IGH Rochester #137 jan 2017 by In Good Health: Rochester's Healthcare Newspaper

in good Meet Your Doctor Larissa Temple in 2016 was named “Best Doctor” by the New York magazine. Now at UR Medicine, she talks about her specialty, caring for colorectal problems, including cancers

Top 10 ways women can improve their health

January 2017 • Issue 137

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Rochester’s Healthcare Newspaper

SMOKING ‘How I Quit After 40 Years’ ‘Trying to quit as a senior citizen turned out to be quite different from all those attempts in my younger years’. page 8

Medical Billing Errors Medical billing errors and overcharging is not uncommon. According to AMA, 7 percent of medical bills in 2013 had errors, and other groups estimate that figure to be much higher. Find out how to watch for mistakes

Cheaper Hearing Aids Coming onto the Market

Friendship, Early Breast Cancer Detection page 17

Finding out a friend has breast cancer

Haddock

‘My family’s go-to fish in January is haddock. Mildtasting and reasonably priced, this flaky white fish teems with good things. It’s a great choice after the end of the eating season’

Excellus: Telemedicine to Surge This Year page 9

Upstate New Yorkers will embrace telemedicine this year, says Excellus BlueCross BlueShield page 11

Pizza Trends Pizzas are trending toward thinner crusts and half of consumers prefer to go thin. Find out the Top 10 habits Americans have when it comes to pizza page XX

U.S. Doctors Still OverPrescribing Drugs: Survey

More than one in four say antibiotics are given when the drugs will likely do no good

espite evidence that certain drugs aren’t always necessary, doctors are still prescribing these treatments, a new survey of doctors reveals. Antibiotics are by far the drugs most frequently used in situations where they’ll provide no value for patients. The survey found that more than a quarter of doctors surveyed (27 percent) said that antibiotics are often administered to patients when the drugs will do no good. In most cases, the antibiotics are prescribed to treat upper respiratory infections even though these are most often caused by viruses unaffected by the medication, said Amir Qaseem. He’s vice president of clinical policy for the American College of Physicians (ACP) and chairman of the ACP’s High Value Care Task Force. Other treatments that doctors use frequently despite their questionable value include aggressive treatments for terminally ill patients (9 percent), drugs prescribed for chronic pain (7 percent), and dietary supplements such fish oil and multivitamins (5 percent), the survey revealed. “There is a lot of waste in our health care system, and we need to acknowledge that,” Qaseem said. The results are from a random

Worldwide Cancer Rates Up More Than One-Third in Past Decade Researchers cite population aging and growth

survey of 5,000 ACP member physicians. The survey asked doctors to identify two treatments frequently used by internists that were unlikely to provide high value care to patients. The CDC itself estimates that as much as one-half of antibiotic use in humans is either unnecessary or inappropriate. An estimated 47 million unnecessary antibiotic prescriptions are handed out in the United States each year, the agency said. Pressure to fulfill patients’ expectations might be driving some doctors to prescribe antibiotics, Qaseem said.

ancer cases rose 33 percent worldwide in the past 10 years, a new study shows. In 2015, there were 17.5 million diagnoses and 8.7 million deaths in the world from the disease, the researchers found. The rise in cancer cases was mainly due to population aging and growth, along with changes in age-specific cancer rates, according to the Global Burden of Disease Cancer Collaboration study. The lifetime risk of developing cancer was one in three for men and one in four for women, the researchers said. Prostate cancer was the most common type of cancer in men (1.6 million cases), and tracheal, bronchus and lung cancer was the leading

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

cause of cancer death in men. Breast cancer was the most common cancer for women (2.4 million cases), and the leading cause of cancer death in women. The most common cancers in children were leukemia, other neoplasms, non-Hodgkin lymphoma, and brain and nervous system cancers, said researcher Christina Fitzmaurice, from the University of Washington in Seattle. The study was published online Dec. 3 in the journal JAMA Oncology. Cancer is the second leading cause of death worldwide, and statistics such as these play an important role in cancer control planning, the researchers said in a journal news release.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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CALENDAR of

HEALTH EVENTS

Jan. 3, Feb. 7

Six-week course on plantbased diet offered

Is Your Medicine Safe at Home? Only YOU Can Secure Your Rx!

MONITOR– count your medication regularly

SECURE– lock up any medication you do not want anyone to access

DISPOSE– drop off any

unwanted/unused and expired medication to your local disposal site For more information, call the Substance Abuse Prevention Coalition of Ontario County at (585) 396-4554 or visit us at substanceabusepreventioncoalitionofontariocounty.com.

Physician Ted D. Barnett, a board certified in diagnostic imaging as well as vascular and interventional radiology, will present a six-week course on plant-based diet: Eating for Happiness and Health.” This six-week course has been offered many times in the area, including at three hospitals. The course outlines the benefits of a whole-food, plantbased diet for human health and all life on the planet, with up-to-date references to scientific studies. Recipes and food samples at each class. The class meets from 6:15 to 8:30 p.m. every Tuesday from Jan. 3 through Feb.7, at the Jewish Community Center, and from 6:15 to 8:30 p.m. every Wednesday from Feb. 22 through April 5, at Highland Hospital. Cost is $150 with a discount for JCC members. Visit roclifemed. com for more information and to register: https://rochesterlifestylemedicine.com/resources/nutrition-course/

Jan. 16

Heart failure, advanced therapies to be discussed Cardiac surgeon Juan LeHoux of Strong Memorial Hospital will make a presentation about advanced therapies in heart failure during a meeting sponsored by Mended

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Jan. 24

Fibromyalgia groupways to start year right The New Fibromyalgia Support Group will start the New Year off showing people how to make small strides and improve their health one step at a time. Titled “5 Simple Ways to Start the New Year Right,” the workshop will focus on modalities such as exercise, diet and stress reduction as tools to work through pain reduction and overall health improvement. Classes meet from 6 to 8:30 p.m., Tuesday, Jan. 24, in the meeting room at Westside YMCA, located at 920 Elmgrove Road in Gates. The meeting is free an 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.

Lifespan offers courses on tai chi for arthritis, fall prevention, diabetes

L Serving Men, Women and Children

Hearts, a cardiovascular peer-topeer support network in Rochester. The event will take place at 2 p.m., Jan. 16, in the conference room at the Jewish Community Center, 1200 Edgewood Ave., Brighton. According to Mended Hearts, caregivers, heart patients and family can benefit from diagnosis though recovery, peer-topeer support and partnerships. The meeting is free and open to the public. For more information, call 234-1538 or visit MendedHeartsRochester.org.

ifespan, a local nonprofit organization that helps older adults and caregivers take on the challenges and opportunities of longer life, will offer a series of classes in January and February. Registration is required for all classes. Go to www.lifespanrochester. org to register online, call Sara Otis at 287-6439 or email sotis@ lifespanrochester.org. Courses are:

A Matter of Balance (fall prevention)

A six-week, peer-led workshop designed to decrease the fear of falling and increase activity levels in older adults.

Locations:

• Eastside Family YMCA, 1835 Fairport Nine Mile Point Road Jan. 3 to Jan. 26, from 12:30 to 2:30 p.m. You do not need to be a YMCA member to attend. • Westside Family YMCA, 920 Elmgrove Road. Jan. 10 to Feb 2, from 12:30 to 2:30 p.m. You do not need to be a YMCA member to attend. • Chapel Oaks, 1550 Portland Ave. Jan. 10 to Feb. 28, from 10 a.m. to noon • Lifespan, 1900 S. Clinton Ave.Jan. 17 to Feb. 9, from 1 to 3 p.m. The Villages at Unity, 1471 Long Pond Road. Jan. 18 to Feb. 10, from 1 to 3 p.m. • Irondequoit Senior Center, 154 Pinegrove Ave. Jan. 23 to March 16, from

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

9 to 11 a.m. • Brighton Senior Center, 220 Idlewood Rd.. Jan. 23 to March 13, from 1:45 to 3:45 p.m. • Maplewood Family YMCA, 25 Driving Pk. Feb. 1 to Feb 24, from noon to 2 p.m.

Tai Chi for Arthritis Locations:

• Lifespan, 1900 S. Clinton Ave. Jan. 9 to March 6, from 10 to 11 a.m. • Sisters of St. Joseph Motherhouse, 150 French Road. Jan. 9 to March 6, from 12:30 to 1:30 p.m.

Living Healthy

A six-week, peer-led health education program that complements your healthcare. The purpose of the workshop is to enhance skills and your ability to manage your health and maintain an active and fulfilling lifestyle. Locations: • Chili Senior Center, 3235 Chili Ave. Jan. 19 to Feb. 23, from 1 to 3:30 p.m. • Eastside Family YMCA, 1835 Fairport Nine Mile Point Road Feb. 6 to March 13, from 12:30 to 3 pm

Living Healthy with Diabetes Location:

• Westside Family YMCA, 920 Elmgrove Ave. Feb. 7 to March 14, from 12:30 to 3 p.m.

Call 585-670-00020 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

January 2017 •

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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By Chris Motola

Larissa Temple, M.D. New doctor at UR Medicine focuses on care for colorectal problems, including colon, rectal cancers. She wants to increase patient access to screenings ter?

Q: What brought you to Roches-

A: I’m new to Rochester. I did my medical schooling in Calgary, Canada, with a residency in Toronto. I moved to New York City for a surgical oncology fellowship. I was invited to stay and completed a colorectal fellowship as well. Most recently I was a member of the Colorectal Surgery Service at Memorial Sloan Kettering Cancer Center. I moved here four months ago and am very excited to be here. The chair of our department is a nationally known surgeon/scientist leader [physician David Linehan]. The opportunity to work for him is inspiring. The team that was already here is fantastic and great at taking care of patients, and I’m really excited about the extensive network we’re building across Upstate New York, which will allow us to increase patient access to subspecialty care for colorectal problems. So there are a lot of great opportunities here. It’s a very exciting place to be. Q: With regard to the focus on colorectal cancers, does this include screenings? A: There are a myriad of ways to screen for colorectal cancers, and we are a strong proponent of the whole population getting screened. Screening, in general, is done by gastroenterology. We do some screening, though, and all of us do screening colonoscopies. We just don’t do nearly the number that gastroenterology does.

were some very important papers in the early 2000s talking about the benefits of screening. They were randomized trials looking at the effectiveness of screening in preventing colorectal cancers. The colonoscopy is probably the most effective mechanism for screening and preventing cancers of all the modalities of screening. The problem, of course, is that the test is fairly intensive. So our job as providers is to try and take away some of the stigma of the colonoscopy and helping them understand just how important a tool it is in avoiding colon cancer. Q: How effective is surgery at treating colon cancer? A: Surgery is the most important piece of all the modalities used for treating colon cancer. But it’s also about using surgery in combination with other treatments like chemotherapy and radiation. It’s very important to individualize the patient’s treatment plan based on the disease and the stage they’re in. At Strong we have a multidisciplinary approach to managing colorectal cancers. We present cancer cases once a week in a forum with five medical oncologists, five surgeons, two radiol-

Q: The strong focus on colon cancer is a fairly recent thing. What pushed it to the forefront of cancers that we look out for? A: I’m not sure I agree. It’s the third most common cancer in America. Obviously, there’s a whole gamut of outcomes for patients with colorectal cancer, but there are a large number of patients who survive. This group of survivors is incredibly inspiring for us and gives us great insights into how to improve their care. To the extent that there is more recognition of colon cancer, I think it’s because most medical conditions are more open and “out” with all of our media. There

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

ogists, pathology, gastroenterology and a geneticist and we talk about how to manage the patients. Surgery is incredibly effective, but it’s most effective in conjunction with other therapies. er?

Q: How quickly do patients recov-

A: We are really working hard at decreasing the complications after surgery. We’ve adopted an enhanced recovery program for our patients to help return regular bowel function as quickly as possible, and encourage early mobilization, early feeding. We encourage the use of specific analgesics to help patients feel better faster and go home earlier. Typically our colon cancer patients go home at around three to four days and rectal cancer patients go home in four to five days. At home, you do have to accept that you’re recovering from major surgery and that can take four to six weeks. We also try to push minimally invasive surgery when possible, which improves recovery time. Q: How did you become interested in colorectal surgery? A: I had great mentors. I think what keeps me inspired is how resilient people are. I follow up with patients for years afterwards, which means they survived. It’s a testament to how impactful our work is. It’s great to get the Christmas card five years later. That’s inspiring to me. Q: Being trained in the Canadian system, was there much acclimation you had to do? A: I came the United States 20 years ago, so I can’t really comment on what the Canadian system is like now, though I am grateful for the training I received there. For me, the question is the acclimation between New York City and Rochester. I have to tell you I’ve been pretty impressed by the quality of care at Strong and the University of Rochester. It’s world class. I’m honored to be here.

Lifelines Name: Larissa Temple, M.D. Specialty: Has expertise in the management of colorectal diseases, and in particular, colorectal malignancies. She performs minimally invasive procedures, including robotic surgery to complex multi-surgeon pelvic procedures. Position: Chief of the division of colorectal surgery at UR Medicine Hometown: Calgary, Alberta Education: University of Toronto; Canada-U; fellowships in surgical oncology at Memorial Sloan Kettering Cancer Center and colorectal surgery at St. Luke’s Roosevelt. Affiliations: University of Rochester Medical Center system Awards: Best Doctors, New York magazine, 2016; Compassionate Caregiver, The Schwartz Center, 2012; New York’s Best Doctors, 2010-2012; New York Super Doctors, New York Magazine, 2009-2012 Organizations: American College of Surgeons; American Society of Colorectal Surgeons; Society for Surgical Oncology; American Society of Clinical Oncology Family: Married, two children Hobbies: Gardening

Cheaper Hearing Aids Coming onto the Market FDA to ease up on hearing aid rules

etting a hearing aid should be less of a hassle — and eventually less expensive — under new rules introduced by the U.S. Food and Drug Administration. The FDA said early in December it will no longer enforce a requirement that people aged 18 and older receive a medical evaluation or sign a waiver before buying most hearing aids. The agency said it will also consider creating a category of overthe-counter hearing aids that could provide innovative and lower-cost devices to millions of Americans. Currently, a pair of hearing aids typically costs $4,000 or more, putting them out of reach for the majority of older Americans who need them, according to the President’s Council of Advisors on Science and Technology. “Today’s actions are an exam-

ple of the FDA considering flexible approaches to regulation that encourage innovation in areas of rapid scientific progress,” FDA Commissioner Robert Califf said in an agency news release. The President’s advisory council and other critics had argued that existing FDA rules were a potential barrier to people getting hearing aids, and provided little to no benefit to patients. “Untreated hearing loss, especially in older Americans, is a substantial national problem,” the council said in a recent report. Hard-of-hearing seniors face significantly impaired communication, social participation and overall health and quality of life, the report noted. Changes to the FDA rules, which take effect immediately, could lead to technological breakthroughs that result in less-expensive hearing-aid

options, according to the council. Although some 30 million people in the United States suffer from hearing loss, only about one-fifth who could benefit from a hearing aid seek help. The FDA said it will continue to enforce the medical evaluation requirement for prospective hearing

aid users younger than 18. The agency will also continue to require that hearing aid labels include information about medical conditions that should be evaluated by a doctor. Also, licensed hearing aid dispensers must still give consumers information and instructions about hearing aids before purchase.

Healthcare in a Minute By George W. Chapman

Merger Mania to Intensify

he trend will continue at an accelerated pace in 2017 as both hospital systems and commercial insurers engage in “bigger is better” business strategy. As the chess pieces move around, the ultimate impact on consumers will most likely differ from market to market. On one hand, bigger really is better for consumers if consolidation results in improved services, access, outcomes and lower prices due to standardization and economies of scale. On the other hand, bigger is worse for consumers if consolidation results in no improvement in services, access, outcomes or prices due to lack of competition and choice. The Department of Justice looks at all mergers and remains vigilant on behalf of consumers. When bigger is better, rural consumer areas tend to benefit the most, but suffer disproportionality when bigger is worse.

Trump Health Appointees

Tom Price, former orthopedic surgeon turned congressman from Georgia, will head Health and Human Services. He has been an outspoken critic of the ACA and advocates its repeal. The American Medical Association has been guarded about its approval/endorsement of Price as physicians seem split 50/50 over the ACA and are frankly tired of all the volatility and wrangling. For inexplicable reasons, Price is in favor of privatizing Medicare, which works well and increased only 1.7 percent in 2015. Seema Verma, former CEO of Seema Verma Consultants, will head CMS. Interestingly, Verma was instrumental in the implementation of Indiana’s expanded Medicaid pro-

gram (ACA) while Mike Pence was governor.

ACA Repeal and Hospitals

Proving there is far more at stake to repealing the ACA, the American Hospital Association projects a collective loss of $166 billion on net income should the ACA be repealed without an adequate replacement due to the loss of insurance coverage by the 20 million people who receive coverage via the ACA.

Healthcare Ads

If it seems like every other ad on TV is either for a drug, hospital or insurance plan, you’re not far off. The healthcare industry is solidly entrenched among the top 10 industries when it comes to advertising, according to Kantar Media. Advertising in healthcare totaled almost $10 billion in 2015, which was an 11 percent increase over 2014 spending. Drug advertising accounted for $6.6 billion, hospitals and healthcare systems $2.3 billion and insurance $1.1 billion. The favorite medium was TV where the industry spent over half of the $10 billion. Other media like magazines, digital, newspapers, billboards and radio combined for the remainder of ad spending. So, when pressed, where does the average person turn to for health information? The Internet. According to a survey by Kantar media, three out of four of us research health issues on the Internet.

How Washington Works

Just how things get done (or not) in Washington is exemplified by how the “21st Century Cares Act” (TCCA) became law. Most agree the current heroine epidemic was created largely January 2017 •

by drug manufacturers spending billions to get the medical community to prescribe their opioids. Four of five heroin addicts started out on an opioid like OxyContin. The TCCA commits billions of tax dollars to medical research and $1 billion to states to combat heroin and pain killer addiction, which all sounds good enough. But a bill this size would never see the light day without the blessing of the various lobbyists on the hill, most notably the drug lobby. A total of 1,455 lobbyists representing more than 400 companies made their client’s views known. As a result, the bill includes reductions in regulations and protocols which the drug industry found too restrictive and costly. While there was broad support for the bill on both sides of the aisle, and from the president, critics see the “compromise” with the drug industry as a blow to consumers who are protected by the protocols and regulations. The FDA will be allowed to expand the use of a previously approved drug, known as going off label, based solely on anecdotal rather than scientific evidence.

Life Expectancy

A recent article in the Wall Street Journal summarized a report by the Centers for Disease Control and Prevention. There was no change in the average life expectancy of all Americans born in 2014 vs 2013. There was a very slight decline in the life expectancy of a white males born in 2014 (78.8) vs 2013 (78.9). Life expectancy is based on the year you were born. The report noted that since 2000, white middle-aged Americans are dying at a rising rate largely due to suicide, drug/alcohol abuse and chronic liver disease. The US ranks only 53rd out of the top 100 countries in life expectancy. Monaco leads the way at 89. We are behind just about

every economically developed country like Italy, Canada, Spain, Sweden, Germany, United Kingdom, France, etc. The good news? We have come a long way. World-wide life expectancy in the Bronze Age, around 3000 BC was 26. In classic Rome times, around 400 AD, it was 20-30. In medieval times, around 1500, it was 35. Just 116 years ago, in 1900, life expectancy world-wide was 31. It has more than doubled to 67 in 2010.

See Your Doctor

The citizens in those 52 countries that rank higher than the US in life expectancy have more contacts with their physician’s practice per year than the average American does. In Japan, for example, they average 13 contacts a year. A “contact” can be through a face to face visit, a phone call, social media, patient portal, telemedicine. In the US, we average only 4 contacts a year. While there can be plenty of reasons why, many feel the biggest reason is simply cost. As premiums spiral upwards, so do deductibles and out of pocket expenses which makes most people think twice about contacting their physician and even put needed treatment off. The grave consequences of being out of touch with your physician are obvious. Make increased “contact” with your physician a resolution for 2017 and live longer. 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.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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How I Quit Smoking After 40 Years ‘Trying to quit as a senior citizen turned out to be quite different from all those attempts in my younger years’ By Suzanne M. Ellis

o you think that because you’re in your 50s, 60s, 70s — or beyond — that it’s too late to quit smoking? Have you tried and failed so many times over the years that you believe it’s a hopeless venture? Do you tell yourself you’ve smoked so long it won’t make any difference? Over the past few decades as a smoker, I’ve felt all of those things and then some. I’ve rationalized many times all the excuses why I shouldn’t even bother attempting to quit. But three and a half years ago, I decided to try one more time, and I’ve been a non-smoker ever since. I realize now that all that rationalizing was just more excuses. And, believe me, I know all about excuses because I smoked for the better part of 40 years and gave myself every reason in the book why I couldn’t or wouldn’t or shouldn’t stop. Even the on-again, off-again health scares weren’t enough to convince me: Not the annual bouts of pneumonia or bronchitis that became ever more debilitating as I aged. Not the chest X-ray six years ago showing “dark spots” on my lungs, and not the eventual diagnosis of early-stage emphysema. Not even the untimely (and most likely preventable) death of my beloved mother, who smoked for 60-plus years and suffered with chronic obstructive pulmonary disease, could convince me to stop. I thought constantly about quitting (don’t we all?), especially in 2013 when I plopped $9.70 on a store counter for my daily fix of Marlboro Lights in a box. When I reached my 60s, I also began to think a lot about my mortality and the time I had left. I knew that smoking a pack a day, or sometimes more, wasn’t going to help me live longer, and I often played that public service announcement in my head, the one that ends with, “It’s never too late to stop.” The encouraging news I’d like to share is that trying to quit as a senior citizen turned out to be quite different from all those attempts in my younger years. For starters, I was retired. Although I still work from home and my retirement is an active one, when push comes to shove, I’m pretty much the one who controls the content of my days. Unlike in the past, if the cravings got to be too much I could close the blinds, lock the doors and spend the day in bed or on the couch watching television. If I needed to get away from my regular routine — somePage 8

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thing that’s extremely important when you’re trying to quit — I could go to the movies at 11 o›clock in the morning. I could lose myself in a museum or the shelves of a library or bookstore until the madness passed. I could walk around the block anytime I needed to get out. I could do whatever it took to survive the desperate pangs of withdrawal, especially during those first seven days, which are so crucial to success. When we are working full-time, those options are not generally available to us and it’s easy to fall prey to the stresses of confinement. Another thing that was different this time is that I had a prescription for Chantix, a relatively new drug that helps significantly with cravings. Yes, I read all the warnings about the possibility of nightmares and other uncomfortable or dangerous side effects. But if you read the fine print on just about any effective drug these days, those warnings are equally frightening. I was fortunate; I used Chantix faithfully for six months and suffered no ill effects. The only change in my dreams was that I began to dream in color, which was a rather pleasant experience. I was also helped by using Nicorette gum, starting with 4 mg pieces and eventually reducing the dosage to 2 mg. That, too, was a different experience from years past. The original (and the only nicotine gum available at the time) was quite distasteful. Today, the flavors include White Ice Mint, Fruit Chill, Cinnamon Surge and Fresh Mint, to name a few. All are far more palatable than the original, and they are also a great help with cravings. Those things, combined with the best tricks I learned over the years to fight the urges, have resulted in more than three smoke-free years. Drink lots of water, treat yourself in some way every day, change up your routine, avoid the “triggers,” those activities you associate with smoking. If you always have a cup of coffee at the kitchen table with your first cigarette of the day, take your coffee elsewhere. If you always smoke when you’re sitting at the computer, use a library’s computers for a few weeks. Shake

things up; it really helps to break the grip of nicotine. I recently saw a pulmonary specialist and underwent a series of tests, and I was told there are no longer signs of chronic obstructive pulmonary disease. The shortness of breath I was experiencing has lessened, and I am sleeping better than I have in years. While I still take medication for high blood pressure, it is now consistently lower than it has been in many years. I’m also saving more than$ 3,500 a year by not buying those Marlboro Lights every day, and that’s a big help when you’re living on a modest fixed income. Sure, there are times I miss smoking, and I probably always will. But those thoughts are just thoughts, not cravings, and they pass quickly as I remind myself how much healthier I’ve become in just a few, short years. Let’s face it, being a smoker these days is embarrassing, not to mention it has become almost impossible to find public places where it’s legal to smoke. So why not give quitting one more try? Now that you’re older, I think you’ll be pleasantly surprised at the difference. And what a difference it will make in your life.

Suzanne Ellis is a freelance writer who retired after more than 30 years as a professional journalist. She lives in Baldwinsville, N.Y.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

Never Too Late to Stop Smoking Even quitting in your 60s can add years to your life, researchers find You’re never too old to reap the health benefits of quitting smoking, a new study finds. “Even participants who quit smoking as recently as in their 60s were 23 percent less likely to die during follow-up than those who continued to smoke into their 70s,” said lead researcher Sarah Nash, who conducted the study while at the U.S. National Cancer Institute. In addition, the age at which you start smoking can have an impact on longevity, the researchers found. “This study confirms that age at smoking initiation and cessation, both key components of smoking duration, continue to be important predictors of mortality in U.S. adults over age 70,” Nash said. “It also underscores the importance of measures to prevent initiation, as well as encourage cessation, for all smokers,” she added. Nash is currently with the Alaska Native Epidemiology Center at the Alaska Native Tribal Health Consortium in Anchorage. Nash’s team found that smoking, which is known to be an important predictor of early death among middle-aged smokers, was also strongly related to early death from smoking-related causes among those aged 70 and older. Compared with those who had never smoked, people who still smoked when they were 70 and older were three times more likely to die during the six-year study period, Nash said. In addition, among current smokers, the age at which they started smoking was linked to an increased risk of smoking-related death, Nash said. “Smokers who started smoking earlier in life were at increased risk of death, as were those who smoked more cigarettes per day over the age of 70,” she said. “Regardless of their age, all smokers benefit from quitting,” Nash added. “Also, smoking patterns early in life may still affect mortality even 50 to 60 years later. So, it is important to support efforts to prevent adolescent smoking initiation.” The study findings were published Nov. 30 in the American Journal of Preventive Medicine.

Telemedicine Visits in Upstate NY Likely to Surge This Year

Excellus BCBS predicts a rapid rise in the use of telemedicine starting this year

pstate New Yorkers will embrace telemedicine as an alternative to getting care for minor conditions this year and are expected to use that option more than 50,000 times by the year 2018, Excellus BlueCross BlueShield officials recently predicted. Relying on national studies, local projections and preliminary results from a pilot program of its own employees’ use of telemedicine, the health plan said a surge in the use of telemedicine is likely to begin in 2017 and grow rapidly every year through the remainder of this decade and beyond. “Ideal medical care is when a patient sees his or her physician face-toface, and both know and trust each other, but in our rapidly changing and fast-paced world, some of those face-to-face visits can’t always take place,” said Martin Lustick, senior vice president and corporate medical officer for Excellus BlueCross BlueShield. “Telemedicine is an alternative that is in place and will gain popularity across the country,” Lustick said. “It allows people in rural areas to see specialists in urban settings. It serves the needs of patients who find it difficult to get out of work to see their doctor when they need to address a problem for themselves or their children. And, it’s a speedy alternative to going to an urgent care center or even the hospital emergency room for minor medical conditions.” Historical advances in clinical decision-making; the evolution of customer-friendly technology applications for smartphones, tablets and computers; and more people having high-deductible health policies are the most frequently cited reasons driving the trend. Remote medical care, known as telemedicine, is when the patient and the provider are in two different locations but linked by telephone or a secure two-way video connection. While telemedicine services are available to anyone with or without health insurance, easy-to-use platforms are being built into most health insurance offerings throughout Upstate New York. Starting Jan. 1, 2017, MDLIVE will be the platform offered by Excellus BlueCross BlueShield to

all privately-insured and Medicare Advantage members as their new enrollment or re-enrollment begins. “There’s an old adage that you should be skeptical of a chef who doesn’t taste his own cooking,” Lustick said. “With that in mind, Excellus BlueCross BlueShield ran a pilot program that encouraged our employees to register themselves and family members with MDLIVE. The responses we received for getting this benefit and using it were overwhelmingly positive.” Relying on New York State Department of Health data labeled “potentially preventable” emergency room visits, Excellus BCBS reported earlier this year that 10 common conditions represent more than 2 million annual visits to hospital emergency rooms statewide, and nine out of 10 of those could have been avoided or treated elsewhere. Of 6.4 million emergency room visits in 2013, more than 2 million were for common conditions, such as ear or sinus infections and sore throats. “We said back then and we’ll repeat today: The ideal method for having minor medical conditions addressed is to see your doctor,” Lustick said. “But if your doctor can’t see you immediately for an office visit, ask whether he or she can address the issue with telemedicine. And if that isn’t available, other telemedicine providers, such as MDLive, can address most of those common conditions and prescribe medicine when medically indicated.” The health plan also announced today that it will invest in a public education campaign that presents telemedicine as an alternative to potentially preventable emergency room visits. “We are at a crossroads in Upstate New York,” Lustick concluded. “Consumers have more choices available to them than they ever have before when it comes to getting their medical needs addressed. We believe the primary care physician should be central to our health care, but recognize that new technologies, clinical decision-making advances and health insurance offerings are about to have an important impact on our Upstate New York health care delivery system.” January 2017 •

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 9

Live Alone & Thrive

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Create an Inviting ‘Table for One’ in 2017

ith the hustle-bustle of the holidays behind us, January can bring a welcome respite and some nice, quiet time to yourself. Until, of course, all that desirable alone time becomes, well, less desirable. For those who live alone, dining solo can present one of the biggest challenges. And it’s no wonder. For most of humanity dining is a social activity. We enjoy sharing our meals with loved ones, friends and colleagues. So when we find ourselves alone at the dinner hour, it can feel a little uncomfortable, even lonely. It’s not unusual to fill in the awkward silence with distractions: the company of TV, the comfort of a good book or the diversion of a favorite magazine. Believe me, I’ve been there. I can’t tell you how many of my favorite books contain food crumbs. But I’m not complaining. Good reading material can be a great dining companion. But it represents just one ingredient of the solo dining experience.

While living alone gives us the freedom to dine as we please (one of its many benefits), I don’t recommend eating breakfast for dinner or munching through a bag of Cheetos as a substitute for a healthy, well-balanced meal. When it comes to eating alone at home, treat yourself as you would treat a good friend you are having over for dinner. Why? Because you are worth it. Because you will feel better about yourself, both physically and emotionally. When you prepare and enjoy a good meal on your own, you’ll be sending yourself a valuable message: It’s important to take good care of myself and to treat myself with respect. I matter enough to treat — and feed — myself well. Eating well and right has all kinds of benefits. And what better way to start enjoying those benefits than by creating an inviting “table for one” in your own home. In fact, why not consider the tips below and give it a try today?

n Stock your kitchen with healthy food. It’s so much easier

to put a healthy meal on the table when the good stuff is plentiful and the junk food is in short supply. I’m fully aware of my own downfalls (ice cream, nuts, sweets, chips) and do not regularly stock these items in my kitchen. Instead, I have on hand a good supply of frozen and fresh vegetables, prepackaged salad greens, fruits in season, and single-serve portions of frozen meat and fish. You’ll also find plenty of grab-and-go “power” bars in my pantry for when I’m on the run.

n Indulge your senses.

Stimulate your appetite by preparing an item or meal that produces a wonderful, delicious aroma. My secret? I love the scent of sautéed garlic, and jump-start many a solo dining experience with a little butter and garlic in my stove-top skillet. The aroma invites me into the cooking process and within minutes the worries and stresses of my day start to melt away. I also try to incorporate foods with a variety of textures and color — soft, chewy, crisp, and firm — into each meal. These touches serve to make the dining experience more interesting and pleasant.

n Select the best seat in the house. While eating in front of the TV may be the perfect choice on

some occasions, I encourage you to find dining spaces inside or outside your home that may offer more inspiration. Chances are, you’ll appreciate the change of scenery. Consider that special nook where the sun filters in or that table by the window with the great view. Mix it up, experiment with different settings, and see how much better it feels. n Set the stage. Create a pleasing table setting and mood: put down a placemat, use a cloth napkin, turn on some enjoyable music, and position a good book, magazine or tablet computer within reach. You might even light a candle. I do. If you’ve never set the stage like this before, it can feel contrived at first, but stay with it. Over time, I’m

confident you’ll find it as enjoyable and relaxing as I have.

n Enjoy your own company.

When you eat alone, you’re in the company of someone special — yourself! You are with someone who approves of your meal choices and cooking techniques, appreciates the candle you lit, and knows that life and good food are to be enjoyed. Cherish this quality time with yourself. Creating a pleasant “table for one” is a great opportunity to focus on yourself and to nourish your body and spirit at the same time. So, pull up a chair, say a few words of gratitude, and enjoy! Gwenn Voelckers is the founder and facilitator of Live Alone and Thrive, empowerment workshops for women held throughout the year in Mendon, NY. For information about her Living Alone workshops or to invite Gwenn to speak, call 585-624-7887 or email: gvoelckers@ rochester.rr.com.

KIDS Corner Martial Arts Can Be Hazardous to Kids

Certain practices put children at risk of serious injury, pediatricians’ group warns

erhaps there’s a black belt in your child’s future. But for safety’s sake, kids should only engage in noncontact forms of martial arts, a new American Academy of Pediatrics report says. About 6.5 million U.S. children practice martial arts such as mixed martial arts, karate, taekwondo and judo. While these popular sports can improve fitness, motor skills and emotional development, they also Page 10

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carry the risk of injury. Certain disciplines are riskier than others, the pediatricians’ group says. “There are so many different types of martial arts for families to consider and enjoy, but such a difference in injury risk between the different non-contact and sparring forms,” report author Chris Koutures said in a news release from the medical group. Koutures is a member of

the academy’s executive committee on sports medicine and fitness. Bruises and sprains account for most martial arts injuries, but more serious injuries also occur. Certain practices in mixed martial arts, for instance, carry a higher risk of concussion, suffocation, spine damage, arterial ruptures or other head and neck injury, the academy notes. These risky movements include direct blows to the head, repetitive head thrusts to the floor and choking movements, the academy says. Injury rates vary from 41 to 133 injuries for every 1,000 athletic exposures, depending on the type of martial art, the report says. With no proof that protective equipment such as soft helmets and mouth and face guards prevent concussions, this gear may provide a false sense of safety, according to the academy.

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

“We hope that this report will enable pediatricians to help families select the most appropriate options for their child and realize how strongly certain practices and rules can impact a participant’s safety,” Koutures added. The group recommends delaying martial arts competition and contact-based training until children and adolescents show adequate physical and emotional maturity. The report also recommends eliminating a taekwondo rule that awards extra points during tournaments for kicks to the head because these increase the risk of concussion. But mixed martial arts seems most concerning. Even watching too much mixed martial arts may put children at risk of injury if they imitate what they see, the academy says. The report appears online Nov. 28 in the journal Pediatrics.

A Cure for Cancer

By Rick Bartell

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Why you should consider HPV vaccine

t is a cliché we often use to trivialize something by saying, “Well, sure it isn’t a cure for cancer, but…” when we try to draw a comparison between something ordinary to something truly important, like a cure for cancer. I was thinking about our use of that phrase the other day when I was reading the statistics on the 10-year anniversary of the HPV vaccine. The data is in and over the next generation we may be truly witnessing a modern cure for certain types of cancers. In an editorial in the June 30 issue of the New England Journal of Medicine, the authors stated that “in the not-to-distant future, current and future generations of adolescent girls will be largely spared from cervical cancer. Eventually — after several decades — cervical cancer screening may no longer be warranted.” That is if we can increase the vaccination rates of young girls and boys aged 9-12. Let’s examine the facts. Study after study has shown a more direct link between HPV infection and cervical cancer in women than the link between smoking and lung cancer. By vaccinating against HPV before contracting the infection you virtually eliminate the risk of certain types of cancer later in life. But,

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unfortunately, vaccination rates in the United States are modest at best. Parents fear another vaccination especially one that deals with a sexually transmitted disease (STD). Doctors sometimes lack the language to discuss the difficult subject with the parents of a young child. Parents are confused as to the safety of the vaccine or of the regimen needed to protect their child. First, there have been more than 80 million doses of the vaccine given with no direct evidence of any longterm adverse side effects. Both boys and girls should receive the vaccine between the ages of 9 and 12 with the completion of the regimen by the time the child is 13. The vaccine is most effective in preventing HPV when it is administered before being exposed to the virus, most often through sexual contact. The vaccine is recommended for people up until the age of 26 but again it is most effective when given before exposure. In the United States, even with relatively low rates of use we are beginning to see the results. The CDC reports that HPV infections have fallen by 56 percent in teenage girls as well as reduced rates of early cervical disease. The vaccine for boys wasn’t approved until 2011 but with increased utilization we can expect to see the same reduction in oral cancers in men, currently on the rise in middle-aged men. So talk to your doctor about the HPV vaccination. Parents, grandparents, and everyone should be aware of this important protection. This is one time when we can truly say, “this is a cure for cancer!”

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Rick Bartell has worked for over 23 years in the area of sexual health education. He currently acts a consult to a number of area nonprofits. You may contact him at bartellrick@gmail. com with any questions or ideas for future columns.

Serving Monroe and Ontario Counties in good A monthly newspaper published

Health

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by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high traffic locations.

If you think something is wrong with this picture, you should see what’s happening in stores.

In Good Health is published 12 times a year by Local News, Inc. © 2017 by Local News, Inc. All rights reserved. 154 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com

Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Jessica Gaspar, Kim Petrone (MD) • Advertising: Anne Westcott, Debra Kells • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.

January 2017 •

That’s where tobacco companies are spending billions on promotions where kids can see them. And the more kids see tobacco, the more likely they are to start smoking. It’s time to draw the line.

Stores located near schools contain nearly

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of tobacco advertisements.

Take action now at SeenEnoughTobacco.org

facebook.com/TobaccoFreeNYS

@TobaccoFreeNYS

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 11

SmartBites

The skinny on healthy eating

Why Haddock is a Nutritious Catch

very fish has its hook and…its sinker. Some, like shrimp, are high in muscle-building protein, but then also potentially high in contaminants if farm-raised in undesirable conditions. Others, like white tuna, keep our bodies humming with energizing B vitamins, but then also give us pause with high mercury levels. Still others, like salmon, are omega-3 superstars, but then not such bigwigs on the fat and calorie front. It’s all relative, especially when it comes to your individual needs. Come January, with the eating season officially over and resolutions on the upswing, many of us desire to cut back on calories and feel more fit. Eating lean protein, such as fish, is universally recommended by nutritionists and leading institutions alike. My family’s go-to fish in January (and throughout the year) is haddock. Mild-tasting and reasonably priced, this flaky white fish teems with good things. An average 3.5-oz serving has only 112 calories, scant fat, a whopping 24 grams of protein and healthy doses of three B vitamins: niacin, B6, and B12. All together, these B vitamins strengthen our immune system, convert food to energy, keep our nerves in tiptop shape and help make red blood cells.

Another nutritious hook? Haddock rocks with impressive amounts of two essential minerals: phosphorous, which helps form and maintain healthy teeth and bones; and selenium, a powerful antioxidant that helps prevent cell damage and that may also prevent certain cancers. As for mercury levels, haddock routinely makes the “lowest levels” list, according to the Natural Resources Defense Council. Mercury can impair the neurological brain development in fetuses, infants and children, which is why children and women of childbearing age are advised to limit their exposure to “high mercury” fish. Wondering if haddock has any “sinkers”? Well, much like sole, snapper and flounder, haddock is no great catch when it comes to the almighty heart-healthy omega-3s. Alternating haddock with a fish that’s high in this fatty acid, like salmon, works for our family.

Helpful tips:

Fresh fish should be cooked within two days, up to three at most, from the time it was purchased (it’s best though to cook it the day you buy it). Once cooked, any leftover fish remains good for three to four days. Frozen haddock, like other lean white fish, typically lasts between six to

Top Eight American Pizza Habits

eight months. The key to keeping haddock’s calorie and fat content low is in its preparation: grilled, broiled or baked versus breaded and fried.

Italian-Style Baked Haddock Adapted from Bon Appetit; serves 4 2 tablespoons olive oil 1 small onion, chopped 2 cloves garlic, minced 1 8-oz. pkg. sliced mushrooms, hard stems removed 1 yellow or orange bell pepper, chopped 1 teaspoon dried basil or 1 Dorot basil cube* 1 14.5 oz. can petite diced tomatoes, drained ¼ teaspoon red pepper flakes (optional) Salt and pepper to taste 1½ pounds haddock fillets 1 cup shredded mozzarella or cheese of choice Preheat oven to 350°F. Lightly oil a nine-inch glass baking dish. Heat olive oil in large skillet over medium-high heat. Add onion, garlic,

mericans consume 350 slices of pizza every second, and 15 percent deem it their top comfort food. In the November issue of Food Technology magazine associate editor Melanie Zanoza Bartelme outlines eight American pizza trends, preferences and consumption habits.

Over half (58 percent) of U.S. pizza eaters say they would buy more frozen pizza if it had more premium or gourmet ingredients.

Pizza consumption in restaurants is trending at its highest level in the past four years . Seventy-six percent of consumers have eaten at a pizza restaurant in the past 12 months.

Pizzas are trending toward thinner crusts and half of consumers prefer to go thin. Hand-tossed, however, is the No. 1 crust type found on restaurant menus, preferred by 57 percent of consumers.

Another trend in pizza crust centers on gluten-free. Gluten-free launches increased 58 percent between 2012 and 2015.

Tomato-based red sauce remains the most common topping on pizzas, but nontraditional sauces such as Page 12

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

mushrooms, bell pepper and basil and sauté until vegetables are tender, about 10 minutes. Stir in tomatoes and red pepper flakes. Season with salt and pepper, and cook for five to eight minutes more, stirring constantly, until slightly thickened. Arrange fish in prepared dish. Pour sauce over. Sprinkle mozzarella on top. Bake until fish is cooked through, about 25 minutes. Pair with rice or linguine. *Dorot basil cubes are a convenient, economical way to add the taste of fresh basil to dishes. They come 16 to a tray and can be found in the frozen section of most major grocery stores. 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.

ranch, alfredo and white sauce are also appearing.

Mozzarella is the most commonly used pizza cheese, with 71 percent, with ricotta and Parmesan at a distant two and three (35 percent and 32 percent, respectively), but alternate cheeses are on the rise. These include goat, gorgonzola, fontina, Romano, asiago, provolone, feta, and even pepper jack gaining traction. In addition, preference for gouda is increasing, and it is among the fastest-growing cheeses on restaurant menus.

Sausage and pepperoni are still the top meats, being featured on 73 percent of restaurant menus, but bacon is also widely available, and chicken breast is up 22 percent, likely due to its perception as a healthier meat. Prosciutto is growing, up 27 percent since 2010. Other emerging meat toppings include meatballs, salami and anchovies (Packaged Facts 2015).

Onion, tomato, mushroom and peppers are featured as pizza toppings on at least 73 percent of restaurant menus.

Weight Loss

‘Super Foods’ Don’t

Equal Miracle

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Weight Loss By Deborah Jeanne Sergeant

You’ve likely seen the online ads touting “super foods” that blast belly fat, melt off flab and produce a svelte, toned body with no other effort. If only it were so. The answer to lasting weight loss doesn’t lie in eating only grapefruit, drinking a special tea or combining a few fad food ingredients into a smoothie. Hannah Smith, registered dietitian with Rochester Regional Health, said that there’s “no evidence to support the use of ‘super foods’, special drinks or supplements for quick and easy weight loss.” Although a severe calorie decrease can force the body to lose weight (which can include water, muscle and/or fat), “there is a lot greater benefit in exploring answers to our questions about choosing healthy eat pattern that works for you and matches your lifestyle, as opposed to a quick fix that results in relapse or no results at all,” Smith said. It’s the long-term pattern of eating and exercising that results in lasting weight loss. Instead of a quick fix “diet” to drop a few sizes before an event, Smith teaches clients to make wise food choices as a lifestyle, not just for weight control, but also for good health. A major problem with “miracle” diets is that they restrict food groups or focus on too few foods. Either of these strategies limits the intake of nutrients. “Recognizing the importance of healthy eating and making it a lifestyle, can help answer the questions of how to integrate healthy food options in everyday life and allow food to be a healthy and enjoyable part of our lives,” Smith said. “The desire to make the change is so admirable and should be matched with proven methods to make the changes that will help you achieve you goals for a lifetime.”

Eating a balanced diet with healthful foods from each food group represents the most beneficial way to lose weight. Dietitian Christina Ganzon with Finger Lakes Health recommends “a general overall healthy diet that provides a variety of vitamins and minerals through food.” Eating this way “will give the body the micro and macro nutrients that it needs. Most vitamins are water soluble, so we cannot store excess and thus need to replenish the body daily.” The best means to obtain these nutrients is through consuming fresh, whole foods that have not been processed. Foods containing refined sugar, for example, contain too many calories and cause the blood sugar to spike, setting off a chain reaction that leads to weight gain as the person’s body goes into “storage mode” and, in addition, feels unsatisfied even after consuming sufficient calories. Whole foods contain more fiber and help the body feel more full, in addition to aiding digestion and slowing absorption of fat. Ganzon recommends replacing crackers and peanut butter with an apple and peanut butter to get more whole foods into the diet. Or instead of mashed potatoes, try mashed cauliflower. “Use a yogurt, fruits or vegetables as snacks more often,” Ganzon said. “All of these little switches will decrease your caloric intake and increase your nutrient density, possibly resulting in improved energy and some weight loss.” Exercising regularly and sticking with a reasonable calorie diet (adjusted for your activity level), whole foods and nutrient-dense foods represents the most healthful way of losing weight for life. Just as in Aesop’s fable of the tortoise and the hare, the slow, sure method wins when it comes to weight loss.

James W. Albright, CAPS, GMB, CGR, CGP 5205 Johnson Hill Drive, Canandaigua, NY 14424 Cell (5850 230-4280; Fax(585) 396- 5879 albright1.j.s@gmail.com www.AlbrightBuild.com

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 13

Women’s HEALTH

Gynecologic Cancer Signs Experts say ignoring certain signs would allow a cancer to grow and possibly spread

ny change in your gynecologic health could indicate you need medical attention, according to experts. While many women fear certain symptoms could indicate cancer, “the signs and symptoms of gynecological cancers can also be indicative of other non-cancerous problems or diagnosis,” according to Martha Ryan, American Cancer Society senior director of community engagement for Western New York, which includes Rochester. Or, if they turn out to be unimportant, a doctor’s visit would bring peace of mind. It’s also vital to note that “women with early cervical cancers and pre-cancers usually have no symptoms,” Ryan said. “Symptoms often do not begin until the cancer becomes invasive and grows into nearby tissue.” Ryan added that at this stage, the most common symptoms include: • Abnormal vaginal bleeding, such as bleeding after vaginal sex, bleeding after menopause, bleeding and spotting between periods, and having (menstrual) periods that are longer or heavier than usual. Bleeding after douching or after a pelvic exam may also occur. • An unusual discharge from the vagina. The discharge may contain some blood and may occur between your periods or after menopause. • Pain during sex. Though attributable to other

health conditions, cancer could cause these symptoms and ignoring them would allow the cancer to grow and possibly spread. Waiting until a more advanced stage may “lower your chance for effective treatment,” Ryan said. She encourages women to receive regular Pap smears and pelvic exams to check for any irregularities. “Receiving the HPV vaccine can actually prevent most cervical cancers,” Ryan said. “The HPV vaccine should be given to boys and girls beginning at the age of 12. This vaccine is a three-dose vaccine and should be given prior to sexual activity.” Signs for endometrial cancer presents few symptoms until it’s advanced. Most women experience abnormal vaginal bleeding, which may include bleeding between cycles or after menopause. Though abnormal bleeding may occur for other reasons, it’s still a good idea to get it checked out, and for women who have undergone menopause “it’s especially important to report any vaginal bleeding, spotting, or abnormal discharge to your doctor,” Ryan said. “Non-bloody vaginal discharge may also be a sign of endometrial cancer. Even if you cannot see blood in the discharge, it does not mean there is no cancer. In about 10 percent of cases, the discharge associated with endometrial cancer is not bloody. Any abnormal discharge should be

By Deborah Jeanne Sergeant

checked out by your doctor.” Other endometrial cancer signs can include pelvic pain from a tumor and unexplained weight loss. Irregular bleeding could also indicate uterine sarcoma, another type of cancer, especially for women who have already experienced menopause. “This symptom is more often caused by something other than cancer, but it is important to have a medical evaluation of any irregular bleeding right away,” Ryan said. “Of the uterine sarcomas, leiomyosarcomas are less likely to cause abnormal bleeding than endometrial stromal sarcomas and undifferentiated sarcomas.” Again, discharge is usually associated with a non-cancerous condition; however, it’s still important to receive an exam to stay on the safe side. Other symptoms could include pelvic pain, a palatable mass, or a feeling of fullness, but only about 10 percent of women experience these feelings. Ryan said that signs of ovarian cancer can include several symptoms, but it’s more likely if the cancer has spread beyond the ovaries. The signs may include bloating, pelvic or abdominal pain, feeling full, urinary urgency, and urinary frequency. As with the other types of cancer, signs of ovarian cancer can also indicate non-cancerous conditions “When they are caused by ovarian cancer, they tend to be persistent and represent a change from normal,” Ryan said. “For example, they occur more often or are Justicia more severe. If a woman has these symptoms more than 12 times a month, she should see her

doctor, preferably a gynecologist.” Ovarian cancer may also be accompanied by fatigue, upset stomach, back pain, pain during sex, constipation, menstrual changes and abdominal swelling with weight loss. But since many women experience these symptoms unrelated to ovarian cancer, medical tests are the only way to determine if that’s the cause. “Women need to know their body and if something is not normal, they need to pursue it with their medical provider to find out what is going on,” Ryan said. “Women need to have regular GYN appointments and receive the recommended screenings.” Usually, just one symptom isn’t as troubling as presenting several symptoms. “The combination of losing weight, yet feeling bloated and having abdominal enlargement is worrisome,” said physician Faye Justicia-Linde, clinical assistant professor, department of obstetrics and gynecology in the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo and a physician with UBMD Obstetrics-Gynecology. “Feeling full after eating very little is also concerning.” She added that changes in bowel function, such as developing chronic constipation or more frequent diarrhea, could also represent symptoms that indicate cancer, as could any change in urination pattern (frequency, incomplete emptying, leakage, blood, pain with urination). “It is still unlikely to be due to cancer, but any persistent discomfort should be checked out and can be treated,” Justicia-Linde said.

What to Do with Dark Circles Around the Eye Do people constantly ask if you’re tired because of dark circles under your eyes? By Deborah Jeanne Sergeant

t’s a fairly common condition. Mild cases may be adequately covered with cosmetics. A professional make-up artist can assist in finding the right make-up primer, foundation, and concealing products. But not everyone finds that make-up provides adequate coverage, especially if the area is saggy and discolored. Michael Nazareth is a board-certified dermatologist. He’s also president of Western New York Dermatology in Williamsville. He said that under-eye circles are most common as facial skin ages. “The skin itself can have increased laxity resulting in the development of superficial fine lines and wrinkles,” Nazareth said. “There can also be some skin hyper-pigmentation that goes along with this. However, some of the under eye ‘bags’ are actually due to a greater protrusion of the small pockets of fat under the eye.” Retinol-based topical treatments can help improve the appearance of fine lines and wrinkles. Laser and Thermi treatments, which uses temperature-controlled radiofrequency Page 14

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energy to help decrease the unwanted pigmentation. “Definitive treatment of any large protruding ‘bags’ requires surgical lower lid blepharoplasty,” Nazareth said. “While that can be more involved, everyone can take simple steps to help.” He advises clients to get enough sleep, moderate salt intake, drink plenty of fluids, and protect skin with sunglasses and hats. Vito C. Quatela, board-certified plastic surgeon at Quatela Center for Plastic Surgery in Rochester, said that dark circles can run in families, and treatment can range from simple remedies to more complex procedures. Under-eye circles may indicate more than a cosmetic concern. “New onset of under-eye bags can be a sign of diseases like thyroid problems, so seeing your doctor regularly is important,” Quatela said. “Healthy eating with minimal salt intake, regular exercise, limiting alcohol, not smoking, controlling your allergies are all important to look your best.” Reducing stress also contributes to good health and appearance.

At-home remedies may offer temporary reduction of the appearance of under-eye circles, including cold cucumber slices, cooled tea bags, Preparation H and creams that contain caffeine. “Some people find these effective to reduce puffiness but are all temporary,” Quatela said. “There are many products on the market that may give this type of temporary relief.” Longer acting treatments will likely incur some recovery time, such as injected fillers. “There are no fillers that are FDA approved for the under-eye area — called the tear trough — but many experienced injectors fill this area in

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

an off-label fashion,” Quatela said. The procedure can cause some initial bruising and swelling, but the results can last a year. Surgery represents the most invasive treatment for under -eye bags. Quatela said that it involves removing excess fat and tightening the loose skin with different methods that could include laser, chemicals or surgical excision. “There is some down time, depending on the technique, but will be at least one week,” Quatela said. “The satisfaction rate for all of these procedures is very high when performed by an experienced physician.”

Women’s HEALTH

Things You Need to Know to Keep Your Bladder Healthy

finally express they are having bladder trouble. Often they had to endure situations that could have been fixed if they would have spoken up earlier. “People who have bladder problems can feel socially isolated so we want to give them ways that can improve their condition and improve their lives,” she said.

Do Kegel exercises:

By Ernst Lamothe Jr.

ladder health can be a delicate subject that many people are too embarrassed to talk about but that can affect someone’s everyday life. Millions of Americans suffer too often in silence and fear telling family members or even physicians. Your bladder — a hollow organ that holds urine from your kidneys — is one of those body parts that you probably don’t think about until it stops working properly. Poor bladder health problems can lead to issues such as urinary incontinence, overactive bladder, urinary tract infections. “It’s an important issue that both men and women suffer from and it can happen at any age,” said physician Gunhilde M. Buchsbaum, a urogynecologist and director of the division of urogynecology at UR Medicine’s pelvic health and continence specialties practice. “The loss of bladder control is something that half of women as they get older and a third of men will suffer from, and it can become serious if you don’t do something about it.” Buchsbaum offers five tips to better bladder health.

Steps

Cut down on caffeine

Americans like to drink a lot of caffeinated beverages whether that is soda or caffee. While it tastes great, it also fills up the bladder rather quickly and makes it less controllable. Lightening up the liquid load can make a big difference. “A lot of people end up drinking overall a lot more than they need to,” said Buchsbaum. “Avoid consuming large amounts of caffeinated or alcoholic beverages, which irritate the bladder. Take the time to empty your bladder regularly every two to four hours, depending on your fluid intake.” She also believes people feed into the myth of needing to drink a large amount of water throughout the day. “All of us don’t need to drink eight glasses of water a day. Drink only what you need to satisfy your thirst and prevent dehydration,” Buschbaum added.

Talk to your physician

Because of the embarrassment factor, Buchsbaum said oftentimes patients will wait until the third or fourth time they see her before they

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Arnold Kegel, a German gynecologist, described exercising the pelvic floor muscles to improve conditions such as incontinence. These exercises are often referred to as Kegel exercises. Men and women can perform these: contract your pelvic floor muscles, as if you were trying to stop your urine stream. When done correctly, the Kegel movement can help to overcome a strong urge to void long enough to make it to the bathroom without an accident. “Tightening the pelvic floor muscles when coughing, sneezing or lifting also may prevent urine leakage,” said Buchsbaum. ”If you do them well and do them regularly, it can really help control your bladder.”

A little exercise

It’s no surprise that exercise is often a remedy for many health ailments. However, it does have an effect when it comes to bladder incontinence. Some people, like those who are sedentary or have heart disease, may develop fluid build-up in their legs during the day. At night, this fluid causes them to need to empty their bladders frequently. If you have fluid retention in your legs that’s causing an active bladder overnight, try walking around more throughout the day. “We are at a time now when many of our jobs cause us to be be-

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hind a desk all day, and then we come home and sit down some more,” said Buchsbaum. “Moving around a little bit and taking a walk throughout the day or after work can do a world of good.”

Consider medication

Buchsbaum said because everyone’s condition varies, they should consider medication to control some of the issues if the problem persists. “There are many treatments to choose from, and it’s important to find the right one for you. There are medications to treat bladder problems, but non-medical options may be a good first step,” she said.

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Page 15

Women’s HEALTH

Top 10 Ways Women Can Improve Their Health Want to be fitter and healthier in 2017? Here are the top tips from local experts. By Deborah Jeanne Sergeant

Match input and output.

“Increase your metabolism. Understand how many calories you consume on a daily basis and offset that with being active.” Kevin Silverman, personal trainer at Brighton Personal Training in Brighton.

2. 3.

Make ﬁtness your lifestyle.

“It’s about routine. For fitness in general, you need to find a routine and a conducive environment for to grow in.

Lift weights.

“Women sometimes are intimidated a little if they’ve never experienced lifting before. We have 3:1 ratio of instructors and it’s all individualized. “As you go throughout your life, you have to be able to contract muscles to propel yourself up stairs for example. It’s paramount for everyone to do that. You don’t need to be a body builder, but you need to work on the functional aspect on a daily basis. “Working out with weight lifting has been evolving since the early 2000s. It’s about perception. You used to hear grunting and groaning and people throwing weight around. Now it’s about people wanting to live longer, about people wanting to function better in their day-to-day life. It serves many purposes such as being strong when going to give birth through staying active all your life.”

Keep ﬁtness fun.

“Find what works for you. That way you will stick with it. At the JCC, there are a lot of options because we look to reach out to the community. Group fitness classes are always popular among women. We have a large variety of classes, regardless of your fitness level and age. It becomes social. Participating in a class helps encourage you to keep going. One of the top classes is yoga, which helps with stress reduction and fitness. We’re going to bring onboard a reiki instructor soon.” • Val Redmond, group ﬁtness and wellness director, JCC, Rochester.

Improve your cardiovascular ﬁtness.

“Everyone has their own individual concerns and limitations, but the most important thing now is to keep an eye on their cardiovascular health and also their ability to recover. That is something generally

not given too much focus, especially as popular as some methods like cross fit have come out. They put a big emphasis on extremes, but not cooling down and giving the body a chance to heal from exertion before the next workout. It allows for more rapid recovery the more you do that.

ing with stress physiologically.” • Tim Kubit, certified instructor in Krav Maga, mixed martial arts fitness instructor and kettle bell fitness instructor, and owner of the Krav Maga in Rochester.

• Martha Ryan, American Cancer Society senior director of community engagement Western New York.

Manage stress.

“Stress management is so important for women dealing with family responsibilities, career, marriage. There’s lots of stuff in our lives and if we don’t know how to cope with stress, it can lead to heart disease and high blood pressure and it contributes to many other health problems. Exercise is the key for dealing with stress.

Stay conditioned.

“If someone is taken by surprise by an attacker, the initial shock of having that ambush happen wouldn’t be quite so debilitating if they were more conditioned to deal-

Get annual exams.

“Regular gynecological checkups is important to a women’s overall health. Have regular Pap tests and pelvic exams. Cervical cancer screening, with a Pap test and HPV DNA test, should begin at age 21. For women age 21 to 29, screening should be done every 3 years. For women ages 30 to 65, screening should be done every 5 years.”

Protect your skin from sun.

“I recommend to every patient to wear a sunscreen of SPF 30-50 every single day, sunshine or rain on the face, neck, and any part of the chest that’s exposed, even in the wintertime. The sun reflects off the snow. Wear wide-brimmed hats and protective clothing and stay in the shade when you’re outside. We see a lot of melanoma because people aren’t used to doing this every single day like in California.

10.

Don’t tan.

“Don’t ever go to a tanning bed. It’s terrible for your skin.”

• Adam Terry, owner of Power Train, Rochester.

• Elise DeLuke, dermatologist and owner of DeLuke Dermatology in Amherst.

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Women’s HEALTH

Cheri Maillie (left) and her friend Susan Catalano, who was diagnosed with breast cancer in 2013. Catalano had had mammograms every five years but changed her routine after her friend Maillie encouraged her to have the test annually. “I got diagnosed at 57 years old. If I would have kept going every five years, then I would have been 60. They wouldn’t have caught it at an early stage and the diagnosis could have been so much different,” said Catalano. She is now cancer free. Photo at the Breast Cancer Coalition of Rochester gala earlier in 2016.

Friendship, Early Detection and a Breast Cancer Diagnosis After a friend’s suggestion to have more regular mammograms, Williamson woman finds out she has breast cancer By Ernst Lamothe Jr.

heri Maillie and Susan Catalano met at a late 1990s at a mutual friend’s party. On that day, neither could know that one would possibly save the other woman’s life more than two decades later. Both women remember that first meeting clearly. They were just casually having a conversation with both being new mothers. They started doting over their daughters, showing each other pictures and just talking about the thrills and struggles of new motherhood. Soon they realized that not only did their first daughters share the same name — Jennifer — but they were both born on Jan. 24 only a year apart. After that, the two women became fast friends. The pair continuously went on trips with other friends and shared stories of good and heartbreaking

times with each other, always being a support system when needed. One of those times was when Maillie’s sister, Laura Kilcoyne, was diagnosed with breast cancer. She confided in Catalano about the struggles seeing her sister dying slowly after a three-year battle that ended in 1999. “My sister was always someone important in my life. When she was diagnosed at 42 years old, I was 40 and that was the time where doctors were telling people to regularly get their mammograms,” said Maillie. “It was pretty hard on me when she died at 45. I had a brother, Tim, who died at 41 from lung cancer and he wasn’t even a smoker. Cancer had hit my family strong.” Then around 2006, both women January 2017 •

were talking and the topic of mammograms came up. “I told Sue I was going to get my yearly mammogram and wanted to know when she was scheduling hers,” said Maillie, 60, of Ontario. “Then she told me she usually gets hers every five years and I couldn’t believe it. I told her you are coming with me and we are making an appointment because my sister died of breast cancer. When you say something like that no one can take no for an answer.” Catalano, 61, of Williamson, remembers the story the exact same way. “She had a persuasive argument. How was I ever going to tell her no I didn’t want to do i?” said Catalano. “And to be honest, I really didn’t want to do it. But I did because I

couldn’t say no.” Instead of viewing getting a mammogram as a nerve-wracking and uncomfortable situation, the pair decided to make it a fun event. “We just said we would have a glass of wine afterwards and hang out. Then the glass of wine eventually turned into a dinner and wine,” added Maillie. “We would be in our robes in the hospital room and we weren’t even thinking about the test because we would spend so much time catching up and deciding where we would be going for dinner.” About seven years and seven mammograms later, Catalano had to get a second reading on her test and needed a biopsy. She wasn’t worried because it had happened before with no issues. Then after the test, she called Maillie, who was coincidentally volunteering at the Breast Cancer Coalition of Rochester. “I told her that I had just been diagnosed with breast cancer,” said Catalano, of the 2013 diagnosis. “I was just in shock so after I said that sentence I said ‘I thought you, Cheri, would be the one to get breast cancer because I don’t have a family history. I never thought it would be me and I was someone who never got sick. To this day, I can’t believe I said that but all my emotions were just hitting me at the same time. We joke about that now.” Catalano said after the diagnosis, which knocked her off her equilibrium for more than just a little while, she realized what could have been. About one in eight U.S. women (about 12 percent) will develop invasive breast cancer over the course of her lifetime, according to the American Cancer Society. In 2016, an estimated 246,660 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S. “It really hit me that Cheri had sort of saved my life,” said Catalano. “I got diagnosed at 57 years old. If I would have kept going every five years, then I would have been 60. They wouldn’t have caught it at an early stage and the diagnosis could have been so much different. She was such a good friend making me go for my yearly mammogram so many years ago.” While the experience was still life-changing, Catalano’s treatment included surgery and radiation, but no chemotherapy. For Maillie, her first thought was simply happiness that her friend’s diagnosis was caught in time. She understood as well as anyone what breast cancer can do to someone you love. “People say I saved her life, but I don’t feel heroic,” added Maillie. “All I did was tell a good friend that she should get her mammogram taken care of every year.” Maillie says she enjoys volunteering at local breast cancer awareness group. It is her way of giving back to a community who cared for her sister. “It is a tribute I do for Laura,” she said. “And something I do for Sue because they were a good support system for her as well.”

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper

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Page 17

Women’s HEALTH Parenting By Jessica Gaspar

Planning a First Birthday (…Already?)

ow the heck has it been a year already? It really seems like I was walking into the hospital waiting to be induced just yesterday. Then, the shock came that I had a 9 pound 10 ounce baby! Now, he’s a playful, laughing, curious 1-year-old boy. Lately, Timmy has been into Mickey Mouse and the show Mickey Mouse Clubhouse — we watch it every day! When the intro song comes on, he stops what he’s doing and starts waving his hands around. I planned a Mickey Mouse-themed birthday party for Sunday, Jan. 8.

He’s also been walking with assistance either with my hands or by pushing his Fisher Price scooter. He loves it. He gets into everything, so I baby-proofed a few months ago. Outlets have been covered and cabinet doors have been secured. I put little cushion protectors on the edges of all our end tables in the living room. On our fireplace, I laid down these colorful large cushioned puzzle pieces that are secured with double-sided tape just in case he falls onto it. We don’t ever use the fireplace, but I ensured he wouldn’t be able to open

the fireplace doors anyway. It’s funny watching him play. He’ll push his trucks across the floor. Every time we get into the car, he grabs the steering wheel and doesn’t let go. He hits all the buttons and gauges. If we’re not in a time crunch, I’ll let him play for a few minutes. I swear he’s destined to empty my windshield washer fluid reservoir. He lays on the lever and soaks my windshield! In early December, Timmy weighed about 21 pounds and stood about 29 inches tall. He’s getting so big! He’ll come off of formula soon and switch to drinking whole milk, which will be a definite cost savings, but I’ll miss mixing his bottles. I hope I don’t cry as much as I did when I went to my OB-GYN for my six-week postpartum check and he said, “OK, so I’ll see you in a year.” I knew that time was moving and I couldn’t slow it down. He goes for his one-year wellness checkup on Monday, Jan. 9, and he will see his dentist, Cheryl Kelley, for the first time on Tuesday, Jan. 24. I’m a bit nervous about his dental appointment because I’m afraid he’ll

be scared. The hardest has been juggling work and everything around taking care of a baby. I work 12-hour shifts, and then pick Timmy up from my aunt’s house. I drop him off around 6:45 in the morning and pick him up at 7:15 after work. Then we go home, eat a quick dinner, and it’s lights out. On my days off, I try to fit in grocery shopping, doctor’s appointments, laundry (which is endless!), and whatever else I need to get done. As we close in on the new year and Timmy’s first birthday, it’s a definite time for reflection. I bought a new car this year, had a baby, and have been on so many adventures with him. My emotions have run the gamut as I’ve watched him grow. I’ve been peed on more times than I care to admit, had to clean up more vomit and poop more times this year than any other time in my life. But I’ve snuggled baby snuggles, laughed at his baby laughs, stolen kisses, and shared so many special times with Timmy. I remain thankful for every single second. I hope next year is as terrific as this year.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

Do you live in Brighton or Webster? By Jim Miller

How Much You’ll Pay for Medicare in 2017 Dear Savvy Senior, I know there won’t be much of a cost-of-living increase in Social Security benefits next year but what about Medicare? How will the 0.3 percent Social Security raise affect our Part B monthly premiums in 2017? Inquiring Beneficiary Dear Inquiring, Considering the rising cost of health care coverage, the news regarding your Medicare costs for 2017 is not too bad. Here’s what you can expect.

Part B Premiums Because the Social Security Administration is giving out a measly 0.3 percent cost of living increase starting in January — that equates to about a $4 to $5 monthly increase on average — the 2017 Part B monthly premium for about 70 percent of Medicare recipients will increase only about $4 to $5. Thanks to the Social Security Act’s “hold harmless” provision, Medicare cannot pass along premium increases greater than the dollar increase in their Social Security checks. So, if your Medicare Part B monthly premium is currently $104.90, you can expect it to be around $109 (on average) in 2017. Or, if you signed up for Part B for the first time in 2016, your $121.80 monthly premium will rise to around $127 (on average) next year.

Some Will Pay More Unfortunately, the hold harmless provision does not protect all Medicare recipients. New Medicare enrollees (those who will enroll in 2017), beneficiaries who are directly billed for their Part B premium, and current beneficiaries who have deferred claiming their Social Security will pay more. If you fit into any of these categories, your Medicare Part B premium will be $134 per month in 2017, up from $121.80. The hold harmless rule also does

not protect high-income Medicare beneficiaries who already pay higher Part B premiums because their annual incomes are above $85,000 for an individual or $170,000 for a couple. If you fit into this category, here’s what you’ll pay for your Part B premium next year, based on your 2015 tax returns. • Individuals with incomes of $85,000 to $107,000, or married couples filing joint tax returns with incomes of $170,000 to $214,000, will pay $187.50 per month. • Individuals earning $107,000 to $160,000 (couples $214,000 to $320,000) will pay $267.90. • Individuals with incomes of $160,000 to $214,000 (couples $320,000 to $428,000) will pay $348.30. • Individuals with incomes over $214,000 or couples above $428,000 will pay $428.60. Another increase high-income beneficiaries (those with incomes over $85,000, or $170,000 for joint filers) need to be aware of is the surcharge on Part D premiums. Affluent seniors that have a Medicare Part D prescription drug plan will pay an additional $13.30 to $76.20 per month, depending on their income, on top of their regular Part D premiums.

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Deductibles and Co-Pays Other changes that will affect all Medicare beneficiaries include the Part B deductible, which will increase to $183 in 2017 from $166 in 2016. The Part A (hospital insurance) annual deductible will also go up to $1,316 in 2017 (it’s currently $1,288) for hospital stays up to 60 days. That increases to $329 per day for days 61-90, and to $658 a day for days 91 and beyond. And the skilled nursing facility coinsurance for days 21-100 will also increase to $164.50 per day, up from $161 in 2016. For more information on all the Medicare costs for 2016 visit Medicare.gov and click on “Find out how much Medicare costs in 2017,” or call 800-633-4227.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. January 2017 •

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Social Security Is Always Evolving

ocial Security is always evolving to meet the needs of the American public. We’re optimistic about the future and the limitless possibilities for progress. Much of the progress we’ve made together, as a nation, is through the shared responsibility of paying Federal Insurance Contributions Act (FICA) tax. This federal payroll tax funds Social Security — programs that provide benefits for retirees, the disabled, and children of deceased workers. You help us keep millions of hard-working Americans out of poverty. Without your contribution, wounded warriors wouldn’t receive the benefits they deserve. Children who have lost parents would have no social safety net. Millions of elderly people would be destitute. In the same way that we take great pride in helping people who need it, you should take pride in making this country stronger. You can see the many ways our retirement benefits help your loved ones and neighbors at www.socialsecurity.gov/retire.

Q&A

Q: I’m trying to figure out how much I need to save for my retirement. Does the government offer any help with financial education? A: Yes. For starters, you may want to find out what you can expect from Social Security with a visit to Social Security’s Retirement Estimator at www.socialsecurity.gov/ estimator. The Financial Literacy and Education Commission has a website that can help you with the basics of financial education: www.mymoney. gov. Finally, you’ll want to check out the Consumer Financial Protection Bureau, which offers educational information on a number of financial matters, including mortgages, credit cards, retirement, and other big decisions. Visit the Consumer Financial Protection Bureau at www.consumerfinance.gov. Q: I got married and I need to change my name in Social Security’s records. What do I do? A: If you change your name due to marriage, or for any other reason, you’ll need to report the change and get a corrected Social Security card with your new name. You will need to fill out form SS-5. You can get a copy of this form by visiting www. socialsecurity.gov/ss5doc or by calling our toll-free number 1-800-7721213 (TTY 1-800-325-0778). You’ll also need to provide the original marriage certificate showing your new and old

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

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The strength of our nation relies on cooperation and the empathy to understand each other’s unique struggles. Similarly, Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards. “Compassionate allowances” offer a way of quickly identifying diseases and other medical conditions that invariably qualify under the listing of impairments based on minimal objective medical information. This also lets Social Security target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly. You can view the list of compassionate allowances at www.socialsecurity.gov/compassionateallowances. Our diversity is an asset that can bring us together, making us stronger as a nation. Visit www.socialSecurity.gov to empower your future, for today and tomorrow.

names. You can mail or take the documentation to your local Social Security office. In some cases, we may need other forms of documentation as well. For more information, visit www.socialsecurity.gov/ssnumber. Q: I’m planning to retire next year. I served in the Navy back in the 1960s and need to make sure I get credit for my military service. What do I need to do? A: You don’t need to do anything to apply for the special credit for your military service — it is added automatically. For service between 1957 and 1967, we will add the extra credits to your record at the time you apply for Social Security benefits. For service between 1968 and 2001, those extra military service credits have already been added to your record. So you can rest assured that we have you covered. Q: How do I report a change of address if I’m getting Supplemental Security Income (SSI)? A: A person receiving SSI must report any change of address by calling our toll-free number, 1-800772-1213 (TTY 1-800-325-0778), or by visiting a local office within 10 days after the month the change occurs. You cannot complete a change of address online. You should report your new address to Social Security so you can continue to get mail from Social Security when necessary, even if you get your benefits electronically by direct deposit or direct express. Learn more about SSI at www.socialsecurity.gov/ssi.

Ask St. Ann’s

Do I Have a Say in Where I Go for Rehab After Surgery?

whenever you need them. And ask about the nursing staff. Some facilities have nurses who “float” between departments. Your needs are not the same as those of patients on residential floors, so look for a place whose nurses specialize in rehab.

By Kim Petrone, MD

hether the new year finds you facing surgery or rehabilitation from a stroke or accident, there’s an important question to answer: Where will you go to get the care and therapy you need to return to health? Many patients feel they must go to the facility their doctor recommends. The truth is, the choice is entirely yours. No one can force you to go to a particular place for rehab (also known as transitional care). So if you’re planning elective surgery, why not take the extra step to pre-plan your rehab stay? Visit your potential choices and ask for a tour. Find out about their clinical outcomes. Make sure they have the sub-specialties to address all of your needs. For example, the Wegman Transitional Care Center at St. Ann’s offers physical,

occupational and speech therapy, which are necessary for patients recovering from stroke or a head injury. Look for a unit offering comprehensive care.

Other points to keep in mind: n Admission seven days a week: Many facilities will not admit patients on Sundays or in the evenings. Choose a facility that will be ready when you are, with medical staff available to evaluate and treat you immediately. n On-site medical staff: Not every facility has a dedicated medical team. Choose one that gives you access to skilled medical personnel

n Sub-specialties: Is the transitional care unit focused on a specific kind of rehabilitation, like joint replacement? Or does the medical staff have significant expertise in other areas? Many patients need multiple kinds of therapies to return to health. For example, swallowing therapy can be important for patients with brain injuries, and even for some cardiac patients. Look for board-certified specialists on staff and a variety of sub-specialties. n Intensive therapy: You want to get better and go home, so select a transitional care center where patients receive therapy throughout the day. Thirty minutes of therapy a day is the absolute bare minimum for Medicare Part A, especially if you need several kinds of therapy (physical, speech, swallowing, etc.). The harder you work, the sooner you’ll go home.

n On-site pharmacy: The last thing you want to do is wait around for a cab to arrive from an outside pharmacy with the medication you need! Choose a transitional care center with its own pharmacy, so you can get your meds in minutes instead of hours. Just as you pre-plan your surgery, pre-plan your rehab stay. You’ll know exactly where you’re going, and they’ll be ready to welcome you. That peace of mind is something you’ll appreciate when the time comes.

Physician Kim Petrone is associate medical director at St. Ann’s Community and medical director of 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 585-922HEAL (4325), or visit www.stannscommunity.com.

How to Spot and Fix Medical Billing Mistakes By Jim Miller

edical billing errors and overcharging is not uncommon. According to the American Medical Association, 7 percent of medical bills in 2013 had errors, and other groups estimate that figure to be much higher. Unfortunately, untangling those mistakes is almost always up to you. Here are some tips and tools that can help.

Check For Errors

To help you get a grip on your medical bills and check for errors, you need to familiarize yourself with what your insurance does and doesn’t cover. Then you need to carefully review the explanation of benefits from your insurer, and the invoices you receive from your doctor, hospital and/or outpatient facility providers. These invoices need to be itemized bills detailing the charges for every procedure, test, service and supply you received. If you didn’t receive an itemized invoice, request it from your health care providers. And if the invoices contain any confusing billing codes or abbreviations that you don’t understand, ask them for an explanation. You can also look up most medical billing codes online by going to any online search engine

and typing in “CPT” followed by the code number. Once you receive and decode the invoices, keep your eyes peeled for these mistakes: • Typos: Incorrect billing codes, a misspelled name or a wrong policy number. • Double billing: Being charged twice for the same services, drugs or supplies. • Canceled work: Charging for a test your doctor ordered, then canceled. • Phantom services: Being charged for services, test or treatments that were never received. • Up-coding: Inflated charges for medications and supplies. • Incorrect length of stay: Most hospitals will charge for the admission day, but not for day of discharge. Be sure you’re not paying for both. • Incorrect room charges: Being charged for a private room, even if you stayed in a semi-private room. • Inflated operating room fees: Being billed for more time than was actually used. Compare the charge with your anesthesiologist’s records. To make sure the charges on your bill are reasonably priced, your insurance provider may offer an online price transparency tool January 2017 •

or use the Healthcare Blue Book (healthcarebluebook.com) or Guroo (guroo.com). These are free resources that let you look up the going rate of many procedures, tests or services in your area.

Make Corrections

If you find errors or have questions about charges, contact your insurer and your health care provider’s billing office. When you call, be sure you write down the date, time and name of the person you speak to and a summary of the conversation, in case you need to refer back to it at a later time. If there’s a billing code error or some other mistake that’s easily correctable, ask your health care provider to resubmit a corrected claim to your insurance company.

Get Help

If you aren’t able to resolve the dispute on your own, you may want to consider hiring a medical billing advocate to work on your

behalf. To find someone, try sites like billadvocates.com or claims.org. Most advocates charge an hourly fee — somewhere between $50 and $200 per hour — for their services, or they may work on a contingency basis, earning a commission of 25 percent to 35 percent of the amount they save you. If you’re a Medicare beneficiary, another resource is your State Health Insurance Assistance Program (SHIP). They provide free counseling and can help you understand your medical bills and Medicare coverage. To find a local SHIP counselor visit shiptacenter.org, or call 800-633-4227. Jim Miller is the author of Savvy Senior column, which is published monthly in In Good Health. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Miller is also a contributor to the NBC Today show and author of “The Savvy Senior” book.

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Health News Lifetime Care Hospice has new medical director Lifetime Care Hospice has recently announced the promotion of physician Miyeon Oh from associate medical director to medical director. She will be responsible for the clinical oversight of the hospice program delivered to residents of Monroe, Wayne and Seneca counties, both in home and home-like Miyeon settings. She brings 15 years of hospice experience to the position.

UR School of Nursing renames PhD program The University of Rochester School of Nursing has changed the name of its PhD in health practice research program to PhD in nursing and health science. The new program title was recently approved by the New York State Education Department and also applies to the school’s seven MS/ PhD dual degree programs. The change affects only the title of the program; admission criteria and the program’s curriculum remain unchanged. “The name change more accurately reflects the interdisciplinary and collaborative nature of the curriculum and helps to ensure that nursing is recognized among the many different kinds of health scientists ushering in the next generation of medical breakthroughs,” said Kathy Rideout, dean of the University of Rochester School of Nursing. UR Nursing’s PhD program is one of the oldest of its kind in the country. It admitted its first students in 1979, and the program’s rigorous and highly focused curriculum was widely acclaimed and served as a pattern for other universities to model. Approaching its 40th year, the program remains synonymous with innovation. The PhD in nursing and health science program welcomes a select handful of students each year. The wide range of expertise in the school’s faculty attracts licensed clinical health professionals from a variety of health-related disciplines, including nursing, social work, speech-language pathology, and others. “A diversity of professional backgrounds in the classroom helps to foster interprofessional communication and collaboration,” said Bethel Powers, director of PhD programs at the School of Nursing. “Regardless of the health discipline to which our students belong, they graduate from our program as scientists Page 22

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well-prepared to conduct meaningful research both independently and as members and leaders of interdisciplinary teams.”

MVP Health donates 6,000 winter coats to children In an effort to help ensure that children stay warm during the long winter months, MVP Health Care has once again spearheaded coat drives in the Capital Region, Rochester and Syracuse region. For the second year, MVP and WTEN in Albany teamed up with local dry cleaners to collect gently used and new coats for children in the area. To help with the increased need for coats, MVP also purchased more than 2,500 coats from Lodge’s Department Store in Albany to supplement the donated coats. In total nearly 6,000 new and used winter coats were distributed to children in Schenectady, Albany, Utica, Rochester, Troy, Syracuse and in Vermont. The donations were coordinated with several human service agencies and schools throughout the health insurer’s coverage area. “Many parents in the communities we serve worry about keeping their children warm during the cold winter months, and we want to help alleviate some of that worry by providing winter coats to children who need them most,” said MVP Vice President of Community Engagement Ellen Sax. “No child should have to brave weather in the Northeast without a warm winter coat, and so we’re doing our part to ensure that doesn’t happen.” MVP Health Care provides corporate support to a large number of community organizations that are aligned with its vision of creating the healthiest communities in the country. It is engaged in several other programs that support the family with food assistance, education, health and wellness programs.

Jewish Senior’s to offer specialized care Jewish Senior Life is expanding its cardiopulmonary rehabilitation program, responding to an increasing need for specialized patient care following a hospital stay. The senior care provider has named the program myHeart™ cardiopulmonary rehabilitation program, solidifying its commitment to focus on this service and remain one of the largest post-acute care providers in Monroe County. “Our cardiopulmonary program has been a trusted resource to help people rebuild their strength and confidence following a procedure, and to help bridge the gap between hospitalization and home,” said Mike King, President and CEO of Jewish Senior Life. “We named the program to give it an identity, and to show our commitment to maintaining and growing our leadership in this area of care.”

Cardiopulmonary rehabilitation services have been available at transitional care program at the Jewish Home for more than 20 years, and nearly 20 percent of patients served in 2015 received cardiopulmonary services. The myHeart cardiopulmonary rehabilitation program will continue to reside within transitional care at The Jewish Home. The myHeart cardiopulmonary rehabilitation program and its fulltime highly skilled medical staff, including physicians, registered nurses, physical/occupational therapists and registered dietitians, offer individualized care plans; anxiety and pain management; physical and occupational therapy available seven days a week; nurses trained in cardiopulmonary intervention and management strategies; and patient and family education Transitional care at the Jewish Home is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), an independent organization that sets stringent standards of care and recognizes only the most qualified providers.

Finger Lakes’ project aims at changing regional realth The Finger Lakes region is one of only six areas across the country chosen to participate in ReThink Health Ventures, a health innovation project funded by the Fannie E. Rippel and Robert Wood Johnson Foundations. The two-year initiative aims to help successful community partnerships reach even higher in their efforts to improve care, increase access and lower medical costs. “ReThink Health Ventures offers a wonderful opportunity for our region to benefit from national expertise in health ecosystem transformation and to learn how some of the most effective communities across the country are moving the needle on health,” said Becky Lyons, director of health and wellness for Wegmans Food Markets and chairwoman of the Greater Rochester Chamber of Commerce’s health care planning team. The Ventures initiative will bring together several of Rochester’s community tables and “ensure that we are pulling in the same direction in our efforts to improve health,” said Trilby de Jung, CEO of Finger Lakes Health Systems Agency. According to a news release, Ventures was launched by ReThink Health to demonstrate to change makers that an integrated, dynamic and high-functioning health ecosystem is possible. While thousands of communities across the country are making great progress in addressing health disparities, conventional thinking simply has not overcome systemic barriers and structural limitations. The Finger Lakes region was selected to join the Ventures cohort because of the area’s advance thinking around these tough issues and its readiness to accelerate change. The Finger Lakes team is working to create a common vision and coordinated

IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

strategies across multiple initiatives aimed at improving community health. The group includes the Finger Lakes Performing Provider System, United Way of Greater Rochester, Rochester RHIO, Monroe County Department of Public Health, Finger Lakes Health Systems Agency, and Greater Rochester Chamber of Commerce’s health care planning team. “ReThink Health is excited to be working with these innovative partnerships to help them break from business as usual, to redesign and transform their health systems,” said Laura Landy, president and CEO of the Rippel Foundation. “It is these exemplars in communities across the country that will help demonstrate the power and necessity of looking at health as an ecosystem rather than as a collection of independent and siloed activities.” For additional information about ReThink Health, visit www.rethinkhealth.org. For more information about the Rippel Foundation, visit www.rippelfoundation.org.

Golisano Children’s Hospital celebrates renovation The Strong Memorial Hospital Nursery, a state-of-the-art facility that provides care for newborns in the Finger Lakes region, recently reopened. The renovated space, part of the Golisano Children’s Hospital Gosnell NICU, will house 24 beds that are predominately single family spaces. The region’s only Level IV NICU, the facility now has the capacity to care for 68 infants, including the 44 beds in the new children’s hospital tower, which opened in July 2015. The renovated space will house 16 private rooms and a transitional care nursery with eight beds. The transitional care nursery will focus on care for babies who need intense observation and monitoring, but whose mothers are inpatient. The private rooms will not only allow for more space, but also support infection control and enable parents to more actively participate in their child’s care. “Our NICU has the latest design elements and the best innovative technology that was available to make it the safest, most advanced NICU for patient care,” said Carl D’Angio, chief of the division of neonatology at Golisano Children’s Hospital. “This renovation not only provides parents with more privacy, but our neonatologists more space to care for the babies we see.” Along with the newly refurbished unit, the SMH Nursery will feature top-of-the-line technology. Just like in the new tower, a variety of beds, warmers, incubators and cribs are available to the baby. Parents can also utilize omnibeds (Giraffe beds), which function as incubators and warmers so the more fragile babies don’t have to be moved between the two. Babies will also be able to be weighed on a built-in scale.

Health Health EMPLOYMENT in good

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Reach thousands of healthcare professionals every month. Advertise with In Good Health Reach thousands of healthcare professionals every month. Advertise with info In Good Call 585-421-8109 for more or Health email: editor@GVhealthnews.com Call 585-421-8109 for more info or email: editor@GVhealthnews.com 1966-2016

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Make a Difference Join Our Team! People Inc., a leading nonprofit, is seeking caring and compassionate staff members to provide support to individuals with disabilities so they can live as independently as possible.

Interim Healthcare is seeking all levels of Nurses both new and experienced who have successfully completed New York State Licensure requirements and are interested in pursuing a career within a licensed home care agency. Applicants should have an award winning attitude, be committed to excellence in patient care with an exceptional work ethic. This is a unique opportunity to enter the home care setting.

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As a full service home care agency, we welcome certified Home Health Aides, Personal Care Aides, LPN’s and RN’s to apply. We offer flexible schedules (Full Time, Part Time and Per Diem), caregiver recognition and employee referral programs. Minimum Education & Experience Reqs: Graduate of an accredited school of nursing and licensed to practice as an RN in the state of New York. License is active and must be CPR certified. Benefits: 401K. Health & Dental Coverage. Weekly Paycheck. Referral Program. Paid Orientation. For Full time employees.

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Call Wendy at: 585-454-4930. Walk-ins Welcome! 1 South Washington Rochester NY 14614. Apply online at: Interimhealthcare.com or email wpaddyfoote@interimhealthcare.com

Interim HealthCare is America’s leading provider of home care and healthcare staffing. We offer one of the most comprehensive selections of career opportunities in the industry ranging from per diem to full-time. Interim HealthCare® is an equal opportunity employer who does not discriminate against applicants, employees or clients on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, veteran status or any other category protected by the law, or patients’ decisions regarding advance directives.

WRITERS WANTED Local News Inc., the publisher of In Good Health, Rochester’s Healthcare Newspaper, and 55 PLUS magazine, is looking for free-lance writers to write news and feature stories. Stories range from profiles of newsworthy people in the community to medical issues to nonprofit organizations. View the publications online at roc55.com and GVhealthnews.com. We’re only hiring FILE: Interim 12.07.16 HN DATE: January Issue, 2017 peopleInterim who have writing experience, preferably in a daily or CLIENT: SIZE: 4.79 x 6.69 weekly newspaper. and: copies of recent PUBS : Health NewsletterPlease send resume NEW LAYOUT published stories to LocalNewsOffice@gmail.com. Along with your resume, please send two story ideas you think would work well in the publications. Pay is commensurable with experience.

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Not a hotel.

(But you’ll feel like you’re in one.) Recovering from surgery or a stroke is no vacation. But the Wegman Transitional Care Center offers advanced rehabilitative care in an environment that’s remarkably comfortable. Rochester’s only freestanding transitional care center. • Separate from St. Ann’s skilled nursing building. • Singularly focused on helping you gain the independence you need to return home. Hotel-like amenities. • Spacious private rooms with shower, complimentary Wi-Fi, and flat-screen TV. • Country kitchen for use 24/7 and on-site bistro.

You’re the boss. Where you go for rehab is strictly up to you. If you have a surgery scheduled, you can preplan your stay with us and eliminate last-minute decisions—and disappointments. Call 585-697-6311. Or visit www.StAnnsCommunity.com Wegman Transitional Care Center

Specialized care to help you get better and get home fast. • The latest technology and training to accelerate your recovery. • Experienced, certified staff skilled in state-of-the-art rehab care.

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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • January 2017

1500 Portland Ave., Irondequoit