trauma or crisis By Ernst Lamothe Jr.
P
aula Busch was in a classroom with a few colleagues 15 years ago trying to wrap her head over the Sept. 11 terrorist attacks, which had occurred a week before. That gathering was the first training group of a new initiative that came to be known as TIG — Consortium of Trauma, Illness and Grief in Schools. Today, Busch and the people behind TIG help train nearly 100 school officials each year on how to aid students and faculty dealing with some of the most trying times of their lives. “Nobody could have known how big this program would become,” said Busch, 61, of Irondequoit, who
worked with Webster Central School District. “The first group of people were only those with mental health or counseling backgrounds from five different school districts, but now we train superintendents, assistant principals, teachers, public safety and the communications department throughout Monroe County. Everyone has a role in helping people get through sometimes expected or unexpected grief.” Busch was instrumental in developing what the program looks like today along with her colleague Sue Kummer, who worked for the Penfield Central School District. Both women, who retired this
Parenting By Jessica Gaspar
Selecting a Pediatric Dentist
S
o my pediatrician recommends babies see a dentist by the time they are 1 year old. I have been thinking about his dentist since his first tooth emerged back in July. I would eventually like him to see my dentist, Rober Kowal on Monroe Avenue in Brighton. My family and I have seen Dr. Kowal for more than 20 years, but he doesn’t see children younger than 3 years of age. For a pediatric dentist, I received a couple of recommendations from friends and family. Though I live on the west side of the city, I prefer doctors and physicians on the east Page 16
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side — preferably Brighton. That’s where all of my doctors are, so that was one criterion. Others included friendliness of staff and doctor. If you’ve been a faithful reader of this column, you may remember the hassle I had when signing Timmy up for health insurance. He’s got MVP, but the dentists I wanted did not accept MVP, so I wound up adding Timmy onto my dental insurance policy through Excellus that I’ve got through my employer. No big deal — the cost went up to just $17 per week. I will still keep him on the MVP for his health insurance just because
summer, have served on the TIG advisory board as well as being the implementation leaders for their districts. Their work has truly formed many of the structures, processes and procedures that school districts throughout Monroe County have implemented to support students, staff and families following crises. And even in retirement, they will continue to train others one last time in the current school year. “There are so many things going on in schools nationwide whether you see school shootings, bullying and mental health issues,” said Kummer, 62, of Pittsford, who instructs on school violence and threat assessment. “I couldn’t image our school districts without an organization like this. Now you have an incredible amount of resources where there is a primary and secondary contact at each school to handle whatever may come up.” The TIG main mission is to provide essential information to school professionals and help them understand, intervene effectively and support students through small and large-scale crises. The nonprofit group also serves as the back-up support network for Monroe County schools to access additional support should a district’s own capacity be exceeded. Based on community response and interest, the organization continues to expand and offers five-day “core curriculum” training twice each school year since 2013. TIG is in every district in Monroe County, three of the private schools and three districts outside of Monroe County. “Everyone experiences some kind of trauma and the worse thing you can do is isolate yourself and try to forge ahead without any support,” said Busch, who teaches grief and loss for the organization. “We’ve had to deal with students committing suicides, parents and teachers dying suddenly and a number of other simply tragic events.” Busch said she was ready for the challenge on the first day of class 15 years ago because Webster had already developed a crisis manual in the late ‘90s. Sharing their mate-
rial with other districts provided a foundation. “Some smaller districts don’t have the resources so it really does help to have a network of people you can turn to for advice, strategy and support,” added Busch. “This has been such a successful program because Monroe County supported us from the very beginning.” For Kummer, counseling was always her passion. She would see students who had to struggle so much with family issues, which could easily slip into their academic lives. And with family being the original teachers for children, an unstable out-of-school life can heighten drop out rates. Then the opportunity to be involved with TIG came up. She has helped counsel students from elementary school to high school. “Whether it is a 5-year-old or a high school sophomore, school can be thrilling and scary at the same time,” added Kummer. “And when something tragic happens, it can affect multiple buildings in a district because there are family members who span various ages.” In her role, she supports teachers and staff when heartbreaking incidents occur. She works with family members, makes sure classroom teachers and even district bus drivers are informed. Kummer has also aided other districts that needed some advice. “When something difficult happens, it has to be all hands on deck. Every section of the school has to be prepared to help that child deal with the situation,” said Kummer. A job that requires patience, love and empathy also creates stress and emotional anxiety for those who must be the rock for others. “In our business, they call it compassion fatigue. It is something that I can image social workers, police officers, nurses, firefighters and ambulance services employees deal with all the time as well,” said Kummer. “It can all build up fast so you have to maintain a balance at home if you are ever going to make it through the school year handling grief, illness and trauma.”
it is a fraction of the cost of what a family plan would cost through my employer. For his dentist, I chose Cheryl Kelley located in the White Spruce medical complex across from Monroe Community College. My sister’s children see her, and one of her employees is actually a customer at my job. She is very friendly and simply raved about Dr. Kelley, so that had me sold. I’m a little apprehensive about taking Timmy to the dentist. He does pretty well at his doctor’s visits, but a dentist is usually a little scarier. I may ask to take a tour with Timmy a week or two before we go so he can be familiarized with the staff and surroundings prior to his appointment at the end of January. He’s been brushing his teeth on a regular basis, so he’s already on the way to optimal oral health. These days, my boy loves spending time outside. He especially loves walks around the neighborhood and swinging in our backyard swing. But, most of all, he particularly enjoys sitting at the front door watching the cars go by.
Sometimes, if it’s nice out, we will sit out on the front porch. He also loves spending time with his cousins Carson, Camryn and Emma. We usually see Carson every Sunday for football. On one Saturday last month, Camryn and Emma spent the night; Timmy had a blast. However, 2-year-old Emma was particularly upset because her ‘buddy’ kept stealing her toys! Camryn absolutely loves spending time with Timmy, and we play games of hide-and-seek through the house. Camryn loves to hide on him, and he laughs so much when we finally find her. I began shopping for Timmy’s first Christmas in October, so I’ve got a good head start on that. His first birthday is in January already — can you believe it?! (Neither can I.) I’ll probably do a small birthday at my parents’ house. Time is just flying, and I thank God every day for giving me this beautiful little boy. It may sound cliche to say, but he is the best thing to ever happen to me.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
Meet Your Provider
Rochester Colon Rectal Surgeons, PC
Since 1977, the trusted team for colon care in Rochester. Practice was the first to perform the robotic colon surgery in the region
R
ochester Colon-Rectal Surgeons, PC was founded in 1977 by a group of surgical specialists committed to caring for people with problems of the intestinal tract. Our expertise includes the treatment of tumors; cancers of the colon, rectum and anus; diverticulosis; diverticulitis; Crohn’s disease; ulcerative colitis (including J pouch surgery); wound and ostomy care, anorectal problems (hemorrhoids, fissure, abscess, fistula, and warts, fecal incontinence). All the surgeons in our practice are fellowshiptrained and board-certified in colon and rectal surgery, which means we not only have the expertise you deserve for this type of surgery, but the dedicated interest of each of the physicians to treat your problem. Our doctors work as a team to provide you the attention you need during normal work hours as well as evening and weekends. At times when your physician may not be available, one of the other RPA-C specialists will always be on call to meet your needs. Rochester Colon Rectal Surgeons were the first colon rectal surgery group to perform the robotic colon surgery in Rochester in 2008. We are No. 1 in the nation performing the most successful
procedures. Rochester Colon Rectal Surgeons perform surgeries at Rochester General, Unity Hospital, Highland Hospital and FF Thompson. Rochester Colon Rectal Surgeons pride itself with prompt high quality service. We have five locations for your convenience, Brighton, Irondequoit,
Greece, Canandaigua and Geneseo. We have eight board-certified surgeons, Drs. Stephen Rauh, Mary Lou O’Neill, Asim Farid, Steven Ognibene, Bastian Domajnko, Claudia Hriesik, Brian Teng, and Patrick Solan. Advance practicing providers, Marie Bianchi, NP, specializes in wound and ostomy care; Leisl Hand, R-PA, specializing in genetic testing; Teresa Schwartz, NP, specializing in high resolution anoscopy; and Carol Strauss, RPA-C, specializing in IBD patients. We regularly screen our patients for colorectal polyps and cancer. We also offer screening for anal cancer, including high -resolution anoscopy. Rochester Colon and Rectal Surgeons, P.C. is devoted to providing high quality colorectal surgical care in an atmosphere of compassion to the patients of the greater Rochester area and surrounding communities. We screen for colon and rectal cancer, including in-office colonoscopy. If you are uninsured or underinsured your colonoscopy may be free of charge to you. RCRS is a partner of CancerServicesProgram of Monroe County. We offer sedation-free colonoscopy.
www.rochestercolon.com • 585-222-6566
Q&A
and offering the support that our physicians need.
3 What are some of the important 3.
with Christopher Bell
New executive director at Monroe County Medical Sociaty
H
e was recently appointed as the new executive director of the Medical County Medical Society. He succeeds Nancy Adams starting Dec. 5. Adams retired after serving the organization since 1997. Founded in 1821, the Monroe County Medical Society (MCMS) is a nonprofit professional organization whose members are physicians, surgeons, medical students, and residents. The society was formed with the purpose of extending medical knowledge, elevating the standard of medical education, promoting reforms and enlightening and directing public opinion in regard to the problems of medicine and health for the best interests of the people in Monroe County.
1 What is some of your previous 1. experience before you decided to take on this new role? A: I have worked with the Finger Lakes Performing Provider
System and UR Medicine, supporting state and federal programs that are transforming healthcare. I have supported the implementation of electronic medical record systems in New York, Louisiana and Illinois, which helps me understand the challenges physician face using these systems. Before taking on this role, I was director of the Children’s Health Home Implementation for the Health Homes of Upstate New York, which provides health home programs for 22 counties.
2 What drew you to this position? 2.
A: I had an opportunity to work alongside physicians in my previous career. I developed a tremendous respect for the work they do for our community. When you combine my previous experience along with knowing the community, I believed this was going to be an ideal fit for me. I really look forward to serving the Monroe County Medical Society December 2016 •
health care issues that are on the horizon for our area? A: I had the pleasure of working in a variety of elements in the health care field. I’ve gotten a sense of how’s the federal government putting new regulations affect doctors and hospitals across the country. Also, a big initiative not only in New York state but nationwide is the expansion of the Medicaid program. You have to be able to have a strong program that ensures health care for at risk populations. We have to mitigate the barriers that prevent anyone from not being able to access treatment in a timely manner.
4. 4 You have an extensive
background in medical records. Why do you believe that is an important element in health care? A: We have to focus on making the process easier for everyone. We have to build seamless processes within the electronic medical system so physicians can better document the work they are required to do. We don’t want to make the process onerous, and we have to be mindful on the number of clicks and pages that a physician has to navigate through to accomplish documenting properly.
5 Can you talk about some of the 5.
biggest shifts that you are seeing in the medical field? A: The buzz word is value-based services and that is very much the direction health care services are
going. Traditionally, we were a feefor-service environment. If you went to the doctor because you were sick, the doctor provided you with what you need to help you get better and then they would get their payment from an insurance company. Now, the focus is on how successful patient outcomes are and how that patient is being treated by the doctors. That isn’t going to change anytime soon and the health care industry understands that.
6 What got you involved in the 6.
medical field as a career? A: I think health care is the whole package. I have always been fascinated with it throughout my life. There is so much that encompasses health care. I have been able to use my marriage and family counseling background along with my clinical, IT system background and my Simon School of Business background. It allows me to understand multiple aspects of health care service.
7 How do you spend your spare 7.
time? A: I enjoy spending time with my wife of four years, Sarah, and my 21-month-old daughter, Chelsea. I treasure the time I spend with them and the time I spend with friends. I have been blessed to have friendships with people in multiple industries. It is always great having conversations about how life is impacting their organization.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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Page 17
Colon Cancer: Preventable, Treatable & Beatable
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Ask St. Ann’s
What Role Does Boredom Play in Depression Among Seniors? By Kim Petrone, MD
N
o one at any age likes to be bored. But research shows that boredom is a huge problem among seniors and retirees. It can lead to depression — which causes multiple health problems — and is typically associated with being inactive or isolated from social activity. Isolation and inactivity can lead to an increased risk of heart disease, high blood pressure, bone and joint disease, Alzheimer’s, and an overall increased risk of death. For seniors who spend much of their day on their own or without a lot of interactions, discovering productive and enjoyable ways to stave off boredom is essential to finding joy and maintaining good health. So what’s the best way to combat boredom? Get involved in your community. When you have a social network and are participating in activities you enjoy, you not only feel healthier, you feel better about yourself and your place in the world. Try these easy ways to stay involved, if not for the health
benefits, then for one simple reason: boredom has no place in the best years of your life.
Keep in touch.
It isn’t enough just to know people; you’ve got to keep in touch to get the full benefit of their companionship. Before retirement, we have our day-to-day interactions with co-workers. Once we retire, we have to make more of an effort to stay connected. The good news is we have more free time to do that! Retirement is the perfect time to call friends and family members and catch up on their lives. Get together for coffee or lunch, or just go for a walk. It’s that interpersonal connection that boosts the spirit.
Try something new.
Is there something you’ve always wanted to try? Painting, playing a musical instrument, woodworking? Retirement is the perfect time to explore the possibilities. It’s never too late to learn something new, especially something that piques your interest. You might also consider a part-
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time job in a field you enjoy. Plenty of organizations are looking for extra help and could benefit from your experience and maturity.
Consider volunteering.
Volunteering keeps you active, introduces you to new people, and lets you put to use the skills and talents you’ve developed over a lifetime. It also engages your mind and is a great way to learn new skills. Places that welcome volunteers include: • Senior living communities. (Volunteers are an integral part of St. Ann’s Community, donating the equivalent of $2 million annually in service hours! Call our volunteer office for more info: 585-697-6523.) • Your church or place of worship. • Local food cupboards. • Animal shelters. • Schools. Consider becoming a mentor or tutor. Lifespan’s “RSVP” program connects people 55 and older with volunteer opportunities. Find out more at www.lifespan-roch.org/ volunteer.
Be a joiner.
Whatever your passion, retirement is the perfect time to pursue it — but more importantly, to pursue it with other people. Join a club or take a class. Or audit a college course. Exploring your interests with people who share those interests is a great way to expand both your knowledge and your social network…and to keep the boredom at bay.
Physician Kim Petrone is associate medical director, St. Ann’s Community, and medical director, Rochester General Wound Healing Center at St. Ann’s (http://bit. do/woundheal ). She is board-certified in internal medicine and geriatrics and is a certified wound specialist. Contact her at kpetrone@mystanns. com or 585-922-HEAL (4325), or visit www.stannscommunity.com.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
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Thyroid Disorders Often Missed in Seniors Dear Savvy Senior,
Can you write a column on the overlooked problem of thyroid disease? After struggling with chronic fatigue, joint pain and memory problems, I was finally diagnosed hypothyroidism. Now, at age 70, I’m on thyroid medication and am doing great. Five years of feeling lousy. I wish I’d have known. Frustrated Patient Dear Frustrated,
I’m glad to hear that you’re finally feeling better. Unfortunately, thyroid problems are quite common in older adults but can be tricky to detect because the symptoms often resemble other age-related health problems. In fact, as many as 30 million Americans have some form of thyroid disorder, but more than half of them aren’t aware of it. Here’s a basic overview: The thyroid is a small butterfly-shaped gland located at the base of your neck that has a huge job. It produces hormones (called T3 and T4) that help regulate the rate of many of your body’s activities, from how quickly you burn calories to how fast your heart beats. It also influences the function of the brain, liver, kidneys and skin. If the gland is underactive and doesn’t produce enough thyroid hormones, it causes body systems to slow down. If it’s overactive, and churns out too much thyroid, it has the opposite effect, speeding up the body’s processes. The symptoms for an underactive thyroid (also known as hypothyroidism) — the most common thyroid disorder in older adults — will vary but may include fatigue, unexplained weight gain, increased sensitivity to cold, constipation, joint pain, muscle stiffness, dry skin and depression. Some patients may even develop an enlarged thyroid (goiter) at the base of the neck. However, in older adults, it can cause other symptoms like memory impairment, loss of appetite, weight loss, falls or even incontinence. And the symptoms of an overactive thyroid (or hyperthyroidism),
which is more common in people under age 50, may include a rapid heart rate, anxiety, insomnia, increased appetite, weight loss, diarrhea, excessive perspiration, as well as an enlarged thyroid gland. Too much thyroid can also cause atrial fibrillation, affect blood pressure and decrease bone density, which increases the risk of osteoporosis. Those with the greatest risk of developing thyroid disorders are women who have a family history of the disease. Other factors that can trigger thyroid problems include: autoimmune diseases like Hashimoto’s or Graves disease; thyroid surgery; radiation treatments to the neck or upper chest; and certain medications including interferon alpha and interleukin-2 cancer medications, amiodarone heart medication and lithium for bipolar disorder.
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If you have any of the aforementioned symptoms or if you’ve had previous thyroid problems or notice a lump in the base of your neck, ask your doctor to check your thyroid levels. The TSH (thyroid-stimulating hormone) blood test is used to diagnosis thyroid disorders. Thyroid disease is easily treated once you’ve been diagnosed. Standard treatment for hypothyroidism involves daily use of the synthetic thyroid hormone levothyroxine (Levothroid, Synthroid and others), which is an oral medication that restores adequate hormone levels. And treatments for hyperthyroidism may include an anti-thyroid medication such as methimazole (Tapazole), which blocks the production of thyroid hormones. Another option is radioactive iodine, which is taken orally and destroys the overactive thyroid cells and causes the gland to shrink. But this can leave the thyroid unable to produce any hormone and it’s likely that you’ll eventually become hypothyroid and need to start taking thyroid medication. For more information on thyroid disorders, visit the American Thyroid Association at Thyroid.org. 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. December 2016 •
Age 3:
Despite my being camera shy, Dad loved taking my picture.
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Age 16:
Dad patiently taught me how to drive a stick shift.
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Age 64:
So happy to be there for Dad as he moved to his own new apartment!
With maintenance free living in one of our spacious apartments, you'll find you have even more time to enjoy life's special moments.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
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The Social Ask Security Office
From the Social Security District Office
Social Security’s Gift to Children Is Security This is the season of caring. No matter your religion or belief, December is also considered a time to focus on the children we love. Whether we’re wrapping Santa’s gifts, buying Hanukkah treats, decorating the house in celebration of Kwanzaa or volunteering for a toy drive, children add joy to the holiday season. And we at Social Security definitely know a thing or two about helping children. Often overlooked in the paperwork that prospective parents fill out in preparation for a child’s birth is an application for a Social Security number and card. Typically, the hospital will ask if you want to apply for a Social Security number for your newborn as part of the birth registration process. This is the easiest and fastest way to apply. The Social Security card typically arrives about a week to 10 days after that little bundle of joy! You can learn about Social Security numbers for children by reading our publication, Social Security Numbers for Children, available at www. socialsecurity.gov/pubs. A child needs a Social Security number if he or she is going to have a bank account, if a relative is buying savings bonds for the child, if the child will have medical coverage, or if the child will receive government services. You’ll also need a Social Security number for a child to claim him or her on your tax returns. If you wait to apply, you will have to visit a Social Security office and you’ll need to: • Complete an “Application For a Social Security Card” (Form SS-5); • Show us original documents proving your child’s U.S. citizenship, age and identity; and • Show us documents proving your identity.
Q&A
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Q: I noticed that my date of birth in Social Security’s records is wrong. How do I get that corrected? A: To change the date of birth shown on our records, take the following steps: • Complete an “Application For A Social Security Card” (Form SS-5); • Show us documents proving: U.S. citizenship (if you have not previously established your citizenship with us); age; and identity; and • Take (or mail) your completed application and documents to your local Social Security office. Note that all documents must be either originals or copies certified by the issuing agency. We cannot accept photocopies or notarized copies of documents. For details on the documents you’ll need, visit www.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2016
Remember, a child age 12 or older requesting an original Social Security number must appear in person for the interview, even though a parent or guardian will sign the application on the child’s behalf. Children with disabilities are among our most vulnerable citizens. Social Security is dedicated to helping those with qualifying disabilities and their families through the Supplemental Security Income (SSI) program. To qualify for SSI: • The child must have a physical or mental condition, or a combination of conditions, resulting in “marked and severe functional limitations.” This means that the condition(s) must severely limit your child’s activities; • The child’s condition(s) must be severe, last for at least 12 months, or be expected to result in death; • If your child’s condition(s) does not result in “marked and severe limitations,” or does not result in those limitations lasting for at least 12 months, your child will not qualify for SSI; and • The child must not be working and earning more than $1,090 a month in 2016. (This amount usually changes every year.) If he or she is working and earning that much money, your child will not be eligible for benefits. Learn the details about benefits for children by reading our publication, Benefits for Children with Disabilities, available at www.socialsecurity.gov/pubs. Visit www.socialsecurity.gov/ people/kids to learn more about all we do to care for children. Caring for the next generation is a central part of securing today and tomorrow, during the holidays and all year long. socialsecurity.gov/ss5doc. Q: How can I get a copy of my Social Security Statement? A: You can get your personal Social Security statement online by using your my Social Security account. If you don’t yet have an account, you can easily create one. Your online statement gives you secure and convenient access to your earnings records. It also shows estimates for retirement, disability, and survivors benefits you and your family may be eligible for. To set up or use your account to get your online Social Security Statement, go to www.socialsecurity.gov/ myaccount. We also mail statements to workers attaining ages 25, 30, 35, 40, 45, 50, 55, 60 and older three months prior to their birthday if they don’t receive Social Security benefits and don’t have a my Social Security account.
Health News Deb Allen joins Fairport Baptist Homes Deb Howe Allen has recently joined Fairport Baptist Homes as director of advancement. In that position she will oversee the operation of the Fairport Baptist Homes Foundation and raise money via Allen annual, sustained, planned giving, corporate and foundation giving. Previously, Allen served as director of development at the Breast Cancer Coalition of Rochester. She has a bachelor’s degree in English, summa cum laude, from SUNY Oswego, and a master’s degree in English from the University of Rochester. She and her husband, Jim, reside in Geneseo with their two children: Paul, 17, and Claire, 13. Allen is a published writer (“The Strand,” “Gourmet,” “The Wall St. Journal,” LinkedIn and E-Zine), an avid traveler who enjoys gardening, reading and quilting. She is a current board member/ volunteer at Habitat for Humanity in Livingston County and the Geneseo Farmers Market. She has previously served on the boards of the Friends of Wadsworth Library; YWCA; Flower City Habitat for Humanity; Planned Parenthood; Susan B. Anthony House; and Women’s Foundation of Genesee Valley.
Hickok Center has new home care program The Hickok Center for Brain Injury announced it is now a licensed home care agency. The new home care program provides 24 hour care, seven days per week for any personal care services needed. “We’re excited to be able to offer this program to a wide range of individuals,” said Elaine Comarella, CEO of the Hickok Center. “Our qualified and dedicated health care professionals will be there when you need them most. Their dependability and compassion to your needs is second to none.” Hickok Home Care Services make it possible for care recipients to remain at home in a safe environment while receiving support from their certified home care staff. The Hickok Center for Brain Injury is a notprofit 501(c)(3) organization dedicated to supporting people in the Monroe County area.
New physician at Perinton Health Center Physician Effat Jehan has recently joined Lifetime Health Medical Group’s family medicine practice at the Perinton Health Center (77 Sully’s Trail, Pittsford). Jehan earned her medical degree from the Dow Medical College in Ka-
rachi, Pakistan, and completed her residency at the University of Arkansas, UAMS, in Little Rock, Ark.. She is board-certified in family medicine, with a special interest in caring Mestan for individuals with back and neck pain. Jehan is a member of the American Academy of Family Physicians, the American Medical Association and the North American Spine Society. She is fluent in English, Urdu and Hindi.
RRH acquires Finger Lakes Bone & Joint Center Rochester Regional Health has announced the acquisition of Finger Lakes Bone & Joint Center, an orthopedic surgery group with offices in Canandaigua, Clifton Springs, Geneva and Newark. Comprised of five physicians and 31 staff members, Finger Lakes Bone & Joint has partnered with Rochester Regional’s Clifton Springs Hospital & Clinic and Newark-Wayne Community Hospital since 2004. “This more formalized relationship solidifies our longstanding partnership with Finger Lakes Bone & Joint,” said physician Dustin Riccio, the president of both Clifton Springs and Newark-Wayne hospitals. “Together we will continue to provide services to meet the needs of the people of the Finger Lakes area and help them enjoy better, healthier lives.” Finger Lakes Bone & Joint Center orthopedic surgeon Daniel Alexander said, “My colleagues and I are proud and honored to be part of the growing Rochester Regional Health family. We have a long tradition of working with Newark-Wayne and Clifton Springs hospitals to provide high-quality care close to where our patients live.” Rochester Regional Health – Finger Lakes Bone & Joint physicians care for patients with fractures; joint, neck, and back pain, and work and sports-related injuries; as well as those requiring hip and knee replacement surgery.
Friendly Senior Living announces new hires Friendly Senior Living, a continuum of caring communities, recently announced two additions to its teams at Cloverwood Senior Living and Friendly Home. Chad Estabrooks, of Webster, has joined the leadership team of Cloverwood Senior Living as the life enrichment director. His responsibilities include developing and implementing a broad range of arts, culture, education and recreation opportunities for residents, which promote personal growth and well-being of the body, mind and spirit. With more than 15 years of related experience, Estabrooks most December 2016 •
recently served as the community life director for Rivers Run Senior Living. Estabrooks holds a degree in graphic design from Cazenovia College. Vanessa Falzarano, of Greece, EstaBrooks has joined the leadership team of the Friendly Home in the newly created position of director of quality. Falzarano is responsible for managing all aspects of quality assessment and process improvement. Most recently, Falzarano served as a performance improvement facilitator for Hartford HealthCare in Hartford, Conn. Her extensive background in senior care and services includes influential leadership roles focused on demenFalzarano tia care services and process/performance improvement focused on achieving organizational goals and objectives. A graduate of King’s College in Wilkes-Barre, Pa., Falzarano earned a B.S. degree in gerontology. She is an alumnus of the Connecticut LeadingAge Leadership Academy Fellowship program.
Lifetime Care named as a “Top Agency” Lifetime Care has been named a top agency of the 2016 HomeCare Elite, a recognition of the top-performing home health agencies in the United States. Lifetime Care is the Rochester/ Finger Lakes region’s largest (ranked by total staff) provider of health care services at home and in home-like settings, with over 1,400 staff members serving more than 28,000 families in Monroe and surrounding counties. For more than 10 years, HomeCare Elite has annually identified the top 25 percent of Medicare-certified agencies and highlights the top 100 and top 500 agencies overall. The ranking is developed by ABILITY Network, a leading information technology company helping providers and payers simplify the administrative and clinical complexities of healthcare; and sponsored by DecisionHealth, publisher of Home Health Line, The Complete Home Health ICD-10-CM Diagnosis Coding Manual and The Home Health Coding Center. Winners are ranked by an analysis of publicly available performance measures in quality outcomes, best practice (process measure) implementation, patient experience (Home Health CAHPS), quality improvement and consistency, and financial performance. In order to be considered, an agency must be Medicare-certified and have data for at least one outcome in Home Health Compare. Out of 9,406
agencies considered, 2,353 are recognized on the 2016 HomeCare Elite winners list overall. “We are excited to receive this distinction again this year,” said physician Stephen H. Cohen, president of Lifetime Care. He credits the commitment to personalized, patient-focused care and continual improvement in quality outcomes with the agency’s ability to achieve recognition as one of the HomeCare Elite.
FLHSA certified as a great workplace Finger Lakes Health Systems Agency has been certified as a great workplace by the independent analysts at Great Place to Work. FLHSA earned this credential based on extensive ratings provided by its employees in anonymous surveys. A summary of these ratings can be found at http:// reviews.greatplacetowork.com/fingerlakes-health-systems-agency. “We are honored that FLHSA has been certified as a Great Place to Work,” said Trilby de Jung, CEO of FLHSA. “Our employees are our most valuable resource, and we are committed to creating an environment in which they are deeply engaged and have fun with their colleagues.” Great Place to Work defines a great workplace as a place where employees trust the people they work for, have pride in what they do, feel respected by management, believe that management policies and procedures are fair and experience camaraderie with their colleagues. In the anonymous survey: • 98 percent of FLHSA employees said they feel good about the ways they contribute to the community • 90 percent said that they felt a sense of pride when reviewing their accomplishments • 88 percent said employees at FLHSA celebrate special events and care about each other According to the survey, 71 percent of Finger Lakes Health Systems Agency employees said it is a great workplace.
Adult day program in Webster extends hours Family members looking for a safe, caring environment for their older loved ones during the day or evening will have additional options through a program offered by St. Ann’s Community. Beginning Jan. 2, the Home & Heart Adult Day program at 696 Ridge Road, Webster, will offer evening and weekend hours and will be open as follows: • Monday through Friday, 7:30 a.m. to 9 p.m. • Saturday and Sunday, 7:30 a.m. to 5 p.m. “We know that the need for a safe place for older adults to socialize doesn’t end at 5 p.m. or on Fridays,” says Rola O’Meally, director of adult day and dementia services at St. Ann’s Community. “Family caregivers who need time for themselves, whether for
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Health News work or personal reasons, have relied on our adult day programs for years. We’re pleased to now extend that reliability to evenings and weekends for their added convenience. They can rest assured their loved one is in good hands.” To register for evening or weekend hours beginning Jan. 2, call 585-6976087. Spaces are limited and will be
filled on a pre-registration basis. Home & Heart Adult Day in Webster is one of three adult day programs offered by St. Ann’s Community. The others are: Home Connection, 1500 Portland Ave., open 7 a.m. to 5 p.m. Monday through Friday and Home & Heart at the Cathedral, 287 Flower City Park, open 7:30 a.m. to 5 p.m. Monday through Friday.
One of the operating rooms at the new building addition at Highland Hospital. The $28 million project includes two floors and approximately 30,000 square feet of space for six new ORs and a 26-bed observation unit.
New operating room at Highland Hospital.
Highland Hospital Holds Ribbon Cutting Ceremony for New Addition $28 million project includes six new operating rooms and a 26-bed observation unit
Lattimore of Pittsford Mendon Physical Therapy Moves to Larger Quarters Lattimore of Pittsford Mendon Physical Therapy recently moved to a larger and more convenient location. It’s now located at 110 Assembly Drive, Mendon, not far from the previous location. “We are very happy to offer a wide variety of physical therapy, manual therapy and sports/ functional training to the Pittsford, Victor and Mendon communities,” said physical therapist Dustin J. Maracle, the practice’s co-owner and clinical director. “The new office offers more space and equipment, and is a stand-alone 3,000-square-foot building.” According to Maracle, pro-
fessionals at new office will have the ability to provide effective, evidence-based care to all patients within the community “Our new office houses a certified orthopedic manual therapist, kineseotaping, certified strength and conditioning specialist, and an APTA [American Physical Therapy Association] board-certified sports specialist,” said Maracle. “We are excited for anyone to come and see the new office and we try to accommodate all new patients within 24 hours of calling or coming in.” For more information, call 585-582-1330.
H
ighland Hospital celebrated a major milestone Oct. 26 when officials and dignitaries held a ribbon-cutting event to unveil a new two-story building addition on the south side of the hospital’s campus. The $28 million expansion will help to enhance patient care by updating hospital facilities. Construction on this project began in July 2015 and the first patients was expected to be treated in the new operating rooms (ORs) starting on Nov. 1. This modernization project will also include renovation of some of the existing ORs and the post anesthesia care unit. “Today’s ribbon cutting is physical proof of Highland Hospital and the University of Rochester’s commitment to this community.” said Joel Seligman, president and CEO of the University of Rochester. “This addition will provide us with the opportunity to expand our services and provide even better care for the Rochester region.” The new building addition has two floors and approximately 30,000 square feet of space for six new ORs
and a 26-bed observation unit. The hospital’s current bed count of 261 will not change but several patient care areas will be able to be reconfigured to be single rooms thanks to the added space in the new observation unit. “This modernization of Highland’s facilities is a crucial part of our master facilities plan,” said Steve Goldstein, president and CEO of Highland Hospital. “The new addition will help Highland continue to provide excellent care, both as a community hospital and as a regional referral center for patients across Western New York.” The building addition answered a number of essential facility-improvement priorities for Highland, including expanding the hospital’s perioperative area and creating a dedicated space for observation patients. Having all observation patients located in the same area will also give the hospital space on inpatient units to convert some of the semi-private inpatient rooms to private rooms.
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