In Good Health: ROC #229 - September 2024

THE SHOCK OF SUICIDE

John and Judy Messenger remember the day in 2012 when they heard a knock on the door of their Pittsford home. When they opened it, two policemen told them that James, their 30-year-old son, had taken his own life. Almost 12 years later, they still wonder why he left them that way.

September is Suicide Prevention month. See stories starting on page 10.

HOUSE CALLS

Mitchell Ehrenberg, a longtime Rochester doctor, now devoted to seeing patients at their homes, through Personal Medicine of Rochester. Page 4

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Why Are Cancer Rates Rising Among Gen X, Millennials?

Cancer rates are rising among Gen Xers and millennials, a new study reports.

Successively younger generations are more frequently being diagnosed with half of the 34 known cancer types, researchers found.

For example, people born in 1990 have two to three times higher rates of pancreatic, kidney and small intestinal cancer than people born in 1955, results show.

Generation X is the demographic cohort following the baby boomers and preceding millennials.

“These findings add to growing evidence of increased cancer risk in post-baby boomer generations, expanding on previous findings of early-onset colorectal cancer and a few obesity-associated cancers to encompass a broader range of cancer types,” said lead researcher Hyuna Sung, a senior principal scientist of surveillance and health equity science at the American Cancer Society.

For the study, researchers analyzed cancer data from 23.6 million patients diagnosed between 2000 and 2019. The analysis also included data on 7.3 million patients who died of cancer.

Researchers broke the data down into five-year birth intervals from 1920 to 1990, and analyzed how cancer risk changed between birth cohorts.

Incidence rates increased with each successive birth cohort since

Build Social Connection. Prevent Loneliness.

We may not think of loneliness as posing serious health risks, but if feelings of loneliness are not addressed, they can significantly impact our health. There are ways to help prevent loneliness and the resulting health impacts. If you’re feeling lonely, consider the following:

• Seek support: Reach out to friends, family or a therapist. Support groups can also foster a sense of community and understanding.

• Volunteer: Helping others can boost self-esteem and foster meaningful relationships.

• Take up a hobby: Engage in activities that bring you joy. Join a club or group with shared interests to meet new people and build relationships.

• Practice self-care: Maintain a healthy diet, get enough sleep, exercise regularly, and practice mindfulness and self-compassion.

• Try something new: Step outside your comfort zone. It can be intimidating but can also lead to new connections and relationships.

1920 for 17 of 34 cancers, researchers found.

Other cancers that have increased in younger generations include liver, breast, uterine, colorectal, gastric, gallbladder, ovarian, testicular and anal cancers, as well as Kaposi sarcoma, results show.

“The increase in cancer rates among this younger group of people indicate generational shifts in cancer risk and often serve as an early indicator of future cancer burden in the country,” said senior researcher and physician Ahmedin Jemal, senior vice president of surveillance and health equity science at the American Cancer Society.

Cancer death rates increased in successively younger generations for liver, uterine, gallbladder, testicular and colorectal cancer, results show.

Unfortunately, Sung said there's no clear explanation for why these rates are rising among younger generations.

“The data highlights the critical need to identify and address underlying risk factors in Gen X and millennial populations to inform prevention strategies,” Jemal said.

The results, published July 31 in the Lancet public health journal, also highlight the need for comprehensive health care among middle-aged and younger Americans, said Lisa Lacasse, president of the American Cancer Society Cancer Action Network (ACS CAN).

A different approach to primary care medicine.

Convenient access. Personalized attention.

Personal Medicine of Rochester’s physicians are dedicated to serving patients with a high standard of care and all the attention you deserve.

Benefits you can count on for an affordable membership fee

• See a physician at each visit and never feel rushed.

• Same day or next day appointments.

• Urgent need after hours? Contact your doctor directly.

• Comprehensive annual health screenings that surpass standard checkups.

• Personalized wellness plan with the resources you need to achieve your goals.

Now accepting new patients, age 18+ for a limited time.

James Budd, M.D.

Mitchell Ehrenberg, M.D.

Moving Day Rochester Raises Funds, Awareness for Parkinson’s Disease

The Parkinson’s Foundation will host Moving Day Rochester Sept. 28 at Monroe Community College Lot G, 1000 E. Henrietta Road in Rochester

Over 300 people are expected to take part in movement demonstrations and walk to beat Parkinson’s.

The family-friendly, in-person event is one of 29 community events taking place across the country in the fall. Funds raised through Moving Day support cutting-edge research, improved quality of care and education programs to improve the lives of people with Parkinson’s disease and their families.

There will also be informational exhibits and a PD experience where people who don’t have Parkinson’s can learn what it’s like to contend with some of the affliction’s symptoms. It is estimated that one million people in the U.S. are living with Parkinson’s, with approximately 90,000 people newly diagnosed each year. Moving Day events across the country have raised more than $35 million supporting the Parkinson’s Foundation’s mission to make life better for people with Parkinson’s disease.

One of the critical efforts supported by Moving Day donations is PD GENEration, a clinical study by the Parkinson’s Foundation. PD GENEration examines the genetic foundations of the disease, opening doors to new treatment approaches and, hopefully, a cure. The Foundation is seeking additional participants for the study, and more information will be available at the event.

“It is so exciting to see the PD community come together in support of each other and in support of the Parkinson’s Foundation. The monies raised through this event will provide resources and education, expand access to quality care and push our research further toward identifying a cure,” said Amy DiPrima, development manager of the New York chapter.

To learn more about Moving Day Rochester and how you, your family and friends, and your company can get involved, please visit: MovingDay Rochester.org.

Meet Your Doctor

By Chris Motola

Mitchell Ehrenberg,

M.D.

Longtime Rochester doctor now devoted to seeing patients at their homes, through Personal Medicine of Rochester

Q: How long have you been doing concierge medicine?

A: I took over the practice in June.

Q: Was it a long ambition of yours to get into this model of medicine or did the opportunity just arise?

A: I wouldn't say it was an ambition. For a long time I was in private practice and then I was in employed in a practice doing exactly what I'm doing now: primary care medicine. I didn't really think about doing concierge medicine until things got a little more difficult at our hospital systems. They began demanding shorter visits and longer patient rosters and made it very difficult for doctors to do medicine the way we wanted to. It took a lot of pushing from the hospital system to get me to think that way. And then this opportunity came up. The Jewish Home, they're the sponsors of this practice, have wanted to get into primary care medicine and took over an existing practice. And then they were looking for a primary care doctor like me. And that's how I got here.

Q: Is the focus on treating older adults?

A: It's not. We take patients from age 18 up, which is what I've always done. We have some patients in their 20s. Most people are older, but by no means do we exclude anyone by age, except for pediatric-aged patients.

Q: From the practitioner's perspective, what are the advantages of concierge medicine?

A: There's a lot of overlap in advantages for both the doctor and the patient. I'm not sure if you're familiar with the phrase “moral injury?”

Essentially hospitals are pushing physicians into situations that are really difficult for them. These are doctors and hospitals who don't have enough time or resources to do their work. The same thing happens in outpatient practices. So I was facing that situation at our local health system where we were being asked to do things that were not in our patients' interests. It's no fun going into work knowing that you have 20 patients on your schedule and then have to squeeze

five more in that day. Switching over to concierge gives you the ability to get patients in quickly the same day or the next day and have the time to actually see them, get to know them and make sure they're heard. So you don't have the physician with a hand on the door handle ready to leave when the patient still has three more questions. That happens a lot in today's medical practices. You have situations where physicians tell patients they can hear one complaint today, but if you have others they need to schedule another appointment. That happens over and over.

Q: And from the patients' point of view?

A: From the patient's point of view they get the time to spill out whatever they need to talk about. They get my full attention and get to see me rather than a nurse practitioner or a PA. From my perspective, I never feel like I'm being rushed. Feeling being scheduled is a terrible feeling. When you're feeling that all day, every day, it leads to burnout. [Now] I have time to look things up, go through the patients’ record while I'm with them and know everything about them. And I can consult with textbooks and other doctors, not in real time, but I have the time to do it.

Q: I understand you have a fairly involved initial intake process.

A: It's usually an hour-and-a-half to two hours' wellness assessment.

Q: As far as payments go, how does the system work? Is it all cash transactions?

A: There's a membership fee. Our practice charges $1,850 a year. But we charge customary things to insurance, so there are co-pays for visits and whatnot. That's the traditional concierge system. There are some other models out there. Some doctors don't want to mess with insurance companies at all, so they may charge a little more.

Q: Is it just you at this practice, physician-wise?

A: I have a partner, Dr. Jim Budd. He's been in practice even longer than I have. He finished his residency in the early ‘80s. I finished mine in ‘91. So he's here with me. We also have support staff, an RN, several medtechs. That's who is in the office.

Q: It seems like it's largely older physicians moving to the concierge model. Do you have any advice for young physicians who want to investigate it? Should they pay their dues in the hospital system first? Can you jump into it right after residency?

A: You can, but it might be a little risky to do it before you have any kind of reputation. The advantage older doctors have is that our patients know us, and we're known by the community, by specialists. So we can get referrals more easily. Younger doctors need to be careful of the things they say in the hospitals because many of their contracts come with a clause that locks them in and prevents them for starting another practice in the community if they want to.

Q: Without violating patient confidentiality, can you give me an example of a time that the extra time you get to spend with patients made a critical difference?

A: Oh, it happens every day. I saw a woman for the first time as a house call, which we also offer. She was in her late 60s and housebound. At the end of the visit she said, “This was unique experience. No one has spent this much time with me and understood what's going on with me like you have.” This is a patient with complex medical issues. I was with her for about an hour and a half. It's something I can do because of the nature of our practice. She's getting much better since I've started taking care of her.

Lifelines

Name: Mitchell Ehrenberg, M.D.

Position: Physician at Personal Medicine of Rochester, affiliated with Jewish Home Life

Hometown: Brooklyn

Education: NYU Medical School

Affiliations: Rochester Regional Health

Organizations: American College of Physicians

Family: Wife, two children

Hobbies: Biking, hiking, woodworking, antique hunting

Nearly 1 in 3 U.S. Adolescents Are Getting Mental Health Treatment

In findings that suggest more young Americans struggling with mental health issues are getting the help they need, a new poll shows that nearly a third of American adolescents and teens received some sort of mental health treatment in 2023.

That translates to over 8 million young people between the ages of 12 and 17 getting counseling, medication or another treatment, the survey from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) found.

"We're pleased to see that more people received mental health treatment in 2023 than the previous year,"

SAMHSA Administrator Miriam Delphin-Rittmon said in an agency news release announcing the survey.

Among adolescents, the biggest increase from 2022 was in the number of those getting mental health medications: Nearly 14% of those age 12 to 17 received such a prescription in 2023, up from 12.8% the year before.

SAMHSA officials said the increase shows that mental health treatment is finally being destigmatized.

Rates of adolescents getting mental health treatment has increased virtually every year since 2009, though the agency noted that changes in how the survey was done were

introduced in 2021.

In 2022, the survey estimated that 7.7 million youths aged 12 to 17 had received mental health treatment of some kind. The increase in 2023 amounts to more than 500,000 more young people getting treatment, SAMHSA noted.

Meanwhile, the rate of adolescents reporting a major depressive episode has remained roughly flat since 2021, at just over 18% of those aged 12 to 17, the survey found.

Psychiatrists classify a major depressive episode as a period of feeling depressed for at least two weeks.

While trends in substance abuse did not see major shifts in the 2023 survey, alcohol use did see a statistically significant drop.

In 2023, 47.5% of adults and adolescents — about 134.7 million Americans — reported drinking alcohol in the past month, down from 48.7% in 2022.

But rates of problem drinking were largely unchanged in 2023, with 21.7% reporting binge drinking and 5.8% reporting "heavy alcohol use." And around 10.2% of adolescents and adults reported drinking to the point where they met the criteria of alcohol use disorder.

Healthcare in a Minute

By George W. Chapman

Hospital Star Ratings Down in 2024

The Centers for Medicare & Medicaid Services developed the five-star system so consumers could make informed decisions. Based on a survey of 46 quality measures, CMS assigns ranking from one to five stars. Undoubtedly, COVID-19 has had a significant impact on ratings. According to the ranking, 766 hospitals received four stars; 825 received three; 595 received two stars and 277 got just one star. You can check any hospital ranking at the

Hospitals and Charitable Care

In order to maintain their tax-exempt status, nonprofit hospitals must provide charitable (free) care. Several states have established oversight of their nonprofit hospitals in order to determine whether or not the amount of charitable care provided is adequate enough to remain tax exempt. Charitable care can include free or discounted care, health education, free screenings and clinics. The obvious dilemma is just how much charitable care is enough to satisfy oversight committees? Ten states require their NFP hospitals to establish broad community benefit plans. Another 25 states require hospitals to publicize their financial assistance policies. Industry analysts believe it is far too difficult to establish fair metrics. Most likely, no steadfast rules are forthcoming and the whole issue may be kicked down the road. 90% of all NFP hospitals are already cash strapped and a 2.9% increase

Hospital Care Compare website. It should be noted CMS will penalize a hospital for deficiencies, but will not reward a hospital for good or improved performance. Hospitals are still reeling from the devastating impact of the pandemic, including staffing shortages, continuing inflation and fragile finances. Despite having fought the COVID-19 war, CMS chooses to kick hospitals when they are down. Lowering hospital ratings makes little sense in lieu of what they

from payers certainly won't make up for historical operating losses and increasing expenses associated with charitable or free services. About half of our 5,000 hospitals are NFP. There is roughly $220 billion in medical debt among consumers.

Self-Managed Abortions Increasing

Since the Supreme Court overturned Roe v Wade a couple years ago, according to JAMA, the Journal of the American Medical Association, self-managed abortions are increasing. (All abortions are increasing.) Per the JAMA report, women cite privacy, the cost of travel to another state, fear of reprisal, the criminalization of abortion, the cost of child care and lost wages as reasons for self-managed abortions. Eleven percent used the abortion pill mifepristone. This has doubled since the overturning of Roe v. Wade. Others

and a half. Both of these metrics are constantly pressured by the massive increase in volume. The White House has recently granted more than $45 million to organizations fighting our

more than $27 billion. Despite this success, ripping off insurers and harming patients must still be worth risking your reputation and license to practice medicine. Physician Adrian Talbot operated Medex Clinical Consultants in Louisiana. He knowingly took cash from drug seekers. Prescriptions were pre signed and he rarely saw the patient. He falsified records to cover his tracks. He illegally distributed 1.8 million pills including opioids and morphine. He has been convicted of conspiracy and unlawful distribution of controlled substances. He is facing 20-40 years in prison.

have been through. Penalizing them is pouring salt on their wounds. CMS continues to be stingy when it comes to hospital payments. Effective Oct. 1, battle weary hospitals will get just a 2.9% increase from Medicare and Medicaid. Private insurers typically follow suit. Skilled nursing facilities, also subject to the five-star rating system and also still reeling from the COVID-19 war, will fare slightly better with a 4.2 % increase Oct. 1.

have resorted to drugs, alcohol, heavy lifting and hot baths to induce an abortion. States like Louisiana have moved mifepristone to the dangerous and controlled substance category meaning any illegal use could result in 10 years imprisonment. Legal use would now be only via prescription from a physician. Two hundred and fifty physicians in Louisiana signed a letter in opposition to changing the status of the abortion pill to a dangerous and controlled substance as mifepristone has been proven to be safe and not addicting.

988 Suicide Hotline

Most of us are unaware of this potential life saver. Since being established in July 2022, monthly calls, texts, chats now average more than half a million. That is up 90% in just two years. The 988 hotline provides crisis counseling, resources and referrals. There is an 89% answering rate and wait times are down to less than a minute

Denied Claims

Less than half of us challenge them. But half of us who do challenge denials prevail per a Commonwealth Fund survey. One third of us who disputed a medical bill had their balance reduced or eliminated. Medicare and Medicaid patients were more prone to disputing denied claims or questionable bills than those commercially insured. Most people are not aware of their right to dispute denied claims or questionable balances due. The Commonwealth Fund suggests more consumer protections and education and increased public awareness. Fifteen percent of all claims submitted to commercial insurers are initially denied. Three percent of all denied claims were actually pre approved via prior authorization. About half of all denied claims are ultimately paid. But that wouldn't happen unless disputed.

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.

Diabetes is a chronic health condition that affects millions of people worldwide, making it a significant topic in healthcare. About 422 million adults live with diabetes. The number is expected to rise, according to the World Health Organization. In addition, diabetes can lead to blindness, kidney failure, heart attacks, stroke and lower limb amputation. The impact of diabetes on an individual’s quality of life and the healthcare system is profound, emphasizing the urgent need for prevention, early detection and management strategies.

The main difference between Type 1 and Type 2 diabetes is the type of insulin problem a person has. Type 1 diabetes is an autoimmune condition that occurs when the body's immune system attacks and destroys the pancreas' insulin-producing cells. It can start at any age, but it often begins in childhood or adolescence. Type 2 diabetes occurs when the body doesn't produce enough insulin, or the body's cells don't react to insulin properly. It can develop at any age, but it's more common in adults.

Physician Susanne Miedlich, associate professor of medicine at the University of Rochester Medical Center, discusses five aspects of diabetes.

1.Symptoms

Classical symptoms of diabetes are increased thirst and urination, fatigue, blurry vision and possibly weight loss. These symptoms can be subtle and may develop gradually over months or years, especially in people with the much more common Type 2 diabetes, which are characterized by resistance to insulin and a slow decline of insulin secretion by the pancreatic beta cells. The latter

5

fact emphasizes the need for screening for diabetes in people at risk for diabetes, such as people with obesity, for instance.

“On the other hand, people with Type 1 diabetes present most often with the relatively sudden occurrence of the above symptoms,” said Miedlich. “Type 1 diabetes is caused by a relatively rapid decline in beta cell function and thus, insulin production as a result of an abnormal immune response that triggers the destruction of the insulin-producing beta cells.”

2.Treatment

Patients with Type 1 diabetes are treated with insulin. Thanks to the advances of modern biotechnology, we now have insulins that act within minutes of injection, insulins whose glucose-lowering effects last for several days after just one injection and insulin pumps, which deliver insulin according to a computer algorithm that incorporates information about the blood glucose trends and the insulin needed to lower glucose levels.

“Lifestyle measures that include a healthy diet, regular exercise, sufficient sleep and stress reduction can greatly improve insulin resistance in patients with early Type 2 diabetes or prediabetes,” said Miedlich.

“People with obesity benefit tremendously from weight loss, achieved by lifestyle measures, medications or weight loss surgery. All of the above measures have the potential to reverse Type 2 diabetes. There is a growing number of oral and injectable medications other than insulin that increase insulin sensitivity and secretion or promote glucose removal by the kidneys and thus lower blood glucose levels in people with Type 2

Statins: A Powerful Ally for People Living with Diabetes

If you are living with diabetes, you may already know you are at higher risk for cardiovascular disease including heart attack, heart failure and stroke.

According to the Centers for Disease Control and Prevention (CDC), people who have diabetes are twice as likely to have cardiovascular disease as people who don’t have diabetes.

What you may not know is that it is important for someone with diabetes to maintain low LDL cholesterol because your blood LDL cholesterol level is a contributing factor to

cardiovascular disease. At your next medical visit, ask your health care provider if statin therapy should become part of your diabetic care.

Statins are a class of medications that can reduce LDL cholesterol. The target LDL levels for people living with diabetes are less than 70 mg/ dl for those without cardiovascular disease, and less than 55 mg/dl for those with cardiovascular disease, according to current clinical practice recommendations from the American Diabetes Association.

“LDL cholesterol is produced by the body and can occur at high levels

Things You Should Know About Diabetes

By Ernst Lamothe Jr

diabetes. Controlling blood glucose levels in people with diabetes is critical to preventing diabetes complications, such as damage to the nerves, eyes, kidneys, and heart.”

3.Trends in diabetes

The incidence and prevalence of diabetes, both Type 1 and Type 2, is increasing. The increased incidence and prevalence of Type 2 diabetes in particular, is noted alongside an increased incidence and prevalence of obesity in both adolescent and adult people. According to the CDC, new cases of both Type 1 and Type 2 diabetes in young people in the United States increased from 2002 to 2018. The number of new cases of Type 1 diabetes per 100,000 young people increased from 20 to 22 per year and the number of new cases of Type 2 diabetes increased from nine to 18 per year.

“The reasons for increased incidence and prevalence of Type 1 diabetes are less clear but may be associated with increased exposure to environmental agents and viruses,” said Miedlich.

4.Prevention

Lifestyle measures such as healthy nutrition, regular exercise, sufficient sleep and stress reduction can prevent Type 2 diabetes. For people with obesity, successful weight loss, either through lifestyle measures, medications, or weight loss surgery, can prevent Type 2 diabetes. The FDA recently approved a new medication that controls the cellbased immune system and delays the onset of Type 1 diabetes in people at risk for over two years. Understanding the complexities of diabetes and its implications can help healthcare professionals provide better care and

naturally, or as the result of excess body weight or lifestyle choices such as smoking or lack of exercise,” says physician Lorna Fitzpatrick, vice president of medical affairs and senior medical director at Excellus BlueCross BlueShield. “LDL forms plaque deposits that stick to the inside walls of arteries, narrowing them and restricting blood flow.”

When blood flow to the heart is reduced, it can cause a heart attack. When blood flow to the brain is reduced, it can cause a stroke. A heart attack or stroke can also occur when a plaque deposit breaks off from the artery wall and travels to the heart or brain.

Statins not only lower bad LDL cholesterol, but also raise the good HDL cholesterol, which helps the body rid itself of the bad cholesterol. They lessen the buildup of plaque

support for those affected.

5.Family history

Compared to someone without a family member with diabetes, a person with a family member with Type 2 diabetes has a significantly increased risk of developing diabetes later in life. That said, lifestyle measures, as detailed above, can reduce this risk. For rare forms of monogenic diabetes, which is caused by a singular gene mutation and different from both Type 1 and Type 2 diabetes, the risk of a first-degree family member developing diabetes is very high. The same cannot be said for Type 1 diabetes.

“While a family history of Type 1 diabetes does increase the risk of diabetes in other family members, this risk is much lower than for people with a family history of Type 2 diabetes or monogenic diabetes,” said Miedlich.

inside arteries and make it more stable, so it doesn’t break away from the artery wall. Statins also decrease swelling (inflammation) caused by plaque in the arteries.

“There is a misconception that people with diabetes should avoid statins because they may cause blood sugar levels to go up a little,” says Fitzpatrick. “The risk is small and usually outweighed by the risk of high LDL cholesterol causing a heart attack, heart failure, or a stroke.”

She advises all individuals living with diabetes to ask their health care provider if they are a candidate for statin therapy. The provider will assess their individual situation and determine whether this class of medication is right for them.

Submitted by Excellus BlueCross BlueShield

Physician Susanne Miedlich, associate professor of medicine at the University of Rochester Medical Center.

By Gwenn Voelckers

‘Leaf’ Lessons: Embracing Change as a Catalyst for Growth

It’s early September, and I can already see the leaves on my sunset maple transitioning from vibrant green to a deep reddish hue.

I love the change of seasons.

And as I sit here staring out the window, I can’t help but reflect on my own journey of change after my divorce.

Just like fall's colorful display of resilience, I've come to realize that life is a series of seasons — and embracing change is the key to personal growth.

It’s just one of many life (and leaf!) lessons nature has taught me.

For those living alone after a significant life event like divorce or the loss of a loved one, it's crucial to acknowledge that change is a natural part of life.

While it can be daunting to embrace yet more change in the midst of an already challenging transition, it's through this process that we discover our strengths and uncover new aspects of ourselves.

As I embarked on this journey of self-discovery, I came to appreciate the benefits of embracing change:

• Personal Growth: Change encourages us to learn, adapt and acquire new skills. We become more

versatile and competent individuals. I felt so proud when I purchased a new car all on my own.

• Resilience: Facing and overcoming life's challenges helps us develop our capacity to recover from setbacks and pull through tough times. Spending a Friday night alone can feel victorious!

• Flexibility: Developing the ability to adapt to change fosters flexibility, a valuable trait that enhances our capacity to navigate life’s twists and turns with grace and ease. This is especially helpful while traveling solo through life, as well through airports.

• Overcoming Fear: Learning to embrace change can help us overcome the fear of the unknown and build confidence in our ability to face and conquer challenges. With

practice, I was finally able to walk into an event alone without shaking like a leaf.

• Self-Discovery: By stepping out of our comfort zones and navigating change, we uncover hidden strengths, values and passions that may have otherwise gone undiscovered. Who knew I would become a drummer at my age?! What’s your yet-to-be-revealed talent?

Over the years, I've developed strategies that have helped me embrace change and foster positive transformations in my life. Check ‘em out:

• Develop a growth mindset, which views challenges and setbacks as learning opportunities rather than insurmountable obstacles. Living alone gives us all plenty of problems to solve. Embrace them!

• Be patient and kind to yourself as you navigate change, recognizing that setbacks and struggles are a natural part of the process.

• Strengthen your resilience by engaging in self-care activities, such as exercise, meditation, and spending time with people you love. I can vouch for pickleball!

• Build a support network of friends, family or advisers who can offer encouragement, advice and accountability as you pursue positive changes. Finding a trusted financial adviser was one of the best decisions I ever made.

• Remain open-minded and flexible in your approach to change,

recognizing that there may be multiple paths to achieving your goals.

• Regularly reflect on your progress and celebrate milestones, no matter how small, to maintain motivation and momentum. Think ice cream, a massage or — my favorite — Saint-André triple crème cheese on a warm baguette. Yum!

• Approach change with curiosity and a desire to learn, recognizing that each experience teaches you valuable lessons about yourself and the world around you.

As you navigate the ever-changing landscape of your own life, remember that each of us possesses a remarkable potential for personal growth and transformation. This capacity is already inside you. It just needs to be tapped.

I found inspiration in nature. It showed me that change is essential for survival and growth.

Just as the leaves change in response to their shifting environment, you, too, can learn to adapt and grow from your circumstances. And enjoy the changing seasons of this new life chapter.

Gwenn Voelckers is the author of “Alone and Content: Inspiring, empowering essays to help divorced and widowed women feel whole and complete on their own.” She welcomes your thoughts on this column as well as topic suggestion for future essays at gvoelckers@rochester. rr.com.

Back-to-School Tips to Helping Your Kids Breathe Easier

As kids and teens return to school, parents might not have protecting their child's lung health on the top of their to-do lists. But experts say it should be.

“A new school year often means a new environment for students and staff, including new asthma triggers, exposure to new viruses, peer pressure to smoke or vape and other stressors that can impact the health of students,” said Harold Wimmer, president and CEO of the American Lung Association (ALA). “Students and staff spend a significant amount of time in school, so it is critical to their well-being and education that they are in the healthiest environment and are making the healthiest

choices possible.”

To that end, the ALA has created a youth initiative to help schools and caregivers address chronic lung issues like asthma, air quality and tobacco-free policies. The initiative offers information, guides and sample policies that can be implemented in schools to protect students and staff.

The group is also working to educate parents, students and school officials in four key areas of lung health:

• Asthma: There are 6.1 million kids under the age of 18 living with asthma, a leading cause of missed school days. The ALA has in-depth resources for parents, young adults

and schools on managing asthma, including a free online course for school personnel who administer asthma medications and seek to understand and implement quick-relief stock asthma medication laws, policies or programs.

• Tobacco Use: A new school year can also mean peer pressure increases to vape or smoke. According to the 2023 National Youth Tobacco Survey, more than 2 million middle and high school students reported that they had used e-cigarettes in the last 30 days. The ALA has resources to prevent tobacco use and help youth quit, specifically designed for schools, parents and teens.

• Indoor Air Quality: Some breathing hazards are not as obvious, like indoor air pollution and greenhouse gas emissions. Poor air quality in schools can affect student, teacher and staff's attention, thinking and ability to learn. The ALA offers a free downloadable guide on how school administrators can improve their indoor air quality.

• Infectious Respiratory Diseases and Vaccinations: A new school year means new friends, new teachers and sometimes, new viruses, so students need to practice good health hygiene habits and get recommended vaccinations, including influenza and COVID-19 shots.

SoftWave Healing Therapy Now Available in the Region

Try SoftWave

By Deborah Jeanne Sergeant

Lower back pain, neck pain, sciatica, tendonitis, plantar fasciitis, arthritis and joint injuries are all tough to manage non-invasively and without medication.

That’s why Chance Lowry, owner of Northeast Pain Solutions, is so excited about shockwave therapy.

His facilities in Rochester, Canandaigua and Geneva offer SoftWave Therapy, a form of shockwave therapy that uses sound waves to stimulate healing in damaged tissues.

These sound pulses use high positive pressure with a fast and steep rise time followed by comparatively small negative pressure.

Lowry explained that the therapy modulates inflammation, creates a localized stem cell response to increase the repair efforts, stimulates blood flow at the injury site and breaks up scar tissues in cases with chronic injuries.

The benefits include pain relief, anti-inflammatory response, antibacterial effects, improved blood flow, tissue growth and regeneration, stem cell activation and tissue generation.

“This has completely changed the way we practiced,” Lowry said. “We can help a lot of injuries that were difficult to work with like

tendonitis. It’s hard to conservatively work with these, but our success rate is through the roof.”

Northeast Pain Solutions has expanded to three offices because of the therapy.

He said that originally, the therapy was used for nonunion bone fractures and then providers began using it with soft tissue issues.

“We don’t use it for that as we’re not orthopedic office,” he added.

“For tendon and ligament injuries, they’re poorly vascularized so they heal poorly. There’s lack of blood supply. This increases blood supply by 400% so tissues heal on a biological level. It’s not just reducing pain but it regenerates tissue. A lot of things in the medical world have claims but not patents to back it up. These patents are very well accepted.”

Some providers use soundwave therapy in urology to treat kidney stones and erectile dysfunction. It’s also used for wound care and women’s urologic and sexual health at other providers. Lowry said that in Europe, providers use it to promote healing after cardiac surgery and for spinal cord injuries.

Lowry uses SoftWave to promote

healing with soft tissues like ligaments and tendons.

The therapy is not covered by insurance. It may take 50 to 100 sessions to treat an area, depending upon its size. Most patients receive a degree of immediate pain relief,

about 30-40%. Within four to eight treatments, many receive 70 to 100% pain reduction.

“I’m a skeptic as an individual because most things in medicine are overplayed,” Lowry said. “This is phenomenal.”

Chiropracticor Chance Lowry offers soundwave therapy as way to alleviate his patients' pain. “This has completely changed the way we practiced,” he says.

Suicide Prevention

Suicide Prevention Month: How to Spot the Warning Signs

How to provide hope, healing and help for young people in crisis

By Kyra Mancine

Suicide is a topic that makes many uncomfortable. Yet it needs to be addressed.

According to the National Alliance on Mental Illness, 20% of high school students reported serious thoughts about suicide. As we start a new school year, your child’s safety, health and well-being are more topof-mind than ever. Suicide prevention month is the perfect opportunity to learn how to recognize and address mental health concerns.

After emerging from years of COVID-19 restrictions, we are just beginning to see how isolation has impacted children, teens and young adults.

While suicide affects individuals of all ages, young people are the most vulnerable.

Did you know that suicide and self-harm incidents have increased by 87% over the past five years? Besides everyday pressures, today’s students face challenges previous generations

didn’t have to worry about, including cyberbullying.

Be aware of the warning signs and risk factors

A family history of suicide, trauma, anxiety disorders, lack of social support or the loss of a relationship can make someone contemplate suicide. Talking about wanting to die, looking online for a way to die, withdrawing, and giving away possessions can be red flags that require intervention.

Encourage open and honest communication

Don’t be afraid to start a dialogue with someone who is struggling. It’s important to establish rapport and trust. Be genuine and empathetic with your choice of words and tone of voice. Talking about suicidal thoughts still has a stigma to it. Let

Support Groups Helpful for Loss by Suicide

There’s help for those hurting

By Deborah Jeanne Sergeant

The loss of a loved one is compounded when suicide was the cause of that loss.

In addition to the grief that accompanies any death, the surviving family may feel numerous other emotions that are difficult to experience.

“There’s shame for the stigma society places on suicide,” said Lynn Acquafondata, licensed mental health counselor and owner of Crossbridge Counseling and Crossbridge Wellness in Rochester. “The loss is devastating.”

Survivors may feel blame for their loved one’s death, as if they “missed something” or that they are somehow responsible. The weight of this misplaced burden can feel overwhelming. On top of all of that, the survivors may feel like no one else understands.

Joining a support group such as the one she operates at Crossbridge can “help people to know that they’re not alone and that there are other people going through a similar loss,” Acquafondata said. “A group helps people feel heard.”

your child know it’s OK to have uncomfortable feelings. Reassure them that you are not there to judge, but to help and support.

Know what your district offers

Are you familiar with how your school handles mental health issues? Many districts use web monitoring software and other technologies to flag, review, and de-escalate harmful language and content before it’s too late.

Advocate for mental health support

There is no shame in reaching out for help. Struggling students can benefit from teletherapy, mental health coaching sessions and, if necessary, assistance from trained crisis counselors with expertise in supporting children and teens.

Recently, there has been a national push to reduce or eliminate cost barriers to these services, which should help to increase participation. By sharing information, we can increase awareness and help support young people in need. From there, compassionate, proactive approaches and tools, including the appropriate interventions, can make a real difference. Staying up-to-date on the latest services and resources can mean the difference between life and death.

If you or someone you know is struggling, there is help

• 988 Suicide & Crisis Lifeline 24/7 free, confidential support https://988lifeline.org/

• National Alliance on Mental Health www.nami.org

emotions feel more normal, as they can range from sadness to regret to anger to guilt.

Dealing with outside people can present a big challenge to family members. Acquafondata said that the support group can help families know what to say when facing intrusive and insensitive questions about the manner of death and about the person who died.

In addition to her regular groups, Acquafondata also hosts four-week intensive groups for support and learning skills. In the ongoing group, some attendees have participated for quite a while since they have found it such a source of solace and comfort.

“They ironically tell me they look forward to it not because it’s fun and easy but they feel connected and they can express things they can’t anywhere else,” Acquafondata said. “They’re so supportive of each other and it’s a beautiful thing. In the midst of the suffering they can help each other with everything they’re going through.”

supports may be very helpful for the family member to process their emotions in healthier ways, to facilitate the bereavement process, and to normalize some of their reactions to reduce their sense of stigmatization,” Gregory said. “Suicide happens despite the best efforts of family members, friends, health care providers and the individual themselves.”

Losing a loved one can feel surreal and more so if the cause of death is suicide. The conversations in a support group can help survivors’ Where to Look for

Other loss groups typically can’t provide the same level of understanding as suicide bereavement groups as the stigma attached to suicide makes it difficult for survivors to feel as welcomed in other groups.

“Families often want to keep it a secret when a member dies by suicide,” said physician Robert Gregory, director of the psychiatry high risk program and professor at Norton College of Medicine at Upstate Medical University. “In addition to the social embarrassment, there is usually also a deep sense of guilt and anger that can interfere with the normal and healthy bereavement process. Family members may be asking themselves, ‘Why didn’t I recognize the signs, so obvious in retrospect?’ ‘Did that argument I had with them last week cause the suicide?’ ‘Why didn’t I reach out more?’”

He added that it's also normal to feel anger toward the person who died because of the trauma and pain they caused. Or sometimes anger toward the healthcare providers who could not help prevent the death.

“Groups, counselors and other

The following organizations host group meetings and offer resources for people who have suffered loss through suicide:

• American Foundation for Suicide Prevention www.afsp.org, 585-202-2783

• NAMI Rochester www.namiroc.org/suicide-bereavement 585-423-1593 info@namiroc.org

• The Grief & Trauma Recovery Counseling Centre, Rochester https://bjwhitelmhc.wixsite.com 585-313-1860

• Forever in Our Hearts, Irondequoit, www.facebook.com/ groups/420112451837051

• Compassionate Friends Rochester www.tcfrochester.org

• Grace Ridge Church GriefShare E. Williamson, 315-521-2053

Lynn Acquafondata is a licensed mental health counselor and owner of Crossbridge Counseling and Crossbridge Wellness in Rochester.

Suicide Prevention

John and Judy Messenger present a photo of their son James that was tak en when he graduated from Sharon High School. The Messengers lived in Sharon, a suburb of Boston, Massachusetts, until they moved to Pittsford in 1999.

ship, but we deal with certain things differently,” he said.

A Knock on the Door

By Mike Costanza

John and Judy Messenger remember the day in 2012 when they heard a knock on the door of their Pittsford home.

When they opened it, two policemen told them that James, their 30-year-old son, had taken his own life.

Almost 12 years later, they still wonder why he left them that way.

“We have no idea what was going on in his mind or why he did it,” Judy said.

James, the second of the Messenger’s three sons, was easygoing, kind and sensitive to the feelings of others.

“I used to say he was exactly like me, only younger, taller, better-looking and more talented,” John said.

James had a talent for music, played the trumpet, guitar and keyboards and sang in his family’s church and at school events — he played Daddy Warbucks in his middle school’s production of “Annie.” As a young man, he played his guitar and sang in local coffee houses and toured Europe with Mastersingers USA, the top-notch men’s chorus of which John is a member. He also enrolled at Syracuse University, intent upon acquiring a degree in communications, but dropped out after two years. He lived in Syracuse for a while, then spent several years living with his parents. During that time, he became a deacon in the First Presbyterian Church of Pittsford, the house of worship his family attended. By the time of his death, James had long grappled with mental health issues. He heard voices and sometimes carried on conversations under his breath with people who didn’t exist. In his early 20s, he was diagnosed with schizoaffective disorder and bipolar disorder and ended up being hospitalized three times for brief periods.

Those suffering from schizoaffective disorder can experience a mix of symptoms, including visual and auditory hallucinations, delusions, depression and mania. Bipolar disorder manifests itself in extreme mood swings. The person diagnosed might feel euphoric one moment and

depressed the next. Both conditions require treatment with medications and counseling. Those who do not obtain treatment are at a greater risk of suicide than the general population.

James obtained treatment for his disorders, but sometimes did not take his medications as required. In addition, he sometimes drank heavily and smoked marijuana, reducing the drugs’ effectiveness. As his disorders and use of alcohol and marijuana took their toll, James lost interest in the things he’d once enjoyed.

“He was failing,” Judy said. “He wasn’t taking care of himself.”

As James struggled, the Messengers had to deal with their own issues. Both were laid off from their jobs in 2012 — John was an in-house attorney and Judy was a regulatory analyst and manager for a local telecom firm. By October of that year, Judy had retired and John was hunting for a new position and doing freelance legal work. The couple was also preparing to sell their Pittsford home and move into a new, smaller residence in Brighton.

Oct. 8, 2012, was a bright, sunny fall day, according to John. He took James to a local Bruegger’s Bagels shop for a sandwich, then home for a visit. James spent hours in his parents’ backyard alone, then joined them for dinner. After that, John drove him to Pinnacle Place, the Rochester high-rise in which he was living.

James hugged his mother just before he left, a gesture that struck Judy, since he had grown distant from her down through the years. At 5 o’clock the next morning, she and John learned from the police that James had jumped from the roof of Pinnacle Place. He was just shy of his 31st birthday.

The news of James’ death hit the Messengers hard.

“We had just spent the previous afternoon and evening with him at our house and everything seemed fine,” Judy said. “If anything, he was a little bit more friendly than he had sometimes been.”

Each of the Messengers reacted to the loss in their own way.

“I think in each of our separate ways, we were a little bit on autopilot and in shock and therefore doing practical things, because it was so hard to process fully,” John said.

Judy offered coffee and breakfast to the officers, which they declined.

“I was trying to process the whole thing, because it didn’t make sense to me,” she said.

John wanted to learn more about the way James died. After the two police officers left, he dressed and drove to Pinnacle Place. The night security guard was still on duty.

“He took me out and showed me a bush that had been crushed by his [James’] fall,” John said.

The couple then started the long, painful journey through their grief.

“Even in the course of a conversation, you experience several different ways of experiencing the grief,” Judy said.

Anger was part of that experience.

“There’s some anger with yourself that you missed it,” she said. “How could you not see the signs?”

Some of that anger was reserved for James.

“I was angry with him for doing it,” she said.

Though family members, friends and members of First Presbyterian offered their support, Judy began working through her feelings on her own.

“A lot of it is being left alone to process through myself,” she said.

Though she turned to some of the women in her church, it wasn’t for sympathy.

“They were just there,” she said. “I knew that if I needed them, they were available to me.”

John was also there for her.

“He was my rock, my support,” she said. “I knew that if I had a question, a concern, I could always go with him.”

John was much more comfortable talking to others about the loss of James.

“Judy and I have a great relation-

John turned to friends, relatives and members of his church to talk about his loss, including Tim Smith, a friend from First Presbyterian who is a Stephen Minister. Stephen Ministers are specially trained, volunteer lay counselors who provide one-toone, Christ-centered care to people who are experiencing life difficulties.

“I tend to want to talk things out. [Judy] often processes things first to herself,” John said. “It was helpful to have some third person to talk to.”

The couple also found they could draw comfort from helping others who had lost someone to suicide or had relatives or friends who were at risk of taking their own lives.

“Both of us, I think, get a lot of our value and purpose in life from helping other people,” Judy said. “I think we are empathetic for someone who has gone through this.”

First Presbyterian’s associate pastor began referring members of her congregation to them for assistance.

“Folks who had someone who was considering suicide or had mental illness of some degree would come and talk to us,” Judy said.

The couple has continued to make themselves available since moving to Rochester’s Asbury First United Methodist Church a few years ago. In addition, Judy volunteers as an office manager for NAMI Rochester, the local chapter of the National Alliance on Mental Illness and makes herself available to talk to those in need.

“When we get a call from NAMI that someone has lost a child, that call comes to me,” Judy said.

Though it’s been 12 years since James left them, he is never far from his parents’ thoughts. They have wind chimes hanging from their car’s rear-view mirror that they bought to remind them of James.

“Whenever they play, I think it’s James talking to me,” Judy said. “It’s just lovely.”

The Messengers moved into a new home in Brighton in 2013. John landed a job that year as an attorney for a local firm and remained in that position until he retired in 2021. As he looks back on the years since James took his own life, he marvels at the way he and Judy have come through them.

“This is the sort of thing that has a lot of collateral damage and we’ve been very aware and lucky that we’re both very strong and resilient people and we have a fabulous relationship,” he said. “If anything, it made us stronger together.”

James Messenger at 29 years of age. He died by suicide when he was 30.

Suicide Prevention

Suicide Risk: Warning Signs

By Deborah Jeanne Sergeant

Why my loved one? Why my friend? What could have kept him from taking his own life?

Preventing death by suicide is not straightforward. But as with any health crisis that causes death, most people want to know afterwards what increased the risk for that individual. Warning signs are common and can point to many other scenarios, yet suicide is rare.

Physician Eric Caine, an international expert in suicide prevention and psychiatrist at University of Rochester Medical Center, offered a simple question: Is this person having a hard time?

“Most people won’t attempt and fewer will die by suicide,” Caine said. “Reaching out to people when they have a hard time doesn’t mean you have to be an expert. Here’s someone who has difficulty; their life is a mess. I’m really offering to be helpful. Ask questions about how they’re doing like, ‘How do you feel?’ and ‘Can I be helpful?’ or ‘Can I connect you or get an appointment for you or take you to the ER?’”

It’s also vital to keep in mind that the issue can present very differently in someone who’s a teen, young adult, middle-aged or older adult. Caine added that the genders present differently. Women tend to display emotions more forthrightly than men.

Regardless of gender, dig deeper when receiving a monosyllabic answer like “fine” to questions about how the person feels.

“At that moment, you need to say, ‘I’ve been worried about you.’ Or ‘It seems like things have been difficult for you’ and you need to show you want to listen to them. The major lesson many have learned is it’s important that you don’t preach ‘You can handle this’ or ‘Things will get better.’ Hear their thoughts,” he said.

Substance abuse can also indicate a person is struggling — and it varies across the lifespan. A young person may dabble in drugs while an older adult might rely upon alcohol. Also look for performance problems at work or school and a decline in self-care or taking care of their belongings. Caine said that these signal things aren’t going well.

Isolation, withdrawing socially and ceasing to participate in previously enjoyed activities can also present as risk factors, as can mental health issues, “whether it’s major depression, clinical depression or bipolar disorder, or someone with psychosis or history of schizophrenia, those are folks who collectively have higher rates,” Caine said. “That doesn’t mean all are immediately at risk. If you see someone’s function going down, that should be the thing that turns on the light. They may not

share they’re feeling depressed, but if they’re functioning different than before, it’s time to pay attention.”

The person’s occupation can also matter. For example a self-employed person whose business is failing. Or a struggling farmer who fears losing the family’s way of life, land, home and profession.

Caine said that asking about whether people are considering suicide doesn’t “put the idea in their heads” but can show how much their friends and loved ones care. Those who aren’t considering suicide will simply say, “I’m not thinking of it.”

Caine also said that concerned loved ones should consider any available methods of death by suicide. Does the person have firearms?

“Have a very honest conversation about that,” Caine said. “We’re being intrusive talking about weapons. Part of that is ‘I’m here to listen, I’m present and it’s important for us to talk about that.’”

So much of suicide risk is tied to people feeling unheard and alone and as if they have no resources or help. They may view ending their own life as their only option to relieving their misery and so that they no longer burden others.

“We need to be letting people talk about what they’re experiencing and not pushing them away but letting them express it even if it’s hard to hear,” said Lynn Acquafondata,

Two Years Later, 988 Crisis Line Has Answered 10 Million Requests

Just two years after the launch of the nation's three-digit crisis hotline, more than 10 million calls, texts and chat messages have been fielded by counselors, U.S. health officials recently announced.

Introduced in July 2022 to simplify emergency calls and help counter a burgeoning mental health crisis in the United States, 988 was touted as a simpler way for folks struggling with their mental health to get help.

“We're connecting more people to help than ever before,” HHS Secretary Xavier Becerra said in a news release announcing the milestone. “We're connecting them faster and with more personalized services, which are critical for helping people in crisis. We know that 988 is saving lives and helping millions of people.

I hope anyone who feels alone, or that they are without options, knows that 988 is there to help.”

Of the 10 million messages answered in the past two years, 1.7 million were texts — with 988 answering 51% more texts in the past 12 months than the year before, the HHS said.

Nearly 1.2 million of 988 calls were answered by the Veterans Crisis Line (VCL), through 988's Press 1 option.

“Our Veterans Crisis Line connects veterans to caring, qualified responders 24/7 — and two years ago, we made it even easier for veterans in crisis and their loved ones to reach out for help by launching 988 then Press 1,” VA Secretary Denis McDonough said in the HHS news release. “One veteran lost to suicide

is too many. We're supporting more veterans than ever through the 988 initiative and will not rest in our continued efforts to spread the word that this resource is available and saves lives.”

The 988 network has been a bipartisanship affair, with former President Donald Trump signing the law that established the new number in 2020 and the Biden administration implementing the number and expanding the network of more than 200 call centers that typically operate 24/7.

So far, the Biden administration has funneled nearly $1.5 billion into 988, while more than $200 million in grants will be given to states in 2024 to support the work, HHS officials said Tuesday.

licensed mental health counselor and owner of Crossbridge Counseling and Crossbridge Wellness in Rochester.

Of course, family members and friends cannot be expected to provide mental health care like a professional. However, they can listen and also help direct the person to care such as connecting to emergency services or setting up a mental healthcare appointment.

Acquafondata said that anyone who has a plan for ending his life must have immediate mental healthcare such as at a psychiatric hospital or emergency room because “typically don’t just throw that out there.”

Despite knowing the risk factors, listening and trying to point people in the right direction, sometimes it’s not enough. The patient himself must be willing and able to receive help. No one should feel blame for the loss of a family member or friend to suicide.

“It’s not always possible to prevent someone who’s that deeply depressed,” Acquafondata said. Suicide is always coming from deep depression. Their life is not livable and they don’t see any other alternative.” She points surviving family members to the “Serenity Prayer”: “Grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference.”

Statistics show the 988 line is needed: A 2022 national survey found that over 12 million adults and nearly 3.5 million adolescents had seriously considered suicide in the previous year, health officials said Tuesday. Meanwhile, nearly 1 in 5 adolescents reported symptoms of depression or anxiety in a federal survey of teen health from 2021 to 2022.

Frank Guido couldn’t be happier he had a choice for treating his prostate cancer!

To hear more of Frank’s story and learn if CyberKnife is right for you, visit hoacny.com

Frank chose non-surgical CyberKnife® at HOA –offering 5 treatments instead of 35!

“The original diagnosis was to treat my prostate cancer with seven weeks of radiation, five days a week. I was kind of upset that I was never given the option of CyberKnife,” said Frank. “The precise radiation achieved by CyberKnife, far fewer treatments, and the personalized care I received from Dr. Chin and his team made my decision an easy one. Better, the treatment was a real success!”

Dad Facts: What Men Need to Know About Their Fertility

When a couple can’t get pregnant, the focus is often on the prospective mom, but that needs to change, a Houston urologist says.

“Both partners need evaluation,” said urologist Larry Lipschultz, a professor at Baylor College of Medicine in Houston. “With fertility, you can’t finger point. It’s not a male or female problem as much as it needs to be considered a couple’s problem.”

Men who are infertile have no way to know unless they’ve had specific surgeries or an accident involving their testicles. The only sign is being unable to get a woman pregnant. A fertility test can confirm this.

Once a man hits his 50s, his fertility drops. It’s not as dramatic a decline as that which a woman experiences during menopause — rather, it happens little by little.

Guys who are obese or who put on weight may also have trouble producing enough sperm. A doctor might recommend losing weight, to boost production of male hormones. A diet rich in foods containing antioxidants may also be suggested.

“The issue with obesity is that fat metabolizes testosterone to estrogen, which is bad for sperm production,” Lipschultz said in a Baylor news release. “Generally, trying to maintain a good bodyweight through exercise and proper diet is going to be helpful.”

Keep in mind that the testoster-

one should not come from an outside source. Men who take outside testosterone in any form are turning off the hormones that promote sperm production. Men who need testosterone should be under a specialist’s care.

Men looking to become fathers should avoid direct heat to the testicles, including a cell phone in a pocket, hot tubs or heating pads.

They should also be aware that chemotherapy, radiotherapy and drugs called biologics can tamp down sperm production.

Men who have fertility issues are also at higher risk for other conditions, including cancer and premature death.

“If you’re in the reproductive age group and you have some type of problem that requires medication, check with your physician that this is not going to hurt your sperm production,” Lipschultz advised. “If you are in a situation that this is going to be permanent, make sure you bank your sperm.”

Men with fertility concerns can get a semen analysis. This will show whether they have enough sperm and whether they move sufficiently to reach an egg. Newer tests can also see if they are capable of fertilization. At-home tests may be misleading.

Men who are having reproductive issues should visit a urologist who specializes in male reproductive health.

SmartBites

By Anne Palumbo

The skinny on healthy eating

How Spaghetti Squash Promotes Longevity

Years

Helpful Tips

contributes to good health and longevity in numerous ways. With proper hydration, your heart can pump blood more efficiently, which reduces strain on your heart. Consuming enough water further reduces heart stress by helping to reduce sodium levels in your blood.

ago, spaghetti squash and I got off to a rocky start.

It refused to yield to my knife; I got frustrated; it retaliated by turning mushy; I huffed, “Never again!”

Stubborn me.

I now adore spaghetti squash and regret not giving it another chance sooner. But now that I know the ropes, I always look forward to its late-summer arrival, above and beyond how easy it is to cook.

Called “spaghetti squash” because it produces angel-hair strands of squash that mimic the appearance of noodles, this squash is a nutrient-dense food, meaning it’s low in calories but a decent source of a wide variety of nutrients.

I’m a fiend about fiber, and spaghetti squash helps meet my 25-grams-a-day fiber goal.

Besides keeping the digestive system in good working order, fiber is a major player in so many of our body’s systems that, according to a study in the Journals of Gerontology, getting enough can actually help us live longer and stay healthier. Fiber works its anti-aging magic by cutting cholesterol, reducing inflammation, protecting against diabetes and controlling weight.

Water—one of spaghetti squash’s most abundant nutrients—also

A recent National Institutes of Health study found that people with higher levels of serum sodium, which can be caused by not getting enough fluids, have a higher risk of dying earlier and may experience biological aging that’s greater than their biological age.

On the vitamin front, spaghetti squash is a good source of several B vitamins, the vitamin group that many experts, like Harvard’s nutritional psychiatrist Uma Naidoo, prioritize most to keep everything in top working order, especially the brain. B vitamins can help slow the aging process by reducing the risk of heart disease, creating new blood cells, and protecting our DNA from free-radical damage.

What’s more, B vitamins can lower levels of homocysteine, an amino acid that, when high, has been linked to dementia, Alzheimer’s disease, and cognitive decline.

Anne Palumbo is a lifestyle columnist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at avpalumbo@aol.com.

Choose bright yellow squash that feels heavy for its size and has no soft spots. Store cooked spaghetti squash in an airtight container in the fridge for up to 5-7 days. Before storing, allow the squash to cool completely. Adapted from loveandlemons.com

1 spaghetti squash

1 - 2 tablespoons olive oil

1 small onion, thinly sliced

1 teaspoon dried rosemary or thyme

Salt and coarse black pepper

3 cups chopped kale or spinach leaves

1. Preheat the oven to 400°F and line a large baking sheet with parchment paper for easy cleanup.

2. Slice the spaghetti squash in half lengthwise (see tip below), scoop out seeds and discard. Brush the insides of each half with some olive oil, lightly sprinkle with salt and pepper, then place halves cut-side down on the prepared baking sheet.

3. Bake for 30 to 40 minutes, until the cut sides are golden and the interiors are fork tender, but still a little firm. (Strands turn mushy if cooked too long.)

4. Remove squash from the oven and flip to cut-side up. When cool to touch, use a fork to scrape and fluff the insides into delicate strands. Set aside.

5. In a large skillet, heat 1 tablespoon olive oil over medium heat, then add the thinly sliced onion, rosemary, a few pinches of salt and coarse black pepper.

1/4 cup fresh lemon juice

1/2 can beans of choice, rinsed and drained (I used cannellini)

1 cup cherry tomatoes, halved

1 garlic clove, minced

1/3 cup grated Parmesan cheese

1/4 cup toasted pumpkin seeds (or preferred nuts)

6. Once the onion starts to soften, add the kale, lemon juice, beans, cherry tomatoes and garlic and cook for a few minutes until the kale starts to wilt. (Add some water if mixture appears too dry.)

7. Once the kale is partially wilted, add the squash strands (all or most), ¼ cup Parmesan cheese, and more salt and pepper, to taste. Toss to incorporate, using a large fork to facilitate mixing. Remove from heat and top with the toasted pumpkin seeds and remaining grated cheese.

Tip: To soften skin for slicing, first pierce the squash all over with a fork. Next, score the squash down the middle on each side, lengthwise. Make several slits along the score line with a paring knife. Microwave for 4-5 minutes, rotating squash at 2-minute mark. Before cutting, slice ends off squash and stand upright for lengthwise halving.

Better Health Includes Walking, Water Consumption

By Shaina Zazzaro

alking and water: two things that we don’t realize can make such a great, positive impact on our health. Two things that we take for granted, really. These two things are so important for healthy living, so let’s

1. Walking. It is so important to move during the day. I know that sometimes it is easy to sit around and relax, but we have to remember to get up and get those steps in! Do not make excuses. Make time to get your steps in whether

it is walking around your house, taking a walk outside (bonus: you get your vitamin D), walking with your kids, friends, family, whoever! Just move those legs!

2. Water! Drink, drink, drink! Water is so very important for a healthy lifestyle. Hydration can help boost your immune system, give you improved energy and help with organ functions. I love to take plain seltzer and add zero calorie cranberry juice to it. It is a delicious, crisp mocktail! Water is water and every person should make sure

they drink enough water. Grab yourself a great water cup and carry it around with you throughout the day and keep hydrated! Do it in good health!!

These two things in conjunction can work together to increase your energy levels throughout the day, you got this!

Shaina Zazzaro is a wife and mother of two, blending her roles with a passion for health and wellness. She is the owner of local meal delivery service, Effortlessly Healthy. For more information, visit www. ehmeals.com.

Tips to Staying Germ-Free at the Gym

Going to the gym is good for your overall health, but if you and the gym aren't practicing good hygiene you could still catch a nasty illness, an expert says.

“Good hygiene prevents sicknesses like a cold, influenza and even salmonella, but cleanliness can also indicate that a gym is well-maintained overall, including the quality of equipment,” said Melanie McNeal, a physical and occupational therapy manager at Baylor College of Medicine in Houston. “If hygiene rules are not followed you could get sick, get others sick or even have your membership cancelled.”

When going to a new gym for the first time, there are a few key indicators to determine if hygiene is prioritized in the space:

• A lack of sanitary wipes for members or staff to wipe down equipment after use often means equipment is harboring unseen bacteria

• No signs posted asking members to clean equipment after using or no cleaning schedule posted suggests cleanliness is not a priority for the gym

• Other gym members using equipment and not cleaning it afterwards on a consistent basis can show there is not a culture of cleanliness

• Caked on layers of dust on equipment can indicate that equipment has not been cleaned in

a while

• Lots of broken-down machines for extended periods of time can be due to a lack of interest from gym management in ensuring the space is well-kept

Your part

To do your part in practicing good gym hygiene, there are several things you can do.

• Wear clean clothes each time you exercise; used clothes accumulate sweat and other bacteria that can cause foul smells or that can spread among gym members

• When approaching equipment, check to see if it is clean

• If you encounter a bench or other piece of equipment with wet residue from a chemical cleaning solution, allow it to dry on its own. This residue indicates that the time it takes to kill all the bacteria is not complete

• After completing your exercise, take a wipe or solution sprayed on a napkin and wipe where your skin made contact with the equipment or where sweat dripped. Avoid directly spraying chemical solutions onto equipment, as excess moisture can cause damage

• If you choose to shower after a workout, McNeal always

recommends wearing flip flops or other footwear that prevent contact between your feet and the floor, as these environments tend to be breeding grounds for mold, fungi and bacteria that can infect your feet

“Expect a clean gym and report concerns to management if

you have any,” McNeal said in a Baylor news release. “You should feel free to ask management about the cleaning schedule and always clean up after yourself. Leave equipment as you would want to find it when you walk up to it."

Partnership Helps Those with Chronic Kidney Disease

Excellus BlueCross BlueShield members with stage 4 or 5 chronic kidney disease (CKD) may be eligible for a new program, REACH Kidney Care, which helps improve care and quality of life while delaying the need for more costly interventions such as dialysis.

The National Institutes of Health estimates that 1 in 7 adults has a form of CKD. That’s about 37 million Americans. People are diagnosed with CKD when their kidneys are damaged and unable to perform their normal function of filtering blood.

About 808,000 Americans are currently living with end-stage kidney disease often requiring dialysis. On average, the cost of dialysis is $15,000 per patient per month.

“When you think about chronic kidney disease, it affects so many people,” said physician Kathleen Robischon, vice president of medical affairs and clinical services at Excellus BlueCross BlueShield. “At Excellus BCBS, we provide care management for members with chronic kidney disease stages 1 through 3,” adds Robischon. “When a member moves into stage 4, we offer the support of REACH Kidney Care.”REACH Kidney Care is a kidney health management program designed to help members with stage 4-5 chronic kidney disease navigate services and follow their physician’s treatment plan. Members work one-on-one

with a multi-disciplinary care team that provides personalized support to help members make the most of their care and manage their CKD. The REACH program is offered virtually, over the phone and in-person at no cost to members that have this benefit included in their plan.

“We are pleased that our eligible patients have the opportunity for additional support and resources,” explains physician Philip T. Ondocin, affiliated with Nephrology Associates of Syracuse, PC. “We encourage all patients to maximize their insurance benefits to support their kidney function and slow down the progression of their disease.”

ElenaMarie Burns, Excellus BCBS provider programs project coordinator, faced the challenges of navigating CKD when her father suffered a stroke in his 50s that led to the discovery that his kidneys were not functioning properly.

She remembers times when her father would stop taking his medication or resist following the doctor’s dietary instructions. “We didn’t have someone to sit and talk to him, like a care management team to have that collaboration of care. I think he could have benefited from that,” says Burns. Within a couple of years of diagnosis, her father began dialysis. “The dialysis really did a number on him,” explains Burn.

Alzheimer's 8 Myths about Alzheimer's

Which ones do you think are true?

By Deborah Jeanne Sergeant

Many people don’t know much about Alzheimer’s disease, a form of dementia. Here are the myths and facts of the disease.

From Physician David Gill, chief of the division of cognitive and behavioral neurology at the University of Rochester Medical Center:

Myth: Memory loss and decline in function are a normal part of aging.

Fact: “While it is true that some decline in cognition — a term for ‘thinking’ — as we age, such as the tip of the tongue phenomenon, none of these changes should affect our ability to function. If you or someone you know has had changes in thinking that limit their ability to function such as forgetting to pay bills or missing appointments, it is important for this person to be evaluated for memory loss.”

Myth: There is no reason to get diagnosed because there are no treatments for Alzheimer’s disease.

Fact: “There have been tremendous advances in the science of diagnosis and treatment of Alzheimer’s disease over the past several years and we now have very accurate tests and we have treatments that can improve memory and, more importantly, slow the progression of Alzheimer’s disease, but only if it is diagnosed early enough, so delaying evaluation can mean it is too late to use the treatments that we currently have to slow the progression of Alz-

heimer’s disease.

“There is no cure for Alzheimer’s disease. While we do have exciting new treatments for Alzheimer’s disease that can slow progression, we do not have a medication that stops the disease entirely.”

Myth: There is nothing I can do to prevent Alzheimer’s disease.

Fact: “From many ongoing research studies, we know that a number of lifestyle changes can reduce the risk of Alzheimer’s disease and other dementias. If a person wants to reduce their risk, they should stop smoking, treat high blood pressure, high cholesterol and diabetes, avoid alcohol use, follow a heart healthy diet and attempt to increase their physical, mental and social activity.

Myth: A person with Alzheimer’s disease is never aware of their own memory problems.

Fact: “We now realize that the Alzheimer’s disease process starts many years prior to diagnosis and many patients are aware of changes in their thinking in the years prior to diagnosis. Therefore, if you are concerned about your memory, you should mention this to your medical provider.”

Myth: Drinking alcohol reduces the risk of Alzheimer’s disease.

Fact: “There is still some controversy regarding whether any amount of alcohol intake is safe. We no longer feel that one or two drinks per day reduces the risk of Alzheimer’s disease and overall the goal should

Family Caregiver Tips

Try these tips for taking care of someone with dementia

By Deborah Jeanne Sergeant

If you’ve met one person who cares for a family member with Alzheimer’s or another form of dementia, you’ve met only one person who’s a caregiver.

“There is no one-size-fits-all profile of a caregiver for someone with Alzheimer’s disease,” said physician David Gill, chief of the division of cognitive and behavioral neurology at the University of Rochester Medical Center. “Just as each person is unique, each caregiving situation has unique circumstances.”

Most caregivers are retirement age, some care for people with early onset dementia and are younger themselves, such as a 30-year-old caring for a 55-year-old parent with dementia. Early onset dementia occurs in people younger than age 65, accounting for about 5% to 6% of those with dementia. A younger adult caring for someone with dementia may still work and have young children at

be to limit alcohol intake as much as possible.”

From Cathy Wilde, director of marketing and public relations at Upstate New York chapters of the Alzheimer's Association:

Myth: The risk from Alzheimer’s is the same for everyone.

Fact: “While the main risk factor for Alzheimer’s is aging, some population groups are at greater risk. Black Americans are twice as likely as whites to develop the disease and Hispanic Americans are 50% more likely than whites. And as a group, two-thirds of Americans with Alzheimer’s disease are women.”

Myth: I can ignore the symptoms of Alzheimer’s and get by.

Facts: “Some people are able

to temporarily work around the memory loss and other symptoms of Alzheimer’s, compensating in other ways, but delaying diagnosis is detrimental because it also delays access to medications, supportive services, planning and other resources that help both the person with Alzheimer’s as well as caregivers and loved ones. Delaying the diagnosis does not delay the progression of the disease.”

Myth: Any type of dementia means someone has Alzheimer's. Facts: “Although Alzheimer's disease is the most common form of dementia, there are several others. This is important to know because many of the new treatments for people in the early stage of Alzheimer's will not be appropriate or effective for people with other types of dementia.”

home, bringing a whole different set of challenges to the caregiver role.

“The increased stress of being sandwiched between caregiving roles for a parent and a child or grandchild adds additional stresses on the caregiver,” Gill said. “The stress of caregiving is a universal challenge as we know that in particular, caring for a person with dementia is one of the most stressful roles a person can fill and is associated with increased rates of depression and anxiety as well as increased risk of other health issues.”

That is why it is vital for providers to connect caregivers to community resources and to help in developing strategies to manage the challenges in this role. Gill referenced the social worker support programs in neurology and psychiatry at URMC as part of the Memory Care Program, along with the local Alzheimer’s Association chapter and Lifespan.

Many social organizations such as community groups and churches provide both formal and informal assistance such as senior day programming, congregant meals, transportation and senior sitting/respite care, which can support family caregivers, depending upon their needs. These resources can also save money compared with the costs of paid assistance.

Gill offered a few tips for family caregivers:

provider who is knowledgeable about dementia and ensure that your loved one has an accurate diagnosis and has access to the current treatments.

ments that are helpful are medica tions. In fact, some medications can make a person’s thinking worse. So it is important to ensure non medication techniques are considered to help the person with dementia.

3. “A routine is critically important to helping a caregiver care for a person with dementia. Both a daily and weekly routine help.

4. “The more educated a person is about dementia and caregiving, the lower the stress they feel and the more confident they are as caregivers. The Alzheimer’s Association and Lifespan provide wonderful educational programs and I encourage all caregivers to contact them to learn more about their programs.

5. “Asking for help is critical to succeeding as a caregiver. It is very difficult to ask for help and often a caregiver feels that they have failed if they need to ask for help. However, asking for help from friends or family can reduce the stress on the caregiver and allow other people to feel involved in care. When this is not enough, looking into paid caregiving and respite care is important.”

Heart Health

Manage Stress, Reduce Heart Risks

Stress is not good for your ticker

By Deborah Jeanne Sergeant

Your probably know that stress is bad for heart health. But both acute stress — the shock of catastrophe — and chronic stress, like the daily grind of a terrible job and domestic strife — are both bad for your heart.

Physician Andrew Mathias, with UR Medicine Cardiac Care said that acute emotional stress can mimic a heart attack and stun the heart muscle or cause significant weakness.

“Even if you’re having chest pain in an acute stressor, you can’t distinguish that clinically from a heart attack without coming in to get checked,” he said. “Take symptoms like that seriously. The prognosis is usually good.”

He sees many cases of this a year, sometimes influenced by other illness or medical stress. People with a good support system typically fare better when faced with shocking trauma.

Mathias added that a lot of data indicates that generalized anxiety disorder and stress in general are increasing among the population and

this is increasing the number of cases of heart attack. That kind of stress can gradually creeps into people’s lives keeping them in a perpetual fight-or-flight mode.

“I counsel my patients in terms of managing stress when they have an event like this, reflecting on things that cause stress and categorizing them as things they can step away from versus things they can’t or don’t want to take out of their life,”

Mathias said. “Also, we talk about stress mitigation, including exercise, meditation, mindfulness practice or investing in relationships where they can talk through things. It can be very helpful which can make a difference in prognosis.”

Chronic exposure to stress hormones also raises inflammation in the body. Mathias said that inflammation plays a role in heart disease in causing plaque build-up in the heart arteries. During a heart attack, plaque ruptures.

“A blood clot forms and blood flow is suddenly restricted to the

Post-heart Attack Care

How to reduce your risk for another cardiac event

By Deborah Jeanne Sergeant

If you’ve suffered a heart attack, you absolutely should follow through with any protocols your healthcare provider recommends.

It’s so important because “there is a lot you can do to prevent recurrent heart attacks,” said physician Andrew Mathias, with UR Medicine Cardiac Care.

“A large percentage of heart attacks are preventable with diet, exercise, medication and controlling cholesterol and diabetes,” according to Mathias.

That applies to secondary heart attacks as well. Mathias advises his patients to avoid smoking. Beyond the cancer risks of smoking, the habit also damages heart health because the toxins in cigarettes harm blood vessels and increase likelihood of atherosclerosis: plaque buildup in the arteries. According to the National Institutes of Health, even occasional smoking can affect the heart and blood vessels and raise risk for peripheral artery disease and thus raise the risk of heart attack and also stroke.

Experiencing a heart attack may seem like a good reason to take it easy and avoid heavy activity. But Mathias said that patients should “partner with their doctor with respect to activity restrictions. Further out, there shouldn’t be a lot of restriction on exercise.

heart,” Mathias said.

Stressed patients are also more likely to engage in behaviors deleterious to good health, such as smoking, poor diet and low activity level. All of these contribute to heart problems.

Arunie Malwatta nutrition and lifestyle medicine physician at Rochester Regional Health, encourages managing stress with counseling.

“Chronic stress is very bad stress,” she said. “It can cause harm to the body. Stress should be a stimulator to keep us ready for a situation.”

Reducing stress can mean walking away from difficult people and situations. Is a relationship, friendship or job that’s constantly embroiled in stress really worth it?

If eliminating the source of chronic stress isn’t possible, miti-

gating its effects can help reduce the negative impact of the stress. Take time to engage in a pleasurable activity each day. Journaling, keeping a gratitude list, prayer, mindfulness and meditation can all help lower chronic stress levels. Going on more frequent vacations such as quarterly long weekends instead of one week altogether may help manage stress better.

Stay better organized to reduce daily stressors.

Streamlining things with fewer daily choices, tasks and options can simplify life and lower stress. Letting go of unrealistic expectations, such as controlling other people’s responses and choices, can also reduce stress. Learn to delegate, lower standards and accept one’s limitations.

“One thing I find is patients feel like they’re very fragile and they shouldn’t do X, Y or Z because they could have another heart attack. The data shows the opposite,” he said.

Exercising 30 minutes a day five times weekly is a good general recommendation. Mathias said this could include a brisk walk that elevates the heart rate. Add to that regimen two sessions of light weights with higher repetitions and patients can dramatically improve their baseline health.

Many physicians feel that their patient education time is limited and typically revolving around medication. Mathias thinks that “things like diet get lost in the shuffle and it’s a shame because dietary changes are probably the most important factor for most patients — the more plantbased, the better.”

He advises the DASH or Mediterranean diet as they’ve both been studied in randomized trials for improving heart health. In addition, Mathias said that reducing saturated fat, red meat, processed carbohydrates and processed foods in general can help. Consuming olive oil can reduce risk of heart attack as well.

“Especially when it comes to heart conditions, my advice is the patient should be happy, come out of the hospital feeling as good as new to help him go on, said Arunie Malwat-

ta nutrition and lifestyle medicine physician at Rochester Regional Health. “He should step into a world that’s stable and has a good environment. It’s not totally cutting off oil and sweets. It should be a balance of eating whole food and understand the food culture.”

It may feel like if a parent suffered a heart attack, you’re slated to have a heart attack yourself. And if you’re already experienced one, it may seem like your fate. However, Malwatta said that genetics only carry 10% of the weight for secondary heart attack risk. The rest is lifestyle.

“Nine times more powerful than genes is the environment: food,

friendship, family, nature, stress management and avoiding drug use, tobacco and alcohol,” Malwatta said. “We should not worry about our genetics, like ‘My father had a heart attack.’ You can be really healthy if you pay attention to your environment. If it doesn’t support your genes, it won’t manifest the disease.”

She encourages patients to spend time outdoors every day. Recent research supports the notion that 20 minutes in nature daily can help support good health.

“It creates health benefits,” Malwatta said. “Going on vacation once a year isn’t enough.”

Physician Andrew Mathias works at UR Medicine Cardiac Care.

Arunie Malwatta is nutrition and lifestyle medicine physician at Rochester Regional Health.

Heart Health

Heart Flutter Surprise

My checkup visit to the doctor went south in a hurry after my doctor measured my pulse and declared, ‘Todd, go to hospital emergency right away. Your heart is fluttering.’

By Todd Etshman

My primary care’s English isn’t perfect, but we work it out. At times, the India native doctor asks me how to spell something during the four and a half minutes that her health care company’s bosses allocate for checkups.

I’ve been meaning to ask her where I should go for a prostate check since my PSA is on a slow-moving up escalator. I’m pretty sure she isn’t keen to do it. But we had other problems to face on this visit.

I hadn’t been feeling great before my last appointment. Another round of COVID-19 followed by a severe respiratory infection plagued me in the months following the new year.

Even when those afflictions were gone, I found I couldn’t get my running or fitness strength back. I couldn’t go half a mile before feeling like I had to stop. Friends and acquaintances said it just took a long time to come back and it had happened to others, too, in the age of COVID-19 and SARS.

But this checkup visit went south in a hurry when my doctor measured my pulse and declared, “Todd, go to hospital emergency right away. Your heart is fluttering.”

Then she left the room and headed back to her office. Incredulous, I stopped her in the hallway and asked if that was really necessary and could I go another day since I had a host of things to do.

She said something like, “No, you go now. I’ll call ahead — they’ll be waiting for you.”

And they were. My pulse was in the 150 beats per minute range and as it turned out, it had been for months.

The next thing I knew I was being led to a private room in Rochester General Hospital emergency past people who looked decidedly worse off than me. People with horrible wounds and health issues lined the hallways outside my room.

The elderly woman outside my room seemed perilously close to death’s door. Benevolence may not come easy to me, but I wanted her to have my room. But for whatever reason, that wasn’t happening.

Quickly, a team of nurses and specialists started their work. The first cardiologist I saw asked if I’d ever run a marathon because my heart had done the equivalent of a marathon a day for weeks on end.

He also said without my lifelong commitment to fitness, I probably would not have made it since the human heart isn’t made to keep going at 150 beats a minute for an extended period of time.

He also thought that COVID-19 and the respiratory illness could be to blame. After recuperating, he said, the heart just didn’t get the message to ease up and it kept on going.

The anti-vaccinators in my family were sure it was the vaccine’s fault and that Robert Kennedy Jr.’s vaccine warning is absolutely not to be taken lightly.

Whatever caused it, however, didn’t matter as much as fixing it.

Quickly, I was placed on med-

Nearly Half of U.S. Counties Lack Cardiologists Despite High Need

Where you live plays a vital role in how easy it is to receive care for heart problems.

Nearly half of U.S. counties don't have a practicing cardiologist, and those are places with the worst heart health, a new study says.

More than 46% of U.S. counties don't have a single heart doctor, even though the rest have an average 24 cardiologists practicing within them, according to findings published July 8 in the Journal of the American College of Cardiology.

Counties without a cardiologist are generally rural and poor, researchers found. In fact, nearly 9 in 10 rural counties (86%) don't have a heart doc.

Those counties without a heart

ications such as Metoprolol. I was supposed to be on Eliquis, a blood thinner, too, before having a TEE test but somehow that didn’t happen so my TEE test was postponed.

The explanation I received regarding the heart flutter was that the heart would be shocked to get it down to speed again. And, if that didn’t work…well, that wouldn’t be good, at all.

I was at risk for a stroke or a heart attack.

Meanwhile, I just felt a little tired, nothing else and watched the New York Rangers on television and ate pizza with the night nurse.

The transesophagael echocardiogram test (TEE) was being performed to see if thickened blood was coagulating around the heart and what, if anything, else was going on. But, getting the TEE test was difficult the second time around, too, when the computers malfunctioned and had to be replaced.

This time, they left me there to wait it out while the computer tech team got the computers hooked up. When I awoke a team of cardiologists that looked like something out of The Matrix, was there at my bedside to give me the mostly good news. Later, one of the young female cardiologists

fell over my phone charge cord in the small, cramped room but opted to keep going.

Fortunately, the TEE test looked good and the shock to the heart brought the beat down but there was some residual effect that may or may not go away, my heart wasn’t pumping blood around completely as it should.

It may have been weakened. A marathon per day will do that. After that, I still couldn’t go home.

That would have to wait a day. When the beat looked consistently lower, I was released.

The next step is a follow-up visit with a cardiologist and another TEE test. I should have made that appointment by now but it doesn’t help that whatever call center the cardiologists use, has dropped my call three times. Call me, if you’re a cardiologist in Irondequoit with a staff that can make appointments.

And, while self-diagnosis is not recommended, once I could run a couple miles without laboring, I had a feeling I was OK. By then, my prostate PSA was high and I had to focus on the next medical challenge: a prostate biopsy. But I’ll save that for another time.

doctor also have an average 31% higher risk of heart disease, and a greater burden of heart health risk factors like diabetes, high blood pressure, elevated cholesterol and smoking.

People are more likely to die from heart-related health problems, and on average have a one-year shorter life expectancy, researchers added.

“While cardiologists are not the only determinants of cardiovascu lar outcomes, the lack of access to cardiologists in areas with greater prevalence of heart disease and mortality is incredibly concerning,” said physician Haider Warraich, director of the heart failure program at VA Boston Healthcare and an associate physician at Brigham and Women's

Hospital in Boston.

People in counties without a cardiologist have to drive

Counties without cardiologists tended to have lower household incomes, more people without health insurance, worse access to primary care doctors and less ability to buy healthy food, results show.

People in those counties also were more likely to experience hospitalizations that could have been prevented through early treatment, researchers

“Our findings really highlight the critical need to find ways to mitigate deep disparities to improve cardiovascular disease outcomes for Americans living in rural and disadvantaged areas,” Warraich said in a hospital

There are ways to combat this lack of access to heart medicine, researchers said. Doctors could be offered more money to practice in these counties, or telemedicine could be used to extend heart care into areas without a heart doc.

Heart Health Take Heart!

UR Medicine and American Heart Association Improve CPR Readiness

By Deborah Jeanne Sergeant

UR Medicine wants more people to know how to perform cardiopulmonary resuscitation (CPR) in an emergency situation.

Working with the American Heart Association, UR Medicine has developed several efforts to aid the community in become heart emergency savvy.

Learning about CPR is so important because victims’ chances of surviving a cardiac arrest double when they receive CPR.

“CPR is undeniably the best response when someone suffers cardiac arrest,” said physician Spencer Rosero, interim chief of UR Medicine Cardiac Care.

More than 350,000 people annually — nearly 1,000 daily — experience cardiac arrests away from a hospital setting, according to the American Heart Association. Performing CPR helps keep life-giving blood flowing throughout the body to decrease risk of neurological damage and death.

Only 32% of people in Monroe and Livingston counties who experience a heart attack at home received CPR before the ambulance came. The national target is 45%. That’s why UR Medicine launched mobile hands-only CPR training kiosks around the area to help passersby learn the lifesaving skill.

In addition, UR Medicine is supplying CPR training kits at Monroe County libraries for small group or individual learning opportunities.

The kiosks include a touchscreen with a video that offers a training session and chance to practice on a built-in rubber torso manikin. This aspect helps learners know where to place their hands, how hard and deeply to compress and the correct rate. The device’s real-time response helps people improve their CPR technique.

“Less than half of all people who

need CPR receive it from bystanders before professional help arrives,” said Jason Stulb, executive director of the American Heart Association, Rochester. “Knowing how to respond in a cardiac emergency when seconds matter can be the difference between life and death. Thanks to UR Medicine, our ‘Life Fierce. Take Action.’ supporter, we are able to use innovative ways, like this mobile CPR kiosk, to improve the chances of surviving a cardiac arrest in our community. We are committed to creating a nation of lifesavers through training and education like this.”

Many people may see automated external defibrillator (AED) boxes at public places and conflate the purposes CPR and AED. Martina Landahl, registered nurse and master’s in nursing education, is part of the learning and development team at URMC, explained that AEDs and CPR complement each other.

“CPR is the first response we can do without any equipment,” Landahl said. “If someone collapses and isn’t breathing normally, you’d start CPR and of course call 911. Put your phone on speaker so the operator can guide you. We don’t say anymore to check for a pulse as many people don’t do it properly. We’re training more to look for breath, like the chest rising and feeling the breath.”

Trying to evoke a response by calling the person’s name or tapping on their shoulder can also indicate CPR is needed for the victim. If there’s no response, that’s when it’s time to start chest compressions and ask a bystander for the AED. Landahl said that the AED can determine what’s happening and deliver a lifesaving shock.

“Neither is wrong to do first,” Landahl said. “If you’re physically unable to do chest compressions, the AED can go first. The AED will guide you and let you know what this per-

son will need.”

The equipment is made so that any layman can safely use it without any training (although training is available and helpful). Simply turning on the AED begins the automated process with both visual and audio guidance.

“It can analyze the heart rhythm and remind you to step back clear of the victim so you don’t get shocked yourself and it will tell you whether the person will require a shock and tell you to deliver the shock,” Landahl said. “The new machines have numbers to direct you what orders to do things, pictures, blinking lights to guide your eyes and it will deliver the shock. After that, the AED will

remind you to go back to chest compressions. Even with all the training when something happens and most likely it’s someone you know and have a connection with, you may have a moment of not knowing what to do and fear. You should feel confident you can help in these situations.”

Although some people fear they’ll make things worse or be sued if the person dies, Landahl said that doing nothing is the worst thing to do.

“Good Samaritan” laws protect people who are acting in good faith to help people who are sick or injured, she said.

Martina Landahl (left) is a registered nurse at URMC. She is training a colleague on how to perform a CPR.

The Face of the Opioid Epidemic Shifts Yet Again

By Jennifer Faringer

The opioid epidemic has seen multiple waves.

It first emerged in the early 2000s with the overprescribing and misuse of pain medications. If individuals became addicted to pain medications and could no longer obtain them either legally or illegally, they shifted their use patterns to heroin which became cheaper and more available, marking the second wave beginning in the 2010s.

The third wave began in 2015 with the appearance of illegal fentanyl, first in the heroin supply, then in a variety of other drugs including lookalike pills. (See United States Drug Enforcement Administration’s One Pill Can Kill campaign). Currently,

since 2023, we find ourselves amidst a fourth wave as illicit fentanyl has entered the illegal stimulant supply at increasing rates.

Drug use trends show there are geographical preferences in the United States with cocaine being the stimulant of choice in the Northeast and methamphetamine being the stimulant of choice in the West, Mid-West, and South. Interviews with individuals following non fatal overdose incidents have shown that those using drugs are often unaware that their cocaine or methamphetamine supply had been laced with fentanyl, and therefore don’t perceive themselves to be at risk for an opioid overdose. Fentanyl test strips or the

opioid reversal medication Narcan and calling 911 are some tools for reducing potential harm and decreasing the likelihood of a fatal overdose.

Illegal fentanyl now makes up 25 percent of the recreational drug supply in terms of toxicity, followed by heroin at 20 percent. It is now a factor in more than half of overdose deaths, rising 2.5 times faster than heroin deaths, as well as outpacing prescription opioid overdose deaths by over 500 percent. One kilogram of fentanyl contains 250,000 lethal doses. With the advent of illegal fentanyl being added to stimulants, statistics show that Black Americans are disproportionally affected by this trend, especially in the Northeast among the 55- to 64-year-old age group. Latinx Americans are also at increasing risk.

Some individuals who use drugs claim they are able to "test" for the presence of fentanyl by noticing if their supply has a sweet smell. In re ality, the only way to verify if a drug contains fentanyl is with tools like

Trained Peers as Good as Social Workers at Preventing Opioid Overdoses

Support provided by someone who has personally lived with addiction is an effective way to follow-up with ER patients after an opioid overdose, new research shows.

Patients who have had a non fatal overdose are at great risk of a fatal overdose in the future, and more than one in four high-risk patients in

Rhode Island has a non fatal opioid overdose within 18 months of leaving the hospital.

A controlled trial involving more than 600 high-risk ER patients found that follow-up support from trained peer recovery specialists was as effective as that provided by a licensed social worker.

"Interviewing and intervention

fentanyl test strips. To get a precise measure of both the amount and the potency, the product must be submitted to a lab for analysis.

Being proactive involves awareness of current drug trends, watching out for signs and symptoms as well as being prepared with fentanyl test strips and Narcan. These, along with educational presentations, information and referral resources are all available at the National Council on Alcoholism and Drug Dependence –Rochester Area (NCADD-RA). More information may be found by visiting www.ncadd-ra.org.

techniques informed by lived experience were as effective as those informed by social work theory and practice," Brown University researchers said.

Certified peer recovery support specialists not only provide referrals for services as patients leave the ER, they also offer follow-up support for up to 90 days. That includes teaching

Jennifer Faringer, CPP-G (Credentialed Prevention Professional—Gambling), is the director of the National Council on Alcoholism and Drug Dependence — Rochester Area (NCADD-RA).

patients how to prevent an overdose, helping them overcome barriers to treatment and recovery, and encour-

Support from social workers typically ends when the patient leaves the ER.

"The results of our trial strongly suggest that trained peers, and the sort of sustained support they deliver, are just as effective at preventing opioid overdoses as the support offered by traditionally trained clinical social workers," said lead study author Laura Chambers, an assistant professor at Brown University School of Public Health.

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Why Do People Get Addicted to Alcohol and Other Substances?

By Mark Winsberg M.D.

Addiction to substances happens for several reasons. Understanding them can help us think about how to prevent it.

One big reason is how substances affect the brain.

Drugs like alcohol, nicotine and others can make the brain feel good by releasing chemicals that create a sense of pleasure. This feeling can make people want to use the substance again and again, leading to addiction.

Another important factor is genetics.

Some people might be more likely to become addicted because of their genes. This means if someone in your family has struggled with addiction, you might be more at risk. However, having a family history of addiction doesn’t mean you will definitely become addicted — it just means you might need to be more careful.

The environment we grow up in

also plays a big role. If we are around people who use drugs or if using drugs seems normal where we live, we might be more likely to try them ourselves. Peer pressure, especially during teenage years, can also push people to use substances even if they know it’s not a good idea.

Mental health is another factor. Sometimes, people use substances to cope with feelings of sadness, anxiety or stress. This can lead to using drugs as a way to feel better, but it often makes things worse in the long-run because it can lead to addiction.

Social and cultural factors also matter.

In some places or groups, using drugs might seem cool or like a way to fit in. Cultural beliefs about drugs can affect whether someone tries them or not. Laws and rules about substance use can also influence people’s behavior — if it’s easy to get drugs or if there are few consequenc

es, more people might try them. Predicting who might become addicted is tricky because it depends on so many things. However, there are ways to reduce the risk. Education is key — teaching young people about the dangers of drugs and how they affect the brain can help them make smart choices. Building strong relationships with family and friends can also provide support and reduce the likelihood of turning to drugs for

help people who are struggling with addiction get back on track.

In conclusion, addiction happens for many reasons, including how substances affect the brain, genetics, environment, mental health and cultural influences. While predicting who might become addicted is hard, there are ways to lower the chances. Educating ourselves and others, building strong relationships, finding healthy coping strategies and providing support to those in need are all steps we can take to prevent addiction and help those who are affected.

, is an addiction who is board-certified in addiction medicine and family medicine. He recently started a solo private practice in the Rochester area. You can contact him

By Jim Miller

This is Not a Scam: Social Security Needs You to Update Your Online Account

Dear Savvy Senior,

I recently received an email that I needed to update my online Social Security account. Is this legit or is it a scam?

Suspicious Susan

Dear Susan,

The Social Security Administration did indeed send out a legitimate email in July to notify recipients that they are making changes to the way you access Social Security’s online services, including your personal “my Social Security” account.

The changes will simplify your sign-in experience and align with federal authentication standards, while at the same time provide you safe and secure access to your account and other online services.

If you created an online My Social Security account before Sept. 18, 2021, you’ll need to shift to a Login. gov account to be able to continue to access your account.

Online My Social Security accounts enable both beneficiaries and people who are not yet receiving benefits to access services, including requesting Social Security card replacements, estimating future benefits, checking on the status of benefit applications and managing current benefits.

The online services aim to save time for both current and future beneficiaries, as well as the Social Security Administration, as the agency grapples with long wait times for its national 800 phone number. The average speed to answer those calls was about 36 minutes in the second quarter, according to the SSA. The agency is working to bring that average wait time down to 12 minutes by the end of September 2025.

Update Your Account

If you already have a My Social Security account, go to ssa.gov/ myaccount and sign in with your Social Security username. You’ll then

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.

be guided through the process of creating a new account with Login. gov. Once you successfully link your personal My Social Security account with your new Login.gov account, you’ll get a confirmation screen and have immediate access to online services. In the future, you’ll sign into your account with Login.gov and not your Social Security username.

If you already have either a Login.gov or ID.me account, you do not have to take any action.

Beware of Scams

To be sure you’re taking the appropriate steps to update your account, it is important to verify any websites or links leading you to the Social Security website. Legitimate Social Security Administration website link is www.ssa.gov and the agency link to my Social Security account is www.ssa.gov/myaccount.

It’s very important to be mindful of potential scam artists who may send you fraudulent websites pretending to direct you to Social Security.

These sites will closely mimic the format of the agency’s links to try to lure you into entering your personal information.

If you see a suspicious email or link, it is best not to respond or click on it. Instead, you can report it to the website of the SSA’s Office of the Inspector General or call the fraud hotline at 800-269-0271.

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.

The Social Security Office Ask Ask St. Ann’s

How Do I Choose a Rehab Location After Leaving the Hospital?

By Nikki Tyler

Sometimes a hospital stay is just the beginning.

If your loved one is hospitalized due to a fall, fracture, cardiac event or other unexpected medical incident, it’s likely they won’t go straight home.

They may need a short-term stay in a skilled nursing facility for rehab or, in more severe situations, for long-term care.

For family members, the situation can be overwhelming. How do you decide where your loved one should go? What’s the process for getting them there? If you know the answers ahead of time, it can take some of the pressure off when anxiety is high.

The first step: Working with the hospital social worker. That’s who will help arrange your loved one’s placement after discharge. Speak frankly with the social worker about where you want your loved one to go; the decision is yours to make.

The social worker should ask for your top five choices. Families often consider location, reputation and past experience with the facility, among other factors when making their choices.

Note: You are not required to stay in the hospital’s system (i.e., the rehab center run by the hospital) unless that is your choice or no other option is available.

Based on your input, the social worker will send a referral to the locations of your choice. The referral includes the patient’s demographic information, insurance and financial disclosure, medical record from their hospital stay and other forms required by New York state.

The referral goes to the admissions departments at the locations you choose. (At St. Ann’s Community, that’s my department.) An admissions professional reviews the referral to determine whether they can accept the patient. That’s based on several factors, including their capability to meet the patient’s clinical needs; the availability of space; and their ability to accept the patient’s “payer source” (e.g., Medicaid, private pay, long-term care insurance).

Important: As your loved one’s advocate, it’s perfectly fine for you to call the admissions department at the facility you prefer and ask if they got

the referral. If they didn’t, notify the hospital social worker. It never hurts to make that personal contact with admissions and give them a headsup that a referral is coming.

If any or all of your top five choices accept the referral, their admissions team will notify the hospital social worker, who will notify you. If more than one accepts, you can choose the one you prefer. Arrangements will then be made for your loved one to be moved there upon discharge.

What if you don’t get your first choice or even one of your top three? Continue advocating for your loved one by asking the social worker why the referral was denied. There may be legitimate reasons, but it never hurts to stay involved in the process and have your questions answered to your satisfaction. It’s a big decision, and your loved one is depending on you.

The reality is your loved one may not qualify for your first-choice location. It’s unfortunate and understandably frustrating, but space may simply not be available or other factors may not be met. The hospital social worker will help get your loved one the best care possible within the available options.

We’ve been discussing emergency hospitalizations, but I want to add something: If your loved one’s hospital stay is a planned one (such as a surgical procedure they’ve scheduled in advance), contact the admissions team at the rehab site of your choice and pre-plan their stay. That way, you’ll have that decision made ahead of time, ensuring that a room is reserved. Be sure to let the hospital social worker know you’ve pre-planned. You and your loved one will be glad you did!

Nikki Tyler is senior admissions professional at St. Ann's Community. She can be reached at 585697-6507 or at ntyler@mystanns. com.

From the Social Security District Office

How We Protect You From Misleading Advertising and Communications

Social Security works with the Office of the Inspector General (OIG) to protect you from scams that use Social Security as bait. Section 1140 of the Social Security Act allows OIG to impose severe penalties against anyone who engages in misleading Social Security-related advertising or imposter communications.

OIG may impose a penalty against anyone who:

• Mails misleading solicitations that appear to be from or authorized by Social Security.

• Operates an imposter website or social media account designed to look like it belongs to or is authorized by Social Security.

• Sends emails or text messages or makes telephone calls claiming to be from Social Security.

• Sells Social Security’s free forms, applications, and publications without our written approval.

• Charges a fee for a service that Social Security provides free of charge without providing a clearly visible notice that Social Security provides the service for free.

If you receive a misleading or suspicious Social Security-related advertisement, phone call or email, you should let us know right away. Try to capture as many details as you can.

Here’s what you can do:

• For suspicious websites or social media accounts, please take a screenshot of the page. Note the website address or social media link — and how you came across it.

• For emails and text messages, capture the entire message and any links or attachments.

• For mail, retain the complete communication, including the outside envelope and all inserts.

• For telephone solicitations, note the caller identification phone number and any company name or call back number provided by the caller or recorded message.

You can help us stop misleading advertising and communications. We encourage you to report possible scams to the OIG at oig.ssa.gov/ report. You can also call our fraud hotline at 1-800-269-0271 or send an email to OIG.1140@ssa.gov.

To learn more, check out our publication, "What You Need to Know About Misleading Advertising", at www.ssa.gov/pubs/EN05-10005.pdf. You can also review Section 1140 at www.ssa.gov/OP_ Home/ssact/title11/1140.htm.

Please share this information with friends and family and help us spread the word on social media.

RESIDENTS, FAMILY, FRIENDS, CARE STAFF, ADVOCATES and LEGISLATORS ARE INVITED TO SHARE CONCERNS AND POSSIBLE SOLUTIONS

Thursday, October 17, 2024 2:00PM – 3:30PM

Pittsford Library – Fisher Meeting Room 24 State St. (rt. 31) Pittsford, NY 14534

Presented By ELDER JUSTICE COMMITTEE of

Health News

Excellus appoints new senior vice president

Susie Hume has been appointed

senior vice president corporate development and strategy, chief risk officer at Excellus BlueCross BlueShield. Hume most recently served as vice president of human resources strategic business partnerships where she was responsible for the development and facilitation of the human resources divisional strategy, enterprise change management to support strategic transactions and provided strategic workforce consultation to the company’s divisional senior leadership. Hume joined the company in 2010.

“I am incredibly proud to take on this exciting and challenging role with oversight of three strategic functions — enterprise risk management, corporate strategy and corporate development,” says Hume. “I hope to help our organization generate lasting growth while maintaining our market-winning position in the industry and am even more proud that I get to lead these functions at a mission-based, local health plan that

is committed to helping our communities.”

Hume just completed the executive education program at the Saunders College of Business at Rochester Institute of Technology and has a Master of Arts degree in journalism from the S.I Newhouse School of Public Communication at Syracuse University and her Bachelor of Arts from University of Rochester. She has been a volunteer or board member for several local organizations including Flower City Arts Center, Lollypop Farm, PUSH Physical Theatre and Writers & Books. Hume recently presented at DisruptHR and is a former Technology Woman of the Year nominee from Digital Rochester.

Hume and her husband reside in Brighton.

RRH hospitals recognized by US News, AHA

Rochester Regional Health announced its outstanding achievements in the 2024 “US News and World Report” rankings, solidifying its position as a leader in healthcare excellence.

This year, Rochester General Hospital has been named among the top 29 hospitals in New York state and is one of only two hospitals in the region to receive such distinguished recognition. Rochester General Hospital also ranked high performing in nine areas: COPD,

diabetes, heart attack, heart failure, kidney failure, leukemia/lymphoma, pneumonia, prostate cancer surgery and stroke.

Unity Hospital also achieved high performing status in five key areas: COPD, diabetes, heart failure, hip replacement and knee replacement.

Also part of the RRH group, Canton-Potsdam Hospital and Newark-Wayne Community Hospital have each been recognized as high performing for their treatment of COPD, underscoring RRH’s widespread excellence in respiratory care.

"We are incredibly proud of these recognitions, which reflect our commitment to delivering the highest standard of care to our community," said Richard “Chip” Davis, CEO of Rochester Regional Health. "These awards are a direct result of the tireless efforts of our teams who strive every day to improve patient outcomes and uphold the values of excellence that Rochester Regional Health stands for."

Adding to these significant accomplishments, the American Heart Association (AHA) has bestowed multiple prestigious recognitions upon three RRH hospitals. Rochester General Hospital has once again demonstrated its superior heart care by receiving the Get With The Guidelines – Gold Plus Achievement for heart failure care for the 11th consecutive year, along with Gold Plus Achievement in stroke care. Addi-

tionally, Rochester General has been honored with an Honor Roll Elite Achievement in heart failure and Honor Roll Achievement in stroke and Type 2 diabetes care.

Unity Hospital also celebrates a decade of excellence, having received the Get With The Guidelines-Gold Plus Achievement and Honor Role Elite Achievement for stroke care, along with Honor Roll Achievement status in Type 2 diabetes care. Newark-Wayne Community Hospital continues to excel with its own Gold Plus Achievement and Honor Roll Elite Achievement in stroke care and Honor Role Achievement for Type 2 diabetes care.

St. John’s announces changes in leadership

St. John’s, a leading provider of a full continuum of services for older adults for 125 years, announced that Charlie Runyon Charlie Runyon, its resident and CEO for 23 years, will retire in February 2025. Robert Earl, St. John’s executive vice president of finance/chief financial officer, has been named as Runyon’s successor and will begin

Susie Humie

assuming duties throughout the remainder of 2024.

“It has been an honor to serve as St. John’s president and CEO,” Runyon said. “I am incredibly proud of what we have accomplished together and am confident in the organization’s future under Rob’s leadership.”

Runyon has served as St. John’s president and CEO since 2001, but has been with the organization since 1993. During his tenure, St. John’s experienced its greatest period of growth, adding St. John’s Meadows in 1996, Penfield Green House Homes in 2011 and Brickstone by St. John’s in 2014. Recent innovations such as the development of a new dementia resource center and a strategic partnership with University of Rochester Medical Center point

to Runyon’s unwavering leadership, commitment and dedication, which have enabled the organization to successfully navigate through the pandemic into its 125th year of operation.

“We are deeply grateful for Charlie’s dedication and leadership. He has made an indelible impact on St. John’s, the senior services sector, and our community. We wish him the very best in retirement,” said Mike Waters, chairman, St. John’s board of directors. Earl, who will fully assume the duties of St. John’s president and

CEO in February 2025, came to St. John’s in 2012 as controller after nearly five years managing the finances for the Monroe County Department of Health and Human Services. Prior to his role at the county, Earl worked in the manufacturing sector, with finance roles at Nalge Nunc International and Dresser-Rand.

MCMS recognizes health professionals

The Monroe County Medical Society has recognized two health professionals with its 2024 Edward Mott Moore Physician and Layperson Awards. This award recognizes individuals whose dedication to the community goes above and beyond the usual call of duty.

They are:

• Physician Michael Nazar, Uni

versity of Rochester. He received the 2024 Edward Mott Moore Physician Award. Nazar is a retired family medicine physician and physician executive.

A graduate of Amherst College and the University of Connecticut School of Medicine and Dentistry, Nazar has lived in Rochester since 1982. He completed his family medicine residency at the University of Rochester / Highland Hospital training program. He is board-certified in family medicine

and geriatric medicine. He was a clinical associate professor of family medicine at the University of Rochester Medical School.

He held several administrative roles at Rochester Regional Health and its legacy institutions, including chairman of family medicine at St. Mary’s Hospital; senior vice president, Unity Medical Group at Unity Hospital; and executive vice president, chief of medical groups at Rochester Regional Health. He left his administrative roles in 2017.

Nazar has been active in several community and healthcare focused entities. He is a past chairman of The Finger Lakes HSA (now Common Ground Health). He remains on the board of FLPPS (Finger Lakes Preferred Provider System) and is co-chairman of its clinical quality committee. He is vice president of the Rochester Regional Physicians Organization and serves on the GRIPA board

Nazar lives in Rochester with his wife, Kate Callery. He has two adult children, William Nazar of Miami and Alice Nazar of Denver.

• Dentist Janice Harbin received

the 2024 Edward Mott Moore Layperson Award.

A 1979 graduate of Howard University College of Dentistry and a 2014 Healthcare Business Fellow, Harbin’s extensive community health career has

been dedicated to serving racially, socially and economically diverse populations for over 40 years. Harbin moved to Rochester in July 2012 to take a position with Anthony L. Jordan Health Corporation, a multisite federally-qualified health center in Western New York, as its dental director, before becoming interim CEO in November 2012. She became president and CEO in October 2013 and remained there until 2023. As a public health dentist since 1979, she headed the Detroit Department of Health and Wellness Promotion Adult Dental department, as well as served as adjunct faculty for the University of Detroit Mercy School of Dentistry, prior to relocating to New York. She served as dental director for Detroit Health Care for the Homeless (Advantage Health Centers), while improving operational efficiency and creating productive and sustainable dental teams and departments. From 1999 to 2003, she was professionally engaged as a community organizer with Metropolitan Organizing Strategy Enabling Strength (MOSES) in Detroit; providing training in leadership development and problem solving, for city and suburban faith-based Christian, Jewish and Muslim organizations. In 1999, representing the grassroots community, she worked on the national planning committee for the President’s Council of Sustainable America, chaired by Vice President Al Gore. She is the mother of three sons, Dane, Spencer, Elliott and niece, Carrie.

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CONTACT:

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Email: CNA_Training@elementalmgt.com

Peg Reith BSN, RN

Phone: 315-529-3267

Phone: 315-529-3267

Email: CNA_Training@elementalmgt.com

Email: CNA_Training@elementalmgt.com