In Good Health: ROC #220 - December 2023

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DECEMBER 2023 • ISSUE 220

THE HOLIDAYS AND OUR Mental Health

PAGES 9-11

Meet Your Doctor BRENT SANDERSON, DO Orthopedic surgeon at URMC discusses sports medicine treatments that should be going mainstream in the next few years.

P. 4 ALSO INSIDE

U.S. INFANT MORTALITY RATE CLIMBS FOR FIRST TIME IN 20 YEARS P. 7

YOU’RE NOT ALONE:

1 IN 5 U.S. ADULTS NOW HAS ARTHRITIS P. 4

SAY HI TO MOXIE

Robots help move things around at Rochester General and Unity hospital P. 21

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Page 2 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

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December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 3

You’re Not Alone: 1 in 5 U.S. Adults Now Has Arthritis

A

rthritis is becoming a disease of the masses, striking 21% of U.S. adults, or over 53 million people, a new report shows.

“It's important first to point out that arthritis is a general term that includes over a hundred different chronic diseases that affect the joints and the tissues around those joints,” said researcher Elizabeth Fallon, an epidemiologist for the U.S. Centers for Disease Control and Prevention.

The finding was culled from an analysis of data from the National Health Interview Survey from 2019 to 2021.

How did the numbers break out? About 88% of all arthritis cases were adults aged 45 and up, while about 50% were working-age people ranging in age from 18 to 64.

Additional risk factors included being a woman, being a veteran or having another chronic disease or disability, Fallon said.

Although this analysis didn't look for trends over time, “it's already a large public health problem,” Fallon noted. “If it's growing, we need to know that so we can appropriately address it from a public health perspective."

Arthritis is a leading cause of activity limitations and disability, as well as chronic pain.

A common thread in the findings was that more than half of folks who had arthritis also had other health conditions. About 58% of people who have COPD have arthritis, as do 56% of those with dementia, 53% who have had a stroke and 52% with heart disease. About 55% of adults with a disability have arthritis.

“Arthritis can be a barrier to engaging in, for example, physical activity, that we know would be beneficial for managing arthritis, but also beneficial for managing those other chronic diseases,” Fallon explained.

“If a physician is working with the individual who has heart disease and is recommending physical activity, they should also be aware that that person is likely to have arthritis,” Fallon added.

“And if that's a barrier to their physical activity, [doctors should] ... help to connect them with community-based programs to help them address physical activity in a way that works for them.”

Steps to help prevent and manage arthritis can include maintaining a healthy weight, exercising regularly and avoiding joint injury, according to the CDC. Individuals with arthritis may find they can engage in a variety of different activities to get exercise, including walking, yoga, tai chi, swimming, water aerobics, gardening and dancing, Fallon said.

“There's a lot of opportunity for people to be physically active in a way that doesn't bring pain associated with it,” Fallon said.

The findings were published Oct. 13 in the CDC's Morbidity and Mortality Weekly Report.

Meet

Your Doctor

By Chris Motola

Brent Sanderson, DO

Orthopedic surgeon at URMC discusses sports medicine treatments that should be going mainstream in the next few years — including biologic augmentation to repair the ligament — and says football, hockey and soccer are the sports causing the most injuries among athletes Q: How are athletes generally injuring themselves these days? What are some of the stresses they're under that the average person may not be dealing with?

A: Athletes these days are mostly injuring themselves through two different mechanisms. One is a contact mechanism, such as a twisting injury or someone putting weight or force on them; like from a slide tackle in soccer or a hit in hockey. Or it there might not be any impact and they're trying to do a move or a cut and their knee or shoulder gives out. So those are probably the two most common ways, contact and non-contact.

Q: Which sports are the biggest offenders?

A: Right now football is probably the main sport I see patients getting injured with, but hockey and soccer are also up there. Lacrosse is becoming more common up here in the Northeast, so we see a lot of lacrosse players who get injured. A lot of weekend warriors are getting injured playing pickleball.

Q: What kinds of injuries are you seeing from pickleball?

A: Pickleball injuries are usually to the knee or the ankle. The most common of those would be an Achilles tendon tear or rupture, similar to that of the quarterbacks from the Vikings and Jets. So it's Achilles tendon injuries and meniscus injuries in the knee.

Q: How easily can athletes return to previous levels of performance after sustaining one of these injuries?

A: It depends on the injury per se. We tend to do conservative treatments with physical therapy and bracing. A lot of the strains, sprains or tendinitis can be treated conservatively that way with pretty good returns to play, about 90% return to play from those. Certain injuries like ACL tears and acute rotator cuff tears and even Achilles tendon

ruptures in our pickleball players need to have a surgical discussion.

Luckily, the majority of them can get back to sports within six to eight months after the injury is repaired and rehabilitated.

Q: Muscle seems like very durable tissue, but the stuff that's anchoring it less so. Why is it so much harder to heal ligaments and tendons?

A: The muscle is able to take a lot more force before it completely tears.

The tendon sees a lot more of that acute force, where there's a rupture rather a strain like there would be for the muscle. A muscle can be strained, the muscles fibers stretched, quite a lot before they rupture. The tendons tend to take the brunt of the injury.

Q: How much does unbalanced muscle strengthening, hypertrophy play into injuries?

A: Yeah, I see a lot of patients where physical therapy would do them a lot of good in helping them rebalance and bringing them back to a more dynamic control of that knee or shoulder or whatever joint they're having pain with. If we have muscle imbalances in our body, it puts more stress on our ligaments and tendons around that joint. I have patients come in all the time that I evaluate to help them get all their muscles balanced and working in fully functional condition.

Q: Do you apply osteopathic principles to sports medicine?

A: While I trained with MD physicians, being a DO [doctor of osteopathic medicine] can give you a little bit of a different perspective.

It's a more holistic approach that encourages looking at all the different factors, like nutrition or looking at joints above or below. Is the knee injury the result of an old ankle injury that was never rehabbed?

Or maybe the muscle is out of balance at the hip

Page 4 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

and we need to evaluate the hip as well. So I like to make sure we're not missing anything and getting tunnel vision. So we're not just treating the injury, we're trying to figure out why it happened and to prevent it from happening again in the future.

Q: Are there new developments in sports medicine that you're excited about?

A: There are a few things in the sports medicine world that should be going mainstream in the next few years. One is biologics. So using the patient's own stem cells or the cells that recruit those cells to promote healing, decrease inflammation and decrease pain. The first of these is platelet-rich plasma (PRP). It's been used in many different joints to help the healing of ligament injuries. The data is still out and there's still some controversy, but I expect more data will come out telling us which specific ailments we can use the PRP on to help patients. The next would be a bone marrow aspirate concentrate, which is a stem cell treatment made from your own bone marrow that we can inject to different sites to do the same kinds of things PRP does while really injecting some stem cells in there. Some controversial literature there too, but I look forward seeing more supporting literature come in in the next couple years. The next big advance is the bridge-advanced ACL repair, which uses a biologic augmentation to repair the ligament instead of replacing it with one from the patient's body or a cadaver. I expect it to become more mainstream going forward. And the last one is advancements in rotator cuff repair and augmentation. Rotator repair has come a long way in the last 10 to 20 years, but right now we're still striving to get better outcomes. Right now, about 80% of patients get back to everything in about six months after rotator cuff repair. But we still have 20% of patients who fail to heal or have a re-rupture. So right now we're looking at augmenting that rotator cuff repair with either cadaver tissue or other biologic augmentation like PRP. Q: Do you play sports?

A: Yes, I play hockey as much as my schedule will allow. Usually you'll find me golfing in the summer.

Q: How do you apply your sports medicine principles to your hobbies?

A: I try to make sure I stretch appropriately before and make sure I have the appropriate nutrition before and after. And then just making sure I'm not putting myself too much at risk and make sure I have everything in dynamic control.

Lifelines

Name: Brent Sanderson, DO Position: Clinical professor of orthopedics at University of Rochester Medical Center Hometown: Rochester. He does surgeries at Thompson Hospital and Highland Hospital, part of URMC Education: A.T. Still University Organizations: American Academy of Orthopedic Surgery, American Orthopedic Society for Sports Medicine, Arthroscopy Association of North America, American Osteopathic Association Family: Wife. 5-year old Australian shepherd Hobbies: Hockey, golf

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December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 5

Healthcare in a Minute

By George W. Chapman

The Big Squeeze: Physicians’ Fees Cut Again While Operating Costs Go Up

M

edicare is proposing to reduce physician payments in 2024 by 3.36%. That comes on the heels of a 2% reduction this year.

The American Medical Association (AMA) figures that, adjusted for inflation, it is tantamount to a 26% cut in reimbursement over the last 20 years. If you factor in the fact that staff and overhead expenses increase at about 3% a year, physicians are getting squeezed from both ends.

Medicare has offered alternative payment models to physicians which have basically made attaining their

fees more complicated, risky, expensive and frustrating. To use a hackneyed sports reference, the Centers for Medicare & Medicaid Services (CMS) keeps moving the goal post.

To make matters worse, commercial payers mimic Medicare when it comes to establishing their physician and hospital fees. It seems like CMS is trying to kill private practice. Over half of all practicing physicians are now employed by either a hospital, gigantic health system or a corporation like CVS or Walmart. That number will go much higher as most physicians finishing their residency

opt for employment versus the hassle of private practice. Ironically, CMS determined reimbursement rates for physicians and hospitals are becoming less relevant as more and more seniors opt for Medicare Advantage plans which are administered by commercial insurers like the Blues, United, Aetna and Cigna. Sooner than later, large health systems with several hospitals and thousands of physicians will sit across the negotiation table with Advantage plans to negotiate fees rather than having to lobby Congress.

RxPass

employers to drop health insurance altogether for their workers. That never happened. The Employee Benefit Research Institute found that between 2014 and 2022 workers eligible for health coverage increased 5 percent. As of 2022, for all employers in aggregate, 81% of private sector workers are eligible to be covered by their employer’s plan. Eligibility is 99% among workers in businesses with more than 1,000 employees.

It’s 97% for businesses with 100-999 workers; 80% for businesses with 25-99 workers and 25% for businesses with less than 10 employees. The ACA did away with denying coverage for pre-existing conditions and established basic coverage requirements for three levels of coverage: bronze, silver and platinum. Critics have tried to repeal the ACA more than 60 times.

authored a resolution to at least maintain neutrality, versus outright disdain, for a single payer system.

It was narrowly defeated 53 to 47.

But the shift in attitude is palpable.

Coincidentally, those numbers (53-47) reflected the 53% of docs in private practice versus the 47% of employed docs. Today, 2023, more docs (over 50%) are employed than in private practice. Times have changed. Commercial insurers are earning billions of dollars annually on both their commercial and Advantage plans, while physician fees are slashed. The hassles of private practice, corporatization of medicine and the desire for better life-work balance among younger docs are driving the AMA ever closer to outright endorsing some sort of single payer or Medicare for All plan.

AMA “Leaning Into” Single Payer

AI in Claims Processing

The old-fashioned proprietary drug store on the corner was replaced decades ago by corporate chain stores operated by Rite Aid, CVS, Walgreens, etc. Now, the corporate chain stores are being replaced.

Rite Aid recently filed for bankruptcy and pharmacists at CVS and Walgreens staged a three-day walk out over working conditions. To cut costs, the chains have understaffed their stores causing poor working conditions. Basically, brick and mortar drug stores are struggling. Who better to come to the “rescue” than Amazon, which has almost single handedly closed thousands of retail stores? Prime members will be issued their RxPass which guarantees twoday delivery in select cities so far: Austin, Seattle, Phoenix, Indianapolis and Miami. And it will someday be delivered via drone.

Impact of ACA When the Affordable Care Act became law in 2010, naysayers said the new minimum requirements for insurance coverage would cause

For almost a century, the American Medical Association was staunchly opposed to any kind of healthcare reform. Any. It lobbied to defeat reform efforts in the 1930s and 1940s. The AMA delayed Medicare for years and killed attempts by President Clinton (famously spearheaded

by Hillary) to overhaul our expensive and disjointed healthcare system.

But then….. it endorsed the ACA in 2009. In 2019, the proactive medical student section of AMA delegates

Providers are already experimenting with AI when it comes to electronic medical records and answering high volume inquiries from patients (ChatGPT).

Congress is now concerned with Medicare Advantage plans using artificial intelligence algorithms and tools to deny claims. (This could also be an issue with commercial plans.) Con-

Page 6 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

gress is concerned Advantage plans will deny more claims than traditional Medicare. Again, Advantage plans are operated by for-profit commercial carriers. A committee is recommending CMS compare Advantage plans to traditional Medicare when it comes to elapsed time between care and denial, the diagnosis, the reason for denial and whether an algorithm is corrected once a certain denial has been reversed in most cases.

Medical Debt While medical debt can no longer affect your credit score, a survey conducted by the Commonwealth Fund of 6,100 INSURED adults revealed medical debt is still a problem. 27% reported medical debt more than $500 and 15% reported debt more than $2,000. Besides causing anxiety, respondents said the debt causes them to postpone care or cut back on prescriptions. And 43% of those covered by employer coverage reported they are struggling with debt. 57% with individual plans reported they are struggling. Also 45% covered by Medicaid and 51% covered by Medicare said they were struggling with medical debt. One can only imagine what the average medical debt is for people without health insurance.

Life Expectancy The good news is that US life expectancy has risen, moderately, from 78.93 years in 2020 to 79.11 in 2023. The bad news is, despite spending more per capita than ALL developed countries, 40 of them have better life expectancy than the U.S. The leaders are Hong Kong 85.29, Japan 85.03, Macao 84.68, Switzerland 84.25, Singapore 84.07, Italy 84 and Spain at 83.99. Most of the 40 countries ahead of us have universal plans or in our vernacular, Medicare for All.

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.

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U.S. Infant Mortality Rate Climbs for First Time in 20 Years

ollowing nearly two decades of decline, U.S. infant death rates edged up by 3% in 2022, new provisional government numbers reveal.

“This was the first year we saw statistically significant increased rates of infant mortality in about 20 years,” said study author Danielle Ely, a statistician at the U.S. National Center for Health Statistics. Infant mortality measures how many babies die before they reach their first birthday.

The study wasn't designed to say why more babies are dying, but at least one expert suggested that the pandemic, which put a strain on the health care system, could have played a role.

“The U.S. was still in the throes of COVID in 2022, which had myriad and varied impacts across the U.S. and disparate impacts by race, ethnicity, maternal age and geographical region,” explained Deborah Campbell, a neonatologist at the Children's Hospital at Montefiore in New York City.

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For the study, researchers looked at birth certificates and infant death data collected through the U.S. National Vital Statistics System for 2021 and 2022. They found that the infant mortality rate in 2022 increased for moms aged 25-29. In addition, the rate also rose for preterm babies, male infants and infants born in Georgia, Iowa, Missouri and Texas.

Infant death rates climbed by more than 20%, from about 7.4 deaths per 1,000 births to more than 9 deaths per 1,000 births, for infants born to American Indian or Alaska Native women. Meanwhile, infant mortality rates for white women increased by about 3%.

Death rates for infants of Black women did not increase by that much, but Black infants still experienced the highest overall rates of infant mortality, Ely noted.

The findings were published in the November issue of Vital Statistics Rapid Release Reports.

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December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 7

Live Alone & Thrive By Gwenn Voelckers Practical tips, advice and hope for those who live alone

with positive energy. Say “yes” to invitations and show up for your happiness fix!

Or become the initiator. Identify a holiday concert or event you’d like to attend and invite family and friends to join you. Take on the role of “social secretary” and you’ll gradually feel your holidays, social life, and social circle becoming more active and interesting.

Say YES to creating a new holiday tradition

Be Happier This Holiday Season: Say ‘YES’ “Thank you so much for thinking of me. I would love to attend but have another commitment. So sorry.”

D

o you find yourself using this familiar refrain? When feeling overwhelmed with life after my divorce, my first line of defense was to say “no” to invitations and opportunities.

This was especially true during the holidays when I was alone and coping with all the decisions and choices and shopping and schlepping. Saying “no” was my way of keeping life simple and more manageable during a hectic, emotion-laden time. I thought it would make life easier and, therefore, happier.

But it didn’t.

Experience has taught me that there’s a downside to “no.” Declining invitations, deciding not to send holiday cards and discounting the value of holiday traditions and gatherings didn’t make me any happier. In fact, the opposite happened. By not showing up I felt empty and lonelier than ever.

One of the world’s longest studies on happiness (conducted by Harvard researchers) revealed that good, close relationships are what keep people happy and healthy throughout their lives.

Saying “no” keeps us apart.

Saying “yes” brings us together. And it’s the togetherness that contributes

to happiness. In the end, doing the things that nurture our relationships is what lifts our spirits.

Whether you celebrate Christmas, Hanukkah, Kwanzaa or the December solstice, the holidays can be a real challenge if you’re newly divorced or widowed. They were for me until I took the reindeer by the horns and decided to say a resounding “YES” to life during this festive time of year.

Consider the following:

Say YES to slowing down Better yet, stop what you’re doing altogether. Find a quiet moment to ask yourself what the holidays really mean to you. Rebirth? Hope?

Generosity and goodwill? Love and connection?

Revisit your most deeply held beliefs about the season and make a conscious decision to participate in the holiday rituals, traditions and activities that align with your values, views, and spiritual underpinnings.

Say YES to accepting and extending invitations It’s the most wonderful time of year to meet and greet old and new friends. This is a joyful time and people at holiday gatherings are typically in good moods and filled

LASIK

This is especially important if you are bemoaning the loss of irretrievable traditions of a “past life.”

Consider instituting your very own “signature” tradition of volunteering to help others. When you give of yourself, you reap two big rewards: First, you’ll develop connections with people who share your spirit of giving and second, you’ll nurture your soul.

I love serving as a gift-wrapping volunteer at my local book store. The tips go to a good cause and I get to chat with patrons about their purchases and delight in finding just the right book for a loved one. The entire experience warms my heart.

Say YES to random acts of kindness If volunteering doesn’t fit into your schedule, bake some holiday goodies for your family and friends.

Or leave a little something (maybe a pine-scented candle?) on a neighbor’s doorstep. When you are thinking about and doing for others, you “get outside” of yourself and feel less lonely – more a part of the world and of this season of giving.

Say YES to inviting people over It will give you an incentive to decorate, if you don’t feel motivated to deck the halls for yourself. No need to plan anything elaborate. Inviting a few friends over for brunch, to make wreaths or to watch a holiday special on TV can brighten your day (and theirs!).

Consider including children in your planning. For years, I hosted a cookie-decorating party for my friends and their kids. The children’s silliness, curiosity and wonder added a magical (and messy!) dimension to the holidays.

Say YES to sending out holiday cards Take this occasion to go “old

school” and send season’s greetings by snail mail. I love getting an unexpected card from a long-lost friend and I delight in tracking down and sending holiday wishes to those who might be surprised to hear from me.

Sure enough, good things happen when you reach out to others.

I encourage you to address a few envelopes this season.

Say YES to being realistic For those who live alone, some degree of loneliness can be considered normal during the holidays. It’s a good time to remember that feelings of loneliness aren’t terminal, nor are they a “state of being” reserved for single people.

Loneliness has very little to do with being alone. It has everything to do with your state of mind. Prayer, meditation, mindfulness and communing with nature can remind you of your intrinsic belonging to your inner self, to others, and to all of life. Embrace the felt experience of belonging to an all-encompassing universe.

Say YES to happiness Let go of the notion that you need to be married or in a romantic relationship to enjoy the holidays.

The potential for happiness is all around you. You’ll find it in the personal connections with family, friends, neighbors, colleagues, even people you meet in passing.

You have a choice. Choose to be with people rather than isolate.

Choose to deepen and strengthen your ties with loved ones. Choose to appreciate what you have rather than focus on what you’re missing.

Choose to say “yes” and be happier this holiday season!

Gwenn Voelckers is the founder and facilitator of Alone and Content empowerment workshops for women (now on hiatus) and the author of "Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own" To contact Voelckers or purchase her book, visit www.aloneandcontent.com

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bring or, to avoid duplicates, ask guests to let you know what they'll bring.

Holidays

Holiday time-and-energy savers

Survival Guide for a StressFree Holiday Season

By Kimberly Blaker

D

o you dread the hustle and bustle of another holiday season? Between shopping, wrapping, baking, holiday cards, parties, and many other obligations and tasks, surviving the season can be a feat, let alone finding the time to enjoy it with your family. This year, why not make a pact to eliminate stress by following these tips?

Early planning First, close your eyes and think back to the last couple of years and how hectic and stressful they felt.

What percentage of holiday activities and tasks would you need to eliminate to make the season truly enjoyable and relatively stress-free?

During this process, don't think about what you can't remove. Just determine the percentage of reduction you need to make.

Next, make a list of everything you need to do during the holiday season, to which parties you'll be invited, and how much money

you'll spend. Now cross off the least important, least necessary, and least popular events and tasks. Then review the list, and calculate how much time and expense you've shaved off.

If you haven't reached your predetermined reduction, go through your list again.

Once you've decided which parties you'll attend and the commitments you'll make, plan how you'll say 'no' to all the others, so you're not caught off guard.

Share in the preparation Enlist your family to help prepare for the holidays, and divvy up the tasks. Don't expect perfection from yourself or your family. Remember, you probably don't notice or mind the imperfections in others' holiday gatherings. They're just as unlikely to see any in yours.

Also, keep in mind the holiday season isn't the time to be head cook.

Plan potluck gatherings. Then, either suggest what each person should

Next Up: Post-Holiday Blues After weeks of build-up, it’s easy to feel let down

By Deborah Jeanne Sergeant

A

fter the busy holiday season, do you feel a little blue? A tad bummed? It’s a common phenomenon.

“There’s a natural process that involves grief and loss when some special time in our lives ends,” said Douglas Guiffrida, Ph.D. “It’s natural and healthy to feel grief when we say goodbye from loved ones — or move back from planning special things to our normal lives that seem boring or less connected to others.”

Guiffrida is a professor and director of the counseling program at and of the advanced certificate program in mind-body healing and wellness at the University of Rochester.

He encourages those encountering the post-holiday blues to “spend

a few moments to feel the pain and loss of the special event that ended.

Or that it didn’t live up to what you expected. It all requires grieving.”

He added that self-care includes “allowing space for our emotional wellbeing.”

Autumn Gallegos Greenwich, Ph.D. and licensed clinical psychologist and associate professor of psychiatry at URMC, views the post-holiday part of winter as a time to listen to the “what the blues are telling us” such as how much we enjoy connecting with others.

“Mindset is so important,” she said. “There’s so much going on during the holiday season. There’s lots of sensory input. During January through March, it’s quiet. Silence is really scary. People try to avoid it.

Save time in gift-wrapping by setting up a station in a spare room or the basement. Or stock a large box or basket with wrapping paper, ribbon, bows, tags, tape, scissors, and pens, so everything is stored in one place. Have extras of everything on hand.

Keep cleaning to a minimum during the holidays. Dismiss unused areas guests won't see or use, and clean only the obvious in rooms that will be seen. The barely-visible layer of dust on your baseboards is unlikely to be noticed with all the holiday decorations and festivities.

Make everyday meals quick and easy throughout the season.

Soups, sandwiches, fresh fruit and vegetables, cottage cheese, pre-cut veggies and dip, and other prepared or semi-prepared healthy foods will suffice for one month of the year.

Do your holiday shopping early in the day on weekdays while your energy is high and crowds are small.

Shop online or by catalog. If an item lacks details, search for a manufacturer's website to get the information you need.

Give gift cards. Hard-to-shop-for recipients will appreciate something practical. Gift cards to restaurants, department stores, sporting good outlets, and specialty shops, or for a massage, pedicure, or round of golf make great gifts.

Don't overdo the baking. Your guests will likely have had their fill of holiday treats long before your gathering arrives. As for the warm gesture of taking a plate of baked goodies to friends or neighbors, instead, show they're in your thoughts by visiting or calling them to wish them a happy holiday season.

Money saver Does your gift list grow each year? Decide with whom it's essen-

In our silence, we can really ‘hear’ ourselves and ask what we need.

What do I need to let go of? What am I thankful for? What am I celebrating? We can connect to who we really are.”

She also sees the post-holiday period as a time to “be cozy, drink warm drinks and have more warm foods” as in traditional Scandinavian culture.

“You spend time with other people having a hot drink. It gets to be its own season,” she said. “There’s also an idea of there’s no bad weather, but just the wrong clothes.”

Planning other things to look forward to can also help build happy anticipation. Perhaps it’s a time to see movies you’ve always wanted, start a new book series, engage in a new hobby or meet up with friends regularly. It’s also helpful to eat a healthful diet, get plenty of rest and exercise.

Of course, lasting “blues” may indicate a more serious mental health issue such as depression.

Paul Schwartzman licensed mental health counselor in private practice at Fairport Counseling Ser-

tial to exchange gifts. Then talk to extended family, friends, coworkers, and others about forgoing gift exchanges, putting a cap on the price, or doing a drawing instead. You'll likely learn many feel the same as you do.

Care for yourself Enjoy holiday treats in moderation. High fat and sugary foods and the lack of healthy meals can lead to tiredness and stress. Keep goodies stored in the freezer where they'll be less of a temptation. Have plenty of convenient, healthy snacks such as raw vegetables and nuts on hand.

Prepare low-fat meals that won't bog you down.

Pace yourself, and don't try to do everything in one day.

Finally, give yourself a break.

Get plenty of exercise such as a brisk walk in the fresh air, and set aside time for relaxation, like a long bubble bath.

Things to do for next year Start your shopping early. Create a new tradition with a friend or family member and set a monthly shopping date for the upcoming year. By making a scheduled commitment, you'll be more likely to follow through. Keep the early holiday shopping fun and choose a different town or shopping center for each trip, focusing on unique malls or trendy cities.

Also, get a label printing software program or app early in the year and enter all of the addresses on your holiday card list. When the holidays roll around, you can print the labels and eliminate the most time-consuming aspect of sending out holiday greetings.

Finally, remember the holiday season should be a joyful time for everyone, including yourself, to join in the good cheer with family and friends. Maximize ways to ease your stress to keep the 'happy' in your holidays!

vices, said that the main differences between depression and the blues is typically longevity and consistency.

“Was there a history of being depressed before the holiday for some time?” he said. “If this is something that came along acutely after a major event, it’s not unusual. It’s typical for a big event like a wedding. The majority of people, it doesn’t last more than a week or two. If it persists more than two weeks and becomes disruptive to their quality of life; that may be depression.”

People may experience profound sadness, withdrawal, isolation, changes of eating habits and sleep, loss of joy in things previously enjoyed, loss of interest in things previously enjoyed and possibly suicide ideation. Schwartzman said that people with depression typically present with several of those symptoms for more than two weeks.

Talking about these symptoms with a primary care provider or mental health professional can help.

Anyone having thoughts of self-harm or harming others should call 911, 988 or seek emergency room care.

December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 9

Holidays

Give Healthful Memberships These gifts keep on giving all year

By Deborah Jeanne Sergeant

Y

ou can support the good health of the health buffs on your list with a yearlong membership.

These kinds of gifts will definitely get used — unlike yet another tchotchke or sweater — and “you can help a friend or loved one reach their wellness goals,” said Kerri Howell, certified personal trainer and owner of The Hourglass Mom in the Rochester area.

Howell suggested membership with a meal kit service. These companies deliver the prepared, measured elements to make a meal, but the recipient does the mixing and cooking. In addition to saving time, meal prep packages also help people learn

how to cook for themselves, which can aid in weight loss and improving produce intake. Most meal kit companies include options such as Mediterranean, keto, vegetarian, lowfat or other health-conscious meals to accommodate any preferred eating plan.

Howell also suggested subscribing to Instacart or other grocery delivery service.

“Think outside the box; this can help make their food shopping even easier,” she said.

Selecting a variety of produce items for regular delivery can especially help busy families or older adults who struggle to do weekly

grocery shopping for perishable items. It also keeps fresh produce in the kitchen: a big plus for people who want to eat right.

Fitness subscriptions can also help people who want to stay healthy. Of course, Jean Sica, tai chi and mindful movement instructor in Rochester, suggested membership in a tai chi center.

“When people think of health memberships, they tend to think of gyms or fitness centers, but I would suggest being more creative in one's thinking when it comes to healthful memberships,” she said. “But I also believe that these practices, such as tai chi, yoga, qigong, and lian gong with their slow-moving, stretching-type health practices are as vital as cardio and strength training and complement them.”

These practices have been linked with stress reduction and tend to be gentle on the joints. Many fitness minded people like trying new activities and a gift certificate for a class may be just the motivation to branch

out. Consider lessons for boxing, dancing or martial arts.

Sica also recommended “membership to one of these new stretching labs cropping up around town.”

StretchLab (www.stretchlab. com) provides assisted stretching to clients. Even some people who are physically active do not stretch as much as they should to stay limber and to excel at their fitness endeavors, activities or sports. Stretching is also said to help improve range of motion and reduce pain for some participants.

Good health also relies upon rest and relaxation, but most people take little time for self-care.

“How about getting someone a gift certificate good for several visits to a massage therapist or maybe several acupressure or acupuncture visits?” Sica suggested. “For the adventurous, how about several visits to a float tank center?”

These modalities can help induce a sense of deep relaxation.

Diane M. DellaValle, Ph.D. and registered dietitian in Geneva

Maureen Ballatori, founder and CEO of Agency 29

English walnuts. Consider securing the fruit in place with cellophane if you need to transport it and top with a large bow.

Give local goods, “like New York state apples, maple syrup, cheese and honey,” Strassman said. “You could also give a gift certificate to farmers’ markets, public markets or CSA subscription.”

Meal preparation delivery helps people save time on fixing meals.

Give a similar type of gift by creating a Mason jar meal, such as layering dried beans, dried pasta and spices and tying a recipe card to the jar with ribbon. https://masonjarrecipe. com/34-mason-jar-dry-soup-mixesrecipes offers numerous healthful mixes.

Dark chocolate has long been touted for its antioxidant properties. Give dark chocolates that have at least 70% cacao. For a DIY dark chocolate gift, create healthful dark chocolate bark by pouring a layer of melted chocolate over broken nuts arranged on waxed paper. Allow the chocolate to harden in the refrigerator before breaking into pieces and packaging.

Create chocolate raspberries by washing raspberries to completely dry. Gently place a dark chocolate chip inside the berry with the flat

side at the bottom and arrange on a glass tray.

Coffee and tea are also rich in antioxidants. Find a few “fancy” flavors to nestle in a basket with mugs, a tea towel and flavoring agents like honey.

Diane M. DellaValle, Ph.D. and registered dietitian in Geneva, said that many people lack iron. She likes to give the Lucky Iron Fish, available on Amazon.com.

After simmering for 10 minutes, the Lucky Iron Fish releases sufficient supplemental iron.

Maureen Ballatori, founder and CEO of Agency 29 in Rochester and Geneva, promotes companies in the food, beverage and agriculture sectors. She encourages considering “locally made consumer packaged goods and bundle those together in a basket. The holidays are a great time to support local businesses. Locally made wine, beer and distilled spirits are also great, but save those for closer friends. You never know when someone may have a sensitivity to alcohol.

“Locally made chocolate is always a great gift if you’re looking for something simple. Tie a nice ribbon around the package to make a bigger impact.”dd

Healthful Food Gifts

Have a foodie on your list? Treat ‘em right

By Deborah Jeanne Sergeant

I

f you want to give a food gift this holiday season, skip the sugary baked goods and candy and give food gifts that are both decadent and healthful.

Elissa S. Strassman, registered dietitian in private practice in Rochester, said that although “no foods are bad foods,” givers can present foods that promote good health. “Give different oils and vinegars and spice mixes,” she said. “It makes it easy for people to make food delicious.

It’s different and unique and helps foods taste good.” She noted roasted vegetables, salads and dips are all enhanced by these flavor boosters.

Many people enjoy nut mixes or

spiced nuts. They’re also good for your health.

“They bring fiber, protein and healthy fats,” Strassman said.

Packaging nuts in glass jars adorned with ribbon bows adds a festive touch. Strassman is also a fan of fruit baskets. “Include a mixture,” she added. “I recommend a variety of fruits in a variety of colors. Mixing it up gives diversity in our eating style.

When package nicely, the presentation counts. It’s everything.”

Lay a tea towel or other padding in the basket to cushion the fruit and arrange the fruit so it piles above the rim of the basket. Tuck in a few small items among the pieces of fruit, like

Page 10 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

Holidays

Mindfulness Helpful for Depression and Anxiety

Mindfulness offers another tool to improve mental health

By Deborah Jeanne Sergeant

A

ccording to the National Alliance on Mental Illness, 42.5 million adults in the US have anxiety and 21 million have depression, including more than six million aged 12 to 17 who have major to severe depression. In addition to other treatments and practices, mindfulness may offer one means of helping those afflicted with anxiety and depression.

Autumn Gallegos Greenwich, PhD., licensed clinical psychologist and associate professor of psychiatry at URMC, has led several mindfulness-base stress reduction programs with the Center for Community Health and Prevention.

“With depression, you might ruminate on the past,” Greenwich said.

“Anxiety is about anticipating what may happen in the future. It’s only in the present that we can learn, change something or grow. Mindfulness is about staying present. We train the mind as to how to pay attention in a particular way.”

This begins with paying attention to the body, beginning with breathing. Slowing breathing helps support the parasympathetic nervous system and calm the “fight or flight” response. People are better able to sensibly respond rather than react.

Mindfulness “teaches to stay present with mundane activities like washing dishes and brushing your teeth,” Greenwich said. “It’s staying close to your life and not going back into the past. The practice of attention with the senses and then we move into awareness. What is the

story I’m telling myself? That allows us to move into the possibility of acceptance and allow things to be what they are. It doesn’t mean we like it.

We say, ‘It is what it is.’”

The results are impressive. Many people in physical pain anecdotally report reduced physical pain through practicing mindfulness, as they are capable of accepting and moving through pain.

“Numerous clinical studies that have shown the benefits of mindfulness in all realms of life,” said Jean Sica, who leads tai chi and is a Mindful Movement instructor in Rochester. “For instance, the American Psychological Association has asserted that ‘mindfulness can help people avoid destructive or automatic habits and responses by learning to observe their thoughts, emotions and other present-moment experiences without judging or reacting to them,’" she said. “We can find similar information in documents from the National Institutes of Health, Harvard Med School and more. Study after study can be found about it.”

Slowing down is a key aspect of mindfulness and paying attention to sensory input: the feel of woolen mittens, the sound of snow squeaking under boots, the feel of snowflakes on the face and bite of cold in the air.

It’s much easier to scurry through the weather on the way to the next errand while ruminating over the embarrassing incident at work yesterday.

“We all tend to be on automatic pilot, so getting yourself used to not

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being on auto pilot is mindful,” Sica said.

Kerri Howell, certified personal trainer and owner of The Hourglass Mom in Rochester coaches women on how to achieve better balance in life. She acknowledges the difficulty in creating space for mindfulness but encourages women to “incorporate time to be alone with your thoughts.”

One way to do this “is to align it with your spiritual life. Prayer is a form of mindfulness. If you struggle with committing to the time or get easily distracted, consider an app, such as Hallow or Calm, to help guide you. Peloton also has a mindfulness category. With an app, you can choose when to do it and for how long, plus you can explore different types of techniques.”

Sabrina Vogler, certified in professional executive coaching, life coaching and grief specialist, is also a certified teacher of mindfulness and owner of Heart in the Moment Mindfulness Coaching in Rochester, finds that mindfulness helps participants gain more perspective.

“Mindfulness lets us take a step back and get clear about what we’re most anxious about,” she said. “It gives us intel on the unmet need.

Once we have that intel, we’re motivated to support ourselves to meet

that need, whether within ourselves or whether we employ mindfulness tools for self-calming or outside to address relationships with people or resources we could access. That can be real game-changers for meeting that unmet need.”

It can be easy to over think an anticipated conversation coming up, for example. But mindfulness can help people better understand what is really bothering them.

“Once we feel more grounded and calmer, we adopt the perspective of a kind outside observer,” Vogler said. “We say, ‘What am I noticing about the emotions here? The thoughts here? Am I ‘time traveling’ and if so, how can I get clear on the unmet need?”

She calls emotional distress about the past or future “time traveling” because the brain “doesn’t know how to tell time” about stressful events.

“Whether we’re feeling depressed or anxious, there’s always the perception of a threat at hand, which makes us more stressed,” Vogler said. “Mindfulness helps us take a step back, rebalance the body chemistry and then look at ourselves through the perspective of a good friend which motivates us to meet ourselves in exactly the place we need to.”

Are you looking for emotional support from people who will work to understand how your experiences and behaviors make sense rather than diagnose you with a mental illness?

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December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 11

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Helpful Tips

The skinny on healthy eating

Why You Should Try Almond Flour

mericans purchase and consume more flour during December than any other month, according to the research elves at Fleischmann’s Yeast and Karo Syrup.

No surprise there! Who doesn’t love to give as well as receive homebaked cookies, cakes, breads and pies during the holidays?

I love to bake — and this year I’m shaking things up by baking with almond flour, a gluten-free flour with enough health benefits to give Santa pause. While I won’t use it for all recipes—the lightness of the real deal is hard to replicate—I’ll use it for many.

Made from blanched almonds that are ground and sifted into a fine flour, almond flour has an astonishing array of valuable nutrients.

One-fourth cup of almond flour (the amount typically found in one baked good) contains around 7 grams of protein, 3 grams of fiber, and 70 mg of calcium—all of which join hands to keep us strong, regular and full of energy.

Almond flour teems with vitamin E, a powerhouse nutrient that acts as an antioxidant, neutralizing harmful free radicals that accelerate

aging and increase your risk of heart disease and cancer. Several studies, in fact, have linked higher levels of vitamin E intakes to lower rates of heart disease and Alzheimer’s.

Consuming flour made of almonds also boosts levels of magnesium, an important nutrient that may help lower blood pressure and control blood sugar. Foods made with refined wheat flour—which are high in carbs but low in magnesium and fiber—may cause spikes in blood sugar followed by rapid drops. Some studies estimate that between 25-38% of people with Type 2 diabetes have a magnesium deficiency.

Although almond flour is slightly higher in calories and fat than wheat flour, its fat is mostly monounsaturated fat—the beneficial fat that helps protect your heart by maintaining levels of “good” HDL cholesterol while reducing levels of “bad” LDL cholesterol.

Another tempting reason to reach for this nutritious flour: Almond flour is both wheat- and gluten-free, making it a great alternative for those who can’t tolerate wheat or gluten.

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CHOCOLATE CHIP COOKIES WITH ALMOND FLOUR Adapted from simplyhomecooked.com | About 24-30 cookies ¾ cup butter, softened ¾ cup brown sugar 1½ teaspoons vanilla extract ¼ teaspoon almond extract (optional) 1 large egg and 1 large egg yolk

3 cups almond flour ½ teaspoon baking soda ½ teaspoon salt 1¼ cups semisweet chocolate chips ¾ cup chopped nuts: pecans, walnuts, or almonds

1. Preheat oven to 350F line two large baking sheets with parchment paper.

2. In a large mixing bowl, beat ¾ cup softened butter with ¾ cup brown sugar at medium speed for 3 minutes.

3. Add both extracts (if using almond, too), egg and egg yolk, and then mix on medium-high speed until well blended.

4. In a separate bowl, whisk together almond flour, baking soda, and salt. For a cookie with a finer texture, sift the dry ingredients right into the mixing bowl and mix at a slow speed until well blended.

Otherwise, slowly add the dry ingredients to the mixing bowl and blend well at a slow speed.

5. Fold in chips and nuts (if using).

6. Drop by large, rounded tablespoons onto prepared sheets and bake for 10 to 12 minutes or until golden brown. Cool on baking sheets for 2 minutes; remove to wire racks to cool completely.

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Note: For a more festive cookie, replace dark chocolate chips with white chips and chopped nuts with dried cranberries.

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For lighter, less-grainy baked goods, look for almond flour that says “super fine or finely sifted,” like Bob’s Red Mill Super Fine Almond Flour or Blue Diamond Finely Sifted Almond Flour. Many recipes recommend additional sifting for an even fluffier result.

In most cases, almond flour can replace wheat flour in a l:1 ratio.

Almond flour should be stored in a fridge, freezer or cool pantry to keep from going bad.

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Page 12 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

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Sitting: The ‘New Smoking’ Excessive sitting contributes to a host of health issues

By Deborah Jeanne Sergeant

Y

ou may not have a pack-a-day tobacco habit. But too much sitting can also cause and exacerbate numerous health issues.

James Levine, physician and a professor of medicine at the Mayo Clinic, developed the concept that “sitting is the new smoking,” referring to excessive time in a seated position, whether driving, working or watching a screen.

Of course, working out for an hour three times a week is good for you. But the medical journal Circulation states that it’s not effective in undoing hours of sitting. It’s about sitting less and breaking up sitting sessions, not about working out longer.

“Those of us who sit at our desk all day without moving periodically or stretching are at risk for muscle imbalances that can cause chronic pain and even affect movement,” said Kerri Howell, certified personal trainer, nutrition coach and owner of The Hourglass Mom in the Rochester area.

Those who hunch over a desk

to work can have more rounded posture, which can cause shoulder and neck pain. Howell also said that sitting can cause “tight hip flexors, the muscles at the top front of your thigh, which in turn can cause low back pain. It's never a good idea to move in one way or stay stationary.”

She encourages people to get up for a few minutes to move and stretch every 30 minutes. Setting an alarm reminder may help.

“For those who are experiencing neck or shoulder pain, bring a resistance band to work and do some band pull-apart movements to strengthen your upper back and stretch your chest muscles, which can get tight,” Howell said. “Be mindful of your posture, too.”

Jean Sica, certified tai chi instructor, certified personal trainer and owner of Kokoro Fitness in Rochester, said that too much sitting can lead to “weight gain, depression, diabetes and weakening of those muscles in our body that help us stand and walk.”

“Too much sitting often leads to

problems with our backs, weakening of our abdominal muscles and sciatica, just to name a few,” she added.

In addition to 150 minutes of aerobic exercise weekly, she also recommends one or two sessions of strength training, plus stretching, including dynamic stretches that are in motion and static stretches when the stretch is held.

“Qigong and tai chi are two examples of dynamic stretches,” she said. “Most yoga stretches are static.

Stretching keeps the muscles strong and lubricates the joints. After a workout, static stretching helps the muscles begin to relax and heal. This ultimately improves performance for your next workout. Dynamic stretching is a good way to warm up your muscles and also to do before bed to help you relax.”

She added that stretching at any point of the day is also a good idea for people whose work is sedentary.

Austyn Affronti, certified personal trainer at Affronti Fitness in Rochester, recommends taking brisk, 10-minute walks at each work break.

“That’s 30 minutes of cardio that activates your metabolism after you’re eating and it helps with absorption of nutrients,” he said.

People who work from home may be able to get in more movement by walking during phone calls or performing bodyweight exercises while on hold.

Parking farther away from the entrance and taking the stairs instead of the elevator can add a bit more

movement into the workday.

“I had a client who is a nurse who used the elevator all the time,” said Tom Renner, master’s in physical education and owner of Flex Training Center in Rochester. “Once she started using the stairs, she lost 20 pounds.”

Although walking while on breaks may not always be advisable in bad weather, Renner said that walking the hallways can also get more steps into the day.

Keeping hand weights or resistance bands at your workstation can also help you get in a few sets of exercises during the day, “as long as what you’re doing is within your capacity,” Renner added.

Consider using a standing desk some of the time and if possible, varying your workday so you can stand for a period each hour.

Ask your primary care provider before beginning an exercise regimen.

Remedies to Excessive Sitting According to the Mayo Clinic: • Five minutes of standing activities (walking the dog, folding laundry or taking out the trash) for every hour of sitting is sufficient to combat sedentary behavior.

• Set alarms on your phone to remind you to stand up and move every hour.

• Walk around while talking on your phone.

• Stand up during television ads and walk around the room.

• A short walk (10 minutes) after each meal reduces the risk of Type 2 diabetes.

• Take the stairs when that is an option.

• One simple lifestyle change: reducing the time you spend sitting is the key to a dramatic difference to your physical and mental health. You have the key.

Make a Difference: Brighten Spirits by Becoming a DePaul Holiday Helper

W

ith the holiday season steadily approaching, DePaul, a nonprofit health and human service agency based in Gates, is seeking the community’s support for its annual holiday helpers program.

Individuals, businesses, schools and service and faith-based organizations can “adopt” clients from DePaul’s mental health residential programs who may not have family support during this meaningful time of year.

Participants can select from items on a wish list or choose to donate generic gifts such as gift cards, personal hygiene and cleaning products. Past

client wishes have included items as simple as a piece of chocolate cake, boots or basic articles of clothing.

If you are interested in adopting actual gifts from an individual’s holiday wish list, arrangements can be made to ship adopted wishes from online retailers directly to DePaul.

If you wish to purchase gifts and personally deliver them, specific appointment times will be available for in-person drop-offs. Donations of gift cards and financial contributions can also be made instead of purchasing gifts.

For over 20 years, generous members of the community have made the season special for those less

fortunate by taking part in DePaul’s holiday helpers program.

DePaul serves some 5,000 people annually in programs that encompass mental health residential and support services, senior living residential services, residential and support services for Veterans addiction prevention and support programs, vocational programs and affordable housing.

For more information about the holiday helpers program, contact

Amy Cavalier via email at acavalier@ depaul.org or by calling 585-4268000, ext. 3102.

Learn more about DePaul by visiting www.depaul. org. Tax-deductible financial contributions can be made by check and mailed to “DePaul Holiday Helpers Program,” 1931 Buffalo Road, Rochester, NY 14624, or made online on DePaul’s website at www.depaul.org/donate/ holiday-helpers-program.

December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 13

Meet Your Provider Club Pilates A High Intensity, Low Impact Exercise for Every Body Interview with Chelsey Vice, lead instructor at Club Pilates Q: What is Pilates? How is it different?

Q: When will I see results from my Pilates classes? What results will I see?

A: Reformer Pilates is a form of strength training. It’s a low impact, high intensity workout that focuses on building a strong core. It will challenge muscles you didn’t even know you had. Pilates will help to enhance your muscular control and improve balanced muscular strength. The reformer has tension springs which add different levels of resistance to your workout. You will mainly lie on the reformer, but you may also sit, kneel, and stand on it depending on the class.

A: Results like improved focus, reduced stress and improved mental overall well-being are immediate.

Depending on how often you practice, you could see a stronger core in three to six weeks. Pilates classes are full body workouts.

You will experience toning in your abdominals, back, hips, glutes, legs and arms. Overall mind body awareness is the real treat. It feels so good!

Q: Do I need to be flexible to do Pilates?

Q: I already workout, what is the benefit of adding Pilates to my regimen?

A: No, absolutely not. You do need to start moving to increase your flexibility though. Pilates is a unique movement that combines strength exercises, mobility exercises and deep stretches to give you a wellrounded fitness routine.

A: Pilates emphasizes both mobility and stability allowing you to achieve optimal performance. In addition, due to its therapeutic nature you can realign, build coordination and prevent injuries.

Q: Can I try it first?

A: Yes! At Club Pilates, we offer a free 30-minute intro class. You will get acclimated with the reformer and other equipment that is used. Don’t forget a water bottle and grippy socks!—both can be purchased at the studio!

Q: What are some tips for my first Pilates class?

A: Arrive a few minutes early so you can find a machine, meet your instructor and relax before you start.

Mindset is everything, come in ready to focus. Most of your classes will focus on precise, intentional, slow movements. Big dramatic movements aren’t necessary, try small and targeted movements instead.

Q: What are the benefits of private Pilates lessons?

A: One on one sessions will help you perfect your form! You and

Reformer Pilates is a form of strength training. The reformer has tension springs which add different levels of resistance to your workout.

your instructor will work to build mental and physical endurance to get the most out of your practice.

Every body is different — learn what feels best. In a private session, your instructor can focus on movement that is most effective and safe for you.

Brighton | 585-361-8520 | www.clubpilates.com/Brightonrochester Perinton | 585-598-7737 | www.clubpilates.com/Canaltown

Page 14 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

Q: Can you tell us of one of FLPPS’s goals?

A: We successfully implemented a maternal child health program where we paired pregnant moms early on with community health workers to make sure that they are getting those prenatal visits in, and so we can lower the rates of low birth weights. We also improved health outcomes.

Q: What are FLPPS’s current aims?

A: The [DSRIP] program ended in 2020. What we have done since then is continue that work. Now, it’s really about community and clinical integration, really connecting the healthcare sector with the social care sector for services like transportation, housing, nutrition, innovative community-based programming.

Addressing those things that impact people’s lives that are not specifically clinical or health care; but rather the things that are going on in your life.

Q A

Q: Could you give the readers an example of what FLPPS is trying to do?

A: For pregnant moms, to make sure they’re eating healthy food; that they’re getting their regular checkups. [It] is really trying to address what’s called the social determinants of health, especially in the more vulnerable population — that’s the Medicaid population. That’s the next evolution of health care.

&

with

Carol Tegas

Executive director of the Finger Lakes Performing Provider System discusses the agency’s mission and how it’s working with local providers to train new home health aides

By Mike Costanza

S

ince 2014, the Finger Lakes Performing Provider System has striven to improve the healthcare delivery systems that serve a 13-county region of Upstate New York.

The Rochester-based nonprofit partners with health and human service providers throughout the region in order to accomplish that goal, including health care systems, behavioral health providers, federally qualified health centers and community-based organizations. It has just 38 employees and a budget of about $25 million.

In Good Health spoke to Carol Tegas, the executive director of the Finger Lakes Performing Provider

System, about the nonprofit’s goals, accomplishments and challenges.

Q: What is the Finger Lakes Performing Provider System?

A: We were started in 2014 for the express purpose of implementing the New York State Delivery System Reform Incentive Payment Program.

The original purpose of the organization was to implement that program over the five years for the purpose of transforming the Medicaid health care delivery system. The very, very high-level goal was to reduce avoidable hospitalizations. We improved clinical outcomes and achieved 99% of all project milestones.

CALENDAR of

HEALTH EVENTS

Music and hearing loss featured at HLAA program The December program at Hearing Loss Association of America – Rochester Chapter will feature “Music and Hearing Loss by Dr. Ron D’Angelo.”

D’Angelo is an audiologist at Clear Choice Hearing and Balance of Rochester. He is also a professional musician who has performed with Paul Simon, Aretha Franklin, Josh Groban, Chuck Mangione, Frank Sinatra, Jr., and other national and regional acts.

Q: Has FLPPS tackled other important issues?

A: The struggles that the health systems, the hospitals have had with a complete backlog of patients in emergency rooms and not being able to move people thorough the system.

There are hundreds of people who are waiting to be discharged, but the skilled nursing facilities can’t take them to that next level of care that’s more appropriate, like for rehab or for nursing home care. The skilled nursing facilities lose so much money in the Medicaid reimbursement they don’t have the workforce and they’ve actually had to close beds. They need workforce, they need the physical beds, they need better payments for all the overhead.

Q: How has FLPPS helped the health care systems deal with that problem?

A: We created a program called the Transformational Community Care Coordination Program using ARPA [American Rescue Plan Act] dollars from Monroe County. There were two pieces to the program.

The Complex Care Program was designed to partner with the health care system and with skilled nursing facilities and help with providing

His presentation will take place from noon to 1 p.m., Dec. 5, at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester.

It will also be available on Zoom. To obtain Zoom link, preregister at the chapter web site hearinglossrochester.org.

The Dec. 5 program will also feature the following: • From 10-11 a.m: HOPE - Hearing Other People’s Experiences. Prospective, new or experienced hearing aid users informally share their experiences, questions, and hearing loss journeys.

• 11-11:30 a.m.: Socializing, in person. Refreshments. St. Paul’s

resources to the skilled nursing facilities so that they could open up beds, have workforce, have the proper equipment so that they could take in what we call difficult-to-place patients. In partner with these skilled nursing facilities and the health systems, we created new workflows, we worked with them to redesign processes, we added funding, and we collected data. We were very successful in moving 545 patients out of the hospital over the course of less than a year.

The second piece of it is the Long-Term Care Workforce Program.

That is focusing on providing tuition assistance, wraparound services for people who are going through certified nursing assistant, licensed practical nurse, registered nurse training so that they can come out and have a career pathway.

Q: FLPPS is also collaborating with HCR Home Care, Rochester Regional Health Home Care and UR Medicine Home Care on a training program for home health aides. Can you tell us about that program?

A: One of the greatest barriers to increasing the healthcare workforce is that people need to work while they’re going to school. That is a real difficulty for a lot of people, especially in that kind of lower socioeconomic kind of band. We partnered with home health aide agencies, with other community-based organizations, wherever we could find a cohort of people who might be interested in getting trained to be a home health aide. The program helps them secure a job and provide the training at the same time that they’re working. From a short-term perspective, you’re trying to relieve that backlog.

From a long term-perspective you’re really enhancing and improving the workforce in our community, in our city and in our county. The program is financed by ARPA funds from the city of Rochester and funds from the ESL Charitable Foundation.

Q: Has the collaboration been successful so far?

A: We have 75 individuals who have already been hired, trained and are certified as home health aides, and we have 24 who are in training.

We’re going through a recruitment campaign now.

Q: What challenges does FLPPS face right now?

A: Workforce on behalf of our partners. If we can start to address the workforce challenges in our healthcare arena, then we can start to really focus on what’s important, which is improving care.

Parish Hall.

• 11:30 a.m.-noon: business meeting and announcements.

HLAA will also present programs on Dec. 21 and 26.

Hearing Loss Association of America – Rochester Chapter is a volunteer, charitable nonprofit organization with the mission of enhancing the world of communication to people with hearing loss by providing support, education, and advocacy.

For more information, view the organization website at hearinglossrochester.org or telephone 585 266 7890.

December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 15

Oral Care

TEETH WHITENING

P

eople want whiter teeth, surveys show, and the American Dental Association (ADA) has some advice on how to accomplish that.

Over time, teeth can become less white due to a number of causes, including food and drink, tobacco use, age, trauma and medications.

According to the American Academy of Cosmetic Dentistry, when people were asked what they most wanted to improve about their smile, the most common response was whiter teeth. Meanwhile, about 90% of patients told the American Association of Orthodontists that they also

wanted tooth whitening.

Coffee, tea and red wine can all stain teeth because of intense color pigments called chromogens that attach to the enamel on the tooth's exterior, the ADA said in a news release. Two chemicals found in tobacco — tar and nicotine — also stain. Tar is naturally dark. Nicotine is colorless, but then turns yellowish when mixed with oxygen.

Below a tooth's hard, white outer shell is dentin, which is softer. The enamel gets thinner with brushing and the dentin can show through as you age. A tooth can also change color because it's been injured and

creates a thicker layer of dentin.

Certain antihistamines, antipsychotics and high blood pressure medications can also darken teeth.

Children who were exposed to antibiotics like tetracycline and doxycycline in utero or as a baby may have discoloration of their teeth as an adult. Chemotherapy and head and neck radiation can also darken teeth, according to the ADA. Teeth can be whitened using products that contain hydrogen peroxide or carbamide peroxide. The bleaches break the stains into smaller pieces, which affects how the color looks.

Unfortunately, this doesn't work on all teeth. Yellow teeth may bleach well, but those that are brown or gray may not respond as well or at all. Whitening will not work on caps, veneers, crowns or fillings. It also won't work on injured teeth or those changed by medications, according to the ADA. For those who seek whiter teeth, your dentist can explain your options.

All toothpastes help remove surface stains. Choose a whitening toothpaste that has earned the ADA Seal of Acceptance for stain removal. These have additional polishing agents. Unlike bleaches, these products do not change tooth color because they only remove surface stains.

In-office bleaching requires only one office visit. The dentist uses a protective gel or rubber shield to protect your gums, then applies bleach to the teeth.

You can also get an at-home, custom-made tray from your dentist and bleach your own teeth. You can then whiten your teeth at a slower pace, but still with the guidance of a dentist. This can take a few days to weeks.

Over-the-counter bleaching products can be purchased online or in retail stores. They may include strips or toothpastes that bleach teeth. These have a lower concentration of bleach than products the dentist uses.

It's possible that tooth whitening will cause sensitivity. The peroxide may irritate your tooth nerves. In most cases, this is temporary, but delay treatment if it happens.

Overuse of whiteners can damage the tooth enamel or gums, the ADA added, so don't overdo it.

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Page 16 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

Oral Care

Routine Dental Care Vital to Oral Health It’s about more than keeping teeth clean

By Deborah Jeanne Sergeant

I

f your philosophy about dental health is “If it ain’t broken, don’t fix it,” you may want to rethink your outlook.

Dentist Wayne Lipschitz compares routine dental exams and cleanings akin to mammography and colonoscopy in that “you often have pathology that’s asymptomatic,” he said. “If you catch it early, you can treat it with conservative treatment versus root canals, crowns or implants.”

Lipschitz is a professor of clinical dentistry and director of both the University Dental Faculty Group and the Specialty Care Clinic at Eastman Institute for Oral Health.

Since cavities may not present with pain — especially when small — oral exams help keep teeth healthier than waiting for pain to exhibit.

Establishing a good relationship with a dentist through regular visits can help in cases when something urgent occurs.

“Sadly, a lot of patients end up in the ER with dental problems,” Lipschitz said. “It’s a strain on our healthcare system. When you go to the ER with a dental problem, it’s hours of waiting and more oral surgery-related whereas if you have your routine checks, you can be treated in a much more comfortable setting.”

If dental infections go unchecked, it can affect other areas of the body and not just the mouth. Lipschitz said that they can cause problems in the cardiac system, lungs and affect

the ability to fight infections for people with compromised immune systems. The American Academy for Oral and Systemic Health states that “emerging science links oral health and systemic disease. Oral infections have been studied to have drastic and life-altering effects on systemic diseases including hypertension, adverse pregnancies, diabetes, Alzheimer's disease, arthritis and more.”

Lipschitz added that good oral health and healthy aging correlate.

In addition to looking for cavities, dentists and hygienists also look for other direct problems in the hard and soft tissues of the mouth, such as the gums, tongue, cheeks and palates.

“Oral cancers are 3% to 4% of all cancers,” Lipschitz said. “About 50,000 people every year will be diagnosed with oral cancer. About 10,000 of those will die and about 50% will survive five years.”

The cancers caught early have a good prognosis. Oftentimes, the dentist or hygienist notices something is amiss in these cases and refers the patient to seek further care with a medical provider.

Arlene Messer, dentist at Contemporary Dentistry Rochester, said that looking for “lumps and bumps can indicate infection and other conditions like thyroid problems and swollen lymph nodes or tumors. We also do a temporomandibular joint check for any abnormalities like if there’s any pain at the joint or bite alignment.”

Problems in the jaw can cause premature wear on the joint and further problems with the teeth.

Dental hygienists clean teeth in ways that even good home care can’t.

“The hygienist uses instruments to remove biofilm between the teeth and along the gumline,” Messer said.

“We use a device that’s like a little sandblaster that helps remove stain and biofilm. And other devices that go along the gumline to remove biofilm and its bacteria. Also, it removes the tartar, the hard stuff that’s on and between the teeth.”

Tartar build-up is important because it causes inflammation, which can go systemic.

Messer also said that people who have dry mouth are more cavity-prone and should especially make sure they see their dentist on the schedule recommended. Saliva provides a protective factor that keeps teeth healthy.

“As soon as I see adults whose salivary glands aren’t working well or they take medications that cause dry mouth, we start to see an uptick in cavities,” Messer said. “It’s an important thing we check.”

Dental care extends to whole patient care in some ways, as dental health can indicate other things going on with a patient.

“Usually, if we’re having a problem with dental health we have a problem with general health,” said Oliver Cabrera, dentist at Greece Family Dentistry and Implantology.

He added that his office provides a holistic approach with patient counseling about smoking, drug abuse, and nutrition as these affect dental health and by extension, overall health. Some patients do not regularly see a primary care provider, but do make it to the dentist.

“We look at other things like cosmetics if there are enhancements they’d like, such as straighter teeth and whiter smiles,” Cabrera said.

Oliver Cabrera, dentist at Greece Family Dentistry and Implantology: “Usually, if we’re having a problem with dental health we have a problem with general health,” he says.

Wayne Lipschitz

Arlene Messer

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December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 17

Health Career

A Multifaceted Career, Podiatrists Care for the Lower Extremities

The median annual income for a podiatrist in the Rochester area is $111,720.

By Deborah Jeanne Sergeant If you want to pursue a medical career and enjoy hands-on patient care and a variety of delivery methods and possibilities of care venues, podiatry could be for you.

Podiatrists complete a four-year undergraduate degree, followed by four years of podiatry school and then a three- to four-year residency.

After completing these, the licensed provider is able to practice.

Lawrence E. LaRussa, doctor of podiatric medicine with Finger Lakes Podiatry in Geneva, became interested in podiatry after receiving podiatry care for his flat feet.

“I had insoles that made a major change in my ability to walk and stand without pain,” he said. “That let me down the pathway.”

He likes that he has “the ability to create a lot of immediate satisfaction in situations where we say,

‘Limp in, leap out.’ There are a lot of things I can do that can help someone with significant pain feel better.”

Podiatrists work in private practice, as part of a hospital system, for orthopedic practices and sometimes in settings such as long-term care facilities. They work with all ages, not only older adults.

The types of problems podiatrists address include creating orthotics, treating wounds, providing patient education about health habits that affect the feet and lower legs, administering injections, treating pain and addressing problems with surgery.

“We care for a lot more problems than just nails,” LaRussa said. “We look at how the mechanics of the foot cause problems in your foot, which is why the internet doesn’t often identify foot problems.”

A big part of his work is patient

education about things like footwear (he’s not a big fan of Crocs and other “squishy” footwear), remaining active and seeking prompt treatment.

“A problem you have for a month might get better by itself, but in two months or more, it is not going to get better without help,” LaRussa said.

For the past 34 years, James Broderick, podiatrist and owner of Broderick Podiatry in Canandaigua, has provided care. He plans to retire in December.

“I’ve really enjoyed my practice; it’s been a wonderful career,” he said.

“The most fulfilling thing is that it’s one of the few areas of medicine that people come in in pain and oftentimes leave feeling better.”

In addition to his private practice, he also works for Thompson Health as an on-call surgeon and provides podiatry services for nursing homes in the area.

The New York State Board for Podiatry requires 50 hours of continuing education every three years to maintain licensure. Broderick said that some hospitals and other organizations have their own requirements for continuing education.

The outlook for podiatrists looks good. The aging Baby Boomer generation will continue to need more healthcare, including podiatry. The obesity epidemic also contributes to the demand for podiatry, as carrying excess weight negatively affects the health of the lower extremities and

D E PAUL Page 18 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

Lawrence E. LaRussa is a doctor of podiatric medicine with Finger Lakes Podiatry in Geneva. “We care for a lot more problems than just nails,” he says. increases the risk forType 2 diabetes.

The Bureau of Labor Statistics predicts that the demand for podiatrists in New York will grow by 12% between 2020 and 2030. The median annual income for a podiatrist in the Rochester area is $111,720.

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What types of programs are available to help seniors struggling with their everyday bills, and how do I go about finding them? Since I lost my husband last year, my Social Security survivor benefit is barely enough to get by on.

Evergreen Place Senior Living Community

Searching Senior

Dear Searching, I’m very sorry for your loss, but you’ll be happy to know that there are dozens of different financial assistance programs and government benefits that may be able to help you with your everyday costs.

To locate these types of programs, your best resource is Benefits CheckUp.org.

This is a free, confidential online screening tool designed for older adults and people with disabilities. It will help you find federal, state and local benefits programs that can assist with paying for food, utilities, health care, medications, housing and many other needs. This site — created by the National Council on Aging in 2001 — contains nearly 2,000 programs across the country.

To identify benefits, you’ll first need to type in your ZIP code and choose the types of benefits you’re interested in. Then you’ll need to answer a few questions regarding your personal and financial situation.

Once completed, you’ll get a list of programs to choose from, followed by a personalized report that explains each program, and tells you where you can get help or how to apply.

If you need some assistance or you don’t have internet access, you can always speak with a benefits support specialist by calling 800-7946559. You can also get help in-person at any of the 85 benefit enrollment centers located across 41 states. See NCOA.org/article/meet-our-benefits-enrollment-centers to search for a center in your area.

Types of Benefits Depending on your income level, location and circumstance, here are a few of the many different benefits you may be eligible for: • Nutrition assistance: Programs like the Supplemental Nutrition Assistance Program (SNAP) can help pay for food at the grocery store. The average SNAP benefit for 60-and-older households is around $105 per month. Some other nutrition programs that are available to seniors include the Senior Farmers Market Nutrition Program and the Commodity Supplemental Food Program.

• Utility assistance: There’s the Low-Income Home Energy Assistance Program (LIHEAP) that provides assistance in lowering home heating and cooling costs. And for broadband assistance, the Affordable Connectivity Program provides a $30 monthly subsidy that can be applied toward your home internet costs.

• Health care and medicine: Medicare Savings Programs and Medicaid can help or completely pay for seniors’ out-of-pocket health care costs.

And for assistance with medications, there’s a low-income subsidy program called ‘Extra Help’ that helps pay premiums, deductibles, and co-payments on Medicare (Part D) prescription drug coverage. You can also search for prescription drug help through patient assistance programs or your state pharmaceutical assistance program at Medicare.gov.

• Supplemental Security Income (SSI): Administered by the Social Security Administration, SSI (see ssa. gov/ssi) provides monthly payments to very low-income seniors, age 65 and older, as well as to those who are blind and disabled. In 2023, SSI pays up to $914 per month for a single person and up to $1,371 for couples.

In addition to these benefits, there are dozens of other programs BenefitsCheckUp can help you identify, like housing assistance, property tax reduction, home weatherization assistance, tax relief, veteran’s benefits, senior transportation, caregiving support, free legal assistance, disability services, job training and more.

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

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December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 19

Ask St. Ann’s By Chef Todd Klugh

The Social Ask Security Office From the Social Security District Office

Social Security Benefits Increase In 2024

M Holiday Meals Can Be Healthy for Seniors and Still Be Delicious

A

h, the holiday meal! We look forward to it all year long as our traditional favorites make their annual appearance, much to our delight.

And here’s a secret: You don’t have to give up healthy eating to enjoy your holiday favorites.

With some minor alterations in the kitchen, those classic dishes can be healthful as well as delicious.

That’s especially important for seniors with dietary restriction due to diabetes, high blood pressure and other chronic conditions.

The rich foods that Grandma used to make have a place in our hearts, but they also had a place on our waistlines and in our arteries!

But take it from me: it’s possible to reduce the fat and calories without sacrificing flavor.

Try these substitutions in your holiday recipes: • Instead of heavy cream, use 2% milk.

• Instead of flour for thickening, use a cornstarch slurry (cornstarch mixed with water or milk).

• When using sour cream, mix some fat-free in with the regular.

• To reduce fat, use vegan butter instead of regular.

• Brine your turkey with dry white wine instead of salt; the acidity will have the same effect, keeping your turkey tender and juicy, but with lower sodium.

In many cases, such as with sour cream, you’re using the ingredient for texture, not taste. The healthier ingredient gets the job done without affecting the flavor.

The same holds true for gluten-free ingredients.

Many people, including seniors, can’t eat gluten, a protein found in wheat, rye and barley. That’s the case for many residents of Chapel Oaks, so we use gluten-free alternatives, specifically, rice or corn flour instead of wheat flour. Again, it serves the same purpose in the recipe (binding, structure, elasticity) but without the

gluten and it doesn’t affect the flavor.

(Since I began preparing gluten-free meals for my mother, the rest of my family has been eating gluten-free without knowing it.) Gluten-free breads and pizza dough — perfect for pies — are also now widely available.

Remember: Using healthier ingredients doesn’t mean sacrificing taste. That means you can serve all your guests a healthier meal that tastes great and meets the needs of those who are diet-restricted. (No need to make a second “healthy” meal on top of the main one, meaning less stress for the chef.)

Bonus Advice: Chef Todd’s Kitchen Hacks • Let your turkey rest for as many hours as you cook it. This will keep the juices in so they won’t be lost when you cut into the bird. Cover it with aluminum foil to retain the heat while resting, then serve with hot gravy.

• Cook your stuffing outside of the turkey (technically making it “dressing”) and stuff the bird with apples, oranges, celery, onions, and fresh herbs. This will enhance the flavor of the meat and your dressing will taste just as good.

• Use a combination of baking apples (20 oz.) and sweet eating apples (such as Crispin) for no-sugar-added apple pie.

Todd Klugh is executive chef, St. Ann’s Community at Chapel Oaks. He can be reached at tklugh@ mystanns.com. Visit St. Ann’s Facebook page for some of Chef Todd’s most popular seasonal recipes.

ore than 71 million Americans will see a 3.2% increase in their Social Security benefits and Supplemental Security Income (SSI) payments in 2024. On average, Social Security retirement benefits will increase by more than $50 per month starting in January.

Federal benefit rates increase when the cost-of-living rises, as measured by the Department of Labor’s Consumer Price Index (CPI-W). The CPI-W rises when inflation increases, leading to a higher cost-of-living.

This change means prices for goods and services, on average, are higher. The cost-of-living adjustment (COLA) helps to offset these costs.

We will mail COLA notices throughout the month of December to retirement, survivors and disability beneficiaries, SSI recipients and representative payees. But if you want to know your new benefit amount sooner, you can securely obtain your Social Security COLA notice online using the Message Center in your personal My Social Security account at www.ssa.gov/myaccount.

You can access this information in early December, prior to receiving the mailed notice. Benefit amounts will not be available before December. Since you will receive the COLA notice online or in the mail, you don’t need to contact us to get your new benefit amount.

If you prefer to access your COLA notice online and not receive

Q&A Q.: Do members of Congress have to pay into Social Security?

A.: Yes, they do. Members of Congress, the president and vice president, federal judges, and most political appointees, have paid taxes into the Social Security program since January 1984. They pay into the system just like everyone else, no matter how long they have been in office. Learn more about Social Security benefits at www.ssa.gov.

Q.: I’m trying to figure out how much I need to save for my retirement. Does the government offer any help with financial education?

A.: Yes. For starters, you may want to find out what you can expect from Social Security with a visit to Social Security’s Retirement Estimator at www.ssa.gov/estimator. The Financial Literacy and Education Commission has a website that can help you with the basics of financial education: www.mymoney.gov.

Finally, you’ll want to check out

Page 20 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • December 2023

the mailed notice, you can log in to your personal my Social Security account at www.ssa.gov/myaccount to opt out by changing your preferences in the Message Center. You can update your preferences to opt out of the mailed COLA notice, and any other notices that are available online. Did you know you can receive a text or email alert when there is a new message waiting for you? That way, you always know when we have something important for you — like your COLA notice.

“Social Security and SSI benefits will increase in 2024, and this will help millions of people keep up with expenses,” said Kilolo Kijakazi, acting commissioner of Social Security.

January 2024 marks when other changes will happen based on the increase in the national average wage index. For example, the maximum amount of earnings subject to Social Security payroll tax in 2024 will be higher. The retirement earnings test exempt amount will also change in 2024. Learn more at www.ssa. gov/news/press/factsheets/colafacts2024.pdf.

Be among the first to know! Sign up for or log in to your personal my Social Security account today at www.ssa.gov/myaccount. Choose email or text under “Message Center Preferences” to receive courtesy notifications.

You can find more information about the 2024 COLA at www.ssa. gov/cola.

the Consumer Financial Protection Bureau, which offers educational information on a number of financial matters, including mortgages, credit cards, retirement, and other big decisions. Visit the Consumer Financial Protection Bureau at www.consumerfinance.gov.

Q.: I worked for the last 10 years and I now have my 40 credits. Does this mean that I get the maximum Social Security retirement benefit?

A.: Probably not. The 40 credits are the minimum number you need to qualify for retirement benefits.

However, we do not base your benefit amount on those credits; it's based on your earnings over a lifetime of work. To learn more about how you earn Social Security credits and how they work, read or listen to our publication How You Earn Credits, available at www.ssa.gov/pubs.

An employee at Rochester General Hopital places a package or other item inside one of the Moxi’s drawers, which then locks. The robot then travels to the appropriate location, where another hospital staff uses his, her or their badge to open the drawer and take the item out.

Casey Wilbert, the senior director of acute care pharmacy services for Rochester Regional Health.

Moxi Is on the Job Robots help move things around at Rochester General and Unity hospital

By Mike Costanza

E

ight robot messengers called Moxis roll around two Rochester Regional Health hospitals, transporting essential supplies and other goods from unit to unit.

“We’re using Moxi to help move medications, to help move labs [laboratory specimens], patient belongings,” said Casey Wilbert, the senior director of acute care pharmacy services for Rochester Regional Health.

“We’ll eventually move to food and nutrition services.”

And the robot does its job with heart—sort of. Moxi waves a greeting with its lone arm whenever it encounters someone on its travels, and

its blue “eyes” turn into pink hearts.

Moxi is the creation of Diligent Robotics, an Austin, Texas, firm that is developing robot assistants that perform routine tasks, freeing health care workers for patient care. Rochester Regional Health (RRH) began using the machines earlier this year to ease the strain on the employees of Rochester General Hospital (RGH) and Unity Hospital.

“Our health care workforce is stretched with the tasks that they have to do,” Wilbert said. “What we need to do to take care of patients is make sure that our team members are back closer to the patient, and

Moxi waves a greeting with its lone arm whenever it encounters someone on its travels, and its blue “eyes” turn into pink hearts.

closer to the bedside.”

Moxi travels around on wheels and has three lockable drawers—a large drawer in the front and two smaller ones in the rear. It uses its arm to open automatic doors and those activated by push plates or employee’s badges.

“It has a built-in employee badge just like any of our team members would have,” Wilbert said. “If we have a door which is badge-access-only, it is still able to get in there.”

In a nutshell, here’s how Moxi does its job. An employee places a package inside one of the robot’s drawers and tells the machine where to take the item. The drawer locks, and Moxi autonomously heads to that location. There, another hospital employee uses his, her or their badge to open the drawer and take the item out. Wilbert said RRH is the first New York state health care provider to employ Moxis in acute care hospitals.

Transporting an item from one hospital unit to another might seem

like a simple task, but the Moxis had to be prepared to do it. When the first machines were delivered in early August, Diligent employees began training their electronic brains to learn how to navigate corridors, open doors and steer clear of objects in the two hospitals in which they’re stationed.

Four Moxis became operational at Unity Hospital on Oct. 12, and the rest were on-the-job at RGH on Oct. 19. Though they can now perform most of the tasks for which they were acquired, the machines are still learning how to do part of their job.

“Elevators are the most complex part of the training,” Wilbert said.

“Diligent Robotics team members meet the robot at the elevator, assist them on, ride the elevator and assist them off.”

Wilbert said RRH’s Moxis should be fully autonomous by April, and that the health care system is exploring the possibility of using the robots at its Potsdam, New York affiliate, Canton-Potsdam Hospital.

December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 21

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Health News Golisano Restorative Neurology & Rehab gets award for excellence Rochester Regional Health (RRH) recently announced that the Golisano Restorative Neurology & Rehabilitation Center at Unity Hospital has been awarded one of the health care industry’s highest honors, a Gold Level Beacon Award for Excellence from the American Association of Critical-Care Nurses (AACN).

“Our Golisano Restorative Neurology & Rehabilitation Center is an exceptional resource for patients in the Greater Rochester region and beyond,” said Richard “Chip” Davis, Ph.D., CEO of Rochester Regional Health. “No other rehabilitation facility in New York, and very few in the country, offers such a broad range of expert services for children, adolescents, and adults. We’re proud that the AACN has spotlighted our quality with its highest-level award.”

The AACN Beacon Award for Excellence recognizes healthcare units devoted to exceptional patient care and healthy work environments.

Established in 1989, the Golisano Restorative Neurology & Rehabilitation Center provides a complete range of services for patients with neurological, orthopedic and complex medical conditions ranging from traumatic brain injury to stroke, spinal-cord injury, heart failure, neuromuscular disease and neurological disease. For over 20 years, the center has been accredited by the Commission on the Accreditation of Rehabilitation Facilities (CARF) for comprehensive integrated inpatient rehabilitation, brain injury and stroke.

Within weeks of receiving the news about the Beacon Award, Unity Hospital also learned that its New York state-certified primary stroke center was recertified with flying colors—no deficiencies noted—by the DNV accreditation agency.

“Both the Golisano Restorative Neurology & Rehabilitation Center and the Stroke Center at Unity Hospital provide an extraordinary continuum of care—from rapid diagnosis and treatment in the emergency department all the way through outpatient rehabilitation,” CEO Davis said.

Doctor joins bariatric surgery team at Highland Hospital Physician Maria Durdach has joined Highland Hospital as assistant professor in the department of surgery and will focus on bariatric and gastrointestinal surgeries. She will also perform general surgery.

Durdach recently finished Maria Durdach a fellowship in bariatric surgery at the University at Buffalo Jacobs School of Medicine and Biomedical

Sciences. Before her fellowship, she completed her residency in general surgery at the University of Rochester Medical Center in 2022. She was the recipient of both the resident of year award and the chief resident teaching award for the 2021-2022 academic year.

Durdach earned her Doctor of Medicine from Pennsylvania State College of Medicine. She is especially interested in performing robotic bariatric procedures.

Hensley joins Thompson’s advanced surgical services UR Medicine Thompson Health’s advanced surgical services department recently welcomed its newest general surgeon, Bradley Hensley.

Hensley received his medical degree from the University of Rochester School of Medicine and Bradley Hensley Dentistry, where he also completed his residency and received a master’s degree in public health. He holds a master’s in business administration from the University of Rochester’s Simon Business School and a bachelor’s in economics from Amherst College in Amherst, Massachusetts. Most recently, he worked as a general surgeon with Rochester Regional Health.

A member of the University of Rochester Medical faculty group, Hensley joins four other surgeons and two nurse practitioners in advanced surgical services at Thompson.

He specializes in advanced minimally invasive surgery, colon and small bowel surgery, general abdominal surgery, breast surgery, skin cancer and soft tissue infections, endocrine surgery, upper and lower endoscopy.

Thompson is designated by the Surgical Review Corporation as a Center of Excellence for Hernia Surgery, Robotic Surgery, and Minimally Invasive Surgery.

Rochester General first to use Aquablation therapy Rochester General Hospital (RGH) is the first hospital in the region to offer Aquablation therapy, a minimally invasive treatment for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH), or enlarged prostate.

One in two men aged 51 to 60 have BPH, and the incidence increases every decade of life. RGH completed the first Aquablation therapy procedures at the hospital [in September].

“Rochester Regional is proud to be among the first in the Finger Lakes, Western and Central New York to offer a solution for men with BPH that provides significant, long-lasting symptom relief with lower risk of sexual dysfunction or incontinence,” said physician Louis Eichel, division chief of urology at Rochester General Hospital. “Aquablation therapy is the next step to furthering our commitment to robotic surgery and men’s health. This new tool is the latest move by Rochester Regional to step up our game as we modernize and transform health care.”

Aquablation therapy uses the AquaBeam Robotic System, the first FDA-cleared, surgical robot utilizing automated tissue resection for the treatment of LUTS due to BPH. Using precise imaging, surgeons create a personalized treatment plan tailored to each patient’s anatomy. Once the map is complete, the robotically controlled, heat-free waterjet ablates the prostate tissue, avoiding critical structures to preserve sexual function and continence.

The procedure is performed while the patient is under anesthesia in an operating room, and typically takes about 45 minutes — almost half as long as traditional surgical options.

Gravino named director of Thompson’s senior communities UR Medicine Thompson Health recently named a new executive director for its independent and assisted living communities of Ferris Hills at West Lake and Clark Meadows.

Meghan Gravino assumed her new role at the senior comMeghan Gravino munities on Oct. 23.

A resident of Williamson in Wayne County, Gravino is a graduate of SUNY Brockport who earned her master’s degree in social work via a collaborative program offered jointly by Brockport and Nazareth University. She is currently pursuing an advanced certificate in long-term care through D’Youville University in Buffalo, with anticipated completion in March of 2024.

Gravino first joined Thompson nearly seven years ago, as a medical social worker in its M.M. Ewing Continuing Care Center. Last year, she became the facility’s assistant administrator. “Meghan is knowledgeable, compassionate, and skilled at making connections. We know she will continue to shine in her new role,” said Thompson Health President and CEO Michael F. Stapleton, Jr. Ferris Hills has 84 independent living apartments. Clark Meadows has 48 assisted living apartments and is in the planning stages of a new memory care unit. Aimee Ward, the executive director for the past 10 years, is retiring and will marked her last day on Nov. 3.

“Ferris Hills and Clark Meadows both have longstanding reputations for excellence, and we are extremely fortunate to be able to ensure a smooth transition from one outstanding leader to the next,” Stapleton said.

Excellus BCBS Awards Upstate NY Hospitals $28 Million Nine hospitals in the region share $16.6 million in awards Thirty-one Upstate New York hospitals and health centers earned a combined $28 million in quality improvement payments from Excellus BlueCross BlueShield last year as part of the nonprofit health insurer’s Hospital Performance Incentive Program.

Since 2005, Excellus BCBS has paid out more than $400 million in quality improvement incentives.

“It’s part of our mission to ensure that all in our communities have equitable access to high quality health care,” said Melissa Gardner, executive vice president, chief population health engagement officer at Excellus BCBS. “The foundation for achieving that is a collaborative relationship with

our local hospital and physician partners.”

Nine hospitals in the Rochester region participated in this program in 2022, sharing $16.6 million in quality improvement incentive payments. Participating hospitals were Clifton Springs Hospital & Clinic, Highland Hospital, Newark-Wayne Community Hospital, Noyes Memorial Hospital, Rochester General Hospital, Strong Memorial Hospital, Thompson Health, United Memorial Medical Center and Unity Hospital.

“In 2022, Excellus BCBS’s Hospital Performance Incentive Program evaluated participating hospitals on projects that are in alignment with and responsive to

the ever-changing health care environment,” says physician Lisa Y. Harris, senior vice president and chief medical officer at Excellus BCBS. Participating hospitals and health centers met goals in the following areas: clinical processes of care, patient safety and patient satisfaction In addition to meeting required clinical and patient safety measures in 2022, other nationally endorsed measures and target outcomes were jointly agreed upon by each hospital and the health insurer using benchmarks established by the Centers for Medicare & Medicaid Services, the Institute for Healthcare Improvement, and others.

December 2023 • IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • Page 23

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