In Good Health: ROC #214 - June 2023

HEALTHY SUMMER

10 Ways to Improve Your Health This Summer

Hospitals Continue to Close

19 hospitals closed last year due to bankruptcy. Other 630 are on the brink of financial disaster this year. P 6

10 (Actually Fun) Things to Do with Your Kids This Season

Highland Hospital geriatrician Jennifer Muniak talks about the key to successful aging

P.4

5 THINGS YOU NEED TO KNOW ARTHRITIS

As any parent knows, your idea of a good time and your kid’s idea of a good time match like the pile of socks at the bottom of the laundry basket.

So, if you’re a parent who seeks entertainment ideas that will make at least 67% of your family happy, look no further. The list of activities on page 13 might just beat the odds and get a smile out of almost everyone in your family.

Interview with Anthony Ocon, attending rheumatologist in the division of allergy, immunology and rheumatology at Rochester Regional Health.

CALENDAR HEALTH EVENTSof

June 5

Chefs to compete to raise funds for Alzheimer’s group

After a four-year hiatus, the Alzheimer’s Association Rochester Finger Lakes Region Chapter will bring back its unique Top Chef Challenge at its annual gala, An Affair to Remember, on June 5. Funds raised

ATRIAL FIBRILATION

at the chapter’s gala will support the full mission of the Alzheimer’s Association.

Executive chefs from seven senior living communities, Rochester Institute of Technology, two BOCES locations and Custom Culinary will team with culinary arts students from Foodlink, Batavia BOCES and Spencerport BOCES to create a fine dining experience with the thrill of a reality-TV chef showdown. The

PARTICIPANTS NEEDED

VPG Medical is seeking eligible participants to test an invetigatorial application for Android smart devices.

To participate you must:

• Be 40 years or older

• Have a history of Paroxysmal Afib

• Use a Samsung Android smartphone daily

You will be compensated for your time and participation.

For more information and to determine if you qualify, please contact Margot Lutz: (585) 622-4410 | m.lutz@vpgmedical.com

375 White Spruce Blvd., Rochester, NY 14623 (585) 622-4410 | www.VPGMedical.com

Celebrate

chef-student teams will go head-tohead in an intense competition to win the coveted Top Chef Award from a panel of celebrity judges. Members of the audience will have the opportunity to taste all the culinary creations, vote for their favorite dish and decide who will win the People’s Choice award

The eleven executive chefs will represent Episcopal SeniorLife Communities (David Watkins), Friendly Senior Living (Sarah Kelsey), the Highlands at Pittsford (Mike Wasylko), Jewish Senior Life (Gene Trotta), St. Ann’s Community (Todd Klugh), Custom Culinary (Mike Speranza), Presbyterian Home (Dan McDonald), Rochester Institute of Technology (Stacy Krebbeks) Heather Heights of Pittsford (Carrie Bardo & Andy Armstrong), Batavia BOCES (Tracy Burgio) and Spencerport BOCES (Jeffery McLean).

This year’s gala will begin at 5:30 p.m. at the Hyatt Regency Rochester.

June 6, 15, 27

HLAA meetings to focus on hearing loss

Anyone interested in hearing loss, either their own or someone else’s, is welcome at Hearing Loss Association of America /Rochester Chapter June programs.

All HLAA programs are free. Some are in person while other, virtual programs, require preregistration. The in-person programs feature an inductive loop hearing system and open captions. To obtain the virtual program Zoom link, preregister at the chapter web site hearinglossroch-

ester.org. For other information, call 585 266 7890.

• Tuesday, June 6

– 10–11 a.m. “Hearing Other People’s Experiences” (HOPE). In person. St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester, across from the George Eastman Museum. Vestry Room. Prospective, new, or experienced hearing aid users can share their experiences, questions. Retired audiologist and hearing aid user Joseph Kozelsky facilitates.

– Noon – 1 p.m. “Accessing Hearing-Accessible Health Care.” Hybrid. In person. St. Paul’s Parish Hall and virtual on Zoom. To obtain Zoom link, preregister at the chapter website. Retired RN Care manager Mary Chizuk seeks positive and negative anecdotes of people’s experiences while using health care facilities. Participants are invited to share their stories at this round table discussion.

• Thursday, June 15

– 10 a.m. – 2 p.m. “Assistive Listening Devices Demo Center.” Technology team. In person. Lifespan, 1900 S. Clinton Ave., Rochester. At this free demonstration area, consumers are invited to view and try out a selection of assistive listening devices before actually buying them.

• Tuesday, June 27

– 8 – 9 p.m. “Hear Together.” Virtual on Zoom. Speech language pathologist Kristin Bergholtz conducts a virtual support group for parents and caregivers of deaf and hard of hearing children. Register at kristinbslp@gmail.com. Bergholtz’s private speech practice is Canalside Speech in Rochester.

Everyone deserves to be cared for and to live well. So, at Excellus BlueCross BlueShield, we’re more focused than ever on making care more accessible in our community. Through affordable plan options, community investments, partnerships and education, we’re working to address inequities to make Upstate New York a better place to live. We’re proud to celebrate the LGBTQ+ community and work toward a world where everyone feels affirmed and respected.

Learn more about adopting an inclusive mindset by listening to our

ExcellusBCBS.com/Podcast

VPG Medical

Meet Your Doctor

By Chris Motola Jennifer Muniak, MD

For Highland Hospital geriatrician key to successful aging is to maximize patients’ positive lifestyle habits while reducing risks for chronic diseases

Q: How gracefully are the baby boomers aging so far?

A: That's a very good question. My parents are in this cohort, so I may be a little bit biased by my own experience, but I think in general, the baby boomers are going to be a very different population of older adults to care for as opposed to the generation before them, the ones I trained on during my residency. I think baby boomers are a lot more technologi-

and will be utilizing technology in ways previous generations of elderly people did not. I think that's a great thing and one that will help them stay engaged in lifestyle measures that will allow them to stay fitter for longer.

Q: Any downsides to this outlook?

A: I think the part where you can get into turbulent territory is when they experience decline that

ailments of aging like dementia, chronic disability, chronic pain. It can really cause some friction, which is what I'm most concerned about with the baby boomer population.

Q: Obviously we can't ward off time forever, but have we made strides in — I think the phrase used to be “compression of morbidity?” What can modern medicine do along those lines?

A: I love that concept of compression of morbidity. I believe it was introduced by James Fries in the ‘80s. I've utilized that idea quite a bit when I've written and taught about the tenets of lifestyle medicine, which is an emerging field and one I hope more geriatricians actively incorporate into their practice. It's just kind of a yin and yang situation. You're never too old to work on lifestyle. However, the other side of that is that longer we've made an arc in a particular direction, the harder it can be to turn the ship around. So we have to take that into consideration. Everyone is so different. It's hard to paint in broad strokes, but everyone's health is a combination of their genetic makeup, their habits, their environment and things that happen to them. We try to optimize what we can. Sometimes even minor lifestyle changes can have profound effects. So my whole deal is taking where somebody is, even if they're in incredible pain, even if they have an incurable illness, and saying what can we do to maintain or improve their function for whatever time they have left. So, again, when you talk about compression of morbidity, a lot of people mistake that as an all-or-nothing proposition. What I'd propose is that we can take a person wherever they currently are and work with them to see what risk factors are modifiable and help them function at the highest possible level for the remainder of their time.

Q: What got you interested in geriat-

A: A lot of different things. I got into internal medicine knowing that I wanted to take care of the whole person. I found that the geriatricians I was working with at the University of Rochester were very inspirational role models. They really turned some of the ways I had been thinking of patient issues on their head. They used the internal medicine framework to understand the diseases and then incorporated additional layers: what is important to this person? What is their social situation? What cognitive limitations do they have? What kind of support network do they have? And then they work with their patient and their families with all of these things in mind to develop a holistic plan with them. That was a bit different than some of the other fields I had been working with. So I was really attracted to that model of getting at what matters most to that patient, patients who are often facing incredible challenges. We don't often have silver bullets for them, but walking with them through this journey and finding ways to improve their quality of life and help guide them through their end of life if that's what's going on. So I've found all that incredibly fulfilling.

Q: One of the challenges of aging seems to be sorting out what is a result of age and what is actually a result of deconditioning.

A: Yeah. I think one of the things I always keep in mind is to be very careful of what we attribute to just getting old, because that's a really easy way to be wrong. It's difficult to sort out. That's where it comes back to that yin and yang of doing what you can with what you have. To maximize the things that are within your power, and to help patients maximize them as a healthcare provider. If you can't maximize it, you may have to consider that some of the issues are a function of normal aging. We do have principles of normal aging that we go by as general tenets, but you want to be careful of, say, chalking knee pain and fatigue up to getting old. It's ageist, for one thing, and you're not treating the patient with the respect they deserve.

Q: There's been some decline in life expectancy recently. How is that playing out in the elderly age cohort? Are people less healthy?

A: I think any answer I can give to that is speculative, but I think some of that reversal is from COVID-19, which took the lives of far more of our older and frailer population than our younger and fitter. The trend I'm more concerned with over the long run, and this goes back to compression of morbidity, is we're seeing the opposite of that. We're seeing trends toward longer periods of disability over the course of life. So people are developing chronic disease states earlier in life and living longer with them. It's a distressing trend, because when people develop diseases earlier in life, they tend to progress and lead to disability at a younger age. If you develop diabetes at age 75, they won't experience as many complications from diabetes before they die compared to a patient who develops it at 45. And a lot of this goes back to our lifestyle habits.

Q: What's something you think other healthcare specialties can learn from geriatricians?

A: I'm an academic geriatrician, which means that I do a lot of work at the university as a teacher and working on quality improvement, which means making your systems better. And one way I'm doing that is by working on making Rochester an age-friendly health system, because the frank reality is there aren't enough geriatricians to see all the patients who need our care. And all health professionals, minus pediatricians, do need these skills.

Lifelines

Name: Jennifer Muniak, MD

Position: Assistant professor of medicine and geriatrician at University of Rochester Medical Center; practices at Highland Hospital and the Highlands at Brighton Nursing Home.

Hometown: Syracuse

Education: SUNY Upstate Medical University, Syracuse

Awards: University of Rochester Medical Center Board Excellence Award, 2023; Susan B Anthony Emerging Leader Award, 2021

Organizations: American Geriatrics Society; AMDA; Monroe County Medical Society

Family: Husband, two children

Hobbies: Yoga, singing, vegan cooking

Pain, Tingling or Numbness in Your Feet?

By Andrea Ide

Pain, Tingling, or Numbness in your hands, feet or legs may be due to Nerve Damage. If left untreated this small annoyance can lead to big problems. Unfortunately, most people have no idea what to do abut this problem and some don’t even realize how big of a problem it is. They tell their doctor who gives them drugs and injections which only mask the pain and there is no surgery, other than amputation, that will heal/stop neuropathy from progressing.

Neuropathy is a term used to describe damaged nerves, primarily in the hands and/or feet, that are progressively breaking down due to a lack of blood supply, nutrients and oxygen reaching the nerves along with a lack of communication from the brain. Since the nerves are what the brain uses to communicate with the area and they are breaking down, the brains ability to communicate with the area lessens over tine, allowing for the progression of more breakdown and worse symptoms. It can be caused by Diabetes, Poor Ciculation, Poor Nutrition, Chemotherapy, Agent Orange, Misaligned Spinal Bones Placing Pressure on the Nerves, along with over 100 other causes. “Patients experience extreme sensations, loss of feeling, even No Feelings in their Hands and/or Feet along with muscle spasms, pain, weakness, numbness, tingling, and burning and many have a very hard time with balance” says Dr. Nathan Riddle of Riddle Wellness, a Neuropathy testing and treatment clinic.

This condition can eventually lead to further nerve damage, causing complete loss of legs or arms leading to amputation, death or brain injury due to falls, burns or other injuries that will not heal, along with organ failure in some cases.

Are you or someone you love suffering with loss of balance, numbness or pain from Nerve Damage in your hands and/or feet that just won’t heal? You don’t have to any longer. This local clinic right here in Rochester, NY is helping people find lasting relief without the use of drugs or surgery! That’s BIG EWS!

HEALING IS POSSIBLE

More than 20 million people in the U.S. Are dealing with some form of Neuropathy. Most commonly noticed first in the hands or feet, causing weakness, numbness, tingling pain and debilitating balance problems, often frustrated with no place to turn to and no hope of recovery. “By the time they come to see us, they feel like they have tried everything. Their MD put them on Anti-Seizure or Epilepsy meds like Gabapentin, Neurotin, Cymbalta or Lyrica and told them they will just have to live with the pain,” said Dr. Riddle.

ADVANCED TECHNOLOGY

With recent advancements in nerve regeneration technology and treatment options, clinics all over are seeing larger success rates and faster results with their neuropathy patients.

“This new technology paired with our multifaceted approach, has been life altering for our patients and our clinic,” said Dr. Riddle.

The development and success of these new, highly effective Neuropathy Protocols by Dr. Riddle and his team at Riddle Wellness have been the talk of the town in recent months. “Neuropathy patients have been coming in from all over the state and the results that they are getting is truly amazing,” said the Patient Coordinator at the Clinic. There are some things people can do at home to aide in the healing process of their neuropathy however, healing neuropathy is an all-encompassing process that ill require lifestyle changes, home care and may or may not include chiropractic, (varying from patient to patient) along with guidance from a medical professional that is experienced, skilled and trained to treat neuropathy.

Dr. Riddle and his skilled care team in Rochester have been treating neuropathy for years now in and judging by their 5 Star patient reviews, and all their patient video testimonials, they have been doing a very good job providing excellent patient care. One person had all but given up, they were crying in their testimonial. They were so thankful and its all because of this amazing new treatment option! They state it

New Treatment Options for Neuropathy

ing pain, numbness, tingling, pins and needle sensations, cramps and burning in your feet, or hands, along with the many other bodily symptions this horrible condition plagues people with, take action because it will progress.

Not everyone is able to start care at the clinic but, those who do are thankful! Find out if you are a candidate for their Neuropathy Protocols so they can help you regain the feeling in your hands or feet, stop the pain and start living life again! “Our Neuropathy Protocol is a multifaceted approach to heal neuropathy by nurturing the nervous system, increasing circulation, blood and oxygen, working to rebuild, strengthen and balance the body, all while stimulating the damaged nerves. Revitalizing and healing the damaged areas, enabling them to reactivate and function at an increasingly higher rate over time, all while increasing the patients quality of life dramatically,” said Dr. Riddle.

has about a 98% effective rate!

FIND

LASTING RELIEF

Claim Your Voucher Now for a Consultation & Examination to determine if you are a good candidate for treatment... Dr. Riddle and his care team are here once again to help readers learn about new options for finding pain relief! Call the clinic today to receive your comprehensive (normally $250).

The clinic utilizes the most advanced Pain Free Testing and a full, easy to understand report of finding

with Dr. Riddle going over your options for care if you are able to move forward.

Call 585-670-0020 and use Code NUMB0021. They have agreed to reduce their usual cost of $250.

But hurry, due to the number of patients the office can see, this is a limited time offer, with only 25 spaces at this exclusively discounted rate. These will be on a first come, first serve basis, messages left will count. My advise, don’t suffer any longer, waiting around for it to get worse... If you or your loved one is experienc-

Over the years they have treated thousands of patients with chronic conditions of Neuropathy, Sciatic nerve pain, Back & Neck problems, Whiplash Injuries along with Knee Pain. The office is well known and has a good reputation. Patients drive hours to this clinic and the vast majority enjoy superior, lasting relief. In fact, many who have suffered and tried other treatment options with no luck, only to have been told that they are just stuck with their pain and discomfort, have credited the care team at Dr. Riddle office for giving them their lives back!

Call them now at their Rochester, NY location, for a full, thorough Consultation and extensive Neuropathy Consultation at $49. Use Code: NUMB0021 (saving you over $200) to determine if and how Dr. Riddle and his team can help you recover, just as they have helped so many others that suffer with the Pain and Numbness of Nerve Damage.

“I feel like myself again. The pain is gone and I am even sleeping through the night”

~Gill B. Rochester NY

Healthcare in a Minute

By George W. Chapman

Hospitals Continue to Close

First, on the provider side, things are bleak. Nineteen hospitals closed last year due to bankruptcy. Industry experts estimate 630 hospitals are on the brink of financial disaster this year. Two hundred of those shaky hospitals serve rural or isolated populations. The pandemic hit nurses and physicians hard. We are entering a veritable crisis in nursing. The ANA estimates we will need 275,000 more nurses between now and 2030. The nursing shortage is worse than any other profession. The AMA estimates we will need between 38,000 and 124,000 more physicians over the next 12 years. And to make matters worse, the US population is aging. But the news isn’t all bad. The top six insurance companies made more than $41 billion last year. United Health Group lead the pack with $20.6 billion. The next five were Cigna $6.7 billion; Elevance, $6 billion; CVS, $4.2 billion; Humana, $2.8 billion; and Cetene, $1.2 billion.

CMS Fining Hospitals

As if things aren’t difficult enough for financially struggling hospitals, Centers for Medicare & Medicaid Services (CMS) is seemingly piling it on by stepping up enforcement of the requirement for hospitals to post prices for several select procedures online for the sake of transparency. Cash strapped hospitals are being fined hundreds of thousands of dollars. By posting prices, consumers can (supposedly) shop around for CT scans, surgery and other procedures. There are problems with the price posting requirement. First, most of us, if we know it or not, are in an organized hospital-centric

healthcare system. Your physician is going to refer you to providers within the system, limiting your choice of a hospital or CT scan. Although your insurance may allow you to go to any participating provider (shop around), for the sake of continuity you are better off staying within your system. Second, 90% of us are insured so none of us will ever pay the full price. It is irrelevant. Your commercial insurer has negotiated what it will pay on your behalf. Medicare and Medicaid have set what they will pay on your behalf. Your copay (or deductible) is determined by your insurer. We have all seen an “explanation of benefits” letter from our insurer indicating the hospital “priceorcharge” and what the insurer ultimately paid. The difference is typically astounding. Third, unlike a car or article of clothing, a hospital price has nothing to do with quality. It is a meaningless number so shopping around based on price is a fool’s errand. Out-of-pocket expenses are the price we pay. Most hospital billing offices can give you a good idea of what you will pay out of pocket based on your insurance.

Socialism’ in Healthcare

If a country (England, Canada, France, Germany, Sweden, etc.) provides universal care for all, critics decry it as socialism. In our country, critics call Medicare and proposed “Medicare for all” plans nothing more than socialism. So, is Medicare still socialism when it is managed by a commercial carrier? Humana made $2.8 billion last year. Virtually all their business and profits were derived from running Medicare and Medicaid plans. United made more than $20 billion last year. One third of their business (and profit) was derived from Medicare and Medicaid plans. We pay into Medicare via payroll taxes all our life. Then, we are still faced with paying more via deductibles, copays and coinsurance. Now commercial insurers are raking in huge profits. But at least it’s not “socialism!”

Even a study recently published by JAMA (Journal of the American Medical Association) concurs. According to the study, chatbots answered more patient queries quicker and with empathy when compared to written physician notes. But instead of replacing physicians, the study proposes that chatbot + MD = better care. In fact, AI should assuage the projected physician and nurse shortage by freeing them up to focus on more critical cases.

Social Media

The American Psychological Association has developed science-based guidelines regarding social media use by teens. There has been a surge in depression, anxiety and loneliness among teens and young adults attributable to social media. The guidelines are directed primarily at teens, parents, counselors and teachers. The APA recommends teens should receive training on the use of social media and parents should monitor social media use and limit screen time.

Artificial Intelligence

I discussed this briefly last month. In various studies, consumers are very satisfied with AI or chatbots.

Mifepristone

In a week (as of this writing in early May), a federal three judge panel will determine the fate of the medical abortion pill. All three- judges have a history of ruling against abortion access or have stated an anti-access position. Most national polls and surveys reveal the vast majority prefers that mifepristone remain available on the market.

Medical Debt Relief

I have written about the fact that medical debt is the leading cause of bankruptcy in our country. The good news is that medical debt can no longer be considered by credit-rating companies. A reader of my column forwarded me some more good news. A nonprofit called RIP Medical Debt can help. Its website address is https://ripmedicaldebt.org.

George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at gwc@gwchapmanconsulting.com.

19 hospitals closed last year due to bankruptcy. Another 630 are on the brink of financial disaster this year. Meanwhile, insurers post strong profits

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5

Things You Should Know About Arthritis

By Ernst Lamothe Jr.

Arthritis is a general term that many people use to describe pain or swelling in their joints.

The health condition affects about one in four US adults (23.7%) or about 58.5 million people, according to the Centers for Disease Control and Prevention.

“Almost everyone at some point in their lives may suffer from joint pain, so it is important to understand the different types of arthritis,” said Anthony Ocon, attending rheumatologist in the division of allergy, immunology and rheumatology at Rochester Regional Health.

Ocon, who is also a clinical assistant professor of medicine at University of Rochester Medical Center, offers five facts about arthritis.

1.Arthritis causes

Osteoarthritis, also called degenerative joint disease, is the most common form. Arthritis symptoms vary depending on the type of arthritis and its severity. The most common symptoms include joint pain, stiffness and swelling. It can also cause fever, weight loss and fatigue.

When patients ignore symptoms, conditions worsen to the point where it reduces mobility making daily tasks more difficult. There is also inflammatory arthritis, which often connects to autoimmune issues.

“Rheumatoid arthritis is one of the most common inflammatory arthritis syndromes where the immune

system attacks different parts of joints,” said Ocon. “Gout is another form of inflammatory arthritis caused by high levels of uric acid in the body. It is important for people to understand the type of arthritis they have so they are able to treat it appropriately. Some people will develop multiple types over their life.”

A person’s chance of developing arthritis increases due to several factors, including simply age. Rheumatoid on the other hand is more common with women and people with a family history of diabetes.

2.Affects all ages

With the rising age of the American population, it is no surprise that there is an increased number of older individuals with arthritis. However, many younger people also develop it. The reasons vary.

“Many younger individuals develop early onset osteoarthritis due to strenuous athletic use or traumatic injuries. Some younger individuals, including children, may develop an autoimmune inflammatory arthritis caused by juvenile idiopathic arthritis.

In addition, there is better awareness by primary care physicians and providers to screen for symptoms of rheumatoid arthritis.

“That brings younger individuals to the attention of arthritis physicians,” said Ocon. “Also, the obesity epidemic may play a role in the

Significant Health Benefits

development of both osteoarthritis, as well as inflammatory arthritis, in younger individuals.”

3.Treatment

There are a variety of treatments for arthritis. The most effective treatment requires differentiating which type or types of arthritis an individual has. For osteoarthritis, some over-the-counter oral medications such as acetaminophen, ibuprofen or naproxen, as well as topical medications such as diclofenac gel, may be effective for mild to moderate arthritis. “Corticosteroid injections often help isolated joint pain. For severe osteoarthritis, orthopedic surgeons are able to replace many joints,” he added. “For inflammatory autoimmune-related arthritis, rheumatologists have a variety of medications for treatment. For a patient with multiple forms of arthritis, a personalized treatment plan for each type may provide the best outcome.”

Other treatments include medication, physical therapy and lifestyle changes. Some medications reduce inflammation and pain, including nonsteroidal anti-inflammatory drugs and disease-modifying antirheumatic drugs. Physical therapy also improves mobility and reduces

4.Family History

Most types of arthritis may have a genetic component. Studies have shown that family history may contribute to rheumatoid arthritis. But it doesn’t entirely explain all the aspects of an individual’s risk. The condition can develop with someone with no family history but also often family members are exposed to the same environmental risk factors that could cause rheumatoid arthritis.

“This can be seen in both osteoarthritis as well as with inflammatory and autoimmune-related arthritis,” said Ocon. “When speaking with patients, they often tell me their parents or grandparents had similar symptoms.”

5.Misconceptions

There are hundreds of variations of arthritis but the two most common types remain osteoarthritis and rheumatoid arthritis. Natural wear and tear causes osteoarthritis on the joints and that comes from natural aging, while rheumatoid arthritis is an autoimmune disorder that occurs when the body’s immune system attacks the joints. This can lead to inflammation and pain.

“Many people believe that their joint pain is part of the aging process and normal. Some people believe there is no treatment for arthritis. Both of these misconceptions lead to delays in care and could cause a person to suffer unduly,” said Ocon.

Anthony Ocon is attending rheumatologist in the division of allergy, immunology and rheumatology at Rochester Regional Health. He is also a clinical assistant professor of medicine at University of Rochester Medical Center.

is a gentle, effective hands-on method of lymphatic drainage that involves gently manipulating specific areas to help lymph move to

CDC: Smoking Rate in the U.S Hits All-Time Low

Fewer U.S. adults are smoking cigarettes, as rates dropped again last year, according to federal health officials.

In all, one in nine American adults smoked cigarettes last year, an all-time low, and a significant change from the 1960s when 42% smoked.

The results weren't all positive, the Associated Press reported, as vaping rose to about one in 17 adults. For 2022, use of electronic cigarettes was about 6% compared to 4.5% the year before.

These preliminary findings are from a survey of more than 27,000 adults by the U.S. Centers for Disease Control and Prevention. The findings are sometimes revised after further analysis.

“I think that smoking will contin-

ue to ebb downwards, but whether the prevalence of nicotine addiction will drop, given the rise of electronic products, is not clear,” Jonathan Samet, dean of the Colorado School of Public Health in Aurora, told the AP.

Roadway Deaths Marked Small Decline in 2022

On average, crashes claimed the lives of 117 people a day — more than 42,000 in all for 2022

Traffic deaths are down on U.S. roadways, but the small drop pales in comparison to the surging rate of recent years.

Deaths in traffic crashes fell 0.3% last year compared to 2021, according to the U.S. National Highway Traffic Safety Administration (NHTSA).

On average, crashes claimed the lives of 117 people a day — more than 42,000 in all for 2022.

“Any reduction in roadway deaths is positive, but the minor decrease announced by NHTSA follows an unprecedented pandemic-fueled surge in roadway fatalities and dangerous driving,” said Jonathan Adkins, chief executive officer of the Governors Highway Safety Association (GHSA). He spoke in a news release from the governors' group responding to the NHTSA announcement.

The GHSA noted that traffic deaths surged 30% over the past decade. Between 2019 and 2022, they rose from 36,355 to 42,795, an increase of nearly 18%.

Dangerous driving behaviors, including speeding, impaired driving and not wearing a seat belt all increased between 2020 and 2021.

Pedestrian deaths reached a 40-year high of nearly 7,500 in 2021, according to a GHSA analysis. Early indications are that 2022 was also a deadly year for people walking, the group said.

“These roadway deaths are heartbreaking, unacceptable and preventable," Adkins said. "We will not accept such incremental safety progress after two years of escalating deaths and more dangerous driving on U.S. roads.”

Adkins pointed an approach outlined in the U.S. Department of Transportation's National Roadway Safety Strategy.

It calls for a number of measures, such as equitable traffic enforcement; infrastructure that slows down drivers and protects pedestrians, bicyclists and other non motorized road users; and community engagement campaigns developed with local input. It also recommends vehicle technology that protects people both inside and outside the vehicle and investments in post-crash care.

SERVING MONROE AND ONTARIO COUNTIES

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We’ll help you find the right position with opportunities for advancement. We offer great benefits including tuition assistance with no waiting period.

Discover the many opportunities that await you at Thompson Health. A monthly newspaper published by Local News, Inc. Distribution: 33,500 copies throughout

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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.

By Gwenn Voelckers

Practical tips, advice and hope for those who live alone

Socializing in a Couples' World

Have you fallen off the social circuit?

There’s no time like spring to hop back on!

The fear of walking into an event by yourself or the discomfort of being “third wheel” can keep lots of single women and men home on the weekend.

Don’t I know it!

Though it was years ago, I still remember the dismal details that followed an invitation to a relative’s wedding. It wasn’t long after my divorce and I surprised myself by actually giving it consideration. What was I thinking?! A wedding? Alone?

But I like marriage ceremonies and I wanted to reconnect with some friends and relatives I hadn’t seen in some time. Plus, it was a reason to dress up and get out of the house.

So on that fateful day, I pulled up to the church, parked and sat in my car. There I waited. And watched. And waited some more. Then withered.

I watched one happy couple after the other walking in, holding hands, laughing and looking oh so in love. I could feel my blood pressure rising and my courage crumbling.

I started to think, “What am I do-

ing here?” And then a surge of “poor me” self-talk showed up and robbed me of my resolve. I sat there in my pretty dress and pumps, unable to muster the confidence to enter the church alone.

I turned on the ignition and returned home to my empty apartment.

Disappointed in myself, I vowed not to let something like that happen again. I wasn’t going to miss out on life’s experiences just because I was single. In that moment, I made a promise to myself: I wouldn’t let my fears and insecurities keep me confined at home and within a safe circle of women friends.

Learning to do things solo and to actually enjoy myself, took time, practice and, frankly, some guts. Over time, I became increasingly comfortable socializing in a couples’ world.

Here’s how:

Overcome self-conscious thinking

Part of what kept me from going out to eat or to a movie by myself was my concern about what people would think of me — or, more ac-

curately, what I thought they would think of me. Did I have no friends? Was I undesirable company? Or worse, was I on the prowl?

Overcoming self-conscious thinking was essential to moving forward and out of my house.

What do you think when you see someone walking into an event alone or sitting by themselves at Starbucks reading the paper? Do you assign negative attributes to them? Probably not. You likely don’t give it a second thought. Or maybe you secretly admire their confidence and ability to enjoy their own good company.

Keep this in mind the next time your fears and doubts keep you from venturing out alone.

Expand your social circle

If you’ve fallen off the social circuit, it’s your responsibility to find a way back on. You need to make the first move, and one of the best ways to get back onto invitation lists is to embrace the theory of reciprocity: You invite people into your world, and they, in turn, will invite you into theirs.

No need to go overboard; inviting a few friends over for coffee or a cookout will get the ball rolling. Your social network will begin to grow and before you know it, you’ll find yourself enjoying the company of good friends, both old and new.

Be prepared to bump into your ex

If concerns about running into an ex-spouse or significant other at a social event keeps you from accepting invitations, be prepared.

Before you go, anticipate and visualize running into your ex. See yourself handling the encounter with grace and, most importantly, brevity. A few pleasantries and a polite “take care” will help you move past the encounter in a relatively quick and painless manner.

Bumping into an ex may be inevitable depending on your situation,

so gear up, grin and bear it, and get going on your way.

Walk in alone with confidence

Even after all these years of living alone and attending social engagements on my own, I still don’t relish the thought of walking into an event by myself. In fact, to make it more palatable, I developed a fivestep formula to ease my way in — and it has never failed me.

Here is my game plan:

1. Pull up to the event and gather my thoughts in the car.

2. Repeat my mantra: “All I need is within me now.”

3. Take a few deep breaths.

4. Remind myself to be myself and to be curious about others.

5. Enter the event and make a beeline for the host to say hello and introduce myself to others standing nearby.

After connecting with the host and a few guests, I can more easily enter into universally accepted smalltalk subjects: books, travel, food, movies and sports (or more precisely, pickleball).

Feeling good about living alone often means confronting social, as well as emotional, challenges. Getting comfortable in a couples’ world is among them. But once mastered, it gets easier and easier. Even fun!

Gwenn Voelckers is the founder and facilitator of Alone and Content, empowerment workshops for women and author of “Alone and Content,” a collection of inspiring essays for those who live alone. For information about her workshops, to purchase her book, or invite her to speak, visit www. aloneandcontent.com

A Trusted Source for Help with Life’s Struggles

drome Network in Rochester and father of an 11-year-old with Down syndrome, said that some naysayers have said that the Down syndrome community doesn’t need representation everywhere, but he views the new doll as a step towards inclusion.

SPECIAL

Down Syndrome Barbie Modeled After Upstate Woman

By Deborah Jeanne Sergeant

t age 35, Kayla McKeon has an impressive

A 2022 graduate of Onondaga Community College in Syracuse, she meets regularly with Congress as the manager of grassroots advocacy for the New York City-based National Down Syndrome Society (NDSS) to discuss issues involving Down syndrome and the disabled commu-

She also helped design Mattel's first and only Barbie doll with Down syndrome. It is part of the toymaker's Fashionista line.

For McKeon, helping design the doll means more than a career highlight. As a person with Down syndrome, the doll means representation in

“When I was a little girl, I had dolls who didn’t look like me,” McKeon said. “It’s an honor to help make a doll who looks like me with some of the same characteristics I

She suggested that the doll design should include a crease in its palm, a trait often seen in people with Down syndrome, and clinodactyly, a curved, short pinkie finger that often occurs as genetic syndromes including Down.

Some of the doll’s other traits indicate Down syndrome, including a flat nasal ridge, small ears, almond-shaped eyes with a tilt, a rounder face, a shorter frame and a

The doll comes with pink ankle foot orthotics and her sneakers include a zipper. These resemble the orthotics used by some children with

The doll’s dress is printed with a symbol of Down syndrome, yellow and blue butterflies and its necklace has bears three upward chevrons that symbolize the three chromosomes of Down syndrome,

“a symbol of those lucky enough to be connected with Down syndrome,” McKeon said.

The idea for a Down syndrome doll began about a year ago as the NDSS began discussing a partnership with Mattel to make the doll.

McKeon wants better representation so that the general public realizes that people with Down syndrome are more like others than unlike them.

“In school, I was included with my peers,” she said. “I want it to be like that everywhere. I live on my own in my own apartment. I have my driver’s license. I have a long-distance relationship.”

McKeon has been interviewed by numerous media outlets and starred Mattel’s video promotion of the new doll.

She hopes to “work herself out of a job” someday when people with disabilities are treated as equals. But in the meantime, she hopes to continue to advance her career with NDSS and perhaps help design a new doll.

McKeon is also considering going back to school to build on her associate degree in general studies. However, her work is keeping her plenty busy presently.

Nancy Carr, director of the Office of Accessibility Resources at Onondaga Community College, noted that McKeon was the first advocate for the NDSS who has Down syndrome.

“It bodes well for Kayla’s future,” Carr said. “Her personality has always been open, exploring, excited and confident. I think she had what everyone should have: a great support team, but she also has her own, innate outgoing personality.

“I like all the publicity the doll is getting; it’s long overdue. I like positivity and creativity and hope it opens the eyes of corporate America in that they’ve overlooked a sizeable population that should be represented. Kayla is wonderful to work with and I wouldn’t be surprised if other offers came her way.”

Brian Callahan, president of Flower City Down Syn-

“We want people to know that people with Down syndrome can do anything and break barriers, like they’ve been doing for years,” he said. “With people with Down syndrome becoming runway models and business owners, it gives good exposure to have this doll also. It’s good for kids to have understanding at a young age.”

He thinks that many typical kids will view the Down syndrome doll as yet another representation of what their community looks like. And children who do not know anyone with Down syndrome can learn as they ask questions about the doll.

“It can be an opportunity for parents to explain,” Callahan said. “It can be a tool, not just a plaything, to increase understanding.”

Donna Rush, executive director of GiGi’s Playhouse in Rochester, thinks it’s “pretty amazing” to have a doll that resembles her granddaughter, who has Down syndrome.

“Our goal is to have our kids and adults in the community,” she said. “That’s what makes this so important. I’m hoping this doll builds more acceptance.”

Mattel’s 2023 Fall Fashionistas dolls, including the Barbie doll with Down syndrome, are available online and in stores for $10.99.

LEFT: Mattel’s newest Barbie Fashionistas doll is modeled after individuals with Down syndrome. Some of the doll’s traits include a flat nasal ridge, small ears, almondshaped eyes with a tilt, a rounder face, a shorter frame and a longer torso. The doll comes with pink ankle foot orthotics and her sneakers include a zipper.

BOTTOM: Kayla McKeon poses in the studio with the new Barbie doll with Down syndrome. “When I was a little girl, I had dolls who didn’t look like me,” she says.

KIDS SPECIAL Schedule Your Well-Child Visits Now

It’s not too later to arrange the medical and dental visits your kids will need over the summer break from school. With planning, you’ll be able to easily fit the wellchild visits, physicals, and dental exams into your summer schedule.

“Don’t wait too long to make your child’s summertime medical and dental appointments because your doctor may not have openings when you want them,” says Mark Brown, a family medicine physician

and medical director at Excellus BlueCross BlueShield. “Appointments can get scarce as we get into the summer, so secure pediatric medical and dental visits now.”

Children aged 2 to 21 years old should have an annual physical to make sure immunizations are up to date; growth and development are on track; hearing and vision are optimal for learning; and important topics are addressed such as eating and sleeping habits, social behaviors, and

Skin Patch Could Help Ease Peanut Allergy in Toddlers

A"peanut patch" worn on the skin may help protect toddlers who have potentially life-threatening peanut allergies, a new clinical trial shows.

The patch is a form of immunotherapy, which means it exposes peanut-allergic children to tiny bits of peanut protein over time — with the goal of training the immune system to better tolerate it.

In the trial, researchers found that of toddlers who wore the peanut patch every day for a year, two-thirds showed a significant reduction in their sensitivity to peanut protein: They were able to eat the equivalent of one to four peanuts without suffering an allergic reaction.

While that might sound like peanuts, experts said that level of tolerance is important.

The goal of immunotherapy is to prevent a severe reaction should a child accidentally ingest a small amount of peanut, said physici-

anAlkis Togias, of the U.S. National Institute of Allergy and Infectious Diseases.

"This is a positive study," said Togias, who wrote an editorial published with the findings on May 10 in the New England Journal of Medicine.

The patch tested in the trial, called Viaskin, is being developed by French biotech company DVB Technologies, which funded the research. It is not yet approved by the U.S. Food and Drug Administration.

If it does win approval, Togias said, "I think that would only be a good thing."

An estimated 2% of U.S. children are allergic to peanuts, and for most the allergy continues into adulthood. That makes it the most common food allergy among kids, and the thirdmost common among adults, according to the nonprofit Food Allergy Research and Education (FARE).

family dynamics.

For children with asthma, an annual physical provides an opportunity to review and update the child’s asthma action plan, and to make sure all adults who care for the child have a copy, including camp counselors, coaches, teachers, caregivers, and

even parents of their friends.

“Routine checkups not only offer preventive care, but also create strong, trusting relationships with providers that will benefit your child throughout their life,” says Brown.

Regular dental care is just as important as well-child visits and is recommended every six months.

“Preventive dental care is essential for good oral health, and also for general health,” says Brown. “Untreated oral disease has a large impact on quality of life and productivity, including for children.” Each year, U.S. children lose an average of 34 million school hours because of emergency dental care.

Brown advises parents to make the most of their children’s medical and dental visits by making a list of topics they’d like to address with their child’s health care provider. “Bring your top three to five questions or concerns with you to discuss at the start of the visit.”

School may not let out for the summer for several more weeks, but that doesn’t mean it is too early to start planning the most efficient way to use the break. Make your wellchild and pediatric dental appointments now.

U.S. Child Deaths From Fentanyl Jumped

30-Fold in Just 8 Years

The synthetic opioid fentanyl is killing increasing numbers of U.S. kids, emulating the chilling trends seen among adults, a new study finds.

Pediatric deaths from fentanyl increased more than 30-fold between 2013 and 2021, according to study author Julie Gaither, an assistant professor of pediatrics at the Yale School of Medicine.

Nearly half of the deaths occurred at home, and most were deemed unintentional. Teens may not have known the drugs they were using were contaminated with fentanyl, while very young children may have touched or swallowed drugs used by their parents.

"The problem is that more adults are exposed to fentanyl now, whether it's a pure form of the drug or it's being cut into other drugs, so kids are more likely to be exposed to it," Gaither explained.

Using death certifi cate data from the U.S. Centers for Disease Control and Pre vention, Gaither assessed deaths from fentanyl over two decades.

Almost 5,200 deaths among near ly 14,000 fatal opioid poisonings between 1999 and 2021 were due to fentan yl, Gaither found.

In 1999, about 5% of the deaths from opioids were from fentanyl; by 2021, that had jumped to 94%, mirroring the pat tern of adult fatalities.

Earlier in May, a CDC report

disclosed that fentanyl overdose deaths in the United States had soared 279% in just five years.

In Gaither's research, she found that a surge in fentanyl-related fatalities that began in 2018 led to a nearly threefold increase in deaths among older teens and a nearly sixfold increase among children younger than 5.

Deaths peaked in 2020 and 2021, Gaither said, suggesting the COVID-19 pandemic made the fentanyl crisis worse.

Nine in 10 of these deaths were among teens aged 15 to 19, and nearly 7% were among kids under 4.

In 2021 alone, fentanyl caused 40 infant deaths and 93 deaths among kids aged 1 to 4, according to Gaither's report.

"There is a general consensus that the overdose deaths involving fentanyl among kids, whether young kids or teens, are primarily unintentional," said Linda Richter, senior vice president at the Partnership to End

"Among younger children, access to pills or substances laced with fentanyl that are left within their reach is the main culprit," said Richter, who was not part of the new research.

"For older adolescents, the culprit is more likely a lack of awareness that the pill they are intentionally taking contains

Mark Brown,MD

Things to Do with Your Kids This Season

By Melissa Stefanec

As any parent knows, your idea of a good time and your kid’s idea of a good time match like the pile of socks at the bottom of the laundry basket.

So, if you’re a parent who seeks entertainment ideas that will make at least 67% of your family happy, look no further. This list of activities that might just beat the odds and get a smile out of almost everyone in your family.

Most of these activities can be also customized for children of any age. So give them a shot. You only have boredom and bickering to lose.

1.Go constellation hunting

There is something magical about staring into the night sky. When the time is right to stargaze, do some research about what constellations are visible. Then see if anyone in the family can connect the orbs in the sky to make a picture. You can also research the story of each constellation.

2.Start a summer mini golf tour

Take your kids on the putt-putt tour this season. Map out a few different places to play mini golf. Then create friendly competitions. See who has the most holes-in-one at the end of the tour. See who had the lowest combined score. See who won the most individual matches. See who landed in the water hazards the most. Make it silly.

3.Get a campsite close to home

Camping is a lot of fun, but it’s also a lot of work to travel far away from home. If there are campsites close to your home, rent one for a night or two. Then you don’t have to travel far to enjoy the outdoors. You

also have a short trip home if it rains. And, if you forget something, your house is guaranteed to have more supplies than the park’s camp store.

4.Go to a park and tell your kids they’re teachers

Upstate New York is home to many state, county and private parks. Many of these parks have informational signs throughout them. Take your kids to one of these parks and have your kids teach you the information on the signs. Even if your child can’t read yet, they can use the pictures to design a story. The role reversal will make it fun.

5.Take turns setting a family barbecue menu

Let each member of your family plan a barbecue. They have to set the menu and help prepare the meal. They can pick their favorite barbecue foods. Sure, one of your barbecues might be just cheese puffs, baked beans, and buttered rolls, but everyone will enjoy the autonomy.

6.Go on a hike no one has been on before

Add some extra adventure to an everyday hike by going somewhere that is new to everyone in the family. Then you can work together to analyze the trail map and plan out the hike. A new hike will encourage collaboration. Just don’t get lost.

7.Start a family movie night

A movie night may sound cliched, but if you spruce it up, you just might get instant buy-in. Plan out a series of movie nights. Each night, each member of your family gets a different responsibility. One person can pick the genre. Another person can pick the movie. Another one can pick a candy. Another one can pick

a salty snack. Shake things up and settle in.

8.Find the best ice cream parlor within 20 miles of your house

Research all the ice cream places that you can reasonably get to over the next few months. Keep a record of which places had things like the best ice cream, the best toppings, the biggest sizes, the funniest sundae name or the softest napkins. The whole family will enjoy being a judge in this delicious competition.

9.Chalk for a better world

Make it your mission to find new and creative places to leave chalk art. You could chalk the end of a neighbor’s driveway with a beautiful picture or kind message. You could go to a public park and leave words of encouragement for strangers. You could go to a family member’s house and draw them a mural to brighten their world for days to come. Chalk is an easy way to spread joy.

10. Have a “say yes” day Set a monetary budget and some gentle boundaries and let the family embark on a “say yes” day. What is a “say yes” day? It’s as easy as it sounds; someone volunteers an idea and you have to say yes. Remind your kids to be reasonable, and then let them live out their simple and realistic dreams. Ice cream for breakfast? Yes. Family video game tournament? Yes. Swimming in a lake? Yes. Three playgrounds in one day? Yes. Let your imagination run you right into happiness.

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WORTH SUPPORTING

Q & A with Karen Zandi

President and CEO of Mary Cariola Center in Rochester discusses mission of the nonprofit — provide services for individuals with disabilities — and says workforce is currently the biggest challenge the center faces

By Steve Yablonski

Q: How long has the center been in operation?

A: We are coming up on our 75th year, 1949 — rocking and rolling!

Q: What are your qualifications — what did you do before you were CEO?

A: I have a master’s in social work. For 25 years I worked for a similar agency [the Hillside Children’s Center].

Q: What’s the meaning of the center's name?

A: A woman named Mary, Mary Cariola, actually started the organization. She had a nephew with multiple disabilities. No school would take him, so she started the agency — one room, eight students and a teacher, for students who would not be served in a public district. It was located in downtown Rochester [on East Avenue].

Q: Please summarize what your agency does.

A: Mary Cariola Center is a private, nonprofit agency and is regarded as a leader in providing education, residential programs and other services for individuals with disabilities, including autism, that have significant educational challenges. We serve children between the ages of 3 and 21. We also have six group homes, residences that take care of young people with developmental disabilities 24/7. We also

have a health home program that does case management. And, there are a few other services that are specific to addressing the children with other behavior challenges.

Q: What are the main challenges you encounter

A: Not unlike other organizations, Mary Cariola is not exempt to the staffing issues. We have challenges with getting enough qualified and skilled people to attend to our fragile children. We have some significant recruiting initiatives and retention ongoing in the development of our staff. I would say workforce is one of our biggest challenges. Another area is there are gaps in services for the people that we serve. The population that we serve is pretty exceptional, and takes a lot of training as well as patience to attend to their needs. So we invest a lot into training and services to close those gaps. And frankly some of the buildings need modification.

Q: How much is your budget?

A: Our current budget is approximately $41 million.

Q: Where does the funding come from? Do you fundraise?

A: Public [school] districts that cannot educate these children in district, pay a tuition to us. It’s as if you were sending your children to private school — but it is free to parents,

A: 636 total. 510 full time, 126 part time — makes Cariola the 46th largest employer in Rochester. We support our staff to become credentialed; we really invest in our staff.

We have what you’d expect at any school — principal, vice principals, certified teachers — certified special ed teachers. We also have teacher aides and certified teaching assistants. We have an array of clinicians and given the medical complexity of the kids that we have here, we have a significant number of nurses. And every family gets a social worker.

There a lot of supports needed for our kids. Sort of parallel in our group homes. Each house has a manager and they’re staffed along with that.

Q: You serve students and residents from 52 school districts and 13 counties … how do you keep it all together?

A: (laughs) Commitment and people who are really good at their jobs. Strong teams, strong community, communication, passionate people and great support from our board and donors and broad community commitment. And frankly — the parents of those we serve. The parents of our students are very invested in their child’s success. They are partners in everything that we do. All counties are in NYS, surrounding Monroe County. School districts are within those counties.

Q: How many hours do you put in?

A: (laughs again) I would say most of our staff in our school works a ‘school cycle.’ The administrators? We are a 24/7 agency — so whatever needs doing, we do it. I can’t count the hours that I work. Because, honestly, it doesn’t matter. I have a passion for this organization. It doesn’t matter. Our administrators say the same. We don’t count our hours. We focus on what the priorities are. What work needs to be done — that’s what we do.

Q: How does someone become a part of the program?

A: The students are referred by their home districts.For our houses, they are referred by the Office for People With Developmental Disabilities.

Q: How long can an individual stay in the program?

A: State education requires students to finish by age 21. You can’t stay in school. We work very hard to get our individuals into day service, whatever that looks like. In our houses, individuals can live beyond 21, stay with us beyond that age. Even though we are focused on being a children’s provider, there are individuals who stay with us beyond 21.

More information on Mary Cariola Center visit www.marycariola. org or call 585-271-0761. The center’s administrative office is located at 1000 Elmwood Ave., suite 100 Rochester.

Feeling the Heat

By Deborah Jeanne Sergeant

Although the summer weather feels good, too much heat and sun can cause health problems.

Here are some of the most common issues associated with high temperatures:

Skin Damage

Sun exposure — not temperature — can cause skin cancer. However, most exposure happens during the warmer months of the year.

The American Academy of Dermatology Association named

skin cancer as the most common kind of cancer nationwide, with 20% of the population receiving a diagnosis at some point, totaling 9,500 new diagnoses daily. The five-year survival rate is 99% if caught early. However, once it spreads to nearby lymph nodes, that drops to 68% and if it spreads to more distant lymph nodes, it plummets to 30%.

Limiting sun exposure can significantly decrease the risk of skin cancer.

“Sunscreen is extremely important,” said Christy L. Richards, registered nurse and health educator with

Ontario County Public Health. “The CDC recommends 15 SPF sunscreen with UVA and UVB filter. Reapply after sweating a lot, swimming and towel drying and every two hours.”

Women who wear makeup should apply sunscreen first or ask a dermatologist about two-in-one products like a tinted moisturizer with SPF or foundation containing SPF. Water-resistant products are recommended during exercise or swimming. Covering the skin and wearing broad-brimmed hats and sunglasses can also help, as well as avoiding exposure to the sun at midday. According to the EPA, “nearly half of UV radiation is received between 10 a.m. and 4 p.m., when the sun’s rays are the strongest.” But keep in mind that even on a cloudy day, it’s possible to be sunburned.

Heat Exhaustion/Heatstroke

If the body becomes too hot, untreated heatstroke can damage the brain, heart, kidneys and muscles. Pregnant women can experience preterm delivery. Richards said that the very young, elderly people and those engaging in heavy physical activity are all more prone to heat exhaustion and heatstroke.

“Limit alcohol, stay in the shade and wear loose, breathable fabric,” Richards said. “Stay in a place where there’s A/C and if you don’t have it, go to places that are air conditioned when it gets really warm. We usually put out a heat warning.”

Schedule outdoor activities in the early morning or evening, not during

the hottest parts of the day. Wearing light-colored, loose-fitting clothing and drinking fluids can help prevent heat exhaustion and heatstroke.

“It’s important to stay hydrated and be mindful of the symptoms of heatstroke,” said Adrienne Goodman-LaMora, doctor of Chinese medicine and owner of Longevity Complementary Care in Macedon.

Heat exhaustion leads to heatstroke if untreated. Heat exhaustion manifests with higher body temperature, cool, sweaty and clammy skin, thirst, head and body aches, slow pulse, and feeling faint. By the time a person reaches the stage of heatstroke, the body is not sweating as much, exhibits hot, flushed skin and the person feels nauseated, confused or possibly unconscious.

“You have to meet your basic hydration needs and if you’re outside and sweating, you have to replace those,” said Sue Czap, registered dietitian with URMC.

Caffeinated beverages can cause more fluid loss, so water is a better choice. Most healthy people need to drink half their weight in ounces each day, so a 130-pound person would need about 65 ounces of fluids daily. That’s a little more than eight glasses of 8 ounces each.

Juice, tea and other beverages count towards that total, but Czap encourages clients to reach for water as the go-to beverage choice, as it’s free of calories. To keep it more flavorful and appealing, she recommends adding cucumber slices, fruit or herbs like basil, mint, dill or tarragon.

As an independent, non-pro t agency, Mary Cariola welcomes new sta , donors and volunteers.

To learn more, visit marycariola.org.

EDUCATING OUR COMMUNITY SINCE 1949

Mary Cariola Center provides educational and residential solutions for children and youth with intellectual developmental disabilities and complex medical conditions.

The services o ered in Cariola schools and residences provide each individual the opportunity to reach their highest potential, meeting milestones that were once thought impossible. Social workers, clinicians, therapists, educators and direct support professionals work as an interdisciplinary team to transform the lives of people with disabilities. Mary Cariola Center School is a vital part of the education community in Rochester.

Summer 10 Ways to Improve Your Health This Summer

By Deborah Jeanne Sergeant

You can enjoy better health by making a few changes this summer.

1.Use the longer days in healthful ways. Kerri Howell, certified personal trainer, nutrition coach and owner of The Hourglass Mom in the Rochester area, suggested using summer’s increased daylight hours for “exercise, journaling or eating a healthy breakfast.” More daylight can also help re-establish a healthy circadian rhythm for restorative sleep. “Whether it’s an evening stroll or an afternoon hike, it’s easier to get outside and get moving when the weather is nice,” Howell said.

2.Focus on self-care. “Especially if you’re a parent, we end up with a lot more time on our hands,” Howell said. “When school’s out, so are many of the extracurricular activities or they shift a bit so you’re not constantly on the run, tiring yourself out. More time means capacity to focus on yourself and your goals.” At some workplaces, this is also true, especially at com-

panies that keep shorter “summer hours.”

3.Get grilling. “Grilling means easy, healthy dinners,” Howell said. “Plus, meal prep is a cinch when you’ve got the grill going.” For example, fill up skewers with veggies like cherry tomatoes, mini sweet peppers and quartered onions, along with chunks of boneless, skinless chicken breast and serve grilled skewers over a salad.

4.Buy local produce Whether from a farm stand, farmers’ market or community supported agriculture (CSA), Sue Czap, registered dietitian with URMC, encourages buying local fruits and vegetables.

“A CSA is a good thing to do,” she said. “Then you get fresh produce on a regular basis. You may try produce you haven’t before.” Her CSA includes recipes, so customers know what to do with less well-known veggies.

In general, a CSA is an agreement in which a consumer pays upfront for the farm’s produce for the season. Each week for a pre-designated time period, the customer receives a box (“share”) of the farm’s harvest. Some farms allow CSA customers to help harvest and some sell other local products in their shares, such as maple syrup, honey, baked goods and jam.

5.Pick your own produce. In addition to obtaining fresher, lower-cost produce, picking your own fruits and vegetables helps kids better understand the source of their food. Many farms offer U-pick experiences that include other activities. Visit www.pickyourown.org to find out where to go.

6.Raise your own fruits and vegetables. Gardening often encourages children to feel more vested in their food. “You can grow tomatoes in a container garden or green beans,” Czap said. “They grow pretty easily and are kid-friendly.” Herbs are also easy to grow in pots indoors or on a patio.

7.Preserve some produce. Although you may not “put up” every fruit and vegetable you’ll eat for the year like your great grandma did, freezing berries during their peak can save money on food costs later. “You can put them in smoothies or use in other ways,” Czap said. “If you freeze berries individually, you can pull them out individually too.” Spread washed, drained berries on a baking sheet to freeze for 30 minutes before placing them in freezer bags to avoid dealing with a solid block of berries later.

8.Drink more water. Czap warned that many people drink far too many calories and too much

sugar in their summertime beverages, from soda to energy drinks to sweet tea. “Try to minimize your intake of sugary beverages because of the extra calories and sugar.” she said. “Plain club soda that’s flavored is great. Pick ones without added sugars or artificial sweeteners.” Unsweetened tea or ice water with fruit, vegetables or herbs can help skip calories while keeping hydration interesting.

9.Load up on whole foods. Picnics, festivals and parties are easy places to find processed foods, like hot dogs, fried foods and fatty meat. “Eat food as close to its natural state,” Czap advised. This strategy helps reduce intake of sodium, fat, additives and excess calories. Grilled chicken breast or fish, corn on the cob, and fresh fruit salad are a few examples of healthful, whole-foodbased summertime fare.

10-. Remember summer activity safety. For example, when hiking, “check yourself and pets and kids for ticks,” said Christy L. Richards, registered nurse and health educator at Ontario County Public Health. “They like those warm areas. They start at a sock and go up to the groin. We find them behind the ears. Watch for those telltale bullseye rash.” She also reminds bike riders to wear helmets, including adults. While engaging in water activities, wear a life jacket.

“Visit the YMCA and get the kids into swim lessons,” Richards added.

“It’s super important.”

SmartBites

By Anne Palumbo

The skinny on healthy eating

Nutritious Perks of Plant-Based Pasta

My husband and I now get most of our protein from plant-based foods: legumes, quinoa, chia seeds, tofu and dairy products.

While we are long past any growth spurts, we still need protein to preserve muscle mass, maintain balance, manage weight and recover from injuries.

Compared to getting protein from meat, however, it’s not always easy to get our daily allotment of protein from plants.

But a food product we recently discovered has facilitated that effort: plant-based pasta.

Most plant-based pastas have considerably more protein than your average refined-wheat pasta. Plus, their pronounced flavor satisfies us more than regular pasta.

Read on for more good reasons to eat plant-based pasta. And why “more protein” is just the tip of this nutrition-packed iceberg.

• Loaded with fiber. Most plantbased pastas have over twice the fiber of regular pasta. Fiber is a boon to health because it stabilizes blood sugar levels, promotes regularity and ferries bad cholesterol out. Many studies suggest that increasing fiber reduces our susceptibility to heart disease, cancer, stroke and diabetes.

• Fewer and healthier carbs. Not only do plant-based pastas have

fewer carbs, but the carbs they do have are the “good” ones—the complex ones. Because these carbs have more fiber than simple carbs, you’ll feel fuller longer and be less likely to overeat. Moreover, their slower digestion provides a steady stream of energy and minimizes spikes in blood sugar.

• Good for the planet. Eating more plant-based proteins can also help protect the environment.

Livestock accounts for around 14.5% of the world’s greenhouse gases each year, which is roughly the same amount as the emissions from all the cars, trucks, planes, and ships combined in the world today. Holy cow! Greenhouse gases, as you may know, contribute to global warming and climate change.

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.

Helpful Tips

Read nutrition labels carefully. While most types of plant-based pasta are similar in terms of calories and overall nutrition, they can vary greatly in protein and fiber content. Also, plant-based pasta shouldn’t take the place of whole vegetables in your diet, as the nutritional content of pasta pales in comparison to actual vegetables. Consider adding vegetables to your pasta dishes to boost nutrients.

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For the dressing:

1 garlic clove, minced

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1/3 cup light sour cream

½ cup fresh parsley

½ cup fresh basil

2 tablespoons chopped chives

2 tablespoons fresh lemon juice

1 tablespoon olive oil

½ teaspoon salt; ¼ teaspoon coarse black pepper

For the salad:

8 oz plant-based pasta (I used red lentil for high protein and fiber)

1 cup cherry tomatoes, halved

2 medium carrots, chopped

1 cup shelled edamame, cooked Parmesan cheese, shredded

Boil the pasta in a large pot of salted water, according to the package’s “al denté” instructions. Once pasta is finished cooking, rinse under cool water and drain well.

While pasta is cooking, make the dressing. Combine all the ingredients in a food processor or blender and purée until smooth.

Transfer cooled pasta to a large serving bowl. Add the cherry tomatoes, carrots, edamame, and dressing, tossing well to combine. To serve, top with grated Parmesan.

Want Better Sleep? Try Working Out

By Deborah Jeanne Sergeant

Nearly 70 million Americans live with a sleep disorder, according to the Centers for Disease Control and Prevention. If you’re one of them, consider your activity level.

“People who exercise tend to be better sleepers,” said physician Michael Yurcheshen, associate professor in the department of neurology and sleep medicine at University of Rochester Medical Center. “Some of this may have to do with the exercise itself; some of it may be that they’re disciplined about sleep. It takes a fair amount of motivation. You have to be on point and dedicated to it. Sleep habits are a matter of consistency and commitment.”

It logically follows that someone disciplined to maintain good exercise habits also maintains good sleep habits.

Exercising regularly helps mitigate the effects of stress, which Yurcheshen said can make a big difference in falling asleep and staying asleep. Exercise helps regulate stress hormones, the kind that may interfere with sleeping well.

Activity can also affect core body temperature. Although sleep experts

recommend a cool environment to promote good sleep, exercise can affect body cooling as well, if timed right.

“When you exercise, your core body temperature goes up but within an hour, that core cools,” Yurcheshen explained. “That’s one of the signals or cues your body uses to initiate rest. When evening comes, your core body temperature drops by a degree or two regardless of exercise. We can use exercise as a specific therapy, particularly ‘night owls’ who find it difficult to fall asleep. Exercising in the evening, though not too late, can play into this. You can get a similar effect with a warm bath.”

If a morning workout fits your day better, just a 30-minute walk in the early evening can provide the same benefit to sleep as timing your workout to benefit sleep.

“A lot of people find exercise helps them stay alert during the day, so there’s less napping during the day,” Yurcheshen said. “They’re less sleepy when they go to bed.”

Soda Kuczkowski, sleep health educator, certified sleep coach and owner of Start with Sleep in Buffalo, also advises exercise for deeper sleep,

Do You Snore?

Snoring can be a sign of Sleep Apnea. There are three types of apnea: obstructive, central and mixed; of the three, obstructive is the most common. People with untreated sleep apnea stop breathing repeatedly during the night, maybe hundreds of times.

Sleep Disorder Symptoms

If you experience any of the following symptoms, you may suffer from a sleep disorder:

• Daytime fatigue

• Morning drowsiness

• Insomnia

• Gasping for breath in the middle of the night

• Snoring

Can lead to:

• High blood pressure

• Memory problems

• Impotence

• Cardiovascular disease

• Weight gain

• Headaches

• Depression

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but added “any vigorous exercise should be avoided before sleep as it can have the opposite effect. Any high-intensity exercise should be finished at least two to three hours before bedtime. Light stretches and yoga are encouraged as an alternative.”

The meditative aspects of yoga can provide mental and emotional calm. Stretching can help improve comfort and relaxation once in bed.

Oral Sleep Appliances can be used to treat sleep apnea and snoring. This is a customized oral device worn by patients during the night to maintain an open airway (reducing snoring and sleep apnea).

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Anyone who experiences an ongoing lack of restful sleep should seek help from a healthcare provider to rule out any other health issues and to obtain advice on what to do to improve sleep. The provider can also recommend a sleep specialist if needed. Before beginning a new exercise regimen, ask a healthcare provider what is right for you.

Groups Unite to Recruit, Train Home Health Aides

Finger Lakes Performing Provider System (FLPPS) and HCR

Home Care are partnering with home health agencies and community-based organizations to develop and manage a program to recruit and train community home health aides (HHAs).

Funded through grants from the city of Rochester and ESL Charitable Foundation, the program’s goal is to recruit, certify and train 660 HHAs over the next three years, with an emphasis on recruiting candidates from eleven ZIP codes in the city of Rochester: 14604, 14605, 14607, 14608, 14609, 14611, 14612, 14613, 14619, 14620 and 14621.

HHAs provide care to people after a hospital stay or to people needing help managing an illness. Tasks include helping people with daily activities like getting dressed, bathing and eating; checking vital signs; and reminding people to take medications. The position can be the beginning of a healthcare career and can lead to other positions such as a licensed practical nurse or a registered nurse.

FLPPS and HCR are collaborating on this program with employers from Rochester Regional Health Home Care and UR Medicine Home Care, as well as the following community organizations: AVS Consulting Strategies, which will provide pre-employment training; EE Pathways (formerly known as Exercise Express), which will assist with candidate recruitment and provide exercise classes and peer mentoring to help new employees become comfortable with their job responsibilities and with the workplace culture; and Wellness Associates of Greater

Rochester, which will provide mental health first-aid training.

“Our community faces a dire need for healthcare workers, especially home health aides,” said Carol Tegas, FLPPS executive director. “We greatly appreciate that Mayor Malik Evans, the city administration and ESL recognized this need and put valuable resources behind this critical program. We look forward to working with employers, recruiters and community partners to meet the program goals.”

HCR Home Care President Suzanne Turchetti said, “Home health agencies are coming together in an unprecedented way to meet the need for community home health aides. HCR is excited to work with FLPPS, our employer colleagues and community organizations to build a pipeline of HHA candidates for all three home health agencies, with the goal of providing quality in-home care for people in our community.”

Applicants must have a high school diploma or a GED. As part of the hiring process, applicants will go through a background check and attend a career readiness workshop to learn more about the role. Once hired, HHAs will need to complete 75 hours of training and pass a test to become certified in New York state. HHAs will be paid during the training. All HHA training will be provided by HCR at its corporate offices in Brighton.

Successful candidates who are hired and complete the required training will receive a $1,000 bonus, which will be paid in increments after completing the training, passing the certification test and remaining employed for six months.

Soda Kuczkowski, sleep health educator, certified sleep coach and owner of Start with Sleep in Buffalo: “Any vigorous exercise should be avoided before sleep.”

Michael E. Yurcheshen

Mediterranean Diet: Possible Prostate Cancer Prevention?

By Deborah Jeanne Sergeant

Numerous studies have linked the Mediterranean diet to a reduction in prostate cancer risk and improved outcomes for men diagnosed with prostate cancer. But while typically touted for its benefits in losing weight and improving heart health, the effect appears muddled as far as its effect on the prostate.

“It is important to conduct more studies focusing on risk factors for prostate cancer by stage and grade,” said Ying Wang, senior principal scientist at the American Cancer Society. “In addition, the most recent nutrition and physical activity guidelines from the American Cancer Society found that men diagnosed with prostate cancer who consumed a Mediterranean dietary pattern tend to have lower risk of death from any cause.”

This may suggest that the Mediterranean diet may promote overall good health in some men, regardless of the presence of prostate cancer.

“While some evidence suggests that following a Mediterranean diet may help reduce the risk of prostate cancer in certain populations, it is important to replicate these findings in other populations and look at different prostate cancer outcomes,” Wang said. “Furthermore, it is essential to recognize that diet is just one of many factors that can contribute to the development of cancer.”

She added that other factors, such as age, family history and race and ethnicity cannot be controlled. However, “avoiding tobacco use, maintaining a healthy body weight, engaging in regular exercise and limiting alcohol consumption, also help to lower the risk of developing prostate cancer.”

Sue Czap, registered dietitians with URMC, said that the Mediterranean diet includes “more nutrient-dense foods as they’re rich in phytonutrients, or plant nutrients. They’re antioxidants and anti-inflam-

matories and lycopene. As they’re minimally processed, these are retained.

“The Mediterranean diet is high in dietary fiber which has a lot of health benefits. You have fewer empty calories. That is associated with a healthier weight and that’s associated with reduced risk for cancer.”

In addition, men should avoid alcohol or limit their consumption to no more than two servings daily.

“It’s best not to drink alcohol,” Czap said. “Alcohol is associated with several cancer types.”

As for the two-per-day limit for men who drink, Czap said it’s not something that can be rolled over for a weekend binge.

Processed foods, cured meat and sugar should be eliminated and red meat should be minimized.

“It’s not necessarily the fat content; it has to do with the chemical composition of the meat and nutrient composition,” she said. “Fish is part of a Mediterranean diet. Eat it a couple times a week, and whole foods, as close as possible to their original state. Salmon, tuna steaks and tuna fillets are good sources of omega-3s which are anti-inflammatory.”

Meatless entrees, such as those containing black beans, chickpeas or lentils, should dominate the diet. Czap said that red meat includes pork.

Mark Richardson, coordinator for Zerocancer, a prostate cancer support group meeting in every second Thursday in Pittsford, said that from his research, it appears that the Mediterranean diet may decrease risk for cancer progression for those diagnosed but on active surveillance.

“Good nutrition may help reduce the risk of developing and slow the progression of the disease and prevent aggressive disease, but these tips should not be used in replacement of treatment,” Richardson said.

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Bone Health Awareness Month Expert: Don’t Accept Osteoporosis As Part of Aging

An estimated 10 million Americans aged 50 years and older have osteoporosis and 20% of them (2 million) are male, according to the U.S. Office of Disease Prevention and Promotion.

An additional 43 million people — including 16 million men — have low bone mass, putting them at risk for developing osteoporosis. The disease affects every race, ethnicity, and gender.

“Osteoporosis shouldn’t be accepted as a normal part of aging,” says physician Ankit Garg, vice president medical affairs and medical director at Excellus BlueCross BlueShield. “There are things everyone can do to improve bone health throughout their life.”

Bones are living, growing tissue, and throughout your life your body is losing and making new bone mass. Osteoporosis develops when bone mineral density and bone mass

decrease, or when the structure and strength of bones change. It is the major cause of fractures in postmenopausal women and older men, most commonly in bones of the hip, wrist, and vertebrae in the spine. Usually there aren’t any symptoms, and many people don’t know they have it until they break a bone.

“You’re never too young, or too old to make lifestyle changes to improve bone health,” says Garg. Lifestyle changes include stopping smoking; reducing alcohol intake; eating a healthy diet with plenty of calcium-containing foods including dark green leafy vegetables; having moderate exposure to sunlight (but avoiding sunburn) to get enough vitamin D; and trying to do 30 minutes of weight-bearing exercise each day, such as walking or strength training with weights. Always consult your health care provider before beginning an exercise program.

Fall prevention is also important to maintaining bone heath and reducing the risk of fractures. Your health care provider can assess your risk of falling, and provide tips to avoid them, and also fall-proof your home. “Preventing falls is important, whether or not you have osteoporosis, because bone fractures can cause other medical problems and take away your ability to live independently,” says Garg.

Bone mineral density (BMD) testing, also known as a dual-energy X-ray absorptiometry, DEXA, or DEZ, is used to determine bone health and diagnose osteoporosis. The test is quick and painless and uses a small amount of X-ray to measure the amount of minerals (mostly calcium and phosphorous) contained in a certain volume of bone. In addition to being used to diagnose the disease, BMD testing is used to determine how well osteoporosis treatment is working, and how likely the patient is to suffer a fracture. If diagnosed, there are many drugs and hormone therapies available to prevent further bone loss and to stimulate new bone formation.

“At your next medical office visit, ask your health care provider if BMD testing should be included among your regular preventative screenings, and about any lifestyle

changes you can make to help prevent osteoporosis or slow its progression,” advises Garg.

May is Bone Health Awareness Month. Learn more about osteoporosis from the National Institutes of Health online at www.bones.nih.gov.

Physician Ankit Garg, vice president medical affairs and medical director at Excellus BlueCross BlueShield

Meet Your Provider Jewish Senior Life

Physical therapist discusses specialized treatment for Parkinson’s patients

Q: You’ve been with Jewish Senior Life since 2018. Can you describe how physical therapy (PT) has evolved during your tenure?

A: The greatest evolution in patient care is the treatment of Parkinson’s disease (PD) and I have been trained at the American Institute of Balance, LSVT [Lee Silverman Voice Treatment] and Rock Steady Boxing to safely and strategically address the symptoms of Parkinson’s; and also improve a patient’s strength, balance and overall quality of life.

Q: How do you structure your PT sessions and what are the most common conditions you treat?

A: We provide one-on-one 45-minute sessions. In addition to PD, I treat the whole spectrum of outpatient physical therapy: joint sprains, muscle strains, back and neck pain, postoperative rehabilitation, dizziness, and more. The majority of people I see are generally deconditioned, unsteady on their feet, and want to get back to moving and feeling better about themselves.

Q: What training or education have you achieved to stay up-todate on current therapy trends?

A: I am certified in Vestibular Therapy and Concussion by the American Institute of Balance to treat patients who have a history of falls, dizziness, unsteadiness, vertigo, vestibular issues and post-concussion syndrome. I am LSVT BIG certified, as well as certified in Rock Steady Boxing.

Q: Tell us about LSVT BIG and LSVT LOUD for Parkinson’s. How can it help and when is the best time to start?

A: LSVT BIG and LSVT LOUD are established treatments and have been used here. Start right away — it’s never too late! PD affects a person’s ability to control amplitude and force of movement and their voice. LSVT BIG and LSVT LOUD were specifically designed to combat this and improve movement and voice volume.

Q: You recently completed Rock Steady Boxing training. How can this improve PD wellness?

A: We are currently developing

a program for Rock Steady Boxing. Guidelines from The Parkinson’s Foundation are that people need 150 minutes (2.5 hours) of intense exercise a week for better quality of life and slower decline. Rock Steady Boxing can safely offer that intense cardiovascular and strength training. The movements involved in boxing perfectly address the deficits and impairments of people with PD. Boxing teaches you how to move in a functional way — with good balance, proper foot work, rotation, dual-tasking movements, and making large amplitude movements. All of this perfectly aligns with improving symptoms and slowing the progression of the disease

Q: How do you set expectations and keep patients motivated?

A: You’ll want to set aside any stress that’s on your mind and in your life, and take one day at a time and focus on yourself while you are in treatment. You will have to challenge yourself in order to change yourself. It’s not going to be easy, but I promise it will be worth it.

Name: Matt Berliner, Physical Therapist - Atkin Center for Outpatient Rehabilitation at Jewish

Senior Life

Hometown: Henrietta, New York

Education: Doctor of Physical Therapy - University of Miami, Florida

Orthopedic Clinical SpecialtyUniversity of Pittsburgh, Pennsylvania

Certifications: Vestibular and Concussion Therapy - American Institute of Balance, LSVT BIG, Rock Steady Boxing

Family: Engaged with two children and two dogs

Hobbies: Family first, boxing, golf, pursuing my private pilot license, and the Buffalo Bills

Frank Guido couldn’t be happier

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A Bout with COVID-19 and Paint Chips

By John Addyman

It’s one thing to talk to yourself. It’s quite something else to watch yourself talk to yourself.

Welcome to the world of COVID-19.

I got my shots — all of them. I couldn’t have been more boosted if I went through life in a highchair. I tried to stay away from crowds. I kept a mask in the car and often wore it. I had hand sanitizer in the car and

went through several bottles. I’m a former nurse. I took all this hygiene stuff very seriously.

And yet, Mr. Covid came calling.

On a Friday, he knocked on the door in my skull at 4:34 in the morning.

I was dreaming about watching a debate. The two guys who were making arguments were me and… me. I had a pretty good seat for the

BECOME A PART OF

‘I got my shots — all of them. I couldn’t have been more boosted if I went through life in a highchair. I tried to stay away from crowds. I kept a mask in the car and often wore it. I had hand sanitizer in the car and went through several bottles. And yet, Mr. Covid came calling.’

conversation, lying in my bed. When the winner was clear, he turned to me and shook my hand.

And just that second, I realized I was lying in bed with my arm fully extended, shaking hands enthusiastically with myself while some other part of myself looked on.

“Whaaat?” I asked (from the bed) out loud. The other guys walked off at the sound of my voice.

Dream over.

Or so I thought.

I went to work that day and when I arrived, I noticed that the atmosphere was a funny shade of yellow. The sky was yellow. Everybody I talked to early that morning looked jaundiced. I kept checking: I didn’t have a fever. I had started coughing earlier in the week and thought I had bronchitis, saw the doctor, and got treated with antibiotics. Up until that morning, I’d felt a little better each day.

After work I got my allergy shots. I don’t remember much about that. I went home, went to bed and stayed there. I felt like someone else was using my body to test germ warfare.

Next morning, after coughing most of the night, I took my second COVID-19 test in several days. This time I was so positive the thing lit up and yelled at me. I called the doctor’s office so he could prescribe Paxlovid for me. It was a Saturday and he wasn’t in. I called his answering service who confusedly told me they had no way to contact him.

What?

I called our local urgent care facility and told them I had tested positive and wanted to get a script for Paxlovid.

“No way, Jose,” the lady on the phone told me. “We don’t do that.”

So I went to the emergency room.

They put me in a low-pressure room when the air comes in but doesn’t go out. They took blood and much later told me it was to measure kidney function. They did their own COVID-19 test after I showed them the one I brought from home.

And I waited seven hours.

In the emergency room, the TV screen was so small and the reception so fuzzy, I was watching a basketball game without being able to see the basketball. Try that sometime. Apparently the managers at the hospital aren’t basketball fans. Golf would have been worse.

Finally, I realized that if I did in fact have COVID-19 and if in fact they were going to prescribe Paxlovid, things would need to happen pretty fast — I knew what time my pharmacy closed and we were getting there. I rang the bell for assistance — something I really didn’t want to do. I knew they’re busy.

The doctor, who explained she was alone on the floor that day and had been busier than a long-tailed cat in a nursing home full of rocking chairs, finally came in, confirmed that I had tested positive for COVID-19 and handed me a release from work on Monday, and told me she had just called the pharmacy and I could get up and scoot out the door to pick up the medicine.

It turns out scooting wasn’t in the cards.

Bobbing and weaving were. I had flashbacks of my college roommate’s 21st birthday party in the dorm when we both drank a bottle of bourbon. I was a little unsteady, but I made it to the car and to the pharmacy. At least I think it was my car.

Once home, I got the Paxlovid down right away. I enjoyed the “evening dose” immensely. The next morning, I had gone from Mr. Covid ruling over me to that being shared with Ms. Paxlovid’s stern hand on me.

The antiviral drug was working. I was bone dry like I’d been walking in the desert and I had a really weird taste in my mouth.

“What’s it taste like?” my wife asked.

“Sometimes it’s like I’ve been chewing paint chips and others it’s like I’ve been sucking an old tire,” I told her.

Two days later, my head was clearer, I wasn’t wobbly anymore, my coughing had subsided a lot and I was feeling better. And I had a new taste in my mouth: discarded washcloth. Yummy.

Did I ever lose my sense of smell or taste? No, not so long as what I needed to smell was paint chips, old tire or stiff and grimy washcloth.

And do I appreciate the efforts of the folks at Newark-Wayne Community Hospital emergency room and the Pfizer folks who developed Paxlovid? I do indeed.

I know I was very lucky to have such a mild case — so far — of COVID-19. I’m glad I got all the shots and boosters. I’m grateful to my pharmacist friend, Stacey, at Wegmans for calling me to make sure I was keeping up with the vaccination protocol. Why? I am an asthmatic who is overweight and well past retirement age — I have the trifecta and lit the scoreboard up for COVID-19 adverse effects. Yet I got away with a very light case — and a new respect for the taste of paint chips.

OUR TEAM

Inc. is seeking motivated RNs to join our team to ensure that people receive the right care, within the right setting and at the right time!

By Jim Miller

How Medicare Covers Physical Therapy Services

Dear Savvy Senior,

Does Medicare cover physical therapy, and if so, how much coverage do they provide? My 66-year-old husband was recently diagnosed with Parkinson’s disease and will need ongoing physical therapy to help keep him moving.

Worried Wife

Dear Worried,

Yes, Medicare does indeed pay for physical therapy along with occupational and speech therapy too, if he needs it, as long as it’s prescribed by his doctor. You’ll also be happy to know that Medicare has no limits on how much it will pay for therapy services, but there is an annual coverage threshold you should be aware of. Here’s what you should know.

Outpatient Therapy

To get Medicare Part B — which covers outpatient care — to help cover your husband’s physical therapy, it must be considered medically necessary and will need to be ordered by his doctor. The same holds true for occupational and speech therapy.

He can get these services as an outpatient at a number of places like a doctor or therapist office; in a hospital outpatient department; at an outpatient rehabilitation facility; at skilled nursing facilities if he is being treated as an outpatient; and at home through a therapist connected with a home health agency when he is ineligible for Medicare’s home health benefit.

For outpatient therapy, Medicare will pay 80% of the Medicare-approved amount after you meet your Part B deductible ($226 in 2023). You will be responsible for the remaining 20% unless you have supplemental insurance.

But be aware that if his therapy costs reach $2,230 in a calendar year (2023), Medicare will require his provider to confirm that his therapy is still medically necessary. Medicare used to set annual limits on what it would pay for outpatient therapeutic services, but the cap was eliminated a few years back.

You also need to know that treatment recommended by a physical therapy provider but not ordered by a doctor is not covered. In this situation, the therapist is required to give your husband a written notice, called an Advance Beneficiary Notice of Noncoverage or ABN, that Medicare

may not pay for the service. If he chooses to proceed with the therapy, he is agreeing to pay in full.

Inpatient Therapy

If your husband happens to need physical therapy at an inpatient rehabili tation facility like at a skilled nursing facility or at your home after a hospitalization lasting at least three days, Medicare Part A — which provides hospital coverage — will pick up the tab.

To be eligible, his doctor will need to certify that he has a medical condition that requires rehabilitation, continued medical supervision, and coordinated care that comes from his doctors and therapists working together.

Whether you incur out-of-pocket costs such as deductibles and coinsurance, and how much they are, will depend on the setting for the treatment and how long it lasts. For more information on inpatient therapy out-of-pocket costs see Medicare. gov/coverage/inpatient-rehabilitation-care.

Medicare Advantage Coverage

If your husband is enrolled in a Medicare Advantage plan (like an HMO or PPO), these plans must cover everything that’s included in original Medicare Part A and Part B coverage. However, some Advantage plans may require a person to use services from physical therapy practices within an agreed network. If he has an Advantage plan, you’ll need to contact his specific plan before selecting a physical therapy provider to confirm they’re within the network.

More Questions?

If you have other questions about coverage and costs for therapeutic services, call Medicare at 800-633-4227 or contact your State Health Insurance Assistance Program (SHIP), which provides free Medicare counseling. Visit ShipHelp.org or call 877-839-2675 to connect with a local SHIP counselor.

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July 8th & 9th , 2023

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JULY 8TH & 9TH, 2023

IN THE HISTORIC CORN HILL NEIGHBORHOOD

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Ask St. Ann’s

By Brian Burger

What is Assisted Living?

Falling Can Have Serious Consequences— Here's How To Reduce the Risk

What comes to mind when you think of assisted living?

At St. Ann’s Community, we describe assisted living as ‘private apartments, with helping hands.’ Apartments are our residents’ private space, and unless help is scheduled or requested through a predetermined individual care plan, any resident here can enjoy a full expectation of privacy.

Additionally, today’s assisted living communities are vibrant places; they’re full of life and activity! Residents find convenience in on-site restaurants, and a community in gathering places. While some choose to bring their car, most residents enjoy the ease of the provided transportation to their appointments.

There’s a lot more to assisted living than just personal care.

Quality assisted living facilities will work hard to make sure that residents have a wide variety of social events to attend each day. With offerings like exercise classes, a variety of games, support groups and other special interest groups like book clubs or bible study groups, there should be something for everyone.

In many cases, a married couple may find that one of them needs more help than the other. The good news is that in almost every case, both spouses can make the transition to an assisted living apartment together — even if only one person wants to take advantage of the care being offered by the community. Both people can still enjoy the fine-dining style food, the social engagements, and the sense of community.

For many, knowing when the right time is to consider more help is a challenge. There’s no universal life

Ask

The Social Security Office

From the Social Security District Office

event that indicates that ‘now is the time to think about assisted living’. Much like individual care plans, it always depends on someone’s personal situation.

Social isolation is another important thing to consider when deciding on next steps.

Oftentimes seniors will forgo the hobbies that make them happy simply because it has become too difficult to get ready on their own. With the help of care staff, residents are able to thrive and find themselves participating in their favorite activities again.

Once you make the leap and move into your new home, settling into the new routines may take some time. That’s completely normal! As the moving process is wrapping up, it’s also not uncommon to feel a surprising sense of relief. Many newly settled residents describe a renewed feeling of security and comfort that they didn’t realize they had been missing for a long time.

If the topic of assisted living has been on your mind, or if it has been a topic of family conversation, the best thing you can do is to prepare a list of any questions on your mind and call a community to chat. A big part of what we do at St. Ann’s is guiding seniors in the community through this whole process, and it’s a very rewarding part of our days. We always look forward to talking to you!

Brian Burger is a marketing representative for St. Ann’s Community at Cherry Ridge in Webster. Contact him at bburger@mystanns. com or 585-697-6702 or visit www.stannscommunity.com.

10 Ways to Protect Your Personal Information

Identity theft affects millions of people each year and can cause serious harm. Protect yourself by securing your personal information, understanding the threat of identity theft and exercising caution. Here are 10 things you can start doing now to protect yourself and your loved ones from identity theft:

1. Protect your Social Security number by keeping your Social Security card in a safe place at home. Don’t carry it with you or provide your number unnecessarily.

2. Be careful when you speak with unknown callers. Scammers may mislead you by using legitimate phone numbers or the real names of officials. If they threaten you or make you feel uneasy, hang up.

3. Create strong, unique passwords so others can’t easily access your accounts. Use different passwords for different accounts so if a hacker compromises one account, they can’t access other accounts.

4. Never give your personal or financial information in response to an unsolicited call or message, and never post it on social media.

5. Shred paper documents that contain personal information, like your name, birth date and Social Security number.

6. Protect your mobile device from unauthorized access by securing it with a PIN, adding a fingerprinting feature, or using facial recognition. You can also add a

password and adjust the time before your screen automatically locks.

7. Regularly check your financial accounts for suspicious transactions.

8. Avoid internet threats by installing and maintaining strong anti-virus software on all your devices—including your mobile device and personal computer. Use a virtual private network (VPN) to stay safe on public Wi-Fi. Do not perform certain activities that involve sensitive data, like online shopping and banking, on public Wi-Fi networks.

9. Protect yourself on social media by customizing your security settings and deleting accounts you no longer use. Also, double-check suspicious messages from your contacts, as hackers may create fake accounts of people you know.

10. Never click on any link sent via unsolicited email or text message—type in the web address yourself. Only provide information on secure websites.

We encourage you to create your own personal My Social Security account to track your earnings record. For more information, please read our publication, “Protecting Personal Information,”åå at oig.ssa. gov/files/21-540_Protecting_Personal_Information.pdf. Contact us if you see suspicious work activity on your record–you could be a victim of identity theft.

Please share this information with your family and friends.

Excellus recognized for commitments to workforce wellbeing

The American Heart Association has awarded Excellus BlueCross BlueShield national silver level recognition for its commitments to employee health and wellbeing as measured in the association’s 2022 Workforce Well-being Scorecard.

The scorecard evaluates factors such as mental health policies, organizational well-being strategies to address burnout, health equity measures, employee financial resources and more to provide a comprehensive assessment of an organization’s culture of health.

A total of 381 organizations completed the scorecard in 2022, and all organizations were recognized with an achievement level of platinum (9%), gold (45%), silver (32%), bronze (9%) or completer (5%).

Excellus BCBS’s employee wellbeing program, be WELL for LIFE, focuses on five areas: emotional support, mindfulness, nourishment, movement and connection. To meet personal health goals, employees are offered challenges, weekly and monthly classes, webinars, the wellbeing incentive program, and a variety of resources. The program is run by two full-time employees and facilitated through an employee wellness committee.

The American Heart Association, a global force for healthier lives for all, developed the Workforce Well-being Scorecard in collaboration with top scientists and industry experts to reflect the latest evidence-based science on workforce health and well-being.

“We are honored to be recognized by the American Heart Association for our commitment to employee health and wellbeing and our continued efforts to promote equity,” said Excellus BCBS President and CEO Jim Reed. “Our organization is dedicated to creating a culture that is safe, supportive, and provides opportunities for everyone to reach their full potential—in and out of the workplace.”

Personal Medicine of Rochester hires doctor

Patients looking for a personal relationship with their doctor now have a new choice. Personal Medicine of Rochester, a practice affiliated with Jewish Senior Life, has welcomed internal medicine physician Mitchell Ehrenberg.

His personalized primary care practice will offer an annual membership with convenient access to same day or next day appointments with the doctor and comprehensive personal wellness plans customized to each patient’s individual needs.

Personal Medicine of Rochester’s goal is to provide members of the greater Rochester community person-centered physician care, with a focus on wellness and prevention, according to the practice.

Ehrenberg started June 1 and brings more than 30 years of experience and a passion for personalized

care.

“The best part of my job is spending time with patients. I look forward to getting to know my patients, having unhurried discussions together, and devoting my time and energy to keeping them well,” said Ehrenberg.

He received his medical degree from New York University School of Medicine, completed his residency at the University of Rochester School of Medicine, and is board certified in internal medicine. The practice plans to add a second physician later this summer.

An annual out-of-pocket membership fee covers in-depth screenings and personal wellness plans, and can be reimbursed through a health savings account. Other benefits include personalized diagnostics, nutrition education seminars, and physical therapy screenings.

URMC honors faculty, staff members

The 14th annual Dr. David Satcher Community Health Improvement Awards, presented by the Center for Community Health & Prevention (CCHP) of the University of Rochester Medical Center (URMC), honored URMC faculty and staff for their contributions to advancing community health and health equity in the Rochester region. The keynote address was presented by the awards’ namesake David Satcher, an internationally recognized and renowned physician who is considered a champion in public health and health equity who began his medical career at URMC.

Receiving the award were:

• Senior Faculty Awardee — Physician Michael D. Mendoza, the ninth commissioner of public health for Monroe County and a professor in the department of family medicine.

Mendoza oversees the Monroe County Department of Public Health’s diverse array of health promotion and disease preparedness efforts serving the residents of Monroe County with a focus on equity and inclusion. Under his oversight of the MCDPH, vaccinating the underserved has been a high priority, mobile outreach services have expanded, a violence prevention program has been initiated, and individuals and families dealing with substance use disorder have gained access to a wider range of support services.

During the COVID-19 pandemic, he demonstrated outstanding leadership by decision-making that was informed equally by science and community input.

• Junior Faculty Awardees (joint): Andrew Cohen, Ph.D.; Allison Stiles, Ph.D.; and Corey Nichols-Hadeed, JD, are faculty in the departments of pediatrics and psychiatry, as well as co-directors for an initiative called “EACH Youth in the RCSD,” where “EACH” stands for “Enhanced Access & Connection to Healthcare.”

EACH seeks to address the health issues of children and youth, including their behavioral and mental health needs, by providing specialty training for school teams and promoting community service

collaboration. The project has partnered with 17 Rochester City School District (RCSD) schools, implemented telehealth services in nine schools, and reached nearly 10,000 students.

The awardees work closely with multiple community partners, including their primary partner – RCSD, as well as the Children's Institute, ROC the Future Alliance, and primary care practices.

• Staff Awardees (joint) —Registered nurses Wendy Hou and Christine Maness are assistant directors of pediatric nursing at Golisano Children’s Hospital.

During the pandemic, they coordinated an interdisciplinary team, called “Little Shots, Big Protection: A Team Providing COVID-19 Vaccine for Our Community’s Children,” that seamlessly navigated numerous logistic barriers to COVID-19 vaccination of the pediatric population. Their collaborative leadership style, adherence to the highest quality standards, organizational excellence, and responsiveness to community needs ensured equitable access to the pediatric vaccine and provided essential guidance and support to community pediatricians. A total of 2,730 pediatric vaccines were administered through 44 clinics.

Hou and Maness worked closely with their primary partner, MCDPH, and Common Ground Health.

Thompson bestows 2023 nurses’ week awards

UR Medicine Thompson Health

• Advance Practice Provider of Distinction: Halie Kemmling-Campbell, of Auburn.

• Provider of Distinction: physician Jillian Babu, of Canandaigua.

• Department of Distinction: Social Work

M.M. Ewing Continuing Care Center honorees included:

• Certified Nursing Assistant of the Year: Faith Searls of Canandaigua.

• Nurse of Distinction — Commitment: Susan Shively, of Canandaigua.

• Nurse of Distinction — Action: Melissa Frarey, of Canandaigua.

• Nurse of Distinction — Respect: Mary Hann, of Prattsburgh.

• Nurse of Distinction — Excellence: Samantha Tassone, of Phelps.

• Nurse of Distinction — Service: Wendy Lackey, of Canandaigua.

• Nurse of Distinction — Rising Star: Kaylee Hoppough, of Springwater.

• CNA of Distinction — Commitment: Judy Cepeda of Manchester.

• CNA of Distinction — Action: Sandra Martin of Farmington.

• CNA of Distinction — Respect: Jamie Colf of Canandaigua.

• CNA of Distinction — Excellence: Amber Lane of Manchester.

• CNA of Distinction — Service: Alishia Turner of Lyons.

• CNA of Distinction — Rising Star: Chastity Butler of Canandaigua.

Kesha Williams joins HCR Cares

HCR Cares has hired Kesha

Williams, a licensed practical nurse (LPN), as its diverse care project field coordinator.

Julia

held its Nurses’ Week 2023 Recognition and Awards Celebration on May 11, naming registered nurse Julia Schmeer its F.F. Thompson Hospital Nurse of the Year and registered nurse Stephanie Gallo its M.M. Ewing Continuing Care Center Nurse of the Year. Schmeer, of Canandaigua, works

on the hospital’s 3 West medical/ surgical unit and Gallo, of Naples, works on the skilled-transitional unit in the nursing home. Sponsored by Thompson’s Nursing Practice Council, the May 11 event included several other awards for nurses, advanced practice providers, technicians, and certified nursing assistants (CNAs) from both the hospital and the Continuing Care Center.

Hospital honorees included:

• Hospital Nurses of Distinction: Dedevie Booth of Honeoye; Tammy Howard of Canandaigua; Barbara Manning of Palmyra; Amy Martin of Rushville.

• Nurse of Distinction — Preceptor/Mentor: Brittany Burke, of Penn Yan.

• Nurse of Distinction — Rising Star: Victoria Verschage, of Geneva.

• Patient Care Technician of Distinction: Avery Temple of Farmington.

Kesha Williams

In this role, Williams will serve as the main point of contact with African American churches as part of HCR Cares’ diverse care project, which is designed to help African American residents over age 65 overcome barriers that have kept them from receiving home health care tailored to their individual needs. Williams will educate and inform church leaders about health disparities to share with their congregations.

With nearly 30 years of healthcare experience, Williams previously served as a nursing supervisor at St. Ann’s Community, as a community health nurse at Rochester Regional Health, as a clinical coordinator at St. John’s Home and as a pharmacy technician at Unity Health.

Kesha Williams earned a bachelor’s degree in healthcare administration from Robert Wesleyan College, an LPN from Isabella Graham Hart School of Practical Nursing and an associate degree in medical assisting from Bryant and Stratton College.

Funding for diverse care project was provided by Greater Rochester Health Foundation and from The Max and Marian Farash Charitable Foundation.

Schmeer

Stephanie Gallo

Part

Highland Hospital Honors Physician and Advanced Practice Provider of the Year

Highland Hospital has recently honored Dmitriy Migdalovich as physician of the year and Courtney Shores as advanced practice provider of the year.

• Dmitriy Migdalovich is a geriatric hospitalist in the Highland Hospital department of medicine. He also serves as assistant professor of clinical medicine, geriatric division, department of medicine at University of Rochester School of Medicine & Dentistry. He has been part of Highland since 2017 and he additionally provides supervision and teaching for internal medicine, medicine-pediatrics and orthopedic resident physicians rotating on the geriatric medicine service.

"I am grateful and humbled to receive the physician of year award,” said Migdalovich. “This award is a reflection of the wonderful people I have the privilege of working with every day at Highland Hospital. It is the kindness and collegiality of each member of our interdisciplinary team that allows us to provide our patients with the best care possible and makes

Highland Hospital such a special place."

Migdalovich received nominations from several colleagues. “Dr. Migdalovich is an extremely capable and compassionate physician,” said one colleague. “It is evident that he cares deeply about the well-being of his patients. He spends a great deal of time educating the patients and their families about their medical problems and treatment. He is the type of physician I would want to care for my family.”

• Courtney Shores serves as a physician assistant in the department of cardiology at Highland. She provides cardiovascular care in the emergency department, intensive care unit, inpatient units and outpatient clinic. She has worked at Highland since 2014 and has also served as part of the National Disaster Medical System for the U.S. Department of Health & Human Services assisting at hurricanes, earthquakes and on COVID-19 response.

“It is a great honor to be recognized,” said Shores. “The past few

years a have been quite challenging, especially in health care, and I am grateful for the camaraderie of my peers. It has always been an honor to serve and help others both here at Highland Hospital and globally.”

Shores was also nominated by several colleagues for the award.

“Courtney embodies the ICARE Values on a regular basis,” said one nominator. “Her patient care skills are excellent, and she is a role model for all staff. She is adored by patients and staff alike. She has gone out of her way to provide the highest level

of patient care. She is always willing to step up and provide support for Highland Hospital, wherever needed. During the early stages of COVID, as she had disaster experience, she volunteered to provide front line care to patients in the ED and tent. She is an example that all should strive for and provides the highest level patient care always.” Both professionals have been recognized during a reception in May and at a Highland board of directors meeting.

Do what you love. Even if it’s nothing at all.

As one of the most important people on earth, you should have nothing to worry about but choosing today’s activity, outing or dining option. Or just enjoying quiet time in beautifully maintained surroundings with 24-hour security.

St. Ann’s Community at Chapel Oaks has no entrance fee, only a low, monthly service fee for all your amenities. You also have complimentary transportation for appointments and activities, and access to higher levels of care if you ever need it.

Dmitriy Migdalovich

Courtney Shores